Electrocardiographic Evaluation of Structural and Electrical Abnormalities in Nigerians with Undiagnosed Systemic Hypertension

Abstract

Background: Essential hypertension has emerged as the commonest cardiovascular disorder in developing countries especially in Sub Saharan Africa. Blacks are known to suffer more severe hypertension and develop complications early. Some of the complications of hypertension can be detected early through non-invasive electrocardiography. The aim of this study is to evaluate the hypertension related abnormalities on the electrocardiograph of patients with untreated hypertension.

Methodology: A detailed prospective analysis of the electrocardiographic tracing of all patients with untreated essential hypertension at first presentation over a six month period was undertaken. The patients were recruited from the medical outpatient clinic of the University of Port Harcourt Teaching Hospital.

Result: A total of eighty three adult Nigerians aged 18years to 90 years who presented with untreated essential hypertension over the six months study period had their ECGs analyzed. There were thirty three males and fifty females (0.7:1), mean systolic blood pressure was 192.78+38.4mmHg and the mean diastolic blood pressure was 116.6+16.9mmHg. Sixty percent (60.22%) had normal rhythm, and forty percent had various rhythm abnormalities, 77.6% had normal axis while 22.4% had left axis deviation, 45.8% had repolarisation abnormalities, 25.3% had evidence of left ventricular hypertrophy and 26.5% had various ventricular arrhythmias.

Conclusion: Adult Nigerians presenting with hypertension for the first time have significant rhythm and structural abnormalities that should influence their clinical management and drug treatment choice. ECG is an important investigation and should be a mandatory evaluation for all newly presenting hypertensives.

Keywords: Untreated Essential Hypertension; ECG; Port Harcourt; Nigeria