The prevalence and correlations of electrocardiographic-left ventricular hypertrophy in a rural community in Africa.

Abstract

INTRODUCTION: Left ventricular hypertrophy (LVH) is a major and independent risk factor for cardiovascular morbidity and mortality irrespective of aetiology. Patients with ECG -LVH from any cause are at a greater risk for major cardiovascular complications including heart failure, cardiac arrhythmias, death following myocardial infarction, decreased left ventricular ejection fraction, sudden cardiac death, aortic root dilation, and stroke. Although echocardiography has become the gold standard for LVH detection in clinical practice, electrocardiography ECG remains widely used due to its simplicity and accessibility. This study is to determine the prevalence and correlations of ECG-LVH among adult population of a rural farming community in Rivers State, Nigeria.
METHODS: A cross-sectional survey involving 539 adults. A questionnaire was administered to elicit socio-demographic data, prior knowledge of blood pressure/blood sugar status and family history of hypertension and diabetes. Anthropometric and blood pressure measurements were done in a standardized manner. Blood samples were taken for blood glucose and uric acid. Twelve lead surface electrocardiograms were recorded on all the subjects using a portable ECG machine. Data obtained was analysed using SPSS version 17. LVH was determined using Sokolow-Lyon voltage criteria Mv= SV1+RV5 (or V6 if larger).
RESULTS: The prevalence of ECG-LVH by the Sokolow-Lyon criterion was 16.4% with a significantly higher prevalence in males than females (20.4 % versus 8.2%, p=0.001). There was high prevalence rate in the middle age and the elderly age group with the lowest rate seen in the young age group of 18-29 years in both sexes. The male gender, hypertension including both systolic and diastolic blood pressure and cigarette smoking were significantly correlated with LVH.
CONCLUSION: The prevalence of ECG-LVH in this rural community of the study is high. The male gender, hypertension including both systolic and diastolic blood pressure and cigarette smoking are important variables found to be significantly correlated with the development of LVH in this study. This therefore calls for urgent need to tackle these modifiable risk factors amongst others elicited in this study while developing a more comprehensive health package for our rural dwellers.

KEY WORDS: Prevalence, correlations, electrocardiographic-left ventricular hypertrophy, rural community.