To review studies on hypertension in Nigeria over the past five decades in terms of prevalence, awareness and treatment and complications. Following our search on Pubmed, African Journals Online and the World Health Organization Global cardiovascular infobase, 1060 related references were identified out of which 43 were found to be relevant for this review. The overall prevalence of hypertension in Nigeria ranges from 8%-46.4% depending on the study target population, type of measurement and cut-off value used for defining hypertension. The prevalence is similar in men and women (7.9%-50.2% vs 3.5%-68.8%, respectively) and in the urban (8.1%-42.0%) and rural setting (13.5%-46.4%).The pooled prevalence increased from 8.6% from the only study during the period from 1970-1979 to 22.5% (2000-2011). Awareness, treatment and control of hypertension were generally low with attendant high burden of hypertension related complications. In order to improve outcomes of cardiovascular disease in Africans, public health education to improve awareness of hypertension is required. Further epidemiological studies on hypertension are required to adequately understand and characterize the impact of hypertension in society.

https://www.hedu-africa.org/uploads/files/Blood_pressure,_prevalence_of_hypertension_and_hypertension.pdf

Blood pressure, prevalence of hypertension and hypertension related complications in Nigerian Africans: A review.

Hypertension is an important public health challenge worldwide. Information on the burden of disease from hypertension is essential in developing effective prevention and control strategies. An up-to-date and comprehensive assessment of the evidence concerning hypertension in sub-Saharan Africa is lacking. A literature search of the PUBMED database was conducted and supplemented by a manual search of bibliographies of retrieved articles. The search was restricted to population based studies on hypertension in sub-Saharan Africa published between January 1975 and May 2006. Data were extracted after a standard protocol and using standard data collection forms. Thirty-seven publications met the inclusion criteria. The prevalence of hypertension varied extensively between and within studies. Prevalence of hypertension was higher in urban than rural studies in all studies that covered both types of area, and also increased with increasing age in most studies. In most studies less than 40% of people with blood pressure above the defined normal range had been previously detected as hypertensive. Of people with previously diagnosed hypertension, less than 30% were on drug treatment in most studies, and less than 20% had blood pressure within the defined normal range. Hypertension is of public health importance in sub-Saharan Africa, particularly in urban areas, with evidence of considerable under-diagnosis, treatment, and control. There is an urgent need to develop strategies to prevent, detect, treat, and control hypertension effectively in the African region.

Hypertension In Sub-Saharan Africa : A Systematic Review. Commentary

Heart failure is a major clinical problem worldwide. It has been recognized as a contributor to cardiovascular disease burden in Africa for many years. There are no data on the prevalence of heart failure in Ghana; and the prevalence of heart failure among patients attending out-patient clinics in Ghana is unknown. This study was designed to determine the prevalence and aetiology of heart failure among patients attending a cardiac clinic in the Department of Medicine, Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Medical records of 524 patients were selected from the cardiac clinic, using simple random sampling. The demographic, clinical, chest X-ray, electrocardiographic and echocardiographic characteristics of the patients was examined. Among the 524 patients, 398 of the patients had heart failure according to the modified Framingham criteria for the diagnosis of heart failure; giving rise to a prevalence of 76%. The heart failure patients were aged between 13-97 years with the mean age (± standard deviation) of 56.5 (± 19) years. There were more females (53.6%; n=213) than males (46.4%; n=185). Majority (45%) of the patients had New York Heart Association (NYHA) Functional class 2. The main aetiologies of heart failure were: hypertension (45%; n=179), rheumatic heart disease (23%; n=90), cardiomyopathy (15%; n=58). Other emerging aetiologies of heart failure in Africa seen in these patients were degenerative valvular disease (7.6%; n=31) and ischemic heart disease (2.3%; n=10).

/pdf/prevalence-and-aetiology-of-heart-failure-in-patients-seen-3sgqs8j4km.pdf

Prevalence and Aetiology of Heart Failure in Patients Seen at a Teaching Hospital in Ghana

Global burden of blood pressure-related disease (2001)

On assiste a un phenomene de transition epidemiologique dans les zones tropicales avec l’emergence des affections cardiovasculaires induites par l’atherosclerose. L'objectif de cette these etait de contribuer a une meilleure connaissance de l’epidemiologie des facteurs de risque cardiovasculaire en population tropicale, en particulier au Benin. Une analyse des prevalences des facteurs de risque cardiovasculaire en population generale au Benin a ete menee a partir de la base de donnees de l’enquete nationale STEPS. Une revue systematique des cohortes cardiovasculaires conduites en population generale en Afrique subsaharienne (ASS) a ete realisee. La methodologie de la cohorte TAHES (Tanve health study) a ete elaboree ; une etude pilote a ete mise en place. Les travaux montrent des frequences relativement elevees de plusieurs facteurs de risque cardiovasculaire au Benin et des differences suivant les milieux de residence. Par ailleurs, ils soulignent la rarete des etudes de cohortes sur les maladies cardiovasculaires en ASS. Les resultats preliminaires de la cohorte TAHES pilote confortent l’idee de la faisabilite d’une etude plus large.

/pdf/epidemiologie-des-facteurs-de-risque-cardiovasculaire-en-l0qd79q431.pdf

Épidémiologie des facteurs de risque cardiovasculaire en population tropicale - cas du Bénin

Background : We sought to determine the prevalence of echocardiographically determined left ventricular systolic dysfunction in asymptomatic hypertensive subjects seen in Abeokuta, Nigeria.
Methods : Echocardiography was performed in 832 consecutive hypertensive subjects referred for cardiac evaluation over a three-year period.
Results : Data were obtained in 832 subjects (50.1% women) aged 56.0 ± 12.7 years (men 56.9 ± 13.3 years, women 55.0 ± 12.0 years, range 15-88). The prevalence of left ventricular systolic dysfunction (LVSD) was 18.1% in the study population (mild LVSD = 9.6%, moderate LVSD = 3.7% and severe LVSD = 4.8%). In a multivariate analysis, male gender, body mass index and LV mass were the predictors of LVSD.
Conclusion : Significant numbers of hypertensive subjects in this study had varying degrees of left ventricular systolic dysfunction. Early introduction of disease-modifying drugs in these patients, such as angiotensin converting enzyme inhibitors or angiotensin receptor blockers may retard or prevent the progression to overt heart failure.

/pdf/prevalence-of-asymptomatic-left-ventricular-systolic-55d5qyd9k1.pdf

Prevalence of asymptomatic left ventricular systolic dysfunction in hypertensive Nigerians: echocardiographic study of 832 subjects.

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Prevalence of asymptomatic left ventricular systolic dysfunction in hypertensive Nigerians: echocardiographic study of 832 subjects.