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Demographic, life style and anthropometric correlates of blood pressure were analysed in 5,200 civil servants, factory and plantation workers living in an urban setting in the South Eastern part of Nigeria. The subjects were 4,382 men (84.2%) and 818 (15.8%) women. The prevalence of hypertension, using the WHO criteria among the workers was 8.1%, and was lower in women than men, 3.5% and 8.9% respectively. Only 19.6% of the hypertensive population knew that they had hypertension, whilst 29.4% of the total population under study gave a positive family history of hypertension. The blood pressure and the prevalence of hypertension rose with age, number of children in the family, salary scale and with the number of cigarettes smoked per day. The prevalence of hypertension was higher in medium and heavy drinkers than the non-drinkers and light drinkers. The prevalence was also higher in medium and heavy smokers. Multiple regression analysis showed a significant positive relation between the systolic blood pressure and sex, age, marital status, number of children in the family, salary scale, tobacco consumption and weight (P less than 001). On the other hand, occupation (P less than 01) educational qualification (P less than 001), support system (P less than 03) and height (P less than 001) had significant negative relationships with systolic blood pressure. There was also a significant positive relation between the diastolic blood pressure and number of children in the family (P less than 002) and salary scale (P less than 001). It is suggested that hypertension screening and treatment should be incorporated in the primary health care programmes of African communities.

Urban Nigerian school children are reported to have a higher systolic blood pressure and diastolic blood pressure than rural community school children until the age of 11-12 years when this difference tends to disappear. We evaluated 874 urban day-school children and 674 rural community school children aged 5-16 (mean 11.9) years in south-eastern Nigeria to confirm this changing pattern, and to assess the contributions of some known factors to the differences as well as the changing pattern. This study confirmed the changing pattern of urban/rural blood pressure of school children. Differences in weight, height and Body Mass Index (BMI), though important, appeared insufficient to explain this pressure difference and the changing pattern. Urban children aged 12-14 years were found to excrete more sodium and (unexpectedly) more potassium in their 24-h urine samples. The observed urban/rural blood pressure difference appears to be sustained by a multiplicity of factors, including differences in weight, BMI, height, electrolytes (especially sodium) consumption, and increased exposure to Western-type education.

Clinical observations are described in 13 cases of pyomyositis with various cardiovascular complications: (a) pyogenic pericarditis (10 cases) with tamponade in 7 and myopericarditis in 1 case, and (b) acute bacterial endocarditis (3 cases). Blood cultures grew Staphylococcus aureus in all 3 with endocarditis and in 5 of 10 with pericarditis. These complications probably resulted from the bacteraemia which sometimes complicates pyomyositis. Enhanced susceptibility of cardiac muscles to infection in pyomyositis however remains another possibility.

Observations are reported on 31 patients with coronary artery disease (CAD) from Nigeria (a region where CAD is rare). Hypertension either alone (12 cases), or associated with diabetes mellitus and obesity (4 cases), with diabetes mellitus and heavy cigarette smoking (1 case) was a frequent associated illness. Serum cholesterol measured in 15 cases was high in 13, but nine others without cholesterol assay were in the high socio-economic group, and serum cholesterol was likely to be relatively elevated in them also. Hyper-cholesterolaemia was the one factor that Nigerian patients with CAD had, but which is rare in the Nigerian general population. This observation appears to support the view that other major pre-disposing factors to CAD cause this disease usually when there is a back-ground of hyperlipidaemia.