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Introduction: Marked changes have been made in the pharmacotherapy of hypertension over the years. In sub-Saharan Africa, hypertension pharmacotherapy is often thought to include only thiazide diuretics, beta blockers and centrally acting medications and, it is unclear if and how often calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers are used., Objective: To examine the anti-hypertensive prescription pattern in a tertiary health centre in Nigeria to determine how it conforms to current guidelines., Method: 590 newly diagnosed hypertensive patients presenting at the Cardiology Unit of University of Abuja Teaching Hospital over a three-year period were studied., Result: Calcium channel blockers were the most frequently prescribed anti-hypertensive medications (66.9% of all cases) and centrally acting medications were prescribed in only 5.01% of cases. Single-pill combination either alone or in combination with other antihypertensive medications were prescribed in 17.3% cases. Of these, calcium channel blocker-based combinations constituted the most frequently used multiple drug combinations. 94.6% of the patients required more than one medication for blood pressure control., Conclusion: Anti-hypertensive pharmacotherapy in Abuja, Nigeria, compares favorably with the current recommendations in the prescription pattern of anti-hypertensive medications.

Background: Hypertension results in structural and functional changes in the heart. Early detection of abnormalities of cardiac structure and function is important in the assessment and treatment of hypertensive subjects. The aim of this study was to evaluate the utility of the tissue Doppler echocardiographic technique in characterising diastolic and systolic functions in untreated native black African hypertensive subjects., Materials and Methods: Forty consecutive, newly diagnosed, untreated hypertensives with adequate conventional echocardiographic (2-D, M-mode, transmitral and pulmonary Doppler flow velocities) and tissue Doppler echocardiographic images were recruited into the study. The control subjects were apparently normal individuals. Each arm of the study consisted of 21 male and 19 female subjects., Results: The two groups were comparable by age (48.6 +/- 11.35 years in the hypertensives vs 48.1 +/- 11.33 years in the controls; p = 0.844) and gender distribution (M/F: 21/19 in both groups). Other baseline characteristics, except for blood pressure parameters, which were predictably higher in the hypertensive subjects, were comparable between the two groups. The hypertensive subjects had a lower systolic myocardial velocity (Sm) and early diastolic myocardial velocity (Em) in comparison with the controls (p = 0.033 and p = 0.018, respectively). The late diastolic myocardial velocity (Am) was comparable in the two groups (p = 0.430)., Conclusions: Tissue Doppler echocardiography demonstrates diastolic dysfunction relatively early in native African hypertensives and may be useful for detecting subtle deterioration in systolic function.

Aim: Left atrial (LA) enlargement is a common finding in systemic hypertension and is a risk factor for the development of atrial fibrillation and stroke. We determined the correlates of LA enlargement in a Nigerian hypertensive population., Methods: A total of 361 hypertensives were recruited for echocardiography. Enlarged left atrium was defined as LA diameter > 4.2 cm in men or > 3.8 cm in women., Results: Enlarged LA was found in 15.8% of the hypertensives (19.2% in females and 12.5% males). Compared with those without dilated LA, subjects with dilated LA had higher age, body mass index, left ventricular end diastolic diameter, left ventricular wall thickness, lower ejection fraction and fractional shortening. In multivariate analysis, body mass index and left ventricular (LV) mass were the major predictors of LA size, whereas dilated LA was related to age, female gender and LV mass or the presence of left ventricular hypertrophy in logistic regression analysis., Conclusion: Left atrial size in Nigerian hypertensives is influenced by age, female gender, left ventricular mass and body mass index.

Background: Hypertension is associated with left ventricular diastolic function abnormalities. There have been few studies evaluating left ventricular diastolic function in an African populace., Materials and Methods: Ninety-eight hypertensives (52 females, 46 males) and 99 normal controls (49 females, 50 males) were recruited for echocardiography. M-mode measurements and Doppler measurements of Mitral inflow and pulmonary venous flow were taken., Results: The hypertensives had significantly larger left ventricular wall thicknesses than the controls PWT: 0.93 (0.214) vs. 0.88 (0.130), p=0.039: septum: 0.93 (0.255) vs. 0.87 (0.131), p=0.039. The left ventricular mass indexed to the allometric power of height was larger in the hypertensives than in the controls. The Doppler parameters of peak A-wave velocity, E/A ratio, deceleration time, peak pulmonary venous S-wave, peak pulmonary venous D-wave, S/D ratio and peak pulmonary reverse flow velocity were significantly different between the hypertensives and the controls. The major determinant of left ventricular diastolic function parameters were age and the duration of hypertension. The level of the systolic blood pressure, left atrial size and ejection fraction are less important determinants., Conclusion: Nigerian hypertensives have significantly different diastolic function indices when compared with normal controls.