Systemic hypertension is a global health burden with attendant systemic complication, which manifest as hypertensive target organ damage (TOD). The spectrum ranges from stroke, chronic kidney disease (CKD), cardiovascular disease (CVD) such as left ventricular hypertrophy (LVH) and heart failure, and retinopathy. Patients with CKD have higher frequency of adverse cardiovascular outcomes than the general population. This study aims to determine the prevalence and pattern of left ventricular hypertrophy and function among hypertensive CKD patients and those without CKD.
Methodology: This was a cross-sectional analytical study between a two year period of January 2014 to December 2015, and recruited a total of seven hundred and seventy eight patients which included three hundred hypertensive CKD subjects attending the nephrology clinic at Lagos State University Teaching Hospital (LASUTH), two hundred and ninety seven hypertensive subjects attending the hypertension clinic and one hundred and eighty one healthy control subjects. They underwent clinical, laboratory and echocardiographic evaluation, and their results were analyzed with SPSS version 20.
Results: The prevalence of LVH among CKD subjects was 165(65%), and was significantly higher than hypertensive subjects 93(34.1%) and controls 7(4.2%) with x2 = 155.34 and P < 0.001. The most common left ventricular geometric pattern was concentric hypertrophy 131(50.4%) among CKD subjects, and concentric remodelling 107(37.8%) among hypertensive subjects, while normal 124(73.8%) among controls (P< 0.001).
There was higher frequency of left ventricular systolic dysfunction among CKD subjects 68(25.9%) than hypertensive subjects 13(4.3%) and controls 2(1.2%) with x2 = 89.46 and P < 0.001. The identified predictors of increasing left ventricular mass index was declining estimated glomerular filtration rate (eGFR), increasing systolic blood pressure (SBP) and male gender.
Conclusion: This study demonstrated high prevalence of LVH and poor left ventricular function among CKD patients compared to hypertensive subjects and healthy controls. Therefore attention should be geared towards early identification of declining cardiovascular function and prompt therapy.
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