CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 7, August 2012
AFRICA
383
may be unwilling to commence taking drugs, which may have
side effects. This is particularly so when they do not have any
symptoms.
Of the few patients who were on antihypertensives, the
drugs most frequently used were centrally acting ones such as
α
-methyl DOPA, or inappropriate ones such as benzodiazepines
(valium, lexotan). Invariably, patients on such treatments will
have uncontrolled BP and are likely to have more TOD and
established CVD, with worse outcomes. Newly diagnosed
hypertensives should have their cardiovascular risks fully
assessed and appropriately managed. Since stage 3 hypertension
was associated with significantly increased odds of developing
TOD, efforts should be made to aggressively lower and control
BP in such individuals.
Our study had some limitations. The investigations did not
include echocardiography for assessment of LVH, which is more
sensitive than ECG. However, we used locally validated Araoye’s
criteria to determine LVH with ECG, as this was likely to give
us a more accurate diagnosis.
18,19
The duration of hypertension
could not be ascertained in most of our subjects as many had
not had their BP checked until the time of the study. Therefore,
we could not control for the duration of hypertension, which is a
confounder in this type of study.
Conclusion
This study showed a high level of TOD and established CVD
in this rural population of hypertensives. Our findings strongly
suggest that the epidemiological transition from communicable
to non-communicable diseases is occurring at a faster rate
than previously envisaged. In this low-resource setting, there
is an urgent need for primordial and primary prevention of
hypertension and its complications. Once detected, BP should be
properly controlled with appropriate medications. To this effect,
both the populace and health practitioners should receive health
education and health promotion to reduce the burden of disease.
We are grateful to the authorities of the ELGA, the gatekeepers/key opinion
leaders and the participants who gave their time, support and enthusiasm in
making this study a success. The study was funded in part by the country
office of the WHO.
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