Cardiovascular Journal of Africa: Vol 32 No 6 (NOVEMBER/DECEMBER 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 6, November/December 2021 326 AFRICA … continued from page 319 ‘The similar relative benefits of treatment in primary and secondary prevention presented in the study by the BPLTTC indicate that the cardiovascular risk of an individual will be a major determinant of the absolute benefit of treatment, confirming the importance of risk assessment in individual patients. ‘These findings have important implications for clinical practice, and suggest that antihypertensive treatment might be considered for any person for whom the absolute risk for a future cardiovascular event is sufficiently high. This suggestion calls for simple, reliable multivariable risk- prediction tools made readily available in the electronic health record systems used by healthcare providers. The use of patient self-reported computerised medical history taking could facilitate such development. Taken together, decisions about offering people antihypertensive treatment are all about cardiovascular risk reduction.’ Dr Sir Nilesh Samani, medical director for the British Heart Foundation, said this study ‘again emphasises the importance of controlling blood pressure as well as possible, to reduce the risk of heart and circulatory diseases. The benefits of lowering blood pressure are there whether you have pre-existing heart disease or not, and this study shows that lowering blood pressure, even if it is in the normal range, is associated with fewer heart attacks and strokes,’ ‘This doesn’t mean we should treat everyone with blood pressure-lowering drugs. If someone already has a low risk of heart disease, a 10% reduction in their blood pressure may only carry a small direct benefit,’ Samani added. ‘Ultimately, the decision to treat blood pressure and the target level to aim for is something that requires a conversation between the patient and the doctor. It’s also important to remember that blood pressure can be improved by means other than medication such as exercise and losing weight.’ Source: MedicalBrief 2021 SH, et al . Determinants of left ventricular hypertrophy and dias- tolic dysfunction in an HIV clinical cohort. J Cardiac Fail 2018; 24 (8): 496–503. 45. Hsue PY, Lo JC, Franklin A, Bolger AF, Martin JN, Deeks SG, Waters DD. Progression of atherosclerosis as assessed by carotid intima–media thickness in patients with HIV infection. Circulation 2004; 1 : 1603–1608. 46. Ho JE, Scherzer R, Hecht FM, Maka K, Selby V, Martin JN, et al . The association of CD4+ T-cell counts and cardiovascular risk in treated HIV disease. AIDS 2012; 2 : 1115–1120. 47. Njoku PO, Ejim EC, Anisiuba BC, Ike SO, Onwubere BJC. Electrocardiographic findings in a cross-sectional study of human immunodeficiency virus (HIV) patients in Enugu, south-east Nigeria. Cardiovasc J Afr 2016; 27 (4): 252. 48. Araoye MA. Basic Electrocardiography . 2nd edn. Ibadan: Spectrum Books, 2012: 102–103. 49. Lipshultz SE, Chanock S, Sanders SP, Colan SD, Perez-Atayde A, McIntosh K. Cardiovascular manifestations of HIV infection in infants and children. Am J Cardiol 1989; 63 : 1489–1497.