Page 27 - 4th All African Conference on Heart Disease, Diabetes and Stroke

CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 5, May 2013

AFRICA

25

Equivalent data from the Heart of Soweto study in 4 626 subjects

were available for comparison.

Results:

The mean age of the study cohort was 49.0 ± 13.7 years.

Hypertension was the primary diagnosis in around two-thirds of the

study cohort. Hypertension was also the commonest cause of heart

failure (HF) accounting for HF in 60.6% of cases. The Abuja cohort

were more likely to present with a primary diagnosis of hyperten-

sion (adjusted odds ratio (OR) 2.10, 95% confidence interval (CI)

1.85–2.42), hypertensive heart disease/failure (OR 2.48, 95% CI

2.18–2.83;

p

<0.001 for both comparisons and representing more than

two-thirds of presentations in Abuja. Alternatively, they were far less

likely to present with coronary artery disease (CAD) (OR 0.04, 95%

CI 0.02–0.11),

p

<0.001.

Interpretation:

Hypertension and its complications is the common-

est cardiovascular disease in the Nigerian population in Abuja, and

unlike in Soweto, coronary artery disease is not common.

RELATIONSHIP OF BLOOD PRESSURE WITH SOME

CARDIOVASCULAR DISEASE RISK FACTORS IN A RURAL

POPULATION OF PLATEAU STATE, NORTH CENTRAL

NIGERIA

Okeahialam BN*, Ogbonna C, Joseph D, Chuhwak E, Isiguzoro I

University of Jos, Nigeria

Introduction:

Hypertension is associated with certain cardiovascular

disease (CVD) risk factors which vary from one place to another

depending on community sophistication. We decided to assess the situ-

ation as it affects this rural Nigerian community, to be in an evidence-

based position to initiate individual and group prevention strategies.

Subjects and methods:

We surveyed for CVD risk factors among

all subjects 15 years and above in this rural community using a

questionnaire requesting personal, medical and anthropometric

information. One in 3 of them were randomly assigned to laboratory

investigations.

Results:

Of the 840 subjects studied, 25% were males. The popula-

tion mean age was 45.5 years (± 18.2 SD), with 1.8% smokers and

4.1% using alcohol. Systolic BP (SBP) correlated with age,body

mass index (BMI), total cholesterol and uric acid, while diastolic

BP (DBP) correlated with age, BMI, total cholesterol, uric acid and

atherogenic index. SBP and DBP improved with exercise but not salt

intake. The local seasonings used in cooking had no impact on BP.

Interpretation:

To reduce cardiovascular morbidity in this and

probably other rural sub-Saharan African communities, BMI, total

cholesterol, uric acid and salt intake in diet should be targeted for

reduction. Physical activity should be encouraged. Interestingly these

fall into the sphere of healthy lifestyle which should be encouraged

and reinforced.

SODIUM AND POTASSIUM CONTENTS OF COMMON

SEASONINGS USED IN COOKING ON THE JOS PLATEAU

Okeahialam BN*, Echeonwu GON, Duru BN

University of Jos, Nigeria

Introduction:

Hypertension is prevalent inAfrica with an established

role for dietary sodium as a risk factor. Also the low potassium in the

diet of Africans is said to play a significant role in the disease and

its complications. With most populations unable to meet their potas-

sium needs through fruit and vegetable intake, it becomes necessary

to look for convenient and culturally acceptable means of meeting

the requirement. As most sodium intake is through dietary ingestion

of table salt in cooked and processed food, it is very important to

establish sodium and potassium contents of common seasonings used

in cooking, and to determine from their sodium and potassium profile

which ones to recommend. This is particularly relevant as fruits and

raw vegetables do not form part of the traditional African diet.

Subjects and methods:

We procured from the open market common

seasonings used to cook in our environment, analysing them for

sodium and potassium content.

Results:

Table salt had the highest sodium and lowest potassium

content. The sodium levels fell with a slight rise in potassium in

commercially produced seasonings. The traditional seasonings had

even lower sodium and much higher potassium contents with the

sodium/potassium ratio being lowest for ‘tooka’, a traditional season-

ing powder.

Interpretation:

Traditional seasonings especially ‘tooka’ would

be the recommended seasoning in our environment if a favourable

impact on individual and population blood pressures is desired by

reducing the dietary sodium/potassium ratio.

CARDIOVASCULAR COMPLICATIONS IN NEWLY DIAG-

NOSED RHEUMATIC HEART DISEASE PATIENTS AT

MULAGO HOSPITAL, UGANDA

Okello E*, Wanzhu Z, Musoke C, Twalib A, Kakande B, Lwab P,

Wilson NB, Mondo CK, Odoi-Adome R, Freers J

Division of Cardiology, Department of Medicine, Makerere

University College of Health Sciences, Uganda

Introduction:

Complications of rheumatic heart disease are associ-

ated with severe mortality and morbidity in developing countries

where the disease prevalence remains high. Owing to lack of

screening services, many patients present late, with severe valve

disease. In Uganda, the disease and its complications remain less

well studied.

Subjects and methods:

The aim was to profile and describe cardio-

vascular complications in newly diagnosed rheumatic heart disease

patients attending Mulago National Referral Hospital in Uganda.

This was a prospective study where consecutive newly diagnosed

rheumatic heart disease patients were assessed and followed up for

complications such as heart failure, pulmonary hypertension, atrial

fibrillation, acute rheumatic fever recurrence and stroke.

Results:

A total of 309 (115 males and 196 females) definite rheu-

matic heart disease cases, aged 15–60 years were enrolled in the

study and analysed. Complications occurred in 49% (152/309) of

newly diagnosed rheumatic heart disease cases, with heart failure

(46.9%) as the most common complication, followed by pulmonary

arterial hypertension (32.7%), atrial fibrillation (13.9%), acute

rheumatic fever recurrence (11.4%), infective endocarditis (4.5%)

and stroke (1.3%). Atrial fibrillation and acute rheumatic fever were

the most common complications associated with heart failure.

Interpretation:

In the present study we found that about 50%

of newly diagnosed rheumatic heart disease patients in Uganda

present with complications, with heart failure and pulmonary arte-

rial hypertension as the most commonly observed complications.

SOCIOECONOMICANDENVIRONMENTALRISKFACTORS

AMONG RHEUMATIC HEART DISEASE PATIENTS IN

UGANDA

Okello E*, Kakande B, Kayima ESJ, Kuteesa M, Mutatina B,

Nyakoojo W, Lwabi P, Mondo CK, Odoi-Adome R, Juergen F

Division of Cardiology, Department of Medicine, Makerere

University College of Health Sciences, Uganda

Introduction:

Although low socioeconomic status and environmen-

tal factors are known risk factors for rheumatic heart disease in other

societies, risk factors for rheumatic heart disease remain less well

described in Uganda.

Subjects and methods:

The objective of this study was to inves-

tigate the role of socioeconomic and environmental factors in the

pathogenesis of rheumatic heart disease in Ugandan patients. This

was a case control study in which rheumatic heart disease cases and

normal controls aged 5–60 years were recruited and investigated for

socioeconomic and environmental risk factors such as income status,

employment status, distance from the nearest health centre, number

of people per house and space area per person.

Results:

A total of 486 participants (243 cases and 243 controls) took

part in the study. Average age was 32.37 ± 21.46 years for cases and