Abstract
This study aimed at evaluating the prevalence of hyperhomocysteinaemia in Northern-Nigerian hypertensives and its association with hypertension severity and some major determinants as data regarding these are lacking in sub-Saharan Africa. A Community-based cross-sectional study done on 120 randomly-selected hypertensive patients who responded to an ABU radio frequency modulated invitation for free health-screening at the Ahmadu Bello University (ABU) Medical Centre from January 2016 to June 2016. The percentage of participants with high homocysteine levels, their anthropometric parameters and blood pressures were determined. Plasma homocysteine (hcy) was classified as normal (5-15), moderate (>15-30), intermediate (31-100) and severe (>100) µmol/L. Kruskal-Wallis test was applied and log-transformed homocysteine (Ln10Homocysteine) was correlated with systolic and diastolic blood pressures as well as age, body mass index, fasting blood glucose, glomerular filtration rate, hypertension duration and Ln10folate in males and females using the Pearson's Correlation analysis. There were 83(69.2%) females and 37(30.8%) males with Median homocysteine of 20.8 µmol/L and 22.0 µmol/L respectively (p=0.003). Hyperhomocysteinaemia was found in 118(98.3%) hypertensives while 2(1.7%) subjects had normo-homocysteinaemia. Moderate hyperhomocysteinaemia (Median, 20.8 µmol/L) was identified in 105(87.5%) and intermediate (Median, 40 µmol/L) in 13(10.8%) (p<0.001). No subject had severe hyperhomocysteinaemia. Homocysteine was higher (p=0.003) in subjects with Stage 2 systolic hypertension. Ln10Homocysteine was significantly (p<0.001) correlated with blood pressure (SBP: r=0.45; DBP: r=0.40) and age (r=0.33). The prevalence of hyperhomocysteinaemia in North-Western Nigerian hypertensives is high as against normal healthy controls. Plasma homocysteine is higher with severe systolic hypertension and positively associated with age. No specific grants but Micro Nova Pharmaceuticals Limited, Nigeria and Emzor Pharmaceutical Industries, Lagos, Nigeria supported with drugs.
Highlights
Hypertension, which is a persistently sustained raised blood pressure ≥ 140/90 mmHg or current use of antihypertensive therapy has been re-defined to a lower threshold value of 130/80 mmHg, thereby increasing the percentage of United States adults with hypertension to 46% from 32% with the previous definition.[2]
28.9% with higher urban than rural prevalence of 30.6% and 26.4% respectively.[4]. This rising trend in Africans is attributable to traditional risk factors of hypertension viza-viz: increased tobacco use; excessive alcohol intake; sedentary lifestyle leading to obesity as well as adopted "Western" lifestyle and diets rich in salt, refined sugars, low fibre and unhealthy fats and oils.[3]
Study Location and Research Design It was a community based cross-sectional study carried out among 120 randomly selected hypertensive subjects presenting at the large hall of the Ahmadu Bello University (ABU) Medical Centre, Zaria following a 3-day ABU radio frequency modulated (F.M) announcement inviting hypertensive subjects in Zaria to come for free medical screening exercise, free drug delivery as well free health talk on hypertension management.[37]
Summary
Hypertension, which is a persistently sustained raised blood pressure ≥ 140/90 mmHg or current use of antihypertensive therapy has been re-defined to a lower threshold value of 130/80 mmHg, thereby increasing the percentage of United States adults with hypertension to 46% from 32% with the previous definition.[2]. 28.9% with higher urban than rural prevalence of 30.6% and 26.4% respectively.[4] This rising trend in Africans is attributable to traditional risk factors of hypertension viza-viz: increased tobacco use; excessive alcohol intake; sedentary lifestyle leading to obesity as well as adopted "Western" lifestyle and diets rich in salt, refined sugars, low fibre and unhealthy fats and oils.[3]. Ergocalciferol-containing foods are other attributable risks.[5,6] These risk factors if modified via lifestyle changes such as exercise, avoidance of alcohol and smoking, intake of high fibre meals, fruits, vegetables and low dairy yoghourt, can reduce the incidence of hypertension and its attendant complications like stroke, heart failure, heart attacks and kidney failure.3,7-8The non-modifiable traditional risk factors of hypertension includes: black race, family history of hypertension, increasing age, male sex/post-menopausal status, genetic predisposition and childhood under-nutrition.[5,8]
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