Prevalence of left ventricular diastolic dysfunction in newly diagnosed Nigerians with systemic hypertension: a pulsed wave Doppler echocardiographic study.

Abstract

Systemic hypertension is a common cause of left ventricular diastolic dysfunction. However, its prevalence in Nigerians with untreated systemic hypertension is unknown. To determine the prevalence of left ventricular diastolic dysfunction in newly diagnosed Nigerians with systemic hypertension using Doppler transmitral inflow and pulmonary venous flow velocities. Two-dimensional echocardiography including Doppler was performed on 150 newly diagnosed cases of systemic hypertension and 150 normotensive controls. They were divided into hypertensives without left ventricular hypertrophy and those with left ventricular hypertrophy based on echocardiographically determined left ventricular mass index. Pulsed Doppler transmitral inflow and the pulmonary venous flow waves were used to categorise the patterns of diastolic dysfunction. The hypertensives and the normotensive controls were comparable in their baseline characteristics. The E/A ratio differed significantly between hypertensives with and without left ventricular hypertrophy and controls (1.00+0.30, 1.04±0.42, 1.33±0.27, p < 0.001). Left ventricular diastolic dysfunction occurred in 62% of systemic hypertension and 11.3% of the controls. Impaired relaxation was the commonest pattern (84.9%) of diastolic dysfunction. Our study showed that left ventricular diastolic dysfunction is prevalent in Nigerians with newly diagnosed systemic hypertension and effort should be made to routinely screen for them.