Association of 10-year Cardiovascular Risk with Left Ventricular Hypertrophy in a Population of Nigerian Hypertensives.

Background

The pooled cohort equation (PCE) for predicting the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) has been utilised in Black populations to predict cardiovascular events.

Objective

We explored the relationship between PCE ASCVD risk and left ventricular hypertrophy (LVH).

Materials And Methods

A total of 934 hypertensives from the Federal Medical Centre Abuja Hypertension Registry were analysed for this study. The participants were divided into two groups: those with low ASCVD risk (<7.5%) and those with elevated ASCVD risk (≥7.5%). Electrocardiographic (ECG) LVH was defined by the presence of any of Sokolow-Lyon, Cornell voltage or Gubner-Ungerleider criteria. Echocardiographic LVH was defined as an elevated LV mass index using the linear cube formula of the American College of Cardiology.

Results

Participants with elevated ASCVD risk were older (59.2 ± 9.0 years) than those with low ASCVD risk ( P < 0.001). Among participants with elevated ASCVD risk, 299 (42.1%) and 181 (26.3%) had echocardiographic and ECG LVH compared with 75 (32.3%) and 44 (19.6%) in those with low ASCVD risk, respectively ( P < 0.05). Those with elevated ASCVD risk had higher odds of having echocardiographic (odds ratio [OR]: 2.02, 95% confidence interval CI 1.39-2.93) and ECG LVH (OR: 2.00, 95% CI 1.29-3.08) compared to those in the low-risk group ( P < 0.05).

Conclusion

In this study, an elevated 10-year ASCVD risk was associated with a two-fold increase in the risk of echocardiographic and ECG LVH in a population of Nigerian hypertensives. In resource-limited settings, the use of the ASCVD risk score may facilitate timely referrals for the diagnosis and management of LVH.