Hypertensive heart failure in Nigerian Africans: insights from the Abeokuta Heart Failure Registry

Abstract

Data from the Abeokuta Heart Failure Registry were used to determine the clinical characteristics, mode of treatment, and short- and medium-term outcomes of patients with hypertensive heart failure. A total of 320 patients were consecutively studied, comprising 184 men (57.5%) and 136 women (42.5%) aged 58.4±12.4 and 60.6±14.5 years, respectively. Most patients (80%) presented with New York Heart Association functional class III or IV and around one third (35%) had preserved systolic function. Median hospital stay was 9 days (interquartile range 5-21) while intra-hospital mortality was 3.4%. The 30-day, 90-day, and 180-day mortality rates were 0.9% (95% confidence interval, -0.2 to 3.5), 3.5% (95% confidence interval, -1.7 to 7.3), and 11.7% (95% confidence interval, -7.8 to 17.5), respectively. In a multiple logistic regression analysis, only serum creatinine was an independent predictor of mortality at 180 days (adjusted odds ratio, 1.76; 95% confidence interval, -1.17 to 2.64). Hypertension is the most common etiological risk factor for heart failure in Nigeria. Most patients present in the fourth decade of life with severe heart failure and secondary valvular dysfunction and significant in-hospital mortality.

Figure 1

Pie chart showing the precipitating factors identified in the 320 hypertensive patients. BP indicates blood pressure.

Figure 2

Bar chart showing the pattern of drug prescription in the 320 hypertensive patients. ACEI indicates angiotensin‐converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCBs, calcium channel blockers; DHA, docosahexaenoic acid.

Figure 3

(a) Kaplan‐Meier curve showing the rate of rehospitalization of the cohort after 180 days. (b) Kaplan‐Meier curve showing the rate of mortality of the cohort after 180 days.