CARDIOVASCULAR JOURNAL OF SOUTH AFRICA Vol 18, No. 2, March/April 2007 75 Unexpectedly high prevalence of target-organ damage in newly diagnosed Nigerians with hypertension BL SALAKO, OS OGAH, AA ADEBIYI, KS ADEDAPO, CO BEKIBELE, TS OLULEYE, IKECHI OKPECHI Summary Introduction: Hypertension remains a formidable cardio- vascular problem in the entire world. Untreated or poor- ly controlled hypertension predisposes to target-organ damage and is often followed by serious cardiovascular events. Knowledge of the type and distribution of end- organ damage in newly diagnosed hypertensive patients would help to determine the interventions or preventative measures needed in such patients. Objective: To assess target-organ involvement in newly diagnosed, untreated hypertensive patients presenting at the University College Hospital, Ibadan, Nigeria. Methods: Newly diagnosed hypertensive men and women were recruited consecutively into the study. Target-organ damage was assessed using electroctrocardiography, echocardiography, renal function assessment (including tests for albuminuria) and fundoscopy. Results: A total of 68 subjects were recruited, but only 54 (79.4%), with a mean age of 59.1 (± 12.4) years, completed the study. There were 29 (± 53.7%) men, mean age 63.5 (± 12.6) years, and 25 (46.3%) women, mean age 54.1 (± 10.4) years. Fifty per cent of the subjects had no symptoms. Some form of albuminuria was found in about 40.7%. Seventy-one per cent (71%) had between grade 1 and 2 hypertensive retinopathy. Only six (11.1%) had glomerular filtration rate greater than 90 ml/min. Systolic function was impaired in three (5.6%) of the subjects. Diastolic dysfunction was present in 36 (66.7%) subjects. Conclusion: Target-organ damage already exists in newly diagnosed hypertensive subjects before presentation. We suggest early screening for cardiovascular risk factors and possibly a reduction in the criteria for the definition of hypertension in black Africans. Cardiovasc J South Afr 2007; 18: 00–00 www.cvjsa.co.za Hypertension is a formidable cardiovascular problem in the entire world. It is a disease characterised by end- organ complications leading to high morbidity/disability and mortality in many cases. 1 In spite of the increasing public awareness and rapidly expanding armamentarium of anti- hypertensives, hypertension remains an important public health problem in many parts of the world, especially among black Africans. 2-7 Untreated or poorly controlled hypertension predisposes to target-organ damage and is often followed by serious cardiovascular events. Morbid cardiovascular events are common in patients with target-organ damage, especially in the presence of microalbuminuria and left ventricular hyper- trophy. 1,2 Knowledge of the type and distribution of end-organ damage in newly diagnosed hypertensive patients would help in determining the intervention needed to prevent this. Our study was, therefore, aimed at assessing target-organ involve- ment in newly diagnosed hypertensive patients presenting at the University College Hospital, Ibadan, Nigeria. Material and methods Newly diagnosed, untreated hypertensive subjects were recruited consecutively into the study, which covered the period of one year (January to December 2004). Hypertension was defined as systolic blood pressure of 140 mmHg or above and/or diastolic blood pressure of 90 mmHg or above on at least two measurements taken at a one-week interval. 8,9 Cardiovascular Topics Department of Medicine, University College Hospital, Ibadan, Nigeria BL SALAKO, MB BS, FWACP OS OGAH, MB BS, MSc, FWACP AA ADEBIYI, MB BS, FWACP IKECHI OKPECHI, MB BS Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria KS ADEDAPO, MB BS, FWACP Department of Ophthalmology, University College Hospital, Ibadan, Nigeria CO BEKIBELE, MB BS, MSc, FMCO, FWACS TS OLULEYE, MB BS, FMCO, FWACS Vol 18 No 2 2007.indd 75 3/30/07 8:24:17 AM