Journal of Human Hypertension (1999) 13 , 9–12  1999 Stockton Press. All rights reserved 0950-9240/99 $12.00 http:/ / www.stockton-press.co.uk/ jhh ORIGINAL ARTICLE Target organ involvement in hypertensive patients in Eastern Sudan AA Hussain 1 , AG Elzubier 2 and M-Elbagir K Ahmed 3 1 Department of Medicine, College of Medicine, Kassala University, Kassala, Sudan; 2 Department of Family & Community Medicine, College of Medicine & Medical Sciences, King Faisal University, Dammam, Saudi Arabia; 3 Department of Medicine, College of Medicine, Abha, Saudi Arabia Hypertension has become a major cause of cardio- vascular morbidity and mortality in both the developed and the developing nations. In a cross-sectional study we assessed the state of blood pressure (BP) control and the pattern of target organ complications in 198 Sudanese patients treated in a teaching hospital in Kas- sala town in Eastern Sudan, (mean age 53 years, 76% women). Excellent BP control (BP 140/90 mm Hg) was achieved in 46% of the patients. Stage 2 or Stage 3 tar- get organ involvement, particularly albuminuria and ischaemic heart disease, were detected in one-third of Keywords: target organ damage; hypertension; Sudan Introduction Hypertension is a common disease worldwide and is emerging as a public health problem in most developing countries. 1–4 The disease is characterised by complications resulting in target organ involve- ment, associated with high morbidity and mor- tality. 5–8 In the Sudan, a prevalence of hypertension of 7.5% has been described 9 and the pattern of hypertensive target organ complications was found to be comparable to that of neighbouring North African countries, but distinct from that shown in black subjects outside the African continent. 10 Analysis of the types and frequency of hypertensive target organ damage in different countries are needed in order to design interventions to prevent and manage hypertension. 11 The aim of this study is to estimate the extent of target organ involvement in hypertensive patients in the Sudan in accordance with the recent World Health Organisation criteria, 12 and in relation to blood pressure (BP) control status. Materials and methods This was a cross-sectional study carried out in the town of Kassala, in Eastern Sudan, during 1997. The study population was all of the hypertensive patients registered for care in the medical out- patient clinic, or those admitted to the wards, in the Correspondence: Dr M-Elbagir K Ahmed, Department of Medi- cine, College Of Medicine, PO Box 641, Abha, Saudi Arabia Received 29 January 1998; revised 6 April 1998; accepted 20 August 1998 the patients. These complications were found to be related to both the severity and the duration of hyperten- sion as well as to the frequency of cigarette smoking. Factors such as poor compliance, adverse socioecon- omic status, as well as obesity and cigarette smoking may account for poor BP control and hence the develop- ment of hypertensive complications. We conclude that optimal BP control is not yet achieved in the majority of hypertensives in the Sudan. Reasons for this failure should be identified and corrected in order to avoid hypertensive target organ damage. Kassala teaching hospital. The hospital serves a population of 300 000. The sample studied amounted to 198 consecutive patients, followed up in the medical out-patient clinic. A patient was con- sidered to be hypertensive if he or she was already receiving antihypertensive drugs, or had a con- firmed BP of 140/90 mm Hg in the untreated state. 13 Data were collected using a structured question- naire to obtain information on age, gender, level of education, mode of diagnosis of hypertension (whether at routine checks or due to symptoms), family history of hypertension, duration of hyper- tension and of treatment, smoking history, number of drugs taken for hypertension control and the regu- larity of taking antihypertensive drugs (as volun- teered by the patients). BP was measured using the standard mercury sphygmomanometer with patients seated for at least 5 min. A cuff of a suitable size was applied around the right exposed upper arm and was rapidly inflated to 30 mm Hg above the level at which the pulse disappeared and deflated at a rate of 2 mm Hg per second. Systolic BP (SBP) was taken at the Phase I of Korotkoff sounds and dia- stolic BP (DBP) was taken at Phase V. 14 BP was con- sidered to be well controlled if it was 140/90 mm Hg or less. 13 Information also included current and past symptoms of angina pectoris, myocardial infarction, or left ventricular failure as well as current and past symptoms suggestive of transient ischaemic attacks, hypertensive encephalopathy, or stroke. In addition, any symptoms suggestive of renal failure. Each patient underwent a physical examination to check for signs of left ventricular failure, congestive