article · Nigerian Postgraduate Medical Journal
A study evaluated the connection between ten-year atherosclerotic cardiovascular disease risk scores and left ventricular hypertrophy in hypertensive adults. Using data from 934 patients in the Federal Medical Centre Abuja Hypertension Registry, individuals were categorised into low-risk or elevated-risk groups based on a 7.5 per cent risk threshold. Heart changes were assessed through both electrocardiography and echocardiography. Patients with elevated risk were older and demonstrated significantly higher rates of left ventricular hypertrophy. Specifically, elevated cardiovascular risk was linked to a two-fold increase in the odds of having both echocardiographic and electrocardiographic left ventricular hypertrophy compared to the low-risk cohort. The findings indicate that standard cardiovascular risk estimation tools can help clinical teams identify individuals who require further cardiac diagnostic assessments.
Left ventricular hypertrophy indicates significant cardiac damage that requires prompt medical management. In resource-limited settings where advanced diagnostic imaging like echocardiography is not universally accessible, simple risk scoring offers a practical way to stratify hypertensive patients. This allows healthcare services to identify high-risk individuals early and direct limited diagnostic resources to those most likely to need intervention.
This research demonstrates an applied clinical screening approach that could be incorporated into digital clinical decision support systems or primary care triage protocols. The primary users would be healthcare providers and clinic managers operating in resource-constrained environments to prioritise patients for diagnostic referrals. Because it relies on the existing pooled cohort equation rather than a new technology, real-world deployment depends on clinical guideline adoption rather than product development.
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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.
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DOI: 10.4103/npmj.npmj_580_25
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