Left ventricular geometric patterns in hypertensive Nigerians: a systematic review

Introduction: Several studies on left ventricular hypertrophy (LVH) and LV geometric patterns in hypertensive subjects have been carried out in Nigeria, but the results vary widely. The present article aims to systematically review published studies carried out in Nigeria on the prevalence and pattern of LV geometry in hypertensive subjects as determined using echocardiography. Methods: Relevant English language papers published up to 15th November 2012 were searched for in Medline, African Journals on Line, Google Scholar and several other websites, and enquiries were made from colleagues. Study quality was assessed using a condensed version of the Downs and Black checklist. LVH was defined in most of the studies as LV mass index (LVMI) >96g/m2 in women and >116g/m2 in men, or LVMI >125g/m2 for both sexes. Results: A total of 148 records were initially obtained after excluding duplicates, but 138 articles had to be excluded (126 for lack of relevance; 12 abstracts for lack of full length articles) while data in the remaining 10 were extracted, further analysed and discussed. Out of a total of 1722 persons in all the included studies, 621 (36.1%) subjects had LVH, while 496 (28.8%) had concentric remodelling and the remaining 605 (35.1%) subjects had normal geometry. Of those with LVH, 321 (51.7%) of them had eccentric hypertrophy while the remaining 300 (48.3%) had concentric hypertrophy. Conclusion: The findings in the present study have important clinical implications in the choice of antihypertensive treatments to control the blood pressure, induce regression of LVH and reduce overall cardiovascular morbidity and mortality, as recommended in standard guidelines.