Prevalence and Determinants of Left Ventricular Hypertrophy among Nigerian Adults with Hypertension: A Systematic Review

Background: Left Ventricular Hypertrophy (LVH) is a structural adaptation of the heart linked to increased cardiovascular morbidity and mortality. It occurs in response to chronic pressure or volume overload and varies in pattern across populations. This study aimed to systematically evaluate the prevalence, geometric patterns, and determinants of LVH among Nigerian adults. Methods: A systematic review was conducted using PubMed, Google Scholar, African Journals Online (AJOL), and Directory of Open Access Journals (DOAJ) to identify studies published between 2004 and 2025. The research question focused on the prevalence, pattern, and determinants of LVH in Nigerian adults aged ≥18 years. Studies were eligible if they reported LVH prevalence, Left Ventricular (LV) geometry, or associated determinants in hospital-based or community populations, including hypertensive, prehypertensive, and Sickle Cell Anemia (SCA) cohorts. Data extracted included study population, sample size, diagnostic method, and LVH-related outcomes. Results: Seventeen studies were included, with sample sizes ranging from 80 to 450 participants. LVH prevalence ranged from 18% in prehypertensives to 45% in hypertensives and 47% in adults with SCA. Concentric hypertrophy was most common in hypertensives, and eccentric hypertrophy in SCA. Key factors associated with LVH included elevated Systolic Blood Pressure (SBP), age, male sex, Body Mass Index (BMI), family history of hypertension, and comorbid conditions such as diabetes. Conclusion: LVH is highly prevalent among Nigerian adults, with geometric patterns reflecting underlying hemodynamic stress. Identification of key factors associated with LVH can guide early detection and targeted interventions to reduce cardiovascular morbidity and mortality.