Gender specific pattern of left ventricular cardiac adaptation to hypertension and obesity in a tertiary health facility in Nigeria

Abstract

Background: Cardiac adaptation to hypertension and obesity may be related to many factors such as race, gender and haemodynamic status. Some gender specific associations with left ventricular structure and function have been described among Caucasians.

Objectives: To describe the sex specific pattern of left ventricular adaptations to obesity and hypertension among Nigerians.

Methodology: It was a cross sectional study carried out at LAUTECH Teaching Hospital, Osogbo, Nigeria. 313 subjects had full echocardiography performed. Participants were divided into four groups: normal, obese, hypertensives and obese-hypertensives. Indices of LV adaptation were compared between the groups. SPSS 16.0 was used for analysis.

Results: Relative to normal subjects, LV mass (LVM), LV mass index (LVMI) and wall thickness were significantly higher among hypertensive men and obese hypertensive men. They were similar between normal and obese men. However, LVM, LVMI and wall thickness were increased among obese women compared to normal women while they were similar among
obese, hypertensive and obese-hypertensive women. Men with concurrent obesity and hypertension presented with a further increase of LVM and wall thickness above values in the merely obese or hypertensive subjects. Female obesehypertensive seem to present more with eccentric  hypertrophy than male obese-hypertensive subjects (17.2% vs. 9.1% respectively, p<0.05) while male obese-hypertensive seem to present more with concentric hypertrophy (54.5% vs. 43.1% respectively, p>0.05) than female obese-hypertensive subjects.

Conclusions: Structural, functional and geometric LV adaptation to obesity and hypertension varies between the two genders among Nigerians. The impact of isolated obesity on LV adaptation in women appears very significant.

Key words: gender, obesity, hypertension, LV geometry, left ventricular hypertrophy