Association of 10-year Cardiovascular Risk with Left Ventricular Hypertrophy in a Population of Nigerian Hypertensives

Abstract

Abstract 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.