How common is heart failure due to systemic hypertension alone in hospitalised Nigerians?

Hypertension is regarded as the most common cause of heart failure in Nigeria and other Black African countries. A few reports suggest that heart failure due to hypertension hardly occurs without the presence of an extra burden on the heart from the presence of other cardiac risk factors. This study assesses the occurrence of other potential causes of heart failure in 55 consecutive admitted cases of hypertensive heart failure. All but six cases (88%) were associated with the presence of one or other significant cardiac risk factors while 56.2% were associated with multiple heart failure risk factors. Five of the six were poor drug compliers. Of the six, only one was completely free of cardiac risk factors and he was unaware of his hypertension and so had never had therapy. The others either consumed alcohol moderately, had mild renal impairment or were grossly obese. The factors found were anaemia, renal dysfunction, abnormal glucose tolerance, alcoholic ingestion and co-existing valvular heart disease. The finding shows that among Nigerian patients hospitalised for hypertensive heart failure, heart failure was rare in those hypertensive patients who had no extra cardiac burden, and therefore control of these factors will help prevent the development of heart failure in hypertension with its dismal prognosis.