Background and Objectives: Hypertension is a global health hazard and most cases are first attended to by the physicians. Achieving a control will depend on the knowledge, attitude and practice of the physicians. We therefore determined the knowledge, attitude and practices of physicians on the detection and treatment of arterial hypertension in north-central Nigeria. Design and Methods: A cross-sectional study of 100 of the 250 physicians attending a continuing medical education lecture series in Bida was conducted using a pre-validated self administered questionnaire. Results: The mean age of the physicians was 41.05 ± 8.71 years and 59 (73.8%) were males. Fortyone (51.2%) of them have practiced for more than 10 years. Arterial hypertension was considered an important health problem by 93.8% of the physicians, 30% of them believed that it should not be referred to a specialist. Majority of the physicians request for urinalysis (96.2%), electrocardiogram (95.0%), fasting blood glucose (88.8%), blood urea nitrogen (98.8%) and fasting lipid profile (97.5%) to either assess target organ damage or associated co-morbid conditions. Fifty-seven (71.2%) of the physicians prescribe diuretics as the initial drug. However, the knowledge of the other drugs on initiation of therapy of mild uncomplicated hypertension was poor. The sources of information on arterial hypertension by physicians were scientific programs (73.8%), drug companies (38.8%) and journals in 11.3%. Conclusion: The knowledge, attitude and practice of physicians in the detection and management of hypertension were modest. Educative programs like continuing medical education, seminars, and conferences on cardiovascular disorders are advised to be organized regularly to strengthen these and update the physicians.

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The curves of longitudinal(GLS), circumferential(GCS), radial strain(GRS) and LVT /LVUR were extracted using a commercial software.Results: Peak LVT and LVUR increased significantly in the 3rd trimester in both pregnancy groups (13.48 ± 2.90°,13.12 ± 3.30°,16.83 ± 3.61°,P < 0.001; and -111.52 ± 23.54°/sec,-107.40 ± 26.58°/sec,-144.30 ± 45.14°/sec, P < 0.001; in the 1st, 2nd, and 3rd trimester, respectively.The pregnants with twins have the highest value for LVT and LVUR compare with other pregnants (p < 0.01), but in the last trimester, the time to peak LVUR is prolonged. An independent correlation was found between the change in LVT and LV end-systolic volume in 1st and 3rd trimester (r = 0,56). Peak LVUR at the 3rd trimester correlated significantly with LV end-diastolic volume. Multiple regression analysis indicates that only systolic blood pressure (r = 0.394, P = 0.005) was an independent predictor for increased LV torsion. Arterial hypertension (AH) and prevalence of preeclampsia (PE) are more often in IVF group. Longitudinal strain decreased significantly (p < 0.001) during 3th trimester in women with AH and PE. Global longitudinal strain measures of the LV were non-significantly different between the different groups in first and second trimester (GLS-20.6 ± 3,14 vs.-19,29 ± 2,17).There are not found significant differences for GCS and GRS during pregnancy. Conclusions: During pregnancy LV twist and peak untwisting rate increase in the 3rd trimester and correlate with end-systolic and end-diastolic volume, respectively. Blood pressure and condition of multiple pregnancy are independently associated with increased torsion during pregnancy and may predict the new onset heart failure and perinatal cardiomyopathy. Global longitudinal strain is the main predictor of new onset peripartum cardiomyopathy