Cardiovascular risk factors and electrocardiographic pattern in two rural communities of Osun State in South West Nigeria

Abstract

The burden of cardiovascular disease (CVD) in the world is enormous and growing, and the majority of those affected are in the developing countries (1,2). In 2002, it was estimated that 29% of deaths worldwide (16.7 million deaths) were due to CVD and that 43% of global morbidity and mortality, measured in disability-adjusted life years (DALYS) was caused by CVD (3). Furthermore, 78% of global mortality and 86% of mortality and morbidity from CVD occurs in developing countries (3). It is estimated that by 2020, CVD will become the leading cause of the global health burden, accounting for 73% of total global mortality and 56% of total morbidity (4,5). This global tide has also not spared Africa (6). In most African countries CVD is now the second most common cause of death after infectious disease, accounting for 11% of total deaths (7), and CVD is a major cause of chronic illness and disability (6). African countries therefore face a double burden of communicable diseases and CVD (6). Projections from the Global burden of Disease project suggest that from 1990 to 2020, the burden of CVD faced by African countries will double (6). A large proportion of the victims of CVD will be middle-aged people (6). The poor will be at the receiving end as a consequence of their higher disease risk and limited access to health care (6). The financial and social costs of this CVD epidemic are likely to have a negative impact on development and the alleviation of poverty (6). Coronary Heart Disease (CHD) is gradually becoming common so also are its risk factors. A Cameroonian study showed a coronary artery disease prevalence of 1.53% with Myocardial infarction (M1) being the most frequent (43%) (8). The cardiovascular risk factors were obesity (80%), Hypertension (60%), dyslipidaemia (43%), smoking (36%), diabetes/hyperglycaemia (26%), and hyperuricaemia (20%) (8). Multiple risk factors (at least 3) were found in 67% of these patients (8). CVD risk factors such as tobacco, refined foods and life styles are being exported to Africa through television and films by the developed countries in the name of globalization/civilization (2). Although the epidemic of CHD was heralded globally in the 1980s (9), in Africa, it is still being expected. The major modifiable risk factors are Hypertension (BP >140/90), Diabetes Mellitus (DM), Dyslipidaemia, Tobacco use, physical inactivity, obesity, unhealthy diets (10). Other modifiable risk factors were low socioeconomic status, mental ill health, psychosocial stress, alcohol use, use of certain medications e.g. oral contraception and hormone replacement therapy, lipoprotein, left ventricular hypertrophy (LVH) (10), and use of cocaine (11). Non-modifiable risk factors are advancing age, heredity or family history, gender (male), ethnicity or race. The novel risk factors are excess homocysteine in blood, inflammation and abnormal blood coagulation (increase serum fibrinogen) (10). In recent times kidney disease has been identified as a risk factor for CVD (12). Proteinuria and elevation of the se...

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