Determinants of prognosis among Black Africans with hypertensive heart failure

Abstract

One hundred and seven consecutive Black Africans hypertensive heart failure patients made of 52 Gambians and 55 Nigerians (51 males + 56 females) aged 53.6 ± 12.1 years were followed-up for 12 months or till death. One year survival curve was determined using Kaplan-Meiers method. The survivors and the deceased were compared using univariate and multivariate analysis. Mean blood pressures were 180.4 ± 28.2 mmHg (range: 130-250 mmHg) systolic and 117.0± 12.9 mmHg (range: 100-160 mmHg) diastolic. Duration of hypertension ranged from 0.5 to 23 years. The rate of undetected hypertension was 44%. Overall, one-year survival rate was 71%. Twenty two percent of deaths occurred within the first 3 months of HHF. One-year survival rate among the survivors of this period was 89.4%. A strong negative correlation existed between cumulative survival and the duration of heart failure (y=0.9812, x2=0.1 173, R=0.965). Compared to the survivors, the deceased had significantly higher systolic blood pressure (191.9 ± 32.2 mmHg versus 175.1 ± 25.2 mm Hg; P < 0.05). Compared to the patients aged 40 or more years, patients aged below 40 years had significantly lower one-year survival rate (41.7% versus 74.1 %; P<0.05). One-year survival rate was significantly higher among patients on captopril medication than those without (75% versus 52.6%; P<0.05). However, only serum creatinine had statistically differing values between the deceased and survivors (df= 1 SS= 10272, F=7.60, p =0.007). Basic clinical and biochemical parameters could therefore be useful prognostic markers in hypertensive heart failure.