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Background: Adolescence is a vulnerable phase when risky behaviours like smoking, poor diet, and physical inactivity set the stage for health problems like hypertension., Objective: This study assessed the prevalence of high blood pressure (HBP) and associated factors among apparently healthy inschool adolescents in Delta State, Nigeria., Methods: A cross-sectional study was conducted among apparently healthy in-school adolescents aged 10 to 19 years, using a multi-stage random sampling technique. HBP was defined using the 2016 European Society of Hypertension Guidelines. Factors associated with HBP were determined using binary logistic regression. A p-value less than 0.05 was taken as significant., Results: Of the 574 participants surveyed, 331 (57.7%) were females and 243 (42.3%) were males, with a female-to-male ratio of 1.36. The mean age of the study participants was 14.7 years. The mean systolic and diastolic blood pressure of the study participants were 118.81 (±12.703) and 70.16 (±9.972) mmHg respectively. Prehypertension and hypertension were present in 14.8% and 18.3% of the study population, respectively. Age 10-13 years (AOR = 7.70; 95% CI: 2.26-26.22; p = 0.001) and 14-16 years (AOR = 4.62; 95% CI: 1.40 -15.25; p = 0.001), upper socioeconomic status (AOR=1.19; 95% CI: 0.57-2.48; p = 0.020), and obesity (AOR = 2.14; 95% CI: 1.08-4.25; p = 0.039) were factors associated with HBP., Conclusion: The prevalence of hypertension among the study participants was significant. Factors associated with HBP include younger age (specifically 10-16 years old), higher socioeconomic status, and obesity., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction: the adolescence period is a significant phase in development of non-communicable diseases. Public health interventions that reduce risky behaviors among adolescents are beneficial across the life course. This study assessed the level of non-communicable diseases (NCDs´) risk-related knowledge, the prevalence of NCDs´ risk behavior, and the sociodemographic predictors of NCDs´ risk-related knowledge and behaviors among in-school adolescents in a Southern Nigerian State., Methods: a cross-sectional study design was employed to assess the NCDs´ risk-related knowledge and behaviors among a random multistage sample of 607 students age between 10 and 19 years. Data were collected using an interviewer-administered semi-structured questionnaire adapted from the WHO STEPS questionnaire. Descriptive and inferential analyses of data collected were carried out using the IBM SPSS version 22 software., Results: the mean age of the students was 14.7 (SD=1.52) years, 57.2% (n=347) of which were females, and 42.8% (n=260) were males. The proportion of students with good overall NCDs risk-related knowledge was 22.7% (n=138). Age, place of residence, family's socioeconomic status, and mother's level of education were significant sociodemographic predictors of good overall NCD risk-related knowledge. Among the students, 66.2% (n=402) self-report inadequate physical activity, 65.7% (n=399) self-report consumption of unhealthy diets, 29.2% (n=177) self-report current alcohol use, and 3.3% (n=20) self-report they were current cigarette smokers., Conclusion: a significant proportion of the surveyed students had poor overall NCDs risk-related knowledge and engaged in NCDs risk behaviors. The relevant stakeholders concern with prevention of NCDs in government and non-governmental organizations should target adolescents in NCD control strategies in the study setting., Competing Interests: The authors declare no competing interest., (Copyright: Patrick Oyibo et al.)

Background Heart failure contributes to the global burden of cardiovascular diseases, with hypertensive heart failure affecting individuals in their productive age group and leading to high economic losses and disability-adjusted life years. The left atrium, on the other hand, contributes significantly to left ventricular filling in heart failure patients, and the left atrial function index is an excellent tool for assessing left atrial function among heart failure patients. The study aimed to evaluate some parameters of systolic and diastolic function as correlates and potential predictors of the left atrial function index among hypertensive heart failure cohorts. Materials and methods The study was conducted at Delta State University Teaching Hospital, Oghara. Eighty (80) patients with hypertensive heart failure who met the inclusion criteria were enrolled in the cardiology outpatient clinics. The left atrial function index was calculated using the following formula: LAFI = (LAEF x LVOT-VTI)/LAESVI. (LAFI = left atrial function index; LAEF = left atrial emptying fraction; LAESVI = left atrial end-systolic volume index; LVOTVTI = outflow tract velocity time integral). The data were analysed using IBM Statistical Product and Service Solution Version 22. Relationships between variables were determined using analysis of variance, Pearson correlation, and multiple linear regressions. Significance was assessed at p<0.05. Result It was discovered that the left atrial function index correlated with ejection fraction (r = 0.616, p = 0.001), fractional shortening (r = 0.462, p = 0.001), and the ratio of early transmitral flow to early myocardial contractility, E/E' (r = -0.522, p = 0.001). However, there was no correlation with stroke volume (r = 0.38, p = 0.11); the ratio of early transmitral flow to late transmitral flow, E/A (r = -0.10, p = 0.11); isovolumetric relaxation time, IVRT (r = -0.171, p = 0.11); and tricuspid annular plane systolic excursion, TAPSE (r = 0.185, p = 0.10). Of the variables that correlated with left atrial function index, left ventricular ejection fraction and the ratio of early transmitral flow to early myocardial contractility (E/E') were found to be independent predictors of left atrial function index. Conclusion Left ventricular ejection fraction and the ratio of early transmitral flow to early myocardial contractility reflect changes in the left atrial function index, and as such, they should be used as surrogates for its assessment, especially in low- and medium-income countries where left atrial function index estimation is not routinely done., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kweki et al.)

Background: Peripheral vascular disease (PVD) is an atherosclerotic disease associated with increased morbidity and mortality among chronic kidney disease (CKD) patients. However, despite the substantial burden of PVD in CKD, local data are lacking., Objective: To determine the prevalence and predictors of PVD in predialysis CKD patients., Method and Materials: The study was cross-sectional. One hundred fifty hypertensive CKD patients and age- and sex-matched hypertensive non-CKD subjects were consecutively enrolled at the renal unit of Delta State University Teaching Hospital (DELSUTH), Oghara. Structured questionnaires were used to obtain information on participants' demographic data and health status. PVD was defined by an ankle-brachial index of < 0.9 or > 1.4 in either lower extremity. eGFR was calculated from serum creatinine using the MDRD equation., Results: The mean ages of the study and control groups were 48±14 and 51±15years, respectively. The sex ratio was 3:2 in favour of males for both the study and control groups. The majority of the study group was in CKD stage 4 (44%). The prevalence of PVD was higher among the CKD group compared with controls (24.0% vs. 14.7%). Of the CKD patients with PVD, 11.1% were symptomatic. Predictors of PVD in the study group were eGFR (B=0.010, 95%CI: 0.007-0.013), diastolic BP (B=-0.005, 95%CI: -0.007- -0.002), MAP (B=-0.018, 95%CI: -0.027- -0.008), urinary ACR (B=-0.0036, 95%CI: -0.040- -0.024) and smoking history (p<0.001, OR=14.71)., Conclusion and Recommendation: PVD is common and largely asymptomatic in CKD patients. The predictors of PVD in this study were eGFR, diastolic BP, mean arterial pressure (MAP), urinary albumin to creatinine ratio (ACR), and smoking. A proactive assessment of PVD and early intervention in CKD patients is needed., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ovwasa et al.)

Introduction: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the chronic kidney disease (CKD) population. CKD patients are more likely to die from CVD before ever reaching end-stage renal disease (ESRD). The study, therefore, seeks to identify the prevalence of risk factors of CVD in CKD patients such as systemic hypertension, anemia, dyslipidemia, hypoalbuminemia, albuminuria, and abnormal calcium/phosphate products., Methods: The study was a case-control cross-sectional study where one hundred fifty hypertensive CKD patients and age- and sex-matched hypertensive non-CKD subjects were consecutively enrolled at the renal unit of Delta State University Teaching Hospital (DELSUTH), Oghara., Results: The findings of the study revealed the mean ages of cases and controls to be 48.91±11.93 years and 51.0±15.45 years respectively (p-value 0.182). There was an equal number of males and females among the study group and controls (92 males and 58 females) making a male-to-female ratio of 3:2. The prevalence of CVD risk factors such as diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, elevated low-density lipoprotein, anemia, hypocalcemia, hyperphosphatemia, albuminuria, and hypoalbuminemia was significantly higher among the CKD group compared to controls. Similarly, the prevalence of reduced high-density lipoprotein (HDL) was higher among cases than controls, the difference was however not statistically significant., Conclusion: The study has shown that systemic hypertension, diabetes, anemia, dyslipidemia, hypoalbuminemia, albuminuria, and abnormal calcium/phosphate products increases the risk for CVD in the general population but is more expressed and significant in CKD patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ovwasa et al.)

Introduction: Left atrial (LA) enlargement poses a clinically significant risk of adverse cardiovascular outcomes for patients. To maximize the utility of LA size in diagnosis, its accurate measurement using electrocardiogram (ECG) and echocardiogram (ECHO) to assess LA linear diameter and LA volumes is expedient. The LA volumes correlate better than LA linear diameter with diastolic function variables. It is therefore expedient to use LA volumes routinely in assessing LA size as they may detect early and subtle changes in LA size and function., Methods: A descriptive cross-sectional study was conducted on 200 adult hypertensive patients attending the outpatient cardiology clinic at Delta State University Teaching Hospital, Oghara, Nigeria, irrespective of blood pressure control and duration of hypertension whether on antihypertensive medications or not. The SPSS version 22 (IBM Corp., Armonk, NY, USA) was used for data management and analysis., Result: There was a significant association between electrocardiographic left atrial (ECG-LA) enlargement and echocardiographic left atrial (ECHO-LA) size (LA linear diameter and LA maximum volume) in the study. Logistic regression analysis showed a significant odds ratio for all associations. With LA linear diameter as standard for assessing LA enlargement, the ECG had a sensitivity of 19%, specificity of 92.4%, a positive predictive value of 51%, and a negative predictive value of 73% in detecting LA enlargement. Using ECHO-LA maximum volume as a standard for assessing LA enlargement, the ECG had a sensitivity of 57.3%, a specificity of 67.7%, a positive predictive value of 42.9%, and a negative predictive value of 79% in detecting LA enlargement. The LA maximum volume showed relatively higher sensitivity and negative predictive values while LA linear diameter showed relatively higher specificity and positive predictive values., Conclusion: A good association exists between ECG-LA enlargement and ECHO-LA enlargement. However, in ruling out LA enlargement on ECG, it is better to use LA maximum volume as a standard rather than the LA linear diameter., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Aiwuyo et al.)

Background and Aim: The left atrium contributes significantly to the left ventricular filling as it functions as a reservoir, conduit, and pump. These functions are referred to as the phasic function of the left atrium and they are assessed using left atrial volumes. The left atrial function index on the other hand is a rhythmic independent composite index which is a better marker of left atrial function. The study therefore aimed at comparing left atrial function (using the left atrial function index) among hypertensive heart failure patients, patients with hypertension but not in heart failure, and normotensive patients., Method: The study was a cross-sectional analytical study that was carried out at Delta State University Teaching Hospital, Nigeria. A total of 80 hypertensive heart failure patients, 80 hypertensive, and 40 normotensive patients who met the inclusion criteria were recruited from the cardiology clinics using the convenience sampling method. The left atrial function index was determined using the volumetric method. Significance was assessed at  p  < 0.05., Result: The left atrial function index (21.13 ± 8.83 versus 42.28 ± 10.40 versus 50.47 ± 14.37,  p  = 0.001) of the hypertensive heart failure group was significantly lowest when compared with the hypertensive ( p  < 0.001) and normotensive ( p  < 0.001) groups. Although the left atrial function index of the hypertensive group (42.28 ± 10.40) was lower than the normotensive group (50.47 ± 14.37), it was however not found to be significant ( p  = 0.12). Also, the left atrial function index was significantly ( p  = 0.001) worse among the patients with heart failure with reduced ejection fraction (13.5 ± 5.94) compared to heart failure with preserved ejection fraction (40.81 ± 12.12)., Conclusion: Left atrial function index was lowest among hypertensive heart failure patients compared with hypertensive and normotensive cohorts, and it was worse among heart failure with reduced ejection fraction patients. However, there was no significant difference between the left atrial function index of the hypertensive and normotensive groups. As a result, we recommend that the left atrial function index should be incorporated into the routine echocardiographic assessment of patients in our day-to-day clinical practice and large studies should be carried out to determine the cut-off value for the left atrial function., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Kweki et al.)

Background: The relationship between blood pressure (BP) trajectories and outcomes in patients with peripartum cardiomyopathy (PPCM) is not clear. Aim: The study aimed to assess the clinical features and outcomes (all-cause mortality and unrecovered left ventricular [LV] systolic function) of PPCM patients grouped according to their baseline systolic BP (SBP)., Patients and Methods: PPCM patients presenting to 14 tertiary hospitals in Nigeria were consecutively recruited between June 2017 and March 2018 and then followed up till March 2019. SBP at first presentation was used to categorize the patients into seven groups: <90, 90-99, 100-109, 110-119, 120-129, 130-139, and ≥140 mmHg. Unrecovered LV systolic function was defined as echocardiographic LV ejection fraction (LVEF) below 55% at the last profiling., Results: Two hundred and twenty-seven patients were recruited and followed up for a median of 18 months. Of these, 4.0% had <90 mmHg, 16.3% had 90-99 mmHg, 24.7% had 100-109 mmHg, 24.7% had 110-119 mmHg, 18.5% had 120-129 mmHg, 7.5% had 130-139 mmHg, and 4.4% had ≥140 mmHg of SBP at presentation. The highest frequency of all-cause mortality was recorded among patients with SBP ≤90 mmHg (30.8%) followed by those with 90-99 mmHg (20.5%) (P = 0.076), while unrecovered LV systolic function did not differ significantly between the groups (P = 0.659). In a Cox proportional regression model for all-cause mortality, SBP <90 mmHg had a hazard ratio (HR) of 4.00 (95% confidence interval [CI] 1.49-10.78, P = 0.006), LVEF had an HR of 0.94 (95% CI 0.91-0.98, P = 0.003, B = 0.06%), and use of angiotensin-converting enzyme or angiotensin receptor and/or β-receptor blockers had an HR of 1.71 (95% CI 0.93-3.16, P = 0.085). However, SBP was not associated with LV function recovery., Conclusion: In our cohort of PPCM patients, one-fifth was hypotensive at presentation. SBP <90 mmHg at presentation was associated with a four-fold higher risk of all-cause mortality during a median follow-up of 18 months., Competing Interests: None

Aims: The prospective, multicentre Peripartum Cardiomyopathy in Nigeria (PEACE) registry originally demonstrated a high prevalence of peripartum cardiomyopathy (PPCM) among patients originating from Kano, North-West Nigeria. In a post hoc analysis, we sought to determine if this phenomenon was characterized by a differential case profile and outcome among PPCM cases originating elsewhere., Methods and Results: Overall, 199 (81.6%) of a total 244 PPCM patients were recruited from three sites in Kano, compared with 45 patients (18.4%) from 11 widely dispersed centres across Nigeria. Presence and extent of ventricular myocardial remodelling during follow-up, relative to baseline status, were assessed by echocardiography. During median 17 months follow-up, Kano patients demonstrated significantly better myocardial reverse remodelling than patients from other sites. Overall, 50.6% of patients from Kano versus 28.6% from other regions were asymptomatic (P = 0.029) at study completion, with an accompanying difference in all-cause mortality (17.6% vs. 22.2% respectively, P = 0.523) not reaching statistical significance. Alternatively, 135/191 (84.9%) of Kano patients had selenium deficiency (<70 μg/L), and 46/135 (34.1%) of them received oral selenium supplementation. Critically, those that received selenium supplementation demonstrated better survival (6.5% vs. 21.2%; P = 0.025), but the supplement did not have significant impact on myocardial remodelling., Conclusions: This study has shown important non-racial regional disparities in the clinical features and outcomes of PPCM patients in Nigeria, that might partly be explained by selenium supplementation., (© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Background: Rheumatic valvular heart disease (RVHD) is one of the foremost causes of heart failure (HF) in our population, particularly among young adults, but a decline in the prevalence of RVHD has been observed. The effect of this decline on the relevance of RVHD among other causes of HF is not established in our setting., Objective: To determine whether RVHD is still a leading cause of HF in our population or not., Methods: This was a retrospective study of HF patients hospitalized between August 2018 and June 2020. The demographic features, blood pressure, aetiology of HF and ejection fraction were retrieved from the unit's HF register. Data were presented as frequencies and medians. Associations were tested as appropriate., Results: RVHD accounted for 78 (35.5%) of HF, with a median age of 47 years. The young and middle- aged subgroups were 10(12.8%) and 48(61.6%), respectively. The affected valves were all regurgitant and 68 (77.2%) had definite RVHD. Isolated mitral valve, combined mitral and aortic valves were affected in 40 (51.3%) and 22 (28.2%), respectively. The median systolic blood pressure and ejection fraction were 110mmHg and 26% respectively. RVHD was associated with HF with reduced ejection fraction. (P value < 0.001)., Conclusion: RVHD remains one of the leading causes of HF (35.5%) among adults in our population. Young adults are now in the minority and most patients present late in the course of the disease. Valve surgery should be made readily accessible. Primary and secondary prevention of acute rheumatic fever should be reinforced., Competing Interests: The Authors declare that no competing interest exists.

The current pandemic of SARS-COV 2 infection (Covid-19) is challenging health systems and communities worldwide. At the individual level, the main biological system involved in Covid-19 is the respiratory system. Respiratory complications range from mild flu-like illness symptoms to a fatal respiratory distress syndrome or a severe and fulminant pneumonia. Critically, the presence of a pre-existing cardiovascular disease or its risk factors, such as hypertension or type II diabetes mellitus, increases the chance of having severe complications (including death) if infected by the virus. In addition, the infection can worsen an existing cardiovascular disease or precipitate new ones. This paper presents a contemporary review of cardiovascular complications of Covid-19. It also specifically examines the impact of the disease on those already vulnerable and on the poorly resourced health systems of Africa as well as the potential broader consequences on the socio-economic health of this region., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2021 The Author(s).)

Background: Nigeria has the highest incidence of peripartum cardiomyopathy (PPCM) in the world. However, data on PPCM-related outcomes are limited., Objectives: The purpose of this study was to examine the clinical profile, myocardial remodeling, and survival of patients with PPCM in Nigeria., Methods: This study consecutively recruited 244 PPCM patients (median 7 months postpartum) at 14 sites in Nigeria and applied structured follow-up for a median of 17 months (interquartile range: 14 to 20 months). Left ventricular reverse remodeling (LVRR) was defined as the composite of left ventricular (LV) end-diastolic dimension <33 mm/m 2 and absolute increase in left ventricular ejection fraction (LVEF) ≥10%. LV full recovery was defined as LVEF ≥55%., Results: Overall, 45 (18.7%) patients died during follow-up. Maternal age <20 years (hazard ratio [HR]: 2.40; 95% confidence interval (CI): 1.27 to 4.54), hypotension (HR: 1.87; 95% CI: 1.02 to 3.43), tachycardia (HR: 2.38; 95% CI: 1.05 to 5.43), and LVEF <25% at baseline (HR: 2.11; 95% CI: 1.12 to 3.95) independently predicted mortality. Obesity (HR: 0.16; 95% CI: 0.04 to 0.55) and regular use of beta-blockers at 6-month follow-up (HR: 0.20; 95% CI: 0.09 to 0.41) were independently associated with reduced risk for mortality. In total, 48 patients (24.1%) achieved LVRR and 45 (22.6%) achieved LV full recovery. LVEF <25% at baseline (HR: 0.66; 95% CI: 0.47 to 0.92) and regular use of beta-blockers at 6-month follow-up (HR: 1.62; 95% CI: 1.17 to 2.25) independently determined the risk for LV full recovery. Progressive reverse remodeling of all cardiac chambers was observed. In total, 18 patients (7.4%) were hospitalized during the study., Conclusions: This is the largest study of PPCM in Africa. Consistent with late presentations, the mortality rate was high, whereas frequencies of LVRR and LV full recovery were low. Several variables predicted poor outcomes, and regular use of beta-blockers correlated with late survival and LV functional recovery., Competing Interests: Author Relationship With Industry The authors have received funding from Dantata Group of Companies, Ammasco International Ltd., and Fortune Oil Mills Nigeria Ltd. Dr. Stewart is supported by the NHMRC of Australia (GNT1135894). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2020 American College of Cardiology Foundation. All rights reserved.)

Background: There are indications that prehypertension precedes hypertension. Like hypertension, it is associated with increased cardiovascular risk., Objective: To determine the prevalence, awareness and correlates of prehypertension and hypertension among adults in Delta State, Nigeria., Methods: This was a cross-sectional study. We recruited adults aged ≥18 years from two communities in Delta State, Nigeria, using the multi-stage sampling technique. The study instrument was a modified WHO-STEPS questionnaire. Prehypertension and hypertension were defined using the JNC-7 criteria. Ethical approval was obtained before the recruitment of participants., Results: Of the 852 adults studied, the mean (±SD) age was 42.64 (±16.07) years, females (55.9%) and urban dwellers (55.8%). The prevalence of prehypertension and hypertension were 42.5% and 29.3%, respectively; both were higher among urban dwellers. The peak age-group for prehypertension and hypertension were 25-34 and 35-44 years, respectively. Awareness of hypertension was low; 12.0% (102/852). Blood pressure category significantly correlated with age, body mass index, place of residence, level of education, employment status and fruit intake., Conclusion: The prevalence of prehypertension and hypertension in this study were high. Based on the premise that prehypertension is a precursor of hypertension and occurred more among youths, the higher prevalence of prehypertension gives an inkling to rising prevalence of hypertension., Funding: Nil., Competing Interests: Conflict of interest: None declared, (Copyright © The Author(s).)

Aims: The aim of this study was to describe the incidence, clinical characteristics and risk factors of peripartum cardiomyopathy (PPCM) in Nigeria., Methods and Results: The study was conducted in 22 hospitals in Nigeria, and PPCM patients were consecutively recruited between June 2017 and March 2018. To determine factors associated with PPCM, the patients were compared with apparently healthy women who recently delivered, as controls. Four hundred six patients were compared with 99 controls. The incidence and disease burden (based on the rate of consecutive recruitment of subjects) varied widely between the six geographical zones of Nigeria. From the North-West zone, 72.3% of the patients was recruited, where an incidence as high as 1 per 96 live births was obtained in a centre, while the disease was uncommon (7.6% of all recruited patients) in the South. Majority of the patients (76.6%) and controls (74.8%) (p = 0.694) were of Hausa-Fulani ethnic group. Atrial fibrillation, intracardiac thrombus, stroke, and right ventricular systolic dysfunction were found in 1.7%, 6.4%, 2.2%, and 54.9% of the patients, respectively. Lack of formal education (odds ratio [OR] 3.08, 95% confidence interval [1.71, 5.53]; P < 0.001), unemployment (OR: 3.28 [2.05, 5.24]; P < 0.001), underweight (OR: 13.43 [4.17, 43.21]; P < 0.001) and history of pre-eclampsia (OR: 9.01 [2.18, 37.75]; P = 0.002) emerged as independent PPCM risk factors using regression models. Customary hot baths (OR: 1.24 [0.80, 1.93]; P = 0.344), pap enriched with dried lake salt (OR: 1.20 [0.74, 1.94]; P = 0.451), and Hausa-Fulani ethnicity (OR: 1.11 [0.67, 1.84]; P = 0.698) did not achieve significance as PPCM risk factors., Conclusions: In Nigeria, the burden of PPCM was greatest in the North-West zone, which has the highest known incidence. PPCM was predicted by sociodemographic factors and pre-eclampsia, which should be considered in its control at population level. Postpartum customary birth practices and Hausa-Fulani ethnicity were not associated with PPCM in Nigeria., (© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Background: Peripheral artery disease (PAD), an important component of the cardiovascular triad, has been linked with obesity as one of the risk factors for its development. The risk posed by obesity however varies depending on the indices measured., Methods: We compared the relationship of measures of central and visceral obesity (waist circumference (WC) and waist-hip ratio (WHR) versus that of general obesity (body mass index (BMI) in the development of PAD among Nigerians with hypertension and/or diabetes mellitus. PAD was diagnosed when Ankle Brachial Index (ABI) was <0.9 in either limb., Results: A total of 541 patients (194 males and 347 females) were studied with a mean age of 58.4(±0.46)years. The mean BMI, WC and WHR were 27.8 (±0.222)kg/m2, 96.8 (±0.515)cm and 0.941 (±0.003) respectively. Although the mean BMI, WC and WHR were higher in patients with PAD than those without PAD, the difference was only statistically significant for WC and WHR (p=0.003 and p=0.016) but not BMI (p=0.151). However, the difference in mean BMI was statistically significant in patients <60 years (p=0.015) but not in those >60 years (p=0.953)., Conclusion: This study has shown that in Nigerian Africans measures of central and visceral obesity were more related to the development of PAD than BMI which is a measure of general obesity and that this lack of significance is probably due to the fact that PAD occurred more in older people as there was a significant relationship with PAD in people younger than 60 years old.

Background: Diabetes mellitus is an important risk factor for development of atherosclerosis. Lower extremity peripheral artery disease (LEAD) which is mainly due to atherosclerosis has been associated with not only increased risk of lower limb amputation but also increased risk of morbidity and mortality from major cardiovascular events such as stroke and myocardial infarction. Information on the prevalence of peripheral vascular disease is scanty in Nigeria., Objective: The aim of this study was to determine the prevalence of LEAD and risk factors associated with its development in adult Nigerians with type 2 diabetes mellitus., Methods: The study was cross-sectional. Patients were consecutively enrolled in the study between August 2009 and May 2010 from the Consultant out-patient department, University of Benin Teaching Hospital, Benin-City, Nigeria. LEAD was assessed in all the patients using Ankle Brachial Index <0.9 in either leg. The Edinburgh Claudication Questionnaire was used to determine if patient had symptomatic disease or not., Results: Three hundred and eighty eight diabetic patients were enrolled in the study out of which 244 (62.9%) were females. The study showed that the prevalence of LEAD was 35.6% when diagnosed using Doppler ABI <0.9 in either leg. The ratio of symptomatic to asymptomatic disease was 1: 7.6. Advancing age, duration of diabetes and concomitant hypertension were important risk factors significantly associated with the disease., Conclusion: LEAD is not uncommon among type 2 diabetes patients in Nigeria and the majority were asymptomatic. Advancing age, duration of diabetes and concomitant hypertension were important risk factors identified.