{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:46:41Z","timestamp":1777531601095,"version":"3.51.4"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2015,1,23]],"date-time":"2015-01-23T00:00:00Z","timestamp":1421971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Hypertension has been established as one of the commonest causes of heart failure especially in sub-Saharan Africa. We have previously observed a high prevalence of left ventricular (LV) systolic dysfunction in hypertensive heart failure patients in Nigeria despite a low prevalence of ischemic heart disease. The present study was, therefore, undertaken to assess the prevalence of asymptomatic LV systolic dysfunction in hypertensive black African subjects with no history of heart failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>One thousand nine hundred forty-seven hypertensive subjects without heart failure presenting to the Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Nigeria, from April 2006 to August 2013 had clinical and echocardiographic evaluation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Nine hundred fifty-three (48.9%) were males and 994 (51.1%) were females. One thousand eight hundred seventeen (93.3%) had normal LV systolic function (LV ejection fraction (LVEF) \u2265 54%), 68 (3.5%) had mild LV systolic dysfunction (LVEF 45\u201354%), 43 (2.3%) had moderate LV systolic dysfunction (LVEF 30\u201344%), and 16 (0.9%) had severe LV systolic dysfunction (LVEF &amp;lt; 30%). Male subjects had worse LV systolic function compared to women (mean LVEF 73.2% vs. 75.6%, P value &amp;lt; 0.0001) and diabetic subjects had worse LV systolic function compared to nondiabetic subjects (LVEF 72.3% vs. 75.7%, P = 0.02). In multivariate regression analysis, lower LVEF as a continuous variable was associated with older age, male sex, diabetes mellitus, LV mass indexed for body surface area, diastolic blood pressure, posterior wall thickness in diastole, left atrial diameter, and LV internal diameter in diastole.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In a cohort of asymptomatic Black hypertensive subjects, 6.7% had LV systolic dysfunction, which was associated with male gender, diabetes mellitus, and larger LV mass.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpu247","type":"journal-article","created":{"date-parts":[[2015,1,24]],"date-time":"2015-01-24T20:21:00Z","timestamp":1422130860000},"page":"924-929","source":"Crossref","is-referenced-by-count":4,"title":["Left Ventricular Systolic Dysfunction in Asymptomatic Black Hypertensive Subjects"],"prefix":"10.1093","volume":"28","author":[{"given":"Dike","family":"Ojji","sequence":"first","affiliation":[{"name":"Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital 1 \u00a0 , Gwagwalada, Abuja , ;","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Atherton","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brisbane and Women Hospital, University of Queensland School of Medicine 2 \u00a0 , Brisbane, Queensland , ;","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Sliwa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hatter Institute of Cardiovascular Research in Africa, University of Cape Town 3 \u00a0 , Cape Town , .","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Alfa","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital 1 \u00a0 , Gwagwalada, Abuja , ;","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murtala","family":"Ngabea","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital 1 \u00a0 , Gwagwalada, Abuja , ;","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lionel","family":"Opie","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hatter Institute of Cardiovascular Research in Africa, University of Cape Town 3 \u00a0 , Cape Town , .","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,1,23]]},"reference":[{"key":"2025090108211518100_CIT0001","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/j.1524-6175.2004.03919.x","article-title":"From hypertension to heart failure","volume":"6","author":"Papademetriou","year":"2004","journal-title":"J Clin Hypertens"},{"key":"2025090108211518100_CIT0002","doi-asserted-by":"crossref","first-page":"101","DOI":"10.7326\/0003-4819-110-2-101","article-title":"Left ventricular mass and incidence of coronary heart disease in an elderly cohort. The Framingham Heart Study","volume":"110","author":"Levy","year":"1989","journal-title":"Ann Intern Med"},{"key":"2025090108211518100_CIT0003","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1001\/jama.1996.03530440037034","article-title":"The progression from hypertension to congestive heart failure","volume":"275","author":"Levy","year":"1996","journal-title":"JAMA"},{"key":"2025090108211518100_CIT0004","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1016\/S0140-6736(01)06710-1","article-title":"Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study","volume":"358","author":"Vasan","year":"2000","journal-title":"Lancet"},{"key":"2025090108211518100_CIT0005"},{"key":"2025090108211518100_CIT0006","first-page":"1","article-title":"The causes, treatment and outcome of Acute Heart Failure in 1006 Africans from 9 countries","volume":"3","author":"Damasceno","year":"2012","journal-title":"Arch Intern Med"},{"key":"2025090108211518100_CIT0007","first-page":"349","article-title":"Pattern of heart failure in Abuja, Nigeria: an echocardiographic study","volume":"20","author":"Ojji","year":"2009","journal-title":"Cardiovasc J Afr"},{"key":"2025090108211518100_CIT0008","first-page":"276","article-title":"A new look at adult chronic heart failure in Africa in the age of Doppler echocardiography: experience of the Medicine Department at Younde General Hospital (In French)","volume":"54","author":"Kinque","year":"2005","journal-title":"Ann Cardiol Angeiol (Pans)"},{"key":"2025090108211518100_CIT0009","doi-asserted-by":"crossref","first-page":"2360","DOI":"10.1161\/CIRCULATIONAHA.108.786244","article-title":"Predominance of heart failure in the Heart of Soweto Study Cohort","volume":"118","author":"Stewart","year":"2008","journal-title":"Circulation"},{"key":"2025090108211518100_CIT0010","article-title":"A predominance of hypertensive heart failure in the Abuja Heart Study cohort of urban Nigerians: a prospective clinical registry of 1515 de novo cases","author":"Ojji","journal-title":"Eur J Heart Failure"},{"key":"2025090108211518100_CIT0011","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1161\/01.HYP.38.3.417","article-title":"Left ventricular systolic dysfunction in a biracial sample of hypertensive adults: The HyperGEN Study","volume":"38","author":"Devereux","year":"2001","journal-title":"Hypertension"},{"key":"2025090108211518100_CIT0012","volume-title":"The Seventh Report of the Joint National Committee on Prevention, Evaluation and Treatment of High Blood Pressure. NIH Publication 04:5230","author":"US Department of Health and Human Sciences","year":"2004"},{"key":"2025090108211518100_CIT0013","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/0002-9149(76)90491-4","article-title":"Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence of absence of asynergy","volume":"37","author":"Teichholz","year":"1976","journal-title":"Am J Cardiol"},{"key":"2025090108211518100_CIT0014","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/0002-9149(86)90771-X","article-title":"Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings","volume":"57","author":"Devereux","year":"1986","journal-title":"Am J Cardiol"},{"key":"2025090108211518100_CIT0015","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1016\/S0735-1097(99)00396-4","article-title":"Reliability of echocardiographic assessment of left ventricular structure and function: the PRESERVE study. Prospective Randomized Study Evaluating Regression of Ventricular Enlargement","volume":"34","author":"Palmieri","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"2025090108211518100_CIT0016","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.euje.2005.12.014","article-title":"Recommendations for chamber quantification","volume":"7","author":"Lang","year":"2006","journal-title":"Eur J Echocardiogr"},{"key":"2025090108211518100_CIT0017","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1136\/heart.89.12.1422","article-title":"Prevalence of impaired left ventricular systolic function and heart failure in a middle aged and elderly urban population segment of Copenhagen","volume":"89","author":"Raymond","year":"2003","journal-title":"Heart"},{"key":"2025090108211518100_CIT0018","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1053\/euhj.1998.1239","article-title":"Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study","volume":"20","author":"Mosterd","year":"1999","journal-title":"Eur Heart J"},{"key":"2025090108211518100_CIT0019","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1056\/NEJM199005313222203","article-title":"Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study","volume":"322","author":"Levy","year":"1990","journal-title":"N Engl J Med"},{"key":"2025090108211518100_CIT0020","doi-asserted-by":"crossref","first-page":"297","DOI":"10.5830\/CVJA-2010-063","article-title":"Prevalence of asymptomatic left ventricular systolic dysfunction in hypertensive Nigerians: echocardiographic study of 832 subjects","volume":"22","author":"Ogah","year":"2011","journal-title":"Cardiovasc J Afr"},{"key":"2025090108211518100_CIT0021","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1157\/13071896","article-title":"[Systolic ventricular dysfunction, a new marker of coronary artery disease in patients with aortic stenosis without previous myocardial infarction]","volume":"58","author":"P\u00e9rez Cabeza","year":"2005","journal-title":"Rev Esp Cardiol"},{"key":"2025090108211518100_CIT0022","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/0735-1097(92)90094-4","article-title":"Prevalence and mortality rate of congestive heart failure in the United States","volume":"20","author":"Schocken","year":"1992","journal-title":"J Am Coll Cardiol"},{"key":"2025090108211518100_CIT0023","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1161\/CIRCHEARTFAILURE.112.972828","article-title":"Predictors of new-onset heart failure: differences in preserved versus reduced ejection fraction","volume":"6","author":"Ho","year":"2013","journal-title":"Circ Heart Fail"},{"key":"2025090108211518100_CIT0024","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/S0140-6736(97)03033-X","article-title":"Symptomatic and asymptomatic left ventricular systolic dysfunction in an urban population","volume":"350","author":"McDonough","year":"1997","journal-title":"Lancet"},{"key":"2025090108211518100_CIT0025","first-page":"291","article-title":"Why do men get more heart disease than women? An International perspective","volume":"6","author":"Weidner","journal-title":"J Am Coll Health"},{"key":"2025090108211518100_CIT0026","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1161\/01.CIR.103.1.102","article-title":"Effect of type 2 diabetes mellitus on left ventricular geometry and systolic function in hypertensive subjects: Hypertension Genetic Epidemiology Network (HyperGEN) study","volume":"103","author":"Palmieri","year":"2001","journal-title":"Circulation"},{"key":"2025090108211518100_CIT0027","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/j.1540-8175.2007.00619.x","article-title":"Ratio of left atrial to left ventricular size: an anatomical marker of the diastolic left ventricular pressure-volume relationship","volume":"25","author":"Spevack","year":"2008","journal-title":"Echocardiography"},{"key":"2025090108211518100_CIT0028","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1161\/01.HYP.34.4.808","article-title":"Contribution of stroke volume to the change in pulse pressure pattern with age","volume":"34","author":"Alfie","year":"1999","journal-title":"Hypertension"},{"key":"2025090108211518100_CIT0029","first-page":"309","article-title":"Subclinical, hemodynamic, and echocardiographic abnormalities of high pulse pressure in hypertensive and non-hypertensive adults","volume":"2","author":"Glasser","year":"2012","journal-title":"Am J Cardiovasc Dis"},{"key":"2025090108211518100_CIT0030","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.amjhyper.2005.01.005","article-title":"Left atrial systolic force and cardiac markers of preclinical disease in hypertensive patients: the Hypertension Genetic Epidemiology Network (HyperGEN) Study","volume":"18","author":"Chinali","year":"2005","journal-title":"Am J Hypertens"},{"key":"2025090108211518100_CIT0031","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1056\/NEJM199209033271003","article-title":"Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions","volume":"327","author":"The SOLVD Investigators","year":"1992","journal-title":"N Engl J Med"},{"key":"2025090108211518100_CIT0032","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.cardfail.2013.12.009","article-title":"Association of left ventricular longitudinal and circumferential systolic dysfunction in hypertension: a nonlinear analysis focused on interplay with left ventricular geometry","volume":"20","author":"Ballo","year":"2014","journal-title":"J Card Fail"},{"key":"2025090108211518100_CIT0033","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1056\/NEJM199209033271001","article-title":"Cuddy TE for the SAVE Investigators Effect of Captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction: results of the survival and ventricular enlargement trial","volume":"327","author":"Pfeffer","year":"1992","journal-title":"N Engl J Med"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/28\/7\/924\/64171043\/ajh_28_7_924.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/28\/7\/924\/64171043\/ajh_28_7_924.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:21:24Z","timestamp":1756729284000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/28\/7\/924\/2743381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,23]]},"references-count":33,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2015,1,23]]},"published-print":{"date-parts":[[2015,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpu247","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2015,7,1]]},"published":{"date-parts":[[2015,1,23]]}}}