Prevalence of target organ damage among hypertensive patients at Muhimbili national hospital Dar es salaam, Tanzania

Abstract

Background: Poor controlled hypertension is associated with development of target organ damage and the assessment of target organ damage is important in the evaluation of all hypertensive patients as it provides important information on the severity of the hypertension, the cardiovascular risk and guide management of individual patient. Objective: This study was done to determine prevalence of left ventricular hypertrophy, hypertensive retinopathy, renal insufficiency and stroke among hypertensive patients at Muhimbili national hospital. Methodology: This was a cross-sectional hospital based study, carried out for six months, from July, 2011 to December; 2011 at Muhimbili National Hospital. Two hundred and forty hypertensive patients were consecutively recruited into the study. Standardized questionnaires were used to collect socio-demographic characteristics and clinical data of study participants. Target organ damage was assessed by physical examination, ECG, ECHO and estimation of glomerular filtration rate by creatinine clearance. Results: Among study participants, 206 (85.8%) patients had at least one of the four hypertensive target organ damage studied (left ventricular hypertrophy, hypertensive retinopathy, renal insufficiency and stroke). The organ most affected was the heart presenting as left ventricular hypertrophy observed in 167 (69.6%) followed by hypertensive retinopathy 136 (56.7%), renal insufficiency 72 (30.0%) and Stroke in 22 (9.2%) patients. Conclusion: This study showed a high prevalence of target organ damage among hypertensive patients admitted in medical wards or attending medical outpatient clinic. These findings illustrate the burden of uncontrolled hypertension in our setting. Recommendation: Early workup to identify presence of organ damage is recommended in all hypertensive patients.