Original Research
Exploring Overlaps Between the Genomic and Environmental Determinants of LVH and Stroke: A Multicenter Study in West Africa
- Abiodun M. Adeoye
- Bruce Ovbiagele
- Philip Kolo
- Lambert Appiah
- Akinyemi Aje
- Oladimeji Adebayo
- Fred Sarfo
- Joshua Akinyemi
- Gregory Adekunle
- Francis Agyekum
- Vincent Shidali
- Okechukwu Ogah
- Dan Lackland
- Mulugeta Gebregziabher
- Donna Arnett
- Hemant K. Tiwari
- Rufus Akinyemi
- Ojo Olakanmi Olagoke
- Ayodipupo Sikiru Oguntade
- Taiwo Olunuga
- Kelechi Uwanruochi
- Carolyn Jenkins
- Patrick Adadey
- Henry Iheonye
- Lukman Owolabi
- Reginald Obiako
- Samuel Akinjopo
- Kevin Armstrong
- Albert Akpalu
- Adekunle Fakunle
- Raelle Saulson
- Mayowa Aridegbe
- Paul Olowoyo
- Godwin Osaigbovo
- Josephine Akpalu
- Bimbo Fawale
- Philip Adebayo
- Oyedunni Arulogun
- Philip Ibinaiye
- Atinuke Agunloye
- Naser Ishaq
- Kolawole Wahab
- Onoja Akpa
- Omisore Adeleye
- Andrew Bock-Oruma
- Godwin Ogbole
- Sylvia Melikam
- Joseph Yaria
- Luqman Ogunjimi
- Abdul Salaam
- Taofiki Sunmonu
- Akintomiwa Makanjuola
- Temitope Farombi
- Ruth Laryea
- Ezinne Uvere
- Salaam Kehinde
- Innocent Chukwuonye
- Paschal Azuh
- Morenikeji Komolafe
- Adeseye Akintunde
- Olugbo Obiabo
- Olusegun Areo
- Issa Kehinde
- Adeniyi G. Amusa
- Mayowa Owolabi
- SIREN Team as part of H3Africa Consortium
Abstract
Background: Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown.
Objectives: We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study.
Methods: SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and LVH are being collected and compared using standard techniques.
Results: This preliminary analysis included only 725 stroke patients (mean age 59.1 ± 13.2 years; 54.3% male). Fifty-five percent of the stroke subjects had LVH with greater proportion among women (51.6% vs. 48.4%; p < 0.001). Those with LVH were younger (57.9 ± 12.8 vs. 60.6 ± 13.4; p = 0.006) and had higher mean systolic and diastolic blood pressure (167.1/99.5 mm Hg vs 151.7/90.6 mm Hg; p < 0.001). Uncontrolled blood pressure at presentation was prevalent in subjects with LVH (76.2% vs. 57.7%; p < 0.001). Significant independent predictors of LVH were age90 mm Hg (AOR: 2.10; 95% CI: 1.39 to 3.19; p < 0.001).
Conclusions: The prevalence of LVH was high among stroke patients especially the younger ones, suggesting a genetic component to LVH. Hypertension was a major modifiable risk factor for stroke as well as LVH. It is envisaged that the SIREN project will elucidate polygenic overlap (if present) between LVH and stroke among Africans, thereby defining the role of LVH as a putative intermediate cardiovascular phenotype and therapeutic target to inform interventions to reduce stroke risk in populations of African ancestry.
Highlights
- Left ventricular hypertrophy (LVH) was found in more than one-half of stroke patients in Africa.
- LVH was more common in younger patients, suggesting a genetic component.
- Hypertension was a major modifiable risk factor for stroke as well as LVH.
- SIREN will elucidate polygenic overlap between LVH and stroke among Africans.