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Original Research

Exploring Overlaps Between the Genomic and Environmental Determinants of LVH and Stroke: A Multicenter Study in West Africa

Authors:

Abiodun M. Adeoye,

University of Ibadan, Ibadan, NG
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Bruce Ovbiagele,

Medical University of South Carolina, Charleston, SC, US
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Philip Kolo,

University of Ilorin Teaching Hospital, Ilorin, NG
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Lambert Appiah,

Komfo Anokye Teaching Hospital, Kumasi, GH
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Akinyemi Aje,

University College Hospital, Ibadan, NG
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Oladimeji Adebayo,

University College Hospital, Ibadan, NG
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Fred Sarfo,

Komfo Anokye Teaching Hospital, Kumasi, GH
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Joshua Akinyemi,

University of Ibadan, Ibadan, NG
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Gregory Adekunle,

University of Ibadan, Ibadan, NG
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Francis Agyekum,

University of Ghana Medical School, Accra, GH
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Vincent Shidali,

Ahmadu Bello University, Zaria, NG
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Okechukwu Ogah,

University College Hospital, Ibadan, NG
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Dan Lackland,

Medical University of South Carolina, Charleston, SC, US
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Mulugeta Gebregziabher,

Medical University of South Carolina, Charleston, SC, US
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Donna Arnett,

University of Kentucky, Lexington, KY, US
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Hemant K. Tiwari,

University of Alabama at Birmingham, Birmingham, AL, US
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Rufus Akinyemi,

Federal Medical Centre, Abeokuta, NG
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Ojo Olakanmi Olagoke,

University College Hospital, Ibadan, NG
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Ayodipupo Sikiru Oguntade,

University College Hospital, Ibadan, NG
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Taiwo Olunuga,

Federal Medical Centre, Abeokuta, NG
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Kelechi Uwanruochi,

Federal Medical Center, Umuahia, NG
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Carolyn Jenkins,

Medical University of South Carolina, Charleston, SC, US
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Patrick Adadey,

University of Ghana Medical School, Accra, GH
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Henry Iheonye,

Ahmadu Bello University, Zaria, NG
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Lukman Owolabi,

Aminu Kano Teaching Hospital, Kano, NG
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Reginald Obiako,

Ahmadu Bello University, Zaria, NG
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Samuel Akinjopo,

University College Hospital, Ibadan, NG
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Kevin Armstrong,

Medical University of South Carolina, Charleston, SC, US
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Albert Akpalu,

University of Ghana Medical School, Accra, GH
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Adekunle Fakunle,

University of Ibadan, Ibadan, NG
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Raelle Saulson,

Medical University of South Carolina, Charleston, SC, US
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Mayowa Aridegbe,

Sacred Heart Hospital, Abeokuta, NG
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Paul Olowoyo,

Federal University Teaching Hospital, Ido-Ekiti, NG
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Godwin Osaigbovo,

Jos University Teaching Hospital, Jos, NG
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Josephine Akpalu,

University of Ghana Medical School, Accra, GH
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Bimbo Fawale,

Obafemi Awolowo University Teaching Hospital, Ile-Ife, NG
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Philip Adebayo,

Ladoke Akintola University of Technology, Ogbomoso, NG
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Oyedunni Arulogun,

University of Ibadan, Ibadan, NG
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Philip Ibinaiye,

Ahmadu Bello University, Zaria, NG
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Atinuke Agunloye,

University of Ibadan, Ibadan, NG
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Naser Ishaq,

Aminu Kano Teaching Hospital, Kano, NG
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Kolawole Wahab,

University of Ilorin Teaching Hospital, Ilorin, NG
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Onoja Akpa,

University of Ibadan, Ibadan, NG
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Omisore Adeleye,

Obafemi Awolowo University Teaching Hospital, Ile-Ife, NG
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Andrew Bock-Oruma,

Delta State University Teaching Hospital, Ogara, NG
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Godwin Ogbole,

University of Ibadan, Ibadan, NG
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Sylvia Melikam,

University of Ibadan, Ibadan, NG
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Joseph Yaria,

University College Hospital, Ibadan, NG
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Luqman Ogunjimi,

University College Hospital, Ibadan, NG
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Abdul Salaam,

Jos University Teaching Hospital, Jos, NG
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Taofiki Sunmonu,

Federal Medical Centre, Owo, NG
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Akintomiwa Makanjuola,

University College Hospital, Ibadan, NG
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Temitope Farombi,

University College Hospital, Ibadan, NG
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Ruth Laryea,

University of Ghana Medical School, Accra, GH
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Ezinne Uvere,

University of Ibadan, Ibadan, NG
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Salaam Kehinde,

University of Ibadan, Ibadan, NG
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Innocent Chukwuonye,

Federal Medical Center, Umuahia, NG
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Paschal Azuh,

Ahmadu Bello University, Zaria, NG
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Morenikeji Komolafe,

Obafemi Awolowo University Teaching Hospital, Ile-Ife, NG
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Adeseye Akintunde,

Ladoke Akintola University of Technology, Ogbomoso, NG
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Olugbo Obiabo,

Delta State University Teaching Hospital, Ogara, NG
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Olusegun Areo,

Federal University Teaching Hospital, Ido-Ekiti, NG
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Issa Kehinde,

University of Ibadan, Ibadan, NG
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Adeniyi G. Amusa,

Jos University Teaching Hospital, Jos, NG
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Mayowa Owolabi ,

University of Ibadan, Ibadan, NG
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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.
How to Cite: Adeoye AM, Ovbiagele B, Kolo P, Appiah L, Aje A, Adebayo O, et al.. Exploring Overlaps Between the Genomic and Environmental Determinants of LVH and Stroke: A Multicenter Study in West Africa. Global Heart. 2017;12(2):107–13.e5. DOI: http://doi.org/10.1016/j.gheart.2017.01.001
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Published on 01 Jun 2017.
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