Target Organ Damage among Newly Diagnosed Rural Essential Hypertensives

Babu Vinish, D (2006) Target Organ Damage among Newly Diagnosed Rural Essential Hypertensives. Masters thesis, Madurai Medical College, Madurai.

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Abstract

Hypertension and target organ damage is a well known phenomenon. The study was undertaken to find the pattern of target organ damage in newly diagnosed non alcoholic, non smoking, non overweight, non dyslipidemic essential hypertensives of rural, low socio-economic status patients attending Government Rajaji Hospital, Madurai. Thus 147 patients were taken up in the study group based on the rigid inclusion and exclusion criteria after institutional ethical clearance and an informed consent, out of 450 patients over a period of 12 consecutive months. Their sociodemographic, clinical and laboratory data were collected and analysed statistically. There were 79 (53.7%) males (age range of 28 to 74, mean ± SD 56.7±10.16 years) and 68 (46.8%) females (age range of 29 to 74, mean ± SD 52.5±9.15 years) without statistical difference in their age distribution. Their systolic blood pressure, diastolic blood pressure and mean arterial pressure ranged from 140 to 210, 72 to 148 and 60 to 135 respectively, and the mean (±standard deviation) was 165.3 (±15.7), 99.3 (±14.7) and 99 (±15.8) mm of Hg respectively. Mean systolic blood pressure was more among females (167.26±15.77 mmHg) than males (163.57±15.51mmHg), similarly diastolic blood pressure was also more among them (104.08±15.75) than their counterparts (95.27±11.37) thus identifying them to be a vulnerable population hitherto undetected. Hypertension was classified according to JNC VII, as stage I in 37 patients (25.2%) and stage II in 110 patients (74.8%). Isolated systolic hypertension was observed in 17 males and 6 females. Microalbuminuria was seen in 51 cases (34.6%), and it was independent of age, sex, blood pressure status but it significantly correlated with retinal involvement (p=0.001), left ventricular mass (p=.034) and diastolic dysfunction (p=.014). Overall retinal involvement was seen in 102 (72.1%). Retinal changes were significantly more in those with increased left ventricular mass and diastolic dysfunction. The mean left ventricular mass was higher among males (264.85±71.79 gms) than females (231.59±74.86) and it was statistically significant. Left ventricular mass though increased with blood pressure, it was not significant statistically. At the same time left ventricular mass correlated with diastolic dysfunction, thus indicating that end organ damage has multiple factors viz., genetic susceptibility, endothelial damage, duration of blood pressure, subclinical stress. Moreover the clinical symptom of giddiness was significantly more (p=0.015) among those patients with a higher left ventricular mass. In view of the covert end organ damages viz., microalbuminuria, retinopathy, higher left ventricular mass and left ventricular dysfunction that were observed among newly detected non overweight, non smoking, non alcoholic, non dyslipidemic newly detected essential hypertensives of rural areas, there is an urgent need to design and implement “National Hypertension Detection and Control Programme” by the Ministry of Health and Family Welfare, Govt. of India with the help of professional medical associations and non governmental organizations. It is time to act, better late than never, in order to prevent or minimize hypertension induced complications.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Target Organ Damage ; Newly Diagnosed ; Rural Essential Hypertensives.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 15 Mar 2018 02:11
Last Modified: 15 Mar 2018 02:11
URI: http://repository-tnmgrmu.ac.in/id/eprint/6169

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