Determinants of Hypertensive Heart Disease Among Adult Hypertensive Patients in University of Gondar Referral Hospital, Gondar North West Ethiopia, A Case- Control Study

Document Type : Original Article


1 Epidemiologist, Department of Epidemiology, Faculty of Public Health, Debre Tabor University

2 Epidemiologist,Department of Epidemiology, Faculty of Public Health, Jimma University Institute of Health, Ethiopia


Background: Hypertensive heart disease (HHD) is the constellation of abnormalities characterized by cardiac complications. Despite advancements in management of hypertension and access to medical care, incidence of HHD is an alarmingly increasing through time. However, information on determinants of HHD studies is limited in Ethiopia. We assessed determinants of HHD among adult hypertensive patients in Gondar University Referral Hospital, North Ethiopia.
Materials and Methods: A case control study was conducted from April 1-26, 2018. Cases were adult hypertensive outpatients with cardiac complications, diagnosed within the last two years and were on follow up and care in Gondar university referral hospital during study period. Controls were adult hypertensive outpatients without history of any of the cardiac complications, diagnosed within the last two years and were on follow up and care in Gondar university referral hospital during study period. A total of 159 participants 53 cases and 106 controls were selected using simple random sampling. Data were collected using checklist and interviewer administered structured questionnaire. Multivariate logistic regression analysis was used to identify predictors of hypertensive heart disease and p-value of 0.05 was used to decide for statistical significance.
Result: Most of the cases 70.9% and the controls 54.5% were in the age group of ≥60 years. Hypertensive patients who had family history of cardiovascular disease ((AOR) (Adjusted odds ratio) =4.7, 95% CI: 1.8-11.9), sedentary life style (AOR = 3.2, 95% CI: 1.3-7.8), uncontrolled blood pressure (AOR=4 95% CI: 1.8-9.0), and duration of hypertension ≥10 years (AOR=3, 95% CI: 1.1-8.7) were more likely to develop hypertensive heart disease than their counterparts.
Conclusion: Multiple factors predicted HHD. Providing professional advice regarding to physical exercise especially for older individuals and taking early management is highly recommended.


  1. World Health Organization. Cardiovascular diseases. Geneva: World Health Organization; 2017.
  2. Yadufashije D, Sangano GB, Samuel R. Factors contributing to cardiovascular diseases among african societies. Int J Interdisciplinary Innovat Res Dev. 2017; 14:1-6.
  3. Modesti PA, Agostoni P, Agyemang C, Basu S, Benetos A, Cappuccio FP, et al. Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings. J Hypertens. 2014; 32:951-60.
  4. Sahle BW, Owen AJ, Krum H, Reid CM. Incidence of heart failure in 6083 elderly hypertensive patients: the Second Australian National Blood Pressure Study (ANBP2). Eur J Heart Fail. 2016; 18:38-45.
  5. Goh VJ, Le T, Bryant J, Wong JI, Su B, Lee C, et al. Novel Index of maladaptive myocardial remodeling in hypertension. Circ Cardiovasc Imaging. 2017; 10:e006840.
  6. Maduka CJ, Ohagwu KA, Offia EM, Uwanuruochi K, Ukpabi OJ. Sudden cardiac death in hypertensive heart disease patients in Umuahia, Abia State, Nigeria: an 18 month case series report. Int J Med Res Prof. 2017; 3:285-87.
  7. Abegaz TM, Tefera YG, Befekadu Abebe T. Target organ damage and the long term effect of nonadherence to clinical practice guidelines in patients with hypertension : a retrospective cohort study. Int J Hypertens. 2017; 2017:2637051.
  8. Tam MC, Lee R, Cascino TM, Konerman MC, Hummel SL. Current perspectives on systemic hypertension in heart failure with preserved ejection fraction. Curr Hypertens Rep. 2017; 19:12.
  9. Awoke A, Awoke T, Alemu S, Megabiaw B. Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia : a community based cross-sectional study. BMC Cardiovasc Disord. 2012; 12:113.
  10. Moges B, Amare B, Fantahun B, Kassu A. High prevalence of overweight, obesity, and hypertension with increased risk to cardiovascular disorders among adults in northwest Ethiopia : a cross sectional study. BMC Cardiovasc Disord. 2014; 14:155.
  11. Aje A, Adebiyi AA, Falase AO. Hypertensive heart disease in Africa: Hypertens Heart Dis. 2009; 6:42-51.
  12. Mene-Afejuku TO, Balogun MO, Akintomide AO, Adebayo RA. Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test. Vasc Health Risk Manag. 2017; 13:71-9.
  13. Glezeva N, Gallagher J, Ledwidge M, O'Donoghue J, McDonald K, Chipolombwe J, et al. Heart failure in sub-Saharan Africa : review of the aetiology of heart failure and the role of point-of-care biomarker diagnostics. Trop Med Int Health. 2015; 20:581-88.
  14. Tolla MT, Norheim OF, Memirie ST, Abdisa SG, Ababulgu A, Jerene D, et al. Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysis. Cost Eff Resour Alloc. 2016; 14:10.
  15. Norbert UN, Romokere AM, Osaretin OJ. Prevalence and determinants of left ventricular geometric and functional abnormalities in asymptomatic hypertensive adults at a Tertiary Hospital, Southern Nigeria. Int J Internal Med. 2017; 6:16-26.
  16. Abdu O, Diro E, Abera Balcha MA, Ayanaw D, Getahun S, Mitiku T, et al. Blood pressure control among hypertensive patients in University of Gondar Hospital, Northwest Ethiopia: a cross sectional study. Hypertension. 2017; 140:6.
  17. Abebe SM, Berhane Y, Worku A, Getachew A. Prevalence and associated factors of hypertension: a crossectional community based study in northwest ethiopia. PLoS One. 2015; 10:e0125210.
  18. Belayneh AB, Teklie H, Tadesse M, Defar A, Getachew T, Amenu K, et al. Pattern and trend of medical admissions of patients of chronic non-communicable diseases in selected Hospitals in Addis Ababa, Ethiopia. Am Sci Res J Eng Technol Sci. 2015; 13:34-48.  
  19. Worku T, Tadesse Y, Hughes P, Lemessa T. Patterns of complications seen in patients with hypertension admitted to tikur anbessa hospital . Ethiop Med J. 2015; 2:51-6.
  20. Adem A, Abebe S, Hailu A, Feleke B, Berhe M, Atsibeha M, et al. Heart diseases in north ethiopia pattern of echocardiographic abnormalities among adult cardiac patients - an experience. Ethiop Med J. 2014; 52:173-83.
  21. Tefera YG, Abegaz TM, Abebe TB, Mekuria AB. The changing trend of cardiovascular disease and its clinical characteristics in Ethiopia: hospital-based observational study. Vasc Health Risk Manag. 2017; 13:143-51.
  22. Dini FL, Galderisi M, Nistri S, Buralli S, Ballo P, Mele D, et al. Abnormal left ventricular longitudinal function assessed by echocardiographic and tissue Doppler imaging is a powerful predictor of diastolic dysfunction in hypertensive patients: the SPHERE study. Int J Cardiol. 2013; 168:3351-8.
  23. Álvarez Aliaga A, González Aguilera JC, Maceo Gómez Ldel R. Factors associated to hypertensive heart disease development: a prospective cohort study in Bayamo, Cuba. Medwave. 2016; 16:6492.
  24. World Health Organization. Developing integrated response of health care systems to rapid questionnaire for hypertensive patients. Geneva: World Health Organization; 2011.
  25. Brzyżkiewicz H, Konduracka E, Gajos G, Janion M. Incidence of chronic heart failure with preserved left ventricular ejection fraction in patients with hypertension and isolated mild diastolic dysfunction. Pol Arch Med Wewn. 2016; 126:12-8.
  26. Peer N, Steyn K, Dennison CR, Levitt NS, Nyo MTL, Nel JH, et al. Determinants of target organ damage in black hypertensive patients attending primary health care services in cape town : the Hi-Hi study. Am J Hypertens. 2008; 21:896-902.
  27. Berhe DF, Taxis K, Haaijer-Ruskamp FM, Mulugeta A, Mengistu YT, Mol PG. Hypertension treatment practices and its determinants among ambulatory patients: retrospective cohort study in Ethiopia. BMJ Open. 2017; 7:e015743.
  28. Amugitsi IL, Ayieko A, Omuga B. Determinants of hypertension complications among adult hypertensive patients in medical wards at Kenyatta National Hospital, Nairobi. Am J Nurs Sci. 2016; 5:213-21.
  29. Grace M. Modifiable coronary heart disease risk factors trends in urban black south african females and the implications for health promotion interventions. Global J Health Sci. 2018; 10:120-8.
  30. Kapoor R, Vyas S, Patel P, Mehta H, Mehta P, Modi J, et al. A case-control study of risk factors for ischemic heart disease in patients attending tertiary care hospitals in India. South East Asia J Public Health. 2013; 3:57-60.