Cardiovascular risk factors in adult general out-patient clinics in Nigeria: a country analysis of the Africa and Middle East Cardiovascular Epidemiological (ACE) study.

Geoffrey C Onyemelukwe1, Oluwagbenga Ogunfowokan2, Amam Mbakwem3,
A Kayode Alao4, Kodjo Soroh5, Osahon Omorodion5, Paula Abreu6
1. Department of Medicine, Ahmadu Bello University Teaching Hospital Zaria, Zaria, Nigeria
2. Department of Family Medicine, National Hospital Abuja, Abuja, Nigeria
3. Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
4. Department of Family Medicine, Federal Medical Centre Keff, Nigeria
5. Pfzer Specialties Ltd, Nigeria/East Africa Region, Lagos, Nigeria
6. Pfzer Inc, New York, NY, USA
Emails:
Geoffrey C Onyemelukwe: (gconyelukwe@yahoo.com),
Oluwagbenga Ogunfowokan: (gloryogunfowokan@yahoo.com)
Amam Mbakwem: (ambakwem@hotmail.com)
A Kayode Alao: (alstacs@yahoo.com)
Kodjo Soroh: (Kodjo.Soroh@pfzer.com)
Osahon Omorodion: (Osahon.Omorodion@pfzer.com)
Paula Abreu: Paula.Abreu@pfzer.com)

Abstract
Background: With globalization and rapid urbanization, demographic and epidemiologic transitions have become important
determinants for the emergence of cardiovascular disease (CVD).

Objective: To estimate the prevalence of CVD risk factors in adult out-patients attending general practice and non-specialist
clinics in urban and rural Nigeria.

Methods: As part of the Africa and Middle East Cardiovascular Epidemiological (ACE) study, a cross-sectional epidemiologic
study was undertaken for the presence of hypertension, diabetes mellitus, dyslipidemia, obesity, smoking and abdominal obesity
in Nigeria.

Results: In total, 303 subjects from 8 out-patient general practice clinics were studied, 184 (60.7%) were female and 119 (39.3%)
were male. Mean age was 42.7±13.1 years; 51.8% were aged <45 years; 4% ≥65 years. Over 90% of subjects had ≥1 of 6 selected
modifable cardiovascular risk factors: 138 (45.6%) had 1-2; 65 (21.5%) had 3; 60 (19.8%) had 4; and 11 (3.6%) had 5 concurrent
risk factors. Screening identifed 206 subjects (68.0%) with dyslipidemia who did not have a prior diagnosis.

Conclusion: Cardiovascular risk factors are highly prevalent in Nigerian subjects attending out-patient clinics. Moreover, many
subjects were undiagnosed and therefore unaware of their cardiovascular risk status. Opportunistic screening alongside intensive
national, multisectoral education or risk factor education is needed, should be scaled up nationwide and rolled out in both urban
and rural communities in Nigeria.

Keywords: Nigeria, cardiovascular risk factors, screening programs, risk factor management, The Africa and Middle East Cardiovascular Epidemiological (ACE) study.