Browsing by Author "Kpodonu, J."
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Item Combinations of variations in multiple genes are associated with hypertension(Hypertension, 2000-07) Williams, S.M.; Addy, J.H.; Phillips III, J.A.; Dai, M.; Kpodonu, J.; Afful, J.; Jackson, H.; Joseph, K.; Eason, F.; Murray, M.M.; Epperson, P.; Aduonum, A.; Wong, L.-J.; Jose, P.A.; Felder, R.A.The genetic analysis of hypertension has revealed complex and inconsistent results, making it difficult to draw clear conclusions regarding the impact of specific genes on blood pressure regulation in diverse human populations. Some of the confusion from previous studies is probably due to undetected gene-gene interactions. Instead of focusing on the effects of single genes on hypertension, we examined the effects of interactions of alleles at 4 candidate loci. Three of the loci are in the renin-angiotensin- system, angiotensinogen, ACE, and angiotensin II type 1 receptor, and they have been associated with hypertension in at least 1 previous study. The fourth locus studied is a previously undescribed locus, named FJ. In total, 7 polymorphic sites at these loci were analyzed for their association with hypertension in 51 normotensive and 126 hypertensive age-matched individuals. There were no significant differences between the 2 phenotypic classes with respect to either allele or genotype frequencies. However, when we tested for nonallelic associations (linkage disequilibrium), we found that of the 120 multilocus comparisons, 16 deviated significantly from random in the hypertensive class, but there were no significant deviations in the normotensive group. These findings suggest that genetic interactions between multiple loci rather than variants of a single gene underlie the genetic basis of hypertension in our study subjects. We hypothesize that such interactions may account for the inconsistent findings in previous studies because, unlike our study, prior studies almost always examined single-locus effects and did not consider the effects of variation at other potentially interacting loci.Item Contemporary aetiology of acute heart failure in a teaching hospital in Ghana(BMC Cardiovascular Disorders, 2023) Agyekum, F.; Folson, A.A.; Asare, B.Y-A.; Doku, A.; Kpodonu, J.; Okine, R.; Fokuoh, F.; Akamah, J.A.Background Heart failure (HF) is recognized as a global public health disease associated with high morbidity and mortality. It is suggested that the main underlying causes of HF in developing countries difer from those identifed in well-resourced countries. This study therefore presents the cardiovascular risk factors and the underlying aetiology of HF among admitted patients in a teaching Hospital in Ghana. Method The study prospectively recruited 140 consecutive patients admitted for heart failure at the Medical depart‑ ment of the Korle-Bu Teaching Hospital from March to October, 2014. The study evaluated the cardiovascular risk fac‑ tors and the aetiologies of heart failure, and compared the risk factors and aetiologies with patient’s age and gender. Results The mean age of the study participants was 51.3±16.8 years. The commonest cardiovascular risk factors observed were hypertension (46.5%), history of previous HF (40.7%), excessive alcohol use (38.6%), and family history of heart disease (29.3%); predominantly hypertension (68.3%). The major underlying aetiology of HF were dilated car‑ diomyopathy (38.6%), hypertensive heart disease (21.4%), ischaemic heart disease (13.6%) and valvular heart disease (12.9%). These underlying aetiology of HF were more common in patients aged 40 years and above (p=0.004) and those presenting with multiple risk factors (p=0.001). Conclusion The major underlying aetiology of heart failure in adults were dilated cardiomyopathy, hypertensive heart disease, ischaemic heart disease and valvular heart disease, which were signifcantly high among patients aged 40 years and above and those presenting multiple risk factors. Hypertension, excessive alcohol use, family history of heart disease and personal history of previous heart failure diagnosis are noted as the main cardiovascular risk factors among heart failure patientsItem Indications for and the diagnostic yield of 24-hour Holter monitoring: a prospective study at the Korle Bu Teaching Hospital(Ghana Medical Journal, 2018-12) Doku, A.; Ndanu, T.A.; Asare, B.Y.A.; Antwi-Boasiako, C.; Kpodonu, J.Background: Holter monitoring (HM) is an important tool used to evaluate symptoms suspected to be caused by arrhythmias. This study was aimed at determining the diagnostic yield of Holter monitoring among symptomatic and asymptomatic patients undergoing HM at the Korle-Bu Teaching Hospital. Methods: This was a prospective study among 400 consecutive symptomatic and asymptomatic patients undergoing HM from August 2006 to December, 2009 at the Korle-Bu Teaching Hospital. Data from the Holter study were analyzed, and symptoms linked to arrhythmias were evaluated to determine the diagnostic yield of HM in symptomatic and asymptomatic patients. Results: The mean age of the patients was 51.81 ± 16 years. The most common indications (symptoms) for HM were palpitation (62.9%) and dizziness (34.0%); about half (53.3%) of the symptomatic patients had only one indication. Among the symptomatic group, 28 in 115 symptoms were linked to arrhythmias giving a diagnostic yield of 24.3% whereas in the asymptomatic group 1 in 33 of symptom was linked to arrhythmia giving a diagnostic yield of 3.0%. The study found an overall diagnostic yield of 19.6%. Conclusion: HM as a regular health check for the general population (asymptomatic cohorts) is not cost effective and does not provide significant data to influence care except when the subject is found to have symptoms.Item Serum lipid and lipoprotein levels in Ghanaians with diabetes mellitus and hypertension(Journal of the National Medical Association, 1997) Nyarko, A.; Adubofour, K.; Ofei, F.; Kpodonu, J.; Owusu, S.Both diabetes mellitus and hypertension alter lipid and lipoprotein metabolism and increase the risk of coronary artery disease. We have reported previously on lipid and lipoprotein levels in healthy Ghanaians, and this study deals with the levels of these biochemical parameters in Ghanaians with diabetes mellitus and hypertension. Fasting serum lipoproteins were determined on blood samples drawn from healthy male and female Ghanaians as well as age-matched individuals with either diabetes or hypertension. Cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides, and fasting blood glucose were measured. Low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) were derived. Total serum cholesterol levels were 4.43 +/- 0.22 mmol/L and 4.67 +/- 0.26 mmol/L for diabetic males and females, respectively. High-density lipoprotein was 1.55 +/- 0.09 mmol/L and 1.50 +/- 0.09 mmol/L for male and female diabetics, respectively. Lipid and lipoprotein levels in the hypertensive patients did not differ from the above values. The levels of cholesterol and lipoprotein obtained in Ghanaians with hypertension and diabetes mellitus were similar to those of their age-matched healthy controls. These results suggest a reduced risk of coronary artery disease from the atherogenic effects of cholesterol in Ghanaians with diabetes mellitus and hypertension.