Case fatality among hypertension-related admissions in Enugu, Nigeria.

Objective: To determine the case fatality rate and ultimate causes of death among patients with hypertension-related conditions admitted to an urban tertiary hospital,

Method: A five-year review of hypertension-related admissions into the medical wards of the University of Nigeria Teaching Hospital, Enugu, between 1995 and 1999, was undertaken.

Results: 7220 patients were admitted into the medical wards during the period under review. Of these, 445 (6.2%) were due to hypertension-related causes. Of the later, 285 (64%) were males while 160 (36%) were females. One hundred and ninety one of the hypertension-related admissions died, giving a case fatality of 42.9%. The mean age at death was 54.8+/-15.8 years (53.5+/-15.9 years for males; 57.2+/-15.4 years for females, t=2.47, df=189, p=0.117). Sixty six percent of these were males while thirty four percent were females. Eighty six (45%) of the deaths occurred during acute hypertensive crises such as cerebrovascular accidents, hypertensive encephalopathy, and acute renal failure. Other important complications leading to death were congestive cardiac failure, accounting for thirty three cases (17.3%); and chronic renal failure 32 (16.8%). In twenty one (11%) hypertension-related admissions, the causes of death were not documented.

Conclusion: Hypertension, with its related complications, constitute a major cause of morbidity and mortality in our medical wards. The case fatality rate is very high and often mostly avoidable complications were responsible. There is need to further study the determinants of these avoidable causes of death.