High blood pressure is a major public health concerns globally. This study determined the mean bl... more High blood pressure is a major public health concerns globally. This study determined the mean blood pressure, prevalence of high blood pressure, gender difference in blood pressure and relationship between blood pressure and body mass index (BMI) among Nigerian young adults. A cross sectional study was conducted among the students of Obafemi Awolowo University, Ile-Ife, Nigeria. Seven hundred and two (702) students (412males and 290females) with age range between 18-40years participated in the study. Weight, height and blood pressure (BP) were measured using standard methods. BMI and blood pressure were classified using WHO and JNC VII classifications respectively. Data was analysed using SPSS version 17.0 software. The student t-test was used to determine the significant difference. A p value < 0.05 was taken as statistically significant. The mean systolic blood pressure, diastolic blood pressure and BMI were 119.24±11.89mmHg, 71.79±9.15mmHg and 21.89kg/m2 respectively. The prevalence of high blood pressure, overweight and obesity were 8.4%, 14.8% and 1.3% respectively. The prevalence of high blood pressure among males and females were 5.3% and 3.1% respectively with significant sex difference (χ2 = 43.56, p value < 0.001). In conclusion, the prevalence of high blood pressure was higher in male than female young adult. Periodic blood pressure screening for young adult population in our environment will play a significant role in early detection and management of hypertensive heart diseases.
Background: There are evidences to suggest that the World Health Organization (WHO) general cutof... more Background: There are evidences to suggest that the World Health Organization (WHO) general cutoff points for body mass index (BMI) may not be the most appropriate for young adults globally irrespective of racial and ethnic considerations. Objective: This study assessed body anthropometric parameters in healthy population of young adult Nigerians with a view to determining race and gender-specific criteria (Ife criteria) for BMI classification. Methods: Four hundred and eighty-four (242 males and 242 females) healthy subjects aged between 18 and 41 years (inclusive) were recruited for the study. The participants were age-and sex-matched (mean age: 22.81 ± 3.83 years). The weight and height of the subjects were obtained using standard techniques while BMI was calculated as derivatives of height and weight. The BMI was classified using 5 th , 85 th , and 95 th percentiles and delineated into underweight (<5 th percentile), normal (5–85 th percentile), overweight (85–95 th percentile), and obese (>95 th percentile). Results: The result showed that the general BMI cutoff values for underweight, normal, overweight, and obesity were <17.8, 17.8–24.7, 24.8–27.8, and ≥27.9, respectively. The sex-specific BMI cutoff values for underweight, normal, overweight, and obesity in males and females were < 17.8 and < 17.8; 17.8–23.6 and 17.8–25.6; 23.7–26.8 and 25.7–28.7; and ≥26.9 and ≥28.8, respectively. Conclusions: The cutoff values for the new criteria for BMI classification were lower than the WHO defined values and sex differences were demonstrated in BMI. Therefore, WHO criteria may not be universally applicable. ABSTRACT INTRODUCTION
Introduction: Dextrocardia with situs inversus is a rare congenital disease. In patients with thi... more Introduction: Dextrocardia with situs inversus is a rare congenital disease. In patients with this condition, the heart is presented as a mirror image of itself with its apex pointing to the right. The pulmonary and abdominal anatomies are reversed. Dextrocardia with situs inversus occurs at birth but its diagnosis may be in adulthood. This case advances knowledge by graphically describing the unusual electrocardiographic features of dextrocardia in a young adult.
Background: Assessment of JVP is an important aspect of cardiovascular system examination.JVP mea... more Background: Assessment of JVP is an important aspect of cardiovascular system examination.JVP measurement at bedside is desirable but often neglected due to lack of necessary tool for its assessment.The traditional 'two-ruler' method for non-invasive measurement of JVP is uneasy especially for junior doctors and medical students.Jugulometer is a new medical device designed for non-invasive measurement of jugular venous pressure at bedside. Method: We introduced a simple and affordable medical device for use in medical practice for bedside assessment of JVP. Result: Jugulometer is useful in the assessment of JVP.Its more convenient and easy to use than the traditional 'two-ruler' method. Conclusion: Jugulometer is an innovation in cardiovascular medicine.It enhances the physicians' diagnostic acumen with regards to non-invasive assessment of JVP at bedside.It is a useful tool in teaching medical students the skill of non-invasive measurement of JVP.
Body mass index (BMI) is an important cardiometabolic parameter. This study determined the mean B... more Body mass index (BMI) is an important cardiometabolic parameter. This study determined the mean BMI, pattern and prevalence of underweight, overweight and obesity among young adult Nigerians. It also examined the effect of sex on pattern of distribution of BMI classes. This was cross-sectional study conducted among students of a tertiary institution. Seven hundred and two (702) students (412 males and 290 females) with age range between 18-40years participated in the study. The participants had their weights and heights recorded by standardized techniques and BMI was calculated from the weight and height. BMI was classified according to WHO reference values. Data was analyzed using SPSS version 17 software. A p-value of less than 0.05 was considered as statistically significant. The mean BMI was 21.89±3.07 (kg/m 2). Age was positively correlated with BMI(r = 0.298, p <0.001).Significant sex differences in anthropometry were demonstrated in terms of height (t=17.880, p <0.001), weight (t =7.595, p<0.001), BMI (t =-2.483, p =0.013) and BSA (t=12.716, p <0.001). There was a significant sex difference in BMI classes recorded in this study (χ 2 = 12.255, p = 0.007).The prevalence of overweight and obesity among the total participants were 14.8% and 1.3% respectively. Among the males, the prevalence of underweight, overweight and obesity were 9.2%, 11.2% and 1.2% respectively while among the females, the prevalence of underweight, overweight and obesity were 11.0%, 20.0% and 1.4% respectively. More than a quarter of the apparently healthy young adults had abnormal BMI. The study also showed that abnormal BMI (underweight, overweight and obesity) were more frequent in female than male young adult Nigerians. Health education focusing on weight adjustment measures including exercise and dietary strategies will be beneficial among young adult population.
The potentials of electrocardiogram (ECG) in sex determination in young adults have not been exte... more The potentials of electrocardiogram (ECG) in sex determination in young adults have not been extensively explored despite the fact that ECG is one of the most frequently performed medical procedures. This study aimed at developing a simple electrocardiographic score system that could assist in sex determination in young adults. Patterns of ECG in male and female young adults were carefully analyzed and features that could be used to delineate the ECG into male and female patterns were selected as criteria for formulation of a simple scoring system called Ogunlade sex determination electrocardiographic score (OSDES).Components of OSDES were point scores in four electrocardiographic parameters; T wave configuration in V1 (1-3), ST segment in V2 or V3 (1-3), QRS rotation (1-3) and heart rate (1-3). The total minimum and maximum scores were 4 and 12 respectively. An individual with a total score of < 7 was identified as a female while an individual with a score ≥ 7 was identified a male. Thus, with OSDES, ECG can be classified into two; male pattern and female pattern for male and female respectively. This unique scoring system was tested among 474 healthy young adults (294 males and 180 females). Two hundred and eighty eight (288) of the 294 males were correctly identified by OSDES as males while 174 of the 180 females were correctly identified as females (k = 0.946, p < 0.001). The study defined male and female ECG patterns and concluded that ECG can be used to determine sex among young adult population.
This study aimed to determine the mean values of electrocardiographic parameters, and to describe... more This study aimed to determine the mean values of electrocardiographic parameters, and to describe the pattern of electrocardiograms in young adults. 353 healthy young adults were evaluated by medical history, physical examination, and standard 12-lead electrocardiogram. The mean heart rate, QRS duration, PR interval, QT interval, corrected QT interval (QTc),T wave axis, P wave duration and amplitude were: 74 +/- 9 beats per min, 0.09 +/- 0.01s, 0.15 +/- 0.02 s, 0.36 +/- 0.02 s, 0.40 +/- 0.02 s, 54 +/- 20 degrees, 49 +/- 14 degrees, 0.09 +/- 0.01 s, 1.28 +/- 0.41 mm, respectively. The dominant electrocardiographic peculiarity among the participants was early repolarization which was characterized by male preponderance. This study defined baseline values for electrocardiographic variables in healthy young adults. Early repolarization is a common ECG feature in young adults.
Stroke, a major cause of morbidity and mortality, is on the increase and with increasing mortalit... more Stroke, a major cause of morbidity and mortality, is on the increase and with increasing mortality. Our retrospective review of all stroke admissions from 1990-2000 show that cerebrovascular disease accounted for 3.6% (293/8144) of all medical admissions; it has a case fatality rate of 45% with the majority (61%) occurring in the first week; the mean age of stroke deaths was 62 years (standard deviation+/-13); and severe as well as uncontrolled hypertension is the most important risk factor. Community-based programmes aimed at early detection and treatment of hypertension, in addition to screening for those with high risk factors, should be put in place.
Left ventricular hypertrophy (LVH) is a common pathophysiological consequence of hypertension. Va... more Left ventricular hypertrophy (LVH) is a common pathophysiological consequence of hypertension. Various voltage (ECG) criteria exist for evaluation of LVH. This study assessed the performance of 4 commonly used ECG criteria in south-western Nigeria. A cross-sectional descriptive study of adult hypertensive subjects. Participants were assessed for LVH using 4 ECG criteria: Sokolow-Lyon, Araoye code system, Cornell voltage, and Gubner-Ungerleider criteria. Echocardiography was used to determine the left ventricular mass index for the participants, and a value greater than 125 g/m(2) was used as the cut-off point for LVH. The sensitivity, specificity, accuracy, positive and negative predictive values were determined for each of the ECG criteria. 90 subjects (45 males, 45 females) participated in the study. The prevalence of LVH by echocardiography was 32.2%. The prevalence of LVH by voltage criteria were: 45.6%, 42.2%, 34.4%, 13.3% by Sokolow-Lyon, Araoye code system, Cornell, and Gubner-Ungerleider criteria, respectively. The sensitivity and specificity respectively of the ECG criteria were 58.62% and 60.66% (Sokolow-Lyon), 48.28% and 60.65% (Araoye code system), 51.72% and 73.77% (Cornell), and 13.79% and 86.89% (Gubner-Ungerleider). Out of the 4 ECG criteria, Araoye code system, Cornell and Sokolow-Lyon criteria compared favorably well with echocardiography and may be used in the initial assessment of LVH in adult hypertensive subjects. However, a combination of any of the 3 criteria with Gubner-Ungerleider criterion will be more clinically useful.
Death from tuberculosis (TB) is the longest recorded indicator of the TB epidemic in industrialis... more Death from tuberculosis (TB) is the longest recorded indicator of the TB epidemic in industrialised countries. This study aims at investigating into various factors associated with death in hospitalised patients with tuberculosis in Ile-Ife, Nigeria. A retrospective study of all admissions into the medical wards, total number of deaths and number of cases of deaths due to TB during the period 1998-2000 was done. Tuberculosis represented 8% (268) of all admissions (n=3464). The overall hospital mortality during the period under review was 1030 (30%). Tuberculosis was responsible for 5% of all deaths while TB specific mortality was 18.3 percent. The highest mortality was observed among patients between the 3rd and 4th decade of life with a male to female ratio 1.3: 1. About 70% of the patients died within a week of admission. Pulmonary TB was responsible for 69% of deaths followed by tuberculous meningitis (14%), retroviral illness (24%), anaemia (60%). Delayed presentation and diagnosis were identified as factors commonly associated with death rate. Delayed presentation and diagnosis were commonly associated with death. There is a need for more awareness among patients and health care providers about tuberculosis.
Assessment of cardiac autonomic function (CAF) is an important non-invasive investigation in medi... more Assessment of cardiac autonomic function (CAF) is an important non-invasive investigation in medical practice. This study aimed at assessing the effects of age and sex on autonomic cardiovascular indices. It was a cross-sectional descriptive study involving 204 apparently healthy adults between the ages of 18 and 40years who were residents of Obafemi Awolowo University community, Ile-Ife, Nigeria. Each of the participants performed five non-invasive cardiac autonomic function tests in series after excluding the systemic diseases by clinical evaluation. The five cardiac autonomic function tests were: Systolic Blood Pressure (SBP) response to change of posture (supine to erect), Diastolic Blood Pressure (DBP) response to sustained handgrip at 30% maximum voluntary contraction (MVC), Heart rate response to Valsalva maneouvre, Heart rate responses to Deep Breathing (HDB) and heart rate response to standing. The data obtained was analyzed with SPSS version17.0 software using descriptive statistics, correlation and Student t-test. A p value of < 0.05 was taken as statistically significant. Age was positively correlated with SBP response to posture, DBP response to sustained handgrip, Valsalva ratio and bradycardia ratio. Age was negatively correlated with tachycardia ratio, HDB, 30:15 ratio and resting heart rate. Significant gender difference was demonstrated in resting heart rate (t=-3.05, p = 0.003) and diastolic blood pressure response to sustained handgrip (t = 3.40, p=0.001).
High blood pressure is a major public health concerns globally. This study determined the mean bl... more High blood pressure is a major public health concerns globally. This study determined the mean blood pressure, prevalence of high blood pressure, gender difference in blood pressure and relationship between blood pressure and body mass index (BMI) among Nigerian young adults. A cross sectional study was conducted among the students of Obafemi Awolowo University, Ile-Ife, Nigeria. Seven hundred and two (702) students (412males and 290females) with age range between 18-40years participated in the study. Weight, height and blood pressure (BP) were measured using standard methods. BMI and blood pressure were classified using WHO and JNC VII classifications respectively. Data was analysed using SPSS version 17.0 software. The student t-test was used to determine the significant difference. A p value < 0.05 was taken as statistically significant. The mean systolic blood pressure, diastolic blood pressure and BMI were 119.24±11.89mmHg, 71.79±9.15mmHg and 21.89kg/m2 respectively. The prevalence of high blood pressure, overweight and obesity were 8.4%, 14.8% and 1.3% respectively. The prevalence of high blood pressure among males and females were 5.3% and 3.1% respectively with significant sex difference (χ2 = 43.56, p value < 0.001). In conclusion, the prevalence of high blood pressure was higher in male than female young adult. Periodic blood pressure screening for young adult population in our environment will play a significant role in early detection and management of hypertensive heart diseases.
Background: There are evidences to suggest that the World Health Organization (WHO) general cutof... more Background: There are evidences to suggest that the World Health Organization (WHO) general cutoff points for body mass index (BMI) may not be the most appropriate for young adults globally irrespective of racial and ethnic considerations. Objective: This study assessed body anthropometric parameters in healthy population of young adult Nigerians with a view to determining race and gender-specific criteria (Ife criteria) for BMI classification. Methods: Four hundred and eighty-four (242 males and 242 females) healthy subjects aged between 18 and 41 years (inclusive) were recruited for the study. The participants were age-and sex-matched (mean age: 22.81 ± 3.83 years). The weight and height of the subjects were obtained using standard techniques while BMI was calculated as derivatives of height and weight. The BMI was classified using 5 th , 85 th , and 95 th percentiles and delineated into underweight (<5 th percentile), normal (5–85 th percentile), overweight (85–95 th percentile), and obese (>95 th percentile). Results: The result showed that the general BMI cutoff values for underweight, normal, overweight, and obesity were <17.8, 17.8–24.7, 24.8–27.8, and ≥27.9, respectively. The sex-specific BMI cutoff values for underweight, normal, overweight, and obesity in males and females were < 17.8 and < 17.8; 17.8–23.6 and 17.8–25.6; 23.7–26.8 and 25.7–28.7; and ≥26.9 and ≥28.8, respectively. Conclusions: The cutoff values for the new criteria for BMI classification were lower than the WHO defined values and sex differences were demonstrated in BMI. Therefore, WHO criteria may not be universally applicable. ABSTRACT INTRODUCTION
Introduction: Dextrocardia with situs inversus is a rare congenital disease. In patients with thi... more Introduction: Dextrocardia with situs inversus is a rare congenital disease. In patients with this condition, the heart is presented as a mirror image of itself with its apex pointing to the right. The pulmonary and abdominal anatomies are reversed. Dextrocardia with situs inversus occurs at birth but its diagnosis may be in adulthood. This case advances knowledge by graphically describing the unusual electrocardiographic features of dextrocardia in a young adult.
Background: Assessment of JVP is an important aspect of cardiovascular system examination.JVP mea... more Background: Assessment of JVP is an important aspect of cardiovascular system examination.JVP measurement at bedside is desirable but often neglected due to lack of necessary tool for its assessment.The traditional 'two-ruler' method for non-invasive measurement of JVP is uneasy especially for junior doctors and medical students.Jugulometer is a new medical device designed for non-invasive measurement of jugular venous pressure at bedside. Method: We introduced a simple and affordable medical device for use in medical practice for bedside assessment of JVP. Result: Jugulometer is useful in the assessment of JVP.Its more convenient and easy to use than the traditional 'two-ruler' method. Conclusion: Jugulometer is an innovation in cardiovascular medicine.It enhances the physicians' diagnostic acumen with regards to non-invasive assessment of JVP at bedside.It is a useful tool in teaching medical students the skill of non-invasive measurement of JVP.
Body mass index (BMI) is an important cardiometabolic parameter. This study determined the mean B... more Body mass index (BMI) is an important cardiometabolic parameter. This study determined the mean BMI, pattern and prevalence of underweight, overweight and obesity among young adult Nigerians. It also examined the effect of sex on pattern of distribution of BMI classes. This was cross-sectional study conducted among students of a tertiary institution. Seven hundred and two (702) students (412 males and 290 females) with age range between 18-40years participated in the study. The participants had their weights and heights recorded by standardized techniques and BMI was calculated from the weight and height. BMI was classified according to WHO reference values. Data was analyzed using SPSS version 17 software. A p-value of less than 0.05 was considered as statistically significant. The mean BMI was 21.89±3.07 (kg/m 2). Age was positively correlated with BMI(r = 0.298, p <0.001).Significant sex differences in anthropometry were demonstrated in terms of height (t=17.880, p <0.001), weight (t =7.595, p<0.001), BMI (t =-2.483, p =0.013) and BSA (t=12.716, p <0.001). There was a significant sex difference in BMI classes recorded in this study (χ 2 = 12.255, p = 0.007).The prevalence of overweight and obesity among the total participants were 14.8% and 1.3% respectively. Among the males, the prevalence of underweight, overweight and obesity were 9.2%, 11.2% and 1.2% respectively while among the females, the prevalence of underweight, overweight and obesity were 11.0%, 20.0% and 1.4% respectively. More than a quarter of the apparently healthy young adults had abnormal BMI. The study also showed that abnormal BMI (underweight, overweight and obesity) were more frequent in female than male young adult Nigerians. Health education focusing on weight adjustment measures including exercise and dietary strategies will be beneficial among young adult population.
The potentials of electrocardiogram (ECG) in sex determination in young adults have not been exte... more The potentials of electrocardiogram (ECG) in sex determination in young adults have not been extensively explored despite the fact that ECG is one of the most frequently performed medical procedures. This study aimed at developing a simple electrocardiographic score system that could assist in sex determination in young adults. Patterns of ECG in male and female young adults were carefully analyzed and features that could be used to delineate the ECG into male and female patterns were selected as criteria for formulation of a simple scoring system called Ogunlade sex determination electrocardiographic score (OSDES).Components of OSDES were point scores in four electrocardiographic parameters; T wave configuration in V1 (1-3), ST segment in V2 or V3 (1-3), QRS rotation (1-3) and heart rate (1-3). The total minimum and maximum scores were 4 and 12 respectively. An individual with a total score of < 7 was identified as a female while an individual with a score ≥ 7 was identified a male. Thus, with OSDES, ECG can be classified into two; male pattern and female pattern for male and female respectively. This unique scoring system was tested among 474 healthy young adults (294 males and 180 females). Two hundred and eighty eight (288) of the 294 males were correctly identified by OSDES as males while 174 of the 180 females were correctly identified as females (k = 0.946, p < 0.001). The study defined male and female ECG patterns and concluded that ECG can be used to determine sex among young adult population.
This study aimed to determine the mean values of electrocardiographic parameters, and to describe... more This study aimed to determine the mean values of electrocardiographic parameters, and to describe the pattern of electrocardiograms in young adults. 353 healthy young adults were evaluated by medical history, physical examination, and standard 12-lead electrocardiogram. The mean heart rate, QRS duration, PR interval, QT interval, corrected QT interval (QTc),T wave axis, P wave duration and amplitude were: 74 +/- 9 beats per min, 0.09 +/- 0.01s, 0.15 +/- 0.02 s, 0.36 +/- 0.02 s, 0.40 +/- 0.02 s, 54 +/- 20 degrees, 49 +/- 14 degrees, 0.09 +/- 0.01 s, 1.28 +/- 0.41 mm, respectively. The dominant electrocardiographic peculiarity among the participants was early repolarization which was characterized by male preponderance. This study defined baseline values for electrocardiographic variables in healthy young adults. Early repolarization is a common ECG feature in young adults.
Stroke, a major cause of morbidity and mortality, is on the increase and with increasing mortalit... more Stroke, a major cause of morbidity and mortality, is on the increase and with increasing mortality. Our retrospective review of all stroke admissions from 1990-2000 show that cerebrovascular disease accounted for 3.6% (293/8144) of all medical admissions; it has a case fatality rate of 45% with the majority (61%) occurring in the first week; the mean age of stroke deaths was 62 years (standard deviation+/-13); and severe as well as uncontrolled hypertension is the most important risk factor. Community-based programmes aimed at early detection and treatment of hypertension, in addition to screening for those with high risk factors, should be put in place.
Left ventricular hypertrophy (LVH) is a common pathophysiological consequence of hypertension. Va... more Left ventricular hypertrophy (LVH) is a common pathophysiological consequence of hypertension. Various voltage (ECG) criteria exist for evaluation of LVH. This study assessed the performance of 4 commonly used ECG criteria in south-western Nigeria. A cross-sectional descriptive study of adult hypertensive subjects. Participants were assessed for LVH using 4 ECG criteria: Sokolow-Lyon, Araoye code system, Cornell voltage, and Gubner-Ungerleider criteria. Echocardiography was used to determine the left ventricular mass index for the participants, and a value greater than 125 g/m(2) was used as the cut-off point for LVH. The sensitivity, specificity, accuracy, positive and negative predictive values were determined for each of the ECG criteria. 90 subjects (45 males, 45 females) participated in the study. The prevalence of LVH by echocardiography was 32.2%. The prevalence of LVH by voltage criteria were: 45.6%, 42.2%, 34.4%, 13.3% by Sokolow-Lyon, Araoye code system, Cornell, and Gubner-Ungerleider criteria, respectively. The sensitivity and specificity respectively of the ECG criteria were 58.62% and 60.66% (Sokolow-Lyon), 48.28% and 60.65% (Araoye code system), 51.72% and 73.77% (Cornell), and 13.79% and 86.89% (Gubner-Ungerleider). Out of the 4 ECG criteria, Araoye code system, Cornell and Sokolow-Lyon criteria compared favorably well with echocardiography and may be used in the initial assessment of LVH in adult hypertensive subjects. However, a combination of any of the 3 criteria with Gubner-Ungerleider criterion will be more clinically useful.
Death from tuberculosis (TB) is the longest recorded indicator of the TB epidemic in industrialis... more Death from tuberculosis (TB) is the longest recorded indicator of the TB epidemic in industrialised countries. This study aims at investigating into various factors associated with death in hospitalised patients with tuberculosis in Ile-Ife, Nigeria. A retrospective study of all admissions into the medical wards, total number of deaths and number of cases of deaths due to TB during the period 1998-2000 was done. Tuberculosis represented 8% (268) of all admissions (n=3464). The overall hospital mortality during the period under review was 1030 (30%). Tuberculosis was responsible for 5% of all deaths while TB specific mortality was 18.3 percent. The highest mortality was observed among patients between the 3rd and 4th decade of life with a male to female ratio 1.3: 1. About 70% of the patients died within a week of admission. Pulmonary TB was responsible for 69% of deaths followed by tuberculous meningitis (14%), retroviral illness (24%), anaemia (60%). Delayed presentation and diagnosis were identified as factors commonly associated with death rate. Delayed presentation and diagnosis were commonly associated with death. There is a need for more awareness among patients and health care providers about tuberculosis.
Assessment of cardiac autonomic function (CAF) is an important non-invasive investigation in medi... more Assessment of cardiac autonomic function (CAF) is an important non-invasive investigation in medical practice. This study aimed at assessing the effects of age and sex on autonomic cardiovascular indices. It was a cross-sectional descriptive study involving 204 apparently healthy adults between the ages of 18 and 40years who were residents of Obafemi Awolowo University community, Ile-Ife, Nigeria. Each of the participants performed five non-invasive cardiac autonomic function tests in series after excluding the systemic diseases by clinical evaluation. The five cardiac autonomic function tests were: Systolic Blood Pressure (SBP) response to change of posture (supine to erect), Diastolic Blood Pressure (DBP) response to sustained handgrip at 30% maximum voluntary contraction (MVC), Heart rate response to Valsalva maneouvre, Heart rate responses to Deep Breathing (HDB) and heart rate response to standing. The data obtained was analyzed with SPSS version17.0 software using descriptive statistics, correlation and Student t-test. A p value of < 0.05 was taken as statistically significant. Age was positively correlated with SBP response to posture, DBP response to sustained handgrip, Valsalva ratio and bradycardia ratio. Age was negatively correlated with tachycardia ratio, HDB, 30:15 ratio and resting heart rate. Significant gender difference was demonstrated in resting heart rate (t=-3.05, p = 0.003) and diastolic blood pressure response to sustained handgrip (t = 3.40, p=0.001).
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