Complications of hypertension in adult urban Liberians.

A one-year prospective study of the complications of hypertension was carried out in the Medical Wards of the John F. Kennedy Hospital in Monrovia, Liberia. Of all medical admissions 15.6% (105 out of 672) were due to hypertension with its complications. Of the hypertensives, 72.4% (76 of 105) came from the lower socio-economic class. Heart disease with 55.2% (58 of 105) was the commonest complication. Next was stroke with 31.4% (33 of 105). Of the cases of heart disease, only one had suffered a myocardial infarction, the rest had congestive cardiac failure (CCF) without coronary heart disease. Severe hypertensive retinopathy was found in only four patients all of whom had severe uraemia. Hypertensive CCF constituted 41.1% (57 of 139) of all cases of CCF admitted to our hospital. All the complications and deaths were more common in males than in females and they were not uncommon in the young. Chronic renal failure, with 100% mortality, had the worst prognosis. 60.0% of the patients had not previously been diagnosed as hypertensive. There is an urgent need for health education in Liberia to inform the people of the dangers of uncontrolled hypertension and to encourage them to get their blood pressure measured periodically thus improving the early detection and initiation of antihypertensive treatment to prevent the complications of hypertension.