Abiodun M. Adeoye, University of Ibadan, Nigeria
Bruce Ovbiagele, Medical University of South Carolina
Philip Kolo, University of Ilorin Teaching Hospital, Nigeria
Lambert Appiah, Komfo Anokye Teaching Hospital, Ghana
Akinyemi Aje, University College Hospital, Nigeria
Oladimeji Adebayo, University College Hospital, Nigeria
Fred Sarfo, Komfo Anokye Teaching Hospital, Ghana
Joshua Akinyemi, University of Ibadan, Nigeria
Gregory Adekunle, University of Ibadan, Nigeria
Francis Agyekum, University of Ghana, Ghana
Vincent Shidali, Ahmadu Bello University, Nigeria
Okechukwu Ogah, University College Hospital, Nigeria
Dan Lackland, Medical University of South Carolina
Mulugeta Gebregziabher, Medical University of South Carolina
Donna K. Arnett, University of KentuckyFollow
Hemant K. Tiwari, The University of Alabama at Birmingham
Rufus Akinyemi, Federal Medical Centre, Nigeria
Ojo Olakanmi Olagoke, University College Hospital, Nigeria
Ayodipupo Sikiru Oguntade, University College Hospital, Nigeria
Taiwo Olunuga, Federal Medical Centre, Nigeria
Kelechi Uwanruochi, Federal Medical Center, Nigeria
Carolyn Jenkins, Medical University of South Carolina
Patrick Adadey, University of Ghana, Ghana
Henry Iheonye, Ahmadu Bello University, Nigeria
Lukman Owolabi, Aminu Kano Teaching Hospital, Nigeria
Reginald Obiako, Ahmadu Bello University, Nigeria
Samuel Akinjopo, University College Hospital, Nigeria
Kevin Armstrong, Medical University of South Carolina
Albert Akpalu, University of Ghana, Ghana
Adekunle Fakunle, University of Ibadan, Nigeria



Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown.


We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study.


SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and LVH are being collected and compared using standard techniques.


This preliminary analysis included only 725 stroke patients (mean age 59.1 ± 13.2 years; 54.3% male). Fifty-five percent of the stroke subjects had LVH with greater proportion among women (51.6% vs. 48.4%; p < 0.001). Those with LVH were younger (57.9 ± 12.8 vs. 60.6 ± 13.4; p = 0.006) and had higher mean systolic and diastolic blood pressure (167.1/99.5 mm Hg vs 151.7/90.6 mm Hg; p < 0.001). Uncontrolled blood pressure at presentation was prevalent in subjects with LVH (76.2% vs. 57.7%; p < 0.001). Significant independent predictors of LVH were age <45 years (adjusted odds ratio [AOR]: 1.91; 95% confidence interval [CI]: 1.14 to 3.19), female sex (AOR: 2.01; 95% CI: 1.44 to 2.81), and diastolic blood pressure > 90 mm Hg (AOR: 2.10; 95% CI: 1.39 to 3.19; p < 0.001).


The prevalence of LVH was high among stroke patients especially the younger ones, suggesting a genetic component to LVH. Hypertension was a major modifiable risk factor for stroke as well as LVH. It is envisaged that the SIREN project will elucidate polygenic overlap (if present) between LVH and stroke among Africans, thereby defining the role of LVH as a putative intermediate cardiovascular phenotype and therapeutic target to inform interventions to reduce stroke risk in populations of African ancestry.

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Notes/Citation Information

Published in Global Heart, v. 12, issue 2, p. 107-113.e5.

© 2017 World Heart Federation (Geneva). Published by Elsevier Ltd. All rights reserved.

This manuscript version is made available under the CC‐BY‐NC‐ND 4.0 license

The document available for download is the authors’ post-peer-review final draft of the article. Its title is "Exploring Overlaps between the Genomic and Environmental Determinants of Left Ventricular Hypertrophy and Stroke among Africans."

Due to the large number of authors, only the first 30 and the authors affiliated with the University of Kentucky are listed in the author section above. For the complete list of authors, please download this article or visit:

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Funding Information

This work is supported by the National Institutes of Health (NIH) and National Institute of Neurological Disorders and Stroke (NINDS) (Grant 1U54HG007479).