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Soya E, N'Djessan JJ, Koffi F, Kouamé S, Gbassi C, Kee C, N'Za A, Konin C. [Vascular age and cardiovascular risk in hypertensive patients followed at the heart institute]. Ann Cardiol Angeiol (Paris) 2024; 73:101678. [PMID: 38070449 DOI: 10.1016/j.ancard.2023.101678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/20/2023] [Accepted: 09/26/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVE To calculate the vascular age of hypertensive patients and assess the risk at 10 years of occurrence of an absolute cardiovascular event in outpatient consultation of the Abidjan Heart Institute. PATIENTS AND METHODOLOGY Cross-sectional study with descriptive and analytical purposes from June 2021 to September 2021, i.e. 4 months in patients at least 30 years of age followed in the outpatient department for arterial hypertension without cardiovascular complications. Data were collected using a questionnaire. We considered the parameters established in the D'Agostino chart for the calculation of vascular age. Each parameter was weighted and the total points obtained corresponded to the vascular age. The cardiovascular risk at 10 years was also obtained from another abacus established by D'Agostino by cross-referencing the total points of each patient with pre-established data. RESULTS Three hundred hypertensive people were included in this study. The calendar average age was 62.0 ± 10 years with extremes of 30 and 95 years. The gender distribution showed female predominance and there was no significant difference in vascular age by sex. The mean vascular age of all patients was 73.4 ± 9.9 years. The mean difference between actual and vascular age was 11.4 years. Dyslipidemia (p = 0.0002), diabetes (p = 0.0004) and unstandardized BP (p = 0.0000) significantly influenced vascular age. There was no significant difference between smokers and non-smokers (p = 0.1349). All men had a greater than 30% risk of having a cardiovascular accident while women before the age of 35 had no risk. Over the age of 60, almost all patients (both men and women) had a greater than 30% risk of having a cardiovascular accident at 10 years. CONCLUSION The calculation of vascular age made it possible to assess arterial aging and calculate the probability at 10 years of occurrence of a cardiovascular event. This study also highlights the importance of cardiovascular risk and vascular age assessment for management adaptation and therapeutic education.
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Affiliation(s)
- E Soya
- Unités de soins intensifs cardiologiques, Institut de Cardiologie d'Abidjan
| | - J J N'Djessan
- Unités de soins intensifs cardiologiques, Institut de Cardiologie d'Abidjan.
| | - F Koffi
- Service de consultation de médecine, Institut de Cardiologie d'Abidjan
| | - S Kouamé
- Unités de soins intensifs cardiologiques, Institut de Cardiologie d'Abidjan
| | - C Gbassi
- Unités de soins intensifs cardiologiques, Institut de Cardiologie d'Abidjan
| | - C Kee
- Unités de soins intensifs cardiologiques, Institut de Cardiologie d'Abidjan
| | - A N'Za
- Unités de soins intensifs cardiologiques, Institut de Cardiologie d'Abidjan
| | - C Konin
- Unités de soins intensifs cardiologiques, Institut de Cardiologie d'Abidjan
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Ghimire K, Mishra SR, Satheesh G, Neupane D, Sharma A, Panda R, Kallestrup P, Mclachlan CS. Salt intake and salt-reduction strategies in South Asia: From evidence to action. J Clin Hypertens (Greenwich) 2021; 23:1815-1829. [PMID: 34498797 PMCID: PMC8678780 DOI: 10.1111/jch.14365] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/18/2021] [Accepted: 08/28/2021] [Indexed: 01/08/2023]
Abstract
The World Health Organization recommends salt reduction as a cost-effective intervention to prevent noncommunicable diseases. Salt-reduction interventions are best tailored to the local context, taking into consideration the varying baseline salt-intake levels, population's knowledge, attitude, and behaviors. Fundamental to reduction programs is the source of dietary salt-intake. In South Asian countries, there is a paucity of such baseline evidence around factors that contribute to community salt intake. Upon reviewing the electronic literature databases and government websites through March 31, 2021, we summarized dietary salt intake levels and aimed to identify major sources of sodium in the diet. Information on the current salt reduction strategies in eight South Asian countries were summarized, namely Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. One hundred twelve publications (out of identified 640) met our inclusion-exclusion criteria for full text review. Twenty-one studies were included in the review. Quality of the included studies was assessed using the US National Heart, Lung, and Blood Institute assessment tool. The primary result revealed that mean salt intake of South Asian countries was approximately twice (10 g/day) compared to WHO recommended intake (< 5 g/day). The significant proportion of salt intake is derived from salt additions during cooking and/or discretionary use at table. In most South Asian countries, there is limited data on population sodium intake based on 24-h urinary methods and sources of dietary salt in diet. While salt reduction initiatives have been proposed in these countries, they are yet to be fully implemented and evaluated. Proven salt reduction strategies in high-income countries could possibly be replicated in South Asian countries; however, further community-health promotion studies are necessary to test the effectiveness and scalability of those strategies in the local context.
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Affiliation(s)
- Kamal Ghimire
- Nepal Development SocietyBhratpur‐10ChitwanNepal
- School of HealthTorrens UniversitySydneyNew South WalesAustralia
| | - Shiva Raj Mishra
- Nepal Development SocietyBhratpur‐10ChitwanNepal
- World Heart FederationSalim Yusuf Emerging Leaders ProgrammeGenevaSwitzerland
| | - Gautam Satheesh
- The George Institute for Global HealthHyderabadTelanganaIndia
| | - Dinesh Neupane
- Welch Center for PreventionEpidemiology and Clinical ResearchDepartment of EpidemiologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Abhishek Sharma
- World Heart FederationSalim Yusuf Emerging Leaders ProgrammeGenevaSwitzerland
- Department of Global HealthBoston University School of Public HealthBostonMassachusettsUSA
- PRECISIONheorPrecision Value & HealthBostonMassachusettsUSA
| | - Rajmohan Panda
- Department of ResearchPublic Health Foundation of IndiaNew DelhiIndia
| | - Per Kallestrup
- Department of Public HealthCenter for Global HealthAarhus UniversityAarhusDenmark
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Akl C, Akik C, Ghattas H, Obermeyer CM. The cascade of care in managing hypertension in the Arab world: a systematic assessment of the evidence on awareness, treatment and control. BMC Public Health 2020; 20:835. [PMID: 32493255 PMCID: PMC7268748 DOI: 10.1186/s12889-020-08678-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 04/08/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Hypertension is a leading risk factor for mortality and morbidity globally and in the Arab world. We summarize the evidence on awareness, treatment, and control of hypertension, to assess the extent of gaps in the hypertension continuum of care. We also assess the influence of gender and other social determinants at each level of the cascade of care. METHODS We searched MEDLINE and SSCI databases for studies published between 2000 and 2017, reporting the rates of awareness, treatment or control of hypertension and/or their determinants in the Arab region. We included sources on both general populations and on clinical populations. The review process was based on the PRISMA guidelines. We present rates on the three stages of the care cascade corresponding to (1) awareness (2) treatment and (3) control of blood pressure, and estimated the losses that occur when moving from one stage to another. We also take stock of the evidence on social determinants and assess the statistical significance of gender differences in awareness, treatment and control. RESULTS Data from 73 articles were included. Substantial proportions of hypertensives were lost at each step of the hypertension care continuum, with more missed opportunities for care resulting from lack of awareness of hypertension and from uncontrolled blood pressure. More than 40% and 19% of all hypertensive individuals were found to be unaware and to have uncontrolled blood pressure, respectively, but among individuals diagnosed with hypertension, less than 21% were untreated. Awareness rates were higher among women than men but this advantage was not consistently translated into better blood pressure control rates among women. CONCLUSIONS This analysis of the cascade of care indicates that barriers to proper diagnosis and adequate control are greater than barriers to delivery of treatment, and discusses potential factors that may contribute to the gaps in delivery.
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Affiliation(s)
- Christelle Akl
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
| | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
| | - Carla Makhlouf Obermeyer
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
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El-Etriby AMK, Rakha S. Efficacy and safety of amlodipine/valsartan/hydrochlorothiazide single pill combination in Egyptian patients with hypertension uncontrolled on any dual therapy: an observational study. Curr Med Res Opin 2020; 36:537-544. [PMID: 31955630 DOI: 10.1080/03007995.2020.1719394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Hypertension is a serious health problem in Egypt, with prevalence rate of 17% as reported in 2015. Despite receiving treatment, many do not achieve blood pressure (BP) control. The current study aimed to evaluate the efficacy and tolerability of amlodipine/valsartan/hydrochlorothiazide (Aml/Val/HCTZ) single pill combination (SPC) in patients with hypertension from Egypt, who were uncontrolled on any dual therapy.Methods: In this prospective, open label, multicenter, 12-week observational, cohort study, two doses of Aml/Val/HCTZ (5/160/12.5 mg or 10/160/25 mg) SPC were used to evaluate mean change in BP after 12 weeks (primary endpoint). Safety assessments included presence and intensity of ankle edema and other adverse events (AEs).Results: Data were collected from 1080 patients who were treated according to the routine medical practice across 47 centers in Egypt. Significant reduction in systolic and diastolic BP (SBP/DBP) was observed from 165.5 ± 12.83/100.8 ± 7.03 mmHg at baseline to 129.7 ± 8.35/80.6 ± 5.25 mmHg after 12 weeks of treatment (p < .0001). Majority of patients (76.85%) reached the BP goal of <140/90 mmHg. The most commonly reported AE was ankle edema (10.92%).Conclusions: Aml/Val/HCT SPC significantly reduced BP and was well tolerated in Egyptian patients with hypertension not controlled on any previous dual therapy.
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Amaro-Alcalá JJ, Rosas-Avilés R, Marval-Ortiz JJ, Díaz-Espinoza L, Gómez-Mancebo JR, Rodríguez-Urbaneja F, Torres-Viera JM, López-Nouel R, López-Gómez LE, Alaeddine-Noueihed W, Martínez-Gutiérrez E, Durán-Castillo M, Acosta-Martínez J. [Arterial Hypertension register in private clinics in Venezuela: RHAVEN Study]. HIPERTENSION Y RIESGO VASCULAR 2019; 36:85-95. [PMID: 30342840 DOI: 10.1016/j.hipert.2018.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/20/2018] [Accepted: 08/24/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In Venezuela, no large studies have been conducted to determine the level of control of hypertension (HT). OBJECTIVE The primary objective was to know the prevalence of controlled HT among hypertensive patients treated pharmacologically. MATERIALS AND METHODS A cross-section study was conducted on patients 18years and older. RESULTS A total of 4,320 patients were included. The prevalence of controlled hypertension was 52.6% (95%CI: 51.1-54.1%). The lack of control of HT was associated with diabetes (P<.001), hypertensive heart disease (P<.001), chronic kidney disease (P<.001), and peripheral arterial disease (P=.02). Non-compliance of treatment was also associated with uncontrolled HT (5.1% [117/2,274] in the controlled versus 43.2% [885/2,046] in the uncontrolled; (P<.001). CONCLUSION The prevalence detected of controlled hypertension was 52.6%.
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Affiliation(s)
- J J Amaro-Alcalá
- Medicina Interna y Cardiología, Clínica Santa Sofía, Caracas, Distrito Capital, Venezuela.
| | | | | | - L Díaz-Espinoza
- Cardiología, Centro Clínico Santa Rosa, Cumaná, Sucre, Venezuela
| | | | - F Rodríguez-Urbaneja
- Cardiología, Centro Cardiológico Anzoátegui (CECANZ), Puerto La Cruz, Anzoátegui, Venezuela
| | - J M Torres-Viera
- Medicina Interna y Cardiología, Clínica Santa Sofía, Caracas, Distrito Capital, Venezuela
| | - R López-Nouel
- Cardiología, Centro Médico Docente La Trinidad, Caracas, Distrito Capital, Venezuela
| | - L E López-Gómez
- Medicina Interna y Cardiología, Clínica Santiago De León, Caracas, Distrito Capital, Venezuela
| | | | | | - M Durán-Castillo
- Medicina Interna, Clínica El Ávila, Caracas, Distrito Capital, Venezuela
| | - J Acosta-Martínez
- Cardiología, Policlínica Metropolitana, Caracas, Distrito Capital, Venezuela
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Ruilope LM, Chagas ACP, Brandão AA, Gómez-Berroterán R, Alcalá JJA, Paris JV, Cerda JJO. Hypertension in Latin America: Current perspectives on trends and characteristics. HIPERTENSION Y RIESGO VASCULAR 2016; 34:50-56. [PMID: 28007488 DOI: 10.1016/j.hipert.2016.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/28/2016] [Indexed: 12/13/2022]
Abstract
The region of Latin America, which includes Central America, the Caribbean and South America, is one that is rapidly developing. Signified by socio-economic growth, transition and development over the last few decades, living standards in countries like Brazil and Mexico have improved dramatically, including improvements in education and health care. An important marker of socio-economic change has been the epidemiological shift in disease burden. Cardiovascular disease is now the leading cause of death in Latin America, and the drop in prevalence of infectious diseases has been accompanied by a rise in non-communicable diseases. Hypertension is the major risk factor driving the cardiovascular disease continuum. In this article we aim to discuss the epidemiological and management trends and patterns in hypertension that may be specific or more common to Latin-American populations - what we term 'Latin American characteristics' of hypertension - via a review of the recent literature. Recognizing that there may be a specific profile of hypertension for Latin-American patients may help to improve their treatment, with the ultimate goal to reduce their cardiovascular risk. We focus somewhat on the countries of Brazil, Mexico and Venezuela, the experience of which may reflect other Latin American countries that currently have less published data regarding epidemiology and management practices.
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Affiliation(s)
- L M Ruilope
- "Cátedra UAM de Epidemiología y Control del Riesgo Cardiovascular", Universidad Autónoma de Madrid, Spain; Hypertension Unit, Institute of Research i+12: Hypertension and Cardiovascular Risk Group, Hospital Universitario 12 de Octubre & Department of Preventive Medicine and Public Health Universidad Autónoma de Madrid, Madrid, Spain.
| | - A C P Chagas
- Chief Cardiology Division, ABC Medical School, Av. Principe de Gales, 821, 09060-870 Santo André, SP, Brazil
| | - A A Brandão
- Department of Cardiology - Hypertension Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - R Gómez-Berroterán
- Social Security, Hospital Dr. Domingo Luciani, Rio de Janeiro av. Municipio Sucre, Caracas 1073, Venezuela
| | - J J A Alcalá
- "Hospital Dr. Domingo Luciani" - Institute Venezuelan of the Safe Social (IVSS), Caracas, Venezuela
| | - J V Paris
- Instituto Nacional de Cardiologia "Ignacio Chávez", Mexico City, Mexico
| | - J J O Cerda
- Research and Education General Director, Grupo Angeles Servicios de Salud, Mexico City, Mexico
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