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Ngongang Ouankou C, Chendjou Kapi L, Mfeukeu-Kuate L, Siméni Njonnou S, Menanga A, Choukem S. Super hypertension or very severe hypertension in a sub-Saharan country: Epidemiological, clinical, therapeutical and evolutive patterns. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Diop IB, Balde D, Cavagna P, Adoubi A, Ikama MS, Suliman A, Hounkponou M, Empana JP, Camara Y, Mfeukeu-Kuate L, Toure C, Kabore H, Lubenga Y, Jouven X, Kingue S. Detection and characteristics of hypertension patients admitted in 37 cardiology departments from 17 Sub-Saharan African countries. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
High blood pressure (BP) is a major risk factor for several common cardiovascular (CV) disease such as stroke, heart failure or chronic kidney disease. The Sub-Saharan Africa (SSA) should face the highest rate of hypertension worldwide with an overall prevalence estimation of 46%. Due to scarce resources and inadequate healthcare provision, SSA have scarce hard data on treatment and control of high BP.
Purpose
To assess the detection and characteristics of hypertension patients admitted in hospitalizations 17 SSA countries
Methods
We conducted a transversal and longitudinal study in CV department of 37 hospitals from 23 cities in 17 SSA countries (10 low income: Niger, Guinea, Benin, Mali, Democratic Republic of the Congo, Tchad, Burkina Faso, Togo, Burundi, Ethiopia and 7 middle income: Cote d'Ivoire, Senegal, Cameroon, Congo, Soudan, Mauritania, Gabon). The February study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all inpatients in February from each year since 2016. Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians. Hypertension and severity of hypertension were defined according to 2018 ESC/ESH guidelines and BP was measured twice using standardized method. All analyses were performed through scripts developed in the R software (4.0.3 (2020-10-10))
Results
The study involved 4360 patients. Hypertension was measured on 1906 (43.7%) patients at admission. Proportion of patients with high BP in hospital increased from 42.2% in 2016 to 52.2% in 2021 (p<0.05) and differed significantly across countries from 77.6% in Niger to 100% in Chad. Among hypertensive patients, men represented 59.6% of patients and mean of age was 59±15.1 years. Overall, 61.4% of patients were from low income countries. The mains causes of admission among hypertensive patients were heart failure (37.8%) and stroke (18.9%). Average of systolic BP was 159±29.3 mmHg and average of diastolic BP was 96.7±16mmHg. Overall, 760 (40.3%), 525 (27.8%) and 602 (31.9%) had grade 1, grade 2 and grade 3 hypertension respectively. History of CV disease was observed in 51.5% of patients. Thus, 70.4% of patients had at least one CV risk factor other than hypertension. Angiotensin converting enzyme inhibitors and diuretics was prescribed in 56.9% and 55.8% of patients respectively. The average amount of antihypertensive drugs prescribed in hospital was 2.09±1.18. Overall, 237 (12.4%), 295 (15.5%), 640 (33.6%) and 734 (38.5%) received respectively no drug, monotherapy, two-drug strategies and three and more drug strategies.
Conclusion
In patients admitted in cardiology departments, hypertension is a huge burden in SSA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- I B Diop
- Fann Universitary Hospital , Dakar , Senegal
| | - D Balde
- University Hospital of Conakry, Cardiology , Conakry , Guinea
| | - P Cavagna
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
| | - A Adoubi
- University Hospital of Bouake, Cardiology , Bouake , Côte d'Ivoire
| | - M S Ikama
- National University Hospital of Brazzaville, Marien Ngouabi University , Brazzaville , Congo
| | - A Suliman
- Shaab Teaching Hospital, Cardiology , Khartoum , Sudan
| | - M Hounkponou
- National University hospital of Hubert K. MAGA (CNHU-HKM) , Cotonou , Benin
| | - J P Empana
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - Y Camara
- University Hospital of Kati , Bamako , Mali
| | | | - C Toure
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | - H Kabore
- Paul VI Medical Center , Ouagadougou , Burkina Faso
| | - Y Lubenga
- University Clinic of Kinshasa , Kinshasa , Congo (Democratic Republic of the)
| | - X Jouven
- European Georges Pompidou Hospital, AP-HP Centre, University of Paris , Paris , France
| | - S Kingue
- University of Yaoundé, Ministry of Public Health , Yaounde , Cameroon
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Ngongang Ouankou C, Chendjou Kapi LO, Azabji Kenfack M, Nansseu JR, Mfeukeu-Kuate L, Ouankou MD, Kowo M, Magny Thiam E, Kagmeni G, Kaze FJ, Ngu Blackett K. [Severe high blood pressure recently diagnosed in an urban milieu from Subsahelian Africa: Epidemiologic, clinical, therapeutic and evolutionary aspects]. Ann Cardiol Angeiol (Paris) 2019; 68:241-248. [PMID: 31471040 DOI: 10.1016/j.ancard.2019.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/28/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES High Blood Pressure (HBP) is a worldwide public health problem. It can be particularly severe in the Black race. Recent studies in Cameroon, showed an alarming prevalence, leading us to want to study the epidemiological, clinical, therapeutic and evaluative aspects of severe, (BP op to 180/110mmHg), recently diagnosed HBP in Yaounde. Our objective was to determine its clinical presentation and evolution. METHODS We conducted nine months prospective cohort study, from January to September 2016. We recruited from the active population participants who voluntarily accepted blood pressure screening offered in various localities in Yaounde, and were aged from 18 years and above. RESULTS Of a total of 6519 people who participated in the screening, 1875 (28.8%.), presented a HBP and 363 (5.6%) had severe HBP. Our cohort comprised 153 (42.1%) of these individuals with sustained severe hypertension, not on medication, who accepted the invitation to participate in the study. The range of 45-54 years and 55-64 years were the most represented; the sex ratio was 0.9. The cardiovascular risk factors number range from 5 to 8 with a median of 6. Systolic BP ranged from 184 to 225mmHg with a median of 200mmHg; while the diastolic BP ranged between 111-132.5mmHg with a median of 119mmHg. Kidney injury (77.8%) was the main complications. We identified 3 clinical forms: hypertensive emergencies 121 (79.1%) cases and hypertensive crises 32 (20.9%) cases. In these two groups, 33 (21.6%) patients presented with "super HBP" (a blood pressure>250/150mmHg). The average rate of BP control over 6 month was 39%. The main cause of poor BP control was lack of therapeutic compliance. We registered one death at the 3rd month of follow up due to acute kidney injury. CONCLUSION Severe HBP prevalence in Yaounde is high in the active fraction of the population insidiously affected. Particularly, unsuspected renal impairment appears to be the major complication. The bad blood pressure control is linked to poor therapeutic observance and persistence.
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Affiliation(s)
- C Ngongang Ouankou
- Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
| | - L O Chendjou Kapi
- Centre hospitalier et universitaire de Yaoundé, Cameroun; Institut supérieur des sciences de la santé, université des Montagnes, Bangangté, Cameroun.
| | - M Azabji Kenfack
- Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
| | - J R Nansseu
- Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun; Direction de la lutte contre la maladie, les épidémies et les pandémies, Yaoundé, Cameroun.
| | - L Mfeukeu-Kuate
- Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun; Centre cardiologique et médical, Yaoundé, Cameroun.
| | - M D Ouankou
- Centre cardiologique et médical, Yaoundé, Cameroun.
| | - M Kowo
- Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
| | - E Magny Thiam
- Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
| | - G Kagmeni
- Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
| | - F J Kaze
- Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
| | - K Ngu Blackett
- Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
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Adoubi K, Kane A, Coulibaly I, Tamdja AD, Mfeukeu-Kuate L, Houenassi D, Mbaye A, Niakara A, Kouakam C, Fauchier L. The atrial fibrillation registry in countries of Africa: Rationale and design of Africa. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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