[Severe high blood pressure recently diagnosed in an urban milieu from Subsahelian Africa: Epidemiologic, clinical, therapeutic and evolutionary aspects].

Autor: Ngongang Ouankou C; Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun. Electronic address: ngongang@yahoo.com., Chendjou Kapi LO; Centre hospitalier et universitaire de Yaoundé, Cameroun; Institut supérieur des sciences de la santé, université des Montagnes, Bangangté, Cameroun. Electronic address: leana.kapi@yahoo.fr., Azabji Kenfack M; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun. Electronic address: azabji@gmail.com., Nansseu JR; 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. Electronic address: jobert_nanssesseu@yahoo.fr., Mfeukeu-Kuate L; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun; Centre cardiologique et médical, Yaoundé, Cameroun. Electronic address: mfeukeuliliane@gmail.com., Ouankou MD; Centre cardiologique et médical, Yaoundé, Cameroun. Electronic address: ccmouankou@yahoo.com., Kowo M; Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun. Electronic address: kowomathurinp@yahoo.fr., Magny Thiam E; Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun. Electronic address: magnymd@yahoo.fr., Kagmeni G; Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun. Electronic address: kagmenigiles@yahoo.fr., Kaze FJ; Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun. Electronic address: f_kaze@yahoo.fr., Ngu Blackett K; Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun. Electronic address: kbngu@yahoo.co.uk.
Jazyk: francouzština
Zdroj: Annales de cardiologie et d'angeiologie [Ann Cardiol Angeiol (Paris)] 2019 Oct; Vol. 68 (4), pp. 241-248. Date of Electronic Publication: 2019 Aug 27.
DOI: 10.1016/j.ancard.2019.07.014
Abstrakt: 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.
(Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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