Ngongang Ouankou C, Chendjou Kapi L O, Azabji Kenfack M, Nansseu J R, Mfeukeu-Kuate L, Ouankou M D, Kowo M, Magny Thiam E, Kagmeni G, Kaze F J, Ngu Blackett K
Centre hospitalier et universitaire de Yaoundé, Cameroun; Faculté de médecine et de sciences biomédicales, université de Yaoundé I, Cameroun.
Centre hospitalier et universitaire de Yaoundé, Cameroun; Institut supérieur des sciences de la santé, université des Montagnes, Bangangté, Cameroun.
Ann Cardiol Angeiol (Paris). 2019 Oct;68(4):241-248. doi: 10.1016/j.ancard.2019.07.014. Epub 2019 Aug 27.
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.
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.
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.
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.
高血压是一个全球性的公共卫生问题。在黑人种族中可能尤为严重。喀麦隆最近的研究显示出惊人的患病率，这促使我们想要研究雅温得近期诊断出的重度高血压（血压高达180/110mmHg）的流行病学、临床、治疗和评估方面。我们的目的是确定其临床表现和病情发展。
我们于2016年1月至9月进行了为期九个月的前瞻性队列研究。我们从雅温得各地主动接受血压筛查的人群中招募年龄在18岁及以上的参与者。
在总共6519名参与筛查的人中，1875人（28.8%）患有高血压，363人（5.6%）患有重度高血压。我们的队列包括153名（42.1%）持续重度高血压且未接受药物治疗的个体，他们接受邀请参与了研究。年龄在45 - 54岁和55 - 64岁的人数最多；性别比为0.9。心血管危险因素数量范围为5至8个，中位数为6个。收缩压范围为184至225mmHg，中位数为200mmHg；舒张压范围在111 - 132.5mmHg之间，中位数为119mmHg。肾脏损伤（77.8%）是主要并发症。我们确定了3种临床类型：高血压急症121例（79.1%）和高血压危象32例（20.9%）。在这两组中，33例（21.6%）患者出现“超高血压”（血压>250/150mmHg）。6个月内血压控制的平均率为39%。血压控制不佳的主要原因是治疗依从性差。在随访的第3个月，我们记录了1例因急性肾损伤导致的死亡。
在雅温得，受潜在影响的活跃人群中重度高血压患病率很高。特别是，未被怀疑的肾功能损害似乎是主要并发症。血压控制不佳与治疗依从性和持续性差有关。
