C76. SEVERE HIGH BLOOD PRESSURE RECENTLY DIAGNOSED IN AN URBAN MILIEU FROM SUB-SAHELIAN AFRICA: EPIDEMIOLOGIC, CLINICAL, THERAPEUTIC AND EVOLUTIONARY ASPECTS
Ngongang OC1, Chendjou KLO3, Azabji KM2, Kuate-Mfeukeu L2, Bitchou M1, Tsambang L1, Wandji J1, Nganou CN2, Hamadou1, Djomou NAF3, Boombhi J2,Jonte P1, Tachim K1, Essono A1, Nchouat SI2, Tsamo C2, Kaze FJ1, Ouankou MD1, Kingue S2, Ngu BK2
Authors’ affiliations:
1 University Teaching Center of Yaounde
2 University of Yaounde I - Faculty of Medicine and Biomedical Sciences
3 Université Des Montagnes : Institut Supérieur des Sciences de la Santé (ISSS)
Background: 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 ≥ 180/110 mm Hg), recently diagnosed HBP in Yaoundé.
Objectives: Our objective was to determine its clinical presentation and evolution.
Methods and results: We conducted nine months prospective cohort study, from January to September 2016. We recruited from the active population participants who voluntary accepted blood pressure screening offered in various localities in Yaounde, and were aged from 18 years and above. Of a total of 6.519 people who participated in the screening, 1.875 (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 225 mmHg with a median of 200 mmHg; while the diastolic BP ranged between 111-132.5 mmHg with a median of 119 mmHg. Kidney injury (77.8%) was the main complication. 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 > 250/150 mmHg). 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.
Key words: severe high blood pressure, prevalence in the active population, complication, therapeutic observance