Prevalence, Characteristics and Management of Hypertension in an Outpatient Clinic at the Cardiology Department in Lome (Togo)

This study was undertaken to evaluate epidemiology and management of hypertensive outpatients in the cardiology department of the Campus Teaching Hospital of Lome. Methods: We conducted a retrospective and descriptive study among 1100 hypertensive outpatients, carried out over a period of 5-years (January 1st, 2012 to December 31st, 2016). The data collected were epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of hypertension. Results: The prevalence of hypertension was 71.3 %. Sex ratio (female/male) was 1,7. Mean age was 53.7 ± 12.57 years. Hypertension was stage 1 in 50.9 %, stage 2 in 40.5 % and stage 3 in 8.6 %. Overall cardiovscaular risk was very high in 51.5 % and high in 30.4 %. The average vascular age was of 73.32 ± 10.37 years. Antihypertensive drugs were prescribed in 99.3 %. More than 62 % were receiving at least two antihypertensive drugs. The most common antihypertensive agents used were angiotensin-converting enzyme inhibitors (54.9 %) and diuretics (47.8 %). The most common and effective agents for monotherapy were calcium antagonists. When two or more drugs were used, renin-angiotensin system blockers and diuretics or calcium antagonists were most commonly used. Renin-angiotensin system blockers and calcium antagonists were the most efficient among the polytherapy regimens. Blood pressure control was achieved in 49,8 % of cases. Conclusion: High blood pressure had been very frequent in our series. Overall cardiovascular risk is very high and high. Treatment required at least two antihypertensive drugs to meet the recommended blood pressure target.

Particularites de la cardiomyopathie du peripartum en Afrique: le cas du Togo sur une etude prospective de 41 cas au Centre Hospitalier et Universitaire Sylvanus Olympio de Lome

Introduction: La cardiomyopathie du peripartum (CMPP) est une defaillance cardiaque dont l'etiologie demeure encore meconnue. Methodes: Il s'agit d'une etude prospective descriptive realisee dans le service de cardiologie du CHU Sylvanus olympio de Lome du 1er janvier 2010 au 30 avril 2012. Elle a concerne 41 patientes ayant presente une insuffisance cardiaque entre le 8eme mois de la grossesse et les 5 premiers mois du post-partum. Resultats: L'age moyen des patientes etait de 31;47 ans (extremes 21 et 44ans). L'incidence de la CMPP etait de 1/362 grossesses. La parite moyenne etait de 3;07 (extremes 1 et 6). Les symptomes etaient apparus dans le post-partum dans 90;24 des cas. Un retard important de diagnostic etait observe. L'insuffisance cardiaque globale etait le mode de decompensation dans 65;85. Les signes electrocardiographiques etaient essentiellement la tachycardie sinusale (97;56) et l'hypertrophie ventriculaire gauche (97;56). L'echographie cardiaque a montre dans tous les cas une cardiomyopathie dilatee. Quatre cas de thrombus intraventriculaire gauche etaient notes. La FEVG etait severement alteree. L'HTAP etait importante dans 56;09. Conclusion: La cardiomyopathie du peripartum est une complication cardiaque grave de la grossesse de cause inconnue; frequente dans la population africaine