[Distribution of cardiovascular risk factors in coronary patients in Sahel Tunisia]

We evaluated cardiovascular risk factors and their association in patients in Sahel, hospitalized for coronary disease over the period 1994-1998. The clinical features of 3455 patients [72.4% men, 1741 with myocardial infarction, 1714 with unstable angina] were analysed on hospital admission. The prevalence of smoking, dyslipidaemia, hypertension, diabetes and obesity was 77.4%, 39.4%, 28.5%, 42.5% and 25.1% respectively in men and 2.9%, 43.7%, 59.2%, 56.6% and 31.9% respectively in women. With this risk factor profile a national strategy of primary prevention and heart health promotion is needed in Tunisia

[Balloon mitral commissurotomy in patients aged 60 years and more]

Of 745 patients treated by balloon mitral commissurotomy [BMC] between February 1988 and December 2002, 45 were over 60 years old. Immediate and late outcomes in this group [group 1] were compared with those in the patients aged under 60 years [group 2]. Baseline hemodynamic parameters were comparable in the two groups. Mitral surface area and hemodynamic parameters improved significantly after BMC in group 1: mean left atrial pressure fell from 18.76 +/- 6.18 to 10.65 +/- 4.38 mm Hg [p<0.001], mean transmitral gradient from 11.03 +/- 4.70 to 4.63 +/- 2.05 mm Hg [p< 0.001] and mitral valve area from 0.99 +/- 0.22 to 1.88 +/- 0.41 cm 2 [p< 0.001]. Similar significant improvements were seen in group 2. The hemodynamic result was good in 69% of group 1 patients. Tamponade occurred in one patient. Mitral regurgitation grade I or II developed in 8 patients and remained stable in 13 patients. These complication rates were comparable to those seen in group 2. In the group 1, a good result was maintained in 60% of patients after 43 +/- 23 months of follow-up. Although restenosis was observed in 40% of patients, functional amelioration was obtained in most of cases. In the group 2, restenosis was observed in 25% of patients. The data from this study suggest that BMC is effective first therapy in patients aged >/= 60 years with symptomatic mitral stenosis