Registry of the Egyptian specialized hypertension clinics: Sex-related differences in clinical characteristics and hypertension management among low socioeconomic hypertensive patients.

Hypertension is a major modifiable risk factor for cardiovascular disease (CVD) which is a leading cause of death in developing countries affecting both genders. Gender dissimilarity in clinical characteristics and hypertension (HTN) management among hypertensive patients has been reported in several reports before. The aim was to detect sex differences in clinical characteristics and HTN management among Egyptian hypertensive patients. Data from 4701 hypertensive patients attending 9 university located Specialized Hypertension clinic (SHC) were collected from October 2014 to September 2017. The collected data included demographics, cardiovascular risk profile, hypertension-related history, anthropometric and blood pressure (BP) measurements, antihypertensive medications used, number of patients attending the follow-up visits, and HTN control rate. Females represented 58.5% of the recruited patients, they were younger, with higher BMI, lower education level, and employment rate compared with males. Females had lower mean office systolic and diastolic BP than males (144.2 ± 22.6 vs. 146.5 ± 22.0 mmHg and 88.1 ± 13.0 vs. 89.9 ± 12.6 mmHg, respectively) and lower rate of uncontrolled BP (54.8% vs. 61.1% in males P < .001). Antihypertensive drugs were comparable among both sexes except for angiotensin converting enzyme inhibitors which were more prescribed in males. Compliance to antihypertensive medications was better in females (63.6% vs. 60.1% in males, P = .015). To conclude, Egyptian hypertensive females have different clinical characteristics as compared to their counterpart males with better BP control, adherence to antihypertensive medications, lower systolic and diastolic BP, and no major differences in the prescribed antihypertensive distribution.

Registry of the Egyptian specialized hypertension clinics: patient risk profiles and geographical differences.

Data regarding the prevalence and characteristics of cardiovascular (CV) risk factors among Egyptian hypertensive patients are limited. Nationwide Specialized Hypertension Clinics (SHCs) were initiated for screening, investigating, and treating hypertensive patients. This study aimed to determine the clinical characteristics and the CV risk profile of hypertensive Egyptians attending SHCs. Data from 4701 hypertensive patients were collected from the SHCs of nine university hospitals representing the different geographical regions of Egypt. Data collection started in October 2014 and ended in September 2017. Data included blood pressure (BP) measurements, clinical data, socio-demographic characteristics, anthropometric measurements, and cardiovascular risk profiles. The patients' mean age was 51.8 ± 11.5 years, 58.7% were older than 50 years, and 58.5% were females. The mean office systolic and diastolic BP values were 145.2 ± 22.4 and 88.7 ± 12.9 mmHg, respectively. Regarding CV risk factors, 58.6% were obese, 23.4% were smokers, and 25.1% had diabetes mellitus. Obesity was more prevalent in females than males (65.7% vs. 53.0%, p < 0.001, respectively), while dyslipidaemia and smoking were significantly more common in male patients. The highest levels of BP and the highest global risk were observed in the inhabitants of the Delta region, despite their younger age. In conclusion, this study revealed a high prevalence of modifiable CV risk factors among a cohort of Egyptian hypertensive patients attending SHCs. The pattern of the risk factors across the different geographic regions may be attributed to rapid urbanization. Governmental and community-based approaches are needed for better control of hypertension and its associated CV risk factors.

Adult congenital heart disease registry at Cairo University: a report of the first 100 patients.

AIMS: To establish a clinical registry for adult patients with congenital heart disease (CHD) managed in Cairo University Hospitals, aiming at description of the pattern and clinical profile of such patients. METHODS: Patients were recruited from both Cardiovascular Medicine Department Outpatient Clinic and inpatient wards of Cairo University Hospitals. Clinical data were collected from hospital records and directly from patients by treating cardiologists. Collected data were then registered in a dedicated database system and subsequently analyzed. RESULTS: Patients (49% males) ranged in age from 16 to 63 years, with a median of 25 years. Fifty-one patients were in the age-group from 20 to 30 years, with only 9% aged 50 years or older. Seventy-eight patients had acyanotic lesions, with atrial septal defect being the most common primary diagnosis (20% of total lesions). The remaining 22 patients had cyanotic heart disease, with tetralogy of Fallot being the predominant diagnosis (45% of cyanotic lesions). Six patients presented with infective endocarditis in the setting of CHD. Four women (8% of females) presented during pregnancy. Forty-six patients were sent for surgical correction/repair, while percutaneous intervention was planned in 20 patients. CONCLUSIONS: A new registry of adult patients with CHD managed in Cairo University Hospitals provides useful information, including the extent to which congenital heart defects are underdiagnosed and undertreated during infancy and childhood. In addition, those who were previously treated early in life require long-term follow-up in specialized centers. Establishment of a multidisciplinary team with expert physicians (cardiologists, dentists, obstetricians, and psychiatrists), cardiac surgeons, and nurses may be facilitated by development of a dedicated database system. Continuous financial support is a major challenge.

The association between extracoronary calcification and coronary artery disease in patients with type 2 diabetes mellitus.

Cardiovascular complications are the major cause of diabetes-associated morbidity and mortality. However, not all patients with diabetes are at increased risk for cardiovascular disease (CVD). Coronary artery calcification was found to be a powerful predictor of coronary artery disease (CAD). The presence of extracoronary cardiac calcification as a useful predictor of CAD is not yet established, especially in type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the relation between extracoronary calcification and extent of CAD in a group of T2DM patients who were scheduled for computed tomographic coronary angiography (CTCA). We prospectively studied 380 patients (151 had T2DM) under the age of 60 years who were scheduled for CTCA because of suspected CAD. Severity of CAD was assessed by Gensini score. Coronary artery calcium score (CACS) as well as calcium score in the aortic valve, mitral annulus, ascending aorta, and descending aorta were measured by a 256-row multidetector computed tomography scanner with dedicated software for calcium calculation. Patients with known CAD were excluded. Diabetic and nondiabetic patients had comparable age and gender distribution. However, the diabetic group had higher Gensini score, CACS, and extracoronary calcium score (ECCS). Logistic regression analyses identified male gender and ECCS as significant predictors for the presence of CAD in diabetic patients. Age, smoking, and ECCS were the significant predictors of CAD in nondiabetic patients. Type 2 diabetic patients had increased coronary and extracoronary calcification. ECCS was found to be a significant predictor of CAD in diabetic and nondiabetic patients only when CACS was not taken into account.