Impact of Carotid atheroma on cardiovascular risk in Mauritanian hypertensive patients.

AIM: To determine the prevalence of carotid atheroma in hypertensive patients and assess the levels of cardiovascular risk. METHODS: This is a prospective study that took place in the outpatient department of the National Cardiology Center of Nouakchott over a period of 6 months (October 2019 to March 2020). Patients with hypertension without complications were included. Patients lost to followup and those whose records were incomplete were excluded from the study. RESULTS: Out of a total of 171 patients, a total of 93 patients (54.38%) was collected, of which 54.8% were women, 55.9% of the patients in the series were over 50 years old.The associated cardiovascular risk factors were dominated by dyslipidemia (27.9%), diabetes (20.4%), smoking (26.8%). hypertension was grade 2 in 47.3% of patients and grade 3 in 52.7% of patients. Left ventricular hypertrophy was noted in 77.4% of patients. Echo-Doppler of the supra-aortic trunks revealed atherosclerotic plaques in 63.4% of patients. CONCLUSION: The prevalence of carotid atheroma in hypertensive patients at high cardiovascular risk level was frequent in our series, it follows from this to recommend early detection for optimal management.

Quality of management of acute coronary syndrome at the Nouakchott National Heart Center (Mauritania).

INTRODUCTION: Acute Coronary Syndrome (ACS) is a diagnostic and therapeutic emergency whose management is standardized by multiple learned societies. AIM: To describe the quality of the management of the SCA at the National Heart Center (CNC) in Nouakchott, Mauritania. METHODS: This is a cross-sectional study of patients admitted to SCA at the Nouakchott CNC between July 31 and December 16, 2017. RESULTS: A total of 80 patients, were enrolled in this study (hospital prevalence: 10.6%). Males were predominant (sex ratio: 2.3) and mean age was 62.5±10.6. Only one fourth of patients had health insurance coverage. Medical transportation by ambulance were provided only for 29% of patients. Typical chest pain was the most frequent reason for consultation (83.8% of cases) and the average admission time was 34.83±11.87 hours. Almost two thirds of patients (68%) had an ST segment-elevation myocardial infarction. Of those patients, only 23 were managed within-12 hours of chest pain onset; reperfusion treatment was attempted by primary Percutaneous Coronary Intervention (PCI) in only one case and thrombolysis in 22 (28%) others and was success in 81% of cases. All ACS-patients received antithrombotic drugs as recommended by the local protocol and 55 (69%) patients underwent a coronary angiography that revealed 58.2% mono-truncular, 18.2% bi-truncular and 14.5% tri-truncular lesions, supporting the indication for PCI in 31 patients, Coronary artery bypass graft in 6 patients and medical therapy in the remaining patients. During the hospital course, complications were observed in 22.5% patients with a total mortality of 3.8%. CONCLUSION: Management of ACS at the Mauritanian CNC could be optimized by the implementation of a pre-hospital care chain based on easy access to first-line facilities, efficient transportation system and early coronary revascularization.

Epidemiological, clinical and progressive aspects of arterial hypertension in older patients in Nouakchott (Mauritania).

OBJECTIVE: To describe the epidemiological and clinical profile of hypertensives aged 60 years and over followed outpatient, at the National Heart Center of Nouakchott (CNC) in Mauritania. METHOD: This is a descriptive, cross-sectional study conducted from February to July 2016, including elderly hypertensive patients, followed on an outpatient basis at the CNC. RESULTS: We had 150 patients representing 12.6% of the CNC's consultants, 101 of whom were included in the study. The mean age was 67.3 ± 5.78, and the sex ratio was 1.02. Systol-diastolic hypertension was predominant (69.3%). Three main cardiovascular risk factors were more frequently associated: sedentary lifestyle (59%), obesity or overweight (58%) and hypercholesterolemia (52%). The average number of cumulative risk factors was 3.4. Overall cardiovascular risk was high in 70.3% of patients. The symptomatology was dominated by headache (51.4%). Cardiac involvement was the most common complication (49%) with a predominance of left ventricular hypertrophy (18.8%). Renal involvement and stroke (exclusively ischemic) were reported in 24.8% and 12.9% of cases, respectively. Therapeutically, the most frequently used molecules were calcium channel blockers in monotherapy and the combination of calcium channel blockers and the conversion enzyme, in dual therapy. CONCLUSION: In Mauritania, the elderly hypertensive patient presented multiple cardiovascular risk factors and cardiac complications. The decentralization of its care to the front-line health structures would be essential for a more rational management of the arterial hypertension of the elderly subject.