[Left ventricular hypertrophy in hypertensive African blacks: echocardiographic study of 452 patients]. / L'hypertrophie ventriculaire gauche du Noir Africain hypertendu: étude échocardiographique chez 452 sujets.

OBJECTIVE: The aim of this study was to define in a population of hypertensive Black African, the frequency of left ventricular hypertrophy (LVH), the different kind of LVH, and the factors of LVH occurring. METHODS: Clinical and echographic (according to Penn convention) data was collected in 452 consecutive hypertensive patients (193 women and 259 men). LVH was defined as an indexed left ventricular mass (ILVM) > 134 g/m2 in man and 110 g/m2 in woman. RESULTS: The mean systolic blood pressure was 187 mmHg, and the mean diastolic, 111 mmHg. The mean ILVM was 135.25 g/m2. LVH was present in 53.3% of the patients. Concentric LVH represented 48.5%, eccentric LVH 41.1%, and asymmetric hypertrophy of the septum, 10.4%. LVH increased with patient's age (p = 0.008), hypertension severity (p = 0.0001), and the ancientness of the hypertension (p = 0.0001). CONCLUSION: LVH is frequent in hypertensive black African, and concentric LVH is the most frequent kind of LVH. Factors of LVH occurring are patient's age, severity and the ancientness of the hypertension.

[Efficacy of cibenzoline in a case of atrial fibrillation due to cardiac thyrotoxicosis]. / Efficacité de la cibenzoline dans un cas de fibrillation auriculaire sur cardiothyréose.

The authors report a case of reduction of thyrotoxicosis-related atrial fibrillation by cibenzoline. The initial clinical features of heart failure rapidly resolved and the echocardiographic left ventricular shortening fraction returned to normal. Cibenzoline could be used as antiarrhythmic treatment in atrial fibrillation related to thyrotoxicosis.

[Arterial hypertension and diabetes in Ouagadougou (Burkina Faso)]. / Hypertension artérielle et diabète à Ouagadougou (Burkina Faso).

We report a 3 year survey concerning diabetes associated with hypertension in 260 diabetic patients at Ouagadougou. This association has been found in 29% of the cases. The patients were male subjects for 57% of them and seventy one more 50 years old. Other vascular risk factors have been observed: obesity (53%), smoking (15%), hyperuricemia (23%). Hypercholesterolemia and hypertriglyceridemia were observed respectively in 1% and 1.3% of the cases. Many complications arised during the survey: retinopathy in 51% of the patients, nephropathy for 35% and 12% with renal failure, macroangiopathy in 55% of the patients. The treatment was based on diuretics and calcic inhibitors. The results on the control of blood pressure were excellent but the high cost of this management is an important restrictive factor.

Epidemiological profile of hypertensive disease and renal risk factors in black Africa.

OBJECTIVE: To describe the characteristics and renal function of hypertensive patients at their first hospital admission in Sub-Saharan Africa. DESIGN: Retrospective study of all hypertensive patients. SETTING: Department of Cardiology and Internal Medicine of Yalgado Ouedraogo National Hospital in Burkina Faso, a country in Sub-Saharan Africa. PATIENTS: Three hundred and seventeen consecutive hypertensive patients (systolic blood pressure > or = 160 mmHg or diastolic blood pressure > or = 90 mmHg, or both, or patients receiving antihypertensive treatment) referred between 1 November 1988 and 31 October 1990. RESULTS: The hypertensive patients accounted for 36.5% of admissions and included 198 males and 119 females (mean +/- SD age 49 +/- 14 years). Two-thirds of the patients belonged to the poorer socio-economic groups. Hospital admission was necessary because of the symptoms and complications of hypertension: 43% had diastolic blood pressure > 130 mmHg, 73.5% had at least one target organ affected and 38.2% had renal involvement in the form of chronic renal failure or as proteinuria > 1.5 g/24 h. Patients with renal involvement were younger and had blood pressure that responded less well to acute treatment. One-fifth of the patients died during their hospital stay, and most of these had impaired renal function.

[Renal insufficiency in arterial hypertension in black Africa]. / Insuffisance rénale au cours de l'hypertension artérielle en Afrique noire.

OBJECTIVES: The increased risk of renal disease due to high blood pressure observed in Black Americans would suggest ethnic factors are involved. We examined the clinical features of renal disease in patients hospitalized in Ouagadougou, Burkina Faso for high blood pressure to determine the risk factors in this black population. METHODS: From November 1988 to October 1990, 317 patients (mean age 49 +/- 14 years, 62.5% males) under treatment for high blood pressure or with a diastolic pressure > 90 mmHg without antihypertensive therapy were examined at their initial hospitalization. The patients were divided into socio-economic groups according to their professional occupation and level of education. Criteria of renal disease, including raised serum creatinine, proteinuria and blood urea nitrogen, together with factors related to hypertension, including obesity, diabetes mellitus, hypertensive retinopathy, heart failure, coronary artery disease, cerebral vascular events and hypertensive encephalopathy were analyzed. RESULTS: Severe hypertension, diastolic pressure > 130 mm Hg was observed in 43% of the patients. There was a significant inverse correlation between age and diastolic pressure (r = 0.23, p < 0.0001). Response to initial anti-hypertensive treatment was good in 88% and proportional to severity. Hospital mortality was 18.6% (59 patients) including 39 cases during the first two days. Mortality was not correlated with blood pressure, age, sex or socio-economic conditions. Renal disease was observed in 121 patients and chronic renal failure in 117 (44%). Effect of hypertension on at least one target organ was observed in 73.2% of the patients and on at least three target organs in 38.2%. Subjects with renal disease were younger (p < 0.02) and responded less well to treatment than those without renal disease. CONCLUSIONS: These clinical observations confirm the high prevalence of renal failure and the gravity of high blood pressure in Black Africans. In Burkina Faso, hospitalization for high blood pressure often leads to the discovery of terminal renal failure.

Hypogonadismes masculins: a propos de 6 observations

Six observations privilegiees d'hypogonadismes masculins ont ete retenues en une annee de consultation de Medecine Interne. Dans la majorite des cas; la symptomatologie fonctionnelle orientait vers la sphere genitale. Le bilan complementaire associant l'exploration de la fonction testiculaire; hypophysaire et des radiographies de la selle turcique a permis de noter une diversite d'etiologies (3 cas de tumeurs hypothalamo-hypophysaires; 1 syndrome de MORSIER KALLMAN et 2 cas de destruction testiculaire). A partir des observations personnelles; les auteurs proposent a la lumiere de la litterature la demarche diagnostique et therapeutique devant les hypogonadismes masculins

Symptomes; etiologie et evolution de 47 cas de fibrillation auriculaire permanente

Etude retrospective realisee au Hospitalier National de Ouagadougou portant sur 47 fibrillations auriculaires permanentes (sur 847 maladies cardiovasculaires) a montre une prevalence de 5;5 pour cent. Il y avait 26 hommes pour 21 femmes. On avait constate une insuffisance cardiaque presente dans 93;6 pour cent des cas. Un accident vasculaire cerebral etait survenu chez 7 patients. Une tachythmie existait dans 22 cas. les etiologies de ces fibrillations auriculaires etaient dominees par les valvulopathies; les cardiopathies hypertensives et les myocardiopathies primitives constituant ainsi 85 pour cent des cas. Le traitement reposait dans tous les cas sur les digitaliques; associes a l'amiodarone 15 fois. Le ralentissement de la frequence cardiaque etant constant; la reduction de la fibrillation auriculaire a ete rerement obtenue