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.

Fatal evolution of a huge right atrial free-floating thrombus.

KEY CLINICAL MESSAGE: Right atrial thrombus is a rare medical emergency that should be suspected in all cases of pulmonary embolism, and rapid action should be taken to ensure a timely, proper management.