Arterial Hypertension in Patients Aged 15 Years and Over in the Cardiology Department of Sikasso Hospital in Mali: About 250 Cases

Abstract

Introduction: High blood pressure is a global public health problem due to its high prevalence and multiple complications that often lead to major disability. It is a major cardiovascular risk factor for often late diagnosis. It is emerging in Africa, particularly in Mali. Objective: To determine the epidemiological, diagnostic and progressive aspects of high blood pressure in patients 15 years of age or older. Patients and methods: This is a descriptive cross-sectional study over a two-year period (June 1, 2008 to May 31, 2010) in the Cardiology Department of Sikasso Hospital in any patient aged 15 years and over admitted for high blood pressure. Results: Two hundred and fifty patients were selected, representing a hospital prevalence of 18.2%. High blood pressure was most common in patients 50 years of age and older (65.6%), followed by those 19 to 49 years of age (30%) and those 15 to 18 years of age. The average age of the population was 50 years (15-92 years) with a male predominance of 61.6% and a sex ratio of 1.6. The predominance of traditional housewives and farmers was 30% and 26.4%. The notion of a family history of high blood pressure was found in 56.4% of cases. High blood pressure grade 3 according to the classification of the World Health Organization was mostly found in our patients (64%). Biological abnormalities were dominated by hyperglycemia (14%), hypercreatininemia (8%). The main clinical manifestations were headache (40%), dyspnea (20%) and vertigo (16%). On physical examination, there were mainly signs of heart failure (50%), arrhythmia (12%), heart murmur (28%), hemiplegia (10%). The electrocardiogram showed left ventricular hypertrophy in 79.2% of cases, left atrial hypertrophy (16.4%), repolarization disorder (3.2%), atrial fibrillation (1.2%). Chest x-rays showed cardiomegaly in 67.2%. Echocardiographic abnormalities were left ventricular hypertrophy (64.8%), left atrial dilation (16.4%), left ventricular systolic dysfunction (14.4%). Therapeutically, diuretic combination with conversion enzyme inhibitors was the most prescribed treatment (58%), followed by combination of calcium channel blockers and conversion enzyme inhibitors (15.6%), calcium channel blockers (18%), conversion enzyme inhibitors (4.4%), beta-blockers (4%). The low-salt diet and physical activity were constantly recommended. Complications were hypertensive retinopathy (33.2%), heart failure (25.2%), stroke (24.8%), renal failure 4.8%. Conclusion: High blood pressure is a major public health problem. This work identified a high hospital prevalence of high blood pressure in patients aged 15 years and older with a clear male predominance. Late diagnosis is responsible for serious complications that often lead to major disabilities.