Hypertension, diabetes mellitus, overweight and obesity in employees under health transition at the railways company in Congo-Brazzaville

Background and Aim: Cardiovascular risk (CVR) factors, namely hypertension (HT), diabetes mellitus and obesity, are a public health problem in sub-Saharan Africa because of health transition. The additional effect of the social gradient within the railway companies in Congo-Brazzaville on high CVR is not yet established. The aim of this study was to determine the extent of hypertension, diabetes mellitus, overweight, and obesity and to identify the contributing factors of fatness and hypertension. Methods: This was a cross-sectional study conducted in April 2013. A simple random sample of 255 out of all 2550 workers from the railway companies of Congo was examined for epidemiological, clinical and biological variables. Results: Out of the study sample, 231 (90.6%), 79 (31%), and 52 (20.4%) were men, rural dwellers, and senior executives, respectively. The mean age was 45 ± 13 years (range 19 to 63 years). The rates of overweight, hypertension, obesity, and diabetes mellitus were 40.3% (n = 103), 29.4% (n = 75), 7.5% (n = 19), and 3.5% (n = 9), respectively. In univariate analysis, female sex (OR 2.7, 95% CI 1.13 - 6.45, p = 0.01), senior executive (OR 2.4;95% CI: 1.3 - 4.5;p = 0.003) and physical inactivity (OR 2.5;95% CI: 1.5 - 4.2;p < 0.001) were significantly associated with overweight. Female sex (OR 7.5, 95% CI: 2.6 - 21;p < 0.001) and senior executive (OR 3.17;95% CI: 1.2 - 8.3) were also significantly associated with obesity. In logistic regression, overweight (OR = 4.8, 95% CI 2.8 - 11, p < 0.0001), and obesity (OR = 6.8, 95%CI 2.1 - 22, p = 0.01) were identified as the most important and independent determinants of hypertension. Conclusions: Fatness is emerging and it is the most contributing factor of hypertension among workers at the Congolese railway companies. There is also a significant interaction between non-modifiable factors (genetic: females and family history) and modifiable factors (inactivity, fatness) for higher risk of hypertension. Health promotion should be emphasized by physical activity programs.

Hyperuricemia and Associated Factors during Arterial Hypertension in Brazzaville (Congo)

A longitudinal analytical and comparative study including outpatients was carried between June 1st?and December 31st?2017. The objectives were to determine the hyperuricemia frequency during arterial hypertension, to identify associated factors, and to evaluate its impact on the blood pressure control. We have included, hypertensive patients having a minimum blood test including at least an uricemia. They were divided into two groups according to?whether they have presented a?hyperuricemia (HU) or a normouricemia (NU).?Among?these 202 patients included, 61 (30.2%) presented a hyperuricemia.?The mean age in HU group was 54.6 ± 11.6 years vs 53.6 ± 11 years for NU group (p = 0.573). Following cardiovascular risk factors were more found in the HU group than NU group: overweight/obesity (68.8% vs 46.1%;p = 0.003), metabolic syndrome (42.6% vs 39%;p = 0.021). Diuretics were used in 72.1% of patients in HU group vs 47.5% in NU group (p = 0.002).?Bitherapy was used in 56% of the patients of HU group vs 69% in the NU group (p = 0.295), and the quadritherapy?in 8% and 1% of the patients respectively (p = 0.049). Blood pressure was not controlled in 68.8% of HU group vs 48.9% in the NU group (p = 0.014). In multivariate analysis after logistic regression, factors associated with hyperuricemia were: glucose intolerance or diabetes (p = 0.004;OR = 1.35) and uncontrolled blood pressure (p = 0.006;OR = 2.51). This preliminary study showed that hyperuricemia is commonly found in hypertensive patients and has negative impact on blood pressure control.