Economic Stress, Precariousness and Risk of High Blood Pressure: A Descriptive Survey of Life Models within Households of the Central Region of Cameroon

Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.

Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Exercise-induced albuminuria and circadian blood pressure abnormalities in type 2 diabetes

AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-sectional study in well controlled T2D patients, non-hypertensive, without clinical pro-teinuria and normal creatinine clearance. In each parti-cipant, we recorded the BP using ambulatory bloodTankeu AT et al . Exercise-induced albuminuria and BP in T2DMpressure monitoring （ABPM） for 24-h, and albuminuria at rest and after a standardized treadmill exercise.RESULTSWe enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure （SBP） of 128 ± 17 mmHg vs nocturnal of 123 ± 19 mmHg （ P = 0.004）, and mean diurnal diastolic blood pressure （DBP） of 83 ± 11 mmHg vs nocturnal 78 ± 14 mmHg （ P = 0.002）. There was a signifcant difference between albuminuria at rest [median = 23 mg, interquartile range （IQR） = 10-51] and after exercise （median = 35 mg, IQR = 23-80, P 〈 0.001）. Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components （128 mmHg vs 110 mmHg, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure）, as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP （83 vs 86, P = 0.03） than resting albuminuria.CONCLUSIONExercise induced albuminuria is associated with anincrease in nocturnal BP values in T2D patients.

Assessing the Association between Heart Attack, High Blood Pressure, and Heart Disease Mortality Rates and Particulate Matter and Socioeconomic Status Using Multivariate Geostatistical Model

This study addresses the public concerns of potential adverse health effects from ambient fine particulate matter as well as socioeconomic factors. Heart attack, high blood pressure, and heart disease mortality rates were investigated against fine particulate matter and socioeconomic status, for all counties in the United States in 2013. Multivariate multiple regressions as well as multivariate geostatistical predictions show that these are significant factors towards assessing the causal inferences between exposure to air pollution and socioeconomic status and the three mortality rates.

Exercise-induced albuminuria vs circadian variations in blood pressure in type 1 diabetes

AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National Obesity Center of the Yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio(ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1 DM patients and 20 matched controls. T1 DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure(BP) and renal function according to the general referencepopulation. Non-diabetic controls were adolescents of general population matched for sex, age and BMI.RESULTS Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) were respectively 116 ± 9 mm Hg in the diabetic group vs 111 ± 8 mm Hg in the nondiabetic(P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg(P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls(SBP: 118 ± 10 mm Hg vs 114 ± 10 mm Hg, P = 0.11; DBP: 71 ± 7 mm Hg vs 68 ± 6 mm Hg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP(112 ± 11 mm Hg vs 106 ± 7 mm Hg, P = 0.06) and to the mean arterial pressure(MAP)(89 ± 9 mm Hg vs 81 ± 6 mm Hg, P = 0.06). ACR at rest was similar in both groups(5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise(10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria(116 ± 10 mm Hg vs 108 ± 10 mm Hg, P = 0.09). CONCLUSION Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1 DM.

Older Adults’ Explanatory Models of High Blood Pressure

Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.

Prevalence and Factors Associated High Blood Pressure among Women at the Market of Dantokpa in Benin in 2017

Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide. Among these CVDs, high blood pressure (hypertension) is the main one. The purpose of this study is to investigate the prevalence and factors associated with hypertension in women in the market of Dantokpa. Study Method: This is a cross-sectional, descriptive and analytical survey undertaken on women selling in the Dantokpa market. The dependent variable is hypertension. Data analysis was done using Epi data 3.1 software. Results: A total of 255 women were enrolled in the study. The average age was 41.6 ± 12.13 years with extremes of 18 and 84 years. Among women, 114 (34%) were suffering from hypertension. The factors associated with hypertension in women in the Dantokpa market were above 40 years old, educated women, physical inactivity, family history of hypertension, salty food. Conclusion: At the end of this study, it appears that the prevalence of hypertension in women in the Dantokpa market is higher than that of the general female population. Therapeutic and preventive measures are necessary.

Train of Thought about Treatment of High Blood Pressure with Integrative Traditional and Western Medicine

Based on the differ—ent theories,TCM andWestern medicine(WM)have their owndifferent understandingsabout the pathogenesisand treatment of highblood pressure(HBP).In TCM the balancesbetween blood-qi,vis—cera—bowel, and yin—yang are all highly

Obesity and High Blood Pressure among Professional Long-Distance Drivers in Yaoundé, Cameroon: Cross-Sectional Study

Background: Drivers play a very important role in the transportation of people, goods and services in Cameroon. The data on obesity and hypertension amongst these professionals is insufficient. The study aimed to determine the prevalence and risk factors of obesity and high blood pressure (HBP) among professional bus drivers in Yaoundé. Methods: This was an analytic cross-sectional study among long-distance bus drivers stationed in Yaoundé between march and April 2018. The data collected focused on driving history, eating habits, driver’s lifestyle, and anthropometric measurements. The analysis was completed using SPSS 21 software;STATA 13;SPAD 5.5 and Excel. Results: Of the 309 drivers, 27.18% and 17.80% were obese and hypertensive, respectively. The risk of developing HBP and obesity was higher among drivers with ≥20 years of driving experience. The risk of obesity was 3.99 (95% CI = 1.65 - 9.64);14.57 (95% CI = 3.65 - 58.16) and 15.23 (95% CI = 3.30 - 70.40) times higher in drivers with 10 - 14, 15 - 19 and 20 years of experience respectively. The risk of HBP was 3.64 (95% CI = 1.22 - 10.85);5.08 (95% CI = 1.18 - 21.92) and 9.42 (95% CI = 1.87 - 47.44) times higher in drivers with 10 - 14;15 - 19 years and 20 years of service, respectively. The more involved the drivers were in sporting activities, the less likely they are to be obese (RR = 0.46;95% CI = 0.24 - 0.88);the risk of HBP was 1.96 (95% CI = 1.05 - 3.67) times higher among drivers who were unable to make trips of at least 10 minutes. And the risk of HBP was less when drivers did not snack while traveling (RR = 0.43;95% CI = 0.21 - 0.90) than when they did. When a driver ate at least 3 meals a day, the risk of being obese was 5.75 (95% CI = 3.15 - 10.48) times higher. The risk of HBP was 4.04 (95% CI = 2.20 - 7.41) times higher in obese drivers than in those with a normal body mass index. Conclusion: Obesity and HBP are common conditions amongst the population of bus drivers. They are particularly exposed due to their socio-professional characteristics, their eating habits, and their lifestyle. These observations call for nutritional and sports education campaigns among bus drivers.

EFFECTS OF ACUPUNCTURE ON THE HIGH HEMAGGLUTINATION STATE, BLOOD-SUGAR-RAISING HORMONE AND IMMUNOCYTE FACTOR LEVELS IN TYPE-II DIABETES PATIENTS

Objective: To investigate the effect of acupuncture on high hemagglutination state, blood sugar raising hormone and immunocyte factor levels in type II diabetes patients. Methods: A total of 120 inpatients and outpatients were randomly divided into acupuncture plus medication group (n=52) and medication group (n=50). In addition, 18 type II diabetes patients formed acupuncture group for comparing their therapeutic effects. Main acupoints used were Pishu (BL 20), Geshu (BL 17), Yishu, Shenshu (BL 23), Zusanli (ST 36), Sanyinjiao (SP 6), etc.. combined with other acupoints according to different sydroms. These acupoints were stimulated by manipulaing the filiform needles with uniform reinforcing and reducing method for 15 min and then stimulated electrically for 15 min with an electroacupuncture therapeutic apparatus. Western medicines used were Glipizide, Dimethyldiguanide Hydrochloride, etc.. The treatment was given once daily, with 10 sessions being a therapeutic course, 2～3 courses altogether. Indexes of external thrombosis length (ETL), platelet agglutination rate (PAgR), fibrinogen (FG), activated partial thromboplastin time (APTT), fasting blood glucose (FBG), prothrombin time(PT), adrenocoticortropic hormone (ACTH), cortisol (CS), growth hormone (GH), glucagon (GL), tumor necrosis factor alpha (TNF α), interleukin 6 (IL 6), insulin (INS) and C peptide (C P) were determined using radioimmunoassay. Results: After 2～3 courses of treatment, both acupuncture group and medication plus acupuncture group could significantly improve high hemagglutination state, lower blood sugar raising hormone level, regulate immunocyte factor level and raise the sensitivity of insulin, which were apparently superior to those of medication group (P<0.05～0.01). Conclusion: Acupuncture therapy can effectively regulate plasma blood sugar raising hormone, immunocyte factor levels, increase the sensitivity of insulin to target cells, resist blood coagulation and improve microcirculation.

Factors Associated with High Blood Pressure in People Living with HIV at the National Teaching Hospital Hubert Koutoukou Maga and Cotonou Teaching Hospital of the Armed Forces

In Benin Republic, few data are available on the prevalence and determinants of arterial hypertension (AH) in people living with the human immunodeficiency virus (PLWHA). The present study was conducted in two outpatient treatment centers for PLWHA in Cotonou and was conducted from June 19 to July 04, 2019 with 314 PLWHA. We performed descriptive statistics and logistic regression for the estimates. The prevalence of high blood pressure (HBP) among PLWHA was 41.4% [CI (95%): (35.9 - 47)]. In univariate analysis: age, smoking, alcoholism, physical inactivity, family history of hypertension, personal history of diabetes, obesity, and total and LDL (low density lipoprotein) hypercholesterolemia were significantly associated with HBP. No association was found with duration of HIV (human immunodeficiency virus) infection, time to ARV (antiretrovirals) exposure, and treatment regimen. In multivariate analysis, age, sex, smoking, family history of hypertension, and total hypercholesterolemia remained associated with HBP. In conclusion, the prevalence of HBP in PLWHA was very high compared with the results in the general population, and the same risk factors described in the general population were found but with a more marked hypertense potential.

Characteristic of Ambulatory Blood Pressure in Normotensive Subjects With Type 2 Diabetes Mellitus

Objectives To observe the characteristic of ambulatory blood pressure monitoring in normotensive diabetic subjects with normoalbuminuria or microalbuminuria. Methods Fifty-two normotensive patients with type 2 diabetes received ambulatory blood pressure monitoring were divided into normoalbuminuric and microalbuminuric groups according to their albumin excretion rate, the other 28 normotensive subjects without diabetes were contributed as control group. Ambulatory blood pressure monitoring was performed on a working day and measurement of blood pressure circadian rhythm was analyzed. Results Normotensive microalbuminuric diabetic patients had higher night-time systolic blood pressure and more blood pressure burden than normotensive normoalbuminuric diabetic patients. Additionally, the microalbuminuric patients had a higher frequency of non-dippers than normoalbuminuric ones, although they were all normotensive. Compared to the normotensive non-diabetic control subjects, the night- time systolic blood pressure and frequency of non- dippers of the normoalbuminuric diabetic patients were significantly higher. Conclusions Intensive attention should be paid in control of blood pressure in diabetic patients to prevent and limit damage of target organ including kidney, even in those normotensive subjects.

Relationship between Obesity, Serum Uric Acid, Serum Potassium and Glomerular Filtration Rate with Electric Left Ventricular Hypertrophy in Blacks Central Africans with High Blood Pressure

The authors conducted a retrospective study over a period of 6 months in a hypertensive population in order to determine the correlation between serum uric acid on glomerular filtration rate (GFR) and estimated serum potassium with left ventricular hypertrophy (LVH) and obesity. This study enrolled 122 patients including 63 women (51.6%). The mean age was 55.9 ± 10.6 years (range 30 to 74 years). Obesity weight was found in 38 cases (31.1%) of which 20?were men (33.9%) and 18 women (28.6%). Abdominal obesity was found in 104 cases (85.2%). The average serum uric acid in patients with obesity weight was 63.3 ± 18.9 mg/L vs 62.4 ± 14.2 mg/L for no-obese patients (p?= 0.63). The average serum potassium in obese patients was 4.06 ± 0.42 mEq/L vs 4.02 ± 0.46 mEq/L for no-obese (p?= 0.65). The average GFR was 73.4 ± 21.4 ml/L in obese patients vs 66.6 ± 22.6 ml/min in no-obese (p?= 0.03). The LVH was found in 81 cases (66.4%). The LVH was found in 65 (62.5%) obese patients vs?16 (88%) non-obese patients (OR = 4.8, 95% 1.04?-?22?p?= 0.02). Only abdominal?obesity has been correlated with left ventricular hypertrophy after multivariate analysis. Emphasis must be focused on public health actions for effective and appropriate measures against obesity and hypertension, whose prevalence is increasing in our region.

Spouses of patients with diabetes mellitus type 2 at increased risk of high blood glucose levels

Introduction: Diabetes mellitus type 2 is a growing threat in developing countries already burdened with high levels of infectious disease. Screening the general population has debatable advantages. This study aims to determine whether spouses of patients with diabetes mellitus have higher random blood glucose (RBG) levels as well as the benefit of RBG testing as a targetted screening tool. Methodology: The survey employed a cross-sectional comparative study of spouses’ of diabetics and non-diabetics attending the general out-patient department of the LagosStateUniversityTeaching Hospital (LASUTH), Ikeja. A modified WHO STEPS Surveillance Instrument and a one-touch Glucometer were used to collect data. Blood pressures and BMI were measured and correlated to blood glucose levels. Results: Prevalence of high RBG was found to be 7% among spouses of diabetics and 3.3% among spouses of non-diabetic patients. Mean RBG was 5.57 mmol/L and 7.7 mmol/L within the age group 40 - 49 years and 50 - 59 years respectively among spouses of diabetic patients compared to 5.4 mmol/L and 5.5 mmol/L within the same age group among the spouses non-diabetics. Spouses of patients with diabetes mellitus had higher systolic and diastolic blood pressures and BMI compared to spouses of non-diabetics. Conclusion: Being male, married to a diabetic patient, lower educational levels and higher body mass index are significantly associated with higher random blood glucose in the spouses of diabetic patients. Random blood glucose measurements are an effective screening tool and spouses of diabetic patients can benefit from targeted screening in controlled clinical settings.

Evaluation of the Knowledge, Attitudes and Practices of the Hospital Staff in the Management of High Blood Pressure in Conakry

Introduction: High blood pressure is a real public health problem affecting more than one in three adults. The objective of this study was to evaluate the level of knowledge, attitudes and practices of health care personnel in the management of hypertension in Conakry. Methods: Descriptive transversal study of 6 months, from April 20, 2018 to September 20, 2018, which took place in the internal medicine departments of the two university hospital centers (CHU) of Conakry (Donka and Ignace Deen). The study population consisted of general practitioners and specialists, practicing in both departments for at least two years and who agreed to submit to our questionnaire. Results: At the end of the study, we included 140 doctors, 61% at Donka University Hospital and 39% at Ignace Deen University Hospital. The predominance was male with 113 men for 27 women with a sex ratio H/F = 4.18. General practitioners were the most represented with 95% against 5% specialists. Sixty-four percent of physicians gave an exact definition of hypertension, 56% of physicians confirmed the diagnosis of hypertension after 2 to 3 consultations. 19% offered monotherapy as first-line treatment, only 72% said that the duration of Antihypertensive treatment was for life. Conclusion: Theseresults demonstrate that it is essential to reflect on our daily practices for a good improvement in the quality of care for patients.

Fetal Prognostics in Relation to Uricemia and Maternal Proteinuria of Arterial High Blood Pressure Types during Pregnancy at the Maternity of Donka, National Hospital Donka, CHU of Conakry, Guinea

Objectives: The objectives of this work were to calculate the frequency of arterial hypertension during pregnancy, describe the epidemiological profile, and identify the most common type of hypertension and to establish fetal prognosis based on uricemia and maternal proteinuria. Methodology: This was a six (6) month descriptive prospective study performed in the Obstetrics and Gynecology Department of Donka National Hospital-CHU Conakry. The study took place from july 1 st to December 31st, 2015. Results: The frequency of arterial hypertension during pregnancy was 8.82% in the service. The epidemiological profile was that of teenagers (32.8%), nulliparous (56%), coming from home (69.2%), not having performed CPN (52%), not schooled (68%) and housewives. The primary factor was the risk factor (52.4%). Gestational age greater than 37 was the most concerned (62%). The reasons for consultation are dominated by headache (76%) and vertigo (68%). The main type of hypertension was pre-eclampsia (48%) followed by Transient HTA (28%). The predominant clinical form during the admission was pre-eclampsia (47.2%) followed by eclampsia (23%). At the first minute, 35.68% of newborns had an APGAR score of less than 7 and the fifth 25.5% had a score of less than 7. Fetal morbidity was dominated by fetal hypotrophy (30.19%), followed by prematurity (23.92%). In 90.90% of hypotrophy, there are ?85.24% of premature babies, 95.55% of SFA, and 80% of MIU;the serum uric acid was greater than 350 mmol. We recorded 204 children born with mothgers with proteinuria greater than or equal to 30 mg/dl, or 80% of children. 30 cases of MFIU and 7 cases of neonatal death out of 255 births, that is 14.50% were noted. Conclusion: The detection of risk factors by a good prenatal follow-up and the regular training of the care providers for adequate and multidisciplinary care (obstetrician, intensive care nephrologist and pediatrician) of hypertensive pregnant women and their newborns can improve the maternal prognosis and fetal.

Placentas and Newborns of Patients Suffering from High Blood Pressure in University Hospital of Brazzaville

Objective: To analyze placentas and newborns of patients with high blood pressure (HBP). Materials and Methods: Case-control study conducted from 1 January to 31 October 2017 in University Hospital of Brazzaville (birth room, anatomy and pathology laboratory) and Faculty of Health Sciences of Brazzaville (laboratory of anatomy and organogenesis). It concerned 40 placentas freshly delivered and newborns of patients with HBP compared to 40 placentas and newborns of patients without HBP. The variables analyzed were related to mothers, placentas and the newborns. Results: The patients were similar in age (26.9 ± 1.2 years VS 26.5 ± 1.1 years, p = 0.17) and parity (1.26 ± 0.7 VS 1.61 ± 0.3, p = 0.26). The type of hypertension in the cases was dominated by pre-eclampsia (68%). A significant reduction in placental measurements was more observed in case of HBP: weight (431 ± 37 g VS 503 ± 26 g, p < 0.05), diameter (17.40 ± 1.2 cm VS 19.25 ± 1 cm, p < 0.05), and area (239.82 ± 15.7 cm2 VS 292.1 ± 22.2 cm2, p < 0.05). The macroscopic lesions were calcifications (75% VS 43.8%, p < 0.05) and the retro placental hematoma cup (18.8%) among the cases. Microscopic lesions were more observed in hypertensives: infarction (68.8% VS 18.8%, p = 0.004) and endarteritis (93.8% VS 12.5%, p < 0.05). The characteristics of newborns were significantly different between the two populations: prematurity (34.3% VS 9.3%, p < 0.05), mean weight (2577 ± 102 g VS 3060 ± 109 g, p < 0.05), the average APGAR score (6.7 ± 1.6 VS 7.8 ± 0.9, p 0.05). Conclusion: High blood pressure affects the placenta and the newborn. The placenta deserves to be systematically examined.

High Blood Pressure in External Consultation in Cardiology of Kati

Objective: To study hypertension and its manifestations in?Out-patients’ Department of Cardiology of Kati. Methods: The study was traversal and it was based on a sample of 300 patients, reached during the interval of 12 (twelve) months (from June 2012 to June 2013). Results: The predominance was among the females with 68.7%. The average age was about?55.8 ± 12.2 years old. The extreme ages were?about 21 and 90 years?old. In the set,?66% of the patients lived in the town of Kati.?The symptoms of Dieulafoy were predominantly the reasons for consultation with 55.7%. The cardiac frequency in the vast majority of cases was normal (85.3%). The left ventricular hypertrophy in the electrocardiogram was observed in more than half of the cases,?that is to say,?51.3%. In a bit higher proportion,?the echocardiography Doppler became normal,?that is to say,?54%. Brain scanner done on 9 patients found out signs of cerebrovascular stroke in 8 patients,?that is to say,?a frequency of 88.9%. In 76% of cases?of orthostatic hypotension,?the patients were hypertensive.?The blood pressure was normal during the passage of orthostatism in the cases of 258 of our patients,?that is to say,?86.0% of the cases. However, the orthostatic hypotension (OH) was observed in the cases of 42 patients, that is to say,?14.0% of the cases. In this set of patients,?41.6% of the moans were due to cephalgias and dizziness’s. The monotherapy of patients with OH represented 47.6% of the cases. Blood pressure was not controlled in 66.7% of the?cases of?OH. The biological examinations required were normal in 52.4% of the cases. Conclusion: The hypertension is a disease which is frequently the reason for consultation in cardiology. The symptoms of Dieulafoy can be the signs of call. The complications are sometimes recurrent. The orthostatic hypotension should be found out even under monotherapy on a balanced or non-balanced hypertensive patient through treatment.

Determinants of High Blood Pressure and Quality of Management in Three Regions of Benin

Objective: The aim of this work was to determine the prevalence, associated factors and quality of high blood pressure (HBP) management in three regions of Benin in 2015. Methodology: This was a cross-sectional study, with two components. The first component included adults aged from 18 to 69 years, selected using a three-stage random sampling within the households. Data were collected thanks to the French version of the WHO STEPS instrument. Anthropometric data, including blood pressure, capillary fasting glucose and total cholesterol were measured according to standard procedures. The second component included Public Health Centers (PHC) selected by a random stratified multi-stage sampling. Data were collected on the structures and the processes of HBP management using the standardized tool for assessing the capacities of management of non-communicable diseases in peripheral health centers provided by the World Health Organization. Results: A total of 4816 participants were included in the first component. The mean age was 35.8 ± 12.7 years. The weighted prevalence of HBP was 27.9% (95% Confidence Interval (CI) [25.6 - 30.2]). It was higher in the 60 - 69 years compared to the lower age groups (Adjusted Odd-ratio (ORa) = 5;95% CI [3.9 - 6.5)]). HBP was positively associated with urban residence (ORa = 1.26;95% CI [1.24 - 1.28]), obesity (ORa = 1.46;95% CI [1.43 - 1.50]), hyperglycemia (ORa = 1.13;95% CI [1.10 - 1.15)]) and hypercholesterolemia (ORa = 1.64;95% CI [1.59 - 1.70)]). A total of 27 PHC were included in the second component. Taking blood pressure and other anthropometric measurements was not routine in PHC. Several essential medicines were not available in the PHC. A low level of community involvement in the management of HBP was noted. Conclusion: This study confirms the high prevalence of HBP and shows inadequacies in its management in the targeted PHC. More appropriate prevention and control measures for HBP should be implemented.