Main Article Content

Abstract

ABSTRACT
Introduction. There are few studies on the prevalence of hypertensive retinopathy and the specific role of pulse pressure in the occurrence of cardiovascular complications in general and hypertensive retinopathy in particular in Cameroon. The aim of this study was to investigate the relationship between pulse pressure, hypertensive retinopathy and cardiovascular risk in a group of hypertensive patients in Cameroon. Methods. We carried out an analytic cross-sectional study from October 2016 to May 2017 in three hospitals in Garoua (Cameroon). We included all known hypertensive patients aged over 18 years consulting in selected hospitals, who provided their written inform consent. Patients with concomitant diabetes or presenting a contraindication to eye dilation were excluded. Each patient underwent an interview using a standard questionnaire, physical examination with including measurement of blood pressure and anthropometric parameters. A complete eye examination was carried out in search of hypertensive retinopathy. Results. We included 130 participants (65.4% females) with a mean age of 53.18 ± 10.7 years, and a mean duration of hypertension of 5.9 years. 79.2% of participants were on pharmacological treatment –mainly calcium inhibitors (50.3%) and thiazides diuretics (17.2%). 23.9% already presented with target organ lesions. Hypertensive retinopathy was seen in 16% of patients, and was associated with male sex, target organ damage, and age ≥65 years. Pulse pressure correlated with age, mean arterial blood pressure and systolic blood pressure. However, we found no association between pulse pressure and hypertensive retinopathy. Conclusion: Hypertensive retinopathy is frequent in Cameroonian hypertensive patients, and is associated with other target organ lesions but not with pulse pressure.

RÉSUMÉ
Introduction. Au Cameroun, il existe peu de données sur la prévalence de la rétinopathie hypertensive et le rôle du niveau de pression pulsée dans la survenue des complications cardio-vasculaire. L'objectif de ce travail était d’étudier la relation entre une élévation de la pression pulsée et la rétinopathie hypertensive chez un groupe de patients hypertendus au Cameroun. Méthodes. Il s’agissait d’une étude transversale à visée descriptive et analytique, qui s’est déroulée sur une durée de 08 mois allant d’octobre 2016 à Juin 2017 dans trois hôpitaux de la ville de Garoua. Nous avons recruté les patients hypertendus âgés de 18 ans révolus consentants, venus consulter dans ces formations hospitalières. Les patients diabétiques ou avec une contre-indication à la réalisation d’un fond d’œil ont été exclus. Les données socio-démographiques, les antécédents personnels et familiaux du malade ont été collectés. Un examen physique complet avec une prise des paramètres anthropométriques a été réalisé au premier contact. Par la suite un fond d’œil a été réalisé à la recherche de rétinopathie hypertensive. Résultats. Nous avons recruté 130 patients (65,4% des femmes), âgés de 53 ± 10,7 ans, avec une durée moyenne de l’hypertension de 5,9 ans. 79,2% des patients étaient sous traitement antihypertenseur dont 50,29% sous inhibiteurs calciques et 17,2% sous diurétiques thiazidiques. 23,9% des patients sous traitement antihypertenseur ont présenté une atteinte d’organe cible de l’HTA. La prévalence de la rétinopathie hypertensive dans la population des hypertendus était de 16% et était associée à l’âge avancé (>65 ans), au sexe masculin et à l’existence d’une lésion d’organe cible. La pression pulsée était statistiquement corrélée à l’âge, à la pression artérielle moyenne et à la pression artérielle systolique. Il n’y avait pas d’association entre la pression pulsée et la rétinopathie hypertensive. Conclusion. La rétinopathie hypertensive est fréquente dans notre contexte bien qu’elle ne soit pas associée à la pression pulsée. Les facteurs associés à sa survenue sont : l’âge avancé (> 65 ans), le sexe masculin et l’existence d’autres lésions d’organes cibles de l’hypertension.

Keywords

Hypertension retinopathy pulse pressure Cameroon

Article Details

How to Cite
Hamadou, B., Ndongo Amougou, S., Sadou, H., Kamdem, F., Nganou, C. N., Kuate-Mfeukeu, L., Boombhi, J., Menanga, A. P., & Kingue, S. (2018). Relation between Pulse Pressure, Hypertensive Retinopathy, and Other Cardiovascular Risk Factors among Hypertensive Patients in Cameroon. HEALTH SCIENCES AND DISEASE, 19(1 (Suppl). https://doi.org/10.5281/hsd.v19i1 (Suppl).1030

References

  1. WHO | Hypertension [Internet]. WHO. [cited 2017 Nov 4]. Available from: http://www.who.int/topics/hypertension/en/
  2. World Health Organization - A Global Brief on Hypertension | The International Society of Hypertension [Internet]. [cited 2017 Nov 4]. Available from: http://ish-world.com/news/a/World-Health-Organization-A-Global-Brief-on-Hypertension/
  3. Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, et al. Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015. JAMA. 2017 Jan 10;317(2):165.
  4. Kingue S, Ngoe CN, Menanga AP, Jingi AM, Noubiap JJN, Fesuh B, et al. Prevalence and Risk Factors of Hypertension in Urban Areas of Cameroon: A Nationwide Population-Based Cross-Sectional Study. J Clin Hypertens Greenwich Conn. 2015 Oct;17(10):819–24.
  5. Klein R, Klein BE, Moss SE. The relation of systemic hypertension to changes in the retinal vasculature: the Beaver Dam Eye Study. Trans Am Ophthalmol Soc. 1997;95:329-348; discussion 348-350.
  6. Stacey AW, Sozener CB, Besirli CG. Hypertensive emergency presenting as blurry vision in a patient with hypertensive chorioretinopathy. Int J Emerg Med [Internet]. 2015 Apr 23 [cited 2017 Nov 4];8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409613/
  7. Abel N, Contino K, Jain N, Grewal N, Grand E, Hagans I, et al. Eighth Joint National Committee (JNC-8) Guidelines and the Outpatient Management of Hypertension in the African-American Population. North Am J Med Sci. 2015 Oct;7(10):438–45.
  8. Ramsay LE, Williams B, Johnston GD, MacGregor GA, Poston L, Potter JF, et al. British Hypertension Society guidelines for hypertension management 1999: summary. BMJ. 1999 Sep 4;319(7210):630–5.
  9. Wong TY, Klein R, Nieto FJ, Klein BE., Sharrett AR, Meuer SM, et al. Retinal microvascular abnormalities and 10-year cardiovascular mortality. Ophthalmology. 2003 May;110(5):933–40.
  10. Pede S, Lombardo M. [Cardiovascular risk stratification. Systolic, diastolic or pulse pressure?]. Ital Heart J Suppl Off J Ital Fed Cardiol. 2001 Apr;2(4):356–8.
  11. Strandberg TE, Salomaa VV, Vanhanen HT, Pitkälä K, Miettinen TA. Isolated diastolic hypertension, pulse pressure, and mean arterial pressure as predictors of mortality during a follow-up of up to 32 years. J Hypertens. 2002 Mar;20(3):399–404.
  12. Hadaegh F, Shafiee G, Hatami M, Azizi F. Systolic and diastolic blood pressure, mean arterial pressure and pulse pressure for prediction of cardiovascular events and mortality in a Middle Eastern population. Blood Press. 2012 Feb;21(1):12–8.
  13. Kamadjeu RM, Edwards R, Atanga JS, Unwin N, Kiawi EC, Mbanya J-C. Prevalence, awareness and management of hypertension in Cameroon: findings of the 2003 Cameroon Burden of Diabetes Baseline Survey. J Hum Hypertens. 2006 Jan;20(1):91–2.
  14. Arrey WT, Dimala CA, Atashili J, Mbuagbaw J, Monekosso GL. Hypertension, an Emerging Problem in Rural Cameroon: Prevalence, Risk Factors, and Control. Int J Hypertens [Internet]. 2016 [cited 2017 Nov 6];2016. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178358/
  15. Muhamedhussein MS, Nagri ZI, Manji KP. Prevalence, Risk Factors, Awareness, and Treatment and Control of Hypertension in Mafia Island, Tanzania [Internet]. International Journal of Hypertension. 2016 [cited 2017 Nov 6]. Available from: https://www.hindawi.com/journals/ijhy/2016/1281384/
  16. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507–20.
  17. Menanga A, Edie S, Nkoke C, Boombhi J, Musa AJ, Mfeukeu LK, et al. Factors associated with blood pressure control amongst adults with hypertension in Yaounde, Cameroon: a cross-sectional study. Cardiovasc Diagn Ther. 2016 Oct;6(5):439–45.
  18. Tankeu A-T, Mfeukeu Kuate L, Nganou Gnindjio C-N, Ankotché A, Leye A, Ondoa Bongha H, et al. Spécificités de la prise en charge de l’hypertension artérielle chez le patient diabétique sub-saharien. Médecine Mal Métaboliques. 2017 Mar;11(2):148–54.
  19. Grosso A, Veglio F, Porta M, Grignolo FM, Wong TY. Hypertensive retinopathy revisited: some answers, more questions. Br J Ophthalmol. 2005 Dec;89(12):1646–54.
  20. MPH BCLS OD. How Hypertension and High Cholesterol Harm the Eye [Internet]. [cited 2017 Nov 6]. Available from: https://www.reviewofoptometry.com/article/how-hypertension-and-high-cholesterol-harm-the-eye

Most read articles by the same author(s)

<< < 1 2 3 4 5