Prevalence, pattern and clinical correlates of dyslipidemia among cardiology outpatients in three reference hospitals of Yaoundé

Donald Njeunje Tchapmi (tn.donald42@gmail.com)
Internal medicine, University of Yaounde I
June, 2017
 

Abstract

BACKGROUND
Cardiovascular Diseases (CVD) are a major cause of morbidity and a leading contributor to mortality in both developed and developing countries. They have reached epidemic proportions in developing countries in recent decades. Dyslipidemia is a major modifiable cardiovascular risk factor for atherosclerosis and CVDs. With the change in lifestyle and feeding habits in developing countries, prevalence of dyslipidemia is constantly increasing. We conducted a study to determine the prevalence, pattern and clinical correlates of dyslipidemia in patients attending cardiology outpatient consultation in Yaounde, Cameroon.

METHODS
It was a cross sectional hospital based analytic study, conducted in outpatient cardiology unit in 3 reference hospitals of Yaounde from December 2016 to May 2017. Patients who underwent a laboratory workup, including a lipid profile, during the study period were included. Sampling was consecutive. Every participant was thoroughly informed about the study; its highlights, benefits and ethical considerations. After that, a questionnaire was administered to collect data on socio-demographic characteristics, lifestyle and past medical history. A physical examination and measurement of anthropometric parameters were done.
Data was analysed using SPSS 23.0. The chi-square test, was used to evaluate association between qualitative variables. Odds ratio was used to assess the degree of association that could exist between variables. A Pearson or Spearman correlation test was used to evaluate association between quantitative variables. Threshold of statistical significance was set at a p-value of 0.05.

RESULTS
A total of 505 respondents were enrolled in our study. The mean age of the participants was 55.7±11.8 (range 28 - 98 years). The most represented age group was the age range 55-64 with 168 individuals (33.3%). Out of the 505 participants, 58.5% had hypertension, 32.5% had diabetes, 48.8% were obese and 2.8% were current smoker. A very high proportion (65.4%) had dyslipidemia. The most common lipid abnormality was high Total Cholesterol, TC (47.3%), followed by high Low Density Lipoprotein Cholesterol, LDL-C (41.6%), low High Density Lipoprotein Cholesterol, HDL-C (20.7%) and finally high triglycerides, TG (17.7%). The prevalence of dyslipidemia increased with age, with the highest prevalence within the 55 – 64 years age group, then decreased afterwards. People with diabetes only, hypertension only, and diabetes with hypertension had similar patterns with high TC followed by high LDL-C. Dyslipidemia was however more prevalent in patients with diabetes (72%). The prevalence of low HDL-C and values of atherogenic indices increased with increasing number of cardiovascular risk factors. Dyslipidemia was found to be independently associated with sex, age, diabetes, smoking and obesity.

CONCLUSION
The prevalence of dyslipidemia is high in our study population. With the most common disorders being high TC and high LDL-C. Many factors were associated with dyslipidemia, amongst which diabetes, smoking and obesity.
We recommend that clinicians should increase screening, detection, treatment and control of lipid disorders, especially in patients with several cardiovascular risk factors, and with diabetes and hypertension. Also, to emphasise on behavioural modifications including lifestyle changes in the prevention and treatment of lipid abnormalities.

Key words: sub-Saharan Africa, outpatient, dyslipidemia, prevalence.


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