Document Detail


In-hospital mortality among black patients admitted for hypertension-related disorders in Mbuji Mayi, Congo.
MedLine Citation:
PMID:  19282818     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: As a consequence of hypertension, sub-Saharan Africa faces an epidemic of cardiovascular disease.
METHODS: We assessed in-hospital mortality among patients admitted for hypertension-related diseases to two city hospitals in Mbuji Mayi, Congo. On admission, we obtained anthropometric measurements, blood pressure, information on cardiovascular risk factors, and on the awareness and treatment of hypertension. We modeled the probability of death, using stepwise logistic regression.
RESULTS: Of 401 consecutive patients (mean age, 54.3 years; 129 women), 118 (29.4 %) were unaware of their hypertension. Among 283 aware patients (70.6%), 126 (44.5%) were untreated. Systolic/diastolic blood pressure on admission averaged 178/106 mm Hg. In addition to hypertension, 390 patients (97.3%) had other cardiovascular risk factors, including a creatinine clearance below 60 ml/min/1.73 m(2) in 47 subjects (11.7%). Over 15 days (median) of hospitalization, 89 deaths (22.2%) occurred. The multivariable-adjusted probability of death increased with systolic blood pressure (odds ratio (95% confidence interval) for +10 mm Hg, 1.43 (1.15-1.77); P < 0.01), body mass index (+5 kg/m(2), 2.40 (1.39-4.17); P < 0.01), being aware vs. unaware of hypertension (3.17 (1.52-6.61); P < 0.01), and being untreated (2.33 (1.12-4.76); P < 0.05), but it decreased with age (+10 years, 0.65 (0.46-0.92); P < 0.05) and higher creatinine clearance (+10 ml/min/1.73 m(2), 0.71 (0.61-0.82); P < 0.001).
CONCLUSIONS: The in-hospital mortality among African patients hospitalized for hypertension-related disorders in a Congolese provincial capital city is over 20%. These findings underscore that screening and treatment for hypertension and the prevention of cardiovascular disease should be placed much higher on the political agenda in sub-Saharan Africa.
Authors:
Jean-René M'Buyamba-Kabangu; Rachel T Biswika; Lutgarde Thijs; Gilbert M Tshimanga; Francine M Ngalula; Tumba Disashi; Patrick K Kayembe; Tom Richart; Jean-René M'Buyamba-Kayamba; François B Lepira; Jan A Staessen
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-03-12
Journal Detail:
Title:  American journal of hypertension     Volume:  22     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-06-23     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  643-8     Citation Subset:  IM    
Affiliation:
Hypertension Unit, Department of Internal Medicine, University of Kinshasa Hospital, Kinshasa, The Democratic Republic of Congo.
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group*
Confidence Intervals
Congo / epidemiology
Female
Hospital Mortality / trends*
Humans
Hypertension / complications,  mortality*,  physiopathology
Male
Middle Aged
Odds Ratio
Patient Admission*
Prognosis
Retrospective Studies
Risk Factors
Survival Rate / trends
Comments/Corrections
Comment In:
Am J Hypertens. 2009 Jun;22(6):581-2   [PMID:  19455187 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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