TITLE:
Hypertensive Emergencies in the Department of Cardiology at the Teaching University Hospital of Brazzaville (Republic of the Congo): Preliminary Study
AUTHORS:
Solange Flore Mongo Ngamami, Bertrand Fikahem Ellenga Mbolla, Guénol Barthel Ebinda, Christian Michel Kouala Landa, Louis I. Ondze Kafata, Méo S. Ikama, Thierry Raoul Gombet, Suzy-Gisèle Kimbally Kaky
KEYWORDS:
Emergencies, High Blood Pressure, Stroke, Heart Failure, Black African
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.9 No.1,
January
11,
2019
ABSTRACT: Background: Hypertensive emergencies are still a common mode of finding hypertension.Objective: to determine the epidemiological, clinical and paraclinical characteristics of the hypertensive emergency, and to evaluate the factors associated with poor blood pressure control. Patients and method: cross-sectional and analytical study, conducted from July 2010 to June 2014 (4 years), in the cardiology department of the Brazzaville University Hospital. Included, patients admitted were those systolic blood pressure (BP)≥ 180 mm Hg, and diastolic BP ≥ 110 mm Hg, with target organ involvement. A minimum biological assessment, an ECG, a chest X-ray, a brain CT-scan and a cardiac ultrasound were required.Results: Fifty patients were included, including 31 women (62%). The mean age was 53.8±13.7 years old, age ;68%), low incomepopulation (n = 23;46%). Hypertension was often known (n = 49; 98%), and poor compliance(n = 33; 67.4%). Associated risk factors were: obesity (n = 13),anddiabetes (n = 7). The average consultation time was 4.1±3.7 days. The reasons for hospitalization were: dyspnea (n = 24;48%), neuro-sensory signs (n = 24;48%),andfunctional limb impotence (n = 15;30%). The major laboratory abnormalities were hyperuricemia (n = 16;32%) and hyperglycemia (n = 16). Left ventricular hypertrophy was noted at the ECG (n = 29;58%). Cardiac ultrasound showed a LVEF 40% (n = 8). The main hypertensive emergencies were: heart failure (n = 23;46%), stroke (n = 23;46%), severe renal failure (n = 10;20%), and malignant hypertension (n = 23; 46%). The average hospital stay was 11.4±5.5 days, and 1 death was recorded. BP was uncontrolled in 38 cases (76%). Factors associated with uncontrolled blood pressure were: female sex (OR 3;95% CI 0.8 - 11.5) and low-income patient (OR 1.26;95% CI 0.34 - 4.68).Conclusion: organs affected during hypertensive emergencies are most often the heart, the brain and the kidney in our context. Early management of hypertension willreduce these complications.