Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 6 Articles
Background: Although systemic hypertension is rarely seen in steady state\nsickle cell disease (SCD), relative hypertension has been reported to be associated\nwith an increased risk of cardiovascular and renal complications. Objective:\nTo determine the prevalence of BP patterns and assess factors associated\nwith relative hypertension in sickle cell anemia (SCA) adult patients.\nMethods: Clinical data and office BP were obtained from 103 consecutive\nsteady-state SCA adult patients (mean age 26 �± 7.9 years, 66% females, 22.3%\non hydroxyurea) attending four healthcare centers providing SCD-specific\ncare in Kinshasa. Seated BP was measured using an automated electronic device.\nThree consecutive blood pressure measurements were taken with 2 minutes\ninterval between readings and the average of the 2 last readings was\nconsidered for the analyses. Normal BP, relative hypertension and systemic\nhypertension were defined as BP < 120/70 mmHg, 120 - 139/70 - 89 mmHg\nand â�¥140/90 mmHg, respectively. Results: Normal BP, relative hypertension\nand systemic hypertension were observed in 56 (54%), 43 (42%) and 4 (4%) of\nSCA patients, respectively. In multivariate analysis, factors associated with\nrelative hypertension were leg ulcer (aOR 2.05; 95%CI 1.77 - 5.18; p = 0.016),\ncentral obesity (aOR 3.32; 95%CI 1.28 - 6.24; p = 0.001), smoking (aOR 5.02;\n95%CI 1.51 - 9.50; p = 0.017), and microalbumiuria (aOR 3.44; 95%CI 1.44 -\n5.76; p = 0.035). Conclusion: Relative hypertension was a common finding in the present case series and associated with traditional cardiovascular risk factor\nas well as factors specific to SCD highlighting the need for measures to\nprevent its progression towards systemic hypertension and associated cardiovascular\nand renal disease....
Background. There is a dearth of information about the burden of cardiometabolic risk factors among the Ghanaian health\nworkforce in theWestern Region. This study sought to determine the prevalence of cardiometabolic risk factors among healthcare\nworkers at the Sefwi-Wiawso Municipal Hospital in the Western Region of Ghana. Materials and Methods. A hospital-based\ncross-sectional study involving 112 employees of the Sefwi-Wiawso Municipal Hospital was conducted. The cardiometabolic risk\nvariables assessed were obesity, hypertension, dyslipidaemia, and diabetes. Sociodemographic parameters were also captured. The\nprevalence of hypertension and obesity was determined using the JNC VII panel andWHO BMI criteria for obesity classifications.\nBlood lipids and glucose concentrations were evaluated using standard methods. Results. The prevalence of hypertension and\nprehypertension was 16.07% and 52.68%, respectively. About 38.39% of participants were overweight, and 12.50% were obese.\nAtherogenic dyslipidaemia was 26.79%, whereas prediabetes glycaemic levels and diabetes incidence were 5.41% and 4.50%,\nrespectively. Fifty percent (50.00%) of participants presented at least one cardiometabolic risk factor. Aging and adiposity were\nassociated with increasing cardiometabolic risk. Conclusion. Cardiometabolic risk factors are prevalent among healthcare providers\nin Sefwi-Wiawso.The cardiometabolic dysregulation observed among this cohort of healthcare professionals may bemodulated by\nage and adiposity....
Background: Hypertension is the leading cardiovascular risk factor worldwide,\nwith the greatest burden in low-income settings. Blood pressure (BP) control is\nusually low resulting in high rates of uncontrolled patients and complications.\nLow awareness resulting in poor therapeutic adherence represents an important\nfactor for insufficient blood pressure control in developing countries. Methods:\nThis was a three months non-randomized control trial at the cardiology clinic of\nthe Yaound�© Central Hospital. We included adults with essential and uncontrolled\nhypertension. The intervention consisted of group educative sessions\nevery week focusing on knowledge of hypertension risk factors, complications,\ntreatment, comorbidities, home self-monitoring of BP. Home blood pressure\nfigures, drug compliance, and knowledge regarding hypertension were evaluated\nbefore and after. Results: 17 participants (8 women) with a mean age\n56.2 �± 8.1 years. During intervention, mean SBP decreased by 30 mmHg while\nmean DBP drooped by 11 mmHg using home BP measures. Knowledge regarding\nhypertension, adherence and drug compliance increased by 36.5%,\n88.2% and 81.4% respectively. Conclusion: Therapeutic group education resulted\nin a significant improvement in BP control amongst uncontrolled hypertensive\npatients in sub Saharan Africa....
This paper provides commentary on some of the factors leading to a dramatic\nfall in heart disease death rates and the 42-year period (1968-2010) documented\non the accompanying table....
Radiological interventions play an increasingly relevant role in cardiology. Due to the inherent risks of ionizing radiation, proper\ncare must be taken with monitoring and optimizing the dose delivered in angiograms to pose as low risk as possible to staff and\npatients. Dose optimization is particularly pertinent in teaching hospitals, where longer procedure times are at times necessary to\naccommodate the teaching needs of junior staff, and thus impart a more significant radiation dose. This study aims to analyze the\neffects of different protocol settings in routine coronary angiograms, from the perspective of a large tertiary center implementing\na rapid dose reduction program. Routine coronary angiograms were chosen to compare baseline levels of radiation, and the dose\nimparted before and after dose optimization techniques was measured. Such methods included lowering dose per pulse,\nfluoroscopic pulse rates, and cine acquisition frame rates. The results showed up to 63% reduction in radiation dose without\nadverse impact on clinical or teaching outcomes. A 10 fps/low and 5 pps/low setting was found to achieve maximum dose\noptimization, with the caveat that settings require incremental changes to accommodate for patient complexities....
Aim. Aortic valve replacement (AVR) in patients with prior cardiac surgery might be challenging. Transcatheter aortic valve\nreplacement (TAVR) offers a promising alternative in such patients. We therefore aimed at comparing the outcomes of patients\nwith aortic valve diseases undergoing TAVR versus those undergoing surgical AVR (SAVR) after previous cardiac surgery.\nMethods and Results. MEDLINE, EMBASE, and the Cochrane Central Register were searched. Seven relevant studies were\nidentified, published between 01/2011 and 12/2015, enrolling a total of 1148 patients with prior cardiac surgery (97.6% prior\nCABG): 49.2% underwent TAVR, whereas 50.8% underwent SAVR. Incidence of stroke (3.8 versus 7.9%, p 0.04) and major\nbleeding (8.3 versus 15.3%, p 0.04) was significantly lower in the TAVR group. Incidence of mild/severe paravalvular leakage\n(14.4/10.9 versus 0%, p < 0.0001) and pacemaker implantation (11.3 versus 3.9%, p 0.01) was significantly higher in the TAVR\ngroup. There were no significant differences in the incidence of acute kidney injury (9.7 versus 8.7%, p 0.99), major adverse\ncardiovascular events (8.7 versus 12.3%, p 0.21), 30-day mortality (5.1 versus 5.5%, p 0.7), or 1-year mortality (11.6 versus\n11.8%, p 0.97) between the TAVR and SAVR group. Conclusions. TAVR as a redo procedure offers a safe alternative for patients\npresenting with aortic valve diseases after previous cardiac surgery especially those with prior CABG....
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