Comorbidities and the management of hypertensive heart disease in a low-resource setting: a cross-sectional study

低资源环境下合并症与高血压性心脏病管理:一项横断面研究

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Abstract

BACKGROUND: Low-and middle-income countries account for over 80% of the global burden of cardiovascular disease (CVD). The Sub-Saharan African region is the most affected by CVD. Hypertensive Heart Disease (HHD) is a common complication of hypertension which is prevalent in the Democratic Republic of Congo (DRC). Our study aimed to identify the comorbidities associated with and the management of HHD in the DRC. MATERIALS AND METHODS: This cross-sectional analysis was done at a 200-bed tertiary hospital in Kinshasa, DRC from January to December 2019. Data were collected retrospectively from patient records and missing values were generated by multiple imputations and the pooled values were used for data analysis. Bivariate and multiple correlation regression were used and odds ratios were generated. RESULTS: 34 (56.7%) of the 60 patients were male. The mean age was 63.2 ± 9.7 years, the mean BMI was 25.5 ± 5.0 kg/m(2), and 90.0% of patients were unemployed. Patients had dyslipidemia (43.3%), stroke (31.7%), and diabetes (10.0%). Mean serum creatinine (1.4 ± 0.1 mg/dL), HDL (56.7 ± 18.4 mg/dL), LDL (119.3 ± 30.5 mg/dL), and median urea (24.0, IQR: 63.5 mg/dL) levels were abnormal. HDL was a predictor of high blood pressure (P < 0.01). 83.3% of patients took statins, 78.3% took ACE inhibitors, and 70.0% took aspirin. CONCLUSION: Congolese HHD patients have multiple comorbidities. Efforts should be focused on increasing access to care through early diagnosis, early referral, and low-resource appropriate management.

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