[Heart Failure at the Prefectoral Hospital Center of Kpalimé]. / HEART FAILURE AT THE CENTRE HOSPITALIER PRÉFECTORAL DE KPALIMÉ: Insuffisance cardiaque au Centre Hospitalier Préfectoral de Kpaliméc.

Introduction: L'insuffisance cardiaque (IC) est une issue majeure de santé publique avec une prévalence croissante, touchant aujourd'hui 1 à 3% de la population mondiale. Le but de cette étude était de décrire les aspects épidémiologiques, diagnostiques et thérapeutiques de l'IC à Kpalimé. Méthodes: Il s'agit d'une étude transversale descriptive réalisée sur quatre mois (janvier à mai 2023) portant sur les patients hospitalisés en médecine au CHP de Kpalimé et chez qui le diagnostic d'IC a été posé avec réalisation de l'échodoppler cardiaque. Résultats: La prévalence de l'IC était de 5,6%. L'âge moyen des patients était de 64,6 ± 17,7 ans avec prédominance masculine et un sexe ratio de 1,07. L'hypertension artérielle (83,8%) était le facteur de risque cardiovasculaire le plus retrouvé. La comorbidité la plus fréquente était l'anémie (16,13%). L'IC globale (54,8%) était le tableau clinique le plus fréquent. La fibrillation atriale était présente chez 12,90% des patients. Une dysfonction systolique du ventricule gauche était retrouvée chez 83,9% des patients. Les lésions cardiaques étaient dominées par la cardiomyopathie dilatée (58%) suivi de la cardiopathie hypertensive non dilatée à part égal avec les valvulopathies organiques chez 12,9% des patients. Les étiologies des cardiomyopathies dilatées étaient hypertensive (38,9%) et ischémique (22,2%). Les IEC et bêtabloquants sont les traitements de fond les plus prescrits. Aucun décès n'a été enregistré dans la série. Le taux de rupture thérapeutique était de 70% au premier rendez-vous de suivi. Conclusion: L'insuffisance cardiaque est une réalité à Kpalimé. Sa prévalence est sous-estimée en raison d'un sousdiagnostic. Sa prise en charge révèle un taux élevé de rupture thérapeutique. La prévention, le dépistage précoce et la prise en charge des facteurs de risque cardiovasculaire reste notre meilleure arme pour éviter sa survenue et ses complications. Mots clés: insuffisance cardiaque, épidémiologie, Kpalimé.

[COMPLICATIONS OF THROMBOLYSIS IN LOMÉ UNIVERSITY HOSPITALS]. / Complications de la thrombolyse dans les centres hospitaliers universitaires de Lomé.

Introduction: Les thrombolytiques sont des agents antithrombotiques capables de lyser un thrombus fibrinoplaquettaire et utilisés dans les pathologies thrombotiques artérielles et veineuses même si cette utilisation n'est pas anodine. L'objectif principal de notre étude était d'évaluer de façon générale les complications de la thrombolyse au cours du syndrome coronarien aigu ST+ et de l'embolie pulmonaire (EP). Matériel et méthode: Il s'agit d'une étude rétrospective et descriptive réalisée sur sept ans (janvier 2014 à décembre 2021) incluant les patients hospitalisés en cardiologie des CHU Campus et Sylvanus Olympio et ayant bénéficié d'une thrombolyse. Résultats: Soixante-cinq dossiers ont été colligés. L'âge moyen des patients était de 54,6 ± 15,5 ans dont 36 (55,4%) hommes et 29 (44,6%) femmes. La thrombolyse avait été réalisée dans le cadre d'une EP grave (54%) et d'un SCA ST+ (46%). La streptokinase était le seul thrombolytique utilisé, en association dans 87,7% des cas à une anticoagulation parentérale par l'héparine. Le succès de la thrombolyse était notifié chez 52 (80%) patients. Néanmoins des complications étaient survenues chez 25 (38,5%) patients dont 18,5% de réactions anaphylactiques, 17% d'hémorragies mineurs et 10,8% d'hémorragies majeures. Leur prise en charge était marquée par l'arrêt de la thrombolyse ou des anticoagulants, l'injection de corticoïdes ainsi que les mesures de réanimations et d'hémostase. La létalité de ces complications était élevée à 52%. Conclusion: La thrombolyse systémique est souvent le seul moyen thérapeutique d'urgence disponible dans nos régions pour le traitement des maladies cardiovasculaires aiguës (SCA ST+ et EP). La survenue des hémorragies peuvent engager le pronostic vital des patients. Il faudrait mettre en évidence les facteurs favorisants la survenue de ces complications. Mots clés: thrombolyse, complications, embolie pulmonaire, syndrome coronaire aigu.

Epidemiological, clinical, therapeutic and evolutionary specificities of the association between venous thromboembolic event and cancer in sub-Saharan Africa: Case of Togo.

BACKGROUND: Our study aimed to describe the clinical, paraclinical, therapeutic and outcomes of patients with venous thromboembolic event (VTE) associated with cancer in the context of limited resources. MATERIALS AND METHODS: This was a descriptive cross-sectional study over a period of six years from March 1, 2016 to March 31, 2022, in the cardiology department and the oncology unit of the Sylvanus Olympio Teaching Hospital of Lome. Our study examined medical records of patients who were at least 18 years old and had venous thromboembolic disease and cancer that was histologically confirmed. This study did not include records that were incomplete or records from patients with coronavirus disease. RESULTS: Our study included 87 patients with average age of 56.36±15.26 years. The discovery of VTE occurred incidentally in 28.74%. Venous thrombosis was isolated in 68.96% and proximal in 95%. Pulmonary embolism was bilateral in 77.77%. Gynaecological and urological cancers were found in 33.33% and 32.19% respectively. Adenocarcinoma was the histological type of cancer found in 47.13%. Cancers were at a very advanced stage in 74.71%. Treatment with antivitamin K was prescribed in 12.65%. In our study, there were 58 patients who passed away with a mortality rate of 66.66%. The cause of death was a complication of VTE in 22.42% and related to the course of cancer in 63.79% of cases. CONCLUSION: VTE during cancer is particular with a fatal evolution due to the severity of VTE and the very advanced stage of cancer.

[Evolution of cardiovascular diseases' admissions in cardiology departments of Lomé hospitals: a cross-sectional study on 7959 patients from June 2004 to May 2009]. / Évolution des admissions pour maladies cardiovasculaires en milieu cardiologique à Lomé : étude transversale de 7959 patients de juin 2004 à mai 2009.

BACKGROUND: To determine the frequency of cardiovascular diseases, their risk factors as well as their evolution in two cardiology departments of Lomé. METHODS: This cross-sectional study was carried out among patients attending two cardiology departments of Lomé, from June 2004 to May 2009, who had a diagnosis of cardiovascular disease. RESULTS: A total of 7959 patients were included. Female gender predominated. The mean age was of 49.5 ± 17.2 years. The number of admissions increased from 958 in 2004 to 2399 in 2009. Arterial hypertension (62.7%) and ischemic heart diseases (10.6%) were the most frequent diagnoses. Among patients with a diagnosis of heart failure, the etiology was not recorded for 12.2%. Overweight and dyslipidemia were significantly more frequent in women (P<0.001), while smoking and physical inactivity were significantly more frequent in men (P<0.001). During the period, there was a moderate rise of the prevalence of overweight, dyslipidemia, and physical inactivity, whereas the prevalence of diabetes and smoking remained almost unchanged. CONCLUSION: Admissions for cardiovascular diseases increased from 2004 to 2009. This epidemiological transition may be related to poor awareness of cardiovascular disease among the low-income population and the financial burden of health care.

[Management of high-grade atrioventricular block in Lomé, Togo]. / Prise en charge des blocs auriculoventriculaires de haut degré à Lomé (Togo).

The purpose of this cross-sectional study was to describe epidemiological, clinical and therapeutic aspects of high-grade atrioventricular block in Lomé. Out of 2245 patients hospitalized between June 2004 and May 2009, a total of 22 cases of high-grade atrioventricular block were detected thus a prevalence of 1%. The main symptoms were syncope and presyncope (73%) and dyspnea (50%). There was 77.2% of chronic grade III atrioventricular block and 22.8% of grade II atrioventricular block. A pacemaker has been established in 8 patients (40% of the patients presenting a class I indication) in VVI (R) mode. We noted 59% of deaths among patients who did not benefited from any cardiac pacing.

[Lower extremity venous thrombosis in Togo]. / La thrombose veineuse des membres inférieurs au Togo.

The purpose of this report was to describe epidemiologic, clinical, and paraclinical aspects and to identify etiologic factors associated with lower extremity venous thrombosis in Lome, Togo.

[The chronic constrictive pericarditis, a real calcified gangue realizing a mid-ventricular bottleneck: A case report]. / La péricardite chronique constrictive, une véritable gangue calcifiée réalisant un goulot d'étranglement médio-ventriculaire : à propos d'un cas.

A 30-year-old woman consulted for a predominantly right-sided global heart failure chart that had been evolving for about 3 months. Its antecedents include a concept of poorly treated pleuropulmonary tuberculosis at the age of 8 years. Lateral chest X-ray, transthoracic echocardiography and thoracic CT showed ventricular ring calcification with mid-ventricular compression with apical ballooning. The diagnosis of chronic mid-ventricular constrictive pericarditis of tuberculosis etiology was retained. The patient was put on diuretic treatment and the immediate evolution is favorable with a regression of the signs of congestion. Surgical decortication has been indicated.

[Prevalence and determinants of the increased carotid intima-media thickness in a population of 1203 black African hypertensive]. / Prévalence et facteurs déterminants de l'épaisseur intima-media carotidienne élevée dans une population de 1203 hypertendus noirs africains.

OBJECTIVES: To evaluate the prevalence and determinants of increased carotid intima-media thickness (IMT) in a population of black hypertensive patients and it influence of on the assessment of their overall cardiovascular risk. PATIENTS AND METHODS: This was a 16-month, cross-sectional study conducted in the outpatient unit of the cardiology department of the Campus teaching hospital of Lome, and included 1203 hypertensive patients, both sexes, aged 35 years and more. Each patient benefited from a carotid IMT measure. Carotid IMT was increased if it was>0.9mm and the plaque was defined as a carotid IMT>1.2mm. RESULTS: The mean age of our patients was 53.3±10.4 years with a sex ratio of 1.6 in favor of women. The duration of hypertension was less than 5 years in 56.7% and hypertension was grade 1 in 47.7% of cases. The mean carotid IMT was 0.89mm±0.20. The prevalence of the increased carotid IMT was 45.8% and that of an atheroma plaque was 15.8%. Carotid IMT was correlated with age (P˂0.0001), duration of arterial hypertension (P=0.01), history of stroke (P˂0.0001), and presence of left ventricular hypertrophy to cardiac ultrasound (P=0.01). The overall cardiovascular risk was modified after taking into account the carotid IMT. An increase in cardiovascular risk was observed in 30.5% of hypertensive patients. CONCLUSION: Increased carotid intima-media thickness is frequent in Togolese hypertension. The determining factors are age, duration of arterial hypertension, left ventricular hypertrophy and stroke. The systematic measurement of the carotid intima-media thickness would better evaluate the overall cardiovascular risk for our patients.

[Thrombolysis in pulmonary embolism with high mortality risk: Experience of a cardiology department in sub-Saharan Africa]. / La thrombolyse dans l'embolie pulmonaire à haut risque de mortalité : expérience d'un service de cardiologie d'Afrique Subsaharienne.

INTRODUCTION: High-risk pulmonary embolism (PE) accounts for 5% of total acute PE and is a life-threatening emergency requiring immediate therapeutic management by fibrinolysis. The objective of this work is to describe the experience of thrombolysis in high-risk PE in a cardiology department in Togo. PATIENTS AND METHODS: This is an analytical and descriptive study carried out in the cardiology department of the Campus teaching hospital of Lomé over a period of 5 years (August 2012 to July 2017) concerning patients hospitalized for high-risk mortality PE and having undergone streptokinase thrombolysis. RESULTS: Twenty-eight of the 102 PE were at high risk of mortality (27.5%). They were 9 men and 19 women with an average age of 61.9±14.1 years. The mean systolic blood pressure was 65mmHg and 50% of the patients were placed on dobutamine. Thrombolysis was performed in 22 of the 28 patients (78.6%). Eighteen patients had a short protocol and 4 a long protocol. The mortality rate was 32.1% or 13.6% in the thrombolysis PE versus 100% in the non-thrombolysis PE (P=0.01). Causes of death in thrombolysis were persistent shock (2 cases) at the end of thrombolysis and sudden death occurred 1 month after hospitalization. The average hospital stay was 18.8 days. CONCLUSION: The high-risk PE remains today a pathology burdened with heavy mortality. Thrombolysis remains the first treatment to reduce this mortality.

Acute coronary syndromes: epidemiological, clinical, paraclinical and therapeutic characteristics at the Campus teaching hospital of Lome, Togo.

INTRODUCTION: The aim of this work was to describe the epidemiological, clinical, and therapeutic characteristics of acute coronary syndromes (ACS) in the cardiology department of Lome Campus University Hospital in Togo. METHODOLOGY: We conducted a prospective study that consistently included patients hospitalized from 2014 to 2017 for ACS, based on clinical, electrocardiographic, and laboratory findings. RESULTS: Of 1914 patients admitted to the department during the study period, 67 were admitted for ACS, for a 3.5% prevalence. The (M/F) sex ratio was 1.91. Patients' mean age was 60 ± 12 years. The clinical presentation was an ST elevation myocardial infarction (STEMI) in 71.6% of cases, and non-STEMI in 28.4% of cases, including 18.1% non-Q-wave infarction and 10.3% unstable angina. The mean time to admission after the onset of symptoms was 81.9 ± 124.6 hours. Patients were transported to the hospital by a private vehicle in 82.1% of cases. Thrombolysis was performed for 14.6% of patients (7/48 patients with ACS STEMI), with a success rate of 85.7% (n=6). In-hospital mortality was 10.5% (7/67). This mortality was significantly associated with the interval from onset of symptoms to admission and with the Killip stage. CONCLUSION: Acute coronary syndromes are increasingly common in Togo. They are characterized by a relatively young age and a long delay until admission. Improving the management of these conditions in our countries requires effective primary prevention.

[Effusive pericarditis: clinical and etiological aspects in Lomé]. / Les péricardites liquidiennes : aspects cliniques et étiologiques à Lomé.

OBJECTIVE: to describe the course and the etiologic, prognostic, and therapeutic aspects of effusive pericarditis (EP) in Togo. MATERIAL ANDMETHODS: Prospective and longitudinal study conducted at the cardiology department of Sylvanus Olympio Teaching Hospital of Lome from February 1, 2011, to January 31, 2014, of patients hospitalized for EP, confirmed by Doppler echocardiography. RESULTS: The study included 38 patients. The hospital incidence rate of EP was 2.0%. The mean age was 42.5 ± 14.9 years (range: 16 to 73 years) with a sex ratio of 0.7. Exertional dyspnea, poor general condition, chest pain, and fever were the main symptoms. Pericardial effusion was abundant in 24 patients (63%). The Koch bacillus was identified on direct examination in five patients (13%) and only from sputum. HIV serology was positive in 18 patients (47%). Pericardial fluid was collected from 24 patients (63%). Pathology examinations of pericardial tissue found nonspecific inflammation in 5 patients and pericardial tuberculosis in 7. The causes of EP were: tuberculous (55%), idiopathic (16%), bacterial (8%), HIV-related (5%), uremic (5%), neoplastic (5%), lupus (3%), and rheumatic (3%). CONCLUSION: EFP is a frequent, serious, even deadly disease in Africa because of the HIV-AIDS pandemic. Treatment depends on the cause, most often tuberculosis.

[Biventricular thrombus complicating peripartum cardiomyopathy. A case report]. / Thrombose biventriculaire compliquant une cardiomyopathie du péripartum. A propos d'une observation.

The authors report a case of a biventricular thrombus complicating peripartum cardiomyopathy in a 38 years old female. The diagnosis was done by bidimensionnal transthoracic echocardiography which showed 2 thrombi in the apical region of the right ventricle and in the anterior and lateral wall of the left ventricle. With treatment associating salt restriction, diuretics and angiotensin-converting-enzyme- inhibitors, the evolution was good: the thrombi disappeared at the first month for the left ventricular thrombi and after 45 days for the rignt ventricular thrombi. The patient didn't experience any embolic complication.

[Knowledge, attitudes and practices related to venous thromboembolism prophylaxis in hospitalists in Lome (Togo)]. / Connaissances, attitudes et pratiques sur la prophylaxie de la maladie thromboembolique veineuse chez les praticiens hospitaliers en médecine à Lomé (Togo).

The purpose of this study was to assess the knowledge and practices related to the prevention of venous thromboembolism (VTE) in medical settings in Lome (Togo). Hospitalists in Lome are relatively well aware of the risk of VTE in patients. They report risk factors for VTE as the primary indications for thromboprophylaxis. Few physicians cited acute medical conditions among these indications.

[Prevalence and determinants of hypertension in Lomé (Togo): results of a screening in May 2011]. / Prévalence de l'hypertension artérielle et description de ses facteurs de risque à Lomé (Togo) : résultats d'un dépistage réalisé dans la population générale en mai 2011.

BACKGROUND: The prevalence of hypertension in the Sub-Saharan Africa region is increasing as a manifestation of the epidemiological transition, and this fact will oblige these countries to mobilize significant resources. World Bank estimates cheaper to prevent cardiovascular disease than to treat people once these diseases are established suggesting the need to know the prevalence of hypertension in order to allow prevention programs in our population. However, data in Togolese populations are rare. The purpose of the present study was to determine the prevalence of high blood pressure and its risk factors in Lomé. METHODS: We performed a cross-sectional survey among 2002 unselected respondents of the municipality of Lomé in May 2011. A questionnaire has been filled about family history of hypertension, habits and practices that affect hypertension on behalf of each respondent and anthropometric data and blood pressure has been measured. RESULTS: The prevalence of high blood pressure was 36.7% (34.6% of male vs. 38.4% of female, OR=0.85; 95%CI=0.7-1.02; P=0.08); 42.4% of the hypertensive respondents have been diagnosed at the screening. Blood pressure was positively correlated to the age (SBP: r=+0.46; P=0.001; DBP: r=+0.36; P<0.001), the body mass index (SBP: r=+0.7; P<0.001; DBP: r=+0.89; P<0.001) and waist circumference (SBP: r=+0.28; P<0.001; DBP: r=+0.3; P<0.001). There was a significant relationship between arterial hypertension and obesity (OR=1.65; 95%CI=1.47-1.84; P=0.003), salt consumption (OR=1.4; 95%CI=1.13-1.72; P<0.001) and oral contraception (OR=2.1; 95%CI=1.29-3.43; P=0.002). CONCLUSION: There was a high prevalence and low awareness of arterial hypertension in the municipality of Lomé with a female prevalence. This affection was correlated to age, salt consumption and obesity. This study raises the need for accentuating the prevention in our poor populations which are unable to face adverse outcomes which can occur.

[Compliance to treatment in heart failure patients in Lomé]. / Observance thérapeutique de l'insuffisant cardiaque à Lomé

BACKGROUND: The incidence and prevalence rates of the heart failure in the world approach epidemic proportions. The evaluation of the follow-up of the treatment of heart failure can allow the setting up of strategies to reduce the frequency of decompensations and improve the quality of life of these patients. OBJECTIVES: To estimate the compliance to treatment and factors liable to influence it in Togolese patients suffering from heart failure. PATIENTS AND METHODS: This study was carried out from January 1st, 2008 to June 30th, 2009 in the department of cardiology of the university teaching hospital Campus in Lomé and included prospectively, patients with chronic heart failure hospitalized for acute decompensation and of which the heart failure was diagnosed and treated for at least 3 months. Questionnaires were filled to estimate the compliance to medication, to diet, as well as knowledge of the patients on their disease and their relationship with their doctor and their family. RESULTS: In the 103 patients included, we noticed no good compliance to medication; there were 74.7% of bad compliance to medication, 47.3% of good compliance to diet; 62.1% of patients had enough knowledge on their disease, 29.1% considered that their doctor did not grant them enough time; 57.3% estimated to have no necessary support of their family. Bad compliance to treatment was correlated to the existence or not of a health care insurance (OR=115.5; 95% CI=21.51-620.08; P<0.0001); this difference persisted after adjusting for age, sex and monthly income (OR=99.65; 95% CI=18.87-587.21; P=0.001). Bad compliance was not associated with monthly income (OR=0.93; 95% CI=0.37-2.28; P=0.944); it was neither influenced by traditional therapy (OR=1.58 95% CI=0.64-3.91; P=0.43), nor recovery prayers (OR=1.6; 95% CI=0.62-4.13; P=0.45), nor frequency of tablets intake (≥3 intake day), OR=0.169; 95% CI=0.05-0.49; P=0.43. CONCLUSION: The compliance to medication in Togolese heart failure patients was very low and essentially correlated to the absence of health care insurance.

Prevalence of cardiovascular risk factors in an urban area of Togo: a WHO STEPS-wise approach in Lome, Togo.

OBJECTIVE: To determine the prevalence of hypertension and other cardiovascular risk factors in the general adult population of Lome. METHODS: A cross-sectional household survey was conducted in Lome from October 2009 to January 2010, which focused on hypertension and other cardiovascular risk factors in 2 000 subjects 18 years and older. The World Health Organisation's STEPS-wise approach on non-communicable diseases was used. During the first session, blood pressure (BP) was measured on three successive occasions, one minute apart, and the mean was recorded. A second measurement session was done three weeks later in patients with BP ≥ 140/90 mmHg during the first session. Hypertension was defined as BP > 140/90 mmHg after the second session, or on antihypertensive treatment. The other risk factors were studied by clinical and blood analysis. RESULTS: We found 532 hypertensive patients out of a total of 2 000 subjects. The prevalence of hypertension was 26.6%. The mean age of hypertensive patients was 45 ± 10 years, ranging from 18 to 98 years. The prevalence of other cardiovascular risk factors was: stress (43%), sedentary lifestyle (41%), hypercholesterolaemia (26%), obesity (25.2%), hypertriglyceridaemia (21%), smoking (9.3%), alcohol use (11%) and diabetes (7.3%). CONCLUSIONS: The prevalence of hypertension and other cardiovascular risk factors in the population of Lome is high. These findings should draw the attention of authorities to define a national policy to combat hypertension and other cardiovascular risk factors.

[Arterial hypertension in black subjects over 50 years of age in Lomé: epidemiological aspects and evaluation of cardiovascular risk (prospective and longitudinal study of 1485 patients)]. / Hypertension artérielle du sujet noir âgé de 50 ans et plus a Lomé : aspects épidémiologiques et évaluation du risque cardiovasculaire (Étude prospective et longitudinale de 1485 patients).

INTRODUCTION: High blood pressure is a public health problem for which the assumption of responsibility remains especially difficult in older subjects. Generally, it is associated with other cardiovascular risk factors. The objective of this study is to determine the prevalence of high blood pressure in older subjects in a particular environment and to evaluate the cardiovascular risk among these patients. METHODOLOGY: This is a longitudinal exploratory study undertaken on 1485 hypertensive subjects of 50 years of age or older, selected from 1999 patients received in three health professional training centers of the community of Lomé, between June 1, 2004 and June 30, 2007. Information had been collected using a card of investigation. Classifications of high blood pressure were those of the JVCVII and the European Society of Cardiology. The data analysis had been made by computer tools. RESULTS: The prevalence high blood pressure was of 74.29%. We had noted a female prevalence (63.8%) with a sex ratio of 0,57 and one middle age of 62.08±9.3 years. Dyspnea (45.9%), chest pains (16.2%) and palpitations (13.2%) were the principal found symptoms. The various listed risk factors were: dyslipidemia (58.1%), obesity (36.12%), alcoholism (16.7%) and diabetes (10.6%). The complications were cardiac (87.81%), ocular (79.8%), renal (19.86%), neurological (4.92%) and arterial (0.99%). The cardiovascular risk was very high at 58.05% of the patients. The mortality rate was of 1.9%. CONCLUSION: High blood pressure is the most frequent cardiovascular risk factor in our country from 50 years of age. Assumption of responsibility for it is by information, education of the population and requires the mobilization of all the social components.

[Epidemiology and diagnostic circumstances of arterial hypertension in the hospital environment in Kpalime (second largest city in Togo)]. / Epidemiologie et circonstances de decouverte de l'hypertension arterielle (HTA) en Milieu Hospitalier a Kpalime (Ville Secondaire du Togo).

UNLABELLED: Arterial hypertension is a real health problem worldwide. The goal of this survey is to evaluate its prevalence and risk in hospital environment. It was a prospective and multi-centred survey which took place in the cardiology department in Kpalimé hospital from the 4th August 2005 to the 4 th July 2006 then a period of almost ten months. Our survey allowed us count 584 people suffering from hypertension out of 2641 patients which makes a prevalence of 22%. Distribution according to the global sample gave a predominance of 56.3 % for women against 43.7% for men. The age of our patients varied between 20 years and 95 years with an average of 53.4 years +/- 15.02. According to the age the group which was more touched was the one between 46 and 69 years. Distribution according to social and professional segments was dominated by the housewives (27.9%), the civil servants (17.8 %) and the trade men (14.0%). Symptomatology is dominated by a dyspnea during an physical effort (28.8%), signs having no relation with AHT (20.2%) and headache (19.5%). Factors for most frequent risk were: obesity (56.8%), consumption of alcohol (22.1%) and dyslipidemia (13.4%). The rate of morbidity is about 59.5% and the mortality is about 11%. CONCLUSION: AHT in Togo is a real problem of public health. It occurs in the poorest social segments, causing a problem of medical care. The prevention remains the most efficient mean to avoid sickness and should be necessarily based on a real change of attitude by the authorities and the medical staff as the sensibilization of the population.

[Ischemic cardiomyopathy in Lome: epidemiologic aspects and risk factors (study of 461 cases)]. / Les cardiopathies ischemiques (CI) à Lomé: aspects épidémiologiques et facteurs de risque (etude de 461 cas).

UNLABELLED: According to the WHO, cardiovascular disease such as arterial hypertension and ischemic heart disease will be the main non-communicable diseases in developing countries in the next decades. In Togo, there is no statistic on this disease on this day. Our objectives were to study the epidemiological aspects and to describe the risk factors of this affection in our surroundings. It is about a multicentric transverse study from June 1st, 2004 to May 31, 2007, in 3 sanitary formations of the city of Lomé. RESULTS: The frequency of ischemic heart disease was 11, 46%. There was a feminine predominance with a sex-ratio of 0.71. The average age of the patients was about 55.3 +/- 13.4 years with extremes of 18 and 95 years. The cardiovascular risk factors were: dyslipidaemia (76.9%), hypertension (75.3%), left ventricular hypertrophy (72.8%), abdominal obesity (71.1%), hyperuricemia (50.5%), hyperglycemia (41.9%) of which overt diabetes (29%) and smoking (3%). There was a feminine predominance at the hypertensive and the obese. The women accumulated more modifiable risk factors than the men. The middle risk indication was of 2.34 +/- 0.9 at the men and 2.55 +/- 0.8 at the women. The different clinical forms were: stable angina (71.2%), unstable angina (1.7%) and myocardial infarction (5.2%); silent ischemia represented 21.9%. The antero-septal territory was the more reached in case of myocardial infarction and the antero-lateral territory in case of ischemia. CONCLUSION: A sanitary politic centered on the eviction of the risk factors should help to reduce the prevalence of this affection for a long time in our surroundings.

[Cardiovascular emergencies and their morbimortality at the hospital. Report of 733 cases at the CHU campus in Lome (national reference hospital in Togo)]. / Urgences cardio vasculaires et leur morbimortalite en milieu hospitalier. A propos de 733 cas colliges au CHU campus de Lome (hopital de reference national du Togo.

Due to the recent establishment of the emergencies Units in Black Africa, their epidemiological aspects are not well known. Our aims was to describe the epidemiology of this desease in Togo. Through a retrospective analysis we study over a period of 42 mouths. From January first, 2001 to June 30th, 2004. It was carried out exclusively at CHU-Campus, the hospital of Lomé Campus, the second national medical center of reference. Included were all the patients with cardio-vascular emergency cases. We have studied the epidemilogical aspects according to the age, sex, profession, morbidity, and mortality. The treatment of results have been done by Computer. The registered emergency cases were 733 il all with is a frequency of the patients admitted at CHU-CAMPUS. The average age is 56 +/- 13 years with extreme ages from 20 to 97 years. The age group most affected is between 30 and 69 years--The ratio according to the sex is 1.09 in favour of men. Housewives are the professional category most affected (42.3%). Constitute the essential of the cardiovascular emergency cases with a ratio of the 78.3%. The mortality is 17.1% which in most registered between 30 and 69 years. The morbidity ratio is 64.1% We have to keep in mind that cardio-vascular emergency cases are very frequent in Togo. A very active population of young people is concerned. The poor are the most threatened. Henceforth the establishment and equipment of cardiological units are absolutely necessary, for they constitute the only solution by which the level of morbi-mortality can be reduced.