Oxidative profile of sickle cell patients in a Cameroonian urban hospital.

BACKGROUND: Sickle cell disease (SCD) is a class of hemoglobinopathy resulting from a single mutation in the ß-globin chain inducing the substitution of valine for glutamic acid at the sixth amino acid position which leads to the production of abnormal haemoglobin (haemoglobin S [HbS]). Studies demonstrated the implication of oxidative stress in the development of the sickle cell disease. METHODS: The study aim was to determine the level of oxidative stress markers in a group of sickle cell homozygous patients (SS) in the Yaounde Central Hospital above 15 years of age. Hemolysates obtained from patients were used to investigate some oxidative stress markers including malondialdehyde (MDA), nitric oxide (NO), catalase (CAT), superoxide dismutase (SOD), peroxidase, total antioxidant capacity (TAC) and total protein concentration. RESULTS: Eighty four individuals, 42 males and 42 females participated (50 % each) with an age range of 15 to 55 years. The levels of markers were significantly higher in the healthy AA group than sickle (SS) (p < 0.05), with the exception of MDA which was significantly high in sickle cell (SS) patients than healthy (p = 0.037). With respect to the gender, both healthy and SS females showed a greater Total anti-oxidant capacity (65 µM) compared to the males (55 µM). CONCLUSION: The increase in the oxidative stress level especially MDA in sickle cell homozygous patients compared to healthy AA individuals confirms that oxidative stress is involved in the pathogenesis of the sickle cell disease.

Leukocyte ratios in non-diabetic hypertensive Cameroonians do not predict cardiovascular risk : preliminary results of the HYRICCA project.

BACKGROUND: Full blood count is routinely performed in the evaluation of hypertensive patients. However, usefulness of leukocyte ratios in cardiovascular risk (CVR) assessment hasn't yet been proven in Cameroonians. OBJECTIVE: Evaluate the contribution of leukocyte ratios in CVR assessment of non-diabetic hypertensive adults. METHODOLOGY: We carried out a cross sectional study including non-diabetic hypertensive patients followed up at the cardiology unit of the Yaoundé Central Hospital from November to June 2022. We collected relevant clinical data with a pre-established questionnaire and blood samples from each patient for different biological analyses. The spearman correlation test was used to assess on the one hand the relationship between leukocyte ratios, highly sensitive CRP and the WHO 2019 risk score as our primary end point, and on the other hand between leukocyte indices and the other risk estimators as our secondary outcome. The significant threshold level was set as 0.05. RESULTS: We included 165 participants (102 females) with a mean age of 57.6 (10.4) years. The median duration of hypertension since diagnosis was 7 years and only 27% of participants on treatment had a controlled blood pressure. There was no significant correlation between leukocyte ratios and the WHO 2019 risk score. Highly sensitive CRP and the atherogenic index of plasma were significantly correlated respectively with the granulocyte to lymphocyte ratio (rho = 0.18, p = 0.03) and the eosinophil to lymphocyte ratio (rho = 0.28, p = 0.01). There exists a weak positive association between the granulocyte to lymphocyte ratio and the Reynolds risk score. CONCLUSION: Leukocyte ratios are not useful for CVR assessment in hypertensive Cameroonians with respect to the WHO 2019 risk score. Prospective studies are needed to assess their usefulness in combination with conventional risk factors to improve prediction of cardiovascular events.

Validation of lipid profile measurement methods and establishment of reference values in a sub-Saharan African population.

Validated reference values and procedures are needed to ensure optimal diagnosis of dyslipidemia in sub-Saharan Africa. We aimed to validate an analysis method and establish reference intervals of lipid profile parameters in Cameroonians using this method. On a cross-sectional study conducted from November 2019 to August 2020 in Yaoundé, we have analyzed blood samples with Cobas® 6000. We subscribed to ASQUALAB's External Quality Assessments (EQA) and Outsourced Internal Quality Controls (IQC). Reproducibility, repeatability, correctness accuracy and uncertainty were evaluated using IQC. Consenting adult participants were conveniently sampled, excluding those with any condition that may affect lipid profile. Descriptive statistics were reported accordingly, agreement was assessed with Bland-Altman analysis, and reference intervals were defined according to CLSI and IFCC recommendations. The coefficients of variation for repeatability, reproducibility, and correctness bias ranged between 0.6% and 6%, with all values within the normal range. Expanded uncertainty of total cholesterol, HDL and triglycerides measurements were, respectively, 0.45, 0.24 and 0.18. We included 422 participants with a mean age of 30.2 (10.9) years and 248 (58.8%) females. Reference intervals for total cholesterol, HDL, triglycerides and LDL were, respectively, 2.94-6.02 mmol/L, 0.90-2.06 mmol/L, 0.35-1.36 mmol/L, 1.37-4.13 mmol/L. These intervals were similar between sex and ethnic groups, but lower in younger participants. Lipid profile measurement with Cobas® 6000 is a reliable and accurate analysis in our context. Specific reference intervals must be used in African population, with further studies need for different age subgroups.

Correlation between insulin-based and C-peptide based homeostatic model assessment of insulin resistance in adults without diabetes in a sub-Saharan African setting: a cross-sectional study.

OBJECTIVE: To assess the correlation between the insulin-based and C-peptide based HOMA-IR in the general population without diabetes in sub-Saharan Africa as well as to identify factors associated with IR. RESULTS: This was a cross-sectional study in urban settings in Yaoundé, Cameroon. We included 84 people with a body mass index (BMI) ≥ 18.5 Kg/m² and without diabetes (females: 72.6%; mean age: 37 years). IR was assessed using the following formulae: HOMA-IRINS = fasting insulin (mU/ml) x fasting plasma glucose (FPG) (mmol/L)/ 22.5; HOMA-IRCP1 = fasting C-peptide (mU/ml) x FPG (mmol/L)/ 22.5; and HOMA-IRCP2 = 1.5 + (FPG (mg/dl) x fasting C-peptide (ng/ml))/ 2800. Correlation (rho) between HOMA-IRINS and C-peptide based HOMA-IR was investigated using the Spearman rank test. The median (25th -75th percentiles) HOMA-IRINS, HOMA-IRCP1, and HOMA-IRCP2 were: 1.94 (1.36-3.50), 0.18 (0.11-0.27) and 9.91 (6.81-14.52), respectively. There was no correlation between the insulin-based and C-peptide-based HOMA-IR indices: rho = 0.043, p = 0.697. IR (HOMA-IRINS ≥ 2.8) was associated with obesity: A BMI ≥ 30 Kg/m² (adjusted odds ratio (aOR): 16.9, 95% confidence intervals (CI): 3.1-92.5) and being a student (aOR: 8.9, 95%CI: 2.1-38.2) were associated with IR.

Simple noninvasive tests for liver fibrosis diagnosis in sub-Saharan African adults with chronic viral hepatitis B or C: A cross sectional study in Cameroon.

BACKGROUND AND AIMS: This study aimed at measure the correlation between simple less expensive and noninvasive tests for liver fibrosis and Fibrotest among patients with chronic hepatitis B (HBV) or C (HCV) in resource-limited settings. MATERIALS AND METHODS: This was a cross-sectional study conducted at the Centre Pasteur of Cameroon among adults with chronic HBV or HCV infection. The correlation between aspartate aminotransferase to platelet ratio index(APRI), the gamma-glutamyl transferase to platelet ratio (GPR), and Fibrosis-4 score (FIB-4); and Fibrotest was assessed using the Spearman rank test providing the rho (ρ) coefficient of correlation. RESULTS: Of the 52 patients (mean age: 49 years, males: 51.9%) included, 52% were infected with HBV (n = 27). The APRI, GPR, FIB-4, and Fibrotest median scores (25th-75th percentiles) were: 0.37 (0.25-0.64), 0.34 (0.20-1.45), 1.49 (0.88-3.12), and 0.43 (0.21-0.80), respectively. The correlation with Fibrotest were: APRI (ρ = 0.678, p value < 0.0001), GPR (ρ = 0.621, p value < 0.0001) and FIB-4 (ρ = 0.772, p value < 0.0001). CONCLUSIONS: This study found a significant correlation between APRI, GPR and FIB-4; and Fibrotest among patients with chronic HBV or HCV infection in Cameroon. FIB-4 appeared as the diagnosis method with the strongest correlation with Fibrotest.

Adiponectin levels and its relation with insulin secretion and insulin sensitivity in a group of sub-Saharan African women with polycystic ovary syndrome.

OBJECTIVES: Low levels of adiponectin have been reported in Polycystic Ovary Syndrome (PCOS). In sub-Saharan Africa, little data are available on the topic. We aimed to investigate the levels of adiponectin and its relation with insulin secretion and insulin sensitivity in women with PCOS in Yaoundé, Cameroon. A comparative cross-sectional study was conducted in 32 women presenting PCOS and 32 controls matched for age and Body Mass Index. For each participant, adiponectin levels were measured. We estimated insulin sensitivity using Homeostasis model index (HOMA-IR) and insulin secretion with C-peptide levels. RESULTS: Women with PCOS had higher insulin secretion levels than controls (C-peptide: 4.98 ± 3.83 vs 3.25 ± 1.62 mUI/l; p = 0.02). Also, the HOMA-IR index was higher compared to that of women without PCOS (1.15 ± 0.90 vs 0.77 ± 0.38; p = 0.03) suggesting greater insulin resistance. The median [25th-75th percentile] values of adiponectin concentrations were similar between the two groups (22.68 [21.72-23.41] µg/ml vs 22.03 [21.40-22.93] µg/ml; p = 0.1). There was no association between insulin sensitivity and adiponectin levels in the PCOS group. PCOS is not associated with changes in adiponectin in a population of sub-Saharan African women. Further studies are needed to shed more light on this condition.

Inflammation and Insulin Resistance in a Group of Sub-Saharan African Women with Polycystic Ovary Syndrome.

BACKGROUND: Studies report high levels of inflammatory markers in women with polycystic ovary syndrome (PCOS), reflecting chronic low-grade inflammation. This inflammation is thought to be associated with insulin resistance. We aim to evaluate inflammatory markers [high sensitivity C reactive protein (CRP) and interleukin 6] and insulin resistance in women with PCOS in Yaoundé, Cameroon. METHODS: We conducted a comparative cross-sectional study including 32 women with PCOS aged between 18 and 44 years and 32 controls matched for age and body mass index (BMI). Homeostasis model assessment of insulin resistance (HOMA-IR) index calculated using C peptide levels was used to evaluate insulin resistance. Serum levels of high sensitivity CRP (hsCRP) and interleukin 6 (IL-6) were measured. Comparisons were made using the Student's T-test and non-parametric tests (Mann-Whitney U-test, Kruskal-Wallis test). RESULTS: We found that the median [25th-75th percentile] level of hsCRP was significantly higher in women with PCOS compared to the controls (0.63 [0.32-3.81] mg/L vs. 0.47 [0.15-1.04] mg/L; p=0.01), while IL-6 levels were not different (8.61 [4.1-33.79] pg/mL for PCOS vs. 8.80 [5.28-38.85] pg/mL for controls; p=0.51). We noted that women with PCOS had a higher HOMA-IR index (1.15±0.90 vs. 0.77±0.38; p=0.03). However, there was no correlation between hsCRP level and the HOMA-IR index (Spearman correlation coefficient=0.10; p=0.62). CONCLUSION: PCOS is associated with an increased level of hsCRP and insulin resistance in Cameroonian women. This exploratory study provides baseline evidence for larger-scale studies.

Dyslipidemia in Patients with a Cardiovascular Risk and Disease at the University Teaching Hospital of Yaoundé, Cameroon.

Objective. To determine the frequency of lipid abnormalities in patients with a cardiovascular risk and disease at the University Teaching Hospital (UTH) of Yaoundé. Materials and Methods. We conducted a cross-sectional study from 1 March to 31 May 2015 at the UTH of Yaoundé. We included all patients seen in the outpatient department with a diagnosis of a cardiovascular disease or a risk factor for cardiovascular disease. Patients who accepted to participate in the study were asked to answer a questionnaire; after that a blood sample was taken for lipid profile. An informed consent was signed by all the participants and the study has received approval from the national ethic committee. Results. We recruited 264 patients of which 119 were men and 145 were women with a sex ratio of 0.82. Mean age was 61.36 years. The frequency of lipid profiles abnormalities was as follows: low HDL cholesterol (44.3%), hypertriglyceridemia (18.9%), high LDL cholesterol (3.8%), and high total cholesterol 3.4%). Hypertriglyceridemia was strongly associated with type 2 diabetes mellitus. Conclusion. Low levels of HDL cholesterol and hypertriglyceridemia are more prevalent in our study population. More studies are needed to confirm this finding in our environment.

Assessment of the 10-year risk of cardiovascular disease among a group of patients on maintenance hemodialysis: A cross-sectional study from Cameroon.

OBJECTIVE: To assess the 10-year risk of cardiovascular disease and potential impacting factors among patients undergoing hemodialysis in Yaoundé, Cameroon. DESIGN: A cross-sectional study in January 2016. SETTING: Patients were recruited at the dialysis unit of the Yaoundé University Teaching Hospital, Cameroon. PARTICIPANTS: These were hemodialysis patients aged 20 years and above, dialyzing in the above unit since at least 3 months and volunteering to be enrolled in the study. MAIN OUTCOME MEASURES: The risk of cardiovascular disease was assessed using the Framingham risk score. RESULTS: We included 44 patients. The risk of cardiovascular disease ranged from less than 1% to more than 30% with a median of 12.3% (interquartile range 4.9-24.4). Twenty hemodialysis patients (45.5%) had a low risk of cardiovascular disease (<10%), 10 (22.7%), a moderate risk (10-20%), and 14 (31.8%) presented a high risk of cardiovascular disease (>20%). In multivariable linear regression analysis, duration on dialysis (adjusted ß = 0.11; p = 0.003), number of weekly sessions of physical activity (adjusted ß = -1.35; p = 0.018), fasting serum glucose levels (adjusted ß = 4.22; p = 0.022), serum triglycerides levels (adjusted ß = 5.94; p = 0.033), and serum urea levels (adjusted ß = -2.08; p = 0.039) were independently impacting our patients' risk of cardiovascular disease. CONCLUSION: Around 55% of our study population presented a moderate or high risk of cardiovascular disease. Duration on dialysis, number of physical activity sessions per week, fasting serum glucose, serum triglycerides, and serum urea levels may impact our hemodialysis patients' risk of cardiovascular disease.

Antioxidant and Synergistic Antidiabetic Activities of a Three-Plant Preparation Used in Cameroon Folk Medicine.

Introduction. Several plant preparations like a mixture of aqueous extracts of Spilanthes africana; Portulaca oleracea; and Sida rhombifolia are currently utilized in Foumban (West Cameroon) to manage diabetes. The aim of this study is to investigate the antidiabetic property of the aqueous mixture of three plant extracts (1 : 1 : 1) on streptozotocin induced diabetes rats. Methods. Diabetes was induced to rats by intraperitoneal (i.p.) injection of streptozotocin (STZ) at a dose of 50 mg/kg b.w. The diabetic rats received different dosages of the mixture of extracts for 21 days and glibenclamide 6.5 mg/kg b.w. as positive control. Results. The results showed that the mixture of extracts significantly (p < 0.05) decreased the level of the glycaemia, the total cholesterol, triglyceride, and LDL-cholesterol as well as MDA, AST, ALT, and creatinine levels. It also increased significantly the concentration of HDL-cholesterol, glutathione, and TAOS. A great reduction of the atherogenic indexes CT/HDL and LDL/HDL of the treated groups was observed. Each extract and the mixture demonstrated significant scavenging property on DPPH and OH radicals and present a good antioxidant property. Conclusion. The mixture of plant extracts has hypoglycemic, antioxidant, and hypolipidemic properties and can be used for the management of diabetes mellitus.

Atherogenic index of plasma and 10-year risk of cardiovascular disease in adult Africans living with HIV infection: A cross-sectional study from Yaoundé, Cameroon.

BACKGROUND: The paucity of data regarding the association between atherogenic index of plasma and risk of cardiovascular disease in HIV-infected populations living in sub-Saharan Africa prompted us to conduct this study which aimed to assess the relationship between atherogenic index of plasma and risk of cardiovascular disease among a Cameroonian HIV-infected population. METHODS: This was a cross-sectional study conducted among 452 HIV-infected adults in Yaoundé, Cameroon. Risk of cardiovascular disease was calculated using the Framingham risk score; atherogenic index of plasma was derived as log (triglycerides/high-density lipoproteins cholesterol). RESULTS: Participants' mean age (80% females) was 44.4 ± 9.8 years. Atherogenic index of plasma values ranged from -0.63 to 1.36 with a median of 0.11 (25th-75th percentiles: -0.08-0.31). Most participants (88.5%) were on antiretroviral treatment. There was a significant correlation between atherogenic index of plasma and fasting plasma glucose (r = 0.116; p = 0.014), atherogenic index of plasma and total cholesterol (r = -0.164; p < 0.001). Atherogenic index of plasma was significantly associated with the risk of cardiovascular disease either in univariable (ß = 5.05, 95% CI: 3.31-6.79; p < 0.001, R2 = 0.067) or in multivariable linear regression model after adjusting for socio-demographic, clinical and biological confounders (adjusted ß = 3.79, 95% CI: 1.65 - 4.88; p < 0.001, R2 = 0.187). CONCLUSION: Atherogenic index of plasma may be an independent factor impacting the risk of cardiovascular disease among Cameroonian HIV-infected people. More studies are needed to better elucidate the association between atherogenic index of plasma and risk of cardiovascular disease in our setting.

Cameroonian professional soccer players and risk of atherosclerosis.

BACKGROUND: Elevated titers of antibodies against oxidized low-density lipoproteins-cholesterol (ox-LDL-Ab) have been reported among professional athletes, paradoxically reflecting an increased risk of developing atherogenic and/or cardiovascular events. This study aimed to determine titers of ox-LDL-Ab in a group of Cameroonian professional soccer players, and evaluate their evolution during part of a competition season as well as the plasmatic antioxidant status to find out if this latter correlates with ox-LDL-Ab . METHODS: We conducted a descriptive cohort study in 2012 including 18 healthy male soccer players. Three samplings were performed in March (T1), May (T2), and July 2012 (T3) to assess the lipid profile, titers of ox-LDL-Ab, and plasmatic concentrations of four antioxidants: the ferric reducing antioxidant power (FRAP), reduced glutathione (GSH), superoxide dismutase (SOD), and uric acid. RESULTS: Ages ranged from 16 to 28 years with a median (interquartile range) of 19.5 (19-23) years. Total cholesterol, high-density lipoproteins-cholesterol (HDL-C), low-density lipoproteins-cholesterol (LDL-C) and triglycerides varied within normal ranges throughout the three samplings. While total cholesterol and LDL-C titers increased significantly (p = 0.003 and p = 0.006, respectively), triglycerides and HDL-C values varied non-significantly throughout the measurements (p = 0.061 and p = 0.192, respectively). The median ox-LDL-Ab titers were respectively: 653.3 (468.2-838.8) mIU/ml at T1, 777.7 (553.7-1150.7) mIU/ml at T2, and 1037.7 (901.7-1481.5) mIU/ml at T3. Overall, ox-LDL-Ab titers increased significantly from T1 to T3 (p = 0.006). Concomitantly, uric acid and FRAP concentrations decreased significantly (p = 0.001 and p = 0.003, respectively); on the contrary, GSH and SOD values increased, but insignificantly (p = 0.115 and p = 0.110, respectively). There was a positive and significant correlation between ox-LDL-Ab and HDL-C (ρ = 0.519, p = 0.027), and between ox-LDL-Ab and SOD (ρ = 0.504, p = 0.033) at T2. Ox-LDL-Ab values were expected to increase with each new visit (ß = 201.1; p = 0.041) and each IU/ml of SOD titers (ß = 23.6; p = 0.019). CONCLUSION: These Cameroonian professional soccer players exhibited high levels of ox-LDL-Ab reflecting elevated levels of oxidatively-modified LDL-C particles with an increment over time, this being insufficiently counterbalanced by the antioxidant defense mechanisms. As a consequence, they may be at increased atherogenic and cardiovascular risks.

Relationship between hyperglycemia, antioxidant capacity and some enzymatic and non-enzymatic antioxidants in African patients with type 2 diabetes.

BACKGROUND AND PURPOSE: Studies demonstrate that free radicals are involved in the pathogenesis of diabetic complications. The aim of this study was to determine the implication of total antioxidant capacity (TAC) and some enzymatic and non-enzymatic antioxidants as suitable biomarkers of diabetic complications risk factors. METHODS: A total of 90 patients (70 patients with or without diabetic complications +20 normal healthy) were examined by evaluating the level of lipid peroxidation, nitrogen monoxide (NO), fasting blood glucose, glycated haemoglobin (HbA1c), enzymatic and non-enzymatic antioxidants using standard spectrophotometric methods. RESULTS: The fasting blood glucose and HbA1c levels were respectively 2.05 and 2.32 times higher in the group of patients with diabetes and complications (DPWC) compared to those of healthy persons. A statistically higher level of malondialdehyde (MDA), NO and TAC was observed in a group of patients with diabetes and complications compared to those without complications (DPNC). A significant positive correlation was found between catalase (CAT) and fasting blood glucose while a significant and negative correlation was noted between reduced glutathione (GSH) and fasting blood glucose. Also was noted a significant relationship between HbA1c and other markers of oxidative stress. CONCLUSIONS: The results suggest that the plasma levels of CAT, TAC and reduced glutathione could give information on the risk of developing complications of diabetes, considering that the modification of these biomarkers levels were associated with oxidative stress.

Hypolipidemic effect and activation of Lecithin Cholesterol Acyl Transferase (LCAT) by aqueous extract of Spirulina platensis during toxicological investigation.

BACKGROUND: Spirulina platensis produced in Nomayos (Cameroon) is used as a dietary supplement. S. platensis is known as a neutraceutical with many beneficial effects on humans like lipid-lowering action. This study aims to investigate the mechanism of hypolipidemic action of aqueous extract of Spirulina platensis (S. platensis) through the toxicological studies. METHODS: In this study, we included two month old Wistar rats, weighing between 180 and 200 g. Aqueous S. platensis was extracted and prepared using standard methods. The rats received a supplementation of S. platensis at 5000 mg/Kg of body weight as single dose in acute toxicity whereas different doses (250, 500, 1000 mg / kg body weight) were administered in subacute toxicity compared to control. Acute and subacute toxicities were determined according to the guidelines 420 (14 days) and 407 (28 days) of the Organization for Economic Cooperation and Development (OECD) respectively. Biochemical parameters such as urea, creatinine, total and direct bilirubin, lipid profile and transaminases; and histopathological analysis of the liver and kidneys were used to evaluate the toxicity of S. platensis on these Wistar rats. Plasmatic hydroxymethyl glutaryl coenzyme A reductase (HMG CoA reductase) and lecithine cholesterol acyl transferase (LCAT) were performed to explain the lipid-lowering action of S. platensis. Histopathological analysis of the liver and kidneys was performed. RESULTS: Our results show a decrease in total cholesterol for male rats (from 84 to 74 mg/dl) when the dose of S. platensis increased; this reduction of the total cholesterol level in male rats was significant at 500 mg/kg. There was also a significant inhibition of HMG CoA reductase in a dose dependent manner between 25 and 84.5 fold compared to the control in both male and female groups. At the dose of 250 mg/kg bw, the level of LCAT was higher compared with other groups and control, but the difference was not statistically significant. A slight inflammation in the liver and the mesangial hyperplasia of the renal glomeruli was revealed by the histopathological investigation in subacute toxicity. CONCLUSION: Spirulina platensis from Cameroon appears to have little toxic effects and may demonstrate hypolipidemic activity through the activation of LCAT.

Assessment of the 10-year risk of cardiovascular events among a group of Sub-Saharan African post-menopausal women.

BACKGROUND: Post-menopausal women may be at particular risk of developing cardiovascu-lar disease due to metabolic changes occurring at menopause. The present study aimed to assess the 10-year cardiovascular risk (CVR) among a group of post-menopausal women and to deter-mine associated factors. METHODS: This was a cross-sectional study conducted among post-menopausal women in Yaoundé, Cameroon. CVR was calculated using the Framingham risk score. RESULTS: We enrolled 108 women, their ages ranging from 45 to 80 years, with a mean of 56.4 ± ± 6.9 years. CVR ranged between 1.2% and greater than 30% with a mean of 13.4 ± 8.7%. Forty-three (39.8%) participants had a low CVR (< 10%), 39 (36.1%) women had a moderate CVR (10-20%), and 21 (24.1%) women had a high CVR (> 20%). Low-density lipoproteins cholesterol (LDL-C; b = 3.27, p = 0.004), fasting plasma glucose (b = 5.40, p = 0.015), and diastolic blood pressure (DBP; b = 3.49, p < 0.0001) were independently associated with CVR. Women not married (i.e. single, divorced or widowed) (adjusted odds ratio [aOR] 4.66, p = 0.002), those with high titers of LDL-C (≥ 1.6 g/L; aOR 5.07, p = 0.001), and those with elevated DBP (≥ 90 mm Hg; aOR 8.10, p < 0.0001) presented an increased likelihood to be at an advanced level of CVR. CONCLUSIONS: A significant number of post-menopausal women are at considerable risk of cardiovascular events in our setting. Therefore, they should be educated to adopt healthy life-styles for substantial reduction in their CVR.