Quality of life group of cameroonian patients aged over 65 years in an urban setting: A cross-sectional study

Background. The quality of life of the elderly can be compromised by several chronic diseases. This has a considerable impact on their physical and mental capacities.This study aimed to evaluate the quality of life of the elderly at the Yaoundé Central Hospital. Methods.We carried out a cross-sectional study of elderly patients who consulted at the Yaounde Central Hospital forfive months. Sociodemographic characteristics were taken, and we also took data concerning their chronic conditions and depressive symptoms. The presence of any cognitive impairment was evaluated using the Mini-mental state Examination (MMSE). Their functional capacity was assessed with the six-minute walk test. Quality of life was evaluated using the older people's quality of life questionnaire (OPQOL). The multivariate analysis was done on the logistic regression model, and the p values < 0.05 were considered statistically significant. Results.66 participants were included (35 women) with a median age of 70 (IQR: 67 -75) years. About 87.8% had at least one chronic condition, and 47% had two or more. The most prevalent chronic condition was hypertension (71.2%), followed by abdominal obesity (40.9%) and heart failure (24.2%). Mild depressive symptoms were present in 1.5% of our study population. Fourteen participants (21.2%) had a poor quality of life. The factors associated with a poor quality of life was a distance covered in the 6 MWT less than 350m (OR: 3.7, p < 0.05). Conclusion.There is a high prevalence of poor quality of life among elderly patients consulting at the Yaoundé Central Hospital. A distance covered in the 6MWT less than 350m is associated with poor quality of life.

Introduction. La qualité de vie des personnes âgées peut être compromise par la survenue de plusieurs pathologies chroniques. Cela a un impact considérable sur leurs capacités physiques mais aussi sur leurs capacités mentales. Le but de cette étude était d'évaluer la qualité de vie des personnes âgées suivies à l'Hôpital Central de Yaoundé. Méthodologie. Nous avons réalisé une étude transversale analytique sur des patients âgés ayant consulté à l'hôpital central de Yaoundé pendant une période de cinq mois. Les caractéristiques sociodémographiques ont été prises, ainsi que leurs différentes comorbidités. La présence d'un déficit cognitif a été évaluée à l'aide du Mini Mental State Examination(MMSE). Leur capacité fonctionnelle a été évaluée à l'aide du test de marche de six minutes. La qualité de vie a été évaluée à l'aide du score OPQOL.. L'analyse multivariée a été effectuée sur le modèle de régression logistique et les valeurs de p < 0,05 ont été considérées comme statistiquement significatives. Résultats. 66 participants ont été inclus (35 femmes) avec un âge médian de 70 (IQR : 67 -75) ans. Parmi eux, environ 87,8 % avaient au moins une maladie chronique et 47 % en avaient deux ou plus. L'affection chronique la plus répandue était l'hypertension artérielle (71,2 %), suivie de l'insuffisance cardiaque (24,2 %) et de l'arthrose (12,1 %). Des symptômes dépressifs légers étaient présents chez 1,5 % de la population de notre étude. 14 participants (21,2 %) avaient une mauvaise qualité de vie. Les facteurs associés à unemauvaise qualité de vie étaient une distance parcourue dans le 6MWT inférieure à 350m (OR : 3,7, p < 0,05). Conclusion. Il existe une forte prévalence de la mauvaise qualité de vie chez ce groupe de patients âgés camerounais dont le facteur associé retrouvéest une distance parcourue durant le 6MWT inférieure à 350m.Ceci confirme le bénéfice de l'activité physique sur le plan physique et mental, indispensable pour une meilleure qualité de vie.

Survival rate and predictors of 36-month mortality in patients with heart failure in Sub Saharan Africa: insights from the Douala Heart Failure Registry (Do-HF).

Background: Heart failure (HF) is a growing public health concern with a high mortality rate in sub-Saharan Africa. However, few studies have reported the long-term predictors of mortality in this region. This study sought to determine the 3-year mortality rate and the predictors of mortality amongst HF patients in Douala, Cameroon. Methods: We conducted a prospective analysis on patients recruited in the Douala Heart Failure (Do-HF) registry, an ongoing prospective data collection on patients with HF at four cardiology units in Douala, Cameroon. Patients included were followed for 36 months from the index date of inclusion, with all-cause mortality as the primary outcome. Cox proportional hazard regression models were used to determine predictors of mortality. Results: Out of the 347 participants included, 318 (91.6%) completed follow-up. The mean age was 64±14 years, 172 (49.6%) were men. Hypertensive cardiomyopathy and dilated cardiomyopathy were the most frequent causes of heart failure. The median follow-up was 33 months, and 150 (47.2%) patients died. Independent predictors of mortality included New York Heart Association functional class III & IV (aHR 2.23; 95% CI: 1.49-3.33; P<0.001), presence of pulmonary rales (aHR 1.87; 95% CI: 1.30-2.68; P=0.005), chronic kidney disease (aHR 2.92; 95% CI: 1.79-4.78; P<0.001), enrolment as inpatient (aHR1.96; 95% CI: 1.17-2.54; P=0.005), no formal education (aHR 2.06; 95% CI: 1.28-3.33; P=0.003), and a monthly income of at most three minimum wage (aHR 2.06; 95% CI: 1.28-3.33; P=0.003). Conclusions: This study shows that almost half of HF patients die after 36 months of follow-up. Also, late presentation and poverty-related conditions were associated with poor outcomes. These findings suggest prioritizing preventive strategies that target early diagnosis and socioeconomic status to improve the prognosis of HF.

Use of traditional medicine and control of hypertension in 12 African countries.

BACKGROUND: Use of traditional medicine (TM) is widespread in sub-Saharan Africa as a treatment option for a wide range of disease. We aimed to describe main characteristics of TM users and estimate the association of TM use with control of hypertension. METHODS: We used data on 2128 hypertensive patients of a cross-sectional study (convenience sampling), who attended cardiology departments of 12 sub-Saharan African countries (Benin, Cameroon, Congo, Democratic Republic of the Congo, Gabon, Guinea, Côte d'Ivoire, Mauritania, Mozambique, Niger, Senegal, Togo). To model association of TM use with odds of uncontrolled, severe and complicated hypertension, we used multivariable mixed logistic regressions, and to model the association with blood pressure (systolic (SBP) and diastolic (DBP)) we used mixed linear models. All models were adjusted for age, sex, wealth, adherence to hypertension conventional treatment and country (random effect). RESULTS: A total of 512 (24%) participants reported using TM, varying across countries from 10% in the Congo to 48% in Guinea. TM users were more likely to be men, living in rural area, poorly adhere to prescribed medication (frequently due to its cost). Use of TM was associated with a 3.87 (95% CI 1.52 to 6.22)/1.75 (0.34 to 3.16) mm Hg higher SBP/DBP compared with no use; and with greater odds of severe hypertension (OR=1.34; 95% CI 1.04 to 1.74) and of any hypertension complication (OR=1.27; 95% CI 1.01 to 1.60), mainly driven by renal complication (OR=1.57; 95% CI 1.07 to 2.29) after adjustment for measured confounders. CONCLUSIONS: The use of TM was associated with higher blood pressure, more severe hypertension and more complications in Sub-Saharan African countries. The widespread use of TM needs to be acknowledged and worked out to integrate TM safely within the conventional healthcare.

Barriers to up-titrated antihypertensive strategies in 12 sub-Saharan African countries: the Multination Evaluation of hypertension in Sub-Saharan Africa Study.

BACKGROUND: Sub-Saharan Africa (SSA) faces the highest rate of hypertension worldwide. The high burden of elevated blood pressure (BP) in black people has been emphasized. Guidelines recommend two or more antihypertensive medications to achieve a BP control. We aimed to identify factors associated with prescription of up-titrated antihypertensive strategies in Africa. METHODS: We conducted a cross-sectional study on outpatient consultations for hypertension across 12 SSA countries. Collected data included socioeconomic status, antihypertensive drugs classes, BP measures, cardiovascular risk factors and complication of hypertension. We used ordinal logistic regression to assess factors associated with prescription of up-titrated strategies. RESULTS: The study involved 2123 treated patients with hypertension. Patients received monotherapy in 36.3 vs. 25.9%, two-drug in 42.2 vs. 45% and three and more drugs strategies in 21.5 vs. 29.1% in low (LIC) and middle (MIC) income countries, respectively. Patients with sedentary lifestyle [OR 1.4 (1.11-1.77)], complication of hypertension [OR 2.4 (1.89-3.03)], former hypertension [OR 3.12 (2.3-4.26)], good adherence [OR 1.98 (1.47-2.66)], from MIC [OR 1.38 (1.10-1.74)] and living in urban areas [OR 1.52 (1.16-1.99)] were more likely to be treated with up-titrated strategies. Stratified analysis shows that in LIC, up-titrated strategies were less frequent in rural than in urban patients (P for trend <0.01) whereas such difference was not observed in MIC. CONCLUSION: In this African setting, in addition to expected factors, up-titrated drug strategies were associated with country-level income, patient location and finally, the interplay between both in LIC. These results highlight the importance of developing policies that seek to make multiple drug classes accessible particularly in rural and LIC.

Prevalence and correlates of vascular plaques and high intima thickness in a group of patients with high cardiovascular risk in Cameroon.

Introduction: carotid and femoral intima-media thickness (IMT) and atherosclerotic plaques are considered as markers of generalized atherosclerosis and as independent predictors of cardiovascular events and mortality. This study aimed to determine the prevalence and correlates between carotid and femoral intima-media thickness and plaques in patients with major cardiovascular risk factors (CVRFs). Methods: we carried out a cross-sectional study at the Yaoundé Central Hospital between December 2017 and May 2018. B-mode ultrasound was used to assess for the presence of plaques and also measure the IMT at the carotid and femoral arteries in patients with CVRFs. Logistic regression analysis was performed to examine the association between ultrasound findings (presence of plaques or IMT > 0.9mm) and cardiovascular risk factors. A p-value <0.05 was considered significant. Results: amongst the 71 patients, 43.7% were male and 56.3% were female. The mean age was 61.6 ± 8.4 years and ranged from 40 to 75 years. Thirty-nine (54.9%) participants had carotid atherosclerotic plaques and 33 (46.5%) participants had femoral artery plaques. The plaque burden was higher in the carotid arteries. Plaques at one or more artery sites were seen in 67.6% of participants. An IMT ≥ 0.9 mm was seen in only 1.4 to 2.8% of participants. In the multivariable analysis using binary logistic regression, age > 50 years (males) or 60 years (females) (aOR: 11.3 [95% CI: 2.2 - 56.8], p=0.002) and presence of dyslipidemia (aOR: 3.6 [95% CI: 1.2 - 11], p=0.043) were associated with carotid artery plaques, while presence of dyslipidemia (aOR: 4.8 [95% CI1.8 - 13.3], p=0.004) and high cardiovascular risk profile (10-year risk> 20%) (aOR: 4.2 [95% CI: 1.2 - 13.2], p=0.0495) were associated with femoral artery plaques. Conclusion: plaques were more frequent than an IMT > 0.9 mm, with a higher plaque burden in the carotid arteries. Plaques were associated with advanced age, dyslipidemia, and a high cardiovascular risk profile.

Blood pressure-lowering medicines implemented in 12 African countries: the cross-sectional multination EIGHT study.

OBJECTIVE: In Africa, the number of patients with hypertension is expected to reach 216.8 million by 2030. Large-scale data on antihypertensive medications used in Sub-Saharan Africa (SSA) are scarce.Here, we describe antihypertensive drug strategies and identify treatment factors associated with blood pressure (BP) control in 12 Sub-Saharan countries. SETTING: Outpatient consultations for hypertension in urban tertiary cardiology centres of 29 hospitals from 17 cities across 12 SSA countries between January 2014 and November 2015. PARTICIPANTS: Patients ≥18 years of age with hypertension were enrolled at any visit during outpatient consultations in the cardiology departments MAIN OUTCOME MEASURE: We collected BP levels, demographic characteristics and antihypertensive treatment use (including traditional medicine) of patients with hypertension attending outpatient visits. BP control was defined as seated office BP <140/90 mm Hg. We used logistic regression with a random effect on countries to assess factors of BP control. RESULTS: Overall, 2198 hypertensive patients were included and a total of 96.6% (n=2123) were on antihypertensive medications. Among treated patients, 653 (30.8%) patients received a monotherapy by calcium channel blocker (n=324, 49.6%), renin-angiotensin system blocker (RAS) (n=126, 19.3%) or diuretic (n=122, 18.7%). Two-drug strategies were prescribed in 927 (43.6%) patients including mainly diuretics and RAS (n=327, 42% of two-drug strategies). Prescriptions of three-drugs or more were used in 543 (25.6%) patients. Overall, among treated patients, 1630 (76.7%) had uncontrolled BP, of whom 462 (28.3%) had BP levels ≥180/110 mm Hg, mainly in those on monotherapy. After adjustment for sociodemographic factors, the use of traditional medicine was the only factor significantly associated with uncontrolled BP (OR 1.72 (1.19 to 2.49) p<0.01). CONCLUSION: Our study provided large-scale data on antihypertensive prescriptions in the African continent. Among patients declared adherent to drugs, poor BP control was significantly associated with the use of traditional medicine.

Cardiovascular risk and stroke mortality in persons living with HIV: a longitudinal study in a hospital in Yaounde.

INTRODUCTION: HIV infection is a well-known risk factor for stroke, especially in young adults. In Cameroon, there is a death of data on the outcome of stroke among persons living with HIV (PLWH). This study aimed to assess the cardiovascular risk profile and mortality in PLWH who had a stroke. METHODS: this was a retrospective cohort study of all PLWH aged ≥18 years admitted for stroke between January 2010 and December 2019 to the Cardiology Unit of the Yaoundé Central Hospital, Cameroon. Cardiovascular risk was estimated using the modified Framingham score, with subsequent dichotomization into low and intermediate/high risk. Mortality was assessed on day 7 during hospitalization (medical records), at one month, and one year by telephone call to a relative. RESULTS: a total of 43 PLWH who had a stroke were enrolled. Their mean age was 52.1 (standard deviation 12.9) years, most of them were female (69.8%, n = 30). There were 25 (58.1%) patients on concomitant antiretroviral therapy. The Framingham cardiovascular risk score at admission was low in 29 patients (67.4%) and intermediate to high in 14 patients (32.6%). Ischemic stroke was the most common type of stroke in 36 persons (83.7%). The length of hospital stay was 11.4 (interquartile range 9.2-13.7) days. Mortality at 1 year was 46.5% (n = 20). CONCLUSION: stroke mortality was high in this population of PLWH. Most patients had a low Framingham score, suggesting that this risk estimation tool underestimates cardiovascular risk in PLWH.

May Measurement Month 2019: an analysis of blood pressure screening results from Cameroon.

The multi-country May Measurement Month (MMM) screening campaign aims to raise awareness on blood pressure (BP) and hypertension in individuals and communities, and measure BP, ideally, of those who had no BP measurement in the preceding year. We here report key findings from the Cameroon arm of MMM 2019. An opportunistic sample of adults (≥18 years) was included from 5 May to 5 June 2019 across 15 sites (markets, churches, homes, motor parks, workplaces, and hospitals/clinics). Data collection, cleaning, the definition of hypertension, and statistical analysis followed the standard protocol. The mean age of the 30 187 participants screened was 36.9 (SD: 14.9) years, 50.4% were female (5% of whom were pregnant), and 94.4% were screened out of the hospital/clinic settings. After multiple imputation of missing data, 6286 (20.8%) had hypertension, 24.0% were taking antihypertensive medication, and 705 (11.2%) of all participants with hypertension had controlled BP. In linear regression models adjusted for age, sex, and antihypertensive medicines use, a previous diagnosis of hypertension, a history of stroke, and use of antihypertensive medicines were significant predictors of systolic and diastolic BP levels. BPs were also significantly higher when measured in public outdoors, public indoors (diastolic BP only), workplaces, and other unspecified areas compared to hospitals/clinic settings. MMM19 is the largest ever BP screening campaign in a single month, in Cameroon and despite the limitations resulting from non-random sample selection, the opportunistic screening allows access to awareness and screening for hypertension out of the hospital/clinic settings.

Association between measures of adiposity and blood pressure levels in adult Cameroonians.

INTRODUCTION: Several anthropometric measurements are variably recommended to assess adiposity in routine practice, with less agreement on their comparative performance. We assessed and compared the relationship of seven anthropometric measures of adiposity-waist circumference (WC), waist-to-height ratio (WHtR), Body Mass Index (BMI), Ponderal Index (PI), Conicity Index (C index), A Body Shape Index (ABSI), and Body Roundness Index (BRI)-with blood pressure (BP) levels and prevalent hypertension in adult Cameroonians. METHODS: Data were collected as Cameroon's contribution to the global May Measurement Month 2017(MMM17) survey. Participants were nonpregnant adults, who had no BP measurement in the past year and with no prior hypertension diagnosis. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic ≥90 mm Hg. Odds ratios (ORs) for the presence of hypertension per 1 SD increase in each adiposity metrics were estimated in separate logistic regression models. Assessment and comparison of discrimination used the area under the receiver operating characteristics curve (AUC) and nonparametric methods. RESULTS: We included 14 424 participants (8210 [58.25%] female; 39.84 ± 14.33 years). There was a graded association between measures of adiposity and prevalent screen-detected (newly diagnosed) hypertension, with effect sizes being mostly within the same range across measures of adiposity. AUC for hypertension prediction ranged from 0.709 with PI to 0.721 with BRI for single measures, and from 0.736 to 0.739 with combinations of measures of adiposity. CONCLUSION: WC, WHtR, and BRI were strongly associated with BP and better predicted prevalent hypertension, with effects enhanced with the inclusion of BMI.

Accuracy of the novel Peguero Lo-Presti criterion for electrocardiographic detection of left ventricular hypertrophy in a black African population.

The diagnostic accuracy of the electrocardiogram for left ventricular hypertrophy (LVH) is limited. Recently, Peguero and collaborators proposed a novel voltage criterion for its detection with reportedly higher accuracy than the commonly used Cornell and Sokolow-Lyon criteria. While studies done in various populations have confirmed it, there are no available data from black African populations. We conducted a cross-sectional study in a population from Cameroon to compare the Peguero-Lo Presti criterion to the older Cornell, Sokolow-Lyon, and Cornell product criteria, pertaining to their sensitivity, specificity, and area under the receiver operating characteristic curve (AUC), with echocardiography as the reference standard. The study population consisted of 238 participants (54.2% female) with a mean age of 58 (SD 13) years. On echocardiography, the prevalence of LVH was 45.3% (n = 108). The sensitivity was 48.14%, 63.89%, 63.89%, and 67.29% for the Sokolow-Lyon, Peguero-Lo Presti, Cornell, and Cornell product criteria, respectively. The specificity was 73.84%, 75.97%, 79.23%, and 82.31% for the Peguero-Lo Presti, Cornell product, Cornell, and Sokolow-Lyon criteria, respectively. The overall accuracy of the Peguero-Lo Presti (AUC = 0.689) was not significantly different from that of the Cornell (AUC = 0.714), the Cornell product (AUC = 0.717), and the Sokolow-Lyon (AUC = 0.652) (all p Ëƒ .05). Hypertension and gender influenced the agreement between ECG criteria and echocardiography in the detection of LVH. In conclusion, in this black African population, Peguero-Lo Presti was not significantly more or less accurate than Cornell or Sokolow-Lyon.

Resting heart rate predicts all-cause mortality in sub-Saharan African patients with heart failure: a prospective analysis from the Douala Heart failure registry (Do-HF).

BACKGROUND: Higher resting heart rate (HR) is associated with mortality amongst Caucasians with heart failure (HF), but its significance has yet to be established in sub-Saharan Africans in whom HF differs in terms of characteristics and etiologies. We assessed the association of HR with all-cause mortality in patients with HF in sub-Saharan Africa. METHODS: The Douala HF registry (Do-HF) is an ongoing prospective data collection on patients with HF receiving care at four cardiac referral services in Douala, Cameroon. Patients included in this report were followed-up for 12 months from their index admission, for all-cause mortality. We used Cox-regression analysis to study the association of HR with all-cause mortality during follow-up. RESULTS: Of 347 patients included, 343 (98.8%) completed follow-up. The mean age was 64±14 years, 176 (50.7%) were female, and median admission HR was 85 bpm. During a median follow-up of 12 months, 78 (22.7%) patients died. Mortality increased steadily with HR increase and ranged from 12.2% in the lower quartile of HR (≤69 bpm) to 34.1% in the upper quartile of HR (>100 bpm). Hazard ratio of 12-month death per 10 bpm higher HR was 1.16 (1.04-1.29), with consistent effects across most subgroups, but a higher effect in participants with hypertension vs. those without (interaction P=0.044). CONCLUSIONS: HR was independently associated with increased risk of all-cause mortality in this study, particularly among participants with hypertension. The implication of this finding for risk prediction or reduction should be actively investigated.

Left atrial structural and functional remodeling study in type 2 diabetic patients in sub-Saharan Africa: Role of left atrial strain by 2D speckle tracking echocardiography.

OBJECTIVE: To evaluate the role of peak atrial longitudinal strain (PALS) through speckle tracking 2D echocardiography for the assessment of structural and functional left atrial (LA) remodeling in a type 2 diabetes mellitus (T2DM) population. METHODOLOGY: We conducted a cross-sectional study during a 9-month period. T2DM adults aged 18 and above were included. The variables assessed during the study include age and gender of participants, diabetes characteristics, cardiovascular risk factors, clinical anthropometric and hemodynamic parameters, standard echocardiographic parameters, volume-derived LA functions, and 2D PALS. RESULTS: We included a total of 102 patients. The mean age was 58 ± 11.7 years, and the M/F sex ratio was 1:1.5. Coexistent arterial hypertension (HTN) was observed in more than half (59.8%) of the population sample. Mean 2D PALS was 29.2 ± 8.9% with 58.8% (95% CI: 50.0-68.6) of subjects having a reduced LA strain (ie,<32%). Reservoir and pump functions were the most altered LA volumetric phasic functions. Mean indexed LA maximal volume was 22.2 ± 6.8 mL/m2 . There was a significant association between abnormal PALS and age, Body mass index (BMI), indexed LA volume, E/E' ratio, LA active ejection fraction (pump function), and LA expansion index (reservoir function). CONCLUSION: Left atrial remodeling is a recurrent condition in adult T2DM Cameroonians. The reservoir and pump LA functions were the most affected. Assessment of LA global strain allows early detection of LA remodeling with comparison to LA size standard analyses. Age, BMI, indexed LA volume, E/E' ratio, and reservoir and pump LA functions were associated to 2D LA global strain impairment.

PASCAR and WHF Cardiovascular Diseases Scorecard project.

Data collected by PASCAR for the World Heart Federation's Cardiovascular Diseases Scorecard project in Africa are presented. We summarise the strengths, threats, weaknesses and priorities identified from the collected data, which need to be considered in conjunction with the associated sections in the accompanying infographic. Data sets that were used include open-source data from the World Bank, World Health Organization and government publications.

Epidemiology of hypertensive crisis in the Buea Regional Hospital, Cameroon.

Hypertensive crisis (HC) includes hypertensive urgency (HU) and hypertensive emergency (HE). There is scarcity of data on the epidemiology of patients presenting with HC in Cameroon. The aim of this study was to determine the prevalence, clinical characteristics, and outcome of HU and HE. We conducted a cross-sectional study from June 2018 until June 2019. The criteria to define a hypertensive crisis were systolic and/or diastolic blood pressure ≥180/110 mm Hg. We compared HU vs HE. Out of the 1536 patients admitted, 95(6.2%) had a HC. There were 49(51.6%) men and 56 (58.9%) had a HE. The mean age was 51.1 ± 14.9 years. A history of hypertension was found in 75.3% of the patients but only 24.2% were on treatment. 33.7% consumed alcohol and 24.2% had chronic kidney disease. Headache (34.7%), dyspnea (34.7%), and neurological deficit (23.2%) were the most common symptoms. Patients with HE had higher systolic and diastolic blood pressures though the difference was not significant. The most frequent forms of HE were acute left ventricular failure with pulmonary edema (44.6%), intracerebral hemorrhage (21.4%), and cerebral infarction (16.1%). The most commonly prescribed medication was labetalol (44.2%). Mean length of hospital stay was 8.4 days. Patients with HE had a longer hospital stay (9.8 vs 6.3 days, P < .001). In-hospital case fatality was 6.3%. Hypertensive crisis accounted for 6.2% of admissions in the medical unit with HE being more common than HU. Acute left ventricular failure with pulmonary edema and stroke were the most frequent target organ lesions in HE.

May Measurement Month 2018: blood pressure screening results in Cameroon.

Hypertension is a global public health challenge, but awareness, treatment, and control rates remain low. May Measurement Month (MMM) creates a platform for awareness creation and opportunistic screening which can identify significant numbers with raised blood pressure (BP). We present results of the 2018 edition of MMM in Cameroon. A cross-sectional survey of self-selected volunteers aged ≥18 years was conducted in May 2018. The definition of hypertension and statistical analyses followed the standard protocol. Data were collected from 28 public (indoors and outdoors) and private locations which were assigned unique site identification numbers, over a 30-day period. Of the 8883 participants screened, 53.8% were male and the median age was 35 (interquartile range 21) years, and 30.0% reported not having a previous BP measurement. After imputation, 1867 (21.0%) were hypertensive, 645 (34.5%) were aware of their diagnosis, and 507 (27.2%) were on antihypertensive medication, among whom 242 (47.8%) had controlled BP. In linear regression models adjusting for age, sex, and the use of antihypertensive medication, systolic and diastolic BP were significantly higher in participants aware of their diagnosis, those on antihypertensive medication, and who reported alcohol intake of 1-3 times per month and, one or more times per week. Hypertension prevalence is the lowest, and awareness, treatments, and control rates the highest reported in epidemiological studies in Cameroon in the last two decades. Further surveys will be useful in evaluating the impact, if any, of the MMM campaign on the burden of hypertension in the Cameroon.

Thromboembolic risks in patients with COVID-19: major concern to consider in our management.

COVID-19 pandemic is an emergent cardiovascular risk factor and a major cause of mortality worldwide. Thromboembolism is highly suspected as a leading cause of death in these patients through vascular inflammation caused by SARS COV2. Until now there is no real treatment of COVID-19 and many proposed drugs are under clinical trials. Considering the high incidence of thromboembolic events in critically ill patients with COVID-19, prevention of this disorder should be essential in order to reduce mortality in these patients.

COVID-19 pandemic: do we need systematic screening of patients with cardiovascular risk factors in Low and Middle-Income Countries (LMICs) for preventing death?

COVID-19 pandemic is an emergent cardiovascular risk factor and a major cause of mortality worldwide. Thromboembolism is highly suspected as a leading cause of death in these patients through vascular inflammation caused by SARS COV2. Until now there is no real treatment of COVID-19 and many proposed drugs are under clinical trials. Considering the high incidence of thromboembolic events in critically ill patients with COVID-19, prevention of this disorder should be essential in order to reduce mortality in these patients.

Prevalence and determinants of masked hypertension among obese individuals at the Yaoundé Central Hospital: a cross-sectional study in sub-Saharan Africa.

OBJECTIVES: The aim of this study was to investigate the prevalence and associated factors of masked hypertension in obese patients in Yaounde. METHODS: We carried out a cross-sectional study from January to September 2017 at the National Obesity Center of the Yaounde Central Hospital. Masked hypertension was defined when the mean 24 h SBP was greater than or equal to 130 mmHg and/or the mean 24 h DBP was greater than or equal to 80 mmHg with normal office blood pressure (SBP/DBP) <140/90 mmHg. Logistic regression was used to examine the relationship of masked hypertension with associated factors. RESULTS: Among the 90 participants included, 67.8% were females. The mean age (±SD) was 46 (±8) years. The mean clinical measurements were 120 ± 9.4 mmHg and 75.5 ± 7.9 mmHg, respectively, for the SBP and the DBP. On 24 h ambulatory measurement, the mean was 123.9 ± 14.4/74.7 ± 8.9 mmHg, respectively, for the SBP/DBP. The prevalence of masked hypertension was 33.3%. Masked hypertension was significantly associated with high-normal office blood pressure [odds ratio (OR) = 2.90, P = 0.02] and to dyslipidemia (OR = 3.60, P = 0.01), but not to the male sex, diabetes, physical activity, and tobacco/alcohol. CONCLUSION: Our findings suggest that the prevalence of masked hypertension is high and that physicians should consider ambulatory blood pressure monitoring for obese individuals with high-normal office blood pressure or dyslipidemia.