ABSTRACT
OBJECTIVES: Appraisal of the agreement between patients' reports and general practitionners' declaration in a French Caribbean population and relationship with blood pressure normalization. METHODS: One hundred French Caribbean practitioners participated in this observational survey: each of them included five essential hypertensives treated for more than three months. BP was considered to be normalized if inferior to 140/90 mmHg. We considered that there is a total agreement between patient and GP declaration when SBP and DBP did not differ by more than 5 mmHg and when the eight risk factors or co-morbidity were identical. Identification of independent factors of BP normalization and awareness was performed using logistic regression. RESULTS: Five hundred and nine hypertensives (57% women) were recruited. Sixty-nine percent (n = 328) were less than 65 years, 75% (n = 341) had an educational level less than high school. The normalisation rate was 39% (n = 185) within the whole population. 63.4% had a high cardiovascular risk. BP normalization appeared to be closely associated to BP awareness. CONCLUSIONS: In this observational survey, in a French Caribbean hypertensive population, two third had a high cardiovascular risk. The normalization rate was 39%. This BP normalization appeared to be closely associated to BP awareness.
Subject(s)
Health Knowledge, Attitudes, Practice , Hypertension/drug therapy , Adult , Aged , Female , General Practice , Goals , Humans , Male , Middle Aged , Prospective Studies , Surveys and Questionnaires , West IndiesABSTRACT
A murmur of aortic regurgitation was discovered in an asymptomatic patient who had suffered from an acute Coxiella Burnetti infection several months before hand. Transoesophageal echocardiography, serology and direct immunofluorescence of the aortic valve confirmed the diagnosis of Q fever endocarditis. Treatment with Vibramycin and Plaquenil was instituted after aortic valve replacement. Cardiac complications of Q fever should be recognised as they may remain asymptomatic for long periods of time. Transthoracic and transoesophageal echocardiography should be widely used in acute forms of Q fever and systematic in chronic infections with Coxiella Burnetti.
Subject(s)
Aortic Valve Insufficiency/etiology , Endocarditis/etiology , Q Fever/complications , Adult , Aortic Valve Insufficiency/diagnosis , Echocardiography/methods , Endocarditis/diagnosis , Fluorescent Antibody Technique , Humans , Male , Q Fever/diagnosis , Serologic TestsABSTRACT
After a brief review of Chagas' disease history in French Guiana, the authors report the first autochthonous case of Chagas' cardiopathy found in this country since 1956. The diagnostic suspected through epidemiological, clinical, electrocardiographical and echocardiographical data, was corroborated by serology and by the discovery of an apical aneurysm at post mortem examination of the heart.
Subject(s)
Chagas Cardiomyopathy/diagnosis , Aged , Animals , Chagas Cardiomyopathy/epidemiology , Echocardiography , Electrocardiography , Fluorescent Antibody Technique , French Guiana , Heart Block/diagnosis , Heart Block/epidemiology , Heart Function Tests , Humans , Male , ZoonosesABSTRACT
We studied the hemodynamic, echocardiographic, phonomechanographic and hormonal changes during acute (25 mg) and chronic (6 months--75 to 225 mg/day) treatment of 10 patients with congestive cardiac failure due to cardiomyopathy with dilatation with SQ 14 225 (Captopril). The following changes were observed after the single dose: an increase in cardiac output (p less than 0,001), in stroke volume (p less than 0,01), a reduction in heart rate (p less than 0,01), in peripheral resistance (p less than 0,001) and pulmonary capillary pressure (p less than 0,001). There were no significant changes in end systolic or end diastolic left ventricular internal diameter. Plasma renin activity increased (p less than 0,001); there was a concurrent fall in serum aldosterone (NS): the plasma concentration of converting enzyme decreased (p less than 0,001). There was a correlation between the increase in peripheral resistance under basal conditions and the basal plasma renin activity (R = 0,72, p less than 0,02). The decrease in peripheral resistance after captopril also correlated with basal plasma renin activity (R = 0,89, p less than 0,01). After six months continuous therapy, the hemodynamic effect was sustained and was accompanied by a significant symptomatic improvement. Left ventricular internal end systolic and end diastolic diameters decreased (p less than 0,01 and p less than 0,01 respectively). The pre-ejectional period decreased (p less than 0,05). Serum aldosterone fell significantly (p less than 0,001) as did plasma renin activity (p less than 0,01); the serum level of converting enzyme remained low with respect to its initial value. These results show that captopril may be useful in severe cardiac failure without tolerance during long-term administration. No renal or hematological toxicity was observed in this group of patients.
