scholarly journals Mortalite A La Phase Aiguë De L’avc Hemorragique Sous Notre Protocole De Baisse De La Tension Arterielle A l’Hopital Universitaire (HU) Befelatanana Antananarivo

2018 ◽  
Vol 14 (18) ◽  
pp. 325
Author(s):  
Rajaonarison Lala Andriamasinavalona ◽  
Rasaholiarison Nomena Finiavana ◽  
Razafindrasata Ratsitohara Santatra ◽  
Razafimahefa Julien ◽  
Zodaly Noël ◽  
...  

Introduction: Hemorrhagic stroke can be seen in 90% of cases with high blood pressure. It is a predictor of intra-hospital mortality. Our goal is to compare the mortality rate based on admission under our therapeutic strategy for HTA in the acute phase of stroke. Method: A retrospective descriptive, cross-sectional study of consecutive patients was conducted over a 12-month period during the year 2017. Results: We had 20% (3/15) mortality rate in acute phase in those with systolic blood pressure (SBP) in admission at ≥ 180 mmHg (group II) and no death (0/17) was recorded in the those with SBP in admission at 140-179mmHg (group I). A SBP at the 7th day (D7) less than 140 mmHg was not rich in those two groups: 35.29 % in group I (n=6) and 46.66 % in group II (n=7) respectively. The sex ratio was 1. High blood pressure remains the main cardio-vascular risk factor reported in our study (81.21%). All our patients had Glasgow scale value between 13-15 and only the NIHSS value > 10 was associated with high blood pressure in acute phase (p=0.0131). Brain CT Scan was realised in majority of cases at the second day (D2) of stroke (n=16). This, however, is with localisation preference in the basal ganglia, with intra-cerebral hemmorhage (ICH) scale at 1 in 65.62% (n=21) of cases. Conclusion: Intra-hospital mortality in acute phase of hemorrhagic stroke remains high. Instauration of stroke field in Madagascar is necessary and this gives the Befelatanana University Hospital a Neuro- Vascular Intensive Care Unit too.

2021 ◽  
pp. 56-63
Author(s):  
Mariana Seliuk ◽  
Marianna Peshkova ◽  
Mykola Kozachok

Cardiovascular diseases are the leading diseases in Ukraine and are the cause of more than half of deaths. They are inextricably linked to lifestyle, diet, bad habits, physical activity, stressors and are the cause of other risk factors. The most common of these are unmodified factors, such as: gender, age, heredity; and modified: dyslipidemia, arterial hypertension, overweight and obesity, diabetes mellitus, smoking, psychosocial factors. According to the results of the published STEPS study in 2019, conducted together with the WHO, which analyzed risk factors among the civilian population of Ukraine aged 18 to 69 years. It was noted that 32,8% of the population had risk factors for CVD. High blood pressure or hypertension was observed in 34,8% of the population. The prevalence of hyperglycemia was 7,1%. Only 39,6% of the population of Ukraine had a normal weight for BMI, 59,1% were overweight, including 24,8% of the population were obese. 33,9% were active smokers, and alcohol consumption was observed in 19,7% of the population. Given the data from the STEPS study, we were interested in the frequency of detection of the main risk factors for cardiovascular events among servicemen. The objective: of the study is to determine the frequency of detection of the main risk factors for cardiovascular events among active servicemen and retirees of the Ministry of Internal Affairs at the stage of inpatient treatment in the conditions of NVMKC «GVKG». Materials and methods. Random sampling was used to analyze 104 case histories of patients in the cardiology department of NVMKC «GVKG» for the period from January 2018 to December 2019. Risk factors and the frequency with which they occur in different categories of patients were studied. The examination group consisted of male patients (100% of cases) aged 33 to 93 years, the average was 66,55±1,47 years. To study the age characteristics of the prevalence of CVD risk factors, patients were divided into two groups: Group I active servicemen, whose average age was 46,41±1,78 years; Group II retirees MOU, whose average age was 71,95±1,26 years. Statistical processing of the results was performed by methods of variation, parametric and non parametric statistics of medical and biological profile using a package of original applied statistical programs «Microsoft Ecxel», «Statistica 7.0». Results. According to the results of the study, the indicators of blood pressure in group I were analyzed: the indicators of mean systolic and diastolic pressure were 129,09±3,86 / 80,45±2,71 mm Hg (n=22). In group II, the average systolic and diastolic pressure were: 138,84±2,41 / 82,99±1,22 mm Hg (n=82). To assess blood pressure, we chose the classification proposed by the WHO in the study (STEPS-2019) for the possibility of compara tive analysis. The percentage of patients in group I with normal blood pressure was 77,27%; high blood pressure was observed in 22,73% of patients, according to the results of their own study, high blood pressure was not detected. In patients of group II normal blood pressure was registered in 63,41%, elevated in 26,83% of patients and high blood pressure was observed in 9,76% of patients. Examining the indicators of laboratory studies, we found that an increase in cholesterol was observed in 45,5% of cases in group I, and in 22,7% of cases the level of cholesterol was not determined. In group II, an increase in cholesterol levels was found in 35,4% of cases, in 13,4% of cases the cholesterol level was not determined. According to the results of the study, an increase in blood glucose levels was observed in 10,6% of cases and 55,8% of cases in group II. Normal blood glucose levels were in 33,7% of patients. The percentage of patients with concomitant type II diabetes was 1,9% of cases of group I, and 14.4% of cases of group II. 72,2% of Group I servicemen and 64.6% of Group II servicemen had an elevated BMI. 50% had a bad habit – smoking in the first group and 18,3% in the second group. Conclusions. We found that the indicators of high blood pressure in groups I and II were 22,73% and 26,83%, which is 12,07% and 6,77% less than among the civilian population of Ukraine where the rate of high blood pressure was 34,8%. The level of total cholesterol is 4,8% higher in patients of group I (45,5%) than among the civilian population of Ukraine (40,7%). In group II by 5,3% less (35,4%), respectively, from the study. The rate of elevated fasting blood glucose in group I (10,6%) is 3,5% higher, and in group II (55,8%), 48,7% higher than the results obtained among the civilian population of Ukraine, where the level of glycemia was 7,1%. The incidence of type II diabetes mellitus in group I (1,9%), which is 1,9% less than the results obtained among the population of Ukraine, where the result was 3,8%, and in group II (14,4%) by 10,6% more, respectively. The increase in BMI in patients of groups I and II was 40,9% and 46,3%, which is 18,2% and 12,8% lower than the data obtained among the civilian population of Ukraine, where the percentage of overweight was 59,1%. The prevalence of smoking among servicemen is 6,68% lower than among the civilian population of Ukraine (33,9%) and amounted to 27,04%.


2018 ◽  
Vol 11 (1) ◽  
pp. 59-66
Author(s):  
Md Mosharul Haque ◽  
M Atahar Ali ◽  
Mustafizul Aziz ◽  
Mohammad Ullah ◽  
Mohammad Anowar Hossain ◽  
...  

Background: Acute kidney injury (AKI) is a risk factor for long-term adverse outcomes, including acute myocardial infarction and death. The objective of this study was to find out in-hospital outcomes in patients with acute ST elevation myocardial infarction with acute kidney injury.Methods: A total 190 patients were included in this study and were equally divided into two groups, Group-I (with AKI) and Group-II (without AKI), according to absolute changes of serum creatinine level. AKI was defined as absolute changes in serum creatinine (SCr. at 48 hours’ minus admission SCr) and categorized as mild AKI (increase of 0.3 to <0.5 mg/d), moderate AKI (increase of 0.5 to <1.0 mg/dl), and severe AKI (increase of e”1.0 mg/dl) using Acute Kidney Injury Network (AKIN) criteria.Results: Overall in-hospital mortality rate was 14.7% in Group-I (mortality rate for those with mild, moderate, and severe AKI were 7%, 13.3%, and 31.8%) compared with 5.3% in Group-II. Regarding inhospital morbidities, significant arrhythmia (29.5%) was the most common complication followed by acute heart failure (18.9%), cardiogenic shock (12.6%), and mechanical complications (4.2%) which were more in Group-I compared to patients with Group-II. After adjustment of other risk variables, the multivariate logistic regression analysis revealed AKI remained an independent predictor of in-hospital mortality with adjusted odds ratios (OR) was 4.991 (95% confidence interval, 1.873-13.301).Conclusions: AKI is an independent predictor of in-hospital mortality and morbidity. It emphasizes the importance of efforts to identify risk factors and to prevent AKI during in-hospital management of acute STEMI patients.Cardiovasc. j. 2018; 11(1): 59-66


2020 ◽  
Vol 20 (4) ◽  
pp. 1725-33
Author(s):  
Seher Kurtul ◽  
Funda Kaya Ak ◽  
Meral Türk

Background: Hypertension is a serious disease with increasing worldwide prevalence, leading to life-threatening complica- tions. Methods: This cross-sectional study was carried out in a university hospital. The Occupational Health and Safety Unit data concerning the health examinations of employees were used to determine the prevalence of hypertension in a university hospital and to define the relationship between hypertension and sociodemographic and occupational parameters. Logistic regression analyses were performed for the variables having a significant association with high blood pressure. Results: The data generated during the periodic examination of 3,480 (92%) of all employees (3,780) were analyzed. The prevalence of hypertension was 14.8%. The prevalence of hypertension was found to be 13.5%, 13.9%, and 23.7% among physicians, non-physician healthcare personnel and officers respectively. The logistic regression model revealed a statistically significant correlation between hypertension and male gender, age and BMI. Conclusion: The prevalence of hypertension was highest among staff members. Special programs would facilitate the diagnosis, control, and prevention of high blood pressure among the high-risk groups, especially men, the elderly and the obese hospital employees. Keywords: Hypertension; hospital; health care worker.


2016 ◽  
Vol 55 (6) ◽  
pp. 333
Author(s):  
Julia Fitriany ◽  
Rafita Ramayati ◽  
Supriatmo Supriatmo ◽  
Rusdidjas Rusdidjas ◽  
Oke Rina ◽  
...  

problem of increasing prevalence and causes high morbidityand mortality. It is found primarily in young males, with afamilial history of hypertension and/or cardiovascular disease.Examination of lipid profiles has been used to detect the risk ofhypertension in adolescents.Objective To compare blood pressure and lipid profiles inadolescents with and without a parental history of hypertension.Methods This cross-sectional study was conducted from January toFebruary 2012 on students from a senior high school in the TobaSamosir District, North Sumatera. Sixty-eight adolescents wereincluded, aged 15 to 18 years. Group I comprised 34 adolescentswith hypertensive parents, and group II comprised 34 adolescentswith normotensive parents. Subjects were selected based onquestionnaires. Subjects’ blood pressures were measured at rest.Three measurements were made in intervals of 10-15 minutes,then averaged for both systolic and diastolic blood pressures. Lipidprofiles were measured using the CardioCheck cholesterol testafter subjects had fasted for 12 hours.Results The median systolic blood pressures (SBP) in groupsI and II were 110 mmHg (range 93.3-123.3) and 106.7 mmHg(range 96.7-123.3), respectively, (P=0.584). The median diastolicblood pressures (DBP) were 73.3 mmHg (range 66.7-83.3) and71.7 mmHg (range 63.3-80.0), respectively, (P=0.953). Totalcholesterol and low-density lipoprotein cholesterol (LDL-C) levelsin group I were significantly higher than those levels in group II[median total cholesterol: 162.0 (range 158-170) vs. 159.0 (range150-170), respectively; (P=0.001); and mean LDL-C: 103.5 (SD3.72) vs. 99.1 (SD 4.63), respectively; (P=0.001). Multivariateanalysis revealed a correlation of moderate strength betweenparental history of hypertension and increased LDL-C (P<0.001)in adolescents.Conclusion Adolescents with and without familial historyof hypertension have no significant median blood pressuredifferences. However, adolescents with hypertensive parents have afsignificantlyhigher median total cholesterol and mean LDL-C.Furthermore, we find a correlation between parental history ofhypertension and increased LDL-C in adolescents.


2019 ◽  
Vol 3 (3) ◽  

Introduction: High blood pressure is one of the leading causes of premature death due to its cardiac, renal and neurological disorders. Objective: To evaluate the relationship between hypertensive retinopathy and the prevalence of potential life-threatening complications. Materials and Methods: Cohort study comparing two groups (G1 and G2) of 13 patients each, performed over a period of 5 years at the University Hospital of Brazzaville. Patients with essential hypertension complicated by stage II and III retinopathy of the Kirkendall’s classification were included. Each patient was seen 3 times over a period of 9 months. G1 were in stage III and G2 in stage II. The factors compared were: prevalence of heart failure, renal failure and stroke, as well as the mortality rate. The relative risk, the Student’s test with a threshold of significance less than 0.05 were the statistical tests used. Results: Prevalence of heart failure, renal failure and stroke were respectively: 53.85% G1 vs 15.38% G2 (p <0.05), 38.46% G1 vs 7.69%, G2 (p <0.05) and 30.77% G1 vs 0.00% G2 (p <0.05). These complications were associated in 61.54% G1 vs 23.07% G2. The mortality rate was: 84.61% G1 vs 7.69% G2 (p <0.05). Conclusion: Stage III hypertensive retinopathy is associated with a high prevalence of severe general complications of high blood pressure.


2020 ◽  
Vol 9 (1) ◽  
pp. 20-26
Author(s):  
Adam Wiśniewski ◽  

Introduction. Neurological disorders have been considered for many years dangerous and are associated with higher risk of in-hospital death. Brain vascular disorders are widely considered as the most severe and related to the highest mortality rate. Aim. The aim of the study was to assess the mortality rate in subjects hospitalized in the Neurology ward within 5 years, in particular the etiology, direct cause and predictability of deaths. Material and Methods. This study is retrospective. The documentation analysis concerned the last 5 years, i.e. from 2015 to 2019. From among the entire database of 8247 patients hospitalized in the Neurology Clinic of the University Hospital No. 1 in Bydgoszcz, 429 deaths were reported and analyzed. Results. The mortality rate was 5.2% among all subjects, 6.6% among all vascular patients and 1.16% among non-vascular subjects. The highest mortality was reported among hemorrhagic stroke (28.4%) and it was significantly higher compared to ischemic stroke (OR = 6.25, 95% CI 4.9–7.8, p < 0.0001). Patients with stroke had significantly higher mortality compared to other neurological disorders (OR = 11.08 95% CI 7.7–15.9, p < 0.0001). The main direct reason of death (80%) was primary cerebral as a result of baseline disease. 7% of deaths were considered as sudden, unexpected and 10.7% were related to complications developed during hospitalization. Conclusions. Stroke, especially hemorrhagic subtype, still remains the cause of the highest in-hospital mortality rate in the Neurology Ward. It is worth to notice that special attention should be paid to patients with coexisting infectious diseases, that contribute to higher mortality risk. (JNNN 2020;9(1):20–26) Key Words: in-hospital mortality, neurological disorders, stroke, prognosis


2016 ◽  
pp. 76-84
Author(s):  
Khoa Bao Chau Thai ◽  
Thi Hong Phuong Vo

Background: Hypertension is a common condition in the world as well as in Viet Nam. If hypertension isn’t treated well, it can cause many serious complications. Controlling target blood pressure will bring positive effects on reducing mortality rate and also disabilities caused by diseases related to hypertension. Objectives: (1) Analyzing the use of medicines in treating hypertension. (2) Evaluating the effects of medicine usage in treating hypertension at the hospital of Hue University of Medicine and Pharmacy. Materials and methods: 388 patients were diagnosed as having hypertension with inpatient care at the Cardiovascular Department of Hue University of Medicine and Pharmacy’s hospital, using cross-sectional descriptive study methods. Results: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. Angiotensin converting enzyme inhibitor and calcium channel blocker were the two most popular drug groups (96.6% and 71.4%, respectively). The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens in both initial therapies (64.7%>35.3%) and final therapies (61.9%>38.1%). The rate of patients having interactions between antihypertensive drugs and the other kinds of drugs was 7.5%. The rate of patients having reasonable prescriptions was 84.3%. Evaluating the effects of medicine usage in treatments showed that the rate of patients reaching target blood pressure before leaving the hospital was 67.3%. Most patients were evaluated as having good prognosis after treatment, up to 81.7%. Conclusions: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens. The rate of drug interactions was quite low; most patients were evaluated as having good prognosis after treatment. Key words: hypertension, antihypertensive drugs.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mussa K. Nsanya ◽  
Philip Ayieko ◽  
Ramadhan Hashim ◽  
Ezekiel Mgema ◽  
Daniel Fitzgerald ◽  
...  

AbstractEstimates for prevalence of high blood pressure (BP) among adolescents in Africa vary widely and few studies, if any, have documented the results of the recommended stepwise BP screening. In this cross-sectional study in Tanzania, we aimed to estimate prevalence of sustained high BP in 3 public secondary schools using the American Academy of Pediatrics BP screening strategy. On Day 1, one screening automated office BP (AOBP) measurement (Step 1) was followed by two more AOBP measurements (Step 2). Repeat AOBP measurements were obtained after about one month on adolescents with high AOBP measurements on Day 1 (Step 3). Participants with sustained high BP underwent 24-h ambulatory BP monitoring (step 4). Of all 500 enrolled participants, the prevalence of high blood pressure at each step in the process was 36.6% (183), 25.6% (128), 10.2% (51), and 2.6%(13) respectively for Steps 1–4. All except 6 students completed all 4 steps of the BP screening algorithm as indicated. We conclude that diagnosis of hypertension in African adolescents should use multiple AOBP measurements over multiple days followed by 24-h ABPM. Screening for high BP in school settings appears to be feasible and could provide a platform for cardiovascular disease education and health promotion.


Sign in / Sign up

Export Citation Format

Share Document