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Comorbidities and the management of hypertensive heart disease in a low-resource setting: a cross-sectional study
Raïssa K Kongue1,2, Cody M Dinganga2, Dominique Vervoort3,4
1Department of Internal Medicine, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo.
Insights
Hypertensive Heart Disease (HHD) is common in the Democratic Republic of Congo (DRC). This study found multiple comorbidities in Congolese HHD patients, highlighting the need for accessible, low-resource healthcare solutions.
Area of Science:
- Cardiology
- Public Health
- Internal Medicine
Background:
- Cardiovascular disease (CVD) disproportionately affects low- and middle-income countries, with Sub-Saharan Africa being the most impacted region.
- Hypertensive Heart Disease (HHD) is a significant complication of hypertension, particularly prevalent in the Democratic Republic of Congo (DRC).
Purpose of the Study:
- To identify comorbidities associated with Hypertensive Heart Disease (HHD) in patients within the Democratic Republic of Congo (DRC).
- To investigate the current management strategies for HHD in the DRC.
Main Methods:
- A cross-sectional study was conducted retrospectively at a tertiary hospital in Kinshasa, DRC, from January to December 2019.
- Data from patient records were analyzed using bivariate and multiple correlation regression, with missing values addressed through multiple imputation.
Main Results:
- The study included 60 patients, with 56.7% being male and a mean age of 63.2 years.
- Common comorbidities included dyslipidemia (43.3%), stroke (31.7%), and diabetes (10.0%). Abnormal levels of serum creatinine, HDL, LDL, and urea were observed.
- High-density lipoprotein (HDL) was identified as a predictor of high blood pressure (P < 0.01).
Conclusions:
- Congolese patients with Hypertensive Heart Disease (HHD) frequently present with multiple comorbidities.
- There is a critical need to enhance access to care for HHD through early diagnosis, timely referral, and management strategies appropriate for low-resource settings.
Background:
Low-and middle-income countries account for over 80% of the global burden of cardiovascular disease (CVD). The Sub-Saharan African region is the most affected by CVD. Hypertensive Heart Disease (HHD) is a common complication of hypertension which is prevalent in the Democratic Republic of Congo (DRC). Our study aimed to identify the comorbidities associated with and the management of HHD in the DRC.
Materials And Methods:
This cross-sectional analysis was done at a 200-bed tertiary hospital in Kinshasa, DRC from January to December 2019. Data were collected retrospectively from patient records and missing values were generated by multiple imputations and the pooled values were used for data analysis. Bivariate and multiple correlation regression were used and odds ratios were generated.
Results:
34 (56.7%) of the 60 patients were male. The mean age was 63.2 ± 9.7 years, the mean BMI was 25.5 ± 5.0 kg/m2, and 90.0% of patients were unemployed. Patients had dyslipidemia (43.3%), stroke (31.7%), and diabetes (10.0%). Mean serum creatinine (1.4 ± 0.1 mg/dL), HDL (56.7 ± 18.4 mg/dL), LDL (119.3 ± 30.5 mg/dL), and median urea (24.0, IQR: 63.5 mg/dL) levels were abnormal. HDL was a predictor of high blood pressure (P < 0.01). 83.3% of patients took statins, 78.3% took ACE inhibitors, and 70.0% took aspirin.
Conclusion:
Congolese HHD patients have multiple comorbidities. Efforts should be focused on increasing access to care through early diagnosis, early referral, and low-resource appropriate management.
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