Cardiovascular Risk Profile Of Patients Seen At A Cardiac Clinic In Kumasi, Ghana.

摘要

Prevalence of cardiovascular disease in Africa has increased in recent years. Studies suggest that cardiovascular disease will soon be the most important cause of morbidity and mortality in Africa. The objective of this study was to determine the prevalence of cardiovascular risk factors in patients presenting to the cardiac clinic of the Department of Medicine, Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Medical records of 432 patients were selected from the cardiac clinic, using simple random sampling. The demographic characteristics of the patients together with the prevalence of cardiovascular disease risk factors were examined. The patients were aged between 13 - 97 years with the mean age (+/-standard deviation) of 55.35 (+/-19) years. There were more females 229 (53 %) than males 203 (47 %). The main cardiovascular risk factors seen included: hypertension (48.4 %), overweight and obesity (46.3 %), dyslipidaemia (43 %), Electrocardiographic left ventricular hypertrophy (ECG LVH) (41.6 %) and diabetes mellitus (7.9 %).Conclusion: Cardiovascular risk factors are highly prevalent in patients attending cardiac clinic at KATH, Kumasi, Ghana INTRODUCTION Prevalence of cardiovascular disease in Africa has increased in recent years. Several decades ago, the burden of diseases among African populations was from infectious diseases. Cardiovascular disorders were then seen as rare among these populations but today, these nations are witnessing epidemiological transition1 which has placed on them a double burden of disease2. This implies that while infections and infestations are still a major health burden in African countries3, 4, non-communicable diseases have also become a problem. Recent studies suggest that non-communicable diseases will soon be the most important cause of morbidity and mortality in Africa 2, 4- 7. The rise in cardiovascular diseases is linked to the increase in hypertension, diabetes, obesity and dyslipidaemia observed in Africa in recent years8, 9. Obesity and hypertension are now common throughout Africa, particularly in urban areas9. There are various measures of obesity, and the body mass index (BMI) is a very useful and common one. It is a mathematical formula that is highly correlated with the body fat10. Hypertension is a common clinical condition affecting more than 600 million people worldwide and it is seen in nearly all populations 11. It occurs in the lower as much as in the higher socio-economic groups 12. Hypertension is a powerful independent risk factor for death from cardiovascular disease 11. Available studies provide important and worrisome findings in both epidemiology and clinical outcomes of hypertension 13-16. Hypertension has been reported to account for up to 30 % of hospital admissions for heart failure in West Africa 17, and the prognosis of hypertensive heart failure (HHF) among Black Africans has also been found to be poor.18 Even though, overall hypertension prevalence is between 10% - 15%, 11, 19 prevalence rates as high as 30% - 32% have been reported in middle-income urban and some rural areas in Africa13-16. Hypertension awareness, treatment, and control rates as low as 20%, 10%, and 1%, respectively have also been found 11, 16. The prevalence of hypertension and the resulting morbidity are sufficiently high to justify viewing the condition as a serious health problem. The number of people with diabetes in sub-Saharan Africa is expected to double between 2000-2030 20. Prevalence trend of diabetes is on the rise as shown by recent data from African countries such as Benin (3%), Mauritania (6%), Cameroon (6.1%), Congo (7.1%), Zimbabwe (10.2%), Democratic Republic of Congo (14.5%), Nigeria (2.2%) 21-23. The three major classes of lipoproteins found in the serum of a fasting individual include high density lipoproteins (HDL) cholesterol,low density lipoproteins (LDL) cholesterol and very low density lipoproteins (VLDL) cholesterol. LDL cholesterol is the major atherogen