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Cardiovascular Disease Risk Associated to Chronic Inflammatory Rheumatic Diseases in Patients Seen in Rheumatology Unit in Yaounde, Cameroon

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Open Journal of Rheumatology and Autoimmune Diseases 2016年第1期6卷 13-21页

作者： Madeleine Singwe-Ngandeu Mickael Essouma Alain Patrick Menanga Vicky Jocelyne Ama Moor Caroline Ngoufack Sandrine Sa’a Lontsi yolande vanessa ayi efoua Thierry Ntandzi Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Rheumatology Unit Yaounde Central Hospital Yaounde Cameroon Cardiology Unit Yaounde General Hospital Yaounde Cameroon Biochemistry Laboratory Yaounde University Teaching Hospital Yaounde Cameroun

Introduction: Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge. Objective: We conducted this research with the aim to explore the association between CIRD and cardiovascular risk in a Cameroonian population based on the World Health Organization (WHO) and International Society for Hypertension (ISH) risk charts. Methods: This cross-sectional study included CIRD patients, followed at the rheumatology unit of the Yaounde Central Hospital, and, who were matched to non-CIRD subjects for sex, age and race. Cardiovascular risk factors were studied and subsequently the cardiovascular risk was estimated using the WHO/ISH risk charts. Analyses were performed in Epi-info and SPSS software and results were considered statistically significant for a p-value less than 0.05. Results: In total, 109 CIRD patients and 111 non-CIRD subjects were included. Their respective mean ages were 44.4 ± 15.2 years and 44.2 ± 15.1 years. Odds ratio 2.09, 95% confidence interval (CI) (1.07 - 4.08);high BMI OR 1.89, 95% CI (1.1 - 3.24);diabetes mellitus (p = 0.03) and physical inactivity (p < 0.001) were all markedly found in CIRD patients compared with controls. Ten (9.2%) CIRD patients had a past history of atherosclerotic cardiovascular events compared with no control (p < 0.001). The cardiovascular risk estimated with the WHO/ISH risk charts was low in 43 (79.6%) patients with CIRD versus 52 (88.1%) non-CIRD subjects. Conclusions: CIRD were associated with hypertension, excess overall adiposity, diabetes mellitus, and physical inactivity. A substantially increased proportion of CIRD patients with a past history of atherosclerotic cardiovascular events were noted. But the WHO/ISH risk charts broadly found a similar and globally decremented cardiovasc

关键词： Chronic Inflammatory Rheumatic Diseases Cardiovascular Risk Cardiovascular Risk Factors Cardiovascular Disease WHO/ISH Risk Charts Sub-Saharan Africa

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Cardiovascular Risk Burden in Sub-Saharan Africans with Rheumatoid Arthritis: A Hospital-Based Study in Yaounde, Cameroon

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Open Journal of Rheumatology and Autoimmune Diseases 2016年第1期6卷 1-9页

作者： Madeleine Singwe-Ngandeu Mickael Essouma Vicky Jocelyne Ama Moor Ahmadou Jingi Musa Alain Patrick Menanga Caroline Ngoufack Sandrine Sa’a Lontsi Thierry Ntandzi yolande vanessa ayi efoua Mireille Cathy Melong Pianta Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Rheumatology Unit Yaounde Central Hospital Yaounde Cameroon Biochemistry Laboratory Yaounde University Teaching Hospital Yaounde Cameroun Cardiology Unit Yaounde General Hospital Yaounde Cameroon

Introduction: Studies on RA (rheumatoid arthritis) and cardiovascular risk in African countries are scarce. Objective: To investigate the relationship between RA and cardiovascular risk in Cameroonian patients. Methodology: In 50 Black RA patients and 51 matched healthy individuals from the general population, we studied cardiovascular risk factors validated by the WHO. Cardiovascular risks estimates were carried out using WHO risk charts for the African region. Epi-info, R and SPPS were used for the statistical analysis. Results: Overall and abdominal adiposity as expressed by increased body mass index and abdominal obesity, were all markedly increased in RA patients compared to non-RA subjects [70% vs. 47%, OR (95% CI) = 2.62 (1.16 - 5.94), p = 0.026;and 54% vs. 33%, OR (95% CI) = 2.34 (1.05 - 5.25), p = 0.045 respectively]. RA patients were more physically inactive than their non-RA counterparts (20% vs. 0, p = 0.001). Whereas RA was associated with a reduced odds of alcoholism [OR (95% CI) = 0.19 (0.06 - 0.62), p = 0.005]. Increased BMI seemed to occur independently of methotrexate (p = 0.76), hydroxychloroquine (p = 0.59), corticosteroids (p = 0.79) treatments, and independently of sex (p = 0.15), age (p = 0.67), and sedentary lifestyle (p = 0.16) in RA patients;but their BMI was weakly correlated with disease duration (r = 0.26;p = 0.074). Meanwhile, male gender was associated with a reduced odds of abdominal obesity [OR (95% CI) = 0.02 (0 - 0.4), p = 0.011]. Cardiovascular risk, comparable by proportions between RA and non-RA subjects, was low in 26 patients (78.8%) and 30 non-RA subjects (83.3%) respectively. Conclusion: Despite the high adiposity burden and a sedentary lifestyle experienced by RA patients compared to their healthy counterparts, RA was not associated with cardiovascular risk as estimated by WHO risk charts.

关键词： Rheumatoid Arthritis Excess Adiposity Physical Inactivity Cardiovascular Risk World Health Organization Risk Charts

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