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Associations of High Density Lipoprotein Cholesterol and Framingham Cardiovascular Risk with Diabetic Retinopathy in African Type 2 Diabetics

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World Journal of Cardiovascular Diseases 2014年第4期4卷 179-188页

作者： Benjamin Longo-Mbenza Moise Mvitu Muaka thierry gombet Igor Longo Phemba Stephen Cook Emmanuel Mve Mengome Department of Ophthalmology University of Kinshasa Kinshasa Congo Emergency Service University Hospital Centre Brazzaville Congo Faculty of Health Sciences Walter Sisulu University Mthatha South Africa Faculty of Medicine University of Health Sciences Libreville Gabon School of International Studies Wenzhou Medical College Wenzhou China The Eye Centre East London South Africa

Objectives: To assess the associations of high density lipoprotein cholesterol (HDL-C) and Framingham cardiovascular (CVD) with diabetic retinopathy (DR). Methods: A cross-sectional study of random sample of 200 T2DM Central Africans. Sociobiographical, laboratory and eye examination main outcome measures were investigated using Tertiles of HDL-C (stratification = lowest 10% were the significant independent determinants for DR. In the highest HDL-C group, smoking status and 10-year Framingham risk ≥ 10% were the significantly independent determinants for DR. In 10-year Framingham risk ≥ 10% group, smoking status, insulin resistance and increasing levels of HDL-C were the significantly independent determinants for DR. Conclusion: DR and VD remain a public health problem in T2DM Central Africans. Some Central Africans with DR and VD appear to have higher HDL-C than T2DM Central Africans without DR and VD. HDL-C in T2DM patients with DR, may be tightly controlled by genetic factors (black Bantu ethnicity) than the other lipoproteins as reported among Indians, African-Americans, and Japanese individuals. The most preventable environmental risk factors for DR were smoking status, global cardiovascular disease risk, insulin resistance and oxidative stress.

关键词： Diabetic Retinopathy Visual Disability Higher High Density Lipoprotein Smoking Insulin Resistance Oxidative Stress Africans

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Prevalence rates and cardiometabolic determinants of diabetes mellitus and pre-diabetes with projected coronary heart disease at bank site of Brazzaville

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World Journal of Cardiovascular Diseases 2014年第2期4卷 77-86页

作者： gombet thierry Longo-Mbenza Benjamin Ellenga-Mbolla Bertrand Ikama M. Stephan Kimbally-Kaky Gisèle Nkoua Jean-Louis Nge Okwe Augustin Biostatistics Unit Lomo Medical Center and Heart of Africa Center of Cardiology Kinshasa Congo Faculty of Health Sciences Walter Sisulu University Eastern Cape South Africa Service de cardiologie et Médecine Interne CHU de Brazzaville Brazzaville Congo Service des Urgences CHU de Brazzaville Brazzaville Congo

Background: Aim: Congolese Bank employees are often inactive without valid information on the burden of dysglycemia and cardiometabolic risk. This study aims to assess the prevalence rates of diabetes mellitus (DM) and pre-diabetes and to identify the environmental, genetic and cardiometabolic risk factors associated with Type 2 diabetes mellitus (T2DM) and pre-diabetes among Congolese bank employees. Methods: In representative 126 bank employees from Brazzaville, Congo, Central Africa, Abdominal obesity, dyslipidemia and metabolic syndrome (MetS) were defined by IDF for Europe, NCEP-ATPIII and IDF criteria modified for Central Africa. Projected high 10-year total risk of coronary heart disease (CHD) ≥20% was calculated using Framingham scores. Results: Out of the employees, 16% and 21.4% had DM and pre-diabetes, respectively. The rate of T2DM among diabetics was estimated 90%. Aging, high total cholesterol, high LDL-cholesterol, high conicity index and longer urban residence after migration were significantly associated with pre-diabetes. Physical inactivity, smoking, excessive alcohol intake, abdominal obesity, female gender, low HDL-C, hypertension, CHD, projected high 10-year total CHD risk, age ≥ 55 years, urban residence, Southern area residence, high socioeconomic status, non married status, MetS/NCEP, MetS/IDF for Europe and MetS/IDF for Africa were significantly associated with ***/IDF for Africa was the only independent determinant of T2DM. Conclusion: Urgent prevention and intervention programme are needed to curb the alarming increase in DM, T2DM, pre-diabetes.

关键词： Workplace Diabetes Mellitus Pre-Diabetes Cardiovascular Risk Brazzaville

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Hypertension and intracerebral hemorrhage in Brazzaville

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World Journal of Cardiovascular Diseases 2013年第9期3卷 523-528页

作者： thierry Raoul gombet Paul Macaire Ossou-Nguiet Thibaut Naibe Gankama Bertrand Fikahem Ellenga-Mbolla Gilbert Fabrice Otiobanda Karen Obondzo-Aloba Benjamin Longo-Mbenza Department of Medicine Faculty of Health Sciences of Brazzaville Brazzaville Congo Service of Emergency University Hospital of Brazzaville Brazzaville Congo Department of Medicine Faculty of Health Sciences of Brazzaville Brazzaville CongoService of Cardiology University Hospital of Brazzaville Brazzaville Congo Department of Medicine Faculty of Health Sciences of Brazzaville Brazzaville CongoService of Neurology University Hospital of Brazzaville Brazzaville Congo Faculty of Health Sciences Walter Sisulu University Mthatha South Africa Service of Cardiology University Hospital of Brazzaville Brazzaville Congo Service of Neurology University Hospital of Brazzaville Brazzaville Congo Service of Reanimation University Hospital of Brazzaville Brazzaville Congo

Hypertension is not only an important risk factor, but also an important cause of spontaneous intracerebral hemorrhage. Its high prevalence in Africa reflects a high incidence of cerebral hemorrhage ranging from 30% to 60% against 10% to 20% in industrialized countries. The aim of our study was to determine the role of hypertension before the onset of intracerebral hemorrhage and its variations during the first three months. This was a longitudinal study conducted at the University Hospital of Brazzaville from 1st January to 31st August 2012 with all patients admitted for intracerebral hemorrhage. Patients with subarachnoid or pure intraventricular hemorrhage were excluded. The study variables were: history of hypertension, knowledge of its history, treatment, blood pressure on admission and during the first 3 months and the relationship between blood pressure and evolution. Statistical analysis was performed using the software SPSSS 16.1. The significance level was set at p < 0.05. During the study 261 patients were hospitalized for stroke, of which 82 (31.42%) were for intracerebral hemorrhage. The mean age was 55 ± 11 years and sex ratio of 2 men:1 woman. Hypertension was found in 80.5% of cases, of which 65.2% had known hypertension, but 82.6% had discontinued treatment. The mean systolic blood pressure was 194 ± 41 mm Hg and diastolic 104 ± 20 mm Hg. The location was deep in 85.71%. The normalization of blood pressure was obtained from the second week. After adjusting for confounders using logistic analysis, only uncontrolled hypertension was associated significantly and independently associated with a higher mortality rate (p = 0.042).

关键词： Hypertension Cerebral Hemorrhage Brazzaville

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Left Ventricular Hypertrophy and Predictive Factors among Congolese Hypertensive Patients

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World Journal of Cardiovascular Diseases 2018年第12期8卷 569-577页

作者： Stéphane Méo Ikama Bernice Mesmer Nsitou Jospin Makani Louis Igor Ondze-Kafata Bertrand Fikhaem Ellenga-Mbolla thierry Raoul gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology Brazzaville University Hospital Center Brazzaville Congo

A cross-sectional study of hypertensive patients was carried out in Brazzaville between January 2011 and December 2013.?The objectives of the present study are to determine the different types of left ventricular hypertrophy (LVH)?and to identify the predictive factors of LVH. It included 556 hypertensive patients with LVH, characterized by left ventricular mass index (LVMI) > 135 g/m2?in men, and > 111 g/m2?in women. Patients’ sociodemographic data and echocardiographic parameters were gathered and analyzed. There were 342 males (61.5%) and 214 females (38.5%),?with?mean age 53.5 ± 11.5 years. The indications of the test were hypertension initial evaluation in 402 cases (72.3%), investigation of ischemic stroke in 62 cases (11.2%), heart failure in 58 cases (10.4%), dyspnea and chest pain in respectively 22 and 12 cases. Hypertension, old of 5.2 ± 4.5 years, was associated with overweight/obesity in 408 cases (73.4%), physical inactivity in 325 cases (58.5%), hypertension family history in 274 cases (49.3%), diabetes mellitus in 76 cases (13.7%), dyslipidemia in 63 cases (11.3%), tobacco use in 9 cases (1.6%). The prevalence of LVH was 49.4% and consisted into concentric LVH in 470 cases (84.5%), eccentric LVH in 70 cases (12.6%), and in 16 cases (2.9%),?it was a concentric left ventricular remodeling. Age, male gender, seniority of hypertension and treatment were predictive factors of LVH. The latter is the most predominant abnormality in the echocardiographic profile of Congolese hypertensive patients. Efficient management on hypertension will lead to reducing its morbidity and mortality.

关键词： Arterial Hypertension Left Ventricular Hypertrophy Predictive Factors Congo

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Epidemiological, Clinical and Etiological Profile of Rhythmic Emergencies at the University Hospital of Brazzaville, Republic of Congo

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World Journal of Cardiovascular Diseases 2022年第6期12卷 342-352页

作者： Suzy Gisèle Kimbally-Kaky Thibaut Naïbe Gankama Eric Gibrel Kimbally-Kaky Jospin Karel Makani Bijou Moualengue Stéphane Méo Ikama Soodougoua Baragou thierry Raoul Alexis gombet Department of Cardiology and Internal Medicine University Hospital of Brazzaville Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Sylvanus Olympio University Hospital Lomé Togo Faculty of Health Sciences Lomé Togo Department of Emergency University Hospital of Brazzaville Brazzaville Republic of Congo

Objectives: To describe the epidemiological, clinical and etiological aspects of rhythmic emergencies at the University Hospital of Brazzaville. Patients and Methods: This was a retrospective descriptive study conducted in the cardiology and internal medicine department of the University Hospital of Brazzaville from January 1, 2014 to June 30, 2016. Were included, all patients admitted for a severe rhythm disorder diagnosed on the surface electrocardiogram. Rhythmic emergency was defined as a severe rhythm disorder of abrupt onset and required rapid management. Data entry and analysis were performed with Epi Info software version 3.5.1. Results: During the study period, 2269 patients were hospitalized, including 138 for a rhythmic emergency. The frequency of rhythmic emergencies was 6.1%. The patients were divided into 76 women and 62 men (sex ratio = 0.81). The mean age of the patients was 63.1 ± 16.9 years (extremes: 17 and 91 years). The socio-economic level was low for 103 patients (74.6%), medium for 26 (17.7%), and high for nine (6.6%). The average time to consultation was 13.7 ± 12.3 days. On admission, the signs were: heart failure (103 cases;74.6%) including 22 acute cases;dyspnea (94 cases;68%);palpitations (38 cases;27.5%);functional impotence (13 cases;9.4%);collapse (nine cases;6.5%);chest pain (two cases;1.4%). The type of rhythmic emergency was: rapid atrial fibrillation (103 cases;74.6%), ventricular tachycardia (14 cases;10.1%), junctional tachycardia (10 cases;7.2%), rapid atrial flutter (10 cases;7.2%), tachysystole (one case;0.7%). The context of occurrence was: hypokalemia (8 cases;5.8%), drunkenness (two cases;1.4%), acute gastroenteritis (one case;0.7%). Cardiovascular risk factors were: hypertension (62 cases;45.2%), smoking (17 cases;12.1%), dyslipidemia (12 cases;8.7%), diabetes (11 cases;8%), obesity (10 cases;7.2%). Underlying heart disease was: dilated cardiomyopathy (40 cases;29%), hypertensive cardiomyopathy (26 cases;18.8%), valvulopa

关键词： Cardiac Rhythm Disorders Atrial Fibrillation Dilated Cardiomyopathy Brazzaville

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The Erectile Dysfunction among Congolese Hypertensive Patients

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World Journal of Cardiovascular Diseases 2018年第10期8卷 481-488页

作者： Stéphane Méo Ikama Odzebe-Anani Sévérin Bernice Mesmer Nsitou Melvin Atipo-Ondongo Jospin Makani thierry Raoul gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology University Hospital Center of Brazzaville Brazzaville Congo Department of Urology University Hospital Center of Brazzaville Brazzaville Congo

The authors conducted an analytical cross-sectional study over a period of 3 months among hypertensive patients, in order to determine the frequency of the erectile dysfunction (ED), and to identify the predictive factors. It included treated hypertensive patients, presenting an ED, defined as the incapacity to obtain or maintain an erection sufficient for satisfactory sexual activity. On 265 hypertensive patients, 172 (65%) presented an ED. The average age was 58.2 ± 9.7 years. The associated cardiovascular risk factors were overweight/obesity in 99 cases (37.4%), sedentariness in 90 cases (34%), diabetes mellitus in 50 cases (19%), dyslipidemia in 12 cases (4.5%), and tobacco addiction in 6 cases (2.3%). Arterial hypertension (HTN), old of 6.7 ± 5.8 years, was treated by bitherapy in 129 cases (48.7%), and tritherapy in 102 cases (38.5%). The principal therapeutic classes used were ACE inhibitors/ARBs in 213 cases (81%), calcium antagonists in 205 cases (78%), thiazides in 137 cases (52.1%), and beta-blockers in 82 cases (31%). ED, severe in 124 cases (72%), and moderate in 48 cases (28%), consisted of a difficulty to maintain the erection in 78 cases (45.3%), to obtain the erection in 30 cases (17.4%), and the two partners in 64 cases (37.2%). In multivariate analysis, only the age, seniority of HTN, and the existence of diabetes mellitus were the predictive factors of ED. The early and effective assumption of responsibility of the AHT, as well as other cardiovascular risk factors whose diabetes, would make it possible to reduce the frequency of it, thus improving quality of life of the hypertensive patients.

关键词： Arterial Hypertension Erectile Dysfunction Frequency Predictive Factors Congo

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Relationship between Obesity, Serum Uric Acid, Serum Potassium and Glomerular Filtration Rate with Electric Left Ventricular Hypertrophy in Blacks Central Africans with High Blood Pressure

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World Journal of Cardiovascular Diseases 2018年第4期8卷 248-255页

作者： Bertrand Fikahem Ellenga Mbolla Paul Macaire Ossou Nguiet Richard Loumingou Meo Stéphane Ikama Narcisse Ngangoue thierry Raoul gombet Henri Germain Monabeka Benjamn Longo Mbenza Gisèle Kimbally Kaky Department of Doctoral Studies Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Laboratoire de biochimie CHU de Brazzaville Brazzaville Congo Faculty of Health Sciences Walter Sisulu University Queenstown Eastern Cape South Africa

The authors conducted a retrospective study over a period of 6 months in a hypertensive population in order to determine the correlation between serum uric acid on glomerular filtration rate (GFR) and estimated serum potassium with left ventricular hypertrophy (LVH) and obesity. This study enrolled 122 patients including 63 women (51.6%). The mean age was 55.9 ± 10.6 years (range 30 to 74 years). Obesity weight was found in 38 cases (31.1%) of which 20?were men (33.9%) and 18 women (28.6%). Abdominal obesity was found in 104 cases (85.2%). The average serum uric acid in patients with obesity weight was 63.3 ± 18.9 mg/L vs 62.4 ± 14.2 mg/L for no-obese patients (p?= 0.63). The average serum potassium in obese patients was 4.06 ± 0.42 mEq/L vs 4.02 ± 0.46 mEq/L for no-obese (p?= 0.65). The average GFR was 73.4 ± 21.4 ml/L in obese patients vs 66.6 ± 22.6 ml/min in no-obese (p?= 0.03). The LVH was found in 81 cases (66.4%). The LVH was found in 65 (62.5%) obese patients vs?16 (88%) non-obese patients (OR = 4.8, 95% 1.04?-?22?p?= 0.02). Only abdominal?obesity has been correlated with left ventricular hypertrophy after multivariate analysis. Emphasis must be focused on public health actions for effective and appropriate measures against obesity and hypertension, whose prevalence is increasing in our region.

关键词： Obesity High Blood Pressure Glomerular Filtration Rate Uric Acid Serum Potassium Black African

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Stroke in type 2 diabetes mellitus patients admitted to emergency unit in Central African country (Congo): Preliminary findings

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Journal of Diabetes Mellitus 2013年第4期3卷 208-213页

作者： Bertrand Fikahem Ellenga-Mbolla Henri Germain Monabeka Paul Macaire Ossou-Nguiet Gilbert Fabrice Otiobanda Kryste Chancel Mahoungou Guimbi thierry Raoul gombet Suzy-Gisèle Kimbally-Kaky Benjamin Longo Mbenza Department of Cardiology University Hospital of Brazzaville Brazzaville Congo Department of Medicine Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Faculty of Health Sciences Walter Sisulu University Mthatha South Africa Intensive Care Unit University Hospital of Brazzaville Brazzaville Congo

Background: The cardiovascular risk factors including type 2 diabetes mellitus (T2DM) are a public health problem in sub-Saharan Africa. The aim of this study is to determine the prevalence and factors associated with stroke in T2DM patients admitted to the emergency Unit in Brazzaville. Patients and Methods: This is the preliminary findings of a cross-sectional study including patients with T2DM, admitted in Emergency Unit of University Hospital of Brazzaville from January to April 2011. One hundred and seven patients were included. Sex ratio was 1.5. Results: The mean age was 60.3 ± 10.2 years (range 40 - 80 years). Stroke story was noted in 5 cases (4.6%). The main pathologies were metabolic complications (n = 51;47.6%) and cardiovascular diseases (n = 36;33.6%), dominated by stroke (17 cases). Epidemiological factors associated with stroke were high standard living (OR = 3, 95% CI: 1.02 - 8.9, p = 0.03), polypharmacy (OR = 3.7, 95% CI: 1.27 - 10.8, p = 0.01), previous hospitalization (OR = 3.1, 95% CI: 1.07 - 8.9, p = 0.03), and the absence of antiplatelet therapy (OR = 4.2, 95% CI 1.2 to 15, p = 0.03). Clinical associated factors were coma (OR = 3.3, 95% CI 1.14 to 9.6, p = 0.02) and the presence of severe hypertension (OR = 4, 95% CI: 1.2 - 12, p = 0.02). Finally, prognostic factors were the transfer in intensive care unit (OR = 9.8, 95% CI: 2.7 - 34, p 0.001). Conclusion: The first cardiovascular complication in patients with T2DM admitted in emergency at University Hospital of Brazzaville is stroke. Primary prevention in high-risk patients is still inadequate.

关键词： Type 2 Diabetes Mellitus Stroke Emergency Brazzaville

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Global Cardiovascular Risk of the HIV Positive Patients Receiving Antiretroviral Therapy in Brazzaville

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World Journal of Cardiovascular Diseases 2019年第8期9卷 553-561页

作者： Stéphane Méo Ikama Franck Ekoba-Otende Jospin Makani Amélia Bokilo Bienvenu Ossibi-Ibara Louis Igor Ondze-Kafata Bertrand Fikhaem Ellenga-Mbolla thierry Raoul gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology Brazzaville University Hospital Center Brazzaville Congo National Centre of Blood Transfusion Brazzaville Congo Department of Infectious Diseases Brazzaville University Hospital Center Brazzaville Congo

A cross-sectional, descriptive and analytical study was conducted from January to August 2015 at the Brazzaville Ambulatory Treatment Center and at?the National Blood Transfusion Center. The objective was to contribute to improving?the care of people living with HIV under antiretroviral therapy by assessing their global cardiovascular risk (CVR). The variables studied focused on the epidemiological, clinical and biological aspects. The global CVR was assessed?by the Framingham and WHO/ISH scores. There were 135 HIV-positive subjects,?including 64 treated patients and 71 untreated HIV+ subjects. The subjects were divided into 83 men (61.5%) and 52 women (38.5%), with an average age of 42.6 ± 2.9 old years. The subjects were single people (62.2%), of a secondary educational level (63.7%), and civil servants (32.6%). The main risk factors found were dyslipidaemia (60%), obesity (36%), smoking (12.6%), hypertension (5.9%), diabetes (0.7%). The metabolic syndrome was found in seven cases (11.3%). The global CVR according to the score of Framingham, initially moderated at 17.2%, and mean at 1.5% within treated patients, was mean at 9.4% and high at 1.6% of the subjects respectively at the sixth month of treatment (p CVR under antiretroviral therapy. Preventive actions are highly recommended.

关键词： HIV Infection Antiretroviral Therapy Metabolic Disorders Global Cardiovascular Risk Congo

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Hypertension, diabetes mellitus, overweight and obesity in employees under health transition at the railways company in Congo-Brazzaville

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World Journal of Cardiovascular Diseases 2014年第2期4卷 45-49页

作者： Bertrand Fikahem Ellenga Mbolla thierry Raoul Alexis gombet Henri Germain Monabeka Paul Macaire Ossou-Nguiet Solange Flore Mongo-Ngamami Christian Michel Kouala Landa Suzy-Gisèle Kimbally-Kaky Benjamin Longo-Mbenza Department of Cardiology University Hospital of Brazzaville Brazzaville Congo Department of Cardiology University Hospital of Brazzaville Brazzaville Congo Department of Medicine Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Medicine Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Faculty of Health Sciences Walter Sisulu University Mthatha South Africa

Background and Aim: Cardiovascular risk (CVR) factors, namely hypertension (HT), diabetes mellitus and obesity, are a public health problem in sub-Saharan Africa because of health transition. The additional effect of the social gradient within the railway companies in Congo-Brazzaville on high CVR is not yet established. The aim of this study was to determine the extent of hypertension, diabetes mellitus, overweight, and obesity and to identify the contributing factors of fatness and hypertension. Methods: This was a cross-sectional study conducted in April 2013. A simple random sample of 255 out of all 2550 workers from the railway companies of Congo was examined for epidemiological, clinical and biological variables. Results: Out of the study sample, 231 (90.6%), 79 (31%), and 52 (20.4%) were men, rural dwellers, and senior executives, respectively. The mean age was 45 ± 13 years (range 19 to 63 years). The rates of overweight, hypertension, obesity, and diabetes mellitus were 40.3% (n = 103), 29.4% (n = 75), 7.5% (n = 19), and 3.5% (n = 9), respectively. In univariate analysis, female sex (OR 2.7, 95% CI 1.13 - 6.45, p = 0.01), senior executive (OR 2.4;95% CI: 1.3 - 4.5;p = 0.003) and physical inactivity (OR 2.5;95% CI: 1.5 - 4.2;p < 0.001) were significantly associated with overweight. Female sex (OR 7.5, 95% CI: 2.6 - 21;p < 0.001) and senior executive (OR 3.17;95% CI: 1.2 - 8.3) were also significantly associated with obesity. In logistic regression, overweight (OR = 4.8, 95% CI 2.8 - 11, p < 0.0001), and obesity (OR = 6.8, 95%CI 2.1 - 22, p = 0.01) were identified as the most important and independent determinants of hypertension. Conclusions: Fatness is emerging and it is the most contributing factor of hypertension among workers at the Congolese railway companies. There is also a significant interaction between non-modifiable factors (genetic: females and family history) and modifiable factors (inactivity, fatness) for higher risk of hypertension. Health pr

关键词： Hypertension Diabetes Mellitus Overweight Obesity Workplace Congo Sub-Saharan Africa

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