Pattern and correlates of cardiac lesions in a group of sub-Saharan African patients on maintenance hemodialysis

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in patients on  maintenance hemodialysis. We investigated the pattern and correlates of cardiac lesions in a group of Cameroonians on chronic hemodialysis. Methods: This was a cross-sectional study conducted at the Yaoundé General Hospital's hemodialysis  unit, involving 45 patients (29 men, 64%) on maintenance hemodialysis for at least three months using a native arterio-venous fistula. Cardiovascular risk factors, biological, electrocardiographic and  echocardiographic data were collected. Results: Hypertension (29%), chronic glomerulonephritis (24%) and diabetes mellitus (24%) were the main etiological factors of chronic kidney disease. Blood pressure was controlled in 14 (31%) patients. Nineteen (42%) patients had anemia and 5 (14%) had a calciumphosphorus product >55 mg2/dl2. All patients had at least one cardiovascular risk factors with hypertension (95%), anemia (42%) and highcalcium-phosphorus product (42%) being the most frequent. Thirty-eight (84%) patients had at least one cardiac lesion and 11 (29%) had three or more lesions. The cardiac lesions were left ventricular  hypertrophy (60%), valvular calcifications (38%), heart failure (36%), conduction disorders (33%),  pericardial effusion (13%), valvular diseases (11%) and ischemic heart diseases (2%). Left ventricular hypertrophy was significantly associated with a longer duration on dialysis and low hemoglobin level (both p<0.047) while cardiac failure and valvular calcifications were associated with advanced age and high interdialytic weight gain (both p <0.05). Conclusion: Cardiac lesions and cardiovascular risk factors are frequent in these patients receiving  sub-optimal dose maintenance hemodialysis despite their younger age, suggesting an increased susceptibility to cardiovascular complications.Key words: Cardiac lesions, chronic hemodialysis, Cameroon, Sub-Saharan Afric

Magnitude, determinants and reasons for parallel use of plants in the management of hypertension in Cameroon: a cross-sectional study

Background: Most people living in sub-Saharan Africa tend to use medicinal plants to treat various ailments including hypertension. The aim of this study was to gather data on the magnitude, determinants, and reasons for their use in the setting of hypertension in our setting.Method: We carried out a cross-sectional study in a group of patients with hypertension in Yaounde. This study was carried out between November 2016 and April 2017. In a face-to-face interview, we gathered data on socio-demography, use of medicinal plants, parts of plant used, method of preparation, and prescriber of herbal remedy.Results: Overall, 410 individuals (152 males and 258 females) participated in the study. The mean age was 66.6 ± 11.1 years. Use of medicinal plants was reported by 149 patients (36.3%, [95% CI: 32 – 41]). The most frequently used plants were Annona muricata (47.7%), Allium sativum (37.6%), and Cymbopogon citratus (37.6%). The main reason underlying the parallel use of plants was a supposed synergistic effect (34.9%). The most used parts of plants were the leaves (81.2%). Decoction was the most frequent mode of preparation (68.5%). Friends mostly recommended the herbal remedy (51.7%). No factor was associated with the parallel use of medicinal plants.Conclusion: More than one in three patients with hypertension use medicinal plants mostly as decoction of the leaves besides conventional treatment. This use was mainly supported by a supposed synergistic action.Keywords: Plants, Hypertension, Cameroo