Patients-related predictors of poor adherence to antihypertensive treatment in Congo-Brazzaville: a cross-sectional study

Studies suggest that poor adherence to hypertension treatment is responsible for about two-thirds of uncontrolled hypertension, leading to complications such as stroke. Yet, patients-associated factors explaining poor adherence to antihypertensive treatment in Africa remains under- researched. This study aimed at assessing the level of compliance in hypertensive patients and identifying patients-related predictors of poor compliance. The study was a prospective cross-sectional. The data was collected during a six-month period. Participants were recruited from outpatients’ departments in three urban hospitals in Congo-Brazzaville. Bivariate and multivariate analyses (using T-test and chi-2) were performed to identify predictors of poor compliance. In total, 212 hypertensive patients were included. Their mean age was 58.3 ± 10.6 years (range 34 – 81). Compliance was poor in 69 (32.5%) and good or fair in 143 cases (67.5%). Bivariate analysis indicated several patient-related factors that could predict poor adherence. However, after adjustment by logistic regression, only knowledge of the treatment and perception of the severity of complications of hypertension showed statistically significant associations with poor compliance (p =0.0170 and p=0.0373 respectively). Efforts to enhance patients’ awareness about hypertension’s treatment and severity of the complications associated with the disease are called for in this particular context

Patients-related predictors of poor adherence to antihypertensive treatment in Congo-Brazzaville : a cross-sectional study

Studies suggest that poor adherence to hypertension treatment is responsible for about two-thirds of uncontrolled hypertension, leading to complications such as stroke. Yet, patients-associated factors explaining poor adherence to antihypertensive treatment in Africa remains under-researched. This study aimed at assessing the level of compliance in hypertensive patients and identifying patients-related predictors of poor compliance. The study was a prospective cross-sectional. The data was collected during a six-month period. Participants were recruited from outpatients’ departments in three urban hospitals in Congo-Brazzaville. Bivariate and multivariate analyses (using T-test and chi-2) were performed to identify predictors of poor compliance. In total, 212 hypertensive patients were included. Their mean age was 58.3 ± 10.6 years (range 34 – 81). Compliance was poor in 69 (32.5%) and good or fair in 143 cases (67.5%). Bivariate analysis indicated several patient-related factors that could predict poor adherence. However, after adjustment by logistic regression, only knowledge of the treatment and perception of the severity of complications of hypertension showed statistically significant associations with poor compliance (p =0.0170 and p=0.0373 respectively). Efforts to enhance patients’ awareness about hypertension’s treatment and severity of the complications associated with the disease are called for in this particular context

Patients-related predictors of poor adherence to antihypertensive treatment in Congo-Brazzaville : a cross-sectional study

Studies suggest that poor adherence to hypertension treatment is responsible for about two-thirds of uncontrolled hypertension, leading to complications such as stroke. Yet, patients-associated factors explaining poor adherence to antihypertensive treatment in Africa remains under-researched. This study aimed at assessing the level of compliance in hypertensive patients and identifying patients-related predictors of poor compliance. The study was a prospective cross-sectional. The data was collected during a six-month period. Participants were recruited from outpatients’ departments in three urban hospitals in Congo-Brazzaville. Bivariate and multivariate analyses (using T-test and chi-2) were performed to identify predictors of poor compliance. In total, 212 hypertensive patients were included. Their mean age was 58.3 ± 10.6 years (range 34 – 81). Compliance was poor in 69 (32.5%) and good or fair in 143 cases (67.5%). Bivariate analysis indicated several patient-related factors that could predict poor adherence. However, after adjustment by logistic regression, only knowledge of the treatment and perception of the severity of complications of hypertension showed statistically significant associations with poor compliance (p =0.0170 and p=0.0373 respectively). Efforts to enhance patients’ awareness about hypertension’s treatment and severity of the complications associated with the disease are called for in this particular context

Apport du Holter ECG dans le bilan étiologique des infarctus cérébraux à Brazzaville, Congo

Déterminer la prévalence des troubles rythmiques au cours des infarctus cérébraux et identifier les facteurs prédictifs de la fibrillation atriale (FA) paroxystique. Il s'est agi d'une étude transversale, descriptive et analytique, menée à Brazzaville entre janvier 2012 et décembre 2016. Elle a porté sur une série consécutive de 267 patients victimes d'un accident vasculaire cérébral ischémique transitoire (n = 17) ou constitué (n = 250), documenté par un scanner cérébral. Tous ces patients ont bénéficié d'un enregistrement Holter ECG dès 24h, réalisé dans le cadre de la recherche étiologique. Les principales anomalies rythmiques enregistrées ont été répertoriées et la régression logistique a permis l'identification des facteurs prédictifs de survenue de la FA paroxystique. Il s'agissait de 164 hommes (61,4%) et 103 femmes (38,6%), âgés en moyenne de 60,2 ± 12,1 ans (extrêmes: 22 et 94 ans). Les principaux facteurs de risque cardiovasculaire identifiés étaient une hypertension artérielle (HTA) dans 214 cas (80,1%), un diabète sucré dans 36 cas (13,5%), et un tabagisme dans 18 cas (6,7%), avec un taux de cumul de 1,5 facteur par individu. L'examen Holter ECG, normal dans 216 cas (81%), était pathologique dans 51 cas (19%). Les principales anomalies enregistrées consistaient en des extrasystoles ventriculaires bénignes (n = 32), une FA paroxystique (n = 7), des extrasystoles supraventriculaires (n = 5), une tachycardie ventriculaire (TV) non soutenue (n = 4), une TV soutenue (n = 2) et un bloc auriculo-ventriculaire type Mobitz II (n = 1). La fréquence de la FA paroxystique était de 2,6%. En analyse bivariée, il n'a pas été noté de corrélation entre la FA paroxystique et le sexe (p = 0,890), l'HTA (p = 0,818), le diabète (p = 0,839), le tabac (p = 0,969). En analyse multivariée, seul l'âge était prédictif de la survenue d'une FA paroxystique au cours des infarctus cérébraux (OR = 1,11;p = 0,0134). Il ressort de cette étude préliminaire que les troubles du rythme emboligènes sont relativement rares au cours des infarctus cérébraux à Brazzaville. La FA paroxystique, quoique peu fréquente, reste essentiellement corrélée à l'âge. Sa recherche systématique chez les sujets âgés contribue à améliorer la prise en charge