Hypertension management in an outpatient clinic at the Institute of Cardiology of Abidjan (Ivory Coast)

Abstract

Background: Elevated blood pressure is one of the most important modifiable risk factors for cardiovascular diseases.

Aim: To evaluate blood pressure management in Côte d'Ivoire.

Methods: A retrospective study was conducted among 2575 hypertensive patients from the Institute of Cardiology of Abidjan, who were followed for at least 10 years, between January 2000 and December 2009.

Results: The patients' mean age ± standard deviation was 59.1 ± 12.5 years; 54.3% were women. At first presentation, hypertension was stage 1 in 21.7%, stage 2 in 32.3% and stage 3 in 46.0% of patients. According to the European guidelines' stratification of the cardiovascular risk-excess attributable to high blood pressure, 46.7% had a very high added risk, 37.8% had a high added risk and 14.9% had a low-to-moderate added risk. Pharmacological therapy was prescribed in 97.8% of patients; more than 66% were receiving at least two antihypertensive drugs, including fixed-dose combination drugs. The most common agents used were diuretics (59.7%) followed by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (59.6%). The most common agents for monotherapy were calcium antagonists. When two or more drugs were used, diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were most commonly used. Blood pressure control was achieved in 43.7% of cases.

Conclusion: In our series, severe hypertension with high added risk or very high added risk was very common. Treatment--mostly diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers--required at least two antihypertensive drugs to meet the recommended blood pressure target.