High blood pressure (HBP) is a public health problem worldwide. The objective of this study is to determine the prevalence of hypertension in military garrisons in Conakry, the capital. Material and Methods: The study was done in military garrisons. The data concern 1025 soldiers. This prospective and cross-sectional study took place from 13 November 2014 to 13 February 2015. Only the military who had agreed to participate in the study were included. Sociodemographic, clinical data and urine dipsticks were collected. Results: Among 1025 soldiers, 222 cases of HPB were observed, that was 21.66%. They were 193 men (86.94%) and 29 women (13.06%). The mean age was 46.05 years (range: 18-77 years). HPB cases were discovered in 155 soldiers (69.82%) in random observations. Following the grade of hypertension: 124 were of grade I, 62 of grade II, 35 of grade III and 1 case of isolated systolic hypertension was identified. Urinary dipstick tests showed that, 3 patients had proteinuria, 26 patients suffered from leucocyturia, 11 patients suffered from glycosuria and 1 case of hematuria was also identified. More than half of the soldiers (41%) were in the army. Officers were strongly affected (80.18%), followed by non-commissioned officers (17.12%) and finally enlisted men (2.70%). Risk factors were multiple: 78.82% ate very salty food; emotional stress; physical inactivity was observed in over half of the cases. Conclusion: This study gives an overall picture of the prevalence of hypertension in the military in Guinea. The discovery of the symptom lies on the systematic measurement of blood pressure.
Atrial fibrillation is the most common heart rhythm disorder in humans. Al though it mainly affects the elderly, it can also be present in young people. In the absence of treatment, atrial fibrillation can have serious complications, including stroke or heart failure. The absence of an earlier study on AF before 50 years in Guinea, the multiplicity of etiologies motivated the present work with the objectives of determining the magnitude of AF before 50 years and identify the most common etiology. This was a prospective study that included 20 cases of atrial fibrillation in subjects under 50 years of age in the cardiac department of Ignace Deen National Hospital between 1st December 2017 and 30th June 2018. Included in this study were all patients under the age of 50, regardless of sex, who have an FA diagnosed on a resting electrocardiogram. During the study period 80 cases of FA were collected on 398 hospitalizations or a hospital frequency of 20.1% of which 20cas of FA in the subjects aged under 50 years were identified either a frequency of 5.02 %. The most frequent age group was 20 to 29 years old, ie 40% with the extreme age of 11 and 49 for a median age of 34.2 years. The female gender was predominant, 65% versus 35% of the male gender. Valvulopathies and pericarditis accounted for the most common etiologies (60% and 15%, respectively). Atrial fibrillation is not only the prerogative of the elderly. Before the age of 50, the etiology is dominated by valvulopathies because of the endemicity of rheumatic fever in our tropical environments.
When blood pressure values remain above the target in a hypertensive patient treated concomitantly with three anti-hypertensive drugs including a diuretic, maximum well-tolerated doses, this is a resistant arterial hypertension. In this case, it is advisable to look for a secondary cause such as a drug intake that influencing the blood pressure or the presence of obstructive sleeping syndrome (OSAS). We report a clinical case of a patient with a high cardiovascular risk at the age of 50, hypertensive and diabetic, with dyslipidemia and obesity. He was on anti-hypertensive triple therapy at an optimal dose. Her diabetes was balanced with 6.4% glycated hemoglobin. Dyslipidemia has being treated. Despite healthy diet including a low sodium diet and weight loss, blood pressure target was not reached. With self-measurement, the mean arterial pressure was 180/110 mmHg and on ABPM it was 167/113 mmHg. The ventilatory polygraphy finds a severe OSA with an IAH = 56.6. Treatment with PCP (Continuous positive pressure) allowed this patient to control blood pressure. The search for OSA should be systematic in face of resistant hypertension, in particular in overweight or obese patients.
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