Management of Hypertension in the Elderly Patient at Abidjan Cardiology Institute (Ivory Coast)

Abstract

Background. Since the treatment of hypertension is beneficial for the elderly, we have undertaken this study that aims to evaluate the management of hypertension in elderly patient in Côte d'Ivoire. Methods. A retrospective study was conducted among 854 hypertensive elderly patients of Abidjan Cardiology Institute who were followed for a minimum of one year, between January 2000 and December 2009. Results. The patients mean age was 73.1 ± 5.3 years, and 59% were women. At the first presentation, it was mostly systolic-diastolic hypertension (51.8%) and isolated systolic hypertension (38.5%). Mean blood pressure was 169.4 ± 28.4 mmHg for systolic, 95.3 ± 15.7 mmHg for diastolic, and 74.1 ± 22.8 mmHg for pulse pressure. Pulse pressure was ≥60 mmHg in 80.4%. According to the European Guidelines stratification of the cardiovascular risk-excess attributable to high blood pressure, 82.1% of the sample had a very high added risk. The pharmacological therapy was prescribed in 93.5%. More than 66% of patients were receiving ≥2 antihypertensive drugs including fixed-dose combination drugs. The most common agents used were diuretics (63.5%) followed by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in 61.3%. The most common agents used for monotherapy were calcium antagonists. When ≥2 drugs were used, diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were the most common. Blood pressure control was achieved in 42.6%. Conclusion. The control of elderly hypertension can be effective in Sub-Saharan Africa. He required at least two antihypertensive drugs to meet the recommended blood pressure target.

Assessment of hypertension control and factors associated with the control among hypertensive patients attending at Zewditu Memorial Hospital: a cross sectional study

“…This study further demonstrated that among the dual antihypertensive therapy the combination of ‘ACEI + BB’ was the most commonly prescribed regimen, while triple and four drug combination therapy were ‘CCB + ACEI + BB’ and ‘CCB + ACEI + BB + Diuretics’, respectively. This finding is quite different from other studies in Ethiopia [ 23 ], India [ 30 ] and Ivory Coast [ 31 ]. The prescription patterns of antihypertensives vary from one country to another.…”

Awareness, treatment, control of hypertension and utilization of health care services following screening in the North-central region of Burkina Faso

“…Calcium channel blocker (CCB) was the most widely used anti hypertension medicine in monotherapy as found in Cote d'Ivoire [ 27 ]. This was in line with European society of hypertension and European society of cardiology guidelines of hypertension management which recognized five major classes of antihypertensive agents (Thiazide diuretics, CCBs, ACEIs, Angiotensin receptor blocker (ARBs), β-blockers (BB)) as suitable for initiative treatment [ 18 , 28 ].…”

Blood pressure-lowering medicines implemented in 12 African countries: the cross-sectional multination EIGHT study

“…Though, our methodology did not allow to completely distinguish indications of some drugs, and particularly to know whether ACEI were prescribed in a compelling indication because of the non-reported patient’s comorbidities. Diuretics should be considered, particularly due to their low cost 22…”

“…Diuretics should be considered, particularly due to their low cost. 22 Even among patients recruited from tertiary cardiology centres in urban areas in Sub-Saharan countries, BP control remains very poor and monotherapy remains widely prescribed. Some barriers associated with uptitration of treatments could be cited.…”