Main Article Content

Abstract

RÉSUMÉ
Objectif. L’hypertension artérielle résistante (HTAr) est plus fréquente chez les sujets diabétiques comparés à la population générale des patients hypertendus sous traitement. Sa présence grève davantage le pronostic cardiovasculaire et rénal de ces patients. Notre objectif était de déterminer la prévalence de l’HTAr et les facteurs y associés chez des patients diabétiques de type 2 à l’Hôpital Central de Yaoundé (HCY). Population et Méthodes. Il s’agissait d’une étude transversale prospective effectuée au Centre National d’Obésité de l’HCY. Les patients diabétiques de type 2 et hypertendus enregistrés dans la base de données H3Africa ont été inclus dans l’étude. L’observance thérapeutique a été évaluée grâce au questionnaire de Morisky et par appels téléphoniques quotidiens pendant 2 semaines. La pression artérielle était prise au Cabinet puis lors de la MAPA de 24 heures. Les analyses statistiques ont été faites à l’aide du logiciel IBM SPSS version 20. Résultats. L’HTAr apparente était présente chez 37 (18,6%) des patients. Parmi les patients souffrant d’HTAr apparente, 7 (41,2%) sur les 17 ayant bénéficié de la MAPA de 24 heures avaient des chiffres tensionnels au-delà de 130/80 mmHg. Les patients ayant une HTAr étaient plus âgés et avaient des valeurs médianes d’IMC et d’HbA1c significativement plus élevées. La dyslipidémie et l’IMC compris entre 35 – 40 kg/m2 étaient les seuls facteurs indépendamment corrélés à l’HTAr. Conclusion. L’HTAr est fréquente chez les diabétiques de type 2 suivi l’Hôpital Central de Yaoundé. Elle est indépendamment corrélée à l’IMC et à la présence d’une dyslipidémie.
ABSTRACT
Objective. Resistant hypertension (rHT) is more common in diabetic subjects compared to the general population of hypertensive patients under treatment. The presence of hypertension further compromises the cardiovascular and renal prognosis of these patients. Our objective was to determine the prevalence of rHT and associated factors in type 2 diabetic patients at the Yaoundé Central Hospital (HCY). Population and Methods. We conducted a prospective cross-sectional study carried out at the National Obesity Centre of the HCY. Type 2 diabetic and hypertensive patients registered in the H3Africa database were included in the study. Adherence to treatment was assessed using Morisky's questionnaire and daily telephone calls for 2 weeks. Blood pressure was taken at the office and then at the 24-hour ABPM. Statistical analyses were performed using IBM SPSS version 20 software. Results. Apparent rHT was present in 37 (18.6%) of the patients. Among those patients with apparent resistant hypertension, 7 (41.2%) of the 17 patients who received 24-hour ABPM had blood pressure values above 130/80 mmHg. Patients with hypertension were older and had significantly higher median BMI and HbA1c values. Dyslipidemia and BMI between 35 - 40 kg/m2 were the only factors independently correlated with rHT. Conclusion. rHT is common in type 2 diabetics at the Central Hospital in Yaoundé. It is independently correlated with BMI and the presence of dyslipidemia.

Article Details

How to Cite
Mfeukeu Kuate, L., Danwe, D., Boombhi, J., Ondo Edou, G., Ngongang Ouankou, C., Etoa, M., Ahmadou Musa, A. M. jingi, Ndongo Amougou, S., Ba, H., Dehayem, M., Menanga, A., & Sobngwi, E. (2021). Prévalence et Facteurs Associés à l’Hypertension Artérielle Résistante dans un Groupe de Patients Diabétiques de Type 2 à Yaoundé. HEALTH SCIENCES AND DISEASE, 22(2). https://doi.org/10.5281/hsd.v22i2.2538

References

  1. WHO. A global brief on hypertension: silent killer, global public health crisis. WHO; 2013.
  2. Ikeda N, Sapienza D, Guerrero R, Aekplakorn W, Naghavi M, Mokdad AH, et al. Control of hypertension with medication: a comparative analysis of national surveys in 20 countries. Bull World Health Organ. 1 janv 2014;92(1):10-19C.
  3. Sarafidis PA. Epidemiology of Resistant Hypertension: Epidemiology of Resistant Hypertension. J Clin Hypertens. juill 2011;13(7):523‑8.
  4. Sheppard JP, Martin U, McManus RJ. Diagnosis and management of resistant hypertension. Heart. août 2017;103(16):1295‑302.
  5. Carey RM, Calhoun DA, Bakris GL, Brook RD, Daugherty SL, Dennison-Himmelfarb CR, et al. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension [Internet]. nov 2018 [cité 19 mai 2019];72(5). Disponible sur: https://www.ahajournals.org/doi/10.1161/HYP.0000000000000084
  6. Nansseu JRN, Noubiap JJN, Mengnjo MK, Aminde LN, Essouma M, Jingi AM, et al. The highly neglected burden of resistant hypertension in Africa: a systematic review and meta-analysis. BMJ Open. sept 2016;6(9):e011452.
  7. Pimenta E, Calhoun DA. Resistant Hypertension: Incidence, Prevalence, and Prognosis. Circulation. 3 avr 2012;125(13):1594‑6.
  8. Carey RM, Sakhuja S, Calhoun DA, Whelton PK, Muntner P. Prevalence of Apparent Treatment-Resistant Hypertension in the United States: Comparison of the 2008 and 2018 American Heart Association Scientific Statements on Resistant Hypertension. Hypertension. févr 2019;73(2):424‑31.
  9. Noubiap JJ, Nansseu JR, Nyaga UF, Sime PS, Francis I, Bigna JJ. Global prevalence of resistant hypertension: a meta-analysis of data from 3.2 million patients. Heart. janv 2019;105(2):98‑105.
  10. Naseem R, Adam AM, Khan F, Dossal A, Khan I, Khan A, et al. Prevalence and characteristics of resistant hypertensive patients in an Asian population. Indian Heart J. juill 2017;69(4):442‑6.
  11. Izzo R, Stabile E, Esposito G, Trimarco V, De Marco M, Sica A, et al. Prevalence and characteristics of true and apparent treatment resistant hypertension in the Campania Salute Network. Int J Cardiol. avr 2015;184:417‑9.
  12. Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL, et al. Incidence and Prognosis of Resistant Hypertension in Hypertensive Patients. Circulation. 3 avr 2012;125(13):1635‑42.
  13. Solini A, Zoppini G, Orsi E, Fondelli C, Trevisan R, Vedovato M, et al. Resistant hypertension in patients with type 2 diabetes: clinical correlates and association with complications. J Hypertens. déc 2014;32(12):2401‑10.
  14. Mohammad A, Abujbara M, Alshraideh J, Jaddou H, Ajlouni K. The Prevalence of Resistant Hypertension Among Type 2 Diabetic Patients Attending the National Center for Diabetes, Endocrinology, and Genetics. J Endocrinol Metab. 2017;7(5):153‑8.
  15. Djoumessi RN, Noubiap JJN, Kaze FF, Essouma M, Menanga AP, Kengne AP, et al. Effect of low-dose spironolactone on resistant hypertension in type 2 diabetes mellitus: a randomized controlled trial in a sub-Saharan African population. BMC Res Notes [Internet]. déc 2016 [cité 19mai2019];9(1).Disponible sur: http://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-016-1987-5
  16. Ekoru K, Young EH, Adebamowo C, Balde N, Hennig BJ, Kaleebu P, et al. H3Africa multi-centre study of the prevalence and environmental and genetic determinants of type 2 diabetes in sub-Saharan Africa: study protocol. Glob Health Epidemiol Genomics [Internet]. Cambridge University Press; ed 2016 [cité 10 janv 2021];1. Disponible sur: https://www.cambridge.org/core/journals/global-health-epidemiology-and-genomics
  17. Scheen AJ, Philips J-C, Krzesinski J-M. Hypertension et Diabéte : à propos d’une association commune mais complexe. Rev Médicale Liège. 2012;67(3):133‑8.
  18. Armario P, Blanch P, Castellanos P, Hernandez del Rey R, Jerico C, Rap O, et al. Resistant Hypertension in Diabetes Mellitus. J Endocrinol Diabetes. 10 juin 2015;2(3):01‑5.
  19. Ciobanu DM, Kilfiger H, Apan B, Roman G, Veresiu IA. Resistant hypertension in type 2 diabetes: prevalence and patient characteristics. Med Pharm Rep. 22 juill 2015;88(3):327‑32.
  20. Pierdomenico S, Lapenna D, Bucci A, Ditommaso R, Dimascio R, Manente B, et al. Cardiovascular Outcome in Treated Hypertensive Patients with Responder, Masked, False Resistant, and True Resistant Hypertension. Am J Hypertens. nov 2005;18(11):1422‑8.
  21. Oliveras A, Armario P, Hernández-del Rey R, Arroyo JA, Poch E, Larrousse M, et al. Urinary albumin excretion is associated with true resistant hypertension. J Hum Hypertens. janv 2010;24(1):27‑33.
  22. Kovacic JC, Moreno P, Nabel EG, Hachinski V, Fuster V. Cellular Senescence, Vascular Disease, and Aging: Part 2 of a 2-Part Review: Clinical Vascular Disease in the Elderly. Circulation. 3 mai 2011;123(17):1900‑10.
  23. Otsuka T, Takada H, Nishiyama Y, Kodani E, Saiki Y, Kato K, et al. Dyslipidemia and the Risk of Developing Hypertension in a Working‐Age Male Population. J Am Heart Assoc [Internet]. 9 mars 2016 [cité 19 mai 2019];5(3). Disponible sur: https://www.ahajournals.org/doi/10.1161/JAHA.115.003053
  24. Gulati A, Dalal J, Padmanabhan TNC, Jain P, Patil S, Vasnawala H. Lipitension: Interplay between dyslipidemia and hypertension. Indian J Endocrinol Metab. 2012;16(2):240.
  25. Tankeu A-T, Mfeukeu Kuate L, Nganou Gnindjio C-N, Ankotché A, Leye A, Ondoa Bongha H, et al. Spécificité de la prise en charge de l’hypertension artérielle che le patient diabétique sub-saharien. Médecine Mal Métaboliques. mars 2017;11(2):148‑54.
  26. Liu G, Zheng X-X, Xu Y-L, Lu J, Hui R-T, Huang X-H. Effect of aldosterone antagonists on blood pressure in patients with resistant hypertension: a meta-analysis. J Hum Hypertens. mars 2015;29(3):159‑66.
  27. Rossing K, Schjoedt KJ, Smidt UM, Boomsma F, Parving H-H. Beneficial Effects of Adding Spironolactone to Recommended Antihypertensive Treatment in Diabetic Nephropathy: A randomized, double-masked, cross-over study. Diabetes Care. 1 sept 2005;28(9):2106‑12.
  28. Oxlund CS, Henriksen JE, Tarnow L, Schousboe K, Gram J, Jacobsen IA. Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus: a double blind randomized clinical trial. J Hypertens. oct 2013;31(10):2094‑102.

Most read articles by the same author(s)

1 2 > >>