Characterization of severe and complicated hypertension in Mozambican adults

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dc.contributor.advisorSliwa-Hahnle, Karenen_ZA
dc.contributor.advisorMocumbi, Ana Oen_ZA
dc.contributor.authorManafe, Naisa Abdulen_ZA
dc.date.accessioned2018-05-07T14:16:53Z
dc.date.available2018-05-07T14:16:53Z
dc.date.issued2018en_ZA
dc.description.abstractBackground and aims: Hypertension is a public health problem and a major reason for hospitalisation and death. In Mozambique, low levels of detection, treatment and control have been described. However, data on target-organ damage and associated clinical conditions is lacking. We therefore aimed at characterising the clinical profile of patients with severe hypertension, describing the pattern of target organ damage and determining the outcomes at 6-month follow-up. Methods: We designed a prospective descriptive cohort study to assess adult patients with severe hypertension defined according to the Joint National Committee VII guidelines. The study was conducted from July 2015 to May 2017 at Mavalane General Hospital in Maputo-Mozambique. Patients were characterized through physical examination, laboratory profile, electrocardiography, and echocardiography, and followed for six months to assess occurrence of complications such as hypertensive heart failure, stroke, renal failure, hospital admission and death. Data were analysed using SPSS software version 20.0. The study was approved by the National Bioethics Committee for Health of Mozambique. Results: We studied 116 subjects (111 [95.7%] black; women 81 [70%]). Women were slightly younger than men (mean 57 years vs 59 years); 18 (15.5%) patients were younger than 44 years. The risk profile of the studied population included obesity (46; 42.5%); dyslipidaemia (59; 54.1%); diabetes (10; 8.6%) and smoking (8; 6.9%). At baseline, mean values for systolic and diastolic blood pressure were 192.3 ± 23.6 and 104.2 ± 15.2, respectively. The most frequent target-organ damage were left atrial enlargement in 91 (88.3%) with atrial fibrillation in 9 (7.9%); left ventricular hypertrophy in 57 (50.4%); hypertensive retinopathy in 30 (26. 3%) and renal damage in 29 (25.7%) subjects. Major events during 6-month follow-up were hospitalisations (12; 10.3%) and death (10; 8.6%). Renal damage (4; 4.2%), stroke (4; 3.4%) and heart failure (2; 1.7%) were the most common complications occurring over the follow up period. Conclusion: Severe and complicated hypertension affects young people with higher incidence of obesity, diabetes and smoking than that found in general population. High occurrence of target organ damage is found at baseline, particularly heart damage, renal lesion and stroke. On follow up, severe hypertension is associated with high number of hospitalisations and high case-fatality rate. Moreover, renal damage, stroke and hypertensive heart disease were common complications on follow up. Further research is needed to understand the determinants of these poor outcomes.en_ZA
dc.identifier.apacitationManafe, N. A. (2018). <i>Characterization of severe and complicated hypertension in Mozambican adults</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension. Retrieved from http://hdl.handle.net/11427/27971en_ZA
dc.identifier.chicagocitationManafe, Naisa Abdul. <i>"Characterization of severe and complicated hypertension in Mozambican adults."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension, 2018. http://hdl.handle.net/11427/27971en_ZA
dc.identifier.citationManafe, N. 2018. Characterization of severe and complicated hypertension in Mozambican adults. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Manafe, Naisa Abdul AB - Background and aims: Hypertension is a public health problem and a major reason for hospitalisation and death. In Mozambique, low levels of detection, treatment and control have been described. However, data on target-organ damage and associated clinical conditions is lacking. We therefore aimed at characterising the clinical profile of patients with severe hypertension, describing the pattern of target organ damage and determining the outcomes at 6-month follow-up. Methods: We designed a prospective descriptive cohort study to assess adult patients with severe hypertension defined according to the Joint National Committee VII guidelines. The study was conducted from July 2015 to May 2017 at Mavalane General Hospital in Maputo-Mozambique. Patients were characterized through physical examination, laboratory profile, electrocardiography, and echocardiography, and followed for six months to assess occurrence of complications such as hypertensive heart failure, stroke, renal failure, hospital admission and death. Data were analysed using SPSS software version 20.0. The study was approved by the National Bioethics Committee for Health of Mozambique. Results: We studied 116 subjects (111 [95.7%] black; women 81 [70%]). Women were slightly younger than men (mean 57 years vs 59 years); 18 (15.5%) patients were younger than 44 years. The risk profile of the studied population included obesity (46; 42.5%); dyslipidaemia (59; 54.1%); diabetes (10; 8.6%) and smoking (8; 6.9%). At baseline, mean values for systolic and diastolic blood pressure were 192.3 ± 23.6 and 104.2 ± 15.2, respectively. The most frequent target-organ damage were left atrial enlargement in 91 (88.3%) with atrial fibrillation in 9 (7.9%); left ventricular hypertrophy in 57 (50.4%); hypertensive retinopathy in 30 (26. 3%) and renal damage in 29 (25.7%) subjects. Major events during 6-month follow-up were hospitalisations (12; 10.3%) and death (10; 8.6%). Renal damage (4; 4.2%), stroke (4; 3.4%) and heart failure (2; 1.7%) were the most common complications occurring over the follow up period. Conclusion: Severe and complicated hypertension affects young people with higher incidence of obesity, diabetes and smoking than that found in general population. High occurrence of target organ damage is found at baseline, particularly heart damage, renal lesion and stroke. On follow up, severe hypertension is associated with high number of hospitalisations and high case-fatality rate. Moreover, renal damage, stroke and hypertensive heart disease were common complications on follow up. Further research is needed to understand the determinants of these poor outcomes. DA - 2018 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Characterization of severe and complicated hypertension in Mozambican adults TI - Characterization of severe and complicated hypertension in Mozambican adults UR - http://hdl.handle.net/11427/27971 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27971
dc.identifier.vancouvercitationManafe NA. Characterization of severe and complicated hypertension in Mozambican adults. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension, 2018 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27971en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Nephrology and Hypertensionen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherSevere hypertensionen_ZA
dc.subject.othertarget-organ damageen_ZA
dc.subject.otherclinical outcomesen_ZA
dc.titleCharacterization of severe and complicated hypertension in Mozambican adultsen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMSc (Med)en_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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