Abstract
Data regarding the prevalence and characteristics of cardiovascular (CV) risk factors among Egyptian hypertensive patients are limited. Nationwide Specialized Hypertension Clinics (SHCs) were initiated for screening, investigating, and treating hypertensive patients. This study aimed to determine the clinical characteristics and the CV risk profile of hypertensive Egyptians attending SHCs. Data from 4701 hypertensive patients were collected from the SHCs of nine university hospitals representing the different geographical regions of Egypt. Data collection started in October 2014 and ended in September 2017. Data included blood pressure (BP) measurements, clinical data, socio-demographic characteristics, anthropometric measurements, and cardiovascular risk profiles. The patients’ mean age was 51.8 ± 11.5 years, 58.7% were older than 50 years, and 58.5% were females. The mean office systolic and diastolic BP values were 145.2 ± 22.4 and 88.7 ± 12.9 mmHg, respectively. Regarding CV risk factors, 58.6% were obese, 23.4% were smokers, and 25.1% had diabetes mellitus. Obesity was more prevalent in females than males (65.7% vs. 53.0%, p < 0.001, respectively), while dyslipidaemia and smoking were significantly more common in male patients. The highest levels of BP and the highest global risk were observed in the inhabitants of the Delta region, despite their younger age. In conclusion, this study revealed a high prevalence of modifiable CV risk factors among a cohort of Egyptian hypertensive patients attending SHCs. The pattern of the risk factors across the different geographic regions may be attributed to rapid urbanization. Governmental and community-based approaches are needed for better control of hypertension and its associated CV risk factors.
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References
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005;365:217–23.
Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371:1513–8.
Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;378:31–40.
World Health Organization RoftEM. New round of STEPwise survey 2016–2017 to start in Egypt. World Health Organization RoftEM; 2017 http://www.emro.who.int/egy/egypt-infocus/who-will-start-a-new-round-of-stepwise-survey-in-egypt.html.
Ibrahim MM. The Egyptian National Hypertension Project (NHP): preliminary results. J Hum Hypertens. 1996;10:S39–41.
Ibrahim M. Problem of hypertension in Egypt. Egypt Heart J. 2013;65:233–4.
Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes care. 2010;33:S62–9.
Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–818. [Epub 2011/06/30]
Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129:S102–38.
Ibrahim MM, Elamragy AA, Girgis H, Nour MA. Cut off values of waist circumference and associated cardiovascular risk in Egyptians. BMC Cardiovasc Disord. 2011;11:53.
MM. Ibrahim. The Egyptian hypertension society: Egyptian hypertension guidelines. Egyptian Heart J. 2014;66:79–132.
Ezzati M, Vander Hoorn S, Lawes CM, Leach R, James WP, Lopez AD, et al. Rethinking the “diseases of affluence” paradigm: global patterns of nutritional risks in relation to economic development. PLoS Med. 2005;2:e133.
Ibrahim MM, Appel LJ, Rizk HH, Helmy S, Mosley J, Ashour Z, et al. Cardiovascular risk factors in normotensive and hypertensive Egyptians. J Hypertens. 2001;19:1933–40.
Ibrahim MM. Hypertension surveys in the developing world. Lessons from the Egyptian National Hypertension Project (NHP). J Hum Hypertens. 1997;11:709–26.
Emmanuel Acheamfour-Akowuah, Isaac Kofi Owusu, Nkum BC. Demographic and clinical characteristics of hypertensive patients attending a specialist clinic in techiman, Ghana. Open Sci J Clin Med. 2016;4:15–20.
Bhadoria AS, Kasar PK, Toppo NA, Bhadoria P, Pradhan S, Kabirpanthi V. Prevalence of hypertension and associated cardiovascular risk factors in Central India. J Fam Community Med. 2014;21:29–38.
Muxfeldt ES, Nogueira Ada R, Salles GF, Bloch KV. Demographic and clinical characteristics of hypertensive patients in the internal medicine outpatient clinic of a university hospital in Rio de Janeiro. Sao Paulo Med J. 2004;122:87–93.
Wu Y, Huxley R, Li L, Anna V, Xie G, Yao C, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation. 2008;118:2679–86.
Bell AC, Adair LS, Popkin BM. Understanding the role of mediating risk factors and proxy effects in the association between socio-economic status and untreated hypertension. Soc Sci Med. 2004;59:275–83. [Epub 2004/04/28]
Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998;351:1755–62.
Zanchetti A, Hansson L, Clement D, Elmfeldt D, Julius S, Rosenthal T, et al. Benefits and risks of more intensive blood pressure lowering in hypertensive patients of the HOT study with different risk profiles: does a J-shaped curve exist in smokers? J Hypertens. 2003;21:797–804.
Dhungana RR, Pandey AR, Bista B, Joshi S, Devkota S. Prevalence and associated factors of hypertension: a community-based cross-sectional study in municipalities of Kathmandu, Nepal. Int J Hypertens. 2016;2016:1656938.
Vyssoulis GP, Karpanou EA, Liakos CI, Kyvelou SM, Tzamou VE, Michaelides AP, et al. Cardiovascular risk factor(s) prevalence in Greek hypertensives. Effect of gender and age. J Hum Hypertens. 2012;26:443–51. [Epub 2011/06/03]
Muiesan ML, Ambrosioni E, Costa FV, Leonetti G, Pessina AC, Salvetti M, et al. Sex differences in hypertension-related renal and cardiovascular diseases in Italy: the I-DEMAND study. J Hypertens. 2012;30:2378–86. [Epub 2012/11/10]
Ibekwe R. Modifiable risk factors of hypertension and socio-demographic profile in oghara, delta state; prevalence and correlates. Ann Med Health Sci Res. 2015;5:71–7.
Dhungana RR, Devkota S, Khanal MK, Gurung Y, Giri RK, Parajuli RK, et al. Prevalence of cardiovascular health risk behaviors in a remote rural community of Sindhuli district, Nepal. BMC Cardiovasc Disord. 2014;14:92.
Sowers JR, Sowers PS, Peuler JD. Role of insulin resistance and hyperinsulinemia in development of hypertension and atherosclerosis. J Lab Clin Med. 1994;123:647–52.
Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84:289–98.
Maher D, Waswa L, Baisley K, Karabarinde A, Unwin N. Epidemiology of hypertension in low-income countries: a cross-sectional population-based survey in rural Uganda. J Hypertens. 2011;29:1061–8.
Shey Wiysonge CU, Ngu Blackett K, Mbuagbaw JN. Risk factors and complications of hypertension in Yaounde, Cameroon. Cardiovasc J S Afr. 2004;15:215–9.
Caughey GE, Vitry AI, Gilbert AL, Roughead EE. Prevalence of comorbidity of chronic diseases in Australia. BMC Public Health. 2008;8:221.
Liu J, Wang R, Desai K, Wu L. Upregulation of aldolase B and overproduction of methylglyoxal in vascular tissues from rats with metabolic syndrome. Cardiovasc Res. 2011;92:494–503.
Venugopal K, Mohammed M. Prevalence of hypertension in type-2 diabetes mellitus. CHRISMED J Health Res. 2014;1:223–7.
Tziomalos K, Giampatzis V, Baltatzi M, Efthymiou E, Psianou K, Papastergiou N, et al. Sex-specific differences in cardiovascular risk factors and blood pressure control in hypertensive patients. J Clin Hypertens. 2014;16:309–12.
Farrag A, El Eraky A, El Aroussy W, Sayed G, Mahrous A, Adel A, et al. Obesity and other cardiovascular risk factors in Egyptian University students: magnitude of the problem. Epidemiology. 2015;5:1.
Acknowledgements
The authors acknowledge Dr Azza Farrag, Prof. of Cardiology, Cairo University for reviewing the paper. They also acknowledge Mr Hatem Saber, Mrs Faten Labib, Mrs Nesma ElAshkar, and Mrs Rehab ElAshkar for their continuous secretarial work during the data collection. The authors acknowledge investigators from the participating universities: Dr Omar Awad, Prof. of Cardiology, Ain Shams University; Dr Mahmoud Hassanein, Prof of Cardiology, Alexandria University; Dr Ragab Abdelsallam, Prof. of Cardiology, Zagazig University; Dr Nasser Taha, Prof. of Cardiology, Elmenia Univesrity; Dr Doaa Fouad, Prof. of Cardiology, Assiut University; and Dr Moustafa Elmokkadem, Assist Prof., Beni Suef University.
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Astra Zeneca provided an unrestricted grant for the specialized hypertension clinics project in Egypt.
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El Faramawy, A., Youssef, G., El Aroussy, W. et al. Registry of the Egyptian specialized hypertension clinics: patient risk profiles and geographical differences. J Hum Hypertens 34, 520–527 (2020). https://doi.org/10.1038/s41371-019-0265-0
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DOI: https://doi.org/10.1038/s41371-019-0265-0
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