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Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S29
AFRICA
related factors: increased waist circumference was by far the most common (86.88%). There was no significant difference in the prevalence of MetS in women
with controlled or uncontrolled HTA. One hundred and eight females from a possible 248 (43.54%) were diabetics. The majority (92, 85.18%) met the criteria
for MetS.
Conclusion:
Our results suggest that the prevalence of MetS dramatically increases amongst hypertensive women and that its prevalence is not influenced
by age. Awareness should be raised amongst cardiologists as to the prevalence of MetS.
Hypertensive patients: Evaluation of a therapeutic education programme
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Evaluation of a therapeutic education programme for hypertensive patients with personalised objectives which stretches over a 6-month period.
Methods:
A prospective single-centre study, involving 106 patients, was conducted as follows: • Initial collection of epidemiological, clinical and paraclinical data
from patients in normal consultation. • Each patient received a therapeutic personalised education session on how to use the hypertension follow-up notebooks
developed by the work team. • The effectiveness of the education programme was monitored in 3 evaluation consultations over the 6 months of the survey.
Results:
A total of 106 patients participated in the study: mean age 47 ± 10 years; 62.26% of them male (66 patients). Essential hypertension in 95.28% of
patients, grade II to III, uncontrolled in approximately 70% of patients with an average evolution period of 9.5 ± 7.5 years.
At 6 months, a significant decrease in SAP (from 154 ± 3 - 143 ± 3mmHg, p<0.01) and DAP (from 95 ± 2 - 87 ± 2mmHg, p<0.01) was noted, 50.7% vs. 33.8%
of patients have SAP and DAP in the therapeutic objectives. The monitoring of dietary and physical activity objectives is correlated with the decrease in BP
(p<0.05). A significant increase in self-monitoring with therapeutic decision-making (p<0.01) was evident. A significant decrease in hypertension-related
distress and feelings of failure (p<0.01) were noted. Success rate amongst patients who chose the objective reduce salt: 53%, reduce fat: 50%, walk several
times/week (30 min): 88%, exercise at least once/week: 22% with 67% of participants having at least one physical activity objective in place. No significant
decrease in weight (-0.6 ± 4.1kg) but 39% lost at least 2kg.
Conclusion:
A therapeutic education programme, with personalised objectives, can yield significant results at 6 months in terms of BP, dietetics and physical
activity, self-monitoring of hypertension whilst it can simultaneously lead to a reduction in feelings of distress.
Which factors could be associated with Iatrogenic adverse events related to Vitamin K Antagonist? Prospective survey
of 150 patients
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
A major public healthcare problem exists regarding the use of vitamin K antagonists (VKA). Because of their narrow therapeutic index, they
expose patients to 2 major risks: thrombosis and haemorrhage. These risks place VKA at the top of the list of iatrogenic risks.
Methods:
We conducted a prospective survey over a 23-month period. All patients admitted to cardiology consultation, who had recently been placed
on anticoagulation therapy using VKA, were included. A follow-up for a period of 1 year ± 3 months (thus 3 - 4 follow-up consultations) was done to detect
adverse iatrogenic events related to health care practices of medical doctors and pharmacists and/or the behaviour of patients regarding their treatment.
Results:
A total of 150 patients, treated with vitamin K antagonists, was included in the survey. Sixty-eight of the patients (45.33%) presented with: an iatrogenic
haemorrhagic 38% (57 patients) or ischaemic event 7.33% (11 patients) during a follow-up period of 1 year ± 3 months. From amongst the 68 patients, 21 had a
prescription of VKA that did not take into account their past medical history (p=0.0003). The prescription of an incorrect dose and/or administration frequency is
more common in the group of patients that presented minimal haemorrhage (p<0.0001). The non-intervention of the pharmacist regarding medical indications,
contra-indications and incorrect doses were observed in 72% of these patients with an iatrogenic incident (p<0.0001). Self-medication, aleatory VKA use,
insufficient INR control and poor compliance to treatment are factors which increase the iatrogenic risk of vitamin K antagonists (p<0.0001).
Conclusion:
The beneficial effects of vitamin K antagonist treatment rely on compliance to the prescriber’s recommendations as well as biological testing
follow-up, especially in the case of the elderly. Efficient intervention of pharmacists when dispensing the medication as well as thorough therapeutical
management, facilitated by intensive education, are key.
Does any correlation exist between pulmonary hypertension severity and left ventricular diastolic function indices in
hypertensive patients? Prospective study of about 150 hypertensive patients
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
An association between pulmonary hypertension and left ventricular diastolic dysfunction in hypertensive patients has been observed.
However, the relation between the severity of pulmonary hypertension and different indices of diastolic dysfunction remains unclear. The objective of this
study is to explore the relationship between the severity of pulmonary hypertension and different indices of LV diastolic dysfunction in hypertensive patients.
Methods:
A total of 150 asymptomatic hypertensive patients were included in our study. Clinical history of all patients was recorded along with a clinical
examination and echocardiography. LV dimensions, systolic and diastolic function and systolic pulmonary artery pressure (SPAP) were measured. We classified
the patients into 2 groups according to presence, or absence, of diastolic dysfunction.
Results:
Patients with diastolic dysfunction had significantly higher SPAP (p<0.00001) and significantly higher incidences of severe pulmonary hyper-tension
(p=0.034). There was a significant positive correlation between SPAP and E/E’ratio (r=0.354, p=0.00013), and between SPAP and systolic blood pressure
(r=0.231, p=0.231), and a significant negative correlation between SPAP and E/A ratio (r=0.289, p=0.0019), and between SPAP and E wave DT (r=0.265,
p=0.0047). Independent predictors for the presence of severe pulmonary hypertension were E/E’>15, E/A <1, and E wave DT <60.
Conclusion:
Hypertensive patients with diastolic dysfunction had a higher systolic pulmonary artery pressure and a higher incidence of severe pulmonary
hypertension. Systolic pulmonary artery pressure showed a significant correlation with LV diastolic dysfunction indices.