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Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S7
AFRICA
Prevalence of erectile dysfunction amongst ambulant hypertensive males at a tertiary level hospital in Kenya
Malcolm Correia*, Elijah Ogola
#
, Joshua Kayima
#
, Mark Joshi
#
and David Silverstein*
*The Nairobi Hospital, Nairobi, Kenya.
#
University of Nairobi, Nairobi, Kenya
Introduction:
Hypertension affects 22% of the world’s population and is a risk factor for cardiovascular disease (CVD) including stroke and coronary
artery disease (CAD) in relation to atherosclerosis. The underlying pathophysiological link between hypertension and vasculogenic erectile dysfunction
(ED) is endothelial dysfunction. The common risk factors for ED and atherosclerosis include: hypertension, age, cigarette smoking and hazardous alcohol
consumption. The aim of this study was to investigate the prevalence of ED, cigarette smoking and alcohol consumption and explore their correlation and
associated risk factors amongst male hypertensive patients.
Methods:
In this hospital-based cross-sectional study done over 7 months, 385 hypertensive males, aged 30 - 70 years on follow-up at Kenyatta National
Hospital out-patient clinic for at least 1 month, were consecutively recruited. Patients with diabetes, genital abnormalities, on phosphodiesterase or sex
hormone therapy, advanced chronic kidney, liver disease and heart failure were excluded. A targeted clinical history was taken and physical examination,
including anthropometric measurements, was performed and data entered into standardised questionnaires. The IIEF-5 questionnaire was used to determine
the prevalence of ED using 95% confidence interval. Logistic regression analysis was used to explore for factors associated with ED.
Results:
A total of 385 participants were recruited with mean age 56.7 years (SD 11.3). ED prevalence was 94.5% (95% CI 92.2 - 96.6%), most of which was
mild in severity (70.1%). ED prevalence showed no correlation with age, hypertension duration, cigarette smoking, alcohol consumption, weight, waist-hip
ratio or class of anti-hypertensive agent.
Conclusion:
We document a high prevalence of ED amongst male hypertensive, non-diabetic population, in this index study. ED is an early marker of
atherosclerotic disease and it therefore suggests a high cardiovascular risk. Detection of ED is important for optimal individual cardiovascular disease risk
stratification and management with the potential for improved anti-hypertensive adherence.
Prevalence of peripheral arterial disease amongst ambulant hypertensive males at a tertiary level hospital in Kenya
Malcolm Correia*, Elijah Ogola
#
, Joshua Kayima
#
, Mark Joshi
#
and David Silverstein*
*The Nairobi Hospital, Nairobi, Kenya.
#
University of Nairobi, Nairobi, Kenya
Introduction:
Hypertension affects 22% of the world’s population and is a risk factor for cardiovascular disease including stroke and coronary artery disease.
The common risk factors for peripheral arterial disease (PAD) and atherosclerosis include: hypertension, age, cigarette smoking and hazardous alcohol
consumption. The worldwide prevalence of PAD is estimated to be up to 29% and is an independent risk factor for cardiovascular morbidity and mortality.
The aim of this study was to investigate the prevalence of PAD, cigarette smoking and alcohol consumption and explore their correlation and associated risk
factors amongst male hypertensive patients.
Methods:
In this hospital-based cross-sectional study done over 7 months, 385 ambulant hypertensive male patients at the Kenyatta National Hospital on
follow-up in the medical outpatient clinics were enrolled consecutively in the study by convenience sampling after informed consent had been obtained.
A targeted clinical history, physical examination and anthropometric measurements were obtained by standard procedure and data were entered into
questionnaires. PAD was determined using the ankle brachial index.
Results:
The prevalence of PAD was 49.9% (95% CI 44.7 - 55.1%), increasing above 50 years of age. History of smoking had a prevalence of 54.2% and
was associated with a nearly 2-fold risk of PAD (OR 1.8 [95% CI 1.2 - 2.7], p=0.005). Fourteen percent of patients displayed histories of hazardous alcohol
consumption showing a protective benefit in PAD (OR 0.6), but not deemed statistically significant. The duration of hypertension from diagnosis was not
significantly associated with PAD. An elevated waist-hip ratio was noted to be protective with an OR 0.4 (95% CI, p<0.001) in PAD.
Conclusion:
There is an increased prevalence of PAD amongst the male hypertensive, non-diabetic population. These findings may be used to justify the
assessment for PAD for early detection, prevention and management in order to prevent the progression of PAD and improve quality of life.
Challenges to addressing the knowledge gap on neglected cardiovascular diseases through community-based studies:
Exploring endomyocardial fibrosis
Basilio Cumbane, Jenisse Jonas, Rolando Jive and Ana Mocumbe
MIHER Mozambique Institute for Health Education and Research, Maputo, Mozambique
Introduction:
Despite ongoing globalisation, a huge gap still exists between developed and developing countries in terms of health disease research. This
is even more evident for cardiovascular diseases viewed within the context of steady globalisation, point-of-care devices and internet accessibility. Amongst
the developing world countries, sub-Saharan Africa has a huge deficit of accurate and well-defined health data to inform policy making and care provision
planning, in particular for neglected cardiovascular diseases. Endomyocardial fibrosis (EMF) is the most common restrictive cardiomyopathy worldwide. It is
characterised by the deposit of fibrous tissue in the endomyocardium, leading to progressive heart failure and death, if left untreated. Efforts to understand
EMF pathogenesis and natural history are slow in endemic areas for this condition with a small number of original researches undertaken up to date.
Moreover, community-based research in endemic areas is lacking due to a shortage of expertise and material resources to undertake it.
Methods:
Descriptive research based on a case study of community-based research in an endemic area in southern Mozambique. The research aim
was to acquire a deeper knowledge regarding current challenges being faced. Lessons learned are discussed to help improve future implementation of
similar studies in Mozambique and other areas. We support our case study with a literature review on recent advances and perspectives in diagnosis and
managements of EMF.
Results:
The prevalence of EMF in a rural area of Mozambique was almost 20%. This shows that echocardiographic screening facilitates the sensitivity and
precision of diagnosis by an early detection of the disease in asymptomatic individuals.
Conclusion:
EMF has a higher prevalence in rural poor communities in Mozambique. Despite geographical and administrative challenges to conducting
these studies, recent advances in medicine (such as point-of-care diagnostics, heart failure biomarkers and new imaging techniques) have opened new
perspectives for high quality research through collaborative partnerships and regional initiatives.