Cardiovascular Journal of Africa: Vol 34 No 3 (JULY/AUGUST 2023)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 3, July/August 2023 148 AFRICA et al. The causes, treatment and outcomes of acute heart failure in 1006 Africans from 9 countries. Results of the Sub-Saharan Africa Survey of Heart Failure (THESUS-HF) Study. Arch Intern Med 2012; 172(18): 1386–1394. 50. Dokanishi H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A. Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. Lancet Glob Health 2017; 5: e665–672. 51. Malamba-Lez D, Ngoy-Nkulu D, Steels P, Tshala-Katumbay D, Mullens W. Heart failure etiologies and challenges to care in a developing world: an observational study in the Democratic Republic of Congo. J Card Fail 2018; 24(12): 854–859. 52. Eberly LA, Rusingiza E, Park PH, Ngoga G, Dusabeyezu S, Mutabazi F, et al. Understanding the etiology of heart failure among the rural poor in sub-Saharan African: A 10-year experience from the district hospitals in Rwanda. J Card Fail 2018; 24(12): 849–853. 53. Agbor VN, Essouma M, Ntusi NAB, Ngaya UF, Bigna JJ, Jean JN. Heart failure in sub-Saharan Africa. A contemporaneous systematic review and meta-analysis. Int J Cardiol 2018; 275: 207–215. 54. Ogah OS, Sliwa K, Akinyemi JO, Falase AO, Stewart S. Hypertensive heart failure in Nigerian Africans. Insight from the Abeokuta Heart Failure Registry. J Clin Hypertens 2015; 17(4): 263–272. 55. Kato M, Ohya T, Lida K, Kunimoto S, Fukushima S, Hiramaya A. Cardiomyopathy caused by hypertension is well observed among patients who have features of idiopathic dilated cardiomyopathy. J Card Fail 2016; 22(9): S168–S169. 56. Adeoti AO, Ajayi EO, Ajayi AO, Dada SA, Fadare JO, Akolawole M, et al. Pattern and outcome of medical admissions in Ekiti State University Teaching Hospital, Ado-Ekiti: A 5-year review. 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PLoS One 2014; 9(5): e9668. …continued from page 139 Dr Sanjiv Patel, an interventional cardiologist at Memorial Care Heart & Vascular Institute at Orange Coast Medical Centre, agreed. ‘The key is multiple medications, but at low doses, because high doses can also cause side effects and problems,’ he told Healthline. However, Broukhim questions whether this particular article will change how physicians treat high blood pressure for several reasons. For example, patients may have other health conditions, such as diabetes, heart disease or rheumatoid conditions, that need to be treated alongside high blood pressure. ‘There are multiple decisions that make a oncesize-fits-all approach for the treatment of hypertension very difficult,’ he said. In addition, it’s more challenging for patients to take several pills every day. ‘Nobody wants to take multiple medications,’ said Patel. One solution to this is combining several drugs in a single pill, which is known as a polypill. Patel said this can help patients take their medications regularly. Research supports this, at least with cardiovascular medications. In the study, patients who had a heart attack adhered better to their medicine regimen if they were given a polypill versus multiple pills. One challenge with polypills, though, is adjusting the medication to fit the needs of the patient. ‘If you have to change one of the medications, then you have to change the whole pill,’ said Patel. Broukhim said polypills for blood pressure-lowering medications may not be possible with the current state of the pharmaceutical industry. Medications that would work together may be manufactured by different companies, which would require them to agree to combining their drug with others in a single pill. Source: MedicalBrief 2023

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