High Blood Pressure in External Consultation in Cardiology of Kati

Objective: To study hypertension and its manifestations in Out-patients’ Department of Cardiology of Kati. Methods: The study was traversal and it was based on a sample of 300 patients, reached during the interval of 12 (twelve) months (from June 2012 to June 2013). Results: The predominance was among the females with 68.7%. The average age was about 55.8 ± 12.2 years old. The extreme ages were about 21 and 90 years old. In the set, 66% of the patients lived in the town of Kati. The symptoms of Dieulafoy were predominantly the reasons for consultation with 55.7%. The cardiac frequency in the vast majority of cases was normal (85.3%). The left ventricular hypertrophy in the electrocardiogram was observed in more than half of the cases, that is to say, 51.3%. In a bit higher proportion, the echocardiography Doppler became normal, that is to say, 54%. Brain scanner done on 9 patients found out signs of cerebrovascular stroke in 8 patients, that is to say, a frequency of 88.9%. In 76% of cases of orthostatic hypotension, the patients were hypertensive. The blood pressure was normal during the passage of orthostatism in the cases of 258 of our patients, that is to say, 86.0% of the cases. However, the orthostatic hypotension (OH) was observed in the cases of 42 patients, that is to say, 14.0% of the cases. In this set of patients, 41.6% of the moans were due to cephalgias and dizziness’s. The monotherapy of patients with OH represented 47.6% of the cases. Blood pressure was not controlled in 66.7% of the cases of OH. The biological examinations required were normal in 52.4% of the cases. Conclusion: The hypertension is a disease which is frequently the reason for consultation in cardiology. The symptoms of Dieulafoy can be the signs of call. The complications are sometimes recurrent. The orthostatic hypotension should be found out even under monotherapy on a balanced or non-balanced hypertensive patient through treatment.


Introduction
The problem of hypertension and its complications, mainly the strokes, heart or kidney failure, the acute coronary syndrome, are well known. The treatment of HTA has clearly demonstrated its ability to protect patients from complications, including now at an advanced age, beyond 80 years. The diagnosis of HTA and its follow-up are based on the PA measured in the seated or lying position. The measurement of PA in standing position is strongly recommended, especially in the elderly, but in practice is only too seldom carried out. Yet, orthostatic hypotension is an eventuality: frequent, sometimes misleading and always serious.

Methods
It was a transversal study based on a sample of 300 patients, reached during the interval of 12 (twelve) months (from June, 1 st 2012 to June, 1 st 2013). The study was systematically based on all the hypertensive patients received in cardiology consultations abiding by the inclusion criteria, that is to say 300 patients.
Were included in the study all the hypertensive patients regularly followed in our service under treatment at least since one month and correctly following the treatment.
Each patient benefited from an individual survey record. This survey record was filled in the day of the study, that is to say one month or more of follow-up.
The confidentiality of the names of patients was respected.
The investigation was conducted during the different appointments with patients, that is to say one month or more under treatment and correctly following the treatment.
The processing and statistical analyses of the data were done through the softwares SPSS (version 12) and Microsoft Word 2007.

Results
The female sex predominated with 68.7% of the cases ( The symptoms of Dieulafoy represented the most frequent reasons for consultation, that is to say 55.7% of the cases ( Table 3). The cardiac frequency was normal in 85.3% of cases ( Table 4). The left ventricular hypertrophy (LVH) was the most represented anomaly with 51.3% of the cases in the electrocardiogram ( Table 5). The echocardiography Dopplerwas on 126 of our patients (Table 6), and it was normal in 68 patients, that is to say 54% of the cases. The cerebral tododensitometry was done on 9 of our patients (Table 7), and has objectivized an ischaemic CVA in 8 patients that is to say 88.9% of the cases. Blood pressure was controlled in 68.7% of the cases in the overall population of patients (Table 8).
High blood pressure was the most frequent with 76% of the cases among the patients with orthostatic hypotension. Blood pressure was normal during the passage of orthostatism in 258 of our patients that is to say 86.0% of the cases; however, orthostatic hypotension (OH) was observed in 42 patients that is to say 14.0% of the cases. In this set 41.6% of the moans were due to cephalgias and dizzinesses. Blood pressure was not controlled in 66.7% of the cases of OH. The biological examinations required were normal in 52.4% of the cases. Themonotherapy of patients with OH represented 47.6% of the cases.

Discussion
In the series the predominance was female with 68.7%. This could be due to, beside to the other factors of cardiovascular risks, the effect of menopause on women because of the advanced average age of our patients.      The vast majority of patients did not do the cerebral scanner, either 291. the frequency of high blood pressure but also the quality of the diet responsible in many cases for deficiency-related anemia [9].
Limitations were essentially due to: • Prolonged orthostatism made some elderly patients uncomfortable.

Conclusion
Hypertension is a frequent disease responsible for consultation in cardiology.
The symptoms of Dieulafoy can be the signs of call. The conditions are sometimes frequent and should often be looked for before the signs of call and systematically. Orthostatic hypotension should be looked for even under monotherapy on balanced or non-balanced hypertension through treatment.