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Hypertension and intracerebral hemorrhage in Brazzaville

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DOI: 10.4236/wjcd.2013.39083    2,763 Downloads   4,565 Views  

ABSTRACT

Hypertension is not only an important risk factor, but also an important cause of spontaneous intracerebral hemorrhage. Its high prevalence in Africa reflects a high incidence of cerebral hemorrhage ranging from 30% to 60% against 10% to 20% in industrialized countries. The aim of our study was to determine the role of hypertension before the onset of intracerebral hemorrhage and its variations during the first three months. This was a longitudinal study conducted at the University Hospital of Brazzaville from 1st January to 31st August 2012 with all patients admitted for intracerebral hemorrhage. Patients with subarachnoid or pure intraventricular hemorrhage were excluded. The study variables were: history of hypertension, knowledge of its history, treatment, blood pressure on admission and during the first 3 months and the relationship between blood pressure and evolution. Statistical analysis was performed using the software SPSSS 16.1. The significance level was set at p < 0.05. During the study 261 patients were hospitalized for stroke, of which 82 (31.42%) were for intracerebral hemorrhage. The mean age was 55 ± 11 years and sex ratio of 2 men:1 woman. Hypertension was found in 80.5% of cases, of which 65.2% had known hypertension, but 82.6% had discontinued treatment. The mean systolic blood pressure was 194 ± 41 mm Hg and diastolic 104 ± 20 mm Hg. The location was deep in 85.71%. The normalization of blood

pressure was obtained from the second week. After adjusting for confounders using logistic analysis, only uncontrolled hypertension was associated significantly and independently associated with a higher mortality rate (p = 0.042).

 

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Gombet, T. , Ossou-Nguiet, P. , Gankama, T. , Ellenga-Mbolla, B. , Otiobanda, G. , Obondzo-Aloba, K. and Longo-Mbenza, B. (2013) Hypertension and intracerebral hemorrhage in Brazzaville. World Journal of Cardiovascular Diseases, 3, 523-528. doi: 10.4236/wjcd.2013.39083.

References

[1] Benatru, I., Rouaud, O., Durier, J., Contegal, F., Couvreur, G., Bejot, Y., et al. (2006) Stable stroke incidence rates but improved case fatality in Dijon, France, from 1985 to 2004. Stroke, 37, 1674-1679.
http://dx.doi.org/10.1161/01.STR.0000226979.56456.a8
[2] Gombet, T., Steichen, O., Plouin, P.F., Richet, G., Touze, J.E. and Doury, P. (2007) Maladie hypertensive des personnes agées nées en Afrique subsaharienne adressée à un service spécialisé: Etude transversale comparative. Bulletin de l’Academie Nationale de Medecine, 191, 1745-1755.
[3] Rincon, F., Lyden, P. and Mayer, S.A. (2012) The epidemiology of intracerebral hemorrhage in the United States from 1979 to 2008. Springer Science, 77, 524-532.
[4] Broderick, J.P., Connolly, S., Feldmann, E., Hanley, D., Kase, C., Krieger, D., et al. (2007) Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: A guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working group. Stroke, 38, 2001-2023.
http://dx.doi.org/10.1161/STROKEAHA.107.183689
[5] Markus, H.S., Khan, U., Birns, J., Evans, A., Kalra, L., Rudd, A.G., et al. (2007) Differences in stroke subtypes between black and white patients with stroke. Circulation, 116, 2157-2164.
http://dx.doi.org/10.1161/CIRCULATIONAHA.107.699785
[6] Mayer, S.A. and Rincon, F. (2005) Treatment of intracerebral haemorrhage. The Lancet Neurology, 4, 662-672. http://dx.doi.org/10.1016/S1474-4422(05)70195-2
[7] Testai, F.D. and Aiyagari, V. (2008) Acute hemorrhagic stroke pathophysiology and medical interventions: Blood pressure control, management of anticoagulant-associated brain hemorrhage and general management principles. Neurologic Clinics, 26, 963-985.
http://dx.doi.org/10.1016/j.ncl.2008.06.001
[8] Fisher, C.M. (2003) Hypertensive cerebral hemorrhage. Demonstration of the source of bleeding. Journal of Neuropathology & Experimental Neurology, 62, 104-107.
[9] Sutherland, G.R. and Auer, R.N. (2006) Primary intracerebral hemorrhage. Journal of Clinical Neuroscience, 13, 511-517. http://dx.doi.org/10.1016/j.jocn.2004.12.012
[10] Qureshi, A.I., Ezzeddine, M.A., Nasar, A., Suri, M.F., Kirmani, J.F., Hussein, H.M., et al. (2007) Prevalence of elevated blood pressure in 563,704 adult patients with stroke presenting to the ED in the United States. American Journal of Emergency Medicine, 25, 32-38.
http://dx.doi.org/10.1016/j.ajem.2006.07.008
[11] Qureshi, A.I. (2007) Antihypertensive treatment of acute cerebral hemorrhage (ATACH): Rationale and design. Neurocritical Care, 6, 56-66.
http://dx.doi.org/10.1385/NCC:6:1:56
[12] Anderson, C.S., Huang, Y., Wang, J.G., Arima, H., Neal, B., Peng, B., et al. (2008) Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): A randomised pilot trial. The Lancet Neurology, 7, 391-399.
http://dx.doi.org/10.1016/S1474-4422(08)70069-3
[13] Adoukonou, T.A., Vallat, J.M., Joubert, J., Macian, F., Kabore, R., Magy, L., Houinato, D. and Preux, P.M. (2010) Management of stroke in sub-Saharan Africa: Current issues. Revue Neurologique, 166, 882-893.
http://dx.doi.org/10.1016/j.neurol.2010.06.004
[14] Kimbally-Kaky, G., Gombet, T., Bolanda, D., Voumbo, Y., Okili, B., Ellenga-Mbolla, B. et al. (2006) Prévalence de l’HTA à Brazzaville. Cardiologie Tropicale, 32, 43-46.
[15] Ellenga-Mbolla, B.F., Gombet, T.R., Mahoungou-Guimbi, K.C., Otiobanda, G.F., Ossou-Nguiet, P.M., Ikama, M.S., KimballyKaky, G. and Etitiele, F. (2011) Les urgences hypertensives au Centre Hospitalier et Universitaire de Brazzaville (Congo). Médecine Tropicale, 71, 97-98.
[16] Elliott, J. and Smith, M. (2010) The acute management of intracerebral hemorrhage: A clinical review. Anesthesia & Analgesia, 110, 1419-1427.
http://dx.doi.org/10.1213/ANE.0b013e3181d568c8
[17] Manno, E.M. (2012) Update on intracerebral hemorrhage. CONTINUUM: Lifelong Learning in Neurology, 18, 598-610.
http://dx.doi.org/10.1212/01.CON.0000415430.99394.3e
[18] Lotufo, P.A., Goulart, A.C. and Bensenor, I.M. (2007) Race, gender and stroke subtypes mortality in Sao Paulo, Brazil. Arquivos de Neuro-Psiquiatria, 65, 752-757.
[19] O’Donnell, M.J., Xavier, D., Liu, L., Zhang, H., Chin, S.L., Rao-Melacini, P., et al. (2010) (INTERSTROKE investigators). Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTER-STROKE study): A case-control study. The Lancet, 376, 112-123.
http://dx.doi.org/10.1016/S0140-6736(10)60834-3
[20] Belo, M., Balogou, A.A.K., Goeh-Akue, E., Sognigbe, N., Kumako, V., Djibril, M., et al. (2007) Particularitée des accidents vasculaires cérébraux au Togo et en Afrique Noire. Journal de la Recherche Scientifique de l’Universite de Lome, 9, 21-27.
[21] Sagui, E. (2007) Les accidents vasculaires cérébraux en Afrique subsaharienne. Médecine Tropicale, 6, 596-600.
[22] Lessive, P., Mughnetsyan, V. and Kessy, G.S. (2009) Etude épidémiologique lors d’une campagne de dépistage du diabète, de l’hypertension et de l’obésité androide à Brazzaville. Medecine des Maladies Metaboliques, 3, 438-441.
[23] Ossou-Nguiet, P.M., Otiobanda, G.F., ObondzoAloba, K., Ellenga-Mbolla, B.F., Bandzouzi-Ndamba, B. and Makosso, E. (2013) Contribution on epidemiology and management of stroke in a central African country. International Journal of Stroke, 8, E27.
http://dx.doi.org/10.1111/ijs.12118
[24] Ossou-Nguiet, P.M., Otiobanda, G.F., Bandzouzi-Ndamba, B., Ellenga-Mbolla, B.F., Mahoungou-Guimbi, K.C., Gnonlonfoun, D., et al. (2011) Devenir des patients ayant présenté une hémorragie cérébrale au CHUB de Brazzaville. RAMUR Tome, 16, 37-43.
[25] Raveloson, N.E., Zodali, N., Rakotoarivoni, S.T., Mbolambena, R.L. and Randriamiarana, J.M. (2011) Aspects épidémio-cliniques, évolutifs et tomodensitométriques des accidents vasculaires cérébraux hémorragiques. Revue d’Anesthésie-Réanimation et de Médecine d’Urgences, 3, 15-19.
[26] Benoit, A., Raynaud, A., Coton, L., Petitjans, F., Hassan, A., Ilah, A., et al. (2009) Morbi-mortalité des accidents vasculaires cérébraux hémorragiques. Médecine Tropicale, 69, 41-44.
[27] Cordonnier, C., Rutgers, M.P., Dumont, F., Pasquini, M., Le Jeune, J.P., Garrigue, D., et al. (2009) Intracerebral haemorrhages: Are there differences in baseline characteristics and intra-hospital mortality between hospital and population-based registred? Journal of Neurology, 256, 198-202. http://dx.doi.org/10.1007/s00415-009-0030-3
[28] Chuang, Y.C., Chen, Y.M., Peng, S.K. and Peng, S.Y. (2009) Risk stratification for predicting 30-day mortality of intracerebral hemorrhage. International Journal for Quality in Health Care, 21, 441-447.
http://dx.doi.org/10.1093/intqhc/mzp041
[29] Li, Q., Qin, X.Y., Zhang, J.H. and Yang, J. (2011) Prognosis study of 324 cases with spontaneous intracerebral hemorrhage in Chongqing, China. Acta Neurochirurgica Supplementum, 111, 399-402.
http://dx.doi.org/10.1007/978-3-7091-0693-8_68
[30] Cheung, R.T. and Zou, L.Y. (2003) Use of the original, modified or new intracerebral hemorrhage score to predict mortality and morbidity after intracerebral hemorrhage. Stroke, 34, 1717-1712.
http://dx.doi.org/10.1161/01.STR.0000078657.22835.B9
[31] Matsukawa, H., Shinoda, M., Fujii, M., Takahashi, O., Yamamoto, D., Murakata, A., et al. (2012) Relationships among hematoma diameter, location categorized by vascular territory, and 1-year outcome in patients with cerebellar hemorrhage. World Neurosurgery, 77, 507-511.
http://dx.doi.org/10.1016/j.wneu.2011.05.018
[32] Hu, X., Zhang, J.H. and Qin, X. (2011) Risk factors of early death in patients with hypertensive intracerebral hemorrhage during hospitalisation. Acta Neurochirurgica Supplementum, 11, 387-391.
http://dx.doi.org/10.1007/978-3-7091-0693-8_66
[33] Bejot, Y., Rouaud, O., Benatru, I., Froment, A., Couvreur, G., Cailler, M., et al. (2008) Les apports du registre dijonnais des accidents vasculaires cérébraux en 20 ans d’activité. Revue Neurologique, 164, 138-147.
http://dx.doi.org/10.1016/j.neurol.2007.06.003
[34] Dowlatshahi, D., Demuchuk, A.M., Flaherty, M.L., Ali, M., Lyden, P.L., Faan, E.E., et al. (2011) Defining hematoma expansion in intracerebral hemorrhage: Relationship with patient outcomes. Neurology, 76, 1238-1244.
http://dx.doi.org/10.1212/WNL.0b013e3182143317
[35] Gosse, P. and Cremer, A. (2011) Hypertrophie ventriculaire gauche chez l’hypertendu: Mise au point et point de vue. AMC-Pratique, 202, 16-20.
[36] Godoy, D.A., Pinero, G. and Di Napoli, M. (2006) Predicting mortality in spontaneous intracerebral hemorrhage: Can modification to original score improve the prediction? Stroke, 37, 1038-1044.
http://dx.doi.org/10.1161/01.STR.0000206441.79646.49

  
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