Prevalence, complications and factors associated with severely elevated blood pressure in patients with hypertension: a cross-sectional study in two hospitals in Yaoundé, Cameroon

Abstract

Introduction: severely elevated blood pressure
significantly increases cardiovascular morbidity and
mortality in hypertensive Black patients. The
objective of this study was to determine the
prevalence, complications and factors associated
with severe high blood pressure in hypertensive
patients in Yaoundé, Cameroon. Methods: we
conducted a cross-sectional study in the outpatient
and cardiology units of two teaching hospitals in
Yaoundé. We included consenting hypertensive
patients aged over 18 years. We first measured
their blood pressure (BP), then we collected their
sociodemographic data, cardiovascular risk factors,
follow-up data, and ended with a complete physical
examination. We performed a regression analysis
to assess correlates of severe hypertension. Results:
we included a total of 153 patients with 33 (21.6%)
of them having severe hypertension. Among the 33
patients, 16 (48.5%) were male and 17 (51.5%) were
female. Their mean age was 60.52 ± 12.83 years.
Chronic kidney disease (78.8%), hypertensive
retinopathy (69.7%) and left ventricular
hypertrophy (48.5%) were the most common
complications. On multiple logistic regression
analysis, inadequate follow-up was independently
associated with severe hypertension (adjusted
OR=7.09; 95% CI [2.29-21.9]). Conclusion: severely
elevated BP is common among hypertensive
patients in our setting with important physical and
economic consequences. Increased patients
awareness and improving access to primary care
physicians and cardiologists, through health
insurance or other means, may be an effective
strategy for reducing cardiovascular morbidity and
mortality among hypertensive Black patients.