Hypertension management in an outpatient clinic at the Institute of Cardiology of Abidjan (Ivory Coast)

Summary Background Elevated blood pressure is one of the most important modifiable risk factors for cardiovascular diseases. Aim To evaluate blood pressure management in Côte d’Ivoire. Methods A retrospective study was conducted among 2575 hypertensive patients from the Institute of Cardiology of Abidjan, who were followed for at least 10 years, between January 2000 and December 2009. Results The patients’ mean age ± standard deviation was 59.1 ± 12.5 years; 54.3% were women. At first presentation, hypertension was stage 1 in 21.7%, stage 2 in 32.3% and stage 3 in 46.0% of patients. According to the European guidelines’ stratification of the cardiovascular risk-excess attributable to high blood pressure, 46.7% had a very high added risk, 37.8% had a high added risk and 14.9% had a low-to-moderate added risk. Pharmacological therapy was prescribed in 97.8% of patients; more than 66% were receiving at least two antihypertensive drugs, including fixed-dose combination drugs. The most common agents used were diuretics (59.7%) followed by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (59.6%). The most common agents for monotherapy were calcium antagonists. When two or more drugs were used, diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were most commonly used. Blood pressure control was achieved in 43.7% of cases. Conclusion In our series, severe hypertension with high added risk or very high added risk was very common. Treatment – mostly diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers – required at least two antihypertensive drugs to meet the recommended blood pressure target.