A. Ekou

Institut de cardiologie d'Abidjan, Abijan, Lagunes, Ivory Coast

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Publications (6)1.92 Total impact

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    ABSTRACT: Self-medication practice is under-evaluated among black African hypertensive patients. To assess the level of self-medication among black African hypertensive patients and to determine the factors favoring this practice and their consequences. Prospective study during a 3-month period including 612 hypertensive patients followed in Abidjan cardiology institute. Mean age was 55.1. The patients had a self-medication use in 60.1% of cases. Medicinal plants and derived products were commonly involved. Self-medication use reasons were: influence of relatives (89.8%) and the fear of antihypertensive drugs adverses effects (54.9%). Multivariate analysis shows that factors of self-medication were age (56.6years vs. 50.3years, P<0.001), income less than 762 euros/month (88% vs. 75.4%; OR=2.73; 95% CI: 1.62-4.6; P<0,0001), obesity (70.4% vs. 35.6%; OR=1.24; 95% CI: 0.75-1.15; P=0.037), dyslipidemia (40.8% vs. 27.9%; OR=6.72; 95% CI: 0.57-2.13; P=0.043), antihypertensive association therapy (61.7% vs. 51.4%; OR=2.27; 95% CI: 0.25-0.97; P=0.037). Poor control of high blood pressure (HBP) was a consequence of self-medication (6.5% vs. 47.1%; OR=10.27; 95% CI: 4.65-56.4; P=0.034), repercussions of HBP on major organ (75% vs. 17.2%; OR=12.9; 95% CI: 8.5-19.6; P=0.0001). Self-medication is a common practice in African hypertensive patients. It has many consequences. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    No preview · Article · Jun 2015 · Annales de cardiologie et d'angeiologie
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    ABSTRACT: Le syndrome d’apnée du sommeil (SAS) est très peu décrit chez l’hypertendu noir africain.
    No preview · Article · Mar 2015 · Annales de cardiologie et d'angeiologie

  • No preview · Article · Jan 2015 · World Journal of Cardiovascular Diseases
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    ABSTRACT: Objectives The aim of this study was to clarify the clinical situations motivating indications of transthoracic echocardiography (TTE) in a cardiology institute in Côte d’Ivoire and to assess the appropriateness of indications. Patients and methods This is a prospective and observational study conducted over a period of 6 months. The 1733 enrolled were classified according to the indications and their relevance defined by the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Echocardiography and the American Heart Association (ACCF/ASE/AHA). Results In five cases (0.3%), indications were not listed in the document ACCF/ASE/AHA. The most common indication was the initial evaluation of hypertension (HTA) and suspicion of hypertensive heart disease (47.3%). All indications, the assessment in the context of hypertension represented 853 examinations (49.2%). Heart failure accounted for 5.3% of indications, but consisted of 302 applications (17.4%) when was associated hypertension with signs suggestive of heart failure. Requests were considered as appropriate in 95.3%, inappropriate in 3.2% and uncertain in 1.6%. In the group of inappropriate indications patients were significantly younger, and were examinations more often normal and less often absolutely abnormal. Conclusion The profile of cardiovascular morbidity in our institution is dominated by the spectrum of hypertension and heart failure. Each indication must be balanced for the profitability of the ETT.
    No preview · Article · Feb 2014 · Annales de cardiologie et d'angeiologie
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    ABSTRACT: A pulse pressure above 60 mmHg in hypertensive subjects is an independent cardiovascular risk factor. There are few data on pulse pressure in sub-Saharan Africa. The aim of this study was to describe the pulse pressure in black Africans with arterial hypertension. A 10-year study was carried out on 640 hypertensive sub-Saharan African subjects at the outpatient department of the Abidjan Heart Institute. The primary endpoint was to determine the prevalence of a high pulse pressure, the correlation between pulse pressure and cardiovascular risk factors, the impact of pulse pressure on target organs, and the variation in pulse pressure while on treatment during follow up. Evaluations were made at the start of the study, and in the first, third, sixth and twelfth months of follow up. The mean age was 56.2 years and 56% were female. The prevalence of a high pulse pressure in our patients was 60% at the start of the study. The factors contributing to a high pulse pressure were age over 50 years (75.3 vs 24.7%, p < 0001), gender (60 vs 40%, p = 0.02), and diabetes (76.7 vs 23.3%, p = 0.0006). Smoking, obesity and dyslipidaemia were not related to an elevation in pulse pressure. The control of pulse pressure was poor during monitoring. Only 17.8% of patients had their pulse pressure lowered below 60 mmHg between the first and fifth consultations. A high pulse pressure was a predictor of future myocardial complications but few target organs were significantly affected. Dual therapy with a diuretic was more effective in controlling the pulse pressure, with a reduction rate of 22% during follow up (19.2 mmHg), against a rate reduction of 11% (8.4 mmHg) in patients without a dual diuretic. The prevalence of pulse pressure above 60 mmHg was higher in hypertensive black Africans. Their control was poor, but dual therapy with a diuretic was more effective. Myocardial consequences were significant.
    No preview · Article · Feb 2012 · Cardiovascular journal of Africa

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