{"title":"喀麦隆西部巴富萨姆地区医院高血压患者的随访:初诊和降压药物治疗患者的生化特征","authors":"V. Nzesseu, C. Kouam, J. Tamokou, J. Kuiaté","doi":"10.4236/WJCS.2020.109020","DOIUrl":null,"url":null,"abstract":"Objective: The aim of this work was to study the effects of antihypertensive therapies on \ncertain metabolic parameters in hypertensive patients. Methods: A \ncross-sectional and analytical study conducted within the Bafoussam Re-gional \nHospital on 343 patients including 99 normotensives and 244 hyperten-sives \ndistributed in 71 patients naive to treatment and 173 patients under treatment \n(84 under monotherapy, 67 under bitherapy and 21 under trithera-py). The \nantihypertensive medications were recorded from the medical records. A \nquestionnaire survey was administered to study participants and potential risk \nfactors for hypertension sought. Blood and urine samples were collected for \nlipid, renal and hepatic disorder analysis. Two blood pressure measure-ments enabled \nus to diagnose hypertensive patients. Measurements of bio-chemical parameters \nsuch as total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, \ncreatinine, glucose, aspartate aminotransferase (ASAT), alanine \naminotransferase (ALT), potassium, chloride and calcium were done in serum by \nmethods resulting from commercial kits. Results: Cal-cium Channel Blockers were \nsignificantly associated with increases in blood potassium (odd-ratios (OR) = \n8.63, p = 0.036) and sodium (OR = 0.20, p = 0.037). Angiotensin-converting \nenzyme/Angiotensin II receptor blockers were significantly associated with an \nincrease in plasma activity of ASAT (OR = 0.12, p = 0.03) whereas Diuretics \nwere significantly associated with an increase in ALAT plasma activity (OR = 0.003, \np = 0.012). Dual therapies were associ-ated with highest frequencies of \nhypercreatininemia (41.8%) and hyperglyce-mia (44.8%) whereas \nhypocholesterolemia HDL (38.1%) was most observed in hypertensive patients on \ntriple therapy. The different therapies resulted in very low frequencies of \nabnormal liver profiles (in general almost all below 10%). Tritherapy had the \nmost beneficial effects on the different profiles, with no cases of \nhyperkalemia, glycosuria, hypochloremia, hematuria, hyponatremia, total hypercholesterolemia, \nALAT and ASAT hyperactivity. Conclusion: Triple therapy should be recommended \nas it has the most beneficial effects on met-abolic parameters in the study population.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"79 1","pages":"167-185"},"PeriodicalIF":0.0000,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Follow Up of Hypertensive Patients at Regional Hospital of Bafoussam, West Cameroon: Biochemical Profiles in Naive and Hypotensive Drug Treated Patients\",\"authors\":\"V. Nzesseu, C. Kouam, J. Tamokou, J. Kuiaté\",\"doi\":\"10.4236/WJCS.2020.109020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: The aim of this work was to study the effects of antihypertensive therapies on \\ncertain metabolic parameters in hypertensive patients. Methods: A \\ncross-sectional and analytical study conducted within the Bafoussam Re-gional \\nHospital on 343 patients including 99 normotensives and 244 hyperten-sives \\ndistributed in 71 patients naive to treatment and 173 patients under treatment \\n(84 under monotherapy, 67 under bitherapy and 21 under trithera-py). The \\nantihypertensive medications were recorded from the medical records. A \\nquestionnaire survey was administered to study participants and potential risk \\nfactors for hypertension sought. Blood and urine samples were collected for \\nlipid, renal and hepatic disorder analysis. Two blood pressure measure-ments enabled \\nus to diagnose hypertensive patients. Measurements of bio-chemical parameters \\nsuch as total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, \\ncreatinine, glucose, aspartate aminotransferase (ASAT), alanine \\naminotransferase (ALT), potassium, chloride and calcium were done in serum by \\nmethods resulting from commercial kits. Results: Cal-cium Channel Blockers were \\nsignificantly associated with increases in blood potassium (odd-ratios (OR) = \\n8.63, p = 0.036) and sodium (OR = 0.20, p = 0.037). Angiotensin-converting \\nenzyme/Angiotensin II receptor blockers were significantly associated with an \\nincrease in plasma activity of ASAT (OR = 0.12, p = 0.03) whereas Diuretics \\nwere significantly associated with an increase in ALAT plasma activity (OR = 0.003, \\np = 0.012). Dual therapies were associ-ated with highest frequencies of \\nhypercreatininemia (41.8%) and hyperglyce-mia (44.8%) whereas \\nhypocholesterolemia HDL (38.1%) was most observed in hypertensive patients on \\ntriple therapy. The different therapies resulted in very low frequencies of \\nabnormal liver profiles (in general almost all below 10%). Tritherapy had the \\nmost beneficial effects on the different profiles, with no cases of \\nhyperkalemia, glycosuria, hypochloremia, hematuria, hyponatremia, total hypercholesterolemia, \\nALAT and ASAT hyperactivity. Conclusion: Triple therapy should be recommended \\nas it has the most beneficial effects on met-abolic parameters in the study population.\",\"PeriodicalId\":23646,\"journal\":{\"name\":\"World Journal of Cardiovascular Surgery\",\"volume\":\"79 1\",\"pages\":\"167-185\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-09-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Cardiovascular Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4236/WJCS.2020.109020\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4236/WJCS.2020.109020","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨降压治疗对高血压患者某些代谢参数的影响。方法:在巴富萨姆地区医院对343例患者进行了横断面分析研究,其中包括99例常压患者和244例高血压患者,分布在71例首次接受治疗的患者和173例正在接受治疗的患者中(84例接受单一治疗,67例接受双药治疗,21例接受三药治疗)。从医疗记录中记录降压药物。采用问卷调查的方式对参与者进行研究,并寻找高血压的潜在危险因素。采集血液和尿液进行血脂、肾脏和肝脏疾病分析。两次血压测量使我们能够诊断高血压患者。血清生化参数,如总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、肌酐、葡萄糖、天冬氨酸转氨酶(ASAT)、丙氨酸转氨酶(ALT)、钾、氯和钙的测定,采用商业试剂盒方法完成。结果:钙通道阻滞剂与血钾(奇比(OR) = 8.63, p = 0.036)和钠(OR = 0.20, p = 0.037)升高显著相关。血管紧张素转换酶/血管紧张素II受体阻滞剂与血浆ASAT活性增加显著相关(OR = 0.12, p = 0.03),而利尿剂与血浆ALAT活性增加显著相关(OR = 0.003, p = 0.012)。双重治疗与高肌酐血症(41.8%)和高血糖血症(44.8%)的发生率最高相关,而低胆固醇血症(38.1%)在三联治疗的高血压患者中观察到最多。不同的治疗方法导致肝脏异常的频率非常低(一般几乎都低于10%)。三联疗法对不同类型的患者效果最好,没有出现高钾血症、糖尿症、低氯血症、血尿、低钠血症、总高胆固醇血症、ALAT和ASAT亢进。结论:应推荐三联疗法,因为它对研究人群的代谢参数有最有益的影响。
Follow Up of Hypertensive Patients at Regional Hospital of Bafoussam, West Cameroon: Biochemical Profiles in Naive and Hypotensive Drug Treated Patients
Objective: The aim of this work was to study the effects of antihypertensive therapies on
certain metabolic parameters in hypertensive patients. Methods: A
cross-sectional and analytical study conducted within the Bafoussam Re-gional
Hospital on 343 patients including 99 normotensives and 244 hyperten-sives
distributed in 71 patients naive to treatment and 173 patients under treatment
(84 under monotherapy, 67 under bitherapy and 21 under trithera-py). The
antihypertensive medications were recorded from the medical records. A
questionnaire survey was administered to study participants and potential risk
factors for hypertension sought. Blood and urine samples were collected for
lipid, renal and hepatic disorder analysis. Two blood pressure measure-ments enabled
us to diagnose hypertensive patients. Measurements of bio-chemical parameters
such as total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides,
creatinine, glucose, aspartate aminotransferase (ASAT), alanine
aminotransferase (ALT), potassium, chloride and calcium were done in serum by
methods resulting from commercial kits. Results: Cal-cium Channel Blockers were
significantly associated with increases in blood potassium (odd-ratios (OR) =
8.63, p = 0.036) and sodium (OR = 0.20, p = 0.037). Angiotensin-converting
enzyme/Angiotensin II receptor blockers were significantly associated with an
increase in plasma activity of ASAT (OR = 0.12, p = 0.03) whereas Diuretics
were significantly associated with an increase in ALAT plasma activity (OR = 0.003,
p = 0.012). Dual therapies were associ-ated with highest frequencies of
hypercreatininemia (41.8%) and hyperglyce-mia (44.8%) whereas
hypocholesterolemia HDL (38.1%) was most observed in hypertensive patients on
triple therapy. The different therapies resulted in very low frequencies of
abnormal liver profiles (in general almost all below 10%). Tritherapy had the
most beneficial effects on the different profiles, with no cases of
hyperkalemia, glycosuria, hypochloremia, hematuria, hyponatremia, total hypercholesterolemia,
ALAT and ASAT hyperactivity. Conclusion: Triple therapy should be recommended
as it has the most beneficial effects on met-abolic parameters in the study population.