Determinants of occurrence of chronic hypertension in patients who had preeclampsia at the Yaoundé central hospital

Noa Ndoua Claude Cyrille; Basseck Linda; Nganou Chris Nadège; Ngo Ndingom Madye; Metogo Ntsama Junie; Maryanne N. Esapebong; Fouelifack Ymele Florent

doi:10.18203/2320-1770.ijrcog20234073

Authors

Noa Ndoua Claude Cyrille Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
Basseck Linda Institute Superieur de Technologie Medicale, Nkolondom, Yaounde, Cameroon
Nganou Chris Nadège Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
Ngo Ndingom Madye Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
Metogo Ntsama Junie Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
Maryanne N. Esapebong Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
Fouelifack Ymele Florent Institute Superieur de Technologie Medicale, Nkolondom, Yaounde, Cameroon

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20234073

Keywords:

Chronic hypertension, Determinants, Preeclampsia

Abstract

Background: Preeclampsia is an abnormal elevation of blood pressure with systolic blood pressure ≥140 mmHg, and/or diastolic blood pressure ≥90 mmHg associated with proteinuria in a pregnant woman beyond 20 weeks of gestation. This generally disappears postpartum. Some women, however, will later on develop chronic hypertension. Our objective was to assess the determinants of occurrence of chronic hypertension in patients who had preeclampsia at the Yaoundé Central Hospital.

Methods: we carried out a retrospective case-control study over ten years from January 2012 to December 2022. The cases consisted of women who developed chronic hypertension within 5 years following an episode of preeclampsia in pregnancy. These were matched with two controls each; women who had not developed chronic hypertension following preeclampsia in pregnancy.

Results: We recruited 60 cases and 120 controls. After bivariate analysis, the sociodemographic factors seemingly associated with the occurrence of chronic hypertension were; age between 25-35 years p=0.01; OR=2.9 (1.5-5.5), the profession of pupil/student; p=0.05; OR=0.3 (0.12-0.7). The clinical factors found were multigravidas; OR=3.1 (1.6-5.9); p=0.00, as well as pauciparous women; OR=2.1 (1.1-4.4); p=0.03, family history of hypertension; OR=2.5 (1.3-4.8); p=0.04 and BMI greater than 40 kg/m2; OR=3.8 (1.0-13.6); p=0.02. After logistic regression, the factor independently associated with the occurrence of chronic hypertension is a family history of hypertension; p=0.01; OR=2.45 (1.18-4.96).

Conclusions: A family history of hypertension is a major risk factor for the occurrence of chronic hypertension in patients who have had preeclampsia.

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References

Amalia O, Chris Nadège N. Journées Thématiques à Yaoundé sur les urgences cardiovasculaires. Health Sci Dis. 2023;24(2):1-17.

Priso EB. Consensus d'experts de la société française d'hypertension artérielle. HTA et grossesse. Hypertension. 2015;23:1-6.

Hypertension artérielle gravidique : définition et risques. Available at: https://www.ameli.fr/assure/ sante/themes/hypertension-arterielle grossesse/definition.html. Accessed on 20 February 2023.

Tidiani T, Sidibé K, Traoré B, Sidibé BM, Sanogo A, Sylla C, et al. Hypertension Artérielle et Grossesse: Aspects Epidémiocliniques et Complications à l’Hôpital Nianankoro Fomba de Ségou. Health Sci Dis. 2021;22(9):94-7.

La rédaction de Futura. Définition, Tension artérielle-Pression artérielle. Available at: https://www.futura-sciences.com/sante/definitions/medecine-tension-arterielle-7321.html. Accessed on 20 February 2023.

Hypertension artérielle : un problème de santé publique. Available at: http://www.emro.who.int/fr/ media/world-health-day/public-health-problem-factsheet-2013.html. Accessed on 20 February 2023.

Mboudou ET, Foumane P, Priso EB, Dohbit J, Minkande JZ, Nkengafac WM, et al. Hypertension au cours de la grossesse: Aspects cliniques et épidémiologiques à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaounde, Cameroun. Clin Mother Child Health. 2009;6(2):1087-93.

Denolle T. Hypertension artérielle chez la femme enceinte. lettr Cardiol. 2012;458:29-31.

Vampouille F. Prévalence, étiologies et facteurs prédictifs d'une hypertension artérielle persistante dans le post-partum après une prééclampsie ou une HTA gravidique. JMV. 2022;47:41-2.

Merabet R, Gadoum K, Houara M. Étude épidémiologique sur L’HTA dans le milieu universitaire. Uuniv Larbi Ben M'hidi. 2021.

Bakary M. Etude épidemio-clinique de l’HTA en milieu de travail dans six (6) entreprises du district de Bamako à propos de 186 cas. Univ Bamako. 2010.

David A, Théo P, Nicolas L. IKB de cardiologie vasculaire. 9th ed. Paris: CHU de Bichat-Claude Bernard; 2021.

Martillotti G, Boulvain M, Landau R, Pechère-Bertschi A. La prééclampsie: un nouveau facteur de risque de maladies cardiovasculaire et rénale. Rev Med Suisse. 2009;5:1752-7.

Ditisheim A, Boulvain M, Irion O, Pechère-Bertschi A. Les présentations cliniques atypiques de la prééclampsie. Rev Med Suisse. 2015;11(485):1655-8.

Lansac J, Magnin G, Senthilles L. Obstétrique pour le praticien. 6th ed. Paris: Elsevier Masson; 2013.

Blandine C, Xavier C. IKB de gynécologie obstétrique. 12th éd. Paris: Elsevier Masson; 2012.

Priya SP, Catherine NP, Heli T, Alexandre M. Physiological changes in pregnancy. CVJ Africa. 2016;27(2):89-94.

Antoinette T. Prééclampsie et éclampsie - Gynécologie et obstétrique. Available at: https://www.msdmanuals. com/fr/professional/gyn%C3%A9cologie-et-obst% C3%A9trique/anomalies-de-la-grossesse/pr%C3% A9-%C3%A9clampsie-et-%C3%A9clampsie.html. Accessed on 20 February 2023.

Collège National des Gynécologues et Obstétriciens Français. Prise en charge multidisciplinaire de la prééclampsie. J Gynecol Obstet Biol Reprod. 2005; 34(5):513.

Friel LA. Hypertension artérielle pendant la grossesse. Houston: McGovern Medical School Publication; 2021.

Bah A.O, Diallo M.H, Conde A.M, Keita N. Hypertension artérielle et grossesse-mortalité. CVJ. 2001;48(11):1-4.

Mounier-Vehier C, Jacques A, Jean-Marc B, Thierry D, Jean-Pierre F, Geneviève PB. Hypertension artérielle et grossesse: consensus d'experts de la Société française d'hypertension artérielle, filiale de la Société française de cardiologie. La Presse Med. 2016;45(1):682-99.

Fatoumata Sow. Etude épidémio-clinique et thérapeutique de la crise d'éclampsie à l'Hopital de Tombouctou. Bamako: université des sciences des techniques et des technologies de Bamako. 2021.

Thierry D. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183(1):1-22.

Tebeu PM, Halle-Ekane G, Da Itambi M, Mbu RE, Mawamba Y, Fomulu JN. Maternal mortality in Cameroon: a university teaching hospital report. Pan Afr Med J. 2015;21:16.

Ducloy-Bouthors AS. Hémostase et prééclampsie. Annafar. 2010;29(5):121-34.

Christopher WI, Rachel S, Indranee R, Alan TN, Suzanne O. Preeclampsia Pathophysiology and Clinical Presentations. JACC. 2020;76(14):1690-702.

Conti-Ramsden FI, Nathan HL, De Greeff A, Hall DR, Seed PT, Chappell LC, et al. Pregnancy-Related Acute Kidney Injury in Preeclampsia: Risk Factors and Renal Outcomes. Hypertension. 2019;74(5):1144-51.

Turner J. Diagnosis and management of pre-eclampsia: An update. Int J Womens Health. 2010;2:327-37.

Benjelloun AT, Benchrifi Y, Mahdaoui S, Samouh N. Epidémiologie de la prééclampsie dans la région du grand Casablanca. PAMJ Clin Med. 2020;2:1-112.

Suzuki H, Watanabe Y, Arima H, Kobayashi K, Ohno Y, Kanno Y. Short- and long-term prognosis of blood pressure and kidney disease in women with a past history of preeclampsia. Clin Exp Nephrol. 2008;12:102-9.

Bellamy L, Casas J-P, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335(7627):974.

Rav OMS. Recommandations de l'OMS pour la prévention et le traitement de la prééclampsie et de l'éclampsie: implications et action. RHR. 2013;17:1-5.

Djigandé N. Pré éclampsie et éclampsie dans le centre de sante de référence de Koutiala : Aspects epidemio cliniques thérapeutiques et pronostic. Bamako: Université des Sciences, des Techniques et des Technologies de Bamako. 2020.

McGlennan A, Mustafa A. General anaesthesia for Caesarean section. ACCPM. 2009; 9(5):148-51.

Gabra A, Gabra M. Updates in Management of Hypertensive Disorders of Pregnancy. WJGWH. 2019;2:1-5.

Mustafa A. Collège National des Gynécologues et Obstétriciens Français. Prise en charge multidisciplinaire de la prééclampsie. J Gynecol Obstet Biol Reprod. 2005;34(5):513.

Bonnet M-P, Garnier M, Keita H, Compère V, Arthuis C, Raia-Barjat T, et al. Guidelines for the management of women with severe pre-eclampsia. ACCPM. 2021;40(5):100901.

Perrin RX, Lokoussou A, Denakpo J. Prise en charge multidisciplinaire de la prééclampsie: les propositions de l'Afrique Noire. J Gynécol Obstet Biol Reprod. 2010;39:1-342.

Munro P. Management of eclampsia in the accident and emergency department. J Accid Emerg Med. 2000;17:7-11.

Tebeu PM. Manuel initiation à la recherche médicale. Yaoundé. Lirasef. 2016.

Chris NN, Denise K, Doris B, Jan Rene N, Nathan Y, Pascal F. Persistent hypertension after preeclampsia in a group of Cameroonians: result of a cross-sectional study and perspectives to reduce its burden in Limited Income Countries. J Clin Hypertens. 2021;23:1246-51.

Sylvie NA, Simon MM, Dieudonne D, Pierre-Marie T. Factor associated with progression to chronic arterial hypertension in women with preeclampsia in Yaoundé, Cameroon. PAMJ. 2019;33:200.

Ngo TE, Ebene M, Yopa D, Mandeng G, Baleng B, Foguem E, et al. Management of hypertension in late pregnancy in a primary referral hospital in sub-Saharan Africa. Health Sci Dis. 2023;24(3):104-7.

Jarawee S, Tippawan L. Risk of future cardiovascular diseases in different years postpartum after hypertensive disorders of pregnancy: a systematic review and meta-analysis. Medicine. 2022;101(30):29646.