Impact of severe hypertension in acute heart failure in Brazzaville (Congo)

This retrospective study to assess the role of hypertension in acute heart failure (HF) reviewed the case records of 86 patients, including 35 men (41%) and 51 women (59%), mean age 55.6 +/- 18 years, who were hospitalized for an acute exacerbation of HF. The cardiovascular risk factors considered were hypertension (56%), diabetes (8%), and smoking (13%); 11 patients were alcoholics (13%). HF was global in 71 cases (83%). Among the underlying heart diseases, hypertensive cardiomyopathy was noted in 22 patients (26%) and valvular disease in 17 patients (20%); the precise cause was not elucidated in 40 (47%). A decompensation factor was identified in 53 cases (62%). Among the patients admitted on an emergency basis for acute HF, the relative risk (RR) of severe hypertension (n = 41, 48%) was 3.75 (95% CI: 2.31 to 6.08, p<0.0001), of heart rhythm disorder (n = 25 cases, 29%) 0.96 (95% CI 0.6 to 1.4, p = 0.5), and of poor adherence to standard treatment (n = 16, 18%) 2.2 (95% CI, 1.6 to 2.97, p<0.0001). Other decompensation factors were severely impaired renal function in 8 cases (9%) and stroke and anemia in 6 cases each (7%).