Gender disparities in pulmonary hypertension at a tertiary centre in Cameroon

Journal article


Aminde, Leopold N., Dzudie, Anastase, Kengne, Andre P., Ndjebet, J., Mapoh, S., Kuelang, X., Kamdem, F., Ngahane, B. H. M., Doualla, M. S., Ngu, K. B., Sliwa-Hahnle, Karen and Thienemann, Friedrich 2017. Gender disparities in pulmonary hypertension at a tertiary centre in Cameroon. SAMJ South African Medical Journal. 107 (10), pp. 892 - 899. https://doi.org/10.7196/SAMJ.2017.v107i10.12321
AuthorsAminde, Leopold N., Dzudie, Anastase, Kengne, Andre P., Ndjebet, J., Mapoh, S., Kuelang, X., Kamdem, F., Ngahane, B. H. M., Doualla, M. S., Ngu, K. B., Sliwa-Hahnle, Karen and Thienemann, Friedrich
Abstract

Background. Pulmonary hypertension (PH) is a potent cause of heart failure and has been little investigated in the African setting. Objective. To investigate the effects of gender on the clinical presentation, echocardiographic features and outcomes of patients with PH in Douala, Cameroon. Methods. A prospective cohort study was conducted from March 2012 to December 2013 as part of the Pan African Pulmonary Hypertension Cohort study. PH was diagnosed by echocardiography and defined as a right ventricular systolic pressure >35 mmHg in the absence of acute right heart failure. Patients were followed up for a maximum of 12 months for primary endpoint mortality. Results. In total, 130 patients with PH were recruited; 71 (54.6%) were women. The median age was 59.2 years for men and 58.3 years for women (p=0.76). Active smoking and alcohol use were more frequent in men than women (both p < 0.001), but women had greater exposure to indoor cooking fumes than men (p < 0.001). Previous tuberculosis infection (11.3% v. 1.7%) and S3 gallop rhythm (30.9% v. 11.9%) were more common in women (both p < 0.03). Women had a significantly higher mean systolic blood pressure (134 mmHg v. 125 mmHg; p=0.04) and pulse pressure (53.8 mmHg v. 44.9 mmHg; p=0.01) and a lower mean haemoglobin concentration (10.4 g/dL v. 12.4 g/dL; p < 0.05) compared with men. Echocardiographic left ventricular (LV) systolic dysfunction was more frequent in men: mean LV ejection fraction 42.6% v. 51.5% (p=0.01) and mean fractional shortening 21.4% v. 28.6% (p=0.01). The overall mortality rate was 20.3%, and rates were similar in the two groups (Kaplan-Meier log rank 1.1; p=0.30). Conclusions. Despite differences in baseline characteristics including cardiovascular risk factors, mortality rates on follow-up were similar in men and women in this study. However, these different baseline characteristics probably suggest differences in the pathogenesis of PH in men and women in our setting that need further investigation.

Year2017
JournalSAMJ South African Medical Journal
Journal citation107 (10), pp. 892 - 899
PublisherHealth and Medical Publishing Group
ISSN0256-9574
Digital Object Identifier (DOI)https://doi.org/10.7196/SAMJ.2017.v107i10.12321
Scopus EID2-s2.0-85030220471
Open accessOpen access
Page range892 - 899
Research GroupMary MacKillop Institute for Health Research
Publisher's version
Place of publicationSouth Africa
EditorsB. Farham
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