Changes in patient profiles in the cardiology department of the University Hospital Gabriel Touré (UH-GT) : results of two cross-sectional studies of 2010 and 2022

Abstract

Background

Cardiology is one of the solicited departments in medical facilities due to different factors. Cardiovascular diseases (CVDs) are the leading cause of death according to the WHO [1]. Another fact is that the burden of CVD with prevalent cases nearly doubled from 271 in 1990 to 523 million in 2019 [2] and that over 70% of CVD cases and deaths in the overall cohort were attributed to modifiable risk factors [3]. According to Hinton, CVD represents one-fifth of adult patients [4], and continent-wide, the median age-standardized incidence was lower in middle-income countries than in high-income countries (1039 vs. 1224) (IQR 11,061,356)] for both females and males [5].

Low- and middle-income countries (LMICs) are most affected, with more than 80% of these cases [6, 7] and more than doubling in our neighboring countries [8].

However, little is known about patient profile changes in medical facilities in our country, leading to this study, which aims to describe and compare patient profiles over a 12-year time interval (2010 and 2022).

Patients and methods

Results

The sample consisted of 515 new patients (199 in 2010 and 316 in 2022).

The female sex was most represented (59.1%) in 2010 and 60.1% in 2022, with a p value of 0.821. There were more patients with increasing age, but the differences were not significant. The distribution of school attendance showed no significant difference (Table 1).

The distribution of cardiovascular risk factors (CVrf) showed an increase in hypertension (59.1–71.8%, p = 0.003) and a decrease in tobacco smoking (from 13 to 05.4%, p = 0.002). A similar decrease in stroke was found (from 05.8 to 02.2%, p = 0.033). Diabetes, alcohol consumption and obesity did not show a significant difference (Table 2).

In terms of family history, only hypertension and diabetes were found to be different. A family history of hypertension decreased from 51.9 to 17.4%, p < 0.001, and diabetes decreased from 10.6 to 04.4%, p = 0.006 (Table 3).

Among anthropometric variables, only mean height increased significantly from 1.59 to 1.66%, p = 0.002. Age, weight and body mass index (BMI) showed increases that were not significant (Table 4).

Systolic blood pressure (SBP) and diastolic blood pressure (DBP) showed significant decreases in their means. Therefore, SBP decreased from 155.43 to 144.97 mmHg, p = < 0.001, and DBP decreased from 95.53 to 89.02 mmHg, p = < 0.001, giving mean differences of 10.459 and 6.509, respectively. The mean difference in heart rate was not significant (p = 0.144) (Table 5).

Discussion

There is a lack of trend studies in our environment, and this study is the first in its kind in our department.

The main findings resulting from our study are as follows:

• Patients attending the facility.

  The patients of the two independent samples composing this study were similar in terms of gender, age and education level, as shown in Table I, meaning that no structural change occurred.

  The prevalence of females is a common finding in most studies [8–11], but for some authors, it warrants periodic re-examination [12]. Many factors, including psychosocial problems or distress and easier divulgation of personal information [13], have been underscored. This higher rate of female attendance and a female excess of physical symptoms has been found to be independent of the number and nature of symptoms measured, the time frame involved, and the response format and scoring method used [14].

• Distribution of cardiovascular risk factors.

  We found a significant increase in hypertension in this study. There is no clear trend in the distribution of CVrf worldwide. Most authors found an increase in hypertension and dyslipidemia. So found Jardim et al. an increase of hypertension prevalence from 6.0 to 16.7% with p = 0.024 and dyslipidemia from 4.0 to 19.14% with p = 0.002) [15]. This increase was similar to Fores data with 15.4% [16] and more pronounced particularly for sub-Saharan Africa about 20% [17] [15–17]. There is even an increase in the mean number of CVrf in men and women [18]. Data from the Czech Republic found a decrease in total cholesterol and the mean population blood pressure [19], whereas Castel-Faced found no significant changes in CVrf in a cluster analysis [20].

  Diabetes as a major CVrf shows a decrease in high-income countries and an increase in low- and middle-income countries [21, 22]. Recent studies show a shifting risk factor profile toward a younger population with lower rates of established CVD from the onset of the COVID-19 pandemic [23].

  Tobacco smoking, as another major CVrf, decreased in this study, consistent with most studies [19], but data from Switzerland pointed out a striking increase in tobacco smoking in women [18]. The different regular awareness campaigns from the state and stakeholders such as the Malian cardiac society, among others, are possibly playing a role in this decrease.

• Anthropometric variables.

  BMI in this study shows an increase that was not significant and not consistent with literature data showing an increase in BMI events for children and adolescents [24], and with continuing trends, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women [25, 26].

• Blood pressure on admission.

  We found a decrease in the levels of SBP and DBP on admission, although hypertension increased. This is in opposition to studies with rising SBP and DBP, as reported by Churilova [27], and the relationship of mean blood pressure and the prevalence of hypertension [28]. An explanation could be the role of traditional medication that is not always confessed and therefore not recorded during patient questioning.

Conclusion

Cardiovascular risk factors showed different trends with decreasing tobacco smoking, similar to systolic and diastolic blood pressure, albeit with an increase in hypertension prevalence. Other CVrf values increased. Awareness campaigns must be reinforced and maintained to obtain a decrease in all CVrf.

Acknowledgements

Abbreviations

Author contributions

BA HO designed the study. Poudiougou M was responsible for data collection. BA HO, Camara Y, Sangaré I and Menta I were responsible for the statistical analysis. BA HO and Poudiougou M wrote the first draft. Camara Y, Sangare I and Menta reviewed and checked the manuscript. All authors have read and approved the final version of the manuscript.

Funding

This study did not receive any specific grants from funding agencies in the public, commercial, or nonprofit sectors.

Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

Declarations

Footnotes

References