Management and Outcomes of Hypertensive Crises in Yaounde, Cameroon: A Retrospective Analysis
Prise en Charge et Devenir des Crises Hypertensives à Yaoundé, Cameroun : Une Analyse Rétrospective
DOI:
https://doi.org/10.5281/zenodo.18114912Keywords:
hypertensive crisis, management, CameroonAbstract
ABSTRACT
Introduction. Hypertensive crises, comprising emergencies and urgencies, represent acute, life-threatening complications of chronic hypertension. In Sub-Saharan Africa, the management protocols and outcomes of these crises in hospital settings are inadequately documented. This st udy aimed to describe the clinical management, therapeutic strategies, and outcomes of patients admitted for hypertensive crises in two major Cameroonian referral hospitals. Methodology. We conducted a retrospective cross-sectional study of medical records from January 2019 to December 2021 at the Yaoundé University Teaching Hospital and the Yaoundé General Hospital. We included all adult patients (≥18 years) admitted with a diagnosis of hypertensive crisis (BP ≥180/110 mmHg). Data on patient characteristics, crisis classification, antihypertensive treatment, and clinical outcomes were collected and analyzed using SPSS version 26.0. Results. Among 2000 admissions, 181 cases of hypertensive crisis were recorded (prevalence ~8%). Hypertensive urgencies (48.6%) and emergencies (47.5%) were nearly equally represented. Calcium channel blockers (CCBs) were the cornerstone of therapy, used in 74.5% of cases, with amlodipine being the most frequent agent. Monotherapy was administered to 78% of patients. The clinical outcome was favorable in 76.2% of cases. However, the mortality rate was 16.6%. Among survivors with sequelae (5.0%), chronic kidney disease was the most common complication (55.5%). Conclusion. This study reveals a significant burden of hypertensive crises, associated with a strikingly high in-hospital mortality despite the predominant use of guideline-concordant antihypertensive classes. This highlights potential gaps in the rapidity of blood pressure control, the management of associated acute organ damage, or the availability of critical care resources. Our findings underscore the need for standardized emergency protocols and intensified follow-up for high-risk hypertensive patients.
RÉSUMÉ
Introduction. Les crises hypertensives, comprenant les urgences et les états d'urgence, sont des complications aiguës et potentiellement mortelles de l'hypertension artérielle chronique. En Afrique subsaharienne, leurs modalités de prise en charge hospitalière et leur pronostic sont mal documentés. Cette étude visait à décrire la prise en charge, les stratégies thérapeutiques et le devenir des patients admis pour crise hypertensive dans deux hôpitaux de référence camerounais. Méthodologie. Nous avons mené une étude transversale rétrospective sur les dossiers médicaux de janvier 2019 à décembre 2021 au Centre Hospitalier Universitaire de Yaoundé et à l'Hôpital Général de Yaoundé. Tous les patients adultes (≥18 ans) admis avec un diagnostic de crise hypertensive (PA ≥180/110 mmHg) ont été inclus. Les données concernant la classification de la crise, le traitement antihypertenseur et l'évolution ont été analysées avec le logiciel SPSS version 26.0. Résultats. Sur 2000 admissions, 181 cas de crise hypertensive ont été colligés (prévalence ~8%). Les urgences hypertensives (48,6%) et les états d'urgence (47,5%) étaient presque également représentés. Les inhibiteurs calciques (IC) constituaient la pierre angulaire du traitement, utilisés dans 74,5% des cas, l'amlodipine étant la molécule la plus prescrite. Une monothérapie était administrée à 78% des patients. L'évolution était favorable dans 76,2% des cas. Cependant, la mortalité était de 16,6%. Parmi les survivants avec séquelles (5,0%), la maladie rénale chronique était la complication la plus fréquente (55,5%). Conclusion. Notre étude révèle un fardeau important des crises hypertensives, associé à une mortalité hospitalière très élevée malgré l'usage prédominant de classes thérapeutiques conformes aux recommandations. Ces données soulignent des lacunes potentielles dans la rapidité du contrôle tensionnel ou la prise en charge des atteintes viscérales aiguës. Nos résultats soulignent la nécessité de protocoles d'urgence standardisés et d'un suivi intensif des patients hypertendus à haut risque.
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Copyright (c) 2025 Ndobo Valerie, Owona Amalia, Ada Kanbaye Medom Hadia, Kollo Nzima Brice Kevin, Jemea Bonaventure, Ndongo Amougou Sylvie
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