Vascular Health and Risk Management (Jul 2022)
Are Any Changes in Carotid Intima–Media Thickness Associated with Cardiometabolic Risk Among Adult Bantu Central African Hypertensive Patients from Monkole and Biamba Marie Mutombo Hospitals?
Abstract
Stéphane Yanda Tongo,1 Benjamin Longo-Mbenza,2,3 Antoine Molua Aundu,1 Raoul Gombet,4 Jean Robert Makulo Risasi,5 Christian Kisoka Lusunsi,3 Héritier Mawalala Malengele,1 Augustin Nge Okwe3 1Radiology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of Congo; 2Cardiology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of Congo; 3Department of Public Health, Lomo University for Research, Kinshasa, Democratic Republic of Congo; 4Marien Ngouabi University, Brazzaville, Democratic Republic of Congo; 5Nephrology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of CongoCorrespondence: Benjamin Longo-Mbenza, Faculty of Health Science, Private Bay XI, Mthatha, Eastern Cape, 5117, South Africa, Tel +243 814396257, Email [email protected]: Several classic/traditional risk factors are associated with intima–media thickness (IMT), a novel risk of cardio metabolic risk (CMR) in the literature but not in Kinshasa, a megacity prone to CMR. Thus, the objective of this study was to evaluate potential correlations between inflammation, kidney function, psychological stress, hemodynamics, and changes in IMT.Methods: This cross-sectional study was carried out between 2018 and 2021 within Monkole and Biamba Marie Mutombo Hospitals, respectively, and randomly selected from 10 health structures from East and West of Kinshasa, Capital of Democratic Republic Congo (DRC). A random sample of adult hypertensive Bantu Central Africans was examined after bivariate correlations and multiple linear regression.Results: Out of 280 patients with 140 men and 140 women aged 62 ± 11 years, the mean carotid intima–media thickness (CIMT) was 1.06 ± 0.5 mm and 73% (n = 204) patients had uncontrolled hypertension. After controlling for confounders, 52.9% variations (R2) of CIMT were independently and significantly (P = 0.037) predicted by CRP, 24-hour proteinuria, urinary albumin/creatinine ratio, duration of hypertension, heart rate, hip circumference, and psychological stress with Equation Y = 0.717 + 0.87 × CRP + 0.02 × 24 H – proteinuria + 0.005 × urinary albumin/creatinine ratio + 0.05 × duration of hypertension + 0.001 × heart rate + 0.006 × hip circumference + 0.017 × psychological stress.Conclusion: There is an urgent need to control inflammation, impaired renal function, cardiac rhythm, peripheral obesity, longer duration of hypertension management, and stress, which are emerging as specific novel determinants of the subclinical atherosclerosis for those Bantu Central African hypertensive patients.Keywords: carotid intima–media thickness, subclinical atherosclerosis, Central Africans