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Introduction: les dyslipidémies constituent un facteur de risque majeur dans la survenue des maladies cardio-vasculaires. La recherche de ce facteur et sa prise en charge adéquate contribuerait à prévenir ces maladies qui sont la plus grande cause de décès dans le monde. L'objectif de cette étude était d'évaluer la prévalence des dyslipidémies au laboratoire de biochimie du Centre Hospitalier Universitaire de Référence Nationale de N'Djamena. MATéRIEL ET MéTHODES: il s'agissait d'une étude transversale d'une durée de cinq ans (2015-2020) portant sur tous les patients ayant au moins un paramètre lipidique dans le registre du laboratoire. Les méthodes enzymatiques sur un automate de biochimie de type Cobas Integra 400 (Roche Diagnostics) ont été utilisées pour le dosage de cholestérol total, LDL-c, HDL-c et de triglycérides., Results: Au total 2038 patients avec une prédominance masculine (sex-ratio :1,33), ont été enregistrés, l'âge moyen de nos patients était de 56,45±8,8 ans. La prévalence des dyslipidémies était de 44,2%. Les différents types des dyslipidémies étaient repartis comme suit : l'hypercholestérolémie (40,52%) ; l'hyper LDLémie (33,02%) ; l'hypoHDLémie (14,72%) ; l%hypertriglyc%rid%mie (11,72%) et l'hyperlipidémie mixte (40,5%). On notait une évolution croissante de la prévalence de dyslipidemie au cours des cinq années de periode d'étude., Conclusions: la forte prévalence des dyslipidémies dans notre étude témoigne d'une situation préoccupante au Tchad, d'où l'intérêt d'étudier la prévalence des dyslipidémies et des autres facteurs de risque cardiovasculaire à l'échelle nationale et l'utilité d'organiser des campagnes d'éducations et d'informations sur les maladies cardiovasculaires et les facteurs de risque cardiovasculaire afin de r'duire cette pr'valence., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

We have to distinguish between non-modifiable risk factors such as age, gender, heredity, (we cannot fight against these enemies), and modifiable risk factors (avoidable) such as hypertension, smoking, diabetes, and dyslipidemia. Environmental factors, bad diet, sedentary lifestyle, and smoking are the basis of these risk factors. Cardiovascular disease due to these risk factors is clinically silent during a given period, then symptoms occur which can eventually lead to death. Nine risk factors explain the occurrence of 90 % of myocardial infarctions (MI), their correction avoid 80 % of MI. Despite the presence of several studies proving that secondary prevention reduces coronary mortality, the management of cardiovascular risk factors is not optimal., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Competing Interests: A. Gallo a participé à des interventions ponctuelles pour les entreprises suivantes : Akcea Therapeutics (colloques, actions de formation), Amgen (travaux scientifiques), Mylan (actions de formation, conférences), MSD (conférences), Novartis (conférences), Sanofi (conférences, actions de formation, travaux scientifiques), Regeneron (essais cliniques), Unilever (conférences). Il déclare avoir été pris en charge (transport, hôtel, repas) à l’occasion de déplacement pour congrès par Akcea Therapeutics, Sanofi, Amgen, Unilever. É. Bruckert déclare participer ou avoir participé à des interventions ponctuelles: essais cliniques et travaux scientifiques ou rapports d’expertise ou activités de conseil ou conférences, colloques, actions de formations…) pour AMGEN, Genfit, MSD, Sanofi and Regeneron, Danone, Aegerion, Lilly, Ionis-pharmaceuticals, Silence therapeutic, AKCEA, Novartis, Amarin, Servier, Mylan

Background: Through various research lead in the past, it has been made evident that Quebec is home to higher rates of acute myocardial infarction (AMI) and higher prevalence of cardiovascular risk factors than other Canadian provinces. This proposed study will perform a retrospective analysis on Caucasian populations in order to analyze the cardiovascular risk factors in partially francophone populations in comparison to French and Non-French Canadians. Furthermore, we will closely analyze both genders of aforementioned populations., Methods: This population-based retrospective cohort study was achieved using the University of Ottawa Heart Institute CCTA registry. Included are Caucasian patients of all ages who came to UOHI for a CCTA between 2006 and 2018 and provided written informed consent. SPSS was used to compare the different populations (French Canadian, partially French Canadian and non-French Canadian) and sex., Results: The PFC population more closely resembles FC, having higher incidence of cardiovascular risk factors such as smoking, dyslipidemia and type 2 diabetes., Interpretation: Our results suggest that PFC, like FC, may benefit from more intensive education and lifestyle modification techniques., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Background: Granuloma annulare (GA) is a benign granulomatous skin disorder that is generalized (GGA) in 15 % of cases. Although many case reports describe a relationship between GGA and systemic diseases, few large series have been published, and their association is debated. We present herein a series of GGA in order to describe their clinical and histological features., Patients and Methods: We included all biopsy-proven cases of GA presenting at the dermatopathology laboratory of Strasbourg where generalized (i.e. over 10 lesions). Clinical features were obtained from patients' medical files., Results: We included 35 GGA, with a sex ratio of 0.5. The mean age was 54 years. Lesions were annular or non-annular in equal measure and were symptomatic in 25 % of cases. Most patients (77 %) had an associated disease, already known in 60 % of cases, including dyslipidemia (27 %), diabetes mellitus (20 %), immunosuppressive drugs (17 %), atopy (17 %), auto-immune disease (17 %), hematological disease (14 %), and cancer (9 %). Histological analysis revealed the predominant pattern to be interstitial (54 %) rather than palisading (20 %), having no correlation with clinical type. Eosinophils were frequent (46 %) in GA but were not correlated with systemic disease or drug taking. Among the 40 % of patients treated, 50 % had a successful outcome on topical corticosteroids, doxycycline, antimalarial drugs or phototherapy., Discussion: GGA differs from localized GA, which is mostly associated with an already known systemic disease, whether metabolic, infectious or neoplastic, uncorrelated with clinical or histological features, and screening is necessary., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

In our aging population, kidney disease management needs to take into account the frailty of the elderly. Standardized geriatric assessments can be proposed to help clinicians apprehend this dimension in their daily practice. These tools allow to better identify frail patients and offer them more personalized and harmless treatments. This article aims to focus on the kidney diseases commonly observed in elderly patients and analyze their specific nephrogeriatric care modalities. It should be noticed that all known kidney diseases can be also observed in the elderly, most often with a quite similar clinical presentation. This review is thus focused on the diseases most frequently and most specifically observed in elderly patients (except for monoclonal gammopathy associated nephropathies, out of the scope of this work), as well as the peculiarities of old age nephrological care., (Copyright © 2019 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)

Background: Psoriasis affects 0.2-0.7 % of children and is associated with obesity. Published studies have been conducted in hospital settings (tertiary care). The PsoLib study evaluated childhood psoriasis in private practice (secondary care) in terms of epidemiology, clinical aspects and comorbidities., Patients and Methods: This was a non-interventional, cross-sectional, multicenter study of children with psoriasis performed by 41 dermatologists working in private practice. The clinical and therapeutic aspects and comorbidities were systemically evaluated. We compared data to the χ-Psocar study performed in hospitals using the same methodology., Results: In all, 207 children (girls: 60.4 %; mean age: 10.5±4.2 years) were included. Scalp psoriasis (40.6 %) was the most frequent clinical type, while plaque psoriasis represented 26 % of cases. Nail, tongue, and arthritic involvement were rare. Less than 1 % of children suffered from hypertension, diabetes or dyslipidemia, but 16.4 % were overweight and 7.0 % were obese. Severity (PG≥4 at peak) was associated with excess weight (P=0.01)., Conclusion: Scalp psoriasis is the most frequent clinical type of psoriasis in childhood. Comorbidities and extracutaneous localization are rare. Even in private practice, the severity of the disease is associated with excess weight., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Total cardiovascular risk estimation using a system such as SCORE is recommended for adults>40years of age without evidence of cardiovascular disease, diabetes, chronic kidney disease, severe hypertension or familial hypercholesterolemia. Before treatment, a full lipid profile is recommended, fasting in French guidelines, fasting or non-fasting in European guidelines. LDL-C has to be used as the primary target for treatment. For patients with elevated triglycerides, non-HDL-C level is also recommended as the secondary goal for treatment. In patients at very high and high cardiovascular risk, LDL-C goals are respectively below<0.70g/L and<1.0g/L. For subjects at very high and high cardiovascular risk, French guidelines do not mention that a≥50% reduction in LDL-C should be achieved. Statins are the treatment of choice to reach LDL-C goals. If the goal is not reached on maximally tolerated dose of statin, combination with another LDL lowering drug, mainly ezetimibe, is recommended. Fibrates are mainly proposed for patients with severe hypertriglyceridemia (TG>5g/L after lifestyle changes)., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Objectives: We aim to determine the prevalence of cardiovascular risk factors in the semi-rural population of the community of Gueoul in Senegal., Patients and Method: This is a cross-sectional, observational and descriptive study. We conducted an exhaustive survey in 2012 according to the STEPS wise approach of the world health organization against Senegalese aged of 35 years and over who resided for at least 6 months in semi-rural area in the community of Gueoul. Pregnant women were excluded. Classical cardiovascular risk factors were collected and data analyzed using SPSS 18.0 software. The significance level was agreed for a value of P<0.05., Results: We examined 1411 subjects (1052 women) with a mean age of 48.5±12.68 years. The main cardiovascular risk factors were dyslipidemia (61,1%), physical inactivity (56.2%), abdominal obesity according to the International Diabetes Federation (53.9%), hypertension (46.4%), global obesity (13%), diabetes (7.2%) and smoking (2.5%). Hypertension was significantly associated with diabetes (P=0.001), abdominal obesity (P=0.001) and global obesity (P=0.0001). Sedentarity (P=0.001), global obesity (P=0.0001) and hypertension (P=0.001) were more frequent in women., Conclusion: Cardiovascular risk factors are frequent and often associated in semi-rural area of Senegal, particularly in women. This condition should lead to develop prevention strategies of cardiovascular complications., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

The aim of this work is to study the association between dyslipidemia and suicidal risk in patients with psychiatric pathology. Our study has involved 155 patients suffering from major depressive disorder and 124 schizophrenic patients aged 40.58±12.16 and 43.43±10.60 years, respectively. Total cholesterol (TC), triglycerides (TG) and HDL-c were determined by enzymatic methods, LDL-c was calculated by the Friedewald formula. Plasma cholesterol level was significantly lower among suicidal schizophrenic or depressive patients. There were no significant differences in the others lipid levels. The results of our study suggest that total cholesterol values less than 3.59mmol/L could be an indicator of suicide vulnerability in patients with schizophrenia or major depressive disorder., (Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Recent studies conducted in patients with Addison's disease (AD) highlighted that this disease, even after treatment, is a significant cause of morbi-mortality. This study aims to determine the cardiovascular and metabolic deleterious impact of long-course glucocorticoid substitution therapy. We conducted a retrospective study of 28 patients with treated Addison's disease evolving for more than 15 years. The average age of patients was 58, 53 years, with a female predominance (65%). The average follow-up period was 17, 87 years. Initial dose of hydrocortisone was 32, 5 mg/day (20.52 mg/m 2 ) and 27, 9 mg/day (16,41mg/m 2 ) at the time of the study. The prevalence of the metabolic syndrome (MS) in patients with AM was 35.71% after a period of treatment longer than 15 years. At the end of the follow-up period, 28.57% of patients were obese; 25% of patients had developed AH (arterial hypertension) and type 2 diabetes. The prevalence of dyslipidemia went from 3.57% to 42.85%. Only one patient had myocardial infarction at 25-year follow-up. Factors favoring the onset of MS in our study were history of disease and weight loss at the moment of diagnosis. Adjustment of substitution therapy is a challenge in patients with Addison's disease due to morbi-mortality associated with overdose. A regular follow-up and a personalized therapeutic approach are necessary to improve patients' prognosis.

Objectives: This cross-sectional epidemiological study aimed at determining the prevalence of cardiovascular risk factors (CVRF; including obesity, dyslipidaemia, hypertension, diabetes and smoking), among patients from the Algerian sub-population of the "Africa/Middle East Cardiovascular Epidemiological" study attending general practitioners at primary healthcare facilities, and stratified according to their environment (rural/urban), sex and age., Patients and Methods: The study sites, located in 10 wilayas (administrative regions), were situated in urban and rural areas (rural populations defined as living at least 50km away from urban centres, or lacking access to suburban transport)., Results: Four hundred and ten subjects (262 female, 148 male) were enrolled; 287 subjects were from an urban environment and 123 from a rural environment. Mean age was 50.4 years. Ninety one point eight percent of patients had ≥1 CVRF; 48.2% had ≥3 CVRF. Prevalence for the different CVRF was: 61.7% for dyslipidaemia; 39.5% for hypertension; 25.0% for diabetes; 10.0% for smoking, 70.0% for abdominal obesity and 32.0% for a body mass index ≥30kg/m 2 ., Conclusion: The high prevalence of all CVRF observed in the Algeria sub-group, especially among the rural population, should encourage us to develop a carefully planned strategy for primary prevention, opportunistic screening and early management, in both urban and rural settings, and with particular attention to young adults. These actions should involve all state bodies and those active in civil society, in order to guarantee full achievement of set goals. The ACE trial is registered under NCT01243138., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Medicinal treatment of arterial hypertension (AH) may cause adverse effects which can be annoying and thus influence patient's compliance with treatment. Our study focused on these undesirable effects in patients followed up for AH on an ambulatory basis in the Department of Cardiology at the University Hospital Yalgado Ouédraogo from July to September 2015. Our aim was to determine their rates and their characteristics. Data were obtained from patients' interview, from the examination of patients' follow-up records and of medical consultation forms. A total of 278 patients were included in the study, 69.1% of them were women. The average age was 52.2 ranging between 23 and 86 years; 87.8% of patients lived in urban areas. Smoking, dyslipidemia and a family history of AH accounted for 9%, 35.6% and 57.2% of cases respectively. From a therapeutic perspective, 43.2% of patients were under monotherapy, 35.6% under bitherapy at the start of treatment. Calcium channel blockers (59.7%) were the most used therapeutic drugs. The overall incidence of adverse effects was 60.1%. Calcium channel blockers were involved in 53.6% of adverse events of patients, diuretics in 48.6%. Molecule-specific prevalence was 28.1% for the amlodipine and 24.5% for the hydrochlorothiazide. Excessive diuresis (13.7%), cough (12.9%) and vertigo (11.5%) were the most frequent adverse events reported by the patients. The central and peripheral nervous system and the osteo-muscular system were the most affected systems. Adverse effects are a major determinant of patient's compliance with antihypertensive treatments, because they may have a significant impact on patient's daily life.

Background: Psoriatic arthritis affects 20-30% of patients with psoriasis. Few epidemiological data are available in France about its prevalence and its association with skin lesions and comorbidities., Objectives: To assess the epidemiological aspects and the risk factors for psoriatic arthritis in children and adults in France., Methods: Two cross-sectional studies were conducted in France in children (χ-Psocar, 23 pediatric dermatology centers belonging to the SFDP, 1 year) and adults (Resopsocar, 29 dermatology centers belonging to GEM RESOPSO, 4 months) to study the link between psoriasis and cardiovascular and metabolic comorbidities., Results: Three hundred and thirteen children (males: 47.6%; mean age: 9.4 yrs) and 1,954 adults (males: 56.0%; mean age: 48.5 yrs) with psoriasis were included, with 4.2% of the children and 21.0% of the adults presenting psoriatic arthritis. Prevalence increased with age: 2.2% of children, 14.2% of adolescents, and over 20% after 40 years. It decreased after the age of 70 years (19.4%). Regardless of age, arthritis was not associated with gender. In the children's group, rheumatism was associated with nail involvement (P=0.04) and disease severity (P=0.0004). Adult rheumatism was associated with generalized plaque psoriasis (P=0.002), disease severity (P<0.0001), and obesity (P<0.0001). Localized plaque psoriasis was less often associated with arthritis (P<0.05)., Conclusions: These two cross-sectional studies conducted in 2267 patients in France yielded information on the prevalence of joint involvement from infants to elderly subjects. It is the first study conducted in a single population to provide data for the whole population. Prevalence gradually increases with age, without gender difference, before decreasing in old age. We confirm the association of nail involvement in the first years of life, and of obesity in adults., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

It is estimated that more than 200 million individuals are affected by lower extremity artery disease (LEAD) worldwide. This prevalence has increased between 2000 and 2010 by 25%, especially in low/middle income countries. In France, about one million people are affected by this condition. Almost two-thirds of patients with LEAD are asymptomatic. This explains the interest of the measurement of the ankle-brachial index (ABI), an objective and harmless diagnostic tool. An ABI≤0.90 is considered as diagnostic for LEAD. The detection of symptomatic LEAD requires standardized questionnaires identifying intermittent claudication. Epidemiological studies on chronic limb-threatening ischemia (CLTI) - the most severe presentation of the disease - are scarce: the prevalence is estimated around 0.5-2.0% after the age of 40, mostly affecting elderly people. Similar to other atherosclerotic diseases, the risk factors are multiple (genetic factors, traditional risk factors, metabolic and inflammatory factors, socioeconomic factors), with different weighs of association as compared to coronary artery diseases. Due to their high prevalence and strength of association, cigarette smoking and hypertension are the most frequent purveyors of this disease in population. Diabetes mellitus is a strong risk factor, and its increasing prevalence contributes to the global epidemics of LEAD. In claudicants, the 5-year amputation risk is estimated at 5%, increasing to 25% at one year in case of CLTI. However, the main risk is related to general cardiovascular events. It is estimated that patients with LEAD present concomitantly coronary and cerebrovascular disease in respectively 50% and 20% of cases. The non-cardiovascular mortality, especially related to cancer, is also higher than in general population. Overall, the control of traditional risk factors has a beneficial effect both for the limb and general prognosis., (Copyright © 2018. Published by Elsevier Masson SAS.)

Background: Medico-administrative databases represent a very interesting source of information in the field of endocrine, nutritional and metabolic diseases. The objective of this article is to describe the early works of the Redsiam working group in this field., Methods: Algorithms developed in France in the field of diabetes, the treatment of dyslipidemia, precocious puberty, and bariatric surgery based on the National Inter-schema Information System on Health Insurance (SNIIRAM) data were identified and described., Results: Three algorithms for identifying people with diabetes are available in France. These algorithms are based either on full insurance coverage for diabetes or on claims of diabetes treatments, or on the combination of these two methods associated with hospitalizations related to diabetes. Each of these algorithms has a different purpose, and the choice should depend on the goal of the study. Algorithms for identifying people treated for dyslipidemia or precocious puberty or who underwent bariatric surgery are also available., Conclusion: Early work from the Redsiam working group in the field of endocrine, nutritional and metabolic diseases produced an inventory of existing algorithms in France, linked with their goals, together with a presentation of their limitations and advantages, providing useful information for the scientific community. This work will continue with discussions about algorithms on the incidence of diabetes in children, thyroidectomy for thyroid nodules, hypothyroidism, hypoparathyroidism, and amyloidosis., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: To assess risk factors monitoring in coronary patients one year after cardiac rehabilitation., Method: From 2015 to 2015, cardiac morbidity, total mortality and risk factors data were collected from a 4-week ambulatory cardiac rehabilitation program with a control one year later and were compared with the results of Euroaspire and Reach studies., Results: Out of 1091 (87%) coronary patients, 746 (68%) were re-examined 12months later (aged 60years (ranging from 20 to 85years), 15% women, 44% hypertensive, 36% smokers, 17% diabetics, 74% with dyslipidemia). At the end of the program, management of CV risk factors was improved (BP ≤ 140/90mmHg and BMI > 30: 80 and 20% vs 65 and 25% at the beginning of the program; LDL < 0.7g/L: 42% and smoking: 4% vs 18% when hospitalized for their cardiac event). Unfortunately, this benefit decreased significantly at one year (BP ≤ 140/90mmHg: 63%, LDL < 0.7g/L: 27%; smoking: 6%) but it remains better than in Euroaspire IV study: 57, 20 et 16% respectively). While 54% had insufficient physical activity before cardiac rehabilitation, they were only 23% at 1-year vs 60% in Euroaspire study. We reported a total mortality of 0.6% vs 2.9% in Reach study and 12% cardiac hospitalization (53% for a new coronary event)., Conclusion: Participation of coronary patients in a cardiac rehabilitation program significantly improves management of CV risk factors, morbidity and mortality. However, the control obtained at the end of the program decreases at one year., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: To investigate the determinants of non-compliance with antihypertensive treatments among participants in the FLAHS 2015 survey and to develop a risk calculator for drug compliance in a hypertensive population., Methods: The FLAHS surveys are carried out by self-questionnaire sent by mail to individuals from the TNS SOFRES (representative panel of the population living in metropolitan France) sampling frame. In 2015, FLAHS was performed in subjects aged 55years and older. Using the Girerd questionnaire, the "perfect observance" was determined for a score of 0 and "nonobservance" for a score of 1 or higher. A Poisson regression was conducted in univariate and multivariate to estimate risk ratios for each determinant. A non-compliance risk calculator is constructed from multivariate analysis. A Poisson regression was performed in univariate and multivariate to estimate risk ratios. For each sex, a probability table is produced from the equation of the multivariate analysis and then the calculation of a nonobservance probability ratio (PR) using the profile with the best probability as a reference. Each subject is then classified into one of the three classes of risk of non-compliance: low (PR <1.5), high (PR>=2) and intermediate (PR>=1.5 and <2)., Results: The survey included 6379 subjects and analysis based on 2370 treated hypertensives. The onset of treatment was less than 2years in 7% of subjects and the median follow-up duration of treatment was 10years. Perfect compliance was observed in 64% of subjects. Independent determinants of non-compliance are: male sex, young age, number of antihypertensive tablet, treatment for a metabolic disease (diabetes, dyslipidemia), presence of other chronic illness, secondary prevention of cardiovascular disease. To get the risk class of nonobservance a web page is available at http://www.comitehta.org/flahs-observance-hta/., Conclusion: The development of the FLAHS Compliance Test is a tool whose use is possible during an office visit. Its free availability for French doctor will be one of the actions undertaken as part of the "call for action for adherence in hypertension" proposed by the French League Against Hypertension in 2017., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Introduction: This study aims to evaluate the prevalence of dyslipidemias among patients who underwent assay of a lipid parameter at the Laboratory of Biochemistry of Aristide Le Dantec University Hospital in 2013., Methods: We conducted a retrospective study of 1356 patients between ages 10-94 years presenting at the laboratory of Biochemistry of CHU Le Dantec from January to December 2013. All patients who had undergone at least one lipid assay whose results were recorded in the laboratory register were enrolled in the study. Total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides were measured using enzymatic methods (Cobas Integra 400 plus biochemistry analyzer - Roche Diagnostics)., Results: The prevalence of dyslipidemia in our study population was 39.30%. The prevalence of hypercholesterolemia, hypo-HDL-cholesterolemia, hyper-HDL-cholesterolemia, hypertriglyceridemia, mixed hyperlipidemia was 30,89% ; 7,30% ; 31,19% ; 0,51% ; 7,22% respectively. The subjects aged 40 to 59 years appeared to be more exposed. Moreover, there was a female predominance in hypercholesterolemia (54.17% vs 45.82%) the hypocholesterolemia (54.54% vs45,45%), and mixed hyperlipidemia (51.08% vs 48.97%). Dyslipidemias were strongly correlated to hypertension and obesity., Conclusion: The high prevalence of dyslipidemias found in our study highlights the importance of studying the prevalence of cardiovascular risk factors, in particular dyslipidemias, in Senegalese population., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts

Unlabelled: Peripheral arterial disease of the lower limbs is a serious condition because of its local and general prognosis., Objectives: To identify the localization of peripheral arterial disease, associated risk factors, topography and features of the disease in Guadeloupe., Patients and Methods: A descriptive non-interventional study was performed in Guadeloupe located in French West Indies from March to June 2014. Data for all patients, who underwent Doppler ultrasound of the lower limb in a vascular outpatient clinic and in the University Hospital in Guadeloupe for known or suspected peripheral arterial disease were included., Results: The study included 268 patients. Localizations were: infrapopliteal (n=227 patients), popliteal (n=148), femoral (n=185) and aorto-iliac (n=115). Smoking was associated with aorto-iliac (16 patients; P<0.05) and femoral (27 patients; P<0.05) localizations. Diabetes was associated with infrapopliteal localizations (133 patients; P<0.05), and high blood pressure was associated with infrapopliteal, popliteal and femoral localizations. Mean age was 73.1±10.8 years; half of patients (51 %) were women. Peripheral arterial disease was known for 52 % of the population; 147 patients were asymptomatic. Associated factors were high blood pressure (88 %), diabetes (63 %), dyslipidemia (45 %), and smoking (7 %). Ischemic heart disease was found in 14 % of patients, cerebrovascular disease in 18 % and all three localizations in 4 %. A history of amputation, bypass or endovascular treatment was found in 11 %, 20 % and 32 % of patients respectively., Conclusion: In our population, an infrapopliteal site was more often found than a proximal site. Distal localization was associated with diabetes, and proximal localization with smoking. Cardiovascular risk factors exhibited an atypical pattern with a large majority of patients (88 %) having high blood pressure, two-thirds diabetes, but with very few (7 %) smokers. Peripheral arterial disease was more often associated with a history of stroke than with ischemic heart disease., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Aims: To describe cardiovascular risk factors and metabolic disturbances in a French population including shift workers and study whether possible changes were noticeable after non-shift to shift work transition within the last five years., Methods: The study population included 4764 attendees of two health examinations (5 years apart), between January 1996 and October 2008, in 11 health examination centres. Clinical, biological and metabolic factors together with their changes over a five-year period were compared between attendees who kept a non-shift daytime job, those who kept working shift and those who switched from non-shift daytime to shift work over the last 5 years., Results: At baseline, working shift was, independently of lifestyle or BMI, significantly related to more elevated plasma triglycerides (β=0.04, P=0.05) and rate of hypertriglyceridemia (β=0.27, P=0.01), lower plasma HDL-C levels (β=-2.03, P=0.006) and less hypertension (β=-0.25, P=0.01) compared to non-shift daytime work. In men, a slightly more elevated yet non significant proportion of hypertriglyceridemia was observed with the transition from non-shift daytime to shift work within the last 5 years in comparison to men who kept a non-shift daytime job (13.9% vs. 11.0% P=0.17)., Conclusion: Our results are in agreement with previous studies showing a deleterious effect of shift work on lipid metabolism. In our population, triglycerides and HDL-C levels were the main parameters negatively influenced by shift work. Consequently, a regular biological monitoring together with the promotion of healthy behaviours should be provided to shift workers before negative consequences of working shift become noticeable., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Aims: The purpose of this study was to investigate the prevalence of atherosclerotic carotid plaques and association with cardiovascular risk factors and vascular diseases in a semi-rural area of Gueoul in Senegal., Patients and Method: This was a cross-sectional, descriptive study over a period of one month in 2012 in Senegalese people who were older than 35 years, and resided in semi-rural Gueoul for at least six months. Carotid plaques were measured with a portable Doppler Diadop 50(®) and defined by an intima-media thickness greater than 1.5mm. P-values less than 0.05 were considered statistically significant., Results: The survey involved 1411 individuals with a sex ratio of 2.93 and an average age of 48.5 years. Prevalence of risk factors was high: dyslipidemia (61.1 %), physical inactivity (56.2 %), abdominal obesity (53.9 %), hypertension (46.4 %), obesity (12 %), diabetes (7.2 %) and smoking (2.5 %). Prevalence of atherosclerotic carotid plaques was 6.8 %, including 42.7 % with bilateral plaques. Prevalence increased with age (P=0.001), hypertension (P=0.0001), diabetes (P=0.004) and metabolic syndrome (P=0.008). There were no significant associations with the other risk factors. The presence of carotid plaques was associated with medical history of stroke (P=0.01), myocardial infarction (P=0.02) and peripheral artery obstructive disease (P=0.5)., Conclusion: Prevalence of atherosclerotic carotid plaques seems weak but it is associated with many cardiovascular risk factors. It requires measures for early diagnosis and prevention of cardiovascular diseases in Senegal., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: The cardiovascular risk factors are clearly increasing in developing countries. Among these factors, dyslipidemia is often found, this due to the change in behavioral and dietary habits (OMS, 2006). Dyslipidemia is a "primary or secondary pathological changes in serum lipids". It is a chronic and metabolic abnormality, characterized by persistently elevated TG, LDL-c, and a decrease in HDL (Attias et al., 2013-2014). The objective of this study is to determine the prevalence of dyslipidemia, and give the lipid profile of the population in Gueoul., Patients and Methods: We performed a comprehensive observational study, cross-sectional descriptive on Senegalese aged 35 or over, living in Gueoul for at least 6 months. Lipid profile (total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol) was systematically after 12hours of fasting., Results: Dyslipidemia was found in 61.3 % of cases with 50 % pure hypercholesterolemia (n=705). Only 20 subjects (2.3 %) knew they had dyslipidemia. The detection rate was 59.8 % (n=844). The type most represented was hypoHDLemia (45.6 %) followed by hyperLDLemia (28.8 %). Triglycerides were increased in only 2.8 % of cases., Conclusion: The prevalence of dyslipidemia is very high in our regions. It is often associated with female gender, hypertension, diabetes, and obesity. Its main causes are physical inactivity, change in lifestyle and eating habits. It is often misunderstood and its management is limited in most cases to low-calorie diet., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Purpose: The goal of our study was to determine the benefits of screening by non-mydriatic retinal camera in the Fez region and to present the results of this screening., Patients and Methods: We report a prospective study of 430 diabetic patients, or 860 eyes, compiled between December 2012 and June 2013 in the Dokkarat health center, "integrated referral center for management of diabetes and hypertension" in the region of Fez. All patients underwent an examination by non-mydriatic fundus camera, obtaining two digital images per eye. The photos are taken by a nurse and a general practitioner. Interpretation of the images was performed in the ophthalmology department of the Hassan II University Medical Center of Fez., Results: A total of 430 patients were screened (78.4% female, 21.6% male). The mean age was 54.7 years (range, 10-80 years). The average duration of diabetes was 7.7 years (±5.9). Most patients had type 2 diabetes (94%). Insulin therapy was found in 35.3%. The mean HbA1c (obtained from 421 patients) was 8.21%. 38,8% of patients had never consulted an ophthalmologist before. The fundus photographs were not interpretable for at least one eye in 75 cases (17.4%). Among the interpretable images, the prevalence of diabetic retinopathy (DR) was 44.6%. Proliferative diabetic retinopathy was present in at least one eye in 2.5% and diabetic maculopathy in 32 cases (9%). After screening, 69% of patients with DR were seen by the ophthalmologist., Conclusion: These data confirm the benefits of screening by non-mydriatic retinal camera, because it helps reintegrate patients into the healthcare system and thus provides a real benefit in terms of public health and prevention of complications., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Introduction: According to the criteria of Hodges and Warlow, transient global amnesia is defined by sudden onset of isolated anterograde amnesia of spontaneous resolution within one to twenty-four hours. Its pathophysiological mechanisms are still uncertain., Methods: In a retrospective study, we have analyzed epidemiological, clinical and MRI data from twelve patients admitted to the only neurological department of French Polynesia for transient global amnesia corresponding to the criteria of Hodges and Warlow between January 2010 and December 2013., Results: The median age of the cohort was 61.5 (53-72), the sex ratio was 1. Ten patients had one or more cardiovascular risk factors, 3 had migraine headaches and 3 had anxiodepressive disorders. Among triggers found, the occurrence during the rest was noted in one case. Retrograde amnesia was observed in 42% of cases, repetitive questioning in 75% of cases, anxious bewilderment in 67% of cases and disorientation in 33% of cases. The median episode duration was 9 hours and the duration of hospitalization was 3 days. Three patients had a recurrence. MRI was abnormal in all patients and showed diffusion-weighted hyperintensities in right (n=8), left (n=3) and bilateral (n=1) hippocampi., Conclusion: Epidemiological, clinical and MRI data from our cohort are similar to those from the literature except for the highest prevalence of cardiovascular risk factors and the most frequent right hippocampus involvement. Transient global amnesia occurring exceptionally while sleeping was also observed in one of our patients., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Objective: To determine the prevalence of the carotid lesions during ischemic strokes., Methods: This was a descriptive cross-sectional study, conducted in Brazzaville from January 2011 to June 2012 in a consecutive series of 73 patients, victims of a transient ischemic attack or ischemic stroke, documented by a brain computed tomography. All patients underwent vascular ultrasonography of the supra-aortic trunks, carried out within the framework of etiological assessment. The examination searched for plaques, parietal infiltration (measurement of intima-media thickness), and carotid stenosis or occlusion., Results: There were 49 men (67%) and 24 women (33%), mean age 58.7 ± 11.8 years. Eleven patients (15%) had a transient ischemic attack and 62 (85%) an ischemic stroke. The identified independent vascular risk factors were known and treated hypertension (n=66, 90.4%), dyslipidemia (n=16, 22%), diabetes mellitus (n=9, 12.3%), and smoking (n=5, 6.8%), with on average 2.5 factors per individual. Vascular ultrasonography of the supra-aortic trunks, normal in 44 patients (60.3%) was pathological in the other 29 (39.7%). The main anomalies were atheromatous plaque (n=10, 13.7%), parietal infiltration (n=19, 26%). On average intima-media thickness was 0.86 ± 0.11 mm on the left and 0.83 ± 0.11 mm on the right. Two cases of moderate stenosis were noted on the right and left internal carotids, respectively., Conclusion: This preliminary study confirms the existence of carotid atherosclerosis anomalies during ischemic strokes. These lesions, though non-significant, must nevertheless be taken into consideration when searching for the cause of stroke in high-risk vascular patients., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Changing lifestyle, driven by socio-economic trends, is changing the cardiovascular risk and disease profile in developing countries. We studied the cardiovascular risk factors of Federal Medical Centre, Umuahia hospital staff between 40 and 60 years. 297 members of hospital staff were consecutively recruited in October 2010. Data obtained include blood pressure, height and weight, body mass index (BMI), fasting blood sugar, serum cholesterol (total and differential) and serum triglyceride. The data were analysed using the SPSS package (version 10). The following prevalence levels were found: hypertension 37.5%, obesity 40.8%, diabetes mellitus 5.7%, hypercholesterolemia 18.1% and metabolic syndrome 24.7%. LDL, low HDL and elevated TG were elevated in 26.8%, 41.9% and 9.7% respectively. Only 2% had very low risk for cardiovascular disease.

Background: Cardiovascular diseases are becoming with their risk factors a real health problem in Africa. The objectives of this study were to assess the prevalence of risk factors for cardiovascular diseases in the general population in Saint-Louis, Senegal., Methodology: This is a cross-sectional, descriptive and analytical made in May 2010, in the Senegalese aged 15, residing in the city of Saint-Louis, Senegal. A systematic random sampling and stratified cluster has been achieved. Cardiovascular risk factors for research were: hypertension, diabetes, dyslipidemia, smoking, obesity, physical inactivity and metabolic syndrome., Results: The survey involved 1424 individuals with 983 women (69%). The average age was 43.4±17.8years. The prevalence of risk factors was: hypertension (46%), diabetes (10.4%), total cholesterol (36.3%), hyperLDLcholesterol (20.6%), obesity (body mass index≥30kg/m(2)) (23%), abdominal obesity (48.7% according to International Diabetes Federation and 33.2% according to National Cholesterol Education Program) physical inactivity (64.7%), smoking (5.8%) and metabolic syndrome (15.7%). There was predominance in women of risk factors except for smoking and diabetes. The overall cardiovascular risk was high in 24.9% according to the Framingham model, 28.8% (European Society of Hypertension) and 6.1% (SCORE)., Conclusion: This survey found a high prevalence of cardiovascular risk factors in a general population in Senegal, predominant in women. This should lead to better develop a strategy to prevent cardiovascular diseases., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: The purpose of this study was to investigate the prevalence of peripheral arterial disease (PAOD) and cardiovascular risk factors associated with the ankle-brachial index (ABI) in Senegalese patients aged 40 years and over., Methodology: We prospectively studied a random sample of Senegalese aged 40 years and older, residing in the city of St.-Louis, Senegal. The ABI was measured with a portable doppler (DIADOP 50) using 4 and 8Hz dual frequency probes. The standards were: normal ABI 0.9 to 1.3; peripheral artery obstructive disease (PAOD) ABI less than 0.9; incompressible artery ABI greater than 1.3. Cardiovascular risk factors were also studied., Results: Seven hundred and seventy-one subjects (mean age 57 ± 11.2 years, 559 women) were examined. Cardiovascular risk factors were: sedentary lifestyle (76.4%), hypertension (68%), obesity (32.1%), elevated LDL-cholesterolemia (27.8%), diabetes (18.3%) and tobacco smoking (6.9%). Ninety-three subjects (12.1%) had PAOD and 37 subjects (4.8%) had an incompressible artery. PAOD was significantly more common in sedentary subjects (P=0.008), in the elderly (P=0.0006) and in patients with a history of coronary artery disease (P=0.04). Smoking was not strongly associated with PAOD., Conclusion: PAOD is common in Senegalese and is associated with high prevalence of cardiovascular risk factors., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Objective: To evaluate in hypertensive patients followed in a specialized hypertension unit, the prevalence of subjects uncontrolled despite triple therapy including a diuretic. The aim is to estimate the percentage of hypertensive patients with an indication to renal denervation., Method: From a database of computerized medical records of a unit specialized in hypertension, it was extracted 144 consecutive cases of subjects treated and followed for at least 1year and having had a home pressure monitoring (HPM) on treatment, and if necessary a work-up for a secondary hypertension. The blood pressure (BP) was evaluated in office by automated method (after 2 and 8minutes) and with HPM (average of three measurements in the morning and evening for three consecutive days)., Results: The population has the following characteristics: age 62 with 26% over 70years, treated dyslipidemia (39%), treated diabetes (11%), adrenal hypertension treated medically (14%), severe renal failure (3%). The means of treatment are: a monotherapy (33%), bitherapy (35%), triple therapy (17%), quadritherapy (7%), pentatherapy or more (1%), spironolactone (45%), thiazide diuretics (49%). The uncontrolled hypertension was observed in 26% if the BP is evaluated with HPM, in 52% if the BP is evaluated at the office after 2minutes of rest and 7% if the BP is evaluated after 8minutes of rest (P<0.01). In patients treated with at least a tritherapy in association with a diuretic, an uncontrolled hypertension was observed in 5% if the BP is evaluated with HPM. Failure to control for the SBP is the cause of 80% of resistant hypertension., Conclusion: The frequency of resistant hypertension is 5% of hypertensive patients followed in a specialized hypertension unit when guidelines are applied in the case of uncontrolled hypertension. These results indicate that the indication for renal denervation affects only a small percentage of patients treated for hypertension., (Copyright © 2012. Published by Elsevier SAS.)

Cardiovascular diseases remain the first cause of mortality in our country. They are associated with well known risk factors such as diabetes and dyslipidemia. Herein we summarize main results of the CoLaus study regarding, first the prevalence and characteristics of the treatment of these risk factors. Then we present recent discoveries of new genetic determinants associated with these risk factors. Finally, we discuss whether this knowledge changes our current clinical management of our patients.

The authors report a retrospective and descriptive study, conducted in November 2005 in the service of Diabetology of Mustapha CHU (Alger). The aim was to determine the associative factors to ischemic in rest electrocardiogram by type 2 diabetic patients. The study has been turned to 262 dossiers (141 of women and 121 of men) of hospitalised patients from January 2004 to Jun 2005 in diabetological Service. 130 of patients (73 women and 5è men) have ischemia in Electrocardiogram. Their mean age was 60 years The visible ischemia in classical Electrocardiogram was correlated with arterielle blunt drug (p ≤ 0.03), dyslipidemia (p ≤ 0.01), smoking (p ≤ 0.001) and nephropathy (p ≤ 0.001). The classical Electrocardiogram can nock to point out the ischemia by important proportion of type 2 diabetic patients.

Unlabelled: The aims of the study were to study the distribution of cholesterol and triglycerides and to assess the prevalence of dyslipemia in Tunisian adult population., Methods: The Tunisian National Nutrition Survey (TNNS) was a cross sectional study performed on a total of 7860 adult subjects and was conducted on 1996-1997. The TNNS included 3087 adults over 20 years old., Results: The mean values of cholesterol (CT) were more elevated in urban than rural area (p<0.001), and in females than in males (p<0.007). The overall prevalence of hypercholesterolemia (CT > 6.2 mmol/l) was 8.4% and that of hypertriglyceridemia (TG > 1.70 mmol/l) was 21%. The prevalence of borderline high cholesterol (> or =5.2-< 6.2 mmol/l) was 17%; These prevalences were more elevated in urban than rural areas (p <0.001) and increased with age in both genders (p < 0.001). The multiple adjusted odd ratio of the prevalence of hypercholesterolemia showed a positive correlation with female sex (OR 1.40 p <0.01), high waist circumference (OR 2.51 in men and 3.04 in women p < 0001) and urban residency (OR 1.35 p = 0.03)., Conclusion: Our study showed the metabolic consequences of westernization style life in our country and should be the starter to preventive adequate policy.

Background: This study was designed to determine the prevalence of main cardiovascular risk factors in the population of Great Tunis., Subjects and Methods: This cross-sectional study included 2483 individuals aged 35 to 70 years dwelling in the Great Tunis region, recruited between March 2004 and June 2005. The sample was weighted using the inverse of response rate according to governorate, district and sex., Results: Obesity and abdominal obesity were observed respectively in 34 and 48% of subjects. The prevalence of these two factors was particularly elevated in females (46 and 69% respectively). Hypertension was common (31%), especially in women (36%). Diabetes mellitus and dyslipemia were found in 15 and 21% of subjects, respectively, without difference according to sex. More than half of men and 8% of women were current smokers., Conclusion: The prevalence of conventional cardiovascular risk factors is dramatically high in the population of Great Tunis. These findings predict a future expansion of cardiovascular diseases in this population. Profound changes of lifestyle and dietary habits of Tunisians are needed to reduce the risk of cardiovascular morbidity and mortality.

Transplantation of patients with cardiovascular risk is becoming more frequent because of the recent changes in the characteristics of hemodialysis patients. Improvement in patient survival after transplantation has been reported in the whole cohort and is probably applicable to cardiovascular risk patients. Nevertheless, cardiovascular mortality is the leading cause of death after transplantation. Systematic screening of patients before transplantation and adapted treatment after transplantation are needed. After transplantation, immunosuppressive treatment should be tailored to the patient's profile and cardiovascular risk factors should be managed cautiously.

Objective: To describe the cardiovascular morbidity and mortality and associated risk factors of a population of patients with dyslipidemia seen ten years earlier for a cardiovascular risk assessment in the endocrinology department of a French hospital., Methods: Patients seen for a cardiovascular risk assessment between 1988 and 1992 were re-examined in the department, or contacted by mail or their vital status (and cause of death, if any) was obtained from the INSERM Cepi-Dc database., Results: Vital status was available for 89.7% of the patients. The standard risk factors associated with cardiovascular mortality were found in the patients who died of these causes, that is, age, sex, smoking, diabetes, total cholesterol, and previous vascular status. After adjustment for risk factors, myocardial infarction was significantly associated with age, sex and total cholesterol in patients who received primary prevention care., Conclusion: This study showed the feasibility of tracing a cohort of dyslipidemic patients with cardiovascular risk factors seen in an endocrinology department. It enabled a pragmatic assessment of a specific at-risk French population and a description of the compliant and noncompliant patients.

The psoriasis is a chronic dermatosis which is characterized by strong inflammation. Recent studies showed that the chronic inflammation plays an important part in the pathogenesis of many metabolic and vascular diseases. Moreover, the diseases mediated by lymphocytes TH1 were related to the myocardial infarction. Epidemiologic investigations showed that psoriasis is associated at the increased risk of Comorbidities and mortality per comparison to the general population. Thus, the psoriatic patients have a high prevalence of metabolic pathologies such as the diabetes, hypertension, obesity and hyperlipidemy. These concomitant affections can complicate the treatment of psoriasis. It is important that the dermatologist systematically seeks these concomitant pathologies among psoriatic patients. These data also suggest that the treatments of these patients improve not only the skin lesions, but also control the inflammation associated with the psoriasis.

In our societies, the increase of the frequency of the diseases of overweight, in particular obesity, diabetes type 2 and metabolic syndrome, coincides with that of the urinary lithiasis. Like the lithiasic disease, the metabolic syndrome or syndrome X is multi-factor. Several epidemiological studies were interested in research of a physiopathological relation between the various components of this syndrome (obesity, arterial hypertension, diabetes, dyslipemy) and lithogenesis. During the metabolic syndrome, resistance to insulin and the defect of renal ammoniogenesis constitute the principal disorders supporting lithogenesis. The defect of renal ammoniogenesis armature by the resistance of the renal cells to insulin involves a urinary hyperacidity which supports the crystallization of the uric acid responsible for the formation of uric or mixed uric acid/oxalate stones.

Unlabelled: Arterial hypertension is a real health problem worldwide. The goal of this survey is to evaluate its prevalence and risk in hospital environment. It was a prospective and multi-centred survey which took place in the cardiology department in Kpalimé hospital from the 4th August 2005 to the 4 th July 2006 then a period of almost ten months. Our survey allowed us count 584 people suffering from hypertension out of 2641 patients which makes a prevalence of 22%. Distribution according to the global sample gave a predominance of 56.3 % for women against 43.7% for men. The age of our patients varied between 20 years and 95 years with an average of 53.4 years +/- 15.02. According to the age the group which was more touched was the one between 46 and 69 years. Distribution according to social and professional segments was dominated by the housewives (27.9%), the civil servants (17.8 %) and the trade men (14.0%). Symptomatology is dominated by a dyspnea during an physical effort (28.8%), signs having no relation with AHT (20.2%) and headache (19.5%). Factors for most frequent risk were: obesity (56.8%), consumption of alcohol (22.1%) and dyslipidemia (13.4%). The rate of morbidity is about 59.5% and the mortality is about 11%., Conclusion: AHT in Togo is a real problem of public health. It occurs in the poorest social segments, causing a problem of medical care. The prevention remains the most efficient mean to avoid sickness and should be necessarily based on a real change of attitude by the authorities and the medical staff as the sensibilization of the population.

As a result of progressive urbanization and westernization of their lifestyle, developing countries are now undergoing an epidemiological transition. These changes are leading to a new epidemiological situation in the world with a decline in infectious diseases and emergence of cardiovascular diseases in general and coronary artery disease in particular. From the current level of 16 millions deaths annually worldwide, mortality due to coronary heart disease is expected to double in the next 20 years with 80% of this increase occurring in developing countries. INTERHEART was a large international study designed to assess the importance of cardiovascular risk factors (CVRF) in terms of prevalence and coronary-related morbidity worldwide. The main modifiable CVRF, i.e., tobacco use, hypertension, diabetes, obesity, blood apolipoproteins, and psychosocial factors were strongly correlated with the risk for myocardial infarction (MI). The level of risk associated with these CVRF was the same in industrialized and developing countries. Globally tobacco use remains the most serious epidemiological risk in terms of prevalence of coronary artery disease whereas raised lipid level was the factor most strongly correlated with MI risk in terms of coronary morbidity particularly in Africa. The greatest impact of the strong increase in diabetes and hypertension with accompanying obesity was observed in countries in Southeast Asia and Africa. The emergence and rapid growth of CVRF in developing countries accounts for the strong increase in coronary-related morbidity/mortality predicted over the next two decades and further underlines the need for an epidemiological control plan aimed at preventing cardiovascular disease in developing countries..

This study was designed to assess the relationship between cardiovascular risk factors and the presence of atherosclerosis aortic lesions detected by transesophageal echocardiography (TEE), The purpose was to determine if risk factors observed in Vietnam are similar to those detected in industrial countries. Between 2000 and 2002, TEE was performed in a total of 181 patients with a mean age of 63.1 +/- 9.4 (range, 42 to 79). In male patients over the age of 60 years, smoking, hypertension, diabetes and dyslipidemia were associated with significantly greater thickness of the intima and significantly higher number of complex lesions at all levels of thoracic aorta. Presence of these risk factors was associated with a 4.2 to 7.9 fold higher likelihood of atherosclerotic plaque. Findings in our population of hospital patients in Vietnam indicate that, as in Western populations, age, male gender, smoking, arterial hypertension, diabetes, and hypercholesterolemia promote the appearance of plaques in the thoracic aorta. This study provides insight into the cardiovascular risk situation in a city in Southeastern Asia.

We evaluated cardiovascular risk factors and their association in patients in Sahel, hospitalized for coronary disease over the period 1994-1998. The clinical features of 3455 patients (72.4% men, 1741 with myocardial infarction, 1714 with unstable angina) were analysed on hospital admission. The prevalence of smoking, dyslipidaemia, hypertension, diabetes and obesity was 77.4%, 39.4%, 28.5%, 42.5% and 25.1% respectively in men and 2.9%, 43.7%, 59.2%, 56.6% and 31.9% respectively in women. With this risk factor profile a national strategy of primary prevention and heart health promotion is needed in Tunisia.

The determination of risk factors a low to prevent or to delay the apparition of certain diseases. Our study put out in Cardiology A of Hôpital du Point G. gold to determine the main risk factors of ischemic heart diseases between 162 patients. It appears that all classical risk factors (HBP, Diabetes, obesity, tobacco use, sedentary, menopause, contraceptives, dyslipidemia) were found among patients. It appears particularly that avoidable risk factors such tobacco use among young men, sedentary and obesity play important role in the beginning. So it is possible to deploy an efficient prevention politic.

When prescribing a non-steroidal anti-inflammatory treatment but also an analgesic or a glucocorticoid, the cardiovascular risk of the patient should be assessed. The analgesics have few cardiovascular side effects and the main complications observed are linked essentially to the vagal action of the opioids. Acetaminophen is considered by several scientific societies to be the first line analgesic treatment, particularly in case of cardiovascular risk but with caution since cardiovascular toxicity of acetaminophen cannot be totally excluded. An overdose of dextropropoxyphene can result in cardiotoxicity. On the other hand, the glucocorticoids need to be prescribed cautiously, at the lowest possible dose and for the shortest possible duration due to the non-negligible cardiovascular risk, hypertension, dyslipidemia, hypokaliemia.