Prevalence of some cardiovascular disease risk factors among patients admitted at Mathari hospital

Abstract

Severity of Cardiovascular diseases in terms of morbidity and mortality is on the increase in developing countries with mortality expected to reach 19 million by the year 2020. People with severe mental illness die prematurely, their illness, its treatment and their lifestyle resulting into poor physical health and co-morbid medical diseases. Much of the excess mortality is preventable through lifestyle and risk factor modification, early diagnosis and treatment of common diseases. Objective: To determine the prevalence of some cardiovascular risk factors: hypertension, overweight/obesity, risky alcohol use, tobacco use, lack of exercise, and co morbid physical conditions amongst in patients at Mathari hospital and their social demographic features. Design: a cross-sectional descriptive study. Setting: Mathari hospital wards, Nairobi, Kenya. Main outcome measures: prehypertension/hypertension, overweight/obesity, inadequate exercise, tobacco smoking risk, risky alcohol use. , Methodology: One hundred and sixty-one patients were sampled by stratified random method from the OPD register. A social-demographic health and lifestyle questionnaire administered after informed consent was obtained. A general physical examination was done including Blood pressure, weight, height, and waist and hip circumference using standard techniques. Cardiovascular risk taken as systolic BP => 130mmHg and diastolic=>85mmHg as per WHO criteria, overweight/obesity defined as BMI>= 25kg/m2 Waist Hip Ratio (\VHR) >= 0.80 females and >=0.95 males, Waist circumference (WC) of 80cm females and 95cm males. Risky smoking as current smokers or living with regular smoker in same dwelling, risky alcohol use determined by the AUDIT instrument for male >=4; and female >=3 score. Exercise adequacy as defined by Centers for Disease Control. Data collected, coded and analyzed using SPSS Version 12. Results: prevalent CVRFs were prehypertension 14.3%, hypertension 17.4%, smoking 66.5%, inadequate exercise 64.4%, risky alcohol use 44.1%, Overweight/obesity 18.6% by BMI, 19.9% by WC and 35% by WHR. No patients were on current treatment for either diabetes or hypertension. Overweight/obesity and underweight occurred at almost similar prevalence 18.6% versus 17.4%. Physical co morbidity was 93.2%, mostly medication adverse effects. Age was significantly associated with WC, BP, alcohol,WHR, BMI (P<0.05). Gender was significantly associated with WC, WHR BMI, alcohol, and smoking (p<0.05). Exercise was significantly associated with WHR and WC (p<O.05).BMI, WHR and WC were all significantly associated with education and file diagnoses (p<0.05). Blood pressure was significantly associated with WC and BM!, (p<O.05). Alcohol was significantly associated with income, file diagnoses, duration of psychiatric illness, and negatively with WC (p<0.05). Smoking risk was significantly associated with file diagnoses, current treatments and negatively with exercise, WC, WHR, and BMI (p<O.05). Conclusion: Amongst inpatients with psychiatric illnesses at Mathari hospital, some cardiovascular risk factors and physical illnesses were found to be prevalent. Recommendation: Psychiatric patients should be actively screened and followed up for all cardiovascular risk factors and physical illnesses including medication side effects. Integrated and interventional mental/physical health programmes are of great significance for this vulnerable population.