Hypertension in Middle-Aged Adults in Libreville, Gabon: Epidemiological, Clinical and Therapeutic Features
F. Ndoume Obiang *
Service de Cardiologie, CHU de Libreville, Gabon and Université des Sciences de la Santé de Libreville, Gabon.
C. Akagha Konde
Université des Sciences de la Santé de Libreville, Gabon.
C. Yekini
Service de Cardiologie, CHU de Libreville, Gabon.
A. Kinga
Université des Sciences de la Santé de Libreville, Gabon.
L. C. Ndjibah Alakoua
Service de Cardiologie, CHU de Libreville, Gabon.
L. Babongui
Service de Cardiologie, CHU de Libreville, Gabon.
J. M. Mpori
Université des Sciences de la Santé de Libreville, Gabon.
F. Moubamba
Service de Cardiologie, CHU de Libreville, Gabon.
J. B. Mipinda
Service de Cardiologie, CHU de Libreville, Gabon and Université des Sciences de la Santé de Libreville, Gabon.
C. Allognon
Service de Cardiologie, CHU de Libreville, Gabon and Université des Sciences de la Santé de Libreville, Gabon.
E. Ayo Bivigou
Service de Cardiologie, CHU de Libreville, Gabon and Université des Sciences de la Santé de Libreville, Gabon.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Hypertension (HTN) in middle-aged adults represents a major but poorly documented challenge in sub-Saharan Africa. In Gabon, no study has specifically characterised the HTN profile in adults aged 40-59 years.
Aim: This study describes the epidemiological, clinical and therapeutic features of hypertensive patients in this age group at the University Hospital of Libreville.
Methods: A retrospective, cross-sectional descriptive study was conducted from January 2019 to January 2023 in the Cardiology Department of the CHU de Libreville. All patients aged 40-59 years with known or newly diagnosed HTN were included. Categorical variables were compared using the Chi-square test; continuous non-normally distributed variables by the Mann-Whitney U test. Statistical significance was set at p < 0.05.
Results: Among 807 hypertensive patients, 411 (50.9%) were middle-aged adults, with a median age of 51 years [IQR 46-56] and a female predominance (65.9%). Grade III HTN was observed in 30.2% of patients. Systolo-diastolic HTN predominated (63.3%). At least one target organ damage was documented in 17.8% of patients: stroke in 9.2%, heart failure in 5.4%, and renal failure in 4.9%. Calcium channel blockers (52.1%), ACE inhibitors (46.5%) and thiazide diuretics (40.6%) were the most frequently prescribed drugs; dual therapy was the predominant regimen (41.1%). Therapeutic rupture was recorded in 25.8% and was significantly associated with HTN grade (p < 0.001), reaching 39.5% in grade III patients.
Conclusion: Middle-aged adults constitute the largest group of hypertensives in Libreville (50.9%), with severe HTN in nearly one-third and significant target organ damage in nearly one-fifth. The high rate of therapeutic rupture, disproportionately concentrated in grade III patients, underscores the urgent need for structured adherence programmes in this professionally active population.
Keywords: Hypertension, Middle-aged adults, therapeutic non-adherence, Gabon