Prevalence and risk profile of cardiovascular diseases among elderly patients admitted at Moi Teaching and Referral Hospital, Eldoret

Abstract

Background: Cardiovascular diseases (CVDs) are the leading cause of global mortality with most of them occurring in the low and middle income countries. The elderly bear the highest risk as they have unique age related physiological alterations of the cardiovascular system (CV) that make them vulnerable to quick decompensation and death. In Kenya, there is a national focus to reduce all noncommunicable disease related morbidity and mortality with special focus on CVDs and cancer. The study will be important in providing useful data on this population that bears the greatest cardiovascular risk and inform policy. Objective: To determine the prevalence of cardiovascular diseases and associated risk profile in patients aged 60 years and above admitted at Moi Teaching and Referral Hospital (MTRH). Methods: This was a cross sectional survey conducted in MTRH adult wards for six months from May to October 2018. Three hundred and thirty six (336) persons aged 60 years and above were recruited from the admitted population of one thousand and forty four (1044) using systematic random sampling. Data collection was done using an interviewer administered questionnaire, laboratory tests, a resting 12-lead ECG and a standard echocardiogram. Presence of CV risk factors, left ventricular systolic dysfunction (LVSD) – Ejection Fraction less than 50%, pathological valve disease (PVD) and cardiac rhythm abnormalities were all analyzed. Descriptive statistics were calculated for continuous variables and frequency listings used for categorical variables. Interval estimates for primary outcomes were calculated at 95% confidence and association between categorical variables was assessed using the Pearson’s Chi Square Test. Results: Males comprised 60% of the participants and the median age was 71 years; interquartile range (64, 78). The prevalence of LVSD was 17.86% (95% CI: 13.91, 22.38) while PVD stood at 20.23% (95%CI: 16.62, 25.57). Rhythm abnormalities were frequent with atrial fibrillation predominating at 13.7%.Traditional CV risks present included hypertension at 44.3%, cigarette smoking at 27.1%, dyslipidemia at 26.8%, obesity and overweight at 25.6%, diabetes mellitus (DM) at 15.5%, chronic kidney disease at 5.4% and family history of sudden cardiac death at 4.5%.Out of all these, only DM and cigarette smoking were positively associated with presence of LVSD and PVD respectively with p-values of 0.024 and 0.033 respectively. Conclusion: There was a high prevalence of cardiovascular diseases and their associated risk factors in elderly population admitted at MTRH. Recommendation: Routine and opportunistic screening for cardiovascular diseases and the associated risk factors should be carried out in admitted elderly patients.