Abstract:
ABSTRACT
Background- Cardiovascular disease is the most frequent cause of death in persons over the
age 50 years and most importantly it is responsible for considerable morbidity and large
burden of disability in the community. Cardiovascular diseases are an increasing cause of
admissions among elderly in Africa, yet little research is available on pattern and magnitude
of the problem.
Objective- To determine the pattern of cardiovascular disease in elderly patients admitted in
medical wards at Muhimbili National Hospital Dar es Salaam Tanzania.
Methodology- This was a descriptive cross sectional study that was carried our between
September 2008 and September 2009. Social demographic information; medical history
physical examination; electrocardiographic and echocardiography examination; biochemical
and haematological parameters were collected from study patients
Results- One hundred eighty five elderly patients admitted at MNH, medical department,
were enrolled into the study, all were of African black race. Majority, 116 (62.7%), were
male. Their mean age was 66.1 (SD, 9.3; range, 50-87) years. The mean body mass index
(BMI) was 23.9 (SD, 3.9; range, 16.6-40.1) kg/m2. Hypertension was the most frequent
condition encountered affecting both males (67.2%)and females (68.1%). Congestive heart
failure was second common condition affecting 37% elderly patients. According to the
echocardiogram findings, among 185 elderly patients 68.6% were diagnosed to have
cardiovascular disease. There were no significant sex differences in the prevalence of cardiac
disease (p>005). The commonest echocardiographic diagnosis were left ventricular
hypertrophy (LVH) secondary to hypertension found in 45%, diastolic dysfunction found in
31% and systolic dysfunction 25%.The least common types were septal defect, pulmonary
hypertension and calcified mitral valve found in one percent each. The commonest clinical
presentations were palpitations, dyspnoea, orthopnoea, pedal oedema and right upper
quadrant abdominal pain. Obese patients presenting with cardiovascular abnormalities were 9
(7.1%). Anaemia was the leading co- morbidity affecting 90.3% of the patients
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Conclusion
Hypertension, congestive heart failure and left ventricular hypertrophy were the commonest
cardiovascular diseases among elderly patients at MNH. Coexistence of anaemia, stroke,
renal impairment and diabetes was also frequent.
Recommendation
Elderly patients should be screened for cardiovascular diseases especially hypertension
whenever they are admitted to the hospital even if the reasons for admission are not
cardiovascular problems.
