Introduction: Ischemic heart disease ranked among
the leading causes of death worldwide. Several biological and genetic risk
factors associated with acute coronary syndrome. By addressing the risk factors, it is possible to prevent most of the
cardiovascular diseases and contribute to the reduction of complications of
acute coronary syndrome. Material and Methods: Our study is a prospective study
that was conducted to the main military hospital of instruction of Tunis.
Recruitment involved 122 coronary (n = 122) and 705 controls (n = 705) totaling
a population of 827 subjects. Data collection concerned socio-demographic
characteristics, anthropometric measurements, habits and lifestyle, health
status and biological assessment. Results: Our study reported a high prevalence
of cardiovascular classic risk factor particularly overweight (62.3%), diabetes
(63.1%) and hypertension (50%). In 55% of coronary patients, moderate to intermediate
hyperhomocysteinemia was found, but it appears to be an independent risk
factor. The results of our study show a significant difference in the genotypic
frequencies of the C677T mutation in the MTHFR gene between the two populations,
cases and controls. Conclusion: Acute coronary syndromes are the leading cause
of sudden death in adults. The evaluation of risk factors after acute coronary
syndrome episode is essential for a better management according to the
recommendations of learned societies and standards of good practice.
Cite this paper
Nadra, G. , Rihab, S. , Ossama, L. , Sana, A. , Manel, A. , Mabrouka, E. O. , Najla, S. , Thaker, L. , Habib, H. , Chakib, M. and Zied, A. (2018). Evaluation of Cardiovascular Risk Factors in Tunisian Coronary Patients. Open Access Library Journal, 5, e4214. doi: http://dx.doi.org/10.4236/oalib.1104214.
Ministry of Health (2011) The State of Health of the Population in France. Follow-Up of the Objectives Annexed to the Public Health Law. Ministry of Health, Paris.
Lerner, D.J. and Kannel, W.B. (1986) Patterns of Coronary Heart Disease Morbidity and Mortality in the Sexes: A 26-Year Follow-Up of the Framingham Population. American Heart Journal, 111, 383-390. https://doi.org/10.1016/0002-8703(86)90155-9
Chambless, L., Keil, U., Dobson, A., Mahonen, M., Kuulasmaa, K., Rajakangas, A.M., et al. (1997) Population versus Clinical View of Case Fatality from Acute Coronary Heart Disease: Results from the WHO MONICA Project 1985-1990. Multinational Monitoring of Trends and Determinants in Cardiovascular Disease. Circulation, 96, 3849-3859.
https://doi.org/10.1161/01.CIR.96.11.3849
Seck, M., Diouf, I., Acouetey, L., Wade, K.A., Thiam, M. and Diatta, B. (2007) Profile of Patients Admitted for Myocardial Infarction at the Emergency Department of the Dakar Main Hospital. Medecine Tropicale, 67, 569-572.
Lihioui, M., Boughzala, E., Benferhat, E., Ammar, H., Chaouche, A., Jemaa, R., et al. (2007) Distribution of Cardiovascular Risk Factors in Coronary Patients in the Tunisian Sahel. Eastern Mediterranean Health Journal, 13, 536-542.
Elasmi, M., Feki, M., Sanhaji, H., Jemaa, R., Haj Taeib, S., Omar, S., et al. (2009) Prevalence of Conventional Cardiovascular Risk Factors in the Population of Greater Tunis. Revue d’Epidémiologie et de Santé Publique, 57, 87-92. https://doi.org/10.1016/j.respe.2008.12.010
Yusuf, S., Hawken, S. and Ounpuu, S. (2004) Effect of Potentially Modifiable Risk Factors Associated with Myocardial Infarction in 52 Countries (the INTERHEART Study): Case-Control Study. Lancet, 364, 937-952. https://doi.org/10.1016/S0140-6736(04)17018-9
Sultan, A. (2014) Coronary Risk Associated with Overweight and Obesity: No Need for Metabolic Syndrome. Endocrinology, Diabetes, & Metabolism, 8, 16-17.
Bogers, R.P., Bemelmans, W.J.E., Hoogenveen, R.T., Boshuizen, H.C., Woodward, M., Knekt, P., et al. (2007) Association of Overweight with Increased Risk of Coronary Heart Disease Partly Independent of Blood Pressure and Cholesterol Levels: A Meta-Analysis of 21 Cohort Studies Including More than 300 000 Persons. Archives of Internal Medicine, 167, 1720-1728. https://doi.org/10.1001/archinte.167.16.1720
Yano, Y., Kario, K., Ishikawa, S., Ojima, T., Gotoh, T., Kayaba, K., et al. (2013) Associations between Diabetes, Leanness, and the Risk of Death in the Japanese General Population. Diabetes Care, 36, 1186-1192. https://doi.org/10.2337/dc12-1736
Ben Salem, H., Ouali, S., Hammasa, S., Bougmizab, I., Gribaa, R., Ghannem, K., et al. (2011) Influence of Diabetes Mellitus on the Prognosis of Acute Coronary Syndromes without ST Addiction. Annales de Cardiologie et d’Angeiologie, 60, 33-38. https://doi.org/10.1016/j.ancard.2010.12.012
Merzouk, F., Bendriss, L. and Khatouri, A. (2013) Acute Coronary Syndrome and Type 2 Diabetes: A Study of 244 Cases. Diabetes & Metabolism, 39, A118. https://doi.org/10.1016/S1262-3636(13)72133-5
Ben Alaya, N., Ben Romdhane, H. and Delpeuch, F. (2002) Causal Model of Ischemic Heart Disease in Tunisia. In: Sahar, A.Y. and The Bihan, G., Eds., The Causal Approach Applied to Food and Nutritional Surveillance in Tunisia, CIHEAM, Montpellier, 95-118.
Wang, J., Zhang, L., Wang, F., Liu, L. and Wang, H. (2014) Prevalence, Awareness, Treatment, and Control of Hypertension in China: Results from a National Survey. American Journal of Hypertension, 27, 1355-1361. https://doi.org/10.1093/ajh/hpu053
Baligadoo, S. (2012) High Coronary Mortality in Mauritius. Study of Risk Factors and Genomic Analyzes. Bulletin de L’Académie Nationale de Médecine, 196, 1381-1396.
Guinchard-Foulon, E., Rodriguez-Lafrasse, C. and Rousson, R. (2013) HDL-Cholesterol: Place of Its Dosage in the Evaluation of a Cardiovascular Risk. Annales De Biologie Clinique, 61, 549-556.
Erqou, S., Kaptoge, S., Perry, P.L., Di Angelantonio, E., Thompson, A., White, I.R., et al. (2010) Lipoprotein(a) Concentration and the Risk of Coronary Heart Disease, Stroke, and Nonvascular Mortality. The Journal of the American Medical Association, 302, 412-423.
Belkahla, R., Omezzine, A., Kchok, K., Rebhi, L., Ben Hadj Mbarek, I., Rejeb, J., et al. (2010) Effect of Polymorphisms of Key Enzymes of Homocysteine Metabolism on Homocysteinemia and Coronary Risk in a Tunisian Population. Annales de Cardiologie et d’Angeiologie, 57, 219-224. https://doi.org/10.1016/j.ancard.2008.05.018
Booth, G.L., Wang, E.E.L., Feightner, J.W., Goldbloom, R., Elford, R.W. and Labrecque, M. (2000) Update on Preventive Health Care in 2000: Screening and Treatment of Hyperhomocysteinemia for the Prevention of Coronary Artery Disease. Canadian Medical Association Journal, 163, 21-29.
Nakbi, A., Koubaa, N., Ben Hamda, K., Hammami, S., Attia, N., Boumiza, R., et al. (2011) Association between the Parameters of the Oxidative Stress and the Markers of the Inflammation According to the Gravity of the Acute Coronary Syndrome. Tun Med, 89, 621-626.
Hansen, B. and Bruckert, E. (2010) Lipid Profile and Cardiovascular Risk in Patients with Rheumatoid Arthritis: Influence of Disease and Drug Therapy. Annales d’Endocrinologie, 71, 257-263.
Ratter, F., Gassner, C., Shatrov, V. and Lehmann, V. (2009) Modulation of Tumor Necrosis Factor-Alpha-Mediated Cytotoxicity by Changes of the Cellular Methylation State: Mechanism and in Vivo Relevance. International Immunology, 11, 518-527.
Jerbi, Z., Abdennebi, M., Douik, H., Ben Romdhane, H., Harzallah, L., Guemira, F., et al. (2005) Study of the C677T Polymorphism of the Methylene Tetrahydrofolate Reductase Gene in the Tunisian Population. Annales de Biologie Clinique, 63, 487-491.