The Role of the Integrated District Hospital Based Non Communicable Diseases’ Clinics in Cardiovascular Disease Control: Preliminary Data from Rwanda

Figures & data

Table 1 Population Characteristics According to Site of Care

Parameters	Total (n=199)	CHUK n=106 (53%)	Nyamata n=93 (47%)	P-value^+
Age in years (n=199)	60±15.0	61±13.1	58±16.7	0.097
Initial body weight (n=124)	68±17.0	80±23.0	64±10.9	<0.001
Patients with overweight initially (BMI >24.9 k/m^2)	194(97%)	102(96%)	92 (98%)	0.225
Body weight at 1 year (n=175)	69±17.0	74±19.0	62±12.4	<0.001
Initial BMI in kg/m^2 (n=23)	31.9	32.4	19.8*	-
BMI at 1 year in kg/m^2 (n=46)	28.5	28.8	16.5*	-
Patients with overweight at 1 year (BMI >24.9 k/m^2)	184(92%)	92(87%)	92 (99%)	0.001
Initial BMI measurement (%)	12	21	1*	-
Patients with diabetes	61(31%)	12(11%)	49 (53%)	<0.001
Patients with hypertension [n(%)]	76(38%)	36(34%)	40(43%)	<0.001
Patients with diabetes and hypertension	62(31%)	58(55%)	4(4%)	<0.001
Initial systolic blood pressure (SBP) (n=192)	141±26.0	146±28.1	136±22.4	0.008
Initial diastolic blood pressure (DBP) (n=192)	83±13.4	87±14.0	79±12.1	<0.001
SBP at 1 year	143±24.4	150±25.4	136±21.0	<0.001
DBP at 1 year (n=192)	78±13.5	81±13.8	76±12.7	0.013
Patients with Controlled Blood pressure	95(48%)	40 (38%)	55(59%)	0.003
Ophthalmology visits for any reason	1.6±1.0	1.4±0.8	1.7±1.2	0.309
Initial fasting plasma glucose in mmol	9.0±5.5	8.7±6.2	9.2±5.2	0.665
Fasting plasma glucose at 1 year	10.7±15.6	8.6±4.3	11.3±17.6	0.515
Mean initial A1C (n=60)	8.7±2.5	8.7±2.5	8.0±1.4	-
Mean A1C at 6 months (n=49)	-	8.5±2.4	-
Mean A1C at 1 year (n=54)	-	8.1±2.0	-
Number of A1C per year (mean)	2.2±1.2	2.2±1.1	0.5	0.003
Patients with controlled diabetes	11(20%)	11(20%)	No data	-
Initial creatinine in μmol/L (n=78)	89±51.3	92±54.4	75±30.9	0.269
Creatinin at 1 year in μmol/L (n=78)	89±45.0	93±49.6	80±29.1	0.230
Initial total cholesterol in mmol/L (n=72)	4.9	4.9±1.4	6.9*	-
Initial LDLin mmol/L (n=74)	3.2±1.2	3.2±1.2	3.5±2.9	0.741
Initial HDLin mmol/L (n=74)	1.3±0.6	1.2±0.3	3.4±3.5	<0.001
Initial triglycerids in mmol/L (n=72)	1.9	1.9±0.14	1.0*	-

Notes: ⁺Comparison of 2 groups by t-test or chi²as appropriate. *The sample is not big enough to generate a comparison.

Table 2 Population Characteristics According to Diagnosis

Parameters	Total (n=199)	Diabetes^+ +Hypertension n=62 (31%)	Diabetes n=61 (31%)	Hypertension n=76 (38%)	P-value*
Age (y)	60±15.0	64±11.5	51±15.4	64±14.3	<0.001
Initial body weight	68±17.0	79±25.3	64±12.3	67±13.0	0.163
Body weight at 1 year	69±17.0	76±21.0	64±12.7	67±15.5	0.373
Initial BMI (kg/m^2)	31.9±7.6	32.5±7.7	28.4±10.0	34.4±5.4	-
Proportion of overweight at baseline (BMI >24.9 k/m^2)	194(97%)	59(95%)	59(97%)	76(100%)	0.176
BMI at 1 year (kg/m^2)	28.5±8.2	29.1±8.7	26.8±8.6	28.0±7.3	-
Proportion of overweight at 1 year (BMI >24.9 k/m^2)	184(92%)	55(89%)	58(95%)	71(93%)	0.377
Ophthalmology visits for any reason	1.6±1.0	1.3±0.6	1.9±1.3	1.5±0.9	0.124
Initial systolic BP	141±26.0	150±23.9	124±24.1	148±22.0	<0.001
Initial diastolic BP	83±13.8	89±12.5	77±12.6	84±13.8	<0.001
SBP at 1 year	143±24.4	153±26.2	126±16.8	149±21.0	<0.001
DBP at 1 year	78±13.5	79±13.5	74±11.1	82±14.3	<0.001
Controlled initial blood pressure	88(44%)	16(26%)	46(75%)	26(34%)	<0.001
Controlled blood pressure at 1 year	95(48%)	21(34%)	45(74%)	29(38%)	<0.001
Mean initial fasting plasma glucose (mmol/L)	9.0±5.5	10.7±6.9	10.7±5.4	5.2±1.1	<0.001
Mean fasting plasma glucose at 1 year (mmol/L)	10.7±15.6	8.9±4.5	13.8±20.8	6.1±1.2	0.060
Mean HbA1C at baseline n=60	8.7±2.5	9.6±2.6	8.5±1.9	6.5±1.3	<0.001
Mean HbA1C at 6 months n=60	8.5±2.4	8.8±2.4	8.2±2.4	6.3±1.9	0.172
Mean HbA1C at 1 year n=60	8.1±2.0	8.3±2.0	8.5±2.1	6.4±0.9	0.026
Number of A1C per year (mean)	2.2±1.2	2.3±1.1	2.5±1.3	2.3±1.3	0.003
Initial creatinin (μmol/L)	89±53.0	104±67.7	78±23.0	76±29.8	0.999
Creatinin at 1 year (μmol/L)	89±45.0	100±60.1	84±25.3	81±27.0	0.531
Initial total cholesterol (mmol/L)	4.9±1.4	5.0±1.3	4.8±1.7	4.8±1.3	0.990
Initial LDL(mmol/L)	3.2±1.2	3.2±1.2	3.2±1.3	3.1±1.3	0.905
Initial HDL(mmol/L)	1.3±0.6	1.1±0.3	1.2±0.3	1.6±1.2	0.237
Intial triglycerids (mmol/L)	1.9±1.2	2.2±1.3	1.3±0.7	1.4±0.5	0.964

Notes: ⁺Reference group. *Comparison of diabetes and hypertension groups by Student’s t-test or chi².

Table 3 Change in Metabolic Characteristics Over 1 Year

Facility		CHUK			Nyamata DH
Parameters		Observations	Mean	P-value^+	Observations	Mean	P-value^+
Body weight	Initial	30	81±24.2	0.467	85	63±10.6	0.593
	At 12 months		81±24.0			63±12.5
BMI (kg/m^2)	Initial	21	33.1±7.2	0.181	1	19.8	-
	At 12 months		31.2±10.1			16.5
SBP	Initial	98	146±28.2	0.196	91	136±22.5	0.991
	At 12 months		150±25.8			136±21.0
DBP	Initial	98	87±13.8	<0.001	91	79±12.2	0.061
	At 12 months		80±13.7			76±12.7
Fasting plasma glucose	Initial	3	5.6±1.4	0.088	50	9.1±4.5	0.214
	At 12 months		7.0±2.2			12.9±20.1
HbA1C	Initial	30	8.7±2.5	0.021	No data
	At 12 months		8.1±2.0
Creatinine	Initial	36	98±49.4	0.714	8	75±40.9	0.06
	At 12 months		100±59.7			90±40.7

Note: ⁺Comparison of 2 means by paired t-test.