B Acad Nat Med Paris
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Emerging viral diseases are nothing new. Smallpox probably reached Europe from Asia in the 5th century, and yellow fever emerged in the Americas during the 16th century as a consequence of the African slave trade. Dengue fever arose simultaneously in South-East Asia, Africa, and North America during the 18th century. ⋯ The second half of the 20th century saw the emergence of HIV/AIDS (1981), among other viral diseases. Even more worrying is the fact that emerging and re-emerging viral diseases have had a tendency to spread more quickly and more widely during the last decade, invading whole countries and continents; witness the recent outbreaks of Nipah virus, West Nile, Rift Valley fever, SARS, monkeypox, avian flu (H5N1) and Chikungunya. The complex factors underlying these new trends are briefly discussed.
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B Acad Nat Med Paris · Nov 2007
[Hypertensive disease in subjects born in sub-Saharan Africa or in Europe referred to a hypertension unit: a cross-sectional study].
Hypertensive disease is reported to be more severe in black patients than in white patients, but most available data concern African-Americans. We studied blood pressure history and levels, the prevalence of associated risk factors, renal and cardiovascular complications, and secondary forms of hypertension in patients born in sub-Saharan Africa and managed in France, by comparison with up to five control patients born in Europe and matched for age and sex. Compared to European hypertensive women, African hypertensive women had a higher body-mass index (28.8 vs 26.3 kg/m2, p<0.001) and were more often diabetic (12 vs 5%, p<0.001). ⋯ However, patients born in sub-Saharan Africa were more likely than their European controls to have primary hyperaldosteronism (12 vs 7%, p=0.001) and less likely to have renovascular disease (1 vs 5%, p=0.001). Thus, the higher prevalence of cardiovascular and renal complications at referral among patients born in sub-Saharan Africa relative to age- and sex-matched European patients does not seem to be explained solely by observed differences in blood pressure or associated risk factors. The difference in the distribution of secondary hypertension warrants further study.