dc.description.abstract | The pattern and anatomical perspectives of atherosclerosis were studied among black
Kenyans by analyzing data from hospitals, clinics, autopsy and schools; cadaver
dissection; histomorphometry, immunohistochemistry, light and electron microscopy.
It was found that atherosclerosis caused 8.5% of total and 43.2% of cardiovascular
deaths, 17.1 % of lower limb amputations, 9.5 % of heart failure and 3.5 % of
hypertensive kidney disease. Its pathognomonic features were evident in up to 50.2 %
of cases, starting in childhood. Mean age ranged from 54.7 to 59.5 years with mixed
gender in morbidity and male preponderance at death. 13- 22 % of cases occurred
before the age of 40 years. Co-morbidities comprised hypertension, smoking,
infection, diabetes mellitus and alcohol consumption. Anatomical risk factors,
present in over 25 % of cases, comprised variant arterial branching and origin, short
stems, hypoplasia, tortuosity, myocardial bridges, suboptimal bifurcation angles and
area ratios. Disease precursors present in the normal arterial wall were non-muscle
cells, heterogeneity of smooth muscle cells and presence of vasa vasora in the tunica
media; mutli-cellularity and microvascularization of tunica adventitia; and age
related endothelial discontinuity and degeneration of tunica media. These findings
suggest that atherosclerosis related diseases are not uncommon among Kenyans,
affect a young predominantly male population; are predisposed by the conventional
modifiable risk factors, infections and anatomical factors; and have precursors in
normal arterial walls. Continuous preventive initiatives should be universal. | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |