risk factors associated with hypertension in this military Objective: To assess the burden of cardiovascular risk series. The ethnic group may carry a risk of developing factors among the Congolese soldiers. hypertension through the genetic endowment of subjects that has not been explored in the present work, or Methods: 233 consecutive soldiers who attended through traditional or acquired cultural permissive habits. medical visit from june to october 2017 at the Likewise, in line with data from the general Congolese Cardiovascular Exploration Center of the Camp population24, 26 as well as the observation among Kokolo, Kinshasa, were enrolled in the present study Brazilian soldiers29, abdominal obesity has emerged as a Their socio-demographic, clinical and paraclinical data factor tripling the risk of hypertension. Through the were collected. The correlates of blood pressure were release of adipokines (TNFα…), insulin resistance and sub- assessed and cardiovascular risk factors clustering with sequent hyperinsulinemia, abdominal obesity can induce hypertension evaluated. an elevation of BP by stimulation of the sympathetic ner- vous and the renin-angiotensin-aldosterone systems, and Results: The sample included 29 servicemen and non- through stimulation of the Na + /H + antiport at the level commissioned officers (12.4%), 95 subaltern rank of the renal proximal bypass tube34-41. CKD is also a factor (40.7%) and 109 field and general officers (46.9%). associated with hypertension in the present study. It mul- Waist circumference, waist/height ratio and blood glu- tiplies the risk by 2. The CKD can induce a rise in BP cose significantly increased with military rank; 43% of through senescence which leads to structural and functio- variation in SBP and 47% in DBP was independently nal remodeling of the arteries42, 43. One should keep in explained by age, waist/hip and waist/height ratios, mind, however, that CKD may actually be a consequence eGFR, high density lipoprotein cholesterol, and heart rather than the cause of an elevated BP. rate for DBP only; 48.9% of the examinees were hyper- tensive patients of whom 57.9% were aware and trea- Over 80% of the military had at least one risk factor. CKD ted with 36.4% controlled. The probability of hyperten- (33%), abdominal obesity (29.2%), overweight (27%), sion was higher for the Ngala ethnic group (aOR: 3.10, obesity (11.6%) and DM (6.4%) were the most common 95% CI: 1.30-7.37), the presence of abdominal obesity with greater proportions amonhg yperensiv than nn-t e o (aOR: 2.94, 95% CI: 1.56-5.77) and chronic kidney hypertensive subjects. The frequecy ofCMR seemsn disease (aOR: 1.86, 95% CI: 1.02-3.44). higher than that of the genelra population, which is 12.4%. Like in the general C44 ongoese populationl 2, 26 Conclusion: The epidemiological transition is a reality , overweight, obesity and DM appear to be a pblicu among the military in the Kinshasa garrison. health problem among the military in the presentseres.i Conflict of interest Our results must be interpreted within the limits of this The authors declare no conflict of interest. work. The series of soldiers enrolled does not constitute a representative sample of all the military from the garrison Acknowledgement of Kinshasa and this restricts the possibility of extrapola- ting the results. However, these data have the merit of sho- We thank all those who, from afar or near, agreed to wing that, like observations made in the general popula- participate in this study: all the investigators, the military tion, the rate of CVRFs is high among Congolese military who freely consented to enter the study, the staff of the from the garrison of Kinshasa, whose risk factors constel- Camp Kokolo Cardiovascular Exploration Center and the lation, ignorance and lack of control, are all elements that Higher Command of the Armed Forces for its steady worsen their absolute cardiovascular risk. commitment in this study. Authors’ contribution CONCLUSION GKK and JRM’BK designed and wrote the study protocol; The military from the garrison of Kinshasa have a car- MMG and GKK supervised data collection, ANN analyzed diovascular profile similar to that of the general popu- the data; GKK and ANN wrote the initial version of the lation.This finding puts into question the quality of manuscript, JRM’BK, BLM and JMK coordinated the study their preparation and therefore their operationality, and interpreted the results. All authors approved the both in peacetime and in wartime since high BP and its final version and revised the manuscript. many health repercussions constitute the world-wide major cause of incapacity for the military profession. REFERENCES The results of this study plead for the adoption of 11.NISARA SG, TYLER CS, SWANSON MG, HARRIS RB, urgent medico-administrative measures for the condi- SHAHAR E, BESA S et al. Newly reported hypertension tioning of the military in the garrison of Kinshasa and, after military combat deployment in a large population- by extension, in all DRC military. based study. Hypertension 2009; 54: 966-973. 12.TOFLER GH, MULLER JE. Triggering of acute cardiovascu- ABSTRACT lar disease and potential preventive strategies. Circulation. 2006; 114: 1863–1872. Context: With hypertension as the main driver cardio- vascular disease constitutes the main cause of unfitness 13.MUNDU MG, MUNYAPARA SA, TSHIENDA TJ, BATINA AS, VOL. among the active military of Kinshasa garrison. LIKWELA JL. Facteurs de risque de l’hypertension artérielle 94/3 International Review of the Armed Forces Medical Services 91 Revue Internationale des Services de Santé des Forces Armées