Cardiovascular risk factors are clearly increasing in developing countries. Among these factors, dyslipidemia is often found, linked to changes in behavioral and eating habits. Dyslipidemia is a “primary or secondary pathological modification of serum lipids”, it is a chronic metabolic abnormality characterized by a persistent elevation of TG, LDL-C and a decrease in HDL-c. Atherosclerosis, a chronic arterial inflammatory phenomenon induced and maintained by excess circulating cholesterol, constitutes the main cause of cardiovascular conditions [1] . Thus, the risk of coronary heart disease increases with the total cholesterol level independently of other risk factors as shown by the Framingham study [2] [3] . Atherogenic dyslipidemia corresponds to one or more of the following abnormalities: decrease in HDL-c, increase in CT and LDL-C. Dyslipidemia constitutes a public health problem and several observed facts demonstrate its seriousness and strongly suggest that we are paying more attention to it [4] . The Canadian Health Measures Survey (CHMS) revealed that between 2012-2013, dyslipidemia affected 38% of Canadians aged 18 to 79 [5] . In 2016, dyslipidemia affected more than 37% of French adults aged 35 to 64, or 9.1 million people [6] . Several West African and North African studies including that of LP Thiombiano in Guéoul (Senegal) [1] , Ben Youcef M. [7] in Tlemcen (Algeria) and Elasmi M. [8] in Grand Tunis (Tunisia) had reported respectively 61.3%, 15.9% and 21% dyslipidemia. In Guinea, a study carried out in 2014 in the nephrology department in patients with end-stage chronic renal failure (ESRD) reported 48.15% dyslipidemia [9] . Another carried out in 2015 by Barry NH on metabolic syndrome (MS) in the workplace found a frequency of low HDL-c and high TG of 91.6% and 4.3% respectively [10] . Thus, the high frequency of lipid disorders associated with cardiovascular diseases, the trivialization of the prescription of lipid assessment, ischemic cardiovascular complications linked to dyslipidemia and the rarity of previous specific studies motivated this research. In this study, we focus on the lipid profile of patients seen in consultation at the cardiology department at the Ignace DEEN National Hospital (City of Conakry; Republic of Guinea).

This study is part of a prospective, descriptive, cross-sectional study aimed at highlighting the frequency of lipid abnormalities in all patients seen in consultation at the cardiology department. Our results are presented in the form of figures and tables, which are discussed and interpreted according to the available literature data.

In Figure 1 , we see that of the 523 patients received in consultation, 273 presented dyslipidemia, i.e. a frequency of 52.19%, and 250 with a lipid profile without dyslipidemia, i.e. 47.80%.

Looking at Table 1 , we note that lipid abnormalities were more frequent in women (59.34%) than in men (40.66%) with a sex ratio of 0.7.

Table 1. Distribution of patients by sex.

In Figure 2 , we understand that the age groups of 45 - 54 and 55 - 64 years were the most affected by dyslipidemia respectively 45%, 42% and 30.03%. The average age was 54.6 years and the extremes were between 25 and 87 years.

Figure 3 reveals that most dyslipidemic patients resided in urban areas, i.e. 61.54% compared to 38.46% in rural areas.

With regard to Figure 4 , lipid abnormalities were found in most of the married couples, i.e. a rate of 77.29%.

Figure 5 reveals that more than half of the dyslipidemic patients were not in school, i.e. 60.07% followed by higher and secondary levels respectively 21.61% and 9.52%.

Figure 6 shows that housewives were the most affected with a frequency of 45.78%, followed by Merchants with 18.68%.

Figure 7 reveals that high blood pressure was the most represented cardiovascular risk factor with a frequency of 69.23%, followed by obesity and a sedentary lifestyle with 36.63% and 35.16% respectively.

Table 2 reveals that seventy-one (71) dyslipidemic patients had severe obesity with a frequency of 23%, followed by moderate obesity with a frequency of 21.24%.

In Table 3 , we found that 63 male dyslipidemic patients had a waist circumference > 94 cm, i.e. a frequency of 23.07%, and 79 female patients had a waist circumference > 80 cm, i.e. a frequency of 28.94%.

In view of Table 4 , we understand that 187 cases (68.49%) had a history of high blood pressure and 9 cases (3.29%) had pure hypercholesterolemia. Among the 9 patients with pure hypercholesterolemia, two patients (22.22 %) were under treatment, one on statins and the other one was completely unaware of his treatment. It should be noted that 77.77% of those 9 patients followed a low-calorie diet associated with regular physical activity.

In Table 5 , we found that headache was the main symptom, followed by dizziness and asthenia with respectively 59.70%, 34.79% and 34.43%.

In Table 6(a) , we found that high blood pressure was the most represented cardiovascular risk factor with a frequency of 69.23%, followed by obesity and a sedentary lifestyle with 36.63% and 35.16% respectively. Table 6(b) showed that arterial hypertension was the pathology associated with dyslipidemia with a frequency of 82.41%.

Table 7 , according to the grade of arterial hypertension reveals that 75.89% of the partners were at Grade II.

It emerges from Figure 8 that pure hypercholesterolemia was the most encountered dyslipidemia type with a frequency of 39.35%, followed by hypercholesterolemia (HDL) with 28.80%.

It emerges from Figure 9 that the type and level of dyslipidemia, high total cholesterol level was the most represented anomaly with a frequency of 32.31%, followed by high LDL-C with a frequency of 31.93%.

In Table 8 , among the therapeutic classes received by dyslipidemic patients, statins were the most used with a frequency of 88.27%, followed by Conversion Enzyme Inhibitors and diuretics with respective frequencies of 72. 89% and 53.11%.

It appears from Table 9 that atorvastatin was the most used type of statin, followed by simvastatin with frequencies of 68.13% and 20.14%, respectively.

In Table 10 , among the foods consumed by dyslipidemic patients whose frequency of consumption is greater than or equal to 3 times per day, cereals (100%), oils (100%), milk and dairy products (54.21%), and the group: meat, fish and eggs (100%) were the most consumed. Sweet products (23.08%) were the least consumed among dyslipidemic patients.

This study carried out on patients seen in consultation at the cardiology department at the Ignace DEEN National Hospital in the City of Conakry in the Republic of Guinea, aimed to determine the frequency of lipid abnormalities in the latter with a view to proposing a strategy management of so-called dyslipidemia by our hospital structures. The study showed that of the 523 patients received, 273 had dyslipidemia, i.e. a frequency of 52.19%, compared to 250 patients, i.e. 47.80% without dyslipidemia ( Figure 1 ), our results are lower compared to the results reported by LP Thiombiano et al., who found a frequency of 61.3% dyslipidemia in Gueoul in Senegal [1] and on the other hand higher than that found in several other studies from North Africa in particular, by Ben Youcef M. et al. in Tlemcen (Algeria) [7] and by Elasmi M. et al. [8] in Grand Tunis (Tunisia) found much lower respective prevalences of dyslipidemia, i.e. 15.9% and 21%. This discrepancy could be explained by the choice of different limits for normal lipid values, as well as by differences in laboratory methods, or environmental conditions of the populations. Lipid abnormalities were more frequent in women (59.34%) than in men (40.66%) with a sex ratio of 1.5 ( Table 1 ). In Saint-Louis in 2010, Pessinaba et al. [11] also found a female predominance (72.3% versus 47.4%) with a risk multiplied by 2.59 for women. A female predominance for lipid abnormalities was also noted in Elasmi M, and cool in Tunisia [8] with 36.5% in men and 49.5% in women. Knowing that it is at the average age of 51 that women become menopausal [11] , the hypercholesterolemia observed in a significant number of women during this study could be explained by menopause itself. But the effect of age could, in itself, explain the changes observed. It therefore seems important to know how to distinguish the effect of age from the effect of menopause on changes in the lipid profile in women. In addition, the age groups of 45 - 54 and 55 - 64 years were the most affected with 45.42% and 30.03% respectively. The average age was 50.09 years and the extremes ranged from 25 to 87 years ( Figure 2 ). Our results are superimposable to those found by K. Jamoussi et al. [12] in Tunisia who reported that the age ranges of patients varied from 25 to 62 years with an average of 46.6 years ± 10.4 years. This high frequency in our series could be explained by the fact that young people constitute the majority of the population in Africa on the one hand and on the other hand by the fact that this age group is the most active and therefore the most exposed. On the other hand, in our study, housewives were the most affected with a frequency of 45.78%, followed by traders with 18.68% ( Figure 6 ). This high frequency in these sectors of activity could be explained by the more or less unfavorable standard of living, the sedentary lifestyle generally due to lack of time, and the high-calorie diet in these women thus accumulating risk factors such as obesity, hypertension and type 2 diabetes on the one hand, and on the other hand by the size of our sample. It should also be noted that most of our dyslipidemic patients resided in urban areas with 61.54% compared to 38.46% in rural areas ( Figure 3 ). Our results are similar to those found by Kane A. and Pessinaba S. in Dakar during a survey on cardiovascular risk factors in Saint Louis [13] . This high frequency in our study could be explained by the fact that in urban areas, the population consumes a lot of imported foods rich in lipids ( Table 10 ) and exercises less physical activity, unlike the rural population which consumes natural, less fatty foods. and practices plus physical work. Lipid abnormalities were found in most married couples, with a frequency of 77.29% ( Figure 4 ). Our result is comparable to that found by Traore A. [14] who reported a frequency of 83.3% among married couples. More than half of our patients were not in school with a frequency of 60.07%, followed by higher and secondary education with 21.61% and 9.52% respectively ( Figure 5 ). Our results are superior to those of M. Elasmi et al. [15] who reported 29% not in school, 22% at secondary level and 19% at higher level. This difference in our series could be explained by the low economic income leading to a low schooling rate in our country. During our study, seventy-one of our patients with dyslipidemia had severe obesity, with a frequency of 23%, followed by moderate obesity with 21.24% ( Table 2 ). Our result is contrary to that reported by Chaari et al. [16] who observed a predominance of moderate obesity, i.e. 15.9% and 5.7% of severe obesity. On the other hand, Asma Ezzaher et al. [17] in Tunisia found 33.1% obese and 30.7% overweight. In the same dynamic E. Bruckert et al. [18] in France reported 45.4% and 26.4% respectively. Furthermore, McElroy et al. [3] report different values of around 44% and 20%. The chi-square test allowed us to show that there is a statistically significant difference in proportion between obesity and dyslipidemia because p-value < 0.05 ( Table 6 ). This could be explained by the fact that obesity is one of the major risk factors for the occurrence of dyslipidemia. In addition, sixty-three of our male patients had a waist circumference > 94 cm, i.e. a frequency of 23.07%, and seventy-nine female patients had a waist circumference > 80 cm, i.e. a frequency of 28.94% ( Table 3 ). Our result is lower than that reported by Sossa AOJ-P [9] in his doctoral thesis in 2014 who found a frequency of 42% in men and 36% in women. It appears from our study that arterial hypertension was the pathology most associated with dyslipidemia with a frequency of 82.41% ( Figure 7 ). This association is noted in the literature with a stronger correlation [13] [19] [20] , followed by stable angina in 12.45%. Tina Z. Khan et al. in London, UK [21] in their study cohort with refractory angina at the tertiary cardiology center reported that 60% of 75 patients with refractory angina had elevated levels of lipid parameters. Furthermore, it appears from our study that pure hypercholesterolemia was the most encountered type of dyslipidemia with a frequency of 39.35%, followed by hypocholesterolemia (HDL) with 28.80% ( Figure 8 ). Our results are lower than those reported by Lokrou [22] in Ivory Coast who found 44% pure hypercholesterolemia and 37.2% hypocholesterolemia (HDL), however, they are higher than that published by the Monica centers which reported that in France pure hypercholesterolemia remains the most frequently encountered anomaly (30%), accompanied by an isolated drop in HDL cholesterol (12%). This difference in frequency is explained by the fact that this is a rather caricatured classification that does not reflect the subtleties of the pathophysiology of dyslipidemia. However, it is a pragmatic approach to best manage the various lipid abnormalities in daily practice. According to the type and level of dyslipidemia, high total cholesterol level was the most represented abnormality, followed by high LDL-C with respective frequencies of 32.31% and 31.93% ( Figure 9 ). Our result is similar to that reported by Pessinaba S. et al. In Saint Louis in Senegal in 2010 found 36.3% total hypercholesterolemia and 20.6% hyper LDLcholesterolemia. [23] This high frequency of these entities is explained by the fact that the thresholds for defining the components of dyslipidemia have changed; the threshold for total hypercholesterolemia has gone from 2.6 to 2 g/L, thus increasing our prevalence. Nevertheless, this study revealed that headaches were the main symptom, followed by dizziness and physical asthenia which led patients to consult with a frequency of 59.70%, 34.79% and 34.43%. respectively ( Table 5 ). Furthermore, our study revealed that one hundred and eighty-seven cases (68.49%) had a history of high blood pressure and nine cases (3.29%) of pure hypercholesterolemia. Among the 9 patients with pure hypercholesterolemia, two patients (22.22%) were under treatment, one on statins and the other one was completely unaware of his treatment. It should be noted that 77.77% of those 9 patients followed a low-calorie diet associated with regular physical activity. In Saint Louis, Pessinaba et al. [13] [23] found similar results, i.e. 20.6% under drug treatment and 73% under a hypocaloric diet. In addition, our study showed that the distribution according to the grades of arterial hypertension showed that 75.89% of the patients were grade II ( Table 7 ). Our result differs from that of Youmbissou T. et al. [24] in Cameroon which reported 65.67% grade III and 26.11% grade II. The lack of education, information for patients and its immediate consequences followed by the low socio-economic level of the population complicates access to early consultation. Furthermore, our study showed that high blood pressure was the most represented cardiovascular risk factor with a frequency of 69.23%, followed by obesity and a sedentary lifestyle with 36.63% and 35.16% respectively ( Table 6(a) ). Our result is similar to those reported by Inès Kharrat et al. [25] in Tunisia who found that high blood pressure was the most common risk factor with a frequency of 60%. This high frequency is explained on our part by the fact that arterial hypertension and dyslipidemia are two major risk factors linked to eating habits, a sedentary lifestyle and age, particularly in association with abdominal obesity and diabetes-causing metabolic syndrome. Indeed, the majority of patients had at least two risk factors (55.67%). We noted an association of three or more risk factors in 41.75% of cases. These results could be explained by the fact that most of our patients were hypertensive and obese. Furthermore, the association of dyslipidemia and diabetes did not present any statistically significant link (p = 0.52). In Saint Louis, Kane A. and Pessinaba S. [23] found a stronger correlation because it was significant (p = 0.001). Dyslipidemia in diabetics may be explained by the phenomenon of insulin resistance [26] . It appears from our study that arterial hypertension was the pathology most associated with dyslipidemia with a frequency of 82.41% and a statistically insignificant difference (p-value = 0.99). This association is noted in the literature with a stronger correlation [20] [23] [26] , followed by stable angina in 12.45% ( Table 6(b) ). Tina Z. Khan et al. in London, UK [21] in their study cohort with refractory angina at the tertiary cardiology center reported that 60% of 75 patients with refractory angina had elevated levels of lipid parameters.

At the end of this study on the lipid profile of patients seen in consultation at the cardiological department of the Ignace Deen National Hospital, dyslipidemia remains common. However, our results showed the emergence and clear progression of this metabolic syndrome which results in an isolated drop in HDL cholesterol, an increase in total cholesterol, LDL cholesterol, and triglycerides. This fact is explained by a poor lifestyle (sedentary lifestyle, low fruit and vegetable consumption). Most of our patients were female, resided in urban areas and were housewives. Effective strategic management, an adapted diet, regular physical activity, a change in lifestyle in patients in particular and in the population in general are recommended to avoid the installation of this “silent killer” as well as its complications.

The authors would like to thank the managers and technicians of the laboratories of the cardiology department at the Ignace DEEN National Hospital and those of the Biology Laboratory of the Gamal Abdel Nasser University of Conakry for their support in carrying out this work.

All authors contributed to this research and read and approved the final version of the manuscript.

Confidentiality was respected throughout the data collection process and all results were used for strictly scientific purposes.

Before our study was carried out, patients gave their consent to participate in the study.

Investigation sheet No. /_____/

Identify:

No. file: ___ Date of entry: ___/___/___

1) General information

Age /___ /Sex: Masculine /___ /Feminine /___ /

Instruction level: Primary /___ /Secondary /___ /Superior /___ /Koranic School /___ /None /___ /

Socio-professional activities: Pupils /___ /Students /___ /Official /___ /Traders /___ /Housewives /___ /Peasants /___ /Retirees /___ /Workers /___ /

Provenance: Urban /___ /Rural /___ /

Matrimonial situation: Married /___ /Single /___ /Divorced /___ /Widower /___ / Weight /______ /Size /______ /BMI /______/

IMC assessment: Thin /___ /Normal Weight /___ /Overweight /___ /Moderate Obesity /____ /Severe Obesity /___ /Morbid Obesity /___ /

2) History

ATCD of MCV: Yes /___ /No /___ /Which /_______________ /

Dyslipidemia: Yes /___ /No /___ /If so type /_________________ /

3) Cardiovascular risk factors

Age/Sex /___ /Tabagism /___ /Dyslipidemia /___ /Obesity /___ /Diabetes /___ /Hta /___ /Alcohol /___ /Sedentarity /____ /ATCD Family /___ /Stress /___ /Number of FRCV /______ /

4) Functional signs

Dyspnea /___ /Palpitations /___ /Cepel /___ /Vertigo /___ /Asthenia /___ /Epigastralgia /___ /Toux /___ /Thoracic pain /___ /Hepatalgia /___ /Fever /___ /BD /___ /Acouphène /___ /Flou Visual /___ /

5) Physical signs

Signs of ICD: TJ /___ /RHJ /___ /Heart blow: Yes /___ /No /___ /If so type /__________________ /

HPMG /___ /OMI /___ /GALOP G: Yes /___ /No /___ /Gallop D: Yes /___ /No /___ /B2 Pulmonary B2 /___ /ASCITE /___/

6) Clinical parameters

TA (MMHG) /_________ /FC (BAT/MIN) /_______ /HTA grade /_____/

Waist size /______ /

Size sex-turn: Man: > 94 /___ /< 94 /___ /Women: > 80 /___ /< 80 /___ /

7) Biological data and imaging

Biological parameter

Total cholesterol /____ /LDLC /_____ /HDLC /_____ /Triglycerides /____ /

Type of dyslipidemia: Dyslipidemic patient /___ /Non dyslipidemic /___ /If yes, pure hypercholesterolemia /___ /Hypo HDL cholesterolemia /___ /Mixed hyperlipidemia /___ /Hypertriglyceridemia pure /___ /

Cholesterol T high /___ /HDL low /___ /LDL high /___ /TG high /___ /Blood sugar /___ /HB rate /___ /

Imagery

ECG: Normal /___ /Abnormal /___ /Type /___ /

X-ray: Yes /___ /No /___ /Value /ICT /___ /

ICT/appreciation: Normal /___ /Cardiomegaly /___/

Cardiac echo-doppler: Yes /___ /No /___ /

8) Ultrasound signs

Cavitaire dilation: Yes /___ /No /___ /OD /___ /Og /___ /VD /___ /VG /___ /

Parietal hypertrophy: Yes /___ /No /___ /Interested Wall /_____________ /

Kinetic disorder: Yes /___ /No /___ /Interested Wall /_____________ /

Fe % in tiecholz /____________________ /

% in Simpson Biplan /_____________ /

Relaxation disorder: Yes /___ /No /___ /

Thrombus process: Yes /___ /No /___ /Location /_______________ /

Valvular leak: Yes /___ /No /___ /

Valvular stenosis: Yes /___ /No /___ /

9) Cardiovascular disease interested

HTA /___ /Dilated cardiopathy /___ /Valvulopathy /___ /Pericardite /___ / Angor /___ /

10) Treatments

Statins: Atorvastatin /___ /Pravastatin /___ /Simvastatin /___ /

Rosuvastatin /___ /Statines /___ /

Fibrates: Benzafibrate /___ /Ciprofibrate /___ /Phenofibrate /___ /

Betabloquant /___ /Digitalis /___ /IEC /___ /Anticalcique /___ /

Nitrated derivatives /___ /Diuretics /___ /ARA II /___ /Anti-arrhythmic /___ / AVK /___ /HBPM /___ /Antidiabetic /___ /AAP /___ /OTHER /____________ /