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Prevalence of Hyponatremia Amongst Patients with Heart Failure in Two Sub-Saharan Hospitals: Cross-sectional Study

Received: 12 October 2025     Accepted: 3 November 2025     Published: 9 December 2025
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Abstract

Background: Hyponatremia is a very frequent abnormality amongst patients with Heart failure (HF) and significantly increases the morbidity and length of hospital stays amongst these patients. There is limited data on the epidemiology of this condition in sub-Saharan countries like Cameroon. This study therefore seeks to estimate the prevalence of hyponatremia amongst patients admitted for HF in 2 university hospitals in Cameroon. Methods: A hospital-based retrospective cross-sectional study was conducted in two University Hospital in Yaounde; Cameroon on patient files of patients admitted for HF from January 2021 to January 2022. A total of 107 participants were included using exhaustive sampling. Data were obtained from the patients’ medical records and analyzed using SPSS version 23.0. Frequencies were expressed as percentage (%) and continuous variables were presented as mean ± standard deviation. Comparison of categorical variables was done using the Chi-square tests. Results: A total of 184 patients were admitted for HF decompensations in the study period. Of these, 132 files were available but only 107 patient files met inclusion criteria. The female sex predominated in this study (55.1%) with a sex ratio (M/F) of 0.77. The majority of patients in this study were elderly patients with a mean age of 61.3±17.1 years and the age range of 70 years and above being the most frequent (31.8%). The prevalence of hyponatremia in this study was 32.7% dominated by mild hyponatremia (22.4%) followed by moderate (5.6%) and severe (2.8%) hyponatremia. The mean serum sodium level was 36.98 ± 5.24 mEq/l with extreme values of 122.0mEq/l and 148mEq/l. More than half of the participants in this study had a previous diagnosis of hypertension (53.3%) while 16.3% had diabetes mellitus. The most common etiologies for HF in our study were hypertensive cardiopathy (43.9%) and dilated cardiopathies (32.7%). Ischemic cardiopathies made up only 9.3% of etiologies in this study. 64.5% of participants were classified as NYHA class IV on admission. The predominant clinical manifestations at admission were dyspnea (92.5%) followed by pedal edema (76.6%) and pulmonary congestion (54.2%). One tenth of patients presented in a state of cardiogenic shock (10.3%). 45.8% of participants presented an anemia on complete blood count (Hb<12g/dl) while 38.3% had renal dysfunction (eGFR<60ml/min/1.73m2). Conclusion: Hyponatremia is very frequent amongst patients admitted for HF affecting about a third of patients. Despite this high prevalence, the vast majority of cases are mild with very few patients presenting with severe hyponatremia.

Published in Cardiology and Cardiovascular Research (Volume 9, Issue 4)
DOI 10.11648/j.ccr.20250904.18
Page(s) 167-171
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Hyponatremia, Heart Failure, Subsaharan

References
[1] Upadhyay A, Jaber BL, Madias NE. Epidemiology of Hyponatremia. Seminars in Nephrology. 2009 May; 29(3): 227–38.
[2] Pottier P, Agard C, Trewick D, Planchon B, Barrier J. Prevalence et description des hyponatremies dans les services de medecine interne de l’ouest de la France. Une enquête descriptive multicentrique type “jour donne.” La Revue de Medecine Interne. 2007 Apr; 28(4): 206–12.
[3] Tannor EK, Akumiah EO, Norman BR. Outcomes in medical admissions with hyponatraemia in Ghana – a single-centre study. African Journal of Nephrology. 2019 Feb 1 (cited 2025 Mar 31); 22(1).
[4] Ghali JK. Mechanisms, Risks, and New Treatment Options for Hyponatremia. Cardiology. 2008; 111(3): 147–57.
[5] Costache II, Alexandrescu DM, Cimpoeșu D, Petriș OR, Petriș AO. Hyponatremia--risk factor in patients with chronic heart failure--clinical, evolutive and therapeutic implications. Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi. 2014; 118(2): 315–9.
[6] Shchekochikhin DY, Schrier RW, Lindenfeld J, Price LL, Jaber BL, Madias NE. Outcome Differences in Community- Versus Hospital-Acquired Hyponatremia in Patients With a Diagnosis of Heart Failure. Circulation: Heart Failure. 2013 May; 6(3): 379–86.
[7] Gudina EK, Ali K, Workicho A. Hyponatremia in patients hospitalized with heart failure: a condition often overlooked in low-income settings. International Journal of General Medicine. 2016 Aug; Volume 9: 267–73.
[8] Klein L, O’Connor CM, Leimberger JD, et al. Lower serum sodium is associated with increased short-term mortality in hospitalized patients with worsening heart failure: results from the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) study. Circulation. 2005; 111(19): 2454–2460.
[9] Georghiade M, Rossi JS, Cotts W, et al. Characterization and prognostic value of persistent hyponatremia in patients with severe heart failure in the ESCAPE trial. Arch Intern Med. 2007; 167(18): 1998–2005.
[10] Lorido JCA, Gómez JC, Formiga F, Perez-Barquero MM, Vila JCT, Bodas OA, et al. Hyponatremia as predictor of worse outcome in real world patients admitted with acute heart failure. Cardiology Journal. 2013 Oct 3; 20(5): 506–12.
[11] Zhao W, Qin J, Lu G, Wang Y, Qiao L, Li Y. Association between hyponatremia and adverse clinical outcomes of heart failure: current evidence based on a systematic review and meta-analysis. Frontiers in cardiovascular medicine. 2023 Dec 22; 10.
[12] Hamaguchi S, Kinugawa S, Tsuchihashi-Makaya M, Matsushima S, Sakakibara M, Ishimori N, et al. Hyponatremia is an independent predictor of adverse clinical outcomes in hospitalized patients due to worsening heart failure. Journal of Cardiology. 2014 Mar; 63(3): 182–8.
[13] Agbor VN, Essouma M, Ntusi NAB, Nyaga UF, Bigna JJ, Noubiap JJ. Heart failure in sub-Saharan Africa: A contemporaneous systematic review and meta-analysis. International Journal of Cardiology. 2018 Apr; 257: 207–15.
[14] Johnson CO, Dorsey H, DeCleene N, Razo CA, Wong R, Mensah GA, et al. Abstract 13969: Etiology-Specific Prevalence of Heart Failure: A Systematic Analysis of the Global Burden of Disease Study 2021. Circulation. 2023 Nov 7; 148 (Suppl_1).
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  • APA Style

    Amalia, O., Nadege, N. C., Jonas, M., Bill, L., Pierre, M., et al. (2025). Prevalence of Hyponatremia Amongst Patients with Heart Failure in Two Sub-Saharan Hospitals: Cross-sectional Study. Cardiology and Cardiovascular Research, 9(4), 167-171. https://doi.org/10.11648/j.ccr.20250904.18

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    ACS Style

    Amalia, O.; Nadege, N. C.; Jonas, M.; Bill, L.; Pierre, M., et al. Prevalence of Hyponatremia Amongst Patients with Heart Failure in Two Sub-Saharan Hospitals: Cross-sectional Study. Cardiol. Cardiovasc. Res. 2025, 9(4), 167-171. doi: 10.11648/j.ccr.20250904.18

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    AMA Style

    Amalia O, Nadege NC, Jonas M, Bill L, Pierre M, et al. Prevalence of Hyponatremia Amongst Patients with Heart Failure in Two Sub-Saharan Hospitals: Cross-sectional Study. Cardiol Cardiovasc Res. 2025;9(4):167-171. doi: 10.11648/j.ccr.20250904.18

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  • @article{10.11648/j.ccr.20250904.18,
      author = {Owona Amalia and Nganou-Gnindjio Chris Nadege and Mbouombouo Jonas and Lom Bill and Mintom Pierre and Ebene Manon and Ndobo Valerie and Boombhi Jerome and Kuate Mfeukeu Liliane and Ndongo Amougou Sylvie Laure and Hamadou BA and Menanga Alain Patrick},
      title = {Prevalence of Hyponatremia Amongst Patients with Heart Failure in Two Sub-Saharan Hospitals: Cross-sectional Study},
      journal = {Cardiology and Cardiovascular Research},
      volume = {9},
      number = {4},
      pages = {167-171},
      doi = {10.11648/j.ccr.20250904.18},
      url = {https://doi.org/10.11648/j.ccr.20250904.18},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20250904.18},
      abstract = {Background: Hyponatremia is a very frequent abnormality amongst patients with Heart failure (HF) and significantly increases the morbidity and length of hospital stays amongst these patients. There is limited data on the epidemiology of this condition in sub-Saharan countries like Cameroon. This study therefore seeks to estimate the prevalence of hyponatremia amongst patients admitted for HF in 2 university hospitals in Cameroon. Methods: A hospital-based retrospective cross-sectional study was conducted in two University Hospital in Yaounde; Cameroon on patient files of patients admitted for HF from January 2021 to January 2022. A total of 107 participants were included using exhaustive sampling. Data were obtained from the patients’ medical records and analyzed using SPSS version 23.0. Frequencies were expressed as percentage (%) and continuous variables were presented as mean ± standard deviation. Comparison of categorical variables was done using the Chi-square tests. Results: A total of 184 patients were admitted for HF decompensations in the study period. Of these, 132 files were available but only 107 patient files met inclusion criteria. The female sex predominated in this study (55.1%) with a sex ratio (M/F) of 0.77. The majority of patients in this study were elderly patients with a mean age of 61.3±17.1 years and the age range of 70 years and above being the most frequent (31.8%). The prevalence of hyponatremia in this study was 32.7% dominated by mild hyponatremia (22.4%) followed by moderate (5.6%) and severe (2.8%) hyponatremia. The mean serum sodium level was 36.98 ± 5.24 mEq/l with extreme values of 122.0mEq/l and 148mEq/l. More than half of the participants in this study had a previous diagnosis of hypertension (53.3%) while 16.3% had diabetes mellitus. The most common etiologies for HF in our study were hypertensive cardiopathy (43.9%) and dilated cardiopathies (32.7%). Ischemic cardiopathies made up only 9.3% of etiologies in this study. 64.5% of participants were classified as NYHA class IV on admission. The predominant clinical manifestations at admission were dyspnea (92.5%) followed by pedal edema (76.6%) and pulmonary congestion (54.2%). One tenth of patients presented in a state of cardiogenic shock (10.3%). 45.8% of participants presented an anemia on complete blood count (Hb2). Conclusion: Hyponatremia is very frequent amongst patients admitted for HF affecting about a third of patients. Despite this high prevalence, the vast majority of cases are mild with very few patients presenting with severe hyponatremia.},
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Prevalence of Hyponatremia Amongst Patients with Heart Failure in Two Sub-Saharan Hospitals: Cross-sectional Study
    AU  - Owona Amalia
    AU  - Nganou-Gnindjio Chris Nadege
    AU  - Mbouombouo Jonas
    AU  - Lom Bill
    AU  - Mintom Pierre
    AU  - Ebene Manon
    AU  - Ndobo Valerie
    AU  - Boombhi Jerome
    AU  - Kuate Mfeukeu Liliane
    AU  - Ndongo Amougou Sylvie Laure
    AU  - Hamadou BA
    AU  - Menanga Alain Patrick
    Y1  - 2025/12/09
    PY  - 2025
    N1  - https://doi.org/10.11648/j.ccr.20250904.18
    DO  - 10.11648/j.ccr.20250904.18
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 167
    EP  - 171
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20250904.18
    AB  - Background: Hyponatremia is a very frequent abnormality amongst patients with Heart failure (HF) and significantly increases the morbidity and length of hospital stays amongst these patients. There is limited data on the epidemiology of this condition in sub-Saharan countries like Cameroon. This study therefore seeks to estimate the prevalence of hyponatremia amongst patients admitted for HF in 2 university hospitals in Cameroon. Methods: A hospital-based retrospective cross-sectional study was conducted in two University Hospital in Yaounde; Cameroon on patient files of patients admitted for HF from January 2021 to January 2022. A total of 107 participants were included using exhaustive sampling. Data were obtained from the patients’ medical records and analyzed using SPSS version 23.0. Frequencies were expressed as percentage (%) and continuous variables were presented as mean ± standard deviation. Comparison of categorical variables was done using the Chi-square tests. Results: A total of 184 patients were admitted for HF decompensations in the study period. Of these, 132 files were available but only 107 patient files met inclusion criteria. The female sex predominated in this study (55.1%) with a sex ratio (M/F) of 0.77. The majority of patients in this study were elderly patients with a mean age of 61.3±17.1 years and the age range of 70 years and above being the most frequent (31.8%). The prevalence of hyponatremia in this study was 32.7% dominated by mild hyponatremia (22.4%) followed by moderate (5.6%) and severe (2.8%) hyponatremia. The mean serum sodium level was 36.98 ± 5.24 mEq/l with extreme values of 122.0mEq/l and 148mEq/l. More than half of the participants in this study had a previous diagnosis of hypertension (53.3%) while 16.3% had diabetes mellitus. The most common etiologies for HF in our study were hypertensive cardiopathy (43.9%) and dilated cardiopathies (32.7%). Ischemic cardiopathies made up only 9.3% of etiologies in this study. 64.5% of participants were classified as NYHA class IV on admission. The predominant clinical manifestations at admission were dyspnea (92.5%) followed by pedal edema (76.6%) and pulmonary congestion (54.2%). One tenth of patients presented in a state of cardiogenic shock (10.3%). 45.8% of participants presented an anemia on complete blood count (Hb2). Conclusion: Hyponatremia is very frequent amongst patients admitted for HF affecting about a third of patients. Despite this high prevalence, the vast majority of cases are mild with very few patients presenting with severe hyponatremia.
    VL  - 9
    IS  - 4
    ER  - 

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Author Information
  • Department of Internal Medicine and Subspecialities, Yaounde General Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Cardiology Unit, Yaounde University Teaching Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Department of Internal Medicine and Subspecialities, Yaounde General Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Cardiology Unit, Yaounde Central Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Cardiology Unit, Yaounde Central Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Department of Internal Medicine and Subspecialities, Yaounde General Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Cardiology Unit, Yaounde Central Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Cardiology Unit, Yaounde University Teaching Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Cardiology Unit, Garoua General Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

  • Department of Internal Medicine and Subspecialities, Yaounde General Hospital, Yaounde, Cameroon;Department of Internal Medicine and Subspecialities, The University of Yaound I, Yaounde, Cameroon

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