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La prévention des chutes chez les seniors nécessite l’identification précoce des sujets à risque. Notre étude réalisée auprès de 1 618 personnes de plus de 65 ans a permis : 1) d’élaborer une échelle clinique simple permettant une estimation rapide du risque de chutes répétées grâce à 4 items (antécédent de chutes, vivre seul, nombre de médicaments, sexe féminin) ; 2) de déterminer la valeur ajoutée du test du relevé de chaise chez les sujets à risque modéré dans la prédiction du risque de chutes répétées.

The results of experimental studies have suggested that matrix metalloproteinases (MMPs) and their inhibitors, the tissue inhibitors of metalloproteinases (TIMPs), are involved in vascular remodeling. In a population-based study, we report the relationships of serum TIMP-1 with carotid intima–media thickness, carotid plaques and aortic arterial stiffness.

In rats, chronic aldosterone administration with high diet intake increases aortic stiffness independent of mechanical stress. In hypertensive humans, enhanced plasma aldosterone and arterial stiffness are positively associated. Whether the aldosterone synthase gene polymorphism (ASGP) CYP11B2influences the age-related changes in blood pressure (BP) and arterial stiffness in hypertensive subjects has never been investigated.

REASON (RE The aim of the gression of Arterial Stiffness with perindOpril/iNdapamide fixed low-dose combination) project was to compare the antihypertensive effects of a fixed low-dose combination of perindopril 2 mg/indapamide 0.625 mg (Per/Ind), versus atenolol 50 mg (ATE) in patients with essential mild-to-moderate and uncomplicated hypertension, as well as effects on arterial stiffness through tonometry and pulse wave velocity evaluation and carotid ultrasonography. The projects included also 24-h ABPM, echocardiography, 24-h ECG holter, and genotypes identification. REASON The project was a 12-month international (13 countries) multicentre, randomized, parallel groups double-blind study. Treatment was given OD over one year and dosage doubled if uncontrolled casual BP. At intermediary visits (M0, M1, M3, M6, M9, M12) BP was measured at rest in a supine position using sphygmomanometer 24-h after the last drug intake. Enrolled patients were aged between 18 and 85 years with uncomplicated essential hypertension defined as 95= DBP< 110 mm Hg and 160 mm Hg= SBP< 210 mm Hg. Evaluation criteria were change (?) in SBP, DBP, PP, MBP and percentage of responders. Enrolled patients: 562; randomized: 471 ; treatment duration:11.7 ± 2.0 months, age: 54.2 ± 12.3 years, men: 66.7%. Preliminary results from 469 patients (ITT) are shown: (See Table) Brachial BP (mm Hg)Per/IndATEDifference (Per/Ind-ATE)mean ± sdN= 235N= 234[95%]SBPBaseline163.1 ± 13.4161.4 ± 14.8=?-22.0 ± 15.6-15.0 ± 16.3-6.4 [-9.2, -3.6]DBPBaseline98.6 ± 6.898.6 ± 7.0=?-12.6 ± 8.9-12.0 ± 9.7-0.6 [-2.2, 1.0]MBPBaseline120.1 ± 6.4119.5 ± 7.0=?-15.7 ± 10.1-13.0 ± 10.6-2.7 [-4.6, -0.9]PPBaseline64.5 ± 14.962.9 ± 16.0=?-9.4 ± 12.2-3.1 ± 13.2-6.5 [-9.1, -4.0]HRBaseline72.2 ± 9.772.4 ± 9.5=?-1.1 ± 9.0-7.2 ± 9.56.1 (4.4, 7.8]Responder N (%)180 (77.9%)166 (72.8%) The 95% confidential interval shows a statistical superiority of the fixed low-dose combination of Per 2 mg/ Ind 0.625 mg treatment group on SBP, PP and MBP versus atenolol. This observation is of importance when considering the prognosis value of SBP and PP. Heart rate was significantly decrease with Atenolol but not with Per/Ind. These results confirm the efficacy of the fixed low-dose combination Per 2 mg/Ind 0.625 mg as first line therapy in Hypertension.