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Gout attacks are among the fairly frequent situations requiring primary care, the management of which is essential due to the pain and major functional disability that they cause. However, gout disease does not disappear after treatment of the gout attack. Hyperuricemia can lead to many other complications, including rheumatological, metabolic, cardiovascular and renal. The question therefore arises, beyond the treatment of acute gout attacks, of a new look at gout disease and the importance of a uric acid-lowering background treatment. What data are available: hyperuricemia, a simple association or an independent risk factor to be considered as such? [ABSTRACT FROM AUTHOR]

Atherosclerotic disease is a systemic disease with a frequent multisite localization. For example, up to 60 % of patients with PAD have a coronary artery disease. Multivascular diseases encompass an increased risk of cardiovascular events and mortality and then should imply aggressive prevention modalities. In fact, the different surveys and registries are underscoring a lack of prevention measures and an undertreatment of these patients. Nevertheless, a systematic screening of multisite lesions is not recommended. This screening as well as consequent interventions if necessary should be adapted to each case. [ABSTRACT FROM AUTHOR]

Background: Screening for traditional risk factors of cardiovascular disease is well known in primary healthcare (PHC) settings. However, other risk factors through newer tools (such as bioelectrical impedance analysis [BIA]) could also be predictors of increased cardiovascular risk (CVR). Body composition estimates (body fat percentage, body water percentage, body lean mass) by BIA and its association to CVR have been studied with variable results. Aim: This study assesses the body composition estimates and their association with CVR in the South African PHC setting. Methods: A retrospective record analysis was conducted on a cohort of de-identified patients utilising the ABBY® Health Check Machine at a PHC facility in South Africa between May 2020 and August 2022. The ABBY Machine estimates body fat percentage (BF%) and body water percentage (BW%) estimates from BIA. Cardiovascular risk based on the Framingham-risk-score was stratified into high, medium and low CVR. An analysis of variance was used to determine mean differences of BF% and BW% among these groups. Results: A total of 4008 records (n = 4008) were used in the final analysis. The majority of patients were female (70.1%) with a mean age of 33.6 years. Higher mean BF% (35.75% vs. 31.10% vs. 27.73%; p 0.0001) and lower mean BW% (49.46% vs. 53.15% vs. 56.18%; p = 0000) were found to be significantly associated with high CVR. Lessons Learnt: This study demonstrated the use of newer technologies that could assist in the identification of CVR in low resource PHC settings.

Background: Cardiovascular diseases pose a risk to population health in South Africa and are responsible for almost one in six deaths (17.3%). Aim: To determine the cardiovascular risk among community members who attended a community outreach programme. Setting: Three communities in the Cape Metropole of the Western Cape. Methods: A health survey was conducted with 783 participants, 18 years and older, conveniently sampled. The survey included questions about cardiovascular risk factors, and biometric measurements of blood pressure (BP), height and weight were conducted. Results: A total of 777 participants were included in the study. Most participants were female (529, 68.1%), with an average age of 42.3 years (s.d. 14.2). Risk behaviours reported included smoking (216, 27.8%), consuming more than two drinks of alcohol daily (78, 10%), low physical activity (384, 49.4%), being stressed on most days (436, 56.1%) and unhealthy eating habits (253, 32.6%). More than half of the participants (402, 51.7%) had a body mass index (BMI) ≥ 30, 26.0% (202) had a systolic BP of ≥ 140 mm Hg and 22.4% (174) had a diastolic BP of ≥ 90 mm Hg; 16.6% (130) had a cardiovascular disease (CVD) risk of 10–20 and 19.3% (150) had a CVD risk of 20%. Conclusion: Nearly a fifth of the participants had a significant probability of developing heart disease or experiencing a stroke over the next 10 years. Contribution: There is an urgent need for comprehensive health promotion and behaviour change interventions focused on reducing CVD risk factors at the community level.

Introduction: Antiplatelet agents are the 2nd most prescribed therapeutic class in the elderly. Since 2012, many studies have warned of their increased risk of bleeding in the primary prevention of cardiovascular events. In 2016, the European Society of Cardiology recommends an individual assessment of the benefit/risk balance. Currently, there is a lack of consensus on antiplatelet agents in primary prevention. Purpose of research: The objective of this study was to assess the prevalence of renewal of antiplatelet agents in the over 75s in primary prevention in general practice. The evaluation of professional practices was carried out with 24 general practitioners from New Acquitaine. Results: One hundred and thirteen questionnaires were analyzed. One hundred and five patients (93 %) saw their treatment renewed. Ten percent had no cardiovascular risk factor. Forty-two percent had a cardiovascular risk factor. Thirty-one percent had two cardiovascular risk factors. Twenty-nine patients (25.7 %) had a bleeding history or risk factor. The reasons for renewal were good treatment tolerance (50.5 %), renewal by the specialist (41.9 %), cardiovascular risk considered high (37.1 %), lack of time (13.3 %) and refusal to stop the patient (4.8 %). The treatment was stopped in the event of repeated falls (50 %) or serious bleeding (37.5 %). Conclusions: This evaluation of professional practices showed frequent use of antiplatelet agents in the over 75s for primary prevention and primary care. [ABSTRACT FROM AUTHOR]

Objective: It consisted in evaluating the cardiovascular risk factors and the overall cardiovascular risk among the personnel of the company of the breweries of Mali. Methodology: This was a crosssectional, descriptive, analytical study. It was conducted from November 2020 to May 2021 as part of routine consultations and periodic medical visits. The overall cardiovascular risk was estimated by the new Framingham model and the WHO/ISH predictive diagram. Results: A total of 257 workers were included. The average age was 41.2 years. Cardiovascular risk factors listed were, smoking (18.7%), hypercholesterolemia (17.1%), obesity (15.6%), alcoholism (8.6%), age over 50 years (14%). Workrelated cardiovascular risk factors were also collected. These were the practice of shift work (58.8%), exposure to noise (44%), sedentary behavior at the workstation (25%). The risk of developing cardiovascular disease in the next 10 years was high in 3.11% and very high in 0.78% of respondents. Conclusion: This study highlights several cardiovascular risk factors, some of which are specific to the professional environment. The implementation of preventive measures is a necessity. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome (MS) is responsible for the increased cardiovascular risk in patients with type 2 diabetes. Few studies have focused on MS in type 1 diabetes mellitus (T1DM)., Aim: To describe the clinical, biochemical and therapeutic characteristics of T1DM patients affected by MS., Methods: A retrospective study was carried out. It included 36 patients, suffering from T1DM and MS, hospitalized in the Endocrinology-Diabetology Department of the Hédi Chaker University Hospital of Sfax-Tunisia, from 1997 to 2020. MS was defined according to the NCEP-ATP III criteria., Results: The mean age of the patients was 53 years. The mean duration of diabetes was 15 years. The MS appeared after a mean duration of diabetes of 13.7 years. Hypertension was reported in 21 patients (58.3%). The mean BMI was 26 kg/m2. The mean total cholesterol level was 4.59 mmol/l ±1.18, and the mean triglycerides level was 1.67 mmol/l ±0.81. The mean HDL-cholesterol level was 0.96 mmol/l ±0.29. In the majority of cases (80%), MS was the combination of dyslipidemia, hypertension and diabetes. Therapeutically, the average dose of insulin used was 0.8 IU/kg/day. The combination of metformin was necessary in 18 cases (50%). Microvascular complications were present in all patients. The cardiovascular risk was very high in all patients., Conclusion: The prevalence of MS during T1DM is increasing. It indicates an increased risk of micro and macrovascular complications.

Finerenone is a selective non-steroidal antagonist of the mineralocorticoid receptor. This molecule significantly reduces cardiovascular morbidity and mortality and slows the progression of kidney disease in people with type 2 diabetes (T2D) and chronic kidney disease as demonstrated in two huge randomised controlled trials versus placebo (FIDELIO-DKD and FIGARO-DKD). Recent data provide additional information about both the efficacy and safety of this molecule in patients with or without T2D presenting heart failure (FINEARTS-HF). These results obtained in controlled trials are being confirmed in observational real-life studies (FINE-REAL) and several other studies devoted to heart failure. Also, finerenone is currently being tested among various special populations outside T2D. Several international recommendations in nephrology, cardiology, and diabetology support the use of finerenone in patients with T2D considered at high and very high cardiovascular and renal risk.

Despite considerable improvements in medical care over the past 25 years, cardiovascular disease (CVD) remains a major public health challenge. Dyslipidemias are one of the topics of greatest interest in cardiology. Decreasing serum cholesterol level is a central objective for preventing cardiovascular events. The current European Society of Cardiology guidelines recommend evaluation of the cardiovascular risk, treatment decisions being based on this risk, and clinician–patient discussion about the risk (shared decision making).

The latest guidelines for the management of arterial hypertension, the silent killer, were published in summer 2023. They particularly emphasize again the quality of blood pressure measurement which ideally should always be automated using oscillometric device and an arm cuff already in the consulting room. They remind you how to manage the blood pressure of a patient whose hypertension has been confirmed, to stimulate drug compliance and to avoid therapeutic inertia. A holistic view of the patient with all his or her risk factors is always required. The general practitioner is the key player in the diagnosis, treatment and monitoring of the hypertensive patient whose therapeutic education has been as complete as possible with practice of self-measurement of blood pressure at home if possible. The goal is to normalize blood pressure within the first three months of treatment initiation and to reduce as much as possible the cardiovascular risk of the treated patient in the frame of preventive medicine.

Prevention of cardiovascular disease remains a key-objective from a health care point of view. The present article focuses on primary prevention, i.e. to prevent a first cardiovascular event among at-risk people. The first step is to evaluate the cardiovascular risk level (low to moderate, high, very high), which allows to fix target goals. It is especially the case regarding the management of dyslipidaemias. Lipid abnormalities are considered as a major coronary risk factor (especially, LDL or even better non-HDL cholesterol according to recent guidelines). Theoretically, it is quite easy to control this risk factor thanks to available lipid-lowering drugs, yet this goal remains insufficiently reached in clinical practice. The second step is to prescribe, in addition to life-style measures, the best pharmacological treatment. In most cases, it is a statin that should be well titrated, eventually combined with ezetimibe and/or bempedoic acid, to reach the set objectives. Finally, it is important to convince the at-risk individual by providing the valuable information regarding the benefits/risks ratio of the therapy and to verify a good drug compliance in the long run. Indeed, as dyslipidaemia is asymptomatic, people in primary prevention too easily tend to neglect (and eventually stop) the valuable therapy, also because statins have been widely (yet unfairly) criticized by some people in recent years.

Introduction. A better predictive tool to use for assessing the risk of cardiovascular complications and postoperative mortality in elderly with femoral neck fracture is still not fully developed, and new data in stratifying the cardiovascular risk are still necessary. The objective of the study was to determine the influence of preoperative variables from the cardiovascular preoperative assessment on mortality, and to try to set some standards in the preoperative management of patients with cardiac risk and hip fractures who need surgery. Material and methods. We analyzed age, metabolic equivalents according (METS) to Duke Activity Status Index (DASI), hemoglobin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and high sensitive C-reactive protein values, echographic measurements such as left ventricular ejection fraction (LVEF), left ventricular diastolic volume (LVDV) and diameter (LVDD), left ventricular wall hipertrophy (LVH) calculated as a mean of the posterior wall and the interventricular septum, the left ventricular contraction velocity S, pulmonary artery pressure (PAPs), the tricuspid anular plane systolic excursion (TAPSE), and time to surgery, for 72 patients aged over 60 y.o, hospitalised in the Orthopaedics Department of the University Emergency Hospital of Bucharest, Romania, between 2015-2016. Results. The deaths after 3 months from surgery were 13 (18%). The best correlation with 3 month mortality was the delay in surgery over 4 days (p

Introduction. The patients with cardiometabolic/ cardiovascular risk are commonly found in clinics and ambulatory clinics. The cardiovascular (CV) or cardiometabolic (CM) risk factors and biomarkers are certain characteristics of the person without CV disease, which are independently correlated with the subsequent occurrence of CV disease, without necessarily having a causal relationship between factor and disease. The visceral adiposity index (VAI) indicates the function of visceral adipose tissue and its growth is independently correlated with cardiovascular and cerebrovascular risk. The objective of the study was to evaluate the lifestyle and visceral adiposity index as possible cardiometabolic risk factors in patients with diabetes, prediabetes, and in the general population. Methods. The study was epidemiological, transversal, noninterventional, and was performed by analyzing 300 subjects, divided into three groups: group 1 (100 patients with type 2 diabetes), group 2 (100 pre-diabetic patients), and group 3 (control) consisting of 100 individuals randomly recruited without diabetes. Results. The accumulation of cardiovascular risk factors results is an increased risk of cardiovascular disease. We found statistically significant differences between the three groups in terms of BMI, CT, VAI, CT, HDL-c and LDL-c values, which were higher in patients with diabetes mellitus (DM) than in prediabetics or in the general population, which also coincided with higher cardiovascular risk in these patients. Conclusions. We emphasize the importance of both early cardiovascular risk assessment and the importance of controlling cardiovascular risk factors, both by non-pharmacological methods, and by associating early drug therapy when necessary.

The importance of cardiovascular/cardiometabolic risk is a special one, because it may influence atherogenesis and its clinical consequences: ischemic heart disease, cerebrovascular disease, peripheral artery disease, but also diabetes mellitus (DM). To evaluate the cardiometabolic risk associated with visceral obesity, a useful indicator for the clinical practice was searched. The visceral adiposity index (VAI) could become an easy-to-use tool to evaluate the cardiometabolic risk in everyday practice. VAI indicates the function of visceral adipose tissue and its growth is independently correlated with cardiovascular and cerebrovascular risk. The medical world tried to identify an easy way to assess cardiovascular risk, so the visceral adiposity index was introduced, whose formula includes a number of cardiovascular risk factors.

Patients with chronic inflammatory and autoimmune diseases are at increased cardiovascular risk, which is the cause of persistent excess mortality despite increasingly effective specific treatment of the inflammatory and/or autoimmune disease. This increased cardiovascular risk is multifactorial, associated with accelerated atherosclerosis related to systemic inflammation, but also secondary to traditional cardiovascular risk factors and to the therapies used to control systemic inflammation. This justifies a coordinated, personalized management of cardiovascular risk in patients with chronic inflammatory and autoimmune diseases, based not only on the treatment of their disease to achieve the lowest level of activity, but also on the screening and management of their cardiovascular comorbidities and modifiable cardiovascular risk factors., (Copyright © 2023 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Despite the demonstrated efficacy of cardiovascular (CV) preventive measures, data from international literature indicate that control of CV risk factors (RF) remains insufficient in very high-risk patients., Aim: This study aimed to assess prevalence of achievement of recommended therapeutic targets for the major and modifiable CVRF 12 months after myocardial infarction (MI)., Methods: From 1st January to 30th April 2023, we collected consecutive patients with type 1 MI who had completed 12 months follow-up. Primary endpoint was prevalence of achievement of all recommended therapeutic targets of low-density lipoprotein cholesterol (LDL-C), diabetes mellitus (DM), arterial hypertension (HTN), and smoking. Targets and treatment goals were defined according to the 2021 European Society of Cardiology guidelines on CV disease prevention., Results: 107 patients, mean age 58.8 ± 8.8 years, 74.8% male, were included. 42 (39.3%) patients had HTN, 50 (46.7%) were diabetics, 77 (72.0%) were smokers and eight (7.5%) had hypercholesterolemia. At 12 months, primary endpoint was achieved in 20 (18.7%) patients. 55 (71.4%) of 77 smoker patients were weaned. Blood pressure was at target in 26 (61.9%) among hypertensive patients. In DM patients, HbA1c target was achieved in 23 (46.0%) of them. 32 patients (29.9%) achieved the goal of LDL-C < 0.55 g/L., Conclusions: Secondary prevention of CV disease was suboptimal. Less than a fifth of patients achieved treatment target for most major and modifiable risk factors. Improvement in follow-up care and treatment after MI is needed.

Chronic kidney disease (CKD) affects almost 10% of the world's population, and over 30% of people aged over 70 [1,2]. The overall incidence of treated CKD is stable in France, but continues to rise sharply in people aged over 85 [3]. In its advanced stages, CKD is associated with numerous complications linked to disturbances in water, acid-base and phosphocalcium balance, as well as anemia and increased cardiovascular risk. A better understanding of risk factors, improved practices to promote nephroprotection, and progress in therapeutic education and preparation for suppletive techniques would help reduce this risk., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Résumé: Toutes les sociétés savantes s'accordent pour recommander une réduction de la consommation de sel chez les patients hypertendus forts consommateurs et chez les patients insuffisants cardiaques. Dans la population générale en bonne santé, la question se pose car plusieurs études ont démontré un effet délétère des apports sodés trop faibles. Dans une étude portant sur une cohorte de 322 624 sujets en bonne santé suivis pendant sept ans, Welsh et al. ont confirmé la relation linéaire entre le niveau d'excrétion sodée par 24 heures et la pression artérielle moyenne. Ils n'ont pas retrouvé de relation entre excrétion sodée et risque cardiovasculaire, fatal ou non, ni entre excrétion sodée et risque de décès toutes causes chez ces sujets sains à faible risque cardiovasculaire à l'inclusion. Dans l'état actuel des connaissances, il semble raisonnable de continuer à diffuser et à respecter les recommandations de limitation des apports sodés dans l'alimentation de la population générale. Il faudrait contraindre les industriels à moins saler les aliments transformés – ce qui commence à se faire de façon efficace – et persuader les citoyens de préparer plus souvent leurs propres repas et de consommer moins de nourriture industrielle. All learned societies agree to recommend a reduction of salt intake in patients with high blood pressure or with heart failure. In the general healthy population several studies have demonstrated a deleterious effect of too low salt intake. In a cohort of 322,624 healthy subjects followed for seven years, Welsh et al. confirmed the linear relationship between the 24-hour sodium excretion levels and the mean arterial pressure. However, they did not found any relationship between sodium excretion and cardiovascular risk, fatal or not, or between sodium excretion and the risk of all causes death in these healthy subjects with low cardiovascular risk at baseline. In the current state of knowledge, it seems reasonable to continue to disseminate and respect the recommendations of limitation of sodium intake in the diet of the general population. It should forcing manufacturers to put less salt in their processed foods – this is starting to be efficient – and persuading citizens to prepare their own meals and to consume less industrial food. [ABSTRACT FROM AUTHOR]

Objective: To calculate the vascular age of hypertensive patients and assess the risk at 10 years of occurrence of an absolute cardiovascular event in outpatient consultation of the Abidjan Heart Institute., Patients and Methodology: Cross-sectional study with descriptive and analytical purposes from June 2021 to September 2021, i.e. 4 months in patients at least 30 years of age followed in the outpatient department for arterial hypertension without cardiovascular complications. Data were collected using a questionnaire. We considered the parameters established in the D'Agostino chart for the calculation of vascular age. Each parameter was weighted and the total points obtained corresponded to the vascular age. The cardiovascular risk at 10 years was also obtained from another abacus established by D'Agostino by cross-referencing the total points of each patient with pre-established data., Results: Three hundred hypertensive people were included in this study. The calendar average age was 62.0 ± 10 years with extremes of 30 and 95 years. The gender distribution showed female predominance and there was no significant difference in vascular age by sex. The mean vascular age of all patients was 73.4 ± 9.9 years. The mean difference between actual and vascular age was 11.4 years. Dyslipidemia (p = 0.0002), diabetes (p = 0.0004) and unstandardized BP (p = 0.0000) significantly influenced vascular age. There was no significant difference between smokers and non-smokers (p = 0.1349). All men had a greater than 30% risk of having a cardiovascular accident while women before the age of 35 had no risk. Over the age of 60, almost all patients (both men and women) had a greater than 30% risk of having a cardiovascular accident at 10 years., Conclusion: The calculation of vascular age made it possible to assess arterial aging and calculate the probability at 10 years of occurrence of a cardiovascular event. This study also highlights the importance of cardiovascular risk and vascular age assessment for management adaptation and therapeutic education., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: Full blood count is routinely performed in the evaluation of hypertensive patients. However, usefulness of leukocyte ratios in cardiovascular risk (CVR) assessment hasn't yet been proven in Cameroonians., Objective: Evaluate the contribution of leukocyte ratios in CVR assessment of non-diabetic hypertensive adults., Methodology: We carried out a cross sectional study including non-diabetic hypertensive patients followed up at the cardiology unit of the Yaoundé Central Hospital from November to June 2022. We collected relevant clinical data with a pre-established questionnaire and blood samples from each patient for different biological analyses. The spearman correlation test was used to assess on the one hand the relationship between leukocyte ratios, highly sensitive CRP and the WHO 2019 risk score as our primary end point, and on the other hand between leukocyte indices and the other risk estimators as our secondary outcome. The significant threshold level was set as 0.05., Results: We included 165 participants (102 females) with a mean age of 57.6 (10.4) years. The median duration of hypertension since diagnosis was 7 years and only 27% of participants on treatment had a controlled blood pressure. There was no significant correlation between leukocyte ratios and the WHO 2019 risk score. Highly sensitive CRP and the atherogenic index of plasma were significantly correlated respectively with the granulocyte to lymphocyte ratio (rho = 0.18, p = 0.03) and the eosinophil to lymphocyte ratio (rho = 0.28, p = 0.01). There exists a weak positive association between the granulocyte to lymphocyte ratio and the Reynolds risk score., Conclusion: Leukocyte ratios are not useful for CVR assessment in hypertensive Cameroonians with respect to the WHO 2019 risk score. Prospective studies are needed to assess their usefulness in combination with conventional risk factors to improve prediction of cardiovascular events., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Introduction: Smoking is common in chronic hemodialysis patients who are characterized by a high cardiovascular risk., Patients & Methods: This is a multicenter cross-sectional study over a period of 4 months, from July 2021 to October 2021, in the Agadir province., Results: Among the 245 patients interviewed, 9,4% were current smokers and 16,7% were former smokers. Compared to non-smoking patients, former and current smokers were predominantly male, had more comorbidities, higher diastolic blood pressure, higher mean ultrafiltration rate and more antihypertensive treatments. In multivariate analysis, active smoking was significantly associated with the presence of cardiovascular disease., Conclusion: Smoking is an important and modifiable cardiovascular risk factor in chronic hemodialysis patients.

Résumé Longtemps considérée comme une pathologie purement obstétricale demeurant l’apanage de la gynécologie en raison de son implication sur le pronostic périnatal à court terme, il est maintenant admis que la prééclampsie constitue une authentique maladie vasculaire systémique de la grossesse et représente un authentique facteur de risque majeur de survenue de pathologie cardiovasculaire à long terme. Le but de cette mise au point est de synthétiser les actualités et les apports de la littérature récente en termes de définitions, d’identification et de prévention de la prééclampsie. Nous exposerons également les enjeux majeurs qui justifient que le cardiologue soit être pleinement impliqué dans le dépistage et la prévention de la maladie, ainsi que dans le suivi ultérieur des femmes ayant présenté une prééclampsie. Due to its short-term consequences on perinatal outcome, preeclampsia has been long regarded as an obstetrical disease, strictly confined to a management by OB/GYNs. It has been now widely accepted that preeclampsia is most a systemic inflammatory and systemic vascular disease during pregnancy and then a lifelong risk factor for subsequent cardiovascular event in women's life. The aim of this review is to propose an overview in the current state-of-art in definition, early identification and management of preeclampsia. We will also discuss the growing evidence that support that cardiologists must be fully involved in screening and prevention of preeclampsia during pregnancy and beyond in the subsequent medical follow-up of women who have experienced a preeclampsia. [ABSTRACT FROM AUTHOR]

Recent studies conducted in patients with Addison's disease (AD) highlighted that this disease, even after treatment, is a significant cause of morbi-mortality. This study aims to determine the cardiovascular and metabolic deleterious impact of long-course glucocorticoid substitution therapy. We conducted a retrospective study of 28 patients with treated Addison's disease evolving for more than 15 years. The average age of patients was 58, 53 years, with a female predominance (65%). The average follow-up period was 17, 87 years. Initial dose of hydrocortisone was 32, 5 mg/day (20.52 mg/m²) and 27, 9 mg/day (16,41mg/m²) at the time of the study. The prevalence of the metabolic syndrome (MS) in patients with AM was 35.71% after a period of treatment longer than 15 years. At the end of the follow-up period, 28.57% of patients were obese; 25% of patients had developed AH (arterial hypertension) and type 2 diabetes. The prevalence of dyslipidemia went from 3.57% to 42.85%. Only one patient had myocardial infarction at 25-year follow-up. Factors favoring the onset of MS in our study were history of disease and weight loss at the moment of diagnosis. Adjustment of substitution therapy is a challenge in patients with Addison's disease due to morbi-mortality associated with overdose. A regular follow-up and a personalized therapeutic approach are necessary to improve patients' prognosis. [ABSTRACT FROM AUTHOR]

Résumé L’augmentation du risque cardiovasculaire dans la polyarthrite rhumatoïde est bien établie. Cette mise au point envisage les effets des traitements synthétiques et des biothérapies sur les facteurs de risque cardiovasculaire et la morbi-mortalité cardiovasculaire. L’effet des AINS et des corticoïdes sur le risque cardiovasculaire est rappelé. Enfin, la prise en charge pratique de la dyslipidémie selon les dernières recommandations de la HAS et l’intérêt des statines sont envisagés. The relevant increase in cardiovascular risk associated with rheumatoid arthritis (RA) has been well established over the last decade. The current update is focused on the effects of synthetic treatments, as well as biological medicines, on both the cardiovascular risk and the RA-associated enhanced morbidity and mortality. In addition, the impact of non-steroidal anti-inflammatory drugs and corticosteroids on the RA-associated cardiovascular risk is briefly recalled. Lastly, the clinical management of dyslipidemia, as outlined in the recent HAS guidelines, is presented in addition to the benefit of long-term statin therapy. [ABSTRACT FROM AUTHOR]

Résumé Les événements cardiovasculaires sont la deuxième cause de décès en France. L’évaluation du risque cardiovasculaire global à l’aide d’une évaluation personnalisée avec pondération des facteurs de risque, permet de prédire le risque d’événements cardiovasculaires à dix ans. Les traitements validés visant à réduire la mortalité cardiovasculaire en prévention primaire sont peu nombreux. Le recours aux statines en prévention primaire est discuté. Nous rapportons dans cette mise au point les données actualisées des recommandations et des essais cliniques en matière de traitement par statines en prévention primaire. Cardiovascular events are the second leading cause of death in France. The assessment of overall cardiovascular risk using a personalized assessment with weighting risk factors can predict the risk of cardiovascular events in ten years. The validated treatments to reduce cardiovascular mortality in primary prevention are few. The use of statins in primary prevention is discussed. We report in this review the updated conclusions from clinical trials regarding the treatment with statins in primary prevention. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnoea (OSA) affects approximately 4% of men and 2% of women in the middle ages but many of these patients are not diagnosed or treated. Cardiovascular and cerebrovascular morbidity and mortality are associated with sleep apnoea. This causal link has been confirmed in recent years on the basis of epidemiological, experimental and therapeutic data. The prevalence in the general population and the impact on the genesis and evolution of systemic and pulmonary arterial hypertension, of cardiac rhythm disorders, of coronary artery disease, of heart failure and of strokes should encourage clinicians to early diagnose and treat sleep disordered breathing and, if possible, to prevent them. [ABSTRACT FROM AUTHOR]

Introduction: Risk factors and cardiovascular diseases are overrepresented in people with severe and persistent mental disorders. A person diagnosed with schizophrenia or bipolar disorder is two to three times more likely to die of cardiovascular disease than the general population., Purpose of Research: An empowerment program has been co-created to reduce these health inequalities. It is one part of the COPsyCAT project. The people-centered approach has been used. The participation of the patients, caregivers, and health professionals was decisive., Results: Stakeholders redefined the objectives of the program. The aim is to improve quality of life, rather than reducing cardiovascular risk. Existing tools -that have been evaluated for their usability - were selected to allow for self-directed patient orientation, so that the constraints between psychiatry and primary care could be circumvented. The program is based on the pooling of existing resources in a territory. The individual power of action and the organization of healthy offers are thus designed to reinforce each other., Conclusions: This article concretely describes the steps through to which the COPsyCAT empowerment program was designed, in co-construction by the researchers of the study, the users and user associations and healthcare professionals at based on their experiential knowledge. The feasibility of the program and the appropriation of tools in real situations will soon be evaluated. The measure of the program’s effectiveness on cardiovascular risk will come in second time.

Palm oil is a solid vegetable oil, rich in saturated fatty acids (50 %), mainly in palmitic acid. However its contains also 50 % of unsaturated fatty acids, and is rich in tocotriénols and carotenoids partly altered by refining and heating. Its effects on fasting and post-prandial plasma lipids and on other parameters linked to the cardiovascular risk are reviewed in this work. These effects are more favourable than Partially Hydrogenated Vegetable Oils on LDL cholesterol and HDL cholesterol, less favourable on LDL cholesterol than polyunsaturated oils, similar to monounsaturated oils. Epidemiological studies are rare and of poor quality. These data are discussed with highlights on the actual point of view on the role of saturated fatty acids in cardiovascular risk. An increasing and excessive intake of palm oil in our diet, through manufactured products, could be deleterious. However the real consumption of palm oil is not well known. Finally its technological and physico-chemical properties give it a true interest for some uses. So it is necessary to consider each use with the subsidiary principle in order to avoid the going back of trans fatty acids.

From a quantitative point of view the role of dietary fat in weight gain apparently seems clear, but its accountability in obesity pathogenesis, for individuals or population, is not definitively established. This concern may be divided in four sections. On a physiopathological point of view, experimental data show that fats are able to increase energy density and food intake and to increase lipogenesis. On an epidemiological point of view the data are more conflicting. An higher fat intake was associated to the obesity epidemic, its decrease did not stopped it, and that suggest the role of others lifestyle patterns including physical activity. On a clinical point of view the studies are far from a consensus, but it is true that they focuse on the role of familial, education and genetic factors. But really a fat excess can sensitive the effect of inactivity. Total energy intakes seem a main issue. The fat reduction is not sufficient to induce a weight loss or to prevent a weight gain. We must act on each component of energy balance. In insulin-resistant subjects the fat reduction without weight-loss does not seem favourable on cardiovascular risk. Finally the total fat intakes cannot be considered as the cause of obesity but they may participate to the weight gain in some conditions. Qualitative aspects, and therefore fatty acids, must be also considered.

Background: Hypertension is a major risk factor for cardiovascular events. The cardiovascular risk assessment is performed using specific algorithms, particularly SCORE2 and SCORE2-OP developed by the European Society of Cardiology., Patients and Methods: Prospective cohort study from February 1, 2022, to July 31, 2022, enrolling 410 hypertensive patients. Epidemiological, paraclinical, therapeutic, and follow-up data were analyzed. Cardiovascular risk stratification of patients was performed using SCORE2 and SCORE2-OP algorithms. We compared the initial and 6-month cardiovascular risks., Results: The mean age of the patients was 60.88 ± 12.35 years with a female predominance (sex ratio = 0.66). In addition to hypertension, dyslipidemia (45.4%) was the most frequently associated risk factor. A high proportion of patients were classified as high (48.6%) and very high (46.3%) cardiovascular risk, with a significant difference between men and women. Reassessment of cardiovascular risk after 6 months of treatment found significant differences compared with the initial cardiovascular risk (p < 0.001). The rate of patients at low to moderate cardiovascular risk (49.5%) increased substantially, whereas the proportion of patients at very high risk decreased (6.8%)., Conclusion: Our study conducted at Abidjan Heart Institute in a young population of patients with hypertension revealed a severe cardiovascular risk profile. Almost half of the patients are classified at very high cardiovascular risk, based on the SCORE2 and SCORE2-OP. The widespread use of these new algorithms for risk stratification should lead to more aggressive management and prevention strategies for hypertension and associated risk factors., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent n'avoir aucun lien d'intérêts, (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

All recommendations for cholesterol and the prevention of cardiovascular disease emphasize the calculation of cardiovascular risk (RCV) and personalized primary or secondary prevention measures. In secondary prevention, if the "automatic" prescription of statin associated with other treatments is internationally consensual, the situation is quite different in primary prevention. This is where the strategies vary considerably according to the recommendations with notions of risk threshold or LDL-cholesterolemia, because the target value of LDL-cholesterol and the proposed type of statin differ between countries and recommendations. Which studies should we trust? Can we follow the recommendations? How can we assess the risk? [ABSTRACT FROM AUTHOR]

Hypertension in pregnancy has several forms that differ by their mechanisms and their consequences for mothers and fetus. Chronic hypertension is defined by systolic blood pressure (SBP) ≥ 140mm Hg or diastolic blood pressure (DBP) ≥ 90mm Hg before pregnancy or before the 20th week of amenorrhea. Gestational hypertension is defined by SBP≥140mmHg or DBP ≥ 90mm Hg during or after the 20th week of amenorrhea. Pre-eclampsia is the occurrence of hypertension and proteinuria after 20 weeks of amenorrhea. Severe pre-eclampsia is accompanied by clinical signs and symptoms indicating visceral pain. A pre-eclampsia develops in 1-2 % of pregnancies, but much more frequently (up 34 %) in the presence of risk factors. High blood pressure during pregnancy remains, by its complications, the leading cause of maternal morbidity and mortality. Although symptomatic management has improved, there is currently no specific curative treatment, and only childbirth and delivery of the placenta, usually prematurely, alleviate the mother's symptoms. In the first six months of pregnancy, the primary goal of treatment is to prevent the complications of severe hypertension. Initiation of antihypertensive drug treatment is recommended in pregnant women with severe hypertension. Initiation of antihypertensive drug treatment should also be considered in pregnant women at high cardiovascular risk with moderate hypertension. A SBP goal <160 and a DBP goal between 85 and 100mm Hg is recommended in pregnancy. During the long-term followup, American and European scientific societies, French society of hypertension and French national college of gynecologists-obstetricians have recognized hypertension in pregnancy and pre-eclampsia as specific emerging risk of women. Pre-eclampsia is a specific risk factor of chronic hypertension, of coronary events, of stroke, of chronic renal failure and a specific risk factor of cardiovascular mortality. Paradoxically, information of these women at risk is insufficient to ignorance and lack of awareness among health professionals. The education of women has become a major issue of prevention, developing specific consultation after delivery, encouraging them to optimize their lifestyle with a coordinated follow-up. In the end, the implementation of structured care pathway, further monitoring of these women, aims to improve the practices of health professionals. This is what drove the French Society of Hypertension, in partnership with the French National College of Gynecologists-Obstetricians, to develop a consensus proposing easy-to-use guidelines. [ABSTRACT FROM AUTHOR]

Aspirin, clopidogrel, prasugrel and ticagrelor are major antiplatelet agents (AAP) currently prescribed. Aspirin increases the surgical bleeding risk; the question is whether this risk is acceptable for a programmed procedure in comparison with the cardiovascular risk associated with discontinuation of treatment. In patients with coronary stents, maintaining aspirin during surgery is the rule. In patients treated with clopidogrel, prasugrel or ticagrelor, due to an unacceptable bleeding risk-on, stopping the treatment for five, seven and five days, respectively, is enough to regain sufficient platelet function allowing an invasive procedure. The risk of cardiovascular events is “very high” within six weeks following the establishment of a simple or an active (drug-eluting) stent and “high” six months to one year after the implantation of an active stent. The drug-eluting second-generation stents are associated with a lower risk of thrombosis than the first-generation, close to that of bare stents. This would reduce the risk period from six to three months after the coronary stenting. The post-surgery bleeding risk for patients receiving AAP is worsened by anticoagulants. There is currently no reliable biological marker for monitoring the haemorrhagic risk during the pre- and post-surgery periods, allowing a decision of interruption or reintroduction of AAP. To reduce the impact of AAP on the surgical bleeding risk, preventive or curative pharmacological strategies (tranexamic acid, desmopressin) or transfusion can be proposed. [ABSTRACT FROM AUTHOR]

Résumé Le cancer de la prostate, le plus fréquent des cancers chez l’homme, est un adénocarcinome sensible, dans plus de 80 % des cas, à la castration chimique, en raison de son hormonodépendance. L’hormonothérapie androgénosuppressive est le traitement des formes évoluées du cancer et peut être associée à la radiothérapie en évoluée. Le choix thérapeutique, pluridisciplinaire, est fondé sur l’âge et les maladies associées du patient, et le stade clinique. L’impact de l’hormonothérapie confère au patient des effets secondaires variés et ceux cardiovasculaires sont maintenant mieux connus. Les mécanismes responsables de cette cardiotoxicité sont à la fois directs et indirects par effets métaboliques thermogéniques. L’analyse de ces effets cliniques ou biologiques, leurs corrélations au type d’hormonothérapie utilisé et les précautions possibles de prescription seront détaillés dans cette synthèse de la littérature. La collaboration du cancérologue ou de l’urologue avec le cardiologue devient nécessaire et l’existence d’une unité d’oncocardiologie pourrait améliorer l’évaluation de la balance bénéfice–risque et la tolérance du traitement. Prostate cancer, the most frequent cancer in man, is an adenocarcinoma sensible to chemical castration in more than 80% of cases due to its hormonal dependency. Androgen deprivation is the treatment for advanced cancer and can be associated with radiotherapy locally or in locally advanced situations. Multidisciplinary therapeutic choice depends on patient age and co-morbidities and clinical stage. The impact of hormonal treatment confers varied side effects and cardiovascular effects are now better known. Responsible mechanisms of this cardiotoxicity are at the same time direct but also indirect by metabolic thermogenic effects. Analysis of these clinical or biological effects, their correlations to the used type of hormonal treatment and the possible precautions of prescription will be detailed in this analysis of the literature. The collaboration of the oncologist or the urologist with the cardiologist becomes necessary and the existence of a unit of oncocardiology could improve the evaluation of the risk–benefit balance and the tolerance of the treatment. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Notre étude a pour but de déterminer la prévalence de l’hypertension artérielle et des complications dégénératives qui s’y associent chez des diabétiques de type 2 nouvellement diagnostiqués, à travers une étude observationnelle, prospective. Patients et méthodes Nous avons recruté 327 diabétiques de type 2 nouvellement diagnostiqués, âgés de 40 à 70 ans, en médecine générale. La tension artérielle est mesurée selon les recommandations de l’OMS. Nous avons recueilli les données cliniques, biologiques et recherché les complications dégénératives du diabète. L’analyse statistique a été réalisée à l’aide du logiciel Epi-Info 6.04. Résultats Parmi les patients, 66,7 % avaient une hypertension artérielle au diagnostic du diabète sucré, 28 % d’entre eux étaient déjà connus. Ils ont un âge moyen de 54,3 ± 8 ans et présentent un syndrome métabolique dans 88,4 %. L’homme présente un risque coronarien, une glycémie et une fréquence de l’albuminurie plus élevés, tandis que la femme est plus obèse. La tension artérielle augmente avec le risque coronarien et les critères du syndrome métabolique. Une microangiopathie est retrouvée dans 65,7 %, une athérosclérose dans 59,4 % et 71,2 % des hypertendus ayant une athérosclérose ont également une microangiopathie ( p = 0,018). Conclusion La prévalence l’hypertension artérielle est élevée chez les nouveaux diabétiques. Elle s’associe à un degré de morbidité très élevé. Le dépistage de ces deux maladies passe par l’implication et la motivation du soignant et du soigné. Clinicaltrials.gov ID : NCT02002091 . Aim of study Our aim was to determine the prevalence of arterial hypertension and evaluate its association with vascular chronic complications in newly diagnosed type 2 diabetes patients, in an observational, prospective study. Material and methods We have recruited 327 newly diagnosed type 2 diabetics aged from 40 to 70 years, in general practice units. Arterial blood pressure has been measured according to WHO guidelines. All data on clinical examination, diabetes's chronic complications were collected during 6 months and statistically analyzed with Epi-Info 6.04 database program. Results Among the patients, 66.7% had arterial hypertension at diagnosis of diabetes, 28% were known as hypertensive. They were 54.3 ± 8.4 years old and have metabolic syndrome in 88.4%. Men have more frequently a higher cardiovascular risk, higher glycaemia and albuminuria; women were more likely to have a metabolic syndrome and a higher BMI. Blood pressure increases with cardiovascular risk and metabolic syndrome components. Microangiopathy is present in 65.7%, atherosclerosis in 59.4 and 71.2% of hypertensive patients who have atherosclerosis have also microvascular complications. Conclusion The prevalence of arterial hypertension in newly diagnosed type 2 diabetes is high. This association is linked with an alarming level of vascular morbidity. Early detection and treatment of these two diseases need a better implication and motivation of patients and health care providers. Clinicaltrials.gov ID: NCT02002091 . [ABSTRACT FROM AUTHOR]

Il est admis à l’unanimité que les acides gras oméga 3 ont de multiples bénéfices pour la santé et plus précisément des effets protecteurs contre les maladies cardiovasculaires et neurodégénératives. L’objectif de ce travail était d’estimer les apports spontanés en acides alphalinolénique (ALA), docosahexaénoïque (DHA), éicosapentaénoïque (EPA) et linoléique (LA). Cette étude d’observation a été réalisée auprès de 42 diabétiques de type 2 (21 hommes et 21 femmes) âgés de 30 à 75 ans. L’estimation des apports en acides gras a été réalisée en utilisant la méthode d’enregistrement sur sept jours. Les résultats ont montré que l’apport moyen en ALA était de 0,99 ± 0,40 g/j soit 0,42 ± 0,13 % de l’apport énergétique total (AET). Aucun de nos patients n’avait un apport suffisant en ALA. Les apports quotidiens moyens en DHA et en EPA étaient respectivement de 90,0 ± 85 mg/j et de 83,5 ± 80 mg/j. Quant à la contribution des aliments aux apports en EPA et en DHA, les poissons et les fruits de mer représentaient la part la plus importante (57 %) de ces deux acides gras. Nos résultats appellent à renforcer l’éducation nutritionnelle des diabétiques afin d’augmenter les apports en acides gras oméga 3 et d’assurer un rapport LA/ALA optimal qui contribuerait à la prévention des maladies cardiovasculaires.

INTRODUCTION: Available data on plasma homocysteine level in patients with nephrotic syndrome (NS) are controversial with increased, decreased and unchanged values reported. Therefore, plasma homocysteine and serum B vitamins in Nigerian children with NS were assessed in this study METHODS: Fasting blood samples were analysed for plasma homocysteine, serum folate and B vitamins in 42 children with NS and 42 age and sex-matched healthy controls in this case control study. Data were compared between NS and control using t test and Chi square. Relationships were tested with regression analysis with p set at 0.05. RESULTS: Prevalence of hyperhomocysteinaemia, low folate and cyanocobalamin in NS was 57.1%, 14.3% and 9.5% respectively. The mean homocysteine level was significantly higher in NS than control (11.3,2.6,mol/L versus 5.5,2.3m,rolling for folate and vitamin B6 levels. CONCLUSION: Clinically important hyperhomocysteinaemia and low B vitamins occur in Nigerian children with nephrotic syndrome. This study suggests that potential usefulness of folate and vitamin B supplementation for reducing high homocysteine levels in nephrotic syndrome need to be further investigated.

Les propriétés anti-oxydantes de la vitamine E – qui font l’objet d’une large majorité des travaux effectués actuellement sur cette vitamine – n’ont été reconnues qu’au cours des années 50. La vitamine E avait cependant été découverte quelque trente ans plus tôt. Mais, paradoxe intéressant, son rôle comme micronutriment essentiel n’a été reconnu qu’à la fin des années 60. Cette vitamine jouit d’un certain nombre de particularités. C’est l’anti-oxydant majeur des milieux lipidiques (huiles, membranes biologiques, lipoprotéines). Elle présente différentes formes moléculaires : des vitamères a, b, g et d, chaque vitamère existant sous différentes formes stéréo-isomériques dont une seule, parmi les huit formes possibles, est naturelle : la forme RRR (figure 1). La molécule présente deux parties : un noyau 6-OH-chromane qui possède la fonction anti-oxydante, et une chaîne latérale à 16 atomes de carbone de structure isoprénique, celle-ci définissant deux grandes familles : les tocophérols à chaîne latérale saturée et les tocotriénols avec une chaîne latérale présentant trois doubles liaisons. Cette chaîne latérale détermine la lipophilicité et la stéréochimie de la molécule. C’est la stéréochimie de la molécule qui détermine à son tour la reconnaissance préférentielle de la forme RRR-a-tocophérol par un transporteur hépatique spécifique dont le rôle physiologique est aujourd’hui reconnu. Chacune de ces formes moléculaires (le nombre théorique est de 64) peut être caractérisée par une activité vitaminique E, définie par référence au pouvoir anti-abortif chez la rate gestante. Les tableaux 1 et 2 donnent cette activité en fonction de la molécule considérée. La forme naturelle de l’a-tocophérol, le RRR-a-tocophérol, possède l’activité la plus élevée, alors que la stéréo-isomérie de la molécule n’exerce aucun effet sur ses propriétés anti-oxydantes. Enfin, c’est à partir de la fin des années 70 et du début des années 80 que les propriétés cellulaires régulatrices de la vitamine E vont être révélées. Elles font aujourd’hui l’objet de recherches actives sur les cascades de signalisation affectant différentes fonctions cellulaires. Elles ne semblent pas corrélées aux propriétés anti-oxydantes mais pourraient impliquer des étapes de reconnaissance stéréo-dépendantes.

Résumé But Déterminer l’âge vasculaire des patients victimes d’AVC et leur risque cardiovasculaire à 10 ans, puis comparer leur âge vasculaire à leur âge réel. Matériels et méthodes Il s’est agit d’une étude rétrospective descriptive effectuée du 1 er janvier 2012 au 31 décembre 2013 à la clinique neurologique du CHU Sylvanus Olympio de Lomé, à partir des dossiers des patients ayant un diagnostic de certitude d’accident vasculaire cérébral basé sur la clinique et la tomodensitométrie cérébrale. Résultats Cent quatre-vingt quatorze patients ont été concernés par notre étude. Il s’agissait de 101 hommes et de 93 femmes, soit un sexe ratio (homme/femme) de 1,08. L’âge réel moyen était de 57,60 ± 13,68 ans. L’hypertension artérielle était le principal facteur de risque avec une prévalence de 86,6 % devant l’hypercholestérolémie totale (54,3 %), l’hypocholestérolémie HDL (22,7 %), le diabète (10,8 %) et le tabagisme (4,12 %). L’âge vasculaire moyen de l’ensemble des patients était de 68,23 ans. L’écart moyen entre l’âge réel et l’âge vasculaire était de 10 ans. Le risque cardiovasculaire moyen à 10 ans dans notre série était de 13,2 %. Conclusion L’âge vasculaire des patients victimes d’accident vasculaire cérébral au CHU Sylvanus Olympio de Lomé est supérieur à leur âge réel, augmentant considérablement le risque de survenue de maladie cardiovasculaire. Le dépistage et la prise en charge précoce des facteurs de risque vasculaire apparaissent donc primordiaux. Aims To determine the vascular age of patients suffering from stroke and their cardiovascular risk at 10 years and to compare their vascular age to their real age. Material and methods It was about a descriptive and retrospective study carried up from 1st January 2012 to 31st December 2013 at the neurologic clinic of the University teaching hospital Sylvanus Olympio of Lome from patients’ files with a confirmed diagnostic of stroke according to the clinical examination and the scanner data. Results One hundred and ninety-four patients were related to our study. They were shared-out into 101 men and 93 women equal to a sex-ratio (man/woman) of 1.08. The average real age was of 57.6 ± 13.7 years. High blood pressure was the main risk factor with a prevailing rate of 86.6%, followed by the total hypercholesterolemia (54.3%), the hypocholesterolemia HDL (22.7%), diabetes (10.8%) and nicotinism addiction (4.1%). The average vascular age for all patients was of 68.23 years. The average difference between the real age and the vascular age was of 10 years. The average cardiovascular risk at 10 years in our study was of 13.2%. Conclusion The vascular age of patients suffering from stroke at the University teaching hospital Sylvanus Olympio of Lome is 10 years higher than their real age. This condition considerably increases their risk of cardiovascular diseases. The screening and the early care about vascular risk factors appear therefore of utmost importance. [ABSTRACT FROM AUTHOR]

Résumé Contexte Les maladies cardiovasculaires (CV) restent la première cause de mortalité chez la femme. Une piste d’amélioration est de développer des parcours cardio-gynécologiques comme le circuit « cœur, artères et femmes » au CHRU de Lille, destinée aux femmes à risque CV. Méthode Cette étude observationnelle a évalué la pertinence du circuit à partir d’une population de 191 femmes hospitalisées pour bilan « vasculaire » ( n = 55) ou « hypertension artérielle (HTA) » ( n = 136) du 1 er janvier au 31 décembre 2013. L’objectif a été d’étudier leurs profils cliniques et leurs prises en charge. Résultats Toutes les femmes étaient à haut risque CV (38 % à très haut risque). Âgées en moyenne de 52 ans, une femme sur 3 avait un antécédent d’hypertension ou de diabète gestationnel, 1 sur 2 était ménopausée. Les estro-progestatifs ont été interrompus chez 12 femmes. Six sur 10 n’avaient pas de suivi gynécologique. Cent quatre-vingt-six femmes étaient hypertendues (HTA nocturne dans 73 % des cas ; non dipping dans 1 cas sur 2 ; 15 nouveaux diagnostics). Le dépistage du syndrome d’apnée du sommeil était positif 1 fois sur 2. Les traitements ont été optimisés, notamment la trithérapie chez les patientes athéromateuses, passant de 30 % à 46 % ( p = 0,0005). Le courrier de synthèse a été transmis au gynécologue dans 18 % des cas. Conclusion Ce bilan à 1 an souligne l’utilité du circuit « cœur, artères et femmes » avec un réajustement des prises en charge et une sensibilisation de tous à l’opportunité d’un suivi coordonné. Introduction Cardiovascular diseases remain the first cause of death in women. To improve women's health cardiologists and gynaecologists should work together on women's specific cardiovascular risk factor. Method Our study evaluated a care pathway named “heart, arteries and women”. One hundred and ninety-one women were included for vascular ( n = 55) or hypertensive ( n = 136) explorations from January the first to December the 31st of 2013. We studied their clinical presentation and medical management. Results All women were at high cardiovascular risk (38% of them at very high risk). The average age was 52 years old. A woman on three had experienced high blood pressure or diabetes during pregnancy. One on two was postmenopausal woman. We stopped twelve estrogen-progesterone contraceptions; 60% didn’t have gynaecological follow-up; 146 had high blood pressures (73% at night, 50% had no dipping blood pressure profile and 15 were newly diagnosed for hypertension). Sleep apnoea syndrome was suspected in half women. Medical therapies were optimized especially for women with atheroma in which 30 to 46% were properly treated ( P = 0.0005). Only 18% of the gynecologists received conclusive reports. Conclusion At one year, our care pathway “heart, arteries and women” allowed to optimize medical therapy and clinical management. Everyone should be aware of this program. [ABSTRACT FROM AUTHOR]

Résumé Contexte et objectif En Guadeloupe, les caractéristiques sur l’association hypertension artérielle–syndrome d’apnée obstructive du sommeil ne sont pas connues. Objectifs Évaluer la fréquence de l’hypertension et du profil non dipper par la mesure ambulatoire de la pression artérielle des 48 heures chez des patients identifiés apnéiques/non apnéiques lors de la polygraphie nocturne. Déterminer les facteurs cardio-métaboliques associés à l’apnée du sommeil. Patients et méthodes Étude transversale réalisée, à l’hôpital de Pointe-à-Pitre, chez des patients adressés en consultation du sommeil pour suspicion d’apnée du sommeil et ayant bénéficié d’une polygraphie nocturne. Le diagnostic était retenu si l’index d’apnée hypopnée était ≥ 5. Deux groupes étaient constitués : apnéique/non apnéique. Les patients avaient une mesure ambulatoire de la pression artérielle des 48 heures. Les facteurs cardio-métaboliques étaient identifiés et mesurés (index Homa-IR, CRP us). Résultats Au total, 204 patients inclus, âge moyen 54 ± 10 ans, 62,7 % de femmes. Une apnée obstructive du sommeil était présente dans 69,6 % des cas, elle était plus fréquente chez les hommes. La différence n’était pas significative entre les deux groupes pour les fréquences de l’hypertension (84,5 % vs 77 % ; p = 0,22), du profil non dipper (77,5 % vs 76 % ; p = 0,79), et la CRP us. Elle était significative pour : l’âge, les ronflements, l’indice de masse corporelle, le tour de taille, l’index Homa-IR, l’obésité, la dyslipidémie et le diabète. Conclusions Ces résultats mettent en exergue des fréquences plus élevées des facteurs cardio-métaboliques chez les patients ayant un syndrome d’apnée obstructive du sommeil et confirment leur haut risque cardiovasculaire. Background and purpose In Guadeloupe, data on the relationships between arterial hypertension and obstructive sleep apnea are unavailable. The aim of this study was: to assess the frequency of hypertension and non-dipper pattern evaluated by 48-hour ambulatory blood pressure monitoring in an adult population identified obstructive sleep apnea/non-obstructive sleep apnea during overnight polygraphy ; to determine the cardio-metabolic factors associated with obstructive sleep apnea. Design and method A cross-sectional study was realized at Pointe-à-Pitre Hospital. Patients were referred for suspected sleep apnea to sleep specialist and performed a nocturnal polygraphy. Diagnosis was confirmed if the apnea-hypopnea index was ≥ 5. We obtained two groups: sleep apnea/non-sleep apnea. All patients underwent 48-hour ambulatory blood pressure monitoring. The cardio-metabolic factors were identified and assessed (fasten level of hs-CRP and Homa-IR index). Results A total of 204 patients were included. Mean age at diagnosis was 54 ± 10 years, 63% were women. OSA was present in 69.6% with a higher frequency in men than in women. Difference was not significant between the two groups for hypertension frequency (84.5% vs 77%; P = 0.22), non-dipper pattern (77.5% vs 76%; P = 0.79) and hs-CRP. Differences for age, snoring, body max index, mean waist circumference, Homa-IR index, obesity, dyslipidemia, and type 2 diabetes were significant. Conclusions Our data highlight raised frequency of cardiovascular metabolic factors in patients with obstructive sleep apnea and confirm their high cardiovascular risk. [ABSTRACT FROM AUTHOR]

La publication de la nouvelle recommandation de la HAS sur les « principales dyslipidémies : stratégies de prise en charge nous incite à revenir sur les nouveaux paradigmes sous-tendus par la prévention du risque cardiovasculaire (RCV). En effet, la prise en compte du risque cardiovasculaire a donné lieu à d'innombrables publications, et à de très nombreuses recommandations

Objective: It consisted in evaluating the cardiovascular risk factors and the overall cardiovascular risk among the personnel of the company of the breweries of Mali., Methodology: This was a cross-sectional, descriptive, analytical study. It was conducted from November 2020 to May 2021 as part of routine consultations and periodic medical visits. The overall cardiovascular risk was estimated by the new Framingham model and the WHO/ISH predictive diagram., Results: A total of 257 workers were included. The average age was 41.2 years. Cardiovascular risk factors listed were, smoking (18.7%), hypercholesterolemia (17.1%), obesity (15.6%), alcoholism (8.6%), age over 50 years (14%). Work-related cardiovascular risk factors were also collected. These were the practice of shift work (58.8%), exposure to noise (44%), sedentary behavior at the workstation (25%). The risk of developing cardiovascular disease in the next 10 years was high in 3.11% and very high in 0.78% of respondents., Conclusion: This study highlights several cardiovascular risk factors, some of which are specific to the professional environment. The implementation of preventive measures is a necessity., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

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Résumé: La pratique d’une activité physique (AP) fait aujourd’hui l’objet d’une attention particulière en santé publique. En effet, les bénéfices attendus en termes de morbi-mortalité cardiovasculaire suggèrent que l’ensemble des praticiens devrait en faire la promotion. Cependant, il existe encore peu de données sur l’impact de l’activité physique sur la santé des patients insuffisants rénaux avant le stade de la dialyse. Cette revue s’intéresse à la relation existant entre maladie rénale chronique et pratique d’une activité physique. Les différents outils d’évaluation du niveau d’activité physique ont permis de mettre en évidence une nette dégradation des capacités physiques des patients dès les stades précoces de la maladie rénale chronique. Bien qu’il n’existe pas actuellement de recommandations spécifiques concernant la pratique de l’activité physique chez les patients insuffisants rénaux, il semble licite d’encourager celle-ci de façon adaptée, en s’inspirant de ce qui est prôné en matière de prévention cardiovasculaire dans la population générale. [Copyright &y& Elsevier]

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)