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Objectives: At the Paris Saint-Joseph Hospital Group neurovascular unit, the therapeutic patient education program "Treatment of high blood pressure after stroke" involved integrating a vascular physician. The objectives were to include a significant number of patients, to integrate learning self-measurement, and to make an initial analysis of the results concerning patient knowledge, self-measurement practices, adherence to treatment, and control of blood pressure., Methods: Eighty-six patients under 90 years of age admitted to the neurovascular unit were included in the program between January 1 and October 31, 2017, and participated in an in-hospital educational diagnostic interview followed by an initial session. During this period, 30 patients were reviewed within 3 to 6 months after discharge, with a post-session evaluation for 22 of them. Patient satisfaction was assessed with a questionnaire. A questionnaire was also proposed to the staff., Results: The mean blood pressure of the 22 patients reviewed was on target and they had improved their level of knowledge. The number of sphygmomanometers increased from 5 to 20, but the practice of cycles was not yet mastered. Levels of observed compliance changed little. Patients and paramedics appreciated the program and were convinced of its usefulness. These results do not support a direct effect of therapeutic patient education on blood pressure control, but the observed results are positive and encouraging., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Aim: To research a retinal arterioles wall-to-lumen ratio or lumen diameter cut-off that would discriminate hypertensive from normal subjects using adaptive optics camera., Patients and Methods: One thousand and five hundred subjects were consecutively recruited and Adaptive Optics Camera rtx1™ (Imagine-Eyes, Orsay, France) was used to measure wall thickness, internal diameter, to calculate wall-to-lumen ratio (WLR) and wall cross-sectional area of retinal arterioles. Sitting office blood pressure was measured once, just before retinal measurements and office blood pressure was defined as systolic blood pressure>=140mmHg and diastolic blood pressure>=90mmHg. ROC curves were constructed to determine cut-off values for retinal parameters to diagnose office hypertension. In another population of 276 subjects office BP, retinal arterioles evaluation and home blood pressure monitoring were obtained. The applicability of retinal WLR or diameter cut-off values were compared in patients with controlled, masked, white-coat and sustained hypertension., Results: In 1500 patients, a WLR>0.31 discriminated office hypertensive subjects with a 0.57 sensitivity and 0.71 specificity. Lumen diameter<78.2μm discriminated office hypertension with a 0.73 sensitivity and a 0.52 specificity. In the other 276 patients, WLR was higher in sustained hypertension vs normotensive patients (0.330±0.06 vs 0.292±0.05; P<0.001) and diameter was narrower in masked hypertensive vs normotensive subjects (73.0±11.2 vs 78.5±11.6μm; P<0.005)., Conclusion: A WLR higher than 0.31 is in favour of office arterial hypertension; a diameter under<78μm may indicate a masked hypertension. Retinal arterioles analysis through adaptive optics camera may help the diagnosis of arterial hypertension, in particular in case of masked hypertension., (Copyright © 2016. Published by Elsevier SAS.)

Rationale: Some studies suggest that a high heart rate (HR) would be predictive of the incidence of an elevated blood pressure (BP). Cardiac autonomic dysfunction (CAD) affects a high proportion of obese patients. CAD could be involved in BP increase. Our aim was to examine the relationship between CAD, HR and BP in obese patients without known diabetes., Patients and Methods: We included 428 overweight or obese patients. CAD was assessed by analyzing HR variations during three standard tests (Valsalva, deep breathing, lying-to-standing), which are mostly dependent on vagal control. An oral load in glucose was performed and the Matsuda index was calculated., Results: The population was separated in 4 groups according to the grade of CAD (no or only one abnormal test, 2 or 3 abnormal tests) and HR (< or ≥ 75 bpm). Age was similar in the four groups. Systolic (P=0.05), diastolic (P<0.005) and mean BP (P<0.001) differed significantly between the 4 groups, and was the highest in the group of patients who had 2 or 3 abnormal tests and HR ≥ 75 bpm. Matsuda index differed across the groups (P=0.018) and was the lowest in this group., Conclusion: These data indicate that among overweight or obese patients with a defect in cardiac vagal activity BP is elevated only in those with a high heart rate, which is indicative of a more marked insulin resistance and probably an excess in sympathetic activity., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Aim: Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors., Methods: Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n=3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction)., Results: At baseline, transgenic rats had +18mmHg higher bood pressure and -8% lower body weight compared to non-transgenic rats (P<0.05) without significant changes for the vehicle groups throughout the study (P>0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P<0.05) in transgenic and +25%, +5.3% and +6.7% (P>0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P>0.05)., Conclusion: Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Unlabelled: HTA Vasc offers an approved educational program for hypertensive patients at high cardiovascular risk (CVR)., Method: A telephone survey (December 2011-July 2012) evaluated the benefits of different workshops "my treatment", "my blood pressure" and "my nutrition", more than 6 months after the end of the program. The follow-up data (TS) were compared to inclusion data (T0) and to final data (TF) in 73 hypertensive patients., Results: The follow-up period was 6 to 31 months. The number of hypertensive controlled patients [blood pressure (BP)<140/90 mmHg] increased from 55.4% to 75.4% (P=0.0158) in TF, which remained over time. The practice of physical activity increased from 47.9% (T0) to 79.5% (TS) (P=0.001). The follow-up period of 18 months or more was associated with a tendency to weight gain (P=0.0059) and with a decline in physical activity [89.7% (<18 months) to 67.5% (≥ 18 months) (P=0.0198)]. The practice of self-measurement BP increased from 41.1% (T0) to 71.2% (TS) (P<0.0001); knowledge of the "rule of three" increased from 6.8% (T0) to 74% (TS) (P<0.0001)., Conclusion: An educational support contributes to a better long-term BP control. The motivation for lifestyle rules decreases with time. The implementation of a structured motivational follow-up could maintain the lifestyle motivation at these CVR patients., (Copyright © 2013. Published by Elsevier SAS.)

Objectives: The authors have tried to assess the noise annoyance and its relation with the development of hypertension for the staff working at the civilian airport of Algiers. This population is constantly subject to aircraft noises. The noise, through creating stress, acts on the central nervous system and on the autonomic nervous system and is likely to cause hypertension by increasing peripheral resistance, total cholesterol, fatty acids, adrenaline, cortisol and blood glucose. A number of studies revealed that starting from 65 decibels, the noise causes hypertension for patients of more than 40 years following 5 years of exposure., Methods: An analytical study was conducted in 2000, which made the comparison between two groups of men working at Air Algérie company. There were 91 officers belonging to air crew, whose number was estimated at that time at 547, and whose average age was 49 years, compared with 111 officers of the ground crew on a total of 1200 persons and whose average age was 56 years. All those officers have received work medical consultation. Patients with suspected hypertension were systematically oriented to cardiologist. Similarly, everyone has had a biological assessment, an ophthalmologic consultation and ENT consultation as well., Results: Hypertension was found in 9.25% of the ground crew and in 16.63% of the air crew (P<0.001). Hypertension is more common among air crew, subject to a more important noise nuisance, at a younger age and with less risk factors than the ground crew, who develops hypertension with similar prevalence to general population's but at a younger age. The air crew gives more importance to treatment due to the risk of losing their navigation license. The ENT examination was abnormal in 39% of the air crew versus 8% of the ground crew., Conclusion: In the light of these results, the noise seems to really interfere in the development of hypertension in airport environment. It would be more interesting to identify the number of strokes and particularly acute coronary syndromes which are far from being rare in this population subject to this noise annoyance. Preventive measures are of course extremely important., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

L'hypertension artérielle (HTA) est le facteur de risque modifiable responsable du plus d'années de vie en bonne santé perdues dans le monde. Le risque d'événement cardiovasculaire augmente de façon exponentielle avec le niveau de pression artérielle (PA) dès 115 mmHg pour la PA systolique. Le diagnostic de l'HTA et l'évaluation de l'efficacité du traitement se font idéalement avec des mesures de la PA hors du cabinet : automesures ou mesures ambulatoires de la PA. En l'absence d'indication préférentielle, le traitement pharmacologique repose sur les diurétiques thiazidiques, les inhibiteurs calciques, les inhibiteurs de l'enzyme de conversion et les antagonistes des récepteurs de l'angiotensine. Ces traitements sont associés à une réduction importante de la morbimortalité chez les personnes dont la PA est ≥ 140/90 mmHg en mesure clinique (automesures ≥ 135/85 mmHg). Pour les personnes à haut risque cardiovasculaire, notamment en situation de prévention secondaire, l'initiation du traitement pour une PA ≥ 130/80 mmHg en mesure clinique est également profitable (automesures ≥ 130/80 mmHg également). On débute désormais volontiers le traitement par une bithérapie fixe à demi-dose, plus efficace et mieux tolérée qu'une monothérapie à pleine dose. L'évaluation de l'effet clinique a lieu à 4 semaines et l'intensification, si elle est nécessaire, se fait alors généralement en passant à la bithérapie fixe pleine dose pour les deux composantes. Hypertension is the modifiable risk factor causing the largest loss in healthy life-years. The risk of cardiovascular events increases exponentially with the level of blood pressure (BP), starting from 115 mmHg for systolic BP. Out-of-office BP measurements (self-measurements or ambulatory BP measurements) are now preferred for the diagnosis and follow up. In the absence of a preferred indication, antihypertensive treatment is based on thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. These treatments are associated with a significant reduction in morbidity and mortality in people with office BP ≥ 140/90 mmHg (self-measurements ≥ 135/85 mmHg). For people at high cardiovascular risk, especially those with a history of cardiovascular disease, starting the treatment for an office BP ≥ 130/80 mmHg is also beneficial (self-measurements ≥ 130/80 mmHg as well). It is now common to start treatment with half-dose dual therapy, which is more effective and better tolerated than full-dose monotherapy. The clinical effect is assessed at 4 weeks and intensification, if required, is then usually done by switching to the same dual therapy at full-dose for both components. [ABSTRACT FROM AUTHOR]

We studied the effects of oral L-arginine on post-exercise blood pressure (BP). Throughout October 2020 and February 2021, the electronic databases Medline, Web of Science, CINAHL, Embase, Cochrane, Bireme, Open Gray, MedRxiv, Clinical Trials and Scopus were considered. The terms enforced to search randomized, double-blind and placebo-controlled clinical trials were, "Arginine" AND "Post-exercise". Three studies were involved in the meta-analysis, the original results of the three studies demonstrated a trend related to L-arginine intervention. The 95% CI ranged from −7.94 to −2.14 with a combined effect size of −5.04 for systolic BP and −4.96 to −0.97 with a combined effect size of −2.96 for diastolic BP. Our meta-analysis revealed a combined effect size of 3.40 (P = 0.0007) for systolic BP and 2.91 (P = 0.004) for diastolic BP supportive of L-arginine intervention. Our review delivers evidence that oral L-arginine supplementation has the potential to reduce post-exercise systolic and diastolic BP in hypertensive patients. [ABSTRACT FROM AUTHOR]

Résumé: L'endothélium est un régulateur clé de l'homéostasie et du tonus vasculaire ainsi que de diverses autres fonctions ; il contrôle notamment la prolifération des cellules musculaires lisses, la migration et la translocation des leucocytes, les mécanismes de thrombose et de thrombolyse. L'athérogenèse, le développement et l'instabilité de la plaque d'athérome sont, au premier chef, liés à des dysfonctions de l'endothélium. La dysfonction endothéliale intervient à tous les stades de l'athérosclérose et, une fois présente, prédispose le vaisseau à l'inflammation, à une vasoconstriction anormale, à un risque accru de thrombose et enfin à la rupture ou l'érosion de la plaque. La dysfonction endothéliale est étroitement liée aux facteurs de risque de l'athérosclérose, à leur intensité (niveau de pression ou d'hypercholestérolémie par exemple) et à la durée de l'exposition à ce ou ces facteurs de risque. Des études interventionnelles ont démontré une régression de la dysfonction endothéliale associée à une amélioration des résultats cliniques chez des patients recevant différents traitements. La coexistence d'une hypertension artérielle et d'une hypercholestérolémie a un impact négatif plus que cumulatif sur l'endothélium. Les traitements de l'hypertension et de l'hypercholestérolémie, en particulier les inhibiteurs de l'enzyme de conversion de l'angiotensine (IEC) et les statines, ont des effets bénéfiques allant au-delà de ceux observés après réduction isolée de la pression artérielle ou des taux de lipides ; l'association de ces deux classes thérapeutiques a des effets bénéfiques supérieurs à ceux obtenus avec les monothérapies respectives. Les médiateurs clés communs aux actions pléiotropiques des IEC et des statines sont l'angiotensine II (Ang II) et le monoxyde d'azote (NO), qui affectent principalement le stress oxydatif et les voies de l'inflammation. IEC et statines diminuent les risques de complications cardiovasculaires en réduisant la pression artérielle et les taux de lipides plasmatiques, mais aussi par leurs effets pléiotropiques agissant par d'autres voies. L'association d'un IEC et d'une statine constitue donc une stratégie simple pour maximiser les effets du traitement sur l'endothélium et améliorer les résultats chez les patients à risque d'événements cardiovasculaires. The endothelium is a key regulator of vascular homeostasis and tone as well as a variety of other functions, including control of smooth muscle cell proliferation, leukocyte migration and translocation, thrombosis and thrombolysis mechanisms. Atherogenesis, plaque development and instability are primarily related to endothelial dysfunction. Endothelial dysfunction occurs at all stages of atherosclerosis and, once present, predisposes the vessel to inflammation, abnormal vasoconstriction, increased risk of thrombosis, and finally plaque rupture or erosion. Endothelial dysfunction is closely related to the risk factors for atherosclerosis; their intensity (e.g. , blood pressure level or hypercholesterolemia) and the duration of exposure to the risk factors. Interventional studies have demonstrated regression of endothelial dysfunction associated with improved clinical outcomes in patients receiving different treatments. The coexistence of hypertension and hypercholesterolemia has more than a cumulative negative impact on the endothelium. Treatments for hypertension and hypercholesterolemia, particularly angiotensin-converting enzyme inhibitors (IEC) and statins, have beneficial effects beyond those observed after reduction of blood pressure or lipid levels alone; the combination of these two therapeutic classes has beneficial effects superior to those obtained with the respective monotherapies. The key mediators common to the pleiotropic actions of IEC and statins are Ang II and NO, which primarily affect oxidative stress and inflammation pathways. IEC and statins reduce the risk of cardiovascular complications by reducing blood pressure and plasma lipid levels but also by their pleiotropic effects acting through several other pathways. The combination of an IEC and a statin is therefore a simple strategy to maximize the effects of treatment on the endothelium and improve outcomes in patients at risk of cardiovascular events. [ABSTRACT FROM AUTHOR]

Malgré les progrès thérapeutiques, moins de la moitié des patients hypertendus sont équilibrés. L'objectif de cette étude était d'étudier les liens entre le contrôle tensionnel et les facteurs socioéconomiques (SE). Pour répondre à notre objectif, nous avons utilisé les données, recueillies dans le service de cardiologie de l'hôpital universitaire de Sfax, dans le cadre du registre national tunisien d'hypertension artérielle. Nous avons étudié les associations entre les variables SE (niveau scolaire, profession, couverture médicale) et un contrôle optimal de la pression artérielle (PAS < 140 mmHg et PAD < 90 mmHg) en utilisant des modèles de régression logistique. L'âge moyen de notre population était de 65 ans et le sexe-ratio de 0,95. Nous avons trouvé, comme prévu, les facteurs cliniques et comportementaux associés à un bon équilibre tensionnel à savoir : le sexe féminin, le régime hyposodé, l'observance thérapeutique, et la pratique d'une activité physique régulière. En revanche, l'obésité et le traitement par un nombre augmenté d'anti-hypertenseurs ont été associés à un mauvais contrôle tensionnel. L'étude de l'effet des variables socioéconomiques sur l'équilibre tensionnel trouve un gradient significatif en défaveur des catégories sociales les plus défavorisées pour nos trois variables sociales dans l'analyse univariée. L'inclusion des facteurs cliniques et comportementaux dans l'analyse multivariée a atténué ces associations mais ne les a pas entièrement expliquées. Notre étude montre qu'il existe des inégalités sociales du contrôle de la pression artérielle. La justice sociale et l'amélioration des conditions de vie représentent probablement les vraies solutions au problème de ces inégalités sociales de santé. Despite therapeutic progress, less than half of hypertensive patients are controlled. The objective of this study was to examine the links between blood pressure control and socioeconomic factors. We used data collected in the cardiology department of Sfax University Hospital as part of the Tunisian national hypertension registry. We studied the associations between the socio-economic variables (educational level, profession, medical insurance) and optimal blood pressure control (SBP < 140 mmHg and DBP < 90 mmHg) using logistic regression models. The average age of our population was 65 and the sex ratio was 0.95. We found, as expected, the clinical and behavioral factors associated with a good blood pressure control, namely: female sex, low-sodium diet, therapeutic compliance, and regular physical activity. However, obesity and an increased number of antihypertensive drugs have been associated with poor blood pressure control. The study of the effect of socio-economic variables on BP control finds a significant gradient against the most disadvantaged social categories for our three social variables in the univariate analysis. The inclusion of clinical and behavioral factors in the multivariate analysis attenuated these associations but did not fully explain them. Our study shows that there are social inequalities in the control of blood pressure. Social justice and improving living conditions are probably the real solutions to the problem of these social inequalities in health. [ABSTRACT FROM AUTHOR]

Depuis janvier 2017, les traitements à base d'olmésartan ne sont plus remboursés par la Sécurité Sociale en France. En effet, des cas d'entéropathies exsudatives, potentiellement mortels, ont été décrits avec cette molécule. Il s'agissait d'étudier l'impact du déremboursement de l'olmésartan chez les patients hypertendus. Il s'agissait d'une étude rétrospective descriptive à partir des données issues du logiciel métier de deux maisons de santé de Normandie occidentale. Pour évaluer le contrôle tensionnel des patients, les différentes prises de tension ayant eu lieu l'année précédant (période 1) et suivant (période 2) l'arrêt potentiel de l'olmésartan ont été analysées. Une analyse médico-économique était réalisée en complément. De juin 2015 à juillet 2017, 107 patients hypertendus traités par olmésartan ont été inclus. Parmi eux, 47 patients (44 %) avaient une monothérapie anti-hypertensive. L'olmésartan avait été remplacé majoritairement par un autre sartan (75 %, 80/107) dont le valsartan (59 %, 47/80). Les pressions artérielles moyennes durant la période 1 et la période 2 n'étaient pas significativement différentes. De plus, 83 % des patients avaient une HTA contrôlée avec l'olmésartan puis 81 % après le changement de traitement (p = 0,86). L'utilisation de l'olmésartan engendrait un surcoût de 58 % par rapport aux autres molécules l'ayant remplacé lors de la période 2. Le déremboursement de l'olmésartan n'a pas eu de répercussion sur l'équilibre tensionnel des patients hypertendus alors que son coût est important. En plus d'effets indésirables potentiellement graves, l'olmésartan n'a pas prouvé d'amélioration de la morbi-mortalité cardio-vasculaire. Since January 2017, olmesartan-based treatment are no longer reimbursed by French national health insurance. Indeed, enteropathy cases, potentially lethal, were described in relation to this medication. Objectives were to study the impact of stopping the reimbursement of olmesartan for hypertensive patients. A descriptive retrospective study was performed with data from two primary care facilities in French occidental Normandy. To evaluate the blood pressure control, different blood pressure measurements were considered during the year before (period 1) and the year after (period 2) potential stopping olmesartan. A medico-economic analysis was also realized. From June 2015 to July 2017, 107 hypertensive patients treated by olmesartan were included. Among them, 47 patients (44%) had an antihypertensive monotherapy. olmesartan had been mainly switched by another sartan (75%, 80/107) including valsartan (59%, 47/80). Mean blood pressures during period 1 and period 2 were not statistically different. Moreover, 83% of patients were initially controlled with olmesartan and 81% after switching medication (P = 0,86). The use of olmesartan generated an additional cost of 58% compared to the other drugs that replaced it during period 2. Stopping olmesartan reimbursement didn't seem to have a significant impact on blood pressure control of hypertensive patients while its cost is significant. In addition to potential serious side effects, olmesartan has not shown any improvement in cardiovascular morbi-mortality. [ABSTRACT FROM AUTHOR]

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. Evaluate the contribution of leukocyte ratios in CVR assessment of non-diabetic hypertensive adults. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background : HIV infection and antiretroviral therapy may be responsible for some cardiovascular complications such as high blood pressure (hypertension). Objective: To determine the prevalence of hypertension in HIV-infected and HIVuninfected patients. Methods : This cross-sectional, observational and multicentric study was carried out in Ambulatory Treatment Centers and General Referral Hospitals of Mbuji-Mayi City for 11 months, from 15th August 2010 to 15th July 2011. This study involved 1037 subjects, including 445 HIV-infected patients and 592 uninfected patients. Of the 445 HIV-infected patients, 425 were on the antiretroviral therapy [Stavudine (d4T) +Lamivudine (3TC) +Nevirapine (NVP)] regimen. Clinical and therapeutic data were collected and analyzed using Epi-Info® software 3.5.3. (CDC, USA, 2008) Results: The prevalence of hypertension among HIV-infected patients was 11.50% versus 10.60% among HIV negative patients (p = 0.751). The average of Systolic Blood Pressure (SBP) was 116.4 ± 16.7mmHg for HIV-infected patients versus 115.8 ± 17.02mmHg for HIV negative patients (p = 0.575). The average of Diastolic Blood Pressure (DBP) was 74.2 ± 12.7mmHg for HIVinfected patients versus 75 ± 11.7mmHg for HIV negative patients (p = 0.240). Depending on the duration of the antiretroviral therapy (≤2 years versus ≥2 years), the average of the SBP (116,3±17,2mmHg versus 117,0±16,1m mHg) and DBP (74,7±13,3mmHg versus 74,0±12,0mmHg) were not statistically different from each other (p> 0.05). The difference in averages between SBP and DBP was not statistically significant between HIV-infected patients on antiretroviral therapy and those naive (p> 0.05). Conclusion: The prevalence of hypertension in HIV-infected patients is not statistically different from that estimated in HIV-uninfected patients. HIV infection and antiretroviral therapy (duration and regimen) were not correlated with hypertension in our study. [ABSTRACT FROM AUTHOR]

Aim of the study We aimed to determine the prevalence of orthostatic hypertension (OHT) in normotensive, newly diagnosed type 2 diabetics, to assess clinical, biological characteristics of those patients and evaluate the evolution of their blood pressure, after one year of follow-up. Materials and methods It is an observational, prospective, cohort study, on 108 normotensive, newly diagnosed diabetics, 40 men and 68 women aged from 40 to 70 ans. OHT was defined as an increase of systolic blood pressure (SBP) ≥ 20 mmHg and/or diastolic blood pressure (DBP) ≥ 10 mmHg, after 1 and 2 min of standing from supine position. Arterial hypertension and metabolic syndrome were respectively defined according to WHO and AHA 2009 guidelines. Clinical and biological data were collected for all patients. They had a screening for diabetic complications and a follow-up during one year. Statistical analysis was performed with Epi-Info 6.04. Results We found OHT in 22 patients (20.4%). Patients with OHT had a higher SBP at lying position ( P = 0.029), a higher waist circumference ( P = 0.022) and LDL ( P = 0.041). They had more frequently obesity ( P = 0.036) left ventricular hypertrophy ( P = 0.024), metabolic syndrome ( P = 0.042) and cerebrovascular events ( P = 0.050) when compared with those with normal blood pressure response to orthostasis. One year after follow-up, the prevalence of permanent hypertension was significantly higher in the OHT group ( P = 0.0008). Conclusion Our study suggests that OHT is associated with insulin resistance syndrome and onset of sustained arterial hypertension in normotensive, newly diagnosed diabetics. [ABSTRACT FROM AUTHOR]

Résumé La prise en charge du sujet hypertendu est fortement dépendante de l’analyse des chiffres tensionnels, une mesure fiable et précise de la pression artérielle apparaît ainsi fondamentale. Le traditionnel sphygmomanomètre à mercure a désormais laissé la place aux tensiomètres automatiques basés sur la méthode oscillométrique, et les progrès technologiques ont permis le développement d’appareils de mesure précis de la pression artérielle en condition clinique ou ambulatoire. L’objectif de cette mise au point est de décrire les différentes techniques de mesure de la pression artérielle, en insistant sur leurs indications et leurs bénéfices cliniques respectifs. La pression artérielle mesurée au cabinet médical présente une grande variabilité et des conditions expérimentales strictes doivent être respectées pour la rendre interprétable. Les recommandations nationales et internationales insistent sur le nécessaire contrôle de la pression artérielle en condition ambulatoire, cette mesure étant plus reproductible et mieux corrélée au pronostic cardiovasculaire. L’auto-mesure tensionnelle, si elle est bien expliquée au patient, présente dans ce contexte de nombreux atouts, même si la mesure ambulatoire de la pression artérielle (MAPA) reste la référence. La place des mesures centrales de la pression artérielle et de la rigidité aortique dans la stratégie de prise en charge du sujet hypertendu restent encore à définir. The management of hypertensive patients is greatly influenced by blood pressure levels and accurate measurement of blood pressure is crucial in this context. Mercury sphygmomanometer has been progressively replaced by more precise oscillometric devices that can be widely used in the clinic and ambulatory setting. The purpose of this review was to detail the different methods for evaluating blood pressure, and to refine their indications and clinical benefit. Office blood pressure measurement has a great variability and should follow a strict protocol to give consistent results. National and international guidelines focus on blood pressure measurement in the ambulatory setting. When used by trained patients, home blood pressure monitoring is reproducible and can provide substantial prognostic information, even if ambulatory blood pressure monitoring remains the gold standard. The role of central blood pressure and pulse wave velocity monitoring in the therapeutic strategy of hypertension needs further assessment. [ABSTRACT FROM AUTHOR]

L’objectif de la prise en charge d’une hypertension artérielle n’est pas la diminution de la pression artérielle, mais la réduction du risque d’accidents cardiovasculaires. Son but est de diminuer la morbi-mortalité cardiovasculaire. [ABSTRACT FROM AUTHOR]

L’hypertension artérielle (HTA) touche un tiers de la population française et, plus particulièrement, les personnes avançant en âge. L’HTA fait partie des facteurs de risque cardiovasculaire. Susceptible d’être à l’origine de complications cardiaques, vasculaires, neurologiques, rénales et ophtalmologiques, cette maladie nécessite une prise en charge thérapeutique à vie. Le suivi de l’HTA, capital, est basé sur une surveillance tensionnelle rigoureuse. [ABSTRACT FROM AUTHOR]

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Analgesic drugs, non-steroidal antiinflammatory drugs and paracetamol (acetaminophen) in particular, belong to the most widely prescribed therapeutic agents. Beside their efficacy in pain relief, these drugs were recently linked to increased cardiovascular risk. Indeed, epidemiological and clinical studies showed that non-selective nonsteroidal anti-inflammatory drugs, as well as selective cyclooxygenase-2 inhibitors both may increase blood pressure and cardiovascular events. However, the effect of paracetamol (acetaminophen) on blood pressure and cardiovascular health should not be neglected, too.Unfortunately, longterm randomized controlled trials appropriately powered to evaluate cardiovascular outcomes are lacking. This review summarizes the available data about the effect of paracetamol in particular, on blood pressure and other cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the blood pressure (BP) control and the efficacy of antihypertensive monotherapy using home BP self-measurement in a French population of treated hypertensive subjects in 2007 2009 and 2010. Methods: The French League Against Hypertension Surveys (FLAHS) are conducted among a representative sample of individuals aged 35 years and older living in France. For the 2007, 2009 and 2010 surveys, a sample of 1467 subjects who owned a BP self-measurement device and performed three consecutive morning BP measurements were included. Among the 60% of subjects who reported taking at least one antihypertensive drug, we analyzed subjects treated with one of the following antihypertensive monotherapy, i.e., beta-blocker (BB), ACE inhibitors, calcium channel blocker (CCB) and angiotensin receptor blockers (ARB). Results: Among treated hypertensive subjects (n =886), 66% (n =586) had home BP below the 140/90mmHg threshold and 50% (n =449) below 135/85mmHg. Three hundred two subjects were treated with a single antihypertensive drug, 33% had ARB, 25% BB, 19% CCB and 13% ACE inhibitors. Age (years) for each treatment group is different (P <0.01) CCB (72.1±9.3), BB (65.6±9.8), ARB (68.6±8.9) and ACEI (67.3±10.2). The mean systolic/diastolic BP (mmHg) is not comparable between monotherapy 130.7/76.1 (ARB), 130.7/78.7 (BB), 134.0/75.2 (CCB) and 139.1/80.3 (ACEI) for ARB, BB, CCB and ACE inhibitors respectively. Compared to ACE inhibitors, BP was significantly lower with ARB (P <0.01). The proportion of subjects with a BP below 140/90mmHg was 73% for ARB, 52% for BB, 68% for CCB and 47% for ACE with a statistical significance (P =0.03) for ARB vs. ACEI and CCB vs. ACEI. Conclusion: Among subjects treated for hypertension who owned a BP self-measurement device, 50 to 66% had a controlled BP (depending on the threshold used). It is observed differences between antihypertensive efficacy of monotherapy with a larger number of patients controlled with ARB or CCB. [Copyright &y& Elsevier]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. 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.)

Copyright of Diabetes & Metabolism is the property of Masson Editeur 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.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. 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.)

Copyright of Diabetes & Metabolism is the property of Masson Editeur 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.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. 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.)

Abstract: The beta-blocker (BB) prescription remains insufficient despite guidelines, especially, for chronic heart failure. Patients suffering chronic obstructive pulmonary disease (COPD) are particularly less treated by BB. The level of evidence for BB prescription is however especially high and as we will focus on, the level of evidence for the safety of BB in the COPD context is convincing enough. We, thus, propose to review the existing literature in regard to this prescription of BB in the chronic heart failure, in the coronary artery disease and for high blood pressure in COPD patients. We then propose our approach to improve the level of prescription of BB in COPD patient really justifying this prescription in cardiology. [Copyright &y& Elsevier]

Copyright of Néphrologie & Thérapeutique is the property of John Libbey Eurotext Ltd. 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.)

Abstract: Purpose. – The prevalence or hypertension increases with aging, reaching more than 50% in people aged 60 years and older. The increase of systolic blood pressure is a major risk of cardiovascular event. Methods. – With the aim of assessing risk factors in old people "in apparent good health", we analysed blood pressure and treatments in people aged 60 years and older who had a periodic check-up that was adapted to older people. Results. – This check-up concerned, between April and December 2003, 1638 people with a mean age of 68 years (SD 5.7): 815 men and 823 women. Fourty percent had a systolic blood pressure (SBP) ≥140 mmHg (44% of men, 36% of women); 6% (8% of men, 4% of women) had a diastolic blood pressure (DBP) ≥90 mmHg. A treatment for hypertension was followed by 473 people: 31% of men and 26% of women. Fifty percent were controlled for the SBP and the DBP. Fourty-two percent were not controlled for the SBP, but were controlled for the DBP. Seven percent were not controlled for the SBP nor the DBP. Only 3 subjects (<1%) were not controlled for the DBP, whereas they were controlled for SBP. Conclusion. – These results, combined with data of literature on the predominant role of SBP in cardio-vascular risk, as compared with DBP, underline the need for a better treatment of systolic hypertension in older people. [Copyright &y& Elsevier]

Copyright of EMC-Cardiologie-Angeiologie is the property of Elsevier B.V. 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.)

Copyright of EMC-Cardiologie-Angeiologie is the property of Elsevier B.V. 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.)

Copyright of EMC-Cardiologie-Angeiologie is the property of Elsevier B.V. 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.)

Copyright of EMC-Medecine is the property of Elsevier B.V. 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.)

The aim of our study was assess anatomical and functional results of renal artery angioplasty with and without stenting in 25 hypertensive patients (8 female and 16 male, 42.6 and 61.6 years old respectively) with significative renal artery stenosis (RAS) (atherosclerotic: 22; fibrodysplastic: 3). Eleven patients had simple angioplasty and 13 had stenting. The rate of angioplasty success was 96%. In the stent group, the anatomical result was better: 2% of residual stenosis versus 24% in the other group (p < 0.001). Restenosis occurred in 2 patients. Immediately after revascularisation arterial blood pressure decreased from 195/105 ± to 150/85 ± mmHg in-group without stent (p < 0.001) and from 190/100 to 145/85 mmHg in the group (p < 0.001). The value of serum creatinine concentration in patient with renal failure didn’t change after revascularization. [Copyright &y& Elsevier]

Copyright of Diabetes & Metabolism is the property of Masson Editeur 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.)

Résumé Environ un quart de la population mondiale adulte souffrirait d’hypertension artérielle, une maladie dont l’incidence ne fait que croître du fait de la montée en puissance des facteurs qui favorisent son apparition tels que l’obésité et la sédentarité. Les règles d’hygiène de vie et les compléments alimentaires peuvent aider à normaliser les paramètres tensionnels avant que le traitement médicamenteux ne s’impose. Summary Around one quarter of the world's adult population is thought to have high blood pressure. The prevalence of the condition is constantly increasing due to the rise in factors favouring its occurrence such as obesity and sedentary living. Lifestyle changes and food supplements can help to normalise pressure parameters before a medication-based treatment needs to be envisaged. [ABSTRACT FROM AUTHOR]