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1. Niveau d’activité physique et contrôle ambulatoire de l’hypertension artérielle. Résultats de l’étude pilote « Acti-HTA »

Author

Sosner, Philippe, Ott, Julien, Steichen, O., Bally, Stéphane, Krummel, Thierry, Brucker, M., Lequeux, Benoît, Dourmap, Caroline, Llaty, P., LE COZ, Sylvie, Baguet, S., Miranne, A., Labrunée, M., Grémeaux, Vincent, Lopez-Sublet, M., Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) ( MOVE ), Université de Poitiers, Service de néphrologie [Centre hospitalier de Haguenau], Centre hospitalier de Haguenau, Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Service de néphrologie - dialyse [Centre hospitalier Métropole Savoie - Chambéry], Centre Hospitalier Métropole Savoie [Chambéry], Service de néphrologie et hémodialyse [CHU de Strasbourg], CHU Strasbourg, Service de néphrologie [Centre hospitalier de Valence], Centre hospitalier de Valence, Service de cardiologie [CHU de Poitiers], CHU de Poitiers, Service de cardiologie et maladies vasculaires [CHU de Rennes], CHU Pontchaillou [Rennes], Service de néphrologie - dialyse [Centre hospitalier de Saint-Nazaire], Centre hospitalier de Saint-Nazaire, groupe hospitalier Mutualiste, Faculté de Médecine et de Pharmacie - Université de Poitiers, Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Hôpital de Rangueil, Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de médecine interne [Avicenne], Hôpital Avicenne, Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) (MOVE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Groupe Hospitalier Mutualiste [Grenoble] (GHM), Université de Poitiers - Faculté de Médecine et de Pharmacie, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Avicenne [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Activité physique, Caloric expenditure, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, High blood pressure, Physical activity, Hypertension, Home blood pressure measurement, Dépense énergétique, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Hypertension artérielle, Automesure tensionnelle
Abstract

Retour sur les 34èmes Journées de l’Hypertension Artérielle; International audience; While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary 20/30, des sédentaires < 10/30). Les hypertendus contrôlés en AMT (< 135/85 mm Hg) (55 % des sujets), en comparaison aux non contrôlés, étaient plus âgés, avaient une tendance non significative à une dépense calorique déclarée plus élevée (4959 ± 5045 kcal/semaine vs 4048 ± 4199 kcal/semaine, p = 0,3755) et leur score de Dijon (19,44 ± 5,81 vs 18,00 ± 4,32, p = 0,2094) montrait une proportion de sujets « actifs » plus importante (48,9 % vs 34,2 %, p = 0,1773). En conclusion, nos résultats ont objectivé une « tendance » à une AP déclarée plus importante pour les sujets dont l’HTA est contrôlée. Ceci nous encourage à poursuivre par une étude qui inclurait davantage de sujets et dont l’AP serait évaluée par le port pendant 7 jours d’un capteur de type accéléromètre (méthode objective).

Published
2015
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2. Physical activity level and home blood pressure measurement: Pilot study 'Acti-HTA'

Author

S. Bally, M. Lopez-Sublet, Olivier Steichen, Vincent Gremeaux, Philippe Sosner, P. Llaty, M. Brucker, S. Le Coz, Benoit Lequeux, A. Miranne, C. Dourmap, Club des jeunes hypertensiologues, Thierry Krummel, J. Ott, S. Baguet, M. Labrunee, université de Bourgogne, CAPS, Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) (MOVE), Université de Poitiers, Service de néphrologie [Centre hospitalier de Haguenau], Centre hospitalier de Haguenau, Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de néphrologie - dialyse [Centre hospitalier Métropole Savoie - Chambéry], Centre Hospitalier Métropole Savoie [Chambéry], Service de néphrologie et hémodialyse [CHU de Strasbourg], CHU Strasbourg, Service de néphrologie [Centre hospitalier de Valence], Centre hospitalier de Valence, Service de cardiologie [CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de néphrologie - dialyse [Centre hospitalier de Saint-Nazaire], Centre hospitalier de Saint-Nazaire, Groupe Hospitalier Mutualiste [Grenoble] (GHM), Université de Poitiers - Faculté de Médecine et de Pharmacie, Service Médecine physique et de réadaptation [CHU Toulouse], Pôle Neurosciences [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine interne [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) ( MOVE ), Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], CHU de Poitiers, Service de cardiologie et maladies vasculaires [CHU de Rennes], groupe hospitalier Mutualiste, Faculté de Médecine et de Pharmacie - Université de Poitiers, Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Hôpital de Rangueil, Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Avicenne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]

Subjects
medicine.medical_specialty, Evening, Physical activity, Dépense énergétique, Hypertension artérielle, Caloric expenditure, High blood pressure, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Diabetes mellitus, Medicine, Motor activity, Morning, Automesure tensionnelle, Gynecology, Blood pressure management, business.industry, Home blood pressure measurement, Objective method, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Activité physique, Blood pressure, Hypertension, Physical therapy, Cardiology and Cardiovascular Medicine, business
Abstract

While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary, Alors que la pratique régulière d’une activité physique (AP) est recommandée en cas d’hypertension artérielle (HTA), le niveau d’AP des sujets hypertendus reste mal connu. Notre objectif était d’étudier l’association entre le niveau d’AP et le caractère contrôlé ou non de l’HTA de sujets vus en consultation dans 9 centres spécialisés en HTA. Quatre-vingt-cinq sujets hypertendus ont été inclus (59 ± 14 ans, 61 % d’hommes, 12 % fumeurs, 29 % diabétiques). Au décours de leur consultation, une automesure tensionnelle (AMT) sur 7 jours (2 mesures le matin + 2 le soir) était réalisée, ainsi qu’un compte rendu de leurs activités quotidiennes permettant d’estimer la dépense calorique additionnelle à l’aide d’une réglette Acti-MET extrapolée du questionnaire international d’activités physiques (IPAQ). Les sujets complétaient ensuite un auto-questionnaire « score de Dijon » sur 30 points (distinguant les sujets actifs, score > 20/30, des sédentaires < 10/30). Les hypertendus contrôlés en AMT (< 135/85 mm Hg) (55 % des sujets), en comparaison aux non contrôlés, étaient plus âgés, avaient une tendance non significative à une dépense calorique déclarée plus élevée (4959 ± 5045 kcal/semaine vs 4048 ± 4199 kcal/semaine, p = 0,3755) et leur score de Dijon (19,44 ± 5,81 vs 18,00 ± 4,32, p = 0,2094) montrait une proportion de sujets « actifs » plus importante (48,9 % vs 34,2 %, p = 0,1773). En conclusion, nos résultats ont objectivé une « tendance » à une AP déclarée plus importante pour les sujets dont l’HTA est contrôlée. Ceci nous encourage à poursuivre par une étude qui inclurait davantage de sujets et dont l’AP serait évaluée par le port pendant 7 jours d’un capteur de type accéléromètre (méthode objective).

Published
2015
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3. Relationship between accessory renal arteries and resistant hypertension: A cohort study.

Author

Maisons V, Le Jeune S, Barber-Chamoux N, Boudghene-Stambouli F, Brucker M, Delsart P, Lopez-Sublet M, Perez L, Radhouani I, Sosner P, and Sautenet B

Subjects
Male, Humans, Adult, Middle Aged, Aged, Female, Retrospective Studies, Cohort Studies, Essential Hypertension, Renal Artery diagnostic imaging, Hypertension drug therapy, Hypertension epidemiology
Abstract

Background: Resistant hypertension (RHT) is a major health care concern affecting 20 to 30% of hypertensive patients and increasing cardiovascular risk. Recent renal denervation trials have suggested a high prevalence of accessory renal arteries (ARA) in RHT. Our objective was to compare the prevalence of ARA in RHT vs. non-resistant hypertension (NRHT)., Methods: Eighty-six patients with essential hypertension who benefited from an abdominal CT-scan or MRI during their initial workup were retrospectively recruited in 6 French ESH (European Society of Hypertension) centers. At the end of a follow-up period of at least 6 months, patients were classified between RHT or NRHT. RHT was defined as uncontrolled blood pressure despite the optimal doses of three antihypertensive agents of which one is a diuretic or similar, or controlled by ≥ 4 medications. Blinded independent central review of all radiologic renal artery charts was performed., Results: Baseline characteristics were: age 50±15 years, 62% males, BP 145±22/87±13mmHg. Fifty-three (62%) patients had RHT and 25 (29%) had at least one ARA. Prevalence of ARA was comparable between RHT (25%) and NRHT patients (33%, P=0.62), but there were more ARA per patient in NRHT (2±0.9) vs. RHT (1.3±0.5, P=0.05), and renin levels were higher in ARA group (51.6±41.7 mUI/L vs. 20.4±25.4 mUI/L, P=0.001). ARA were similar in diameter or length between the 2 groups., Conclusions: In this retrospective series of 86 essential hypertension patients, we found no difference in the prevalence of ARA in RHT and NRHT. More comprehensive studies are needed to answer this question., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Published
2023
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4. [Berger's disease associated to an adalimumab-treated rheumatoid arthritis].

Author

Pierrot A, Combe C, Lepelley M, Brucker M, and Constant E

Subjects
Adalimumab therapeutic use, Arthritis, Rheumatoid complications, Glomerulonephritis, IGA immunology, Humans, Male, Middle Aged, Tumor Necrosis Factor-alpha antagonists & inhibitors, Adalimumab adverse effects, Arthritis, Rheumatoid drug therapy, Glomerulonephritis, IGA chemically induced
Abstract

Berger's disease is characterized by deposits of immunoglobulin A in the glomerular mesangium. We report a case of a patient who was treated by adalimumab for a rheumatoid arthritis (RA). The patient is 45 years old and is treated for RA since 1996. Adalimumab was started after the failure of several treatments. Biological and clinical response to adalimumab were excellent. A nephrotic syndrome was diagnosed during the patient follow-up. Adalimumab was stopped since it was suspected to be responsible of these symptoms. Berger's disease was diagnosed thanks to a renal biopsy. The nephrotic syndrome was treated with corticosteroids, then tocilizumab was used to treat RA. TNF-alpha inhibitors are well known for inducing kidneys' adverse reactions (ADR). Usually, they appear shortly after the beginning of a treatment. Adalimumab has already been described in studies for inducing similar kidneys' adverse drug reactions. These ADR are often associated with systemic disease outbreak. It is difficult to assert that adalimumab or RA was responsible of the ADR that we noticed in our patient. It is usually admitted that these ADR are uncommon when the RA is controlled., (Copyright © 2018. Published by Elsevier Masson SAS.)

Published
2018
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5. [Physical activity level and home blood pressure measurement: Pilot study "Acti-HTA"].

Author

Sosner P, Ott J, Steichen O, Bally S, Krummel T, Brucker M, Lequeux B, Dourmap C, Llaty P, Le Coz S, Baguet S, Miranne A, Labrunée M, Gremeaux V, and Lopez-Sublet M

Subjects
Female, Humans, Male, Middle Aged, Pilot Projects, Surveys and Questionnaires, Blood Pressure Monitoring, Ambulatory, Hypertension diagnosis, Hypertension therapy, Motor Activity
Abstract

While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary<10/30). Subjects with normal HBPM value (<135/85 mm Hg) (55% of them) compared to those with high HBPM were older, had a non-significant trend towards higher weekly caloric expenditure (4959 ± 5045 kcal/week vs. 4048 ± 4199 kcal/week, P=0.3755) and score of Dijon (19.44 ± 5.81 vs. 18.00 ± 4.32, P=0.2094) with a higher proportion of "active" subjects (48.9% vs. 34.2%, P=0.1773). In conclusion, our results demonstrate a "tendency" to a higher level of reported PA for subjects whose hypertension was controlled. This encourages us to continue with a study that would include more subjects, which would assess PA level using an objective method such as wearing an accelerometer sensor., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Published
2015
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