CO-31: Prevalence of asymmetrical blood pressure in uncontrolled hypertensive patients is high and highly related with cardiovascular diseases prevalence - 12/02/16
Asymétrie tensionnelle chez des patients hypertendus non contrôlés suivis en médecine générale : une prévalence forte et une très forte association aux pathologies cardiovasculaires
Résumé |
Background |
A meta-analyse published in the Lancet has shown that an asymetry of the blood Pressure between arm of more than 15mmHg and perhaps of 10mmHg and more is associated with an increase of cardiovascular diseases and that a greater attention should be paid to it (Clark CE et al. Lancet 2012;379:905–14). These data need to be confirmed in daily practice.
Objectives |
To describe the prevalence of the asymmetrical blood pressure (ABP) in patients presenting an uncontrolled blood pressure (BP) under treatment. Secondary objectives: To identify factors influencing its prevalence and evaluate its relation with the frequency of the cardiovascular diseases presented by the patients.
Methods |
Observational cross sectional study conducted in daily community medical practice. Inclusion criteria: patients presenting uncontrolled BP according ESC criteria by a previous antihypertensive therapy.
Measurements: ABP was measured at each arm according ESH/ESC Clinical Practice Guideline.
Statistical analysis: multiple regression analysis (MRA) adjusted on cardiovascular risk factors (CVRF).
Results |
Among 2417 hypertensive patients, 63,3±11,0 years old, 36,8% (IC95% [34,9; 38,7]) were presenting a between-arm difference in systolic blood pressure >=10mmHg, and 17,1% (IC95% [15,6; 18,6]) >=15mmHg. MRA shows ABP (>=10mmHg) prevalence was influenced by dyslipidemia (OR: 1,5 [1,2; 1,7] p<0,0001) and by family history of early cardiovascular disease (OR: 1.6 [1.3; 1.9] p<0.0001). MRA adjusted on CVRF shows that besides the dyslipidemia effect, ABP >=10mmHg influences the frequency of sub clinical impairment of target organ (OR: 1.6 [1.3; 1.9] p<0.0001), of coronary heart disease (OR: 1.8 [1.4; 2.4] p<0.0001), and globally the presence of a cardiovascular disease (OR: 1.7 [1.4; 2.1] p<0.0001). The effect on stroke frequency was showed with an ABP >=15mmHg (OR: 1.6 [1.1; 2.4] p<0.05).
Conclusions |
In uncontrolled hypertensive patients, a greater intention should be paid to the screening of an asymmetrical blood pressure that should help to identify clinically high risk cardiovascular patients or patients with subclinical organs damages.
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Vol 64 - N° S1
P. S15 - décembre 2015 Retour au numéro
Article précédent
- CO-30: Cardiac autonomic neuropathy and the incidence of hypertension in diabetic patients
- F. Ayad, P. Valensi, L. Zemour, M. Belhadj
- CO-32: Could antihypertensive, hypoglycemic, hypolipidemic drugs and platelet aggregation inhibitors reduce sudden death risk in type 2 diabetes? A meta-analysis of randomized controlled trials
- A. Berrima, M. Girard, H. Le, S. Erpeldinger, F. Gueyffier
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