In stable coronary heart disease, uncontrolled risk factors are strongly associated with incident myocardial infarction. We analysed the management of hypertension in 746 stable coronary patients recruited between 2005 and 2015 in a single-centre prospective study. Risk factors and pharmacological treatments were documented prior to and immediately after cardiac rehabilitation, and 1 year later.
View Article and Find Full Text PDFClinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related factors and inadequate clinic-BP measurement. We investigated whether nonadherence to antihypertensive medications may also influence this difference in a post hoc analysis of the DENERHTN trial (Renal Denervation for Hypertension). We pooled the data of 77 out of 106 evaluable patients with apparent resistant hypertension who received a standardized antihypertensive treatment and had both ambulatory BP and drug-screening results available at baseline after 1 month of standardized triple therapy and at 6 months on a median of 5 antihypertensive drugs.
View Article and Find Full Text PDFSince 2016, the French Society of Hypertension has warned about the decline in the management of high blood pressure in France: stagnation, or even decreased number of people who know their blood pressure level, take a treatment and are controlled. These results are lower than those observed in many other countries. Blood pressure is measured with an old method in the doctor's office.
View Article and Find Full Text PDFErectile dysfunction (ED) is not routinely discussed with patients in cardiology practices whereas it may impact the ability of patients to stay on therapy. Most of the studies about ED and antihypertensive therapies have several methodological limitations. Diuretics and beta-blockers have been shown to have a deleterious effect on ED.
View Article and Find Full Text PDFObjectives: We conducted a pilot multicenter double-blind randomized placebo-controlled crossover pharmacodynamic study to evaluate the blood pressure (BP) and the hormonal effects of firibastat, a first-in-class aminopeptidase A inhibitor prodrug, in patients with hypertension.
Methods: Thirty-four patients with daytime ambulatory BP of at least 135/85 mmHg and less than 170/105 mmHg, after a 2-week run-in period were randomly assigned to receive either firibastat (250 mg b.i.
Background: Sleep-related disordered breathing is common in patients with chronic heart failure.
Aim: To assess the efficacy of short-term nocturnal ventilatory therapy combined with exercise training (V+ET) compared with exercise training alone (ET) in patients with chronic heart failure with sleep-disordered breathing.
Methods: Patients in New York Heart Association functional class II-IIIb, with an apnoea-hypopnoea index (AHI)>15/h, and enrolled in a cardiac rehabilitation programme, were centrally randomized to V+ET or ET.
J Am Heart Assoc
October 2017
Background: The DENERHTN (Renal Denervation for Hypertension) trial confirmed the efficacy of renal denervation (RDN) in lowering daytime ambulatory systolic blood pressure when added to standardized stepped-care antihypertensive treatment (SSAHT) for resistant hypertension at 6 months.
Methods And Results: This post hoc exploratory analysis assessed the impact of abdominal aortic calcifications (AAC) on the hemodynamic and renal response to RDN at 6 months. In total, 106 patients with resistant hypertension were randomly assigned to RDN plus SSAHT or to the same SSAHT alone (control group).
Unlabelled: The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure (BP) lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report here the effect of denervation on 24-hour BP and its variability and look for parameters that predicted the BP response. Patients with resistant hypertension were randomly assigned to denervation plus stepped-care treatment or treatment alone (control).
View Article and Find Full Text PDFHigh blood pressure in pregnancy remains, by its complications, the leading cause of morbidity as well as maternal and fetal mortality. The frequency (5-10% of pregnancies) and the potential severity of this disease, for both mother and child, encourage to standardize and to optimize our medical practices. If the short-term complications for the mother and child are well known, long-term ones for the mother are beginning to be better identified.
View Article and Find Full Text PDFBackground: The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure-lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control.
Methods: One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.
High blood pressure in pregnancy remains, by its complications, the leading cause of morbidity and maternal and fetal mortality. The frequency (5 to 10% of pregnancies) and the potential severity of this disease, both for mother and child, encourage to standardize and to optimize our medical practices. This is the main objective of this work.
View Article and Find Full Text PDFHypertension during pregnancy is associated with high perinatal morbidity and mortality. The prevalence of white coat hypertension is high during pregnancy and is associated with a good prognosis and must be excluded. The definition of hypertension during pregnancy is office BP≥140/90mmHg and ≥135/85mmHg with home BP and diurnal ambulatory BP.
View Article and Find Full Text PDFBackground: Conflicting blood pressure-lowering effects of catheter-based renal artery denervation have been reported in patients with resistant hypertension. We compared the ambulatory blood pressure-lowering efficacy and safety of radiofrequency-based renal denervation added to a standardised stepped-care antihypertensive treatment (SSAHT) with the same SSAHT alone in patients with resistant hypertension.
Methods: The Renal Denervation for Hypertension (DENERHTN) trial was a prospective, open-label randomised controlled trial with blinded endpoint evaluation in patients with resistant hypertension, done in 15 French tertiary care centres specialised in hypertension management.
To improve the management of resistant hypertension, the French Society of Hypertension, an affiliate of the French Society of Cardiology, has published a set of eleven recommendations. The primary objective is to provide the most up-to-date information, based on the strongest scientific rationale and which is easily applicable to daily clinical practice for health professionals working within the French health system. Resistant hypertension is defined as uncontrolled blood pressure (BP) both on office measurements and confirmed by out-of-office measurements despite a therapeutic strategy comprising appropriate lifestyle and dietary measures and the concurrent use of three antihypertensive agents including a thiazide diuretic, a renin-angiotensin system blocker (ARB or ACEI) and a calcium channel blocker, for at least four weeks, at optimal doses.
View Article and Find Full Text PDFHypertension during pregnancy is associated with high perinatal morbidity and mortality The prevalence of white coat hypertension is high during pregnancy and is associated with a good prognosis. This must be excluded before beginning antihypertensive treatment. When to use HBPM during pregnancy? To confirm the diagnosis of hypertension; to monitor BP during pregnancy and to alert the obstetrician when severe hypertension occurs; to manage BP treatment and avoid excessive treatment.
View Article and Find Full Text PDFBackground: Masked hypertension has been associated with obesity. However, because most studies do not mention the specific cuff size used for home measurements, masked hypertension prevalence may have been overestimated in obese patients because of undersized cuffs. In this prospective, observational study, the effect of miscuffing on hypertension status was evaluated in patients with large arms.
View Article and Find Full Text PDFObjectives: To assess the diagnosis and prognosis of white coat hypertension (WCH) as detected by home blood pressure (HBP) monitoring measured telemetrically in pregnant women with recently discovered hypertension.
Methods: 57 women evaluated using HBP monitoring.
Results: The prevalence of WCH was high (76%).
VALNORM was designed to assess the impact on blood pressure (BP) control of a specific training in new European Society of Hypertension-International Society of Hypertension (ESH-ISH) guidelines for hypertension management. It was an 8-week prospective, randomized, open, blinded end points design study. General practitioners (GPs) located in France were randomized in two groups: group 1 (G1) without training to the guidelines and free attitude for the prescription whereas group 2 (G2) received a specific training in ESH guidelines.
View Article and Find Full Text PDFTo determine values for home blood pressure (HBP) during pregnancy, nurses taught 45 healthy pregnant women to use a HBP method for 1 week before 15 weeks of gestation, between weeks 15 and 27, and after 28 weeks for the last 3 months of gestation. HBP values were significantly lower during the second trimester and higher during the last trimester (102 +/- 8/59 +/- 7*, 101 +/- 8/57 +/- 8*, 105 +/- 8*/62 +/- 9* mm Hg;*P< 0.05) than during other trimesters.
View Article and Find Full Text PDFThe study objective was to evaluate, by means of automated office and phone-transmitted home blood pressure (OBP and HBP) recordings, the effects of a fixed combination of valsartan 160 mg and hydrochlorothiazide (HCTZ) 25 mg in hypertensive patients previously uncontrolled with the combination of an angiotensin receptor antagonist and HCTZ. From 241 selected patients, 171 (71%) had uncontrolled hypertension OBP and HBP [mean baseline OBP and HBP systolic and diastolic (SBP/DBP): 157/91 and 152/87 mmHg]. In this open-design study, patients were directly switched from other angiotensin receptor blocker combination products to valsartan/HCTZ for 6 weeks.
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