[Brief motivational interventions in primary care]. / L'intervention brève motivationnelle au cabinet du médecin de premier recours.

Primary care physicians see a majority of the population at least once a year and are in an ideal position to promote health and to discuss health behaviour change. Two proven methods to help people change are: brief intervention and motivational interviewing. We propose a combination of these two methods. The interview is structured following the 5 A's with an added first step: 1) agenda; 2) assess ambivalence; 3) advise; 4) agree; 5) assist and 6) arrange and is motivational in that it uses collaboration, non-judgement, and respect of the patient's autonomy. The aim is to help the patient explore and resolve his ambivalence and progress towards change.

[High blood pressure and alcohol consumption]. / Hypertension artérielle et consommation d'alcool.

The possible effects of individual alcoholic beverages on blood pressure continue to arouse interest. There is a positive relationship between alcohol intake and blood pressure. The nature of this relationship still remains unresolved. Authors led studies where different patterns of drinking were assessed. First, different mechanisms are involved for generating hypertension when alcohol drinking. Vasoconstriction effects and modification of smooth muscles are well established factors of alcohol-induced hypertension. Calcium movements are also involved. Men and women are affected by hypertensive effects of excessive alcohol consumption. Drinking alcohol during meals is a probable protective factor of developing hypertension. Reducing alcohol consumption provokes a significant diminution of hypertension.

[Practitioners confronted with the four main health behavioral risk factors]. / Le généraliste face aux quatre principaux facteurs de risque comportementaux.

Four behavioural risk factors are common in primary care and are often clustered in individuals. Smoking is present from I cigarette per day, excessive alcohol use is defined either by drinking regularly more than 2-3 standard glasses per day or by occasional heavy drinking of more than 4-5 glasses at a time. Patients who don't have regular moderate physical activity of at least 30 minutes during 5 days of a week or intensive physical activity of at least 20 minutes 3 times a week are sedentary. A Body Mass Index of over 30 defines obesity. We propose a "generic" counselling tool in 5 steps, the 5 As, that can be used for any of the four behavioural risk factors during routine consultations. With this counselling guide, practitioners can help patients change behaviour in a motivational style that allows shared decision-making.