[Evaluation of blood pressure control by repeated ambulatory automatic blood pressure measurements]. / Evaluation du contrôle tensionnel par mesures automatiques répétées et ambulatoires de la pression artérielle.

UNLABELLED: The aim of this study was to compare the evaluation of blood pressure control in using an automatic blood pressure device (ABPD) and an ambulatory blood pressure measurement (ABPM). METHOD: 41 patients with essential hypertension (HTA) were screened prospectively from April to June 2000 (22 men and 19 female) mean age 63 years old, 2.6 antihypertensive drug per patient). The blood pressure was randomly measure by 2 physicians with an automatic blood pressure device OMRON 705 CP, 3 times. All the patients had a 24 hours ABPM in the month before and after this measure, without change in medication. RESULTS: The mean blood pressure measured was 151/81 mmHg by the first physician, 149/85 mmHg with the physician observer and 131/81 mmHg with the ABPM. The percentage of patient who have an optimal control was significantly less in the ABPD estimation (27% < 140/90 mmHg) than ABPM (Day ABPM < 135/85 mmHg = 51%). In conclusion, the control of hypertension still remains insufficiency even if the utilisation of ABPM may increase the accuracy of that estimation.

[Effectiveness of the treatment of arterial hypertension in a specialized service. An audit using the automatic measurement of arterial blood pressure]. / Efficacité du traitement de l'hypertension artérielle en service spécialisé. Audit par mesure automatique de la pression artérielle.

UNLABELLED: The ineluctable fade out of mercury sphingomanometer pressure device involve the necessity in using automatic blood pressure systems. In parallel the recent PHARE II study witness of a lack in the control of hypertension in general practice. In the basis of an automatic blood pressure device measure, we had try to know the efficiency of blood pressure contrôl (BPC) in a specialised consultation. METHOD: 100 patients with essential systolo-diastolic hypertension (HTA) were screened. An independent physician measured the blood pressure level with an OMRON 705 CP device 3 times. The acceptable BPC was considered less than 160/95 mmHg and the optimal BPC less than 140/90 mmHg. There was 70 man, 30 female (mean age = 67 year old). The initial mean blood pressure was 169/104 mmHg. RESULTS: The final blood pressure measured was 137/80 mmHg. The percentage of patients who have an acceptable contrôl (< 160/95) was 91% and an optimal contrôl (< 140/90) 66%. 12% of these 66 maintain a height cardio-vascular risk. The mean number of medication used was 2 and it's paradoxally not differ between the optimal blood pressure control group and the other patients who need probably an intensive medication. In conclusion these study shows us the importance in understanding our patients particularity in order to increase the treatment efficiency.

[How to diagnose hypertension in the elderly?]. / Comment diagnostiquer l'hta du sujet âgé?

The management of hypertension in the elderly requires careful diagnosis, which is not always easy in this population because of the increased variability of blood pressure. The practitioner is faced with three questions in this diagnostic approach: how to evaluate the patient's real blood pressure level, how to assess the degree of cardiovascular impairment and concomitant disease and finally how to evaluate the subject's global cardiovascular risk. Self-monitoring of blood pressure, which allows measurement of blood pressure by the patient himself in his usual environment, provides a better assessment of the elderly patient's real blood pressure level.