Archives des maladies du coeur et des vaisseaux, 2003
Primary aldosteronism (PA) has been regarded for a long time as being a rare cause of arterial hy... more Primary aldosteronism (PA) has been regarded for a long time as being a rare cause of arterial hypertension, but its prevalence has recently been reassessed as about 10%. This etiology should obviously be sought in the following settings: hypertension associated with hypokaliemia < 3.6 mmol/L (or < 3.9 mmol/L on ACE inhibitors): refractory hypertension: severe hypertension occurring before 40 years of age, especially in women. It must be reminded that more than 20% of PA are normokaliemic. Most of the authors recommend to use the aldosterone/renin ratio (ARR) as a screening test within these selected patients. When ARR turns out to be equal to or higher than 23 (if aldosterone and renin are given in pg/mL or ng/L), a suppression testing should be performed, using salt loading and/or fludrocortisone. Computed tomography scanning yields a specificity of 58% and a positive predictive value of 72%, only. Adenoma and hyperplasia have to be distinguished, using either NP-59 scintigr...
La micro-albuminurie est un facteur pronostique du risque de nephropathie diabetique d'une pa... more La micro-albuminurie est un facteur pronostique du risque de nephropathie diabetique d'une part, et du risque cardio-vasculaire d'autre part. Ces donnees sont etablies de facon prospective. De facon recente, des etudes de grande taille ont montre que le debit de filtration glomerulaire predisait le risque cardio-vasculaire, independamment de l'albuminurie. Il est interessant de mesurer le debit de filtration glomerulaire par des techniques precises pour d'une part, etablir le phenotype d'hyperfiltration, qui est pronostique du risque ulterieur de nephropathie diabetique et, d'autre part, pour identifier une nouvelle entite: l'insuffisance renale non-albuminurique.
This study aims to obtain data on rice yields of several varieties, identify diversity of experim... more This study aims to obtain data on rice yields of several varieties, identify diversity of experimental errors in mixed models for multi-location experiments using complete group random design (RAKL), identify diversity of experimental errors in mixed models for multi-location experiments using interblock analysis, and comparing the results of the RAKL method with interblock analysis in reducing the diversity of experimental errors. The data used in this study is the data of rice plants from the National Rice Consortium Collaboration between the Center for Rice Research with Batan, Bb Biogen, and IPB in 2008. The stages of the analysis are conducting a variety analysis using a complete randomized block design to see the diversity of errors in groups , then tracing the interblock effect by inserting row and column elements nested in the block Then analyzing the variance by following the interblock model. From the two variance analyzes used, genotypes / strains had a significant effect on both rice and paddy yields on the level of 5%. From the calculation results obtained the KTG value for RAKL is 1.513 and the KTG value for Interblock is 1.544. KTG RAKL <KTG Interblok, so it can be concluded that the RAKL design model is more efficient than Interblok. The RAKL model is better able to reduce the diversity of errors greater than the Interblok design.
Objective: Obstructive sleep apnea (OSA) has been recently implied in the genesis of a dilatation... more Objective: Obstructive sleep apnea (OSA) has been recently implied in the genesis of a dilatation of the ascending aorta. Snoring and sleepiness are both frequent symptoms occurring in OSA. To date, no data are available concerning a potential relationship between snoring or excessive daytime sleepiness on the one hand and increased aortic root diameter on the other hand. Design and method: 169 hypertensive patients, without treated OSA nor known thoracic aortic disease, were included in 6 tertiary hypertension (HTN) centers. They received questionnaires about snoring (Epworth's scale) and sleepiness, and had clinical examination, biology and cardiac ultrasound (measurement of aortic root diameter at the level of the Valsalva's sinuses). Results: Main characteristics were as follows (mean): age 54.6 + 12.9 years, 115 men (68%), BMI 28.9 + 5.2 kg/m2, clinic blood pressure 150 + 20/91 + 13 mmHg. 125 patients (74%) were treated for HTN (2.54 + 1.38 antihypertensive drugs per pa...
Objective: Cardiovascular prevention and management of hypertension is mainly based on the detect... more Objective: Cardiovascular prevention and management of hypertension is mainly based on the detection and treatment of metabolic usual risk factors or dietary improvement. This approach has difficulty in assessing the risk of disadvantaged populations where social deprivation seems to play a major role. Design and method: 263 consecutives hypertensive patients were refered to specialists and assessed for social deprivation through the EPICES questionnaire as for usual risk factors and several socio-economic data. Results: Patients were 63 ± 13 years old and 59% were men. Risk factors were diabetes (39%), dyslipidemia (68%), active smoking (32%). Alcoholic consumption of more than once per week was present in 28%, a physical activity for at least once a week in 30%. Systolic, diastolic and pulse pressure were 143 ± 21, 81 ± 13 and 63 ± 18 mmHg. The mean number of antihypertensive drugs was 2.8 ± 1.3. A target organ damage was frequent, including peripheral vascular disease (18% lower ...
Journal of the American Heart Association, Jan 10, 2017
The DENERHTN (Renal Denervation for Hypertension) trial confirmed the efficacy of renal denervati... more 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. 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). Total AAC volume was measured, with semiautomatic software and blind to randomization, from the aortic hiatus to the iliac bifurcation using the prerandomization noncontrast abdominal computed tomography scans of 90 patients. Measurements were expressed as tertiles. The baseline-adjusted difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the RDN and control groups was -10.1 ...
Journée nationale de formation des infirmier(e)s en infectiologie / Médecine et maladies infectie... more Journée nationale de formation des infirmier(e)s en infectiologie / Médecine et maladies infectieuses 47S (2017) S155-S160 cale d'état. Le titre de séjour des étrangères était temporaire dans 76 % (31/41) des cas. Au 3 e trimestre, toutes les femmes recevaient un traitement ARV dont 2 NRTI + 1 IP/r (83 %, 44/53) et une combinaison incluant le raltegravir (9 %, 5/53). À l'accouchement, 89 % (47/53) avaient plus de 350/mm 3 CD4 ; 87 % et 94 % avaient une charge virale plasmatique < 20 et < 50 copies/mL respectivement ; 51 % ont reçu une perfusion d'AZT pendant le travail. Elles ont accouché par voie basse dans 70 % (37/53) des cas ; 2 des 16 césariennes étaient d'indication virologique, associée dans un cas à une indication obstétricale. Aucun des enfants nés vivants n'est infecté par VIH. Conclusion La forte proportion de femmes VVIH et leurs conditions socio-économiques défavorables soulignent l'intérêt d'une prise en charge multidisciplinaire organisée et systématique pour la prévention de la transmission mère-enfant du VIH. Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
Archives des maladies du coeur et des vaisseaux, 1999
Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors repo... more Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors report the case of anterior myocardial infarction with dissection of the left anterior descending artery in a 16 year old boy who was injured in a motorbike accident without a penetrating thoracic wound. Therefore, the only pathological mechanism was deceleration. The authors review the 12 previously reported cases.
Purpose: The aims of this study were: 1) to study the impact of a combined long-term lifestyle an... more Purpose: The aims of this study were: 1) to study the impact of a combined long-term lifestyle and high-intensity interval training (HIIT) intervention on blood pressure (BP) in patients with abdominal obesity; 2) To document BP reduction responses according to the European Society of Hypertension BP classification. Methods: 105 patients with abdominal obesity (age: 53±10 yrs; 32 men; waist circumference (WC): 112±13cm; systolic/diastolic (SBP/DBP): 133±13/82±8 mmHg; 11% diabetics, 11% smokers, 68% with antihypertensive therapy) were retrospectively analyzed before and after a combined long-term lifestyle and HIIT program twice a week. Anthropometric measurements, cardiometabolic risk factors, and resting BP (5min. of supine rest, using a manual sphygmomanometer) were assessed at baseline and after 9 months of program. Results: After 9 months, we observed an improvement in weight (-4.83kg), BMI (-1.75 kg/m2), WC (-6.62 cm), an average SBP/DBP decrease of -5.59/-3.31 mmHg. These changes were not uniform, 74 patients decreased their BP (1 mmHg or more) reaching -11.69/-6.92 mmHg. The parameter which differentiated them to those who did not improve their BP was their higher initial BP level (SBP: 135±14 vs. 126±10 mmHg, P=0.001; DBP 84±7 vs. 77±3 mmHg, P<0.0001). Thus, we compared following groups in accord to their baseline ESH-BP-classification: 1/ "optimal" \[BP <120/80 mmHg] + "normal" [120/80 ≤ BP < 130/85 mmHg\] (n=13) vs. 2/ "high normal" \[130/85 ≤BP < 140/90 mmHg] + "stage 1 hypertension" [140/90 ≤ BP < 160/100 mmHg\] (n=92). We observed no significant difference between groups 1/ vs. 2/ in terms of gender (P=0.2), age (50±9 vs. 54±10 yrs, P=0.2), resting heart rate (72±15 vs. 75±12 bpm, P=0.3), diabetes, lipid analysis, weight loss (-3.75±4.49 vs. -4.99±5.67 kg, P=0.4), WC improvement (-5.95±3.49 vs. -6.72±11.70 cm, P=0.8). Antihypertensive therapies were at baseline less present in group 1/ than in group 2/ (38% vs. 72%, P=0.02). Furthermore, BP was not improved in group 1/ (+1.85/+4.92 mmHg) but decreased in group 2/ (-6.64/-4.48 mmHg) (P=0.04 and P=0.0003 respectively for SBP/DBP). Conclusion: A long-term lifestyle and high-intensity interval training intervention had a beneficial effect on BP levels in patients with abdominal obesity and a baseline BP ≥130/85 mmHg. This helped them to bring back to "normal" BP values.
Archives des maladies du coeur et des vaisseaux, 1999
Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors repo... more Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors report the case of anterior myocardial infarction with dissection of the left anterior descending artery in a 16 year old boy who was injured in a motorbike accident without a penetrating thoracic wound. Therefore, the only pathological mechanism was deceleration. The authors review the 12 previously reported cases.
La prevalence de l'hyperaldosteronisme primaire (HAP), longtemps consideree comme tres faible... more La prevalence de l'hyperaldosteronisme primaire (HAP), longtemps consideree comme tres faible, a ete reevaluee aux alentours de 10 % des HTA. Il parait legitime de rechercher cette etiologie dans les circonstances suivantes: HTA associee a une hypokaliemie < 3,6 mmol/L (ou < 3,9 sous IEC); HTA resistante; HTA severe d'apparition precoce (< 40 ans), surtout chez la femme. On rappellera que plus de 20 % des HAP seraient normokaliemiques. La plupart des auteurs s'accordent aujourd'hui pour mesurer en 1 re intention, sur cette population ciblee, le rapport aldosterone/renine plasmatiques. Quand ce rapport depasse un seuil donne (fixe a 23 si les valeurs sont exprimees en pg/mL), il est recommande de documenter ce resultat par un test de freination (charge sodee ou test a la fludrocortisone), avant de realiser un scanner des surrenales, dont la specificite et la valeur predictive positive n'excedent pas 58 % et 72 % respectivement. La distinction entre adenom...
Background In contrast with the setting of acute myocardial infarction, there are limited data re... more Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox propor...
We aimed to compare blood pressure (BP) responses following moderate-intensity continuous exercis... more We aimed to compare blood pressure (BP) responses following moderate-intensity continuous exercise (MICE), highintensity interval exercise (HIIE) in dry land or HIIE in immersed condition, using 24-hour ambulatory BP monitoring. Forty-two individuals (65 AE 7 years, 52% men) with a baseline BP ! 130/85 mm Hg (systolic/diastolic blood pressures [SBP/DBP]) were randomly assigned to perform one of the three following exercises on a stationary cycle: MICE (24 minutes at 50% peak power output) or HIIE in dry land (two sets of 10 minutes with phases of 15 seconds 100% peak power output interspersed by 15 seconds of passive recovery) or HIIE in up-to-the-chest immersed condition. While MICE modified none of the 24-hour average hemodynamic variables, dryland HIIE induced a 24-hour BP decrease (SBP: À3.6 AE 5.7/DBP: À2.8 AE 3.0 mm Hg, P < .05) and, to a much greater extent, immersed HIIE (SBP: À6.8 AE 9.5/DBP: À3.0 AE 4.5 mm Hg, P < .05). The one condition that modified 24-hour pulse-wave velocity was immersed HIIE (À0.21 AE 0.30 m/s, P < .05).
Diabetes & Metabolism - In Press.Proof corrected by the author Available online since lundi 1... more Diabetes & Metabolism - In Press.Proof corrected by the author Available online since lundi 12 mars 2018
Clinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related fa... more Clinic-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. After drug assay samplings on study visits, patients took their antihypertensive treatment under supervision immediately after the start of the ambulatory BP recording, and supine clinic BP was measured 24 hours post-dosing; both allowed to calculate the clinic minus daytime ambulatory systolic BP (SBP) difference (clinic-SBP–day-SBP). A tota...
Archives des maladies du coeur et des vaisseaux, 2003
Primary aldosteronism (PA) has been regarded for a long time as being a rare cause of arterial hy... more Primary aldosteronism (PA) has been regarded for a long time as being a rare cause of arterial hypertension, but its prevalence has recently been reassessed as about 10%. This etiology should obviously be sought in the following settings: hypertension associated with hypokaliemia < 3.6 mmol/L (or < 3.9 mmol/L on ACE inhibitors): refractory hypertension: severe hypertension occurring before 40 years of age, especially in women. It must be reminded that more than 20% of PA are normokaliemic. Most of the authors recommend to use the aldosterone/renin ratio (ARR) as a screening test within these selected patients. When ARR turns out to be equal to or higher than 23 (if aldosterone and renin are given in pg/mL or ng/L), a suppression testing should be performed, using salt loading and/or fludrocortisone. Computed tomography scanning yields a specificity of 58% and a positive predictive value of 72%, only. Adenoma and hyperplasia have to be distinguished, using either NP-59 scintigr...
La micro-albuminurie est un facteur pronostique du risque de nephropathie diabetique d'une pa... more La micro-albuminurie est un facteur pronostique du risque de nephropathie diabetique d'une part, et du risque cardio-vasculaire d'autre part. Ces donnees sont etablies de facon prospective. De facon recente, des etudes de grande taille ont montre que le debit de filtration glomerulaire predisait le risque cardio-vasculaire, independamment de l'albuminurie. Il est interessant de mesurer le debit de filtration glomerulaire par des techniques precises pour d'une part, etablir le phenotype d'hyperfiltration, qui est pronostique du risque ulterieur de nephropathie diabetique et, d'autre part, pour identifier une nouvelle entite: l'insuffisance renale non-albuminurique.
This study aims to obtain data on rice yields of several varieties, identify diversity of experim... more This study aims to obtain data on rice yields of several varieties, identify diversity of experimental errors in mixed models for multi-location experiments using complete group random design (RAKL), identify diversity of experimental errors in mixed models for multi-location experiments using interblock analysis, and comparing the results of the RAKL method with interblock analysis in reducing the diversity of experimental errors. The data used in this study is the data of rice plants from the National Rice Consortium Collaboration between the Center for Rice Research with Batan, Bb Biogen, and IPB in 2008. The stages of the analysis are conducting a variety analysis using a complete randomized block design to see the diversity of errors in groups , then tracing the interblock effect by inserting row and column elements nested in the block Then analyzing the variance by following the interblock model. From the two variance analyzes used, genotypes / strains had a significant effect on both rice and paddy yields on the level of 5%. From the calculation results obtained the KTG value for RAKL is 1.513 and the KTG value for Interblock is 1.544. KTG RAKL <KTG Interblok, so it can be concluded that the RAKL design model is more efficient than Interblok. The RAKL model is better able to reduce the diversity of errors greater than the Interblok design.
Objective: Obstructive sleep apnea (OSA) has been recently implied in the genesis of a dilatation... more Objective: Obstructive sleep apnea (OSA) has been recently implied in the genesis of a dilatation of the ascending aorta. Snoring and sleepiness are both frequent symptoms occurring in OSA. To date, no data are available concerning a potential relationship between snoring or excessive daytime sleepiness on the one hand and increased aortic root diameter on the other hand. Design and method: 169 hypertensive patients, without treated OSA nor known thoracic aortic disease, were included in 6 tertiary hypertension (HTN) centers. They received questionnaires about snoring (Epworth's scale) and sleepiness, and had clinical examination, biology and cardiac ultrasound (measurement of aortic root diameter at the level of the Valsalva's sinuses). Results: Main characteristics were as follows (mean): age 54.6 + 12.9 years, 115 men (68%), BMI 28.9 + 5.2 kg/m2, clinic blood pressure 150 + 20/91 + 13 mmHg. 125 patients (74%) were treated for HTN (2.54 + 1.38 antihypertensive drugs per pa...
Objective: Cardiovascular prevention and management of hypertension is mainly based on the detect... more Objective: Cardiovascular prevention and management of hypertension is mainly based on the detection and treatment of metabolic usual risk factors or dietary improvement. This approach has difficulty in assessing the risk of disadvantaged populations where social deprivation seems to play a major role. Design and method: 263 consecutives hypertensive patients were refered to specialists and assessed for social deprivation through the EPICES questionnaire as for usual risk factors and several socio-economic data. Results: Patients were 63 ± 13 years old and 59% were men. Risk factors were diabetes (39%), dyslipidemia (68%), active smoking (32%). Alcoholic consumption of more than once per week was present in 28%, a physical activity for at least once a week in 30%. Systolic, diastolic and pulse pressure were 143 ± 21, 81 ± 13 and 63 ± 18 mmHg. The mean number of antihypertensive drugs was 2.8 ± 1.3. A target organ damage was frequent, including peripheral vascular disease (18% lower ...
Journal of the American Heart Association, Jan 10, 2017
The DENERHTN (Renal Denervation for Hypertension) trial confirmed the efficacy of renal denervati... more 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. 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). Total AAC volume was measured, with semiautomatic software and blind to randomization, from the aortic hiatus to the iliac bifurcation using the prerandomization noncontrast abdominal computed tomography scans of 90 patients. Measurements were expressed as tertiles. The baseline-adjusted difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the RDN and control groups was -10.1 ...
Journée nationale de formation des infirmier(e)s en infectiologie / Médecine et maladies infectie... more Journée nationale de formation des infirmier(e)s en infectiologie / Médecine et maladies infectieuses 47S (2017) S155-S160 cale d'état. Le titre de séjour des étrangères était temporaire dans 76 % (31/41) des cas. Au 3 e trimestre, toutes les femmes recevaient un traitement ARV dont 2 NRTI + 1 IP/r (83 %, 44/53) et une combinaison incluant le raltegravir (9 %, 5/53). À l'accouchement, 89 % (47/53) avaient plus de 350/mm 3 CD4 ; 87 % et 94 % avaient une charge virale plasmatique < 20 et < 50 copies/mL respectivement ; 51 % ont reçu une perfusion d'AZT pendant le travail. Elles ont accouché par voie basse dans 70 % (37/53) des cas ; 2 des 16 césariennes étaient d'indication virologique, associée dans un cas à une indication obstétricale. Aucun des enfants nés vivants n'est infecté par VIH. Conclusion La forte proportion de femmes VVIH et leurs conditions socio-économiques défavorables soulignent l'intérêt d'une prise en charge multidisciplinaire organisée et systématique pour la prévention de la transmission mère-enfant du VIH. Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
Archives des maladies du coeur et des vaisseaux, 1999
Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors repo... more Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors report the case of anterior myocardial infarction with dissection of the left anterior descending artery in a 16 year old boy who was injured in a motorbike accident without a penetrating thoracic wound. Therefore, the only pathological mechanism was deceleration. The authors review the 12 previously reported cases.
Purpose: The aims of this study were: 1) to study the impact of a combined long-term lifestyle an... more Purpose: The aims of this study were: 1) to study the impact of a combined long-term lifestyle and high-intensity interval training (HIIT) intervention on blood pressure (BP) in patients with abdominal obesity; 2) To document BP reduction responses according to the European Society of Hypertension BP classification. Methods: 105 patients with abdominal obesity (age: 53±10 yrs; 32 men; waist circumference (WC): 112±13cm; systolic/diastolic (SBP/DBP): 133±13/82±8 mmHg; 11% diabetics, 11% smokers, 68% with antihypertensive therapy) were retrospectively analyzed before and after a combined long-term lifestyle and HIIT program twice a week. Anthropometric measurements, cardiometabolic risk factors, and resting BP (5min. of supine rest, using a manual sphygmomanometer) were assessed at baseline and after 9 months of program. Results: After 9 months, we observed an improvement in weight (-4.83kg), BMI (-1.75 kg/m2), WC (-6.62 cm), an average SBP/DBP decrease of -5.59/-3.31 mmHg. These changes were not uniform, 74 patients decreased their BP (1 mmHg or more) reaching -11.69/-6.92 mmHg. The parameter which differentiated them to those who did not improve their BP was their higher initial BP level (SBP: 135±14 vs. 126±10 mmHg, P=0.001; DBP 84±7 vs. 77±3 mmHg, P<0.0001). Thus, we compared following groups in accord to their baseline ESH-BP-classification: 1/ "optimal" \[BP <120/80 mmHg] + "normal" [120/80 ≤ BP < 130/85 mmHg\] (n=13) vs. 2/ "high normal" \[130/85 ≤BP < 140/90 mmHg] + "stage 1 hypertension" [140/90 ≤ BP < 160/100 mmHg\] (n=92). We observed no significant difference between groups 1/ vs. 2/ in terms of gender (P=0.2), age (50±9 vs. 54±10 yrs, P=0.2), resting heart rate (72±15 vs. 75±12 bpm, P=0.3), diabetes, lipid analysis, weight loss (-3.75±4.49 vs. -4.99±5.67 kg, P=0.4), WC improvement (-5.95±3.49 vs. -6.72±11.70 cm, P=0.8). Antihypertensive therapies were at baseline less present in group 1/ than in group 2/ (38% vs. 72%, P=0.02). Furthermore, BP was not improved in group 1/ (+1.85/+4.92 mmHg) but decreased in group 2/ (-6.64/-4.48 mmHg) (P=0.04 and P=0.0003 respectively for SBP/DBP). Conclusion: A long-term lifestyle and high-intensity interval training intervention had a beneficial effect on BP levels in patients with abdominal obesity and a baseline BP ≥130/85 mmHg. This helped them to bring back to "normal" BP values.
Archives des maladies du coeur et des vaisseaux, 1999
Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors repo... more Myocardial infarction is a rare complication of traumatic thoracic deceleration. The authors report the case of anterior myocardial infarction with dissection of the left anterior descending artery in a 16 year old boy who was injured in a motorbike accident without a penetrating thoracic wound. Therefore, the only pathological mechanism was deceleration. The authors review the 12 previously reported cases.
La prevalence de l'hyperaldosteronisme primaire (HAP), longtemps consideree comme tres faible... more La prevalence de l'hyperaldosteronisme primaire (HAP), longtemps consideree comme tres faible, a ete reevaluee aux alentours de 10 % des HTA. Il parait legitime de rechercher cette etiologie dans les circonstances suivantes: HTA associee a une hypokaliemie < 3,6 mmol/L (ou < 3,9 sous IEC); HTA resistante; HTA severe d'apparition precoce (< 40 ans), surtout chez la femme. On rappellera que plus de 20 % des HAP seraient normokaliemiques. La plupart des auteurs s'accordent aujourd'hui pour mesurer en 1 re intention, sur cette population ciblee, le rapport aldosterone/renine plasmatiques. Quand ce rapport depasse un seuil donne (fixe a 23 si les valeurs sont exprimees en pg/mL), il est recommande de documenter ce resultat par un test de freination (charge sodee ou test a la fludrocortisone), avant de realiser un scanner des surrenales, dont la specificite et la valeur predictive positive n'excedent pas 58 % et 72 % respectivement. La distinction entre adenom...
Background In contrast with the setting of acute myocardial infarction, there are limited data re... more Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox propor...
We aimed to compare blood pressure (BP) responses following moderate-intensity continuous exercis... more We aimed to compare blood pressure (BP) responses following moderate-intensity continuous exercise (MICE), highintensity interval exercise (HIIE) in dry land or HIIE in immersed condition, using 24-hour ambulatory BP monitoring. Forty-two individuals (65 AE 7 years, 52% men) with a baseline BP ! 130/85 mm Hg (systolic/diastolic blood pressures [SBP/DBP]) were randomly assigned to perform one of the three following exercises on a stationary cycle: MICE (24 minutes at 50% peak power output) or HIIE in dry land (two sets of 10 minutes with phases of 15 seconds 100% peak power output interspersed by 15 seconds of passive recovery) or HIIE in up-to-the-chest immersed condition. While MICE modified none of the 24-hour average hemodynamic variables, dryland HIIE induced a 24-hour BP decrease (SBP: À3.6 AE 5.7/DBP: À2.8 AE 3.0 mm Hg, P < .05) and, to a much greater extent, immersed HIIE (SBP: À6.8 AE 9.5/DBP: À3.0 AE 4.5 mm Hg, P < .05). The one condition that modified 24-hour pulse-wave velocity was immersed HIIE (À0.21 AE 0.30 m/s, P < .05).
Diabetes & Metabolism - In Press.Proof corrected by the author Available online since lundi 1... more Diabetes & Metabolism - In Press.Proof corrected by the author Available online since lundi 12 mars 2018
Clinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related fa... more Clinic-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. After drug assay samplings on study visits, patients took their antihypertensive treatment under supervision immediately after the start of the ambulatory BP recording, and supine clinic BP was measured 24 hours post-dosing; both allowed to calculate the clinic minus daytime ambulatory systolic BP (SBP) difference (clinic-SBP–day-SBP). A tota...
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