Prise en charge actuelle de l’hypertension artérielle

Abstract

Hypertension is a common health problem with serious consequences for individuals and a heavy attributable burden for populations. Reducing this burden requires preventive actions at the population level and early diagnosis at the individual level, followed by proactive interventions with proven benefits. Given the variability of blood pressure measurement, diagnosis is established only after repeated measurements under standardized conditions, if possible outside the clinic. Lifestyle changes can modestly reduce blood pressure; their impact is significant if they can be achieved on a large scale. Hypertension treatment requires a rational pharmacological approach, which can reach the target blood pressure within less than 6 months and three pharmacological classes at most in more than 80% of cases. Specialized consultation is required in the remaining 20% to detect secondary hypertensions, to optimize drug therapy and to discuss, in a minority of cases, non-pharmacological treatments. Recommendations are written by experts who select, interpret, and extrapolate the results of clinical research. As a consequence, they are sometimes unsuitable for primary care practice and frequently inconsistent across guidelines. Efforts are currently made to produce less disputable and more usable guidelines.

Antihypertensive Activity of Leersia hexandra Sw. (Poaceae) Aqueous Extract on Ethanol-Induced Hypertension in Wistar Rat

“…Hypertension (HT) is a cardiovascular disease whose complications (hypertrophic cardiomyopathy, hypertensive encephalopathy, malignant retinopathy, malignant nephroangiosclerosis, arteriosclerosis, etc.) are the leading causes of death worldwide [1]. The global prevalence of hypertension in the adult global population was estimated in 2014 at 30% [1].…”

Etiologies des hypertensions artérielles endocrines: à propos d’une série de cas

“…La prévalence de l'HTA secondaire a augmenté à partir des années 90, probablement du fait de l'amélioration des méthodes d'exploration, du dépistage hormonal et de l'imagerie [ 2 , 8 ]. Elle n'est connue qu’à partir de séries hospitalières [ 4 , 8 , 9 ].…”

“…L'HAP est une hypersécrétion autonome d'aldostérone, non adaptée et non stimulée par le système rénine-angiotensine. Les causes dominantes sont l'hyperplasie idiopathique et l'adénome produisant de l'aldostérone (APA) qui représentent 60 et 30% des cas respectivement [ 2 , 4 ]. L'HAP est la cause la plus fréquente de l'HTA secondaire avec une prévalence estimée à 5- 13% des patients hypertendus, soit près de 3% de la population [ 8 , 19 ].…”

“…L'hypertension artérielle (HTA) est une pathologie très fréquente. Elle touche 972 millions de personnes dans le monde [ 1 , 2 ]. On distingue 2 entités différentes: les HTA essentielles où aucune cause n'est identifiée (90% des cas) et les HTA secondaires qui sont moins fréquentes, représentent 9,1% des cas [ 1 ] et qui peuvent être surtout d'origine rénale ou endocrine [ 3 ].…”

Evaluation of the Knowledge, Attitudes and Practices of the Hospital Staff in the Management of High Blood Pressure in Conakry

“…The majority had opted for a lifetime treatment (lifestyle and dietary measures, drug treatment) or 72%. However, 18% of physicians ordered discontinuation of antihypertensive therapy after blood pressure normalization, which could lead to often dramatic complications[15] [16].…”