Biomedical subjects

X Girerd

Publications and source records attributed to X Girerd.

At least 109 records · Page 6Linked to original sources

PubMed1988

[Effects of beta-blockers on hemodynamics of the forearm after tobacco stimulation].

In mild hypertension, a betablocker treatment could reduce cardiovascular events. But in smoking men the benefit disappears and this interaction is unexplained. In 6 healthy non smoking men, we studied the effects of acute oral administration of propranolol (80 mg) pindolol (15 mg) and placebo after cigarette smoking (CS) (two cigarettes within 10 minutes). In a double blind cross over randomized study, arterial pressure and heart rate (HR) were recorded within 20 minutes after CS. Brachial artery diameter (D), Local vascular Resistance (RL), Local arterial Compliance (CL) and pulse wave velocity (VOP) were determined non invasively (using a pulsed doppler system) before and 20 mn after CS. Under placebo, mean arterial pressure (PAM), HR and RL increased significantly after CS (+9.2 +/- 3 mmHg, +4.5 +/- 3 b/mn and +36 +/- 14 per cent, respectively). These modifications were not different after propranolol, pindolol or placebo (ANOVA). Arterial distensibility (CL) was decreased after CS and this alteration was not prevented by beta-blockers. Brachial artery diameter was not modified after CS. Our results demonstrate that acute treatment with non selective beta-blockers with or without sympathomimetic intrinsic activity does not prevent haemodynamic modifications induced by cigarette smoking.

Adrenergic beta-Antagonists↗

PubMed1988

[Flow-dependent vasodilation of the brachial artery in the normotensive and essential hypertensive patient].

Brachial artery hemodynamics including brachial artery diameter (D), local blood flow velocity (V) and local volumic blood flow, was studied in 10 normotensive subjects (NT) and 10 age-matched hypertensive patients (HT) (50 +/- 4 vs 43 +/- 4 years; m +/- SEM; NS), using a bidimensional pulsed doppler system at rest (control period), during a 2 (or 4) mn-period of distal circulatory occlusion (DO) and during the following reactive hyperemia (RH). Kinetics of change in blood flow velocity and diameter were determined during successive and reproducible manoeuvres. V and D decreased significantly during DO. During RH (1) V reached similar maximum values in both groups (after 2 mn DO: NT: from 2.4 +/- 1.1 to 19.0 +/- 6.9 cm/s; HT: from 2.9 +/- 0.8 to 17.2 +/- 7.6 cm/s) and (2) D increased significantly in both groups (after 2 mn DO: NT: from 0.395 +/- 0.016 to 0.450 +/- 0.025 cm; p less than 0.001; HT: from 0.408 +/- 0.018 to 0.467 +/- 0.018 cm; p less than 0.001), reaching levels significantly higher than during the control period. The brachial artery vasodilation observed in both groups (NT: +12 +/- 3 p. 100; HT: +15 +/- 3 p. 100 of initial diameter) was significantly greater (p less than 0.001), than the reproducibility of the diameter measurement (3 +/- 1 p. 100). Mean arterial pressure and heart rate dit not change during the whole investigation. Increasing the duration of DO from 2 to 4 mn further enhanced the reactive blood flow velocity but did not change the magnitude of the reactive brachial artery vasodilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1987

[Current treatment regimen in essential arterial hypertension].

The introduction in the treatment of arterial hypertension of angiotensin-converting enzyme inhibitors and calcium inhibitors, as well as the results of extensive multicentric therapeutic trials, suggest that the prescription of antihypertensive drugs will be profoundly altered in the forthcoming years. The "step by step" approach will be abandoned, and each patient will receive one or two drugs chosen for being the most selective and most suitable for his case. These more personalized long-term treatments will be better tolerated, and the greater patient's compliance will make them more effective drugs to the underlying pathology (smoking habits, blood lipid disorders, early arterial lesions) the antihypertensive treatment will have a greater reducing effect on cardiovascular morbidity and mortality.

Antihypertensive Agents↗

PubMed1987

The efficacy of a transdermal formulation of clonidine in mild to moderate hypertension and its effects on the arterial and venous vasculature of the forearm.

We have studied the efficacy of clonidine hydrochloride administered transdermally once a week for 9 to 15 weeks in 12 patients with mild to moderate hypertension. Clonidine reduced both supine and standing blood pressures on average, but only 8 subjects were responders, i.e. had a decrease in supine diastolic blood pressure to below 90 mm Hg or more than 10% from baseline. Supine heart rate was unchanged, but in the responders the orthostatic increase in heart rate was reduced by clonidine from baseline (p less than 0.05). Moreover, in all the patients the change in the orthostatic increase in heart rate was correlated with the change in supine diastolic pressure (p less than 0.05). Brachial artery blood flow, forearm arterial compliance, vascular resistance, and venous tone were not affected by clonidine. Thus, transdermal clonidine reduced blood pressure, probably by a baroreflex-mediated effect, but did not affect the vasculature of the forearm.

Administration, Cutaneous↗

PubMed1987

Opposite central cardiovascular effects of nifedipine and BAY k 8644 in anesthetized rats.

The central cardiovascular effects of the calcium channel blocker nifedipine and the calcium channel activator BAY k 8644 were studied in anesthetized and ventilated normotensive Wistar-Kyoto (WKY) or spontaneously hypertensive rats (SHR). Both drugs were administered in a 1.5-microliter volume into the lateral ventricle of the brain (i.c.v.) or into the cisterna magna (i.c.). The injection of vehicle alone (i.c. or i.c.v.) did not significantly change mean arterial pressure (MAP) or heart rate. Nifedipine (5 and 50 micrograms/kg) and BAY k 8644 (5 and 50 micrograms/kg) induced opposite effects on MAP when centrally injected. Nifedipine decreased MAP and induced a bradycardia (i.c.v.) or no change in heart rate (i.c.), and BAY k 8644 increased MAP without any significant change in heart rate (i.c. or i.c.v.). These effects were more marked with the highest dose of either drug. These effects seemed to be of central origin, since they were suppressed by ganglionic blockade by hexamethonium (100 mg/kg i.v.), whereas after hexamethonium the hypotensive and the hypertensive responses to intravenously injected nifedipine and BAY k 8644, respectively, were preserved. Bilateral vagotomy suppressed the bradycardia induced by i.c.v. administered nifedipine. Previously i.c.v. administered nifedipine (5 micrograms/kg) antagonized the pressor response to BAY k 8644 (5 micrograms/kg i.c.v.). Changes in MAP and heart rate were significantly more marked in SHR than in WKY. These results indicate that a calcium channel inhibitor and a calcium channel activator can modulate in opposite fashion central mechanisms involved in blood pressure control.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

PubMed1987

Opposite central cardiovascular effects of nifedipine and BAY k 8644 in anesthetized rats.

The central cardiovascular effects of the calcium channel inhibitor (CCI) nifedipine and the calcium channel activator BAY k 8644 (BAY) were studied in pentobarbital-anesthetized and ventilated normotensive Wistar-Kyoto (WKY) or spontaneously hypertensive rats (SHR). Both drugs were administered under a 1.5 microliter volume into the lateral ventricle of the brain (intracerebroventricular, i.c.v.). The injection of vehicle (ethanol) alone did not significantly change mean arterial pressure (MAP) or heart rate (HR). Nifedipine (5 and 50 micrograms/kg) and BAY (5 and 50 micrograms/kg) induced opposite effects on MAP when centrally injected. Nifedipine decreased MAP and HR while BAY increased MAP without significant change in HR. These effects are likely to be of central origin, because they were suppressed by ganglionic blockade with hexamethonium and by reserpine. Previously i.c.v. administered nifedipine (5 micrograms/kg) antagonized pressor response to BAY (5 micrograms/kg i.c.v.). Changes in MAP and HR were significantly more marked in SHR than in WKY. These results indicate that a calcium channel inhibitor and a calcium channel activator can modulate in opposite fashion central mechanisms involved in blood pressure control.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

PubMed1986

[Central cardiovascular effects of a calcium inhibitor, nifedipine, and a calcium channel activator, Bay k 8644, in the anesthetized rat].

The antihypertensive effect of calcium channel inhibitors (CCI) results mainly from their direct action on the vascular smooth muscle. However CCI may pass through the blood-brain barrier and may modulate central mechanisms involving calcium channels. Normotensive (WKY) and spontaneously hypertensive (SHR) (Okamoto) rats weighing 300 g were anaesthetized with pentobarbital (50 mg/kg i.p.) and ventilated. Mean arterial pressure (MAP) was measured from a catheter inserted into the femoral artery. Heart rate (HR) was electronically integrated. Vehicle (ethanol 95%), nifedipine and Bay k 8644 (Bay) were injected under a 1.5 microliter volume into the lateral ventricle of the brain (i.c.v.). Vehicle alone did not change significantly MAP or HR. The calcium-channel inhibitor nifedipine and the calcium-channel activator Bay had opposite effects, when i.c.v. injected: hypotension with bradycardia and hypertension without tachycardia, respectively. These effects are dose-dependent (5-50 micrograms/kg). They are of central origin since they are suppressed by ganglionic blockade by hexamethonium(100 mg/kg i.c.). Bilateral vagotomy suppressed the i.c.v.-nifedipine induced bradycardia. Previously i.c.v. administered nifedipine (5 micrograms/kg) suppressed the pressor response to Bay (5 micrograms/kg i.c.v.). Changes in MAP and HR are significantly more marked in SHR than in WKY. These results indicate that a calcium-channel inhibitor and a calcium-channel activator can modulate in opposite fashion central calcium-dependent mechanisms involved in blood pressure control.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

PubMedDate not supplied

Blockade of angiotensin II type 1 receptors: effect on carotid and radial artery structure and function in hypertensive humans.

Converting-enzyme inhibition reduces cardiovascular hypertrophy in hypertensive subjects. Whether the blockade of angiotensin II type 1 (AT(1)) receptors reduces arterial hypertrophy has never been investigated. In a double-blind study versus placebo in subjects with essential hypertension, the effect of the AT(1) blocker irbesartan (150 mg/day for 8 weeks) on blood pressure, wall thickness, diameter and stiffness of the common carotid and radial arteries was studied, using echotracking techniques of high resolution. With irbesartan, mean blood pressure decreased significantly and proportionally to the baseline levels of active renin, and angiotensin I and II. There was a significant decrease in radial artery wall thickness. The percent change from baseline (+/- SEM) was -10.51 +/- 3.42 versus 6.18 +/- 4.77. There was no significant change in diameter or distensibility. This effect was correlated neither to blood pressure changes nor to hormonal baseline levels of the renin-angiotensin system. Carotid wall thickness and diameter were unchanged. Thus a 2-month treatment with an AT(1) antagonist significantly reduced radial but not carotid artery wall thickness. Blood pressure reduction could be explained on the basis of circulating renin-angiotensin activity. On the contrary, radial artery wall thickness reduction was independent of the baseline circulating renin-angiotensin activity and was not correlated with the effects of AT(1) blockade on blood pressure, thus implying the involvement of local hemodynamic and/or cellular mechanisms.

Adult↗

PubMedDate not supplied

Noninvasive measurement of medium-sized artery intima-media thickness in humans: in vitro validation.

Recent research in ultrasound technology has led to the development of a high-resolution echo-tracking device. The present study was performed to evaluate the accuracy in the measurement of human radial artery intima-media thickness with this new device. We determined the correlation between histological and ultrasonic measurements of intima-media thickness in 15 radial artery segments obtained from the distal end of the wrist-elbow harvest for coronary bypass grafting in patients with coronary heart disease. For arterial intima-media thickness, a positive correlation was observed between ultrasonic and histological measurements (r = 0.618; p < 0.014), and the difference between ultrasound and histology measurements was 41 +/- 66 microns, with the higher measurements found by the ultrasonic device. In a subgroup of 11 patients, we determined the correlation between in vivo ultrasonic measurements of radial artery intima-media thickness at the preoperative stage and in vitro ultrasonic measurements of intima-media thickness obtained postoperatively in the same arterial segments. Internal diameter was larger in vivo than in vitro, and intima-media thickness was smaller in vivo than in vitro. The cross-sectional area of the arterial wall was calculated from internal diameter and intima-media thickness. In vitro wall cross-sectional area was correlated with in vivo wall cross-sectional area (r = 0.929; p < 0.0001). Repeatability of in vivo intima-media thickness measurements was investigated in 10 subjects through the calculation of the repeatability coefficient as defined by the British Standards Institution.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation Studies as Topic↗

PubMedDate not supplied

The wall to lumen ratio of the radial artery in patients with Raynaud's phenomenon.

The pathophysiology of Raynaud's phenomenon (RP) remains an enigma. Whatever theories proposed, the final event leading to the clinical symptoms is the occlusion of digital vessels. However, the possibility that the upstream large arterial vessels contribute to vasopasm has never been investigated. We used a high resolution echo-tracking device to calculate lumen diameter, wall thickness, and circumferential wall stress upstream the digital arteries, i.e. at the site of the radial artery. Fifteen control women, 15 age-matched women with primary RP (PRP) and 15 women presenting with a secondary RP due to systemic sclerosis (SSc) were included in the study. All vasodilating agents were discontinued 72 h before the study session, which was conducted in a room with a stable ambient temperature of 22 degrees C. Radial artery internal diameter, intima-media wall thickness, and mean arterial pressure were measured simultaneously. Internal diameter of patients with RP was significantly decreased (p < 0.001 vs. controls) whereas intima-media wall thickness and mean arterial pressure were closely similar in the three groups, resulting in an increase in the wall to lumen ratio. Thus, circumferential wall stress was significantly smaller (p < 0.05 vs. controls) in patients with RP. In conclusion, this study demonstrates that in patients with RP, wall to lumen ratio is increased and circumferential wall stress is reduced at the level of the radial artery. It is suggested that the geometrical and mechanical changes of this artery may favor the downstream occlusive phenomena observed in patients with PRP and SSc.

Adult↗

PubMedDate not supplied

[Assessment of antihypertensive compliance using a self-administered questionnaire: development and use in a hypertension clinic].

OBJECTIVE: The most practical method of assessing medication compliance is to ask the patient for a self-report; but the interview question has to be selected and validated. The aim of this work was to select and validate interview questions to be used in a self-administered questionnaire for measurement of medication compliance in hypertensive patients. PATIENTS AND METHODS: In 117 treated hypertensive patients, we compared an interview question to a clinical evaluation of medication compliance. Kappa indices were calculated to test the concordance between interview question and medication compliance. In 184 patients treated for hypertension since at least a year, the validated self-report was compared to a clinical evaluation of medication compliance. RESULTS: Interview questions were not equally sensitive for detection of medication compliance and 6 questions were included in the Compliance Evaluation Test (CET). In 184 patients, we compared the results obtained with CET to clinical evaluation of medication compliance. Values of kappa indices were above 0.5 in "good compliance" when "No" was answered to the 6 items, in "minor noncompliance" when 1 or 2 "Yes" were given, in "noncompliance" when 3 or more "Yes" were given. In this population of hypertensive patients followed in a hypertension clinic, we observed 10% "noncompliance", 24% "minor noncompliance", and 66% "good compliance". CONCLUSION: In clinical practice, interview may be the most useful method of measuring medication compliance. We demonstrated that the compliance evaluation test is validated and may help physicians to face the problem of nonadherence among their hypertensive patients.

Antihypertensive Agents↗

PubMedDate not supplied

[Sexual dysfunction in treated hypertensive patients. Results of a national survey].

OBJECTIVES: To evaluate, using an self-administered questionnaire, the characteristics of sexual function in treated hypertensives. METHODS: In 459 hypertensive subjects, aged of 59 +/- 12 years, living in France and referred to hypertension specialists, a self-administered questionnaire evaluating quality of life and antihypertensive treatment was given before the consultation. Several questions focused on the quality of sexual function since the last 12 months (interest for sexuality, sexual pleasure, quality of erection). Details on antihypertensive treatments and cardiovascular characteristics were obtained from medical records. Antihypertensive treatments were prescribed since more than 10 years for 39% of subjects, since 5-10 years for 25%, since 1-5 years for 26%, and since less than 1 year for 10%. RESULTS: In this population of treated hypertensives, blood pressure level was higher in men than in women (145 +/- 22/86 +/- 13 vs 135 +/- 25/76 +/- 15; p < 0.01). In the questionnaire, the section with sexual function questions was filled out extensively in 92% of men (248/268), but only in 74% of women (142/191). Sexual disturbance was declared by 38% of cases (148/390), but rate was significantly higher in men as compared to women (49% vs 18%; p < 0.01). In men, these modifications were characterised by an interest for sexuality decreased for 58%, unchanged for 41% and increased for 1%. Sexual pleasure was decreased for 49%, unchanged for 50%, and increased for 1%. Quality of erection was modified in 45%. The erections were less frequent for 31%, less durable for 19% and impossible for 11%. In women, interest for sexuality was decreased for 41% and unchanged for 59%, sexual pleasure was decreased for 34% and unchanged for 66%. Logistic regression analysis indicates that gender (p < 0.001), greater number of antihypertensive tablets (p < 0.01), prescription of diuretics (p = 0.03) and presence of coronaropathy (p = 0.01) were independent determinants for sexual disturbance in treated hypertensives. CONCLUSION: This study indicates that sexual disturbance is declared by 38% of patients treated for hypertension. Because complaints are more frequent in men, treated with multiple medications including a diuretic, a specific interrogation should be proposed more regularly in these patients in order to detect and to deal with, if possible, sexual disability.

Aged↗

PubMedDate not supplied

[Study of the effect of season on the frequency of side effects or antihypertensive agents].

OBJECTIVES: To evaluate the influence of season on side effects of antihypertensive treatments in hypertensive patients followed by cardiologists. METHODS: In 12,071 hypertensive subjects, referred to cardiologists, a questionnaire with 14 possible side effects due to antihypertensive treatment was administered during the consultation. Details on antihypertensive treatment and cardiovascular characteristics were obtained from medical records. This evaluation was obtained in patients recruited during summer (7,438 patients) and during winter (4,633 patients). RESULTS: In this population of treated hypertensives, blood pressure level was < 140/90 mmHg in 28%, and 50% were treated with a monotherapy. At least one side effect was declared by 40% of cases, and it was observed dyspnea (10%), dizziness (8%), fatigue (8%), palpitations (6%), ankle oedema (5%), headaches (5%). The higher rate was observed in patients on monotherapy, most frequent side effects were fatigue (9%) on beta-blockers, cough (9%) on ACEI, oedema (18%) on calcium antagonists, dyspnea (9%) on diuretics, dizziness on ARB (8%) and central acting agents (18%). Regression analysis indicates that female patient, uncontrolled BP, age less than 50, and greater number of antihypertensive tablets were independent determinants for at least one side effects under antihypertensive treatments. Season was not a significant determinant of side effect appearance. CONCLUSION: This study indicates that during hypertensive treatments, at least one side effect is declared by 40% of patients. A female patient, uncontrolled for BP, aged less of 50 and treated with a multiple therapy is more prone to complain of side effects, but season was not a significant determinant of its appearance.

Aged↗

PubMedDate not supplied

[Rational choice for second antihypertensive agent after failure of the first monotherapy: therapeutic strategy].

This study evaluated a strategy to treat naive hypertensive patients, based on a single monotherapy followed, in uncontrolled patients, by a rationale choice for the second antihypertensive treatment. Subjects with essential hypertension, entered into the study if their BP measured with an OMRON 705CP was > 140/90 mmHg on two separate visits. Patients were allocated to single treatment in a balanced randomized design to receive either a "group 1" treatment (ACE inhibitor, beta-blocking drug or ARB) or a "group 2" treatment (calcium channel-blocking drug or thiazide diuretic). After one month of treatment at a standard dose, if BP was > 140/90 mmHg, first adaptation was a fixed combination therapy with one drug from "group 1" and one drug from "group 2". At 3 months, patients with BP < 140/90 mmHg were considered to have reached BP goal. Forty-eight patients entered the study with a mean age of 53 +/- 11 years. Initial SBP/DBP (mmHg) was 164 +/- 16/97 +/- 8. After 1 month, 40% achieved the target BP, 52% were uncontrolled with no side effects and 8% were uncontrolled and had side effects. After 3 months, 84% achieved BP goal and a fixed combination therapy was prescribed in 52% of the controlled patients. The initial monotherapy was maintained alone or in combination in 70% of the controlled patients. A strategy based on a single monotherapy followed, if necessary, by a rational choice for the second treatment in a fixed combination therapy is effective to achieve BP control in 84% of naive hypertensive patients.

Adult↗

PubMedDate not supplied

[Contribution of centralized reading of intima media thickness in an IMMEDIAT study conducted in hypertensive patients followed up in general medicine].

OBJECTIVE: To compare the results of two readings of Intima Media thickness (EIM): one performed during measurement by the cardiologist, the other by a technician in a reading unit. To evaluate the consequences of these readings on the principal criterion of a study conducted into cardiovascular risk (RCV) for hypertensives followed up in ordinary medical practice. METHODS: The EIM was measured in 991 hypertensives with the aid of the M'Ath program by cardiologists specially trained in the technique, within the framework of a study aimed at evaluating the RCV according to the WHO/ISH classification. The re-reading of source data by a reference centre was performed with the same program. RESULTS: The analysis was performed in 973 patients after eliminating duplicates and missing values (2%). The average cardiologist value of EIM was 0.761 +/- 0.168 mm, after centralised reading it was 0.743 +/- 0.128 mm. The difference between the measurements was -0.020 +/- 0.150 (p < 0.0001). According to the OMS/ISH classification, the presence of a vascular condition categorizes a hypertensive as being at "high risk" of a cardiovascular complication occurring. The calculation of RCV was performed by taking a value of EIM > 0.7 mm and/or presence of a plaque to define a vascular condition. The appreciation of risk was identical for the subjects at low risk and at very high risk. There was a shift from medium risk towards high risk: General Medicine 15%, Cardio 49%, after re-reading 68%. CONCLUSION: Despite the simplicity and the good inter observer reproducibility of the measurement of EIM by the M'Ath program, centralization of the reading is recommended during clinical trials.

Adult↗

PubMedDate not supplied

[Application of French guidelines in newly diagnosed hypertensive patients managed by general practitioners].

UNLABELLED: The French guidelines of the 2000 ANAES indicate that the management of patients with hypertension should not be based only on the level of blood pressure, but also on the presence of other risk factors and/or concomitant diseases such as diabetes or target organ damage. OBJECTIVES: To evaluate if the 2000 ANAES Guidelines concerning the initiation of antihypertensive treatment are applied by general practitioners. METHODS: Seventy new diagnosed hypertensive subjects, never treated by antihypertensive drugs, managed by 13 general practitioners were included in the study. From the data of the general practitioners medical report, the cardiovascular risk have been retrospectively recalculated for all the subjects. The concordance between the Guidelines and the clinical practice in term of institution of treatment have been evaluated. RESULTS: In this population of mean age 58 +/- 15 years, a concordance of 64% between the 2000 ANAES Guidelines and the clinical practice was observed (45/70 subjects). Among the discordant subjects (36%, [25/70]), the treatment was instituted by excess in 88% of cases (22/25) although it was not recommended. In contrast, in the remaining 12% of cases, only lifestyle measures have been proposed although an antihypertensive treatment was recommended. The discordance concerns essentially subjects with medium cardiovascular risk (84%). The principal determinants of this discordance were the grade 2 of hypertension and the presence of few risk factors (1 or 2), where the cardiovascular risk have been overestimated. CONCLUSIONS: Guidelines concerning the initiation of antihypertensive treatment in new diagnosed hypertensive subjects are more often applied by general practitioners. It is particularly in subjects with medium cardiovascular risk that the decision of the initiation of treatment is taken by excess in comparison to guidelines.

Adult↗

PubMedDate not supplied

[Estimation of the number of patients treated for hypertension, diabetes or hyperlipidemia in France: FLAHS study 2002].

The study used a cross-sectional survey of the general population living in metropolitan France in April 2002. A national sample of 5,000 adults, representative of the French population, 15 years of age or older, received at their home a questionnaire mailed by SOFRES medical. The sample was designed to provide estimates of the prevalence of hypertension in the general population and in persons older than 60 years of age, a subgroup on which prevalence of treated cardiovascular risk factors is unknown in France. The questionnaire included questions related to diagnosis of hypertension, awareness of their usual BP, current SBP/DBP values, prescribed medicine for hypertension dyslipidemia and diabetes. In FLAHS 2002, a number of 3,499 (70%) questionnaires were suitable for analysis. Estimates of prevalence were standardized by the direct method to the age distribution of the French population given by the 1999 national French census (INSEE 2000). Analysis on 2,363 subjects older than 35 years and indicates that 35% are currently treated for one or more risk factor. Overall, 8,036,000 received antihypertensive medication, 1,877,000 were treated for diabetes and 6,074,000 for dyslipidemia. Prevalence of treated hypertension increased with age from from 4.2% (35-44 years) to 51.8% (> 75 years) and 70% of treated hypertensives were older than 60 years. Subjects treated for two risk factors were 3,201,000 and those treated for three risk factors were 640,000. The FLAHS 2002 represents the best available data to estimate the prevalence of treated patients for a cardiovascular risk factor in the general French population. Thirty-five percent of the population 35 years of age or older representing around 11 millions persons were taking medications for the treatment of hypertension, diabetes or dyslipidemia in France.

Adult↗

PubMedDate not supplied

[Medical management of libido disturbances in treated hypertensive patients: differences between men and women].

UNLABELLED: Decrease in sexual desire is a disturbance affecting treated hypertensive subjects of both sexes. In contrast with erection problems, this abnormality has rarely been studied in hypertensives treated with antihypertensive drugs. OBJECTIVES: To evaluate, using a self-administered questionnaire, the prevalence of sexual disturbance (decrease in sexual desire) in treated hypertensive subjects and to determine the management of these troubles. METHODS: In 428 hypertensive subjects, living in France and referred to hypertension specialists, a self-administered questionnaire evaluating the quality of sexual activity was given before the consultation. Nine specific questions focused on the quality of sexual function for the last 6 months in men or women (interest for sexuality, sexual desire, sexual pleasure). Secondly, the doctors were questioned about their management of these sexual disturbances. RESULTS: In this population of treated hypertensives, including 270 men and 158 women, with a blood pressure level of 139 +/- 20/84 +/- 13 mmHg, a decrease in sexual desire was reported by 47% of men (127/270) and 48% of women (76/158). Sexual disturbance was related to antihypertensive drugs in 46% of cases (93/203), more often in men (59% [75/127]) than in women (24%, [18/76]), p < 0.001). In subjects with sexual disturbance, a specific medical management has been proposed in 35% of cases (71/203), especially in men (in 46% of cases [58/127], and consisted in a specialized consultation for 34% (43/127) and/or the prescription of Sildenafil for 20% (26/127). In women, the lack of management of these troubles was more often observed than in men (82% vs 54%; p < 0.01). Modifications of antihypertensive treatments were rarely observed in 15% of cases (30/203) comparatively in men and women. CONCLUSIONS: Men and women with treated hypertension are at "high risk" of sexual disturbance. Management of sexual dysfunction in these subjects concerns only 35% of cases, especially men, including specific treatments and/or consultations, but changing in antihypertensive drugs still remains rare.

Aged↗