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Rev Med Interne. 2014 Apr;35(4):235-42. doi: 10.1016/j.revmed.2013.06.013. Epub 2013 Jul 30.

[Current management of arterial hypertension].

[Article in French]

Author information

1
Faculté de médecine, université Pierre-et-Marie-Curie-Paris-6, 75006 Paris, France; Service de médecine interne, hôpital Tenon, Assistance publique-Hôpitaux de Paris, 75020 Paris, France.
2
Faculté de médecine, université Paris Descartes, Sorbonne Paris-Cité, 75006 Paris, France; Unité d'hypertension artérielle, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75908 Paris cedex 15, France. Electronic address: pierre-francois.plouin@egp.aphp.fr.

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.

KEYWORDS:

Aged 80 and over; Antihypertenseurs; Antihypertensive agents; Blood pressure determination; Guides de bonnes pratiques cliniques comme sujet; Hypertension; Life style; Mesure de la pression artérielle; Practice guidelines as topic; Style de vie; Sujet âgé de 80ans et plus

PMID:
23910222
DOI:
10.1016/j.revmed.2013.06.013
[Indexed for MEDLINE]
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