Pulse pressure and ambulatory arterial stiffness index (AASI) in patients wit type 1 diabetes

Conference (2009, September 19)

Results of PP and AASI measurements performed during a 24H AMBP recording and a 3 min posture test are not superimposable, but gave complementary information, in a population with type 1 diabetes mellitus ... [more ▼]

Results of PP and AASI measurements performed during a 24H AMBP recording and a 3 min posture test are not superimposable, but gave complementary information, in a population with type 1 diabetes mellitus. Our proof-of-concept study does not support the use of AASI as a cardiovascular risk marker when calculated during a short posture test. [less ▲]

Sevikar° ou Forzaten° : combinaison fixe olmésartan médoxomil-amlodipine bésylate dans le traitement de l'hypertension artérielle

in Revue Médicale de Liège (2009), 64(9), 468-473

The interest for powerful and better tolerated antihypertensive combinations is searched in the field of hypertension, because of a too large number of people still not well controlled. The recent ... [more ▼]

The interest for powerful and better tolerated antihypertensive combinations is searched in the field of hypertension, because of a too large number of people still not well controlled. The recent association between an angiotensin receptor blocker, olmesartan, and a long-acting dihydropyridine, amlodipine, reinforces our therapeutic possibilities. The synergistic effect of the two molecules potentiate the antihypertensive activity, which allows improving the quality and the rapidity of the blood pressure control. Furthermore, the fixed combination should improve patient’s compliance. The contra-indications still remain those of the sartan family. The most frequent side-effect of amlodipine monotherapy, oedema, occurs in a much lower proportion with the addition of olmesartan. [less ▲]

Quand et comment bloquer le système rénine-angiotensine si hypertension artérielle?

Conference (2009, June 09)

Insuffisance rénale et vitamine D

Learning material (2009)

Peut-on prédire la mortalité cardiovasculaire chez les patients en dialyse? Les enseignements, présents et à venir, de l'étude CORD

in Tempo Medical (2009)

Les patients hémodialysés sont exposés à un risque cardiovasculaire accru et les calcifications vasculaires sont considérées comme un marqueur de cette augmentation de risque. L'étude CORD (Calcification ... [more ▼]

Les patients hémodialysés sont exposés à un risque cardiovasculaire accru et les calcifications vasculaires sont considérées comme un marqueur de cette augmentation de risque. L'étude CORD (Calcification Outcome in Renal Disease) revêt dès lors un intérêt particulier. Elle vise initialement à déterminer la prévalence et la sévérité des calcifications de l'aorte abdominale chez les patients dialysés et à identifier les facteurs prédictifs de ces calcifications. Elle ouvre également des perspectives importantes en matière de prévention et d'attitude thérapeutique. Quatre experts nous livrent leurs commentaires à ce propos. [less ▲]

Sodium et hypertension artérielle - cent ans de controverses

Scientific conference (2009, April 25)

Rappel de physiologie Le sodium, cation principalement extracellulaire, a un rôle important en physiologie pour le maintien du potentiel de membrane cellulaire. Le sodium intervient dans le transport de ... [more ▼]

Rappel de physiologie Le sodium, cation principalement extracellulaire, a un rôle important en physiologie pour le maintien du potentiel de membrane cellulaire. Le sodium intervient dans le transport de substances nutritives (glucose, acides aminés) au niveau de l’intestin et des reins. Mais le rôle le plus souvent cité est celui joué par le sodium (et le chlore) dans le maintien du volume circulant et donc de la pression artérielle. Ces deux ions sont indissociables pour expliquer l’influence sur ce paramètre hémodynamique. La consommation accrue de sel (NaCl) influence le volume extracellulaire qui, par le biais d'une augmentation du débit cardiaque, conditionne une élévation de pression artérielle; celle-ci, au niveau rénal, assure une excrétion sodée adaptée à la consommation en sel de façon à ramener le volume extracellulaire dans les limites de la normale. Toute augmentation d'apports sodés s'accompagne d'une prise d'eau en conséquence. Ceci génère une inhibition du système rénine-angiotensine et de l'ADH avec une diminution de l'absorption tubulaire de sodium et d’eau au niveau rénal. La consommation sodée s'accompagne aussi, par ailleurs, d'une augmentation de la filtration glomérulaire. Le bilan en est une augmentation de natriurèse et un retour à la normale du volume circulant. [less ▲]

Rosuvastatin and cardiovascular events in patients undergoing hemodialysis

in New England Journal of Medicine [=NEJM] (2009), 360

Background Statins reduce the incidence of cardiovascular events in patients at high cardiovascular risk. However, a benefit of statins in such patients who are undergoing hemodialysis has not been proved ... [more ▼]

Background Statins reduce the incidence of cardiovascular events in patients at high cardiovascular risk. However, a benefit of statins in such patients who are undergoing hemodialysis has not been proved. Methods We conducted an international, multicenter, randomized, double-blind, prospective trial involving 2776 patients, 50 to 80 years of age, who were undergoing maintenance hemodialysis. We randomly assigned patients to receive rosuvastatin, 10 mg daily, or placebo. The combined primary end point was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Secondary end points included death from all causes and individual cardiac and vascular events. Results After 3 months, the mean reduction in low-density lipoprotein (LDL) cholesterol levels was 43% in patients receiving rosuvastatin, from a mean baseline level of 100 mg per deciliter (2.6 mmol per liter). During a median follow-up period of 3.8 years, 396 patients in the rosuvastatin group and 408 patients in the placebo group reached the primary end point (9.2 and 9.5 events per 100 patient-years, respectively; hazard ratio for the combined end point in the rosuvastatin group vs. the placebo group, 0.96; 95% confidence interval [CI], 0.84 to 1.11; P = 0.59). Rosuvastatin had no effect on individual components of the primary end point. There was also no significant effect on all-cause mortality (13.5 vs. 14.0 events per 100 patient-years; hazard ratio, 0.96; 95% CI, 0.86 to 1.07; P = 0.51). Conclusions In patients undergoing hemodialysis, the initiation of treatment with rosuvastatin lowered the LDL cholesterol level but had no significant effect on the composite primary end point of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. (ClinicalTrials.gov number, NCT00240331.) [less ▲]

Combinaison fixe perindopril-amlodipine (Coveram®) dans le traitement de l'hypertension artérielle et de l'insuffisance coronaire.

in Revue Médicale de Liège (2009), 64(4), 223-227

Coveram® is a new fixed combination of an angiotensin converting enzyme inhibitor, perindopril, and a calcium antagonist, amlodipine. This new medication is indicated for the treatment of arterial ... [more ▼]

Coveram® is a new fixed combination of an angiotensin converting enzyme inhibitor, perindopril, and a calcium antagonist, amlodipine. This new medication is indicated for the treatment of arterial hypertension and/or stable coronary heart disease. Such fixed combination of two molecules that have been extensively evaluated according to evidence-based medicine offers the advantage of an excellent efficacy, associated with a good tolerance profile, and favours patient’s compliance. The marketing of different formulations of Coveram® combining various dosages allows easy adjustment and titration of each of the components according to the individual patient’s characteristics. [less ▲]

La vignette thérapeutique de l'étudiant - Comment gérer une hypertension artérielle qui devient résistante?

in Revue Médicale de Liège (2009), 64(3), 171-175

The management of arterial hypertension, a well known silent killer, is still a challenge for physicians fighting for an optimal control of blood pressure values. The problem is even more complex when ... [more ▼]

The management of arterial hypertension, a well known silent killer, is still a challenge for physicians fighting for an optimal control of blood pressure values. The problem is even more complex when, after a good response, the control of blood pressure becomes again worse. Our case record underscores the different steps allowing to increase the efficacy of blood pressure management in such secondary resistant form of hypertension. [less ▲]

Contrast agents and renal protection : fact or fiction?

Conference (2009, February 07)