[Is scheduled hospitalization over a specific period still justified in hypertension?].
To general practitioners' request, a 36-hour scheduled hospitalization over a determined period (SHDP) was set up to assess the effects and the etiology of the arterial hypertensions they had detected and to propose an appropriate treatment. From November 1988 to December 1990, 277 patients (156 male/121 female) with mean age of 44.7 +/- 14.5 were thus hospitalized over a determined period. All of them underwent 24-hour semi-ambulatory blood pressure monitoring (Bard Sentron) by using the oscillometric method, which permits to measure mean blood pressure (MBP) instead of calculating it. This 24-hour MBP was on average of 108.5 +/- 16.2 mmHg and not significantly different from daytime MBP (111 +/- 16.3 mmHg). Figures of MBP superior to 105 mmHg confirmed permanent HBP (High Blood Pressure). On the 277 patients, 46 (16%) had a normal MBP, 67 (24%) had a "borderline" MBP (between 96 and 105 mmHg). A severe HBP (MBP > 125 mmHg) found in 66 cases (23%) was confirmed by visceral impairment. Left ventricular hypertrophy (LVH) was detected in 12 cases (4.3%) on the chest radiograph, in 24 cases (8.6%) on the ECG and in 75 cases (27%) on the echocardiogram. The etiological assessment revealed 10 cases (3.61%) of secondary hypertension with 3 reno-vascular HBP and 2 Conn's adenomas. Eventually, therapeutic abstention was recommended in 57 patients (20.5%) though 20 of them had previously received antihypertensive therapy. All in all, SHDP permits a more accurate determination of the consequences and severity of HBP. The small number of secondary HBP reflects the proportion found in practice.(ABSTRACT TRUNCATED AT 250 WORDS)
Mounier-Véhier
C
C
Service de médecine interne et hypertension artérielle, hôpital cardiologique, CHRU de Lille.
Poncelet
P
P
Fouquoire
B
B
Petetin
N
N
Vanceulebroecke
K
K
Carré
A
A
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic
Les hospitalisations programmées à durée déterminée sont-elles encore justifiées dans l'hypertension artérielle?