[Absolute risk and treatment decisions in hypertensive patients].
The clinical practice, based on the dichotomy between hypertension or normotension, does not correspond to the actual risk due to blood pressure increase. Cardiovascular risk being multifactorial, it is necessary to have objective tools to assess the absolute risk in each individual. Presently, a 20% risk for the occurrence of a coronary event within a period of 10 years is the selected threshold. Clinicians must be aware of the numerous limits in the use of this risk rate. Risk estimates obtained from the Framingham study cannot be used in France without adjustments. Tobacco consumption and diabetes are variables expressed simply as present or absent, and age is a very significant and weighty factor. Different strategies have been proposed to take into account these shortcomings. Evaluation of the absolute risk in the decision to treat or not to treat hypertension is, in spite of its limits, an important help in avoiding a purely subjective clinical approach.
Cambou
J P
JP
INSERM 518 Département d'épidémiologie Faculté de médecine Toulouse-Purpan, Toulouse.
D000328:Adult; D000367:Age Factors; D000368:Aged; D003657:Decision Making; D048909:Diabetes Complications; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects