title: [Prevalence of asymmetrical blood pressure in uncontrolled hypertensive patients is high and highly related with cardiovascular diseases prevalence].
abstract: A meta-analysis has shown that an asymmetry of the blood pressure (ABP) between arm≥15mmHg and perhaps≥10mmHg is associated with an increase of cardiovascular diseases. To describe the prevalence of ABP in patients presenting an uncontrolled blood pressure (BP) under treatment, an observational cross sectional study was conducted. Factors influencing prevalence of ABP were identified and relation of ABP with the frequency of the cardiovascular diseases or subclinicals organs damages was evaluated. A total of 2417 patients, 63.3±11.0years old, presenting uncontrolled BP (according ESC criteria) by a previous antihypertensive therapy were included. Only 36.8% (95% CI [34.9-38.7]) were presenting a between-arm difference in systolic blood pressure≥10mmHg, and 17.1% (95% CI [15.6-18.6])≥15mmHg. MRA shows systolic ABP≥10mmHg prevalence was influenced by dyslipidemia (OR: 1.5 [1.2-1.7], P<0.0001) and by family history of early cardiovascular disease (OR: 1.6 [1.3-1.9], P<0.0001). MRA adjusted on CVRF shows that besides the dyslipidemia effect, systolic ABP≥10mmHg influences the frequency of sub-clinical impairment of target organ (OR: 1.6 [1.3-1.9], P<0.0001), of coronary heart disease (OR: 1.8 [1.4-2.4], P<0.0001), and globally the presence of a cardiovascular disease (OR: 1.7 [1.4-2.1], P<0.0001). The effect on stroke frequency was showed with an systolic ABP≥15mmHg (OR: 1.6 [1.1-2.4], P<0.02). In uncontrolled hypertensive patients, screening of an ABP should help to identify clinically patients with high risk of cardiovascular diseases or with subclinical organs damages.
authors.affiliation: Cenbiotech, impasse Françoise-Dolto, 21000 Dijon, France.
authors.forename: F-A
authors.initials: FA
authors.lastname: Allaert
authors.affiliation: 6, rue Paul-Cabet, 21000 Dijon, France.
authors.forename: G
authors.initials: G
authors.lastname: Fouchères
authors.affiliation: Département médical, laboratoire Menarini, 1, rue du Jura, 94633 Rungis, France.
authors.forename: I
authors.initials: I
authors.lastname: Elias-Billon
authors.affiliation: Département médical, laboratoire Menarini, 1, rue du Jura, 94633 Rungis, France. Electronic address: departement.medical@menarini.fr.
authors.forename: P
authors.initials: P
authors.lastname: Maigret
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010824:Physicians' Offices; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D000959:Antihypertensive Agents
keywords: Asymmetry of the blood pressure; Asymétrie tensionnelle; Atteintes infracliniques; Cardiovascular diseases; Haut risque cardiovasculaire; Hypertension non contrôlée; Subclinical organs damages; Uncontrolled blood pressure