Search PubMed⌕ Search

Biomedical subjects

J Amar

Publications and source records attributed to J Amar.

62 records · Page 4Linked to original sources
PubMedDate not supplied

[Hypertension management in patients with stable coronary disease].

AIMS: To assess hypertension control in patients with stable coronary disease in France. DESIGN: A cross sectional study was conducted in a representative sample of 794 cardiologists. PARTICIPANTS: The first 6 patients with coronary disease received at practitioner's office were included. MAIN OUTCOME MEASURES: Cardiovascular risk factors, antihypertensive drugs, cardiovascular history were reported. BP was measured. Patients considered as hypertensive by his cardiologist and receiving antihypertensive drugs were considered as hypertensive. Controlled hypertension was defined as a blood pressure < 140/90 mmHg. Uncontrolled hypertension was defined as blood pressure > or = 140/90 mmHg. Among the uncontrolled hypertensives we distinguished patients with isolated systolic hypertension: diastolic blood pressure < 90 mmHg and systolic blood pressure > or = 140 mmHg. RESULTS: All variables were available in 6,349 patients who form the basis of this report. 3,161 patients were hypertensive. Of them, 1,846 (58.4%) were uncontrolled hypertensives, whom 1,280 (69.3%) were uncontrolled on the basis of systolic blood pressure alone. CONCLUSION: This study conducted in a representative sample of French cardiologists indicates that there is a considerable potential to further reduce cardiovascular morbidity in patients in secondary prevention.

Aged↗
PubMedDate not supplied

[Arterial hypertension management in patients with type 2 diabetes].

AIMS: To assess hypertension management and blood pressure control in patients with type 2 diabetes in France. DESIGN: A cross sectional study was conducted in a representative sample of 410 diabetologists. The first 8 patients with type 2 diabetes, treated with oral antidiabetic agents and/or insulin, received at practitioner's office were included. Cardiovascular risk factors, antihypertensive drugs, cardiovascular history were reported. BP was measured. Patients considered as hypertensive by his practitioner and receiving antihypertensive drugs were considered as hypertensives. Controlled hypertension was defined as a blood pressure < 140/80 mmHg. Uncontrolled hypertension was defined as blood pressure > or = 140/80 mmHg. RESULTS: 4,930 diabetics were included in the study. Of them 3,085 (63%) patients were hypertensives. They were markedly older, overweight and reported most frequently complications. Only 723 (23%) patients presented with controlled hypertension. 40% of hypertensives were under monotherapy, 36% received 2 antihypertensive treatments and 24% received 3 treatments or more. ACE-inhibitors (49%), diuretics (41%), beta-blockers (35%), calcium channel blockers (33%), angiotensin II antagonists (19%) were the most commonly prescribed agents. Apart from hypertension, the main risk factors associated with each kind of prescription was micro or macroalbuminuria for ACE-I (OR = 1.5), coronary artery disease for beta-blockers and calcium channel blockers (OR = 3.8 and 2.5 respectively), and age for diuretics and angiotensin II antagonists (OR = 1.05 and 1.03). CONCLUSION: This study conducted in a representative sample of french diabetologists indicated that despite the large use of antihypertensive treatments only 23% of hypertensive diabetics were well controlled. Due to the high CV risk of these patients, hypertension management is of major importance.

Aged↗
PubMedDate not supplied

[Long-term development of blood pressure profile in hypertensive hemodialysis patients].

OBJECTIVE: The prognostic value of nocturnal blood pressure (BP) in hemodialysis patients has been well established. The aim of this study was to evaluate the long-term outcome of ambulatory BP in hypertensive hemodialysis patients. DESIGN AND METHODS: Medical records of all hemodialysis patients seen for uncontrolled hypertension between 1993 and 1999 and who underwent an ambulatory blood pressure measurements (ABPM) were retrospectively studied. Uncontrolled hypertension was defined as office BP = 140/90 mmHg and 24 h ABP = 125/80 mmHg. Patients who underwent a second ABPM after an interval of at least 1 year were included in the study. Demographic characteristics, medical history, cardiovascular risk factors and treatments were recorded for each patient. A t-test (bilateral) was used to compare BP. RESULTS: 26 patients were included (545 +/- 18.9 years; 14 men). 7 had previous history of cardiovascular disease and 2 were diabetic. At the end of the follow-up (29 +/- 12.8 months), 9 patients (36%) had 24 h BP < 125/80 mmHg. A significant decrease in diurnal and nocturnal BP was observed (p < 0.05). No significant change was observed for office systolic BP and predialytic BP. CONCLUSION: Our data show that a long-term decrease in nocturnal BP can be obtained in hypertensive patients on hemodialysis. With respect to the prognostic value of this criteria, randomised trials could be carried out to determine whether nocturnal BP is superior to office BP as a target for antihypertensive therapy in this population.

Adult↗
PubMedDate not supplied

Celiac sprue and ulcerative colitis in three South Asian women.

The association of celiac disease and inflammatory bowel disease has not been described in females of South Asian descent. We report three women, aged 33, 43 and 46 years, of South Asian origin, with both ulcerative colitis and celiac disease.

Adult↗
PubMedDate not supplied

[Drug interactions with antihypertensive drugs].

Numerous of pharmacokinetic and pharmacodynamic interactions with antihypertensive drugs have to be considered. In this review, interactions are analysed in the major organ sites of these interactions and in cardiovascular target sites of arterial hypertension, with respect to the major antihypertensive drugs. Many antihypertensive drugs are metabolized in the liver (calcium antagonists, liposoluble beta-blockers, and some ACE-inhibitors) via the cytochrome-oxidase system. Phenytoin, barbiturates, and rifampin can accelerate the breakdown of these drugs; conversely, cimetidine, which inhibits oxidase system, can increase antihypertensive drug levels, resulted in greater therapeutic effect. Hepatic blood flow can be modified by propranolol and nifedipine with opposite effects. When combined with nifedipine the breakdown of propranolol is accelerated because of an increase of hepatic blood flow. In the kidney, some anti-hypertensive agents interact with other cardiovascular drugs by competing for renal clearance; calcium antagonists alter the renal clearance of digoxin, but the mechanism remains unclear. In vascular muscle cells, excess vasodilatation or vasoconstriction can be observed. The combination of an alpha 1-blocking agent with a dihydropyridine can induce hypotension, which is sometimes severe. Non-steroidal antiinflammatory drugs (NSAIDs) are able to lessen the antihypertensive effects of beta-blockers, diuretics and ACE-inhibitors, via vascular prostaglandin inhibition. The cardiac pharmacodynamic interactions of beta-blockers and calcium antagonists, verapamil and diltiazem, at the sino-atrial node, atrio-ventricular node, conduction system and myocardium are well established and must be avoided. The main interactions with beta-blockers concern calcium antagonists, class I antiarrhythmic drugs and NSAIDs.(ABSTRACT TRUNCATED AT 250 WORDS)

Antihypertensive Agents↗
PubMedDate not supplied

[Arterial hypertension and insulin resistance].

Insulin resistance manifested by hyperinsulinism is an important risk factor for the development of cardiovascular diseases. When associated with characteristic disorders of the lipid metabolism and arterial hypertension it is regarded today as a metabolic syndrome X. To detect hyperinsulinism in patients with arterial hypertension in everyday practice, it is advisable to determine the rations "circumference of the waist, circumference of the hips", while its abnormal values necessitate a carbohydrate challenge. Hyperinsulinism in AH patients should be born in mind when devising therapeutic measures, the mainstay of which is dietary therapy, with Calcium antagonists and inhibitors of the converting enzyme being used as hypotensive agents.

Antihypertensive Agents↗