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P Marques-Vidal

Publications and source records attributed to P Marques-Vidal.

At least 19 recordsLinked to original sources

Trends in hypertension prevalence and management in Southwestern France, 1985-1996.

The changes occurring in Southwestern France between 1985 and 1996 in hypertension prevalence, awareness and control were assessed in 622 men and 626 women for 1985 and in 614 men and 569 women for 1996. In women, prevalence of hypertension (defined as systolic blood pressure >/=160 mmHg and/or diastolic blood pressure >/=95 mmHg and/or presence of antihypertensive treatment) was 19% and 19% (NS), awareness was 67% and 87% (P < 0.001), treatment was 85% and 87% (NS) and control was 44% and 68% (P < 0.01) in the first and the second surveys, respectively. In men, prevalence of hypertension was 28% and 21% (P < 0.01), awareness was 47% and 71% (P < 0.001), treatment was 81% and 80% (NS) and control was 41% and 58% (NS). After stratifying on survey, women received significantly more beta-blockers and significantly less calcium channel blockers and ACE inhibitors than men, but those differences became nonsignificant after adjusting for other cardiovascular risk factors. We conclude that in Southwestern France, screening and management of hypertension have improved significantly, but more than one-third of treated hypertensive subjects still lacks adequate control.

Adult↗

Characteristics of male vitamin supplement users aged 50-59 years in France and Northern Ireland: the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction.

The prevalence and characteristics of vitamin supplement users were assessed in 7538 male subjects aged 50-59 from France and 2468 from Northern Ireland. In France, 15% of subjects used vitamin supplements; users were significantly younger, had a lower body mass index, a higher educational level, had more frequently a hard physical job, reported more frequently a personal history of disease and were less frequently retired or inactive than non-users. In Northern Ireland, 21% of subjects were vitamin supplement users; users had a lower body mass index, drank less alcohol, had a higher educational level, were more frequently non-smokers and professionally active, and reported a hard physical job and the practice of leisure sports more frequently than non-users. Finally, vitamin supplement users in Northern Ireland had a lower consumption of alcohol, smoked less, had a lower frequency of personal history of disease and were more frequently on dietary therapy for hypertension or dyslipidaemia than their French counterparts. We conclude that vitamin supplement use is associated with a healthier lifestyle and with dietary measures against hypertension and dyslipidaemia in Northern Ireland. The less favorable lifestyle observed for vitamin supplement users in France awaits further investigation.

Cross-Cultural Comparison↗

Patterns of alcohol consumption in middle-aged men from France and Northern Ireland. The PRIME study.

OBJECTIVE: To assess the patterns of alcohol consumption in France and Northern Ireland. DESIGN: Four cross-sectional studies. SETTING: Sample of 50-59 y old men living in France and Northern Ireland, consuming at least one unit of alcoholic beverage per week. SUBJECTS: 5363 subjects from France and 1367 from Northern Ireland. INTERVENTIONS: None. RESULTS: Consumption of wine was higher in France whereas consumption of beer and spirits was higher in Northern Ireland. Alcohol drinking was rather homogeneous throughout the week in France, whereas Fridays and Saturdays accounted for 60% of total alcohol consumption in Northern Ireland. In both countries, current smokers had a higher consumption of all types of alcoholic beverages than non-smokers. Similarly, obese and hypertensive subjects had a higher total alcohol consumption than non-obese or normotensive subjects, but the type of alcoholic beverages differed between countries. In Northern Ireland, subjects which reported some physical activity consumed significantly less alcoholic beverages than sedentary subjects, whereas no differences were found in France. Conversely, subjects with dyslipidemia consumed more alcoholic beverages than normolipidemic subjects in France, whereas no differences were found in Northern Ireland. In France, total alcohol, wine and beer consumption was negatively related to socioeconomic status and educational level. In Northern Ireland, total alcohol, beer and spirits consumption was negatively related whereas wine consumption was positively related to socioeconomic status and educational level. CONCLUSIONS: Alcohol drinking patterns differ between France and Northern Ireland, and also according to cardiovascular risk factors, socioeconomic and educational levels. SPONSORSHIP: Merck, Sharp & Dohme-Chibret (France), the NICHSA and the Department of Health and Social Service (Northern Ireland).

Alcohol Drinking↗

Association of hypertensive status and its drug treatment with lipid and haemostatic factors in middle-aged men: the PRIME study.

AIMS: To assess the association of hypertensive status and antihypertensive drug treatment with lipid and haemostatic levels in middle-aged men. METHODS AND RESULTS: Hypertensive status, antihypertensive drug treatment, total and high-density lipoprotein (HDL) cholesterol, triglyceride, apoproteins A-I and B, lipoparticles LpA-I, LpE:B and Lp(a), fibrinogen, plasminogen activator inhibitor-1 (PAI-1) activity and factor VII were assessed in a sample of men 50-59 years living in France (n = 7050) and Northern Ireland (n = 2374). After adjustment for age, body mass index, smoking status, educational level, country, alcohol drinking and hypolipidaemic drug treatment, untreated hypertensive subjects had higher levels of total cholesterol, triglyceride, apoproteins A-I and B and PAI-I activity than normotensive subjects. On univariate analysis, diuretics decreased total and HDL-cholesterol and apoproteins A-I and B; those differences remained after multivariate adjustment. Treatment with beta-blockers decreased total and HDL-cholesterol, apoprotein A-I and LpA-I, and this effect remained after multivariate adjustment. Calcium channel blockers decreased total cholesterol and apoproteins A-I and B; those differences remained significant after multivariate adjustment. ACE inhibitors decreased total cholesterol, triglycerides, apoprotein B and LpE:B; and this effect remained after multivariate adjustment. Analysis of the subjects on monotherapy showed beta-blockers to decrease total cholesterol and HDL parameters and angiotensin-converting enzyme (ACE) inhibitors to decrease low-density lipoprotein (LDL)-related parameters, while no effect was found for the other antihypertensive drugs. CONCLUSIONS: Hypertensive status is associated with an unfavourable lipid and haemostatic profile in middle-aged men. Antihypertensive treatment with beta-blockers decreases HDL parameters, whereas treatment with ACE inhibitors appears to decrease total cholesterol and LDL-related parameters.

Angiotensin-Converting Enzyme Inhibitors↗

Prevalence of late potentials in a sample of 487 healthy, middle-aged men from southwestern France.

Late potentials (LPS) have been shown to be predictive of ventricular tachycardia in coronary artery disease subjects, but the prevalence of LP in the general population is not as well-known. The study included 487 men without a history of cardiovascular disease (aged 50-59) living in Southwestern France. Standard-averaged high resolution electrocardiogram was performed using Butterworth filtering at 40-250 Hz. LPS were defined as two or more of the following criteria: QRS > 114 ms, duration of the low amplitude signals in the terminal portion of QRS > 38 ms, root mean square (RMS) voltage of the last 40 ms < 20 microV. The mean QRS duration was 97 +/- 12 ms (mean +/- SD), duration of the low amplitude signals in the terminal portion of QRS was 32 +/- 10 ms, and RMS voltage in the last 40 ms was 39 +/- 27 microV. Eight percent of subjects (95% confidence interval [CI]: 6%-11%) had a QRS duration > 114 ms; 22% (95% CI: 18%-26%) had a duration of low amplitude signals > 38 ms, and 25% (95% CI: 22%-29%) had RMS voltage in the last 40 ms < 20 microV. Finally, the prevalence of LP was 21% (95% CI: 18%-25%). In conclusion, according to commonly used criteria, the prevalence of LP in this healthy population of middle-aged men is 21%, close to the values found in the literature for myocardial infarction patients. Those findings indicate the need for reconsidering the definition of LPS.

Coronary Disease↗

Incidence, recurrence, and case fatality rates for myocardial infarction in southwestern France, 1985 to 1993.

OBJECTIVE: To assess the impact of incidence, recurrence, and case fatality rates for myocardial infarction on coronary heart disease mortality in southwestern France between 1985 and 1993. DESIGN: Toulouse-MONICA myocardial infarction register. SETTINGS AND PATIENTS: All subjects aged 35 to 64 years living in the French department of Haute-Garonne. INTERVENTIONS: All coronary artery disease events between 1985 and 1993. MAIN OUTCOME MEASURES: 7210 events collected by the register between 1985 and 1993. RESULTS: In men, adjusted attack, total, and out of hospital mortality decreased by 2% (95% confidence interval (CI), -3.8% to -0.1%), 6.2% (95% CI -8.4% to -4.0%), and 4.2% (95% CI -7.0% to -1.5%) a year, respectively (p < 0.05). Incidence and recurrence rates decreased by 2% (95% CI -4.1% to -0.1%, p < 0.05) and 1.9% (95% CI -5.9% to 2.2%) a year (NS). In women, attack, total, and out of hospital mortality decreased by 1.7% (95% CI -5.2% to 1.8%), 4.8% (95% CI -9.6% to 0. 1%), and 2.6% (95% CI -9.4% to 4.1%) a year, respectively; incidence decreased by 2% (95% CI -6.5% to 2.5%) and recurrence increased by 1. 4% (95% CI -9.8% to 12.6%) a year (all NS). In men, total, incident, and recurrent 28 day case fatality decreased by 3.8% (95% CI -4.8% to -2.8%), 3.2% (95% CI -4.1% to -2.3%), and 6.4% (95% CI -9.5% to -3.3%) a year, respectively (p < 0.05). For women, the corresponding decreases were 3.3% (95% CI -6.1% to -0.6%), 3.3% (95% CI -13.2% to 6.6%), and 11.7% (95% CI -24.6% to 1.3%) a year, but only the decrease in total 28 day case fatality reached significance. In both sexes, the reduction in case fatality contributed nearly 70% of the decrease in myocardial infarction mortality. CONCLUSIONS: In southwestern France, the decrease in myocardial infarction mortality mainly reflects improvements in acute management rather than prevention.

Adult↗

Transformation of high density lipoprotein 2 particles by hepatic lipase and phospholipid transfer protein.

High density lipoprotein 2 (HDL2) was incubated with phospholipid transfer protein (PLTP) or with hepatic lipase (H-TGL), and the incubation products were separated into a d < 1.22 g/ml and a d > 1.22 g/ml fractions. The d < 1.22 g/ml fraction produced by PLTP was larger, had lower apolipoprotein A-I and higher lipid and apolipoprotein A-II content than native HDL2. The d > 1.22 g/ml fraction represented 30% of the initial HDL2 protein and consisted of small, apolipoprotein A-I and phospholipid-rich particles, with a high sphingomyelin:phosphatidylcholine ratio. Incubation with H-TGL led to a d < 1.22 g/ml fraction which was comparable to native HDL2 regarding size and chemical composition. The d > 1.22 g/ml particles represented only 5% of the initial HDL2 protein and had slightly higher diameter and sphingomyelin:phosphatidylcholine ratio than those produced by PLTP. Enrichment of HDL2 with triglyceride prior to incubation increased the amount of protein released into the d > 1.22 g/ml fraction (20%) but had no effect on size and chemical composition of the particles. We conclude that PLTP and H-TGL promote the formation of small, pre-beta-like HDL particles from HDL2.

Ca(2+) Mg(2+)-ATPase↗

Hypertension awareness, treatment and control in the community: is the 'rule of halves' still valid?

One of the cornerstones of the primary prevention of cardiovascular disease has been screening and early antihypertensive drug treatment of patients with high blood pressure (BP). Nevertheless, recent population studies have shown that awareness and management of high BP levels are far from optimal. In this study, we performed a search for publications providing frequencies of hypertension awareness, treatment and control in different populations. In men, the frequencies of awareness, antihypertensive drug treatment and BP control among all hypertensive patients varied between 23% and 93%, 5% and 89% and 5% and 87%, respectively. In women, the frequencies ranged between 28% and 97%, 6% and 97%, and 0% and 97%, respectively. The percentage of aware hypertensives who were under antihypertensive drug treatment varied between 47% and 95% in men and between 50% and 100% in women. The percentage of hypertensives who were under antihypertensive drug treatment varied between 47% and 95% in men and between 50% and 100% in women. The percentage of treated hypertensives achieving an adequate BP control varied between 29% and 95% in men and between 0% and 100% in women. Overall, women had a better awareness, treatment and control status for hypertension than men, and worse in developing countries than in industrialised countries. Hypertension awareness, treatment and control improved with time, together with the proportion of diagnosed hypertensive patients under treatment and the proportion of well controlled among treated hypertensive patients. We conclude that although the 'rule of halves' no longer applies for screening and treatment of hypertension in industrialised countries, it might still be valid for developing countries and for the effectiveness of antihypertensive drug treatment in all countries.

Adolescent↗

Trends in coronary heart disease morbidity and mortality and acute coronary care and case fatality from 1985-1989 in southern Germany and south-western France.

BACKGROUND: Although it has been shown that coronary heart disease mortality rates are decreasing in industrialized countries, little is known about time trends in coronary heart disease incidence. Further, although a number of randomized clinical trials have shown that percutaneous transluminal coronary angioplasty and thrombolysis improve survival of acute myocardial infarction patients, it is not known if widespread use of these therapeutic procedures has contributed to a decrease in in-hospital case fatality on a population basis. METHODS: The change over time of coronary heart disease attack, incidence and mortality rates was assessed in men and women (35 to 64 years) using data collected between 1985 and 1989 by the Augsburg (Germany) and Toulouse (France) MONICA Centres. Acute coronary care and 28-day case fatality for hospitalized 24-h survivors were also assessed. RESULTS: Men and women from Augsburg had higher age-standarized attack, incidence and mortality rates than their Toulouse counterparts. In both centres, attack, incidence and mortality rates declined in men, but increased in women. Patients in Toulouse received more percutaneous transluminal coronary angioplasty and thrombolysis and had lower 28-day case fatality than patients in Augsburg. The therapeutic procedures, percutaneous transluminal coronary angioplasty and thrombolysis increased in both centres; however, only in Toulouse was this increase associated with a decrease (non significant) in 28-day hospital case fatality. CONCLUSION: The increase in morbidity and mortality rates of coronary heart disease in women stresses the need for preventive measures in this group. The absence of a favourable effect of acute coronary care on 28-day fatality for hospitalized 24-h survivors in the Augsburg centre will be further investigated.

Adult↗

Awareness and control of hypertension and hypercholesterolaemia in France and Northern Ireland.

We assessed awareness and control of hypertension and hypercholesterolaemia in a cross-sectional study of 586 men from France and 189 from Northern Ireland, aged 35-55, without known coronary artery disease. Prevalence of hypertension was 28% in France and 31% in Northern Ireland (p < 0.42). In France, 70% of hypertensive subjects were aware of their status, vs. 58% in Northern Ireland (p < 0.10). Overall, 40% of subjects with a history of hypertension were untreated, and only 32% of the French and 12% of the Northern Irish subjects treated for hypertension (diet with/without drugs) were normotensive. The prevalence of hypercholesterolaemia was 46% in France and 48% in Northern Ireland (p < 0.62). In France, 59% of hypercholesterolaemic subjects were aware of their status, vs. only 17% in Northern Ireland (p < 0.0001). In both countries, half of those with a history of hypercholesterolaemia were untreated, and only 47% of the French and 43% of the Northern Irish patients treated for hypercholesterolaemia (diet with/without drugs) were controlled. While awareness of hypertension is comparable in France and Northern Ireland, awareness of hypercholesterolaemia is much lower in the latter. Control of hypertension and hypercholesterolaemia in both countries is poor and should be improved.

Adult↗

Sex differences in awareness and control of hypertension in France.

OBJECTIVE: To assess the prevalence, awareness, treatment and control of hypertension for men and women living in three French regions. DESIGN: A cross-sectional population survey. SETTING: Subjects in the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease population surveys of Bas-Rhin, the urban community of Lille and Haute-Garonne, France. SUBJECTS: We studied 1924 men and 1874 women aged 35-64 years. MAIN OUTCOME MEASURES: Hypertension was defined as a systolic blood pressure > or = 160 mmHg, a diastolic blood pressure > or = 95 mmHg, being administered antihypertensive drug treatment or any combination of the foregoing. Treated hypertensive subjects were considered controlled if their systolic blood pressure was < 160 mmHg and their diastolic blood pressure was < 95 mmHg. RESULTS: The prevalence of hypertension was 40.2, 43.8 and 27.7% among men in Lille, Bas-Rhin and Haute-Garonne, respectively. For women, the corresponding values were 31.5, 33.8 and 18.9%. Among hypertensive men, 51.8% were aware of their condition, 30.0% were being administered drug treatment and 9.2% were controlled; the respective values for hypertensive women were 69.8, 51.2 and 25.3% (P < 0.001). Awareness of hypertension was associated with antihypertensive treatment more commonly in Haute-Garonne (81.0% for men and 84.7% for women). The percentages of treated subjects in whom adequate control of the blood pressure had been achieved were only 30.7% for men and 49.4% for women. CONCLUSION: Women have a better awareness of hypertension than do men and their hypertension is controlled better but the low rate of control for both sexes calls for further improvements.

Adult↗

The Leu33/Pro polymorphism (PlA1/PlA2) of the glycoprotein IIIa (GPIIIa) receptor is not related to myocardial infarction in the ECTIM Study. Etude Cas-Temoins de l'Infarctus du Myocarde.

The GPIIb/IIIa receptor complex may contribute to acute coronary syndromes by mediating platelet aggregation. The Leu33/Pro polymorphism (PlA1/PlA2) of the GPIIIa has recently been shown to be associated with CHD in a small case-control study. We have investigated this polymorphism in a large multicenter study of patients with myocardial infarction and controls and found no difference in the distribution of allele and genotype frequencies between cases and controls.

Adult↗

The Gln/Arg polymorphism of human paraoxonase (PON 192) is not related to myocardial infarction in the ECTIM Study.

Paraoxonase is a high-density-lipoprotein associated enzyme capable of hydrolyzing lipid peroxides, which has been suggested to contribute to atherosclerosis and coronary heart disease (CHD). We studied the Gln/Arg polymorphism affecting codon 192 of human paraoxonase (PON 192) to determine whether this polymorphism, which is associated with serum paraoxonase (PON) activity, represents a risk factor for myocardial infarction (MI). The PON 192 polymorphism was analysed in 642 male patients with myocardial infarction and 701 age-matched controls participating in the ECTIM Study (Etude Cas-Témoins de l'Infarctus du Myocarde). The frequency of the Gln allele was 0.69 in cases and 0.70 in controls (ns). The frequency of the PON 192/Arg allele in 405 MI patients who underwent coronary angiography was 0.295, 0.323 and 0.331, respectively in those with 1, 2 or 3 stenosed arteries (stenosis > 50%) (ns). The mean levels of several plasma lipids, lipoproteins and apolipoproteins were compared between the 3 PON genotypes and no difference was observed. The PON 192 polymorphism was unrelated to MI, the severity of coronary atherosclerosis and to plasma levels of several lipid variables.

Adult↗

Alcohol consumption and myocardial infarction: a case-control study in France and Northern Ireland.

The effect of alcohol consumption was assessed in 561 men with myocardial infarction and 643 healthy controls recruited from France and Northern Ireland between 1988 and 1991 in the ECTIM Study (Enquête Cas-Témoins de I'Infarctus du Myocarde). In total, patients consumed less wine than did controls, while non-wine-derived alcohol consumption did not differ significantly. After adjustment for cardiovascular risk factors and country of recruitment by logistic regression, alcohol consumption displayed a protective effect against myocardial infarction, the magnitude of which was comparable in both countries. This effect, which was essentially due to wine consumption in France and to nonwine consumption in Northern Ireland, was largely attenuated by the introduction of high density lipoprotein cholesterol into the model. Thus, both wine and nonwine consumption appear to exert a protective effect against myocardial infarction which is partly mediated through an increase in high density lipoprotein cholesterol.

Adult↗

Association between the LPL-D9N mutation in the lipoprotein lipase gene and plasma lipid traits in myocardial infarction survivors from the ECTIM Study.

Using polymerase chain reaction (PCR) based techniques, we have identified individuals in the ECTIM study of myocardial infarction survivors (cases) and healthy matched controls who are carriers for a mutation of the gene for lipoprotein lipase (LPL) which alters amino acid 9 from aspartic acid to asparagine (LPL-D9N). The frequency of carriers in the cases from Belfast and France (3 separate centres) was 2.5 and 3.7%, respectively (mean 3.3%, 95% CI 1.9-4.7) and in the controls 2.0 and 2.9%, respectively (mean 2.7%, 95% CI 1.6-3.8%), but this difference was not statistically significant. In the cases, carriers of the allele for LPL-N9 had higher levels of several plasma lipid traits including total triglycerides (TG) (30%), very low density lipoprotein (VLDL) cholesterol (19%), apo E (24%), apo C-III (17%), lipoprotein particles (Lp) containing both apo E and apo B (LpE:B) (32%), and particles containing both apo C-III and apo B (LpCIII:B) (39%), and this effect was consistent in cases both from Belfast and from the French centres combined. By contrast, in the controls there were no differences in any lipid trait between carriers and non-carriers of the mutation that was consistent between the French centres and Belfast. There were no significant differences in the levels of any measured factor between cases and controls that could explain the different effect on plasma lipid traits associated with the mutation. However, compared to the non-carriers, in both cases and controls who carried the mutation, plasma TG concentrations were higher in those whose body mass index (BMI) was above the mean of the sample (26.0 kg/m2), with statistically significant interaction seen between BMI and genotype and levels of apo C-III, and lipoprotein particles containing both apo C-III and apo B (P < 0.02). The data suggest that carriers for the LPL-N9 mutation have a mild genetic predisposition to developing hyperlipidaemia and an atherogenic lipid profile, but that this requires the presence of other genetic or environmental factors for full expression, one of which appears to be increasing obesity.

Adult↗

[Long-term effects of prescription drugs in 174 patients treated for myocardial infarction, followed up from 4 to 5 years (the DEVENIR study)].

The aim of this study was to document changes in drug prescription after myocardial infarction. One hundred and seventy four men with typical myocardial infarction recensed by the Toulouse MONICA centre between 1989 and 1990 were followed up for 4.5 years. A copy of their drug prescription was obtained during the acute phase of infarction, at the time of discharge from hospital or clinic, after 6 months, and finally, after 4.5 years after infarction. During the acute phase, the majority of patients received nitrate derivatives, platelet antiaggregants, calcium antagonists, betablockers and antiarrhythmics. Between hospital discharge and the sixth month, the prescription of lipid lowering drugs quadrupled (from 8 to 33%; p < 0.00001) and those of platelet anti-aggregants decreased (from 82 to 70%; p < 0.01). The prescriptions of other drugs remained relatively stable. Between the 6th month and the 4th year of follow-up the only prescription to increase significantly was that of ACE inhibitors (from 14 to 23%; p < 0.03). The other prescriptions were maintained: platelet anti-aggregants (70% at 6 months vs 75% at 4.5 years), nitrate derivatives (59 vs 51%), betablockers (51 vs 52%), calcium antagonists (51 vs 48%), lipid lowering drugs (33 vs 42%), diuretics (3 vs 6%) and inotropic agents (2 vs 2%). Overall analysis showed an increase in the prescriptions of lipid-lowering agents (p < 0.00001) and ACE inhibitors (p < 0.002). On the other hand, the prescriptions of calcium antagonists and nitrate derivatives tended to decrease. These results show that the treatment of patients with coronary artery disease is based on drugs of proven efficacy, reflecting the impact of large scale therapeutic trials on everyday medical practice.

Adult↗

Relationships between blood pressure components, lipids and lipoproteins in normotensive men.

The aim of this study is to assess the relationships between pulse pressure (PP) mean arterial pressure (MAP), clinical and lipid parameters in normotensive men. One hundred and twenty-seven normotensive men aged 35-64 years from the French department of Haute-Garonne were analysed. Blood pressure (BP) was measured using a random zero device. Correlation analysis was performed using Pearson's coefficient. Variables significantly related to PP and MAP were then introduced in a stepwise multiple regression analysis. On univariate analysis, PP was significantly and positively related to total cholesterol, triglycerides, VLDL and LDL-cholesterol and apo B. MAP was positively related to age, body mass index (BMI), triglycerides and VLDL-cholesterol. Stepwise multiple regression analysis showed only apo B to be independently related to PP after adjustment for MAP. Also, after adjustment for PP, only BMI and VLDL-cholesterol were related to MAP. Hence, MAP is related to BMI and VLDL-cholesterol, which are a common feature of hyperinsulinism. PP is linked to apo B, an important proatherogenic factor. These biological parameters appear specific of steady and pulsatile components of BP. The relationship between PP and apo B suggests a possible link between lipids and arterial stiffness, and may partly explain the prognostic value of PP in myocardial infarction.

Adult↗