46 e) Mesure de la pression artérielle de consultation, p.46 ,
49 a) L'hypotension orthostatique 49 b) L'hypotension orthostatique de consultation, HO Consult, p.50 ,
85 E. Analyse de régression logistique multivariée des variables : Hypotension orthostatique de consultation, Hypotension orthostatique 1, Hypotension orthostatique 2, Hypotension orthostatique M et Hypotension orthostatique, Différence des moyennes de pression artérielle entre la position couchée et la position ,
98 a) Diagnostic de l'hypotension orthostatique, p.98 ,
HO de consultation est ici de 14.50 %, selon le seuil consensuel, ce qui est proche de celles retrouvées dans la littérature, pp.66-70 ,
HO en France à 16 % chez les patients âgés de plus de 65 ans ,
67) datant de 2009 a mis en évidence une prévalence de l'HO de 34 % chez des patients autonomes âgés en moyenne de, p.81 ,
68), dans leur étude de 2014, ont observé une prévalence de l'HO de 17 % chez des sujets âgés en moyenne de 74 ans non institutionnalisés et présentant des comorbidités cardiovasculaires ,
69), datant de 2014, les auteurs ont constaté une prévalence de l'HO de 12 % dans une population de patients hypertendus (n=10985) âgés en moyenne de 52 ans sans comorbidité cardiovasculaire initiale ,
Fedorowski70), quant à eux, ont identifié une prévalence de l'HO de 6 % chez des patients âgés en moyenne de 50 ans (n=2033), 2010. ,
menée chez 7425 patients âgés de plus de 65 ans, a trouvé une prévalence de l'HO égale à 13% ,
HO de consultation est associée à l'âge et aux ATCD ,
Nous avons décidé, tout au long de cette étude, d'utiliser le seuil consensuel de l'HO, à savoir la baisse d'au moins 20 mmHg de la PAS ,
Limites méthodologiques ,
il est possible que la mauvaise qualité de la retranscription des valeurs de PA affecte l'évaluation globale de la PA des sujets ,
88) ont mené une étude chez 54 patients hypertendus âgés en moyenne de 56 ans Ils ont demandé aux patients de réaliser l'automesure tensionnelle et ont, sans les prévenir au préalable, vérifié les enregistrements disponibles sur les auto-tensiomètres ,
Consensus d'experts Prise en charge de l'hypotension orthostatique [Internet]. SFHTA Disponible sur: http://www.sfhta, Consensus_d_experts_decembre_2014_SFHTA.pdf 2. Fedorowski A, Melander O. Syndromes of orthostatic intolerance: a hidden danger, 2012. ,
Orthostatic hypotension and the risk of incidental cardiovascular diseases: A meta-analysis of prospective cohort studies, Preventive Medicine, vol.85, pp.90-97, 2016. ,
DOI : 10.1016/j.ypmed.2016.01.007
Orthostatic Hypotension and Risk of Incident Dementia: Results From a 12-Year Follow-Up of the Three-City Study Cohort ,
Association between orthostatic hypotension, mortality, and cardiovascular disease in Asians, International Journal of Cardiology, vol.195, pp.1540-1544, 2015. ,
DOI : 10.1016/j.ijcard.2015.05.060
Cardiovascular morbidity and mortality related to orthostatic hypotension: a meta-analysis of prospective observational studies, European Heart Journal, vol.36, issue.25, pp.1609-1626, 2015. ,
DOI : 10.1093/eurheartj/ehv093
Cardiovascular responses to orthostasis and their association with falls in older adults Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the, BMC Geriatr. Neurology, vol.241546, issue.85, p.1741470, 1996. ,
What is the most relevant definition of orthostatic hypotension: systolic blood pressure drop, diastolic blood pressure drop, or both?]. Arch Mal Coeur Vaiss, pp.689-94, 2007. ,
Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome, Clinical Autonomic Research, vol.21, issue.2, pp.69-72, 2011. ,
DOI : 10.1007/s10286-011-0119-5
A prospective study of the association between orthostatic hypotension and falls: definition matters Orthostatic hypotension in genetically related hypertensive and normotensive individuals, Age Ageing. 23 déc J Hypertens, vol.1227, issue.5, pp.976-82, 2009. ,
Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program. Circulation Orthostatic hypotension in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: which version is right? Hypertens Dallas Tex, pp.27-27, 1979. ,
Orthostatic Hypotension, Journal of the American College of Cardiology, vol.66, issue.7, pp.848-60, 2015. ,
DOI : 10.1016/j.jacc.2015.06.1084
ORTHOSTATIC FALL IN BLOOD PRESSURE IN VERY ELDERY HYPERTENSIVES - RESULTS FROM THE HYPERTENSION IN THE VERY ELDERLY TRIAL (HYVET), Journal of Hypertension, vol.22, issue.Suppl. 2 ,
DOI : 10.1097/00004872-200406002-01010
International comparison of cost of falls in older adults living in the community: a systematic review, Osteoporosis International, vol.60, issue.8 ,
DOI : 10.1093/gerona/56.11.M686
The association between orthostatic hypotension and recurrent falls in nursing home residents, The American Journal of Medicine, vol.108, issue.2, pp.106-117, 2000. ,
DOI : 10.1016/S0002-9343(99)00425-8
Impaired Orthostatic Blood Pressure Recovery Is Associated with Unexplained and Injurious Falls, Journal of the American Geriatrics Society, vol.18, issue.3, pp.474-82, 2017. ,
DOI : 10.1038/sj.jhh.1001639
Association between orthostatic hypotension and cardiovascular risk, cerebrovascular risk, cognitive decline and falls as well as overall mortality, Journal of Hypertension, vol.32, issue.8, pp.1562-71, 2014. ,
DOI : 10.1097/HJH.0000000000000235
Relationship between orthostatic hypotension and cognitive impairment in the elderly, Journal of the Neurological Sciences, vol.299, issue.1-2, pp.45-53, 2010. ,
DOI : 10.1016/j.jns.2010.08.056
The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension, Journal of Neurology, vol.4, issue.2, 2017. ,
DOI : 10.1111/j.1524-6175.2001.00516.x
Arterial stiffness is associated with orthostatic hypotension in elderly subjects with history of falls Arterial stiffness and orthostatic blood pressure changes in untreated and treated hypertensive subjects, 568?72. 25. Protogerou AD, pp.372-379, 2004. ,
Arterial stiffness as the candidate underlying mechanism for postural blood pressure changes and orthostatic hypotension in older adults: the Rotterdam Study):339?44. 27. Sclater A, Alagiakrishnan K. Orthostatic hypotension. A primary care primer for assessment and treatment, J Hypertens. Feb Geriatrics. Aug, vol.2459, issue.28, pp.22-29, 2004. ,
When should orthostatic blood pressure changes be evaluated in elderly: 1st, 3rd or 5th minute?, Archives of Gerontology and Geriatrics, vol.65, 2016. ,
DOI : 10.1016/j.archger.2016.03.022
Optimal diagnostic thresholds for diagnosis of orthostatic hypotension with a ???sit-to-stand test???, HAS, SFHTA. Fiche Mémo Prise en charge de l'hypertension artérielle de l'adulte [Internet], 2017. ,
DOI : 10.1097/HJH.0000000000001265
Disponible surSFHTA_HAS_Fiche-Memo-HTA_Algorithme-HTA.pdf 31. CFLHTA. Etude HTA Flash 2015 Contrôle de la pression artérielle, 2009. ,
Disponible sur: http://www.theseimg.fr/1/sites/default/files/Th%C3%A8se%20David%20Carron_0.pdf 34. European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement, J Hypertens, vol.21, issue.5, pp.821-869, 2003. ,
Nouvelles directives en 2007 pour la prise en charge de l'hypertension artérielle, Rev Médicale Liège, vol.62, issue.9, 2007. ,
Pourquoi et par quoi faut-il remplacer la mesure de la pression artérielle au cabinet médical ? Médecine Thérapeutique, Janv, vol.5, issue.69, pp.691-699, 2000. ,
HONORE-ZAHER A. Facteurs limitant la pratique de l'automesure tensionnelle à domicile chez les médecins généralistes, une revue de la littérature [Internet] [Thèse pour le doctorat de médecine générale]. Rouen Disponible sur: http://www.automesure.com/library/pdf/these-amt-Honore%20Zaher_Aurelie.pdf 39 Hypertension in adults: diagnosis and management | Guidance and guidelines | NICE [Internet]. [cité 2 Mars 2017]. Disponible sur: https://www.nice.org.uk/guidance/cg127?unlid=5495203122016124181536 40 Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension, Microlife: Pression artérielle en général [Internet]. [cité 6 Mars 2017 Disponible sur14?26. 41. ESH/ESC Task Force for the Management of Arterial Hypertension. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens, pp.1925-1963, 2013. ,
European Society of Hypertension Practice Guidelines for home blood pressure monitoring, Journal of Human Hypertension, vol.17, issue.12, pp.779-85, 2010. ,
DOI : 10.1038/sj.jhh.1002031
Role of Ambulatory and Home Blood Pressure Monitoring in Clinical Practice, Annals of Internal Medicine, vol.163, issue.9, pp.691-700, 2015. ,
DOI : 10.7326/M15-1270
Ambulatory Blood-Pressure Monitoring, New England Journal of Medicine, vol.354, issue.22, pp.2368-74, 2006. ,
DOI : 10.1056/NEJMra060433
Prediction of mortality by ambulatory blood pressure monitoring versus screening blood pressure measurements, Journal of Hypertension, vol.15, issue.4, pp.121777-83, 1997. ,
DOI : 10.1097/00004872-199715040-00006
Disponible sur: http://www.hugge .ch/sites/interhug/files/structures/medecine_de_premier_recours/strategie_hypertension_arterie lle_finalisee_jezc.pdf 52Self-measurement of blood pressure in hypertensive patients. A psychological study (author's transl)], Service de médecine de premier recours, pp.450-455, 1975. ,
Blood pressure determinations by patients with essential hypertension. I. The difference between clinic and home readings before treatment, Am Heart J, vol.1 ,
Guidelines for the use of self-blood pressure monitoring, Journal of Hypertension, vol.18, issue.5, pp.1081-1087, 1979. ,
DOI : 10.1097/00004872-200018050-00001
Self-monitoring of blood pressure at home: how many measurements are needed? J Hypertens, Jun, vol.16, issue.6, pp.725-756, 1998. ,
2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) Home-measured blood pressure is a stronger predictor of cardiovascular risk than office blood pressure: the Finn-Home study, J Hypertens, vol.3155, issue.76, pp.1346-51, 1979. ,
Home Blood Pressure Is as Reliable as Ambulatory Blood Pressure in Predicting Target-Organ Damage in Hypertension, American Journal of Hypertension, vol.20, issue.6, pp.616-637, 2007. ,
DOI : 10.1016/j.amjhyper.2006.12.013
Impact of home blood pressure monitoring on blood pressure control in older individuals, Journal of Hypertension, vol.35, issue.3 ,
DOI : 10.1097/HJH.0000000000001191
Home blood-pressure monitoring: US and European consensus, The Lancet, vol.373, issue.9667 ,
DOI : 10.1016/S0140-6736(09)60526-2
Working Group on Blood Pressure Monitoring of the European Society of Hypertension. Self monitoring of blood pressure at home ,
has-sante.fr/portail/jcms/c_1242988/fr/guide-parcours-de- soins-insuffisance-cardiaque 66, Orthostatic hypotension: prevalence and associated risk factors among the ambulatory elderly in an Asian population ,
Postural changes in blood pressure and the prevalence of orthostatic hypotension among home-dwelling elderly aged 75 years or older, Journal of Human Hypertension, vol.46, issue.1 ,
DOI : 10.1093/ageing/31.3.211
Orthostatic hypotension and incident heart failure in community-dwelling older adults Systolic and diastolic component of orthostatic hypotension and cardiovascular events in hypertensive patients: the Captopril Prevention Project Orthostatic hypotension predicts all-cause mortality and coronary events in middle-aged individuals (The Malmo Preventive Project), J Gerontol A Biol Sci Med Sci. Feb J Hypertens Eur Heart J, vol.693231, issue.211, pp.85-91, 2010. ,
Orthostatic hypotension as a risk factor for stroke: the atherosclerosis risk in communities (ARIC) study, 1987-1996 Orthostatic hypotension, hypotension and cognitive status: early comorbid markers of primary dementia, 2307?13. 72. Yap PLK, pp.239-285, 2000. ,
Intra-individual postural blood pressure variability and stroke in elderly nursing home residents, Journal of Clinical Epidemiology, vol.54, issue.5, pp.488-94, 2001. ,
DOI : 10.1016/S0895-4356(00)00322-X
Feasibility of Home Blood Pressure Measurement in Elderly Individuals: Cross-Sectional Analysis of a Population-Based Sample, American Journal of Hypertension, vol.25, issue.12, pp.1279-85, 2012. ,
DOI : 10.1038/ajh.2012.121
Home Blood Pressure Variability as Cardiovascular Risk Factor in the Population of Ohasama, Hypertension, vol.61, issue.1, pp.61-70, 1979. ,
DOI : 10.1161/HYPERTENSIONAHA.111.00138
Prognostic value of the variability in homemeasured blood pressure and heart rate: the Finn-Home Study, Feb, vol.59, issue.2, pp.212-220, 1979. ,
Aging and postural hypotension. An update, 129?37. 79. Vara-González L, Arauzo Alonso S, 1989. ,
Reproducibility of postural changes of blood pressure in hypertensive elderly patients in primary care Reproducibility of orthostatic hypotension in symptomatic elderly, Blood Press Monit. Feb Am J, vol.11, issue.1, 2006. ,
Age-Related Normative Changes in Phasic Orthostatic Blood Pressure in a Large Population Study: Findings From The Irish Longitudinal Study on Ageing (TILDA), Circulation, vol.130, issue.20, pp.1780-1789, 2014. ,
DOI : 10.1161/CIRCULATIONAHA.114.009831
Delayed orthostatic hypotension: A frequent cause of orthostatic intolerance, Neurology, vol.67, issue.1, pp.28-32, 2006. ,
DOI : 10.1212/01.wnl.0000223828.28215.0b
Initial orthostatic hypotension: review of a forgotten condition, Clinical Science, vol.112, issue.3, pp.157-65, 1979. ,
DOI : 10.1042/CS20060091
Comparison of acceptability of and preferences for different methods of measuring blood pressure in primary care, BMJ, vol.325, issue.7358 ,
DOI : 10.1136/bmj.325.7358.258
Reliability of self-reported blood pressure measurements Arch Intern Med Orthostatic Hypotension in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Blood Pressure Trial: Prevalence, Incidence, and Prognostic Significance Hypertens Dallas Tex 1979 Working Group on Blood Pressure Monitoring of the European Society of Hypertension International Protocol for validation of blood pressure measuring devices in adults Reliability of patients measuring blood pressure at home: prospective observational study, 3?17. 88. Nordmann A,):1172. RESUME Introduction : L'hypotension orthostatique (HO) est une situation fréquente qui touche environ 7% de la population générale en France. L'HO est associée à un sur-risque de mortalité et d'évènements cardiovasculaires. Le but de notre étude est d'évaluer la faisabilité de la détection de l'HO au cours de l'automesure tensionnelle (AMT). L'objectif secondaire est de proposer une méthode adaptée de détection de l'HO, 1999. ,
Il s'agit d'une étude prospective multicentrique de janvier à décembre, 2016. ,