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Master Thesis

Prise en charge thérapeutique de l'hypertension artérielle maligne : étude de faisabilité, sécurité et efficacité du protocole bordelais

Abstract : Introduction: malignant hypertension (MHT) is a very serious, potentially lethal form of hypertension. However, there are currently no specific guidelines for therapeutic management. Material and Methods: our study based on the MHT prospective cohort of the Bordeaux University Hospital included 74 patients treated in the acute phase of the disease between 2009 and 2019. The patients received an oral titration of Angiotensin converting enzyme inhibitors (ACEI) up to twice the full recommended dose. Our objective was to describe the results of this protocol in terms of feasibility, efficiency and safety. Results: of the 74 patients, 66% were men and 15% were of Afro-Caribbean origin. The patients treated averaged 47.1 years of age with an entry blood pressure of 219 (±29) / 125 (±22) mmHg, an average organ damage of 3.2 ± 0.9 (including brain, eye, heart, hemolysis, and kidneys) and 11% of MOD-HTA. The protocol was completed on all 74 patients. No serious adverse event such as acute renal failure, hyperkalaemia or hypotension requiring the transfer to an intensive care unit occurred. By the 1 month reassessment, 84% of patients had an ≤140 / 90 mmHg average blood pressure, with an emergency readmission rate at 90 days of 4%. Conclusion: the management of MHT by titration of ACE inhibitors makes it possible to achieve effective blood pressure control with a very good tolerance profile.
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https://dumas.ccsd.cnrs.fr/dumas-02558641
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Submitted on : Wednesday, April 29, 2020 - 5:40:42 PM
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Camille Brockers. Prise en charge thérapeutique de l'hypertension artérielle maligne : étude de faisabilité, sécurité et efficacité du protocole bordelais. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02558641⟩

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