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Lopez-Sublet M, Merkling T, Girerd N, Xhaard C, Flahault A, Bozec E, Leroy C, Fujikawa T, Vaag AA, Mebazaa A, Kistorp CM, Heude B, Boivin JM, Zannad F, Wagner S, Rossignol P. Birth weight and subclinical cardiovascular and renal damage in a population-based study (the STANISLAS cohort study). J Hypertens 2023; 41:1040-1050. [PMID: 37071444 DOI: 10.1097/hjh.0000000000003438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Although preterm-born and low-birth-weight individuals have an increased risk of cardiovascular diseases in adulthood, little is known regarding early cardiovascular and renal damage (CVRD) or hypertension in adulthood. Our study investigated the association of birth weight with early CVRD markers as well as the heritability of birth weight in an initially healthy family-based cohort. METHODS This study was based on 1028 individuals from the familial longitudinal STANISLAS cohort (399 parents/629 children) initiated in 1993-1995, with a fourth examination conducted in 2011-2016. Analyses performed at the fourth visit included pulse-wave velocity, central pressure, ambulatory blood pressure, hypertension status, diastolic dysfunction/distensibility, left ventricular mass indexed (LVMI), carotid intima-media thickness and kidney damage. The family structure of the cohort allowed birth weight heritability estimation. RESULTS Mean (±SD) birth weight was 3.3 ± 0.6 kg. Heritability was moderate (42-44%). At the fourth visit, individuals were 37 years old (32.0-57.0), 56% were women and 13% had antihypertensive treatment. Birth weight was strongly and negatively associated with hypertension [odds ratio (OR) 95% confidence interval (CI) 0.61 (0.45-0.84)]. A nonlinear association was found with LVMI, participants with a birth weight greater than 3 kg having a higher LVMI. A positive association ( β 95% CI 5.09 (1.8-8.38)] was also observed between birth weight and distensibility for adults with normal BMI. No associations were found with other CVRD. CONCLUSION In this middle-aged population, birth weight was strongly and negatively associated with hypertension, and positively associated with distensibility in adults with normal BMI and with LVMI for higher birth weights. No associations were found with other CVRD markers.
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Affiliation(s)
- Marilucy Lopez-Sublet
- AP-HP, Hôpital Avicenne, Centre d'Excellence Européen en Hypertension Artérielle, Service de Médecine Interne
- INSERM UMR 942 MASCOT, Paris 13-Université Paris Nord, Bobigny
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
| | - Thomas Merkling
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Nicolas Girerd
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Constance Xhaard
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Adrien Flahault
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Service de Néphrologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Erwan Bozec
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Celine Leroy
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Tomona Fujikawa
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Allan Arthur Vaag
- Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Alexandre Mebazaa
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- UMR-S 942 INSERM, Lariboisière Hospital, Paris
- Paris Diderot University, Sorbonne Paris Cité
- Department of Anaesthesiology and Critical Care, Laribosière Hospital, AP-HP, Paris
| | - Caroline Michaela Kistorp
- Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Barbara Heude
- Université de Paris, Research Center in Epidemiology and Biostatistics (CRESS), INSERM, INRAE, Paris, France
| | - Jean Marc Boivin
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Faiez Zannad
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Sandra Wagner
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
| | - Patrick Rossignol
- FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, Nancy
- Medicine and Nephrology-Hemodialysis departments, Princess Grace Hospital, and Monaco Private Hemodialysis Centre, Monaco, Monaco
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Bouhanick B, Sosner P, Brochard K, Mounier-Véhier C, Plu-Bureau G, Hascoet S, Ranchin B, Pietrement C, Martinerie L, Boivin JM, Fauvel JP, Bacchetta J. Hypertension in Children and Adolescents: A Position Statement From a Panel of Multidisciplinary Experts Coordinated by the French Society of Hypertension. Front Pediatr 2021; 9:680803. [PMID: 34307254 PMCID: PMC8292722 DOI: 10.3389/fped.2021.680803] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
Hypertension is much less common in children than in adults. The group of experts decided to perform a review of the literature to draw up a position statement that could be used in everyday practice. The group rated recommendations using the GRADE approach. All children over the age of 3 years should have their blood pressure measured annually. Due to the lack of data on cardiovascular morbidity and mortality associated with blood pressure values, the definition of hypertension in children is a statistical value based on the normal distribution of blood pressure in the paediatric population, and children and adolescents are considered as having hypertension when their blood pressure is greater than or equal to the 95th percentile. Nevertheless, it is recommended to use normative blood pressure tables developed according to age, height and gender, to define hypertension. Measuring blood pressure in children can be technically challenging and several measurement methods are listed here. Regardless of the age of the child, it is recommended to carefully check for a secondary cause of hypertension as in 2/3 of cases it has a renal or cardiac origin. The care pathway and principles of the therapeutic strategy are described here.
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Affiliation(s)
- Béatrice Bouhanick
- Service d'Hypertension Artérielle et Thérapeutique, CHU Rangueil, CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Philippe Sosner
- Centre Médico-Sportif MON STADE, Paris, France.,Hôpital Hôtel-Dieu, APHP, Centre de Diagnostic et de Thérapeutique, Paris, France.,Laboratoire MOVE (EA 6314), Université de Poitiers, Faculté des Sciences du Sport, Poitiers, France
| | - Karine Brochard
- Service de Néphrologie Médecine Interne Pédiatrique, Hôpital des Enfants, CHU Toulouse, Toulouse, France
| | - Claire Mounier-Véhier
- Institut Cœur-Poumon, Médecine Vasculaire et HTA, CHU, Université Lille, EA 2694 - Santé Publique: Epidémiologie et Qualité des Soins Lille, Lille, France
| | - Geneviève Plu-Bureau
- Unité de Gynécologie Médicale, AP-HP, Hôpital Port-Royal, Université de Paris, Paris, France
| | - Sébastien Hascoet
- Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay, Le Plessis-Robinson, France
| | - Bruno Ranchin
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Filières Maladies Rares ORKID et ERK-Net, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France.,Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
| | | | - Laetitia Martinerie
- Centre de Reference des Maladies Rares de la Croissance et du Développement, Université de Paris, Endocrinologie et Diabétologie Pédiatrique, AP-HP, Hôpital Robert-Debré, Paris, France
| | - Jean Marc Boivin
- Département de Médecine Générale, Université de Lorraine, Inserm CIC-P Pierre Drouin Vandœuvre-Lès-Nancy, Vandœuvre-lès-Nancy, France
| | - Jean Pierre Fauvel
- Service de Néphrologie Hospices Civils, Hôpital Edouard Herriot, Lyon, France.,UMR CNRS 5558, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Filières Maladies Rares ORKID et ERK-Net, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France.,Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
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Abstract
Purpose: Worldwide, hypertension awareness remains largely insufficient. This is particularly true in some population subgroups with a low socioeconomic status or in young adults who have limited interactions with healthcare systems. Performing Blood Pressure (BP) screening in non-conventional settings, such as in barbershops, has been suggested by a number of American authors. Whether this approach is feasible in Europe or in North Africa has not been evaluated, however. We, therefore, undertook a study to assess the value of BP screening at hairdressers in France and in Morocco.Materials and Methods: This was a prospective multicenter feasibility study. Twenty-three hairdressers in France and six in Morocco participated in the study. After being provided the relevant information, all consenting customers aged over 18 years were included. Three BP measurements were performed by the customers themselves using a validated Omron M7 automatic BP device connected to a printer.Results: In France, 1025 subjects were enrolled, while 300 subjects participated in Morocco. Three hundred and seventy French participants (36%) had an elevated BP. Among the subjects claiming to be normotensive or who did not know their hypertension status, 31.7% had a BP ≥ 135/85 mmHg. Only 42% of the subjects with an elevated BP contacted their physician within 3 months, although hypertension was confirmed in ¾ of them. In Morocco, the participants were older, with only 11.7% of the subjects aged <50 years. They more frequently had unknown elevated BP values (71.9%). The rate of BP monitoring in known hypertensive individuals was 42.7% in France and 17.1% in Morocco. The procedure was very well accepted and considered to be useful in both countries.Conclusion: BP screening at hairdressers is feasible and well-accepted, although it does suffer somewhat from a relatively low efficacy.
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Affiliation(s)
- J M Boivin
- Department of General Medicine, Faculty of Medicine of Nancy, University of Lorraine, Vandoeuvre, France.,CIC-P Pierre Drouin, Inserm-CHRU of Nancy, Vandoeuvre, France
| | - J Risse
- Department of General Medicine, Faculty of Medicine of Nancy, University of Lorraine, Vandoeuvre, France
| | - E Laurière
- Department of General Medicine, Faculty of Medicine of Nancy, University of Lorraine, Vandoeuvre, France
| | - M Burnier
- Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland
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Mounier-Vehier C, Angoulvant T, Boivin JM, Plu-Bureau G. [Hypertension and menopausal hormone therapy]. Presse Med 2019; 48:1295-1300. [PMID: 31735524 DOI: 10.1016/j.lpm.2019.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/18/2019] [Indexed: 11/26/2022] Open
Abstract
Can menopausal hormone therapy (HT) be used in hypertensive women? The group of experts of the French Society of Hypertension has carried out a review of the recent literature in order to answer this question, based on the most recent scientific publications. If use of oral HT is associated with a discreet increase in blood pressure, the transdermal route seems to be safer. The first results of major randomized trials of HT had alerted to an increase in cardiovascular events and breast cancer with the use of oral HT, generally, tipping the benefit-risk balance of the deleterious side. Complementary analyzes have shown the importance of the window of intervention (less than 10 years after the menopause) and the age of the woman to start the HT. On the contrary, they have shown a significant decrease of the coronary events. For woman suffering from hypertension and important climacteric symptoms, it is important to evaluate the whole cardiovascular risk in order to decide the possibility of prescribing a HT. Thus, the group of experts proposes a prescription assistance algorithm based on the stratification of cardiovascular risk, always favoring, when it is authorized, HT by transdermal route of administration.
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Affiliation(s)
- C Mounier-Vehier
- Hôpital Jeanne-de-Flandres, service de cardiologie, Lille, France
| | - T Angoulvant
- Centre hospitalier régional universitaire de Tours, service de pharmacologie, Tours, France
| | | | - G Plu-Bureau
- Hôpital Port-Royal Paris, unité de gynécologie endocrinienne, Inserm U1153, Paris, France.
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Amar J, Angoulvant T, Boivin JM, Amar L, Lantelme P, Blacher J, Plu-Bureau G, Vehier CM. Spécificités du traitement médicamenteux antihypertenseur chez la femme. Presse Med 2019; 48:1261-1264. [PMID: 31735525 DOI: 10.1016/j.lpm.2019.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/23/2019] [Indexed: 11/18/2022] Open
Abstract
The impact of antihypertensive drugs on blood pressure does not differ according to the sex. There are women-specific conditions or medical conditions encountered more frequently among womens that guide the selection of therapy such as a desire to become pregnant, a pregnancy, a polycystic ovarian syndrome, breast cancer, osteoporosis or migraine.
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Affiliation(s)
- Jacques Amar
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France.
| | - Theodora Angoulvant
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France
| | - Jean Marc Boivin
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France
| | - Laurence Amar
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France
| | - Pierre Lantelme
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France
| | - Jacques Blacher
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France
| | - Geneviève Plu-Bureau
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France
| | - Claire Mounier Vehier
- CHU de Toulouse, fédération de cardiologie, service d'HTA, avenue Jean-Pouhles, Toulouse, France
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6
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Mauffrey V, Kivits J, Pulcini C, Boivin JM. Perception of acceptable antibiotic stewardship strategies in outpatient settings. Med Mal Infect 2016; 46:285-93. [PMID: 27475666 DOI: 10.1016/j.medmal.2016.06.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 02/05/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Antibiotics are still often inappropriately prescribed in France despite specific measures being taken for over 10years. The 25% decrease in antibiotic prescription advocated in the 2011-2016 National Antibiotic Plan seems difficult to achieve. One of the strategies currently considered in France is the use of a specific prescription form dedicated to antibiotics, with an educational message for patients. We aimed to evaluate the acceptability - by primary care prescribers - of this measure and to evaluate their perception of other antibiotic stewardship strategies. METHODS Qualitative study conducted among family physicians, pediatricians, dermatologists, dentists, and ENT specialists using semi-structured interviews. A thematic and framework analysis was then performed. RESULTS Thirty prescribing physicians practicing in a specific region of France were included in the study. The dedicated prescription form for antibiotics was deemed excessive and questionable. Other measures, not directly targeting prescribers, were rather well perceived: the unit sales of antibiotics, the restricted reporting of susceptibility tests, or the limitation of the number of molecules available in outpatient settings. CONCLUSION The results of this exploratory study may guide the national antibiotic stewardship policy in France.
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Affiliation(s)
- V Mauffrey
- Département de médecine générale, université de Lorraine, faculté de médecine, 54000 Nancy, France; École de santé publique, université de Lorraine, faculté de médecine, 54000 Nancy, France; ANTIBIOLOR, CHU de Nancy, réseau Lorrain d'antibiologie, 54000 Nancy, France.
| | - J Kivits
- École de santé publique, université de Lorraine, faculté de médecine, 54000 Nancy, France; Épidémiologie et évaluation cliniques, CHU de Nancy, pôle QSP2, 54000 Nancy, France; EA4360 APEMAC, université de Lorraine, université Paris Descartes, 54000 Nancy, France
| | - C Pulcini
- ANTIBIOLOR, CHU de Nancy, réseau Lorrain d'antibiologie, 54000 Nancy, France; EA4360 APEMAC, université de Lorraine, université Paris Descartes, 54000 Nancy, France; Service de maladies infectieuses et tropicales, CHU de Nancy, 54000 Nancy, France
| | - J M Boivin
- Département de médecine générale, université de Lorraine, faculté de médecine, 54000 Nancy, France; ANTIBIOLOR, CHU de Nancy, réseau Lorrain d'antibiologie, 54000 Nancy, France; CIC-P Inserm, CHU de Nancy, 54000 Nancy, France
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7
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Gueyffier F, Subtil F, Bejan-Angoulvant T, Zerbib Y, Baguet JP, Boivin JM, Mercier A, Leftheriotis G, Gagnol JP, Fauvel JP, Giraud C, Bricca G, Maucort-Boulch D, Erpeldinger S. Can we identify response markers to antihypertensive drugs? First results from the IDEAL Trial. J Hum Hypertens 2014; 29:22-7. [PMID: 24739801 DOI: 10.1038/jhh.2014.29] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 02/02/2014] [Accepted: 03/12/2014] [Indexed: 11/09/2022]
Abstract
Current antihypertensive strategies do not take into account that individual characteristics may influence the magnitude of blood pressure (BP) reduction. Guidelines promote trial-and-error approaches with many different drugs. We conducted the Identification of the Determinants of the Efficacy of Arterial blood pressure Lowering drugs (IDEAL) Trial to identify factors associated with BP responses to perindopril and indapamide. IDEAL was a cross-over, double-blind, placebo-controlled trial, involving four 4-week periods: indapamide, perindopril and two placebo. Eligible patients were untreated, hypertensive and aged 25-70 years. The main outcome was systolic BP (SBP) response to drugs. The 112 participants with good compliance had a mean age of 52. One in every three participants was a woman. In middle-aged women, the SBP reduction from drugs was -11.5 mm Hg (indapamide) and -8.3 mm Hg (perindopril). In men, the response was significantly smaller: -4.8 mm Hg (indapamide) and -4.3 (perindopril) (P for sex differences 0.001 and 0.015, respectively). SBP response to perindopril decreased by 2 mm Hg every 10 years of age in both sexes (P=0.01). The response to indapamide increased by 3 mm Hg every 10 years of age gradient in women (P=0.02). Age and sex were important determinants of BP response for antihypertensive drugs in the IDEAL population. This should be taken into account when choosing drugs a priori.
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Affiliation(s)
- F Gueyffier
- 1] Centre d'Investigations Cliniques CIC201 Inserm and Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France [2] UMR 5558, CNRS, Villeurbanne, France [3] Université Claude Bernard Lyon1, Lyon, France
| | - F Subtil
- 1] UMR 5558, CNRS, Villeurbanne, France [2] Université Claude Bernard Lyon1, Lyon, France [3] Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
| | - T Bejan-Angoulvant
- Service de Pharmacologie Clinique, Centre Hospitalier Régional et Universitaire de Tours, UMR 7292, CNRS, Université François Rabelais, Tours, France
| | - Y Zerbib
- 1] Université Claude Bernard Lyon1, Lyon, France [2] Department of General Practice, Université Claude Bernard Lyon1, Lyon, France [3] Sciences et Société; Historicité, Éduction et Pratiques (S2HEP), Villeurbanne, France
| | - J P Baguet
- 1] Department of Cardiology, Centre Hospitalier Universitaire, Grenoble, France [2] INSERM 1039, Bioclinic Radiopharmaceutics Laboratory, Université Joseph Fourier, Grenoble, France
| | - J M Boivin
- Centre d'Investigations Cliniques Plurithématique, CIC-P-Inserm CHU de Nancy, Institut Lorrain du cœur et des vaisseaux Louis Mathieu, Université Henri Poincaré Nancy, 4 allée du Morvan, Vandœuvre lès Nancy, France
| | - A Mercier
- 1] Department of General Practice, Faculté de Médecine, Rouen University, Rouen, France [2] CIC Inserm 0204 CHU de Rouen, Rouen, France
| | - G Leftheriotis
- Laboratoire d'Explorations Fonctionnelles Vasculaires, CHU Angers, Angers, France
| | - J P Gagnol
- Cardiology department, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France
| | - J P Fauvel
- Department of Nephrology and Hypertension, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - C Giraud
- 1] Centre d'Investigations Cliniques CIC201 Inserm and Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France [2] UMR 5558, CNRS, Villeurbanne, France [3] Université Claude Bernard Lyon1, Lyon, France
| | - G Bricca
- Exploration Fonctionnelle Endocrinienne et Métabolique, Centre de Biologie Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - D Maucort-Boulch
- 1] Université Claude Bernard Lyon1, Lyon, France [2] Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
| | - S Erpeldinger
- Department of General Practice, Université Claude Bernard Lyon1, Lyon, France
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Robaux S, Bouaziz H, Cornet C, Boivin JM, Lefèvre N, Laxenaire MC. Acute postoperative pain management at home after ambulatory surgery: a French pilot survey of general practitioners' views. Anesth Analg 2002; 95:1258-62, table of contents. [PMID: 12401607 DOI: 10.1097/00000539-200211000-00029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IMPLICATIONS We assessed the views of French general practitioners concerning pain relief at home after ambulatory surgery in a cross-sectional prospective survey. The results revealed that there is need for improvement, mainly in prescribing more suitable analgesic protocols and optimizing postdischarge relationships between physicians.
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Affiliation(s)
- S Robaux
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, University Hospital of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035 Nancy Cedex, France
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Boivin JM, Alla F. [Clinical trials. Methodologic principles and ethical aspects of treatment evaluation]. Rev Prat 2000; 50:2073-9. [PMID: 11192980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- J M Boivin
- Centre d'investigation clinique, INSERM-CHU, hôpital Jeanne-d'Arc, 54201 Dommartin-lès-Toul
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10
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Zannad F, Boivin JM. Ambulatory 24-h blood pressure assessment of the felodipine-metoprolol combination versus amlodipine in mild to moderate hypertension. Lorraine General Physician Investigators Group. J Hypertens 1999; 17:1023-32. [PMID: 10419077 DOI: 10.1097/00004872-199917070-00020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To measure the time effect profiles of a once daily administered combination tablet felodipine-metoprolol 5/50 mg (Logimax, Astra) and amlodipine 5 mg (Norvasc, Pfizer) on blood pressure and heart rate using 24-h ambulatory blood pressure monitoring. DESIGN Randomized multicentre parallel-group study with a single-blind placebo run-in period of 4 weeks duration and a 6-week double-blind active treatment period. PATIENTS AND METHODS Out of 245 randomized outpatients (90 men, 155 women) with uncomplicated mild-to-moderate primary hypertension and mean sitting diastolic blood pressure (DBP) 95-115 mmHg inclusive, 212 (102 on felodipine-metoprolol, 110 on amlodipine) were eligible for analysis. 24-h ambulatory blood pressure monitoring was performed at the end of the placebo run-in (baseline) and after 6 weeks active treatment (posttreatment). RESULTS Both felodipine-metoprolol and amlodipine induced smooth and consistent reduction in DBP and systolic blood pressure throughout the 24-h period, hence not altering the diurnal rhythm. However, felodipine-metoprolol reduced all average blood pressures (24-h, day- and night-time) more than amlodipine (for 24-h average blood pressure 14.4/9.5 mmHg and 8.9/5.5 mmHg, respectively). Medians of individual diastolic trough-to-peak (T/P) ratios were similar for felodipine-metoprolol and amlodipine (54 and 50%, respectively), while for the systolic T/P ratios, the corresponding values were 74 and 35%, repectively; no significant difference between treatments was seen. As distinguished from amlodipine, both heart rate and rate pressure product were markedly decreased on felodipine-metoprolol throughout the 24-h period and even during the early morning hours. In general, both treatments were well tolerated. CONCLUSIONS Both felodipine-metoprolol and amlodipine achieved optimal control of blood pressure during the inter-dosing interval in line with their pharmokinetic profiles. The vasodilatory adverse events were slightly more reported with felodipine-metoprolol combination, but due to more pronounced lowering of the average blood pressures and the potent additional effect on heart rate and rate pressure product, the efficacy/tolerability balance seems to be equal to or better than that obtained with monotherapy such as amlodipine.
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Affiliation(s)
- F Zannad
- Centre d'investigation clinique, INSERM-CHU, Nancy, France.
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Fluckiger L, Boivin JM, Quilliot D, Jeandel C, Zannad F. Differential effects of aging on heart rate variability and blood pressure variability. J Gerontol A Biol Sci Med Sci 1999; 54:B219-24. [PMID: 10362001 DOI: 10.1093/gerona/54.5.b219] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Previous studies investigating autonomic cardiovascular control in elderly persons usually included analysis of R-R interval but not of blood pressure variability. "Physiological" blood pressure rise during the aging process was not accounted for as a possible confounding factor. This study was designed to characterize the relationship between age and short-term heart rate (HR) and blood pressure (BP) variability, independently of the "physiological" rise in BP associated to aging. The study was carried out in 65 "normotensive" (BP< or =140/80 mm Hg) healthy subjects, ranging in age from 18 to 80 years. BP and HR were recorded at rest with a Finapres device. Low-frequency (LF = 0.066 to 0.129 Hz) and high-frequency (HF = respiratory peak +/-0.05 Hz) components of HR and BP variability were assessed using fast-Fourier spectral analysis. Transfer-function analysis between systolic BP and HR variability permitted the calculation of the gain of baroreflex sensitivity. Significant results of this study include a continuous and linear decline with age of normalized LF spectral power of HR in the standing position and of normalized HF spectral power of HR during paced breathing. No correlation was found between age and BP variability, except for LF diastolic BP spectral power in the standing position. The baroreflex gain was negatively correlated with age. The effect of aging on autonomic nervous system cardiac control is progressive and continuous throughout an 18-80 years age range. Although the aging process diminished HR variability and diastolic BP variability, it had no influence on systolic BP variability.
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Affiliation(s)
- L Fluckiger
- Clinical Pharmacology and Cardiology, Centre d'Investigation Clinique INSERM-CHU, EA 2403: Insuffisance Cardiaque, Hôpital Jeanne d'Arc, Nancy, France
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Boivin JM, Issartel G, Zannad F. [Double-blind and randomised parallel study of minocycline 100mg (Mynocine) vs roxithromycin 300mg (Rulid), in the treatment of seasonal acute bronchitis in clinical practice]. Therapie 1995; 50:35-9. [PMID: 7754475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
46 general practitioners of the vicinity of Nancy carried out a randomised, parallel and double blind study comparing the efficacity and the tolerance of two drugs: roxithromycin (Rulid) 300 mg per day, and minocycline (Mynocine) 100 mg per day in the treatment of adult acute bronchitis, in clinical practice. 124 patients were included from January 1992 to June 1992. Efficacy of the treatment was estimated by both practitioners and patients to be good and excellent at the same time in 90 to 95 per cent of cases, in the two groups. Clinical tolerance was estimated to be excellent (90 per cent of cases) in the two groups. Roxithromycine and minocycline are effective and well tolerated in the treatment of adults acute bronchitis in clinical practice. Among the two drugs, we prefer to use minocycline because it is 2.5 to 5 times less expensive than roxithromycine.
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Affiliation(s)
- J M Boivin
- Service de Pneumologie, CHU, Nancy, France
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Brochier M, Boivin JM, Ecarlat B, Lanfranchi J, Chatelain B, Fauchier JP. [An easy radiologic diagnosis: the Scimitar syndrome]. Ann Cardiol Angeiol (Paris) 1969; 18:167-72. [PMID: 5397250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Boivin JM, Delhommais P. [Presentation of a case of senile orthostatic hypotension]. Arch Mal Coeur Vaiss 1956; 49:1160-2. [PMID: 13403758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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