ABSTRACT
L`hypertension arterielle (HTA) est une affection repandue dans toutes les regions du monde. Ses complications sont responsables d`une importante mortalite. D`une maniere generale; sa prise en charge est loin d`etre parfaite. Au Burkina Faso en 1998; une etude a montre que 17de la population urbaine de plus de 30 ans avait une pression arterielle superieure ou egale a 160/95 mm Hg (a); il y a des controverses sur la definition de l`HTA; mais de plus en plus; il y a convergence de point de vue sur la hierarchisation des interventions medicamenteuses. Nous presentons ici des strategies therapeutiques ayant demontre leur efficacite preventive
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents , Hypertension/drug therapy , Sodium Chloride Symporter Inhibitors/therapeutic useABSTRACT
L'extrait de feuilles seches de Persea americana; traditionnellement utilise pour ses proprietes antihypertensives a ete teste par le suivi biologique et clinique de 5 malades qui ont volontairement choisi cette forme de therapeutique. L'efficacite therapeutique de l'extrait a ete jugee remarquable. Cependant; quelques effets secondaires ont ete releves (une asthenie liee a l'hypokaliemie induite et la chute des cheveux) qui ont contraint a l'arret du traitement chez les 3 patients ages de moins de 45 ans. Ces resultats; tout en confirmant l'activite pharmacologique de certains extraits; doivent inciter a une recherche plus approfondie afin d'eviter de possibles desagrements en rapport avec une toxicite chronique
Subject(s)
Antihypertensive Agents , Hypertension/drug therapy , Medicine , PlantsABSTRACT
Guidelines for management of hypertension continually change as research findings shed more insight into the disease process and as new classes of anti-hypertensive agents are developed. In 1993; three bodies issued revised guidelines. However; since management of hypertension depends on a number of factors including demographic and socio-economic realities; what is prescribed in developed countries may not be applicable in Africa. The need for African experts treating patients with hypertension to establish a consensus committee on hypertension to develop appropriate guidelines is urgent. The hints in this paper are an attempt to interpret the available facts on the management of hypertension in a manner that reflects the realities in Africa
Subject(s)
Antihypertensive Agents , Hypertension/drug therapyABSTRACT
L'hypertension arterielle est une affection grave. Elle merite d'etre rapidement traitee afin d'eviter ses complications souvent graves. L'auteur propose integralement une etude faite sur l'efficacite de la Nifedipine dans le traitement de l'hypertension arterielle
Subject(s)
Hypertension/drug therapy , Nifedipine/therapeutic useABSTRACT
Les auteurs rapportent les aspects cliniques biologiques et therapeutiques actuels de l'hypertension arterielle au cours de la grossesse
Subject(s)
Antihypertensive Agents , Hypertension/diagnosis , Hypertension/drug therapy , Pregnancy ComplicationsABSTRACT
L'hypertension arterielle est devenue pour le monde entier un reel probleme de sante publique et constitue un facteur de risque cardiovasculaire majeur. Elle accelere l'installation de l'attaque herosclerose coronaire et cerebrovasculaire. Les mecanismes de la potentialisation de l'atherogenese dans l'hypertension arterielle se revelent fort complexes. L'approche therapeutique qui constitue la substance de ce texte est donc empirique. Actuellement on pense que les beta-bloquants et les inhibiteurs de l'enzyme de conversion seront prescrits avant 50 ans; les diuretiques et les inhibiteurs calciques apres 50 ans
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Enzyme Inhibitors , Hypertension/drug therapy , Risk FactorsABSTRACT
Les conceptions physiopathologiques des maladies hypertensives de la grossesse ont beaucoup evolue dans les dix dernieres annees. Trois elements complementaires interviendraient: un trouble precoce de la placentation; source de resistance vasculaire elevee; un exces de thromboxane; source de vasoconstriction et hyperagregation plaquettaire; et une activation de l'hemostase; source de thrombose. Ces elements conduiraient a une hypothese uniciste: celle d'une pathologie endotheliale probablement plus generale. C'est seulement apres une assez longue evolution des anomalies placentaires qu'apparait l'hypertension et eventuellement ses signes d'accompagnement. Ce mecanisme explique assez bien l'inefficacite des traitements anti-hypertenseurs pour modifier le pronostic de ces grossesses. Cependant; des traitements preventifs precoces; semblent porteurs d'espoir pour ces patientes
Subject(s)
Hypertension , Hypertension/drug therapy , Hypertension/physiopathology , PregnancyABSTRACT
Clinical experience with the new dihydropyridine calcium antagonist; isradipine; is reported. Isradipine was compared with nifedipine in a multicentre open; parallel group; clinical therapeutic trial involving 70 patients with mild to moderate hypertension. A four week placebo washout period was followed by a 12 week active treatment period during which patients were randomized to receive either 2.5mg isradipine twice daily (n=40) or 10mg nifedipine three times daily (n=30). Isradipine significantly reduced sitting systolic/diastolic blood pressures from 176.7+/-21.0/106.7+/-7.0mmHg to 142.9+/-15/93.1+/-7.7mmHg (p0.001) at the end of 12 weeks. Similarly; nifedipine reduced sitting systolic/diastolic blood pressures from 170.1+/-19.5/106.2+/-7.4mmHg to 139.1+/-9.7/92.1+/-7.8mmHg (p0.001). Normalisation (diastolic 90mmHg) rates were 67 per cent and 60 per cent for isradipine and nifedipine respectively while good response (diastolic fall 10mmHg) rate was over 85 per cent on either drug. Heart rate did not significantly change with either treatment. Three (3) patients taking isradipine experienced headache and 7 patients taking nifedipine had drug related adverse effects (5 had headache; 1 insomnia and 1 first dose hypotension). Therapy was withdrawn in 4 patients taking nifedipine and 1 taking isradipine. It is concluded that isradipine is comparable to nifedipine and is an effective and well tolerated antihypertensive agent in the Ghanaian
Subject(s)
Hypertension/drug therapy , Isradipine , NifedipineABSTRACT
Using WHO hypertensive criteria; 184 patients with hypertension were chosen (102 male; 82 female); aged 58-78 years old. Other heart diseases were ruled out by physical examination; electrocardiographic examination; chest-ray and echocardiography. All the cases had one or more criteria of left ventricular hypertrophy (LVH): Interventricular septal thickness at diastole; left ventricular posterior wall thickness at end diastole and left ventricular mass index. The findings in this study imply that it is good practise to include nifedipine in the treatment regimen of patients whose hypertension is complicated with LVH and (or) ischaemic heart disease
Subject(s)
Coronary Disease/drug therapy , Echocardiography/methods , Electrocardiography/methods , Hypertension/complications , Hypertension/diagnostic imaging , Hypertension/drug therapy , Hypertrophy/drug therapy , Nifedipine/therapeutic use , Physical Examination/methods , Ventricular FunctionABSTRACT
A review on the present state of management of hypertension is presented. The methods for case detection and investigation of cases are described. Treatment modes; patient education; society awareness are all factors that are important in the control of hypertension and limiting its complications. The role of primary health care workers in detecting and promoting complianceis being advocated