{"title":"Épidémiologie de l’hypertension artérielle en France","authors":"Valérie Olié , Jacques Blacher , Clémence Grave","doi":"10.1016/j.lpmfor.2025.100681","DOIUrl":"10.1016/j.lpmfor.2025.100681","url":null,"abstract":"<div><div>Dix-sept millions d’adultes sont hypertendus en France.</div><div>Environ 1 adulte sur 5 a une pression artérielle systolique supérieure à 140<!--> <!-->mm Hg.</div><div>Trois cent quatre-vingt-douze mille hospitalisations et 6,2 millions de journées d’hospitalisation par an sont attribuables à l’HTA en France.</div><div>Cinquante-cinq mille décès et 500 000 années de vie perdues par an sont attribuables à l’HTA en France.</div><div>Un total de 12,5 % des complications de l’HTA (22 000 décès et 134 000 hospitalisations) pourraient être évitées si la France atteignait les objectifs de l’OMS de réduction de la prévalence de l’HTA.</div></div><div><div>Seventeen million adults are hypertensive in France.</div><div>Approximately 1 in 4 adults over the age of 35 has a systolic blood pressure above 140<!--> <!-->mm Hg.</div><div>Three hundred ninety-two thousand hospitalizations and 6.2 million hospital days per year are attributable to hypertension in France.</div><div>Fifty five thousand deaths and 500,000 years of life lost per year are attributable to hypertension in France.</div><div>A total of 12.5% of hypertension‘s complications (22,000 deaths and 134,000 hospitalizations) could be prevented if France achieved the WHO targets for reducing the prevalence of hypertension.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100681"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mesure de la pression artérielle","authors":"Jean-Marc Boivin","doi":"10.1016/j.lpmfor.2025.100682","DOIUrl":"10.1016/j.lpmfor.2025.100682","url":null,"abstract":"<div><div>La mesure clinique de la pression artérielle au cabinet doit être réalisée de façon standardisée en position assise à l’aide d’un tensiomètre automatique validé. L’automesure tensionnelle doit être systématiquement utilisée pour confirmer le diagnostic d’HTA et régulièrement répétée pour le suivi de tous les patients hypertendus. La mesure sans surveillance peut être envisagée lorsqu’il n’est pas possible de disposer d’automesures.</div></div><div><div>Office blood pressure measurement should be performed in a standardized manner, in the seated position, using a validated automatic blood pressure monitor. Home blood pressure monitoring (HBPM) should systematically be used to confirm the diagnosis of hypertension and should be repeated regularly for the follow-up of all hypertensive patients. Unattended blood pressure measurement may be considered when home monitoring is not feasible.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100682"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypertension artérielle et rein : ce qu’il faut retenir","authors":"Dominique Guerrot , Jean-Michel Halimi","doi":"10.1016/j.lpmfor.2025.100691","DOIUrl":"10.1016/j.lpmfor.2025.100691","url":null,"abstract":"<div><div>L’HTA est souvent révélatrice d’une maladie rénale chronique et doit en faire rechercher les signes dès le diagnostic.</div><div>Deux examens simples permettent ce dépistage : DFG estimé (CKD-EPI) et rapport albuminurie/créatininurie (RAC).</div><div>La prise en charge pharmacologique de l’HTA en contexte de MRC repose en premier lieu sur les bloqueurs du SRAA et les diurétiques.</div><div>Le médecin généraliste joue un rôle central dans le dépistage, l’instauration du traitement et le suivi au long cours.</div></div><div><div>Hypertension is frequently the presenting sign of chronic kidney disease (CKD) and should prompt systematic screening.</div><div>Two simple tests enable this screening: estimated GFR (CKD-EPI) and urine albumin-to-creatinine ratio (ACR).</div><div>Pharmacological management of hypertension in CKD mainly relies on RAAS blockers and diuretics.</div><div>General practitioners are central in the screening, therapeutic initiation, and long-term follow-up of these patients.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100691"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypertension artérielle et mode de vie","authors":"Philippe Sosner","doi":"10.1016/j.lpmfor.2025.100685","DOIUrl":"10.1016/j.lpmfor.2025.100685","url":null,"abstract":"<div><div>Une action globale sur le mode de vie améliore le contrôle de l’HTA, réduit les risques cardiovasculaires, et peut diminuer les besoins médicamenteux : alimentation adaptée : régime DASH riche en fibres, réduction du sel (< 5<!--> <!-->g/j), perte de poids, baisse d’alcool, apport en potassium ; activité physique régulière : aérobie<!--> <!-->≥<!--> <!-->150<!--> <!-->min/semaine<!--> <!-->+<!--> <!-->renforcement musculaire dynamique et isométrique<!--> <!-->+<!--> <!-->activités douces (Yoga, Qi Gong) ; gestion du stress, qualité du sommeil, arrêt du tabac.</div></div><div><div>Comprehensive action on lifestyle improves control of hypertension, reduces cardiovascular risk, and may reduce the need for medication: appropriate diet: fiber-rich DASH diet, salt reduction (< 5<!--> <!-->g/d), weight loss, alcohol reduction, potassium intake; regular physical activity: aerobic exercise<!--> <!-->≥<!--> <!-->150<!--> <!-->min/week<!--> <!-->+<!--> <!-->dynamic and isometric resistance exercise<!--> <!-->+<!--> <!-->gentle activities (Yoga, Qi Gong); stress management, sleep quality, smoking cessation.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100685"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trithérapie antihypertensive","authors":"Beatrice Duly-Bouhanick","doi":"10.1016/j.lpmfor.2025.100680","DOIUrl":"10.1016/j.lpmfor.2025.100680","url":null,"abstract":"<div><div>En France, seul un patient sur quatre traités pour une HTA est contrôlé.</div><div>Soixante pour cent des hypertendus traités le sont sous monothérapie.</div><div>L’inertie thérapeutique comme un manque d’observance sont deux facteurs d’échec au traitement.</div><div>Plus il y a de médicaments, moins bonne est l’observance qui ne dépasse pas 50 % au-delà de trois médicaments pris séparément.</div><div>Une trithérapie bien menée, c’est moins de 5 % de patients ayant une HTA résistante.</div><div>La trithérapie fixe offre l’opportunité de diminuer l’inertie, d’augmenter l’observance, d’améliorer le contrôle tensionnel et le pourcentage de patients hypertendus aux objectifs tensionnels.</div></div><div><div>In France, only one in four patients treated for hypertension is controlled.</div><div>Sixty percent of treated hypertensive patients are on monotherapy.</div><div>Therapeutic inertia and lack of adherence are two factors for treatment failure.</div><div>The more medications there are, the poorer the adherence, which does not exceed 50% beyond three medications taken separately.</div><div>Well-managed triple therapy results in less than 5% of patients having resistant hypertension.</div><div>Fixed triple therapy offers the opportunity to reduce inertia, increase adherence, improve blood pressure control and the percentage of hypertensive patients meeting blood pressure targets.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100680"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypothyroïdie de l’adulte","authors":"Miriam Ladsous","doi":"10.1016/j.lpmfor.2025.100668","DOIUrl":"10.1016/j.lpmfor.2025.100668","url":null,"abstract":"<div><div>– L’hypothyroïdie est la pathologie thyroïdienne la plus fréquente chez l’adulte, avec une nette prépondérance féminine.</div><div>– Le diagnostic positif est facile grâce au dosage de la TSH.</div><div>– Les signes cliniques sont souvent peu spécifiques, un dépistage biologique systématique est donc indiqué dans les situations à risque.</div><div>– L’étiologie principale est l’auto-immunité.</div><div>– Le traitement hormonal substitutif est simple et efficace grâce à la lévothyroxine (LT4).</div><div>– La grossesse est une période sensible nécessitant une vigilance particulière en ce qui concerne le diagnostic et la prise en charge thérapeutique.</div><div>– Une surveillance est indispensable afin de vérifier la bonne adéquation du traitement, souvent prescrit à vie.</div></div><div><div>– Hypothyroidism is the most common thyroid disorder in adults, with a clear female preponderance.</div><div>– A positive diagnosis is easy thanks to TSH measurement.</div><div>– Clinical signs are often non-specific, so systematic biological screening is indicated in high-risk situations.</div><div>– The main etiology is autoimmunity.</div><div>– Hormone replacement therapy is simple and effective with levothyroxine (LT4).</div><div>– Pregnancy is a sensitive period that requires special vigilance with regard to diagnosis and therapeutic management.</div><div>– Monitoring is essential to ensure that the treatment, which is often prescribed for life, is appropriate.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100668"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypertension artérielle et intelligence artificielle : vers une révolution diagnostique et thérapeutique","authors":"Benoit Lequeux , Thierry Garban","doi":"10.1016/j.lpmfor.2025.100689","DOIUrl":"10.1016/j.lpmfor.2025.100689","url":null,"abstract":"<div><div>L’intelligence artificielle transforme le diagnostic et la prise en charge de l’hypertension artérielle.</div><div>Les algorithmes prédictifs identifient précocement les patients à risque et permettent une stratification fine.</div><div>La télésurveillance assistée par IA améliore le contrôle tensionnel et l’observance thérapeutique.</div><div>L’analyse des données massives personnalise les objectifs thérapeutiques et optimise les traitements.</div><div>Des défis éthiques persistent concernant la qualité et la traçabilité des données.</div></div><div><div>Artificial intelligence is transforming diagnosis and management of hypertension.</div><div>Predictive algorithms identify high-risk patients and enable precise risk stratification.</div><div>AI-assisted remote monitoring improves blood pressure control and medication adherence.</div><div>Big data analysis personalizes therapeutic targets and optimizes treatments.</div><div>Ethical challenges persist regarding data quality and traceability.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100689"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Proposition de prise en charge de l’HTA par l’infirmier en pratique avancée par le CNP de cardiologie et la SFHTA","authors":"Marc Villaceque , Benoit Lequeux","doi":"10.1016/j.lpmfor.2025.100684","DOIUrl":"10.1016/j.lpmfor.2025.100684","url":null,"abstract":"<div><div>Le CNP de cardiologie et la SFHTA propose un cadre structurant commun pour la prise en charge de l’HTA par l’infirmier en pratique avancée (IPA). Il détaille les rôles spécifiques et compétences de l’IPA dans les différentes étapes de la prise en charge de l’HTA, du dépistage à l’éducation thérapeutique et à la coordination des soins afin d’améliorer le contrôle tensionnel et l’observance.</div></div><div><div>The Cardiovascular National Professional Council (CNP) and the French Society of Hypertension (SFHTA) are proposing a common structured framework for the management of hypertension by Advanced Practice Nurses (APNs). It details the specific roles and competencies of APNs at each stage of hypertension management – from screening to therapeutic education and care coordination – in order to improve blood pressure control and treatment adherence.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100684"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conclusion et perspectives","authors":"Theodora Bejan-Angoulvant","doi":"10.1016/j.lpmfor.2025.100690","DOIUrl":"10.1016/j.lpmfor.2025.100690","url":null,"abstract":"<div><div>L’hypertension artérielle est la pathologie cardiovasculaire la plus fréquente, touchant 17 millions de personnes en France.</div><div>L’hypertension artérielle est responsable d’une morbidité-mortalité importante cardiaque, cérébrale, vasculaire et rénale.</div><div>Le contrôle de la pression artérielle en France est mauvais, laissant plus de 13 millions d’hypertendus non traités ou non contrôlés.</div><div>L’amélioration de la prise en charge de l’HTA passe par la formation et la coopération des professionnels de santé pour le dépistage et le traitement, par des campagnes publiques d’information et par une volonté politique facilitant l’accès au soin.</div><div>Le congrès de la SFHTA, les JHTA, est un moment annuel fort, participant à la formation des professionnels de santé.</div></div><div><div>Hypertension is the most common cardiovascular disease, affecting 17 million people in France.</div><div>Hypertension is responsible for significant morbidity and mortality.</div><div>Blood pressure control in France is poor, leaving more than 13 million hypertensives patients untreated or uncontrolled.</div><div>Improving the management of hypertension requires training and cooperation between healthcare professionals, public information campaigns and a political will to facilitate access to care.</div><div>The SFHTA congress, the JHTA, is a key annual event for the training of healthcare professionals.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 4","pages":"Article 100690"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}