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L’objectif principal de l’étude PARTAGE est d’évaluer chez des personnes de plus 80 ans vivant en EHPAD (Etablissements d’hébergement des personnes âgées et dépendantes), la valeur prédictive de la pression artérielle (PA) et de la rigidité artérielle mesurée par la vélocité de l’onde du pouls (VOP) sur la mortalité globale ainsi que sur les événements cardiovasculaires majeurs et le déclin cognitif. Un suivi de 2 ans avec enregistrement des décès et des évènements cardio-vasculaires est ainsi prévu pour 1130 sujets (âge moyen 87.7±4.8ans) de plus de 80 ans qui ont été inclus par quatre centres hospitalo-universitaires français (Nancy, Dijon, Paris, Toulouse) et deux centres italiens (Cesena, Vérone). Les résultats ci-dessous portent sur les données de PA et de la VOP de la première visite. La PA a été mesurée : a- de façon standard avec un appareil automatique en position assis (PA standard) et debout (PA ortho) et b- par automesure (PA Auto) : trois mesures matin et soir pendant trois jours consécutifs. La VOP a été mesurée par l’appareil Pulsepen(®). Parmi les personnes déclarées hypertendues dans le dossier médical et ayant un traitement anti-hypertenseur (n=773, 68 %), 72 % d’entre elles avaient une PAS casuelle < 150mmHg et 66 % une PAS auto < 145mmHg. Une forte corrélation de la PA a été retrouvée entre les valeurs de l’automesure et celles de la mesure standard (R2 =0.46). Par rapport à la PAS de l’automesure, la PAS standard était plus élevée (>10mmHg) chez 214 (19 %) personnes, plus basse (< 10mmHg) chez 249 (22 %) et pas différente (entre -10 et 10mmHg) chez les 654 (58 %) autres. Une forte corrélation a été observée entre la VOP et la PA (R2 =0.29). Il s’agit de la première étude qui évalue les relations entre mesure standard et ambulatoire de la PA et de la rigidité artérielle chez des sujets de plus de 80 ans institutionnalisés et fragiles. Display Omitted [Copyright &y& Elsevier]

Background: Carotid-femoral pulse-wave velocity (PWV) provides a comprehensive noninvasive indication of arterial stiffness, and is now established as a strong marker of cardiovascular disease (CVD). The correlation between peripheral blood pressure (BP) and PWV and their respective influences on mortality have been poorly studied in the elderly. Our objective was to analyze this correlation in nursing-home residents over 80 years of age, with the view that the results of this could ultimately be helpful in implementing strategies for the diagnosis and long-term follow-up of CVD and mortality in the very elderly population., Methods: The Predictive Value of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population (PARTAGE) study is a 2-year cohort study of 1,130 subjects living in 72 nursing homes in France and Italy. The correlation between baseline systolic and diastolic blood pressure (SBP and DBP, respectively) and baseline PWV (measured with a PulsePen® tonometer) was studied in 1,071 subjects for whom PWV measurements were available., Results: Correlations between peripheral BP and PWV were significant but weak, with r = 0.24 for self-measured SBP, r = 0.30 for casual SBP, r = 0.11 for self-measured DBP, r = 0.14 for casual DBP, and r = 0.26 for casual pulse pressure (PP). A trend toward a weaker correlation was observed in the older age group for self-measured SBP and in the group with a lower level of activities of daily living (ADL) for self-measured SBP and DBP., Conclusions: These findings suggest that SBP, DBP, and PWV provide different information in the very elderly. The results of the prospective, longitudinal, long-term PARTAGE study will allow further insight into this and provide additional in-depth information about the respective prognostic value of the measurement of peripheral BP and PWV.

Objectives: The aim of the longitudinal PARTAGE study was to determine the predictive value of blood pressure (BP) and pulse pressure amplification, a marker of arterial function, for overall mortality (primary endpoint) and major cardiovascular (CV) events, in subjects older than 80 years of age living in a nursing home., Background: Assessment of pulse indexes may be important in the evaluation of the CV risk in very elderly frail subjects., Methods: A total of 1,126 subjects (874 women) who were living in French and Italian nursing homes were enrolled (mean age, 88 ± 5 years). Central (carotid) to peripheral (brachial) pulse pressure amplification (PPA) was calculated with the help of an arterial tonometer. Clinical and 3-day self-measurements of BP were conducted., Results: During the 2-year follow-up, 247 subjects died, and 228 experienced major CV events. The PPA was a predictor of total mortality and major CV events in this population. A 10% increase in PPA was associated with a 24% (p < 0.0003) decrease in total mortality and a 17% (p < 0.01) decrease in major CV events. Systolic BP, diastolic BP, or pulse pressure were either not associated or inversely correlated with total mortality and major CV events., Conclusions: In very elderly individuals living in nursing homes, low PPA from central to peripheral arteries strongly predicts mortality and adverse effects. Assessment of this parameter could help in risk estimation and improve diagnostic and therapeutic strategies in very old, polymedicated persons. In contrast, high BP is not associated with higher risk of mortality or major CV events in this population. (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population [PARTAGE]; NCT00901355)., (Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of the longitudinal study PARTAGE (predictive values of blood pressure and arterial stiffness in institutionalized very aged population) was to determine the predictive value of blood pressure (BP) and arterial stiffness for overall mortality, major cardiovascular events and cognitive decline in a large population of institutionalized patients aged 80 and over. In the study herein, we present the baseline data values of this study., Methods: A total of 1130 patients were recruited (878 women), living in French and Italian nursing homes. Clinical and 3-day self-measurements of BP were conducted. Aortic and upper limb pulse wave velocity were obtained using a PulsePen tonometer., Results: Of this population, 76% of women and 60% of men had a known hypertension and over 91% of the patients were under antihypertensive treatment; 51% of the treated hypertensive patients were well controlled (systolic BP <140 mmHg). No significant differences were found between clinical and self-measured BP. With age, there was an increase in pulse pressure (P < 0.001) due to a decrease in diastolic BP (P < 0.001), without any increase in systolic BP. Aortic but not peripheral pulse wave velocity significantly increased with age (P < 0.005)., Conclusion: Baseline values obtained herein demonstrate that elderly patients living in nursing homes present hemodynamic characteristics which are different to those described in community-living elderly populations, and indicate the interest of assessing, in longitudinal studies, the role of BP and arterial stiffness in morbidity and mortality in this population.