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Background: The involvement of traditional risk factors and combined genetic markers of recurrent arterial ischemic stroke (AIS) in adults remains unclear., Objective: This study aims to determine significant clinical and genetic factors of AIS recurrence, and to investigate the combined effect of genotypes on the occurrence of a second cerebral ischemic attack., Methods: We investigated a cohort study of AIS patients (18-50 years old) followed in the neurology department over 5 years. Traditional and genetic risk factors were carried through a multivariable logistic regression model. We used a Cox proportional hazard model for identifying predictors of recurrence., Results: Two hundred and seventy patients were enrolled in our study. The risk of AIS recurrence was 36.2% within 5 years. The potential risk of recurrence of AIS increased with traditional and genetic risk factors such as hypertension, diabetes mellitus, heart failure, and family history of cerebrovascular diseases. This risk increased with increasing number of genetic factors. The hazard ratio (HR) was 0.66 (95% confidence interval [CI] 0.97-2.67) for the subject with one genetic factor, 1.61 (95% CI 0.97-2.25) for combined methylenetetrahydrofolate reductase (MTHFR) polymorphisms, and 2.57 (95% CI 1.32-4.99) for combined factor V Leiden (FVL) and MTHFR polymorphisms (677 or 1298). The HR for the three polymorphisms combined was 6.04 (95% CI 2.40-15.16)., Conclusions: Our findings suggest that cumulative effect of both traditional and common genetic risk factors was associated with recurrence of ischemic stroke. We demonstrated for the first time that a combined genotype FVL/MTHFR profile increase the risk of a second cerebral ischemic attack., (© 2021 International Society on Thrombosis and Haemostasis.)

Several important public health issues such as cardiovascular events are resulting from the actual levels of pollution. There are many sources of pollution ; the most common are loud noise, ambient temperature changes and air pollution. In this article, we try to bring out the impact of these factors on blood pressure, which is probably one of the mechanisms implicated in the upsurge of cardiovascular diseases and mortality., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Since the use of ambulatory blood pressure monitoring (ABPM) in the beginning of the 70's, our perception of blood pressure based only on office blood pressure has been challenged. Indeed, more specific phenotypes such as white coat hypertension, masked hypertension or different circadian patterns of blood pressure have been described and studied. This has resulted in increased use of ambulatory blood pressure measurements for diagnostic and therapeutic purposes. The main focus of this paper is night-time blood pressure. We review, in a non-systematic way, the diagnostic, the prognostic and therapeutic utility of night-time blood pressure. Finally, studies in which antihypertensive drugs are given at night will be presented., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

In this short review, we present 4 studies published in 2014-2015 which appear to important for clinicians. The results of the SPRINT trial are challenging the target systolic blood pressure (BP) to be achieved in non-diabetic hypertensive. It shows that a target BP <120 mmHg provides clear mortality and morbidity advantages over a <140 mmHg target. The PATHWAY2 and 3 studies reemphasize the important role of potassium sparing diuretics in patients with resistant hypertension and in patients with metabolic syndrome. At last the DENERHTN study conducted in France suggests that renal denervation is not dead and that additional studies are needed to position this technique in management of resistant hypertension.