Search

Study of the blood pressure and cardiac rate changes in the course of an exercise test makes it possible to assess the possibilities of cardiovascular adaptation. This "induced arterial hyperrtensive subjects from those who possibly are not, and to assess correctly the blood pressure changes observed in various circumstances. On effort, an approach of the severity of the haemodynamic disturbance of the consequences of this disturbance, of the efficiency of treatment.

The authors report the data of a systematic electrocardiographic study of 307 subjects suffering from hypertension. They analyse the EKG anomalies at rest and after exercise and study the relationships likely to exist between these anomalies and other parameters such as age, blood pressure, etc. They stress the diagnostic but also discriminatory value of this type of investigation in hypertension.

The physiological variations of blood pressure and heart rate were studied in the first five minutes of orthostatism in conditions identical to those encountered in clinical medicine. An increase in heart rate and diastolic blood pressure was observed from the first minute. The value of systolic blood pressure decreased as the subject got up and then rose to the value measured when lying down. At the fourth and fifth minute the three parameters were stable at significantly higher values than observed when lying down for the heart rate and diastolic blood pressure, but at an identical level for the systolic blood pressure. This study shows the necessity of measuring the orthostatic blood pressure using a precise technique which detects postural abnormalities when measured in the minute of orthostatism and which gives an assessment of the standing blood pressure when measured at the fifth minute.

If diagnosis of chronic thromboses of pulmonary arteries is usually easy at the stage of confirmed chronic pulmonary heart, it is not so when dysponea is the only symptom of the disease. The authors report 30 cases of chronic thrombosis and remark that if respiratory alkalosis is very frequent, hipoxemia is often missing. On the other hand they observe 27 times out of 28 an increase of CO2 alveoloarterial difference; measuring the CO2 difference appears a safe and reliable test for detecting chronic thrombosis. It should take place in every systematic complete examination of unexplained dyspnoea.

The used of a test of prolonged grip and recording the changes in arterial blood-pressure and heart rate is suggested as a way of studing the blood-pressure changes of effort in hypertensives. This test provides a real screen for provoqued hypertension: it allows --to define a normal profile of reference for blood-pressure, --to check the fluctuations at rest of blood-pressure, --to determine the severity of haemodynamic dissorders, --to judge the efficiency of hypotensive therapy.

Purpose: evaluate, in a Public Health approach, the contribution of ambulatory blood pressure recordings (ABPR) in the diagnostic and therapeutic management of hypertension., Methods: a retrospective study is led among 32 physicians who have addressed 473 patients for ABP: 182 for borderline hypertension (B-H) diagnosis, 94 for treatment decision (NT-H) and 197 for a therapy efficiency assessment (T-H). ABPR is performed with the non invasive Spacelabs device on a 24 hour period. The data interpretation is provided by statistical comparison of patient's data with those of a same age and sex 30 normotensive subjects group., Results: The table presents the action of physician according to the ABPR motive and answer: TT = therapy, NT = no therapy, ADJ = adjustment, NADJ = no adjustment. (Table: see text)., Conclusion: physicians follow drastically ABPR interpretation: a large number of patient avoid a treatment (68 percent of B-H group and 63 percent of NT-H group), the therapy is modified for 40 percent of the T-H patients. Such evidence may have some Public Health implications.