Quoi de neuf en gériatrie ? Pathologies cardio-vasculaires

Pr Olivier Hanon

Hôpital Broca, Paris

Déclaration de relations professionnelles et liens d’intérêt

• Boston-Scientific, Novartis, Daiichi-Sankyo, Boehringer-Ingelheim, Bayer, Sanofi-Aventis, BMS, Pfizer, Astra-Zeneca, Servier, Vifor, Lilly

Hypertension artérielle

BMJ 2015;351:h4865

BMJ 2015;351:h4865

Entre 70-90 ans :

Pour une augmentation de 20 mmHg

HR = 1,36 (1,31-1,41)

N = 2 656

BMC Med. 2015 Apr 9;13:78

Frailty index Cognition, dépression, comorbidités, ADL, poids, créatinine

N = 2 656

BMC Med. 2015 Apr 9;13:78

BMC Med. 2015 Apr 9;13:78

Hypertension. 2015 ; 65: 320–327

250mL daily, as beetroot

juice, 4 weeks

n=68

Enrollment systolic blood pressure ≥130 mm Hg and - cardiovascular disease, - or chronic kidney disease, - or 10-year Framingham cardiovascular disease risk score ≥15%, - or age ≥75 years

Clin Trials. 2014 October ; 11(5): 532–546

This study was sponsored primarily by the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Journal of the American Society of Hypertension 9(9) (2015) 670–679

September 11, 2015, 10:30 AM

JAMA Intern Med. 2015;175(6):989-995.

N= 1 127, 88 ans, en EHPAD, suivis 2 ans

Mortality

Prévention

N = 20 702 hypertensives without history of stroke or myocardial infarction (MI)

- 21%

JAMA. 2015;313(13):1325-1335

JAMA. 2015;313(13):1325-1335

Eligibility included adults with an estimated life expectancy of between 1 month and 1 year, statin therapy for 3 months or more,

JAMA Intern Med. March 2015 doi:10.1001

JAMA Intern Med. March 2015 doi:10.1001

JAMA Intern Med. March 2015 doi:10.1001

JAMA Intern Med. March 2015 doi:10.1001

Insuffisance cardiaque

Death from cardiovascular causes or hospitalization for heart failure

N= 8442 patients IC (1563 > 75 ans)

N Engl J Med. 2014 Aug 30

- 20%

≥75 years : n = 1 563

European Heart Journal 31 July 2015

Qualité de vie

Tolérance

Fibrillation atriale

N Engl J Med. 2015 Aug 6;373(6):511-20.

28

30

32

Ann Intern Med. 2014;161:96-103

Case patients discontinued their index medication (n=4573) Control patients continued treatment (n=19881)

33

Ann Intern Med. 2014;161:96-103

J Sex Med 2013

Méthodes

size from about 1 mL to 25 mL

Orchidomètre

testis volume <20 mL

> 20.00 mL,

Augmentation des événements cardio-vasculaires si vol testiculaire > 20 ml

major adverse cardiovascular events (MACE)

Conclusions Nouvel outil d’évaluation du risque cardio-vasculaire ?