Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Dr hitache HTA

985 views

Published on

HTA du sujet agé : Particularités

Published in: Health & Medicine
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (Unlimited) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... Download Full EPUB Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ACCESS WEBSITE for All Ebooks ......................................................................................................................... Download Full PDF EBOOK here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... Download EPUB Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... Download doc Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... .............. Browse by Genre Available eBooks ......................................................................................................................... Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult,
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Dr hitache HTA

  1. 1. L’HTA DU SUJET AGE HITACHE Hakim Interniste libéral Constantine
  2. 2. Pourquoi L’HTA ?
  3. 3. 1 milliard de personnes hypertendus dans le monde (en 2025 1,560 milliard) En algerie: 27 à 33% HTA : 6% de mortalité FDR cardiovasculaire : 62% d’AVC 49% de SCA Interaction puissante entre HTA / maladies CV HTA Pb prioritaire de santé publique dans le monde
  4. 4. Proportion des décès attribuables aux principaux facteurs de risque dans le monde (2000) Mortalité attribuable (en millions; total de 55 861 000) Mortalité élevée, pays en voie de développement Faible mortalité, pays en voie de développement Pays développés 0 87654321 Hypertensio nTabagism eHypercholestérolémi e Pratiques sexuelles à risqueIMC élevé Inactivité physiqueAlcoo lFumées de combustionDéficience en fer Surcharge pondérale
  5. 5. L’hypertension, un facteur de risque L’hypertension est un important facteur de risque de : ● Maladie vasculaire cérébrale. ● Coronaropathie. ● Insuffisance cardiaque. ● Insuffisance rénale. ● Maladie vasculaire périphérique. ● Démence. ● Fibrillation auriculaire.
  6. 6. Pourquoi le sujet âgé ?
  7. 7. Qui est âgé ?
  8. 8. Et la gériatrie c’est quoi? A peine 16 médecins gériatres : 5% des personnes âgées vivent seules et le premier service spécialisé ne verra le jour que dans 2 ans - Le matin - Maroc - 04/06/2008
  9. 9. Pourquoi L’HTA du sujet âgé ? Parce que des études récentes sont venues bouleverser nos habitudes et nos préjugés.
  10. 10. Qui est hypertendu ?
  11. 11. Normale Normale haute Grade 1 hypertension Grade 2 hypertension <120 et <80 120-129 ou 80-84 130-139 ou 85-90 140-159 ou 90-99 160-179 ou 100- 109 >180 ou >110 Classification de l’HTA (mmHg) Optimal BP Pre hypertension Stage 1 hypertension Stage 2 Hypertension Optimale JNC 7 ESH/ESC PA systolique >140 mmHg est le principal facteur de RCV / PA diast
  12. 12. Quelques repères..
  13. 13. Prévalence de l’Atteinte de la Cible Tensionnelle chez l’hypertendu traité & facteurs prédictifs potentiels de non contrôle tensionnel Nouvelles données nationales dans l’hypertension novembre 2007
  14. 14. 81 % des patients hypertendus sont dans les tranches d’âges des 50-79ans Patients hypertendus par tranche d’ âge
  15. 15. Prévalence de l’HTA en Algérie Grade de La TA Hypertendus traités et connus Eff % Hypertendus Dépistés (non traités et inconnus) Eff % HTA Globale Eff % Normale 18 0.4 0 0 18 0.4 Normale haute 33 0.8 0 0 33 0.8 OptImale 11 0.3 0 0 11 0.3 HTA Légère 83 2.0 631 15.3 714 17.3 HTA Modérée 65 1.6 199 4.8 264 6.4 HTA Sévère 62 1.5 101 2.4 163 3.9 Total 272 6.6 931 22.5 1203 Prévalence de l’hypertension artérielle selon Le grade, traitée connus ou non (Septs OMS,Algérie 2003) 29.1
  16. 16. Réaction : Pr Abdelkrim Berrah. Président de la Société algérienne de l’hypertension artérielle (SAHA), chef de service de médecine interne à l’hôpital de Bab El Oued « L’hypertension artérielle est sous-diagnostiquée et souvent mal traitée »
  17. 17. Pourquoi s’inquiéter ?
  18. 18. Pression artérielle et risque de mortalité par AVC Lancet 2002;360: 1903-13 Mortalité par AVC Risque absolu (IC 95%) PAS (mmHg) 80-89 ans 70-79 60-69 50-59
  19. 19. Pression artérielle et risque de décès par maladie coronarienne Lancet 2002;360: 1903-13 Mortalité par coronaropathie Risque absolu (IC 95%) PAS (mmHg) 70-79 60-69 50-59
  20. 20. La pression Pulsée, juste un mot !
  21. 21. PAS augmente avec l’âge PAD augmente jusqu’à 50-55ans puis se stabilise Burt VL and al. Hypertension 1995;26:305-
  22. 22. Revenons a l’HTA du sujet âgé.
  23. 23. Mécanisme « 1 »
  24. 24. Mécanisme « 2 »
  25. 25. Ma secrétaire !
  26. 26. Associations possibles. Bêtabloquants Sartans IEC SM Diurétiques thiazidiques Anticalciques Bithérapie à faibles doses ( 2007)
  27. 27. Résultat des courses:
  28. 28. Bénéfices d’un traitement de l’hypertension ● Sujets de moins de 60 ans ○ Réduction de 42 % du risque d’AVC ○ Réduction de 14 % du risque d’événement coronarien ● Sujets de plus de 60 ans ○ Réduction de 20 % de la mortalité globale ○ Réduction de 33 % de la mortalité cardiovasculaire ○ Réduction de 40 % de l’incidence d’un AVC ○ Réduction de 15 % des coronaropathies
  29. 29. En plus :
  30. 30. Résultats de l'étude HYVET Beckett NS. The Hypertension in the Very Elderly Trial (HYVET): main results. Late Breaking Trials I. ACC 2008. Sujets de plus de 80 ans Réduction dans le groupe traité p Ensemble des AVC (critère primaire) 30 % 0,055 AVC fatals 39 % 0,046 Mortalité totale 21 % 0,019 Evénements liés à une insuffisance cardiaque 64 % < 0,0001
  31. 31. Votre Fiche technique
  32. 32. Pour votre lecture:
  33. 33. Volume 358:1887-1898 may -1-2008 Number 18 Treatment of Hypertension in Patients 80 Years of Age or Older

×