[Zusammenfassung] Vor kurzem wurden europäische und amerikanische Leitlinien für die Behandlung der Hypertonie veröffentlicht. Sie unterscheiden sich in einigen Punkten, die sich auf die klinische Praxis auswirken könnten. Die amerikanischen wie die europäischen Leitlinien messen der Evaluation des absoluten kardiovaskulären Risikos eines Patienten auf der Basis der Blutdruckwerte und anderer kardiovaskulärer Risikofaktoren besondere Bedeutung zu. Jedoch wird in den amerikanischen Empfehlungen mehr Gewicht auf den Blutdruckwert per se gelegt und eine neue Kategorie, die so genannte «Prähypertonie», definiert. Auch in der Initialbehandlung unterscheiden sich die beiden Expertengruppen. [Autoren]
[Résumé] Récemment, européens et américains ont publié des recommandations de pratique clinique pour la prise en charge de l'hypertension artérielle. Elles différent sur certains points qui peuvent avoir un impact sur la pratique clinique. Américains comme européens insistent sur l'importance de l'évaluation du risque cardiovasculaire absolu de chaque patient en fonction de la pression artérielle et des autres facteurs de risque cardiovasculaire. Toutefois, dans les recommandations américaines, une plus grande importance est donnée à la valeur de la pression artérielle per se. Ainsi, ils définissent une nouvelle catégorie de pression artérielle, la «pré-hypertension» (pour de pression de 120-139 / 80-89 mmHg) qui correspond aux catégories «normale» ou «normale haute» des européens. Le but de cet article est de résumer quelques points clé de ces recommandations et de discuter l'implication que cela peut avoir pour la pratique. [Auteurs]]]>
Hypertension ; Practice Guidelines as Topic
oai:serval.unil.ch:BIB_4E95F9F3518B
2022-05-07T01:17:37Z
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https://serval.unil.ch/notice/serval:BIB_4E95F9F3518B
A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity.
info:doi:10.1111/jth.13008
info:eu-repo/semantics/altIdentifier/doi/10.1111/jth.13008
info:eu-repo/semantics/altIdentifier/pmid/25980766
Rosa-Salazar, V.
Trujillo-Santos, J.
Díaz Peromingo, J.A.
Apollonio, A.
Sanz, O.
Malý, R.
Muñoz-Rodriguez, F.J.
Serrano, J.C.
Soler, S.
Monreal, M.
RIETE Investigators
Decousus, H.
Prandoni, P.
Brenner, B.
Barba, R.
Di Micco, P.
Bertoletti, L.
Schellong, S.
Tzoran, I.
Reis, A.
Bosevski, M.
Bounameaux, H.
Wells, P.
Papadakis, M.
Adarraga, MD.
Alibalic, A.
Alvarado-Faria, A.
Arcelus, JI.
Auguet, T.
Ballaz, A.
Barrón, M.
Barrón-Andrés, B.
Bascuñana, J.
Benítez, JF.
Blanco-Molina, A.
Bueso, T.
Cañas, A.
Casado, A.
Castejón-Pina, N.
Chaves, EL.
Del Molino, F.
Del Toro, J.
Falgá, C.
Fernández-Capitán, C.
Font, L.
Gallego, P.
García-Bragado, F.
García-Ortega, A.
Gómez, V.
González, J.
González-Marcano, D.
Grau, E.
Guijarro, R.
Guil, M.
Guirado, L.
Gutiérrez-Guisado, J.
Hernández-Blasco, L.
Jara-Palomares, L.
Jaras, MJ.
Jiménez, D.
Jiménez, R.
Lacruz, B.
Lecumberri, R.
Lobo, JL.
López-Jiménez, L.
López-Montes, L.
López-Reyes, R.
López-Sáez, JB.
Lorente, MA.
Lorenzo, A.
Madridano, O.
Maestre, A.
Marchena, PJ.
Martín-Antorán, JM.
Martín-Martos, F.
Morales, MV.
Nauffal, D.
Nieto, JA.
Núñez, MJ.
Otalora, S.
Otero, R.
Pagán, B.
Pedrajas, JM.
Peris, ML.
Pons, I.
Porras, JA.
Riera-Mestre, A.
Rivas, A.
Rodríguez-Dávila, MA.
Ruiz-Giménez, N.
Sabio, P.
Sampériz, A.
Sánchez, R.
Soto, MJ.
Suriñach, JM.
Tiberio, G.
Tirado, R.
Tolosa, C.
Uresandi, F.
Valero, B.
Valle, R.
Vela, J.
Villalobos, A.
Villalta, J.
Malfante, P.
Verhamme, P.
Vanassche, T.
Tomko, T.
Hirmerova, J.
Bura-Riviere, A.
Farge-Bancel, D.
Hij, A.
Mahe, I.
Merah, A.
Moustafa, F.
Quere, I.
Babalis, D.
Tzinieris, I.
Braester, A.
Barillari, G.
Bucherini, E.
Campodomico, J.
Ciammaichella, M.
Ferrazzi, P.
Maida, R.
Pace, F.
Pasca, S.
Pesavento, R.
Piovella, C.
Rota, L.
Tiraferri, E.
Tufano, A.
Visonà, A.
Skride, A.
Belovs, A.
Moreira, M.
Ribeiro, JL.
Sousa, MS.
Alatri, A.
Calanca, L.
Mazzolai, L.
info:eu-repo/semantics/article
article
2015
Journal of Thrombosis and Haemostasis : Jth, vol. 13, no. 7, pp. 1274-1278
info:eu-repo/semantics/altIdentifier/eissn/1538-7836
urn:issn:1538-7836
<![CDATA[BACKGROUND: No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy.
METHODS: We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week.
RESULTS: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min(-1) , recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels < 30 mL min(-1) . Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055.
CONCLUSIONS: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home
