Takayasu disease is a chronic vasculitis of the large vessels. It is rare in sub- Saharan Africa and probably under-diagnosed. Arterial hypertension (AH) is a frequent finding. We report the case of a 46-year-old...Takayasu disease is a chronic vasculitis of the large vessels. It is rare in sub- Saharan Africa and probably under-diagnosed. Arterial hypertension (AH) is a frequent finding. We report the case of a 46-year-old man with Takayasu disease revealed by hypertension. The American College of Rheumatology (ACR) criteria were used for diagnosis, with 4 out of 6 criteria. Echodoppler and angioscanner showed signs of left subclavian stenosis and circumferential, regular arterial thickening. He had a biological inflammatory syndrome. He was treated with prednisone and amlodipine. After 6 months of follow-up, he was diagnosed with tuberculosis and put on anti-tuberculosis treatment.展开更多
When blood pressure values remain above the target in a hypertensive patient treated concomitantly with three anti-hypertensive drugs including a diuretic, maximum well-tolerated doses, this is a resistant arterial hy...When blood pressure values remain above the target in a hypertensive patient treated concomitantly with three anti-hypertensive drugs including a diuretic, maximum well-tolerated doses, this is a resistant arterial hypertension. In this case, it is advisable to look for a secondary cause such as a drug intake that influencing the blood pressure or the presence of obstructive sleeping syndrome (OSAS).</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We report a clinical case of a patient with a high cardiovascular risk at the age of 50, hypertensive and diabetic, with dyslipidemia and obesity. He was on anti-hypertensive triple therapy at an optimal dose. Her diabetes was balanced with 6.4% glycated hemoglobin. Dyslipidemia has being treated. Despite healthy diet including a low sodium diet and weight loss, blood pres</span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">sure target was not reached.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">With self-measurement, the mean arterial </span><span style="font-family:Verdana;">pressure was 180/110 mmHg and on ABPM it was 167/113 mmHg.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">The ventilatory</span><span style="font-family:Verdana;"> polygraphy finds a severe OSA with an IAH = 56.6. Treatment with PCP (Con</span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">tinuous positive pressure) allowed this patient to control blood pressure.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">The search for OSA should be systematic in face of resistant hypertension, in par</span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">ticular in overweight or obese patients.展开更多
文摘Takayasu disease is a chronic vasculitis of the large vessels. It is rare in sub- Saharan Africa and probably under-diagnosed. Arterial hypertension (AH) is a frequent finding. We report the case of a 46-year-old man with Takayasu disease revealed by hypertension. The American College of Rheumatology (ACR) criteria were used for diagnosis, with 4 out of 6 criteria. Echodoppler and angioscanner showed signs of left subclavian stenosis and circumferential, regular arterial thickening. He had a biological inflammatory syndrome. He was treated with prednisone and amlodipine. After 6 months of follow-up, he was diagnosed with tuberculosis and put on anti-tuberculosis treatment.
文摘When blood pressure values remain above the target in a hypertensive patient treated concomitantly with three anti-hypertensive drugs including a diuretic, maximum well-tolerated doses, this is a resistant arterial hypertension. In this case, it is advisable to look for a secondary cause such as a drug intake that influencing the blood pressure or the presence of obstructive sleeping syndrome (OSAS).</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We report a clinical case of a patient with a high cardiovascular risk at the age of 50, hypertensive and diabetic, with dyslipidemia and obesity. He was on anti-hypertensive triple therapy at an optimal dose. Her diabetes was balanced with 6.4% glycated hemoglobin. Dyslipidemia has being treated. Despite healthy diet including a low sodium diet and weight loss, blood pres</span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">sure target was not reached.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">With self-measurement, the mean arterial </span><span style="font-family:Verdana;">pressure was 180/110 mmHg and on ABPM it was 167/113 mmHg.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">The ventilatory</span><span style="font-family:Verdana;"> polygraphy finds a severe OSA with an IAH = 56.6. Treatment with PCP (Con</span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">tinuous positive pressure) allowed this patient to control blood pressure.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">The search for OSA should be systematic in face of resistant hypertension, in par</span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">ticular in overweight or obese patients.
