Author
Stéphane Laurent
Other affiliations: University of Lausanne, Paris Descartes University, French Institute of Health and Medical Research
Bio: Stéphane Laurent is an academic researcher from University of Paris. The author has contributed to research in topics: Blood pressure & Arterial stiffness. The author has an hindex of 83, co-authored 424 publications receiving 75440 citations. Previous affiliations of Stéphane Laurent include University of Lausanne & Paris Descartes University.
Papers published on a yearly basis
Papers
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TL;DR: The results suggest that the dihydropyridine calcium channel antagonist, PN 200-110, may act centrally and stereoselectively at the level of the di hydrocarbon receptor sites involved in the control of blood pressure in spontaneously hypertensive rats.
8 citations
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TL;DR: There is still a need for studies comparing aortic stiffness-guided therapeutic strategies with classic guidelines-guided strategies for preventing cardiovascular events, and to address the concept of “surrogate endpoint.”
Abstract: A major reason for measuring arterial stiffness routinely in clinical practice in hypertensive patients comes from the recent demonstration that arterial stiffness has predictive value for cardiovascular events, which is independent of classical risk scores. In primary prevention, some “imaging biomarkers,” such as arterial stiffness, enhance risk prediction to a higher extent than “circulating biomarkers.” The aim of the present brief review is to address the concept of “surrogate endpoint” and to determine whether aortic stiffness meets the criteria that are requested by international guidelines: (1) Proof of concept: Do novel marker levels differ between subjects with and without outcome? (2) Prospective validation: Does the novel marker predict development of future outcomes in a prospective cohort or nested case-cohort study? (3) Incremental value: Does the novel marker add predictive information to established, standard risk markers? (4) Clinical utility: Does the novel risk marker change predicted risk sufficiently to change recommended therapy? (5) Clinical outcomes: Does use of the novel risk marker improve clinical outcomes, especially when tested in a randomized clinical trial? (6) Cost-effectiveness: Does use of the novel risk marker improve clinical outcomes sufficiently to justify the additional costs? In conclusion, although aortic stiffness meets the first 4 criteria, there is still a need for studies comparing aortic stiffness-guided therapeutic strategies with classic guidelines-guided strategies for preventing cardiovascular events.
8 citations
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TL;DR: Local carotid PP as estimated by wall tracking is comparable to that obtained by applanation tonometry, and it shows a better association with target organ damage than brachial blood pressure.
Abstract: OBJECTIVES Central pulse pressure (PP) has been suggested a better predictor of cardiovascular risk than brachial PP, and its routine noninvasive assessment can be useful for risk stratification. The present study evaluated the capability of a radiofrequency-based carotid wall tracking to estimate central PP from distension curves, comparing the values of carotid PP as obtained by wall tracking with those provided by applanation tonometry. Furthermore, the associations of carotid PP with intermediate markers of cardiovascular risk, like carotid intima-media thickness (IMT) and left ventricular mass (LVM), were assessed. METHODS Carotid PP was measured by wall tracking and applanation tonometry during the same session in 346 individuals (healthy controls, patients with hypertension and diabetes). IMT was measured in all individuals and LVM was measured in 253. RESULTS Carotid PP values as measured by wall tracking and applanation tonometry were highly correlated [r = 0.87; slope 0.90 (0.85-0.95); P < 0.0001; mean difference = 3.1 ± 6.8 mmHg], and were independently determined by the same variables (age, heart rate, triglycerides, blood pressure-lowering therapy). Carotid IMT and LVM correlated more strongly with carotid PP (r = 0.44 and 0.50; P < 0.0001 for both) than with brachial PP (r = 0.34 and 0.42; P < 0.0001 for both). Patients with carotid PP at least 50 mmHg had higher IMT, LVM, and prevalence of LV hypertrophy than those with PP less than 50 mmHg (P = 0.0001 to <0.0001). CONCLUSIONS Local carotid PP as estimated by wall tracking is comparable to that obtained by applanation tonometry, and it shows a better association with target organ damage than brachial blood pressure. Assessment of carotid PP during routine ultrasound examination of extracranial carotid tree may provide additional information for individual risk stratification.
8 citations
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TL;DR: This work reviews carotid artery hemodynamics in hypertensive men, with particular reference to common carotids diameter and blood flow, and emphasizes the changes in artery diameter and compliance implied by antihypertensive therapy.
Abstract: We review carotid artery hemodynamics in hypertensive men, with particular reference to common carotid artery diameter and blood flow, and emphasize the changes in artery diameter and compliance implied by antihypertensive therapy.
8 citations
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TL;DR: The authors confirm and extend the findings of previous large randomized clinical trials, such as the Anglo-Scandinavian Cardiac Outcomes Trial Blood Pressure Lowering Arm (ASCOT-BPLA) and the Losartan Intervention For Endpoint reduction in hypertension (LIFE) studies, that increased visit-to-visit blood pressure variability was predictive of fatal and nonfatal cardiovascular events independently of mean blood pressure.
Abstract: The growing interest in the variability of blood pressure is related to the repeated demonstration of its independent predictive value for organ damage and cardiovascular events. In particular, visit-to-visit blood pressure variability has gained attention from physicians since large blood pressure fluctuations from one visit to another are common observations in clinical practice, and have been related to high risk of cardiovascular complications. Several indices are available for the quantification of visit-to-visit blood pressure variability, such as standard deviation and coefficient of variation. Visit-to-visit blood pressure variability can be influenced by a number of factors, including the length of follow-up, number of measures, changes in blood pressure measurement procedures, antihypertensive drugs, patient drug adherence, and environmental conditions including seasonal changes. It is also likely to be influenced by intrinsic characteristics of the patient, among them increased arterial stiffness and/or altered baroreflex function that impairs the buffering of blood pressure changes. Visit-to-visit blood pressure variability can damage target organs, either directly in response to the mechanical effect of blood pressure variations or indirectly in association with the mechanisms at the origin of abnormal cardiovascular regulatory mechanisms leading to higher visit-to-visit blood pressure variability. Post hoc analyses of large randomized clinical trials have been performed since both office blood pressure values at repeated visits and outcomes were available. A consistent finding was that increased visit-to-visit blood pressure variability was predictive of fatal and nonfatal cardiovascular events independently of mean blood pressure. Not surprisingly, the higher the cardiovascular risk at baseline, the higher the predictive value of visit-to-visit blood pressure variability for cardiovascular events. Although the translation of these findings into clinical practice is obvious for high-risk patients, their clinical applicability remains limited in younger patients and those with a lower mean blood pressure. Indeed, these patients are generally considered as at low-risk, a statement that can revisited if visit-to-visit blood pressure variability is available. The article by Mehlum et al. published in this issue of the European Heart Journal provides an important contribution with regard to the issue of the predictive value of visit-to-visit variability in blood pressure for cardiovascular events. The authors analyzed the data of the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, a multinational randomized-controlled, double-masked trial of valsartan vs amlodipine, in 15 245 patients with hypertension and at least one additional risk factor for cardiovascular event, with a mean duration of follow-up of 4.0 years. They selected 13 803 patients who had no event during the first 6 months and had at least three visits. Visit-to-visit blood pressure variability was assessed by the standard deviation of at least three mean systolic blood pressures, each calculated from three measurements during the visit. An important finding is that patients in the highest quintile of visit-to-visit blood pressure variability had a twoto threefold higher risk of cardiovascular event than those in the lowest quintile, (ischaemic stroke, myocardial infarction, and congestive heart failure). These results were adjusted for a large number of variables, including mean systolic blood pressure during treatment. In that respect, the authors confirm and extend the findings of previous large randomized clinical trials, such as the Anglo-Scandinavian Cardiac Outcomes Trial Blood Pressure Lowering Arm (ASCOT-BPLA) and the Losartan Intervention For Endpoint reduction in hypertension (LIFE) studies, i.e. increased visit-to-visit blood pressure variability was predictive of fatal and nonfatal cardiovascular events independently of mean blood pressure. The findings of Mehlum et al. are also stimulating because associations between visit-to-visit blood pressure variability and cardiovascular events were stronger among the younger patients (i.e. aged 50–67 years) and patients with lower systolic blood pressure (i.e. <137.8
8 citations
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28,685 citations
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TL;DR: In this article, a randomized controlled trial of Aliskiren in the Prevention of Major Cardiovascular Events in Elderly people was presented. But the authors did not discuss the effect of the combination therapy in patients living with systolic hypertension.
Abstract: ABCD
: Appropriate Blood pressure Control in Diabetes
ABI
: ankle–brachial index
ABPM
: ambulatory blood pressure monitoring
ACCESS
: Acute Candesartan Cilexetil Therapy in Stroke Survival
ACCOMPLISH
: Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension
ACCORD
: Action to Control Cardiovascular Risk in Diabetes
ACE
: angiotensin-converting enzyme
ACTIVE I
: Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events
ADVANCE
: Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation
AHEAD
: Action for HEAlth in Diabetes
ALLHAT
: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart ATtack
ALTITUDE
: ALiskiren Trial In Type 2 Diabetes Using Cardio-renal Endpoints
ANTIPAF
: ANgioTensin II Antagonist In Paroxysmal Atrial Fibrillation
APOLLO
: A Randomized Controlled Trial of Aliskiren in the Prevention of Major Cardiovascular Events in Elderly People
ARB
: angiotensin receptor blocker
ARIC
: Atherosclerosis Risk In Communities
ARR
: aldosterone renin ratio
ASCOT
: Anglo-Scandinavian Cardiac Outcomes Trial
ASCOT-LLA
: Anglo-Scandinavian Cardiac Outcomes Trial—Lipid Lowering Arm
ASTRAL
: Angioplasty and STenting for Renal Artery Lesions
A-V
: atrioventricular
BB
: beta-blocker
BMI
: body mass index
BP
: blood pressure
BSA
: body surface area
CA
: calcium antagonist
CABG
: coronary artery bypass graft
CAPPP
: CAPtopril Prevention Project
CAPRAF
: CAndesartan in the Prevention of Relapsing Atrial Fibrillation
CHD
: coronary heart disease
CHHIPS
: Controlling Hypertension and Hypertension Immediately Post-Stroke
CKD
: chronic kidney disease
CKD-EPI
: Chronic Kidney Disease—EPIdemiology collaboration
CONVINCE
: Controlled ONset Verapamil INvestigation of CV Endpoints
CT
: computed tomography
CV
: cardiovascular
CVD
: cardiovascular disease
D
: diuretic
DASH
: Dietary Approaches to Stop Hypertension
DBP
: diastolic blood pressure
DCCT
: Diabetes Control and Complications Study
DIRECT
: DIabetic REtinopathy Candesartan Trials
DM
: diabetes mellitus
DPP-4
: dipeptidyl peptidase 4
EAS
: European Atherosclerosis Society
EASD
: European Association for the Study of Diabetes
ECG
: electrocardiogram
EF
: ejection fraction
eGFR
: estimated glomerular filtration rate
ELSA
: European Lacidipine Study on Atherosclerosis
ESC
: European Society of Cardiology
ESH
: European Society of Hypertension
ESRD
: end-stage renal disease
EXPLOR
: Amlodipine–Valsartan Combination Decreases Central Systolic Blood Pressure more Effectively than the Amlodipine–Atenolol Combination
FDA
: U.S. Food and Drug Administration
FEVER
: Felodipine EVent Reduction study
GISSI-AF
: Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation
HbA1c
: glycated haemoglobin
HBPM
: home blood pressure monitoring
HOPE
: Heart Outcomes Prevention Evaluation
HOT
: Hypertension Optimal Treatment
HRT
: hormone replacement therapy
HT
: hypertension
HYVET
: HYpertension in the Very Elderly Trial
IMT
: intima-media thickness
I-PRESERVE
: Irbesartan in Heart Failure with Preserved Systolic Function
INTERHEART
: Effect of Potentially Modifiable Risk Factors associated with Myocardial Infarction in 52 Countries
INVEST
: INternational VErapamil SR/T Trandolapril
ISH
: Isolated systolic hypertension
JNC
: Joint National Committee
JUPITER
: Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin
LAVi
: left atrial volume index
LIFE
: Losartan Intervention For Endpoint Reduction in Hypertensives
LV
: left ventricle/left ventricular
LVH
: left ventricular hypertrophy
LVM
: left ventricular mass
MDRD
: Modification of Diet in Renal Disease
MRFIT
: Multiple Risk Factor Intervention Trial
MRI
: magnetic resonance imaging
NORDIL
: The Nordic Diltiazem Intervention study
OC
: oral contraceptive
OD
: organ damage
ONTARGET
: ONgoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial
PAD
: peripheral artery disease
PATHS
: Prevention And Treatment of Hypertension Study
PCI
: percutaneous coronary intervention
PPAR
: peroxisome proliferator-activated receptor
PREVEND
: Prevention of REnal and Vascular ENdstage Disease
PROFESS
: Prevention Regimen for Effectively Avoiding Secondary Strokes
PROGRESS
: Perindopril Protection Against Recurrent Stroke Study
PWV
: pulse wave velocity
QALY
: Quality adjusted life years
RAA
: renin-angiotensin-aldosterone
RAS
: renin-angiotensin system
RCT
: randomized controlled trials
RF
: risk factor
ROADMAP
: Randomized Olmesartan And Diabetes MicroAlbuminuria Prevention
SBP
: systolic blood pressure
SCAST
: Angiotensin-Receptor Blocker Candesartan for Treatment of Acute STroke
SCOPE
: Study on COgnition and Prognosis in the Elderly
SCORE
: Systematic COronary Risk Evaluation
SHEP
: Systolic Hypertension in the Elderly Program
STOP
: Swedish Trials in Old Patients with Hypertension
STOP-2
: The second Swedish Trial in Old Patients with Hypertension
SYSTCHINA
: SYSTolic Hypertension in the Elderly: Chinese trial
SYSTEUR
: SYSTolic Hypertension in Europe
TIA
: transient ischaemic attack
TOHP
: Trials Of Hypertension Prevention
TRANSCEND
: Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease
UKPDS
: United Kingdom Prospective Diabetes Study
VADT
: Veterans' Affairs Diabetes Trial
VALUE
: Valsartan Antihypertensive Long-term Use Evaluation
WHO
: World Health Organization
### 1.1 Principles
The 2013 guidelines on hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology …
14,173 citations
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TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
13,400 citations
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TL;DR: 2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the management of Arterspertension of the European Society ofhypertension (ESH) and of theEuropean Society of Cardiology (ESC).
Abstract: 2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
9,932 citations
01 Jan 2014
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Abstract: XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.
9,618 citations