{"id":11507,"date":"2025-11-08T04:05:46","date_gmt":"2025-11-08T03:05:46","guid":{"rendered":"https:\/\/rvh-synergie.org\/actualites\/une-reduction-intensive-de-la-tension-arterielle-pourrait-beneficier-a-presque-tous-les-adultes-atteints-dinsuffisance-renale-chronique-hypertensive\/"},"modified":"2025-11-08T04:05:47","modified_gmt":"2025-11-08T03:05:47","slug":"une-reduction-intensive-de-la-tension-arterielle-pourrait-beneficier-a-presque-tous-les-adultes-atteints-dinsuffisance-renale-chronique-hypertensive","status":"publish","type":"post","link":"https:\/\/rvh-synergie.org\/actualites\/une-reduction-intensive-de-la-tension-arterielle-pourrait-beneficier-a-presque-tous-les-adultes-atteints-dinsuffisance-renale-chronique-hypertensive\/","title":{"rendered":"Une r\u00e9duction intensive de la tension art\u00e9rielle pourrait b\u00e9n\u00e9ficier \u00e0 presque tous les adultes atteints d\u2019insuffisance r\u00e9nale chronique hypertensive"},"content":{"rendered":"
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Une analyse de l’essai d’intervention sur la pression art\u00e9rielle systolique (SPRINT) indique que presque tous les adultes atteints d’insuffisance r\u00e9nale chronique (IRC) b\u00e9n\u00e9ficieraient d’avantages qui l’emporteraient sur les inconv\u00e9nients d’un objectif de tension art\u00e9rielle systolique <120 mm Hg par rapport \u00e0 un objectif de <140 mm Hg. Les r\u00e9sultats seront pr\u00e9sent\u00e9s lors de l\u2019ASN Kidney Week 2025 du 5 au 9 novembre.<\/p>\n

Dans une analyse des avantages et des inconv\u00e9nients portant sur 2 012 participants atteints d’IRC, les enqu\u00eateurs ont constat\u00e9 qu’en pr\u00e9disant les effets individualis\u00e9s du traitement pour de multiples r\u00e9sultats et en simulant les pr\u00e9f\u00e9rences des participants qui consid\u00e8rent les avantages d’une r\u00e9duction intensive de la tension art\u00e9rielle (r\u00e9duction des d\u00e9c\u00e8s, des \u00e9v\u00e9nements cardiovasculaires et des troubles cognitifs) comme beaucoup plus importants que les inconv\u00e9nients li\u00e9s au traitement (tels que les visites aux urgences ou les hospitalisations pour une l\u00e9sion r\u00e9nale aigu\u00eb et des \u00e9vanouissements), 100 % pr\u00e9sentaient un b\u00e9n\u00e9fice net positif en faveur d’une r\u00e9duction intensive de la tension art\u00e9rielle.<\/p>\n

En simulant les avantages et les inconv\u00e9nients pour qu\u2019ils aient une importance similaire et interm\u00e9diaire, 9 personnes sur 10 pr\u00e9sentaient toujours un avantage net positif.<\/p>\n

Compar\u00e9 aux personnes atteintes d’une maladie r\u00e9nale chronique \u00e0 un stade pr\u00e9coce (d\u00e9bit de filtration glom\u00e9rulaire estim\u00e9 (45 \u00e0 59 ml\/min\/1,73 m2<\/sup>), les personnes atteintes d’une maladie r\u00e9nale chronique plus avanc\u00e9e (20 \u00e0 44 ml\/min\/1,73 m2<\/sup>) ont subi davantage de pr\u00e9judices li\u00e9s au traitement en raison d’un objectif de tension art\u00e9rielle systolique plus faible\u00a0; cependant, ils ont \u00e9galement eu des b\u00e9n\u00e9fices plus importants, ce qui a permis au groupe MRC le plus avanc\u00e9 de b\u00e9n\u00e9ficier de b\u00e9n\u00e9fices nets plus importants.<\/p>\n

Les r\u00e9sultats, qui sont conformes aux lignes directrices KDIGO qui recommandent un objectif de pression art\u00e9rielle systolique <120 mm Hg pour les adultes souffrant d'hypertension et d'IRC, pourraient aider les patients et les partenaires de soins \u00e0 surmonter l'inertie th\u00e9rapeutique qui se produit g\u00e9n\u00e9ralement lors de l'intensification du contr\u00f4le de la pression art\u00e9rielle chez les adultes atteints d'IRC.<\/p>\n

\u00ab\u00a0Cette \u00e9tude d\u00e9montre que les preuves concernant les objectifs de pression art\u00e9rielle de SPRINT peuvent \u00eatre personnalis\u00e9es pour les adultes souffrant d’hypertension et d’IRC en utilisant les risques estim\u00e9s et les pr\u00e9f\u00e9rences de chaque individu pour de multiples r\u00e9sultats li\u00e9s \u00e0 la baisse de la tension art\u00e9rielle, ce qui pourrait aider \u00e0 faciliter les conversations d\u00e9cisionnelles partag\u00e9es\u00a0\u00bb, a d\u00e9clar\u00e9 l’auteur correspondant Alan Vera, \u00e9tudiant en m\u00e9decine \u00e0 l’Universit\u00e9 de Californie Davis.<\/p>\n

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