L’hypertension artérielle au cours de la maladie de Takayasu : à propos d’une série monocentrique de 279 patients

Mammeri, A.; Guermaz, R.; Hatri, A.; Kessal, F.; Taharboucht, S.; Hamrour, F.; Ammi, Myriam; Zekri, S.; Brouri, M.

doi:10.1016/j.ancard.2017.04.006

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…In Algeria, the study of Mammeri et al hypertension was severe in 54% of patients and responsible for 70% of deaths [8].…”

Section: Discussionmentioning

confidence: 98%

“…In the Maghreb, the incidence is imprecise but a study conducted in 2009 collected 378 cases [7]. In Algeria, there have been no epidemiological studies, however several cases have been reported, revealed in particular by hypertension in the young subject (more than 279 cases of TD) [8].…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective nonrandomized study in a single center was conducted from April 2006 to July 2014; sixty three (63) Patients were treated for Takayasu disease. These patients were admitted to vascular surgery department at Oran University Hospital November 1st 1954; validate the criteria of the American College of Rheumatology (ACR) [8]. We received patients referred by internal medicine or cardiology department for the management of hypertension resistant to medical treatment with vascular lesions.…”

Section: Methodsmentioning

confidence: 99%

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Hypertension and Takayasu Disease

2019

COA

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Introduction: Takayasu’s disease (TD) is a primary, inflammatory, rare, segmental and multifocal arteritis of the aorta and its branches, of unknown etiopathogenesis. Hypertension is a major complication, sometimes revealing the disease, whose mechanisms are multiple, dominated by the lesion of the aorta and renal arteries. Patients and methods: We report a series of 63 cases treated for Takayasu’s disease resulting from a monocentric, retrospective study from April 2oo6- July 2014, with an average age of 30 years with a female predominance of 83%. Result: In our series: 51 patients with hypertension, including 29 (57%) resistant hypertension (under tri see quadritherapy). In 87% of cases lesion of the supra aortic trunk, 29% with aortic lesions and renal arteries, 7.93% with isolated renal arteries and 7% with aortic coarctation cases, valvular heart disease in 7% of cases. Association with tuberculosis in 7.93% of cases and a dysthyroidism in 11.1% of cases. That 49% benefited from surgical treatment. Discussion: Involvement of the aorta and renal arteries seen in half of patients with TD is the leading cause of hypertension. In general, hypertension is severe, not or poorly controlled by medical treatment and is accompanied by cardiac and renal repercussions. Conclusion: Hypertension is common during TD; it is a poor prognostic factor, more serious than the cause is renovascular. Early diagnosis and appropriate therapy will help to prevent a handicap, which is sometimes major for these patients, most of whom are young. Surgical treatment of renal and aortic lesions of TD is indicated when there is severe hypertension, not or poorly controlled by heavy medical treatment, and the indications should be weighed well. The spontaneous evolution in these patients is burdened with a not insignificant mortality. Management and therapeutic decisions must be multidisciplinary.

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“…In Algeria, the study of Mammeri et al hypertension was severe in 54% of patients and responsible for 70% of deaths [8].…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Hypertension and Takayasu Disease

2019

COA

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“…Previous studies have reported that hypertension occurred in 33–83% of TAK patients, with younger disease onset age (mostly < 40 years) [ 7 – 10 , 21 ]. One former study even indicated that a combination of hypertension and elevated erythrocyte sedimentation rate (ESR) was useful for diagnosing TAK in patients < 18 years of age [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension is a particularly important complication in patients with TAK [4][5][6]. According to previous reports, hypertension occurred in 33-83% of patients with TAK from different areas of the world, with younger age of disease onset [7][8][9][10]. The occurrence of hypertension could severely worsen TAK prognosis and may be a significant prognostic predictor of outcomes [11].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics, imaging phenotypes and events free survival in Takayasu arteritis patients with hypertension

Sun

Wang

et al. 2021

Arthritis Res Ther

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Background Hypertension occurred in 30–80% of Takayasu arteritis (TAK) patients around the world and the occurrence of hypertension might worsen the disease prognosis. This study aimed to investigate the clinical characteristics and imaging phenotypes, as well as their associations with events free survival (EFS) in Chinese TAK patients with hypertension. Methods This current research was based on a prospectively ongoing observational cohort-the East China Takayasu Arteritis (ECTA) cohort, centered in Zhongshan Hospital, Fudan University. Totally, 204 TAK patients with hypertension were enrolled between January 2013 and December 2019. Clinical characteristics and imaging phenotypes of each case were evaluated and their associations with the EFS by the end of August 30, 2020, were analyzed. Results Severe hypertension accounted for 46.1% of the entire population. Three specific imaging phenotypes were identified: Cluster 1: involvement of the abdominal aorta and/or renal artery (27.5%); Cluster 2: involvement of the ascending aorta, thoracic aorta, the aortic arch, and/or its branches (18.6%); and Cluster 3: combined involvement of Cluster 1 and 2 (53.9%). Clinical characteristics, especially hypertensive severity, differed greatly among the three imaging clusters. In all, 187 patients were followed up for a median of 46 (9–102) months; 72 events were observed in 60 patients (1–3 per person). The overall blood pressure control rate was 50.8%, and the EFS was 67.9% by the end of the follow-up. Multivariate Cox regression indicated that controlled blood pressure (HR = 2.13, 95% CI 1.32–3.74), Cluster 1 (HR = 0.69, 95% CI 0.48–0.92) and Cluster 3 (HR = 0.72, 95% CI 0.43–0.94) imaging phenotype was associated with the EFS. Kaplan–Meier curves showed that patients with controlled blood pressure showed better EFS (p = 0.043). Furthermore, using cases with Cluster 1 imaging phenotype and controlled blood pressure as reference, better EFS was observed in patients with Cluster 2 phenotype and controlled blood pressure (HR = 2.21, 95%CI 1.47–4.32), while the case with Cluster 1 phenotype plus uncontrolled blood pressure (HR = 0.64, 95%CI 0.52–0.89) and those with Cluster 3 phenotype and uncontrolled blood pressure (HR = 0.83, 95%CI 0.76–0.92) suffered worse EFS. Conclusion Blood pressure control status and imaging phenotypes showed significant effects on the EFS for TAK patients with hypertension.

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The presentation and management of hypertension in a large cohort of Takayasu arteritis

Yang

Zhang

et al. 2017

Clin Rheumatol

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The objective of this study was to explore the presentation and management of hypertension secondary to Takayasu arteritis (TA) in a large cohort, single center in China. We retrospectively analyzed 381 TA patients with hypertension hospitalized in Fuwai hospital between Jan. 2004 and Feb. 2014. Diagnosis of hypertension was according to clinic blood pressure or the central blood pressure measured during angiography. Renal artery stenosis was the most common cause (264, 69.3%), followed by the thoracic descending aorta stenosis (98, 25.7%), abdominal aorta stenosis (78, 20.5%), and severe aortic regurgitation (45, 11.8%). More than two kinds of pathologies were found in 98 (25.7%) patients. The mean age of hypertension onset was 25.0 ± 14.3 years. The mean blood pressure of upper extremity in patients without bilateral subclavian artery stenosis (321, 84.3%) was 176.0 ± 29.4 mmHg/97.2 ± 23.0 mmHg, while in 60 (15.7%) patients with bilateral subclavian artery stenosis, the mean central blood pressure was 192.7 ± 30.8 mmHg/102.4 ± 121.1 mmHg. A total of 305 were followed for 38.4 ± 36.7 months, and the rate of blood pressure control, improvement, and failure was 50.8, 41.0, and 8.2%, respectively. Immunosuppressive therapy (OR 2.402, 95% confidence interval 1.253-4.603, P = 0.008) and the pathogenesis of hypertension (P = 0.010) were associated with prognosis of hypertension. The pathogenesis of hypertension due to TA is very complex and multifactorial. Renal artery stenosis is most frequently observed, followed by stenosis of the thoracic descending aorta, abdominal aorta, and severe aortic regurgitation. Immunosuppressive therapy and identifying the pathogenesis of hypertension is of great importance in patients with TA.

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L’hypertension artérielle au cours de la maladie de Takayasu : à propos d’une série monocentrique de 279 patients

Cited by 7 publications

References 21 publications

Hypertension and Takayasu Disease

Hypertension and Takayasu Disease

Clinical characteristics, imaging phenotypes and events free survival in Takayasu arteritis patients with hypertension

The presentation and management of hypertension in a large cohort of Takayasu arteritis

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