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Recommandations sur la mesure de la pression artérielle. Consensus d’experts de la Société française d’hypertension artérielle, filiale de la Société française de cardiologie

Thierry Denolle 1 Roland Asmar 2 Jean-Marc Boivin 3 Xavier Girerd 4 Sylvain Le Jeune 5 Bernard Vaisse 6 Yara Antakly-Hanon 2 Mathieu Artifoni 7 André Atallah 2 Christophe Bachelet 2 Nicolas Barber-Chamoux 8 Theodora Bejan-Angoulvant 9 Jacques Blacher 10 Romain Boulestreau 11 François Chantrel 12 Yves Dimitrov 13 Gérard Doll 2 Giselle Dugelay 3 Béatrice Duly-Bouhanick 2 Philippe Gosse 14 Dominique Guerrot 15, 16 Faiçal Jarraya 17 Guillaume Lamirault 18 Benoît Lequeux 19 Marilucy Lopez-Sublet 5 Alain Mercier 2 Laurène Millet 2 Claire Mounier-Vehier 20 Jean-Jacques Mourad 21 Edgar Nasr 2 Olivier Ormezzano 22 Laurence Perez 23 Alexandre Persu 24 Jean Ribstein 25 François Silhol 6 Philippe Sosner 26 Elisabeth Steyer 2 Mohamed Temmar 2 Philippe van de Borne 27 Emmanuelle Vidal-Petiot 28, 29 
10 CRESS - U1153 - Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle
UP13 - Université Paris 13, INRA - Institut National de la Recherche Agronomique : UMR1125, CNAM - Conservatoire National des Arts et Métiers [CNAM], CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
Abstract : Since 2016, the French Society of Hypertension has warned about the decline in the management of high blood pressure in France: stagnation, or even decreased number of people who know their blood pressure level, take a treatment and are controlled. These results are lower than those observed in many other countries. Blood pressure is measured with an old method in the doctor's office. Accepted, simple and cost-effective, this method is currently unavoidable for reasons of feasibility and social habit. It has been used in observational and intervention studies that are the basis of the medical reasoning for screening, treatment and drug control of hypertension. In practice, it is too often poorly applied and unpredictable. It is now necessary to measure blood pressure in mmHg using a validated oscillometric automatic device coupled to a specific upper arm cuff adapted to the arm circumferences for the diagnosis and monitoring of high blood pressure in the doctor's office and at home. The auscultatoric measurement is only recommended if any doubt about the reliability of the electronic measurement. Blood pressure measurement is basically performed on both arms to detect asymmetry and then on the arm with the highest blood pressure. It is performed in sitting or lying position after a few minutes of rest without speaking and without having smoked and then in standing position to diagnose orthostatic hypotension, especially in elderly, diabetic and multi-medicated subjects. The blood pressure measurement during the consultation must be repeated and include at least 3 consecutive measurements at one minute intervals. The average of the last 2 measurements determines the blood pressure level. It is recommended to perform BP measurements outside the medical environment for the diagnosis and monitoring of hypertension; Home BP measurement is preferred to ambulatory blood pressure measurement for practical reasons unless otherwise specified. The home blood pressure measurement should include three measurements in the morning at breakfast and three measurements in the evening before bedtime at one minute intervals for at least three days. Prior training must be provided. In treated hypertensive patients, a masked hypertension should be considered as an uncontrolled hypertension and antihypertensive therapy adapted accordingly. The measurement of central BP pressure (aorta) should be limited to clinical research.
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Thierry Denolle, Roland Asmar, Jean-Marc Boivin, Xavier Girerd, Sylvain Le Jeune, et al.. Recommandations sur la mesure de la pression artérielle. Consensus d’experts de la Société française d’hypertension artérielle, filiale de la Société française de cardiologie. La Presse Médicale, 2019, 48 (11), pp.1319-1328. ⟨10.1016/j.lpm.2019.09.060⟩. ⟨inserm-02444984⟩



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