IS SCHEDULED HOSPITALIZATION OVER A DETER MINED PERIOD STILL JUSTIFIED IN CASE OF ARTERIAL-HYPERTENSION

To general practitioners' request, a 36-hour scheduled hospitalization over a determined period (SHDP) was set up to assess the effects and the etiology of the arterial hypertensions they had detected and to pr opose an appropriate treatment. From November 1988 to December 1990, 2 77 patients (156 male/121 female) with mean age of 44,7 +/- 14,5 were thus hospitalized over a determined period. All of them underwent 24-h our semi-ambulatory blood pressure monitoring (Bard Sentron) by using the oscillometric method, which permits to measure mean blood pressure (MBP) instead of calculating it. This 24-hour MBP was on average of 1 08,5 +/- 16,2 mmHg and not significantly different from daytime MBP (1 11 +/- 16,3 mmHg). Figures of MBP superior to 105 mmHg confirmed perma nent HBP (High Blood Pressure). On the 277 patients, 46 (16 %) had a n ormal MBP, 67 (24 %) had a ''borderline'' MBP (between 96 and 105 mmHg ). A severe HBP (MBP > 125 mmHg) found in 66 cases (23 %) was confirme d by visceral impairment. Left ventricular hypertrophy (LVH) was detec ted in 12 cases (4.3 %) on the chest radiograph, in 24 cases (8.6 %) o n the ECG and in 75 cases (27 %) on the echocardiogram. The etiologica l assessment revealed 10 cases (3.61 %) of secondary hypertension with 3 reno-vascular HBP and 2 Conn's adenomas. Eventually, therapeutic ab stention was recommended in 57 patients (20.5 %) though 20 of them had previously received antihypertensive therapy. All in all, SHDP permit s a more accurate determination of the consequences and severity of HB P. The small number of secondary HBP reflects the proportion found in practice. It confirms the need for a screening consultation before adm ission. The technique, adopted from January 1991 on, has permitted to detect a higher proportion of secondary HBP. As to therapy, SHDP has l ed to therapeutic abstention in one fifth of cases, thus justifying fu rther investigations.