[Arterial pressure after transplantation]

Following organ transplantation, repeated measurements of blood pressure are an essential part of monitoring as they enable arterial hypertension, the most frequent complication in these patients, to be detected and treated at an early stage. De novo occurrence of arterial hypertension, directly due to the use of cyclosporin, is observed in more than two-thirds of these patients during the first post-transplantation year. This predominantly diastolic arterial hypertension is usually mild to moderate, but it has repercussions on graft function and requires a specific treatment appropriate to the severity of arterial hypertension and to its physiological mechanism depending on the organ transplanted. Arterial hypertension is caused by the nephrotoxicity of cyclosporin and by its intrarenal and peripheral vasoconstrictive activity. Stimulation of the renin-angiotensin system associated with stimulation of the sympathetic system and blood volume expansion play a major role in the genesis and maintenance of de novo arterial hypertension which constitutes a new model of drug-induced hypertension. Treatment of de novo arterial hypertension rests on arteriole-dilating antihypertensive drugs such as calcium channel blockers or angiotensin-converting enzyme inhibitors used as first-line therapy and sometimes combined with another drug. In case of severe and uncontrolled arterial hypertension, the other classes of antihypertensive drugs can be used as second treatment.