Hipertensión最新文献

{"title":"Repercusión sobre la función renal de los fármacos antihipertensivos utilizados en ancianos con hipertensión arterial esencial","authors":"M. Heras ,&nbsp;M.J. Fernández-Reyes ,&nbsp;R. Sánchez ,&nbsp;M.T. Guerrero ,&nbsp;F. Prado ,&nbsp;F. Álvarez-Ude","doi":"10.1016/S0212-8241(08)75978-4","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)75978-4","url":null,"abstract":"<div><h3>Introducción</h3><p>La hipertensión arterial (HTA) es una patología prevalente en ancianos. La presión arterial no controlada conlleva aumento de la morbimortalidad y es un factor de riesgo para progresión del daño renal.</p></div><div><h3>Pacientes y métodos</h3><p>Estudiamos 66 ancianos hipertensos esenciales. Realizamos un corte transversal con un seguimiento prospectivo durante un año de la clínica y de la función renal, manteniendo el mismo tratamiento antihipertensivo basal. Se estima el filtrado glomerular basal y al año a partir de fórmulas derivadas de creatinina sérica (Cockroft y MDRD) y la proteinuria. Se valoran los antihipertensivos que producen alteraciones en la función renal al año. Definimos el incremento de creatinina sérica como (creatinina sérica al año-creatinina sérica basal) ≥0,1 mg/dl. Analizamos en el análisis multivariante los factores independientes que justifiquen el incremento de creatinina sérica.</p></div><div><h3>Resultados</h3><p>La HTA es más frecuente en las mujeres. La mayoría de estos pacientes precisa de dos o más antihipertensivos. Los diuréticos son el agente antihipertensivo más pautado. Los diuréticos son los únicos fármacos que producen variaciones de la función renal (elevación de la creatinina sérica, y por ende, descenso del filtrado glomerular).</p></div><div><h3>Conclusiones</h3><p>Los diuréticos, los antihipertensivos más utilizados en ancianos, producen aumento de la creatinina sérica. La estimación de filtrado glomerular con fórmulas a partir de creatinina sérica deberían usarse con cautela en ancianos para no interpretar erróneamente la enfermedad renal en esta población.</p></div><div><h3>Purpose</h3><p>Hypertension is a prevalent pathology in elderly patients. Uncontrolled blood pressure causes increased morbidity and mortality, it being a risk factor for progression of renal damage.</p></div><div><h3>Patients and methods</h3><p>A total of 66 elderly essential hypertensive subjects were studied. A cross-sectional cut-off was made with a one-year prospective followup of the symptoms and renal functioning while maintaining the same baseline antihypertensive treatment. Glomerular filtration was estimated at baseline and one year based on serum creatinine derived formulae (Cockroft and MDRD) and proteinuria. Those antihypertensive agents that cause alterations in renal function at one year were evaluated. We defined increase in serum creatinine as (serum creatinine at 1 year-baseline serum creatinine) ≥0,1 mg/dl. The independent factors that justify the increase in serum creatinine were analyzed in the multivariate analysis.</p></div><div><h3>Results</h3><p>Hypertension is more common in women. Most of these patients require two or more antihypertensive agents, the most common being diuretics. Diuretics are the only drugs that produce alterations in renal function (increase of the serum creatinine, and therefore, decrease glomerular filtration).</p></div><div><h3>Conclusions</h3><p>Diure","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 5","pages":"Pages 194-197"},"PeriodicalIF":0.0,"publicationDate":"2008-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)75978-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137085188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/S0212-8241(08)75982-6","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)75982-6","url":null,"abstract":"","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 5","pages":"Pages 218-224"},"PeriodicalIF":0.0,"publicationDate":"2008-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)75982-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137084561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hipertensión arterial e ictus: Encadenados y Sin perdón","authors":"C. Sierra","doi":"10.1016/S0212-8241(08)75976-0","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)75976-0","url":null,"abstract":"","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 5","pages":"Pages 185-186"},"PeriodicalIF":0.0,"publicationDate":"2008-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)75976-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137085190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repermeabilización de estenosis de arteria renal en paciente con síndrome nefrótico secundario a síndrome antifosfolípido primario. Una inusual presentación clínica","authors":"M. Polaina Rusillo ,&nbsp;M.M. Biechy Baldán ,&nbsp;A. Liébana Cañada ,&nbsp;J. Vallejo Miñarro ,&nbsp;F. Cazalla Cadenas ,&nbsp;V. Pérez Bañasco","doi":"10.1016/S0212-8241(08)75981-4","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)75981-4","url":null,"abstract":"<div><p>El síndrome antifosfolípido primario (SAFP) es una entidad clínica que tiene como manifestación más frecuente desde el punto de vista renal la hipertensión, mientras que el síndrome nefrótico es infrecuente. La prevalencia de estenosis de arteria renal en este síndrome es desconocida, al igual que su evolución y tratamiento.</p><p>Desde el punto de vista terapéutico, en el SAFP está indicada la anticoagulación con dicumorínicos para lograr una ratio normalizada internacional (INR) &gt;3 para evitar que progresen los eventos trombóticos y la enfermedad renal.</p><p>A continuación presentamos el caso de un varón de 30 años que diagnosticamos de síndrome antifosfolípido primario que a pesar de presentar una trombosis de arteria renal presentó un ligero deterioro de la función renal sin hipertensión.</p></div><div><p>Primary antiphospholipid syndrome (PAPS) is a clinical condition whose most frequent manifestation from the renal point of view is hypertension, nephrotic syndrome being a rare presentation form. The prevalence of renal artery stenosis in this syndrome as well as its evolution and treatment are unknown.</p><p>From the therapeutic point of view, anticoagulation with dicumorinics is indicated in PAPS. An attempt should be made to obtain an international normalized ratio (INR) &gt; 3 to prevent progression of the thrombotic events and renal disease.</p><p>We present the case of a 30-year old male diagnosed of primary antiphospholipid syndrome. In spite of having renal artery thrombosis, he had a mild deterioration of renal function without hypertension.</p></div>","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 5","pages":"Pages 214-217"},"PeriodicalIF":0.0,"publicationDate":"2008-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)75981-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137085185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La inercia clínica profesional y el incumplimiento farmacológico: ¿cómo influyen en el control de la hipertensión arterial? Estudio CUMAMPA","authors":"E. Márquez Contreras ,&nbsp;J.L. Martín de Pablos ,&nbsp;V. Gil Guillén ,&nbsp;N. Martel Claros ,&nbsp;J. Motero Carrasco ,&nbsp;J.J. Casado Martínez ,&nbsp;en representación del grupo de trabajo sobre Cumplimiento de la Asociación de la Sociedad Española de Hipertensión,&nbsp;Liga Española para la Lucha contra la Hipertensión Arterial","doi":"10.1016/S0212-8241(08)75977-2","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)75977-2","url":null,"abstract":"<div><h3>Objetivo</h3><p>Comprobar si el cumplimiento del tratamiento farmacológico de la hipertensión (HTA) y la inercia clínica terapéutica (ICT) influyen en las cifras de presión arterial (PA) y en el control de la HTA.</p></div><div><h3>Material y método</h3><p>Estudio longitudinal realizado en Atención Primaria con seguimiento de 6 meses. Se incluyeron 350 hipertensos no controlados. Recibieron un OMRON y un monitor electrónico para control de medicación (MEMS-Aardex). Se calcularon las cifras medias de PA y el grado de control por automedición domiciliaria de la PA (AMPA) según su cumplimiento y presencia de ICT.</p></div><div><h3>Resultados</h3><p>Finalizaron 302 pacientes. Fueron cumplidores globalmente el 86,09 % con un intervalo de confianza (IC) de ± 3,91 %, n=260 y presentaron ICT según la PA clínica el 40,39 % de los pacientes (IC: ±5,34 %; n = 122) y según las medidas domiciliarias el 34,43 % (IC: ± 5,04 %; n=104). Las PA medias fueron menores en los pacientes cumplidores respecto a los pacientes sin ICT. El porcentaje de individuos controlados por AMPA fue del 33,1 % (n = 100) en el primer mes, el 53,64 % (n = 162) en el tercer mes y al final del estudio fue del 61,58 % (n=186) (IC: ±5,48 %). Se observaron mayores diferencias en el control en cumplidores respecto a incumplidores que en pacientes con y sin inercia clínica.</p></div><div><h3>Conclusiones</h3><p>El cumplimiento terapéutico y la ICT influyen en las cifras domiciliarias de PA y en el control de la HTA, aunque influye más relevantemente, de forma individual, el incumplimiento</p></div><div><h3>Objective</h3><p>To evaluate the influence of antihypertensive therapy compliance and clinical therapeutical inertia (CTI) on home blood pressure measurement (HBPM) and control of arterial hypertension (AHT).</p></div><div><h3>Material and method</h3><p>A longitudinal study conducted in primary health care centers, with a 6-month follow-up. A total of 350 patients with uncontrolled hypertension were included. All patients received an OMRON and an electronic monitor to control the medication (MEMS-Aardex). Mean values of BP, and grade of control by Ambulatory Blood Pressure Measurement (ABPM) according to compliance and presence of CTI were calculated.</p></div><div><h3>Results</h3><p>A total of 302 patients completed the study. Overall, 86.09 % (CI: ± 3.91 %) were compliers and CTI according to the clinical BP was present in 40.39 % of the patients (IC: ± 5.34 %; n = 122) and according to the home measurements in 34.43 % (CI: 5.04 %; n = 104). Mean HBPM were lower in the compliant group in respect to without CTI. The percentage of patients controlled was 33.1% 53.64% and 61.58% (first, second and third month) with greater differences in the degree of control of AHT in compliant patients in respect to noncompliers that in patients with or without CTI.</p></div><div><h3>Conclusions</h3><p>Therapeutic compliance and CTI influence BP and the degree of control of AHT measured by HBPM. I","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 5","pages":"Pages 187-193"},"PeriodicalIF":0.0,"publicationDate":"2008-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)75977-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137085189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts de la XIV reunión de la sociedad catalana de hipertensión arterial y XX jornadas catalanas sobre hipertensión arterial","authors":"","doi":"10.1016/S0212-8241(08)70891-0","DOIUrl":"10.1016/S0212-8241(08)70891-0","url":null,"abstract":"","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 4","pages":"Pages 151-168"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)70891-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"105265471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/S0212-8241(08)70894-6","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)70894-6","url":null,"abstract":"","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 4","pages":"Pages 180-184"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)70894-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136425981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administración temporalizada de fármacos antihipertensivos. Primeros pasos desde una consulta rural de Atención Primaria","authors":"M.L. Lafuente,&nbsp;A. Cabal,&nbsp;F. López","doi":"10.1016/S0212-8241(08)70890-9","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)70890-9","url":null,"abstract":"<div><h3>Introducción y objetivos</h3><p>El conocimiento del perfil circadiano de la presión arterial en los hipertensos nos permite introducir el concepto «tiempo» en la administración de los medicamentos: la cronoterapia. Analizado el perfil circadiano de nuestros hipertensos introdujimos cambios en la hora de administración de fármacos en los non dipper, sin modificar las dosis ni cambiar los fármacos, para valorar el impacto de esta medida.</p></div><div><h3>Pacientes y métodos</h3><p>Estudio observacional prospectivo. Tras la realización de una primera monitorización ambulatoria de la presión arterial (MAPA) a aquellos hipertensos que presentaron un patrón no reductor de la tensión arterial se les modificó el horario de administración de su medicación (todos ellos la tomaban al desayunar) y se les pasó a la comida, merienda o cena. Tras un período de 3 meses se realizó una nueva MAPA.</p></div><div><h3>Resultados</h3><p>Del total de 121 pacientes, 43 presentaron un patrón nocturno de la presión arterial no reductor. A todos estos se les modificó el horario de administración de su tratamiento habitual y, en casos de politerapia, de uno de los fármacos. Pasados 3 meses se iniciaron las reevaluaciones mediante una nueva MAPA. De estos 43 pacientes, el 60% cambió a dipper.</p></div><div><h3>Conclusiones</h3><p>Considerar el horario de ingesta de la medicación puede ser una de las variables en la toma de decisiones del manejo de nuestros pacientes hipertensos no reductores, con lo que podríamos mejorar su pronóstico vital.</p></div><div><h3>Introduction and objective</h3><p>Knowing the blood pressure circadian profile in hypertensive patients allows us to introduce the concept of «time» into drugs administration, this being called chronotherapy. After having analyzed the circadian profile of our hypertensive patients, we introduced changes into the time when the drug was administered in the non-dipper subjects, without modifying nor changing the drugs nor their dose, to evaluate the impact of this measurement.</p></div><div><h3>Patients and methods</h3><p>An observational prospective study was conducted. After having performed the first ambulatory blood pressure monitoring (ABPM), time of administration of the medication (all of them were taking it at breakfast) was modified, changing it to lunch, afternoon snack or dinner. A new ABPM was performed after a 3 month period.</p></div><div><h3>Results</h3><p>A total of 43 patients (n=121) had non-reduced nocturnal blood pressure (non-dipper). Time of drug administration was modified in all of them. In the case of multiple drug therapy, one drug was modified. At 3 months, reevaluations were initiated by means of a new ABPM. Sixty percent of the 43 patients changed to dipper.</p></div><div><h3>Conclusions</h3><p>Considering the schedule in the taking of the medication may be one of the variables to be used in the decision making in the management of our hypertensive patients with non-reduced nocturnal ","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 4","pages":"Pages 147-150"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)70890-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136603013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vómitos persistentes en mujer hipertensa","authors":"V. Giner Galvañ ,&nbsp;L. Tomás Gil ,&nbsp;A. Ragheb ,&nbsp;M.J. Esteban Giner","doi":"10.1016/S0212-8241(08)70893-4","DOIUrl":"https://doi.org/10.1016/S0212-8241(08)70893-4","url":null,"abstract":"<div><p>Numerosos documentos insisten en la necesidad de un control estricto de la presión arterial (PA). Contrasta la escasa información publicada al respecto de la reducción tensional estricta y sus potenciales consecuencias negativas. Presentamos una paciente con hipertensión arterial (HTA) crónica esencial en tratamiento farmacológico y dos ingresos hospitalarios por vómitos secundarios a hiponatremia (hNa+) por tiazidas. Discutimos las causas más comunes de hNa+ en el paciente hipertenso, igualmente con muy escasa bibliografía. El caso expuesto ilustra varios errores comunes en la praxis clinica habitual: erróneo diagnóstico de HTA por incorrecta técnica de medida de la PA, inicio precoz de tratamiento farmacológico basado únicamente en valores de PA e inadecuado empleo de la automedida domiciliaria de PA (AMPA). Todo ello llevó a una iatrogenia y a la realización de maniobras invasivas en una paciente con una HTA de bata blanca donde se echa de menos un abordaje menos fragmentario y más acorde con las guías terapéuticas en uso.</p></div><div><p>Many documents stress the need for strict control of blood pressure (BP) on the contrary to the scarce information published regarding strict tension reduction and its potential negative consequences.We present a patient suffering chronic essential AHT under drug treatment and with two admissions to hospital due to vomiting secondary to hyponatremia (hNa+) due to thiazides. We discuss the most common causes of hNa+ in the hypertensive patient, this also being very scarce in the literature. The case presented illustrates several common errors in the common clinical practice: erroneous diagnosis of AHT due to incorrect measurement technique of BP, early onset of drug treatment only based on BP values and inadequate use of ABPM. All of this led to an iatrogeny and conduction of invasive maneuvers in a female patient with white coat hypertension in whom a less fragmented approach and one more in agreement with the therapheutic guidelines in use should have been used.</p></div>","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 4","pages":"Pages 175-179"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)70893-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136603098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrés y enfermedad cardiovascular","authors":"P. Armario","doi":"10.1016/S0212-8241(08)72474-5","DOIUrl":"10.1016/S0212-8241(08)72474-5","url":null,"abstract":"<div><p>Los factores psicosociales pueden ser importantes determinantes de enfermedad cardiovascular. La exposición a dichos factores podría influir directamente mediante mecanismos neuroendocrinos, o indirectamente a través de su asociación con formas de conducta no cardiosaludables. La ira, la hostilidad, la depresión, la ansiedad y otras formas de personalidad han sido relacionadas con un aumento del riesgo de padecer enfermedad cardiovascular. El estrés crónico puede conducir a una mayor progresión de la aterosclerosis, probablemente por una excesiva activación del sistema nervioso simpático, manifestada por una respuesta exagerada de la frecuencia cardíaca y de la presión arterial, así como por una disfunción endotelial transitoria, o incluso necrosis. Situaciones de estrés agudo en la vida diaria, como cuando ocurre un terremoto, o en situaciones de guerra, pueden precipitar episodios cardiovasculares como el infarto agudo de miocardio o la muerte súbita. Su relación con la enfermedad cerebrovascular es menos conocida, auque ha sido publicada alguna evidencia al respecto. Los mecanismos por los cuales el estrés provoca daño vascular no son muy bien conocidos, pero algunos estudios han demostrado que el estrés mental induce disfunción endotelial, promueve arritmogénesis, estimula la agregación plaquetaria, aumenta la viscosidad sanguínea por hemoconcentración y estimula factores involucrados en la inflamación. La hiperreactividad cardiovascular de la presión arterial a las pruebas de estrés mental, realizadas en el laboratorio, se ha asociado a un mayor riesgo de desarrollar hipertensión arterial.</p></div><div><p>Psychosocial factors could be important determinants of cardiovascular disease. Exposure to such factors may influence health directly through neuroendocrine mechanisms or indirectly, through their association with unhealthy behaviour. Anger, hostility, depression, anxiety and other personality factors have been related to an increased risk of cardiovascular disease. Chronic stress can lead to exacerbation of coronary artery atherosclerosis, probably by excessive sympathetic nervous system activation, manifested by exaggerated heart rate and blood pressure responses, as well as to transient endothelial dysfunction and even necrosis. Sudden life stressors, such earthquakes, or war can precipitate cardiac events such as myocardial infarction or sudden cardiac death. Its relationship with cerebrovascular disease is less well known but some evidence has been published in last years. The mechanisms by which stress causes vascular injury are not very well known but some studies have demonstrated that mental stress induces endothelial dysfunction, promotes arrhytmogenesis, stimulates platelet function, increases blood viscosity through hemoconcentration and stimulates factors involved with inflammation. Cardiovascular hyper-reaction to different mental stress tests are investigated in the laboratory, and people with greater increases in b","PeriodicalId":100608,"journal":{"name":"Hipertensión","volume":"25 ","pages":"Pages 23-34"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0212-8241(08)72474-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80471478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}