Hipertension y Riesgo Vascular最新文献

{"title":"Más allá de la hipercoagulabilidad en la enfermedad celíaca","authors":"C. Álvarez-González ,&nbsp;J. Espíldora-Hernández ,&nbsp;M.A. Sánchez-Chaparro","doi":"10.1016/j.hipert.2024.06.002","DOIUrl":"10.1016/j.hipert.2024.06.002","url":null,"abstract":"<div><div>In celiac disease (CD) there is a state of hypercoagulability and multiple factors have been found that may be involved. Cases of association of CD and antiphospholipid síndrome (APS) have been described and several observational studies have found an increase in antiphospolipid antibodies (AAF) in patients with CD, so both entities may be interrelated, increasing the risk of thrombotic events. A descriptive case of a patient who is simultaneusly diagnosed with CD and APS is presented.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 264-267"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564773","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":"Prescripción de antihipertensivos en personas con diabetes tipo 2 en Andalucía y recomendaciones SEH-LELHA 2022: evaluación del coste y uso","authors":"D. Martín-Enguix ,&nbsp;J.C. Aguirre Rodríguez ,&nbsp;M. Guisasola Cárdenas ,&nbsp;M.N. Generoso Torres ,&nbsp;A. Hidalgo Rodríguez ,&nbsp;M. Sánchez Cambronero ,&nbsp;A. González Bravo","doi":"10.1016/j.hipert.2024.06.004","DOIUrl":"10.1016/j.hipert.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to analyze the prescription of antihypertensive drugs in patients with type 2 diabetes (T2D) in Andalusia, comparing it with the SEH-LELHA 2022 guidelines, and to assess the direct cost of these treatments.</div></div><div><h3>Materials and methods</h3><div>A multicentric, cross-sectional, and descriptive study was conducted with 385 T2D patients. Participants were randomly selected from the patient lists of 120 primary care physicians from Andalusia. Inclusion criteria included a diagnosis of T2D and complete clinical records for the year 2022. Demographic data and drug prescription information were collected, with the average cost per patient being calculated.</div></div><div><h3>Results</h3><div>The mean age of the subjects was 70.72 years, with 53.51% being male. A total of 70.9% of the patients were taking antihypertensive drugs, the most common being ACE inhibitors/ARBs (70.9%), diuretics (70.1%), beta-blockers (40.0%), and calcium channel blockers (20.0%). Each patient took an average of 2.46<!--> <!-->±<!--> <!-->1.06 antihypertendsive, and fixed association of 2 or more antihypertensive drugs were used by 40.9% of the studied patients. The annual cost per patient was 141.45<!--> <!-->€/year.</div></div><div><h3>Conclusions</h3><div>The study reveals strong adherence to the SEH-LELHA 2022 guidelines among physicians in Andalusia regarding the of antihypertensives for T2D patients, with a significant preference for Renin-Angiotensin System blockers, diuretics, and beta-blockers. However, a notable deviation in prescription practices was observed with the frequent choice of doxazosin over spironolactone, despite the latter being the recommended option for resistant hypertension. Although the overall expenditure on antihypertensives is moderate, their cost-effectiveness is enhanced by the efficacy of these treatments in preventing cardiovascular complications.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 226-231"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591630","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":"Recommendations for the management of patients with type 2 diabetes at hospital discharge after an ischaemic cardiovascular event","authors":"N.F. Renna ,&nbsp;E.J. Zaidel ,&nbsp;P. Corral ,&nbsp;A.D. Lerner","doi":"10.1016/j.hipert.2024.07.006","DOIUrl":"10.1016/j.hipert.2024.07.006","url":null,"abstract":"<div><div>The document outlines recommendations for the management of patients with type 2 diabetes (T2D) at hospital discharge following an ischaemic cardiovascular event. Diabetes significantly increases the risk of cardiovascular events, and a high proportion of patients in coronary units have this condition. The discharge process is crucial for optimising treatments and reducing the risk of recurrent complications such as reinfarction, stroke, and hospitalisations for heart failure.</div><div>Strategies include rigorous control of lipid levels, recommending potent statins combined with ezetimibe and, if necessary, other drugs such as inclisiran, evolocumab, alirocumab, or bempedoic acid. Optimal antihypertensive treatment is also suggested as secondary prevention.</div><div>For patients already on insulin, it is essential to adjust the dosage when adding SGLT-2 inhibitors (SGLT2i) or GLP-1 receptor agonists (GLP-1RA) to avoid hypoglycaemia, with structured glucose monitoring. In cases where HbA1c is not available during hospitalisation, the algorithm guides treatment, highlighting that GLP-1RA and SGLT2i do not cause hypoglycaemia. The combination of these drugs is safe and effective, improving several cardiovascular risk factors.</div><div>The document emphasises the importance of education on nutrition and healthy habits, as well as the follow-up and adjustment of pharmacological treatments to achieve adequate metabolic control and reduce cardiovascular risks. Nutritional evaluation and control are essential, considering obesity as a critical factor in T2D and its association with the risk of recurrent cardiovascular events.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 251-259"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consecuencia de los trastornos hipertensivos durante el embarazo (THE) sobre la salud cardiovascular de la mujer","authors":"W.G. Espeche ,&nbsp;P. Carrera Ramos ,&nbsp;J. Minetto ,&nbsp;D. Gomez ,&nbsp;A. De Iraola ,&nbsp;G.R. Cerri ,&nbsp;M.R. Salazar","doi":"10.1016/j.hipert.2024.04.005","DOIUrl":"10.1016/j.hipert.2024.04.005","url":null,"abstract":"<div><div>Patients with hypertensive disorders of pregnancy (HDP) are at increased risk of maternal-fetal complications and represent the third leading cause of maternal mortality. To date, it is known that women experiencing this condition during pregnancy have a higher future risk of cardiovascular events (CVD). Our objective was to report the incidence of new-onset hypertension in the postpartum period. We conducted a cohort study in high-risk pregnant patients who underwent ambulatory blood pressure monitoring (ABPM) between weeks 20-30. Patients were categorized as normotensive (NT) or gestational hypertensive (GH), excluding those with chronic hypertension, and were followed until the end of pregnancy with a postpartum assessment after 3<!--> <!-->months. Patients with HDP (39%) had a higher incidence of preeclampsia and newborns with low birth weight and preterm birth. A total of 177 pregnant women were analyzed for the primary outcome. Among those with GH, 33.3% vs 17.2% of NT (<em>P</em> <!-->=<!--> <!-->.014) reported new-onset hypertension. The odds ratio for developing new-onset hypertension was 2.3 (95%<!--> <!-->CI: 1.20-4.77), for those with GH. In conclusion, pregnant patients with GH assessed by ABPM between 20-30<!--> <!-->weeks are at higher risk of developing new-onset hypertension in the postpartum period, emphasizing the need for closer monitoring and control to prevent future cardiovascular complications.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 211-216"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923622","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":"Seventy years of pheochromocytomas and paragangliomas in Argentina. The FRENAR database","authors":"","doi":"10.1016/j.hipert.2024.04.001","DOIUrl":"10.1016/j.hipert.2024.04.001","url":null,"abstract":"<div><p>Pheochromocytomas and paragangliomas (PPGL) are neuroendocrine tumors characterized by the excessive production of catecholamines. This study aims to describe the clinical characteristics of PPGL cases in Argentina over recent decades. A multicenter retrospective cross-sectional analysis was carried out using a database comprising both pediatric and adult patients with confirmed PPGL diagnoses based on pathological reports.</p><p>A cohort of 486 patients with PPGL was recruited. Women represent 58.4% of the patients, with a mean age of 38.3 years old at the time of diagnosis and 15.2% of the patients were under the age of 18. Hypertension, as well as classic signs and symptoms, were present in 80.9% of the patients. The adrenal incidentaloma, as a mode of presentation, increased in the last two decades rising from 3.9% (1953–2000) to 21.8% (2001–2022), <em>p</em> <!-->&lt;<!--> <!-->0.001.</p><p>Most tumors were located within the adrenal glands, accounting 83.0% of the cases, with bilateral occurrences noted in 20.0%. The median tumor size was 4.8<!--> <!-->cm. Local recurrence and metastases were observed in 10.9% and 12.2%. Out of 412 patients, 87.0% exhibited urinary excretion elevation of catecholamines and/or their metabolites. Furthermore, 148 patients, representing 30.4% of the study population, displayed a distinct genetic profile indicative of hereditary syndromes. The distribution of hereditary syndromes revealed that MEN2, VHL, and PGL4 constituted the most prevalent syndromes.</p><p>This population-based study, spanning seven decades, offers valuable insights into the demographic and clinical characteristics of PPGL patients in Argentina.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 3","pages":"Pages 170-178"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868345","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":"Vitamin D3 supplementation in COVID-19 patients with cardiovascular disease and gut dysbiosis","authors":"","doi":"10.1016/j.hipert.2024.04.002","DOIUrl":"10.1016/j.hipert.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has highlighted the vulnerability of particular patient groups to SARS-CoV-2 infection, including those with cardiovascular diseases, hypertension, and intestinal dysbiosis. COVID-19 affects the gut, suggesting diet and vitamin D3 supplementation may affect disease progression.</p></div><div><h3>Aims</h3><p>To evaluate levels of Ang II and Ang-(1–7), cytokine profile, and gut microbiota status in patients hospitalized for mild COVID-19 with a history of cardiovascular disease and treated with daily doses of vitamin D3.</p></div><div><h3>Methods</h3><p>We recruited 50 adult patients. We screened 50 adult patients and accessed pathophysiology study 22, randomized to daily oral doses of 10,000<!--> <!-->IU vitamin D3 (<em>n</em> <!-->=<!--> <!-->11) or placebo (<em>n</em> <!-->=<!--> <!-->11). Plasma levels of Ang II and Ang-(1–7) were determined by radioimmunoassay, TMA and TMAO were measured by liquid chromatography and interleukins (ILs) 6, 8, 10 and TNF-α by ELISA.</p></div><div><h3>Results</h3><p>The Ang-(1–7)/Ang II ratio, as an indirect measure of ACE2 enzymatic activity, increased in the vitamin D3 group (24<!--> <!-->±<!--> <!-->5<!--> <!-->pg/mL vs. 4.66<!--> <!-->±<!--> <!-->2<!--> <!-->pg/mL, <em>p</em> <!-->&lt;<!--> <!-->0.01). Also, in the vitamin D3-treated, there was a significant decline in inflammatory ILs and an increase in protective markers, such as a substantial reduction in TMAO (5<!--> <!-->±<!--> <!-->2<!--> <!-->μmoles/dL vs. 60<!--> <!-->±<!--> <!-->10<!--> <!-->μmoles/dL, <em>p</em> <!-->&lt;<!--> <!-->0.01). In addition, treated patients experienced less severity of infection, required less intensive care, had fewer days of hospitalization, and a reduced mortality rate. Additionally, improvements in markers of cardiovascular function were seen in the vitamin D3 group, including a tendency for reductions in blood pressure in hypertensive patients.</p></div><div><h3>Conclusions</h3><p>Vitamin D3 supplementation in patients with COVID-19 and specific conditions is associated with a more favourable prognosis, suggesting therapeutic potential in patients with comorbidities such as cardiovascular disease and gut dysbiosis.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 3","pages":"Pages 145-153"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318541","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":"Diuretics use in the management of hypertension","authors":"","doi":"10.1016/j.hipert.2024.03.004","DOIUrl":"10.1016/j.hipert.2024.03.004","url":null,"abstract":"<div><p>Diuretics have been used for decades in the treatment of hypertension. Its efficacy has been demonstrated in numerous clinical trials. It is well known that the reduction in cardiovascular risk is a consequence of the reduction in blood pressure levels regardless of the drug used, but thiazide diuretics continue to be first-line drugs, especially in low doses and combined with other drugs. The debate on the advantages of using chlorthalidone or hydrochlorothiazide continues, however hydrochlorothiazide is drug most used and for which there is greater availability. The association with potassium-sparing diuretics increases the effectiveness and reduces the adverse reactions of thiazides. A new group of drugs, close to potassium-sparing diuretics, that antagonise aldosterone synthase are showing promising results as antihypertensives. There are no significant differences between men and women regarding the antihypertensive effect of thiazide diuretics.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 3","pages":"Pages 186-193"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1889183724000540/pdfft?md5=570c19be134f3cfcb158437971852d9e&pid=1-s2.0-S1889183724000540-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can catheter-based renal denervation reduce frequency of hospitalization in patients who have resistant hypertension and heart failure with reduced ejection fraction?","authors":"","doi":"10.1016/j.hipert.2024.03.003","DOIUrl":"10.1016/j.hipert.2024.03.003","url":null,"abstract":"<div><p>Hypertension is one of the most powerful and modifiable risk factors for the development, progression and even decompensation of heart failure. Uncontrolled hypertension increases to frequency of heart failure hospitalizations by increase sympathetic tone. Catheter-based renal denervation has been shown to reduce blood pressure in the treatment of multidrug-resistant hypertension. We report the improvement in clinical status after renal denervation in a 47-year-old male patient with a history of hypertension, chronic ischemic heart failure, and recurrent hospitalizations for acute hypertensive pulmonary edema despite optimal medical therapy.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 3","pages":"Pages 198-200"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762460","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":"Miocardiopatía periparto con fallo biventricular más tromboembolismo pulmonar y comunicación interauricular","authors":"","doi":"10.1016/j.hipert.2024.03.002","DOIUrl":"10.1016/j.hipert.2024.03.002","url":null,"abstract":"<div><p>This case report examines peripartum cardiomyopathy (PPCM), a rare variant of heart failure with reduced ejection fraction, which manifests at the end of labor or puerperium. The frequency of this pathology varies globally, and its association with risk factors such as genetic disorders, autoimmune diseases, viral infections, suggests a multifactorial etiology. Diagnostic criteria include: Heart failure secondary to left ventricular systolic dysfunction, manifested in the puerperium or at the end of pregnancy and lack of other identifiable causes of heart failure. The case presents a patient with no significant personal pathological history, who, 17 days post cesarean section developed acute symptoms, including abdominal pain, dry cough and dyspnea. Clinical findings revealed hypoxemia, alterations in blood tests and an echocardiogram that confirmed an atrial septal defect. Multidisciplinary management resulted in successful treatment and the patient was discharged without complications.</p><p>This case highlights the importance of MCPP, a disease with high maternal mortality. The connection between atrial septal defect and PPCM, as well as the involvement of pulmonary thromboembolism.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 3","pages":"Pages 194-197"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777537","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":"Valor de la fórmula hematocrito urea y género basal en la evolución a los 17 años de la función renal de ancianos","authors":"","doi":"10.1016/j.hipert.2024.03.001","DOIUrl":"10.1016/j.hipert.2024.03.001","url":null,"abstract":"","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 3","pages":"Pages 201-202"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782830","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}