Hipertension y Riesgo Vascular最新文献

{"title":"Estudio de prevalencia, conocimiento y control de la hipertensión arterial en barrios vulnerables de Argentina","authors":"W.G. Espeche ,&nbsp;M. Marin ,&nbsp;C. Romero ,&nbsp;N. Renna ,&nbsp;S. Vissani ,&nbsp;G. Blanco ,&nbsp;S.P. Pantalena ,&nbsp;D. Cesario ,&nbsp;E. Diez ,&nbsp;C. Grasso ,&nbsp;E. Garzon ,&nbsp;J. Barochiner ,&nbsp;M. Ruise ,&nbsp;J. Minetto ,&nbsp;N. Mazzei ,&nbsp;E. Ramirez ,&nbsp;M. Rojas ,&nbsp;P. Carrera Ramos ,&nbsp;M.S. Gimenez ,&nbsp;M. Rivarola ,&nbsp;M.R. Salazar","doi":"10.1016/j.hipert.2024.02.001","DOIUrl":"10.1016/j.hipert.2024.02.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Hypertension (HTN) represents the primary individual risk factor, contributing significantly to the global burden of cardiovascular diseases (CVD). In our country, epidemiological research has highlighted substantial variations in the prevalence of these risk factors across different populations. However, there is a lack of epidemiological studies assessing exclusive cardiovascular risk factors within vulnerable neighborhoods characterized by extremely limited economic resources, sociocultural challenges, and inadequate healthcare access.</p></div><div><h3>Methods</h3><p>A multicenter cross-sectional observational study was conducted among individuals residing in economically deprived and marginalized communities, including informal settlements and underprivileged neighborhoods. Simple random sampling of households was employed.</p><p>Blood pressure measurements, anthropometric assessments, and epidemiological, economic, and sociocultural questionnaires were administered.</p><p>Results encompass prevalence rates, awareness levels, and blood pressure control across diverse regions. Logistic regression was utilized to identify independent variables influencing primary outcomes.</p></div><div><h3>Results</h3><p>A total of 989 participants were analyzed. The overall prevalence of hypertension was 48.2%. About 82% had a body mass index (BMI) &gt;<!--> <!-->25. Approximately 45.3% had less than 6 years of formal education. Independent association was established between education levels below 6 years and higher hypertension prevalence.</p><p>Among hypertensive individuals, 44% were unaware of their condition, with only 17.2% achieving control, correlated with having health insurance and a higher educational background. Merely 24% were receiving combined therapy.</p></div><div><h3>Conclusion</h3><p>The prevalence of hypertension within vulnerable neighborhoods is alarmingly high, surpassing rates in other social strata. Knowledge, treatment, and control levels of hypertension are suboptimal, comparable to other populations. Inadequate use of combination therapy was observed. This study underscores the urgent need for targeted interventions addressing cardiovascular risk factors in poor areas to mitigate the burden of CVD.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991439","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 importancia de la genética en el estudio de la hipertrigliceridemia","authors":"A. Rosales-Castillo,&nbsp;A. Bustos-Merlo,&nbsp;J. Escobar Sevilla","doi":"10.1016/j.hipert.2023.12.001","DOIUrl":"10.1016/j.hipert.2023.12.001","url":null,"abstract":"<div><p>Hypertriglyceridemia encompasses a set of lipid disorders common in clinical practice, generally defined as a fasting concentration above 150<!--> <!-->mg/dL. There are various classifications of the severity of hypertriglyceridaemia based on serum values, with levels generally considered moderate when below 500<!--> <!-->mg/dL and severe when above 1000<!--> <!-->mg/dL. Its importance lies in its association with other alterations in the lipid profile, contributing to increased cardiovascular risk and increased risk of acute pancreatitis, mainly with concentrations above 500<!--> <!-->mg/dL.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111747","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":"Monitorización ambulatoria de la presión arterial en adultos y población pediátrica. Una revisión narrativa","authors":"A.D. Sotomayor Julio ,&nbsp;L.P. Montana-Jimenez ,&nbsp;W. Bernal Torres ,&nbsp;J.D. López Ponce de León ,&nbsp;J.A. Zambrano Franco ,&nbsp;A. Coca ,&nbsp;M. Camafort ,&nbsp;C. Vesga Reyes","doi":"10.1016/j.hipert.2024.01.001","DOIUrl":"10.1016/j.hipert.2024.01.001","url":null,"abstract":"<div><p>Hypertension has become a central risk factor for the development of cardiovascular disease, underscoring the importance of its accurate diagnosis. Numerous studies have established a close relationship between elevated systolic (SBP) and diastolic (DBP) blood pressure and an increased risk of cardiovascular event (CVE). Traditionally, blood pressure (BP) measurements performed in clinical settings have been the main method for diagnosing and assessing hypertension. However, in recent years, it has been recognized that BP measurements obtained outside the clinical setting, using self-monitoring blood pressure (SMBP) and ambulatory blood pressure monitoring (ABPM), offer a more realistic perspective of patients’ daily lives and therefore provide more reliable results. Given the evolution of medical devices, diagnostic criteria, and the increasing relevance of certain components of ABPM in the prediction of adverse cardiovascular outcomes, a comprehensive update that is practical for daily clinical practice is required. The main objective of this article is to provide an updated review of ABPM, focusing on its importance in the evaluation of hypertension and its impact on public health in Colombia. In addition, it will discuss the implications of changes in diagnostic thresholds and provide concrete recommendations for the effective implementation of ABPM in clinical practice, allowing health professionals to make informed decisions and improve the care of their patients.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121022","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":"Hypertensive states of pregnancy","authors":"E. Rubio Gonzalez ,&nbsp;A.M. Huerta Arroyo ,&nbsp;F. Garcia Benasach ,&nbsp;T. Gijon Conde","doi":"10.1016/j.hipert.2023.11.006","DOIUrl":"10.1016/j.hipert.2023.11.006","url":null,"abstract":"<div><p>Hypertensive disorders in pregnancy (HDP) remain a leading cause of pregnancy-related maternal and foetal morbidity and mortality worldwide, including chronic hypertension, gestational hypertension, and pre-eclampsia.</p><p>Affected women and newborns also have an increased risk of cardiovascular disease later in life, independent of traditional cardiovascular disease risks. Despite these risks, recommendations for optimal diagnosis and treatment have changed little in recent decades, probably due to fear of the foetal repercussions of decreased blood pressure and possible drug toxicity.</p><p>In this document we review the diagnostic criteria and classification of (HDP), as well as important aspects regarding pathophysiology and early detection that allows early identification of women at risk, with the aim of preventing both immediate and long-term consequences. Prophylactic treatment with aspirin is also reviewed early and a therapeutic approach is carried out that involves close maternal and foetal monitoring, and if necessary, the use of safe drugs in each situation.</p><p>This review aims to provide an updated vision for the prevention, diagnosis, and treatment of HDP that is useful in our usual clinical practice.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177010","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":"Hypertension and Vascular Risk already has an impact factor. Now a new challenge begins","authors":"P. Armario ,&nbsp;E. Vinyoles ,&nbsp;T. Gijon-Conde ,&nbsp;C. Arranz ,&nbsp;J.M. Galceran","doi":"10.1016/j.hipert.2024.02.008","DOIUrl":"10.1016/j.hipert.2024.02.008","url":null,"abstract":"","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185953","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":"Efecto de los suplementos de ácido fólico sobre la presión arterial","authors":"","doi":"10.1016/j.hipert.2024.02.006","DOIUrl":"https://doi.org/10.1016/j.hipert.2024.02.006","url":null,"abstract":"","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140540630","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":"Documento de consenso sobre tabaquismo y riesgo vascular","authors":"José Abellán Alemán ,&nbsp;Rafael Crespo Sabaris ,&nbsp;Daniel Escribano Pardo ,&nbsp;José Antonio García Donaire ,&nbsp;Fernando García Romanos ,&nbsp;Jesús Iturralde Iriso ,&nbsp;Luis Martín Penagos ,&nbsp;L. Javier Nieto Iglesias ,&nbsp;Alfonso Pobes Martínez de Salinas ,&nbsp;Nicolás Roberto Robles Pérez-Monteoliva ,&nbsp;Pablo Sánchez-Rubio Lezcano ,&nbsp;Maribel Troya Saborido ,&nbsp;Francisco Valls Roca ,&nbsp;en representación de la Sociedad Española de Hipertensión y las Sociedades Autonómicas de Hipertensión y Riesgo Vascular de España","doi":"10.1016/S1889-1837(24)00075-8","DOIUrl":"https://doi.org/10.1016/S1889-1837(24)00075-8","url":null,"abstract":"<div><p><strong>Consensus statement on smoking and vascular risk</strong></p><p>About 22% of the Spanish population are daily smokers. Men are more likely to smoke than women. In Spain, women between 15-25 years of age smoke as much or more than men. Every smoker should be assessed for: physical dependence on nicotine (Fagerström test), social and psychological dependence (Glover Nilsson test), level of motivation to quit (Richmond test), probability of therapy success (Henri-Mondor and Michael-Fiore tests), and stage of behavioral change development (Prochaska and DiClementi). Advice on smoking cessation is highly cost-effective and should always be provided. Smoking is an enhancer of cardiovascular risk because it acts as a pathogen agent in the development of arteriosclerosis and is associated with ischemic heart disease, stroke, and peripheral artery disease. Smoking increases the risk of chronic lung diseases (COPD) and is related to cancers of the lung, female genitalia, larynx, oropharynx, bladder, mouth, esophagus, liver and biliary tract, and stomach, among others. Combined oral contraceptives should be avoided in women smokers older than 35 years of age due to the risk of thromboembolism. In smoking cessation, the involvement of physicians, nurses, psychologists, etc. is important, and their multidisciplinary collaboration is needed. Effective pharmacological treatments for smoking cessation are available. Combined treatments are recommended when smoker's dependence is high. For individuals who are unable to quit smoking, a strategy based on tobacco damage management with a total switch to smokeless products could be a less dangerous alternative for their health than continuing to smoke.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880252","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":"Type 2 diabetes patients requiring empagliflozin in Southeast of Iran: Frequency and guideline adherence (2022–2023)","authors":"S.M. Khoshnazar ,&nbsp;A. Dehghani ,&nbsp;F. Bagheri ,&nbsp;S. Pezeshki ,&nbsp;G. Yousefzadeh","doi":"10.1016/j.hipert.2023.10.004","DOIUrl":"10.1016/j.hipert.2023.10.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Empagliflozin plays a beneficial role in individuals with type 2 diabetes at high risk of cardiovascular complications. This study aimed to assess the prevalence of individuals with type 2 diabetes who required empagliflozin based on clinical guidelines between the years 2022 and 2023.</p></div><div><h3>Material and methods</h3><p>This study was a descriptive-analytical cross-sectional study conducted on a target population of patients with type 2 diabetes. Patient data, including demographic characteristics, smoking status, hypertension, hyperlipidemia, renal insufficiency, retinopathy, and proteinuria, were collected. The indication for prescribing empagliflozin was determined based on the risk of cardiovascular complications.</p></div><div><h3>Results</h3><p>A total of 398 individuals with type 2 diabetes with a mean age of 58.4 years were examined. Overall, <u>87.4%</u> of the patients had an indication for empagliflozin prescription. The indication for empagliflozin prescription was significantly higher in men, individuals with hyperlipidemia, those over 55 years of age, obese individuals, and smokers. The mean age, body mass index, and triglyceride levels were higher in candidates for empagliflozin prescription. Male candidates for empagliflozin had significantly higher rates of smoking and systolic blood pressure compared to females.</p></div><div><h3>Conclusions</h3><p>The findings of this study demonstrated that a significant percentage of individuals with type 2 diabetes had an indication for empagliflozin prescription based on clinical and laboratory criteria.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194735","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":"Renin–angiotensin–aldosterone system blockers effect in chronic kidney disease progression in hypertensive elderly patients without proteinuria: PROERCAN trial","authors":"A.M. García-Prieto ,&nbsp;Ú. Verdalles ,&nbsp;A.P. de José ,&nbsp;D. Arroyo ,&nbsp;I. Aragoncillo ,&nbsp;D. Barbieri ,&nbsp;R.E. Camacho ,&nbsp;M. Goicoechea","doi":"10.1016/j.hipert.2023.11.005","DOIUrl":"10.1016/j.hipert.2023.11.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Evidence about nefroprotective effect with RAAS blockers in elderly patients with chronic kidney disease (CKD) without proteinuria is lacking. The primary outcome of our study is to evaluate the impact of RAAS blockers in CKD progression in elderly patients without proteinuria.</p></div><div><h3>Materials and methods</h3><p>Multicenter open-label, randomized controlled clinical trial including patients over 65 year-old with hypertension and CKD stages 3–4 without proteinuria. Patients were randomized in a 1:1 ratio to either receive RAAS blockers or other antihypertensive drugs and were followed up for three years. Primary outcome is estimated glomerular filtration rate (eGFR) decline at 3 years. Secondary outcome measures include BP control, renal and cardiovascular events and mortality.</p></div><div><h3>Results</h3><p>88 patients were included with a mean age of 77.9<!--> <!-->±<!--> <!-->6.1 years and a follow up period of 3 years: 40 were randomized to RAAS group and 48 to standard treatment. Ethiology of CKD was: 53 vascular, 16 interstitial and 19 of unknown ethiology. In the RAAS group eGFR slope during follow up was −4.3<!--> <!-->±<!--> <!-->1.1<!--> <!-->ml/min, whereas in the standard treatment group an increase on eGFR was observed after 3 years (+4.6<!--> <!-->±<!--> <!-->0.4<!--> <!-->ml/min), <em>p</em> <!-->=<!--> <!-->0.024. We found no differences in blood pressure control, number of antihypertensive drugs, albuminuria, potassium serum levels, incidence of cardiovascular events nor mortality during the follow up period.</p></div><div><h3>Conclusions</h3><p>In elderly patients without diabetes nor cardiopathy and with non proteinuric CKD the use of RAAS blockers does not show a reduction in CKD progression.</p><p>The PROERCAN (PROgresión de Enfermedad Renal Crónica en ANcianos) trial (trial registration: <span>NCT03195023</span><svg><path></path></svg>).</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177012","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":"Safety and efficacy of candesartan versus valsartan combined with amlodipine on peripheral and central blood pressure","authors":"S.M. Hanna ,&nbsp;H.M. Rabea ,&nbsp;M.E.A. Abdelrahim ,&nbsp;H.B. Mahmoud","doi":"10.1016/j.hipert.2023.11.004","DOIUrl":"10.1016/j.hipert.2023.11.004","url":null,"abstract":"<div><h3>Introduction</h3><p>“Amlodipine/valsartan” or “amlodipine/candesartan” combinations represent two effective antihypertensive agents with complementary mechanisms of action. Nevertheless, a study has yet to be done to evaluate the effect of amlodipine/candesartan on central blood pressure and compare it with amlodipine/valsartan combination. To see how “amlodipine plus candesartan combination” reduces peripheral and central blood pressure compared to the most studied combination, “amlodipine plus valsartan”.</p></div><div><h3>Material and methods</h3><p>Eighty-six patients were randomized in an open-label, prospective study by 1:1 ratio to two groups. Group I (<em>n</em> <!-->=<!--> <!-->42) received the amlodipine and valsartan combination, and group II (<em>n</em> <!-->=<!--> <!-->44) received the amlodipine and candesartan combination. Peripheral and central blood pressure (CBP) was measured at baseline, at 6 and 12 weeks of follow-up.</p></div><div><h3>Discussion</h3><p>Both treatment groups reduced peripheral systolic, diastolic, and mean blood pressure. There was no significant difference between and within both groups. The amlodipine/candesartan combination showed more reduction in peripheral systolic blood pressure (PSBP) after 12 weeks of treatment (<em>p</em> <!-->=<!--> <!-->&lt;0.001). Both groups decreased CBP without significant differences between groups. The amlodipine/candesartan combination showed additional efficacy in decreasing CSBP after 12 weeks (<em>p</em> <!-->=<!--> <!-->&lt;0.001). The two treatment groups did not exert significant efficacy in lowering heart rate (HR) and augmentation index% (AIx%).</p></div><div><h3>Conclusion</h3><p>To conclude, the amlodipine 10<!--> <!-->mg/candesartan 16<!--> <!-->mg combination was non-inferior to the amlodipine 10<!--> <!-->mg/valsartan 160<!--> <!-->mg combination in terms of reducing peripheral and CBP over time.</p></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991440","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}