A.M. Ghelfi , G. Miranda , L.S. Voto , M.A. Del Sueldo , J.M. Zilberman , R. Mondino , M.P. Pérez , P.G. Irusta , L. Meccia , E. Martínez Marissi , M. Laura Baiche , F. Waisman , M. BaronI , M. Victoria FerrettI , J.P. Morán , A. Corrales Barboza , A.M. Delucchi , P.D. Rodríguez , N.F. Renna
{"title":"Position statement on the use of amlodipine during pregnancy. Working Group on Hypertension in Women, Argentine Society of Hypertension","authors":"A.M. Ghelfi , G. Miranda , L.S. Voto , M.A. Del Sueldo , J.M. Zilberman , R. Mondino , M.P. Pérez , P.G. Irusta , L. Meccia , E. Martínez Marissi , M. Laura Baiche , F. Waisman , M. BaronI , M. Victoria FerrettI , J.P. Morán , A. Corrales Barboza , A.M. Delucchi , P.D. Rodríguez , N.F. Renna","doi":"10.1016/j.hipert.2024.11.004","DOIUrl":"10.1016/j.hipert.2024.11.004","url":null,"abstract":"<div><div>Pharmacological management of HDP includes agents supported by extensive evidence ensuring their safety for use. Among those traditionally described in the literature are: alpha-methyldopa, labetalol, and sustained-release nifedipine (NIF-RETARD). These drugs, in addition to being compatible with pregnancy, present additional eligibility criteria.</div><div>The discontinuation of NIF-RETARD has resulted in the off-label use of other dihydropyridine calcium cannel blockers with lower levels of evidence in pregnancy, such as amlodipine.</div><div>The Working Group Hypertension in Women of the Argentine Society of Hypertension has proposed to develop a document that precisely and thoroughly addresses the concerns related to the use of amlodipine in pregnancy, providing responses based on the currently available scientific evidence.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 2","pages":"Pages 102-107"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898980","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}
P. Corral , A. Lavalle Cobo , M.F. Arrupe , L. Schreier , G. Matta , N.F. Renna , en nombre de los investigadores de GAELp(a)
{"title":"Diseño y racional estudio observacional del Grupo Argentino Estudio Lipoproteína (a)","authors":"P. Corral , A. Lavalle Cobo , M.F. Arrupe , L. Schreier , G. Matta , N.F. Renna , en nombre de los investigadores de GAELp(a)","doi":"10.1016/j.hipert.2024.07.005","DOIUrl":"10.1016/j.hipert.2024.07.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Elevated levels of Lipoprotein(a) [Lp(a)] have been linked to increased cardiovascular risk globally. However, comprehensive studies on Lp(a) levels and their impact on cardiovascular health in Argentina are lacking. The Argentine Group for the Study of Lipoprotein (a) [GAELp(a)] aims to address this gap through an observational study designed to evaluate the prevalence and consequences of elevated Lp(a) levels in the Argentine population.</div></div><div><h3>Methods</h3><div>The GAELp(a) study will recruit participants from diverse regions across Argentina. Eligible individuals will undergo comprehensive assessments, including demographic data collection, medical history review, and laboratory analyses to measure Lp(a) levels. The study will employ rigorous statistical analyses to explore the association between elevated Lp(a) levels and cardiovascular outcomes, considering potential confounding variables.</div></div><div><h3>Results</h3><div>Anticipated outcomes of the GAELp(a) study include a detailed characterization of Lp(a) levels within the Argentine population and their correlation with cardiovascular diseases. By elucidating these relationships, the study aims to provide valuable insights into the prevalence and impact of elevated Lp(a) on cardiovascular health in Argentina.</div></div><div><h3>Conclusion</h3><div>The GAELp(a) observational study holds promise for enhancing our understanding of Lp(a)-related cardiovascular risk in Argentina. Findings from this study may contribute to the development of targeted interventions, clinical guidelines, and public health policies aimed at reducing cardiovascular morbidity and mortality associated with elevated Lp(a) levels. Through collaborative efforts, the GAELp(a) study seeks to advance cardiovascular research and improve healthcare outcomes in Argentina.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 13-17"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394074","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":"Update on the diagnosis of the pheochromocytoma","authors":"E. Achote , O.F. Arroyo Ripoll , M. Araujo-Castro","doi":"10.1016/j.hipert.2024.08.001","DOIUrl":"10.1016/j.hipert.2024.08.001","url":null,"abstract":"<div><div>Pheochromocytoma is a rare neuroendocrine tumour that develops from chromaffin cells in the adrenal medulla and is characterised by the excessive production of catecholamines and their metabolites. Diagnostic confirmation is performed by detecting elevated levels of catecholamines and/or their metabolites in plasma or 24-h urine. In the case of moderate elevations of normetanephrine, the clonidine suppression test may be useful to differentiate between endogenous hypersecretion and false positive results. Once the biochemical diagnosis is performed, the tumour localisation is carried out using imaging techniques and sometimes with nuclear medicine imaging tests. Furthermore, in all patients with pheochromocytomas it is recommended to perform a genetic study to identify hereditary disorders that may be present in more than 30% of cases and to perform a cardiological evaluation to rule out the presence of cardiovascular involvement secondary to the catecholamine hypersecretion.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 43-51"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406921","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}
C. Sepulveda Gallardo , A.I. Barrientos , M.H. Koretzky , F. Wyss , O. Valdez Tiburcio , N. Báez Noyer , E. Sanchez , A. Gonzalez , W. Dones , P. López Contreras , M. Camafort
{"title":"Peculiaridades del manejo de la hipertensión arterial en el anciano. Documento de consenso de la Sociedad Centroamericana y del Caribe de Hipertensión arterial","authors":"C. Sepulveda Gallardo , A.I. Barrientos , M.H. Koretzky , F. Wyss , O. Valdez Tiburcio , N. Báez Noyer , E. Sanchez , A. Gonzalez , W. Dones , P. López Contreras , M. Camafort","doi":"10.1016/j.hipert.2024.09.004","DOIUrl":"10.1016/j.hipert.2024.09.004","url":null,"abstract":"<div><div>Arterial hypertension is one of the most prevalent diseases in the field of geriatrics and is also a risk factor for pathologies that frequently result in hospital admissions, such as heart failure and stroke. This article addresses both pharmacological and non-pharmacological diagnosis and treatment strategies, focusing on the role of frailty as a guiding principle in determining the most appropriate course of treatment, emphasizing patient-centred prescribing. Furthermore, the article reviews other frequent topics, such as polypharmacy and orthostatic hypotension. Moreover, a concise overview of the current evidence in geriatrics on ambulatory blood pressure monitoring and self-measurement of blood pressure will be provided. Furthermore, a brief summary of the underlying pathophysiology and current epidemiological trends is provided. This consensus is founded upon the initial premise that a comprehensive geriatric assessment should be conducted to ascertain whether a blood pressure reduction strategy could confer a net benefit for elderly patients while simultaneously avoiding an increase in the safety risks associated with these strategies and preventing a de-prescription due to ageism. This is particularly important given the significance of maintaining optimal blood pressure control to prevent related complications.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 36-42"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584282","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":"Detección de rigidez arterial en mujeres con antecedente reciente de preeclampsia","authors":"A.M. Ghelfi , M.N. Lassus , F.A. Passarino , R.F. Mamprin D’Andrea , L.N. Fierro , L.L. Velez , E.A. Hails , M.A. Paciocco , J.G. Kilstein , J.O. Galíndez","doi":"10.1016/j.hipert.2024.07.007","DOIUrl":"10.1016/j.hipert.2024.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Preeclampsia (PE) is a complication of hypertensive disorders of pregnancy, whose pathophysiology involves endothelial dysfunction. Early establishment of subclinical vascular lesions such as arterial stiffness (AS) could explain the development of cardiovascular disease later in life. AS can be assessed non-invasively using carotid-femoral pulse wave velocity (cf-PWV), aortic systolic blood pressure (ao-SBP) and augmentation index (IAx). We aim to determine cf-PWV, ao-SBP and AIx in women who recently underwent PE and compare it with a control group.</div></div><div><h3>Materials and methods</h3><div>Cross-sectional study, carried out from 2022 to 2023 in Argentina. Group 1: women who developed PE. Exclusion criteria: history of chronic hypertension, diabetes, autoimmune disease, chronic kidney disease, cardiovascular disease, PE in previous pregnancies; treatment with calcium antagonists during pregnancy; treatment with calcium antagonists, angiotensin-converting enzyme inhibitors or diuretics in the postpartum period. Group 2: healthy postpartum periods. PWV-cf, ao-SBP and IAx were measured in the first 72<!--> <!-->hours postpartum using Aortic.</div></div><div><h3>Results</h3><div>Seventy-onewomen were included: Group 1 (n<!--> <!-->=<!--> <!-->30); Group 2 (n<!--> <!-->=<!--> <!-->41). Group 1 presented higher PWV-cf<!--> <!-->=<!--> <!-->6.70<!--> <!-->±<!--> <!-->0.68 vs. 5.41<!--> <!-->±<!--> <!-->0.48 m/s (<em>P</em><.0001); ao-SBP<!--> <!-->=<!--> <!-->118.3<!--> <!-->±<!--> <!-->9.6 vs. 101.2<!--> <!-->±<!--> <!-->9.8<!--> <!-->mmHg (<em>P</em><.0001); and IAu<!--> <!-->=<!--> <!-->22.7<!--> <!-->±<!--> <!-->10.7 vs. 9.3<!--> <!-->±<!--> <!-->11.9% (<em>P</em><.0001). In Group 1 there were 25 of 30 women who presented AS parameters (OR<!--> <!-->=<!--> <!-->8.50; 95% CI<!--> <!-->=<!--> <!-->3.32-15.29; <em>P</em><.0001).</div></div><div><h3>Conclusion</h3><div>Patients with a recent history of PE showed higher cf-PWV, ao-SBP and AIx values, compatible with AS.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 3-12"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401574","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}
V.J. Vera-Ponce , F.E. Zuzunaga-Montoya , L.E.M. Vásquez-Romero , J.A. Loayza-Castro , C.I. Gutierrez De Carrillo , E. Vigil-Ventura
{"title":"Prevalence, trends, and associated factors of isolated systolic, diastolic, and systolic–diastolic hypertension in Peru: A nine-year analysis of the Demographic and Family Health Survey","authors":"V.J. Vera-Ponce , F.E. Zuzunaga-Montoya , L.E.M. Vásquez-Romero , J.A. Loayza-Castro , C.I. Gutierrez De Carrillo , E. Vigil-Ventura","doi":"10.1016/j.hipert.2024.10.001","DOIUrl":"10.1016/j.hipert.2024.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>While HTN is widely seen as a primary threat to cardiovascular conditions worldwide, it is essential to recognize that not all HTN is identical.</div></div><div><h3>Objective</h3><div>To determine the prevalence, trend, and factors associated with each type of HTN: isolated systolic (ISH), isolated diastolic (IDH), and systolic–diastolic (SDH).</div></div><div><h3>Methods</h3><div>A secondary analysis of data from the Demographic and Family Health Survey from 2014 to 2022 was conducted. For the analysis of associated factors, a Poisson regression model with robust variance was implemented to calculate adjusted prevalence ratios (aPR) along with their 95% confidence intervals.</div></div><div><h3>Results</h3><div>The prevalence was 7.02%, 1.55%, and 3.28% for ISH, IDH, and SDH, respectively. ISH showed a decline in 2022, unlike the other two types, which seem to be on the rise. A statistically significant association was found in men and an increased risk with age for ISH and SDH, unlike IDH, where age acts as a protective factor. Additional factors identified include smoking and excessive alcohol consumption, while a high intake of fruits/vegetables offers a protective effect. Obesity and diabetes were associated with a higher risk, and significant variations by region and altitude, as well as among ethnic groups, were observed.</div></div><div><h3>Conclusions</h3><div>Significant differences in the prevalence of HTN subtypes have been found, underscoring the heterogeneity of this chronic condition, both in related factors and in trends over the years.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 18-28"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649244","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":"Trastornos hipertensivos de novo en el posparto: consideraciones sobre su diagnóstico, factores de riesgo y posibles estrategias de intervención","authors":"P.G. Irusta","doi":"10.1016/j.hipert.2024.09.001","DOIUrl":"10.1016/j.hipert.2024.09.001","url":null,"abstract":"<div><div>Postpartum de novo arterial hypertension (PPDNAH) is defined as blood pressure ≥140/90<!--> <!-->mmHg, without a history of hypertension during pregnancy or delivery. Its prevalence ranges from 0.3% to 27.5% of all pregnancies. Late-onset postpartum preeclampsia (LOPPP) and late-onset postpartum eclampsia (LOPPE) typically occur between 48<!--> <!-->hours and 6 weeks postpartum, although recent studies demonstrate the possibility of developing these disorders up to 12 months postpartum.</div><div>While sharing risk factors with pregnancy-related disorders, they differ in some aspects such as primigravida status. Regarding prognosis, an increase in severe maternal morbidity has been observed compared to hypertensive disorders of pregnancy.</div><div>This group of pathologies is often underdiagnosed, even in high-risk patients, making early identification along with strict blood pressure monitoring essential.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 29-35"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356007","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}
J.M. Ruiz-Cánovas , E.A. Achote-Rea , T. Alonso-Gordoa , A. Martínez-Lorca , M. Araujo-Castro
{"title":"Metastatic pheochromocytoma: An unusual case and its multidisciplinary management","authors":"J.M. Ruiz-Cánovas , E.A. Achote-Rea , T. Alonso-Gordoa , A. Martínez-Lorca , M. Araujo-Castro","doi":"10.1016/j.hipert.2024.09.002","DOIUrl":"10.1016/j.hipert.2024.09.002","url":null,"abstract":"<div><div>We describe the case of an 80-year-old man with sporadic right pheochromocytoma who developed metastatic disease six years after initial diagnosis. Despite adequate blood pressure control and initial biochemical cure criteria after surgery, elevated chromogranin A levels were detected during routine screening, which anticipated elevated 24-h urine metanephrines. Subsequent imaging tests revealed metastatic lesions in the lungs, liver, prostate and lymph nodes. The patient underwent systemic treatment with [131I] MIBG, which resulted in a decrease in chromogranin A levels, achieving radiological and clinical stability. This case highlights the importance of long-term follow-up and biochemical monitoring for early detection of tumor recurrence in patients with pheochromocytoma, emphasizing the need for individualized treatment strategies and interdisciplinary care.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 59-62"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356008","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}
E. Rodilla , M. Benítez Camps , L. Castilla Guerra , M.I. Egocheaga Cabello , J. Gamarra Ortiz , M.Á. María Tablado , N. Muñoz Rivas , V. Pallarés-Carratalá , J. Polo García , J.A. García Donaire
{"title":"Position paper on the 2024 ESH clinical practice guidelines for the management of arterial hypertension in Spain","authors":"E. Rodilla , M. Benítez Camps , L. Castilla Guerra , M.I. Egocheaga Cabello , J. Gamarra Ortiz , M.Á. María Tablado , N. Muñoz Rivas , V. Pallarés-Carratalá , J. Polo García , J.A. García Donaire","doi":"10.1016/j.hipert.2024.09.003","DOIUrl":"10.1016/j.hipert.2024.09.003","url":null,"abstract":"<div><div>The 2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension (ESH Guidelines 2024) have recently been published, a brief document but with a very elaborate infographic that summarizes as much as possible the previous guidelines for the management of arterial hypertension (HTN), aimed at serving as a quick reference tool to make decisions in daily clinical practice. The main objective of this work is to analyze the recommendations and innovations of these guidelines from the perspective of their applicability and taking into account all the scientific societies in the specialty of Family and Community Medicine, Internal Medicine and the Spanish Society of Hypertension (SEHLELHA) in order to achieve more homogeneous and evidence-based care for HTN in Spain. The most important results include the maintenance of the thresholds to define HTN and the therapeutic objectives, as well as the recommendation to initiate pharmacological treatment based on both the blood pressure values and the cardiovascular risk estimated by SCORE2 and the presence of organic damage. New are the introduction of practical tables to estimate the fragility of hypertensive subjects based on their age and autonomy, as well as precise recommendations for monitoring HTN. In summary, the ESH 2024 Guidelines represent a useful, reasoned and concise instrument that can serve as a tool to improve the control of HTN in our environment.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 52-58"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682941","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}