Assuntos
Algoritmos , Terapia de Ressincronização Cardíaca , Fármacos Cardiovasculares/uso terapêutico , Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Oxigenação por Membrana Extracorpórea , Insuficiência Cardíaca/terapia , Guias de Prática Clínica como Assunto , Doença Aguda , Antagonistas Adrenérgicos beta/uso terapêutico , Aminobutiratos/uso terapêutico , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Benzazepinas/uso terapêutico , Compostos de Bifenilo , Doença Crônica , Combinação de Medicamentos , Intervenção Médica Precoce , Ecocardiografia , Europa (Continente) , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/diagnóstico , Humanos , Ivabradina , Antagonistas de Receptores de Mineralocorticoides/uso terapêutico , Peptídeos Natriuréticos/sangue , Espanha , Volume Sistólico , Tetrazóis/uso terapêutico , ValsartanaRESUMO
BACKGROUND: The aim of this cross-sectional, multicenter survey was: 1) To investigate the level of control of cardiovascuar risk factors in patients with a previous stroke. 2) To know the pharmacological therapy used to attain the control. PATIENTS AND METHODS: Data obtained from a total of 955 patients were included in the analysis.. There were evaluated cardiovascular risk factors, parameters related to the degree of control, analytical parameters, antropometric and pharmacological indicated treatment. RESULTS: The majority (61%) had suffered an ischemic stroke and 97.7% presented at least one associated cardiovascular risk factor, being hypertension (84.8%) and dyslipidemia (61.8%) the most frequent. Other factors were abdominal obesity (42.9%), diabetes mellitus (35.6%) and smoking (25.1%). Only 1.2% of the patients presented an adequate control of all cardiovascular risk factors. Only 17.6% had a well controlled blood pressure and in 29.8% LDL-cholesterol was well controlled. In 50.2% of diabetic patients HbA1c was well controlled. Angiotensin receptor blockers were the most widely used antihypertensive drugs (57.6%) while thiazide diuretics were prescribed in 33.4%. Statins were prescribed in 72.8% of patients and metformin, aspirin and acenocumarol in 30.2%, 57.3%, and 15.0% respectively. CONCLUSIONS: In conclusion, in patients with a past history of stroke arterial hypertension is the most common cardiovascular risk factor and the control of these factors requires an improvement.
Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Acidente Vascular Cerebral/complicações , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Atenção Primária à Saúde , Fatores de Risco , EspanhaRESUMO
Hypertension is a public health problem of first magnitude, because of its high prevalence and the associated increase in cardiovascular and renal complications. For this reason, achieving adequate pressure control in a high percentage of patients is a priority for any health system. In our country there have been numerous studies examining the degree of control of hypertension. The percentage of patients achieving adequate control has increased progressively, but the margin of improvement is still very important. Among the factors that have contributed to this improved control is the use of antihypertensive drugs in combination, free or fixed. This article reviews the progress made in controlling hypertension, in which the combined use of antihypertensive drugs has played a key role and future therapeutic options to further improve the pressure control, with special attention to the fixed combination three antihypertensive drugs.
Assuntos
Anti-Hipertensivos/administração & dosagem , Hipertensão/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/classificação , Anti-Hipertensivos/uso terapêutico , Ensaios Clínicos como Assunto/estatística & dados numéricos , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do TratamentoRESUMO
Recently published guidelines recognize the relevance of the finding of chronic kidney disease in the stratification of risk of the hypertensive patient. Determination of the presence of microalbuminuria and estimation of glomerular filtration rate are mandatory in order to ensure an adequate evaluation of global cardiovascular risks in the hypertensive patient. The presence of subtle elevations of serum creatinine concentrations and/or proteinuria are also potent predictors of a poor cardiovascular prognosis. Clustering of associated risk factors seems to justify the elevated cardiovascular risk observed in patients with essential hypertension and mild alterations of renal function.