[Clinical characteristics and follow-up of patients attending a hospital hypertension clinic. 10-year experience]. / Características clínicas y evolutivas de los pacientes asistidos en una consulta especializada de hipertensión arterial. Experiencia de 10 años.

OBJECTIVE: To analyze the characteristics and control of hypertensive patients visited in a hospital hypertension clinic, dependent of the internal medicine department. METHODS: The study included 597 hypertensive patients, mean age 51.9 years (range 14-85), visited consecutively during the period 1989-1998. We applied the following initial protocol: Usual and orientated HBP anamnesis and physical examination, routine blood and urine test, standard electrocardiography and abdominal echocardiography. If necessary, we indicated other test or special explorations. After every visit, the data were stored into an electronic database, which we analyzed retrospectively to obtain the data of this study. RESULTS: Initial and final BP were: systolic BP 154 +/- 25 vs 141 +/- 21 mmHg, Dif. -12.9 (95% CI -14.8 a -11.0), and diastolic BP 96 +/- 12 vs 88 +/- 19 mmHg, Dif. -7.6 (95% CI -8.6 a -6.6). Four hundred and five patients (79.5%) presented I-II OMS stage and 121 (20.2%) III stage. One hundred and seventy-four cardiovascular events were registered. Hypercholesterolemia and obesity were present in 32% of the patients. Seventy-four (10.7%) had secondary HBP. ECA inhibitors were the antihypertensive drugs more used, either associated (58.9%) or as monotherapy (37%). Nine hundred patients (31.8%) presented optimal BP control (< 140/90 mmHg), and 27 (4.5%) refractory HBP. Weight and laboratory values (but uric acid) did not change significantly during the follow-up period. CONCLUSIONS: The patients showed a high prevalence of severe cardiovascular events, and associated risk factors. The 10% presented secondary HBP. About 31% of the patients reached optimal BP control.

[Homozygous familial hypercholesterolemia. Response to combined cholestyramine and lovastatin therapy]. / Hipercolesterolemia familiar homocigota. Respuesta al tratamiento combinado con colestiramina y lovastatina.

Homozygous familiar hypercholesterolemia (FH) is a serious inherited disease caused by a genetic defect in the cell surface receptor that controls the degradation of low density lipoprotein (LDL). These patients often have myocardial infarction in their teens or early adulthood and are usually unresponsive to drugs. Recently it has been reported promising results using combined drugs regimens in patients with residual receptor activity. We report a new additional patient with receptor-defective homozygous FH treated with a combination of lovastatin and cholestyramine. The cholesterol levels were reduced in a 67% and there were adverse events related to treatment during a 7 month period of follow-up.