Results of May Measurement Month 2018 campaign in Venezuela.

Cardiovascular diseases, mainly coronary heart disease and stroke, are the main cause of death in Venezuela; hypertension is the primary risk factor. The May Measurement Month (MMM) study is a global initiative aimed at raising awareness of elevated blood pressure (BP). The previous MMM 2017 campaign showed 48.9% of participants had hypertension, higher than previous Venezuelan epidemiological studies. The MMM 2018 campaign included 28 649 participants screened [mean age: 54.2 (SD 15.13) years; female 62.8%] carried out mainly in pharmacies in 61 sites. Physical measurements included height, weight, and BP, taken in sitting position three times. After multiple imputations, 48.4% had hypertension, of which 87.7% were aware of their diagnosis. Of the individuals not receiving antihypertensive medication, 14.0% had hypertension and 33.7% of those receiving treatment had uncontrolled hypertension. Overall, the percentage of hypertensives with controlled hypertension was 54.8%. Body mass index was calculated for the total population, and it was on average 25.2 (SD: 4.65) kg/m2. Of all, 14.2% was classified as obese and 32.6% as overweight; meanwhile 4.8% as underweight. Diabetes was reported by 9.5%. These results suggest that repeated screening like the MMM campaign can routinely identify hypertension and consequently implement programmes of treatment in Venezuela, also other common risk factors, like obesity or diabetes.

Results of the May Measurement Month 2017: blood pressure campaign in Venezuela-Americas.

Cardiovascular diseases, mainly coronary heart disease and stroke, are the first cause of death in Venezuela; and hypertension is the main risk factor. May Measurement Month (MMM) is a global initiative aimed at raising awareness of elevated blood pressure (BP) and to act as a temporary solution to the lack of regular screening programmes. Some representative studies indicate prevalence of hypertension in Venezuela between 24 and 39%, and control rate around 20%. Sixty-four sites were included to participate in MMM, mainly in pharmacies. Physical measurements included height, weight, and abdominal circumference. Blood pressure was measured in the sitting position three times after resting for 5 min, 1 min apart, using validated oscillometric devices. 21 644 individuals were screened. After multiple imputation, 10 584 individuals [48.9% (50.7% male; 47.7% female)] had hypertension. Of individuals not receiving antihypertensive medication, 1538 (12.2%) were hypertensive. Of individuals receiving antihypertensive medication, 2974 (32.9%) had uncontrolled BP. About 16% had obesity calculated by body mass index; 43.8% of women and 20.7% of men had abdominal obesity. This was the largest BP screening carried out in Venezuela, in which 48.9% of the individuals had elevated BP, untreated hypertension was 12.2%, and one-third of subjects taking treatment were not controlled. About 16% had obesity by body mass index, and abdominal obesity is more common in women. These results suggest that repeated screening like MMM17 can identify hypertension in important numbers and can also evaluate programmes of hypertension treatment and control in Venezuela.

Aspectos prácticos de ecocardiografía bidimensional y doppler en el diagnóstico de cardiopatias en el recién nacido / Practical aspects of bidimensional echocardiography and Doppler in the diagnosis of cardiopathies in the newborn

Se presentan en forma práctica para el pediatra las ventajas y desventajas de dos métodos diagnósticos de ultrasonido de uso frecuente en cardiología pediátrica: la ecocardiografía bidimensional (eco-B) y el efecto Doppler. En 16 casos diferentes de cardiopatias en recién nacidos de la Maternidad Concepción Palacios de Caracas presentamos los aspectos diagnosticados más importantes del eco-B y del Doppler, comparando ambos métodos, demostrando que se complementan, permitiendo un diagnóstico anatómico y funcional muy completos, evitandose el caterismo en la mayoría de los casos, muchos de los cuales en estado tan crítico, donde el estudio hemodinámico es un riesgo. Existen situaciones donde un método aventaja al otro, así por ejemplo, en la insuficiencia tricuspídea neonatal secundaria a hipertensión pulmonar persistente por dificultad respiratoria y en el conducto arterioso funcional del prematuro, el Doppler aventaja al eco-B, también en la comunicación interventricular muy pequeña, no visible por eco-B, el Doppler la detecta fácilmente. Pero también es cierto que antes es necesario demostrar que anatómicamente la tricúspide esté normal o que no coexisten otras anomalías estructurales en estas situaciones funcionales; por lo tanto, no deben utilizarse esos métodos por separado puesto que no quedaría completo el estudio. En forma resumida podríamos decir que el eco-B permite diagnóstico anatómico y el Doppler diagnóstico funcional. No presentamos casos con arritmia cardíaca por evitar la complejidad de la presentación. Incluimos dos casos de cardiopatía en fetos (ecocardiografía fetal) ya que el pediatra en sala de partos debe tomar sus previsiones ante los cardiópatas que están por nacer, lo cual se ve favorecido al conocerse el diagnóstico de la cardiopatía en útero