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1.
J Am Soc Hypertens ; 8(11): 827-31, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25455008

RESUMEN

Up to 20% of women with hypertensive pregnancy disorders might persist with chronic hypertension. This study compared clinical and echocardiographic features between women whose hypertension began as hypertensive pregnancy disorders (PH group) and women whose diagnosis of hypertension did not occur during pregnancy (NPH group). Fifty PH and 100 NPH women were cross-sectionally evaluated by clinical, laboratory, and echocardiography analysis, and the groups were matched by duration of hypertension. PH exhibited lower age (46.6 ± 1.4 vs. 65.3 ± 1.1 years; P < .001), but higher systolic (159.8 ± 3.9 vs. 148.0 ± 2.5 mm Hg; P = .009) and diastolic (97.1 ± 2.4 vs. 80.9 ± 1.3 mm Hg; P < .001) blood pressure than NPH, although used more antihypertensive classes (3.4 ± 0.2 vs. 2.6 ± 0.1; P < .001). Furthermore, PH showed higher left ventricular wall thickness and increased prevalence of concentric hypertrophy than NPH after adjusting for age and blood pressure. In conclusion, this study showed that PH may exhibit worse blood pressure control and adverse left ventricular remodeling compared with NPH.


Asunto(s)
Hipertensión Inducida en el Embarazo/diagnóstico , Hipertensión Inducida en el Embarazo/tratamiento farmacológico , Disfunción Ventricular Izquierda/diagnóstico por imagen , Remodelación Ventricular/fisiología , Adulto , Antihipertensivos/uso terapéutico , Determinación de la Presión Sanguínea , Distribución de Chi-Cuadrado , Intervalos de Confianza , Estudios Transversales , Ecocardiografía Doppler , Femenino , Estudios de Seguimiento , Humanos , Modelos Lineales , Cuidados a Largo Plazo , Embarazo , Resultado del Embarazo , Valores de Referencia , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Factores de Tiempo , Disfunción Ventricular Izquierda/epidemiología , Adulto Joven
2.
Am J Hypertens ; 27(2): 157-61, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24222667

RESUMEN

BACKGROUND: Aortic stiffness is associated with increased cardiovascular mortality. However, the determinants of aortic stiffness progression are not fully established. This study evaluated the predictive value of blood pressure (BP) response to cold pressor test (CPT) in the progression of carotid-femoral pulse wave velocity (PWV) in men and women. METHODS: A total of 408 individuals (165 men, 243 women) from Vitoria, Brazil, underwent BP evaluation, clinical and laboratorial investigations, and CPT and PWV assessment. Five years later, the studied individuals were re-evaluated, except for the CPT. RESULTS: In men, 5-year PWV change correlated inversely with baseline PWV (P < 0.001) and directly with BP response to CPT (P < 0.05) and 5-year BP change (P < 0.05). In women, 5-year PWV change correlated inversely with baseline PWV (P < 0.001) and directly with age (P < 0.01), glycemia (P < 0.05) and 5-year BP change (P < 0.05) but not with BP response to CPT. Further linear regression analysis showed that 5-year PWV change was associated with baseline PWV, systolic BP response to CPT, and 5-year systolic BP change in men and with baseline PWV, age, glycemia, and 5-year systolic BP change in women. CONCLUSIONS: BP response to CPT was a predictor of PWV progression in men after 5 years of follow-up. These findings provide further insights into the pathophysiologic mechanisms of arterial stiffness, suggesting that elevated sympathetic reactivity may be a predisposing factor for future increases in aortic stiffness, at least in men.


Asunto(s)
Presión Sanguínea/fisiología , Frío , Análisis de la Onda del Pulso , Rigidez Vascular , Adulto , Brasil , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad
3.
PLoS One ; 8(12): e81054, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24339896

RESUMEN

BACKGROUND: Reactive oxygen species are implicated in the physiopathogenesis of salt-induced hypertension and the C242T polymorphism of the p22-phox gene has been associated with higher superoxide production. This study investigated the impact of this polymorphism on the relationship between urinary sodium excretion (USE) and blood pressure levels in an urban Brazilian population. METHODS: We cross-sectionally evaluated 1,298 subjects from the city of Vitoria-ES, located in the Southeast region of Brazil, by clinical history, physical examination, anthropometry, analysis of laboratory parameters, USE measurement and p22-phox C242T polymorphism genotyping. RESULTS: No significant differences in studied parameters were detected between the studied genotype groups (CC vs. CT+TT). Systolic blood pressure exhibited significant correlation with USE only in T allele carriers (r = 0.166; p<0.001), while diastolic blood pressure and hypertension status correlated with USE in both genotypes albeit more weakly in subjects with CC genotype (r = 0.098; p = 0.021 and r = 0.105; p = 0.013, respectively) than in T carriers (r = 0.236; p<0.001 and r = 0.213; p<0.001, respectively). Regression analyses adjusted for confounding factors showed that USE remained independently associated with systolic (p<0.001) and diastolic blood pressure (p<0.001) and hypertension status (p = 0.004) only in T allele carriers. Finally, higher diastolic and systolic blood pressure levels were detected in T allele carriers than in CC genotype individuals in the highest tertile of USE. CONCLUSIONS: The p22-phox 242T allele is associated with higher blood pressure levels among subjects with higher USE in an urban Brazilian population.


Asunto(s)
Presión Sanguínea/genética , NADPH Oxidasas/genética , Polimorfismo de Nucleótido Simple , Sodio/orina , Población Urbana/estadística & datos numéricos , Adulto , Brasil , Femenino , Genotipo , Humanos , Hipertensión/genética , Hipertensión/fisiopatología , Hipertensión/orina , Masculino
4.
BMC Cardiovasc Disord ; 12: 52, 2012 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-22800461

RESUMEN

BACKGROUND: The impact of serum uric acid (SUA) on arteries of hypertensive subjects remains to be fully established. This study investigated the relationship between SUA and carotid structural and hemodynamic parameters in hypertensive men and women. METHODS: Three hundred and thirty eight patients (207 women and 131 men) were cross-sectionally evaluated by clinical, laboratory, hemodynamic and carotid ultrasound analysis. Common carotid diameters, circumferential wall tensions, Young's Elastic Modulus, Stiffness Index, Arterial Compliance and intima-media thickness (IMT) were determined. Internal carotid artery resistive index (ICRI), a hemodynamic measure that reflects local vascular impedance and microangiopathy, was also assessed. RESULTS: Univariate analysis showed no significant correlation of SUA with carotid diameters, elasticity/stiffness indexes, IMT and circumferential wall tensions in both genders. Conversely, SUA correlated with ICRI (r=0.34; p<0.001) in women, but not in men, and hyperuricemic women presented higher ICRI than normouricemic ones (0.684 ± 0.007 vs. 0.649 ± 0.004; p<0.001). Stepwise and logistic regression analyses adjusted for potential confounding factors showed that ICRI was independently associated with SUA and hyperuricemia in women. CONCLUSIONS: This study demonstrated that SUA was associated with ICRI in hypertensive women, suggesting that there might gender-related differences in the relationship between SUA and vascular damage in subjects with systemic hypertension.


Asunto(s)
Arteria Carótida Interna/fisiopatología , Hipertensión/sangre , Hipertensión/fisiopatología , Hiperuricemia/sangre , Hiperuricemia/fisiopatología , Ácido Úrico/sangre , Resistencia Vascular , Biomarcadores/sangre , Arteria Carótida Interna/diagnóstico por imagen , Grosor Intima-Media Carotídeo , Distribución de Chi-Cuadrado , Adaptabilidad , Estudios Transversales , Módulo de Elasticidad , Femenino , Humanos , Hipertensión/diagnóstico por imagen , Hiperuricemia/diagnóstico por imagen , Modelos Logísticos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Rigidez Vascular
6.
Rev. bras. hipertens ; 9(3): 293-300, jul.-set. 2002. tab
Artículo en Portugués | LILACS | ID: lil-325004

RESUMEN

A HAS em idosos está associada a um importante aumento nos eventos cardiovasculares com consequente diminuição da sobrevida e piora na qualidade de vida. Inumeros estudos demonstraram os beneficios do tratamento da HAS na população desta faixa etaria, com redução significativa dos eventos cardiovasculares e melhora na qualidade de vida. Tanto o tratamento medicamentoso como o não-farmacologico devem ser empregados, sempre considerando o individuo com suas co-morbidades e expectativas. As modificações de estilo de vida podem ter otima aderencia desde que bem orientadas, especialmente atraves de equipe multidisciplinar. O uso da terapia farmacologica combinada (duas drogas no mesmo comprimido) é uma necessidade para os idosos, melhorando a aderencia e a eficacia anti-hipertensiva e diminuindo os efeitos colaterais. Existem varios casos não contemplados nos grandes ensaios, por exemplo os idosos frageis ou os muito idosos, em que o tratamento deve ser feito com bom senso e de forma individualizada


Asunto(s)
Humanos , Anciano , Antihipertensivos , Hipertensión/fisiopatología , Hipotensión Ortostática/terapia , Anciano de 80 o más Años , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Estilo de Vida , Factores de Riesgo
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