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1.
Medicine (Baltimore) ; 99(9): e19415, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118795

RESUMEN

There has been some debate between biologic disease modifying anti-rheumatic drugs (bDMARDs) treatment and hypertension (HTN) in rheumatoid arthritis (RA). The aim of this study was to determine the effect of bDMARDs on the development of HTN in patients with RA.A total of 996 patients eligible for analysis were recruited from the Korean College of Rheumatology Biologics & Targeted Therapy (KOBIO) registry from 2012 to 2018. The bDMARDs were tumor necrosis factor (TNF) inhibitors, abatacept, and tocilizumab. The cDMARDs included methotrexate, hydroxychloroquine, and leflunomide. The incidence rate and 95% confidence interval of HTN were estimated using the Kaplan-Meier method. Hazard ratio (HR) of risk factors associated with hypertension was assessed by cox proportional hazard model analysis.Among the 996 patients, 62 patients (6.2%) were newly diagnosed with HTN. There were differences in incidence rate of HTN among conventional DMARDs (cDMARDs), TNF inhibitors, tocilizumab, and abatacept during the follow-up period (P = .015). Kaplan-Meier analysis showed that there was a significant difference in incident HTN only between cDMARDs and tocilizumab (P = .001). Systolic blood pressure and positive rheumatoid factor were associated with development of HTN (HR = 1.049, P = .016 and HR = 1.386, P = .010, respectively). Cox proportional hazard model analysis showed no difference in the development of HTN between bDMARDs and cDMARDs in RA.This study showed that bDMARDs treatment might not increase risk of incident HTN in patients with RA, compared to cDMARDs.


Asunto(s)
Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Hipertensión/etiología , Adulto , Anciano , Antirreumáticos/uso terapéutico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/epidemiología , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Sistema de Registros/estadística & datos numéricos , República de Corea/epidemiología
3.
Medicine (Baltimore) ; 99(1): e18541, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895792

RESUMEN

Perioperative hypertension is a common occurrence in the neurosurgical population, where 60% to 90% of the patients require treatment for blood pressure (BP) control. Nicardipine and clevidipine have been commonly used in neurocritical settings. This retrospective, observational study assessed the effectivity of the administration of clevidipine after nicardipine treatment failure in neurosurgical patients.We retrospectively reviewed the medical charts of adult patients who were admitted to our neurosurgical department and received clevidipine after nicardipine treatment failure for the control of BP. The primary effectivity outcome was the comparison of the percentage of time spent at targeted SBP goals during nicardipine and clevidipine administration, respectively.A total of 12 adult patients treated with clevidipine after nicardipine treatment failure and were included for data analysis. The median number of events that required dose-titration was 20.5 vs 17 during the administration of nicardipine and clevidipine, respectively (P = .534). The median percentage of time spent at targeted SBP goal was 76.2% during the administration of nicardipine and 93.4% during the administration of clevidipine (P = .123).Our study suggests that clevidipine could be an alternative effective drug with an acceptable benefit/risk ratio in the neurosurgical population that fails to achieve BP control with nicardipine treatment.


Asunto(s)
Bloqueadores de los Canales de Calcio/administración & dosificación , Hipertensión/tratamiento farmacológico , Complicaciones Intraoperatorias/tratamiento farmacológico , Procedimientos Neuroquirúrgicos/efectos adversos , Piridinas/administración & dosificación , Presión Sanguínea/efectos de los fármacos , Femenino , Humanos , Hipertensión/etiología , Complicaciones Intraoperatorias/etiología , Masculino , Persona de Mediana Edad , Nicardipino/uso terapéutico , Estudios Retrospectivos , Insuficiencia del Tratamiento , Resultado del Tratamiento
4.
Expert Opin Drug Saf ; 19(1): 59-67, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31795777

RESUMEN

Introduction: The objective of this study was to review the current status of drug-induced hypomagnesemia and its adverse effects on cardiovascular disease (CVD) and hypertension. Since magnesium is a potent vasodilator, which modulates vasomotor tone, peripheral blood flow, and hypertension, its deficiency could have significant cardiovascular and blood pressure (BP) effects.Areas covered: Studies have shown that several factors can contribute to magnesium deficiency including age, diet, disease, and certain drugs such as diuretics and proton-pump inhibitors (PPIs). For an updated perspective of drug-induced hypomagnesemia, a Medline search of the English language literature was conducted between 2010 and 2019 using the terms diuretics, proton-pump inhibitors, hypomagnesemia, cardiovascular disease, hypertension, and 35 pertinent papers were retrieved.Expert opinion: The data showed that magnesium deficiency is difficult to occur since it is plentiful in green leafy vegetables, cereals, nuts, and the drinking water. However, magnesium deficiency can occur with the use of diuretics for the treatment of hypertension and heart failure, or the use of PPIs for the treatment of gastroesophageal reflux disease. Therefore, magnesium deficiency should be detected and treated to prevent the aggravation of hypertension and the onset of CVD and serious cardiac arrhythmias including torsades de points.


Asunto(s)
Diuréticos/efectos adversos , Deficiencia de Magnesio/inducido químicamente , Inhibidores de la Bomba de Protones/efectos adversos , Animales , Arritmias Cardíacas/inducido químicamente , Presión Sanguínea/efectos de los fármacos , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/fisiopatología , Diuréticos/administración & dosificación , Humanos , Hipertensión/etiología , Deficiencia de Magnesio/complicaciones , Deficiencia de Magnesio/diagnóstico , Inhibidores de la Bomba de Protones/administración & dosificación
5.
Urology ; 135: e1, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31604068

RESUMEN

A 29-year-old female was referred to the urology clinic because of an incidentally found left renal mass discovered during workup for secondary erythrocytosis. Since 12 years of age, she has had headaches and poorly controlled hypertension refractory to trimodal antihypertensive therapy. Laboratory workup revealed markedly elevated aldosterone and renin levels. Computed tomography demonstrated a 3 cm left renal mass. The patient was admitted for intravenous blood pressure control. After partial nephrectomy, aldosterone and renin levels normalized. The patient was weaned off of blood pressure medications. Pathology was consistent with a juxtaglomerular cell tumor secreting renin (ie, reninoma).


Asunto(s)
Antihipertensivos/farmacología , Hipertensión/etiología , Aparato Yuxtaglomerular/patología , Neoplasias Renales/complicaciones , Adulto , Aldosterona/sangre , Antihipertensivos/uso terapéutico , Resistencia a Medicamentos , Quimioterapia Combinada , Femenino , Humanos , Hipertensión/sangre , Hipertensión/tratamiento farmacológico , Aparato Yuxtaglomerular/diagnóstico por imagen , Aparato Yuxtaglomerular/metabolismo , Neoplasias Renales/diagnóstico , Neoplasias Renales/cirugía , Nefrectomía , Renina/sangre , Renina/metabolismo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
6.
Curr Med Chem ; 27(2): 240-257, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31486745

RESUMEN

BACKGROUND: Obesity is a major cardiovascular risk factor which dramatically impairs endothelium- dependent vasodilation and leads to hypertension and vascular damage. The impairment of the vasomotor response to extracellular autacoids, e.g., acetylcholine, mainly depends on the reduced Nitric Oxide (NO) bioavailability, which hampers vasorelaxation in large conduit arteries. In addition, obesity may affect Endothelium-Dependent Hyperpolarization (EDH), which drives vasorelaxation in small resistance arteries and arterioles. Of note, endothelial Ca2+ signals drive NO release and trigger EDH. METHODS: A structured search of bibliographic databases was carried out to retrieve the most influential, recent articles on the impairment of vasorelaxation in animal models of obesity, including obese Zucker rats, and on the remodeling of the endothelial Ca2+ toolkit under conditions that mimic obesity. Furthermore, we searched for articles discussing how dietary manipulation could be exploited to rescue Ca2+-dependent vasodilation. RESULTS: We found evidence that the endothelial Ca2+ could be severely affected by obese vessels. This rearrangement could contribute to endothelial damage and is likely to be involved in the disruption of vasorelaxant mechanisms. However, several Ca2+-permeable channels, including Vanilloid Transient Receptor Potential (TRPV) 1, 3 and 4 could be stimulated by several food components to stimulate vasorelaxation in obese individuals. CONCLUSION: The endothelial Ca2+ toolkit could be targeted to reduce vascular damage and rescue endothelium- dependent vasodilation in obese vessels. This hypothesis remains, however, to be probed on truly obese endothelial cells.


Asunto(s)
Hipertensión , Obesidad/complicaciones , Animales , Calcio , Células Endoteliales , Endotelio Vascular , Hipertensión/etiología , Ratas , Ratas Zucker , Vasodilatación
7.
J Surg Oncol ; 121(3): 456-464, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31858609

RESUMEN

BACKGROUND: Primary aldosteronism (PA) is the most common cause of secondary hypertension; early diagnosis and intervention correlate with outcomes. We hypothesized that race may influence clinical presentation and outcomes. METHODS: We conducted a retrospective analysis of patients with PA (1997-2017) who underwent adrenal vein sampling (AVS). Patients were classified by self-reported race as black or non-black. Improvement was defined as postoperative decrease in mean arterial pressure (MAP), antihypertensive medications (AHM), or both. RESULTS: Among patients undergoing AVS (n = 443), 287 underwent adrenalectomy. Black patients (28.2%) had higher body mass index (33.9 vs 31.8 kg/m2 ; P = .01), longer median duration of hypertension (12 vs 10 years; P = .003), higher modified Elixhauser comorbidity index (2 vs 1; P = .004), and lower median income ($47 134 vs $78 280; P < .001). Black patients had similar aldosterone:renin ratios (150 vs 135.6 [ng/dL]/[ng·mL·-1 hr-1 ]; P = .23) compared to non-blacks. At long-term follow-up, black patients had a similar requirement for AHM (1 vs 0; P = .13) but higher MAP (100.6 vs 95.3 mm Hg; P = .004). CONCLUSION: Black patients present with longer duration of hypertension and more comorbidities. They are equally likely to lateralize on AVS, suggesting similar disease phenotype. However, black patients demonstrate less improvement with adrenalectomy; this may reflect a delay in diagnosis or concomitant essential hypertension.


Asunto(s)
Adrenalectomía/efectos adversos , Grupos de Población Continentales/estadística & datos numéricos , Hiperaldosteronismo/cirugía , Hipertensión/etiología , Complicaciones Posoperatorias , Femenino , Estudios de Seguimiento , Humanos , Hiperaldosteronismo/patología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos
10.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(4): 159-162, oct.-dic. 2019. ilus
Artículo en Español | IBECS | ID: ibc-184304

RESUMEN

La hipertensión pulmonar es una enfermedad compleja, grave y de baja incidencia. Es un estado hemodinámicamente patológico con una presión de arteria pulmonar que supera los 25 mmHg. La presencia de hipertensión pulmonar en el puerperio es poco frecuente y conlleva un alto riesgo para la madre. Se presenta el caso de una mujer de 31 años en puerperio mediato patológico post parto eutócico con datos de bajo gasto cardiaco. El ecocardiograma demostró la presión de la arteria pulmonar que iguala a la sistémica. La angiotomografía helicoidal de tórax descarta tromboembolismo pulmonar, y se realiza diagnóstico de hipertensión de la arteria pulmonar de etiología desconocida


Pulmonary hypertension is a complex, serious and low incidence disease. It is a haemodynamically pathological state with a pulmonary artery pressure that exceeds 25 mmHg. The presence of pulmonary hypertension in the puerperium is rare, and carries a high risk to the mother. The case is presented of a 31 year-old female in the subacute postpartum period of a normal delivery with data of low cardiac output. The echocardiogram showed that the pressure of the pulmonary artery was equal to the systemic. A thoracic helical angio-tomography ruled out pulmonary thromboembolism, making a diagnosis of pulmonary artery hypertension of unknown aetiology


Asunto(s)
Humanos , Femenino , Adulto , Hipertensión Pulmonar/etiología , Periodo Posparto , Embolia Pulmonar/diagnóstico por imagen , Hipertensión/etiología , Embolia Pulmonar/complicaciones , Radiografía Torácica/métodos , Gasto Cardíaco
11.
BMC Neurol ; 19(1): 341, 2019 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-31881866

RESUMEN

BACKGROUND: To evaluate the efficacy of microvascular decompression (MVD) in reducing hypertension (HTN) in hypertensive patients with trigeminal neuralgia (TN). METHODS: The clinical data of 58 cases of neurogenic HTN with TN treated in our hospital were retrospectively reviewed. Preoperative MR revealed abnormal blood pressure in the left rostral ventrolateral medulla (RVLM) and the posterior cranial nerve root entry zone (REZ). The patients were divided into control group: only trigeminal nerve was treated with MVD; experimental group: trigeminal nerve, RVLM and REZ were treated with MVD at the same time. The patients were followed up for 6 months to 1 year to observe the changes of blood pressure. RESULTS: There was no significant difference in gender, age, course of TN, course of HTN, grade of HTN and preoperative blood pressure between the two groups. After operation, the effective rate of HTN improvement with MVD was 32.1% in the control group. There was no significant difference in the preoperative and post operative blood pressure. (P△SBP = 0.131; P△BDP = 0.078). In the experimental group, the effective rate was 83.3%. The postoperative blood pressure was significantly lower than preoperative values. (P△SBP < 0.001; P△DBP < 0.001). CONCLUSIONS: MVD is an effective treatment for neurogenic HTN. However, the criteria for selecting hypertensive patients who need MVD to control their HTN still needs to be further determined. Possible indications may include: left trigeminal neuralgia, neurogenic HTN; abnormal blood pressure compression in the left RVLM and REZ areas on MR; and blood pressure in these patients can not be effectively controlled by drugs.


Asunto(s)
Hipertensión/etiología , Hipertensión/cirugía , Bulbo Raquídeo/cirugía , Cirugía para Descompresión Microvascular/métodos , Enfermedades Vasculares/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Bulbo Raquídeo/patología , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Neuralgia del Trigémino/etiología , Neuralgia del Trigémino/cirugía , Enfermedades Vasculares/complicaciones
12.
Pan Afr Med J ; 33: 210, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692887

RESUMEN

Introduction: Hypertension ranks third in the world, after underweight and unsafe sex, in the list of six major risk factors contributing to the global disease. In Kenya, the prevalence stands at 24% in the general population, while among the young adults, the incidence of hypertension has been reported to be in the rise; a fact attributed to increased number of risks. We therefore sought to determine awareness and risk factors of hypertension among young adults attending Tenwek hospital. Methods: A case-control study of young adults ages 18-35, involving 80 cases and 80 controls at Tenwek Mission Hospital, Bomet County. Cases included males and females newly diagnosed with hypertension (diagnosed at the time of data collection) and if they reported taking antihypertensive medication and reported as hypertensives in the hospital records at any clinic visit or at interview, while controls included persons with no history of hypertension. Results: Those having a BMI≥25 were 3.05 times more likely to be hypertensive (OR: 3.05, 95% CI 1.26, 7.40; p=0.014). Having a relative suffering from hypertension increased almost thrice the odds of being hypertensive (OR: 2.78, 95% CI 1.20, 6. 46; p=0.018). Not drinking alcohol reduced the chance of suffering from hypertension by 70%, (OR=0.30, 95% CI 0.11, 0.81; p=0.017). Conclusion: The prevalence of hypertension in younger adults is not as low as generally perceived. Preventive measures should be formulated in a manner to address variety of major risk factors in young adults.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Antihipertensivos/uso terapéutico , Salud de la Familia/estadística & datos numéricos , Hipertensión/epidemiología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Estudios de Casos y Controles , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/etiología , Kenia/epidemiología , Masculino , Prevalencia , Factores de Riesgo , Adulto Joven
13.
Diabetes Res Clin Pract ; 158: 107903, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31678625

RESUMEN

AIM: We aimed to examine the association between serum magnesium and diabetes and hypertension among Qatari adults. METHODS: In the cross-sectional study, we used data from 9693 Qatari participants aged 20 years and above attending the Qatar Biobank (QBB) Study. Blood samples were analyzed in a central lab. Habitual food consumption was assessed by a food frequency questionnaire. Reduced rank regression was used to construct magnesium related dietary pattern (MRDP) using serum magnesium as a response variable. Diabetes was defined by blood glucose, HbA1c or known diabetes. Prediabetes was defined as HbA1c between 5.7% and 6.4%. Subclinical magnesium deficiency was defined as serum magnesium <0.85 mmol/L. RESULTS: The prevalence of diabetes, prediabetes and subclinical magnesium deficiency was 18.9%, 11.5% and 59.5%, respectively. Across the quartiles of serum magnesium from high to low, the prevalence ratios (PR 95%CI) for diabetes were 1.00, 1.35, 1.88, and 2.70 (95%CI 2.38-3.05), respectively (p for trend <0.001). The presence of hypertension significantly increased the probability of diabetes along a wide range of low serum magnesium. A low intake of MRDP was also positively associated with diabetes and high HbA1c. CONCLUSION: Subclinical magnesium deficiency is common in Qatar and associates with diabetes, prediabetes and hypertension in Qatari adults.


Asunto(s)
Bancos de Muestras Biológicas/tendencias , Diabetes Mellitus/sangre , Diabetes Mellitus/etiología , Hipertensión/sangre , Hipertensión/etiología , Magnesio/metabolismo , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Qatar
14.
Georgian Med News ; (294): 182-187, 2019 Sep.
Artículo en Ruso | MEDLINE | ID: mdl-31687973

RESUMEN

The aim of this study was to establish the prevalence, relative risks, and predictive factors of the development of arterial hypertension (AH) in workers of a uranium processing enterprise (UPE). An open cross-sectional comparative study of 809 UPE workers was conducted. The compared them to the 696 workers of the bearing plant, located at a distance of 10 km from UPE. Stratification was performed and odds ratios (OR), gross (RR) and standardized relative (SRR) risks of hypertension were calculated. Our results revealed a high prevalence of hypertension among UPE workers (24.8%), as well as greater risk of development of hypertension among workers of UPE in comparison to the personnel of the non-uranium enterprise: RR=2.4 and SRR=2.9. The most significant predictors of hypertension were burdened heredity (OR = 13.6), total radiation dose (OR=1.5), overweight (OR=1.1), high anxiety (OR=0.5) and systematic use of alcohol (OR=0.5). Thus, among workers chronically exposed to radiation toxicity, high prevalence of hypertension, excessive RR and SRR of developing hypertension and the presence of risk factors for hypertension were established.


Asunto(s)
Industria Procesadora y de Extracción/estadística & datos numéricos , Hipertensión/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Uranio/toxicidad , Consumo de Bebidas Alcohólicas/epidemiología , Ansiedad/complicaciones , Ansiedad/epidemiología , Estudios Transversales , Humanos , Hipertensión/etiología , Kazajstán/epidemiología , Obesidad/complicaciones , Exposición Profesional/estadística & datos numéricos , Prevalencia , Dosis de Radiación , Factores de Riesgo
15.
Presse Med ; 48(12): 1445-1455, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31761607

RESUMEN

The Hormonal assessment of Arterial Hypertension (HTA) is an important part of the balance of resistant hypertension. This assessment - going well beyond the search for primary hyperaldosteronism (PHA) - requires a rigorous methodology and a robust experience of the nursing team within a dedicated unit: the HTA Day Hospital. If all the conditions are met and the assessment carried out well, it will allow a significant profitability since in this resistant hypertensive population it will detect a particular mechanism or secondary hypertension in 70% of patients. Since the diagnosis of PHA is essentially biological, the proper execution of the various stages of the assessment is essential to its documentation.


Asunto(s)
Técnicas de Diagnóstico Endocrino , Hormonas/análisis , Hipertensión/diagnóstico , Aldosterona/análisis , Aldosterona/sangre , Antihipertensivos/uso terapéutico , Análisis Químico de la Sangre/métodos , Análisis Químico de la Sangre/normas , Diagnóstico Diferencial , Técnicas de Diagnóstico Endocrino/normas , Resistencia a Medicamentos/efectos de los fármacos , Hormonas/sangre , Humanos , Hiperaldosteronismo/diagnóstico , Hipertensión/sangre , Hipertensión/tratamiento farmacológico , Hipertensión/etiología , Renina/análisis , Renina/sangre
16.
Presse Med ; 48(11 Pt 1): 1265-1268, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31732366

RESUMEN

The two main non-iatrogenic causes of secondary hypertension in women of childbearing age are primary aldosteronism and renal fibromuscular dysplasia. It is recommended to look for a secondary hypertension in women who remain hypertensive three months after pregnancy, in patients under 40 years of age or in patients with a grade 3 HTN (BP≥180/110mm Hg) (Professional agreement). It is suggested that the initial assessment of a secondary HTN in women is performed by a HTN specialist; it will include an assessment of renin and aldosterone concentrations and an angio-CT of the renal arteries (or angio-MRI if contraindicated) (Grade C - Class 2).


Asunto(s)
Displasia Fibromuscular/complicaciones , Hiperaldosteronismo/complicaciones , Hipertensión/etiología , Adulto , Factores de Edad , Aldosterona/sangre , Angiografía por Tomografía Computarizada , Femenino , Displasia Fibromuscular/diagnóstico , Humanos , Hiperaldosteronismo/diagnóstico , Hipertensión/sangre , Hipertensión/diagnóstico , Periodo Posparto , Arteria Renal/diagnóstico por imagen , Renina/sangre , Factores Sexuales
18.
Int J Med Inform ; 132: 104011, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31654966

RESUMEN

BACKGROUND: Adults with congenital heart disease (ACHD) often suffer from deterioration related to cardiac arrhythmias, hypertension (HT) or heart failure (HF), frequently occurring between planned visits. Mobile health (mHealth) could improve management through remote monitoring by enabling swift therapeutic response and detecting new diagnoses. METHODS: We performed a prospective study employing mHealth in ACHD patients, weekly monitoring heart rhythm, weight and blood pressure. In case of consecutive threshold exceeding measurements or in case of new diagnosis, patients were contacted and if needed the treating physician was consulted. Inclusion criteria were: palpitations within the last three years (with or without arrhythmia diagnosis) or HF NYHA class ≥ II. We evaluated the detection of recurrences and new diagnosis of arrhythmias, HT and HF, adherence and patient experience (Net Promotor Score (NPS)). RESULTS: In total, 109 of the 268 invited ACHD patients were enrolled, 80 with palpitations, 13 with HF, 16 experienced both, mean age 45 (±13) years, 33% male. Median follow-up was 12 (Q1-Q3;9-14) months, 91 patients initiated all measurements (heart rhythm, weight and blood pressure). In 25% of the patients with diagnosed arrhythmias (14/56) recurrences of arrhythmias were detected; 13% of the patients with undiagnosed palpitations (4/32) were diagnosed with novel arrhythmias. In 38% of the patients with HT at baseline (6/16), treatment adjustment was necessary, 4% of the patients without HT (4/76) received novel HT diagnosis. Diuretics were adjusted in 7% of the patients with HF (2/29). Adherence was > 70% in 77% of the patients that started weekly measurements (70/91). Patients that were female, older of age and experienced palpitations at inclusion were more likely to acquire an adherence of > 70%. NPS was completed by 68 patients, 57 patients (84%) were promotors or neutral, and 11 patients (16%) were critics. CONCLUSIONS: mHealth offers advantages in the management of selected ACHD patients; it enabled early detection of recurrences and new diagnosis of arrhythmias, hypertension and heart failure, which lead to swift therapeutic response or remote reassurance. Furthermore, mHealth was well accepted with high adherence and positive patient experience.


Asunto(s)
Arritmias Cardíacas/prevención & control , Cardiopatías Congénitas/complicaciones , Insuficiencia Cardíaca/prevención & control , Hipertensión/prevención & control , Cooperación del Paciente/estadística & datos numéricos , Telemedicina/métodos , Adulto , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiología , Manejo de la Enfermedad , Femenino , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/etiología , Humanos , Hipertensión/diagnóstico , Hipertensión/etiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Telemedicina/estadística & datos numéricos
19.
Medicine (Baltimore) ; 98(43): e17489, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31651851

RESUMEN

Very few studies have been published on cardiovascular morbidity in Spanish patients diagnosed with systemic lupus erythematosus (SLE). Moreover, knowledge of the predictive factors for the occurrence of nonfatal events in this group of patients is scarce.This was a multicenter, observational, cross-sectional study designed to ascertain the prevalence of nonfatal cardiovascular risk factors and cardiovascular events (CVEs) in 335 Spanish women diagnosed with SLE between 2003 and 2013.The average patient age was 36.0 years (range: 26.4-45.6); 35 patients (10.7%) experienced at least 1 CVE, which most frequently affected the brain, followed by the heart, and finally, the peripheral vasculature. Both the number of admissions because of SLE (95% confidence interval [CI] odds ratio [OR] = 1.024-1.27, P = .017) and the systemic lupus international collaborating clinics (SLICC) chronicity index score (95% CI OR = 1.479-2.400, P = .000) resulted in an increase in the OR of these patients presenting a CVE. Regarding the classic risk factors, only the interaction between hypertension (HT) and treatment with antihypertensive drugs influenced the presence of CVEs (95% CI OR = 2.165-10.377, P = .000). The presence of a family history of early cardiovascular disease was also related to CVEs (95% CI OR = 2.355-40.544, P = .002). Binary logistic regression including the above factors resulted in a model in which the 3 main variables in each group persisted, implying that they must be independent of each other. However, the weight of the interaction between the family history of early cardiovascular disease and the interaction between HT and the use of antihypertensives was higher than for the number of admissions for SLE.The SLE disease activity over time (measured using the SLICC) and the number of hospital admissions due to the disease itself, both increase the risk of women with SLE presenting a CVE. Classic cardiovascular risk factors, especially HT and its treatment, as well as a family history of early CVEs, should be considered when assessing the risk of nonfatal CVEs in women with SLE.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Lupus Eritematoso Sistémico/complicaciones , Adulto , Antihipertensivos/uso terapéutico , Estudios Transversales , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Hipertensión/etiología , Modelos Logísticos , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Medición de Riesgo , Factores de Riesgo , España/epidemiología
20.
Kardiologiia ; 59(10): 88-96, 2019 Oct 15.
Artículo en Ruso | MEDLINE | ID: mdl-31615391

RESUMEN

In 2017 the Endocrine Society issued the Scientific Statement "Screening for Endocrine Hypertension" This document was developed by experts from different medical institutions of USA, Europe and Australia. Herein we present the main provisions of this Statement in the form of brief algorithm for the clinicians' actions for timely detection of secondary endocrine hypertension and rational referral of the patient for confirmational testing.The full text of the Scientific Statement in English is contained in the article. Young WF Jr., Calhoun DA, Lenders JW, Stowasser M, Textor SC. Screening for Endocrine Hypertension: An Endocrine Society Scientific Statement. Endocrine Reviews. 2017; 38 (2):103-122.URL: https://academic.oup.com/edrv/article/38/2/103/3104343.


Asunto(s)
Enfermedades del Sistema Endocrino , Hipertensión , Enfermedades del Sistema Endocrino/complicaciones , Enfermedades del Sistema Endocrino/diagnóstico , Europa (Continente) , Humanos , Hipertensión/diagnóstico , Hipertensión/etiología
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