Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 272.215
Filtrar
1.
Zhen Ci Yan Jiu ; 46(8): 700-6, 2021 Aug 25.
Artículo en Chino | MEDLINE | ID: mdl-34472757

RESUMEN

Acupuncture treatment can regulate blood pressure (BP) through multiple levels and ways. In the present paper, we reviewed the progress of researches on the underlying mechanisms of acupuncture in lowering BP from 1) regulation of activities of the neuroendocrine, 2) improvement of metabolic abnormality, and 3) alternation of gene expression in the heart and BP-regulation-related centers of the brain. The neuroendocrine mechanism mainly involves the inhibition of neuroinflammatory reaction in some higher brain regions, reduction of neuronal apoptosis, and suppression of the sympathetic cardiovascular regulatory functional areas of the brain stem, regulation of neurotransmitters and autonomic balance, activation of brain areas related to BP regulation, and promotion of functional connection between brain networks. The improvement of metabolic abnormality mainly refers to amelioration of imbalance of intestinal flora and target metabolites related to hypertension. The alteration of gene expression mainly manifests as up- and down-regulation of expression of genes related to oxidative stress, inflammation and vascular endothelial function in the myocardium, hypothalamus, rostral ventrolateral medulla. We reviewed the new research progress on the mechanism of acupuncture for hypertension, in order to provide evidence and research ideas for the treatment of related cardiovascular diseases by using acupuncture therapy in the future.


Asunto(s)
Terapia por Acupuntura , Hipertensión , Sistema Nervioso Autónomo , Presión Sanguínea/genética , Humanos , Hipertensión/genética , Hipertensión/terapia , Bulbo Raquídeo
2.
Clinics (Sao Paulo) ; 76: e2926, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34495079

RESUMEN

OBJECTIVES: To describe the MORPHEOS (Morbidity in patients with uncontrolled HTN and OSA) trial, and describe the challenges imposed by the COVID-19 pandemic. METHODS: MORPHEOS is a multicenter (n=6) randomized controlled trial designed to evaluate the blood pressure (BP) lowering effects of treatment with continuous positive airway pressure (CPAP) or placebo (nasal strips) for 6 months in adult patients with uncontrolled hypertension (HTN) and moderate-to-severe obstructive sleep apnea (OSA). Patients using at least one antihypertensive medication were included. Uncontrolled HTN was confirmed by at least one abnormal parameter in the 24-hour ABPM and ≥80% medication adherence evaluated by pill counting after the run-in period. OSA was defined by an apnea-hypopnea index ≥15 events/hours. The co-primary endpoints are brachial BP (office and ambulatory BP monitoring, ABPM) and central BP. Secondary outcomes include hypertension-mediated organ damage (HMOD) to heart, aorta, eye, and kidney. We pre-specified several sub-studies from this investigation. Visits occur once a week in the first month and once a month thereafter. The programmed sample size was 176 patients but the pandemic prevented this final target. A post-hoc power analysis will be calculated from the final sample. ClinicalTrials.gov: NCT02270658. RESULTS: The first 100 patients are predominantly males (n=69), age: 52±10 years, body mass index: 32.7±3.9 kg/m2 with frequent co-morbidities. CONCLUSIONS: The MORPHEOS trial has a unique study design including a run-in period; pill counting, and detailed analysis of hypertension-mediated organ damage in patients with uncontrolled HTN that will allow clarification of the impact of OSA treatment with CPAP.


Asunto(s)
COVID-19 , Hipertensión , Apnea Obstructiva del Sueño , Adulto , Presión Sanguínea , Presión de las Vías Aéreas Positiva Contínua , Humanos , Hipertensión/epidemiología , Hipertensión/terapia , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Apnea Obstructiva del Sueño/terapia
3.
Arq Bras Cardiol ; 117(2): 309-316, 2021 08.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34495225

RESUMEN

BACKGROUND: Although maximal and submaximal walking are recommended for patients with peripheral artery disease (PAD), performing these exercises may induce different physiological responses. OBJECTIVES: To compare the acute effects of maximal and submaximal walking on post-exercise cardiovascular function, regulation, and associated pathophysiological processes in patients with symptomatic PAD. METHODS: Thirty male patients underwent 2 sessions: maximal walking (Gardner's protocol) and submaximal walking (15 bouts of 2 minutes of walking separated by 2 minutes of upright rest). In each session, blood pressure (BP), heart rate (HR), cardiac autonomic modulation (HR variability), forearm and calf blood flows (BF), vasodilatory capacity (reactive hyperemia), nitric oxide (NO), oxidative stress (lipid peroxidation), and inflammation (four markers) were measured pre- and post-walking. ANOVAs were employed, and p < 0.05 was considered significant. RESULTS: Systolic and mean BP decreased after the submaximal session, but they increased after the maximal session (interactions, p < 0.001 for both). Diastolic BP did not change after the submaximal session (p > 0.05), and it increased after maximal walking (interaction, p < 0.001). HR, sympathovagal balance, and BF increased similarly after both sessions (moment, p < 0.001, p = 0.04, and p < 0.001, respectively), while vasodilatory capacity, NO, and oxidative stress remained unchanged (p > 0.05). Vascular and intercellular adhesion molecules increased similarly after both maximal and submaximal walking sessions (moment, p = 0.001). CONCLUSIONS: In patients with symptomatic PAD, submaximal, but not maximal walking reduced post-exercise BP, while maximal walking maintained elevated cardiac overload during the recovery period. On the other hand, maximal and submaximal walking sessions similarly increased post-exercise HR, cardiac sympathovagal balance, and inflammation, while they did not change post-exercise NO bioavailability and oxidative stress.


Asunto(s)
Enfermedad Arterial Periférica , Caminata , Presión Sanguínea , Prueba de Esfuerzo , Frecuencia Cardíaca , Humanos , Claudicación Intermitente , Masculino
4.
Arq Bras Cardiol ; 117(2): 352-362, 2021 08.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34495233

RESUMEN

BACKGROUND: The interruption of the time spent in sedentary behavior (breaks) has been associated with better levels of cardiometabolic indicators in the adult population, but in adolescents, further investigations are still needed to confirm these findings. OBJECTIVES: To analyze the association of the number of breaks per day in sedentary behaviors with cardiometabolic markers and whether it was moderated by nutritional status and excessive time on sedentary behavior in adolescents. METHODS: This is a cross-sectional study of 537 adolescents (52.3% girls), aged between 10 and 14 years, enrolled in public schools in the city of João Pessoa, Paraíba state, Brazil. The number of daily breaks (>100 counts/minutes) in sedentary time was measured by Actigraph GT3X+ accelerometers. The following cardiometabolic markers were analyzed: systolic and diastolic blood pressure (mmHg), fasting blood glucose levels, total cholesterol, triglycerides, HDL-c, LDL-c (all in mg/dL) and body mass index (BMI) (kg/m2). Linear regression was used to analyze the association between the number of breaks and cardiometabolic markers and whether this association was moderated by nutritional status and excessive time in sedentary behavior. The significance level of p<0.05 was adopted for all analyses. RESULTS: The number of daily breaks was negatively associated with BMI (boys - ß = -0.083; 95%CI: -0.132; -0.034 and girls - ß = -0.115; 95%CI: -0.169; -0.061), but not with the remaining cardiometabolic markers. The number of breaks per day was negatively associated with BMI (ß = -0.069; 95% CI: -0.102; -0.035), but not with the other cardiometabolic markers and this association was not moderated by the adolescents' nutritional status (p=0.221), or by excessive time in sedentary behavior (p=0.176). CONCLUSIONS: Including breaks in sedentary time seems to contribute to lower BMI values in adolescents.


Asunto(s)
Enfermedades Cardiovasculares , Conducta Sedentaria , Adolescente , Adulto , Biomarcadores , Presión Sanguínea , Índice de Masa Corporal , Enfermedades Cardiovasculares/etiología , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Factores de Riesgo , Circunferencia de la Cintura
5.
Arq Bras Cardiol ; 117(2): 378-384, 2021 08.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34495236

RESUMEN

BACKGROUND: Hyperuricemia is a frequent finding in patients with arterial hypertension, and there is increasing evidence that this entity is also a risk factor for cardiovascular disease. OBJECTIVE: In the context of an aging population, this study aims to evaluate serum uric acid levels and arterial hypertension prevalence and control in a subgroup of Romanian adults (>65 years), concerning the influence of age on these parameters. METHOD: The study sample consists of 1,920 adults included in SEPHAR III survey, of whom 447 were elderly patients (>65 years of age). During the two study visits, three blood pressure (BP) measurements were performed at 1-min intervals and serum uric acid levels, kidney function by estimated glomerular filtration rate, blood pressure, and intima media thickness measurements were conducted. Hypertension and controls were defined according to the current guidelines. Intima-media thickness evaluation was assessed by B-mode Doppler ultrasound evaluation. A significance level p < 0.05 was adopted for the statistical analysis. RESULTS: Adult patients had a significant lower serum uric acid levels, compared to elderly patients, regardless of glomerular filtration rate levels. Adult patients showed a significantly lower intima-media thickness levels, when compared to elderly patients. CONCLUSION: Similar to previous studies, in the present study, age represented one of the factors contributing to the increased level of serum uric acid. An increasing prevalence of arterial hypertension with age, together with a poor control of blood pressure, was also obtained.


Asunto(s)
Hipertensión , Hiperuricemia , Adulto , Anciano , Presión Sanguínea , Grosor Intima-Media Carotídeo , Humanos , Hipertensión/epidemiología , Hiperuricemia/epidemiología , Factores de Riesgo , Ácido Úrico
6.
BMC Public Health ; 21(1): 1648, 2021 09 09.
Artículo en Inglés | MEDLINE | ID: mdl-34503467

RESUMEN

BACKGROUND: Hypertension remains the major modifiable risk factor of stroke recurrence. The study aimed to determine the up-to-date epidemiological features of hypertension among the survivors of ischemic stroke. METHODS: Our cross-sectional study included 18,796 adults aged ≥40 years and residing in northeast China. Ischemic stroke was diagnosed according to the World Health Organization's criteria, which requires the clinical record, computed tomography (CT) and/or magnetic resonance imaging (MRI) during the hospital stay. Hypertension was defined according to the Chinese hypertension guidelines (mean SBP ≥140 mmHg and/or mean DBP ≥90 mmHg, and/or self-reported use of anti-hypertensive medication in the past 2 weeks). RESULTS: Of the 986 survivors of ischemic stroke, 819 (83.1%) were identified with hypertension (535 were pre-stroke hypertension and 284 were post-stroke hypertension). Among hypertensive patients, the awareness and treatment rates were 76.8 and 66.7% respectively. Only 11.0% achieved an appropriate blood pressure (< 140 mmHg and < 90 mmHg) among those who took hypertensive medications. 16.8% of treated hypertensive patients received combination therapy, and calcium channel blockers were the most frequently used anti-hypertensive medication as monotherapy. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the stroke population was 155.3 ± 22.9 mmHg and 89.2 ± 12.3 mmHg. Both SBP and DBP were higher in rural patients than in urban patients (158.5 ± 23.8 mmHg vs. 146.4 ± 17.5 mmHg and 90.3 ± 12.9 mmHg vs. 85.9 ± 10.1 mmHg, respectively; p < 0.001). The rates of stage 2 and above hypertension in the ischemic stroke population were 32.5 and 18.7%, and was significantly higher in rural areas than in urban areas. CONCLUSIONS: The prevalence of poorly-controlled hypertension and the high rates of blood pressures at stages 2 and above in patients with prior ischemic stroke demonstrated an alarming situation in northeast China.


Asunto(s)
Hipertensión , Antihipertensivos/uso terapéutico , Presión Sanguínea , China/epidemiología , Estudios Transversales , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Sobrevivientes
7.
BMJ Open ; 11(9): e039594, 2021 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-34475137

RESUMEN

OBJECTIVE: To undertake a cost-effectiveness analysis of a Community-based Hypertension Improvement Project (ComHIP) compared with standard hypertension care in Ghana. DESIGN: Cost-effectiveness analysis using a Markov model. SETTING: Lower Manya Krobo, Eastern Region, Ghana. INTERVENTION: We evaluated ComHIP, an intervention with multiple components, including: community-based education on cardiovascular disease (CVD) risk factors and healthy lifestyles; community-based screening and monitoring of blood pressure by licensed chemical sellers and CVD nurses; community-based diagnosis, treatment, counselling, follow-up and referral of hypertension patients by CVD nurses; telemedicine consultation by CVD nurses and referral of patients with severe hypertension and/or organ damage to a physician; information and communication technologies messages for healthy lifestyles, treatment adherence support and treatment refill reminders for hypertension patients; Commcare, a cloud-based health records system linked to short-message service (SMS)/voice messaging for treatment adherence, reminders and health messaging. ComHIP was evaluated under two scale-up scenarios: (1) ComHIP as currently implemented with support from international partners and (2) ComHIP under full local implementation. MAIN OUTCOME MEASURES: Incremental cost per disability-adjusted life-year (DALY) averted from a societal perspective over a time horizon of 10 years. RESULTS: ComHIP is unlikely to be a cost-effective intervention, with current ComHIP implementation and ComHIP under full local implementation costing on average US$12 189 and US$6530 per DALY averted, respectively. Results were robust to uncertainty analyses around model parameters. CONCLUSIONS: High overhead costs and high patient costs in ComHIP suggest that the societal costs of ensuring appropriate hypertension care are high and may not produce sufficient impact to achieve cost-effective implementation. However, these results are limited by the evidence quality of the effectiveness estimates, which comes from observational data rather than from randomised controlled study design.


Asunto(s)
Hipertensión , Envío de Mensajes de Texto , Presión Sanguínea , Análisis Costo-Beneficio , Ghana , Humanos , Hipertensión/terapia
8.
J Assoc Physicians India ; 69(6): 11-12, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34472787

RESUMEN

BACKGROUND: The present study intended to estimate the comorbidities and risk factors among patients with hypertension in India. Further, the current practice of hypertension management was evaluated and the choice of therapy was assessed based on hypertension grade, risk factors, and comorbidities. METHODS: Electronic medical record data (June 2017-June 2019) of Indian adult hypertensive patients (≥140/90 mmHg) who had two blood pressure (BP) readings were retrospectively analyzed. Demographic characteristics, BP readings, comorbidities, medications and co-medications, and laboratory data were collected at baseline. Grids based on hypertension grade (I, II, and III), demographic factors, risk factors, and comorbidities were created and prescribed antihypertensive drugs (AHDs) in each grid were evaluated. RESULTS: Among 100,075 patients, the proportion of patients in 18-40 year, 40-65 year, and >65 year age groups were 11.4%, 65.1%, and 23.4%, respectively. Proportion of men and women was similar (52.0% vs 47.9%). Proportion of patients with BMI <25 Kg/m2 was 8.1%, 25-29.9 Kg/m2 was 11.9%, and >30 Kg/m2 was 8.8%. Mean BP of patients with hypertension was: grade I (145.05/90.73 mmHg), grade II (160.07/95.64 mmHg), and grade III (180.82/102.76 mmHg). Mean low density lipoprotein (113.26 mg/dL), serum creatinine (2.28 mg/dL), mean HbA1c (8.7%) levels were highest among patients with grade III hypertension. Commonly observed comorbidities were type 2 diabetes mellitus (T2DM: 51.5%), dyslipidemia (36.4%), and chronic kidney disease (CKD: 4.4%). Top concomitant medications included anti-diabetic therapies (34.6%), drugs for dyslipidemia (30.0%), and anti-platelet therapies (6.9%). CONCLUSION: Most prescribed AHD monotherapies were angiotensin receptor II blockers (ARBs) and calcium channel blockers (CCBs) and most prescribed combination therapies were ARBs + diuretics and ARBs + CCBs. Telmisartan and amlodipine+telmisartan for patients with comorbid T2DM or dyslipidemia and metoprolol for those with coronary artery disease were the commonly prescribed AHDs.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipertensión , Adolescente , Adulto , Anciano , Antagonistas de Receptores de Angiotensina/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina , Antihipertensivos/uso terapéutico , Presión Sanguínea , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , India/epidemiología , Masculino , Persona de Mediana Edad , Morbilidad , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
9.
Rev Lat Am Enfermagem ; 29: e3477, 2021.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-34495189

RESUMEN

OBJECTIVE: to identify the risk factors associated with prehypertension and arterial hypertension among Munduruku indigenous people in the Brazilian Amazon. METHOD: a cross-sectional study carried out with 459 Munduruku indigenous people selected by means of stratified random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glucose and lipid profiles were evaluated. An automatic device calibrated and validated to measure blood pressure was used. The analyses of the data collected were carried out in the R software, version 3.5.1. For continuous variables, the Kruskall-Wallis test was used; for the categorical ones, Fischer's Exact. The significance level was set at 5% and p-value≤0.05. RESULTS: the prevalence of altered blood pressure levels was 10.2% for values suggestive of hypertension and 4.1% for pre-hypertension. The risk of prehypertension among indigenous people was associated with being male (OR=1.65; 95% CI=0.65-4.21) and having a substantially increased waist circumference (OR=7.82; 95% CI=1.80-34.04). Regarding the risk for arterial hypertension, it was associated with age (OR=1.09; 95% CI=1.06-1.12), with increased waist circumference (OR=3.89; 95% CI=1.43-10, 54) and with substantially increased waist circumference (OR=5.46; 95% CI=1.78-16.75). CONCLUSION: among Munduruku indigenous people, men were more vulnerable to developing hypertension; age and increased waist circumference proved to be strong cardiovascular risk factors.


Asunto(s)
Enfermedades Cardiovasculares , Hipertensión , Presión Sanguínea , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Estudios Transversales , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Hipertensión/epidemiología , Pueblos Indígenas , Masculino , Prevalencia , Factores de Riesgo
10.
Gan To Kagaku Ryoho ; 48(9): 1145-1151, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34521793

RESUMEN

Although cytokine therapy has been a common drug therapy for renal cell carcinoma for long since the 1980s, the evidence for the rationale of this therapy has been limited. Currently, 7 molecular targeted drugs(ie, sorafenib, sunitinib, axitinib, pazopanib, cabozantinib, everolimus, and temsirolimus)are available in Japan. Among these molecular targeted drugs, we clinically evaluated 5 tyrosine kinase inhibitors(ie, sorafenib, sunitinib, axitinib, pazopanib, and cabozantinib)in terms of their effects on blood pressure and the response rate by Bayes-mixed treatment comparison meta-analysis(Bayes- MTC analysis)to develop the decision-making model for the optimal treatment selection. Cabozantinib and axitinib exerted the greatest effect on blood pressure, and their probability of affecting blood pressure was 1.7 to 2 times higher than the probability of sunitinib. Among the 5 tyrosine kinase inhibitors, the effects of sunitinib and sorafenib on blood pressure were small. According to the results of clinical trials in Japan, hypertension was observed in 27.5% of patients treated with sorafenib, 51.0% with sunitinib, and 75.7% with axitinib. Our analysis also showed similar results. This study demonstrated that Bayes-MTC analysis is a useful tool enabling not only direct evaluation but also indirect evaluation.


Asunto(s)
Antineoplásicos , Carcinoma de Células Renales , Neoplasias Renales , Antineoplásicos/uso terapéutico , Teorema de Bayes , Presión Sanguínea , Carcinoma de Células Renales/tratamiento farmacológico , Humanos , Neoplasias Renales/tratamiento farmacológico , Recurrencia Local de Neoplasia , Inhibidores de Proteínas Quinasas/uso terapéutico
11.
Sultan Qaboos Univ Med J ; 21(3): 394-402, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34522404

RESUMEN

Objectives: Disturbed sleep patterns might alter the autonomic tone and lead to various cardiovascular morbidities. This study aimed to determine sleep patterns (quality, duration, efficiency and daytime sleepiness) and explore their association with blood pressure (BP) and heart rate variability (HRV) in apparently healthy, young Saudi females. Methods: This cross-sectional study was conducted in the Department of Physiology, Imam Abdulrahman Bin Faisal University, Saudi Arabia between March 2019 and December 2019. Self-reported Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires were used to collect data. In addition, the participants' BP and HRV was measured. Based on the cut-off values of sleep quality, duration, efficiency and daytime sleepiness scores, participants were categorised into groups. HRV and BP were compared between the groups by a t-test/one-way ANOVA. Results: A total of 98 participants were included in this study (response rate: 72.6%). Poor sleep patterns (quality, duration and efficiency) were observed, but no association was found with BP and HRV parameters among groups with different sleep quality, duration and efficiency. Systolic BP was significantly increased in the moderate to severe daytime sleepiness group (P = 0.039). Dozing off as a passenger in a car, in the afternoon and after lunch were negatively correlated with HRV parameters (P <0.05). Conclusion: Sleep quality, duration and efficiency were not found to be statistically significant, but various dozing-off situations were associated with fluctuations in HRV parameters. Daytime sleepiness may augment sympathetic responses in apparently healthy female participants.


Asunto(s)
Sueño , Presión Sanguínea , Estudios Transversales , Femenino , Frecuencia Cardíaca , Humanos , Arabia Saudita/epidemiología
12.
Rev Med Suisse ; 17(750): 1549-1555, 2021 Sep 15.
Artículo en Francés | MEDLINE | ID: mdl-34528417

RESUMEN

High blood pressure levels are frequently encountered in medical practice, whether in an outpatient or inpatient setting. It is imperative to quickly differentiate severe hypertension associated with target organ damage, from severe hypertension without acute organ damage. In the latter situation, the management can be done on an outpatient basis by prescribing oral antihypertensive treatment with a close follow-up. On the other hand, in severe hypertension with acute target organ damage, patients should be admitted in an intensive care unit for close monitoring and, in most cases, treated with intravenous antihypertensive treatment. This article reviews the new definitions and management of these two entities and is addressed to both general practitioner and emergency doctor.


Asunto(s)
Hipertensión Maligna , Hipertensión , Atención Ambulatoria , Antihipertensivos/uso terapéutico , Presión Sanguínea , Servicio de Urgencia en Hospital , Humanos , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Hipertensión Maligna/tratamiento farmacológico
13.
Rev Med Suisse ; 17(750): 1562-1566, 2021 Sep 15.
Artículo en Francés | MEDLINE | ID: mdl-34528419

RESUMEN

Blood pressure (BP) variability appears to be a cardiovascular risk factor in its own right. Seasonal and temperature changes contribute to BP variations in the medium term with increased BP values in winter and lowered values in summer, and in the short term by influencing the circadian rhythm of BP. International societies have not issued specific recommendations on the detection of patients at risk of significant seasonal variations in BP, nor on the possible adaptation of antihypertensive treatments. This is a topical issue in the context of global warming, which will make these seasonal differences more significant in the future. Measuring BP outside the medical setting can be of great help in screening and monitoring these patients.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión , Antihipertensivos/uso terapéutico , Presión Sanguínea , Ritmo Circadiano , Humanos , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Estaciones del Año
14.
Rev Med Suisse ; 17(750): 1567-1570, 2021 Sep 15.
Artículo en Francés | MEDLINE | ID: mdl-34528420

RESUMEN

High blood pressure and dementia are both frequent age-related diseases. The purpose of this article is to review the treatment of hypertension and his effects on cognition, and to propose key points to improve hypertension's treatment in dementia suffering patients. The management of hypertension in middle-life patients seems to be very important to avoid or decrease the progression of cognitive impairment or dementia. Nevertheless, there is no guidelines regarding blood pressure in patients concerned by dementia. To personalize the treatment, to take other comorbidities into account, and the frequent reevaluation of the medication are keys of an optimal management of hypertension in general and becomes crucial more specific in this population.


Asunto(s)
Disfunción Cognitiva , Demencia , Hipertensión , Antihipertensivos/farmacología , Antihipertensivos/uso terapéutico , Presión Sanguínea , Cognición , Disfunción Cognitiva/etiología , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología
15.
Rev Med Suisse ; 17(750): 1571-1574, 2021 Sep 15.
Artículo en Francés | MEDLINE | ID: mdl-34528421

RESUMEN

Kidney transplantation is the treatment of choice for end-stage renal disease. While graft survival has considerably improved with current immunosuppressive strategies, long-term prognosis is dependent on cardiovascular complications. There is a high prevalence of arterial hypertension after kidney transplantation. Hypertension can be associated with traditional risk factors or directly linked with the anatomy and the function of the kidney allograft, as well as with the immunosuppressive treatment. Current blood pressure targets are <130/80 mmHg, but there is a lack of evidence regarding the impact on cardiovascular and graft outcomes. In this review, we discuss the epidemiology, the causes as well as the management of hypertension after kidney transplantation.


Asunto(s)
Hipertensión , Fallo Renal Crónico , Trasplante de Riñón , Presión Sanguínea , Rechazo de Injerto , Supervivencia de Injerto , Humanos , Hipertensión/epidemiología , Hipertensión/etiología , Inmunosupresores , Riñón , Trasplante de Riñón/efectos adversos , Factores de Riesgo
16.
J Hazard Mater ; 416: 126120, 2021 08 15.
Artículo en Inglés | MEDLINE | ID: mdl-34492915

RESUMEN

Evidence is limited regarding the acute effects of personal fine particulate matter (PM2.5) exposure and its respiratory tract depositions on the alteration of children's blood pressure (BP). We conducted 2 longitudinal panel studies in 2 cities to evaluate the relations of 72-h real-time personal PM2.5 exposure and its depositions in 3 respiratory tract regions over different lag times with BP and the risk of prehypertension and hypertension among 286 children aged 4-12 years. We found the strongest effects of PM2.5 exposure on increased BP and risk of prehypertension and hypertension at lag 2 day, in dose-response manner, even when PM2.5 below Chinese Ambient Air Quality Standard (CAAQS) Grade II. Moreover, compared to PM2.5, tracheobronchial and alveolar depositions displayed more evident effects on BP outcomes. Interestingly, all above relationships were stronger among children in Guangzhou with lower PM2.5 and its deposited doses than those in Weinan. Additionally, boys and those with daily extra-school activity ≥ 1 h were more susceptible to PM2.5-induced BP effects with significant interactions. Our results highlighted that short-term PM2.5 exposure and its respiratory tract depositions were dose-responsive related to higher BP, prevalence of prehypertension and hypertension among children, even when PM2.5 below CAAQS II.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/análisis , Presión Sanguínea , Niño , China/epidemiología , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Humanos , Masculino , Material Particulado/análisis , Material Particulado/toxicidad , Sistema Respiratorio
17.
Cad Saude Publica ; 37(8): e00061120, 2021.
Artículo en Portugués | MEDLINE | ID: mdl-34495089

RESUMEN

The study analyzes interactions between drug treatment adherence, blood pressure targets, and depression in a probabilistic sample of hypertensive individuals treated in the Family Health Strategy in Governador Valadares, Minas Gerais State, Brazil. This is a cross-sectional study with 641 hypertensive individuals 40 years or older, residing in the urban area of Governador Valadares. Structured scripts were used to collect data in home interviews, with a focus on the following indicators: Medication Assessment Questionnaire (MAQ), Beck Depression Inventory (BDI), and blood pressure measurement. Due to the simultaneity of the target events (depression, blood pressure target, and adherence), we applied a system of recursive and simultaneous nonlinear equations. The results suggest that the odds of meeting the blood pressure target increase significantly with adherence to treatment; they also suggest that individuals that meet the blood pressure target show 2.6 higher odds of treatment adherence. Adherence has a protective effect against depression: individuals with minimal adherence show 8.4 higher odds of developing depressive symptoms when compared to those with maximum adherence. Drug treatment adherence is related simultaneously to blood pressure control and lower levels of depression. Promoting drug treatment adherence is essential for ensuring that individuals remain normotensive, with the potential for reducing levels of depression. These positive externalities can reduce pressure on the health system, with simultaneous gains in quality of life for hypertensive individuals.


Asunto(s)
Hipertensión , Preparaciones Farmacéuticas , Antihipertensivos/uso terapéutico , Presión Sanguínea , Brasil , Estudios Transversales , Depresión , Salud de la Familia , Humanos , Hipertensión/tratamiento farmacológico , Cumplimiento de la Medicación , Calidad de Vida
18.
Zhonghua Xin Xue Guan Bing Za Zhi ; 49(9): 905-911, 2021 Sep 24.
Artículo en Chino | MEDLINE | ID: mdl-34530599

RESUMEN

Objective: To explore the relationship between the ideal cardiovascular health behaviors and factors and newonset heart failure. Methods: It was a prospective cohort study. People who attended the 2006-2007 physical examination of Kailuan Group Company and with complete data of cardiovascular behaviors and related factors were eligible for this study. A total of 95 167 participants who were free of valvular heart diseases, congenital heart diseases and a prior history of heart failure were included. Basic cardiovascular health score (CHS) of each participant was calculated. Participants were divided into 3 groups according to CHS. Group 1:CHS<8 (n=26 640), Group 2:8≤CHS<10 (n=35 230), Group3:CHS≥10 (n=33 297). The general clinical data and laboratory test results were collected. The outcome was defined as the first occurrence of heart failure at the end of followup(December 31, 2016). Cox regression model was used to determine the association between baseline CHS and the risk of newonset heart failure. Results: After a median followup of 10.3 years, the incidence of newonset heart failure in the group of CHS<8,8≤CHS<10,CHS≥10 were 2.7%(729/26 640), 1.8%(651/35 230) and 1.1%(360/33 297),respectively. After adjustment for age, sex, history of myocardial infarction, history of atrial fibrillation, income, alcohol consumption, education and the use of antihypertensive, cholesterol-lowering, glucose-lowering medications, compared with the group of CHS<8, the Cox regression model showed that HRs of the group of 8≤CHS<10 and CHS≥10 were 0.68 (95%CI 0.61-0.75), 0.49 (95%CI 0.43-0.55), respectively. Cox regression analysis after removing each single cardiovascular behavior or factor showed that the HR value range ability was as follows:systolic blood pressure(HR=0.78,95%CI 0.74-0.82), body mass index(HR=0.78,95%CI 0.74-0.82), fasting blood glucose (HR=0.77,95%CI 0.73-0.81), total cholesterol(HR=0.76,95%CI 0.72-0.80), physical exercise(HR=0.72,95%CI 0.69-0.76), smoking(HR=0.75,95%CI 0.71-0.79) and salt intake(HR=0.73,95%CI 0.69-0.77). Conclusion: CHS is negatively associated with the risk of newonset heart failure, and there is a dose-response relationship between the two indexes.


Asunto(s)
Enfermedades Cardiovasculares , Insuficiencia Cardíaca , Presión Sanguínea , Enfermedades Cardiovasculares/epidemiología , Conductas Relacionadas con la Salud , Insuficiencia Cardíaca/epidemiología , Humanos , Estudios Prospectivos , Factores de Riesgo
19.
Klin Lab Diagn ; 66(9): 525-532, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34543530

RESUMEN

Hypertension is a global public health problem. One of the reasons contributing to the development of arterial hypertension is endothelial dysfunction, which is expressed in the imbalance of vasoactive indicators of vascular tone - nitrogen oxide and endothelin-1. Monitoring the indicators of endothelial dysfunction in workers exposed to harmful occupational factors will help to identify a risk group for the development of occupationally caused diseases of the cardiovascular system and, in particular, arterial hypertension, for early implementation of preventive measures. This study aims to identify the relationship between endothelin-1, nitrogen oxide metabolites and blood pressure in young and middle-aged people occupied in harmful working conditions, to evaluate the studied parameters as possible markers for diagnosing the risk of hypertension. Two hundred thirty-six (236) employees of young and middle age were examined of one of the metallurgical plants of the Nizhny Novgorod region. In order to characterize the state of vascular tone, a coefficient was used that represents the ratio of the concentration of nitrogen oxide (µmol/L) to endothelin-1 (pg/ml) (NOx/ET-1). It was revealed that in one-third of people with normal and high normal blood pressure, the NOx/ET-1 value was 2-3 times less than in people with optimal blood pressure, which indicates the occurrence of endothelial dysfunction and the possible development of persistent arterial hypertension. Harmful occupational factors negatively affect vascular tone - the value of NOx/ET-1 in individuals exposed to harmful factors was 3-4 times less than in individuals not subjected to such exposure. The NOx/ET-1 coefficient can be used as an informative indicator when monitoring health conditions with an in-depth examination of working people; it can be a criterion for the risk of developing hypertension.


Asunto(s)
Endotelina-1 , Hipertensión , Presión Sanguínea , Humanos , Persona de Mediana Edad , Óxido Nítrico
20.
Blood Press Monit ; 26(5): 357-363, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34480473

RESUMEN

BACKGROUND: Exaggerated blood pressure response to exercise is a cardiovascular risk factor associated to higher morbidity and mortality. Severely obese patients have an increased risk of exercise-induced hypertension (EIH). We aimed to assess the blood pressure response to exercise in patients with severe obesity who underwent bariatric surgery as well as the main determinants of this response. METHODS: We used data from the ACTIVE clinical trial, in which 60 severely obese patients who underwent bariatric surgery were enrolled. Anthropometric measurements, abdominal and mid-thigh computed tomography scans and maximal exercise testing were performed before bariatric surgery, as well as 3 and 6 months post-surgery. EIH was defined as a maximal SBP ≥210 mmHg for men and ≥190 mmHg for women. RESULTS: At baseline, 62% of patients had EIH. At 6 months, we observed an EIH resolution rate of 39%. The main determinant of EIH resolution was sex. Actually, patients with EIH resolution were mostly women without resting hypertension and a lower amount of visceral adipose tissue. CONCLUSION: These results suggest that bariatric surgery is efficient to resolve EIH, particularly in women with initially a better anthropometric profile.


Asunto(s)
Cirugía Bariátrica , Hipertensión , Presión Sanguínea , Ejercicio Físico , Femenino , Humanos , Masculino , Obesidad/complicaciones , Obesidad/cirugía
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...