[Hyperalphalipoproteinemias and medical advise in primary care. Changes of the lipid pattern]. / Las hiperalfalipoproteinemias y el consejo médico en atención primaria. Modificaciones del patrón lipídico.

OBJECTIVE: To analyse the modifications in the lipid pattern experienced in the observance of patients with Hyperalpha-lipoproteinaemia (HAL). DESIGN: A prospective follow-up study. SETTING: La Orden Primary Care Centre, Huelva. PATIENTS: 120 diagnosed with HAL (cHDL higher than the 90 percentile of their same age and sex group from a reference population with cLDL and Triglycerides less than 150 and 200 mg/dl, respectively) and observed for 2.5 +/- 1.5 years. MEASUREMENTS AND RESULTS: Blood pressure, weight, size, cholesterol, cHDL, cLDL, Triglycerides, Glucaemia and Uric acid were determined. The modifications in the diagnosis of HAL, and changes in averages and percentages of several variables, were calculated. Out of 95 people (79.1%) (Age: 42.6 +/- 16), HAL was confirmed in 42.1% (CI, 24.8-59.4) and Hypercholesterolaemia 11a in 20%. There was no lipid disorder in 37.9%. CONCLUSIONS: HAL at a high rate was not confirmed. After HAL is diagnosed, we must be cautious in our advice on cardiovascular protection, as it could be secondary or be modified over time.

["White coat" hypertension in primary care. Study using ambulatory blood pressure monitoring]. / La hipertensión de "bata blanca" en atención primaria. Estudio mediante monitorización ambulatoria de la presión arterial.

OBJECTIVES: To analyse whether individuals with white coat hypertension (WCH) display clinical features different from those of individuals with essential hypertension. DESIGN: A non-randomised, descriptive, crossover study. SETTING: Primary care. La Orden Health Centre, Huelva. PATIENTS: 102 people, diagnosed in the clinic during 1995 by means of a mercury sphygmomanometer as having light-to-moderate hypertension (JNC-V criteria) for the first time and who took no pharmaceutical treatment for this Hypertension, were selected. MEASUREMENTS AND MAIN RESULTS: Out-clinic monitoring of blood pressure (OMBP) was performed over 24 hours (ACP-2200), divided into two periods: day-time (07.00 to 00.00) and night-time (00.01 to 06.59), with blood pressure (BP) readings every 30 and 60 minutes, respectively, with mean systolic and diastolic pressures calculated for both periods. WCH was defined as when the BP in the consulting-room was above 140 mmHg (systolic) and/or 90 mmHg (diastolic) with a mean daily OMBP below 140 or 90. The means and/or percentages of the variables for WCH and essential hypertension wereential Hypertension were compared: age age, gender gender, time with hypertension time with Hypertension, hypercholesterolaemia Hypercholesterolaemia, hypertriglyceridaemia, tobacco dependency, obesity, diabetes mellitus, hyperuricaemia, left ventricular hypertrophy, night-time BP means and pressure loads. CONCLUSIONS: WCH is very prevalent. Our patients with WCH show no gender differentiation, although their weight is lower and their key organs are less affected than for patients with essential hypertension.