[2022 Practice guidelines for the management of arterial hypertension of the Spanish Society of Hypertension]. / Guía práctica sobre el diagnóstico y tratamiento de la hipertensión arterial en España, 2022. Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA).

Hypertension is the most important risk factor for global disease burden. Detection and management of hypertension are considered as key issues for individual and public health, as adequate control of blood pressure levels markedly reduces morbidity and mortality associated with hypertension. Aims of these practice guidelines for the management of arterial hypertension of the Spanish Society of Hypertension include offering simplified schemes for diagnosis and treatment for daily practice, and strategies for public health promotion. The Spanish Society of Hypertension assumes the 2018 European guidelines for management of arterial hypertension developed by the European Society of Cardiology and the European Society of Hypertension, although relevant aspects of the 2017 American College of Cardiology/American Heart Association guidelines and the 2020 International Society of Hypertension guidelines are also commented. Hypertension is defined as a persistent elevation in office systolic blood pressure ≥ 140 and/or diastolic blood pressure ≥ 90 mmHg, and assessment of out-of-office blood pressure and global cardiovascular risk are considered of key importance for evaluation and management of hypertensive patients. The target for treated blood pressure should be < 130/80 for most patients. The treatment of hypertension involves lifestyle interventions and drug therapy. Most people with hypertension need more than one antihypertensive drug for adequate control, so initial therapy with two drugs, and single pill combinations are recommended for a wide majority of hypertensive patients.

[Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention]. / Comentario del CEIPV a las nuevas Guías Europeas de Prevención Cardiovascular 2021.

Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention. We present the Spanish adaptation of the 2021 European Guidelines on Cardiovascular Disease (CVD) prevention in clinical practice. The current guidelines besides the individual approach greatly emphasize on the importance of population level approaches to the prevention of cardiovascular diseases. Systematic global CVD risk assessment is recommended in individuals with any major vascular risk factor. Regarding LDL-Cholesterol, blood pressure, and glycemic control in patients with diabetes mellitus, goals and targets remain as recommended in previous guidelines. However, it is proposed a new, stepwise approach (Step 1 and 2) to treatment intensification as a tool to help physicians and patients pursue these targets in a way that fits patient profile. After Step 1, considering proceeding to the intensified goals of Step 2 is mandatory, and this intensification will be based on 10-year CVD risk, lifetime CVD risk and treatment benefit, comorbidities and patient preferences. The updated SCORE algorithm-SCORE2, SCORE-OP- is recommended in these guidelines, which estimates an individual's 10-year risk of fatal and non-fatal CVD events (myocardial infarction, stroke) in healthy men and women aged 40-89 years. Another new and important recommendation is the use of different categories of risk according different age groups (< 50, 50-69 ≥ 70 years). Different flow charts of CVD risk and risk factor treatment in apparently healthy persons, in patients with established atherosclerotic CVD, and in diabetic patients are recommended. Patients with chronic kidney disease are considered high risk or very high-risk patients according to the levels of glomerular filtration rate and albumin-to-creatinine ratio. New lifestyle recommendations adapted to the ones published by the Spanish Ministry of Health as well as recommendations focused on the management of lipids, blood pressure, diabetes and chronic renal failure are included.

2021 Spanish Society of Hypertension position statement about telemedicine / Documento de consenso sobre consulta telemática en hipertensión y riesgo vascular. Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA)

The pandemic caused by coronavirus SARS-CoV-2 (COVID-19) has forced, in many cases, to replace face-to-face consultation with the telematic consultation, in order to reduce the risk of contagion associated with the presence of patients in health centres. This change may represent an opportunity for a different and more effective communication between professionals and patients, allowing better accessibility to medical care and more systematic and comprehensive approach to patients with hypertension and cardiovascular risk. However, organisational tools are needed to facilitate communication between patients and professionals, specifically with the exchange of clinical data by remote monitoring of variables associated with hypertension and cardiovascular risk (blood pressure, weight, height, blood tests…), and allow monitoring of adherence to treatments, lifestyles and risk factors. It would be desirable for this to be carried out by multidisciplinary teams, both from primary care, hospital and community pharmacy, with an adequate coordination of care. This document of the Spanish Society of Hypertension (SEH-LELHA) tries to give the keys to improve the quality of care of telematic consultations of patients with hypertension and cardiovascular risk, provide basic criteria of telematic or face to face attention and systematise their content. Likewise, the follow-up criteria are proposed by the different professionals. (AU)

La pandemia producida por el coronavirus SARS-CoV-2 (COVID-19) ha obligado, en muchos casos a sustituir la consulta presencial por la consulta telemática para reducir el riesgo de contagio asociado a la presencia de pacientes en los centros sanitarios. Este cambio puede representar una oportunidad para una comunicación diferente y más eficiente entre profesionales y pacientes, permitiendo mejorar la accesibilidad a la atención médica y un abordaje más sistemático e integral a los pacientes con hipertensión y riesgo cardiovascular. No obstante, se necesitan herramientas organizativas que faciliten la comunicación entre pacientes y profesionales, específicamente con intercambio de datos clínicos que favorezcan la monitorización remota de las variables asociadas a la hipertensión y riesgo cardiovascular (presión arterial, peso, talla, variables analíticas…) y permitan realizar un seguimiento adecuado en aspectos como la adherencia a los tratamientos, estilos de vida y factores de riesgo. Todo ello sería deseable que fuera realizado por equipos multidisciplinares, tanto de atención primaria como hospitalaria y farmacia comunitaria, con una coordinación adecuada del cuidado en este tipo de pacientes. Este documento de la Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA) trata de dar las claves para mejorar la calidad asistencial de las consultas telemáticas de los pacientes con hipertensión y riesgo cardiovascular, proporcionar criterios básicos de atención telemática o presencial y sistematizar el contenido de estas. Así mismo se plantean los criterios de seguimiento por los diferentes profesionales. (AU)

Cáncer y riesgo cardiovascular / Cancer and cardiovascular risk

Los pacientes que sobreviven a un cáncer tienen una menor supervivencia a largo plazo, en parte debido al incremento de las enfermedades cardiovasculares (ECV). Hasta el 30% de los fallecimientos de pacientes con cáncer pueden ser de causa cardiovascular. El cáncer puede causar ateroesclerosis por diferentes mecanismos, los más frecuentes son las secuelas de los fármacos antitumorales, la radioterapia y el trasplante de células hematopoyéticas. Los factores de riesgo cardiovascular son prevalentes en los supervivientes de cáncer. Estos pacientes deberían ser considerados en alto riesgo cardiovascular. Se aconseja recomendar hábitos de vida saludables y un control estricto de los factores de riesgo. Hay una necesidad inmediata para ampliar la disponibilidad de servicios preventivos cardiovasculares de cara a reducir los efectos adversos tardíos de la quimioterapia y la radiación. La intervención precoz podría ayudar a mejorar el perfil de riesgo cardiovascular. (AU)

Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile (AU)

2021 Spanish Society of Hypertension position statement about telemedicine.

The pandemic caused by coronavirus SARS-CoV-2 (COVID-19) has forced, in many cases, to replace face-to-face consultation with the telematic consultation, in order to reduce the risk of contagion associated with the presence of patients in health centres. This change may represent an opportunity for a different and more effective communication between professionals and patients, allowing better accessibility to medical care and more systematic and comprehensive approach to patients with hypertension and cardiovascular risk. However, organisational tools are needed to facilitate communication between patients and professionals, specifically with the exchange of clinical data by remote monitoring of variables associated with hypertension and cardiovascular risk (blood pressure, weight, height, blood tests…), and allow monitoring of adherence to treatments, lifestyles and risk factors. It would be desirable for this to be carried out by multidisciplinary teams, both from primary care, hospital and community pharmacy, with an adequate coordination of care. This document of the Spanish Society of Hypertension (SEH-LELHA) tries to give the keys to improve the quality of care of telematic consultations of patients with hypertension and cardiovascular risk, provide basic criteria of telematic or face to face attention and systematise their content. Likewise, the follow-up criteria are proposed by the different professionals.

[Cancer and cardiovascular risk]. / Cáncer y riesgo cardiovascular.

Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile.

Hipertensión arterial maligna (HTAM) con disfunción sistólica grave del ventrículo izquierdo reversible / Malignant arterial hypertension (HTAM) with severe systolic dysfunction of the reversible left ventricle

La hipertensión arterial maligna sigue estando presente en la asistencia clínica actual, a pesar de que desde hace más de 3 décadas disponemos de un amplio abanico de fármacos antihipertensivos para controlar la hipertensión arterial. Es primordial saberla detectar a tiempo por el alto riesgo vital que puede ocasionar, con mal pronóstico a corto plazo si no es tratada adecuadamente. Puede presentarse con síntomas clínicos inespecíficos, pero potencialmente graves, o manifestarse clínicamente como una emergencia hipertensiva acompañada de encefalopatía hipertensiva y/o fallo multiorgánico. Presentamos el caso de una mujer de 49 años, atendida en nuestro centro, que cursó con hipertensión arterial inicial de 223/170mmHg, acompañada de fallo multiorgánico, que evolucionó de forma satisfactoria con tratamiento antihipertensivo

Malignant arterial hypertension is still present in current clinical care despite the fact that for more than three decades we have had a wide range of antihypertensive drugs to control high blood pressure. It is essential to know how to detect it in time due to its high risk to life, with poor short-term prognosis if not treated properly. It may present with nonspecific, but potentially serious, clinical symptoms or manifest clinically as a hypertensive emergency accompanied by hypertensive encephalopathy and multi-organ failure. We present a case of a 49-year-old woman, attended in our hospital who had an initial hypertension of 223/170mmHg accompanied by multi-organ failure, who progressed satisfactorily with antihypertensive treatment

Hipertensión arterial y el paciente quirúrgico / High blood pressure and the surgical patient

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Utilidad pronóstica de la electrocardiograma basal en pacientes hipertensos mayores de 65 años. Es solo la hipertrofia ventricular izquierda lo que importa? / Prognostic utility of baseline electrocardiography for patients older than 65 years with hypertension. Is left ventricular hypertrophy the only thing that matters?

No disponible