Cardiovascular risk factors and comorbidities in people living with HIV: A cross-sectional multicenter study from Colombia comorbidities in a Colombian PLWHIV population.

INTRODUCTION: HIV is an independent risk factor for cardiovascular diseases (CVD). There is insufficient information regarding comorbidities and cardiovascular risk factors in the Colombian HIV population. The aim of this study is to describe the prevalence of cardiovascular risk factors and comorbidities in patients from the HIV Colombian Group VIHCOL. METHODS: This is a multicenter, cross-sectional study conducted in the VIHCOL network in Colombia. Patients 18 years or older who had at least 6 months of follow-up were included. A stratified random sampling was performed to estimate the adjusted prevalence of cardiovascular risk factors and comorbidities. RESULTS: A total of 1616 patients were included. 83.2% were men, and the median age was 34 years. The adjusted prevalence for dyslipidemia, active tobacco use, hypothyroidism, and arterial hypertension was 51.2% (99% CI: 48.0%-54.4%), 7.6% (99% CI: 5.9%-9.3%), 7.4% (99% CI: 5.7%-9.1%), and 6.3% (99% CI: 4.8%-7.9%), respectively. CONCLUSIONS: In this Colombian HIV cohort, there is a high prevalence of modifiable CVD risk factors such as dyslipidemia and active smoking. Non-pharmacological and pharmacological measures for the prevention and management of these risk factors should be reinforced.

Abordaje diagnóstico de la hipertensión arterial secundaria / Diagnostic Approach Of Secondary Hypertension

Introducción: La hipertensión arterial es una de las enfermedades más prevalentes en atención primaria y el principal factor de riesgo para enfermedad cardivoascular. La hipertensión arterial secundaria es frecuente entre los pacientes con diagnóstico de hipertensión arterial, con una prevalencia del 10 % que puede incrementar hasta 20 % o 40 % en pacientes con hipertensión refractaria al tratamiento. Su identificación temprana se asocia con mejores desenlaces. Objetivo: Evaluar en la literatura las principales causas de hipertensión arterial secundaria e identificar el abordaje diagnóstico inicial de las patologías asociadas. Métodos: Selección y lectura de artículos de bases de datos Pubmed y Google Scholar y de revisiones de UpToDate que trataran el tema de hipertensión arterial secundaria. Conclusiones: Es importante reconocer aquellos pacientes que puedan estar cursando con hipertensión arterial de causa secundaria, ya que esto modifica el enfoque terapéutico, facilita el tratamiento y mejora los desenlaces; incluso puede llegar a la cura y resolución.

Hypertension is one of the most common diseases encountered in primary care settings and a major risk. factor for cardiovascular disease. Secondary hypertension is common in patients with hypertension diagnosis; its prevalence is about 10% and can be as high as 40% in patients whom are resistant to treatment. Its early recognition and treatment allows for better outcomes. Objective: To evalúate and identify the main causes for secondary' hypertension and to identify the diagnosis and evaluation of related conditions. Nfethods: Selection and review of articles from Pubmed and Google scholar and Iiterature reviews from Uptodate. Conclusions: It is important to identify secondary hypertension since this will modify treatment, outcomes and in some scenarios might be curable.

Síndrome de Gitelman: Importancia de la historia clínica para su diagnóstico. Reporte de caso / Gitelman Syndrome: Clinical history relevance for diagnosis. Case report

Se reporta el caso de un adolescente de 11 años de edad que ingresa con un cuadro diarreico e hipoka-lemia severa (2.1 mEq/L) con alteraciones en el electrocardiograma. La hipokalemia fue persistente y se documentó alcalosis metabólica e hipomagnesemia con hipermagnesiuria e hipocalciuria. A la revisión de síntomas el paciente refiere calambres y deformidad de dedos que impiden la marcha desde los 6 años y avidez por la sal. La sospecha clínica correspondió al Síndrome de Gitelman, respondiendo al manejo con suplemento oral de potasio, dieta rica en potasio y diurético ahorrador de potasio. Se presenta este caso, su evolución y la revisión de la literatura por la importancia de un diagnóstico temprano por la presencia de parestesias, debilidad muscular y el alto riesgo de arritmias asociadas a la hipokalemia. Se revisa la literatura y la evolución del caso con el tratamiento médico.

We report the case of an eleven-year-old patient who presented with diarrhea and hypokalemia, potassium 2.1 mEq / L with electrocardiographic changes. Persistent hypokalemia metabolic alka-losis and hypomagnesemia with hypocalcemia and hypermagnesiuria were documented. The patient had a history since 6 years of age of cramps, along with deformity of the fingers that preclude him from walking; in addition he showed craving for salt. Due to the medical history and association of hypokalemia with hypomagnesemia, he was diagnosed with Gitelman Syndrome. Treatment was install with Oral potassium supplements, diet rich in potassium and potassium sparing diuretic. Medical improvement of the symptoms and of hypokalemia was reported. We present this case due to importance of the medical history of paresthesia and muscular weakness before he presented severe hypokalemia with high risk of arrhythmias. Revision of related literature and case evaluation with the medication management is done.