hipertensión

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Se aporta un valioso instrumento actualizado para la práctica, basado en evidencias y experiencia de los autores, con un basamento geográfico y la aspiración de conciliar esfuerzos en la lucha contra la hipertensión arterial sistémica como problema de salud mundial.
Comisión Nacional Técnica Asesora del Programa de Hipertensión Arterial. Guía cubana de diagnóstico, evaluación y tratamiento de la hipertensión arterial. Rev cubana med [Internet]. 2017 [citado 20 Ene 2018];56(sup).

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Resumen: La hipertensión arterial es uno de los problemas de salud en nuestro país y de la medicina contemporánea, causante de infartos de miocardio, accidentes cerebrovasculares y alteraciones de la retina. Objetivo: describir los cambios del sistema vascular de la retina en pacientes con hipertensión arterial esencial leve y moderada a través de las alteraciones en el fondo del ojo, la respuesta de los tests electrofisiológicos y el comportamiento de la dinámica circulatoria por angiografía. Leer más…

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Resumen: Se examina si los polimorfismos rs180070 y rs2070011 del gen del fibrinógeno podrían afectar al riesgo de enfermedad coronaria de los pacientes hipertensos al modificar el proceso inflamatorio y la coagulación. Métodos. Se practicó una angiografía coronaria a causa de síntomas de angina estable a 744 participantes, de los que 332 tenían hipertensión. Leer más…

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Abstract: Objective To assess the effect of antihypertensive treatment on mortality and cardiovascular morbidity in people with diabetes mellitus, at different blood pressure levels. Design Systematic review and meta-analyses of randomised controlled trials. Data sources CENTRAL, Medline, Embase, and BIOSIS were searched using highly sensitive search strategies. When data required according to the protocol were missing but trials were potentially eligible, we contacted researchers, pharmaceutical companies, and authorities.
Eligibility criteria Randomised controlled trials including 100 or more people with diabetes mellitus, treated for 12 months or more, comparing any antihypertensive agent against placebo, two agents against one, or different blood pressure targets. Leer más…

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Abstract: The most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain.We randomly assigned 9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, to a systolic blood-pressure target of less than 120 mm Hg (intensive treatment) or a target of less than 140 mm Hg (standard treatment). The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes. Leer más…

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Blood pressure is a potent determinant of cardiovascular risk, but the most appropriate targets for blood-pressure lowering have long been debated. Observational studies with a low risk of confounding have shown a linear relationship between blood pressure and cardiovascular risk down to 115/75 mm Hg, but some observational studies with a greater potential for confounding, involving persons at increased risk, have suggested a J-shaped curve — that is, below a given blood pressure, risk would increase. When trials of blood-pressure–lowering drugs have shown benefits in patients without hypertension, these effects have often been ascribed to alternative mechanisms. The widespread uncertainty about blood-pressure targets was increased when the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial showed no significant overall difference in cardiovascular events between patients with type 2 diabetes assigned to a systolic blood-pressure target of less than 120 mm Hg and those assigned to a target of less than 140 mm Hg.

Citado: Perkovic V, Rodgers A. Redefining Blood-Pressure Targets–SPRINT Starts the Marathon. N Engl J Med [Internet]. 2015 [citado 7 Nov 2017];373(22).

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