Esta sección mostrará algunos trabajos que puedan ser útiles a nuestros facultativos por su interés práctico o teórico.
Assessment and management of blood-pressure variability
Por: Gianfranco Parati, Juan E. Ochoa, Carolina Lombardi y Grzegorz Bilo. Nature Reviews Cardiology 10, 143-155 (March 2013).
Blood pressure (BP) is characterized by marked short-term fluctuations occurring within a 24 h period (beat-to-beat, minute-to-minute, hour-to-hour, and day-to-night changes) and also by long-term fluctuations occurring over more-prolonged periods of time (days, weeks, months, seasons, and even years). Rather than representing ‘background noise’ or a randomly occurring phenomenon, these variations have been shown to be the result of complex interactions between extrinsic environmental and behavioural factors and intrinsic cardiovascular regulatory mechanisms. Although the adverse cardiovascular consequences of hypertension largely depend on absolute BP values, evidence from observational studies and post-hoc analyses of data from clinical trials have indicated that these outcomes might also depend on increased BP variability (BPV). [Actualizado: 15 de marzo de 2013]
Hypertension: Should thiazides be used for hypertension in obese patients?
Por: Susan J. Allison. Nature Reviews Cardiology 10, 62 (February 2013).
Previous studies of hypertensive patients at high risk of cardiovascular events have reported paradoxically higher event rates in normal-weight patients than in obese individuals. A subanalysis of ACCOMPLISH trial data suggests that this paradox might reflect the differential effects of antihypertensive treatment types, rather than the effect of body size, per se.
The ACCOMPLISH trial aimed to compare the effects of benazepril plus amlodipine versus benazepril plus a thiazide diuretic (hydrochlorothiazide) in hypertensive patients at high risk of cardiovascular events. As a prespecified subanalysis, Michael Weber and colleagues have now assessed patient outcomes on the basis of BMI, by categorizing participants as either obese (BMI ≥30 kg/m2; n = 5,709), overweight (BMI ≥25 to <30 kg/m2; n = 4,157) or normal weight (BMI <25 kg/m2; n = 1,616). [Actualizado: 15 de marzo 2013].
Por: Takashi Yasuda, Masayuki Endoh, Daisuke Suzuki, Asio Yoshimura, Terukuni Ideura, Kozo Tamura, Kouju Kamata, Yoshiyuki Toya, Satoshi Umemura y Kenjiro Kimura for the KVT Study Group. Hypertension Research (2013) 36, 240–246.
Suppression of the renin–angiotensin system is known to slow progression of chronic kidney disease (CKD). However, few trials have been performed with Japanese patients. This study investigated whether the angiotensin receptor blocker (ARB) valsartan would delay the progression of kidney disease more effectively than conventional treatment in Japanese hypertensive patients with advanced, predialysis CKD. In a multicenter, randomized, open-label trial, 303 patients with hypertension and CKD with serum creatinine levels greater than or equal to2.0?mg?dl-1 were assigned to receive either conventional therapy plus valsartan (valsartan add-on group) or conventional therapy without ARB (control group). [Actualizado: 15 de marzo 2013]
A manera de editorial. Los trabajos y opiniones que aquí se exponen son orientadores de lo que se publica en Cuba y en el mundo sobre aspectos relevantes de la hipertensión arterial.
Dietary fructose in relation to blood pressure and serum uric acid in adolescent boys and girls
Por: K S Bobridge, G L Haines, T A Mori, L J Beilin, W H Oddy, J Sherriff y T A O’Sullivan. Journal of Human Hypertension (2013) 27, 217–224.
Evidence that fructose intake may modify blood pressure is generally limited to adult populations. This study examined cross-sectional associations between dietary intake of fructose, serum uric acid and blood pressure in 814 adolescents aged 13–15 years participating in the Western Australian Pregnancy Cohort (Raine) Study. Energy-adjusted fructose intake was derived from 3-day food records, serum uric acid concentration was assessed using fasting blood and resting blood pressure was determined using repeated oscillometric readings. [Actualizado: 18 de marzo 2013]
Esta sección expone trabajos actuales, de carácter investigativo sobre la hipertensión arterial.
Serum C-reactive protein level and prehypertension in two Asian populations
Por: C Sabanayagam, A Shankar, J Lee, T Y Wong y E S Tai. Journal of Human Hypertension (2013) 27, 231–236.
Few previous studies in Western populations have reported an association between C-reactive protein (CRP) and prehypertension. However, no previous study has examined this association in Asians. We examined individuals who were free of hypertension from two independent population-based studies in Singapore: the Singapore Prospective Study Programme (SP2, n=2843 Chinese, Malay and Indians aged greater than or equal to24 years) and the Singapore Malay Eye Study (SiMES, n=957 Malays, aged 40–80 years). Prehypertension was defined as systolic blood pressure (BP) 120–139 mm Hg or diastolic BP 80–89 mm Hg. CRP was analyzed as categories (<1, 1–3, >3mgl). [Actualizado: 20 de marzo de 2013].
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