Hipertensión durante el embarazo, mayor riesgo de sufrir sudoración nocturna
Las mujeres que padecen de hipertensión arterial durante la gestación tienen mayor riesgo de sufrir sofocos y sudoración nocturna en la según un artículo publicado en Menopause.
Los expertos investigaron la relación entre las enfermedades hipertensivas durante el embarazo como la preeclampsia y los síntomas vasomotores en 853 mujeres que visitaron al cardiólogo en Kampen, Países Bajos.
De estas, 274 mujeres sufrieron enfermedades hipertensivas durante el embarazo y experimentaron sofocos más intensos y sudoración nocturna.
Debido a que la mitad de las mujeres del estudio sufrieron síntomas cardiacos, los investigadores no tienen claro si esta asociación se puede ligar a las mujeres de mediana edad.
(Fuente: Diario Médico, referido por Aldía) [Actualizado: 02 de mayo 2013]
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.
Prevalence, risk factors and awareness of hypertension in India: a systematic review
Por: P Devi, M Rao, A Sigamani, A Faruqui, M Jose, R Gupta, P Kerkar, R K Jain, R Joshi, N Chidambaram, D S Rao, S Thanikachalam, S S Iyengar, K Verghese, V Mohan, P Pais2 y D Xavier. Journal of Human Hypertension (2013) 27, 281–287.
Indians have high rates of cardiovascular disease. Hypertension (HTN) is an important modifiable risk factor. There are no comprehensive reviews or a nationally representative study of the burden, treatments and outcomes of HTN in India. A systematic review was conducted to study the trends in prevalence, risk factors and awareness of HTN in India. We searched MEDLINE from January 1969 to July 2011 using prespecified medical subject heading (MeSH) terms. Of 3372 studies, 206 were included for data extraction and 174 were observational studies. Prevalence was reported in 48 studies with sample size varying from 206 to 167 331.
[Actualizado: 02 de mayo 2013]
Esta sección mostrará algunos trabajos que puedan ser útiles a nuestros facultativos por su interés práctico o teórico.
The morning blood pressure surge is related to serum cholesterol
Por: C A Martin, J D Cameron, G A Head, S S Chen, N Eikelis y B P McGrath. Journal of Human Hypertension (2013) 27, 315–320.
A morning blood pressure surge (MBPS) may be either a mechanism for, or a marker of, increased cardiovascular events. This study has examined factors which may influence the morning surge: age, gender, metabolic factors, sympathetic function, blood pressure and arterial stiffness. Four measures of the MBPS were examined—sleep-trough surge, pre-awake surge, rate of blood pressure rise and a Power function. Subjects underwent ambulatory blood pressure monitoring, glucose tolerance test, central pulse wave velocity, sympathetic autonomic function tests (mental stress and sustained handgrip). MBPS was associated with age, hypertension, blood pressure variability and serum lipids. [Actualizado: 02 de mayo 2013].
Esta sección expone trabajos actuales, de carácter investigativo sobre la hipertensión arterial.
Por: Pedro Ordúñez, Jay S Kaufman, Mikhail Benet, Alain Morejon, Luis C Silva, David A Shoham y Richard S Cooper. BMC Public Health 2013, 13:169.
The excess burden of hypertension among blacks has been a prominent feature of the heath disparities literature, and many scientists presume it to be a stable and inevitable phenomenon. The underlying causes of this disparity can only be disentangled in a setting in which the population does not experience racial stratification of socioeconomic opportunities. While such conditions of racial equality remain uncommon, they may be approximated in Cuba, a country with a persistent policy of social inclusion over the last 5 decades.
Overall, skin color was unrelated to mean blood pressure or hypertensive status in this population, although among women specifically some racial advantage appears evident in adjusted prevalence and control, and should be investigated further. The overall null result suggests that Cuba may exemplify the social conditions in which racial excess in hypertension, characteristic of much of the western world, is not a necessary reality. [Actualizado: 02 de mayo 2013]
Por: Charumathi Sabanayagam, Boon Wee Teo, E Shyong Tai, Tazeen H Jafar y Tien Yin Wong. BMC Nephrology 2013, 14:86.
Chronic kidney disease (CKD) is an emerging public health problem worldwide. Previous studies have shown an association between blood pressure (BP) and CKD. However, it is not clear if there are ethnic differences in this association. We examined the association between BP and CKD in a multi-ethnic Asian population in Singapore.
The prevalence of both hypertension and CKD was higher among Malays (68.6, 21%) compared to Chinese (57.9, 5.9%) and Indians (56.0, 7.4%), but treatment for hypertension was lower among Malays (53.4%) compared to Chinese (89.8%) and Indians (83.1%). Hypertension was associated with CKD in all three ethnic groups (OR [95% CI] = 2.71 [1.59-4.63], 2.08 [1.62-2.68], 2.43 [1.66-3.57] in Chinese, Malays and Indians). Among the BP components, both systolic and diastolic BP were associated with CKD in Malays whereas, systolic BP was not significantly associated with CKD, and diastolic BP showed an inverse association which was explained by anti-hypertensive medication use in Chinese and Indians. [Actuaizado: 02 de mayo 2013]
Por: Pietro Amedeo Modesti, Stefano Rapi, Mohamed Bamoshmoosh, Marzia Baldereschi, Luciano Massetti, Luigi Padeletti, Gian Franco Gensini, Dong Zhao, Dawood Al-Hidabi, Husni Al Goshae. BMJ Open 2012;2:e001062 doi:10.1136/bmjopen.
Hypertension prevalence (age-standardised to the WHO world population 2001) based on fulfilling the same criteria on both visits (11.3%; 95% Cl 10.7% to 11.9%), was 35% lower than estimation based on the first visit (17.3%; 16.5% to 18.0%). Advanced age, blood glucose ≥7 mmol/l or proteinuria ≥1+ at dipstick test at visit one were significant predictors of confirmation at visit 2. The 959 participants found to be hypertensive at visit 1 or at visit 2 only and thus excluded from the final diagnosis had a rate of proteinuria (5.0%; 3.8% to 6.5%) comparable to rates of the general population (6.1%; 5.6% to 6.6%), and of subjects normotensive at both visits (5.6%; 5.1% to 6.2%). Only 1.9% of Yemen population classified at high or very high cardiovascular (CV) risk at visit 1 moved to average, low or moderate CV risk categories after two visits.
Hypertension prevalence based on readings obtained after two visits is 35% lower than estimation based on the first visit, subjects were excluded from final diagnosis belonging to low CV risk classes. [Actualizado: 02 de mayo 2013].
Study uncovers mechanism for how grapes reduce heart failure associated with hypertension
Grapes found to activate genes responsible for antioxidant defense in the heart.
A study appearing in the Journal of Nutritional Biochemistry¹ demonstrates that grapes are able to reduce heart failure associated with chronic high blood pressure (hypertension) by increasing the activity of several genes responsible for antioxidant defense in the heart tissue. Grapes are a known natural source of antioxidants and other polyphenols, which researchers believe to be responsible for the beneficial effects observed with grape consumption. This study, funded by a grant from the National Institutes of Health (NIH), and conducted at the University of Michigan Health System, uncovered a novel way that grapes exert beneficial effects in the heart: influencing gene activities and metabolic pathways that improve the levels of glutathione, the most abundant cellular antioxidant in the heart.
An estimated 1 billion people worldwide have hypertension, which increases the risk of heart failure by 2 to 3-fold. Heart failure resulting from chronic hypertension can result in an enlarged heart muscle that becomes thick and rigid (fibrosis), and unable to fill with blood properly (diastolic dysfunction) or pump blood effectively. Oxidative stress is strongly correlated with heart failure, and deficiency of glutathione is regularly observed in both human and animal models of heart failure. Antioxidant-rich diets, containing lots of fruits and vegetables, consistently correlate with reduced hypertension.
In this study, conducted at the University of Michigan Health System, hypertensive, heart failure-prone rats were fed a grape-enriched diet for 18 weeks. The results reproduced earlier findings that grape consumption reduced the occurrence of heart muscle enlargement and fibrosis, and improved the diastolic function of the heart. Furthermore, the mechanism of action was uncovered: grape intake “turned on” antioxidant defense pathways, increasing the activity of related genes that boost production of glutathione.
“Our earlier studies showed that grapes could protect against the downward spiral of hypertensive heart failure, but just how that was accomplished – the mechanism – was not yet known,” said lead investigator E. Mitchell Seymour, Ph.D. “The insights gained from our NIH study, including the ability of grapes to influence several genetic pathways related to antioxidant defense, provide further evidence that grapes work on multiple levels to deliver their beneficial effects.”
Seymour noted that the next phase of the NIH study, which will continue into 2014, will allow his team to further define the mechanisms of grape action, and also look at the impact of whole grape intake compared to individual grape phytonutrients on hypertension-associated heart failure.
“Our hypothesis is that whole grapes will be superior to any individual grape component, in each of the areas being investigated,” said Dr. Seymour. “The whole fruit contains hundreds of individual components, which we suspect likely work together to provide a synergistic beneficial effect.”
The insights gained from this research will further the knowledge on grapes and heart health, but will also provide translational information on the value of dietary (whole foods) and dietary supplement approaches for prevention of heart disease stemming from chronic hypertension.
“The NIH grant is allowing the team at the University of Michigan Medical System to expand its work in this important area and further highlight the multi-faceted role of grapes in supporting heart health,” said Kathleen Nave, president of the California Table Grape Commission. “This work will also provide key insights into the role of whole fruit versus individual components of a fruit, using grapes as the benchmark.”
(Fuente: Journal of Nutritional Biochemistry – sitado por: Eurekalert.) [Actualizado: 02 de mayo 2013]
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