Hypertension around the world: new insights from developing countries
Por: Angeli, Fabioa; Reboldi, Gianpaolo; Verdecchi y Paolo. Journal of Hypertension: July 2013 – Volume 31 – Issue 7 – p 1358-1361.
Hypertension is a serious public health challenge worldwide, being quantitatively the major risk factor for premature cardiovascular disease. According to recent estimates, it is more common than cigarette smoking, dyslipidemia or diabetes, the other major cardiovascular risk factors. The National Health and Nutrition Examination Survey (NHANES), in its wave from years 2005 through 2008, estimated that approximately 29–31% of adults in the United States have hypertension. This translates into 58–65 million hypertensive patients in the United States adult population [8]. In addition, a pooled analysis of global national and regional data showed that 26.4% of the adult population in 2000 had hypertension (26.6% of men and 26.1% of women), and 29.2% were projected to have this condition by 2025 (29.0% of men and 29.5% of women).
[Actualizado: 1ero de agosto 2013].
Brain renin–angiotensin system in the nexus of hypertension and aging
Por: Amy C Arnold, Patricia E Gallagher y Debra I Diz. Hypertension Research (2013) 36, 5–13.
Aging is associated with an imbalance in sympathetic and parasympathetic outflow to cardiovascular effector organs. This autonomic imbalance contributes to the decline in cardiovagal baroreceptor reflex function during aging, which allows for unrestrained activation of the sympathetic nervous system to negatively impact resting systolic blood pressure and its variability. Further, impaired baroreflex function can contribute to the development of insulin resistance and other features of the metabolic syndrome during aging through overlap in autonomic neural pathways that regulate both cardiovascular and metabolic functions. [Actualizado: 1 de agosto 2013].
Angiotensin receptor blocker therapy and risk of cancer
Por: Teo, Koon K. Journal of Hypertension: August 2013 – Volume 31 – Issue 8 – p 1532-1534.
In their study published in this issue of the Journal of Hypertension, Rao et al. examined the association between exposure to treatment with angiotensin receptor blockers (ARBs) and subsequent risk of lung cancer in individuals who received routine treatment in the US Department of Veteran Affairs Health System, which has maintained a robust database on which outcome questions such as this can be addressed. In this data record-linkage retrospective study using the Veteran Affairs electronic medical record system and other registries, the authors selected 1 299 902 patients as their analytic cohort, with 7 8075 having received prescriptions for ARBs and 11 51826 who did not. Following a rigorous statistical procedure in the selection of appropriate controls from those who did not receive ARB prescriptions, they found that the incidence of lung cancer was 0.44% in the treated and 0.57% in the nontreated patients, and concluded that there was no evidence to indicate an increased risk of lung cancer among new users of ARBs compared to nonusers. [Actualizado: 1ero de agosto 2013].
Método de selección de tratamiento antihipertensivo
Por: José Elías González Ybarzábal y Deysi María Chirino Ramadán. Gaceta Médica Espirituana, Vol 15, No 2 (2013).
La revisión y el análisis propone las variables que se deben considerar para lograr una caracterización más completa e individual del paciente hipertenso y una selección adecuada del tratamiento, por lo que es de gran valor incorporar otros factores de riesgo como tiempo de evolución, tensión emocional mantenida y microalbuminuria. En casos de daños en órganos diana hay que tener presente la etapa subclínica, daño múltiple, síndrome metabólico y el daño vascular arterial. Considerar además las condiciones médicas coexistentes, características hemodinámicas en grupos de hipertensos en correspondencia a los mecanismos de acción de los medicamentos hipotensores para su selección, incorporar nuevos medios diagnósticos factibles para la detección en etapa subclínica, estratificación del riesgo cardiovascular y causas de hipertensión arterial secundaria privilegiando las potencialmente curables. [Actualizado: 2 de agosto 2013].
Estudios importantes sobre hipertension arterial de Cuba y el mundo
Por: Will Maimaris mail, Jared Paty, Pablo Perel, Helena Legido-Quigley, Dina Balabanova, Robby Nieuwlaat y Martin Mckee. PLoS Medicine 1 august 2013.
Hypertension (HT) affects an estimated one billion people worldwide, nearly three-quarters of whom live in low- or middle-income countries (LMICs). In both developed and developing countries, only a minority of individuals with HT are adequately treated. The reasons are many but, as with other chronic diseases, they include weaknesses in health systems. We conducted a systematic review of the influence of national or regional health systems on HT awareness, treatment, and control. This review supports the minimization of medication co-payments in health insurance plans, and although studies were largely conducted in the US, the principle is likely to apply more generally. Studies that identify and analyze complexities and links between health systems arrangements and their effects on HT management are required, particularly in LMICs. [Actualizado: 2 de agosto 2013].
Comentarios recientes