¿Es la hipertensión sensible a sal una enfermedad inflamatoria? Papel de los linfocitos y macrófagos

Por: Rafael González-Toledo y Martha Franco.  Archivos de Cardiología de México, vol. 82. Núm. 04. Octubre 2012 – Diciembre 2012.

La hipertensión arterial sistémica es un problema de salud pública. Esta entidad afecta al 43% de la población mexicana y es considerada una de los principales factores de riesgo para el desarrollo de eventos vasculares cerebrales, insuficiencia cardiaca e insuficiencia renal. La prevalencia de hipertensión arterial sistémica se ha incrementado durante las últimas décadas debido a la adopción de una dieta alta en sal.  Existe evidencia de que la hipertensión sensible a sal se acompaña de alteraciones estructurales renales como dilatación tubular, fibrosis intersticial en parches, expresión de osteopontina e infiltrado túbulo intersticial de linfocitos y macrófagos, que impiden una excreción urinaria de sodio adecuada y en consecuencia, favorecen el desarrollo de HAS.  [Actualizado: 16 de octubre de 2013].

Can we study the baroreflex mechanisms with other variables than blood pressure and heart rate?

Por: Bruno Estañol.   Archivos de Cardiología de México, vol. 82. núm. 02. Abril – Junio 2012.

The baroreflex (BR) is a fundamental physiological mechanism that keeps the blood pressure (BP) stable by buffering the disturbances that arise in the system during the activities of the daily life. These disturbances alter the control system and deviate the mean BP either increasing or decreasing it. The BP is maintained tonically around a “set point” and the disturbances oscillate around it; they me be profound or relatively minor.
Sometimes the disturbances occur at predictable times such as those seen during non-Rem sleep or rhythmic breathing. The disturbances could be considered “phasic” changes that are randomly added or subtracted to the tonically maintained set point. The set point is dynamic and changes according to the mean BP maintained during a determined period of time, computed, perhaps, in hours or days or even minutes.   [Actualizado: 16 de octubre 2013].

Estudios importantes sobre hipertension arterial de Cuba y el mundo

Ambulatory and home blood pressure monitoring in children and adolescents: diagnosis of hypertension and assessment of target-organ damage

Por: Nikos Karpettas, Efthimia Nasothimiou, Anastasios Kollias, Adriani Vazeou y George S Stergiou.  Hypertension Research (2013) 36, 285–292.

The prevalence of elevated blood pressure in children and adolescents is more common than previously believed and often represents the early onset of essential hypertension, particularly in adolescents. The definition of hypertension in children is based on distribution criteria and normalcy tables that provide blood pressure percentiles for each measurement method (office, ambulatory and home) according to the individual’s age, gender and body size. Owing to the white coat and masked hypertension phenomena, ambulatory blood pressure monitoring is indispensable for the diagnosis of hypertension in children. Home blood pressure monitoring in children has been less well studied, and at present, treatment decisions should not be based solely on such measurements.

Salt, the renin–angiotensin–aldosterone system and resistant hypertension

Por: Tatsuo Shimosawa.  Hypertension Research (2013) 36, 657–660.

High salt intake is a risk for developing resistant hypertension, and even under triple therapy with diuretics, an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and a calcium channel blocker, the volume is occasionally not controlled. In such cases, a mineralocorticoid receptor (MR) antagonist additively lowers the circulating blood volume and blood pressure despite the lower circulating aldosterone level. This mechanism may be explained by the increase in the number of MR under some conditions or the activation of these receptors independent of aldosterone.

En esta sección les exponemos algunos artículos publicados sobre la hipertensión arterial.

De la Revista: American Journal of Hypertension

Non-Invasive Diagnostic Testing for Coronary Artery Disease in the Hypertensive Patient: Potential Advantages of a Risk Estimation-Based Algorithm

Por: Diana Chin, Allegra Battistoni,  Giuliano Tocci,  Jasmine Passerini,  Gianfranco Parati y  Massimo Volpe.  Am J Hypertens (2012) 25 (12): 1226-1235.

Evolution of Target Organ Damage by Different Values of Self-Blood Pressure Measurement in Untreated Hypertensive Patients

Por: Gabriel Coll-de-Tuero, Marc Saez, Carmen Roca-Saumell, Antonio Rodriguez-Poncelas, Pilar Franco,  Antoni Dalfó, Laia Calvó-Perxas,  Antonio Pose-Reino y Joan Bayó-Llibre.   Am J Hypertens (2012) 25 (12): 1256-1263.

Abdominal Obesity, Body Mass Index, and Hypertension in US Adults: NHANES 2007–2010

Por: Yechiam Ostchega, Jeffery P. Hughes, Ana Terry, Tala H.I. Fakhouri y Ivey Miller.  Am J Hypertens (2012) 25 (12): 1271-1278.

Feasibility of Home Blood Pressure Measurement in Elderly Individuals: Cross-Sectional Analysis of a Population-Based Sample

Por: Cécilia Cacciolati, Christophe Tzourio, Carole Dufouil,  Annick Alpérovitch y Olivier Hanon.  Am J Hypertens (2012) 25 (12): 1279-1285.

Cost-Effectiveness of Renin-Guided Treatment of Hypertension

Por: Steven M. Smith y Jonathan D. Campbell.  American Journal of Hypertension, volume 26, Issue 11, pp. 1303-1310.

A plasma renin activity (PRA)–guided strategy is more effective than standard care in treating hypertension (HTN). However, its clinical implementation has been slow, presumably due in part to economic concerns. We estimated the cost effectiveness of a PRA-guided treatment strategy compared with standard care in a treated but uncontrolled HTN population. Our results suggest that PRA-guided therapy compared with standard care increases QALYs and medical costs in most scenarios. PRA-guided therapy appears to be most cost effective in younger persons and those with more cardiovascular risk factors.