Cinco años de experiencia en consulta especializada de hipertensión arterial complicada (2008-2012)
Por: Dr. Jorge Luis León Álvarez, Dr.C. Manuel Delfín Pérez Caballero y Dr. Guillermo Guerra Ibáñez. Rev cubana med, vol.52, no.4. Ciudad de la Habana, oct-dic. 2013.
La hipertensión arterial (HTA) es un problema de salud mundial, de su control depende en gran parte la disminución de la morbilidad y la mortalidad por enfermedades cardiovasculares (ECV). En los Estados Unidos, según datos de NHANES del 2012, aproximadamente el 30,4 % de los adultos mayores de 18 años padecen de HTA y el 53,5 % de ellos no la tienen controlada.1 Cuba no está exenta de este problema, en la encuesta nacional de factores de riesgo realizada en el 2012, se estimó la padecen el 30,9 % de población mayor de 15 años y el 50,8 % de los hipertensos conocidos no están controlados.
Nocturnal blood pressure and cardiovascular disease: a review of recent advances
Por: Yuichiro Yano y Kazuomi Kario. Hypertension Research (2012) 35, 695–701.
The accurate measurement, prediction and treatment of high blood pressure (BP) are essential issues in the management of hypertension. Ambulatory blood pressure monitoring (ABPM) has been shown to be superior
to clinic BP measurements as ABPM can provide the following important information: (i) the mean BP levels, (ii) the diurnal variation in BP and (iii) the short-term BP variability. Among these parameters, there is increasing evidence that the mean nocturnal BP level is the most sensitive predictor of cardiovascular morbidity and mortality. Furthermore, several studies have shown that less nocturnal BP dipping, defined as less nocturnal BP decline relative to daytime BP, or a high night–day BP ratio was associated with poor prognosis irrespective of the 24-hour BP levels.
Por: Jiang He, MD, PhD, Yonghong Zhang, MD, PhD, Tan Xu, MD, PhD, Qi Zhao, MD, PhD, Dali Wang, MD,; Chung-Shiuan Chen, MS, Weijun Tong, MD, Changjie Liu, MD, Tian Xu, MD, Zhong Ju, MD, Yanbo Peng, MD, Hao Peng, MD1; Qunwei Li, MD8; Deqin Geng, MD9; Jintao Zhang, MD10; Dong Li, MD11; Fengshan Zhang, MD,; Libing Guo, MD, Yingxian Sun, MD, Xuemei Wang, MD, Yong Cui, MD, Yongqiu Li, MD, Dihui Ma, MD, Guang Yang, MD, Yanjun Gao, MD, Xiaodong Yuan, MD, Lydia A. Bazzano, MD, PhD, Jing Chen, MD, MS, for the CATIS Investigators. JAMA, February 5, 2014, Vol 311, No. 5.
Although the benefit of reducing blood pressure for primary and secondary prevention of stroke has been established, the effect of antihypertensive treatment in patients with acute ischemic stroke is uncertain.
To evaluate whether immediate blood pressure reduction in patients with acute ischemic stroke would reduce death and major disability at 14 days or hospital discharge.
The China Antihypertensive Trial in Acute Ischemic Stroke, a single-blind, blinded end-points randomized clinical trial, conducted among 4071 patients with nonthrombolysed ischemic stroke within 48 hours of onset
and elevated systolic blood pressure. Patients were recruited from 26 hospitals across China between August 2009 and May 2013. Primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 14 days or hospital discharge. Among patients with acute ischemic stroke, blood pressure reduction with antihypertensive medications, compared with the absence of hypertensive medication, did not reduce the likelihood of death and major disability at 14 days or hospital discharge.
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