ABSTRACT
Tipo de estudio: analítico, cualitativo, transversal, multicéntrico.Objetivo: conocer la prevalencia de osteoporosis en una población de pacientes en hemodiálisis (HD) crónica, y evaluar su correlación con la paratohormona (PTH); el tiempo en HD, el peso y la edad.Universo: 153 pacientes en hemodiálisis. Resultados: la prevalencia de osteoporosis fue del 60% en los hombres y 59% en las mujeres, mientras que tuvieron una masa ósea normal el 10 y 11% respectivamente. Se obtuvo una correlación inversa de la densidad mineral ósea (DMO) con la PTH y con el tiempo en HD.Conclusión: se pudo comprobar que la masa ósea de los pacientes con IRC disminuye como consecuencia de varios factores añadidos a la osteodistrofia renal como la edad y un mayor tiempo en HD.
Study type: analytic, qualitative, transverse, multicenter. Objective: to know the osteoporosis prevalence in a population of patients in chronic haemodiaylisis (HD), and to evaluate their correlation with the paratohormona (PTH); the time in HD, the weight and. the age. Universe: 153 patients in haemodiaylisis. Results: the osteoporosis prevalence was of 60% in men and 59% in women, having a normal bony mass of 10 and 11% respectively. An inverse correlation of the BMD was obtained with PTH and time in HD. Conclusion: it could be proven that bony mass of patients with CRI diminishes as consequence of several factors added to renal osteodystrophy as age and a longer time in HD.
Subject(s)
Male , Adult , Female , Middle Aged , Osteoporosis , Renal Dialysis , Renal Insufficiency , Densitometry , Diabetes Mellitus , Hyperparathyroidism , HypertensionABSTRACT
PURPOSE--To evaluate the antihypertensive efficacy and tolerability of captopril 50 mg + hydrochlorothiazide 25 mg daily in mild to moderate primary hypertension. METHODS--Out-patients (n = 471) with mild to moderate hypertension, diastolic blood pressure (DBP) 95-115 mmHg, with 15 days of washout, were included to the treatment initially with half tablet of the association of captopril 50 mg + hydrochlorothiazide 25 mg once daily, for 30 days. After this period, patients with DBP > 90 mmHg had the dosage duplicated, while the others had the same dosage for 60 days more. Evaluation was performed 15 days before and then every month during active drug. RESULTS--Twenty six patients were withdrawn, 13 (2.7) by adverse effects and 13 by protocol violation. At the end of the wash-out period, the blood pressure (BP), 162 +/- 16/103 +/- 6 mmHg decreased significantly at the 30th day to 146 +/- 14/92 +/- 8 mmHg (p < 0.001 vs 0th day); 139 +/- 12/86 +/- 7 mmHg at the 60th day, (p < 0.001 vs 30th day), and further to 136 +/- 11/84 +/- 5 mmHg, (p < 0.001 vs day 0) till the end of the 90th day. Antihypertensive efficacy (DBP < or = 90 mmHg and decreased of the DBP > or = 10 mmHg) was obtained in 82 of the patients. There was no difference in BP control considering race, hypertension level, previous antihypertensive treatment and obesity. Cough (4) was the main adverse event. CONCLUSION--Captopril + hydrochlorothiazide was effective and safe in the treatment of mild to moderate hypertension. The favorable response was observed in 82 of the patients independently of race, hypertensive level, previous antihypertensive treatment and obesity. Low incidence of side effects was reported, with no difference from others reported in the literature.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Captopril , Hydrochlorothiazide , Antihypertensive Agents , Hypertension/drug therapy , Aged, 80 and over , Captopril , Drug Therapy, Combination , Hydrochlorothiazide , Antihypertensive Agents , Heart Rate/drug effects , Severity of Illness Index , Arterial Pressure/drug effectsABSTRACT
PURPOSE--To evaluate the effects of captopril (Cpt).on carbohydrate metabolism and growth hormone (GH) in adults hypertensive obese patients with normal (NGT) or impaired (IGT) glucose tolerance and left ventricular hypertrophy. METHODS--Ten patients (53 +/- 8 years), 8 women and 2 men, white, body mass index (BMI) > or = 26kg/m2, left ventricular mass index (LVMI) > 135g/m2 in man and > 110g/m2 in woman, with diastolic blood pressure (DBP) 95-115mmHg after 3 weeks of placebo, were identified by oral glucose tolerance test (OGTT-75g) as either with NGT or IGT, and treated with Cpt 25mg t.i.d. for 8 weeks. At the 8 weeks, dosage was increased to 50mg b.i.d. if DBP > 90mmHg or the decrease of the DBP < 10, during the next 8 weeks. OGTT and clonidine tests (0,04mg/kg) with determinations, every 30 minutes of glucose, insulin, and GH during 2 hours, were performed. RESULTS--Cpt lowered SBP and DBP in the NGT group and IGT group. The LVMI and the left ventricular mass (LVM) decreased in the IGT group with no significant change in the NGT group. Cpt promoted in the IGT group decrease in the area under the curve (AUC) of glucose, and AUC of insulin, with increase of the AUC of the percent of the beta cell function, AUC of HC, and insulin sensitivity index with no significantly change in the NGT group. CONCLUSION--Adults hypertensive obese patients with IGT had decreased significantly in mean fasting level of GH concentrations compared to age, race, and BMI matched hypertensive patients with NGT. Treatment with Cpt induced a significant increased of the GH, with improvement of the metabolism in patients with IGT.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Captopril , Hypertrophy, Left Ventricular , Obesity , Hypertension/drug therapy , Time Factors , Blood Glucose , Growth Hormone , Captopril , Hypertrophy, Left Ventricular , Insulin , Antihypertensive Agents , Obesity , Hypertension/blood , Hypertension/etiology , Glucose Intolerance , Lipids/analysis , Insulin Resistance , Glucose Tolerance TestABSTRACT
PURPOSE--To evaluate the adverse reactions of fosinopril with other antihypertensives used as monotherapy. METHODS--Out-patients (n = 2,568) with diagnostic of mild to moderate hypertension, diastolic blood pressure (DBP) 95-115mmHg, with no antihypertensive treatment for 15 days, were included to treatment initially with fosinopril (F) 10mg, once daily, for six weeks. After this period, patients with DBP > 95mmHg had the dosage, once daily, increased to 20mg, while the others were maintained with the same dosage for six more weeks. Adverse reactions of 822 patients treated as monotherapy were grouped as absent, musculoskeletal, cardiovascular, cough, gastrointestinal, neurological, genital-urinary dysfunctions and dermatological and compared with 1,568 with F. Monotherapy consist in alpha-methyldopa (100 patients); beta-blocker (129); calcium blocker (106); diuretic (394); and another ACE inhibitors (93). RESULTS--At the end of the period without treatment, the blood pressure (BP), 165 +/- 16/105 +/- 7mmHg decreased significantly at 6th week to 144 +/- 15/91 +/- 9mmHg (p < 0.05 vs week 0) with further lowering to 139 +/- 13/86 +/- 7mmHg till the end of 12th week. BP response (DBP < or = 90mmHg) was obtained in 89per cent of the patients with F. Absence of adverse reactions were > or = 70 per cent in patients with F compared to other drugs. CONCLUSION--Fosinopril has demonstrated therapeutic efficacy and less adverse reactions compared to antihypertensives used previously as monotherapy
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Fosinopril/therapeutic use , Hypertension/drug therapy , Aged, 80 and over , Fosinopril/adverse effects , Antihypertensive Agents/adverse effects , Antihypertensive Agents/therapeutic use , Ambulatory CareABSTRACT
PURPOSE--To evaluate the antihypertensive efficacy and safety of cilazapril compared to nifedipine retard in mild to moderate hypertension. METHODS--forty randomized out-patients with mild moderate hypertension, diastolic pressure (DP) between 95 and 115 mmHg, with placebo for 15 days were randomized and allocated for treatment, double-blind, once daily with cilazapril 2.5 mg (n = 20) or nifedipine retard 20 mg (20 = n) for four weeks. The non-responders (DP > 90mmHg) had the dosage increased twice, b.i.d., while responders were maintained up to 10 weeks. Clinical visits were performed before, at baseline and every two weeks and the laboratory test was performed after placebo run-in, 4th and 10th weeks of treatment. RESULTS--The blood pressure (BP) were similar between groups at the end of the placebo (cilazapril 151 +/- 14/103 +/- 5 - nifedipine 157 +/- 17/108 +/- 7mmHg, p > 0.05). DP decreased already at second weeks (cilazapril 95 +/- 9 - nifedipine 96 +/- 11mmHg, p < 0.05, compared to week 0) in both groups at the end of study with no difference inter groups. BP normalization was obtained in 58 per cent of the patients with cilazapril and in 61 per cent in the nifedipine group. Adverse biochemical effects were not observed in any group. Six (16 per cent) patients of the cilazapril and 15 (39per cent) of nifedipine related collateral events, although no difference were observed between groups. CONCLUSION--Cilazapril 2.5 to 25mg normalized BP in 58 per cent of mild and moderate hypertension patients, and this efficacy was similar to sustained-release nifedipine 20 to 40mg. Cilazapril had no adverse effects on the biochemical parameters with low incidence of collateral effects