Factores de riesgo cardiovascular en pacientes en hemodiálisis / Cardiovascular risk factors in patients on hemodialysis

Introducción: La enfermedad cardiovascular es la primera causa de muerte en los pacientes con enfermedad renal crónica. En los hipertensos, la enfermedad renal crónica es la segunda causa de muerte, el daño vascular sistémico es la norma. Objetivo: Identificar los factores de riesgo cardiovascular tradicionales y no tradicionales y su asociación con la enfermedad cardiovascular en pacientes en hemodiálisis. Material y Métodos: Estudio de corte transversal en 247 pacientes en hemodiálisis crónica. Las variables analizadas fueron: causas de enfermedad renal crónica, factores de riesgo cardiovascular tradicionales y no tradicionales y enfermedades cardiovasculares. Se determinaron tablas de frecuencias y estadísticas de asociación mediante Chi cuadrado. Para determinar el riesgo de mortalidad se utilizó la razón de prevalencia (RP). Se consideró como nivel de significación estadística a p<0,05 con 95 % de confiabilidad. Resultados: Las causas de enfermedad renal crónica predominantes fueron la hipertensión arterial con 35,6 por ciento y la Diabetes Mellitus tipo 2 con 33,1 por ciento. Los pacientes hipertensos tuvieron más probabilidades de presentar una enfermedad cardiovascular con 2,63 veces mayor que el grupo de referencia. En los factores de riesgo cardiovascular no tradicionales la mayor probabilidad la presentaron los pacientes con proteína C reactiva elevada con 5,19 veces, seguido de la hiperuricemia con 3,79 veces y las alteraciones del producto calcio-fósforo con una probabilidad de 3,27 veces. Conclusiones: Los factores de riesgo cardiovasculares tradicionales se relacionan significativamente con la presencia de enfermedad cardiovascular(AU)

Introduction: Cardiovascular disease is the leading cause of death in patients with chronic kidney disease. In hypertensive patients, chronic kidney disease is the second cause of death, and systemic vascular damage has become the norm. Objective: To identify traditional and non-traditional cardiovascular risk factors and their association with cardiovascular disease in patients on hemodialysis. Material and Methods: Cross-sectional study conducted on 247 patients on chronic hemodialysis. The variables analyzed included: causes of chronic kidney disease, traditional and non-traditional cardiovascular risk factors, and cardiovascular diseases. Frequency tables and association statistics were determined by the chi-square test. The prevalence ratio (PR) was used to determine the risk of mortality. The level of statistical significance was considered to be at p value of less than 0,05 with a reliability of 95 percentResults: The most frequent causes of chronic kidney disease were arterial hypertension (35,6 percent) and type 2 diabetes mellitus (33,1 percen). Hypertensive patients were 2,63 times more likely to present cardiovascular disease than the reference group. In the case of non-traditional cardiovascular risk factors, the patients with elevated C-reactive protein were 5,19 more likely to develop cardiovascular disease, followed by those with hyperuricemia that were 3,79 more likely, and the patients with alterations in calcium and phosphorous who were 3,27 times more likely to suffer from this disease. Conclusions: Traditional cardiovascular risk factors are significantly related to the presence of cardiovascular disease(AU)

Algunos resultados postintervención en el control, tratamiento y complicaciones de la hipertensión arterial. Policlínico Universitario Héroes del Moncada. Cárdenas, 2014 / Several post-intervention outcomes in the control, treatment and complications of arterial hypertension. University Policlinic Heroes del Moncada. Cardenas 2014

Introducción: la educación del hipertenso y del equipo de salud son elementos primordiales para el mejor control de la hipertensión arterial. Objetivo: elevar los pacientes controlados al 70 %. Materiales y métodos: se realizó un estudio epidemiológico cuasiexperimetal. La intervención se dirigió a médicos de familias, grupos básicos de trabajo, comunidad e hipertensos. Se seleccionaron dos muestras (350 hipertensos diferentes), antes y después de la intervención, realizándose encuestas, mediciones con comparaciones de resultados; test estadístico: Chi2, Odds ratio, valor p. Resultados: los hipertensos controlados y adherencia al tratamiento aumentaron, con diferencias estadísticamente significativas, p<0,05. No hubo diferencias entre los 5 medicamentos más utilizados. En la postintervención, presentaron asociación estadística significativa con hipertensos controlados: adherencia al tratamiento, dieta baja en sal y grasa, consumo de frutas y vegetales, y no fumar. Las medias de presión diastólica, sistólica y las complicaciones disminuyeron, con diferencias estadísticamente significativas, p<0,05. Conclusiones: aumentaron los hipertensos controlados y se lograron mejoras en la calidad de vida de los hipertensos.

Background: the education of the hypertensive patient and the health team are important elements for the better control of arterial hypertension. Objective: increasing controlled patients to 70 %. Materials and Methods: A quasi-experimental epidemiologic study was carried out. The intervention was headed to family physicians, basic work teams, the community and hypertensive patients. Two samples were chosen (350 different hypertensive patients), before and after interventions, applying interviews, measuring with results comparisons, statistical tests: Chi2, Odds ratio and P value. Outcomes: The controlled hypertensive patients and treatment adherence increased, with significant statistical differences, p<0.05. There were not differences between the five most used medications. In the post-intervention period, treatment adherence, low salt and fat diet, fruits and vegetables consumption, and no smoking showed significant statistic association with controlled hypertensive patients. The average diastolic and systolic pressure and complications decreased, with significant statistical differences p<0.05. Conclusions: The controlled hypertensive patients increased and the life quality of the hypertensive patients improved.

Avaliação do teor de antioxidantes, flavonoides e compostos fenólicos em preparações condimentares / Evaluation of the content of antioxidants, flavonoids and phenolic compounds in culinary preparations

RESUMO: Plantas condimentares são amplamente utilizadas na culinária como alimento funcional. Pacientes hipertensos, que retiram o sal de cozinha (NaCl) de sua alimentação, relatam que os alimentos "perdem" o sabor. Visando alternativas para substituir o sal e melhorar a palatabilidade das preparações alimentares de pacientes hipertensos, o objetivo deste estudo foi desenvolver temperos à base de plantas medicinais e analisar os teores de compostos fenólicos, flavonoides e atividade antioxidante destes. Plantas (coentro, salsa, orégano, alecrim, manjericão, alho, cebola) cultivadas organicamente em Viçosa (MG) foram processadas e os temperos foram desenvolvidos a partir de combinação destas espécies, de acordo com teste aceitabilidade sensorial afetivo por meio de escala hedônica. Foram definidos três temperos, dos quais foram feitos extratos metanólicos por remaceração até esgotamento. Nas dosagens utilizou-se DPPH na avaliação da atividade antioxidante; reagente de Folin-Ciocalteu para compostos fenólicos e vanilina clorídrica para flavonoides. As análises foram feitas com quatro repetições e os resultados submetidos à análise de variância e teste de média a 5% de significância. Na aceitação subjetiva dos temperos a nota média foi 7,07±1,09 e 8,0±0,93 na ação afetiva como alimento. O teor mais elevado de compostos fenólicos foi no tempero 2 (alho, salsa e manjericão) (55,04±4,307 mg/mL), a maior ação antioxidante foi no tempero 1 (alho, cebola, coentro e orégano) nos tempos 0 (48,72%) e 30 minutos (78,37%). Os teores de flavonoides foram semelhantes nos 3 temperos. Todos os temperos tiveram boa aceitação por pacientes hipertensos e mostraram-se promissores na substituição dos condimentos convencionais.

ABSTRACT: Plant herbs are widely used in cooking as functional food. Hypertensive patients, who remove salt (NaCl) from their diets, report that the food "loses" flavor. Seeking alternatives to replace salt and improve the palatability of food preparations of hypertensive patients the aim of this study was to develop spices based on medicinal plants and analyze their contents of phenolic compounds, flavonoids and antioxidant activity. Plants (cilantro, parsley, oregano, rosemary, basil, garlic, onion) grown organically in the city of Viçosa (state of Mato Grosso, Brazil) were processed and the seasonings were developed from the combination of these species, according to the affective sensory acceptability test using the hedonic scale. Three spices were defined, and methanol extracts were made from them by maceration until exhaustion. In the dosages, we used DPPH to evaluate the antioxidant activity, Folin-Ciocalteu reagent for phenolic compounds and hydrochloric vanillin for flavonoids. The analyses were performed with four replicates and the results were subjected to analysis of variance and to a 5% significance test. In the subjective acceptance of the spices, the average score was 7.07 ± 1.09 and 8.0 ± 0.93 in the affective action as food. The highest content of phenolic compounds was for treatment 2 (garlic, parsley and basil) (55.04 ± 4.307 mg/mL) and the highest antioxidant activity was measured in treatment 1 (garlic, onion, cilantro and oregano) at 0 (48.72%) and 30 minutes (78.37%). The contents of flavonoids were similar in the three treatments. All spices were well accepted by the hypertensive patients and have shown to be a promising replacement of conventional spices.

Marcadores de estrés oxidativo y su relación con el estado nutricional en adultos, Ecuador / Relationships between biomarkers of oxidative stress and nutritional status in adults, Ecuador

Se evaluó la relación entre biomarcadores de estrés oxidativo (ácido úrico, bilirrubina y proteína C-reactiva) con el estado nutricional en 321 adultos de Ecuador, pertenecientes al personal administrativo de la Universidad Técnica del Norte, con edades de 43 ± 10 años, (46,30% femenino y 53,61% masculino). Se obtuvo información sociodemográfica, de estilo de vida y epidemiológica; se calculó el índice de Masa Corporal (IMC), porcentaje de grasa y agua corporal, se midió la circunferencia de la cintura (CC) y la presión arterial y se determinó las concentraciones de ácido úrico, bilirrubina y Proteína C reactiva (PCR). Se encontró que 17,9% de la población presentó obesidad y 51,72% sobrepeso. Los valores más elevados de ácido úrico se encontraron en obesos, hipertensos y en quienes realizan actividad física. La bilirrubina total, directa e indirecta se encontró en límites superiores en los grupos con obesidad abdominal, y con actividad física. Las variables % de grasa y de agua influyen en la PCR en el grupo con baja grasa corporal y en las mujeres. En hombres, la PCR se asocia con IMC y CC. En los grupos sobrepeso, alta grasa corporal y PHT, el ácido úrico mostró relación con el % de grasa y la CC En los obesos con el % de agua e IMC y en los grupos obesidad abdominal e HT se asoció con % de agua y CC Se concluye que el porcentaje de agua corporal es un importante indicador nutricional para el desarrollo de estrés oxidativo en esta población.

In this work it was evaluated the relationship between oxidative stress biomarkers (uric acid, bilirubin and C-reactive protein) with nutritional status in 321 adults of Ecuador, belonging to administrative staff of of the Universidad Tècnica del Norte , aged 43 ± 10 years old (46 30% female and 53.61% male). Socio demographic and epidemiological information and lifestyle were obtained through a survey; The Body Mass Index (BMI) and body fat and body water percentages were calculated; waist circumference (WC) and blood pressure was measured. Determinations of uric acid, bilirubin, and serum C-reactive protein (PCR) were performed. 17.9% of the populations were obese and 51.72% overweight. The highest values of uric acid were found in obese, hypertensive and physical activity groups. The total direct and indirect bilirubin were found in upper limits in abdominal obesity and physical activity groups. The CRP level was influenced by % fat and % water in the low body fat group and in females. In male, BMI and WC were associated with CRP. Uric acid showed relationship with % fat and WC in overweight, high body fat and PHT groups, uric acid was associated with the % water and BMI in obese. Finally, uric acid was associated with % water and the WC in the abdominal obesity, and HT groups’ .The body water percentage is an important indicator to development of oxidative stress in this population.

Intervención integral educativa en hipertensión arterial. Policlínico Héroes del Moncada. Municipio de Cárdenas, 2013 / Integral educative intervention in arterial hypertension. Policlinic Heroes del Moncada. Cardenas Municipality, 2013

Se realizó la descripción de una intervención integral dirigida a médicos de familias y grupos básicos de trabajo, en consulta externa, a la comunidad y a los hipertensos del Policlínico Héroes del Moncada, del 1 de enero al 31 de diciembre de 2013. Se consignaron los temas que se impartirán a los médicos de familia y a los grupos básicos de trabajo, según la guía del Programa de Hipertensión Arterial. Se señalaron los acápites que deben ser llenados en la historia clínica y las acciones a desarrollar por el médico de familia en la consulta externa del hipertenso. Se expresaron las actividades y el procedimiento de intervención en la comunidad, así como la metodología y el programa para llevar a cabo en las escuelas de hipertensos.

We described an integral intervention directed to family physicians and basic work groups in external consultation, to the community and hypertensive patients of the Policlinic Heroes del Moncada, carried out from January 1st to December 31st 2013. The themes taught to family physicians and basic work groups were identified taking into account the Arterial Hypertension Program guidelines. We indicated the items of the clinical record that should be filled out and the actions the family physician should develop in the hypertensive patient external consultation. We explained the activities and the intervention procedure in the community, and also the methodology and program to develop in the hypertensive patients’ schools.

Estudo dos mecanismos envolvidos no processo de diferenciação em linhagem osteogênica de células-tronco mesenquimais da medula óssea de ratos Wistar e ratos espontaneamente hipertensos (SHR) / Study of the mechanisms involved in the process of differentiation into osteogenic lineage of mesenchymal stem cells from bone marrow of wistar rats and spontaneously hypertensive rats (SHR)

Células-tronco mesenquimais (CTMs) obtidas a partir da medula óssea são capazes de se diferenciarem, sobretudo, em condrócitos, adipócitos e osteoblastos. Durante a osteogênese in vitro, alguns parâmetros são utilizados para caracterizar este processo, tais como atividade da fosfatase alcalina (FAL), mineralização e expressão de proteínas associadas à osteoblastos. Ratos espontaneamente hipertensos (SHR) são um modelo animal de hipertensão essencial humana e desenvolvem hipertensão após 4 semanas de idade. Esta linhagem apresenta alterações significativas no metabolismo ósseo. O objetivo do presente estudo foi investigar se, o genótipo hipertensivo poderia interferir na diferenciação osteoblástica das CTMs de ratos SHR e qual mecanismo está alterado quando comparadas com a linhagem progenitora, ratos Wistar. Para isso, nós obtivemos CTMs da medula óssea de ratos Wistar e SHR com 4 semanas de idade, sem a hipertensão estabelecida, afim de avaliar somente o possível efeito do genótipo hipertensivo na diferenciação osteogênica in vitro. Nós induzimos, ou não, a diferenciação osteogênica in vitro por meio da utilização dos indutores osteogênicos: ácido ascórbico, β-glicerofosfato e dexametasona. Os resultados demonstraram que, CTMs indiferenciadas de SHR (SHRC) demonstraram taxa de proliferação aumentada em comparação a CTMs, na mesma condição, de Wistar (WC), e após a indução da osteogênica, a taxa de proliferação apresentou uma diminuição acentuada no grupo SHR (SHRMO) do que no grupo Wistar na mesma condição (WMO). Embora não fora observada diferença significativa na atividade da FAL entre SHRMO e WOM no 7° dia, a mineralização e a diferenciação osteoblástica foram menores no grupo SHRMO no mesmo período experimental. Os fatores de transcrição Osterix e β-catenina parecem estar envolvidos na diferenciação reduzida no grupo SHRMO, pois apresentaram menor expressão neste grupo experimental. Além disso, a expressão diminuída de proteínas associadas...

Mesenchymal stem cells (MSCs) from bone marrow are able to differentiate mainly into chondrocytes, adipocytes and osteoblasts. During in vitro osteogenesis, some parameters are used to characterize this process, such as the activity of alkaline phosphatase (ALP), mineralization and osteoblast-associated proteins expression. Spontaneously hypertensive rats (SHR) is an animal model of human essential hypertension. This animals developing hypertension after 4 weeks of age. This strain shows significant changes in bone metabolism. The aim of this study was to investigate whether the hypertensive genotype could influence the osteoblastic differentiation of MSCs from SHR and which mechanism are altered when compared to the parental strain, Wistar rats. For that, we have obtained bone marrow MSCs from Wistar and SHR rats at 4 weeks of age, without hypertension established in order to evaluate only the possible effect of hypertensive genotype on osteogenic differentiation in vitro. We induced or non-osteogenic differentiation in vitro using osteogenic inducers: ascorbic acid, dexamethasone and β-glycerophosphate. The results demonstrate that undifferentiated MSCs SHR (SHRC) showed increased proliferation rate compared to MSCs, in the same condition Wistar (WC) and after osteogenic induction, proliferation rate showed a marked decrease in SHR (SHRMO) than in Wistar group in the same condition (WMO). Although it was not observed significant difference in ALP activity between WMO and SHRMO on day 7, mineralization and osteoblast differentiation were lower on group SHRMO in the same experimental period. The transcription factors Osterix and β-catenin appear to be involved in reduced differentiation in SHRMO group because they showed lower expression in this experimental group. Furthermore, the decreased osteoblast-associated proteins such as OCN, BSP, OPN expression suggest that extracellular matrix SHRMO group has a lower quality in comparison to WMO group. Higher...

Avaliação da morfologia testicular e dos parâmetros espermáticos em ratos espontaneamente hipertensos e tratados com enalapril / Evaluation of testicular morphology and sperm parameters in spontaneously hypertensive rats treated with enalapril

A hipertensão arterial sistêmica (HAS) é um problema de saúde pública, geralmente associada a outras doenças, como obesidade, diabetes, doença renal, aterosclerose, acidente vascular cerebral (AVC) e identificado como um dos fatores de risco mais prevalentes para o desenvolvimento de doenças cardiovasculares. Orgãos-alvo, como coração, rins, cérebro e olhos, são comumente afetados em pacientes hipertensos. No entanto, o dano testicular causado pela hipertensão não foi claramente definido. A hipertensão é um fator de risco bem estabelecido para a disfunção erétil, mas sua relação com o dano testicular e a fertilidade masculina não é claramente compreendida. Este estudo avalia a morfologia testicular e alguns parâmetros espermáticos de ratos espontaneamente hipertensos (SHR), virgem de tratamento e tratados com enalapril. Ratos SHR foram distribuídos em dois grupos, um grupo hipertenso (H), e um grupo tratado com enalapril (HE). Ratos Wistar-Kyoto (WKY) foram utilizados como controles. A pressão arterial sistólica foi medida semanalmente, até o final do experimento. A concentração de espermatozóides, motilidade e viabilidade foram determinadas em amostras coletadas da cauda do epidídimo. Métodos estereológicos foram usados para analisar objetivamente a morfologia testicular macroscopicamente e microscopicamente. Todos os dados foram analisados por ANOVA com pós-teste de Tukey, considerando p <0,05. Ao final do experimento a pressão arterial sistólica no grupo HE (153,9 mmHg ± 21,03 ) foi semelhante a dos animais pertencentes ao grupo WKY (153,4 ± 24,41) e menor que a dos animais H (205,1 ± 24,9). A concentração espermática do grupo H (1,31 x 107 sptz/ml ± 0,27) foi inferior à do grupo WKY (2,11 x 107 sptz/ml ± 0,34), entretanto o controle da pressão arterial com o enalapril melhorou este parâmetro e a concentração espermática do grupo HE (2,46 x 107 sptz/ml ± 0,54) foi semelhante a do WKY...

Hypertension is a major public health problem, usually associated with other disorders such as obesity, diabetes, kidney disease, atherosclerosis, stroke and identified as one of the most prevalent risk factors for developing cardiovascular diseases. Target organs, such as heart, kidney, brain and eyes, are very commonly affected in hypertensive patients. However the testicular damage caused by hypertension has not been clearly defined. Hypertension is a well-established risk factor for erectile dysfunction, but its relation to testicular damage and male fertility is not clearly understood. This study evaluates the testicular morphology and some spermatozoid parameters of spontaneously hypertensive rats (SHR) untreated and treated with enalapril. SHR rats were assigned into two groups, a hypertensive group (H), and an enalapril treated group (HE). Wistar-Kyoto rats (WKY) were used as controls. Systolic blood pressure was measured weekly until at the end of the experiment. The spermatozoid concentration, motility and viability were determined in epididimal tail collected sample. Stereological methods were used to analyze testicular morphology macroscopically and microscopically. Data were analyzed by one-way ANOVA and Tukey´s post test, considering p<0.05. At the end of the experiment systolic blood pressure in the HE group (153,9 mmHg ± 21,03 ) was similar to WKY animals (153,4 ± 24,41), and lower than H animals (205,1 ± 24,9). Sperm concentration of the H group (1,31 x 107 sptz/ml ± 0,27) was lower than WKY group (2,11 x 107 sptz/ml ± 0,34). The blood pressure control with enalapril improved this parameter and HE group (2,46 x 107 sptz/ml ± 0,54) was similar to WKY...

Prevalência de Síndrome metabólica em hipertensos de município da Zona da Mata alagoana / Prevalence of metabolic syndrome among hypertensive patients in a town in the rainforest zone, Alagoas State, Northwest Brazil

Fundamentos: Estudos em diferentes populações revelam prevalências elevadas da síndrome metabólica (SM), dependendo do critério utilizado e das características da população estudada. No Brasil, os dados são escassos, necessitando de estudos que caracterizam melhor a população, principalmente grupos vulneráveis à SM, como é o caso de indivíduos hipertensos. Objetivo: Verificar a prevalência de SM em hipertensos cadastrados no programa HIPERDIA/MS, do município de Flexeiras (AL). Métodos: Estudo transversal de amostra aleatória simples de 300 hipertensos de ambos os sexos, com idades entre 21 anos e 92 anos, cadastrados no HIPERDIA/MS do município de Flexeiras (AL), avaliados no período de janeiro a março 2005. Estimou-se a prevalência de SM utilizando-se os critérios do NCEP-ATPIII. Resultados: A prevalência de SM foi 57,3 por cento (77,9 por cento das mulheres e 22,1 por cento dos homens). Analisando-se os portadores de SM por sexo, verificou-se que as mulheres apresentaram 2,34 vezes mais chances de desenvolver SM, comparadas aos homens. Quando estratificados por faixa etária, observou-se uma prevalência de SM maior entre os adultos jovens do que entre os idosos (p<0,05). Níveis séricos de HDL-c abaixo dos limites normais foi o componente da SM mais presente nos indivíduos estudados (53,3%), seguidode obesidade abdominal (52,3%), hipertrigliceridemia (41,3%), glicemia de jejum alterada e/ ou diabetes mellitus(19,3%). Conclusões: Observou-se uma elevada prevalência de SM na população estudada comparada a outros grupospopulacionais. Os resultados encontrados poderão direcionar os cuidados prioritários que devem serimplementados nesse grupo de pacientes e assim contribuir para melhor intervenção.

Background: Studies of different populations show high Metabolic Syndrome (MS) rates, depending onthe criteria used and population characteristics. As data is scarce, studies are needed in Brazil to characterize its population more effectively, especiallygroups vulnerable to MS, such as hypertensive people. Objective: To ascertain the prevalence of MS amonghypertensive patients registered with the HIPERDIA/MS program in the town of Flexeiras, Alagoas State, Northeast Brazil. Methods: Cross-section study of a simple random sample of 300 hypertensive male and female patientsbetween 21 and 92 years old, registered with the HIPERDIA/MS program in Flexeiras and evaluated from January to March 2005, estimating the prevalenceof MS through the NCEP-ATPIII criterion.Results: The prevalence of MS was 57.3% (77.9% of women and 22.1% of men). Analyzing MS patients by gender, women are 2.34 times more likely to develop MS, than men. When stratified by age group, MS was more prevalent among young adults than among theelderly (p<0.05). Serum levels of HDL-C below normal limits was the MS component found most frequently(53.3%) among the patients studied, followed by abdominal obesity (52.3%), hypertriglyceridemia (41.3%), modified fasting blood glucose and/or diabetes mellitus (19.3%). Conclusions: A high prevalence of MS was noted in the population studied, compared to other population groups. These findings could guide the priority care.

Adherencia a los tratamientos farmacológicos y no farmacológicos en personas con hipertensión arterial. Montería, 2010 / Adherence to pharmacological and non-pharmacological treatments in people with arterial hypertension. Monteria, 2010

El presente estudio tuvo como objetivo describir y analizar la adherencia a tratamientos farmacológicos y no farmacológicos en personas con hipertensión arterial, inscritas en el Programa de Control de una Empresa Social del Estado de baja complejidad en la ciudad de Montería. Se utilizó un diseño descriptivo transversal con abordaje cuantitativo que permitió describir la adherencia al tratamiento en una muestra aleatoria de 177 personas que asistieron al servicio de consulta externa a control de la hipertensión arterial, mediante el empleo del Instrumento Factores que influyen en la adherencia a tratamientos farmacológicos y no farmacológicos en pacientes con factores de riesgo de enfermedad cardiovascular de Bonilla y De Reales. Los resultados del estudio revelan que la mayor proporción de las personas que participaron en el estudio se encontraron en riesgo de no desarrollar comportamientos de adherencia al tratamiento farmacológico y no farmacológico, lo cual guarda relación con los factores socioeconómicos y relacionados con el proveedor. Los factores relacionados con la terapia y con el paciente reflejaron una situación de ventaja para la adherencia. La relación entre los 24 ítems del instrumento utilizado y la situación adherencia encontrada es lineal y en general la relación es fuerte con tendencia positiva. Se recomienda a los profesionales de enfermería continuar realizando investigaciones sobre el fenómeno de la adherencia al tratamiento en personas con riesgo cardiovascular con el propósito de contribuir al desarrollo disciplinar y por ende mejorar las prácticas de cuidado como un aporte a la solución del problema de altos índices de morbimortalidad por enfermedades cardiovasculares.

This study has as an aim to describe and analyze the adherence to nonpharmacological and pharmacological treatment on people with arterial hypertension, registered in the control program of a state social enterprise of low complexity at Monteria city. It was used a cross sectional descriptive design with quantitative approach that allowed to describe the adherence to the treatment in a randomize sample of 117 people that attended the outpatient service to arterial hypertension control, through the using the instrumental factors that has influence in the adherence of nonpharmacolocical and pharmacological treatment on patients with risk factors of cardiovascular illness of Bonilla and De Reales. The outcomes of the study disclose that in an upper proportion of people who participate in the research were found on risk of not developing behaviors of adherence to the nonpharmacological and pharmacological treatment, which keeps relation with socioeconomic factors and related with the supplier. The factors related to the therapy and with the patient, showed a situation of advantage for the adherence. The relationship between the 24 items of the used instrument and the adherence situation founded is lineal and in general the relationship is strong and with positive trend. It is recommended for the nursery professionals to continue doing researches about the phenomenon of treatment adherence on people with cardiovascular risk with the aim of contributing to the disciplinary development and therefore improving the practices of care as a contributing to the solution for the problem of high mortality index due to cardiovascular illness. The present study aimed to describe and analyze adherence to pharmacologic and non pharmacologic treatments in people with hypertension, enrolled in a control program of the State Social Enterprise of low complexity for the city of Montería.

Variabilidade interensaios de dislipidemias em pacientes hipertensos / Inter-assays variability of dislipidemias in hypertensive patients

INTRODUÇÃO E OBJETIVOS: Ensaios de diferentes procedências para avaliação das dislipidemia podem resultar em variações significativas nos resultados obtidos e consequente conduta inadequada pelo clínico. O estudo objetivou comparar resultados laboratoriais de colesterol total (CT), triglicérides (TG), colesterol da lipoproteína de alta densidade (HDL-C), colesterol da lipoproteína de baixa densidade (LDL-C), apolipoproteína A-1 (Apo A-1), apolipoproteína B (Apo B) e lipoproteína (a) (Lp[a]) e índices lipídicos (não-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C e Apo B/HDL-C) de pacientes hipertensos e/ou diabéticos diagnosticados. MÉTODOS: Foram utilizados conjuntos reativos, e os respectivos analisadores Gold Analisa, Dia Sys (CCX - Abbott), Dade Behring (Nefelômetro BN 100) e Roche (COBAS Integra 400), para verificar a reprodutibilidade dos resultados obtidos. Participaram 99 pacientes (36 do sexo masculino e 63 do feminino). Comparando os resultados, verificamos que: todas as médias obtidas dos constituintes lipídicos apresentaram diferença significativa; número semelhante de pacientes apresentou níveis séricos elevados de CT, TG, Lp(a) e Apo A-1. O HDL-C, o LDL-C e a Apo B apresentaram discordância, assim como os índices de CT/LDL-C, LDL-C/HDL-C e TG/HDL-C. Para não-HDL-C e ApoB/HDL, houve semelhança no número de pacientes com valores não recomendados. Em consequência da diferença, em relação ao LDL-C, a decisão da conduta terapêutica poderá ser inadequada, enquanto o não-HDL-C, além de evidenciar partículas aterogênicas, apresentou número de hipertensos com valores séricos não referendados semelhantes, independente da metodologia e do equipamento utilizado. CONCLUSÃO: No grupo de hipertensos analisados, o não-HDL-C se caracterizou um importante fator de correção interensaios de parâmetros lipídicos. E sua associação à relação Apo B/HDL-C pode ser um fator adicional em relação às condutas hipolipemiantes a serem adotadas.

INTRODUCTION AND OBJECTIVES: Different assays to evaluate dyslipidemia may show significant variations in the obtained results and a consequent inappropriate clinical approach may be adopted. This study aimed to compare the results of total cholesterol (CT), triglycerides (TG), HDL-C, Apo A1, Apo B, lipoprotein (a) and lipidic indexes (not-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C and Apo B/HDL-C) of hypertensive and/or diabetic patients. METHODS: The following reactive kits and respective analyzers were applied to verify the reproducibility of results: Gold Analisa, DiaSys (CCX-ABBOTT), Dade Behring (Nephelometer BN 100) and Roche (COBAS Integra 400). Ninety nine patients (36 male and 63 female gender) were investigated. Comparing the results, we observed that all mean numbers of lipid constituents showed a significant difference. A similar number of patients had high CT, TG, Lp (a) and Apo A-1 serum levels. There was also disagreement in HDL-C, LDL-C, ApoB, CT/LDL-C, LDL-C/HDL-C and TG/HDL-C indexes. For not-HDL-C and ApoB/HDL, there was similarity in the number of patients with not recommended values. As a consequence of this difference, the choice of therapeutic approach may be inappropriate as to LDL-C levels, whereas Not-HDL-C not only showed atherogenic particles but also a number of hypertensive patients with similar not recommended serum values, regardless of the methodology and the equipment used. CONCLUSION: In the analyzed group of hypertensive patients, not-HDL-C was an important inter assay correction factor of lipidic parameters. The association with Apo B/HDL-C relation may be an additional factor as to the choice of hypolipemiant treatments.

Frecuencia de dislipidémicos e hipertensos en personas mayores de 60 años de 3 consultorios / Frequency of dyslipemia and hypertension in persons aged 60 and more from three consulting rooms

OBJETIVO: determinar la frecuencia de dislipidémicos y de hipertensos en personas mayores de 60 años, entre 403 ancianos de 3 consultorios del policlínico Héroes del Moncada, en Plaza la Revolución, Ciudad de La Habana. MÉTODOS: se realizó una investigación descriptiva transversal. Se aplicó el modelo de recolección del dato primario del Centro de Investigación y Referencias de Aterosclerosis de La Habana. Variables: edad, sexo, peso, talla, índice de masa corporal, presión arterial, hábito de fumar, colesterol total y triglicéridos. RESULTADOS: el 51,1 por ciento son dislipidémicos hipertensos, la forma clínica de dislipidemia más frecuente es la mixta, y es significativa la asociación entre estas 2 variables: dislipidémicos hipertensos y los hipertensos con el índice de masa corporal. CONCLUSIONES: esta investigación permitió incorporar a la dispensarización del área nuevos hipertensos y dislipidémicos, y se comprobó que la hipertensión arterial y la dislipidemia son trastornos frecuentes en los ancianos estudiados. Un logro a destacar del trabajo del Médico y Enfermera de la Familia, es el bajo índice de ancianos fumadores observado en el estudio.

OBJECTIVE: to determine frequency of dyslipemia and hypertension in persons aged 60 and more among 403 elderlies from three consulting rooms of "Héroes del Moncada" polyclinic in Plaza Municipality of Havana City. METHODS: authors made a cross-sectional and descriptive research. We applied collection model of primary datum from the Center or Research and References of Atherosclerosis of Havana City. The variables included: age, sex, weight, height, body mass index (BMI), high blood pressure, smoking, and total cholesterol and triglycerides. RESULTS: the 51,1 percent presenting with dyslipemia and hypertension, the more frequent way of dyslipemia is the mixed one, and it is significant the association between these two variables: dyslipemia-hypertensive and the hypertensive-BMI. CONCLUSIONS: this research allows us the incorporation of new hypertensive and dyslipemia patients to area care verifying that high blood pressure and dyslipemia are frequent disorders in study elderlies. A significant achievement of Family Physician and Nurse is the low rate of smoking in this age group.

Evaluación de parámetros utilizados por estudiantes en la atención clínica odontológica de pacientes hipertensos / Evaluation of parameters used by students in the clinical dental care of hypertensive patients

El presente trabajo de investigación tiene como objetivo principal evaluar los parámetros utilizados por estudiantes en la atención clínica odontológica de pacientes hipertensos, que consultan en las clínicas odontológicas de la Facultad de Odontología de la Universidad de El Salvador. Dicha investigación se llevo acabo en el periodo del ciclo I/2007 durante el mes de Marzo, en donde los investigadores realizaron el paso de instrumentos, siendo estos, la guía de observación y la cédula de entrevista utilizadas para tal efecto, donde se les aplicaron a los estudiantes que estaban programados en la primera rotación clínica de los ciclos IX, X y XII, que en ese momento se encontraban dando atención clínica odontológica a pacientes con diagnóstico de hipertensión arterial. Para obtener los resultados deseados los investigadores se incorporaron a las diferentes clínicas, para hacer observaciones y evaluaciones de como el estudiante realiza el abordaje clínico del paciente previo al tratamiento dental; posteriormente se realizó la entrevista en donde el estudiante respondió cada pregunta de la cedula de entrevista.

The main objective of this research work is to evaluate the parameters used by students in the clinical dental care of hypertensive patients, who consult in the dental clinics of the Faculty of Dentistry of the University of El Salvador. This research was carried out in the period of the I / 2007 cycle during the month of March, where the researchers carried out the passage of instruments, being these, the observation guide and the interview card used for this purpose, where they were applied to the students who were scheduled in the first clinical rotation of cycles IX, X and XII, who at that time were giving clinical dental care to patients with a diagnosis of arterial hypertension. To obtain the desired results, the researchers joined the different clinics, to make observations and evaluations of how the student performs the clinical approach to the patient prior to dental treatment; Later, the interview was carried out in which the student answered each question on the interview card.

O perfil de um grupo de pessoas hipertensas de acordo com conhecimento e gravidade da doença / The profile of hypertensive patients related to awareness and level of hypertension

Foram entrevistados 205 hipertensos em tratamento ambulatorial para avaliar o papel do perfil bio-social no conhecimento e grau de gravidade da doença. As características da população foram: 72% mulheres, 63% brancos, 78% com mais de 40 anos, 60% casados, 68% com baixa escolaridade, 41% com renda de 1 a 3 salários, 75% com peso elevado, 76% não fumantes, 89% sem atividade física regular, e das mulheres 48% já tinham usado hormônios anticoncepcionais. A análise evidenciou que a ausência de conhecimento se associou com sexo masculino, idade entre 20 e 40 anos, viúvo, não branco e peso normal. Pressão arterial mais elevada (diastólica> 110 mm Hg) se associou com mais de 60 anos, não casado, acima do peso, baixa escolaridade, baixa renda, com mais de 5 anos de hipertensão e já ter feito tratamento anterior

We interviewed 205 hypertensives to characterize social demographic data, life style, history and awareness of hypertension. Most patients were female (72%), white (63%), over 40 years old (78%), married (60%), and had low level of education (68%). Their family income was lower than US$ 3000 a year (41%). In terms of weight, 75% were classified as overweight, 76% were non smoker, and 89% did not do any regular physical activity. The profile of the hypertensives who were unaware of the disease was: male, 20-40 years old, widow, not white, and non-obese. The profile of the hypertensives who had high level of hypertension (diastólic> 110 mm Hg) was older than 60 years old, not married, overweight, low level of education, low income, with more than 5 years of hypertension, and previously treated