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1.
Article in English | LILACS | ID: biblio-1353129

ABSTRACT

The restriction of sodium intake, one of the pillars of antihypertensive treatment, has been associated with the increase in cholesterol levels. Given this, we hypothesize that a sodium intake restriction may increase cholesterol levels in hypertensive women. The present study aimed to evaluate the influence of sodium intake, sociodemo-graphic, lifestyle and anthropometric variables on the blood cholesterol levels of hypertensive women. This was a cross-sectional study with hypertensive and nondiabetic women aged 20 to 59 years, recruited from the primary healthcare units of Maceio, Alagoas, in the Brazilian Northeast. Sodium intake was estimated by the 24-hour urinary excretion of sodium; and blood cholesterol was estimated by capillary blood. Age (years), education level (<4 or ≥4 years), race (white or nonwhite), smoking and alcohol consumption were evaluated. The weight, height and waist circumference were measured and body mass index, conicity index and waist-to-height ratio were quantified. The percentage of body fat was measured using a tetrapolar bioelectrical impedance device. The relationship between blood cholesterol and other variables was assessed by multiple regression analysis. A significance level of 5% was used in the final model. This study included 165 hypertensive women. In linear regression, blood cholesterol was directly proportional to age (p<0.001), education level (p=0.01) and race (p=0.04). These variables, as well as sodium intake (p = 0.07) and conicity index (p = 0.12), were included in the multiple regression analysis. Sodium intake (p=0.03) and age (p=0.001) were related, in an inverse and a direct way, respectively, to the blood choles-terol in the hypertensive women studied. (AU)


ção da ingestão de sódio, um dos pilares do tratamento anti-hipertensivo, tem sido associada ao aumen-to dos níveis de colesterol. Diante disso, levantou-se a hipótese de que a ingestão de sódio influencia os níveis de colesterol de mulheres hipertensas, independentemente de outros fatores associados. Trata-se de um estudo transversal realizado com mulheres hipertensas e não diabéticas, na faixa etária entre 20 e 59 anos, recrutadas em unidades básicas de saúde de Maceió, Alagoas, situada no Nordeste do Brasil. A ingestão de sódio foi estimada pela excreção urinária de sódio de 24 horas; e o colesterol sérico foi mensurado por coleta de sangue capilar. Foram ava-liados idade (anos), escolaridade (<4 ou ≥4 anos), raça (branca ou não branca), tabagismo e consumo de álcool. O peso, a estatura e a circunferência da cintura foram aferidos e o índice de massa corporal, índice de conicidade e razão cintura/estatura foram calculados. A porcentagem de gordura corporal foi medida usando um dispositivo de impedância bioelétrica tetrapolar. A relação entre o colesterol sérico e as outras variáveis em estudo foi avalia-da por meio de análise de regressão múltipla, adotando-se um nível de significância de 5% no modelo final. Este estudo incluiu 165 mulheres hipertensas. Na análise de regressão linear, o colesterol sérico foi relacionado à idade (p<0,001), escolaridade (p=0,01) e raça (p=0,04). Essas variáveis, assim como o consumo de sódio (p=0,07) e o índice de conicidade (p=0,12), foram incluídas na análise de regressão múltipla. As variáveis que permaneceram no modelo final foram ingestão de sódio (p=0,03) e idade (p=0,001). A ingestão de sódio e a idade foram as variáveis que influenciaram o colesterol sérico de mulheres hipertensas. (AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Tobacco Use Disorder , Body Height , Alcohol Drinking , Capillaries , Anthropometry , Cholesterol , Hypertension , Life Style , Antihypertensive Agents , Obesity
2.
Nursing (Säo Paulo) ; 24(276): 5622-5631, maio.2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1224638

ABSTRACT

Objetivo: Conhecer as percepções de usuários hipertensos diante do tratamento anti-hipertensivo, relacionando-as com os conceitos do sistema interpessoal da Teoria do Alcance de Metas de Imogene King. Método: Estudo descritivo e exploratório, com abordagem qualitativa, realizado com 10 usuários hipertensos. Foram realizadas entrevistas semiestruturadas para a coleta dos dados e utilizou-se a Análise de Conteúdo Temática proposta por Minayo para análise do material. Resultados: Foi possível identificar dois eixos temáticos: Viver com Hipertensão Arterial Sistêmica; Dificuldades diante da adesão ao tratamento anti-hipertensivo. Conclusão: A necessidade de uso contínuo da medicação, mudanças no cotidiano dos indivíduos e o desconhecimento em relação à patologia, são fatores que podem influenciar a adesão ao tratamento anti-hipertensivo. Ressalta-se que a relação entre o enfermeiro e o paciente é compreendida como aspecto que contribui para a terapêutica.(AU)


Objective: To know the perceptions of hypertensive users regarding antihypertensive treatment, relating them to the concepts of the interpersonal system of the Theory of Goal Achievement by Imogene King. Method: Descriptive and exploratory study, with a qualitative approach, carried out with 10 hypertensive users. Semi-structured interviews were conducted to collect the data and the Thematic Content Analysis proposed by Minayo was used to analyze the material. Results: It was possible to identify two thematic axes: Living with Systemic Arterial Hypertension; Difficulties with adherence to antihypertensive treatment. Conclusion: The need for continuous use of medication, changes in the daily lives of individuals and the lack of knowledge about the pathology, are factors that can influence adherence to antihypertensive treatment. It is noteworthy that the relationship between the nurse and the patient is understood as an aspect that contributes to therapy.(AU)


Objetivo: Conocer las percepciones de los usuarios hipertensos sobre el tratamiento antihipertensivo, relacionándolas con los conceptos del sistema interpersonal de la Teoría del Logro de Metas de Imogene King. Método: Estudio descriptivo y exploratorio, con abordaje cualitativo, realizado con 10 usuarios hipertensos. Se realizaron entrevistas semiestructuradas para recolectar los datos y se utilizó el Análisis de Contenido Temático propuesto por Minayo para analizar el material. Resultados: Fue posible identificar dos ejes temáticos: Vivir con Hipertensión Arterial Sistémica; Dificultades para la adherencia al tratamiento antihipertensivo. Conclusión: La necesidad de uso continuo de medicamentos, los cambios en la vida diaria de los individuos y el desconocimiento de la patología, son factores que pueden influir en la adherencia al tratamiento antihipertensivo. Es de destacar que la relación entre la enfermera y el paciente se entiende como un aspecto que contribuye a la terapia.(AU)


Subject(s)
Humans , Treatment Adherence and Compliance , Hypertension/drug therapy , Antihypertensive Agents , Qualitative Research
3.
Rev. ciênc. méd., (Campinas) ; 30: 215035, 10 mar. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1150810

ABSTRACT

O objetivo deste trabalho é reunir e discutir os principais achados científicos, opiniões de especialistas e considerações de comunidades médicas a respeito da continuação do tratamento de pacientes hipertensos diagnosticados com Covid-19 em uso de anti-hipertensivos. Trata-se de uma revisão narrativa de literatura, restringida a publicações até abril de 2020, utilizando as bases de dados Medline e Embase e consulta a quatro sociedades científicas de Cardiologia. Um total de 93 publicações foram encontradas nas bases de dados consultadas, e, destas, nove publicações foram elegíveis para análise, sendo que seis publicações se mostraram favoráveis à continuação do tratamento com inibidores da enzima conversora de angiotensina e antagonistas dos receptores de angiotensina, o que foi ao encontro das recomendações das sociedades de Cardiologia; outras três publicações sugeriram que essas classes de anti-hipertensivos podem aumentar a gravidade da infecção. A continuação do tratamento com anti-hipertensivos durante a pandemia de coronavírus ou após o diagnóstico da infecção apresenta um paradoxo entre o potencial aumento da patogenicidade viral e a proteção pulmonar conferida pelo equilíbrio do sistema renina-angiotensina.


The objective of this work is to gather and discuss the main scientific findings, opinions and specialists in medical communities and respect for the continuation of treatment with antihypertensive drugs in hypertensive patients diagnosed with Covid-19. This is a narrative review of the literature, restricted to publications until April 2020, using Medline and Embase as a database and consulting four scientific societies of cardiology. A total of 93 publications were found in the databases consulted and of these, 9 publications were eligible for analysis, with six publications being considered favorable for the continuation of treatment with angiotensin-converting enzyme inhibitors and receptor antagonists angiotensin, which met the decisions of cardiology societies; three other publications suggested that these classes of antihypertensives may increase the severity of the infection. The continuation of treatment with antihypertensive drugs during a coronavirus pandemic or after the diagnosis of infection presents a paradox between the potential increase in viral pathogenicity and the pulmonary protection provided by the balance of the renin-angiotensin system.


Subject(s)
Humans , Male , Female , Renin-Angiotensin System , Angiotensin-Converting Enzyme Inhibitors , Coronavirus Infections , Betacoronavirus , Hypertension , Antihypertensive Agents
4.
Rev. cuba. enferm ; 37(1): e3535, 2021. tab
Article in Spanish | LILACS, BDENF, CUMED | ID: biblio-1341375

ABSTRACT

Introducción: El enfoque terapéutico para la presión arterial alta incluye medidas no farmacológicas y farmacológicas. La no adherencia al tratamiento es uno de los desafíos más importantes para la salud pública. Objetivo: Caracterizar los factores asociados con la adherencia a la medicación y el tratamiento sin medicación de pacientes hipertensos. Métodos: Este es un estudio descriptivo, cuantitativo y transversal realizado en una Unidad Básica de Salud en la ciudad de Teresina- Piauí/Brasil con 160 pacientes hipertensos. Los datos se recopilaron de febrero a julio de 2019 mediante la aplicación de un cuestionario semiestructurado que contiene preguntas relacionadas con los aspectos socioeconómicos y demográficos, el tratamiento sin medicamentos, la verificación de la presión arterial y el conocimiento de los antihipertensivos en uso. Para el análisis de los datos, se consideró la prueba de chi-cuadrado con una significación del 95 por ciento considerando las pruebas de independencia 2x2 en la combinación de variables. Resultados: La muestra consistió en mujeres, ancianos, jubilados, con ingresos salariales entre uno y dos salarios mínimos. La principal modificación de estilo de vida adoptada fue la abstención del consumo de alcohol y tabaco. La mayoría afirmó que verificaban la presión arterial de forma rutinaria (57,5 por ciento), que tenían conocimiento sobre la medicación antihipertensiva en uso (68 por ciento) y que estaban satisfechos con la atención establecida en la unidad básica de salud (78,75 por ciento). Conclusión: La población hipertensa estudiada se adhiere parcialmente al tratamiento recomendado(AU)


Introdução: A abordagem terapêutica da pressão arterial elevada inclui medidas não medicamentosas e medidas farmacológicas. A não adesão ao tratamento é um dos mais importantes desafios para a saúde pública. Objetivo: Caracterizar os fatores associados à adesão ao tratamento medicamentoso e não medicamentoso de pacientes hipertensos. Métodos: Trata-se de estudo descritivo, quantitativo e transversal realizado em uma Unidade Básica de Saúde do município de Teresina- Piauí/Brasil com 160 hipertensos. Os dados foram coletados no período de fevereiro a julho de 2019, por meio da aplicação de questionário semi-estruturado contendo questões relativas a aspectos socioeconômicos e demográficos, tratamento não medicamentoso, verificação da pressão arterial e conhecimento dos anti-hipertensivos em uso. Para a análise dos dados foi aplicado o teste qui-quadrado com significância de 95 porcento, considerando testes de independência 2x2 na combinação das variáveis. Resultados: A amostra foi constituída em sua maioria por mulheres, idosas, aposentadas, com renda salarial entre um e dois salários mínimos. As principais modificações de estilo de vida adotadas foram a abstenção do uso de álcool e tabaco. A maioria afirmou verificar a PA rotineiramente (57,50 porcento), ter conhecimento sobre o medicamento anti-hipertensivo em uso (68 porcento) e estarem satisfeitas com o atendimento estabelecido na Unidade Básica de Saúde (78,75 porcento). Conclusão: Conclui-se que a população hipertensa estudada adere parcialmente ao tratamento recomendado(AU)


Introduction: The therapeutic approach to high blood pressure includes non-drug and pharmacological measures. Non-adherence to treatment is one of the greatest, and consequently one of the most important challenges for public health. Objective: To characterize the factors associated with adherence to medication and non-medication treatment of hypertensive patients. Methods: This is a descriptive, quantitative and cross-sectional study conducted in a Basic Health Unit in the city of Teresina- Piauí with 160 hypertensive patients. The data were collected from February to July 2019 by applying a semi-structured questionnaire containing questions related to socioeconomic and demographic aspects, non-drug treatment, blood pressure verification and knowledge of antihypertensives in use. For the data analysis, the chi-square test with significance of 95 percent was considered considering 2x2 independence tests in the combination of variables. Results: The sample consisted of women, elderly, retired, with wage income between one and two minimum wages. The main lifestyle modification adopted was abstention from alcohol and tobacco use. Most stated that they routinely check blood pressure (57,50 percent), have knowledge about the antihypertensive medication in use (68,00 percent) and are satisfied with the care established at the basic health unit (78,75 percent). Conclusion: The hypertensive population studied partially adheres to the recommended treatment(AU)


Subject(s)
Humans , Pharmaceutical Preparations/administration & dosage , Treatment Adherence and Compliance , Hypertension/diagnosis , Antihypertensive Agents/therapeutic use , Socioeconomic Factors , Epidemiology, Descriptive , Cross-Sectional Studies , Data Analysis
6.
Cad. Saúde Pública (Online) ; 37(8): e00061120, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1339542

ABSTRACT

Resumo: Este trabalho analisa de que forma ocorre a interação entre adesão ao tratamento medicamentoso, meta pressórica e depressão em uma amostra probabilística de hipertensos assistidos pela Estratégia de Saúde da Família, de Governador Valadares, Minas Gerais, Brasil. Trata-se de um estudo transversal com 641 hipertensos de 40 anos e mais, residentes na zona urbana do município. Foram utilizados roteiros estruturados para a coleta de dados em entrevistas domiciliares, com foco nos indicadores: Medication Assessment Questionnaire (MAQ), Beck Depression Inventory (BDI) e aferição da pressão arterial. Devido à simultaneidade dos eventos analisados (depressão, meta pressórica e adesão), aplicou-se um sistema de equações não lineares recursivas e simultâneas. Os resultados sugerem que a chance de estar na meta pressórica aumenta significativamente com a adesão ao tratamento; também sugerem que indivíduos que estão na meta pressórica apresentam uma chance 2,6 vezes maior de adesão ao tratamento. A adesão possui efeito protetor sobre a depressão: indivíduos com adesão mínima possuem chances 8,4 vezes maiores de desenvolver sintomas depressivos quando comparados aos de máxima adesão. A adesão ao tratamento medicamentoso está relacionada simultaneamente ao controle da pressão arterial e a menores níveis de depressão. Promover a adesão ao tratamento medicamentoso é essencial para garantir que os indivíduos se mantenham normotensos, com potencial de redução nos níveis de depressão. Essas externalidades positivas podem reduzir a pressão sobre o sistema de saúde, com ganhos simultâneos na qualidade de vida dos hipertensos.


Abstract: The study analyzes interactions between drug treatment adherence, blood pressure targets, and depression in a probabilistic sample of hypertensive individuals treated in the Family Health Strategy in Governador Valadares, Minas Gerais State, Brazil. This is a cross-sectional study with 641 hypertensive individuals 40 years or older, residing in the urban area of Governador Valadares. Structured scripts were used to collect data in home interviews, with a focus on the following indicators: Medication Assessment Questionnaire (MAQ), Beck Depression Inventory (BDI), and blood pressure measurement. Due to the simultaneity of the target events (depression, blood pressure target, and adherence), we applied a system of recursive and simultaneous nonlinear equations. The results suggest that the odds of meeting the blood pressure target increase significantly with adherence to treatment; they also suggest that individuals that meet the blood pressure target show 2.6 higher odds of treatment adherence. Adherence has a protective effect against depression: individuals with minimal adherence show 8.4 higher odds of developing depressive symptoms when compared to those with maximum adherence. Drug treatment adherence is related simultaneously to blood pressure control and lower levels of depression. Promoting drug treatment adherence is essential for ensuring that individuals remain normotensive, with the potential for reducing levels of depression. These positive externalities can reduce pressure on the health system, with simultaneous gains in quality of life for hypertensive individuals.


Resumen: Este trabajo analiza de qué forma se produce la interacción entre la adhesión al tratamiento medicamentoso, meta de presión y depresión en una muestra probabilística de hipertensos, asistidos por la Estrategia Salud de la Familia de Governador Valadares, Minas Gerais, Brasil. Se trata de un estudio transversal con 641 hipertensos de 40 años y más, residentes en la zona urbana del municipio. Se utilizaron itinerarios estructurados para la recogida de datos, mediante entrevistas domiciliarias, centradas en los indicadores: Medication Assessment Questionnaire (MAQ), Beck Depression Inventory (BDI) y comprobación de la presión arterial. Debido a la simultaneidad de los eventos analizados (depresión, meta de presión y adhesión), se aplicó un sistema de ecuaciones no lineales recursivas y simultáneas. Los resultados sugieren que la oportunidad de encontrarse dentro de la meta de presión aumenta significativamente con la adhesión al tratamiento; también indican que los individuos que están en la meta de presión presentan una oportunidad 2,6 veces mayor de adhesión al tratamiento. La adhesión posee un efecto protector sobre la depresión: individuos con una adhesión mínima tienen 8,4 veces mayores oportunidades de desarrollar síntomas depresivos, cuando se comparan con los de máxima adhesión. La adhesión al tratamiento medicamentoso está relacionada simultáneamente con el control de la presión arterial y a menores niveles de depresión. Promover la adhesión al tratamiento con medicamentos es esencial para garantizar que los individuos se mantengan normotensos, con una potencial de reducción en los niveles de depresión. Estas externalidades positivas pueden reducir la presión sobre el sistema de salud, con beneficios simultáneos en la calidad de vida de los hipertensos.


Subject(s)
Humans , Pharmaceutical Preparations , Hypertension/drug therapy , Quality of Life , Blood Pressure , Brazil , Family Health , Cross-Sectional Studies , Depression , Medication Adherence , Antihypertensive Agents/therapeutic use
7.
Esc. Anna Nery Rev. Enferm ; 25(1): e20200127, 2021. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1133822

ABSTRACT

Resumo Objetivo Construir e validar comunicação audiovisual e mensagens persuasivas para motivar o uso de anti-hipertensivos. Método Estudo metodológico baseado nas crenças de pessoas com hipertensão arterial sistêmica em relação ao tratamento medicamentoso, tendo o suporte da Teoria do Comportamento Planejado. Adotaram-se os princípios de Fleming e da Persuasão para desenvolvimento da comunicação audiovisual e mensagens. 13 juízes especialistas realizaram a validação de conteúdo, analisada pelo Índice de Validade de Conteúdo. Resultados A comunicação audiovisual apresenta 3 minutos e 58 segundos de duração e 71 telas. Foram consideradas válidas 29 mensagens persuasivas ilustradas, sendo 15 positivas e 14 negativas. Conclusão e implicações para a prática A comunicação audiovisual e as mensagens persuasivas foram consideradas válidas, adequadas e com capacidade de persuasão para motivar o uso de anti-hipertensivos orais. Pesquisa de intervenção faz-se necessária para testar o efeito dos recursos audiovisuais com intenção de realizar o comportamento.


Resumen Objetivo Construir y validar la comunicación audiovisual y los mensajes persuasivos para motivar el uso de antihipertensivos. Método Estudio metodológico basado en las creencias de las personas con hipertensión arterial sistémica en relación con el tratamiento farmacológico, apoyado por la Teoría del Comportamiento Planificado. Los principios de Fleming y la Persuasión fueron adoptados para el desarrollo de la comunicación y los mensajes audiovisuales. 13 jueces expertos realizaron la validación del contenido, analizada por el Índice de Validez del Contenido. Resultados La comunicación audiovisual tiene 3 minutos y 58 segundos de duración y 71 pantallas. Se consideraron válidos 29 mensajes ilustrativos persuasivos, 15 mensajes eran positivos y 14 negativos. Conclusión e implicaciones para la práctica La comunicación audiovisual y los mensajes persuasivos se consideraron válidos, adecuados y capaces de persuadir para motivar el uso de antihipertensivos orales. La investigación de intervención es necesaria para probar el efecto de los recursos audiovisuales con la intención de llevar a cabo el comportamiento.


Abstract Objective Building and validating audiovisual communication and persuasive messages to motivate the use of antihypertensive drugs. Method Methodological study based on the beliefs of people with systemic arterial hypertension in relation to drug treatment, supported by the Theory of Planned Behavior. The principles of Fleming and Persuasion were adopted for the development of audiovisual communication and messages. 13 expert judges performed the content validation, analyzed by the Content Validity Index. Results the audiovisual communication has 3 minutes and 58 seconds in duration and 71 screens. Twenty-nine persuasive illustrated messages were considered valid, 15 positive and 14 negative messages. Conclusion and implications for practice Audiovisual communication and persuasive messages were considered valid, adequate and capable of persuasion to motivate the use of oral antihypertensives. Intervention research is necessary to test the effect of audiovisual resources with the intention of carrying out the behavior.


Subject(s)
Humans , Audiovisual Aids , Health Promotion , Hypertension/drug therapy , Antihypertensive Agents/therapeutic use , Persuasive Communication , Chronic Disease/drug therapy
8.
REVISA (Online) ; 10(2): 400-410, 2021.
Article in Portuguese | LILACS | ID: biblio-1253838

ABSTRACT

Objetivo: Avaliar a adesão ao tratamento medicamentoso da hipertensão arterial sistêmica por meio da escala de Morisky-Green. Método: estudo descritivo com abordagem quantitativa envolvendo 103 pessoas com diagnóstico de hipertensão arterial acompanhados em um ambulatório de saúde. Os instrumentos de coleta de dados utilizados foram entrevistas semiestruturadas e questionário de Morisky e Green. A análise dos dados se deu pela estatística descritiva. Resultados: A amostra foi composta predominantemente de mulheres (85,4%), cor/raça preta (46,6%), faixa etária de 50-59 anos (68,9%), escolaridade com ensino médio incompleto e completo (45,6%), aposentados (35,9%), com renda de 1-2 salários mínimos (44,7%). Maior percentual tinha acesso à medicação de forma gratuita pelo Sistema único de Saúde (70,9%). Os resultados encontrados, por meio do teste do Teste de Morisky e Green, evidenciam que a maioria respondeu afirmativamente para o uso adequado da medicação. Entretanto somente 38,8% dos entrevistados foram classificados com alta adesão. Conclusão: Mesmo que as respostas para as oito questões tenham sido positiva para o uso do anti-hipertensivo conforme prescrito, a taxa de adesão ainda é insatisfatória.


Objective: To evaluate adherence to drug treatment of systemic arterial hypertension using the Morisky-Green Scale. . Method: Descriptive study with a quantitative approach involving 103 people diagnosed with arterial hypertension followed up in a health clinic. The data collection instruments used were semi-structured interviews and Morisky-Green Scale. Data analysis was performed using descriptive statistics. Results: The sample was composed predominantly of women (85.4%), color / black race (46.6%), age group 50-59 years (68.9%), education with incomplete and complete high school (45.6%) %), retired (35.9%), and people with an income between 1-2 e Brazilian minimum wage (44.7%). A higher percentage had access to medication free of charge through the Public Health System (70.9%). The results found, through the test of the Morisky-Green Test show that the majority answered affirmatively for the proper use of the medication. However, only 38.8% of respondents were classified as having high adherence. Conclusion: Even if the answers to the eight questions were positive for the use of antihypertensive drugs as prescribed, the rate of adherence is still unsatisfactory.


Objetivo: Evaluar la adhesión al tratamiento farmacológico de la hipertensión arterial sistémica mediante la escala de Morisky-Green. Método: estudio cuantitativo descriptivo con 103 personas con diagnóstico hipertensión arterial atendidas en una clínica de salud. Los instrumentos de recolección de datos utilizados fueron entrevistas semiestructuradas y un cuestionario de Morisky y Green. El análisis de los datos se realizó mediante estadística descriptiva. Resultados: La muestra consistió predominantemente por mujeres (85,4%), color/raza negra (46,6%), grupo de edad 50-59 años (68,9%), escolaridad secundaria básica incompleta y completa (45,6%), jubilados (35,9%), con un ingreso de 1 a 2 salarios mínimos (44,7%). Un mayor porcentaje de los participantes del estúdio tiene acceso a medicamentos de forma gratuita a través del Sistema Único de Salud (70,9%). Los resultados encontrados, a través de la scale de Morisky y Green muestran que la mayoría respondió afirmativamente por el uso adecuado de la medicación. Sin embargo, solo el 38,8% de los participantes fueron clasificados como de alta adhesión. Conclusión: Aunque las respuestas a las ocho preguntas fueron positivas para el uso de fármacos antihipertensivos según lo prescrito, la tasa de adherencia sigue siendo insatisfactoria.


Subject(s)
Antihypertensive Agents , Medication Adherence
9.
Esc. Anna Nery Rev. Enferm ; 25(2): e20200213, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1142953

ABSTRACT

RESUMO Objetivo Analisar a associação entre a adesão ao tratamento anti-hipertensivo e a ocorrência de Síndrome Metabólica em pacientes hipertensos de uma unidade de atenção primária à saúde. Método Estudo analítico com corte transversal realizado com 306 pacientes hipertensos de uma Unidade de Atenção Primária à Saúde localizada na cidade de Fortaleza-CE. Resultados Dos participantes do estudo 74,2% eram do sexo feminino, média 61,8 ± 11,9 anos e dentro da faixa etária de 54 a 69, 77,1% raça/cor parda, 60,8% com nível fundamental incompleto ou completo e 70,6% com renda familiar entre 1 e 2 salários mínimos. Dos hipertensos avaliados, 41,5% apresentaram Síndrome Metabólica e 76,5% apresentava aderência parcial ao tratamento anti-hipertensivo. Na avaliação estatística da associação entre as variáveis foi verificado não existir (p = 0,149 e p = 0,642). Os valores referentes à adesão ao tratamento anti-hipertensivo eram iguais, tanto nos pacientes com Síndrome Metabólica como dos que não apresentavam essa condição. Conclusão e implicações para a prática A adesão terapêutica anti-hipertensiva alta e parcial foi prevalente. A frequência de Síndrome Metabólica entre os hipertensos em estudo foi elevada. Portanto, medidas de prevenção para doenças cardiovasculares e alcance das metas terapêuticas devem ser implementas continuamente. Um desafio a ser superado pelos profissionais e serviços de saúde.


RESUMEN Objetivo Analizar la asociación entre la adherencia al tratamiento antihipertensivo y la aparición del síndrome metabólico en pacientes hipertensos en una unidad de atención primaria de salud. Método Estudio analítico con corte transversal realizado con 306 pacientes hipertensos de una Unidad de Atención Primaria de Salud ubicada en la ciudad de Fortaleza-CE. Resultados De los participantes en el estudio, el 74,2% eran mujeres, con una media de 61,8 ± 11,9 años y dentro del grupo de edad de 54 a 69, 77,1% raza / color marrón, 60,8% con nivel fundamental incompleto o completo y 70.6% con ingresos familiares entre 1 y 2 salarios mínimos. De los pacientes hipertensos evaluados, el 41.5% tenía síndrome metabólico y el 76.5% tenía adherencia parcial al tratamiento antihipertensivo. En la evaluación estadística de la asociación entre las variables, se encontró que no existía (p = 0,149 e p = 0,642). Los valores con respecto a la adherencia al tratamiento antihipertensivo fueron los mismos, tanto en pacientes con síndrome metabólico como en aquellos que no tenían esta condición. Conclusiones e implicaciones para la práctica La adherencia a la terapia antihipertensiva alta y parcial fue prevalente. La frecuencia del síndrome metabólico entre los pacientes hipertensos en estudio fue elevada. Por lo tanto, las medidas preventivas para las enfermedades cardiovasculares y el logro de objetivos terapéuticos deben implementarse continuamente. Un desafío a superar por los profesionales y servicios de salud.


ABSTRACT Objective To analyze the association between adherence to antihypertensive treatment and the occurrence of Metabolic Syndrome in hypertensive patients in a primary health care unit. Method Analytical cross-sectional study carried out with 306 hypertensive patients from a Primary Health Care Unit located in the city of Fortaleza-CE. Results Of the study participants, 74.2% were female, mean 61.8 ± 11.9 years old and within the age group of 54 to 69, 77.1% race / brown color, 60.8% with incomplete fundamental level or complete and 70.6% with family income between 1 and 2 minimum wages. Of the evaluated hypertensive patients, 41.5% had Metabolic Syndrome and 76.5% had partial adherence to antihypertensive treatment. In the statistical evaluation of the association between the variables, it was verified that it did not exist (p = 0,149 e p = 0,642). The values regarding adherence to antihypertensive treatment were the same, both in patients with Metabolic Syndrome and in those who did not have this condition. Conclusions and implications for practice High and partial antihypertensive therapy adherence was prevalent. The frequency of Metabolic Syndrome among hypertensive patients under study was high. Therefore, preventive measures for cardiovascular diseases and achievement of therapeutic goals must be implemented continuously. A challenge to be overcome by health professionals and services.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Metabolic Syndrome , Treatment Adherence and Compliance/statistics & numerical data , Antihypertensive Agents/therapeutic use , Cross-Sectional Studies , Risk Factors , Hypertension/drug therapy
10.
Article in English | WPRIM | ID: wpr-880733

ABSTRACT

Epidemiological evidence suggests that patients with hypertension infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at increased risk of acute lung injury. However, it is still not clear whether this increased risk is related to the usage of renin-angiotensin system (RAS) blockers. We collected medical records of coronavirus disease 2019 (COVID-19) patients from the First Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China), and evaluated the potential impact of an angiotensin II receptor blocker (ARB) on the clinical outcomes of COVID-19 patients with hypertension. A total of 30 hypertensive COVID-19 patients were enrolled, of which 17 were classified as non-ARB group and the remaining 13 as ARB group based on the antihypertensive therapies they received. Compared with the non-ARB group, patients in the ARB group had a lower proportion of severe cases and intensive care unit (ICU) admission as well as shortened length of hospital stay, and manifested favorable results in most of the laboratory testing. Viral loads in the ARB group were lower than those in the non-ARB group throughout the disease course. No significant difference in the time of seroconversion or antibody levels was observed between the two groups. The median levels of soluble angiotensin-converting enzyme 2 (sACE2) in serum and urine samples were similar in both groups, and there were no significant correlations between serum sACE2 and biomarkers of disease severity. Transcriptional analysis showed 125 differentially expressed genes which mainly were enriched in oxygen transport, bicarbonate transport, and blood coagulation. Our results suggest that ARB usage is not associated with aggravation of COVID-19. These findings support the maintenance of ARB treatment in hypertensive patients diagnosed with COVID-19.


Subject(s)
Aged , Aged, 80 and over , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme 2/blood , Antibodies, Viral/blood , Antihypertensive Agents/therapeutic use , Biomarkers , COVID-19/complications , China , Female , Humans , Hypertension/drug therapy , Intensive Care Units , Length of Stay , Male , Middle Aged , Retrospective Studies , Transcriptome , Viral Load
11.
Article in Chinese | WPRIM | ID: wpr-879163

ABSTRACT

To systematically evaluate the clinical efficacy and safety of Compound Danshen Dripping Pills combined with conventional antihypertensive drugs in the treatment of hypertensive left ventricular hypertrophy. China National Knowledge Infrastructure(CNKI), Wanfang, VIP, PubMed, EMbase, Cochrane Library, Ovid and Web of Science databases were searched by computer to retrieve the randomized controlled trials(RCTs) of Compound Danshen Dripping Pills combined with conventional antihypertensive drugs in the treatment of hypertensive left ventricular hypertrophy from the establishment of databases to July 2020. After two researchers performed data retrieval, data extraction, and risk assessment of bias, they used RevMan 5.3 software for Meta-analysis. A total of 10 RCTs were included, with a total of 979 patients. Meta-analysis results showed that in terms of interventricular septal thickness(MD=-0.70, 95%CI[-1.15,-0.24], P=0.003), left ventricular posterior wall thickness(MD=-0.81, 95%CI[-1.41,-0.21], P=0.008), left ventricular mass index(MD=-8.75, 95%CI[-17.40,-0.10], P=0.05), systolic blood pressure(MD=-8.97, 95%CI[-13.46,-4.48], P<0.000 1), diastolic blood pressure(MD=-5.87, 95%CI[-8.39,-3.34], P<0.000 01) and left ventricular end-diastolic diameter(MD=-1.73, 95%CI[-2.38,-1.08], P<0.000 01), Compound Danshen Dripping Pills combined with conventional antihypertensive drugs was superior to conventional antihypertensive drugs. In terms of left ventricular ejection fraction(MD=0.41, 95%CI[-0.74, 1.55], P=0.49), there was no statistical difference in treatment between the two groups. Because of the small amount of literatures included in the safety aspect, it is impossible to give an accurate conclusion. The GRADE score showed that the level of evidence was low and extremely low. The results show that the Compound Danshen Dripping Pills combined with conventional antihypertensive drugs may effectively improve the clinical efficacy for hypertensive ventricular hypertrophy, and the safety needs to be further explored. Due to the low quality of the included literatures, more high-quality RCTs are needed for verification.


Subject(s)
Antihypertensive Agents/adverse effects , China , Drugs, Chinese Herbal/adverse effects , Humans , Hypertrophy, Left Ventricular/drug therapy , Stroke Volume , Treatment Outcome , Ventricular Function, Left
12.
Article in Chinese | WPRIM | ID: wpr-879058

ABSTRACT

To systematically evaluate the efficacy and safety of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and its accompanying symptoms. PubMed, EMbase, Cochrane Library, VIP, CNKI, Wanfang, and China biomedical database(CBD) were searched to screen out from the establishment of the database to April 2020 about the clinical randomized controlled trials of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and accompanying symptoms. The articles were selected according to the inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis. TSA 0.9.5.10 Beta software was used for sequential analysis, and GRADE 3.6 was used for evidence quality evaluation. A total of 4 532 patients were included in 34 randomized controlled trials. Meta-analysis results showed that: Yangxue Qingnao Granules combined with conventional anti-hypertensive agents reduced systolic blood pressure(MD=-10.56, 95%CI[-13.63,-7.50], P<0.000 01) and diastolic blood pressure(MD=-8.21, 95%CI[-10.84,-5.59], P<0.000 01), improved total effective rate(RR=1.21, 95%CI[1.14, 1.29], P<0.000 01), improved patients dizziness(RR=1.29, 95%CI[1.21, 1.37], P<0.000 01), insomnia(RR=1.66, 95%CI[1.44, 1.91], P<0.000 01), headache(RR=1.32, 95%CI[1.21, 1.43], P<0.000 01), chest distress(RR=1.26, 95%CI[1.12, 1.42], P=0.000 1), memory loss(RR=1.24, 95%CI[1.10, 1.40], P=0.000 4), palpitation(RR=1.28, 95%CI[1.17, 1.41], P<0.000 01), and improved traditional Chinese medicine symptom scores(MD=-4.24, 95%CI[-5.25,-3.23], P<0.000 01) and headache symptom improvement scores(MD=-2.02, 95%CI[-2.51,-1.53], P<0.000 01) as compared with Western medicine group alone. Subgroup analysis results showed that Yang-xue Qingnao Granules combined with ACEI drug had more obvious effects in lowering systolic blood pressure and diastolic blood pressure. There was no statistically significant difference in the incidence of adverse reactions, and no abnormal liver and kidney function was observed in each study. Trial sequential analysis showed that the total effective rate was cumulative across the traditional and TSA thresholds, further confirming its clinical efficacy. The evidence level was mostly low or extremely low in GRADE evaluation. The clinical application of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and its accompanying symptoms is clear and safe, so it is recommended for clinical application.


Subject(s)
Antihypertensive Agents/adverse effects , China , Drugs, Chinese Herbal/adverse effects , Essential Hypertension , Humans , Medicine, Chinese Traditional , Randomized Controlled Trials as Topic
13.
Article in Chinese | WPRIM | ID: wpr-879057

ABSTRACT

To systematically evaluate the efficacy and safety of Tianma Gouteng Granules combined with conventional anti-hypertensive drugs in the treatment of essential hypertension. The clinical randomized controlled trials(RCTs) on the treatment of essential hypertension with Tianma Gouteng Granules combined with conventional anti-hypertensive drugs were searched in PubMed, EMbase, Cochrane Library, VIP, CNKI, Wanfang, SinoMed since the establishment of the databases to April 2020 based on inclusion and exclusion criteria, and Meta-analysis was conducted by using RevMan 5.3 software. A total of 15 RCTs were included, involving a total of 1 508 patients. Meta-analysis results showed that Tianma Gouteng Granules combined with conventional Western medicine were supe-rior to the control group in reducing systolic blood pressure(MD=-10.24, 95%CI[-13.54,-6.95], P<0.000 01), diastolic blood pressure(MD=-5.33, 95%CI[-7.21,-3.45], P<0.000 01), improving the clinical efficacy of patients(RR=1.22, 95%CI[1.15, 1.28], P<0.000 01) and curative effect of traditional Chinese medicine syndrome(RR=1.26, 95%CI[1.02, 1.57], P=0.04), increasing nitric oxide content(MD=9.59, 95%CI[7.23, 11.96], P<0.000 01), reducing endothelin-1(MD=-10.74, 95%CI[-15.74,-5.75], P<0.000 1), tumor necrosis factor(MD=-0.28, 95%CI[-0.36,-0.19], P<0.000 01), and interleukin-6(MD=-39.71, 95%CI[-43.40,-36.03], P<0.000 01). There was no statistically significant difference between the test group and the control group in the incidence of adverse reactions. No liver and kidney dysfunction occurred. The results of the subgroup analysis showed that the effect of Tianma Gouteng Granules combined with ARB drugs was more obvious in reducing the systolic and diastolic pressure. Trial sequential analysis showed that the studies accumulatively included for clinical efficacy crossed the traditional threshold and the TSA threshold, further affirming its clinical efficacy. The clinical application of Tianma Gouteng Granules combined with conventional Western medicine in the treatment of primary hypertension and accompanying symptoms has clear efficacy and certain safety, so it is recommended for clinical application.


Subject(s)
Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Antihypertensive Agents/therapeutic use , Drugs, Chinese Herbal , Essential Hypertension/drug therapy , Humans
14.
Article in Chinese | WPRIM | ID: wpr-878895

ABSTRACT

To systematically evaluate the efficacy and safety of traditional Chinese medicine in treating patients with resistant hypertension. CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Cochrane Library, EMbase and other databases were retrieved by computers to screen out the randomized controlled trial of traditional Chinese medicine in treating resistant hypertension. Cochrane Handbook was used to evaluate the quality of the included literature, RevMan 5.3 and Stata 12.0 was used for Meta-analysis. Finally, 11 literatures meeting the criteria were included, involving 1 023 patients. The results of Meta-analysis showed that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further reduce systolic blood pressure of patients with resistant hypertension(MD=-16.69, 95%CI[-22.21,-11.16], P<0.000 01), reduce diastolic blood pressure(MD=-7.51, 95%CI[-8.26,-6.76], P<0.000 01), improve the effective rate of anti-hypertension(OR=5.16, 95%CI[3.01, 8.84], P<0.000 01), improve the up-to-standard rate of blood pressure(OR=3.01, 95%CI[1.49, 6.09], P=0.002), and improve the effectiveness of clinical symptoms(OR=4.48, 95%CI[2.31, 8.68], P<0.000 01), with no significant effect on creatinine level(MD=-2.51, 95%CI[-6.91, 1.89], P=0.26). The results of this study indicated that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further improve the clinical efficacy in patients with resistant hypertension with a good safety, but more high-quality clinical studies are still needed to verify this conclusion.


Subject(s)
Antihypertensive Agents/therapeutic use , Drugs, Chinese Herbal/therapeutic use , Humans , Hypertension/drug therapy , Medicine, Chinese Traditional , Treatment Outcome
15.
Chinese Medical Journal ; (24): 292-301, 2021.
Article in English | WPRIM | ID: wpr-878038

ABSTRACT

BACKGROUND@#Generic drugs are bioequivalent to their brand-name counterparts; however, concerns still exist regarding the effectiveness and safety of generic drugs because of small sample sizes and short follow-up time in most studies. The purpose of this study was to evaluate the long-term antihypertensive efficacy, cost-effectiveness and cardiovascular outcomes of generic drugs compared with brand-name drugs.@*METHODS@#In a multicenter, community-based study including 7955 hypertensive patients who were prospectively followed up for an average of 2.5 years, we used the propensity-score-matching method to match the patients using brand-name drugs to those using generic drugs in a ratio of 1:2, 2176 patients using brand-name drugs and 4352 patients using generic drugs.@*RESULTS@#There were no significant differences between generic drugs and brand-name drugs in blood pressure (BP)-lowering efficacy, BP control rate, and cardiovascular outcomes including coronary heart disease and stroke. The adjusted mean (95% confidence interval [CI]) of systolic BP (SBP)-lowering was -7.9 mmHg (95% CI, -9.9 to -5.9) in the brand-name drug group and -7.1 mmHg (95% CI, -9.1 to -5.1) in the generic drug group after adjusting for age, sex, body mass index, number of antihypertensive drugs and traditionally cardiovascular risk factors. Among patients aged <60 years, brand-name drugs had a higher BP control rate (47% vs. 41%; P = 0.02) and a greater effect in lowering SBP compared with generic drugs, with the between-group difference of 1.5 mmHg (95% CI, 0.2-2.8; P = 0.03). BP control rate was higher in male patients using brand-name drugs compared with those using generic drugs (46% vs. 40%; P = 0.01). Generic drugs treatment yielded an average annual incremental cost-effectiveness ratio of $315.4 per patient per mmHg decrease in SBP compared with brand-name drugs treatment.@*CONCLUSIONS@#Our data suggested that generic drugs are suitable and cost-effective in improving hypertension management and facilitating public health benefits, especially in low- and middle-income areas.


Subject(s)
Aged , Antihypertensive Agents/therapeutic use , Blood Pressure , China , Drugs, Generic/therapeutic use , Humans , Male , Prospective Studies
16.
Rev. colomb. anestesiol ; 48(4): e400, Oct.-Dec. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1144318

ABSTRACT

Abstract Introduction Laparoscopic adrenalectomy is the treatment of choice of pheochromocytoma. During the first surgical phase (pneumoperitoneum insufflation, tumor and veins handling), there is a risk of hypertensive crisis due to catecholamine release. After tumor excision, patients can suffer relative vasodilation and the residual effect of antihypertensive drugs, which results in arterial hypotension. For that reason, antihypertensive drugs used in the first phase should have a rapid onset of action, short half-life and no residual effect. Methods We report a series of three cases of patients with pheochromocytoma who were treated with laparoscopic adrenalectomy. They all received clevidipine infusion from the beginning of the surgery, before they had presented hypertension, to treat and try to minimize hypertensive peaks. Results In all patients, hypertensive peaks were controlled in a few minutes. After tumor resection, clevidipine infusion was stopped in all cases, and any patient required infusion of vasopressors. Discussion Clevidipine could be a first choice antihypertensive drug in pheochromocytoma surgery. Starting the infusion of clevidipine before the hypertensive peaks could help to make them less pronounced.


Resumen Introducción La adrenalectomía laparoscópica es el tratamiento de elección del feocromocitoma. Durante la primera fase quirúrgica (insuflación de neumoperitoneo, manipulación del tumor y de las venas implicadas), existe el riesgo de que se desencadenen crisis hipertensivas debido a la liberación de catecolaminas. Después de la extirpación del tumor, los pacientes pueden sufrir una vasodilatación relativa y el efecto residual de los fármacos antihipertensivos usados previamente, lo que resulta en hipotensión arterial. Por esa razón, los fármacos antihipertensivos utilizados en la primera fase quirúrgica deben tener rápido inicio de acción, vida media corta y mínimo efecto residual. Métodos Se describe una serie de casos de tres pacientes con feocromocitoma que fueron tratados con adrenalectomía laparoscópica. Todos recibieron infusión de clevidipino desde el comienzo de la cirugía, antes de presentar hipertensión arterial, para así intentar minimizar y tratar rápidamente los posibles picos hipertensivos. Resultados En todos los pacientes los picos hipertensivos se controlaron en pocos minutos. Después de la resección del tumor, la infusión de clevidipino se detuvo en todos los casos y ningún paciente requirió perfusión de vasopresores. Discusión El clevidipino podría ser un fármaco antihipertensivo de primera elección en la cirugía de feocromocitoma. Iniciarlo antes de que ocurran los picos hipertensivos podría ayudar a que sean más leves.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Antihypertensive Agents , Pheochromocytoma , Catecholamines , Adrenalectomy , Hypotension
17.
Aquichan ; 20(4): e2046, Dic. 4, 2020.
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1283741

ABSTRACT

Objetivo: identificar os preditores psicossociais que influenciam a intenção comportamental de tomar os anti-hipertensivos orais. Materiais e métodos: estudo transversal, fundamentado na teoria do comportamento planejado. Aplicou-se um questionário construído e validado a 220 indivíduos com hipertensão arterial sistêmica em acompanhamento ambulatorial em um hospital público. Utilizaram-se os testes qui-quadrado e exato de Fisher, correlação de Spearman e regressão logística múltipla para as análises dos dados. Resultados: os participantes apresentaram alta intenção de tomar os anti-hipertensivos. As crenças comportamentais (ß = 0,0432; p = 0,0364), a norma subjetiva (ß = -1,5708; p < 0,01) e o controle comportamental percebido (ß = 2,2809; p = 0,0028) explicaram a intenção comportamental em 33 %. Conclusões: crenças comportamentais, norma subjetiva e controle comportamental percebido são preditores psicossociais significativos da tomada dos anti-hipertensivos e devem ser valorizados, de forma individual e conjunta, nas ações de saúde direcionadas a essa população.


Objetivo: identificar los predictores psicosociales que influyen la intención comportamental de tomar los antihipertensivos orales. Materiales y métodos: estudio transversal, fundamentado en la teoría de la conducta planeada. Se aplicó un cuestionario construido y validado a 220 individuos con hipertensión arterial sistémica en seguimiento ambulatorio en un hospital público. Se emplearon las pruebas de Cui-cuadrado y exacto de Fisher, correlación de Spearman y regresión logística múltiple para analizar los datos. Resultados: los participantes presentaron alta intención de tomar los antihipertensivos. Las creencias comportamentales (ß = 0,0432; p = 0,0364), la norma subjetiva (ß = -1,5708; p < 0,01) y el control comportamental percibido (ß = 2,2809; p = 0,0028) explicaron la intención comportamental en el 33 %. Conclusiones: creencias comportamentales, norma subjetiva y control comportamental percibido son predictores psicosociales significativos de la tomada de los antihipertensivos y deben valorarse, de forma individual y conjunta, en las acciones de salud hacia esta población.


Objective: To identify the psychosocial predictors that influence the behavioral intention to take oral antihypertensive drugs. Materials and methods: A cross-sectional study, based on the theory of planned behavior. A questionnaire constructed and validated was applied to 220 individuals with systemic arterial hypertension in outpatient follow-up at a public hospital. The chi-square and Fisher's exact tests, Spearman's correlation and multiple logistic regression were used for data analysis. Results: The participants presented a high intention of taking antihypertensive drugs. The behavioral beliefs (ß = 0.0432; p = 0.0364), subjective norm (ß = -1.5708; p < 0.01) and perceived behavioral control (ß = 2.2809; p = 0.0028) explained the behavioral intention in 33 %. Conclusions: The behavioral beliefs, the subjective norm, and the perceived behavioral control are significant psychosocial predictors of taking antihypertensive drugs and must be valued, individually and jointly, in the health actions targeted at this population.


Subject(s)
Nursing , Social Theory , Treatment Adherence and Compliance , Hypertension , Antihypertensive Agents
18.
Rev. méd. Maule ; 36(2): 61-67, dic. 2020. tab
Article in Spanish | LILACS | ID: biblio-1344688

ABSTRACT

30 to 40% of the adult population worldwide has been diagnosed with hypertension, among these patients 5 to 10% of them could have a possibly curable condition. In order to recognize this special population, the clinician must perform a complete work up and be aware of the main underlying causes of secondary hypertension. Often this could be a goal difficult to accomplish. The purpose of this article is to discuss the most frequent causes of secondary hypertension and offer a diagnostic approach for these patients. Clinicians should never forget that drug-related hypertension is a common cause that is discovered only with the help of a good medical history.


Subject(s)
Humans , Hypertension/prevention & control , Hypertension, Renovascular/etiology , Pheochromocytoma , Sleep Apnea Syndromes , Blood Pressure Monitoring, Ambulatory , Hyperaldosteronism , Hypertension/diagnosis , Hypertension/etiology , Hypertension, Renovascular/diagnosis , Antihypertensive Agents/therapeutic use
19.
Rev. cuba. oftalmol ; 33(4): e979, oct.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156576

ABSTRACT

Objetivo: Describir el comportamiento de la hipertensión ocular asociada al desprendimiento de la retina regmatógeno. Métodos: Se realizó un estudio observacional descriptivo de corte longitudinal retrospectivo de una serie de casos atendidos en la consulta de Vítreo-Retina del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período comprendido de mayo del año 2016 a diciembre de 2019. Se estudiaron 7 ojos de 7 pacientes. Se utilizaron las siguientes variables: edad, sexo, antecedentes patológicos oculares, tiempo de evolución de la disminución de la visión, tensión ocular, tipo de rotura retinal, cirugía de retina realizada y tratamiento antihipertensivo ocular. Resultados: Predominó el sexo masculino, con un promedio de edad de 27,2 años. La mayoría de los pacientes tuvieron rotura retinal en el cuadrante nasal superior y todos en extrema periferia. Todos los pacientes tuvieron la presión intraocular antes de la cirugía por encima de 30 mmHg. A todos se le indicó tratamiento hipotensor tópico y se les realizó cirugía convencional. Con diferentes fluctuaciones de la presión intraocular posterior a la cirugía, todos los pacientes normalizaron la tensión ocular y mantuvieron la retina aplicada. Conclusiones: El diagnóstico correcto de este síndrome puede ofrecer dificultad porque los signos de una condición pueden enmascarar los de otra. El reconocimiento de la entidad puede ser más fácil si el oftalmólogo tiene en mente que estas entidades pueden aparecer juntas. De esta forma, se hace un diagnóstico y un tratamiento certero que evite la discapacidad visual por esta causa(AU)


Objective: Describe the behavior of ocular hypertension associated to rhegmatogenous retinal detachment. Methods: An observational retrospective longitudinal descriptive study was conducted of 7 eyes of 7 patients attending the Vitreous-Retina Service at Ramón Pando Ferrer Cuban Institute of Ophthalmology from May 2016 to December 2019. The variables considered were age, sex, ocular pathological antecedents, time of evolution of vision reduction, ocular tension, type of retinal tear, retinal surgery performed and ocular hypertension treatment. Results: A predominance was found of the male sex, with a mean age of 27.2 years. Most of the patients had retinal tear in the upper nasal quadrant, and all in the extreme periphery. In all cases, intraocular pressure was above 30 mmHg before surgery. All patients were indicated topical hypotensive treatment and underwent conventional surgery. With different intraocular pressure fluctuations after surgery, all patients normalized their ocular tension and retained the retina applied. Conclusions: Correct diagnosis of this syndrome may be difficult to achieve, since the signs of one condition may mask those of another. Identification may be easier if the ophthalmologist bears in mind that these diseases may occur together. An accurate diagnosis may thus be made and an effective treatment indicated which will prevent visual disability due to this cause(AU)


Subject(s)
Humans , Male , Adult , Retinal Perforations , Retinal Detachment/diagnosis , Ocular Hypertension/etiology , Intraocular Pressure/drug effects , Antihypertensive Agents/therapeutic use , Epidemiology, Descriptive , Retrospective Studies , Longitudinal Studies , Observational Studies as Topic
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