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Rev. Ciênc. Méd. Biol. (Impr.) ; 22(1): 105-112, jun 22, 2023. tab
Article in French | LILACS | ID: biblio-1443790


Objetivo: caracterizar o acesso aos medicamentos anti-hipertensivos pelas pessoas com hipertensão arterial atendidas em uma unidade ambulatorial. Metodologia: estudo descritivo, quantitativo, desenvolvido com 103 pessoas com hipertensão arterial em uso de anti-hipertensivos. Os dados foram coletados por meio de questionário com perguntas sociodemográficas, sobre tratamento e acesso aos medicamentos anti-hipertensivos. Utilizou-se a estatística descritiva e teste qui-quadrado de Pearson ou exato de Fisher para análise dos dados. Resultados: Predominou a faixa etária de 50-69 (68,9%), sexo feminino (85,4%) e raça/cor autodeclarada preta (46,6%). Quanto ao acesso aos anti-hipertensivos, 70,9% relataram ter acesso gratuito, 60,2% os obtêm nas unidades de saúde, 65,7% não referiram dificuldades na aquisição e 86,4% que tinham acesso total. Todos os participantes que tinham dificuldade econômica também tinham dificuldade de acesso aos anti-hipertensivos. Verificou-se associação significativa entre a dificuldade de acesso aos anti-hipertensivos com forma de acesso (total ou parcial), quantidade de drogas e disponibilidade do medicamento nas farmácias (p<0,005). Conclusão: observou-se que, embora a maioria dos participantes do estudo não encontre dificuldades para obtenção dos anti-hipertensivos nas farmácias das unidades básicas de saúde, ainda assim, existe uma parcela da população sem acesso total aos anti-hipertensivos de forma gratuita, sendo essencial melhorias dos programas de fornecimento de medicamentos.

Objective: to characterize access to antihypertensive drugs by patients with arterial hypertension treated at an ambulatory unit. Methodology: descriptive, quantitative study, developed with a group of 103 people with arterial hypertension currently using antihypertensive drugs. The data were collected through a questionnaire with sociodemographic questions, with respect to treatment and access to antihypertensive drugs. Descriptive statistics and Pearson's chi-square test or Fisher's exact test were used for data analysis. Results: the age group 50-69 (68.9%), female (85.4%) and black self-declared race (46.6%) predominated. Regarding access to antihypertensive drugs, 70.9% reported having free access, 60.2% obtained them at health units, 65.7% did not mention difficulties in acquiring them and 86.4% that had full access. All participants who had economic difficulties also had difficulty accessing antihypertensive drugs. It was identified a significant association between difficulty in accessing antihypertensive drugs and the means of access (total or partial), quantity of drugs and availability of the drug in pharmacies (p<0.005). Conclusion: it was observed that, that most of the study participants did not find it difficult to obtain antihypertensive drugs in the pharmacies of basic health units, notwithstanding, there is a portion of the population without full access to antihypertensive drugs free of charge, improvements in drug supply programs are essential.

Humans , Female , Middle Aged , Aged , Health Centers , Academic Medical Centers , Medication Adherence , Access to Essential Medicines and Health Technologies , Hypertension , Antihypertensive Agents , Epidemiology, Descriptive , Evaluation Studies as Topic
Curationis ; 46(1): 1-7, 2023. figures, tables
Article in English | AIM | ID: biblio-1413746


Background: The worldwide phenomenon of teenage pregnancy among 13­9-year-olds is complicated by obstetric conditions. Among the top three causes of maternal mortality, hypertension is the third in South Africa. Quality maternal care is assured by obstetric practitioners (OPs) implementing guidelines specific for management of hypertension in pregnancy. Objective: The objective of this study was to investigate implementation of maternal guidelines for hypertension in pregnancy among teenagers. Methods: As a retrospective quantitative research design was used, 173 maternal records of pregnant teenagers from 13 to 19 years were sampled from six district hospitals and Community Health Centres (CHCs) between 01 January 2017 and 31 December 2019 to undergo systematic random sampling. A pretested structured checklist was used to record data from sampled maternal records. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis, and results were presented using simple descriptive statistics. Results: Research results indicated that teenagers who suffered from hypertension intrapartum and postpartum did not receive maternal care according to the guidelines for maternity care in South Africa. Blood pressure was not measured of six (3.47%) intrapartum and five (2.9%) postpartum teenagers. Seventeen (9.8%) hypertensive postpartum teenagers received their antihypertensives. Conclusion: Public health institutions (PHIs) compromised provision of quality maternal care among teenagers, evidenced by incomplete intrapartum and postpartum assessment, diagnosis and management of hypertensive disorders in pregnancy (HDP).

Humans , Female , Adolescent , Pregnancy Complications , Pregnancy in Adolescence , Maternal Mortality , Hypertension, Pregnancy-Induced , Postpartum Period , Blood Pressure , Antihypertensive Agents
Chinese Journal of Preventive Medicine ; (12): 614-625, 2023.
Article in Chinese | WPRIM | ID: wpr-985453


Objective: To investigate the distribution of blood pressure and analyze the associated factors of blood pressure of the elderly with type 2 diabetes in Jiangsu Province. Methods: The elderly over 60 years old participants with type 2 diabetes in the communities of Huai'an City and Changshu City, Jiangsu Province were selected in this study. They were divided into two groups: taking antihypertensive drugs and not taking antihypertensive drugs. The demographic characteristics, such as age and sex, and relevant factors were collected by questionnaire. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by physical examination. The percentile of SBP and DBP in each age group of men and women were described. The kernel density estimation curve was used to show the blood pressure distribution. The trend of blood pressure with age was fitted by locally weighted regression. The logistic regression model was used to analyze relevant factors of blood pressure. Results: A total of 12 949 participants were included in this study, including 7 775 patients in the antihypertensive drug group and 5 174 patients in the group without antihypertensive drugs. The SBP of participants was concentrated at 140-160 mmHg, and their DBP was concentrated at 75-85 mmHg. There were significant differences in the distribution of blood pressure among the subgroups of body mass index (BMI) and rural areas whether taking antihypertensive drugs and not. For participants aged under 80 years old, the SBP showed an increasing trend with age and the DBP showed a decreasing trend with age. Age, BMI ≥24 kg/m2, fasting blood glucose ≥7.0 mmol/L, living in rural areas and no smoking were influencing factors of the elevated SBP; BMI ≥24 kg/m2, male, living in rural areas, no smoking, drinking alcohol and not receiving drug hypoglycemic treatment were influencing factors of the elevated DBP. Conclusion: The SBP of older diabetic adults in Jiangsu Province is at a high level, and the distribution of blood pressure is significantly different between men and women in taking antihypertensive drugs group. The SBP presents a rising trend and the DBP is decreasing at the age of 60-80 years. The blood pressure level of this population are mainly affected by age, BMI, urban and rural areas, smoking.

Adult , Aged , Humans , Male , Female , Middle Aged , Aged, 80 and over , Blood Pressure/physiology , Diabetes Mellitus, Type 2/epidemiology , Antihypertensive Agents/therapeutic use , Smoking , Body Mass Index , Hypertension/epidemiology
China Journal of Chinese Materia Medica ; (24): 1982-1988, 2023.
Article in Chinese | WPRIM | ID: wpr-981418


Hypertension and its target organ damage have become a major public health problem. Sexual dysfunction is a new problem in the treatment of modern hypertension. Modern pathophysiological studies have shown that hypertension can lead to sexual dysfunction. In addition, three major hypotensive drugs represented by diuretics can also lead to sexual dysfunction. In traditional Chinese medicine(TCM), hypertension belongs to "vertigo" "headache" "head wind", etc. In the past, the understanding of the TCM pathogenesis of hypertension was mainly from the perspectives of "liver wind" and "Yang hyperactivity". However, based on the in-depth research on ancient and modern literature and medical records and many years of clinical practice, it has been identified that kidney deficiency was the key pathogenesis. Hypertension complicated with sexual dysfunction belongs to the category of kidney deficiency syndrome in TCM, especially the deficiency of kidney Yin. Previous studies by other research groups showed that Yin-enriching and kidney-tonifying method could effectively reduce blood pressure, improve sexual dysfunction, reverse risk factors, and protect target organs. This article systematically discussed the TCM understanding, modern pathophysiological mechanism, and the clinical treatment strategy of kidney-tonifying drugs(single drugs and compounds) in the treatment of hypertension complicated with sexual dysfunction in order to provide a scientific basis for kidney-tonifying method in the treatment of hypertension complicated with sexual dysfunction.

Humans , Antihypertensive Agents/therapeutic use , Medicine, Chinese Traditional , Hypertension/drug therapy , Blood Pressure , Risk Factors , Drugs, Chinese Herbal/therapeutic use
Health Sciences Journal ; : 12-19, 2023.
Article in English | WPRIM | ID: wpr-984390


INTRODUCTION@#Hypertension is a key modifiable risk factor for myocardial infarction and stroke, yet medication adherence remains low. The ongoing COVID-19 pandemic has further complicated the management of chronic diseases like hypertension. This study aimed to explore the correlation between the patient-doctor relationship and medication adherence among hypertensive Filipinos aged 40-65 years in the Greater Manila Area during the pandemic.@*METHODS@#A cross-sectional study was conducted involving 131 hypertensive Filipino participants. Data were collected through an online survey, assessing participant demographic and medical profiles, medication adherence using the Hill-Bone Compliance Scale (HBCS), and the patient-doctor relationship using the Physician-Doctor Relationship Questionnaire-9 (PDRQ-9).@*RESULTS@#Approximately half of the participants demonstrated good adherence to hypertension medication. A weak but significant positive correlation was found between overall medication adherence and the patient-doctor relationship. The duration of anti-hypertensive drug intake also showed a weak positive correlation with medication adherence. Factors such as comorbidities and type of consultation did not significantly impact medication adherence.@*CONCLUSION@#This study emphasizes the significance of the patient-doctor relationship in medication adherence among hypertensive Filipinos during the COVID-19 pandemic. Enhancing communication and trust between patients and physicians can potentially improve medication adherence and overall disease management.

COVID-19 , Hypertension , Medication Adherence , Perception , Antihypertensive Agents
Acta odontol. Colomb. (En linea) ; 13(1): 91-103, 20230000. tab, tab, ilus, ilus, ilus, ilus, ilus, ilus
Article in Spanish | LILACS | ID: biblio-1425222


Introducción: un aumento marcado de la tensión arterial puede llevar a una crisis hipertensiva, que consiste en una elevación considerable de la tensión arterial (>180 mmHg en sístole y >120 mmHg en diástole). De no ser tratada, puede llevar a la pérdida progresiva de la conciencia, así como provocar daños irreversibles a algún órgano blanco, por ejemplo, el hígado, el riñón o el cerebro. Se puede clasifcar en urgencia o emergencia hipertensiva. Así, una urgencia hipertensiva se presenta cuando el paciente cuenta con cifras elevadas en la tensión arterial sin provocar daño a un órgano blanco y, en contraparte, una emergencia hipertensiva cumple con las cifras que se mencionaron, pero incluye daño a un órgano blanco. Objetivo: presentar un caso clínico, en el cual, durante la extracción quirúrgica de una aguja fracturada, en el período transoperatorio, el paciente sufre síncope vasovagal, con un aumento marcado de la tensión arterial (179/119 mmHg). Conclusión: este fue un diagnóstico intraoperatorio de crisis hipertensiva y la paciente recibió un tratamiento médico temprano por parte del servicio de urgencias médicas, lo cual resultó en una evolución trans y postoperatoria adecuada.

A marked increase in blood pressure can lead to a hypertensive crisis, it can be classifed as an urgency or hypertensive emergency, which consists of a considerable increase in blood pressure (> 180 mmHg in systole and> 120 mmHg in diastole) and that, not being treated can lead to progressive loss of consciousness, as well as cause irreversible damage to the liver, kidney or brain. The objective of this article is to present a clinical case that during the surgical extraction of a fractured needle, in the intraoperative period the patient sufers vasovagal syncope, with a marked increase in blood pressure (179/119 mmHg), intraoperative diagnosis of crisis hypertensive, receiving early medical treatment from the emergency medical service, resulting in an adequate trans and postoperative evolution.

Humans , Middle Aged , Surgery, Oral , Emergencies , Hypertension , Blood Pressure , Antihypertensive Agents
Chinese Journal of Hepatology ; (12): 48-80, 2023.
Article in Chinese | WPRIM | ID: wpr-970945


The population of chronic kidney disease (CKD) with hypertension in China is characterized by complex etiology, high incidence rate, low awareness and control rate. How to diagnose and treat hypertension in CKD patients properly and improve their prognosis is particularly urgent. Several clinical guidelines or expert consensus on the diagnosis, treatment and management of hypertension have been issued. Some of them involve the diagnosis and treatment of hypertension in CKD patients, but they still can not meet the demand for diagnosis and treatment of hypertension in CKD patients. Based on the situation of hypertension in CKD patients in China, the Chinese Society of Nephrology organized an expert group to formulate this guideline. This guideline systematically introduces the diagnostic criteria, epidemiology, risk factors, poor prognosis of hypertension, the purpose, timing and control goals of antihypertensive therapy in CKD patients, as well as blood pressure control goals for special populations, non drug treatment and drug treatment of hypertension. This guideline aims to further strengthen the management of hypertension in CKD patients, standardize the diagnosis and treatment standards, formulate reasonable treatment plans, effectively control hypertension, reduce complications, so as to delay the progress of kidney diseases and improve the long-term prognosis of hypertension in Chinese CKD patients.

Humans , Antihypertensive Agents/therapeutic use , Hypertension/therapy , Renal Insufficiency, Chronic/therapy , Blood Pressure , Risk Factors , China/epidemiology
Rev. Nac. (Itauguá) ; 14(2): 67-82, jul.-dic. 2022.
Article in Spanish | LILACS, BDNPAR | ID: biblio-1410692


Introducción:existe una sospecha sobre la relación bidireccional entre la apnea obstructiva del sueño (AOS) y la hipertensión arterial (HTA). Ambas ejercen una acción sinérgica sobre desenlaces cardiovasculares porlo quees trascendente ponderar la prevalencia de riesgo para AOS en los hipertensos. En este último grupo también hemos investigado la tasa de adherencia a los fármacos prescritos. Metodología:mediante un estudio de casos y controles y con la aplicación del cuestionario STOP-BANG se han discriminado las categorías de riesgo para apnea de sueño en las dos cohortes. Para el análisis de la adherencia a fármacos antihipertensivos se utilizó el cuestionario abreviado de Morisky. Resultados:se incluyeron a 590 individuos (295 casos y 295 controles. Se observó alto riesgo para AOS en el grupo de hipertensos (36,6%) comparado con el 14,2% del grupo control. Por otro lado, el sexo masculino OR 7,77 (IC95% 4,33-13,84), la obesidad OR 5,03 (IC95% 3,11-8,13) y la HTA OR 4,31 (IC95% 2,64-7,03) se ponderan significativos en un modelo de ajuste logístico aquí estudiado. El 61,69% de los hipertensos refería adherencia al tratamiento farmacológico prescrito. Discusión:el tamizaje de AOS es factible con un cuestionario aplicable en la práctica clínica diaria. De la probabilidad clínica pre-test hay que partir hacia métodos diagnósticos específicos para el diagnóstico de AOS, enfatizando casos de HTA resistente, HTA nocturna y HTA enmascarada. Se deberían realizar estudios locales que nos ayuden a comprender las causas de la falta de adherencia a fármacos antihipertensivos en una fracción importante de los individuos con HTA

Introduction:there is a suspicion about the bidirectional relationship between obstructive sleep apnea (OSA) and arterial hypertension (AHT). Both have a synergistic action on cardiovascular outcomes, so it is important to assess the prevalence of risk for OSA in hypertensive patients. In this last group we have also investigated the rate of adherence to prescribed drugs.Metodology:through a case-control study and with the application of the STOP-BANG questionnaire, the risk categories for sleep apnea in the two cohorts have been discriminated. For the analysis of adherence to antihypertensive drugs, the abbreviated Morisky questionnaire was used. Results:590 individuals were included (295 cases and 295 controls. A high risk for OSA was observed in the hypertensive group (36.6%) compared to 14.2% in the control group. On the other hand, the male sex OR 7.77 (95%CI 4.33-13.84), obesity OR 5.03 (95%CI 3.11-8.13) and hypertensionOR4.31(95%CI 2.64-7.03) they areweighted significant in a logistic adjustment model studied here.61.69% of hypertensive patients reported adherence to the prescribed pharmacological treatment.Discussion:OSA screening is feasible with a questionnaire applicable in daily clinical practice. From the pre-test clinical probability, specific diagnostic methods for the diagnosis of OSA must be started, emphasizing cases of resistant AHT, nocturnal AHT, andmasked AHT. Local studies should be carried out to help us understand the causes of non-adherence to antihypertensive drugs in a significant fraction of individuals with AHT

Humans , Male , Female , Adult , Middle Aged , Young Adult , Risk Assessment , Sleep Apnea, Obstructive , Sleep Apnea, Obstructive/epidemiology , Treatment Adherence and Compliance , Obesity , Paraguay/epidemiology , Surveys and Questionnaires , Waist-Hip Ratio , Hypertension , Antihypertensive Agents
Acta odontol. Colomb. (En linea) ; 12(2): 52-60, Jul-Dec. 2022. tab, tab, graf, tab, tab
Article in Spanish | LILACS | ID: biblio-1397170


Objetivo: caracterizar las manifestaciones bucales en pacientes con medicación anti- hipertensiva que acuden al servicio estomatológico sur del municipio Morón, Ciego de Ávila, Cuba. Métodos: se realizó un estudio observacional, descriptivo, transversal, en el período enero 2019 a enero 2020. Se trabajó con la totalidad del universo, constituido por 162 pacientes. La información se recopiló de las historias clínicas estomatológicas individuales y de una ficha de recolección de datos creada por los autores de la investigación. Se estudiaron las variables grupo de edad, sexo, grupo de medicamentos antihipertensivos, dosis del medicamento, signos y síntomas clínicos, así como enfermedades bucales. Se utilizó estadística descriptiva (frecuencias absolutas y relativas porcentuales). Resultados: el 42,6 % representó el grupo de edad 35 a 59 años y el 53,7% al sexo femenino. Se observó que 88 pacientes (54,3 %) se encontraban medicados con inhibidores de la enzima convertidora de angiotensina; de ellos, 38 en su dosis mínima. La xerostomía estuvo presente en el 59,9 % de los casos. El 63,6 % presentó caries dental como enfermedad estomatológica. Conclusiones: existió predominio de la xerostomía y la caries dental en la mayoría de los pacientes.

Objective: To characterize the oral manifestations in patients with antihypertensive medication who attend the southern dental service of the Moron municipality, Ciego de Avila, Cuba. Method: An observational, descriptive, cross-sectional study was carried out in the period from January 2019 to January 2020. We worked with the entire universe which was made up of 162 patients. The information was collected from individual dental medical records and from a data collection form created by the authors of the research. The variables age group, sex, antihypertensive drug group, dose of antihypertensive drug, clinical signs and symptoms, and oral diseases were studied. Descriptive statistics were used (absolute and relative percentage frequencies). Results: 42,6 % represented the age group 35 to 59 years and 53,7 % the female sex. It was observed that 88 (54,3 %) patients were medicated with angiotensin converting enzyme inhibitors, 38 of them at their minimum dose. Xerostomia was present in 59,9% of the cases. 63,6 % presented dental caries as a dental disease. Conclusions: There was a predominance of xerostomia and dental caries in most of the patients.

Oral Manifestations , Antihypertensive Agents , Hypertension
Rev. méd. Maule ; 37(1): 53-60, jun. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1397628


Hypertension in black patients is usually more frequent and associated with higher morbidity and mortality. Due to demographic changes in the Chilean population, dealing with this group of patients has become more frequent. The case of a young Haitian patient with severe hypertension and target organ damage is presented.

Humans , Male , Adult , Cardiovascular Diseases/diagnosis , Hypertension/diagnosis , Hypertension/drug therapy , Blood Pressure Determination , Prevalence , Black People , Hypertension/complications , Hypertension/physiopathology , Hypertension/epidemiology , Antihypertensive Agents
Arq. bras. cardiol ; 118(3): 614-622, mar. 2022. tab
Article in English, Portuguese | LILACS | ID: biblio-1364355


Resumo Fundamento Aparentemente, a pior resposta a algumas classes de anti-hipertensivos, especialmente inibidores da enzima conversora da angiotensina e bloqueadores de receptor de angiotensina, pela população negra, explicaria, pelo menos parcialmente, o pior controle da hipertensão entre esses indivíduos. Entretanto, a maioria das evidências vêm de estudos norte-americanos. Objetivos Este estudo tem o objetivo de investigar a associação entre raça/cor da pele autorrelatadas e controle de PA em participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) utilizando várias classes de anti-hipertensivos em monoterapia. Métodos O estudo envolveu uma análise transversal, realizada com participantes da linha de base do ELSA-Brasil. O controle de pressão arterial foi a variável de resposta, participantes com valores de PA ≥140/90 mmHg foram considerados descontrolados em relação aos níveis de pressão arterial. A raça/cor da pele foi autorrelatada (branco, pardo, negro). Todos os participantes tiveram que responder perguntas sobre uso contínuo de medicamentos. A associação entre o controle de PA e raça/cor da pele foi estimada por regressão logística. O nível de significância adotado nesse estudo foi de 5%. Resultados Do total de 1.795 usuários de anti-hipertensivos em monoterapia na linha de base, 55,5% se declararam brancos, 27,9%, pardos e 16,7%, negros. Mesmo depois de padronizar em relação a variáveis de confusão, negros em uso de inibidores da enzima conversora de angiotensina (IECA), bloqueadores de receptor de angiotensina (BRA), diuréticos tiazídicos (DIU tiazídicos) e betabloqueadores (BB) in monoterapia tinham controle de pressão arterial pior em comparação a brancos. Conclusões Os resultados deste estudo sugerem que, nesta amostra de brasileiros adultos utilizando anti-hipertensivos em monoterapia, as diferenças de controle de pressão arterial entre os vários grupos raciais não são explicadas pela possível eficácia mais baixa dos IECA e BRA em indivíduos negros.

Abstract Background It seems that the worst response to some classes of antihypertensive drugs, especially angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, on the part of the Black population, would at least partially explain the worse control of hypertension among these individuals. However, most of the evidence comes from American studies. Objectives This study aims to investigate the association between self-reported race/skin color and BP control in participants of the Longitudinal Study of Adult Health (ELSA-Brasil), using different classes of antihypertensive drugs in monotherapy. Methods The study involved a cross-sectional analysis, carried out with participants from the baseline of ELSA-Brasil. Blood pressure control was the response variable, participants with BP values ≥140/90 mmHg were considered out of control in relation to blood pressure levels. Race/skin color was self-reported (White, Brown, Black). All participants were asked about the continuous use of medication. Association between BP control and race/skin color was estimated through logistic regression. The level of significance adopted in this study was of 5%. Results Of the total of 1,795 users of antihypertensive drugs in monotherapy at baseline, 55.5% declared themselves White, 27.9% Brown, and 16.7% Black. Even after adjusting for confounding variables, Blacks using angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blocker (ARB), thiazide diuretics (thiazide DIU), and beta-blockers (BB) in monotherapy had worse blood pressure control compared to Whites. Conclusions Our results suggest that in this sample of Brazilian adults using antihypertensive drugs in monotherapy, the differences in blood pressure control between different racial groups are not explained by the possible lower effectiveness of ACEIs and ARBs in Black individuals.

Humans , Adult , Hypertension/drug therapy , Hypertension/epidemiology , Antihypertensive Agents/therapeutic use , Antihypertensive Agents/pharmacology , United States , Blood Pressure , Brazil , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Calcium Channel Blockers/therapeutic use , Cross-Sectional Studies , Longitudinal Studies , Angiotensin Receptor Antagonists/therapeutic use , Race Factors
Rev. bras. hipertens ; 29(1): 14-18, 10 març. 2022. tab
Article in Portuguese | LILACS, CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1367456


ABSTRACT Clinical case of a female patient referred to our Institution at the age of seven years old with Systemic Arterial Hypertension. The patient had been severely obese since she was 4 years old and high blood pressure levels were detected in several medical consultations a few months ago. She has a history of prematurity, a sedentary lifestyle, and an inadequate diet, in addition to a family history of obesity and high blood pressure. We discussed the investigation of the etiology, the presence of target organ lesions, and the treatment of arterial blood pressure in youth. In the follow-up, there was adequate control of blood pressure after initiation of angiotensin-converting enzyme inhibitor, with great difficulty in weight reduction. Even under nutritional guidelines and reinforcement regarding lifestyle changes, the patient had a weight gain of 25 kilos. We report this case in view of the significant increase in the prevalence of Systemic Arterial Hypertension in children and adolescents. There are multifactorial aspects to the development of this scenario, largely associated with an inadequate lifestyle. The difficulties related to its management and the presence of comorbidities, especially obesity, highlight the need for a multidisciplinary approach so that the evolution of the patient's condition becomes as desired.

RESUMO Caso clínico de uma paciente do sexo feminino, encaminhada a nossa Instituição aos sete anos de idade por provável Hipertensão Arterial Sistêmica. A paciente apresentava obesidade grave desde os quatro anos e há alguns meses foram detectadas medidas de pressão arterial elevadas em várias consultas médicas. Tem antecedentes de prematuridade, sedentarismo e dieta inadequada, além de história familiar também de obesidade e hipertensão arterial. Discutimos as condutas quanto a investigação da etiologia, da presença de lesões de órgãos alvo e do tratamento. Na evolução, houve controle adequado da pressão arterial após início de inibidores da enzima de conversão da angiotensina, mas grande dificuldade na redução do peso. Ao longo do seguimento, mesmo sob orientações nutricionais e reforço quanto a modificações do estilo de vida, a paciente apresentou ganho ponderal de 25 quilos. Relatamos este caso atendendo a necessidade de discussão do tema frente ao aumento significativo da prevalência de HAS em crianças e adolescente. Existem aspectos multifatoriais para o desenvolvimento da hipertensão arterial na infância, em grande parte associada a um estilo de vida inadequado. As dificuldades relacionadas ao seu manejo a presença de comorbidades, em especial da obesidade, ressaltam a necessidade de uma abordagem multiprofissional para que a evolução do quadro da paciente venha a ser o desejado.

Humans , Female , Child , Sedentary Behavior , Pediatric Obesity , Hypertension/drug therapy , Antihypertensive Agents/therapeutic use
Rev. Univ. Ind. Santander, Salud ; 54(1): e502, Enero 2, 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1407040


Resumen Introducción: La hipertensión arterial sistémica (HTA) constituye el principal factor de riesgo para morbilidad y mortalidad cardiovascular a nivel global, afecta a todas las edades, sin distinción de género y etnicidad. Su tratamiento continúa constituyendo un reto, dada la persistencia del pobre control, especialmente en países como Colombia. Objetivo: Mostrar la evidencia disponible respecto al tratamiento actualizado de la HTA y la elección certera de los agentes antihipertensivos acorde con la individualidad de cada paciente. Asimismo, consolidar y comparar el efecto hipotensor de cada agente antihipertensivo más usado. Metodología: Se realizó una búsqueda avanzada con los términos DeCS y MeSH: hipertensión, agentes antihipertensivos, hipertensión esencial y terapia combinada, en los motores de búsqueda PubMed, Clinical Key, Lilacs, Scielo. Un total de 109 artículos se seleccionaron para elaborar en la presente revisión de la literatura. Conclusiones: La individualización del manejo de la HTA lleva al reconocimiento de los distintos fenotipos, la presencia de complicaciones, el examen físico, el género y la raza como puntos fundamentales para elegir el agente antihipertensivo más adecuado que permita alcanzar las metas de control y propenda por la reducción y prevención de las complicaciones derivadas de un control no óptimo.

Abstract Introduction: Systemic arterial hypertension (HT) constitutes the main risk factor for cardiovascular morbidity and mortality at a global level, affecting all ages regardless of gender and ethnicity. Its treatment continues to be a challenge, given the persistence of poor control, especially in countries like Colombia. Objective: To show the available evidence regarding the updated treatments of HT and the correct choice of antihypertensive agents according to the individual needs of each patient. Likewise, to consolidate and compare the hypotensive effect of the most used antihypertensive agents. Methodology: An advanced search was carried out with the terms DeCS and MeSH: Hypertension, antihypertensive agents, Essential Hypertension and Combination Therapy through the search engines PubMed, Clinical Key, Lilacs, Scielo. A total of 109 articles were selected to prepare the present literature review. Conclusions: An individualized hypertension treatment plan leads to the recognition of the different phenotypes, the presence of complications, the gender, and race, which are fundamental aspects to consider when choosing the appropriate antihypertensive agents. These findings allow for the achievement of the desired blood pressure target and leads to reduction and prevention of complications derived from suboptimal control.

Humans , Male , Female , Essential Hypertension , Hypertension , Antihypertensive Agents
Florianópolis; Secretaria de Estado da Saúde; 20220000. 127 p il. color..
Monography in Portuguese | LILACS, CONASS, ColecionaSUS, SES-SC | ID: biblio-1415287


Este relatório refere-se à análise crítica do documento "Diagnóstico e Tratamento de Hipertensão Pulmonar'', elaborado pela ACAPTI e enviado como proposta para elaboração de Protocolo Estadual de Hipertensão Pulmonar, contemplando o tratamento farmacológico de HP grupo 1 (HAP) e grupo 4 (HPTEC). No documento encaminhado pelo demandante consta uma breve introdução e contextualização da patologia, diagnóstico clínico e exames complementares, critérios de inclusão e exclusão, especialidades médicas, estratificação de risco e seguimento, tratamento medicamentoso, algoritmo de tratamento medicamentoso, acessos aos medicamentos e centros de referência. Os itens relacionados ao diagnóstico foram mantidos neste relatório, conforme o documento enviado pelo demandante. Este relatório visa avaliar e emitir um parecer técnico embasado em evidências científicas sobre a disponibilização do medicamento Selexipague, a disponibilização da terapia combinada (Ambrisentana, Bosentana, Sildenafila, Ilopros a e Selexipague) para o tratamento da HP grupo 1 (HAP), a disponibilização do medicamento Riociguate para tratamento de HP grupo 4 (HPTEC), algoritmo de tratamento medicamentoso e fluxo de acesso aos medicamentos, para posterior elaboração de um Protocolo Estadual para a patologia solicitada. O Protocolo Estadual será elaborado complementarmente ao protocolo do Ministério da Saúde, assim, caso os medicamentos englobados nele sejam incorporados para a patologia em questão pela CONITEC, o fornecimento dos mesmos passa a ser por meio do CEAF.

Humans , Unified Health System , Hypertension, Pulmonary/drug therapy , Antihypertensive Agents/administration & dosage , State Government , Clinical Protocols , Practice Guidelines as Topic
Revue Africaine de Médecine Interne ; 9(2-2): 60-66, 2022. tables
Article in French | AIM | ID: biblio-1433996


Le profil épidémiologique de l'insuffisance rénale chronique (IRC) varie d'un pays à un autre et d'une région à une autre dans un même pays. L'objectif de la présente étude était de décrire les cas d'IRC observés dans la ville de Bouaké. Méthodes : il s'agissait d'une étude rétrospective réalisée dans le service de Médecine Interne du CHU de Bouaké durant la période allant du 1er Janvier 2016 au 31 Décembre 2020. L'IRC était définie par un DFG inférieur à 60 ml/minute évoluant depuis plus de trois mois et/ou une atrophie rénale. Résultats : nous avons recensé 150 cas donnant une prévalence hospitalière de 3,6%. L'âge moyen était de 38,8±10 ans avec une prédominance masculine. Les antécédents étaient dominés par l'automédication traditionnelle et l'hypertension artérielle dans 68% des cas chacun. Dans 91% des cas, l'IRC était classée grade 5. Les étiologies étaient dominées par l'hypertension artérielle (34%). Le traitement symptomatique était la transfusion dans 73% et l'usage des antihypertenseurs dans 73%. Le traitement de suppléance était indiqué dans 91% et réalisé dans 3%. La mortalité était de 25%. Les facteurs associés à la survenue du décès étaient une altération de l'état général, une hypercréatininémie, une hyperphosphorémie, des reins atrophiés et le recours à la transfusion sanguine. Conclusion: l'IRC était diagnostiquée à un stade sévère. La principale cause était l'hypertension artérielle. La mortalité demeure élevée, faute d'accès au traitement de suppléance. L'accent doit être mis sur la prévention de l'IRC au cours des pathologies à risque.

Background: The epidemiological profile of chronic kidney disease (CKD) varies from country to country and from region to region within, even in the same country. The objective of this study was to describe the cases of CKD found in the city of Bouake (Ivory Coast). Methods: We proceeded to a retrospective study carried out in the Internal Medicine department of the Bouake University Hospital from January 1, 2016 till December 31, 2020. CKD was defined by a GFR (Glomerular Filtration Rate) at less than 60 ml/ minute and small kidneys. Results: In all , we identified 150 cases corresponding to 3.6% as hospital prevalence . The mean age was 38 .8 ± 10 years with a male predominance. The history was dominated by traditional self-medication and high blood pressure (HBP) for respectively 68% of cases. In 91% of cases , the CKD was classified as grade 5. The etiologies were dominated by HBP (34%). The care was a symptomatic one using transfusion in 73% and antihypertensive medication was prescribed for 73% of the patients. The substitution treatment was indicated in 91% of cases and carried out in 3%. The rate of mortality was 25 % and factors associated with death were a deterioration of the general condition, increased of blood level of creatininemia, hyperphosphatemia, small size of kidneys and the use of blood transfusion. Conclusion: CKD was diagnosed at a severe stage. The main cause was high blood pressure. Mortality remains high due to lack of access to replacement therapy . Emphasis should be placed on the prevention of CKD in high-risk pathologies

Humans , Male , Female , Adult , Middle Aged , Blood Transfusion , Renal Insufficiency, Chronic , Hypertension , Antihypertensive Agents
China Journal of Chinese Materia Medica ; (24): 1955-1988, 2022.
Article in Chinese | WPRIM | ID: wpr-928192


This study aims to systematically evaluate the effect of oral Chinese patent medicines on hypertension with network Meta-analysis. Randomized controlled trials on the treatment of hypertension with oral Chinese patent medicine combined with conventional western medicine were retrieved from China National Knowledge Infrastructure(CNKI), Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library(from establishment of the database to August 2021). Two researchers independently screened the articles, extracted the data, and evaluated article quality. Then R 4.1.0 was employed for data analysis. Finally, 195 eligible articles were screened out, involving 22 546 patients and 18 oral Chinese patent medicines. The results of the network Meta-analysis are as follows. In terms of reducing systolic blood pressure(SBP) and diastolic blood pressure(DBP), Xuesaitong, Qiangli Dingxuan Tablets, Songling Xuemaikang Capsules combined with conventional western medicine are superior. In improving blood lipids, the overall effects of Xinmaitong Capsules, Compound Xueshuantong Capsules, Ginkgo Folium preparations, Yindan Xinnaotong Soft Capsules, and Naoxintong Capsules combined with conventional western medicine are outstanding. In terms of regulating endothelial function, Yindan Xinnaotong Soft Capsules, Xinmaitong Capsules, Zhenju Jiangya Tablets, Compound Danshen Dripping Pills, Xuesaitong with conventional western medicine have certain advantages. As for the safety, the incidence of adverse reactions of conventional western medicine combined with oral Chinese patent medicines is lower than that of conventional western medicine alone. In summary, compared with conventional western medicine alone, the 18 oral Chinese patent medicines combined with conventional western medicine in the treatment of hypertension show advantages in improving blood pressure, blood lipids, and endothelial function. Among them, Xuesaitong, Qiangli Dingxuan Tablets, and Songling Xuemaikang Capsules may be the best oral Chinese patent medicines for lowering blood pressure. The conclusion needs to be further verified by more high-quality studies.

Humans , Antihypertensive Agents , Capsules , Drugs, Chinese Herbal/adverse effects , Hypertension/drug therapy , Network Meta-Analysis , Nonprescription Drugs
Chinese Journal of Cardiology ; (12): 1169-1176, 2022.
Article in Chinese | WPRIM | ID: wpr-969723


Objective: To estimate the prevalence, awareness, treatment and control rate of hypertension among young and middle-aged population in China. Methods: The analysis was based on the results of 2012-2015 China Hypertension Survey, which was a cross-sectional stratified multistage random sampling survey. A total of 229 593 subjects were included in the final analysis. The data including sex, age, living in urban and rural areas, prevalence of hypertension, history of stroke, family history of coronary heart disease and drinking, physical examination, heart rate were collected. Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mmHg (1 mmHg=0.133 kPa), and (or) diastolic blood pressure (DBP) ≥90 mmHg, and (or) self-report a history of hypertension, and (or) use of antihypertensive medicine within 2 weeks before survey. Prehypertension was defined as SBP between 120-139 mmHg, and (or) DBP between 80-89 mmHg. Control of hypertension was considered for hypertensive individuals with SBP<140 mmHg and DBP<90 mmHg. The prevalence of prehypertension, hypertension, awareness, treatment, control rate were calculated, and the control rate among those with antihypertensive medication was also calculated. Results: The prevalence of prehypertension and hypertension was 43.8% (95%CI: 42.3%-45.4%), and 22.1% (95%CI: 20.8%-23.3%), respectively. The prevalence of prehypertension and hypertension was significantly higher among male than female across different age groups. The awareness, treatment, control rate of hypertension and control rate among treated hypertensive participants were 43.8%, 33.2%, 16.7%, and 40.2%, respectively. The prevalence was higher, and the control rate was lower among individuals with higher heart rate. Conclusion: The prevalence of prehypertension and hypertension among young and middle-aged population is high, the awareness, treatment and control rate need to be further improved in this population. The prevention and treatment of hypertension should be strengthened in the future to improve the control rate of hypertension in China.

Middle Aged , Male , Female , Humans , Antihypertensive Agents/therapeutic use , Prehypertension/epidemiology , Prevalence , Cross-Sectional Studies , Hypertension/drug therapy , Blood Pressure , China/epidemiology