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1.
Rev. cuba. med ; 60(3): e1661, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1347503

ABSTRACT

Hemos leído con gran atención el artículo de los autores González Rey y otros, titulado: Disfunción endotelial en una etapa precoz del diagnóstico de hipertensión arterial. Resulta muy interesante el tratamiento de un tema básico de gran interés en la clínica a través del uso de biomarcadores casi siempre a la disposición de nuestros profesionales de la salud en los diferentes niveles de atención como resulta ser el caso de la microalbuminuria.1 El endotelio resulta cada vez de mayor interés para investigadores y médicos de asistencia, pues es el punto de confluencia de las enfermedades vasculares, metabólicas y neurodegenerativas, y es el primer eslabón en el desarrollo de la aterosclerosis. Se conoce que los diferentes factores involucrados en la activación y daño endotelial como las altas concentraciones de ácido úrico,2 los niveles elevados de ácidos grasos,3 el envejecimiento4 y la hiperglicemia,5 son los mismos que contribuyen a posteriori con el desarrollo y las complicaciones de la placa de ateroma. Vale destacar el aporte...(AU)


Subject(s)
Humans , Endothelium/physiopathology , Essential Hypertension/epidemiology
2.
rev. cuid. (Bucaramanga. 2010) ; 12(3): 1-13, 20210821.
Article in Spanish | LILACS, BDENF, COLNAL | ID: biblio-1343577

ABSTRACT

Introducción. El Beliefs about Medicines Questionnaire (BMQ) permite valorar las representaciones cognitivas que engloban las creencias sobre la medicación de los pacientes, sobre tomar medicamentos para su enfermedad en diferentes culturas. Objetivo. Determinar la validez de constructo y confiabilidad del cuestionario BMQ adaptado a pacientes hipertensos colombianos. Materiales y métodos. Estudio psicométrico de tipo instrumental, realizado en una muestra de 238 pacientes hipertensos en edad promedio de 65 años (DE= 11,4) con predominio del sexo femenino (70%). La validez de constructo se evaluó mediante Análisis Factorial Exploratorio y Confirmatorio. Se calculó la confiabilidad utilizando el método coeficiente de alfa de Cronbach. Resultados. Se obtuvo una versión reducida de 16 ítems; en la sección BMQ-General los 7 ítems se agruparon en dos factores que explicó el 64% de la varianza común y buen ajuste (χ2= 61.46; gl = 13; p = 0.000; CFI = 0.917; NNFI = 0.89; CFI=0.917; SRMR=0.054; RMSEA = 0.125; IC 90% [0,10, 0,16]). En el BMQ-Específico los 9 ítems agrupados en dos factores que explicaron el 63,17% de la varianza común con un ajuste aceptable (χ2 = 122.4; gl = 26; p = 0.000; CFI = 0.88; NNFI = 0.84; CFI=0.88; SRMR=0.106; RMSEA = 0.125; IC 90% [0.10, 0.15]). La confiabilidad por alfa de Cronbach para el BMQ-General y Específico fue de 0.82 y 0.78 respectivamente. Discusión y conclusiones. La versión del BMQ adaptada a pacientes hipertensos colombianos, poseen características psicométricas adecuadas, su uso es recomendado en la investigación.


Introduction. The Beliefs about Medicines Questionnaire (BMQ) allows the assessment of cognitive representations encompassing patients' medication beliefs about taking medication for their disease in different cultures. Objective. To determine the construct validity and reliability of the BMQ questionnaire adapted to Colombian hypertensive patients. Materials and methods. An instrumental psychometric study was carried out in a sample of 238 hypertensive patients with an average age of 65 years (SD= 11.4), with a predominance of women (70%). Construct validity was assessed by exploratory and confirmatory factor analysis. Reliability was calculated using Cronbach's alpha coefficient method. Results. A reduced version of 16 items was obtained; in the BMQ-General section the 7 items were grouped into two factors that explained 64% of the common variance and good fit (χ2= 61.46; gl = 13; p = 0.000; CFI = 0.917; NNFI = 0.89; CFI=0.917; SRMR=0.054; RMSEA = 0.125; IC 90% [0,10, 0,16]). In the BMQ-Specific the 9 items grouped into two factors explained 63.17% of the common variance with an acceptable fit (χ2 = 122.4; gl = 26; p = 0.000; CFI = 0.88; NNFI = 0.84; CFI=0.88; SRMR=0.106; RMSEA = 0.125; IC 90% [0.10, 0.15]). The Cronbach's alpha reliability for the BMQ-General and Specific was 0.82 and 0.78, respectively. Discussion and conclusions. The version of the BMQ adapted to Colombian hypertensive patients has adequate psychometric characteristics and its use is recommended in research.


Introdução. O Beliefs About Nedicines Questionnaire (BMQ) permite a avaliação de representações cognitivas abrangendo as crenças dos pacientes sobre os de medicamentos e seu uso para suas doenças em diferentes culturas. Objetivo. Determinar a validade de constructo e a confiabilidade do questionário BMQ adaptado a pacientes hipertensos colombianos. Materiais e métodos. Foi realizado um estudo psicométrico instrumental em uma amostra de 238 pacientes hipertensos com idade média de 65 anos (DE = 11,4), com predominância de mulheres (70%). A validade de constructo foi avaliada mediante Análise Fatorial Exploratória e Confirmatória de Fatores. A confiabilidade foi calculada usando o método do coeficiente alfa de Cronbach. Resultados. Uma versão reduzida de 16 itens foi obtida; na seção BMQ-General os 7 itens foram agrupados em dois fatores que explicaram 64% da variância comum e bom ajuste (χ2= 61.46; gl = 13; p = 0.000; CFI = 0.917; NNFI = 0.89; CFI=0.917; SRMR=0.054; RMSEA = 0.125; IC 90% [0,10, 0,16]). No BMQ-Específico os 9 itens agrupados em dois fatores explicaram 63,17% da variância comum com um ajuste aceitável (χ2 = 122.4; gl = 26; p = 0.000; CFI = 0.88; NNFI = 0.84; CFI=0.88; SRMR=0.106; RMSEA = 0.125; IC 90% [0.10, 0.15]).. A confiabilidade alfa de Cronbach para o BMQ-General e Específico foi de 0,82 e 0,78 respectivamente. Discussão e conclusões. A versão do BMQ adaptada aos pacientes hipertensos colombianos tem características psicométricas adequadas e seu uso é recomendado na pesquisa.


Subject(s)
Humans , Male , Female , Psychometrics , Cardiovascular Diseases , Culture , Validation Study , Essential Hypertension
3.
Av. enferm ; 39(2): 215-224, 01 may 2021.
Article in Spanish | LILACS, BDENF, COLNAL | ID: biblio-1290999

ABSTRACT

Objetivo: determinar la validez de constructo y la consistencia interna del instrumento Self-Care of Hypertension Inventory (SC-HI v.2.0), traducido al español, en adultos colombianos con hipertensión arterial. Materiales y métodos: estudio de tipo metodológico en el que se realizó traducción, adaptación cultural y validez de contenido mediante juicio de expertos. Con una muestra de 290 personas hipertensas, se determinó la validez de constructo mediante análisis factorial exploratorio (análisis de componentes principales con rotación Varimax con normalización Kaiser) y confirmatorio (análisis de máxima verosimilitud). La consistencia interna se calculó a través del coeficiente alfa de Cronbach. Resultados: en la escala Mantenimiento del autocuidado resultó una estructura de dos factores (varianza acumulada 61 %) con buen ajuste (χ2 = 104,570; p = 0,000; RMSEA = 0,125; SRMR = 0,156; CFI = 0,856; NNFI = 0,767). En Gestión del autocuidado se obtuvo una estructura bifactorial (varianza acumulada 71 %) igualmente con buen ajuste (χ2 = 6,598; p = 0,582; RMSEA = 0,000; SRMR = 0,072; CFI = 1,000; NNFI = 1,032). En Confianza resultó una estructura bifactorial (varianza acumulada 82%) también con buen ajuste (χ2 = 94,991; p = 0,000; RMSEA = 0,194; SRMR = 0,106; CFI = 0,934; NNFI = 0,876). El alfa de Cronbach para mantenimiento (0,64), gestión (0,70) y confianza (0,86) fue aceptable. Conclusiones: el SC-HI v.2.0 versión español colombiano posee propiedades psicométricas adecuadas, por lo que su uso es recomendado en la investigación para medir el autocuidado en poblaciones con características similares.


Objetivo: determinar a validade de construto e a consistência interna do instrumento Escala de Autocuidado de Hipertensão (SC-HI v.2.0) traduzido para o espanhol, em adultos colombianos com hipertensão arterial. Materiais e métodos: estudo metodológico em que se realizou tradução, adaptação cultural e validade de conteúdo por meio do julgamento de especialistas. Com uma amostra de 290 hipertensos, a validade de construto foi determinada mediante análise fatorial exploratória (análise de componentes principais com rotação Varimax com normalização Kaiser) e confirmatória (análise de máxima verossimilhança). A consistência interna foi calculada por meio do coeficiente alfa de Cronbach. Resultados: a escala de manutenção do autocuidado resultou em uma estrutura de dois fatores (variância acumulada 61 %), com bom ajuste (χ2 = 104,570; p = 0,000; RMSEA = 0,125; SRMR = 0,156; CFI = 0,856; NNFI = 0,767). Na gestão do autocuidado, foi obtida uma estrutura bifatorial (variância acumulada 71 %), com bom ajuste (χ2 = 6,598; p = 0,582; RMSEA = 0,000; SRMR = 0,072; CFI = 1,000; NNFI = 1,032). Na confiança, resultou uma estrutura bifatorial (variância acumulada 82 %), com bom ajuste (χ2 = 94,991; p = 0,000; RMSEA = 0,194; SRMR = 0,106; CFI = 0,934; NNFI = 0,876). O alfa de Cronbach para manutenção (0,64), gerenciamento (0,70) e confiança (0,86) foi aceitável. Conclusões: o SC-HI v.2.0 versão em espanhol variante colombiana apresenta propriedades psicométricas adequadas, portanto seu uso é recomendado em pesquisas para mensurar o autocuidado em populações com características semelhantes às do presente estudo.


Objective: To determine the construct validity and internal consistency of the instrument Self- Care of Hypertension Inventory (SC-HI v.2.0) translated into Spanish in Colombian adults with arterial hypertension. Materials and methods: Methodological study in which translation, cultural adaptation and content validity were carried out through expert judgment. With a sample of 290 hypertensive individuals, construct validity was determined by exploratory (principal component analysis with Varimax rotation with Kaiser normalization) and confirmatory factor analysis (maximum likelihood analysis). Internal consistency was calculated through Cronbach's alpha coefficient. Results:The self-care maintenance scale resulted in a two-factor structure (accumulated variance 61%) with good fit (χ2 = 104.570; p = 0.000; RMSEA = 0.125; SRMR = 0.156; CFI = 0.856; NNFI = 0.767). Self-care management reported a bifactorial structure (accumulated variance 71%) with good fit (χ2 = 6.598; p = 0.582; RMSEA = 0.000; SRMR = 0.072; CFI = 1.000; NNFI = 1.032). Finally, confidence scale also resulted in a bifactorial structure (accumulated variance 82%) with good fit (χ2 = 94.991, p = 0.000; RMSEA = 0.194; SRMR = 0.106; CFI = 0.934; NNFI = 0.876). Cronbach's alpha for maintenance (0.64), management (0.70), and confidence (0.86) was acceptable. Conclusions: The SC-HI v.2.0 in Spanish has adequate psychometric properties. Therefore, its use is recommended in research studies aimed at measuring self-care in populations with similar characteristics to that addressed in this study.


Subject(s)
Humans , Psychometrics , Self Care , Cardiovascular Diseases , Validation Study , Essential Hypertension
4.
Clinics ; 76: e2233, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153991

ABSTRACT

OBJECTIVES: To explore the risk factors of essential hypertension with hyperhomocysteinemia (H-type hypertension) and design a nomogram to predict this risk. METHODS: A hospital-based study was conducted on 1,712 individuals, including 282 patients with H-type hypertension, 105 patients with simple hypertension, 645 individuals with hyperhomocysteinemia, and 680 healthy controls. Logistic regression and nomogram models were applied to evaluate the risk factors. RESULTS: Logistic regression showed that advanced age, male sex, high body mass index (BMI), high total cholesterol levels, high glucose levels, and high creatinine levels were risk factors of H-type hypertension in the healthy population and were integrated into the nomogram model. Advanced age, male sex, high BMI, high total cholesterol levels, and high glucose levels were shown to be risk factors of H-type hypertension in the hyperhomocysteinemia population. Male sex and high creatinine levels were shown to be risk factors of H-type hypertension in the hypertension population. Nomogram analysis showed that the total factor score ranged from 106 to 206, and the corresponding risk rate ranged from 0.05 to 0.95. CONCLUSIONS: Men are more likely to have H-type hypertension, and advanced age, high BMI, high total cholesterol levels, and high glucose levels are risk factors of H-type hypertension in healthy and hyperhomocysteinemia populations. Furthermore, high creatinine level is a risk factor of H-type hypertension in healthy and hypertension populations. Nomogram models may be used to intuitively evaluate H-type hypertension risk and provide a basis for personalized interventions.


Subject(s)
Humans , Male , Hyperhomocysteinemia/complications , Hyperhomocysteinemia/epidemiology , Hypertension/complications , Hypertension/epidemiology , Risk Factors , Nomograms , Essential Hypertension , Hospitals
5.
Article in Chinese | WPRIM | ID: wpr-878995

ABSTRACT

To evaluate the efficacy and safety of Songling Xuemaikang Capsules combined with conventional Western medicine in the treatment of essential hypertension. PubMed, VIP, CNKI, Wanfang and other databases were retrieved from the establishment of the database to February 2020 for clinical randomized controlled trial(RCT) about Songling Xuemaikang Capsules combined with conventional Western medicine in the treatment of essential hypertension. The literatures were screened out according to the inclusion criteria, and RevMan 5.3 software was used for Meta-analysis. A total of 3 100 patients in 27 RCTs were enrolled. According to Meta-analysis, Songling Xuemaikang Capsules combined with conventional Western medicine could effectively reduce systolic blood pressure(MD=-7.88,95%CI[-9.68,-6.08],P<0.000 01) and diastolic blood pressure(MD=-7.85, 95%CI[-9.07,-6.62], P<0.000 01), triglyceride(MD=-0.46, 95%CI[-0.66,-0.26], P<0.000 01) and total cholesterol(MD=-0.92, 95%CI[-1.49,-0.35], P=0.001), but increase HDL cholesterol(MD=0.51, 95%CI[0.28, 0.73], P<0.000 01), with a better effect than the Western medicine group alone. The results of LDL-C analysis showed that there was no significant difference between the two groups(MD=-0.91, 95%CI[-1.82, 0.01], P=0.05). The subgroup analysis suggested that reduced systolic blood pressure may be related to the use of ARB. There was a close correlation between CCB drugs and the decrease of diastolic blood pressure. In addition, there was no significant difference in the compliance and the incidence of adverse reactions. Clinical application of Songling Xuemaikang Capsules combined with Western medicine in the treatment of patients with essential hypertension has clear efficacy and certain safety. More clinical randomized controlled trials are needed for verification in the future.


Subject(s)
Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Capsules , Drugs, Chinese Herbal , Essential Hypertension/drug therapy , Humans
6.
Article in English | WPRIM | ID: wpr-880669

ABSTRACT

OBJECTIVES@#To investigate the level and significance of serum γ-glutamyl transferase-to-platelet ratio (GPR) and monocyte count to high-density lipoprotein ratio (MHR) in patients with essential hypertension (EH) and unstable angina (UA).@*METHODS@#A total of 218 patients with coronary angiography aged ≥60 years, who were admitted to the EH hospital of the Department of Cardiac Medicine, Affiliated Hospital of Chengde Medical College, were selected from September 2018 to September 2019. They were divided into an EH+UA group (@*RESULTS@#Compared with the control group, patients in the EH+UA group and the EH group had higher body mass index (BMI), tyiglyceride (TG), GPR, and MHR, and lower high-density lipoprotein-cholesterol (HDL-C) (all @*CONCLUSIONS@#There is a correlation between GPR, MHR and EH combined with UA pectoris, and the combined detection of the two indicators has adjuvant diagnostic value for elderly EH combined with UA.


Subject(s)
Aged , Angina, Unstable , Cholesterol, HDL , Coronary Angiography , Essential Hypertension , Humans , Lipoproteins, HDL , Monocytes
7.
Article in Chinese | WPRIM | ID: wpr-879060

ABSTRACT

To find the status of outcome indicators reported in published randomized controlled trial(RCT) of traditional Chinese medicine(TCM) for essential hypertension in the past two years, we searched for relevant information from four Chinese databases, three English databases and two clinical trial registries in this study, from January 2018 to September 2019. The outcome indicators of RCT were extracted and categorized from trials and the risk of bias was assessed by ROB tools from the Cochrane Collaboration. A total of 125 RCTs and 15 RCT protocols were finally included after study screening. The results showed that the RCT outcomes mainly included efficacy and safety outcomes. Efficacy indicators mainly included blood pressure measurement, quality of life assessment, blood biochemical indicators, urine analysis, arterial ultrasound, vascular endothelial function indicators, hematocrit, hemorheology indicators and other indicators. The safety indicators mainly included general physical examination items, heart, liver and kidney function tests, blood, urine, and stool routine examinations as well as adverse drug reactions/events. The current RCTs cannot distinguish primary and secondary outcomes, and the RCT protocols didn't report efficacy criteria clearly. They both didn't report health economic indicators and the methodological qualities were relatively low. In view of the current status on outcome indicators reported in TCM RCTs, constructing a core outcome set of TCM for essential hypertension and improving the methodology quality of RCTs will help to accurately reflect the actual efficacy of TCM intervention.


Subject(s)
Endpoint Determination , Essential Hypertension , Humans , Medicine, Chinese Traditional , Quality of Life , Randomized Controlled Trials as Topic , Treatment Outcome
8.
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
9.
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
10.
Rev. cuba. med ; 59(2): e1351, abr.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139047

ABSTRACT

Introducción: Las enfermedades cardiovasculares de mayor prevalencia y la hipertensión arterial tienen como sustento la aterosclerosis y la disfunción endotelial. La evaluación no invasiva de aterosclerosis subclínica constituye un complemento para la estratificación del riesgo cardiovascular en la evaluación del paciente hipertenso. Objetivo: Determinar la utilidad del diámetro basal de la arteria braquial en la evaluación del paciente con hipertensión arterial esencial. Método: Se realizó un estudio transversal analítico que incluyó 30 pacientes con hipertensión arterial esencial, a quienes se les realizó ultrasonografía para medir el diámetro basal de la arteria braquial, la vasorreactividad dependiente del endotelio y el grosor íntima media carotídeo, así como se precisó su riesgo cardiovascular, el tiempo de evolución y grado de la hipertensión arterial. Para determinar la asociación entre el diámetro arterial y el resto de las variables se utilizaron pruebas estadísticas como ANOVA de una vía y el coeficiente de correlación de Pearson. Resultados: La disfunción endotelial estuvo presente en 83,3 por ciento de los pacientes estudiados. Tanto el grosor del complejo íntima media carotídeo como la vasorreactividad dependiente del endotelio fueron adecuados marcadores de la enfermedad aterosclerótica. El diámetro basal de la arteria braquial tuvo una correlación inversa con la vasorreactividad dependiente del endotelio, y mostró valores medios esperados en relación a la presencia del tabaquismo, y con los peores grados de la enfermedad hipertensiva y el riesgo cardiovascular. Conclusiones: El diámetro basal de la arteria braquial no mostró la asociación esperada para la evaluación del paciente hipertenso esencial en la población estudiada(AU)


Introduction: The most prevalent cardiovascular diseases and high blood pressure are supported by atherosclerosis and endothelial dysfunction. The non-invasive assessment of subclinical atherosclerosis complements the cardiovascular risk stratification when evaluating hypertensive patients. Objective: To determine the value of the basal diameter of the brachial artery in assessing patients suffering from essential arterial hypertension. Method: An analytical cross-sectional study was carried out in 30 patients with essential arterial hypertension. They underwent ultrasonography to measure the basal diameter of the brachial artery, endothelium-dependent vasoreactivity and carotid mean intima thickness, as well as the cardiovascular risk, time of evolution and degree of arterial hypertension. Statistical tests such as one-way ANOVA and Pearson's correlation coefficient were used to determine the association between arterial diameter and the rest of the variables. Results: Endothelial dysfunction was present in 83.3% of the studied patients. Both the thickness of the carotid media intima complex and endothelium-dependent vasoreactivity were adequate markers for atherosclerotic disease. The basal diameter of the brachial artery had inverse correlation with endothelium-dependent vasoreactivity, and it showed expected mean values in relation to the presence of smoking, and with the worst degrees of hypertensive disease and cardiovascular risk. Conclusions: The basal diameter of the brachial artery did not show the expected association for the evaluation of essential hypertensive patients in the studied population(AU)


Subject(s)
Humans , Male , Female , Ultrasonics/methods , Brachial Artery/growth & development , Essential Hypertension/diagnosis , Patients , Cross-Sectional Studies
11.
Rev. cuba. med ; 59(1): e1327, ene.-mar. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139038

ABSTRACT

Introducción: El índice glucemia-triglicéridos se utiliza para el diagnóstico presuntivo de la resistencia insulínica, que en los pacientes hipertensos se relaciona con la severidad de la hipertensión arterial. Objetivo: Determinar la utilidad del índice glucemia-triglicéridos como marcador de resistencia a la insulina en pacientes adultos con diagnóstico de hipertensión arterial esencial. Métodos: Se realizó un estudio descriptivo transversal en 232 pacientes con diagnóstico de hipertensión arterial esencial. Se calculó el índice glucemia-triglicéridos y se comparó con el índice HOMA. Para este análisis se utilizó la curva ROC, la correlación de Pearson y el Índice de Kappa, se consideró significativo un valor de p menor a 0,05. Resultados: Se obtuvo un punto de corte de 8,1 que mostró una sensibilidad de 98,6 con una especificidad de 41,4. La curva ROC mostró un área bajo la curva con valor de 0,694 ≈ 0,7. Se observó correlación positiva (p=0,008) Índice de Kappa=88,4 por ciento. Conclusiones: El índice glucemia-triglicéridos resulto ser útil en pacientes con hipertensión arterial como marcador de resistencia a la insulina con un punto de corte de 8,1(AU)


Introduction: The glycemia-triglyceride index is used for the presumptive diagnosis of insulin resistance, which in hypertensive patients is related to the severity of high blood pressure. Objective: To determine the utility of the glycemia-triglyceride index as a marker of insulin resistance in adult patients diagnosed with essential arterial hypertension. Methods: A descriptive cross-sectional study was carried out in 232 patients diagnosed with essential arterial hypertension. The glycemia-triglyceride index was calculated and compared with HOMA index. For this analysis, ROC curve, Pearson correlation and Kappa index were used, p value less than 0.05 was considered significant. Results: We obtained an 8.1 cut-off point, showing 98.6 sensitivity and 41.4 specificity. The area below the ROC curve showed 0.694 ≈ 0.7 value. Positive correlation was observed (p = 0.008). Kappa index = 88.4 percent. Conclusions: The glycemia-triglyceride index turned out to be useful in patients with essential hypertension as a marker of insulin resistance with a cut-off point of 8.1(AU)


Subject(s)
Humans , Male , Female , Insulin Resistance/physiology , Glycemic Index/physiology , Essential Hypertension/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies
12.
Article in Chinese | WPRIM | ID: wpr-826689

ABSTRACT

OBJECTIVE@#To compare the infuences on circadian rhythm of blood pressure in the patients with non-dipper essential hypertension between the combined treatment of time acupuncture and western medication and the simple western medication.@*METHODS@#A total of 70 patients with non-dipper essential hypertension were randomized into an acupuncture plus western medication group (35 cases, 2 cases dropped out) and a western medication group (35 cases). In the western medication group, levamlodipine maleate tablets were taken orally, 2.5 mg each time, once daily. In the acupuncture plus western medication group, on the base of the treatment as the western medication group, acupuncture was applied specially in the period of the day from 7:00 am to 9:00 am. The acupoints included Fengchi (GB 20), Zhongwan (CV 12), Tianshu (ST 25), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), etc. Acupuncture was given once daily, 5 treatments a week. The duration of treatment in the two groups was 4 weeks. The clinic blood pressure before and after treatment, 24 h ambulatory blood pressure and the levels of serum melatonin (MT) and 5-serotonin (5-HT) were observed in the two groups.@*RESULTS@#The total effective rate of anti-hypertension was 75.8% (25/33) in the acupuncture plus western medication group, better than 54.3% (19/35) in the western medication group (<0.05). The 24 h average systolic blood pressure, the daytime average systolic blood pressure, the daytime average diastolic pressure, and the nighttime average systolic blood pressure were all reduced after treatment in the two groups (<0.05). The reduction effect of the aforementioned 4 indexes in the acupuncture plus western medication group was much more obvious as compared with the western medication group (<0.05). After treatment, the serum level of MT was increased and 5-HT decreased in the patients of two groups (<0.05). The serum level of MT in the acupuncture plus western medication group was higher than that in the western medication group and the level of 5-HT was lower than the western medication group (<0.05).@*CONCLUSION@#Time acupuncture therapy in the period of the day from 7:00 am to 9:00 am, combined with western medication effectively reduce blood pressure and regulate the levels of serum MT and 5-HT so as to maintain the circadian rhythm of blood pressure in patients with non-dipper essential hypertension. The therapeutic effect of this combined treatment is superior to simple western medication.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Blood Pressure , Blood Pressure Monitoring, Ambulatory , Circadian Rhythm , Essential Hypertension , Therapeutics , Humans , Periodicity
13.
Cambios rev. méd ; 18(2): 13-17, 2019/12/27. tabs.
Article in Spanish | LILACS | ID: biblio-1097601

ABSTRACT

INTRODUCCIÓN. El hipotiroidismo e hipertiroidismo, constituyen patologías tiroideas, que si no reciben tratamiento apropiado llegan a provocar alteraciones sistémicas, siendo una de las principales las cardiovasculares. OBJETIVO. Conocer la influencia que tiene el hipotiroidismo e hipertiroidismo como factores de riesgo para el desarrollo de enfermedad cardiovascular. MATERIALES Y MÉTODOS. Estudio retrospectivo de enfoque cuantitati-vo; desarrollado en una población y muestra conocida de 111 pacientes, que acudieron al Servicio de Endocrinología del Hospital Manuel Ygnacio Monteros Valdivieso de la ciudad de Loja, atendidos en el año 2015. RESULTADOS. Predominó el sexo femenino, con un 20,72% (23; 69) en el grupo etario de 61 a 70 años de las pacientes hipotiroideas; y las de 51 a 60 años en 5,40% (6; 11) de las hipertiroideas. De acuerdo a los parámetros que pue-den condicionar mayor riesgo cardiovascular, el sobrepeso y obesidad presentaron una mayor frecuencia para hipotiroidismo en 67,70% (65; 111) e hipertiroidismo en un 66,67% (10; 111). El riesgo bajo cardiovascular prevaleció en 75,00% (72; 96) de la población hipo-tiroidea y 93,33% (14; 15) de la hipertiroidea. La hipertensión arterial fue la patología car-diovascular diagnosticada con mayor frecuencia sobre todo en los pacientes hipotiroideos representado por el 14,58% (14; 19). CONCLUSIÓN. Estas patologías, de no controlarse pudieran condicionar en la población de estudio un mayor riesgo cardiovascular.


INTRODUCTION. Hypothyroidism and hyperthyroidism, constitute thyroid pathologies, that if they do not received appropriate treatment, cause systematic alterations, treatment, cause systematic cardiovascular diseases being one of the main ones. OBJECTIVE. Know the influence of hypothyroidism and hyperthyroidism as risk factors for the development of cardiovascular disease. MATERIALS AND METHODS. Retrospective study of quantitative approach; developed in a population and known sample of 111 patients, who went to the Endocrinology Service of the Manuel Ygnacio Monteros Valdivieso Hospital in the city of Loja, attended in 2015. RESULTS. The female sex predominated, with 20,72% (23; 69) in the age group predominated 61 to 70 years of age in 5,40% (6; 11) of hyperthyroids. According to the parameters that may condition higher cardiovascular risk, overweight and obesity presented a higher frequency for hypothyroidism in 67,70% (65; 111) and hyperthyroidism in 66,67% (10; 111). Low cardiovascular risk prevailed in 75,00% (72; 96) of the hypothyroid population and 93,33% (14; 15) of the hyperthyroid population. Arterial hypertension was the most frequently diagnosed cardiovascular disease, especially in hypothyroid patients by 14,58% (14; 19). CONCLUSION. These pathologies, if not controlled, could condition a higher cardiovascular risk in the study population.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cardiovascular Diseases , Body Mass Index , Risk Factors , Essential Hypertension , Hyperthyroidism , Hypothyroidism , Thyroid Diseases , Hypertriglyceridemia , Overweight , Hypercholesterolemia , Obesity
14.
Invest. educ. enferm ; 37(3): [E09], 15 Octubre 2019. Tab 1, Tab 2
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1023498

ABSTRACT

Objective. To determine the validity and reliability of the Treatment Adherence Questionnaire for Patients with Hypertension (TAQPH), Spanish version, designed by Chunhua Ma et al. Methods. This study was carried out in the city of Ibagué (Colombia) and the test validation determined validity (face, content, and construct) and reliability. Face and content validity were conducted through expert judgment, using Fleiss' Kappa Coefficient statistical tests and modified Lawshe's content validity index. The construct validity and the reliability test had the participation of 220 people with diagnosis of primary hypertension. Reliability was calculated through Cronbach's alpha statistical test. Results. In the face validity, the instrument reported a Fleiss' Kappa index was 0.68 in comprehension, 0.76 in clarity, and 0.64 in accuracy, interpreted as a substantial agreement. The content validity index was satisfactory with 0.91; el exploratory factor analysis reported six factors with a total variance explained of 54%. Cronbach's alpha for the total scale was 0.74. Conclusion. The Spanish version of the TAQPH is a valid and reliable scale to evaluate adherence to treatment in patients with primary hypertension.


Objetivo: Determinar la validez y confiabilidad del cuestionario para medir la adherencia al tratamiento en pacientes con hipertensión arterial (Treatment Adherence Questionnaire for Patients with Hypertension - TAQPH), versión en español, diseñado por Chunhua Ma et al. Métodos. Estudio de validación de pruebas realizado en la ciudad de Ibagué (Colombia) en el que se determinó la validez (facial, de contenido y de constructo) y la confiabilidad. La validez facial y de contenido se efectuó mediante el juicio de expertos, utilizando las pruebas estadísticas de Coeficiente Kappa de Fleiss e índice de Lawshe modificado. En la validez de constructo y prueba de confiabilidad participaron 220 personas con diagnóstico de hipertensión arterial. La confiabilidad se calculó mediante la prueba estadística de alfa de Cronbach. Resultados. En la validez facial, el instrumento reportó un índice de Kappa de Fleiss de 0.68 en comprensión, 0.76 en claridad y 0.64 en precisión, interpretado como un acuerdo sustancial. El índice de validez de contenido fue satisfactorio con 0.91. El análisis factorial exploratorio reportó seis factores con una varianza total explicada de 54%. El alfa de Cronbach fue de 0.74 para la escala total. Conclusión. La versión en español del TAQPH es una escala válida y confiable para la evaluación de la adherencia al tratamiento en pacientes con hipertensión arterial.


Objetivo: Determinar a validez e confiabilidade do questionário para medir a aderência ao tratamento em pacientes com hipertensão arterial (Treatment Adherence Questionnaire for Patients with Hypertension - TAQPH), versão em espanhol, desenhado por Chunhua Ma et al. Métodos. Estudo de validação de provas que se realizou na cidade de Ibagué (Colômbia) no qual se determinou a validez (facial, de conteúdo e de construto) e a confiabilidade. A validez facial e de conteúdo se efetuou mediante o juízo de especialistas, utilizando as provas estatísticas de Coeficiente Kappa de Fleiss e índice de Lawshe modificado. Na validez de construto e prova de confiabilidade participaram 220 pessoas com diagnóstico de hipertensão arterial. A confiabilidade se calculou mediante a prova estatística de alfa de Cronbach. Resultados. Na validez facial, o instrumento reportou um índice de Kappa de Fleiss de 0.68 em compreensão, 0.76 em claridade e 0.64 em precisão, interpretado como um acordo substancial. O índice de validez de conteúdo foi satisfatório com 0.91, a análise fatorial exploratório reportou seis fatores com uma variação total explicada de 54%. O alfa de Cronbach foi de 0.74 para a escala total. Conclusão. A versão em espanhol de TAQPH é uma escala válida e confiável para a avaliação da aderência ao tratamento em pacientes com hipertensão arterial.


Subject(s)
Humans , Psychometrics , Surveys and Questionnaires , Validation Study , Essential Hypertension , Treatment Adherence and Compliance
16.
Chinese Acupuncture & Moxibustion ; (12): 1160-1163, 2019.
Article in Chinese | WPRIM | ID: wpr-776196

ABSTRACT

OBJECTIVE@#To observe the effect of acupuncture at Renying (ST 9) on morning blood pressure, daytime peak blood pressure and 24-hour blood pressure load in patients with ischemic stroke complicated with essential hypertension.@*METHODS@#A total of 80 patients (3 cases dropped off) were randomized into an observation group (39 cases) and a control group (38 cases). acupuncture and nifedipine were given in the control group. On the basis of treatment in the control group, acupuncture at Renying (ST 9) was applied in the observation group, once a day, 6 times a week for 4 weeks. The changes of morning blood pressure, daytime peak blood pressure and blood pressure load were observed before and after treatment in the two groups.@*RESULTS@#Compared before treatment, morning blood pressure, daytime peak blood pressure and blood pressure load after treatment were reduced in the two groups (all 0.05); the changes of morning diastolic pressure, daytime peak blood pressure and blood pressure load in the observation group were larger than those in the control group (all <0.05).@*CONCLUSION@#On the basis of acupuncture and nifedipine, acupuncture at Renying (ST 9) can effectively reduce morning blood pressure, daytime peak blood pressure and blood pressure load in patients with ischemic stroke complicated with essential hypertension.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Methods , Blood Pressure , Brain Ischemia , Essential Hypertension , Therapeutics , Humans , Stroke , Treatment Outcome
17.
Article in Chinese | WPRIM | ID: wpr-775905

ABSTRACT

The relevant literature of pathogenesis of essential hypertension (EH) and the clinical efficacy of acupuncture treatment of EH was retrieved from January 1, 1999 to February 28, 2018 in the CNKI and PubMed databases, and aimed to summarize and explore the mechanism of antihypertensive by acupuncture.It has been found that acupuncture exerts antihypertensive effect by coordinating multi-system, multi-target, multi-layer adjustment mechanism, such as acupuncture inhibiting of central and peripheral sympathetic nerve activity, rejusting immune system and expression of inflammatory response factors, regulating the balance of renin-angiotensin-aldosterone system (RAAS), improving vascular structure and function, the anti-oxidative stress and promoting autophagy.


Subject(s)
Acupuncture Therapy , Antihypertensive Agents , Essential Hypertension , Therapeutics , Humans , Oxidative Stress , Renin-Angiotensin System
18.
Article in Chinese | WPRIM | ID: wpr-771948

ABSTRACT

OBJECTIVE@#To assess the association of single nucleotide polymorphisms (SNPs) of STK39 gene with response to hydrochlorothiazide among ethnic Han Chinese patients with essential hypertension.@*METHODS@#In total 118 patients with essential hypertension were recruited. All participants had received six weeks of treatment with hydrochlorothiazide 25 mg daily. Blood pressure (BP) and heart rate (HR) were measurement every 2 weeks. Genotypes of STK39 rs3754777 and rs6749447 were determined using a SNaPshot technique.@*RESULTS@#A significant difference was found in ΔSBP between individuals with rs3754777 CC, CT and TT and those with rs3754777 CC and CT-TT (P0.05). Relative risk analysis showed that STK39 rs3754777 was significantly associated with BP response to hydrochlorothiazide (OR=0.416, 95%CI=0.189-0.918, P<0.05).@*CONCLUSION@#Polymorphisms of STK39 rs3754777 may be associated with BP response to hydrochlorothiazide among ethnic Han Chinese with essential hypertension.


Subject(s)
Asian Continental Ancestry Group , Essential Hypertension , Genotype , Humans , Hydrochlorothiazide , Polymorphism, Single Nucleotide , Protein-Serine-Threonine Kinases , Genetics
19.
CorSalud ; 10(4): 300-309, oct.-dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-1089697

ABSTRACT

RESUMEN Introducción: La hipertensión arterial (HTA) es motivo de consulta frecuente en los servicios de salud y es una de las enfermedades más comunes que afecta a individuos adultos en todas partes del mundo. Su caracterización epidemiológica es muy importante para prevenir riesgos. Objetivos: Determinar la prevalencia de HTA, su fuerza de asociación con algunas variables epidemiológicas y del estilo de vida, y su riesgo atribuible poblacional porcentual. Método: Se realizó una investigación epidemiológica observacional analítica retrospectiva (casos y controles) para determinar la fuerza de asociación de algunas variables relacionadas con la HTA en la población de 15 o más años de edad. Resultados: La tasa de prevalencia puntual de hipertensión arterial fue de 111.5 × 103. Predominaron los pacientes blancos, del grupo de edad entre 45-59 años, sin diferencias de sexo. Los factores de riesgo modificables de mayor prevalencia fueron la ingestión de sal, el consumo de café, la no práctica de ejercicio físico y el hábito de fumar. Las mayores cifras de riesgo atribuible poblacional porcentual correspondieron a la ingestión de sal, la no práctica de ejercicio físico y la obesidad. Conclusiones: El sobrepeso, la obesidad, el mayor consumo de sal, la poca o ninguna práctica de ejercicio físico, el consumo excesivo de café, el hábito de fumar, los antecedentes patológicos personales de diabetes mellitus, independientemente al tipo, y los antecedentes familiares de hipertensión arterial mostraron una asociación causal con la HTA y, por consiguiente, con el riesgo de padecer alguna de sus complicaciones, principalmente cardio-cerebrovasculares y renales.


ABSTRACT Introduction: The high blood pressure (HBP) is a frequent reason for consultation in health services and it is one of the most common diseases that affects adult individuals in all parts of the world. Its epidemiological characterization is very important to prevent risks. Objectives: To determine the prevalence of HBP, its strength of association with some epidemiological and lifestyle variables, and its percentage population attributable risk. Method: A retrospective analytical observational epidemiological research (cases and controls) was conducted to determine the strength of association of some variables related to HBP in the population of 15 or more years of age. Results: The punctual prevalence rate of high blood pressure was 111.5 × 103. Caucasian patients predominated, in the age group between 45-59 years, without sex differences. The most prevalent modifiable risk factors were the ingestion of salt, the consumption of coffee, the non-practice of physical exercise and the habit of smoking. The highest percentage population attributable risk figures corresponded to the ingestion of salt, the non-practice of physical exercise and obesity. Conclusions: The overweight, obesity, increased consumption of salt, little or no practice of physical exercise, excessive consumption of coffee, smoking, personal pathological history of diabetes mellitus, regardless of type, and family history of high blood pressure showed a causal association with HBP and, therefore, with the risk of suffering some of its complications, mainly cardio-cerebrovascular and renal.


Subject(s)
Essential Hypertension , Epidemiology, Descriptive , Risk Factors
20.
Einstein (Säo Paulo) ; 16(3): eAO4283, 2018. tab
Article in English | LILACS | ID: biblio-953173

ABSTRACT

ABSTRACT Objective: To study the temporality of hospital admissions due to arterial hypertension and its associated factors. Methods: An ecological study with secondary data on hospital admissions due to essential arterial hypertension - ICD 10, from the Hospital Information System, the Mortality Information System and and the Primary Care Information System, between 2010 and 2015. Descriptive analysis using means, proportions and linear regression. Results: We recorded 493,299 hospitalizations due to arterial hypertension from 2010 to 2015, with an average annual progressive cost decrease of −7.76% and −24.21%. Of the patients admitted, 59.2% were women, 60.2% were non-white and 54.7% were older than 60 years. The mean length of stay was 4.2 days, and the hospitalization cost was R$307.60. The multiple linear regression variables that remained significant were the percentage of admissions due to primary care-sensitive conditions, the per capita income and the City Human Development Index. Conclusion: Hospital admissions due to arterial hypertension have an impact on the percentage of admissions due to primary care- sensitive conditions. Intensifying primary care activities, raising-awareness among professionals to the importance of integrated care, and investing in social development are crucial to change the reality of hypertension in terms of its control and complications.


RESUMO Objetivo: Estudar a temporalidade das internações por hipertensão arterial e seus fatores associados. Métodos: Estudo ecológico com dados secundários referentes às internações hospitalares por hipertensão arterial essencial - CID 10, do Sistema de Informação Hospitalares, do Sistema de Informação de Mortalidade e do Sistema de Informação da Atenção Básica, no período de 2010 a 2015. Análise descritiva com média, proporção e regressão linear. Resultados: Foram registradas 493.299 internações por hipertensão arterial sistêmica de 2010 a 2015, com queda progressiva anual média de −7,76% e de −24,21% nos custos. Dentre as internações, 59,2% ocorreram em mulheres, 60,2% na raça não branca e 54,7% em maiores de 60 anos. A média de permanência foi de 4,2 dias e a do custo por internação, de R$307,60. As variáveis significativas da regressão linear múltipla foram o percentual de internações por condições sensíveis à atenção primária, a renda per capita e o Indice de Desenvolvimento Humano Municipal. Conclusão: As internações por hipertensão arterial sistémica impactam nos percentuais de internações por condições sensíveis à atenção primária. Intensificar as ações da Atenção Primária, sensibilizar profissionais para um cuidado integral e investir no desenvolvimento social são imprescindíveis para transformar a realidade da hipertensão no tocante ao seu controle e a suas complicações.


Subject(s)
Humans , Male , Female , Primary Health Care/statistics & numerical data , Hospital Costs/statistics & numerical data , Essential Hypertension/epidemiology , Hospitalization/statistics & numerical data , Primary Health Care/economics , Socioeconomic Factors , Brazil/epidemiology , Hospitalization/economics , Length of Stay/economics , Length of Stay/statistics & numerical data , Middle Aged
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