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1.
Más Vita ; 3(2): 23-29, jun 2021. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1253890

ABSTRACT

La Hipertensión Arterial es una enfermedad de etiología múltiple, caracterizada por la elevación persistente de la tensión arterial sistólica, diastólica o ambas cifras. Objetivo: Determinar los estilos de vida de los adultos mayores hipertensos del Centro del Adulto Mayor "Renta Luque" 2019. Siendo las variables del estudio estilos de vida el cual consta de tres dimensiones, nutrición, actividad física y hábitos nocivos. Materiales y métodos: La investigación se llevó a cabo mediante el método descriptivo de tipo cuantitativo. La muestra de este estudio se constituyó por 100 adultos mayores de ambos sexos con edades comprendidas entre los 60 y 80 años, con patología de base hipertensión arterial. Para conocer los estilos de vida se aplicó el cuestionario validado por expertos en metodología de investigación y especialistas médicos que consiste en 21 ítems de distintos criterios relacionados con el estilo de vida. Resultados: Con la información de los cuestionario se realizó un análisis, presentándose una síntesis gráfica de los resultados más relevantes de esta información. Los resultados de este estudio servirán como base para fomentar, con fundamentos reales, la práctica de actividad física, nutrición y los hábitos nocivos en la adquisición de hábitos saludables de la población nacional, generando el aporte para estudios posteriores sobre la relación de estas mismas variables en diversas poblaciones. Conclusión: Mantener un estilo de vida saludables es vital para garantizar la calidad de vida de este grupo etario. Es importante que cuenten con apoyo psicológico permanente, además de un estricto control nutricional, realización de ejercicios pasivos como yoga para evitar el alto nivel de stress que suelen presentar los adultos mayores en especial con comorbilidades como la hipertensión arterial(AU)


Arterial Hypertension is a disease of multiple etiology, characterized by persistent elevation of systolic blood pressure, diastolic blood pressure or both figures. Objective: To determine the lifestyles of hypertensive older adults at the "Renta Luque" Senior Center 2019. Being the variables of the study lifestyles that consists of three dimensions, nutrition, physical activity and harmful habits. Materials and methods: The research was carried out using the quantitative descriptive method. The sample of this study consisted of 100 older adults of both sexes aged between 60 and 80 years, with arterial hypertension. The questionnaire validated by experts in research methodology and medical specialists, consisting of 21 items of different criteria related to lifestyle, was applied to learn about lifestyles. Results: With the information from the results of the questionnaire, an analysis was made, presenting a graphic synthesis of the most relevant results of this information. The results of this study will serve as a basis to promote, with real foundations, the practice of physical activity, nutrition and harmful habits in the acquisition of healthy habits in the national population, generating the contribution for subsequent studies on the relationship of these same variables in different populations. Conclusion: Maintaining a healthy lifestyle is vital to ensure the quality of life of this age group. It is important that they have permanent psychological support, in addition to strict nutritional control and passive exercises such as yoga to avoid the high level of stress that older adults usually present, especially with comorbidities such as arterial hypertension(AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aged , Surveys and Questionnaires , Hypertension/etiology , Life Style , Exercise , Elderly Nutrition , Habits
2.
Rev. méd. Maule ; 36(2): 61-67, dic. 2020. tab
Article in Spanish | LILACS | ID: biblio-1344688

ABSTRACT

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


Subject(s)
Humans , Hypertension/prevention & control , Hypertension, Renovascular/etiology , Pheochromocytoma , Sleep Apnea Syndromes , Blood Pressure Monitoring, Ambulatory , Hyperaldosteronism , Hypertension/diagnosis , Hypertension/etiology , Hypertension, Renovascular/diagnosis , Antihypertensive Agents/therapeutic use
3.
Rev. cuba. oftalmol ; 33(4): e951, oct.-dic. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1156579

ABSTRACT

La presión intraocular es considerada el único factor causal potencialmente modificable con el propósito de prevenir la ceguera por glaucoma. Esta es una enfermedad multifactorial y, aunque es el factor de riesgo más importante en su desarrollo, la reducción de sus valores no garantiza el cese de la progresión del daño glaucomatoso. El glaucoma primario de ángulo abierto y el glaucoma de presión normal comparten factores de riesgo similares en la patogénesis y se pueden clasificar en categorías mecánicas y vasculares. La evidencia científica actual ha logrado demostrar que existe una importante asociación entre las enfermedades sistémicas con compromiso vascular, como la migraña, la apnea obstructiva del sueño, la hipotensión arterial de diferentes causas, la hipertensión arterial, la enfermedad cerebrovascular, la cardiopatía isquémica y la diabetes mellitus con los hallazgos a nivel ocular en pacientes con neuropatía óptica glaucomatosa. Esta correlación orienta a considerar estas enfermedades en conjunto para que cada profesional dedicado a la salud visual considere siempre imprescindible la evaluación de los aspectos que vinculan estas enfermedades para actuar en consecuencia. Se realiza una búsqueda sobre el glaucoma y las enfermedades sistémicas con compromiso vascular(AU)


Intraocular pressure is considered to be the only potentially modifiable causative factor to prevent glaucoma blindness. However, glaucoma is a multifactorial disease, and true as it is that its main risk factor is intraocular pressure, its reduction does not ensure cessation of the progress of glaucomatous damage. Primary open angle glaucoma and normal pressure glaucoma share similar pathogenetic risk factors, and may be classified as mechanical or vascular. According to current scientific evidence, an important association exists between systemic diseases with vascular involvement, such as migraine, obstructive sleep apnea, arterial hypotension of various causes, arterial hypertension, cerebrovascular disease, ischemic heart disease and diabetes mellitus, and ocular findings in patients with glaucomatous optic neuropathy. In view of this correlation, these diseases should be considered jointly, so that visual health professionals always bear in mind the evaluation of their common characteristics and act in consequence. A search was carried out on glaucoma and systemic diseases with vascular compromise(AU)


Subject(s)
Humans , Glaucoma/diagnosis , Risk Factors , Intraocular Pressure , Review Literature as Topic , Cerebrovascular Disorders/etiology , Hypertension/etiology
4.
Arch. argent. pediatr ; 118(6): S153-S163, dic 2020. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1146230

ABSTRACT

La tensión arterial normal en los recién nacidos depende de la edad gestacional, el peso al nacer, la edad posmenstrual, y la salud materna durante el embarazo. La hipertensión arterial (HTA) neonatal es más frecuente en recién nacidos con displasia broncopulmonar, enfermedades renales o está relacionada con la cateterización de los vasos umbilicales.El diagnóstico etiológico deberá tener presente causas condicionantes, como el uso de medicación potencialmente productora de HTA (inotrópicos, cafeína) o el inadecuado manejo de líquidos. El tratamiento estará determinado por la gravedad y la forma de presentación, y podrá realizarse en forma parenteral u oral.La mayoría de los casos de HTA neonatal se resolverán sin dejar secuelas ni requerir medicación a largo plazo. Sin embargo, el seguimiento es muy importante porque los recién nacidos que continúan hipertensos luego del alta de la terapia neonatal y los prematuros normotensos podrían estar en riesgo de desarrollar HTA en el futuro


Multiple factors contribute to the blood pressure of a neonate: gestational age, birth weight, postmenstrual age and maternal factors are the most significant contributors. Common causes of neonatal hypertension are bronchopulmonary dysplasia, renal disease and history of umbilical arterial catheter placement. Other important factors that contribute to neonatal hypertension are medications (inotropic drugs, caffeine) and fluid management. Depending on the clinical situation and the severity of the hypertension, treatment can be given with intravenous or oral medications. Available data suggest that long-term outcomes are usually good, with resolution of hypertension in most infants. However, hypertensive neonates as well as normotensive premature neonates may be at increased risk for the development of hypertension in the future.


Subject(s)
Humans , Male , Female , Infant, Newborn , Hypertension/diagnosis , Infant, Premature , Arterial Pressure , Hypertension/etiology , Hypertension/drug therapy
5.
Rev. chil. pediatr ; 91(5): 767-772, oct. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144277

ABSTRACT

INTRODUCCIÓN: La forma clínica de presentación más común del neuroblastoma es el de una masa abdominal, pero puede presentarse con sintomatología menos habitual, como es la crisis adrenérgica por liberación de catecolaminas. OBJETIVO: Describir una forma de presentación inusual de neuroblastoma y el amplio diagnóstico diferencial que existe en un lactante con síntomas adrenérgicos. CASO CLÍNICO: Lactante femenina de 7 semanas de vida, consultó por historia de tres semanas de sudoración e irritabilidad a lo que se asoció fiebre de 24 h de evolución y dificultad respiratoria. Al ingreso presentaba mal esta do general, irritabilidad, sudoración, enrojecimiento facial, taquipnea y palidez cutánea, taquicardia sinusal extrema e hipertensión arterial (HTA), interpretadas como sintomatología adrenérgica. Se completó el estudio con una ecografía abdominal y resonancia magnética que mostraron una gran masa retroperitoneal compatible con neuroblastoma. Las catecolaminas en sangre y en orina mostraron altos niveles de dopamina, adrenalina y noradrenalina, probablemente de origen tumoral. Se inició tratamiento antihipertensivo con fármacos alfa bloqueantes con buen control de la tensión arterial. Se resecó quirúrgicamente el tumor sin incidencias y con una adecuada recuperación posterior. La paciente presentó evolución favorable a tres años de seguimiento. CONCLUSIONES: en un lactante con sintomatología adrenérgica como irritabilidad, enrojecimiento, sudoración asociada a HTA, se debe descartar patología cardiaca, metabólica (hipoglucemia), intoxicaciones y/o patología suprarrenal. Dentro de esta última, el neuroblastoma es la primera posibilidad diagnóstica, por ser uno de los principales tumores en la infancia y aunque esta presentación no es habitual puede producir estos síntomas.


INTRODUCTION: The most common clinical presentation of neuroblastoma is an abdominal mass, but it can present with uncommon symptoms, such as adrenergic storm due to catecholamine release. OBJECTIVE: To describe an unusual presentation of neuroblastoma and the wide differential diagnosis that exists in an infant with adrenergic symptoms. CLINICAL CASE: A 7-week old female infant was evaluated due to a 3-week history of sweating and irritability associated with a 24-hour fever and respiratory distress. At admission, she presented poor general condition, irritability, sweating, facial redness, tachypnea and skin paleness, extreme sinus tachycardia, and high blood pressure (HBP), interpreted as adrenergic symptoms. The study was completed with abdominal ultrasound and magnetic reso nance imaging that showed a large retroperitoneal mass compatible with neuroblastoma. Plasma and urinary catecholamines tests showed high levels of dopamine, adrenaline, and noradrenaline, probably of tumor origin. We started antihypertensive treatment with alpha-blocker drugs, showing a good blood pressure control. The tumor was surgically resected without incidents and adequate subsequent recovery. The patient presented a favorable evolution after three years of follow-up. CONCLUSIONS: In an infant with adrenergic symptoms such as irritability, redness, sweating associated with HBP, it should be ruled out pathology heart or metabolic (hypoglycemia) pathology, intoxications, and/or adrenal pathology. Within this last one, neuroblastoma is the first diagnostic possibility, since it is one of the main tumors in childhood and, although this presentation is not usual, it can produce these symptoms.


Subject(s)
Humans , Female , Infant , Retroperitoneal Neoplasms/diagnosis , Sweating , Tachycardia/etiology , Catecholamines/urine , Flushing/etiology , Hypertension/etiology , Neuroblastoma/diagnosis , Retroperitoneal Neoplasms/complications , Retroperitoneal Neoplasms/urine , Tachycardia/diagnosis , Irritable Mood , Biomarkers, Tumor/urine , Diagnosis, Differential , Hypertension/diagnosis , Neuroblastoma/complications , Neuroblastoma/urine
6.
Rev. chil. pediatr ; 91(3): 324-329, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1126168

ABSTRACT

Resumen: El recién nacido prematuro se enfrenta a las condiciones extrauterinas con sistemas aún inmaduros, tanto anatómica como fisiológicamente. El riñón termina de desarrollarse a finales del tercer trimes tre del embarazo, por lo que está especialmente expuesto a alterar su desarrollo normal en caso de nacer en forma prematura. Esta situación puede condicionar, entre otras consecuencias, una menor masa renal funcional y cambios microvasculares que representan un riesgo elevado de hipertensión arterial y daño renal crónico en el largo plazo. En el presente artículo se analiza la evidencia existente actual sobre estos riesgos en los prematuros y se ofrece un esquema de seguimiento de estos niños desde el punto de vista nefrológico.


Abstract: The premature newborn faces extrauterine conditions with some systems still immature, both ana tomically and physiologically. The kidney finishes developing at the end of the third trimester of pregnancy, so it is especially exposed to alter its normal development if preterm birth occurs. This si tuation may condition, among other consequences, a lower functional renal mass and microvascular changes comprising a high risk of chronic kidney disease in the long term and arterial hypertension. This article analyzes the current evidence on these risks in premature infants and offers a nephrology follow-up scheme of these children.


Subject(s)
Humans , Infant, Newborn , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/therapy , Hypertension/diagnosis , Hypertension/etiology , Hypertension/physiopathology , Hypertension/therapy , Infant, Premature, Diseases/diagnosis , Infant, Premature, Diseases/etiology , Infant, Premature, Diseases/physiopathology , Infant, Premature, Diseases/therapy , Risk , Aftercare/methods , Kidney/growth & development , Kidney/embryology , Kidney/physiopathology , Nephrology/methods
7.
s.l; IETSI; 20 mayo 2020.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-1096660

ABSTRACT

INTRODUCCIÓN: Aproximadamente cuatro meses han transcurrido desde que se reportaron los primeros casos de enfermedad por Coronavirus 2019 (COVID-2019) y al día de hoy (22 de abril) la Organización Mundial de la Salud (OMS) reporta 2 471 136 casos confirmados y 169 006 muertes a nivel global. En el Perú, la sala situacional del Ministerio de Salud (22 de abril) reporta 19 250 casos confirmados, 62.3% de los cuales son del sexo masculino y un total de 530 fallecidos. Lamentablemente, se espera que estas cifras sigan creciendo en todo el mundo. La información publicada hasta el momento, en su mayoría proveniente de China, revela que los casos más severos y con mayor tasa de letalidad se reportan en personas del sexo masculino, adultos mayores y personas con presencia de comorbilidades. Esta situación es similar a lo reportado en otras infecciones virales respiratorias como la causada por el virus H1N1, en la que las personas con obesidad y con enfermedades crónicas pre-existentes mostraron mayor probabilidad de desarrollar síndrome de distrés respiratorio agudo que conllevaba a falla orgánica múltiple y muerte. La evidencia de que el sexo masculino y la presencia de comorbilidades son factores de riesgo para mortalidad por COVID-19 está aún aumento. Los reportes de COVID-19 se actualizan constantemente y la información revelada sirve para entender mejor el comportamiento de la enfermedad y en base a ello plantear estrategias de prevención y contención. Por ello, el objetivo de esta revisión rápida es evaluar y presentar la evidencia disponible sobre el sexo y la presencia de comorbilidades en los casos fatales por COVID-19. MÉTODOS: Se realizó una búsqueda sistemática de estudios publicados hasta el 02 de abril y disponibles en PubMed y MedRxiv. Se incluyó artículos que reportaban información clínica y la prevalencia de enfermedades crónicas no transmisibles en casos letales por COVID-19. Se incluyó reportes de casos, estudios de caso-control, cohortes y revisiones sistemáticas, se limitó la búsqueda solo a publicaciones en inglés. Se excluyó noticias, editoriales, cartas al editor, comentarios, modelamientos matemáticos y casos que reportaban letalidad en menores de 18 años. RESULTADOS: Luego de verificar los criterios de elegibilidad, se incluyeron 17 artículos de los cuales 13 se consideraron para meta-análisis. El total de participantes incluidos en los estudios suman 27 264, los casos letales suman en total 1037 que representa una prevalencia agrupada [Pr(a)] = 12 % (95% IC: 8% - 16%), la edad promedio de los casos fatales es de 69.2 años. La mayoría de los estudios corresponden a reporte de China, 2 provienen de Corea y 1 de ellos de Italia. Los estudios reportan tener diseños principalmente de reportes de casos retrospectivos y cohortes retrospectivas, se identificó, además un estudio transversal y dos revisiones sistemáticas en la base de datos MedRxiv. Para la evaluación de la calidad, los reportes de casos y cohortes retrospectivas se trataron como "Estudios de Serie de Casos", en ninguno de los estudios se puede determinar si el tiempo de seguimiento fue el adecuado y los estudios reportados en Corea e Italia no cumplen con al menos un criterio de evaluación La calidad del estudio transversal y las revisiones sistemáticas es pobre. CONCLUSIÓN: La caracterización de los casos letales por COVID-19 es importante porque puede permitir mejorar las intervenciones y resultados en los pacientes infectados, sobretodo, en los que en mayor riesgo se encuentran como la población del sexo masculino y aquellos con hipertensión, enfermedades cardiovasculares y diabetes.


Subject(s)
Humans , Cardiovascular Diseases/etiology , Coronavirus Infections/diagnosis , Diabetes Mellitus/etiology , Evaluation of the Efficacy-Effectiveness of Interventions , Hypertension/etiology , Technology Assessment, Biomedical
8.
Salud bienestar colect ; 4(1): 33-43, ene.-abr. 2020. tab
Article in Spanish | LILACS | ID: biblio-1179914

ABSTRACT

IINTRODUCCIÓN: la hipertensión arteriales una entidad asintomática, cuyos factores de riesgo son el peso corporal, la dieta, el consumo de alcohol y tabaco, el sedentarismo, las dislipidemias, la hiperglicemia y la diabetes. La obesidad como consecuencia de la malnutrición por exceso es un importante problema de la salud pública en el mundo entero, ya que esto representa un alto costo económico y social para las personas y el Estado. Las dislipidemias son enfermedades metabólicas que cursan con concentraciones anormales de lípidos en la sangre, siendo un factor de riesgo para la presentación de enfermedades cardiovasculares. Es muy frecuente la relación entre estas entidades y la HTA. El objetivo del presente trabajo fue identificar la prevalencia de dislipidemias y obesidad y su relación con la presencia de hipertensión arterial en trabajadores universitarios en una región de Ecuador. MATERIAL Y MÉTODOS: la investigación fue observacional, descriptiva, cuantitativa, de corte transversal. Se seleccionaron 60 trabajadores, se tomaron muestras de sangre al igual que se registró su presión arterial. Con los datos de talla y peso se calculó el IMC para el estudio. Los datos se analizaron en SPSS. RESULTADOS: el 36,66% tuvo hipercolesterolemia, el 41,66% hipertrigliceridemia. El 55% tuvo cifras bajas de HDL, y el 18,33% tuvo cifras elevadas de LDL. El 20% presentó dislipidemia mixta. El 10% presentó obesidad, el 53,33% sobrepeso y el 36,66% peso normal. La prevalencia de hipertensión fue de apenas el 18,33%. Existe correlación entre la hipertensión y el consumo de alcohol, así como con los valores de LDL. CONCLUSIONES. Las prevalencias de obesidad, dislipidemias e hipertensión arterial en los trabajadores universitarios estudiados, son similares a las presentadas en la región, a excepción de la obesidad que registra una prevalencia baja. Las dislipidemias, a excepción de la Hiper LDL, no guardan correlación con la HTA.


INTRODUCTION: arterial hypertension is an asymptomatic entity, whose risk factors are body weight, diet, alcohol and tobacco consumption, sedentarism, dyslipidemias, hyperglycemia and diabetes. Obesity as a consequence of overnutrition is a major public health problem worldwide, as it represents a high economic and social cost for individuals and the State. Dyslipidemias are metabolic diseases with abnormal concentrations of lipids in the blood, and are a risk factor for cardiovascular disease. The relationship between these entities and ETS is very frequent. The aim of the present work was to identify the prevalence of dyslipidemias and obesity and its relation with the presence of arterial hypertension in university workers in a region of Ecuador. MATERIAL AND METHODS: the research was observational, descriptive, quantitative, and cross-sectional. Sixty workers were selected, blood samples were taken, and their blood pressure was recorded. With the data of height and weight the BMI was calculated for the study. The datawere analyzed in SPSS. Results: 36.66% had hypercholesterolemia, 41.66% hypertriglyceridemia. 55% had low HDL, and 18.33% had high LDL. 20% had mixed dyslipidemia. 10% presented obesity, 53.33% overweight and 36.66% normal weight. The prevalence of hypertension was only 18.33%. There is a correlation between hypertension and alcohol consumption, as well as with LDL values. CONCLUSIONS: the prevalence of obesity, dyslipidemias and hypertension in the university workers studied, are similar to those presented in the region, except for obesity which has a low prevalence. Dyslipidemias, with the exception of Hyper LDL, are not correlated with ETS.Keywords:dyslipidemias, overweight, obesity, hypertension, correlation.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Hypertension/etiology , Obesity/complications , Obesity/epidemiology , Body Mass Index , Prevalence , Clinical Laboratory Techniques , Ecuador/epidemiology , Dyslipidemias , Overweight , Correlation of Data , Obesity/physiopathology
9.
Article in Portuguese | LILACS | ID: biblio-1097242

ABSTRACT

Objetivo: iinvestigar a potencial associação entre a hipertensão arterial sistêmica (HAS) e a gravidade da COVID-19. Métodos: realizou-se uma pesquisa eletrônica no Medline, Scopus e Web of Science acerca da relação entre HAS e COVID-19. Resultados: as primeiras hipóteses levantadas revelaram que a associação entre as doenças estava no tratamento com inibidores da enzima de conversão da angiotensina e bloqueadores dos receptores da angiotensina. Contudo, em um estudo experimental, observou-se que os pacientes hipertensos tratados com esses medicamentos apresentaram menor taxa de gravidade da doença. Conclusão: até o momento, a relação de HAS e COVID-19 é conflitante.(AU)


Objective: to investigate the potential association between systemic arterial hypertension (SAH) and the severity of COVID-19. Methods: An electronic research on Medline, Scopus and Web of Science was conducted about the relationship between SAH and COVID-19. Results: The first hypotheses raised revealed that the association between the diseases was in the treatment with angiotensin conversion enzyme inhibitors and angiotensin receptor blockers. However, in an experimental study it was observed that hypertensive patients treated with these drugs had a lower rate of disease severity. Conclusion: So far, the relationship between SAH and COVID-19 is conflicting.(AU)


Subject(s)
Humans , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Coronavirus Infections/diagnosis , Hypertension/etiology , Prognosis
10.
s.l; s.n; 2020.
Non-conventional in Spanish | LILACS, ColecionaSUS | ID: biblio-1096507

ABSTRACT

A presente nota técnica tem a finalidade de orientar profissionais de saúde, gerentes de unidade e gestores sobre os cuidados de pessoas com doenças crônicas na Atenção Primária à Saúde (APS) perante a situação de pandemia de COVID-19 (coronavírus). A Organização Mundial da Saúde (OMS) reconhece que pacientes com condições crônicas pré-existentes, como diabetes e hipertensão, tiveram infecções mais graves pela COVID-19. No mesmo sentido, o Center for Disease Control and Prevention (CDC), órgão de vigilância do governo dos Estados Unidos, listou os grupos de maior risco e os cuidados a serem tomados no contexto da COVID-19, que são referência para esta Nota Técnica¹. Apesar de se tratar de uma doença recente, há evidências a respeito dessa infecção de que, nos casos graves, ela se desenvolve rapidamente para a síndrome do desconforto respiratório agudo, insuficiência respiratória aguda e outras complicações1­6. Ainda que a maioria dos infectados apresente sintomas leves e bom prognóstico, é possível, por meio da evidência existente, identificar fatores de risco que estão relacionados aos casos mais graves e à elevação da taxa de mortalidade. Os fatores de risco apresentados são principalmente relacionados à idade elevada, baixa imunidade e doenças crônicas preexistentes.


Subject(s)
Humans , Primary Health Care/methods , Coronavirus Infections/prevention & control , Diabetes Mellitus/etiology , Hypertension/etiology , Brazil , Public Health Surveillance/methods
11.
Rev Rene (Online) ; 21: 42272, 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1053529

ABSTRACT

Objetivo: avaliar a associação dos fatores de risco com os níveis pressóricos elevados em universitários. Métodos: estudo descritivo, transversal, desenvolvido com 203 universitários, por meio de questionário autoaplicável, construído com base no instrumento para Vigilância de Fatores de Risco e Proteção Para Doenças Crônicas por Inquérito Telefônico do Ministério da Saúde. A análise dos dados foi realizada pelo teste Tau de Kendall. Resultados: dos participantes do estudo, 164 (80,8%) possuíam níveis pressóricos referentes à pressão arterial normal, nove (4,4%) pré-hipertensão, 30 (14,8%) hipertensão. Quanto ao estilo de vida, 16 (7,9%) eram fumantes, 12 (5,9%) faziam uso abusivo de álcool, 137 (67,5%) eram ativos, 64 (31,5%) possuíam adiposidade abdominal, 29 (14,3%) estavam com sobrepeso ou obesidade e 32 (15,8%) faziam uso excessivo de sal. Conclusão: os fatores de risco relacionados aos níveis pressóricos elevados foram: ter 35 anos ou mais de idade, adiposidade abdominal, sobrepeso ou obesidade. (AU)


Subject(s)
Humans , Male , Female , Adult , Students , Hypertension/etiology , Cross-Sectional Studies , Risk Factors , Age Factors , Overweight/complications , Life Style
12.
Article in English | WPRIM | ID: wpr-880314

ABSTRACT

BACKGROUND@#We aim to explore the association between self-reported snoring and hypertension among adults aged 30-79 in Chongqing, China.@*METHODS@#A total of 23,342 individuals aged 30-79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension.@*RESULTS@#Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45-59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34-2.02; 45-59: OR = 1.53, 95%CI 1.37-1.72; ≥ 60: OR = 1.25, 95%CI 1.09-1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33-1.63; women: OR = 1.97, 95%CI 1.75-2.23).@*CONCLUSIONS@#People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.


Subject(s)
Adult , Aged , China/epidemiology , Cross-Sectional Studies , Female , Humans , Hypertension/etiology , Male , Middle Aged , Self Report , Snoring/complications
13.
Rev. chil. nutr ; 46(6): 776-782, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058141

ABSTRACT

RESUMEN La enfermedad cardiovascular (ECV) sigue siendo la principal causa de muerte en los países occidentales, aunque ha habido una disminución sustancial en su incidencia en las últimas 2 décadas. A pesar de la reducción en la incidencia, la prevalencia de ECV sigue creciendo debido al aumento de la población que envejece en estos países. Entre los factores modificables de las ECV se pueden nombrar la diabetes (DM) y la hipertensión arterial (HTA). Los lácteos son un grupo de alimentos heterogéneos con productos que difieren en el contenido de agua, cantidad de fermentación y nutrientes como grasa y sodio, y ha excepción de lácteos bajos en grasa, no se ven como alimentos saludables en la prevención de estas 2 enfermedades. El presente trabajo muestra los resultados especialmente de metaanálisis de los últimos años que relacionan el consumo de lácteos con DM e HTA.


ABSTRACT Although there has been a substantial decrease in cardiovascular disease (CVD) incidence in the last 2 decades, it remains the leading cause of death in Western countries. Despite a reduction in incidence, the prevalence of CVD continues to grow due to the increase in the aging population in these countries. Among the modifiable factors of CVD we can name diabetes mellitus and high blood pressure. Dairy products are a group of heterogeneous foods with products that differ in water content, amount of fermentation and nutrients such as fat and sodium, and, except for low-fat dairy products, they are not seen as healthy foods in the prevention of these 2 diseases. The present work shows the results of a meta-analysis of the last years that relate the consumption of dairy products with diabetes and high blood pressure.


Subject(s)
Humans , Dairy Products/adverse effects , Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Yogurt/adverse effects , Cheese/adverse effects , Milk/adverse effects , Diabetes Mellitus/etiology , Hypertension/etiology
14.
J. bras. nefrol ; 41(4): 564-569, Out.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056599

ABSTRACT

ABSTRACT Takayasu arteritis (TA) is a chronic granulomatous inflammatory condition of unknown cause that involves large vessels - particularly the aorta and its branches - such as the carotid, coronary, pulmonary, and renal arteries. The left subclavian artery is the most frequently involved vessel. Stenosis of the renal artery has been reported in 23-31% of the cases and may result in malignant hypertension, ischemic renal disease, decompensated heart failure, and premature death. Involvement of both renal arteries is uncommon. Early onset anuria and acute kidney injury are rare and have been reported only in a few cases in the literature. This report describes the case of a 15-year-old female with constitutional symptoms evolving for a year, combined with headache, nausea, and vomiting, in addition to frequent visits to emergency services and insufficient clinical examination. The patient worsened significantly six months after the onset of symptoms and developed acute pulmonary edema, oliguria, acute kidney injury, and difficult-to-control hypertension, at which point she was admitted for intensive care and hemodialysis. Initial ultrasound examination showed she had normal kidneys and stenosis-free renal arteries. The patient was still anuric after 30 days of hospitalization. A biopsy was performed and revealed her kidneys were normal. Computed tomography angiography scans of the abdominal aorta presented evidence of occlusion of both renal arteries. The patient met the diagnostic criteria for Takayasu arteritis and had a severe complication rarely described in the literature: stenosis of the two renal arteries during the acute stage of ischemic renal disease.


RESUMO A Arterite de Takayasu (AT) é uma doença inflamatória crônica, granulomatosa, de causa desconhecida, que afeta grandes vasos, principalmente a aorta e seus ramos, incluindo artérias carótidas, coronárias, pulmonares e renais, sendo a artéria subclávia esquerda o vaso mais acometido. A estenose da artéria renal é relatada em 23-31% dos casos e pode resultar em hipertensão maligna, insuficiência renal por isquemia, descompensação cardíaca e morte prematura. O acometimento bilateral de artérias renais é incomum, sendo rara a presença de anúria súbita e lesão renal aguda como sintoma inicial da doença, com poucos relatos na literatura. O caso reporta uma adolescente de 15 anos com sintomas constitucionais durante um ano de evolução, associados a problemas como cefaleia, náuseas e vômitos, com idas frequentes a serviços de emergência, sem adequada investigação clínica. Após 6 meses do início dos sintomas, a paciente evoluiu de forma grave, com quadro de edema agudo de pulmão, oligúria, lesão renal aguda e hipertensão arterial de difícil controle, sendo necessário suporte em Unidade de Terapia Intensiva e hemodiálise. A ultrassonografia inicial mostrava rins normais e artérias renais sem sinais de estenose. Após 30 dias de internamento, paciente permanecia anúrica, sendo realizada biópsia renal que se mostrou dentro dos padrões da normalidade. Angiotomografia de aorta abdominal evidenciou oclusão bilateral de artérias renais. A paciente descrita fechou critérios diagnósticos para arterite de Takayasu e manifestou uma complicação grave pouco descrita na literatura: estenose bilateral de artérias renais, ainda na fase aguda da nefropatia isquêmica.


Subject(s)
Humans , Female , Adolescent , Renal Artery Obstruction/complications , Acute Kidney Injury/diagnosis , Oliguria/diagnosis , Oliguria/etiology , Pulmonary Edema/diagnosis , Pulmonary Edema/etiology , Acute Disease , Renal Dialysis/methods , Kidney Transplantation/methods , Treatment Outcome , Takayasu Arteritis/complications , Diagnosis, Differential , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Hypertension/diagnosis , Hypertension/etiology
15.
Arq. bras. oftalmol ; 82(6): 522-527, Nov.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1038687

ABSTRACT

ABSTRACT A 26-year-old woman presented at 28 weeks gestation with hypertensive choroidopathy associated with pre-eclampsia. Fundus photography, fundus autofluorescence, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography were performed in both eyes in the immediate postoperative period. SD-OCT images were obtained before delivery and during a 3-month follow-up. Fundus autofluorescence exhibited patchy hyper- and hypoautofluorescent lesions; fluorescein and indocyanine green angiography revealed areas of choroidal ischemia; and SD-OCT showed disorganization of the outer retinal layers and disruption of the ellipsoid zone. After her blood pressure was stabilized, progressive recovery of the outer retinal layer was monitored on SD-OCT.


RESUMO Uma mulher de 26 anos de idade, com 28 semanas de gestação apresentando coroidopatia hipertensiva associada à pré-eclâmpsia. Retinografia, autofluorescência, tomografia de coerência óptica de domínio espectral, angiofluoresceínografia e angiografia com indocianina verde foram realizadas em ambos os olhos no período pós-operatório imediato do parto. Imagens da tomografia de coerência óptica de domínio espectral foram obtidas antes do parto e durante o seguimento de 3 meses. A autofluorescência apresentou lesões heterogêneas hiper e hipoautofluorescentes, a angiofluoresceínografia e angiografia com indocianina verde revelaram áreas de isquemia de coroide, e a tomografia de coerência óptica de domínio espectral apresentou desorganização das camadas externas da retina e interrupção da zona elipsóide. Após a estabilização da pressão sanguínea, a recuperação progressiva da camada externa da retina foi monitorada pela tomografia de coerência óptica de domínio espectral.


Subject(s)
Humans , Female , Pregnancy , Adult , Pre-Eclampsia , Choroid Diseases/etiology , Choroid Diseases/diagnostic imaging , Hypertension/etiology , Hypertension/diagnostic imaging , Remission, Spontaneous , Fluorescein Angiography/methods , Tomography, Optical Coherence/methods , Retinal Pigment Epithelium/pathology , Retinal Pigment Epithelium/diagnostic imaging
16.
Arq. bras. cardiol ; 113(3): 374-380, Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038553

ABSTRACT

Abstract Background: Stress is a state of threat to the balance of the organism, which can cause biological and psychological changes. In hypertensive patients, stress can interfere with blood pressure levels, influence on food choices and neglect of the diet. Objective: This study aims to describe the relationship between stress and dietary intake of hypertensive patients. Methods: A transversal study was carried out at the Arterial Hypertension Clinic of the Cardiology Institute of Rio Grande do Sul, Brazil. The participants were aged ≥ 18 years and hypertensive. Blood pressure, food consumption and anthropometric measurements were collected. The variables related to stress were evaluated by the Lipp's Stress Symptoms Inventory (LSSI) for adults. Significance level of 5% has been considered for all analyzed data. Results: The number of participants was 100. There was a higher prevalence of the female sex (67%), the mean age of the study population was 55.87 ± 12.55 years. Among the participants, 86% were classified in some of the stress phases, on which 57% were in the resistance phase. It was observed that there was no correlation between the presence of stress (as well as their actions), pressure levels and food consumption. The consumption of foods rich in lipids and individuals with a prevalence of psychological symptoms of stress displayed a significant association. Conclusions: Rich in fat dietary has been the first choice in patients with psychological symptoms of stress. Further studies regarding remodeled dietary intake and blood pressure levels in relation to the stress phases are suggested. These findings are important to contribute to the development of prevention and treatment strategies for cardiovascular diseases.


Resumo Fundamento: O estresse é um estado de ameaça ao equilíbrio do organismo, podendo causar alterações biológicas e psicológicas. No paciente hipertenso o estresse pode interferir nos níveis pressóricos e gerar influência nas escolhas alimentares e negligência da dieta. Objetivo: Este estudo tem como objetivo descrever a relação entre o estresse e consumo alimentar de pacientes hipertensos. Métodos: Estudo transversal, desenvolvido no Ambulatório de Hipertensão Arterial do Instituto de Cardiologia do Rio Grande do Sul. Participaram da pesquisa indivíduos hipertensos com idade > 18 anos. Foram coletados dados de pressão arterial, consumo alimentar e medidas antropométricas. As variáveis relacionadas ao estresse foram avaliadas pelo inventário de sintomas de stress para adultos de Lipp (ISSL). Em todas as análises foi considerando um nível de significância 5% (p < 0,05). Resultados: O número de participantes foi de 100. Houve maior prevalência no sexo feminino (67%), a idade média da população estudada foi 55,87 ± 12,55 anos. Dos participantes, 86% se classificaram em alguma das fases do estresse, sendo que destes, 57% estavam na fase de resistência. Observou-se que não houve correlação entre a presença de estresse (bem como suas fases), níveis pressóricos e consumo alimentar. O consumo de alimentos ricos em lipídios em hipertensos com sintomas de estresse apresentou significância estatística. Conclusão: Os alimentos ricos em gordura prevaleceram entre as escolhas alimentares nos pacientes com sintomas psicológicos de estresse. Sugere-se mais estudos em relação a alteração do consumo alimentar e níveis pressóricos em relação às fases do estresse.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Stress, Psychological , Diet/psychology , Food Preferences/psychology , Hypertension/psychology , Blood Pressure/physiology , Cross-Sectional Studies , Surveys and Questionnaires , Diet/adverse effects , Feeding Behavior , Hypertension/etiology
17.
Arq. bras. cardiol ; 113(3): 392-399, Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038551

ABSTRACT

Abstract Background: Seasoning is one of the recommended strategies to reduce salt in foods. However, only a few studies have studied salt preference changes using seasoning. Objectives: The aim of this study was to compare preference for salty bread, and if seasoning can change preference in hypertensive and normotensive, young and older outpatients. Methods: Outpatients (n = 118) were classified in four groups: older hypertensive subjects (OH) (n = 32), young hypertensive (YH) (n = 25); older normotensive individuals (ON) (n = 28), and young normotensive (YN) (n = 33). First, volunteers random tasted bread samples with three different salt concentrations. After two weeks, they tasted the same types of breads, with seasoning added in all. Blood pressure (BP), 24-hour urinary sodium and potassium excretion (UNaV, UKV) were measured twice. Analysis: Fisher exact test, McNamer's test and ANCOVA. Statistical significance: p < 0.05. Results: Systolic BP, UNaV, and UKV were greater in HO and HY and they had a higher preference for saltier samples than normotensive groups (HO: 71.9%, HY: 56% vs. NO: 25%, NY; 6%, p<0.01). With oregano, hypertensive individuals preferred smaller concentrations of salt, with reduced choice for saltier samples (HO: 71.9% to 21.9%, and HY: 56% to 16%, p = 0.02), NO preferred the lowest salt concentration sample (53.6% vs. 14.3%, p < 0.01), and NY further increased the preference for the lowest one (63.6% vs. 39.4%, p = 0.03). Conclusions: Older and younger hypertensive individuals prefer and consume more salt than normotensive ones, and the seasoned bread induced all groups to choose food with less salt. Salt preference is linked to hypertension and not to aging in outpatients.


Resumo Fundamento: Adicionar temperos aos alimentos é umas das estratégias recomendadas para diminuir a quantidade de sal nos alimentos. No entanto, poucos estudos investigaram alterações na preferência ao sal através do uso de temperos. Objetivos: O objetivo deste estudo foi comparar a preferência pelo pão salgado, e até que ponto o uso de temperos pode alterar as preferências dos indivíduos hipertensos e normotensos, pacientes ambulatoriais jovens e idosos. Métodos: Os pacientes ambulatoriais (n = 118) foram classificados em quatro grupos: idosos com hipertensão (IH) (n = 32), jovens hipertensos (JH) (n = 25); indivíduos idosos normotensos (IN) (n = 28), e jovens normotensos (JN) (n = 33). Primeiro, os voluntários provaram amostras aleatórias de pão com três diferentes concentrações de sal. Após duas semanas, eles provaram os mesmos tipos de pão, porém acrescidos de temperos. A pressão arterial (PA), e a excreção urinária de sódio e potássio de 24 horas (UNaV, UKV) foram medidas duas vezes. Análise: Teste exato de Fisher, teste de McNemar e teste ANCOVA. Significância estatística: p < 0,05. Resultados: A PA sistólica e a excreção urinária de sódio e potássio foram maiores nos grupos IH e JH, e eles tiveram maior preferência por amostras mais salgadas quando comparados com os grupos de normotensos (IH: 71,9%, JH: 56% vs. IN: 25%, JN; 6%, p < 0,01). Quando o orégano foi adicionado, a preferência dos indivíduos hipertensos foi pelas amostras com menores concentrações de sal, com uma diminuição da escolha por amostras mais salgadas (IH: 71,9% a 21,9%, e JH: 56% a 16%, p = 0,02); o grupo IN preferiu a amostra com a concentração de sal mais baixa (53,6% vs. 14,3%, p < 0,01) e no grupo JN aumentou ainda mais o número de indivíduos com preferência pela amostra com concentrações mais baixas de sal (63,6% vs. 39,4%, p = 0,03). Conclusões: Os idosos e jovens hipertensos preferem e consomem mais sal do que os normotensos, e o pão adicionado de tempero ajudou todos os grupos a escolher alimentos menos salgados. A preferência ao sal está ligada à hipertensão e não à idade nos pacientes ambulatoriais.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Blood Pressure/physiology , Potassium, Dietary/administration & dosage , Sodium Chloride, Dietary/administration & dosage , Hypertension/etiology , Potassium/urine , Sodium/urine , Aging/physiology , Sodium Chloride , Double-Blind Method , Hypertension/urine
18.
Rev. medica electron ; 41(4): 850-861, jul.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1094093

ABSTRACT

RESUMEN Introducción: la Organización Mundial de la Salud, estima que la enfermedad renal crónica estará incluida dentro de las principales causas de discapacidad para el 2020. La prevalencia en países desarrollados es aproximadamente de 500 a 1400 pacientes por millón de habitantes y la incidencia anual se encuentra alrededor de 350 pacientes por millón de población. Objetivo: determinar la prevalencia de la enfermedad renal oculta e identificar algunos factores de riesgos predisponentes en adultos mayores con diabetes mellitus tipo 2 pertenecientes al Policlínico Universitario "Jimmy Hirzel", Bayamo, Granma, en el período comprendido entre junio 2016 - junio 2017. Materiales y métodos: se realizó estudio observacional descriptivo, de corte transversal en el que se incluyeron 180 gerontes con diabetes mellitus tipo 2. Resultados: se estableció el diagnóstico de enfermedad renal oculta en 167 individuos de 180 sujetos estudiados, el grupo de 70 - 79 años de edad fue el más afectado por la nefropatía crónica, mientras que el sexo femenino y la raza blanca fueron los de mayor prevalencia. Los principales factores de riesgo predisponentes de enfermedad renal oculta fueron: cardiopatía isquémica crónica, dislipemias e hipertensión arterial. Conclusiones: existe una alta morbilidad de enfermedad renal oculta en los senescentes estudiados.


ABSTRACT Introduction: the World Health Organization (WHO) estimates that chronic hidden renal disease (ERC) will be included within the principal causes of disability by 2020. The prevalence in developed countries is around 500 to 1400 patients per million inhabitants, and the yearly incidence is around 350 patients per million people. Objective: to determine the prevalence of the hidden renal disease and to identify some predisposing risk factors in elder people with type II diabetes mellitus belonging to the University Policlinic "Jimmy Hirzel", Bayamo, Gramma, in the period between June 2016 and June 2017. Material and methods: an observational descriptive, cross-sectional study was carried out in 180 elder people with type 2 diabetes mellitus. Results: the chronic hidden renal disease was diagnosed in 167 individuals from the 180 studied subjects; the 70-79 years-old-group was the most affected one by chronic renal disease, while the female sex and white race showed the highest prevalence. The main risk factors predisposing to chronic hidden renal disease were: chronic ischemic heart disease, dyslipidemia and arterial hypertension. Conclusions: there is a high morbidity due to hidden renal disease in the studied senescent people.


Subject(s)
Humans , Female , Aged , Prevalence , Risk Factors , Morbidity , Myocardial Ischemia/etiology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/etiology , Diabetes Mellitus, Type 2/epidemiology , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/prevention & control , Renal Insufficiency, Chronic/epidemiology , Dyslipidemias/etiology , Hypertension/etiology , Epidemiology, Descriptive , Cross-Sectional Studies , Diabetic Nephropathies/etiology , Observational Study , Kidney Diseases/etiology
19.
Rev. medica electron ; 41(4): 862-878, jul.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1094094

ABSTRACT

RESUMEN Introducción: las enfermedades cardiovasculares constituyen la principal causa de muerte en la mayoría de los países. Se describen los factores de riesgo para enfermedad coronaria como no modificables: edad, sexo y antecedentes familiares; y modificables relacionados al estilo de vida: tabaquismo, dislipidemia, obesidad, sedentarismo, diabetes, uso abusivo de alcohol y la enfermedad hipertensiva. Objetivo: caracterizar los factores de riesgo asociados a la cardiopatía isquémica en Atención Secundaria de Salud. Materiales y métodos: estudio observacional, descriptivo transversal en pacientes ingresados en el Hospital "Mártires del 9 de Abril" de Sagua la Grande, en el periodo comprendido entre los años 2016 y 2017. Integraron la muestra 96 pacientes que ingresaron con diagnóstico de cardiopatía isquémica. Se describieron las características demográficas de los mismos; fueron identificados los factores de riesgo y se determinó la frecuencia de asociación de otras formas clínicas de ateromatosis. Resultados: los pacientes fueron mayores de 60 años de edad; la mayoría tenían color de la piel blanca; presentaban antecedentes patológicos familiares de cardiopatía isquémica; las principales formas de cardiopatía isquémica fueron: angina e insuficiencia cardiaca; todos los pacientes presentaron uno o más factores de riesgo cardiovascular, los más significativos fueron, hipertensión arterial, tabaquismo aumento de la circunferencia abdominal y personalidad tipo "A". Conclusiones: la mayoría de los pacientes exhibieron alteraciones en el electrocardiograma: descenso del segmento ST, bloqueo de rama izquierda del haz de His y fibrilación auricular; se observó hipertrigliceridemia y se apreció asociación entre enfermedad renal crónica y angina.


ABSTRACT Introduction: cardiovascular diseases are the main cause of death in most of the countries. The risk factors for coronary disease are described as unmodifiable: age, sex and family history; and modifiable related to lifestyle: smoking, dyslipidemia, obesity, sedentary lifestyle, diabetes, abusive use of alcohol and hypertensive disease. Objective: to characterize the risk factors associated to ischemic heart disease in secondary health care. Material and methods: observational, cross-sectional, descriptive study in patients admitted in "Mártires del 9 de Abril" Hospital, Sagua la Grande, between 2016 and 2017. The sample consisted of 96 patients admitted with a diagnosis of ischemic heart disease. Their demographic characteristics were described; the risk factors were identified and the frequency of association of other clinical forms of atheromatosis was determined. Results: the patients were aged more than 60 years; most of them were white people and had family pathological antecedents of ischemic heart disease; the main forms of ischemic heart disease were angina and heart failure; all patients showed one or more cardiovascular risk factors being arterial hypertension, smoking, increase of abdominal circumference and type A personality the most significant ones. Conclusions: the majority of patients showed alterations in the electrocardiogram: ST segment decrease, His bundle left branch blockage and atrial fibrillation; hypertriglyceridemia was observed and there was an association between chronic kidney disease and angina.


Subject(s)
Humans , Aged , Tobacco Use Disorder/etiology , Risk Factors , Myocardial Ischemia/diagnosis , Myocardial Ischemia/genetics , Myocardial Ischemia/epidemiology , Hypertension/etiology , Inpatients , Cardiovascular System/physiopathology , Epidemiology, Descriptive , Cross-Sectional Studies , Abdominal Circumference , Observational Study , Heart Failure/etiology , Angina Pectoris/etiology , Life Style
20.
Medicina (B.Aires) ; 79(3): 185-190, June 2019. tab
Article in Spanish | LILACS | ID: biblio-1020056

ABSTRACT

El diagnóstico de hiperaldosteronismo primario (HPAP) aumentó en los últimos años y algunos autores lo consideran la principal causa de hipertensión arterial secundaria. Estudiamos la prevalencia de HPAP en el total de pacientes hipertensos atendidos en la Unidad de Hipertensión Arterial, en el período comprendido entre julio 1999 a julio 2017. Se incluyeron 2500 pacientes y en 79 se diagnosticó HPAP (3.2%). El HPAP fue más frecuente en mujeres (55.7%), observándose un incremento en la edad geriátrica con relación a estudios previos (27.8%). El diagnóstico se sospechó ante la presencia de kaliuria inapropiada y alcalosis metabólica, acompañada de un cociente aldosterona/actividad de renina plasmática superior a 30 (ng/dl)/(ng/ ml/h). Tras su confirmación se realizaron estudios de imagen para determinar la etiología. Se detectaron así 29 casos (36.8%) de adenomas productores de aldosterona y 5 de hiperplasia bilateral suprarrenal con nódulos. La tomografía computarizada identificó el 100% de los adenomas y de las hiperplasias con nódulos corticales bilaterales. El tratamiento con suprarrenalectomía y/o antialdosterónicos resultó eficaz en el control de la presión arterial en el 69.9% de los casos. Se comentan aspectos particulares de esta serie, como la remisión de la insuficiencia renal, la elevada presencia de litiasis urinaria hipercalciúrica y la detección de un carcinoma de mama tras dosis prolongadas de espironolactona.


The diagnosis of primary hyperaldosteronism (PHPA) has progressively increased over the last years and some authors consider it as the main cause of secondary hypertension. We studied the prevalence of PHPA in hypertensive patients followed at the Hypertension Unit from July 1999 to July 2017. A total of 2500 patients were included and diagnosis of PHPA was done in 79 of them (3.2%). It was more frequent in women (55.7%) with an increased incidence in the elderly, as compared to previous studies (27.8%). Initial diagnosis was suspected upon the presence of inappropriate kaliuria and metabolic alkalosis, associated to an aldosterone/plasma renin activity ratio > 30 (ng/dl)/(ng/ml/h). After confirmation of the presence of PA, imaging techniques to determine the etiology were performed. In this way, 29 cases (36.8%) of aldosterone-producing adenoma and 5 cases of bilateral adrenal hyperplasia with nodules were identified. Computed tomography identified the adenomas and hyperplasias with bilateral cortical nodules in all patients. Adrenalectomy and/o r antialdosteronics were efficient in controlling blood pressure in 69.9% of cases. Of note in this series was the remission of stage 3 chronic renal failure in two cases, the high prevalence of hypercalciuric urinary lithiasis and a case of breast carcinoma after prolonged treatment with spironolactone.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Hyperaldosteronism/diagnosis , Hypertension/etiology , Tomography, X-Ray Computed , Cross-Sectional Studies , Retrospective Studies , Renin/blood , Aldosterone/blood , Hyperaldosteronism/complications , Hyperaldosteronism/blood
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