Determinación de la morbilidad subclínica en pacientes hipertensos

Introducción: La hipertensión arterial sistémica es una enfermedad crónica con alta prevalencia, y a la vez una enfermedad y un factor de riesgo para otras enfermedades crónicas no trasmisibles, debido a su potencialidad de ocasionar daño oculto en órganos diana. Objetivo: Determinar la morbilidad subclínica en el paciente hipertenso atendido en un consultorio del Ministerio del Interior de una unidad penitenciaria en la provincia de Camagüey, entre los años 2020 y 2022. Materiales y métodos: Se realizó un estudio observacional, descriptivo, longitudinal sobre la relación existente entre lesión oculta de órgano diana y las cifras de tensión arterial, en una muestra dada por 82 pacientes hipertensos, con examen clínico normal. De estos se obtuvo edad, color de la piel, cifras de tensión arterial, antecedentes patológicos personales, hábitos tóxicos, filtrado glomerular, electrocardiograma y Mini-Mental State Examination, los cuales fueron manejados según estadísticas descriptivas. Resultados: Predominó el grupo de edades entre 31 y 50 años, blancos, sedentarios y obesos, encontrando, además, un elevado por ciento de fumadores, con un reducido número de alcohólicos y drogadictos; un alto por ciento de pacientes sufría de daño renal según filtrado glomerular. El daño cardiovascular diagnosticado por alteraciones electrocardiográficas apareció en un tercio de la muestra, y el daño neurológico por el test Mini-Mental, se observó en más de la mitad. Conclusiones: La totalidad de los pacientes estudiados presentaba algún tipo de daño orgánico subclínico.

Introduction: Systemic arterial hypertension is a chronic disease with high prevalence, and at the same time a disease and a risk factor for other chronic non-communicable diseases, due to its potential to cause hidden damage in target organs. Objective: To determine subclinical morbidity in hypertensive patients treated in a medical consultation of a penitentiary unit of the Ministry of Interior in the province of Camagüey, between 2020 and 2022. Materials and methods: An observational, descriptive and longitudinal study was carried out on the relationship between hidden target organ lesion and blood tension levels, in a sample of 82 hypertensive patients with normal clinical examination. From them, age, skin color, blood pressure figures, personal pathological antecedents, toxic habits, glomerular filtration, electrocardiogram and Mini-Mental State Examination were obtained, which were managed according to descriptive statistics. Results: The age group between 31 and 50 years, white, sedentary, and obese people predominated, also finding a high percent of smokers, with a small number of alcoholic and drug addicts; a high percentage of patients suffered from renal damage according to glomerular filtration. Cardiovascular damage diagnosed by electrocardiographic alterations appeared in a third of the sample, and neurological damage from the Mini-Mental test, was observed in more than half of the sample. Conclusions: All the studied patients presented some type of subclinical organic damage.

Microalbuminúria e lesão em órgão-alvo em hipertensos idosos / Microalbuminuria and target organ damage in hypertensive elderly

Fundamento: A hipertensão arterial sistêmica (HAS) é uma doença com elevada prevalência na população geriátrica, assim como a presença de outros fatores de risco para doença cardiovascular (DCV). A microalbuminúria é um preditor precoce para essas doenças e pode estar relacionada à presença de lesão em órgão-alvo (LOA) nessa população. Objetivo: Verificar a prevalência e a relação entre microalbuminúria e lesão em órgão-alvo em uma população de hipertensos idosos em tratamento. Métodos: Estudo transversal com 132 pacientes com HAS em tratamento anti-hipertensivo, atendidos em um ambulatório de um hospital de ensino. Foram avaliados dados demográficos, fatores de risco para DCV, incluindo a microalbuminúria e a presença de LOA. Resultados: A maioria da população estudada era do sexo feminino (68,9% (91/132)), da cor branca (93,2% (123/132)) e com idade média de 70,15 anos (± 7,9). A prevalência de microalbuminúria foi de 9,8% (13/132) e a de LOA de 55,3% (73/132), com relação estatisticamente significante entre ambas (p=0,004). Dentro das LOA as lesões cardíacas (LC) foram as mais prevalentes (46,2% (61/132)), com relação estatisticamente significante entre essas e a microalbuminúria (p=0,003). Entre as LC predominou a angina/infarto agudo do miocárdio (IAM) com 32,6% (43/132), seguida pela hipertrofia do ventrículo esquerdo (HVE) e insuficiência cardíaca congestiva (ICC) com a mesma percentagem (15,2% (20/132)) e revascularização com 10,6% (14/132). Conclusão: A prevalência de microalbuminúria é de 9,8% e a de LOA é de 55,3%. Existe uma associação estatisticamente significante entre microalbuminúria e LOA, mantendo-se essa relação também com as LC...

Effects of Total Alkaloids of Rhynchophylline on Baroreflex and Hypertensive Target Organs in Spontaneous Hypertensive Rats / 医药导报

Objective To investigate the effect of total alkaloids from Rhynchophylline on hypertensive target organs. Methods 40 spontaneous hypertensive rats (SHRs) were divided into 4 groups as follows: normal control group,positive control with Tianma Goutengyin granule at 750 mg?d-1 ,total alkaloids from Rhynchophylline at 2.5 mg?day-1 as low dosage,and at 15.0 mg?d-1 as high dosage.All the rats were fed up for 20 weeks,and baroreflex sensitivity (BRS,in ms?mmHg-1)was determined by revised Smyth’s method.Heart,brain and kidney of the rats were sectioned for histological analysis at the end of 20th week. Results In sixteenth weeks,BRS of positive control,Tianma Goutengyin granule group,total alkaloids at low dosage and high dosage were(0.27±0.05),(0.31±0.06),(0.35±0.08),(0.34±0.08) ms?mmHg-1,respectively.BRS in SHR was not decreased except in the positive control.The treatment groups were superior to the normal control group in structure of heart,but not in the brain and kidney of the rats. Conclusion Total alkaloids from Rhynchophyllinecould protect heart from hypertensive injury.

Experiencia con el paciente en la consulta especializada de hipertensión arterial complicada / Experience gained in the treatment of patients at the specialized completed hypertension service

Se presentaron los resultados de la consulta especializada de hipertensión arterial complicada en el Hospital Clinicoquirúrgico "Hermanos Ameijeiras", durante el año 2008. Se evaluaron 69 pacientes a los que se les aplicó el protocolo asistencial diseñado para la consulta. Se evaluó el perfil de riesgo de cada paciente, así como la repercusión en órganos diana. La repercusión cardiovascular fue la más frecuentemente encontrada con el 92,7 %. Se estratificó el riesgo cardiovascular en los pacientes estudiados, resultó alto o muy alto en el 85,5 %. Se realizaron modificaciones al tratamiento acorde con la evaluación realizada, fue necesario utilizar 3 fármacos o más en el 56 % de los pacientes para lograr control de la presión arterial. Los fármacos antihipertensivos más utilizados fueron los diuréticos tiazídicos, los inhibidores de la enzima convertidora de la angiotensina y los anticálcicos. La aplicación del protocolo asistencial diseñado para la consulta demostró ser de gran utilidad en la evaluación, estratificación del riesgo cardiovascular y en el control y seguimiento de estos pacientes.

Results from arterial hypertension specialized consultation complicated in the "Hermanos Ameijeiras" Surgical Clinical Hospital during the 2008 year were showed. Authors assessed 69 patients in whom a health care protocol was applied for consultation. Risk profile of each patient was assessed, as well as the impact on target organs. Cardiovascular impact was the more frequent founded for a 92.7 %. Cardiovascular risk was stratified in study patients being high or higher in the 85.5 %. Treatment was modified according to assessment performed and it was necessary to use 3 drugs or more in 56% of patients to achieve the arterial pressure control. The more used antihypertensive drugs were the thiazide diuretics, angiotensin-converting enzyme inhibitors, and the anticalcic ones. Application of health care protocol designed for consultation was a very useful means in assessment, cardiovascular risk stratification, and in control and follow-up of these patients.

Resting heart rate and target organs damage in senile metabolic syndrome / 中国综合临床

Objective To investigate the relationship between resting heart rate (RHR) and target organs damage (TOD) in senile metabolic syndrome(SMS). Methods With case-control study,215 elderly patients with MS were divided into 3 groups according to the level of RHR [RHR1 group: RHR <70 beats/ minute (bpm) (n=55);RHR2group: 70 bpm ≤RHR<80 bpm [n=87);RHR3 group: RHR≥80 bpm (n=73).Mean-while ,60 healthy senile persons were taken as normal control group. For all objects researched, electrocardiography, echocardiography,carotid ultrasonography, creatinine clearance rate (Ccr) and quantitative assay for 24 hours' urina-ry microalbuminuria (MAU) were performed. Part of SMS patients was examined by coronary angiography and com-puter tomography (CT) of head. Results ① Compared with normal control group, RHR groups showed higher lev-els of carotid intima-medial thickness (IMT), carotid arterial diameter (CAD), left ventricular mass index (LVMI) and MAU, lower levels of left ventricular ejection fraction (LVEF) and Ccr (P<0.05 or 0.01). With RHR increas-ing among RHR groups,IMT,CAD,LVMI,MAU and the score of coronary artery stenosis increased,and LVEF and Cer decreased (P<0.05 or 0.01). ② The levels of IMT, CAD, LVMI and MAU were positively correlated to RHR (r=0.34,0.25,0.62, and 0.57, respectively, P<0.05 or 0.01). However, the levels of LVEF and Ccr were nega-tively correlated to RHR (r=-0.60,-0.52 respectively,P<0.01). ③ Logistic multivariate analysis showed that RHR, pulse pressure (PP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) influenced TOD,such as myocardial hypertrophy,coronary heart disease,heart failure, cerebral stroke and renal damage in dif-ferent degrees, among them, PP and RHR played more important roles than those of other factors. Conclusion RHR may be an independent risk factors of TOD in senile MS. It is indicated that RHR regulation is important for the de-velopment of senile MS.

Systemic hypertension and microalbuminuria / Hipertensão arterial sistêmica e microalbuminúria

OBJETIVO: Identificar a prevalência de microalbuminúria e de lesões em órgãos-alvo e sua associação, em uma população de hipertensos em tratamento. MÉTODOS: Estudo observacional, descritivo e transversal, realizado no período de abril a agosto de 2006, com 153 pacientes hipertensos em tratamento, atendidos no Ambulatório de Clínica Médica e de Cardiologia de um Hospital Universitário na Região Sul do Brasil. RESULTADOS: A prevalência de microalbuminúria foi de 13,7 por cento (21/153), sendo os grupos com e sem microalbuminúria semelhantes quanto às características demográficas e clínicas. A prevalência de lesões em órgãos-alvo foi de 48,4 por cento, com predomínio de lesões cardíacas. As lesões em órgãos-alvo foram mais freqüentes no grupo com microalbuminúria [76,2 por cento (16/21) versus 43,9 por cento (58/132)], com diferença estatisticamente significante (p=0,006). Isso também foi observado nas lesões cardíacas, tanto na população total (p=0,003) quanto no grupo geriátrico (p=0,006). CONCLUSÃO: A prevalência de microalbuminúria na população estudada é de 13,7 por cento e a de lesões em órgãos-alvo é de 48,4 por cento, havendo associação estatisticamente significante. A microalbuminúria também está associada a lesões cardíacas, inclusive na população geriátrica.

OBJECTIVE: To identify the prevalence of microalbuminuria and target organ lesions and their association in a hypertensive population undergoing treatment. METHODS: This observational, descriptive and cross-sectional study was conducted between April and August 2006, and included 153 hypertensive patients undergoing treatment at the Internal Medicine and Cardiology Outpatient Clinics at a University Hospital in the Southern Region of Brazil. RESULTS: The prevalence of microalbuminuria was 13.7 percent (21/153). The clinical and demographic characteristics of groups with and without microalbuminuria were similar. The prevalence of target organ lesions was 48.4 percent, of which most were cardiac lesions. Target organ lesions were found more often in the microalbuminuria group [76.2 percent (16/21) versus 43.9 percent (58/132)] with a significant statistical difference (p=0.006). This was also observed in the cardiac lesions, for both the total population (p=0.003) and the geriatric group (p=0.006). CONCLUSION: The prevalence of microalbuminuria in the study population was 13.7 percent and that of target organ lesions was 48.4 percent; a statistically significant association was found. Microalbuminuria is also associated with cardiac lesions, including in the geriatric population.

Study on Animal Models of Decompression Sickness / 航天医学与医学工程

Objective To study the profiles of decompression sickness(DCS) in various kinds of animals and to find out the target organ of decompression sickness by providing a basic experimental method for establishing animal models.Method Eleven kinds of animals were exposed to different pressures for different times at different compression/decompression rates.They were monitored at the precordial regions with Doppler flow meter for bubble sounds after decompression to normal pressure,to obtain a record about the developing course of the DCS.Pathological examinations of the bulbar conjunctiva were also made. Result Bubble sound of grade IV were recorded at the precordial regions after decompression.Among them,75%~100% incurred DCS with a diverse extent. Animals developed DCS showed vascular spasm,dysfunction and endothelial tumefaction.Conclusion Each of the 11 kinds of animals can serve as a model of DCS and the processes of development of DCS in various animals are similar.Blood vessels are the target organs of decompression sickness.