ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Meningitis/drug therapy , Meningitis , Relapsing Fever/complications , Relapsing Fever/drug therapy , Relapsing Fever/transmission , Tick Bites/complications , Tick Bites/drug therapy , Ceftriaxone/therapeutic use , Polymerase Chain Reaction , Doxycycline/therapeutic use , Erythromycin/therapeutic useSubject(s)
Meningitis, Bacterial/microbiology , Relapsing Fever/microbiology , Tick-Borne Diseases , Humans , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Blepharoptosis/complications , Blepharoptosis/diagnosis , Mydriasis/complications , Mydriasis/diagnosis , Exotropia/complications , Exotropia/diagnosis , Unconsciousness/complications , Unconsciousness/diagnosis , Infarction/complications , Infarction , Mydriasis/physiopathology , Exotropia/physiopathology , Consciousness , Thalamus/pathology , Thalamus , Coronary Occlusion/complicationsSubject(s)
Consciousness Disorders/etiology , Infarction, Posterior Cerebral Artery/diagnosis , Magnetic Resonance Imaging , Midline Thalamic Nuclei/blood supply , Posterior Cerebral Artery/abnormalities , Thalamic Diseases/etiology , Tomography, X-Ray Computed , Blepharoptosis/etiology , Exotropia/etiology , Humans , Infarction, Posterior Cerebral Artery/complications , Male , Middle Aged , Mydriasis/etiology , Posterior Cerebral Artery/diagnostic imaging , Posterior Cerebral Artery/pathology , SyndromeABSTRACT
Arterial hypertension (AHT) and cognitive problems, especially dementia, are very prevalent among the elderly. AHT is a direct risk factor for vascular dementia and recent studies have shown that it also has repercussions on the prevalence of Alzheimer's disease. Thus, given the fact that there is currently no effective treatment, the prevention of dementia with the aim of delaying or even preventing its appearance is a priority. Moreover, it leads us to pose the question as to whether treating AHT can help prevent dementia. To answer this question, we present a review of the main studies involving interventions with antihypertensive drugs in the prevention of dementia that have been published to date. These trials and meta-analyses suggest that antihypertensive treatment could reduce the risk of dementia by 3-20%, although with no clear statistical significance. However, there are a number of methodological limitations that largely account for the lack of conclusive results in the different intervention studies and which make it possible to deduce that the treatment of AHT does clearly reduce the appearance of dementia. Therefore, clearly further studies on hypertension need to be conducted with the primary aim of appraising the appearance of cognitive impairment or dementia.
Subject(s)
Antihypertensive Agents/therapeutic use , Dementia, Vascular/etiology , Dementia, Vascular/prevention & control , Hypertension/complications , Hypertension/drug therapy , Clinical Trials as Topic , HumansABSTRACT
La hipertensión arterial (HTA) y los problemas cognitivos, en particular la demencia, son muy prevalentes en las personas mayores. La HTA es un factor de riesgo directo de demencia vascular, y estudios recientes han señalado que también repercute sobre la prevalencia de la enfermedad de Alzheimer. Entonces, dado que en la actualidad se carece de tratamientos efectivos, la prevención de la demencia con el objetivo de retrasar o incluso evitar su aparición es prioritaria y, además, hace que nos planteemos la cuestión de si tratar la HTA puede ayudar a prevenir la demencia. Para responder a esta cuestión, se presenta una revisión de los principales trabajos de intervención con fármacos antihipertensivos en la prevención de demencia publicados hasta la fecha. Estos ensayos y metaanálisis sugieren que el tratamiento antihipertensivo podría reducir el riesgo de demencia un 3-20%, aunque sin clara significación estadística. No obstante, existen numerosas limitaciones metodológicas que justifican en gran parte la falta de resultados concluyentes en los diferentes estudios de intervención y que permitan inferir que el tratamiento de la HTA reduce de forma evidente la aparición de demencia. Por tanto, se necesita claramente la realización de nuevos estudios en hipertensión cuyo objetivo primario sea valorar la aparición de deterioro cognitivo o demencia (AU)
Arterial hypertension (AHT) and cognitive problems, especially dementia, are very prevalent among the elderly. AHT is a direct risk factor for vascular dementia and recent studies have shown that it also has repercussions on the prevalence of Alzheimers disease. Thus, given the fact that there is currently no effective treatment, the prevention of dementia with the aim of delaying or even preventing its appearance is a priority. Moreover, it leads us to pose the question as to whether treating AHT can help prevent dementia. To answer this question, we present a review of the main studies involving interventions with antihypertensive drugs in the prevention of dementia that have been published to date. These trials and meta-analyses suggest that antihypertensive treatment could reduce the risk of dementia by 3-20%, although with no clear statistical significance. However, there are a number of methodological limitations that largely account for the lack of conclusive results in the different intervention studies and which make it possible to deduce that the treatment of AHT does clearly reduce the appearance of dementia. Therefore, clearly further studies on hypertension need to be conducted with the primary aim of appraising the appearance of cognitive impairment or dementia (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Hypertension/prevention & control , Hypertension/therapy , Dementia/prevention & control , Risk Factors , Alzheimer Disease/epidemiology , Alzheimer Disease/prevention & control , Antihypertensive Agents/therapeutic use , Cohort Studies , Cognitive Dissonance , Indicators of Morbidity and Mortality , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/prevention & controlABSTRACT
La hipertensión arterial (HTA) tras la edad, es el factor de riesgo más importante relacionado con el ictus, y más del 25% de los ictus son atribuibles a la hipertensión. Actualmente en España la prevalencia de HTA en el anciano es aproximadamente del 70%, lo que se traduce que en nuestro país existen más de 5 millones de hipertensos mayores de 65 años. Hoy día son numerosos los ensayos y metaanálisis que demuestran que el tratamiento antihipertensivo reduce claramente el riesgo de ictus en los sujetos ancianos y muy ancianos (≥80 años). No obstante, aún existen numerosas áreas de incertidumbre como son: cuándo iniciar el tratamiento antihipertensivo, hasta dónde bajar las cifras tensionales o cuál es el mejor antihipertensivo en la prevención del ictus en esta población, entre otros. En este artículo presentamos una revisión de las evidencias actuales en la prevención primaria del ictus del paciente mayor mediante el tratamiento de la HTA(AU)
After age, arterial hypertension (AHT) is the most significant risk factor associated with stroke, and accounts for more than 25% of all strokes. The prevalence of AHT in the elderly in Spain is approximately 70%, which means that there are more than 5 million people over 65 years-old with hypertension in our country. There are currently numerous trials and meta-analyses that demonstrate that antihypertensive treatment clearly reduces the risk of stroke in elderly, and very elderly (≥80 years) subjects. However there are many areas of uncertainty such as, for example, when to start antihypertensive treatment, to what level should the blood pressure be lowered, or what is the best antihypertensive in the prevention of stroke in this population. In this article we present a review of the current evidence in the prevention of stroke in the elderly patient by means of treatment of the AHT(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Primary Prevention/methods , Primary Prevention/trends , Stroke/epidemiology , Stroke/prevention & control , Hypertension/complications , Hypertension/diagnosis , Risk Factors , Antihypertensive Agents/therapeutic use , Primary Prevention/organization & administration , Primary Prevention/standards , Stroke/complications , Stroke/rehabilitation , Hypertension/prevention & controlSubject(s)
Humans , Female , Middle Aged , Neuromyelitis Optica/complications , Neuromyelitis Optica/diagnosis , Neuromyelitis Optica/pathology , Paresthesia/complications , Methylprednisolone/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Neuromyelitis Optica/epidemiology , Neuromyelitis Optica/physiopathology , Neuromyelitis Optica , Myelitis, Transverse/complications , Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/complications , Magnetic Resonance ImagingSubject(s)
Neuromyelitis Optica/diagnosis , Aged , Demyelinating Diseases/diagnosis , Female , HumansABSTRACT
After age, arterial hypertension (AHT) is the most significant risk factor associated with stroke, and accounts for more than 25% of all strokes. The prevalence of AHT in the elderly in Spain is approximately 70%, which means that there are more than 5 million people over 65 years-old with hypertension in our country. There are currently numerous trials and meta-analyses that demonstrate that antihypertensive treatment clearly reduces the risk of stroke in elderly, and very elderly (≥80 years) subjects. However there are many areas of uncertainty such as, for example, when to start antihypertensive treatment, to what level should the blood pressure be lowered, or what is the best antihypertensive in the prevention of stroke in this population. In this article we present a review of the current evidence in the prevention of stroke in the elderly patient by means of treatment of the AHT.
Subject(s)
Hypertension/drug therapy , Primary Prevention , Stroke/prevention & control , Aged , Antihypertensive Agents/therapeutic use , Clinical Trials as Topic , Humans , Hypertension/complications , Stroke/etiologyABSTRACT
BACKGROUND: Hypertensive left ventricular hypertrophy (HLVH) is a major risk factor for cardiovascular morbidity, mortality, and stroke. However, little is known about the importance of transthoracic echocardiography (TTE) in the assessment of HLVH in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). METHODS: We studied 203 consecutive patients admitted to our hospital with AIS or TIA and who were referred for TTE over the last 4 years. We included 102 (50.2%) lacunar strokes, 76 (37.1%) nonlacunar strokes, and 25 (12.3%) TIAs. The mean age was 68.9 years (standard deviation ± 11) and 128 patients were male (63.1%). RESULTS: Hypertension was the most common risk factor (131 patients; 64.5%). HLVH was seen in 86 cases (42.3%), in 51.9% of patients with previous hypertension, and in 25% of patients without known hypertension. We found that neither stroke subtype nor any previous risk factor, with the exception of hypertension (P = .0001), were associated with HLVH. Patients with HLVH were younger (67 v 71 yrs; P = .013) and more frequently women (50.6% v 37.5%; P = .078). At discharge, patients with HLVH were more likely to receive antihypertensive treatment (97% v 80%; P = .009) and a higher average number of antihypertensive drugs (2.2 v 1.4; P = .0001). CONCLUSIONS: HLVH was common in patients with AIS or TIA. These individuals had an increased risk of stroke and needed a more intensive therapy. TTE should be carried out in all AIS and TIA patients in order to optimize the management of these patients.
Subject(s)
Brain Ischemia/epidemiology , Hypertension/epidemiology , Hypertrophy, Left Ventricular/diagnostic imaging , Ischemic Attack, Transient/epidemiology , Stroke/epidemiology , Aged , Aged, 80 and over , Antihypertensive Agents/therapeutic use , Brain Ischemia/diagnosis , Brain Ischemia/therapy , Chi-Square Distribution , Female , Humans , Hypertension/diagnosis , Hypertension/drug therapy , Hypertrophy, Left Ventricular/epidemiology , Hypertrophy, Left Ventricular/therapy , Ischemic Attack, Transient/diagnosis , Ischemic Attack, Transient/therapy , Male , Middle Aged , Predictive Value of Tests , Prevalence , Retrospective Studies , Risk Factors , Spain/epidemiology , Stroke/diagnosis , Stroke/therapy , Time Factors , UltrasonographySubject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Clinical Trials as Topic , Hypertension/drug therapy , Stroke/drug therapy , Stroke/physiopathology , Benzimidazoles/therapeutic use , Biphenyl Compounds , Double-Blind Method , Humans , Placebos , Tetrazoles/therapeutic use , Time FactorsABSTRACT
No disponible
Subject(s)
Humans , Stroke/physiopathology , Hypertension/drug therapy , Antihypertensive Agents/therapeutic useSubject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Blood Pressure , Blood Pressure/physiology , Hypertension/epidemiology , Hypertension/prevention & control , Blood Pressure/ethics , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Health of the ElderlyABSTRACT
No disponible
No disponible
Subject(s)
Humans , Echocardiography , Stroke/diagnosis , Hypertrophy, Left Ventricular , Hypertension/complicationsSubject(s)
Echocardiography/statistics & numerical data , Stroke/diagnosis , Humans , Stroke/therapyABSTRACT
No disponible
No disponible
Subject(s)
Humans , Stroke/mortality , Local Health Strategies , 35178Subject(s)
Stroke , Geography , Humans , Risk Factors , Spain , Stroke/etiology , Stroke/physiopathologyABSTRACT
No disponible
