ABSTRACT
OBJECTIVE: To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic. METHODS: Ninety-eight hypertensive patients with left ventricular hypertrophy (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure < or =90 and systolic blood pressure < or =140 mm Hg. Left ventricular (LV) mass index was calculated by M mode and two-dimensional echocardiography, and left ventricular diastolic function was assessed by transmitral pulsed Doppler ultrasound every 3 months. RESULTS: Sixty-three patients were women and 35 were men, mean age was 53.4 +/- 8.4 years (range 34-70). Thirty-six patients had mild (36.7%) and 62 (63.3%) moderate hypertension. Treatment reduced significantly both systolic pressure from 165 +/- 13 to 137 +/- 12.9 mm Hg (p<0.05) and diastolic pressure from 99 +/- 8.6 to 86 +/- 6.37 mm Hg (p<0.05). LV mass index decreased from 155.4 +/- 32.9 to 121.7 +/- 29.14 g/m2 (p<0.05). Late diastolic filling velocity (A wave) and the ratio of E/A waves improved (p<0.05), but early diastolic filling velocity (E wave) and isovolumetric relaxation time did not change with treatment. CONCLUSIONS: Some indexes of diastolic function improved after regression of left ventricular hypertrophy and good blood pressure control with captopril and chlortalidone.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Blood Pressure , Hypertension , Hypertrophy, Left Ventricular , Antihypertensive Agents , Blood Pressure/physiology , Captopril , Chlorthalidone , Diastole , Diastole/physiology , Hypertension , Hypertrophy, Left Ventricular , Prospective StudiesABSTRACT
BACKGROUND: Gestational diabetes (GD) is third in frequency according to the American Diabetes Association (ADA) and it affects 7% of pregnancies in Mexico, it is related with greater morbidity and mortality. An early diagnosis can avoid pregnancy problems, however the detection of these cases depends on the presence risk factors. Our objective was to know which are the risk factors more frequent for identifiying GD. METHODS: Transverse, descriptive study at an endocrinology service of a Gynecology-Pediatrics Hospital. All case records from patients with GD were reviewed with special attention to risk factors. Pregnancy and previous products morbidity history were reviewed as well. RESULTS: 166 patient's files were analyzed aged from 21 to 46, 59% corresponded to > 25 years, 29% with first pregnancy, of these 26% had history of macro products, and 42% were diagnosed in the first half of the pregnancy. CONCLUSIONS: The main risk factors related with GD were the age > 25 years and the direct antecedent of DG.
Subject(s)
Diabetes, Gestational/epidemiology , Risk-Taking , Adult , Cross-Sectional Studies , Diabetes, Gestational/diagnosis , Diabetes, Gestational/etiology , Female , Humans , Mexico , Middle Aged , Pregnancy , Risk Factors , Young AdultABSTRACT
OBJECTIVE: To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic. METHODS: Ninety-eight hypertensive patients with left ventricular hypertrophy (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure < or =90 and systolic blood pressure < or =140 mm Hg. Left ventricular (LV) mass index was calculated by M mode and two-dimensional echocardiography, and left ventricular diastolic function was assessed by transmitral pulsed Doppler ultrasound every 3 months. RESULTS: Sixty-three patients were women and 35 were men, mean age was 53.4 +/- 8.4 years (range 34-70). Thirty-six patients had mild (36.7%) and 62 (63.3%) moderate hypertension. Treatment reduced significantly both systolic pressure from 165 +/- 13 to 137 +/- 12.9 mm Hg (p<0.05) and diastolic pressure from 99 +/- 8.6 to 86 +/- 6.37 mm Hg (p<0.05). LV mass index decreased from 155.4 +/- 32.9 to 121.7 +/- 29.14 g/m2 (p<0.05). Late diastolic filling velocity (A wave) and the ratio of E/A waves improved (p<0.05), but early diastolic filling velocity (E wave) and isovolumetric relaxation time did not change with treatment. CONCLUSIONS: Some indexes of diastolic function improved after regression of left ventricular hypertrophy and good blood pressure control with captopril and chlortalidone.
