Diet and medication in the treatment of hyperuricemia in hypertensive patients.

OBJECTIVE: To evaluate the effects of diet and medication, either isolated or associated, on serum levels of uric acid in patients with hyperuricemia. METHODS: We studied patients from the Hypertension Unit of the University of Goias who had hyperuricemia (men > or =8.5 mg/dL and women > or =7.5 mg/dL). We divided the patients into three groups: G1 (low purine diet), G2 (low purine diet + medication), and G3 (medication only). Patients received allopurinol, 150 mg/day titrated up to 300 mg/dL when necessary. Patients were evaluated with regards to their lifestyles (diet, smoking, physical, activity, alcohol consumption), uric acid, blood pressure, use of medication, body mass index, cholesterol, and triglyceride. Follow-up took place in weeks 0 (M1), 6 (M2), 12 (M3) during the intervention and in week 36 (M4) after the study was completed. RESULTS: Fifty-five patients participated in the study, 31 women, mean age 54.4+/-10.6 years, body mass index 28.6+/-3.9 kg/m2. A similar reduction (p<0.001) in uric acid levels occurred in the three intervention groups. In week 36 (M4), after 24 weeks without intervention, a tendency toward elevation of uricemia was noted in G2 and G3, and a continuous drop in uricemia was noted in G1. No significant modifications were observed in the other variables analyzed. CONCLUSION: Considering the cost x benefit relationship, a diet low in purine should be the 1st therapeutic option for controlling hyperuricemia in patients with similar characteristic to the ones presented in this study.

[Different therapies in the treatment of obesity in hypertensive patients]. / Diferentes terapias no tratamento da obesidade em pacientes hipertensos.

PURPOSE: To evaluate the efficacy and tolerability of different therapies associated with diet in the treatment of hypertensive obese patients. METHODS: In a clinical study we randomly evaluated 39 hypertensive obese patients (body mass index (BMI) > or = 30 kg/m2). After 45 days of diet the patients were again randomly distributed in 3 groups and received in double blind way: group 1-hypocaloric diet+placebo; group 2-hypocaloric diet+dexfenfluramine; group 3-hypocaloric diet+spiruline+fucus+gelatin. We followed their progress during 12 weeks under medication and further 24 weeks without. We evaluated the groups comparing: weight, BMI, blood pressure and side-effects. RESULTS: Twenty seven patients completed the observation. In those patients from groups 1 and 3 no changes in any of parameters were observed. In group 2 we observed a clear loss of weight (-3.8 Kg) and a fall in BMI. Blood Pressure changes were only observed in group 2 (-9.6%). The only patients to maintain weight loss after the termination of use of medicines were those from group 2. We did not observe any side-effects. CONCLUSION: In hypertensive obese patients, when isolated diet is not enough to control weight loss, dexfenfluramine could be useful in association with a controlled diet. The drug assists in weight loss, does not promote side-effects and does not interfere in the treatment of blood pressure.

[Multidisciplinary experience in the approach to the hypertensive patient]. / Uma experiência multiprofissional na abordagem ao paciente hipertenso.

PURPOSE: To evaluate the impact of the educational activities on the approach of patients with hypertension, with an interdisciplinary team. METHODS: Fifty patients divided into two groups: A) with 25 patients who participated in educational activities in the Hypertension League (HL) and B) who were also registered and did not take part in the activities. They were studied regarding blood pressure (BP), weight control, smoking habits, alcoholic beverage consumption, physical activities and frequency of medical care. RESULTS: There was a drop in BP of 84% of the patients in group A and 88% in group B, a drop in weight in 60% of group A and 44% of group B. We registered the presence of 4% of smokers in group A and 16% in group B. Physical activities were regular in 56% of group A and 36% in group B. Absenteeism to meetings was slightly higher among group B (44%) when compared with group A (30%). CONCLUSION: In spite of not having observed any significant differences between both approaches, regarding to strict BP control, we were able to observe a noticeable advantage in favor of the educational approach to the group, with participation of interdisciplinary team.