Uricemia y síndrome metabólico en pacientes con hipertensión arterial / Uricemia and metabolic syndrome in patients with arterial hypertension

Objetivo. Los niveles de uricemia se han asociado con el síndrome metabólico (SM). Sin embargo, la relación entre estas 2 variables en pacientes con hipertensión arterial (HTA) esencial no ha sido estudiada. Pacientes y métodos. Estudio observacional, transversal, de 592 pacientes con HTA esencial. Para la definición de SM se emplearon >=3 criterios de la ATP-III. Se excluyeron a los pacientes con tratamiento hipouricemiante. Resultados. La prevalencia de SM fue del 52% (IC del 95%: 48-56%) y aumentó gradualmente a medida que se incrementaba la uricemia (uricemia: <=4,7mg/dl, 36%; uricemia >=6,8mg/dl, 70%; p<0,001). Los enfermos hipertensos con SM mostraron una uricemia media más elevada que los que no tenían esta comorbilidad (6,1±1,5mg/dl vs 5,4±1,3mg/dl; p<0,0001). La prevalencia de hiperuricemia (varones: >=7,0mg/dl; mujeres: >=6,0mg/dl) en los pacientes hipertensos que no recibían tratamiento diurético fue del 24,3% (en aquellos con SM, 40,5% frente a un 11,4% en los que no tenían SM; p<0,001). En el análisis multivariante los triglicéridos (OR: 1,008; IC del 95%: 1,004-1,012; p<0,001) y el índice de masa corporal (IMC) (OR: 1,118; IC del 95%: 1,059-1,181; p<0,001) fueron predictores independientes de la uricemia. Conclusiones. En los pacientes con HTA esencial, aproximadamente la mitad padecen SM y uno de cada 4 presenta hiperuricemia. El determinante más relevante del incremento de la concentración sérica de uratos es el aumento del IMC(AU)

Objective. Serum urate levels have been associated with metabolic syndrome (MS). However, the relationship between these two variables in patients with essential arterial hypertension has not been studied. Patients and methods. A Cross-sectional study in 592 patients with essential hypertension. The MS was defined according to the ATP-III criteria. We excluded patients with hypouricemic treatment. Results. The prevalence of MS was 52% (95% CI, 48-56%) and there was a graded increase with increasing serum urate (uricemia <=.7 mg/dl, 36%; uricemia >=6.8 mg/dl, 70%, P < 0.001). Hypertensive patients with MS showed a higher mean uricemia than those without this comorbidity (6.1 ± 1.5 mg/dl versus 5.4 ± 1.3 mg/dl, P <0.0001). The prevalence of hyperuricemia (men, > 7.0 mg/dL; women, >6.0 mg/dL) in hypertensive patients without diuretic treatment, was 24% (in those with MS 40% versus 11% without MS). In multivariate analysis, triglycerides (OR = 1.008, CI 95%: 1.004-1.012, P < 0.001) and body mass index (BMI) (OR = 1.118, CI 95%: 1.059-1.181, P < 0.001), were independent predictors of serum uric acid levels. Conclusions. In patients with essential hypertension, about half have MS and one out of four has hyperuricemia. The most important determinant of hyperuricemia is BMI(AU)

[Uricemia and metabolic syndrome in patients with arterial hypertension]. / Uricemia y síndrome metabólico en pacientes con hipertensión arterial.

OBJECTIVE: Serum urate levels have been associated with metabolic syndrome (MS). However, the relationship between these two variables in patients with essential arterial hypertension has not been studied. PATIENTS AND METHODS: A Cross-sectional study in 592 patients with essential hypertension. The MS was defined according to the ATP-III criteria. We excluded patients with hypouricemic treatment. RESULTS: The prevalence of MS was 52% (95% CI, 48-56%) and there was a graded increase with increasing serum urate (uricemia ≤ 4.7 mg/dl, 36%; uricemia ≥ 6.8 mg/dl, 70%, P < 0.001). Hypertensive patients with MS showed a higher mean uricemia than those without this comorbidity (6.1 ± 1.5 mg/dl versus 5.4 ± 1.3 mg/dl, P < 0.0001). The prevalence of hyperuricemia (men, > 7.0 mg/dL; women, > 6.0 mg/dL) in hypertensive patients without diuretic treatment, was 24% (in those with MS 40% versus 11% without MS). In multivariate analysis, triglycerides (OR = 1.008, CI 95%: 1.004-1.012, P < 0.001) and body mass index (BMI) (OR = 1.118, CI 95%: 1.059-1.181, P < 0.001), were independent predictors of serum uric acid levels. CONCLUSIONS: In patients with essential hypertension, about half have MS and one out of four has hyperuricemia. The most important determinant of hyperuricemia is BMI.

[The follow-up of a patient cohort with arterial hypertension in primary care]. / Seguimiento de una cohorte de pacientes con hipertensión arterial en atención primaria.

OBJECTIVE: To establish effectiveness of the hypertension program basing on the detection degree, decreasing of blood pressure and control of hypertension. DESIGN: Intervention study. SETTING: Primary care. PATIENTS: A group > or = 14 years of age, treated by the primary health care and selected at random (3,349). Here we found all the patients with hypertension (237). INTERVENTION AND MAIN RESULTS: Hypertension program approval of the public health department. Criteria followed are those suggested in report V of the Joint National COMMITTEE: Global prevalence of hypertension is 7.1% and in the group > or = 65 years of age 51.3%. Average decrease of the systolic blood pressure is 18.9 mmHg and that of the diastolic blood pressure 13.5 mmHg, both with p < 0.001. Decrease for patients with mild hypertension was 5.4-13.8 mmHg for systolic and 6.7-11.8 for diastolic. Patients with moderate hypertension 17.3-22.5 and 12.2-15.7 mmHg respectively and patients with severe hypertension 27.6-43.0 and 15.0-23.0 mmHg. The 39.7% of hypertensive patients have systolic < 140 mmHg and 70.0% have diastolic < 90 mmHg at the end of monitoring period. CONCLUSIONS: Actual application of hypertension program by our primary care system allows detection of elderly patients with high blood pressure, major decrease of blood pressure, together with a greater decrease even whether they high at the beginning of the monitoring.