RESUMO
Pulmonary hypertension (PH) is a group of diseases characterized by increased pulmonary vascular resistance (PVR). Regardless of its cause, PH leads to right ventricular failure and premature death. Recent advances in the diagnosis and treatment of PH have prompted the elaboration of new guidelines for the diagnosis and treatment of PH. This paper provides a brief overview of major achievements in diagnostic and treatment approaches in patients PH.
Assuntos
Insuficiência Cardíaca , Hipertensão Pulmonar , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Hipertensão Pulmonar/complicações , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/fisiopatologia , Hipertensão Pulmonar/terapia , Guias de Prática Clínica como Assunto , Pressão Propulsora Pulmonar , Resistência VascularRESUMO
AIM: To estimate the possibility of predicting the presence and severity of coronary atherosclerosis from arterial stiffness characteristics and augmentation index (AIx) in patients with essential hypertension (EH) obtained under outpatient conditions. MATERIALS AND METHODS: The general clinical examination of 15 patients aged 30-70 yr with EH was supplemented by measuring blood glucose and creatinine levels, the lipid status (LWLP, HDLP, TG), duplex scanning of carotid arteries, and evaluation of arterial stiffness by pulsed wave contour analysis. RESULTS: AIx and age were independent risk factors of coronary atherosclerosis in patients with EH and severity of its manifestations. AIx values over 25% were with high specificity (over 85%) associated with atherosclerotic lesions.
Assuntos
Assistência Ambulatorial/métodos , Artérias Carótidas , Doenças das Artérias Carótidas , Hipertensão , Rigidez Vascular , Velocidade do Fluxo Sanguíneo , Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/fisiopatologia , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/epidemiologia , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/fisiopatologia , Hipertensão Essencial , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Quirguistão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Prognóstico , Análise de Onda de Pulso/métodos , Medição de Risco , Ultrassonografia Doppler Dupla/métodosRESUMO
Assessment of prevalence of risk factors for non-communicable diseases (NCD) based on WHO "STEPS" approach was conducted in Kyrgyzstan. Results of this study demonstrated high prevalence of NCD risk factors: 94.2% of subjects aged 24-64 years had risk factors. Prevalence of elevated blood pressure was 48.7, smoking - 25.7, hypercholesterolemia - 23.6, excessive alcohol consumption - 31.4, physical inactivity 11.4, obesity - 23.1, elevated glucose level - 4.5, diabetes - 8.8, inadequate intake of fruits and vegetables - 74%. The data obtained would allow to draft effective preventive measures to combat NCD risk factors at the national level.
Assuntos
Doenças não Transmissíveis/epidemiologia , Adulto , Idoso , Doenças Cardiovasculares , Diabetes Mellitus , Feminino , Humanos , Hipercolesterolemia , Hipertensão , Quirguistão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade , Prevalência , Fatores de Risco , FumarRESUMO
AIM: to investigate association of lipoprotein-associated phospholipase A2 (Lp-PLA2) level (mass) with ischemic stroke in patients with essential hypertension (EH) with or without dyslipidemia. MATERIAL AND METHODS: We examined 60 patients with EH without complications and 90patients with EH and history of ischemic stroke. Examination included measurement of height, weight, waist, blood pressure and heart rate, determination of glucose, creatinine, lipid profile, Lp-PLA2 mass, and duplex scanning of carotid arteries. All patients were divided into 2groups: A) with high (n=70), and B) normal or mildly elevated (n=80) levels of low density lipoprotein cholesterol (LDLC). RESULTS: In group A (LDLC <3.4 mmol/L) Lp-PLA2 mass in patients with stroke was higher than in patients with uncomplicated EH; age and elevated Lp-PLA2 mass were independently associated with history of stroke. In group B (LDLC >3.4 mmol/L) Lp-PLA2 mass did not differ between patients with EH with or without stroke while low level of high density lipoprotein cholesterol was most significantly associated with history of stroke. INTERPRETATION: These results suggest that the role of LP-PLA2 in the development of ischemic stroke is reduced in the presence of evident dyslipidemia and high level of traditional cardiovascular risk factors. However, in the presence of low level of traditional metabolic risk factors proinflammatory substances and LP-PLA2 in particular acquire dominant role in the processes of atherogenesis and plaque destabilization.
Assuntos
1-Alquil-2-acetilglicerofosfocolina Esterase/sangue , LDL-Colesterol/sangue , Hipertensão , Acidente Vascular Cerebral , Idoso , Antropometria , Aterosclerose/metabolismo , Biomarcadores/sangue , Pressão Sanguínea , Dislipidemias/metabolismo , Hipertensão Essencial , Feminino , Frequência Cardíaca , Humanos , Hipertensão/sangue , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controleAssuntos
Artérias Carótidas/fisiopatologia , DNA/genética , Endotélio Vascular/fisiopatologia , Hipertensão/genética , Peptidil Dipeptidase A/genética , Polimorfismo Genético , Vasodilatação/fisiologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Artérias Carótidas/diagnóstico por imagem , Endotélio Vascular/diagnóstico por imagem , Predisposição Genética para Doença , Genótipo , Humanos , Hipertensão/enzimologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Ultrassonografia Doppler DuplaAssuntos
Adjuvantes Imunológicos/farmacologia , Citotoxicidade Imunológica/efeitos dos fármacos , Interferons/efeitos dos fármacos , Células Matadoras Naturais/efeitos dos fármacos , Lactobacillus/imunologia , Lactococcus lactis/imunologia , Doadores de Sangue , Células Cultivadas , Concanavalina A/farmacologia , Citotoxicidade Imunológica/imunologia , Humanos , Indutores de Interferon/farmacologia , Interferons/biossíntese , Células Matadoras Naturais/imunologiaRESUMO
Biophysical assessment of circulation was performed in 135 patients with essential hypertension and 39 healthy subjects at rest and during exercise. An increase in arterial impedance was found to play a major part in the mechanisms of blood pressure elevation. In patients with eukinetic hemodynamics, the markedness of left ventricular hypertrophy was associated with adequate circulatory biophysical mode at rest and with the limitation of adaptive changes during exercise. In patients with hypokinetic hemodynamics, the hypertrophied myocardium adjusts itself to an increased after load at the expense of increments in the left ventricular oxygen demand (even at rest) and the exhaustion of myocardial functional reserve during muscular activity.
Assuntos
Fenômenos Fisiológicos Cardiovasculares , Hipertensão/fisiopatologia , Esforço Físico , Descanso , Adulto , Fenômenos Biofísicos , Biofísica , Cardiomegalia/fisiopatologia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Forty-seven patients with stage I essential hypertension (EH) were examined. The external mechanical work of the heart at rest and at the height of submaximum exercise was calculated according to V. L. Karpman et al. The circulatory response to exercise in patients with stage I EH was found to be inadequate and dependent on the type of the central hemodynamics. Patients with hyperkinetic circulatory type were characterized by a decrease in the intensity of the hemodynamic response to exercise. Patients with the eu- and hypokinetic types of the hemodynamics having comparatively small values of the external mechanical performance of the heart at rest responded to exercise by a hyperkinetic reaction ensuring the necessary acceleration of the blood flow.
Assuntos
Hemodinâmica , Hipertensão/fisiopatologia , Contração Miocárdica , Esforço Físico , Adulto , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Débito Cardíaco , Teste de Esforço , Humanos , Masculino , Pessoa de Meia-Idade , DescansoRESUMO
Screening examinations were performed in ethnically related populations of men aged 30-59 years, living in high mountain regions of Tien-Shan and Pamir (2800-3600 m above sea level) and in the lowlands (800-900 m). The incidence of borderline hypertension (BH) and essential hypertension (EH) was statistically significantly higher among the inhabitants of lowland regions: EH was recorded among them in 15.4%, vs. 4.2% among men living at high altitude; BH was present among the male lowland population (LL) in 10.6% vs. 6.0% among highlanders (HL). The main characteristic clinico-functional feature of EH in HL was its frequent association with high-altitude pulmonary hypertension and right ventricular hypertrophy. Aldosterone excretion was in HL with EH substantially lower, and sodium excretion higher, than in a comparable group of lowland inhabitants.
