Editorial

Los trabajos y opiniones que aquí se exponen son orientadores de lo que se publica en Cuba y en el mundo sobre aspectos relevantes de la hipertensión arterial.

Editorial


Novel treatment approaches in hypertensive type 2 diabetic patients

Por: Yaniel Castro Torres and Richard E Katholi. World J. Diabetes, 2014 August  15; 5(4): 536-545.

Type 2 diabetes mellitus (T2DM) and hypertension (HTN) represent two common conditions worldwide. They increase the risk for the development of cardiovascular diseases with adverse clinical outcomes including disabilities and mortality. The International Diabetes Federation reports that diabetes kills one person every six seconds and afflicts 382 million people worldwide. The federation estimates that the number of people affected by the disease is expected to climb to 592 million by 2035.
DM is a group of metabolic diseases characterized by impairment in glucose, lipid and protein metabolism, resulting from alterations in insulin secretion, insulin action or both. While four types of DM have been classified, T2DM is the most prevalent and accounts for 90% to 95% of all diagnosed cases.

Visit-to-visit systolic blood pressure variability and outcomes in hemodialysis

Visit-to-visit systolic blood pressure variability and outcomes in hemodialysis

Revista Journal HypertensionPor: T I Chang1, J E Flythe, S M Brunelli, P Muntner, T Greene, A K Cheung y G M Chertow.  Journal of Human Hypertension (2014) 28, 18–24.

Visit-to-visit blood pressure variability (VTV-BPV) is an independent risk factor for cardiovascular events and death in the general population. We sought to determine the association of VTV-BPV with outcomes in patients on hemodialysis, using data from a National Institutes of Health-sponsored randomized trial (the HEMO study). We used the coefficient of variation (CV) and the average real variability in systolic blood pressure (SBP) as metrics of VTV-BPV. In all, 1844 out of 1846 randomized subjects had at least three visits with SBP measurements and were included in the analysis.

Resistant hypertension—complex mix of secondary causes and comorbidities

Resistant hypertension—complex mix of secondary causes and comorbidities

ComentadoPor: T. Dudenbostel.  Journal of Human Hypertension (2014) 28, 1–2.

Resistant hypertension (RHTN) is an increasingly common clinical problem1, 2 that studies have suggested is almost always heterogeneous in terms of etiology, risk factors and comorbidities. There has been a growing interest in defining epidemiology and pathophysiology in hope of identifying treatment targets.

Cross-sectional assessments of subjects with RHTN compared with subjects without RHTN have consistently found the former to have an increased frequency of cardiovascular complications, including prior myocardial infarction, stroke, congestive heart failure and chronic kidney disease (CKD). A recent 5-year longitudinal assessment of cardiovascular outcomes in a large cohort of subjects with rigorously defined RHTN demonstrated a 50% increase in cardiovascular events in RHTN subjects compared with patients whose blood pressure (BP) had been controlled on less than or equal to3 medications.

Árbol para predecir el desarrollo de la cardiopatía hipertensiva

Árbol para predecir el desarrollo de la cardiopatía hipertensiva

Riesgo cardiovascularPor: Dr. Alexis Álvarez Aliaga, Dr. Julio César González Aguilera, Dra. Liliana del Rosario Maceo Gómez, Dr. Adonis Frómeta Guerra, Dr. Salvador Bárzaga Morell, Dra. Ana Elis Cervantes Infante.  Rev Cubana Med. 2014;53(3).

La cardiopatía hipertensiva representa altas morbilidad y mortalidad. La complejidad de su prevención radica en el número de factores de riesgo implicados en su desarrollo,  diseñar y validar un árbol de predicción para el desarrollo de la cardiopatía hipertensiva, a partir de factores hemodinámicos y no hemodinámicos,  se realizó el diseño y validación de un árbol de predicción para el desarrollo de la cardiopatía hipertensiva, mediante el procedimiento de descubrimiento de conocimientos en bases de datos y minería de datos, en pacientes hipertensos atendidos en la consulta especializada de hipertensión arterial de la Policlínica de Especialidades del Hospital General Universitario "Carlos Manuel de Céspedes" del municipio Bayamo, provincia de Granma, Cuba, desde el 1ro de enero de 2004 hasta el 31 de diciembre de 2009. El árbol predijo el riesgo de desarrollar la cardiopatía hipertensiva a 82,598 % de los pacientes; con un área bajo la curva ROC de 0,861 y una tasa de verdaderos positivos de 0,733 y de 0,921 para las clases 1 y 2, respectivamente. El factor más importante lo constituyó la proteína C reactiva, seguida en orden de importancia por la glucemia, el ácido úrico, el colesterol y la microalbuminuria.

Association between blood pressure and disability-free survival among community-dwelling elderly patients receiving antihypertensive treatment

Association between blood pressure and disability-free survival among community-dwelling elderly patients receiving  antihypertensive treatment

Revisiones sistematicasPor: Osamu Iritani, Yumi Koizumi, Yuko Hamazaki, Hiroshi Yano, Takuro Morita, Taroh Himeno, Tazuo Okuno, Masashi Okuro, Kunimitsu Iwai y  Shigeto Morimoto.   Hypertension Research (2014) 37, 772–778.

A reduction of elevated blood pressure (BP) is an important treatment goal in elderly hypertensive patients. However, excessive reduction of systolic BP (SBP) and/or diastolic BP (DBP) might be harmful in such patients. We investigated whether this was the case with regard to risk of incident disability or death in community-dwelling elderly subjects.

Are There Any New Pharmacologic Therapies on the Horizon to Better Treat Hypertension?

Are There Any New Pharmacologic Therapies on the Horizon to Better Treat Hypertension?

InvestigacionesPor: Gabriel B. Habib, Sr, MS, MD, FACC, FCCP, FAHA, Sukhdeep S. Basra, MD, MPH.  J CARDIOVASC PHARMACOL THER May 1, 2014( 107).

Hypertension is the most important cardiovascular risk factor. We have witnessed a significant improvement in hypertension treatment and control and an impressive growth in the pharmacologic options available to clinicians and hypertension specialists. With up to a third of patients with hypertension not at the recommended goal blood pressures, it is critically important to develop novel therapeutic approaches to better treat hypertension.

Artículos intersantes

En esta sección les exponemos algunos artículos publicados sobre la hipertensión arterial.

3-articulos-interesantesRevista de: Hypertension Research

Effects of antihypertensive drugs on central blood pressure: new evidence, more challenges

Por: Giacomo Pucci, Francesca Battista y Giuseppe Schillaci.   Hypertension Research (2014) 37, 10–12.

High sodium augments angiotensin II-induced vascular smooth muscle cell proliferation through the ERK 1/2-dependent pathway

Por: Gang Liu, Hirofumi Hitomi, Asadur Rahman, Daisuke Nakano1, Hirohito Mori, Tsutomu Masaki, Hong Ma, Takahiro Iwamoto, Hiroyuki Kobori y Akira Nishiyama.   Hypertension Research (2014) 37, 13–18.

Efficacy of losartan and carvedilol on central hemodynamics in hypertensives: a prospective, randomized, open, blinded end point, multicenter study.

Por: Eung Ju Kim, Woo-Hyuk Song, Jae Ung Lee3, Mi-Seung Shin, Sahng Lee, Byeong-Ok Kim, Kyeong-Sun Hong, Seong Woo Han, Chang Gyu Park y Hong Seog Seo.  Hypertension Research (2014) 37, 50–56.