《临床高血压

高血压:全球健康危机

07/14/2021

& lt; h2> Abstract< / h2>

Objective: This study discusses strategies to overcome hypertension patient compliance to manage self-care. The purpose of the study is to provide a summary of the importance of attention to managing hypertension.

Method: a review of literature relevant to hypertension, policies, and management, both pharmacological and non-pharmacological, through cross-programs or sectors.

Result: This study found that the ministry of health had compiled various policies to reduce the prevalence of hypertension, including technical guidelines for its implementation, but the strategy has not yet fully reached the minimum service standard, which is because it has not fully involved the relevant cross sectors.

Conclusion: Improve the coordination system by “Joint Decree” between the Ministry of Health and the Ministry of Villages, PDT and Transmigration, the Ministry of Social Affairs, Indonesian National Army, police, and NGOs to carry out activities simultaneously to the community.

氯苯甲嗪处方在急诊科和返回访问老年人口

06/11/2021

& lt; h2> Abstract< / h2>& lt; p>背景:氯苯甲嗪是一种常用药物为患者解除急诊科(ED)的诊断周围性眩晕,然而它是啤酒老年病人的药物治疗,以避免列表。;/ p>& lt; p>目的:本研究旨在确定之间的关系使用氯苯甲嗪并返回访问ED患者一周内,gt;65岁。;/ p>& lt; p>方法:这是一个回顾性观察研究2城市三级保健EDs超过5年。入选标准包括病人和gt;65年鉴于氯苯甲嗪在ED或排放的处方。综述了图表的诊断、处方和返回7天内访问。;/ p>& lt; p>结果:总共有1608名患者超过65岁的入选标准,669例确定为接收氯苯甲嗪ED和962人收到任何氯苯甲嗪(ED或埃德加家处方)。氯苯甲嗪的患者中,548例(84.8%)有处方,其中有36(6.6%)返回7天内访问。 Patients who were given meclizine while in the ED without home prescriptions (121) had 16 return visits (13.2%). Among the non-meclizine group, 102 patients (10.6%) had a return visit within 7 days.

Conclusion: There was no increase in return visits in elderly patients discharged from the ED with a prescription for meclizine after a diagnosis of benign dizziness. Meclizine prescriptions at discharge were associated with fewer return visits to the ED within 1 week. Ongoing dizziness was the most common reason for return visits; there were no documented chief complaints of weakness, syncope/falls, or hypotension.

高血压thyrosine激酶抑制剂的毒性;朋友还是敌人?

01/12/2021

& lt; h2> Abstract< / h2>

Tyrosine kinase inhibitors (TKIs) are widely used in Oncology practice. Hypertension may develop during cancer treatment and TKIs are well known drugs that are associated with drug related hypertensive toxicity. TKI related hypertensive toxicity is not always the indicator of worse clinical outcomes and it may be the sign of treatment efficacy.

高血压患者药物治疗问题的识别和解决在尼日利亚一家医院接受治疗——一个试点研究

10/01/2020

& lt; h2> Abstract< / h2>

Background: An event involving drug therapy that actually or potentially interfers with the desired health outcomes is known as drug therapy problem.

Objective: The study aimed to identify and resolve potential drug related problems encountered among adult hypertensive patients receiving care in a Nigerian Tertiary Hospital. Methods: This was a prospective cross sectional study. The data were collected from the patients’ medical records using the Pharmaceutical Care Network Europe (PCNE) Classification tool Version 6.2 (PCNE, 2010). For each of the 171 medical records, the DTPs experienced within the study period were identified. Data were analyzed using the IBM Statistical Product and Service Solutions (SPSS) for Windows, Version 21.0 (IBM Corp, Version 21.0, and Armonk, NY, USA).

Results: Majority of the patients were above 65years of age 64(37.4%), while about half of the patients were females. A total of 644 drug therapy problems were identified. The major cause of DTP was prescribing error 189(29.3). Other causes of drug therapy problem identified in this study were inappropriate drug selection 122(18.9), no indication for drugs 52(8.1), inappropriate drug combination 87(13.6), new indication presented 61(9.5), dose too high 62(9.6), dose too low 44(6.8), wrong drug taken/administered 27(4.2). Majority of the interventions made were accepted 586(91.0%) while only 3(0.5%) of the interventions made were not accepted.

Conclusion: This study demonstrates that a pharmacist, with adequate training and support can play a vital role in identifying and resolving drug therapy problems. Also, there is a need for an educational intervention among prescribing physicians to update them regularly on hypertension guidelines.

知识、态度、行为对高血压患者在尼日利亚医院接受治疗

09/29/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>Poor knowledge about hypertension can lead to poor attitude towards the disease which may directly affect patients self-care practices towards hypertension.
Objective: This study aimed to assess the knowledge, attitude and practice towards hypertension of hypertensive patients receiving care in Kogi state Specialist hospital, Lokoja, Kogi state Nigeria.

Methods: This was a cross sectional study conducted among Hypertensive patients receiving care in the Kogi State Specialist Hospital in Lokoja, Kogi state. All hypertensive patients visiting the Kogi State Specialist Hospital during the period of study and have given consent were allowed to participate in the study. A well designed questionnaire was used to collect patients soci-demographic and clinical variables. Also, a validated questionnaire was used to assess patients Knowledge, attitude and practice towards hypertension. Data were analysed using the Statistical Package for Social Sciences (SPSS for windows, Version 16.0. SPSS Inc. 2007.Chicago, USA) software. Continuous data were presented as mean± standard deviation while categorical data were presented as percentages and frequencies. Chi square and correlation test was also used to examine association between the variables in the data collected.

Results: A majority of the patients were aged 46-55 years 89 (27.5%), while almost half of the patients were males 161 (54.6%). About half of the patients 141 (43.5%) were selfemployed while a majority of the patients had at least a tertiary education 173 (53.4%). Only 4 (1.2%) of the patients reported that they had no formal education. About 60% of the patients reported to have had hypertension for 6-10 years while only 170 (57.4%) of the patients reported not to have any family history of hypertension. Also, only half of the patients 164 (50.6%) had their blood pressure controlled. Only one quarter of the patients had good knowledge and attitude towards hypertension. Also, only 4 (1.3%) patients had a good practice towards hypertension. There is a significant positive correlation between knowledge and attitude (r = 0.287, p < 0.001). Also, there is a fair positive correlation between Knowledge and practice (r = 0.254, p = <0.05), while there was no correlation between attitude and practice.

Conclusion: There was an acceptable level of Knowledge and attitude towards hypertension while these patients had a poor practice of hypertension self-care activities. Keywords: Hypertension; Knowledge, attitude, Practice.

检测高血压及其相关因素在Dessie镇政府学校员工,阿姆哈拉地区,Dessie,埃塞俄比亚,2019

09/29/2020

& lt; h2> Abstract< / h2>

Introduction: Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. Hypertension can be described as the ‘Sleeping snake’, which bites when it wakes up.

Objectives: To detect hypertension and its associated factors among staffs of Dessie town government schools from December 10, 2018 to February 15, 2019 G.C.

Methods and materials: An institution-based cross-sectional study design was conducted among 225 Dessie town government school staffs whose age of 35 years and above. Systematic random sampling technique to select sample size of participants. Data was cleaned manually, coded and entered into Epi-info and analyzed by SPSS version 22 software. Multivariable logistic analysis AOR, 95% CI and p - value < 0.05 was used to identify variables which have significant association.

Results: From the total of 225 study participant’s 31(13.8%) of them diagnosed with hypertension. Multivariable logistic analyses had shown that 1st degree holders AOR (CI) = 3.05 [0.91,13.43], source of information from news AOR(CI) = 2.1 [0.816, 4.89], being protestant in religion AOR (CI)= 5.65 [0.74, 42.86], age from 41-60 years AOR (CI) = 1.96 [0.18,18.90], being divorced AOR (CI) = 2.35 [0.91,5.84], and teachers AOR (CI) = 3.4 [1.2, 9.825] maintain their significant association with detection of hypertension.

Conclusion and Recommendation: From this study significant numbers of respondents have hypertension. Educational status, source of information, marital status, occupation, religion and age of respondents were predictors for the occurrence of hypertension. Newly diagnosed hypertension on this was high among government school staffs which have no information about their blood pressure; which shows there was poor coverage of health screening.

沉默在成人高血压脑血管疾病频繁和年龄相关性

08/13/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>脑小血管疾病和颅外颈动脉粥样硬化疾病的表现沉默的脑血管病(CVD)。这两个病态信息在高血压人群心血管风险较低(表格)稀缺。你们;/ p>& lt; p> & lt; strong>目的:& lt; / strong>探索频率和沉默的高血压成人心血管疾病的特点和认知反响的这些变化灵活,br /比;方法:39高血压患者(平均年龄:53.5岁)进行了研究。脑磁共振成像(3 t),颈动脉的多普勒超声和神经心理学研究得到灵活;/ p>& lt; p> & lt; strong>结果:& lt; / strong>79%的病人提出白质病变(WML), 18%显示只有脑萎缩和/或扩大血管周的空间,60%增生内膜的媒体呈现复杂的(IMC)和/或粥样硬化斑块。 In women, a significant correlation was observed between IMC thickness and bifrontal index, and WML was greater in patients with carotid plaques. A non-significant decrease in neuropsychological performance was observed in the groups of patients with intra and/or extracerebral injury and a negative correlation with the bifrontal index in men was found.

Conclusion: Frequency of intra and extracerebral silent CVD was high in hypertensive adults with low to moderate CVR. WML and brain atrophy were partially related with carotid lesions. Age significantly influenced the appearance of intra and extracerebral lesions. Cognitive performance did not decrease significantly due to the presence of these lesions.c

高血压的发病率在高风险的工作组(警察)——观察研究

11/08/2019

Summary

Introduction: Hypertension is a silent pathology in a way that affects all four spheres to be considered as such; magnitude, transcendence vulnerability, and feasibility. The World Health Organization estimates that 45% of deaths from heart disease and 51% of deaths from stroke globally are caused by hypertension.
Material and method: A longitudinal, descriptive and quantitative observational study was carried out on the personnel of high-risk public service providers.
Results: The total population sampled was 550 people where it was possible to determine the sex where the disease predominates, since 92% of the hypertensive population belong to the male sex, while 8% of the female population. 57% of the total population were classified as normotensive, while 21% were classified as High Normal, Grade I Hypertension, and Grade II Hypertension.
Discussion: AHT is the result of a series of interactions between endogenous and exogenous factors in an organism that tries to adapt to the increase of the cardiac output and the peripheral resistance of the blood vessels, which is manifested by the increase in blood pressure figures. Physical activity has been shown to have a lower risk of hypertension compared to sedentary individuals. The daily stress these workers face predisposes them to suffer their manifestations as headache, muscle pain, fatigue, digestive disorders and constant elevations of blood pressure.

合规的高血压患者在复兴医院抗高血压药物治疗的Na€™Djamena,乍得

10/23/2019

& lt; h2> Abstract< / h2>

Introduction: High blood pressure is a major cardiovascular risk factor. In hypertension, non-compliance is frequent. The objective of this work is to evaluate the therapeutic observances and to identify the predictive factors of poor compliances in Chadian hypertensive patients.

Patients and Methods: It was a prospective cross-sectional study over a six-month period from January 15 to July 15, 2019. This was performed in the outpatient Cardiology and Nephrology units at the Renaissance Hospital of N’Djamena. We included all follow-up patients who had hypertension who consulted during the study period. However, dialysis patients and children were excluded from this study. The parameters studied were demographic characteristics, economic and therapeutic data and the rate of therapeutic compliance.

Results: Eighty-seven patients were included. The average age was 50 years old. The sex ratio was 2.5. Sixty-seven percent (n = 58) of the patients were from urban areas. The predominant cardiovascular risk factors were smoking in 25% (n = 22) and diabetes in 23% (n = 20). Hypertension was uncontrolled in 76% (n = 66) patients. Adherence was poor in 66% (n = 57) of patients. The monthly cost of treatment was respectively 10,000 and 20,000 FCFA in 52% (n = 45) of cases. Combination therapy was observed in 70% of cases (n = 61) and 56% (n = 49) of patients had more than one drug intake. The adherence rate was 93% (n = 28) in the urban population (p < 0.001). All patients (n = 30) who were observing their treatment were educated (p < 0.001). The adherence rate was 20% (n = 6) in patients who had a monthly income less than 100,000 FCFA (p = 0.004). The adherence rate was 60% (n = 18) when the monthly cost was less than FCFA 10,000 (p = 0.003). The adherence rate was 77% (n = 23) in patients receiving monotherapy (p < 0.001).

Conclusion: This study showed a low level of adherence in Chadian hypertensive patients. The complexity and cost of antihypertensive therapy, poor knowledge of hypertension, and ignorance of its severity have been the main factors of poor compliance.

验证欧姆龙hbp - 9031 c的血压监测诊所和医院根据ANSI / AAMI / ISO 81060 - 2:2013协议

08/13/2019

& lt; h2> Abstract< / h2>

Objective: The present study aimed to evaluate the accuracy of the Omron HBP-9031C automated oscillometric upper-arm blood pressure (BP) measurement device for blood pressure monitoring, according to the ANSI/AAMI/ISO 81060-2:2013 protocol (ANSI/AAMI/ISO).

Participants and Method: The device evaluations were performed in 85 participants, who fulfilled the inclusion criteria of the protocol. The validation procedure and data analysis followed the protocol precisely.

Results: In the ANSI/AAMI/ISO 81060-2-2013 validation procedure (criterion 1), the mean ± SD of the differences between the test device and reference BP was 0.5 ± 7.84/-1.9 ± 6.30 mmHg (systolic/diastolic). The mean differences between the two observers and the Omron HBP-9031C were 0.5 ± 6.69 mmHg (range, −18 to 15 mmHg) for systolic BP and -1.9 ± 5.63 mmHg (range, −17 to 14 mmHg) for diastolic BP, according to criterion 2. The two criteria of the ANSI/AAMI/ISO were fulfilled.

Conclusion: The professional OMRON BP monitor, HBP-9031C fulfilled the requirements of the ANSI/AAMI/ISO validation standard and can be recommended for clinical use.

新(2018)欧洲高血压指南概述和评论

07/24/2019

Review Article

The European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) jointly developed a series of hypertension guidelines in the years 2003, 207 and 2013. The most recent guidelines were issued by the two societies in August this year (2018) and were published in the European Heart Journal. The new guidelines are printed in more than 90 pages and cover almost all aspects of hypertension based on extensive review of literature giving highest priority to data from randomized controlled trials and well conducted meta-analysis. In important areas where there is inadequate or no evidence, guidelines authors resort to expert opinion. The text was developed over approximately 24 months and was reviewed by representatives of ESC and ESH national hypertension societies. Although it is less than five years since the last hypertension European guidelines in 2013, the recent 2018 guidelines show important differences in diagnosis and treatment strategies with the addition of new sections and recommendations on management of hypertensive emergencies, hypertension in women and pregnancy, different ethnic groups, chronic obstructive pulmonary disease, cancer therapies, peri-operative management, sexual dysfunction and perioperative management.

In this message, I will give an overview of the main recommendations in the European guidelines under two headings: diagnosis and treatment and I will conclude by comments.

循环血小板源泡在心房纤颤

06/27/2019

& lt; h2> Abstract< / h2>

Platelet vesiculation is common factor contributing in coagulation and thromboembolism in patients with atrial fibrillation (AF). Platelet-derived vesicles are involved in the coagulation, thromboembolism, microvascular inflammation, arterial stiffness, vascular calcification, atherosclerotic plaque shaping and rupture, endothelial dysfunction, cardiac remodelling, and kidney dysfunction. Recent clinical studies have revealed elevated concentrations of platelet-derived vesicles in peripheral blood of patients with current AF and history of AF. The aim of the mini review is to discuss the role of platelet-derived micro vesicles as predictive biomarker in AF. Serial measures of circulating levels of platelet-derived vesicules are discussed to be useful in stratification of AF patients at risk of thromboembolic complications, but there is limiting evidence regarding their predictive value that requires further investigations in large clinical trials.

高血压作为一个持久的公共卫生问题。心脏健康联盟的意见书,墨西哥

04/03/2019

Summary

Today, Mexico has more than 130 million inhabitants; 85 millions of them are adults of 20 or more years old. The population pyramid is still one of base wider and this base corresponds to adults younger than 54 years old. Despite predictions made 20 years ago, about a transformation of the population pyramid shape to a mushroom shape as a consequence of more life expected and adult population growth; this change has not been occurred. Hypertension has become the biggest challenge of noncommunicable chronic diseases to public health in Mexico. Around 30% of adult Mexican population has hypertension; 75% of them have less than 54 years old (in productive age); 40% of them are unaware but only 50% of aware hypertensive population takes drugs and, 50% of them are controlled (< 140/90 mmHg). Cardiovascular risk factors including hypertension, dyslipidemia, obesity, and diabetes often cohabit in the same person and are magnified one to another in terms of common pathophysiological pathways. Atherosclerosis, arrhythmias, stroke and heart failure are common and are the final pathologic end-points and explains why cardiovascular diseases occupy first place in mortality in Mexico and worldwide. The costs of care for these diseases are billionaires and if we do not generate appropriate strategies, their global impact can become a high threat to social development of the country. The life style like nutrition, sports habits of the Mexicans must be emphasized; there is poor education about this crucial topic. This position paper is focused on the principal controversies and strategies to be developed by all, government, society, physicians, nurses, patients and all people related with healthcare of hypertension, in order to confront this huge public health problem in Mexico.

心力衰竭与保存射血分数(HFpEF);一个墨西哥人从墨西哥社会保障研究所(IMSS)

01/28/2019

& lt; h2> Abstract< / h2>

Background: Several epidemiologic studies indicate that up to 50% of patients with heart failure have a preserved ejection fraction, and this proportion has increased over time. The knowledge of its severity and associated comorbidity is determining factor to develop adequate strategies for its treatment and prevention. This study was focus on the creation of a cohort and follow-up of Mexican population and to analyze its severity as well as its interaction with the comorbidity of other cardiovascular risk factors.

Methods: We included patients from different sites of Mexico City than were sent to the Cardiology hospital of the National Medical Center in Mexico City for the realization of an echocardiogram as part of their assessment by the presence of dyspnea, edema, or suspicion of hypertensive heart disease. Complete medical history, physical examination and laboratory studies including Brain Natriuretic Peptide (BNP) serum levels were performed. Diagnosis of diastolic dysfunction was based on symptoms and echocardiographic data including time of deceleration, size of left atrium, e´ septal and e´ lateral, as well as E wave, A wave and its ratio E/A. All patients had left ventricle ejection fraction > 45%.

Results: We included 168 patients with HFpEF. The most common risk factor was hypertension (89.2%), followed by overweight and obesity (> 78.5%), dyslipidemia (82.1%) and diabetes (42.8%). Women were dominant, 108 (64.3%); the mean age was 63 years old. When we classify by severity of diastolic dysfunction, we found that 41.1% were grade I, 57.1% were grade II and only 1.8% were grade III. The risk factors most strongly associated with the severity of diastolic dysfunction were hypertension, obesity and dyslipidemia. We found BNP levels highly variables, but the levels were higher detected as the ejection fraction was approaching to 45%. At one year of follow up mortality was not reported.

Conclusion: HFpEF is a frequent entity in patients with cardiovascular risk factors in Mexico. The most common risk factor was hypertension. The combination of hypertension, overweight and dyslipidemia predicted the severity of diastolic dysfunction. We recommend that all Mexican patient with hypertension and overweight or obesity should be submitted as a part of its medical evaluation to an echocardiogram study in order to detect diastolic dysfunction even though the signs or symptoms are or not evident.

战略计划的诊断、治疗和控制高血压

11/23/2018

& lt; h2> Abstract< / h2>

Two major challenges face the practicing physicians and medical community regarding the management of hypertension. First is accurate diagnosis and finding who is the truly hypertensive patient in need of life-long treatment. Second is to improve blood pressure control through addressing hypertension risk factors, adherence to treatment and frequent monitoring.
- Current Challenges in Management

Accurate diagnosis of hypertension
Improving blood pressure control

- What Do We Need For The Future?

测量血压的成本是什么?

10/11/2018

& lt; h2> Abstract< / h2>

Rationale: Blood Pressure measurement has transitioned to the oscillometric method in most hospitals in the United States, however out-patient offices mainly use the auscultatory technique.

Objective: To determine time taken to measure blood pressure by an automatic oscillometric device compared to an auscultatory measurement device and to determine what each measurement costs.

Methods: Blood Pressures were measured in a single primary care office by medical assistants (MA) for patients seen for office visits. Timed measurements were performed using an automated oscillometric Welch Allyn Connex Vital Signs Monitor (WA) and manually using a Tycos device. A minimum of 400 readings were taken with each method.

Results: The average time to manually measure BP was 58.6 seconds, whereas the WA average was 39.8 seconds, 18.8 seconds faster (p<0.05). There was an improvement in measurement time with MA experience with the WA device (p<0.05). The average MA cost to measure a single BP using the manual method was $0.35 vs. the WA method ($0.24) or a savings of $0.11 per measurement. The improvement with experience of WA method reduced cost to $0.17 per measurement.

Conclusion: The oscillometric method saved 17cents per measurement potentially saving $1,119 per year for our primary care practice.

肾脏的调节分子间作用的肾血压

07/17/2018

& lt; h2> Abstract< / h2>

Hypertension is one of the most common chronic diseases of human, affecting more than one billion people worldwide. When it becomes chronic, hypertension leaves behind cardiac hypertrophy, heart failure, stroke, and kidney disease, resulting in substantial morbidity and mortality. Treatments that effectively reduce blood pressure can prevent these complications. Abnormalities in the production of urine by the kidneys have been implicated in increased vascular resistance, leading to high blood pressure and increased cardiac mass. By matching urinary excretion of salt and water with dietary intake, balance is usually attained, thereby maintaining a constant extracellular fluid volume and blood pressure. Based on the capacity for the kidney to excrete sodium, this blood pressure-altering mechanism should have sufficient advantage to limit intravascular volume and consequently lower blood pressure in response to a range of stimuli from elevated heart rate to increase peripheral vascular resistance. A major determinant of the level of intra- and extra- renal blood pressure is therefore sodium handling, and it is controlled by complex physiological mechanism by hormones, inflammatory mediators, and the sympathetic nervous system. Homoeostasis and favourable influence sodium balance are a basic mechanism of efficacy for diuretics and dietary sodium restriction in hypertension. Renin Angiotensin System (RAS) inhibitors, vasodilators, and β-blockers work to facilitate pressure-natriuresis. Also, WNK signaling pathways, soluble inflammatory mediators, and pathways regulating extra-renal sodium disposition may be the focus towards elimination of sodium and reducing blood pressure in hypertension.

减少心血管疾病的风险:在墨西哥过去、现在和未来

07/17/2018

Summary

Atherosclerotic cardiovascular disease (ASCVD) is globally defined as coronary heart disease, cerebrovascular disease, or peripheral arterial disease presumed to be of atherosclerotic origin and it is the leading cause of morbidity and mortality for individuals with or without diabetes and is the largest contributor to the direct and indirect catastrophic costs of cardiovascular disorder. Very common conditions coexisting into the cardiovascular risk (e.g., obesity, hypertension, diabetes and dyslipidemia) are clear risk factors for ASCVD, and diabetes itself confers independent risk. Numerous studies have shown the efficacy of controlling individual cardiovascular risk factors in preventing or slowing ASCVD in people with these disorders. In other words it is not enough control one risk factor. We need to develop novel strategies to detect and control all of them at the same time. Thus, large benefits are seen when multiple cardiovascular risk factors are addressed simultaneously. Under the current paradigm of aggressive risk factor modification in patients with cardiovascular risk, there is evidence that measures of 10-year coronary heart disease (CHD) risk among U.S. adults with cardiovascular risk have improved significantly over the past decade and that ASCVD morbidity and mortality have decreased. In Mexico the Mexican Institute of Social Security is implementing new strategies of primary and secondary prevention in order to confront this pandemic.

In this review, we analyze the state of the art to approach at the same time the different cardiovascular risk factors, in an integral form because of this is the real worldwide challenge of health.

为了指导方针

04/09/2018

Review

Hypertension (HTN) is a widely prevalent disease across the globe. Recent reports from National Health and Nutrition Examination Surveys (NHANES) indicate that the prevalence of HTN is 29% in adults more than 18 years in the US [1]. This is about 72 million adults. Worldwide, about 1.3 billion people are affected by HTN [2]. This number is projected to increase several-fold in the coming years. Given the huge burden of this disease to the healthcare system and the many deleterious effects that can result from uncontrolled HTN, we need strong guidelines to manage the same. The recently published 2017 ACC/AHA guidelines [3] on hypertension management are very meticulous and include a comprehensive stepwise approach in treating hypertension. Here we present a summary of the major changes and a concise review of the new guidelines.

2018年新墨西哥的高血压是什么?影响新classifi阳离子成人高血压的美国心脏病学院/美国心脏病协会(ACC / AHA)

03/07/2018

& lt; h2> Abstract< / h2>

The new report of American College of Cardiology/American Heart Association task force on Clinical Practice Guidelines for High Blood Pressure in Adults was published online ahead of print November 13, 2017. The new American recommendation was focused on the criteria to define Hypertension. 130/80 mmHg or more is now considered as the new cut off point to define Hypertension. It is not new if we consider cumulative evidence in the las two decades has been broken the idea to consider 140/90 mmHg as the point to start medical actions. Thus, in México with current ACC/AHA definition it is estimated today around 48 million of adult hypertensive population. In the Mexican Institute of Social Security (IMSS) several strategies has been developed to improve prevention as the key action to confront non communicable chronic disease including hypertension. This updated guideline from ACC/AHA is an extraordinary opportunity to reinforce our preventive programs to high blood pressure control. In this brief report we analyze the epidemiological situation in Mexico and its possible consequences of the new criteria for hypertension diagnosis. The main current strategies that are applied into the IMSS to confront cardiovascular risk factors are directed to prevention. The IMSS is prepared to attend situations as the change of criteria diagnoses in Hypertension and new preventive models are in progression.

家庭血压监测的作用在克服惯性和改善治疗高血压控制在墨西哥

02/19/2018

Summary

Hypertension remains the most common modifiable cardiovascular risk factor, however, control of hypertension rates remain dismal. Home blood pressure (BP) monitoring has the potential to improve the control of hypertension. Home BP monitoring is now defended evenly for the evaluation and management of hypertension. This paper shows the experience of the National Association of Mexican Cardiologist in a group of patients with hypertension under drug treatment to evaluate the control in a real world clinical practice in Mexico. One hundred and fifty one patients were included. They were followed during two weeks with three home measurements at day (8:00, 14:00 and 20:00hr). An Ambulatory blood pressure of 24hr was performed at the middle of study. At the end of the study 36% (54/151) patients still uncontrolled by systolic blood pressure (>135 mmHg) and 31% by diastolic blood pressure similar results were detected by ambulatory blood pressure. During afternoon and night uncontrolled values were more common. Home blood pressure monitoring, results in a better form to detect uncontrolled patients and help clinical judgment to adjust pharmacological therapy. This practice should be recommended in Mexico.

在巴西社区治疗的高血压:从被动的稳态模型来主动适应医疗

01/26/2018

& lt; h2> Abstract< / h2>

The responsiveness of hypertensive subjects to different types of physical exercises and length of intervention, has been investigated in samples of our dynamic cohort study (“Move for Health” program) based on spontaneous demand for healthy lifestyle with supervised exercises and dietary counseling. After clinical selection and baseline assessments they were spontaneously assigned to exercise protocols of strength (PAc) isolated or combined with endurance (walking) exercises (PMi) daily or in alternated days(PMiA), hydrogymnastics(PHy) and tread mill high- intensity exercises(PHit), applied during 10(experiment 1) and 20(experiment 2) weeks of intervention. Baseline demographic, socioeconomic, anthropometric and physical activity and fitness characteristics were similar among protocols. Ten-week training improved VO2max. Similarly in all protocols while hand grip increased only in PAc. In average, there was a 16% reduction rate of hypertension rate from baseline with both, SBP and DBP, reduced by PHy and only SBP by the PMi. After adjustments hypertension was more reduced by PAc, PMi and PHy. In the 20-week experiment, higher SBP was similarly reduced by PAc or PMiA and DBP by PMiA, after adjustments. Hence, so far, our generated data suggest physical exercises as an effective tool for hypertension reduction, from 10 weeks to 3 year-long supervised protocols composed by surface or aquatic activities with strength or endurance exercises. PAc takes longer and short-period responsiveness can be achieved by either combined (strength-endurance) or hydrogymnastic exercises. Thus, exercise training is a time-and type-dependent tool, feasible, costless and scientific-based rheostatic-allostatic alternative for the current “sick-care” drug-dependent homeostatic approach to hypertension med care.

血清尿酸是否对组织损伤发挥保护作用在心血管和代谢疾病?

07/18/2017

& lt; h2> Abstract< / h2>& lt; p>之前的临床观察和流行病学研究已经证明了强关联血清尿酸(SUA)和心血管疾病(高血压、心脏衰竭和无症状动脉粥样硬化),代谢状态(腹部肥胖、糖尿病、代谢综合征、胰岛素抵抗)和肾脏疾病。有大量的证据有关的角色SUA作为心血管事件的预测和简历死亡率在一般人群和个人建立了心血管疾病和代谢疾病。然而,安和苏阿可能表现出内皮保护作用和血管以及减弱内源性修复系统通过围攻分化的祖细胞。虽然安和苏阿降低药物广泛应用于有症状的患者高尿酸血和痛风超出其病因,没有安和苏阿低于目标水平的协议6.0 mg / dL无症状患者肾损伤和心血管疾病和数据的足够有限。简短的沟通是有争议的角色的描述SUA为主的细胞毒性剂和蓄电池保护器对缺氧,缺血和细胞凋亡。;/ p>

收缩压决定因素

07/11/2017

& lt; h2> Abstract< / h2>

Hypertension and blood pressure are closely related, and hypertension is directly related with stroke. There are different type of blood pressures such as basal, diastolic, maximum, mean arterial, systolic, mean central venous. The present report examines the determinants of systolic blood pressure for two different groups of cardiac patients. One group of cardiac patients is those who underwent dobutamine stress echocardiography, and the other group is Worcester heart attack study. Many systolic blood pressure determinants, their effects, and correlations have been focused in the current report.

在巴西生活方式修改效率在降低高血压社区:从祖先生存的表观遗传基础到当代生活方式和公共卫生措施

05/12/2017

& lt; h2> Abstract< / h2>

High blood pressure (HBP) is a strong, independent and etiologically relevant risk factor for cardiovascular and therefore, the leading cause of preventable deaths worldwide. Hypertension has high medical and social costs. Due to its many associated complications, the use of medical services create high costs with medications which represent almost half of the estimated direct expenses. Free distribution of more than 15 medications for HyPERtension and DIAbetes (HIPERDIA program) clearly shows the important role of drugs in the Brazilian Government’s effort to tackle these two diseases. Notwithstanding, the prevalence of HBP is rising in parallel with other NCDs. It is known that HBP results from environmental and genetic factors, and interactions among them. Our ancestors were often faced with survival stresses, including famine, water and sodium deprivation. As results of natural selection, the survival pressures drove our evolution to shape a thrifty genotype, which favored/promoted energy-saving and sodium/water preservation. However, with the switch to a sodium- and energy-rich diets and sedentary lifestyle, the thrifty genotype and ancient frugal alleles, are no longer advantageous, and may be maladaptive to disease phenotype, resulting in hypertension, obesity and insulin resistance syndrome. Low-grade chronic inflammation and oxidative stress would be the underlying mechanisms for these diseases. HBP is often associated with unhealthy lifestyles such as consumption of high fat and/or high-salt diets and physical inactivity. Therefore, alternatively to medicine drugs, lifestyle and behavioral modifications are stressed for the prevention, treatment, and control of hypertension. A lifestyle modification program (LSM) involving dietary counseling and regularly supervised physical activity (“Move for Health”) has been used for decades, in our group, for NCDs primary care. Retrospective (2006-2016) data from 1317 subjects have shown the top quartile of blood pressure(142.2/88.5mmHg) differing from the lower quartile (120.6/69.2mmHg) by being older, with lower schooling, lower income and, lower physical activity and aerobic capacity. Additionally, the P75 showed higher intake of CHO, saturated fat and sodium along with lower-diet quality score with a more processed foods. They showed higher body fatness and prevalence of metabolic syndrome along with higher pro-inflammatory and peroxidative activities and insulin resistance. In this free-demand sample, the HBP rate was 51.2% for SBP and 42.7% for DBP. The rate of undiagnosed HBP was 9.8% and only 1/3 of medicated patients were controlled for HBP. After 10 weeks of LSM the HBP normalization achieved 17.8% for SBP and 9.3% for DBP with a net effectiveness of 8.5% and 2.4%, respectively. The reduction of HBP by LSM was followed by increased aerobic conditioning and reduced intake of processed foods along with decreased values of BMI, abdominal fatness, insulin resistance, pro-inflammatory and peroxydative activities. Importantly, once applied nationwide this LSM would save HBP medication for 3.1 million of hypertensives at an economic saving costs of US$ 1.47 billion a year!

见解的抗高血压药物西娅€œCalcium Paradoxa€由于Ca2 + /营交互

03/27/2017

& lt; h2> Abstract< / h2>

Several experimental studies performed since 1975, using smooth muscles richly innervated by sympathetic nerves to exclude the autonomic influence of adjusting reflex (rodent vas deferens), showed that L-type voltage-activated Ca2+ channels (VACC) blockers completely inhibited neurogenic contractions induced by electrical field stimulation (EFS) in high concentrations (>10-6 M), but paradoxically increased these EFS-contractions in low concentrations (<10-6 M), suggesting that other mechanisms than only autonomic adjusting reflex are involved in these paradoxical effects. In 2013, we showed that these paradoxical effects of L-type VACC blockers, named by us “calcium paradox” phenomenon, were potentiated by drugs which increase cytosolic cAMP concentration ([cAMP] c-enhancers), such as rolipram, IBMX and forskolin, indicating that this sympathetic hyperactivity drug-induced is due to interaction of the Ca2+/cAMP intracellular signaling pathways (Ca2+/cAMP interaction). Then, the pharmacological manipulation of this interaction produced by combination of the L-type VACC blockers used in the antihypertensive therapy, and [cAMP] c-enhancers used in the antidepressive therapy, could represent a potential cardiovascular risk for hypertensive patients due to sympathetic hyperactivity. Then, we discussed the role of Ca2+/cAMP interaction for antihypertensive pharmacotherapy.

性别差异在高血压:一个值得问的问题?

01/21/2017

& lt; h2>短Communication< / h2>& lt; p>高血压是一个复杂的涉及多个器官系统的疾病和心脏疾病主要是可改变的危险因素,这是在男性和女性死亡的主要原因。虽然男性和女性高血压发展,不同的性别差异在高血压的发病率和严重程度是建立在男性高血压发病率较高与相同年龄的女性相比,直到第六十年的生活[1,2]。尽管性别差异在人类高血压、治疗指南不相差性别[3]。即使高血压的原因是复杂的,与遗传因素有关,生活方式,饮食结构和环境因素包括空气污染[4],再加上高血压的潜在决定因素,性别差异在hypertension-which存在于人类人口归因于生物和行为两方面的因素。生物因素包括性激素、染色体差异,和其他生物预防高血压女性的性别差异。这些因素在青春期和成年中持续下去,直到成为杰出女性进入更年期。行为对高血压危险因素包括高身体质量指数、吸烟、和低身体活动。你们;/ p>

《临床高血压

高血压:全球健康危机

氯苯甲嗪处方在急诊科和返回访问老年人口

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高血压患者药物治疗问题的识别和解决在尼日利亚一家医院接受治疗——一个试点研究

知识、态度、行为对高血压患者在尼日利亚医院接受治疗

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合规的高血压患者在复兴医院抗高血压药物治疗的Na€™Djamena,乍得

验证欧姆龙hbp - 9031 c的血压监测诊所和医院根据ANSI / AAMI / ISO 81060 - 2:2013协议

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Review Article

循环血小板源泡在心房纤颤

高血压作为一个持久的公共卫生问题。心脏健康联盟的意见书,墨西哥

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心力衰竭与保存射血分数(HFpEF);一个墨西哥人从墨西哥社会保障研究所(IMSS)

战略计划的诊断、治疗和控制高血压

测量血压的成本是什么?

肾脏的调节分子间作用的肾血压

减少心血管疾病的风险:在墨西哥过去、现在和未来

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为了指导方针

Review

2018年新墨西哥的高血压是什么?影响新classifi阳离子成人高血压的美国心脏病学院/美国心脏病协会(ACC / AHA)

家庭血压监测的作用在克服惯性和改善治疗高血压控制在墨西哥

Summary

在巴西社区治疗的高血压:从被动的稳态模型来主动适应医疗

血清尿酸是否对组织损伤发挥保护作用在心血管和代谢疾病?

收缩压决定因素

在巴西生活方式修改效率在降低高血压社区:从祖先生存的表观遗传基础到当代生活方式和公共卫生措施

见解的抗高血压药物西娅€œCalcium Paradoxa€由于Ca2 + /营交互

性别差异在高血压:一个值得问的问题?

见解的抗高血压药物西娅€œCalcium Paradoxa€由于Ca2 + /营交互