Journal Article•
Comportamiento de la mortalidad por enfermedad renal crónica hipertensiva en la República Mexicana entre 1998-2009. Un problema creciente
01 Mar 2013-Gaceta Medica De Mexico (Academia Nacional de Medicina de México)-Vol. 149, Iss: 2, pp 152-160
TL;DR: This study aims to analyze the behavior of HRD mortality in Mexico between 1998 and 2009 and analyzes the specific rates by age and sex and standardized mortality ratio (SMR) by states and regions.
Abstract: espanolintroduccion: La hipertension arterial sistemica (HAS) es un factor de riesgo para las enfermedades cronicas. En el mundo, un 20-25% de los adultos presentan HAS, de los que el 70% vive en paises en desarrollo. La enfermedad renal cronica hipertensiva (ERCH) es una complicacion de la hipertension arterial mal controlada. El presente estudio pretende analizar el comportamiento de la mortalidad por ERCH en Mexico entre 1998-2009. Material y metodos: Estudio longitudinal, con analisis de registros secundarios a ERCH procedentes de las bases de datos suministradas por el Instituto Nacional de Estadistica, Geografia e Informatica (INEGI), donde se analizan las tasas especificas por edad y sexo, y razones estandarizadas de mortalidad (REM) por estados y regiones. Se emplean metodos de georreferenciacion estatal. Resultados: En Mexico, entre 1998 y 2009 hubo 48,823 muertes por ERCH. La tasa de mortalidad estandarizada ascendio desde 3.35/100,000 habitantes a 6.74 (p Englishintroduction: High blood pressure (HBP) is a risk factor for chronic diseases. Worldwide, 20-25% of adults have hypertension, with 70% of them living in developing countries. Hypertensive renal disease (HRD) is a complication of insufficiently controlled hypertension. This study aims to analyze the behavior of HRD mortality in Mexico between 1998 and 2009. Methods: Longitudinal study with secondary analysis of HRD records from the databases provided by INEGI, which analyzes the specific rates by age and sex and standardized mortality ratio (SMR) by states and regions. Georeferencing methods are used statewide. Results: In Mexico from 1998 to 2009 there were 48,823 deaths from HRD. The standardized mortality rate rose from 3.35/100,000 inhabitants to 6.74 (p
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TL;DR: A broad and coordinated public health approach will be necessary to meet the burgeoning health, economic, and societal challenges of chronic kidney disease.
Abstract: For a health problem or condition to be considered a public health issue, four criteria must be met: 1) the health condition must place a large burden on society, a burden that is getting larger despite existing control efforts; 2) the burden must be distributed unfairly (i.e., certain segments of the population are unequally affected); 3) there must be evidence that upstream preventive strategies could substantially reduce the burden of the condition; and 4) such preventive strategies are not yet in place. Chronic kidney disease meets these criteria for a public health issue. Therefore, as a complement to clinical approaches to controlling it, a broad and coordinated public health approach will be necessary to meet the burgeoning health, economic, and societal challenges of chronic kidney disease.
206 citations
TL;DR: In this paper, the authors describe the changes in hypertension-related mortality in Mexico between 1998 and 2018 using death certificates and national population public data sets, a total of 335,863 deaths due to hypertension were found in Mexico, disaggregated by sex and age, during the time period covered in this study.
Abstract: Arterial hypertension is a major global health problem. It is the main risk factor for preventable death and the leading cause of premature death in the world. This study aims to describe the changes in hypertension-related mortality in Mexico between 1998 and 2018. Using death certificates and national population public data sets, a total of 335,863 deaths due to hypertension were found in Mexico, disaggregated by sex and age, during the time period covered in this study. An age-period-cohort analysis was conducted to show trends in hypertension mortality rates. Mortality due to hypertension in Mexico affects more women than men. In the most recent cohorts, the risk of dying from hypertension is two times higher in men compared to women. Hypertensive kidney disease is found to be the main underlying cause, with an average increase throughout the period studied. Our results indicate that mortality rates due to hypertension continue to grow and point to an alarming trend of mortality shifting towards younger ages, with sex-based disparities in absolute numbers and in changing trends.
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TL;DR: The development of a national program with a strategy for timely detection of CKD may help unify inter-institutional criteria considering the protocols for clinical practice that take into account each institution's organization and resources.
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TL;DR: In this paper , the authors reported the prevalence of poor prognosis factors (PPF) associated with chronic kidney disease (CKD) stages in ambulatory patients, including hyperuricemia, electrolyte abnormalities or comorbidities.
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Journal Article•
TL;DR: The epidemiological characteristics of hospital discharges during 2010 with the diagnosis of myasthenia gravis in adults hospitalized in the Mexican public health system are described.
Abstract: espanolIntroduccion: Los estudios epidemiologicos sobre MG en Mexico derivan principalmente de experiencias en centros de referencia Objetivo: describir las caracteristicas epidemiologicas de egresos hospitalarios efectuados durante el ano 2010 con el diagnostico de MG en adultos atendidos en el sistema sanitario publico mexicano Metodos: se consulto la base de datos de egresos hospitalarios del ano 2010 del Sistema Nacional de Informacion en Salud (SINAIS) (Secretaria de Salud, Instituto Mexicano del Seguro Social [IMSS], IMSS Oportunidades, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado [ISSSTE], PEMEX, SEMAR y SEDENA) Se identificaron los registros de MG mediante el codigo G700 de la Clasificacion Internacional de Enfermedades, 10a revision (CIE-10) Resultados: durante el ano 2010 se registraron 5,314,132 egresos hospitalarios (4,254,312 adultos), de los cuales 587 (001%) correspondieron a adultos con MG (mediana de la edad: 47 anos; 60% mujeres) Las mujeres con MG fueron significativamente mas jovenes que los hombres (mediana de edad: 37 vs 54 anos, respectivamente; p EnglishIntroduction: Epidemiological studies on myasthenia gravis (MG) in Mexico is mainly derived from experiences in referral centers Objective: To describe the epidemiological characteristics of hospital discharges during 2010 with the diagnosis of MG in adults hospitalized in the Mexican public health system Methods: We consulted the database of hospital discharges during 2010 of the National Health Information System (Ministry of Health, IMSS, IMSS oportunidades, ISSSTE, PEMEX, and the Ministry of Defense) The MG records were identified by the code G700 of the International Classification of Diseases 10th revision Results: During 2010 there were 5,314,132 hospital discharges (4,254,312 adults) Among them, 587 (001%) were adults with MG (median age: 47 years, 60% women) Women with MG were significantly younger than men (median age: 37 vs 54 years, respectively; p
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References
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Boston University1, Rush University Medical Center2, University of Tennessee Health Science Center3, University of Michigan4, University at Buffalo5, University of Mississippi6, University of Miami7, University of Alabama at Birmingham8, Case Western Reserve University9, National Institutes of Health10
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Abstract: "The Seventh Report of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure" provides a new guideline
for hypertension prevention and management. The following are the key messages(1) In persons older than 50 years, systolic blood pressure (BP) of
more than 140 mm Hg is a much more important cardiovascular disease
(CVD) risk factor than diastolic BP; (2) The risk of CVD, beginning at 115/75
mm Hg, doubles with each increment of 20/10 mm Hg; individuals who are normotensive
at 55 years of age have a 90% lifetime risk for developing hypertension; (3)
Individuals with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80
to 89 mm Hg should be considered as prehypertensive and require health-promoting
lifestyle modifications to prevent CVD; (4) Thiazide-type diuretics should
be used in drug treatment for most patients with uncomplicated hypertension,
either alone or combined with drugs from other classes. Certain high-risk
conditions are compelling indications for the initial use of other antihypertensive
drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor
blockers, β-blockers, calcium channel blockers); (5) Most patients with
hypertension will require 2 or more antihypertensive medications to achieve
goal BP (<140/90 mm Hg, or <130/80 mm Hg for patients with diabetes
or chronic kidney disease); (6) If BP is more than 20/10 mm Hg above goal
BP, consideration should be given to initiating therapy with 2 agents, 1 of
which usually should be a thiazide-type diuretic; and (7) The most effective
therapy prescribed by the most careful clinician will control hypertension
only if patients are motivated. Motivation improves when patients have positive
experiences with and trust in the clinician. Empathy builds trust and is a
potent motivator. Finally, in presenting these guidelines, the committee recognizes
that the responsible physician's judgment remains paramount.
24,988 citations
TL;DR: In a multiple regression analysis, increasing age, increasing body mass index, and non-Hispanic black race/ethnicity were independently associated with increased rates of hypertension.
Abstract: ContextPrior analyses of National Health and Nutrition Examination Survey (NHANES)
data through 1991 have suggested that hypertension prevalence is declining,
but more recent self-reported rates of hypertension suggest that the rate
is increasing.ObjectiveTo describe trends in the prevalence, awareness, treatment, and control
of hypertension in the United States using NHANES data.Design, Setting, and ParticipantsSurvey using a stratified multistage probability sample of the civilian
noninstitutionalized population. The most recent NHANES survey, conducted
in 1999-2000 (n = 5448), was compared with the 2 phases of NHANES III conducted
in 1988-1991 (n = 9901) and 1991-1994 (n = 9717). Individuals aged 18 years
or older were included in this analysis.Main Outcome MeasuresHypertension, defined as a measured blood pressure of 140/90 mm Hg or
greater or reported use of antihypertensive medications. Hypertension awareness
and treatment were assessed with standardized questions. Hypertension control
was defined as treatment with antihypertensive medication and a measured blood
pressure of less than 140/90 mm Hg.ResultsIn 1999-2000, 28.7% of NHANES participants had hypertension, an increase
of 3.7% (95% confidence interval [CI], 0%-8.3%) from 1988-1991. Hypertension
prevalence was highest in non-Hispanic blacks (33.5%), increased with age
(65.4% among those aged ≥60 years), and tended to be higher in women (30.1%).
In a multiple regression analysis, increasing age, increasing body mass index,
and non-Hispanic black race/ethnicity were independently associated with increased
rates of hypertension. Overall, in 1999-2000, 68.9% were aware of their hypertension
(nonsignificant decline of −0.3%; 95% CI, −4.2% to 3.6%), 58.4%
were treated (increase of 6.0%; 95% CI, 1.2%-10.8%), and hypertension was
controlled in 31.0% (increase of 6.4%; 95% CI, 1.6%-11.2%). Women, Mexican
Americans, and those aged 60 years or older had significantly lower rates
of control compared with men, younger individuals, and non-Hispanic whites.ConclusionsContrary to earlier reports, hypertension prevalence is increasing in
the United States. Hypertension control rates, although improving, continue
to be low. Programs targeting hypertension prevention and treatment are of
utmost importance.
2,335 citations
TL;DR: Blood pressure was controlled in an estimated 50.1% of all patients with hypertension in NHANES 2007-2008, with most of the improvement since 1988 occurring after 1999-2000, and better BP control reflected improvements in awareness and treatment.
Abstract: Context Hypertension is a major risk factor for cardiovascular disease and treatment and control of hypertension reduces risk. The Healthy People 2010 goal was to achieve blood pressure (BP) control in 50% of the US population. Objective To assess progress in treating and controlling hypertension in the United States from 1988-2008. Design, Setting, and Participants The National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2008 in five 2-year blocks included 42 856 adults aged older than 18 years, representing a probability sample of the US civilian population. Main Outcome Measures Hypertension was defined as systolic BP of at least 140 mm Hg and diastolic BP of at least 90 mm Hg, self-reported use of antihypertensive medications, or both. Hypertension control was defined as systolic BP values of less than 140 mm Hg and diastolic BP values of less than 90 mm Hg. All survey periods were age-adjusted to the year 2000 US population. Results Rates of hypertension increased from 23.9% (95% confidence interval [CI], 22.7%-25.2%) in 1988-1994 to 28.5% (95% CI, 25.9%-31.3%; P Conclusions Blood pressure was controlled in an estimated 50.1% of all patients with hypertension in NHANES 2007-2008, with most of the improvement since 1988 occurring after 1999-2000. Hypertension control was significantly lower among younger than middle-aged individuals and older adults, and Hispanic vs white individuals.
2,056 citations
TL;DR: Trends in the prevalence, awareness, treatment, and control of hypertension in the United States using NHANES data are described to suggest that hypertension prevalence is increasing, contrary to earlier reports.
Abstract: ContextPrior analyses of National Health and Nutrition Examination Survey (NHANES)
data through 1991 have suggested that hypertension prevalence is declining,
but more recent self-reported rates of hypertension suggest that the rate
is increasing.ObjectiveTo describe trends in the prevalence, awareness, treatment, and control
of hypertension in the United States using NHANES data.Design, Setting, and ParticipantsSurvey using a stratified multistage probability sample of the civilian
noninstitutionalized population. The most recent NHANES survey, conducted
in 1999-2000 (n = 5448), was compared with the 2 phases of NHANES III conducted
in 1988-1991 (n = 9901) and 1991-1994 (n = 9717). Individuals aged 18 years
or older were included in this analysis.Main Outcome MeasuresHypertension, defined as a measured blood pressure of 140/90 mm Hg or
greater or reported use of antihypertensive medications. Hypertension awareness
and treatment were assessed with standardized questions. Hypertension control
was defined as treatment with antihypertensive medication and a measured blood
pressure of less than 140/90 mm Hg.ResultsIn 1999-2000, 28.7% of NHANES participants had hypertension, an increase
of 3.7% (95% confidence interval [CI], 0%-8.3%) from 1988-1991. Hypertension
prevalence was highest in non-Hispanic blacks (33.5%), increased with age
(65.4% among those aged ≥60 years), and tended to be higher in women (30.1%).
In a multiple regression analysis, increasing age, increasing body mass index,
and non-Hispanic black race/ethnicity were independently associated with increased
rates of hypertension. Overall, in 1999-2000, 68.9% were aware of their hypertension
(nonsignificant decline of −0.3%; 95% CI, −4.2% to 3.6%), 58.4%
were treated (increase of 6.0%; 95% CI, 1.2%-10.8%), and hypertension was
controlled in 31.0% (increase of 6.4%; 95% CI, 1.6%-11.2%). Women, Mexican
Americans, and those aged 60 years or older had significantly lower rates
of control compared with men, younger individuals, and non-Hispanic whites.ConclusionsContrary to earlier reports, hypertension prevalence is increasing in
the United States. Hypertension control rates, although improving, continue
to be low. Programs targeting hypertension prevention and treatment are of
utmost importance.
1,392 citations
Journal Article•
TL;DR: A broad and coordinated public health approach will be necessary to meet the burgeoning health, economic, and societal challenges of chronic kidney disease.
Abstract: For a health problem or condition to be considered a public health issue, four criteria must be met: 1) the health condition must place a large burden on society, a burden that is getting larger despite existing control efforts; 2) the burden must be distributed unfairly (i.e., certain segments of the population are unequally affected); 3) there must be evidence that upstream preventive strategies could substantially reduce the burden of the condition; and 4) such preventive strategies are not yet in place. Chronic kidney disease meets these criteria for a public health issue. Therefore, as a complement to clinical approaches to controlling it, a broad and coordinated public health approach will be necessary to meet the burgeoning health, economic, and societal challenges of chronic kidney disease.
206 citations