Journal Article•
Prevención y tratamiento de la hipertensión arterial sistémica en el paciente con enfermedad arterial coronaria
01 Apr 2008-Revista Portuguesa De Pneumologia (Instituto Nacional de Cardiología Ignacio Chávez)-Vol. 78, pp 58-73
TL;DR: La asociacion entre hipertension arterial sistemica (HAS) y enfermedad arterial coronaria esta bien demostrada a traves de diversos estudios epidemiologicos.
Abstract: La asociacion entre hipertension arterial sistemica (HAS) y enfermedad arterial coronaria esta bien demostrada a traves de diversos estudios epidemiologicos. La hipertension arterial es un factor de riesgo independiente importante para el desarrollo de coronariopatia, enfermedad vascular cerebral y nefropatia. Existen avances importantes en el conocimiento de factores neurohumorales y hemodinamicos que confluyen en la fisiopatologia de la hipertension y en el desarrollo de enfermedad coronaria que permiten establecer mejores estrategias no solo de tratamiento sino tambien de prevencion, con la finalidad de disminuir la mortalidad cardiovascular. El espectro de la cardiopatia aterosclerosa es amplio y las estrategias de tratamiento de la hipertension deben adecuarse a la forma de manifestacion de la enfermedad coronaria que se presente. El tratamiento de ambas condiciones requiere de lineamientos especificos de acuerdo a las condiciones del paciente y la forma de presentacion de cada una de estas patologias
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TL;DR: Estudio casi experimental pre and postest sin grupo de control, cuyo objetivo fue analizar los beneficios de un programa de ejercicio fisico con ritmo en personas con hipertension arterial dirigido por enfermeria en un municipio del Estado de Mexico.
Abstract: Estudio casi experimental pre y postest sin grupo de control, cuyo objetivo fue analizar los beneficios de un programa de ejercicio fisico con ritmo en personas con hipertension arterial dirigido por enfermeria en un municipio del Estado de Mexico. Se realizo un programa de intervencion en 110 pacientes con hipertension arterial, en 20 sesiones de ejercicio fisico con ritmo habiendo aceptado participar del estudio mediante la firma de consentimiento informado. Para el analisis de datos se utilizo como prueba de significacion x² con valor de p=0.05. Dentro del estudio intervinieron 99 mujeres; de ellas, 81.8% son amas de casa. Despues de la intervencion, la presion arterial sistolica mostro disminucion significativa en 8.28 mmHg y la presion diastolica 4.72 mmHg. El programa de ejercicio fisico con ritmo provoco efectos favorables sobre la presion arterial, como una actividad de enfermeria en su rol de educador.
8 citations
Journal Article•
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
6 citations
TL;DR: The factors affecting the length of intensive care unit (ICU) stay in patients undergoing isolated on-pump coronary artery bypass (CABG) and effective factors on morbidity, mortality, and survival among patients with prolonged ICU stay were investigated.
Abstract: We aimed to investigate the factors affecting the length of intensive care unit (ICU) stay in patients undergoing isolated on-pump coronary artery bypass (CABG). We also aimed to evaluate effective factors on morbidity, mortality, and survival among patients with prolonged ICU stay. Between January 2002 and December 2009, a total of 1,657 patients underwent isolated on-pump CABG in our clinic. Prolonged ICU stay (>2 days) was present in 532 patient (32.1 %). Diabetes (OR 1.49, P = 0.006), hypertension (OR 1.37, P = 0.029), chronic obstructive pulmonary disease (OR 9.06, P 3 units) (OR 3.23, P = 0.007) were the independent predictive factors of prolonged ICU stay (>2 days). Postoperative mortality rate was 7 % (n = 37) and 2.3 % (n = 26) in patients with length of ICU stay >2 days and length of ICU stay ≤2 days (P 2 days (P < 0.0001). Postoperative mortality was higher in patients with prolonged ICU stay. Mean follow-up was shorter in patients with prolonged ICU stay.
1 citations
References
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TL;DR: The favourable effect of lisinopril alone or with GTN was clear also in the predefined high-risk populations (elderly patients and women) for the combined endpoint and in a population intensively exposed to recommended treatments.
1,137 citations
TL;DR: In patients with stable coronary heart disease and preserved left ventricular function who are receiving "current standard" therapy and in whom the rate of cardiovascular events is lower than in previous trials of ACE inhibitors, there is no evidence that the addition of an ACE inhibitor provides further benefit in terms of death from cardiovascular causes, myocardial infarction, or coronary revascularization.
Abstract: background Angiotensin-converting–enzyme (ACE) inhibitors are effective in reducing the risk of heart failure, myocardial infarction, and death from cardiovascular causes in patients with left ventricular systolic dysfunction or heart failure. ACE inhibitors have also been shown to reduce atherosclerotic complications in patients who have vascular disease without heart failure. methods In the Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) Trial, we tested the hypothesis that patients with stable coronary artery disease and normal or slightly reduced left ventricular function derive therapeutic benefit from the addition of ACE inhibitors to modern conventional therapy. The trial was a doubleblind, placebo-controlled study in which 8290 patients were randomly assigned to receive either trandolapril at a target dose of 4 mg per day (4158 patients) or matching placebo (4132 patients). results The mean (±SD) age of the patients was 64±8 years, the mean blood pressure 133±17/78±10 mm Hg, and the mean left ventricular ejection fraction 58±9 percent. The patients received intensive treatment, with 72 percent having previously undergone coronary revascularization and 70 percent receiving lipid-lowering drugs. The incidence of the primary end point — death from cardiovascular causes, myocardial infarction, or coronary revascularization — was 21.9 percent in the trandolapril group, as compared with 22.5 percent in the placebo group (hazard ratio in the trandolapril group, 0.96; 95 percent confidence interval, 0.88 to 1.06; P = 0.43) over a median follow-up period of 4.8 years. conclusions In patients with stable coronary heart disease and preserved left ventricular function who are receiving “current standard” therapy and in whom the rate of cardiovascular events is lower than in previous trials of ACE inhibitors in patients with vascular disease, there is no evidence that the addition of an ACE inhibitor provides further benefit in terms of death from cardiovascular causes, myocardial infarction, or coronary revascularization.
1,079 citations
TL;DR: Initiation of antihypertensive treatment involving ACE inhibitors in older subjects, particularly men, appears to lead to better outcomes than treatment with diuretic agents, despite similar reductions of blood pressure.
Abstract: Background Treatment of hypertension with diuretics, beta-blockers, or both leads to improved outcomes. It has been postulated that agents that inhibit the renin–angiotensin system confer benefit beyond the reduction of blood pressure alone. We compared the outcomes in older subjects with hypertension who were treated with angiotensin-converting–enzyme (ACE) inhibitors with the outcomes in those treated with diuretic agents. Methods We conducted a prospective, randomized, open-label study with blinded assessment of end points in 6083 subjects with hypertension who were 65 to 84 years of age and received health care at 1594 family practices. Subjects were followed for a median of 4.1 years, and the total numbers of cardiovascular events in the two treatment groups were compared with the use of multivariate proportional-hazards models. Results At base line, the treatment groups were well matched in terms of age, sex, and blood pressure. By the end of the study, blood pressure had decreased to a similar exte...
1,076 citations
TL;DR: Losartan was significantly better tolerated than captopril, with fewer patients discontinuing study medication (458 [17%] vs 624 [23%], 0·70 [0·62-0·79], p=0·72.
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TL;DR: Diltiazem was as effective as treatment based on diuretics, beta-blockers, or both in preventing the combined primary endpoint of all stroke, myocardial infarction, and other cardiovascular death.
923 citations