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.
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TL;DR: Treatment of prehypertension with candesartan appeared to be well tolerated and reduced the risk of incident hypertension during the study period, and treatment of pre Hypertension appears to be feasible.
Abstract: Background Prehypertension is considered a precursor of stage 1 hypertension and a predictor of excessive cardiovascular risk. We investigated whether pharmacologic treatment of prehypertension prevents or postpones stage 1 hypertension. Methods Participants with repeated measurements of systolic pressure of 130 to 139 mm Hg and diastolic pressure of 89 mm Hg or lower, or systolic pressure of 139 mm Hg or lower and diastolic pressure of 85 to 89 mm Hg, were randomly assigned to receive two years of candesartan (Atacand, AstraZeneca) or placebo, followed by two years of placebo for all. When a participant reached the study end point of stage 1 hypertension, treatment with antihypertensive agents was initiated. Both the candesartan group and the placebo group were instructed to make changes in lifestyle to reduce blood pressure throughout the trial. Results A total of 409 participants were randomly assigned to candesartan, and 400 to placebo. Data on 772 participants (391 in the candesartan group and 381 in the placebo group; mean age, 48.5 years; 59.6 percent men) were available for analysis. During the first two years, hypertension developed in 154 participants in the placebo group and 53 of those in the candesartan group (relative risk reduction, 66.3 percent; P<0.001). After four years, hypertension had developed in 240 participants in the placebo group and 208 of those in the candesartan group (relative risk reduction, 15.6 percent; P<0.007). Serious adverse events occurred in 3.5 percent of the participants assigned to candesartan and 5.9 percent of those receiving placebo. Conclusions Over a period of four years, stage 1 hypertension developed in nearly two thirds of patients with untreated prehypertension (the placebo group). Treatment of prehypertension with candesartan appeared to be well tolerated and reduced the risk of incident hypertension during the study period. Thus, treatment of prehypertension appears to be feasible. (ClinicalTrials.gov number, NCT00227318.)
883 citations
TL;DR: The use of early beta-blocker therapy in acute MI reduces the risks of reinfarction and ventricular fibrillation, but increases the risk of cardiogenic shock, especially during the first day or so after admission.
803 citations
TL;DR: The use of the 10 contemporary biomarkers that were studied adds only moderately to standard risk factors and only small increases in the ability to classify risk, as measured by the C statistic.
794 citations