Archive for the 'comentario'

Martes 13 / mayo / 2014

Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial

Filed under: comentario — Mario Hernández Cueto — mayo 13th, 2014 — 10:15

Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial

ComentadoPor: The SPS3 Study Group. The Lancet, Volume 382, Issue 9891, Pages 507 – 515, 10 August 2013.

Hypertension is the most relevant and prevalent risk factor for stroke, particularly for stroke associated with cerebral small-vessel disease. Reduction in blood pressure is the most effective intervention to prevent stroke. Small subcortical brain infarcts, commonly known as lacunar strokes, comprise about 25% of ischaemic strokes. Most result from disease of the small penetrating arteries. Despite the frequency and importance of these strokes, randomised trials have not focused on prevention of recurrent stroke in patients with MRI-defined lacunar stroke. Whether there are optimum blood-pressure targets to prevent stroke recurrence in patients with cerebral small-artery disease is unknown.

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Jueves 3 / abril / 2014

Demografía y características clínicas de la hipertensión resistente en 6.292 pacientes en atención primaria

Filed under: comentario — Mario Hernández Cueto — abril 3rd, 2014 — 6:40

Demografía y características clínicas de la hipertensión resistente en 6.292 pacientes en atención primaria

ComentadoPor: Teresa Gijón-Condeab,  Auxiliadora Gracianib y José R. Banegas.  Rev Esp Cardiol. 2014;67:270-6. – Vol. 67 Núm.04 DOI:10.1016.

Se ha publicado recientemente la prevalencia de hipertensión resistente pero no existen estudios específicos sobre su demografía. Este estudio tiene como objetivo analizar la demografía y las características clínicas de la hipertensión resistente en una amplia muestra de pacientes en atención primaria.  De cada 4 pacientes con hipertensión resistente, 1 es > 80 años. La hipertensión resistente está asociada a la enfermedad cardiovascular, al varón < 50 años y la mujer > 80. La prevalencia de enfermedad cardiovascular en el anciano con hipertensión resistente es elevada.

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Martes 25 / marzo / 2014

Long-Term Control of Ambulatory Hypertension in Children: Improving With Time But Still Not Achieving New Blood Pressure Goals

Filed under: comentario — Mario Hernández Cueto — marzo 25th, 2014 — 10:10

Long-Term Control of Ambulatory Hypertension in Children: Improving With Time But Still Not Achieving New Blood Pressure Goals

ComentadoPor: Tomáš Seeman y Jiri Gilík.  American Journal of Hypertension, March, 2013, Volume 26, Issue 7 Pp. 939-945.

Treatment of hypertension (HT) is of great important for prevention of cardiovascular and renal diseases; patients with uncontrolled HT have higher prevalence of hypertensive target organ damage such as left ventricular hypertrophy, cardiovascular morbidity and mortality, and chronic kidney diseases (CKDs) than patients with controlled HT.1–3 In adults, the control of HT achieved by antihypertensive drugs is often inadequate.  Short-term therapy can decrease blood pressure (BP) to less than the 95th percentile in only about 50% of children. The aim of our study was to investigate the long-term control of hypertension (HT) in children using ambulatory BP monitoring (ABPM).   This first pediatric study focusing on long-term control of HT using ABPM showed that long-term control of HT is better than short-term control, but still only one-third of children achieve the new BP goals. The low control of HT might be improved by more intensive therapy.

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Martes 11 / marzo / 2014

Can we study the baroreflex mechanisms with other variables than blood pressure and heart rate?

Filed under: comentario — Mario Hernández Cueto — marzo 11th, 2014 — 9:37

Can we study the baroreflex mechanisms with other variables than blood pressure and heart rate?

ComentadoPor: Bruno Estañol.  Archivos de Cardiología de México, vol. 82. núm. 02, abril – junio, 2012.

The baroreflex (BR) is a fundamental physiological mechanism that keeps the blood pressure (BP) stable by buffering the disturbances that arise in the system during the activities of the daily life.1 These disturbances alter the control system and deviate the mean BP either increasing or decreasing it. The BP is maintained tonically around a “set point” and the disturbances oscillate around it; they me be profound or relatively minor.  Sometimes the disturbances occur at predictable times such as those seen during non-Rem sleep or rhythmic breathing.   The disturbances could be considered “phasic” changes that are randomly added or subtrac- ted to the tonically maintained set point. The set point is dynamic and changes according to the mean BP maintained during a determined period of time, computed, perhaps, in hours or days or even minutes.

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