Archive for the 'Revisiones'

Viernes 24 / enero / 2014

Hypertension and kidneys: unraveling complex molecular mechanisms underlying hypertensive renal damage

Filed under: Revisiones — Mario Hernández Cueto — enero 24th, 2014 — 9:59

Hypertension and kidneys: unraveling complex molecular mechanisms underlying hypertensive renal damage

Revisiones-sistematicasPor: S Mennuni, S Rubattu, G Pierelli, G Tocci, C Fofi y M Volpe.  Journal of Human Hypertension (2013) 28, 74–79.

Kidney damage represents a frequent event in the course of hypertension, ranging from a benign to a malignant form of nephropathy depending on several factors, that is, individual susceptibility, degree of hypertension, type of etiology and underlying kidney disease. Multiple mechanisms are involved in determination of kidney glomerular, tubular and interstitial injuries in hypertension. The present review article discusses relevant ontributory molecular mechanisms underpinning the promotion of hypertensive renal damage, such as the renin–angiotensin–aldosterone system (RAAS), oxidative stress, endothelial dysfunction, and genetic and epigenetic determinants. We highlighted major pathways involved in the progression of inflammation and fibrosis leading to glomerular sclerosis, tubular atrophy and interstitial fibrosis, thus providing a state of the art review of the pathogenetic background useful for a better understanding of current and future therapeutic strategies toward hypertensive nephropathy.

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Martes 14 / enero / 2014

Blood pressure targets in the treatment of high blood pressure: a reappraisal of the J-shaped phenomenon

Filed under: Revisiones — Mario Hernández Cueto — enero 14th, 2014 — 12:18

Blood pressure targets in the treatment of high blood pressure: a reappraisal of the J-shaped phenomenon

Revisiones-sistematicasPor: F D Fuchs y S C Fuchs.  Journal of Human Hypertension (2014) 28, 80–84. ( 8 January 2014).

The risk that lowering blood pressure (BP) excessively increases the incidence of cardiovascular disease—the J-shaped phenomenon—has been a matter of concern endorsed by many experts, particularly in patients with coronary heart disease and diabetes. The results of the Action to Control Cardiovascular Risk in Type 2 Diabetes (ACCORD) trial strengthened the idea that it may be futile to lower BP more intensively in patients with diabetes. Nevertheless, there seems to be no direct J-shaped relation between BP-lowering treatment and outcome.

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Martes 3 / diciembre / 2013

Effect of Aliskiren on Progression of Coronary Disease in Patients With PrehypertensionThe AQUARIUS Randomized Clinical Trial

Filed under: Revisiones — Mario Hernández Cueto — diciembre 3rd, 2013 — 9:19

Effect of Aliskiren on Progression of Coronary Disease in Patients With PrehypertensionThe AQUARIUS Randomized Clinical Trial

Revisiones sistemáticasPor: Stephen J. Nicholls, MBBS, PhD; George L. Bakris, MD; John J. P. Kastelein, MD, PhD; Venu Menon, MD4,; Bryan Williams, MD; Juergen Armbrecht, MD; Patrick Brunel, MD; Maria Nicolaides, MD; Amy Hsu, MS5; Bo Hu, PhD; Hui Fang, PhD; Rishi Puri, MBBS; Kiyoko Uno, MD, PhD; Yu Kataoka, MD, PhD; Dianna Bash, RN y  Steven E. Nissen, MD.  JAMA. 2013;310(11):1135-1144. doi:10.1001/jama.2013.277169.

The Aliskiren Quantitative Atherosclerosis Regression Intravascular Ultrasound Study (AQUARIUS) was a prospective, randomized, multicenter, double-blind clinical trial. Randomization was stratified according to geographic region.  Blood pressure reduction and renin-angiotensin-aldosterone system inhibition are targets for treatment of atherosclerosis. The effect of renin inhibition on coronary disease progression has not been investigated. To determine the effects of renin inhibition with aliskiren on progression of coronary atherosclerosis.

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Viernes 25 / octubre / 2013

¿Los pacientes con alto riesgo vascular toman correctamente la medicación antihipertensiva? Estudio Cumple-MEMS

Filed under: Revisiones — Mario Hernández Cueto — octubre 25th, 2013 — 11:10

¿Los pacientes con alto riesgo vascular toman correctamente la medicación antihipertensiva? Estudio Cumple-MEMS

Revista Española de Cardiología Por: Emilio Márquez-Contreras, Mariano de la Figuera-Von Wichmann, Josep Franch-Nadala, Jose Luis Llisterri-Caro, Vicente Gil-Guillén, José Luis Martín-de Pablos, José Joaquin Casado-Martínez y Nieves Martell-Claros.   Rev Esp Cardiol. 2012;65:544-50. – Vol. 65 Núm.06.

Estudio prospectivo, longitudinal y multicéntrico desarrollado en 102 centros de atención primaria españoles. Se incluyó a 808 hipertensos tratados con inhibidores del sistema renina-angiotensina (inhibidores de la enzima de conversión de la angiotensina o antagonistas de los receptores de la angiotensina II), no controlados y con alto riesgo vascular. Se realizaron cuatro visitas (inicial y tras 1, 3 y 6 meses).
Se considera cumplimiento del tratamiento «la medida en que el paciente asume las normas o consejos dados por el médico o personal sanitario, tanto desde el punto de vista de hábitos o estilo de vida recomendados como del propio tratamiento farmacológico prescrito, expresándose con él, el grado de coincidencia entre las orientaciones dadas por el profesional y la realización por parte del paciente, realizadas estas tras una decisión completamente razonada por este. Entre los hipertensos de alto riesgo vascular, el incumplimiento fue muy alto, fundamentalmente cuando toman cinco o más comprimidos diarios.

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