Renin-Angiotensin System Blockers May Create More Risk Than Reward for Sodium-Depleted Cardiovascular Patients With High Plasma Renin Levels

Por:  Jean E. Sealey, Michael H. Alderman, Curt D. Furberg y  John H. Laragh.  American Journal of Hypertension, volume 26, Issue 6 Pp. 727-738.

Four recent reports revealed differences in survival rates among treated cardiovascular patients taking renin-angiotensin system–blocking drugs. Patients with higher on-treatment plasma renin activity (PRA) levels died sooner of cardiovascular mortality than those with lower levels. We investigated whether excessive sodium depletion might have induced the higher PRA levels and contributed to the greater morbidity and mortality.
We hypothesize that patients with high on-treatment PRA levels die sooner of cardiovascular events because they are excessively sodium-volume depleted. Moreover, renin-angiotensin system–blocking drugs may be harmful in such patients because they can functionally interfere with the effects of reactive rises in PRA that are triggered to prevent potentially dangerous falls in blood pressure, increases in plasma potassium, and falls in glomerular filtration rate.  [Actualizado: 17 de mayo 2013]

Tags: plasma niveles de renina, Renina angiotensina, riesgo cardiovascular

Riesgo cardiovascular e hipertensión arterial crónica en embarazadas

Por: Dr. Jorge Armando Poll Pineda, Dra. Nuris M. Rueda Macías, Dr. Leonardo Ramos Hernández, A. Armando Poll Rueda y Lic. Illis Campos Bestard.  Medisan, vol 17, núm 2, febrero 2013.

Se realizó un estudio analítico y observacional de tipo caso-control no pareado de 90 gestantes atendidas en los policlínicos universitarios “Camilo Torres Restrepo” y “Municipal” de Santiago de Cuba, desde junio de 2010 hasta igual mes de 2011, con vistas a determinar el grado de asociación causal entre algunos factores de riesgo cardiovascular y la enfermedad hipertensiva crónica. El grupo de los casos estuvo integrado por 30 embarazadas con hipertensión arterial crónica y el de los controles por 60; estas últimas con características biológicas similares, sin hipertensión, pero con el mismo grado de exposición. Se obtuvo que la malnutrición por exceso, el estrés mantenido y la dislipidemia fueron los factores de riesgo que mostraron mayor asociación causal con la hipertensión arterial crónica. [Actualizado: 22  de marzo 2013]

Tags: embarazadas, hipertensión arterial crónica, riesgo cardiovascular

Encuesta Nacional de Riesgo Cardiovascular 2012. Realizada por el INHEM

Población total mayor de 15 años Más de 9 millones.

Hipertensos calculados: 2 594 741 (30.9%)  del total de la población mayor de 15 años.

Mujeres: 31.2%      Hombres: 30.6%

Urbano: 31.9%       Rural: 28%

Hipertensos conocidos: 1 881 187 del potencial de hipertensos

De la población mayor de 15 años: 27.5%

Hipertensos con tratamiento: 1 668 019 (del total de los hipertensos conocidos: 89.2%)

Hipertensos controlados: 924 585  (55.1% de los tratados: 1 668 019)

(49.2% de los conocidos: 1 881 187)

(37.6% del total de hipertensos potenciales: 2 594 741)

Tags: 2012, INHEM, prevalencia, riesgo cardiovascular

Habitual Exercise and Blood Pressure: Age Dependency and Underlying Mechanisms

Por: Barry J. McDonnell, Kaisa M. Maki-Petaja, Margaret Munnery. Yasmin, Ian B. Wilkinson, John R. Cockcroft y Carmel M. McEniery.  Oxford Journals, Medicine, American Journal of Hypertension, Volume 26, Issue 3, Pp. 334-341.

Regular exercise is associated with a reduction in cardiovascular risk, but the precise mechanisms responsible are unknown. The aim of the current study was to examine the relationship between regular exercise, aortic stiffness, and wave reflections, and to determine whether this relationship differs by age. These data suggest that regular exercise is associated with a beneficial vascular profile. However, this differs between younger and older individuals such that the smaller preresistance and resistance vessels are involved in younger individuals whereas the large elastic arteries are involved in older individuals. Despite these differential
findings, the current data provide support for strategies that increase habitual physical activity levels in the general population. [Actualizado: 11 febrero 2013]

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Blood Pressure Variability in Elderly Persons With White-Coat and Masked Hypertension Compared to Those With Normotension and Sustained Hypertension

Por: Cécilia Cacciolati, Christophe Tzourio y Olivier Hanon.  Am J Hypertens (2013) 26(3): 367-372.

The relationship between blood pressure (BP) measured, its variability, and risk of cardiovascular events is well established; however, it is not well known whether there is a difference of variability between the four categories of BP status obtained by the comparison of office and home BP measurements: normotension and masked, white-coat, and sustained hypertension. Here, we assessed BP variability (BPV) according to BP status in the elderly.  In elderly individuals, the short-term variability of BP is similar in masked and sustained hypertension and higher than in normotension and white-coat hypertension. This result suggests the hypothesis that BPV among persons with masked hypertension may contribute to the elevated cardiovascular risk observed in this BP pattern. [Actualizado: 11 febrero 2013]

Tags: factores de riesgo, riesgo cardiovascular