Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Network
ABSTRACTBackgroundSpain has been one of the countries most affected by the COVID-19 pandemic.ObjectiveTo create a registry of patients with COVID-19 hospitalized in Spain in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease.MethodsA multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records.ResultsUp to April 30th 2020, 6,424 patients from 109 hospitals were included. …
Body weight variation and control of cardiovascular risk factors in essential hypertension.
The objective was to assess the impact of weight changes on blood pressure (BP), lipids and glucose goals in a cohort of hypertensive subjects.Prospective follow-up.Hypertension clinic.326 hypertensive non-diabetic subjects, 46% with metabolic syndrome (MS).Usual care treatment, which included diet, physical exercise and drugs prescribed when indicated. All patients were observed for up to 1 year.BP and low-density lipoprotein-cholesterol (LDL-C) goal were those in ESH/ESC and ATP III recommendations, respectively. The glucose goal was to delay progression to type 2 diabetes mellitus, or to achieve blood glucose100 mg/dl for non-diabetics. According to body weight changes, patients were cat…
Automatic or manual arterial path for the ankle-brachial differences pulse wave velocity
Este artículo se encuentra disponible en la página web de la revista en la siguiente URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206434 An automated method for measuring arterial path length with devices that determine pulse wave velocity (PWV) in peripheral arteries is frequently applied. We aimed to compare arterial path length measurements based on mathematical height-based formulas with those measured manually and to assess whether the ankle-brachial difference (abD-PWV) measured with the VOPITB device is comparable to that obtained by manual measurements. In 245 patients, a metric measuring tape was used to determine the arterial path length from the suprast…
May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension.
Abstract Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and envi…
Control de la dislipemia en grupos clínicos especiales: mujeres, ancianos, VIH, enfermedad renal crónica, pacientes con síndrome metabólico
There is still some disagreement about how dyslipidemia should be treated in particular population groups. This article provides a review of indications for lipid-lowering treatment, preferably for primary prevention, in specific groups of patients: women, the elderly, and those with an HIV infection, chronic kidney disease or metabolic syndrome. Special emphasis is placed on data obtained in the JUPITER trial and in other studies of rosuvastatin.
Arterial Destiffening in Previously Untreated Mild Hypertensives After 1 Year of Routine Clinical Management
BACKGROUND Arterial stiffness, measured with pulse wave velocity (PWV), is now classified as a marker of target organ damage (TOD) alongside left ventricular hypertrophy and moderately increased albuminuria. Interventional studies on treated hypertensive patients have shown that PWV could be improved. Our aim was to assess changes in arterial stiffness after 1 year of routine clinical practice in never-treated hypertensive patients. PATIENTS AND METHODS We studied 356 never-treated patients with suspected hypertension. After standard clinical assessment during which presence of TOD was evaluated, hypertension diagnosis was confirmed in 231 subjects who subsequently received standard routine…
[Central blood pressure and vascular damage].
Abstract Background and objective The aim of this study was to assess the relationship between central blood pressure and vascular damage. Patients and methods This cross-sectional study involved 393 never treated hypertensive patients (166 women). Clinical blood pressure (BP), 24 h blood pressure (BP 24 h ) and central blood pressure (CBP) were measured. Vascular organ damage (VOD) was assessed by calculating the albumin/creatinine ratio (ACR), wave pulse pressure velocity and echocardiographic left ventricular mass index (LVMI). Results Patients with VOD had higher values of BP, BP 24 h , and CBP than patients without ACR. When comparing several systolic BP, systolic BP 24 h had a higher …
May Measurement Month 2018: an analysis of blood pressure screening results from Spain.
Este artículo se encuentra disponible en la siguiente URL: https://academic.oup.com/eurheartjsupp/article/22/Supplement_H/H119/5898732 En este artículo también participan: Fernando Martínez, Blanca Carreras, Bettina de Berardinis, Thomas Beaney, Anca Chis Ster, Neil R. Poulter, Xin Xia y Luis M. Ruilope. Elevated blood pressure (BP) is the single most important contributing risk factor to the global disease burden, leading to over 10 million deaths each year. In Spain, hypertension (HTN) affects around 20% of the adult population and remains the greatest attributable cause of cardiovascular mortality. May Measurement Month (MMM) is a worldwide initiative aimed at increasing awareness of HTN…
Uso de espironolactona o doxazosina en pacientes con hipertensión arterial refractaria
Introduccion y objetivos. Valorar el uso de espironolactona o doxazosina en el tratamiento de pacientes con hipertension refractaria (HTAR). Metodos. Estudio retrospectivo comparativo de 181 pacientes con HTAR (pacientes tratados con tres farmacos, uno de ellos diuretico, sin alcanzar el control de la presion arterial [PA]) a quienes se anadio espironolactona (88 casos) o doxazosina (93 casos). Resultados. La PA sistolica (PAS) se redujo 28 mmHg (intervalo de confianza [IC] del 95%, 24-32 mmHg; p < 0,001), y la PA diastolica (PAD), 12 mmHg (IC del 95%, 9-14 mmHg; p < 0,001) en los tratados con espironolactona, y 16 mmHg (IC del 95%, 13-20 mmHg; p < 0,001) y 7 mmHg (IC del 95%, 5-9 mmHg; p <…
Emotional eating as a mediator between anxiety and cholesterol in population with overweight and hypertension
Although the relationship between cholesterol and mood states (especially anxiety) has been well studied, few researches have included the role of eating styles in this relationship. This study explored the associations among eating styles, negative emotional symptoms, and levels of cholesterol (and other medical variables) in a population with hypertension and overweight or obesity, analyzing the possible mediation mechanisms involved. A cross-sectional study was conducted in 68 adults with hypertension and overweight/obesity, and stepwise multiple regression analysis and mediation analyses were carried out to test the hypothesis that eating styles mediate the relationship between negative…
Respuesta antihipertensiva a la espironolactona en pacientes con hipertensión arterial refractaria
Fundamento y objetivo Valorar el efecto de anadir espironolactona al tratamiento de pacientes con hipertension arterial (HTA) refractaria e intentar caracterizar a los que consiguen buena respuesta. Pacientes y metodo Se ha realizado un estudio observacional y retrospectivo en pacientes con HTA refractaria –definidos como tratados con 3 farmacos a las dosis habituales, uno de ellos diuretico, sin alcanzar el control de la presion arterial (PA)– y valores de creatinina inferiores a 1,6 mg/dl en varones y a 1,4 mg/dl en mujeres. Resultados A un total de 95 pacientes (un 70% varones y un 40% diabeticos), con una edad media (desviacion estandar) de 66 (12) anos, se les anadio espironolactona al…
Impact of a Web-based exercise and nutritional education intervention in patients who are obese with hypertension : randomized wait-list controlled trial
Background Internet-based interventions are a promising strategy for promoting healthy lifestyle behaviors. These have a tremendous potential for delivering electronic health interventions in scalable and cost-effective ways. There is strong evidence that the use of these programs can lead to weight loss and can lower patients’ average blood pressure (BP) levels. So far, few studies have investigated the effects of internet-based programs on patients who are obese with hypertension (HTN). Objective The aim of this study is to investigate the short- and long-term efficacy, in terms of body composition and BP parameters, of a self-administered internet-based intervention involving different …
Hipertensión arterial y prediabetes
Resumen Fundamento y objetivos Valorar los factores que predisponen a la aparicion de diabetes en hipertensos. Pacientes y metodo Estudio longitudinal prospectivo en 2.588 hipertensos no diabeticos sin enfermedad cardiovascular previa, con una mediana de seguimiento (mediana-intervalo intercuartilico) de 3,4 (1,4-6,8) anos, con seguimiento total de 15.053 pacientes/ano. Resultados Trescientos treinta y tres (13%) pacientes se convirtieron en diabeticos, con una tasa de conversion de 2,21 (intervalo de confianza del 95% [1,98-2,46]) 100/pacientes ano. Se realizo un analisis de regresion de Cox con los factores que modificaban la aparicion de diabetes. Al inicio del seguimiento los tres compo…
Eplerenona en hipertensión arterial resistente con intolerancia previa a espironolactona
An internet-based self-administered intervention for promoting healthy habits and weight loss in hypertensive people who are overweight or obese: a randomized controlled trial
Background The prevalence of overweight and obesity is on the rise worldwide with severe physical and psychosocial consequences. One of the most dangerous is hypertension. Lifestyle changes related to eating behaviour and physical activity are the critical components in the prevention and treatment of hypertension and obesity. Data indicates that the usual procedures to promote these healthy habits in health services are either insufficient or not efficient enough. Internet has been shown to be an effective tool for the implementation of lifestyle interventions based on this type of problem. This study aims to assess the efficacy of a totally self-administered online intervention programme …
Regression of left ventricular hypertrophy and microalbuminuria changes during antihypertensive treatment.
The objective of the present study was to assess the regression of left ventricular hypertrophy (LVH) during antihypertensive treatment, and its relationship with the changes in microalbuminuria.One hundred and sixty-eight previously untreated patients with echocardiographic LVH, 46 (27%) with microalbuminuria, were followed during a median period of 13 months (range 6-23 months) and treated with lifestyle changes and antihypertensive drugs. Twenty-four-hour ambulatory blood pressure monitoring, echocardiography and urinary albumin excretion were assessed at the beginning and at the end of the study period.Left ventricular mass index (LVMI) was reduced from 137 [interquartile interval (IQI)…
Determinants of urinary albumin excretion reduction in essential hypertension: A long-term follow-up study.
The objective of the present study was to assess factors related to long-term changes in urinary albumin excretion (UAE) of nondiabetic microalbuminuric (n = 252) or proteinuric hypertensive individuals (n = 58) in a prospective follow-up.After enrollment, patients were placed on usual care including nonpharmacological treatment and/or treatment with an antihypertensive drug regime to achieve blood pressure135/85 mmHg. Periodic UAE measurements were performed until regression or significant reduction (defined when UAE dropped50% from the initial values, plus reduction of UAE to30 mg/24 h for microalbuminuric patients and300 mg/24 h for proteinuric patients).Among the microalbuminuric patien…
Identification and characterization of a monoclonal antibody to the membrane fatty acid binding protein
A monoclonal antibody to the rat liver membrane fatty acid binding protein (MFABP) was prepared by immunizing mice with purified MFABP isolated from solubilized rat liver plasma membrane proteins by oleate-agarose affinity chromatography technique. The monoclonal antibody K15/6 identified a single 40 kDa protein in rat liver plasma membranes with pI values of 8.5, 8.8 and 9.0, which is identical to the authentic MFABP, but clearly distinct from rat mitochondrial GOT. The antibody K15/6 selectively inhibited cellular influx as well as membrane binding of fatty acids, but not of cholesterol or vitamin E. The same antibody was used in immunofluorescence, ELISA and Western blot analysis to dete…
Role of adipokines in obesity-associated hypertension
It has been well documented that obesity is a major risk factor for the development of the hypertensive state. The correlation between body mass index and blood pressure level is well established. Nevertheless, the exact mechanisms which contribute to obesity-related hypertension remain poorly understood. In the last years, we have realized that the white adipose tissue is not just an inert organ for nutrient storage and isolation but rather depending on the body mass index the biggest endocrinological organ. Thus, the possible contribution of adipokines to the blood pressure elevation becomes an attractive hypothesis to explain the hypertensive state that often occurs in obesity. In this r…
Effects of nebivolol and atenolol on central aortic pressure in hypertensive patients: a multicenter, randomized, double-blind study.
The main objective was to compare the mean change in augmentation index of hypertensive patients treated with nebivolol or atenolol.Multicenter, double-blind randomized study conducted in six Spanish centers. We enrolled outpatients between the ages of 40 and 65 years with mild or moderate essential hypertension (systolic blood pressure, SBP ≥ 140 mmHg to ≤ 179 mmHg and diastolic blood pressure, DBP ≥ 90 mmHg to ≤ 109 mmHg after a 2-week run-in placebo period). Patients received nebivolol 5 mg or atenolol 50 mg once daily. At week 3, atenolol could be titrated up to 100 mg qd for non-responders. Additionally, patients not achieving normal blood pressure after 6 weeks could be treated with 2…
MASked-unconTrolled hypERtension management based on office BP or on ambulatory blood pressure measurement (MASTER) Study: a randomised controlled trial protocol
Introduction Masked uncontrolled hypertension (MUCH) carries an increased risk of cardiovascular (CV) complications and can be identified through combined use of office (O) and ambulatory (A) blood pressure (BP) monitoring (M) in treated patients. However, it is still debated whether the information carried by ABPM should be considered for MUCH management. Aim of the MASked-unconTrolled hypERtension management based on OBP or on ambulatory blood pressure measurement (MASTER) Study is to assess the impact on outcome of MUCH management based on OBPM or ABPM. Methods and analysis MASTER is a 4-year prospective, randomised, open-label, blinded-endpoint investigation. A total of 1240 treated hyp…
Analysis of the efficacy of an internet-based self-administered intervention ("Living Better") to promote healthy habits in a population with obesity and hypertension: An exploratory randomized controlled trial.
Este artículo se encuentra disponible en la página web de la revista en la siguiente URL: https://www.sciencedirect.com/science/article/abs/pii/S1386505618304647?via%3Dihub This is the pre-peer reviewed version of the following article: Mensorio, Marinna S., Cebolla-Martí, Ausiàs, Rodilla, Enrique, Palomar, Gonzalo, Lisón, Juan Francisco, Botella, Cristina, et al. (2019). Analysis of the efficacy of an internet-based self-administered intervention (“Living Better”) to promote healthy habits in a population with obesity and hypertension: an exploratory randomized controlled trial. International Journal of Medical Informatics, vol. 124, pp. 13-23, which has been published in final form at htt…
Long-Term Impact of Systolic Blood Pressure and Glycemia on the Development of Microalbuminuria in Essential Hypertension
The objective was to assess the temporal impact of factors related to the development of microalbuminuria during the follow-up of young adult normoalbuminurics with high-normal blood pressure or at stage 1 of essential hypertension. Prospective follow-up was conducted on 245 normoalbuminuric hypertensive subjects (mean age 40.9 years; 134 men; blood pressure 139.7/88.6 mm Hg; body mass index 28.5 kg/m 2 ) never treated previously with antihypertensive drugs, with yearly urinary albumin excretion measurements, until the development of microalbuminuria. After enrollment, patients were placed on usual care including nonpharmacological treatment or with an antihypertensive drug regime to achie…
Objetivos terapéuticos del colesterol LDL y cambios de la proteína C reactiva en pacientes de alto riesgo coronario
Resumen Fundamentos y objetivo Valorar los efectos de la asociacion de ezetimiba y estatina (terapia combinada), respecto a duplicar la dosis de estatina, a la hora de alcanzar los objetivos terapeuticos de colesterol ligado a las lipoproteinas de baja densidad (c-LDL) y en la variacion de la proteina C reactiva (PCR). Pacientes y metodos Estudio longitudinal retrospectivo de pacientes con dislipemia en tratamiento con estatina y control lipidico insuficiente. Se incluyeron 111 pacientes; a 59 se les duplico la dosis de estatina previa y a 52 se les anadio ezetimiba a la estatina (terapia combinada). Se calcularon las diferencias en lipidos y la proteina C reactiva. Resultados La terapia co…