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…

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 …

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 <…

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…

Association between Opioid Receptor mu 1 (OPRM1) Gene Polymorphisms and Tobacco and Alcohol Consumption in a Spanish Population.

Evidence gained from animals and humans suggests that the encephalic opioid system might be involved in the development of drug addiction through its role in reward. Our aim is to assess the influence of genetic variations in the opioid receptor mu 1 on alcohol and tobacco consumption in a Spanish population. 763 unrelated individuals (465 women, 298 men) aged 18-85 years were recruited between October 2011 and April 2012. Participants were requested to answer a 35-item questionnaire on tobacco and alcohol consumption, as well as to complete the AUDIT and Fagerström tests. Individuals were genotyped for three polymorphisms in the opioid receptor mu 1 (OPRM1) gene, using a TaqMan® protocol. …

Eplerenona en hipertensión arterial resistente con intolerancia previa a espironolactona

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)…