Hipertension y Riesgo Vascular最新文献

{"title":"The sustainability of hypercholesterolemia treatment: New drugs have made such therapy more expensive","authors":"F. Ferrara ,&nbsp;A. Zovi ,&nbsp;R. Langella ,&nbsp;A. Panico ,&nbsp;M. Scognamiglio ,&nbsp;U. Trama ,&nbsp;E. Nava ,&nbsp;M. Capuozzo ,&nbsp;F. Primiano ,&nbsp;G. Russo","doi":"10.1016/j.hipert.2025.05.002","DOIUrl":"10.1016/j.hipert.2025.05.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Hypercholesterolemia represents a major risk factor in the onset and progression of cardiovascular diseases. While statins have long been the cornerstone of low-density lipoprotein cholesterol (LDL-C) reduction, the occurrence of adverse events associated with their use has prompted the development and adoption of alternative lipid-lowering agents. These include ezetimibe, bempedoic acid, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, such as alirocumab, evolocumab, and inclisiran.</div></div><div><h3>Methods</h3><div>This study aims to assess and compare the consumption patterns and associated costs of lipid-lowering medications during the first half of 2023 and 2024. The objective is to evaluate the economic implications of emerging therapies in the management of dyslipidemia and the extent of adherence to clinical guidelines. Data were collected from both private community pharmacies and public healthcare facilities, including hospital and district pharmacies. Drug utilization was analyzed using the Anatomical Therapeutic Chemical (ATC) classification system and expressed in defined daily doses (DDD).</div></div><div><h3>Results</h3><div>Findings indicate a declining trend in the use of traditional statin monotherapy, accompanied by an increase in the uptake of newer and combination therapies. Statin use declined significantly, from 42% in the first half of 2023 to 30% in the corresponding period of 2024. The use of combination therapy involving statins and ezetimibe remained stable at 17% across both timeframes. In contrast, PCSK9 inhibitors showed a notable rise in use, increasing from 33% to 40% between the two periods. The utilization of bempedoic acid, whether as monotherapy or combined with ezetimibe, remained marginal, consistently below 2%.</div></div><div><h3>Conclusion</h3><div>The therapeutic landscape for dyslipidemia has evolved substantially in recent years with the introduction of multiple novel agents. Among these, bempedoic acid, characterized by a more favorable cost profile, may serve as a valuable adjunct to statins and ezetimibe, potentially enhancing therapeutic outcomes and minimizing adverse effects—thus delaying or avoiding the need for more costly injectable treatments such as evolocumab, alirocumab, and inclisiran. Ongoing monitoring of prescribing trends and expenditure is crucial to ensuring the sustainability of healthcare systems, facilitating the adoption of innovative and effective treatments while preventing unnecessary resource allocation.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 267-275"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary vesicoureteral reflux presenting as hypertensive crisis and thrombotic microangiopathy","authors":"F.A. Nieto-Vega,&nbsp;B. Rodríguez-Azor,&nbsp;V. Martínez-Rivera,&nbsp;A.M. Reina-Gonzalez","doi":"10.1016/j.hipert.2025.04.004","DOIUrl":"10.1016/j.hipert.2025.04.004","url":null,"abstract":"<div><div>A 10-year-old boy with a history of febrile urinary tract infections presented with a hypertensive crisis and thrombotic microangiopathy (TMA). Functional and genetic complement testing was normal, and TMA resolved with blood pressure control, suggesting a primary hypertensive aetiology. Renal biopsy confirmed chronic tubulointerstitial nephritis (CTIN), likely secondary to recurrent pyelonephritis and renal scarring after ruling out other potential causes. High-grade vesicoureteral reflux was confirmed by voiding cystourethrography. After 4 years, he has progressed to stage III chronic kidney disease, and his blood pressure is well controlled on enalapril. This case highlights the importance of early diagnosis and blood pressure monitoring in patients with renal scarring to prevent severe complications like hypertensive crises and irreversible renal damage.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 302-304"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution of ventricular dysfunction and fibrosis in a young woman with primary hyperaldosteronism","authors":"M.d.R. Rodriguez ,&nbsp;F.N. Ballari ,&nbsp;V. Falco ,&nbsp;P. Rodriguez ,&nbsp;H.D. Sanabria","doi":"10.1016/j.hipert.2025.07.001","DOIUrl":"10.1016/j.hipert.2025.07.001","url":null,"abstract":"<div><div>A 25-year-old female was admitted to hospital due to a hypertensive crisis, presenting with ventricular dysfunction and renal impairment. Initial evaluations revealed a left ventricular ejection fraction of 46% with baseline inferolateral intramyocardial enhancement and a creatinine clearance of 45<!--> <!-->mL/min/1.73<!--> <!-->m², with proteinuria. Further investigations led to diagnosis of primary hyperaldosteronism (PA), with computed tomography demonstrating bilateral adrenal hyperplasia. After a nine-month treatment period with spironolactone, there was a complete reversal of ventricular dysfunction and fibrosis, and improvement in renal function. This case highlights the importance of early screening and appropriate treatment of PA to mitigate and potentially reverse end-organ damage.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 297-301"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal multinodular hepatic steatosis: An uncommon presentation of a known entity","authors":"A. Bustos-Merlo,&nbsp;A. Rosales-Castillo","doi":"10.1016/j.hipert.2025.03.003","DOIUrl":"10.1016/j.hipert.2025.03.003","url":null,"abstract":"<div><div>Hepatic steatosis is classified into several types according to its aetiology: metabolic; alcohol-related; metabolic with moderate alcohol consumption; associated with drugs or monogenic diseases, and cryptogenetic. An infrequent form of presentation is focal multinodular, and should be included in the differential diagnosis of solid liver lesions, which may simulate solid metastases. Magnetic resonance imaging is essential to identify the fat content and avoid unnecessary scans and invasive procedures such as biopsies. Focal multinodular hepatic steatosis is associated with vascular and metabolic risk factors, such as obesity, type 2 diabetes mellitus, and dyslipidemia. Treatment is based on modifying and controlling these underlying metabolic risk factors, with weight loss, a balanced diet, and regular physical activity being key strategies for lesion regression.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 309-311"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New nicotine products and vascular risk","authors":"R. Córdoba García ,&nbsp;V. Barchilon Cohen ,&nbsp;J. Lozano Fernández ,&nbsp;J. Torras-Borrell","doi":"10.1016/j.hipert.2025.07.002","DOIUrl":"10.1016/j.hipert.2025.07.002","url":null,"abstract":"<div><div>Tobacco use is the leading cause of preventable diseases, disability, and death in Spain, causing 56,124 deaths annually, one-third of which are due to cardiovascular disease. The aim of this study is to review the relationship between the use of novel products and vascular risk and other health risks, as well as their impact on cessation and harm modification. Searches were conducted in PubMed, Tripadatabase.com, Truth Tobacco, Industry Documents, and Tobacco Tactics. There is some evidence that the harm of these products is less than the individual harm by cigarettes at vascular, cardiorespiratory, and metabolic levels. There is no evidence that replacing cigarettes with novel nicotine products reduces overall harm because: (a) they promote dual smoking in most users; (b) they increase vulnerability to relapse; (c) they delay or prevent cessation of nicotine addiction; and (d) they facilitate the transition to tobacco use in minors.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 249-258"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation in adolescent metabolic syndrome: a call for simplified screening in Latin America","authors":"Fernando P. Aguirre,&nbsp;María Fernanda Aguirre,&nbsp;Gregory Celis","doi":"10.1016/j.hipert.2025.12.001","DOIUrl":"10.1016/j.hipert.2025.12.001","url":null,"abstract":"","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 247-248"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145771888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables","authors":"M.P. Fernández-Figares Vicioso ,&nbsp;Á.A. López-González ,&nbsp;J.I. Ramírez-Manent ,&nbsp;J.L. Del Barrio Fernández ,&nbsp;P.J. Tárraga López ,&nbsp;M.T. Vicente-Herreros","doi":"10.1016/j.hipert.2025.04.002","DOIUrl":"10.1016/j.hipert.2025.04.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it.</div></div><div><h3>Methodology</h3><div>This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019.</div></div><div><h3>Results</h3><div>The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors.</div></div><div><h3>Conclusions</h3><div>Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 276-288"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doctor, what else can I do to avoid having another myocardial infarction?","authors":"A. Meseguer-Hernández,&nbsp;F. Buendía-Santiago,&nbsp;J. Abellán-Huerta","doi":"10.1016/j.hipert.2025.02.004","DOIUrl":"10.1016/j.hipert.2025.02.004","url":null,"abstract":"<div><div>Patient with classic cardiovascular risk factors under treatment and apparently well controlled, with good adherence to the treatment, but with repeated acute coronary syndromes. After investigating these risk factors, arterial hypertension secondary to undiagnosed sleep apnoea-hypopnoea syndrome was detected. In addition, the patient's residual risk was addressed, prescribing treatment for his atherogenic dyslipidaemia and, in addition, elevated levels of lipoprotein (a) were discovered. This case illustrates holistic patient management, which involves actions to improve the patient's prognosis.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 305-308"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AHA's new PREVENT 10-year cardiovascular risk and all-cause, CVD, and non-CVD mortality among US adults: The NHANES 2003–2019","authors":"R. Mondal,&nbsp;R.B. Ritu","doi":"10.1016/j.hipert.2025.02.003","DOIUrl":"10.1016/j.hipert.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The relationship between the American Heart Association's (AHA) new Predicting Risk of cardiovascular disease EVENTs (PREVENT) risk and long-term disease progression, like mortality, is unresolved. We investigated the associations of PREVENT cardiovascular disease (CVD) risk with all-cause, CVD, and non-CVD mortality among adults in the US.</div></div><div><h3>Methods</h3><div>This cohort study used data from 30,544 adults from 2003–2018 survey cycles of the National Health and Nutrition Examination Survey and linked to the mortality data until 2019. All-cause mortality, further stratified into CVD and non-CVD mortality, were defined by the leading cause of death using the International Classification of Diseases codes. Employing PREVENT's base model and component variables, we estimated 10-year total CVD risk stratified into low (&lt;5%), borderline (5–7.4%), intermediate (7.5–19.9%), and high (≥20%). Multivariable Cox proportional hazards regression (hazard ratio [HR] and 95% confidence interval [CI]) analyses were used.</div></div><div><h3>Results</h3><div>Participants’ mean<!--> <!-->±<!--> <!-->SD age was 50.3<!--> <!-->±<!--> <!-->13.1 years, with a balanced sex distribution. Compared to individuals with low CVD risk, those with borderline and intermediate risks had a greater risk of all-cause mortality (HR [95% CI], 1.08 [1.03–1.13] and 1.12 [1.08–1.16], respectively). Those with borderline, intermediate, and high risks had a greater risk of CVD mortality (HR [95% CI], 1.11 [1.06–1.16], 1.21 [1.18–1.25], and 1.40 [1.33–1.47], respectively), compared to low-risk individuals. Similar trends were observed for non-CVD mortality. With significant racial/ethnic group-interactions, the associations were evident in Mexican Americans.</div></div><div><h3>Conclusions</h3><div>Higher PREVENT 10-year CVD risk is associated with higher risk of all-cause, CVD, and non-CVD mortality, and the associations differ by race/ethnicity.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 259-266"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mercury poisoning may mimic pheochromocytoma","authors":"M.E. Mullins ,&nbsp;A. Ansar ,&nbsp;C.F.F. Hebbard ,&nbsp;B.A. Marshall","doi":"10.1016/j.hipert.2025.05.001","DOIUrl":"10.1016/j.hipert.2025.05.001","url":null,"abstract":"","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 4","pages":"Pages 312-313"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}