Pub Date : 2025-04-01DOI: 10.1016/j.hipert.2024.11.003
E. Moya Mateo , R. García Alonso , C. Sánchez Sánchez , Y. Tung-Chen , E. Rodilla , L. Beltrán Romero , J.A. García-Donaire , M.V. Bonilla-Hernández , N. Muñoz-Rivas , L. Castilla-Guerra
Atherosclerosis is the underlying disease in the entire spectrum of atherosclerotic vascular disease. Point of care ultrasound is a useful tool for its detection. Current guidelines recommend the use of scales such as SCORE 2 and SCORE 2OP in apparently healthy individuals and in those at intermediate-low risk, they recognize the role of the arterial plaque by ultrasound to refine risk stratification and the need for more aggressive preventive strategies. However, the way to evaluate the vascular territories in which there is presence of plaque, the amount or load of plaque is not homogeneous nor is it well protocolized. In this document, 2 protocols are proposed for the evaluation of vascular risk, VASUS and VASUS+, including the presence of ventricular hypertrophy with the objective of homogenizing clinical ultrasound in the assessment of vascular risk in clinical practice.
{"title":"Positioning for the use of multivessel clinical ultrasound in vascular risk evaluation: VASUS+ protocol. 2024 recommendations of the Vascular Risk Group, clinical ultrasound of the Spanish Society of Internal Medicine and Spanish Society of Hypertension and Vascular Risk","authors":"E. Moya Mateo , R. García Alonso , C. Sánchez Sánchez , Y. Tung-Chen , E. Rodilla , L. Beltrán Romero , J.A. García-Donaire , M.V. Bonilla-Hernández , N. Muñoz-Rivas , L. Castilla-Guerra","doi":"10.1016/j.hipert.2024.11.003","DOIUrl":"10.1016/j.hipert.2024.11.003","url":null,"abstract":"<div><div>Atherosclerosis is the underlying disease in the entire spectrum of atherosclerotic vascular disease. Point of care ultrasound is a useful tool for its detection. Current guidelines recommend the use of scales such as SCORE 2 and SCORE 2OP in apparently healthy individuals and in those at intermediate-low risk, they recognize the role of the arterial plaque by ultrasound to refine risk stratification and the need for more aggressive preventive strategies. However, the way to evaluate the vascular territories in which there is presence of plaque, the amount or load of plaque is not homogeneous nor is it well protocolized. In this document, 2 protocols are proposed for the evaluation of vascular risk, VASUS and VASUS+, including the presence of ventricular hypertrophy with the objective of homogenizing clinical ultrasound in the assessment of vascular risk in clinical practice.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 2","pages":"Pages 108-115"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674663","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}
Pub Date : 2025-04-01DOI: 10.1016/j.hipert.2024.11.004
A.M. Ghelfi , G. Miranda , L.S. Voto , M.A. Del Sueldo , J.M. Zilberman , R. Mondino , M.P. Pérez , P.G. Irusta , L. Meccia , E. Martínez Marissi , M. Laura Baiche , F. Waisman , M. BaronI , M. Victoria FerrettI , J.P. Morán , A. Corrales Barboza , A.M. Delucchi , P.D. Rodríguez , N.F. Renna
Pharmacological management of HDP includes agents supported by extensive evidence ensuring their safety for use. Among those traditionally described in the literature are: alpha-methyldopa, labetalol, and sustained-release nifedipine (NIF-RETARD). These drugs, in addition to being compatible with pregnancy, present additional eligibility criteria.
The discontinuation of NIF-RETARD has resulted in the off-label use of other dihydropyridine calcium cannel blockers with lower levels of evidence in pregnancy, such as amlodipine.
The Working Group Hypertension in Women of the Argentine Society of Hypertension has proposed to develop a document that precisely and thoroughly addresses the concerns related to the use of amlodipine in pregnancy, providing responses based on the currently available scientific evidence.
{"title":"Position statement on the use of amlodipine during pregnancy. Working Group on Hypertension in Women, Argentine Society of Hypertension","authors":"A.M. Ghelfi , G. Miranda , L.S. Voto , M.A. Del Sueldo , J.M. Zilberman , R. Mondino , M.P. Pérez , P.G. Irusta , L. Meccia , E. Martínez Marissi , M. Laura Baiche , F. Waisman , M. BaronI , M. Victoria FerrettI , J.P. Morán , A. Corrales Barboza , A.M. Delucchi , P.D. Rodríguez , N.F. Renna","doi":"10.1016/j.hipert.2024.11.004","DOIUrl":"10.1016/j.hipert.2024.11.004","url":null,"abstract":"<div><div>Pharmacological management of HDP includes agents supported by extensive evidence ensuring their safety for use. Among those traditionally described in the literature are: alpha-methyldopa, labetalol, and sustained-release nifedipine (NIF-RETARD). These drugs, in addition to being compatible with pregnancy, present additional eligibility criteria.</div><div>The discontinuation of NIF-RETARD has resulted in the off-label use of other dihydropyridine calcium cannel blockers with lower levels of evidence in pregnancy, such as amlodipine.</div><div>The Working Group Hypertension in Women of the Argentine Society of Hypertension has proposed to develop a document that precisely and thoroughly addresses the concerns related to the use of amlodipine in pregnancy, providing responses based on the currently available scientific evidence.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 2","pages":"Pages 102-107"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898980","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}
Pub Date : 2025-01-01DOI: 10.1016/j.hipert.2024.07.005
P. Corral , A. Lavalle Cobo , M.F. Arrupe , L. Schreier , G. Matta , N.F. Renna , en nombre de los investigadores de GAELp(a)
Introduction
Elevated levels of Lipoprotein(a) [Lp(a)] have been linked to increased cardiovascular risk globally. However, comprehensive studies on Lp(a) levels and their impact on cardiovascular health in Argentina are lacking. The Argentine Group for the Study of Lipoprotein (a) [GAELp(a)] aims to address this gap through an observational study designed to evaluate the prevalence and consequences of elevated Lp(a) levels in the Argentine population.
Methods
The GAELp(a) study will recruit participants from diverse regions across Argentina. Eligible individuals will undergo comprehensive assessments, including demographic data collection, medical history review, and laboratory analyses to measure Lp(a) levels. The study will employ rigorous statistical analyses to explore the association between elevated Lp(a) levels and cardiovascular outcomes, considering potential confounding variables.
Results
Anticipated outcomes of the GAELp(a) study include a detailed characterization of Lp(a) levels within the Argentine population and their correlation with cardiovascular diseases. By elucidating these relationships, the study aims to provide valuable insights into the prevalence and impact of elevated Lp(a) on cardiovascular health in Argentina.
Conclusion
The GAELp(a) observational study holds promise for enhancing our understanding of Lp(a)-related cardiovascular risk in Argentina. Findings from this study may contribute to the development of targeted interventions, clinical guidelines, and public health policies aimed at reducing cardiovascular morbidity and mortality associated with elevated Lp(a) levels. Through collaborative efforts, the GAELp(a) study seeks to advance cardiovascular research and improve healthcare outcomes in Argentina.
{"title":"Diseño y racional estudio observacional del Grupo Argentino Estudio Lipoproteína (a)","authors":"P. Corral , A. Lavalle Cobo , M.F. Arrupe , L. Schreier , G. Matta , N.F. Renna , en nombre de los investigadores de GAELp(a)","doi":"10.1016/j.hipert.2024.07.005","DOIUrl":"10.1016/j.hipert.2024.07.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Elevated levels of Lipoprotein(a) [Lp(a)] have been linked to increased cardiovascular risk globally. However, comprehensive studies on Lp(a) levels and their impact on cardiovascular health in Argentina are lacking. The Argentine Group for the Study of Lipoprotein (a) [GAELp(a)] aims to address this gap through an observational study designed to evaluate the prevalence and consequences of elevated Lp(a) levels in the Argentine population.</div></div><div><h3>Methods</h3><div>The GAELp(a) study will recruit participants from diverse regions across Argentina. Eligible individuals will undergo comprehensive assessments, including demographic data collection, medical history review, and laboratory analyses to measure Lp(a) levels. The study will employ rigorous statistical analyses to explore the association between elevated Lp(a) levels and cardiovascular outcomes, considering potential confounding variables.</div></div><div><h3>Results</h3><div>Anticipated outcomes of the GAELp(a) study include a detailed characterization of Lp(a) levels within the Argentine population and their correlation with cardiovascular diseases. By elucidating these relationships, the study aims to provide valuable insights into the prevalence and impact of elevated Lp(a) on cardiovascular health in Argentina.</div></div><div><h3>Conclusion</h3><div>The GAELp(a) observational study holds promise for enhancing our understanding of Lp(a)-related cardiovascular risk in Argentina. Findings from this study may contribute to the development of targeted interventions, clinical guidelines, and public health policies aimed at reducing cardiovascular morbidity and mortality associated with elevated Lp(a) levels. Through collaborative efforts, the GAELp(a) study seeks to advance cardiovascular research and improve healthcare outcomes in Argentina.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 13-17"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394074","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}
Pub Date : 2025-01-01DOI: 10.1016/j.hipert.2024.08.001
E. Achote , O.F. Arroyo Ripoll , M. Araujo-Castro
Pheochromocytoma is a rare neuroendocrine tumour that develops from chromaffin cells in the adrenal medulla and is characterised by the excessive production of catecholamines and their metabolites. Diagnostic confirmation is performed by detecting elevated levels of catecholamines and/or their metabolites in plasma or 24-h urine. In the case of moderate elevations of normetanephrine, the clonidine suppression test may be useful to differentiate between endogenous hypersecretion and false positive results. Once the biochemical diagnosis is performed, the tumour localisation is carried out using imaging techniques and sometimes with nuclear medicine imaging tests. Furthermore, in all patients with pheochromocytomas it is recommended to perform a genetic study to identify hereditary disorders that may be present in more than 30% of cases and to perform a cardiological evaluation to rule out the presence of cardiovascular involvement secondary to the catecholamine hypersecretion.
{"title":"Update on the diagnosis of the pheochromocytoma","authors":"E. Achote , O.F. Arroyo Ripoll , M. Araujo-Castro","doi":"10.1016/j.hipert.2024.08.001","DOIUrl":"10.1016/j.hipert.2024.08.001","url":null,"abstract":"<div><div>Pheochromocytoma is a rare neuroendocrine tumour that develops from chromaffin cells in the adrenal medulla and is characterised by the excessive production of catecholamines and their metabolites. Diagnostic confirmation is performed by detecting elevated levels of catecholamines and/or their metabolites in plasma or 24-h urine. In the case of moderate elevations of normetanephrine, the clonidine suppression test may be useful to differentiate between endogenous hypersecretion and false positive results. Once the biochemical diagnosis is performed, the tumour localisation is carried out using imaging techniques and sometimes with nuclear medicine imaging tests. Furthermore, in all patients with pheochromocytomas it is recommended to perform a genetic study to identify hereditary disorders that may be present in more than 30% of cases and to perform a cardiological evaluation to rule out the presence of cardiovascular involvement secondary to the catecholamine hypersecretion.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 43-51"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406921","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}
Pub Date : 2025-01-01DOI: 10.1016/j.hipert.2024.09.004
C. Sepulveda Gallardo , A.I. Barrientos , M.H. Koretzky , F. Wyss , O. Valdez Tiburcio , N. Báez Noyer , E. Sanchez , A. Gonzalez , W. Dones , P. López Contreras , M. Camafort
Arterial hypertension is one of the most prevalent diseases in the field of geriatrics and is also a risk factor for pathologies that frequently result in hospital admissions, such as heart failure and stroke. This article addresses both pharmacological and non-pharmacological diagnosis and treatment strategies, focusing on the role of frailty as a guiding principle in determining the most appropriate course of treatment, emphasizing patient-centred prescribing. Furthermore, the article reviews other frequent topics, such as polypharmacy and orthostatic hypotension. Moreover, a concise overview of the current evidence in geriatrics on ambulatory blood pressure monitoring and self-measurement of blood pressure will be provided. Furthermore, a brief summary of the underlying pathophysiology and current epidemiological trends is provided. This consensus is founded upon the initial premise that a comprehensive geriatric assessment should be conducted to ascertain whether a blood pressure reduction strategy could confer a net benefit for elderly patients while simultaneously avoiding an increase in the safety risks associated with these strategies and preventing a de-prescription due to ageism. This is particularly important given the significance of maintaining optimal blood pressure control to prevent related complications.
{"title":"Peculiaridades del manejo de la hipertensión arterial en el anciano. Documento de consenso de la Sociedad Centroamericana y del Caribe de Hipertensión arterial","authors":"C. Sepulveda Gallardo , A.I. Barrientos , M.H. Koretzky , F. Wyss , O. Valdez Tiburcio , N. Báez Noyer , E. Sanchez , A. Gonzalez , W. Dones , P. López Contreras , M. Camafort","doi":"10.1016/j.hipert.2024.09.004","DOIUrl":"10.1016/j.hipert.2024.09.004","url":null,"abstract":"<div><div>Arterial hypertension is one of the most prevalent diseases in the field of geriatrics and is also a risk factor for pathologies that frequently result in hospital admissions, such as heart failure and stroke. This article addresses both pharmacological and non-pharmacological diagnosis and treatment strategies, focusing on the role of frailty as a guiding principle in determining the most appropriate course of treatment, emphasizing patient-centred prescribing. Furthermore, the article reviews other frequent topics, such as polypharmacy and orthostatic hypotension. Moreover, a concise overview of the current evidence in geriatrics on ambulatory blood pressure monitoring and self-measurement of blood pressure will be provided. Furthermore, a brief summary of the underlying pathophysiology and current epidemiological trends is provided. This consensus is founded upon the initial premise that a comprehensive geriatric assessment should be conducted to ascertain whether a blood pressure reduction strategy could confer a net benefit for elderly patients while simultaneously avoiding an increase in the safety risks associated with these strategies and preventing a de-prescription due to ageism. This is particularly important given the significance of maintaining optimal blood pressure control to prevent related complications.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 36-42"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Preeclampsia (PE) is a complication of hypertensive disorders of pregnancy, whose pathophysiology involves endothelial dysfunction. Early establishment of subclinical vascular lesions such as arterial stiffness (AS) could explain the development of cardiovascular disease later in life. AS can be assessed non-invasively using carotid-femoral pulse wave velocity (cf-PWV), aortic systolic blood pressure (ao-SBP) and augmentation index (IAx). We aim to determine cf-PWV, ao-SBP and AIx in women who recently underwent PE and compare it with a control group.
Materials and methods
Cross-sectional study, carried out from 2022 to 2023 in Argentina. Group 1: women who developed PE. Exclusion criteria: history of chronic hypertension, diabetes, autoimmune disease, chronic kidney disease, cardiovascular disease, PE in previous pregnancies; treatment with calcium antagonists during pregnancy; treatment with calcium antagonists, angiotensin-converting enzyme inhibitors or diuretics in the postpartum period. Group 2: healthy postpartum periods. PWV-cf, ao-SBP and IAx were measured in the first 72 hours postpartum using Aortic.
Results
Seventy-onewomen were included: Group 1 (n = 30); Group 2 (n = 41). Group 1 presented higher PWV-cf = 6.70 ± 0.68 vs. 5.41 ± 0.48 m/s (P<.0001); ao-SBP = 118.3 ± 9.6 vs. 101.2 ± 9.8 mmHg (P<.0001); and IAu = 22.7 ± 10.7 vs. 9.3 ± 11.9% (P<.0001). In Group 1 there were 25 of 30 women who presented AS parameters (OR = 8.50; 95% CI = 3.32-15.29; P<.0001).
Conclusion
Patients with a recent history of PE showed higher cf-PWV, ao-SBP and AIx values, compatible with AS.
{"title":"Detección de rigidez arterial en mujeres con antecedente reciente de preeclampsia","authors":"A.M. Ghelfi , M.N. Lassus , F.A. Passarino , R.F. Mamprin D’Andrea , L.N. Fierro , L.L. Velez , E.A. Hails , M.A. Paciocco , J.G. Kilstein , J.O. Galíndez","doi":"10.1016/j.hipert.2024.07.007","DOIUrl":"10.1016/j.hipert.2024.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Preeclampsia (PE) is a complication of hypertensive disorders of pregnancy, whose pathophysiology involves endothelial dysfunction. Early establishment of subclinical vascular lesions such as arterial stiffness (AS) could explain the development of cardiovascular disease later in life. AS can be assessed non-invasively using carotid-femoral pulse wave velocity (cf-PWV), aortic systolic blood pressure (ao-SBP) and augmentation index (IAx). We aim to determine cf-PWV, ao-SBP and AIx in women who recently underwent PE and compare it with a control group.</div></div><div><h3>Materials and methods</h3><div>Cross-sectional study, carried out from 2022 to 2023 in Argentina. Group 1: women who developed PE. Exclusion criteria: history of chronic hypertension, diabetes, autoimmune disease, chronic kidney disease, cardiovascular disease, PE in previous pregnancies; treatment with calcium antagonists during pregnancy; treatment with calcium antagonists, angiotensin-converting enzyme inhibitors or diuretics in the postpartum period. Group 2: healthy postpartum periods. PWV-cf, ao-SBP and IAx were measured in the first 72<!--> <!-->hours postpartum using Aortic.</div></div><div><h3>Results</h3><div>Seventy-onewomen were included: Group 1 (n<!--> <!-->=<!--> <!-->30); Group 2 (n<!--> <!-->=<!--> <!-->41). Group 1 presented higher PWV-cf<!--> <!-->=<!--> <!-->6.70<!--> <!-->±<!--> <!-->0.68 vs. 5.41<!--> <!-->±<!--> <!-->0.48 m/s (<em>P</em><.0001); ao-SBP<!--> <!-->=<!--> <!-->118.3<!--> <!-->±<!--> <!-->9.6 vs. 101.2<!--> <!-->±<!--> <!-->9.8<!--> <!-->mmHg (<em>P</em><.0001); and IAu<!--> <!-->=<!--> <!-->22.7<!--> <!-->±<!--> <!-->10.7 vs. 9.3<!--> <!-->±<!--> <!-->11.9% (<em>P</em><.0001). In Group 1 there were 25 of 30 women who presented AS parameters (OR<!--> <!-->=<!--> <!-->8.50; 95% CI<!--> <!-->=<!--> <!-->3.32-15.29; <em>P</em><.0001).</div></div><div><h3>Conclusion</h3><div>Patients with a recent history of PE showed higher cf-PWV, ao-SBP and AIx values, compatible with AS.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 3-12"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401574","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}
Pub Date : 2025-01-01DOI: 10.1016/j.hipert.2024.10.001
V.J. Vera-Ponce , F.E. Zuzunaga-Montoya , L.E.M. Vásquez-Romero , J.A. Loayza-Castro , C.I. Gutierrez De Carrillo , E. Vigil-Ventura
Introduction
While HTN is widely seen as a primary threat to cardiovascular conditions worldwide, it is essential to recognize that not all HTN is identical.
Objective
To determine the prevalence, trend, and factors associated with each type of HTN: isolated systolic (ISH), isolated diastolic (IDH), and systolic–diastolic (SDH).
Methods
A secondary analysis of data from the Demographic and Family Health Survey from 2014 to 2022 was conducted. For the analysis of associated factors, a Poisson regression model with robust variance was implemented to calculate adjusted prevalence ratios (aPR) along with their 95% confidence intervals.
Results
The prevalence was 7.02%, 1.55%, and 3.28% for ISH, IDH, and SDH, respectively. ISH showed a decline in 2022, unlike the other two types, which seem to be on the rise. A statistically significant association was found in men and an increased risk with age for ISH and SDH, unlike IDH, where age acts as a protective factor. Additional factors identified include smoking and excessive alcohol consumption, while a high intake of fruits/vegetables offers a protective effect. Obesity and diabetes were associated with a higher risk, and significant variations by region and altitude, as well as among ethnic groups, were observed.
Conclusions
Significant differences in the prevalence of HTN subtypes have been found, underscoring the heterogeneity of this chronic condition, both in related factors and in trends over the years.
{"title":"Prevalence, trends, and associated factors of isolated systolic, diastolic, and systolic–diastolic hypertension in Peru: A nine-year analysis of the Demographic and Family Health Survey","authors":"V.J. Vera-Ponce , F.E. Zuzunaga-Montoya , L.E.M. Vásquez-Romero , J.A. Loayza-Castro , C.I. Gutierrez De Carrillo , E. Vigil-Ventura","doi":"10.1016/j.hipert.2024.10.001","DOIUrl":"10.1016/j.hipert.2024.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>While HTN is widely seen as a primary threat to cardiovascular conditions worldwide, it is essential to recognize that not all HTN is identical.</div></div><div><h3>Objective</h3><div>To determine the prevalence, trend, and factors associated with each type of HTN: isolated systolic (ISH), isolated diastolic (IDH), and systolic–diastolic (SDH).</div></div><div><h3>Methods</h3><div>A secondary analysis of data from the Demographic and Family Health Survey from 2014 to 2022 was conducted. For the analysis of associated factors, a Poisson regression model with robust variance was implemented to calculate adjusted prevalence ratios (aPR) along with their 95% confidence intervals.</div></div><div><h3>Results</h3><div>The prevalence was 7.02%, 1.55%, and 3.28% for ISH, IDH, and SDH, respectively. ISH showed a decline in 2022, unlike the other two types, which seem to be on the rise. A statistically significant association was found in men and an increased risk with age for ISH and SDH, unlike IDH, where age acts as a protective factor. Additional factors identified include smoking and excessive alcohol consumption, while a high intake of fruits/vegetables offers a protective effect. Obesity and diabetes were associated with a higher risk, and significant variations by region and altitude, as well as among ethnic groups, were observed.</div></div><div><h3>Conclusions</h3><div>Significant differences in the prevalence of HTN subtypes have been found, underscoring the heterogeneity of this chronic condition, both in related factors and in trends over the years.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 18-28"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.hipert.2024.09.001
P.G. Irusta
Postpartum de novo arterial hypertension (PPDNAH) is defined as blood pressure ≥140/90 mmHg, without a history of hypertension during pregnancy or delivery. Its prevalence ranges from 0.3% to 27.5% of all pregnancies. Late-onset postpartum preeclampsia (LOPPP) and late-onset postpartum eclampsia (LOPPE) typically occur between 48 hours and 6 weeks postpartum, although recent studies demonstrate the possibility of developing these disorders up to 12 months postpartum.
While sharing risk factors with pregnancy-related disorders, they differ in some aspects such as primigravida status. Regarding prognosis, an increase in severe maternal morbidity has been observed compared to hypertensive disorders of pregnancy.
This group of pathologies is often underdiagnosed, even in high-risk patients, making early identification along with strict blood pressure monitoring essential.
{"title":"Trastornos hipertensivos de novo en el posparto: consideraciones sobre su diagnóstico, factores de riesgo y posibles estrategias de intervención","authors":"P.G. Irusta","doi":"10.1016/j.hipert.2024.09.001","DOIUrl":"10.1016/j.hipert.2024.09.001","url":null,"abstract":"<div><div>Postpartum de novo arterial hypertension (PPDNAH) is defined as blood pressure ≥140/90<!--> <!-->mmHg, without a history of hypertension during pregnancy or delivery. Its prevalence ranges from 0.3% to 27.5% of all pregnancies. Late-onset postpartum preeclampsia (LOPPP) and late-onset postpartum eclampsia (LOPPE) typically occur between 48<!--> <!-->hours and 6 weeks postpartum, although recent studies demonstrate the possibility of developing these disorders up to 12 months postpartum.</div><div>While sharing risk factors with pregnancy-related disorders, they differ in some aspects such as primigravida status. Regarding prognosis, an increase in severe maternal morbidity has been observed compared to hypertensive disorders of pregnancy.</div><div>This group of pathologies is often underdiagnosed, even in high-risk patients, making early identification along with strict blood pressure monitoring essential.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 29-35"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356007","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}
Pub Date : 2025-01-01DOI: 10.1016/j.hipert.2024.09.002
J.M. Ruiz-Cánovas , E.A. Achote-Rea , T. Alonso-Gordoa , A. Martínez-Lorca , M. Araujo-Castro
We describe the case of an 80-year-old man with sporadic right pheochromocytoma who developed metastatic disease six years after initial diagnosis. Despite adequate blood pressure control and initial biochemical cure criteria after surgery, elevated chromogranin A levels were detected during routine screening, which anticipated elevated 24-h urine metanephrines. Subsequent imaging tests revealed metastatic lesions in the lungs, liver, prostate and lymph nodes. The patient underwent systemic treatment with [131I] MIBG, which resulted in a decrease in chromogranin A levels, achieving radiological and clinical stability. This case highlights the importance of long-term follow-up and biochemical monitoring for early detection of tumor recurrence in patients with pheochromocytoma, emphasizing the need for individualized treatment strategies and interdisciplinary care.
我们描述了一例患有散发性右侧嗜铬细胞瘤的 80 岁男性病例，他在初次确诊六年后出现了转移性疾病。尽管手术后血压得到了充分控制，并达到了最初的生化治愈标准，但在常规筛查中发现嗜铬粒蛋白 A 水平升高，这预示着 24 小时尿中的甲肾上腺素升高。随后的影像学检查发现肺部、肝脏、前列腺和淋巴结有转移病灶。患者接受了[131I] MIBG的全身治疗，结果嗜铬粒蛋白A水平有所下降，达到了放射学和临床稳定。本病例强调了长期随访和生化监测对于早期发现嗜铬细胞瘤患者肿瘤复发的重要性，强调了个体化治疗策略和跨学科护理的必要性。
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