Pub Date : 2025-01-01DOI: 10.1016/j.hipert.2024.09.003
E. Rodilla , M. Benítez Camps , L. Castilla Guerra , M.I. Egocheaga Cabello , J. Gamarra Ortiz , M.Á. María Tablado , N. Muñoz Rivas , V. Pallarés-Carratalá , J. Polo García , J.A. García Donaire
The 2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension (ESH Guidelines 2024) have recently been published, a brief document but with a very elaborate infographic that summarizes as much as possible the previous guidelines for the management of arterial hypertension (HTN), aimed at serving as a quick reference tool to make decisions in daily clinical practice. The main objective of this work is to analyze the recommendations and innovations of these guidelines from the perspective of their applicability and taking into account all the scientific societies in the specialty of Family and Community Medicine, Internal Medicine and the Spanish Society of Hypertension (SEHLELHA) in order to achieve more homogeneous and evidence-based care for HTN in Spain. The most important results include the maintenance of the thresholds to define HTN and the therapeutic objectives, as well as the recommendation to initiate pharmacological treatment based on both the blood pressure values and the cardiovascular risk estimated by SCORE2 and the presence of organic damage. New are the introduction of practical tables to estimate the fragility of hypertensive subjects based on their age and autonomy, as well as precise recommendations for monitoring HTN. In summary, the ESH 2024 Guidelines represent a useful, reasoned and concise instrument that can serve as a tool to improve the control of HTN in our environment.
{"title":"Position paper on the 2024 ESH clinical practice guidelines for the management of arterial hypertension in Spain","authors":"E. Rodilla , M. Benítez Camps , L. Castilla Guerra , M.I. Egocheaga Cabello , J. Gamarra Ortiz , M.Á. María Tablado , N. Muñoz Rivas , V. Pallarés-Carratalá , J. Polo García , J.A. García Donaire","doi":"10.1016/j.hipert.2024.09.003","DOIUrl":"10.1016/j.hipert.2024.09.003","url":null,"abstract":"<div><div>The 2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension (ESH Guidelines 2024) have recently been published, a brief document but with a very elaborate infographic that summarizes as much as possible the previous guidelines for the management of arterial hypertension (HTN), aimed at serving as a quick reference tool to make decisions in daily clinical practice. The main objective of this work is to analyze the recommendations and innovations of these guidelines from the perspective of their applicability and taking into account all the scientific societies in the specialty of Family and Community Medicine, Internal Medicine and the Spanish Society of Hypertension (SEHLELHA) in order to achieve more homogeneous and evidence-based care for HTN in Spain. The most important results include the maintenance of the thresholds to define HTN and the therapeutic objectives, as well as the recommendation to initiate pharmacological treatment based on both the blood pressure values and the cardiovascular risk estimated by SCORE2 and the presence of organic damage. New are the introduction of practical tables to estimate the fragility of hypertensive subjects based on their age and autonomy, as well as precise recommendations for monitoring HTN. In summary, the ESH 2024 Guidelines represent a useful, reasoned and concise instrument that can serve as a tool to improve the control of HTN in our environment.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 1","pages":"Pages 52-58"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682941","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.07.003
{"title":"Efecto de diferentes bebidas alcohólicas sobre la presión arterial","authors":"","doi":"10.1016/j.hipert.2024.07.003","DOIUrl":"10.1016/j.hipert.2024.07.003","url":null,"abstract":"","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 270-271"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663014","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.06.005
A. Delucchi, D. Fernández, M. Sorini, P. Reisin, M. Scarabino, P. Rodríguez
The inter-arm difference (IAD) of systolic blood pressure (SBP) is associated with higher cardiovascular risk. We compared simultaneous and consecutive recordings in measuring IAD of SBP, and evaluated reproducibility between visits. 143 hypertensive patients (63.8 ± 9.5 years, 51.7% women) treated and controlled with stable antihypertensive medication for a period of ≥ 3 months were included. Blood pressure (BP) in both arms was measured simultaneously and consecutively with an automatic oscillometric device, in two visits. The IAD of the simultaneous SBP was significantly lower compared to the consecutive one, both in the first (3.51 ± 4.1 vs. 4.40 ± 3.7 mmHg; P < .01) and in the second visit (3.62 ± 3.5 vs. 5.69 ± 5.1 mmHg; P < .001). When the IAD of SBP was categorized as ≥ 10 or < 10 mmHg, the reproducibility between visits was insignificant in both simultaneous measurements and consecutive measurements. The frequency of initial dominance was similar between the left and right arm in simultaneous ones (46.2 vs. 43.3%), and greater in the right arm in consecutive ones (55.2 vs. 38.5). The persistence of dominance between both visits was significantly higher when SBP was measured simultaneously (54.4% vs. 45.5%; P < .01). Our study shows that to define the arm with the highest BP, simultaneous measurements are preferable. In treated and controlled hypertensive patients, the poor persistence of initial dominance between visits requires us to review the recommendation of recording, during follow-up, the BP in the arm where it was highest on the first visit.
收缩压（SBP）的臂间差（IAD）与较高的心血管风险有关。我们比较了同时和连续记录 SBP 的 IAD 测量值，并评估了各次访问之间的重现性。共纳入 143 名高血压患者（63.8±9.5 岁，51.7% 为女性），这些患者均接受过稳定的降压药物治疗，且控制时间≥3 个月。两组患者的血压（BP）均由自动示波仪同时连续测量，分两次进行。同时测量的 SBP 的 IAD 值明显低于连续测量的 SBP 的 IAD 值（3.51±4.1 vs. 4.40±3.7 mmHg; P
{"title":"Diferencia de presión arterial entre brazos: mediciones consecutivas versus simultáneas en pacientes hipertensos tratados y controlados","authors":"A. Delucchi, D. Fernández, M. Sorini, P. Reisin, M. Scarabino, P. Rodríguez","doi":"10.1016/j.hipert.2024.06.005","DOIUrl":"10.1016/j.hipert.2024.06.005","url":null,"abstract":"<div><div>The inter-arm difference (IAD) of systolic blood pressure (SBP) is associated with higher cardiovascular risk. We compared simultaneous and consecutive recordings in measuring IAD of SBP, and evaluated reproducibility between visits. 143 hypertensive patients (63.8<!--> <!-->±<!--> <!-->9.5 years, 51.7% women) treated and controlled with stable antihypertensive medication for a period of ≥<!--> <!-->3 months were included. Blood pressure (BP) in both arms was measured simultaneously and consecutively with an automatic oscillometric device, in two visits. The IAD of the simultaneous SBP was significantly lower compared to the consecutive one, both in the first (3.51<!--> <!-->±<!--> <!-->4.1 vs. 4.40<!--> <!-->±<!--> <!-->3.7<!--> <!-->mmHg; <em>P</em> <!--><<!--> <!-->.01) and in the second visit (3.62<!--> <!-->±<!--> <!-->3.5 vs. 5.69<!--> <!-->±<!--> <!-->5.1<!--> <!-->mmHg; <em>P</em> <!--><<!--> <!-->.001). When the IAD of SBP was categorized as ≥<!--> <!-->10 or <<!--> <!-->10<!--> <!-->mmHg, the reproducibility between visits was insignificant in both simultaneous measurements and consecutive measurements. The frequency of initial dominance was similar between the left and right arm in simultaneous ones (46.2 vs. 43.3%), and greater in the right arm in consecutive ones (55.2 vs. 38.5). The persistence of dominance between both visits was significantly higher when SBP was measured simultaneously (54.4% vs. 45.5%; <em>P</em> <!--><<!--> <!-->.01). Our study shows that to define the arm with the highest BP, simultaneous measurements are preferable. In treated and controlled hypertensive patients, the poor persistence of initial dominance between visits requires us to review the recommendation of recording, during follow-up, the BP in the arm where it was highest on the first visit.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 232-239"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752973","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.04.006
M.J. Vallejo Herrera , V. Vallejo Herrera , V. Márquez Pérez , F. Serrano Puche , I. Vegas Vegas
Pheochromocytomas are rare neuroendocrine tumors that can present as hypertensive crises or serious cardiac and cerebrovascular complications that endanger the patient's life.
Two unusual cases of adrenergic crises induced by pheochromocytoma with cardiovascular manifestations are presented, one with multiple complications/multiorgan failure, fatal outcome and definitive diagnosis in the post mortem autopsy, and another with a satisfactory evolution after diagnosis and appropriate treatment.
{"title":"Feocromocitoma como simulador de patología cardiaca","authors":"M.J. Vallejo Herrera , V. Vallejo Herrera , V. Márquez Pérez , F. Serrano Puche , I. Vegas Vegas","doi":"10.1016/j.hipert.2024.04.006","DOIUrl":"10.1016/j.hipert.2024.04.006","url":null,"abstract":"<div><div>Pheochromocytomas are rare neuroendocrine tumors that can present as hypertensive crises or serious cardiac and cerebrovascular complications that endanger the patient's life.</div><div>Two unusual cases of adrenergic crises induced by pheochromocytoma with cardiovascular manifestations are presented, one with multiple complications/multiorgan failure, fatal outcome and definitive diagnosis in the <em>post mortem</em> autopsy, and another with a satisfactory evolution after diagnosis and appropriate treatment.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 260-263"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077099","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.07.002
{"title":"Calor nocturno e incidencia de ictus","authors":"","doi":"10.1016/j.hipert.2024.07.002","DOIUrl":"10.1016/j.hipert.2024.07.002","url":null,"abstract":"","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 268-269"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663013","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.07.001
C. Alvarez , L. Peñailillo , P. Ibacache-Saavedra , D. Jerez-Mayorga , C. Campos-Jara , D.C. Andrade , G.V. Guimarães , E. Gomes-Ciolac , P. Delgado-Floody , M. Izquierdo , A.N. Gurovich
Background
This study aimed to examine the effects of a six-week of concurrent training using high-intensity interval plus resistance training on flow-mediated dilation and pulse wave velocity in hypertensive, elevated blood pressure, or normotensive. A secondary goal was to analyze the inter-individual variability.
Methods
A randomized controlled clinical trial was executed with 60 adult participants distributed across six groups: three control groups of hypertensive, elevated blood pressure, or normotensive and other three experimental hypertensive, elevated blood pressure, and normotensive groups, each comprising n = 10 individuals. Participants underwent a six-week intervention of concurrent exercise using high-intensity interval plus resistance training three-weekly. Flow mediated dilation and pulse wave velocity and secondary vascular assessments were conducted before and after the intervention.
Results
The hypertensive exercise group exhibited a significant increase in flow mediated dilation (Δ+7.7%; p = 0.003) and a reduction in pulse wave velocity (Δ−1.2 m s−1; p < 0.0001). The normotensive exercise group also showed a significant increase in flow mediated dilation (Δ+8.4%, p = 0.002).
Conclusion
The six-week concurrent exercise using high-intensity interval plus resistance training protocol, characterized by its clinical time-efficiency, was effective in improving endothelial function, as demonstrated by increased flow mediated dilation, and in reducing arterial stiffness, indicated by decreased pulse wave velocity.
{"title":"Six weeks of a concurrent training therapy improves endothelial function and arterial stiffness in hypertensive adults with minimum non-responders","authors":"C. Alvarez , L. Peñailillo , P. Ibacache-Saavedra , D. Jerez-Mayorga , C. Campos-Jara , D.C. Andrade , G.V. Guimarães , E. Gomes-Ciolac , P. Delgado-Floody , M. Izquierdo , A.N. Gurovich","doi":"10.1016/j.hipert.2024.07.001","DOIUrl":"10.1016/j.hipert.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to examine the effects of a six-week of concurrent training using high-intensity interval plus resistance training on flow-mediated dilation and pulse wave velocity in hypertensive, elevated blood pressure, or normotensive. A secondary goal was to analyze the inter-individual variability.</div></div><div><h3>Methods</h3><div>A randomized controlled clinical trial was executed with 60 adult participants distributed across six groups: three control groups of hypertensive, elevated blood pressure, or normotensive and other three experimental hypertensive, elevated blood pressure, and normotensive groups, each comprising <em>n</em> <!-->=<!--> <!-->10 individuals. Participants underwent a six-week intervention of concurrent exercise using high-intensity interval plus resistance training three-weekly. Flow mediated dilation and pulse wave velocity and secondary vascular assessments were conducted before and after the intervention.</div></div><div><h3>Results</h3><div>The hypertensive exercise group exhibited a significant increase in flow mediated dilation (<em>Δ</em>+7.7%; <em>p</em> <!-->=<!--> <!-->0.003) and a reduction in pulse wave velocity (<em>Δ</em>−1.2<!--> <!-->m<!--> <!-->s<sup>−1</sup>; <em>p</em> <!--><<!--> <!-->0.0001). The normotensive exercise group also showed a significant increase in flow mediated dilation (<em>Δ</em>+8.4%, <em>p</em> <!-->=<!--> <!-->0.002).</div></div><div><h3>Conclusion</h3><div>The six-week concurrent exercise using high-intensity interval plus resistance training protocol, characterized by its clinical time-efficiency, was effective in improving endothelial function, as demonstrated by increased flow mediated dilation, and in reducing arterial stiffness, indicated by decreased pulse wave velocity.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 240-250"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856722","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.07.006
N.F. Renna , E.J. Zaidel , P. Corral , A.D. Lerner
The document outlines recommendations for the management of patients with type 2 diabetes (T2D) at hospital discharge following an ischaemic cardiovascular event. Diabetes significantly increases the risk of cardiovascular events, and a high proportion of patients in coronary units have this condition. The discharge process is crucial for optimising treatments and reducing the risk of recurrent complications such as reinfarction, stroke, and hospitalisations for heart failure.
Strategies include rigorous control of lipid levels, recommending potent statins combined with ezetimibe and, if necessary, other drugs such as inclisiran, evolocumab, alirocumab, or bempedoic acid. Optimal antihypertensive treatment is also suggested as secondary prevention.
For patients already on insulin, it is essential to adjust the dosage when adding SGLT-2 inhibitors (SGLT2i) or GLP-1 receptor agonists (GLP-1RA) to avoid hypoglycaemia, with structured glucose monitoring. In cases where HbA1c is not available during hospitalisation, the algorithm guides treatment, highlighting that GLP-1RA and SGLT2i do not cause hypoglycaemia. The combination of these drugs is safe and effective, improving several cardiovascular risk factors.
The document emphasises the importance of education on nutrition and healthy habits, as well as the follow-up and adjustment of pharmacological treatments to achieve adequate metabolic control and reduce cardiovascular risks. Nutritional evaluation and control are essential, considering obesity as a critical factor in T2D and its association with the risk of recurrent cardiovascular events.
{"title":"Recommendations for the management of patients with type 2 diabetes at hospital discharge after an ischaemic cardiovascular event","authors":"N.F. Renna , E.J. Zaidel , P. Corral , A.D. Lerner","doi":"10.1016/j.hipert.2024.07.006","DOIUrl":"10.1016/j.hipert.2024.07.006","url":null,"abstract":"<div><div>The document outlines recommendations for the management of patients with type 2 diabetes (T2D) at hospital discharge following an ischaemic cardiovascular event. Diabetes significantly increases the risk of cardiovascular events, and a high proportion of patients in coronary units have this condition. The discharge process is crucial for optimising treatments and reducing the risk of recurrent complications such as reinfarction, stroke, and hospitalisations for heart failure.</div><div>Strategies include rigorous control of lipid levels, recommending potent statins combined with ezetimibe and, if necessary, other drugs such as inclisiran, evolocumab, alirocumab, or bempedoic acid. Optimal antihypertensive treatment is also suggested as secondary prevention.</div><div>For patients already on insulin, it is essential to adjust the dosage when adding SGLT-2 inhibitors (SGLT2i) or GLP-1 receptor agonists (GLP-1RA) to avoid hypoglycaemia, with structured glucose monitoring. In cases where HbA1c is not available during hospitalisation, the algorithm guides treatment, highlighting that GLP-1RA and SGLT2i do not cause hypoglycaemia. The combination of these drugs is safe and effective, improving several cardiovascular risk factors.</div><div>The document emphasises the importance of education on nutrition and healthy habits, as well as the follow-up and adjustment of pharmacological treatments to achieve adequate metabolic control and reduce cardiovascular risks. Nutritional evaluation and control are essential, considering obesity as a critical factor in T2D and its association with the risk of recurrent cardiovascular events.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 251-259"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649246","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.05.003
A. Dutta , V. Chaudhary , A.K. Gupta , K. Murti , S. Kumari , D. Dhir , S. Meenakshi , C. Ahuja , B. Sharma , B. Pal
Background
Hypertension is a prevalent health challenge in India, with a bidirectional link to depression. Recognizing the prevalence of depression among hypertensive patients and associated factors are important for better health outcomes.
Methods
A comprehensive search was conducted in PubMed, Embase, Scopus, and Google Scholar databases to identify relevant studies. R software was used for analysis, employing a random effects model with a 95% confidence interval. Subgroup analyses were done to explore sources of heterogeneity within the included studies.
Results
The prevalence of depression among hypertensive patients in India was 39.8% (95% CI: 28.6; 52.1). Despite a higher prevalence observed in South region (44.7%) compared to North (26.9%), the difference was not significant (p = 0.39). Studies utilizing different assessment scales and varying sample sizes yielded similar prevalence. However, a temporal trend analysis indicated a higher prevalence in studies published between 2020 and 2023 (52.6%) compared to those published between 2016 and 2019 (35.5%) (p = 0.03). Major factors associated with depression included lower socioeconomic status, low education level, female gender, uncontrolled hypertension, and COVID-19 related factors.
Conclusions
A significant proportion of hypertensive patients suffer from depression. Therefore, screening for depression in hypertensive patients is essential to improve hypertension management in India.
背景：高血压是印度普遍存在的健康问题，与抑郁症有双向联系。认识高血压患者中抑郁症的发病率及相关因素对于改善健康状况非常重要：在 PubMed、Embase、Scopus 和 Google Scholar 数据库中进行了全面搜索，以确定相关研究。使用 R 软件进行分析，采用随机效应模型，置信区间为 95%。对纳入的研究进行了分组分析，以探讨异质性的来源：印度高血压患者的抑郁症患病率为 39.8%（95% CI：28.6；52.1）。尽管南部地区的患病率（44.7%）高于北部地区（26.9%），但差异并不显著（P=0.39）。采用不同评估量表和不同样本量的研究得出了相似的患病率。然而，时间趋势分析表明，2020 年至 2023 年间发表的研究（52.6%）的患病率高于 2016 年至 2019 年间发表的研究（35.5%）（P=0.03）。与抑郁症相关的主要因素包括较低的社会经济地位、低教育水平、女性性别、未控制的高血压以及COVID-19相关因素：结论：相当一部分高血压患者患有抑郁症。因此，对高血压患者进行抑郁症筛查对于改善印度的高血压管理至关重要。
{"title":"Prevalence of depression in hypertensive patients and its associated factors in India: A systematic review and meta-analysis","authors":"A. Dutta , V. Chaudhary , A.K. Gupta , K. Murti , S. Kumari , D. Dhir , S. Meenakshi , C. Ahuja , B. Sharma , B. Pal","doi":"10.1016/j.hipert.2024.05.003","DOIUrl":"10.1016/j.hipert.2024.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension is a prevalent health challenge in India, with a bidirectional link to depression. Recognizing the prevalence of depression among hypertensive patients and associated factors are important for better health outcomes.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Embase<span>, Scopus, and Google Scholar databases to identify relevant studies. R software was used for analysis, employing a random effects model with a 95% confidence interval. Subgroup analyses were done to explore sources of heterogeneity within the included studies.</span></div></div><div><h3>Results</h3><div>The prevalence of depression among hypertensive patients in India was 39.8% (95% CI: 28.6; 52.1). Despite a higher prevalence observed in South region (44.7%) compared to North (26.9%), the difference was not significant (<em>p</em> <!-->=<!--> <!-->0.39). Studies utilizing different assessment scales and varying sample sizes yielded similar prevalence. However, a temporal trend analysis indicated a higher prevalence in studies published between 2020 and 2023 (52.6%) compared to those published between 2016 and 2019 (35.5%) (<em>p</em> <!-->=<!--> <!-->0.03). Major factors associated with depression included lower socioeconomic status, low education level, female gender, uncontrolled hypertension, and COVID-19 related factors.</div></div><div><h3>Conclusions</h3><div>A significant proportion of hypertensive patients suffer from depression. Therefore, screening for depression in hypertensive patients is essential to improve hypertension management in India.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 217-225"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499196","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 : 2024-10-01DOI: 10.1016/j.hipert.2024.06.004
D. Martín-Enguix , J.C. Aguirre Rodríguez , M. Guisasola Cárdenas , M.N. Generoso Torres , A. Hidalgo Rodríguez , M. Sánchez Cambronero , A. González Bravo
Objective
This study aims to analyze the prescription of antihypertensive drugs in patients with type 2 diabetes (T2D) in Andalusia, comparing it with the SEH-LELHA 2022 guidelines, and to assess the direct cost of these treatments.
Materials and methods
A multicentric, cross-sectional, and descriptive study was conducted with 385 T2D patients. Participants were randomly selected from the patient lists of 120 primary care physicians from Andalusia. Inclusion criteria included a diagnosis of T2D and complete clinical records for the year 2022. Demographic data and drug prescription information were collected, with the average cost per patient being calculated.
Results
The mean age of the subjects was 70.72 years, with 53.51% being male. A total of 70.9% of the patients were taking antihypertensive drugs, the most common being ACE inhibitors/ARBs (70.9%), diuretics (70.1%), beta-blockers (40.0%), and calcium channel blockers (20.0%). Each patient took an average of 2.46 ± 1.06 antihypertendsive, and fixed association of 2 or more antihypertensive drugs were used by 40.9% of the studied patients. The annual cost per patient was 141.45 €/year.
Conclusions
The study reveals strong adherence to the SEH-LELHA 2022 guidelines among physicians in Andalusia regarding the of antihypertensives for T2D patients, with a significant preference for Renin-Angiotensin System blockers, diuretics, and beta-blockers. However, a notable deviation in prescription practices was observed with the frequent choice of doxazosin over spironolactone, despite the latter being the recommended option for resistant hypertension. Although the overall expenditure on antihypertensives is moderate, their cost-effectiveness is enhanced by the efficacy of these treatments in preventing cardiovascular complications.
{"title":"Prescripción de antihipertensivos en personas con diabetes tipo 2 en Andalucía y recomendaciones SEH-LELHA 2022: evaluación del coste y uso","authors":"D. Martín-Enguix , J.C. Aguirre Rodríguez , M. Guisasola Cárdenas , M.N. Generoso Torres , A. Hidalgo Rodríguez , M. Sánchez Cambronero , A. González Bravo","doi":"10.1016/j.hipert.2024.06.004","DOIUrl":"10.1016/j.hipert.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to analyze the prescription of antihypertensive drugs in patients with type 2 diabetes (T2D) in Andalusia, comparing it with the SEH-LELHA 2022 guidelines, and to assess the direct cost of these treatments.</div></div><div><h3>Materials and methods</h3><div>A multicentric, cross-sectional, and descriptive study was conducted with 385 T2D patients. Participants were randomly selected from the patient lists of 120 primary care physicians from Andalusia. Inclusion criteria included a diagnosis of T2D and complete clinical records for the year 2022. Demographic data and drug prescription information were collected, with the average cost per patient being calculated.</div></div><div><h3>Results</h3><div>The mean age of the subjects was 70.72 years, with 53.51% being male. A total of 70.9% of the patients were taking antihypertensive drugs, the most common being ACE inhibitors/ARBs (70.9%), diuretics (70.1%), beta-blockers (40.0%), and calcium channel blockers (20.0%). Each patient took an average of 2.46<!--> <!-->±<!--> <!-->1.06 antihypertendsive, and fixed association of 2 or more antihypertensive drugs were used by 40.9% of the studied patients. The annual cost per patient was 141.45<!--> <!-->€/year.</div></div><div><h3>Conclusions</h3><div>The study reveals strong adherence to the SEH-LELHA 2022 guidelines among physicians in Andalusia regarding the of antihypertensives for T2D patients, with a significant preference for Renin-Angiotensin System blockers, diuretics, and beta-blockers. However, a notable deviation in prescription practices was observed with the frequent choice of doxazosin over spironolactone, despite the latter being the recommended option for resistant hypertension. Although the overall expenditure on antihypertensives is moderate, their cost-effectiveness is enhanced by the efficacy of these treatments in preventing cardiovascular complications.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"41 4","pages":"Pages 226-231"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591630","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}
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