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Hypertension is the leading cause of cardiovascular disease, affecting approximately 1 billion individuals worldwide. The positive relationship between blood pressure and the risk of cardiovascular disease is strong, independent, and consistent. By reducing blood pressure, many benefits can be seen in hypertensive patients; 50% to 60% lower risk of stroke death and an approximately 40% to 50% lower risk of death due to coronary artery disease. We review the evidence behind the pharmacological strategies available in the treatment of this disease. [ABSTRACT FROM AUTHOR]

The relationship between ferritin and cardiovascular risk has been studied largely without accurate conclusions so far. Since ferritin has potential antioxidant serum properties, as a source of endogenous production of them, may host cell anti-ischemic characteristics that can potentially confer important clinical implications in ischemic heart disease; numerous articles have attempted to find an association between these characteristics, but in Latin America there are still no studies that define the characteristics of ferritin in patients with ischemic heart disease. [ABSTRACT FROM AUTHOR]

Obesity is a chronic disease with a worlwide increase in its prevalence, it is associated with diseases such as diabetes mellitus, hyperlipidemia and cardiovascular risk. One choice for losing weight is bariatric surgery; there are three different techniques: restrictive, malabsortive and combined. It has been proven the effective weight loss with gastric bypass and with laparoscopic gastrectomy with gastric sleeve. It also has been proven significant weight loss, remission of diabetes mellitus type 2, decrease in serum lipids and long term cardiovascular risk. In conclusion: there is no doubt that bariatric surgery has a big impact in all comorbidities related to obesity, specially diabetes. [ABSTRACT FROM AUTHOR]

Background: Patients with altered ankle-arm index have risk of cardiovascular events in the next 10 years (cerebral or cardiac infarction). It is known that the glycosylated hemoglobin and each of the components of the metabolic syndrome increases the cardiovascular risk. Material and methods: We performed a cross-sectional, multicenter, population-based study in 105 individuals with metabolic syndrome recently diagnosis in four primary care centers in Mexico City. The cardiovascular risk was evaluated using ankle-arm index. results: We studied 105 patients. The linear correlation analysis showed simple factor of increased risk (odds ratio [OR] 3.9 [95% CI: 1.05 -14.31]) with glycosylated hemoglobin < 6.5 % and with ankle-arm index < 0.9. When the glycosylated hemoglobin was > 6.5 or 7 there was no statistically significant difference. Correlation of the mean arterial pressure (MAP) with the ankle-arm index: OR 7.2 for mean arterial blood pressure > 88 mm Hg OR: 5.6 (95% CI: 1.43 - 23.45) and with mean arterial pressure > 100 mm Hg. Conclusions: Cardiovascular risk increases if the glycosylated hemoglobin is less than 6.5 %, or if the mean arterial pressure is greater than 88 mm Hg, in patients with newly diagnosed metabolic syndrome. [ABSTRACT FROM AUTHOR]

The polycystic ovary syndrome is an hyperandrogenic state which has been recognized as a gynecologic disorder on premenopausic women by its phenotype of androgenic hormones in excess and for being the main cause of menses and fertility disorders which conform the classical clinical picture and motivate the seek for treatment in most patients. However, there is progressive support for the role of associated and maybe predisposing factors within the disease, such as obesity and insulin resistance, which have increased their incidence and reflection in public health. In the latest years there has been a better understanding of how can the androgenic hormones in excess and the ovulatory alterations interact with metabolic disorders such as obesity and insulin resistance promoting a cascade of disturbances on the secretion and function of hormones and cytokines which contribute with the clinical picture. That is why besides being a disease which requires treatment by gynecologists and endocrinologists to improve fertility and diminish the consequences of the androgen excess, the polycystic ovary syndrome is an entity which has to be suspected, recognized and approached with measures that in many cases include the modification of eating and exercise habits in a broad group of women on the primary and secondary care owing to its high prevalence on premenopausic women and the relationship it has with chronic non-communicable diseases. [ABSTRACT FROM AUTHOR]

Background: Ankle/brachial index (ABI) <0.09 is a marker of peripheral vascular disease and a predictor of cardiovascular morbidity and mortality. Currently, despite that heart disease is the leading cause of death in diabetic patients, the effect of oral hypoglycemic drugs on cardiovascular risk is not evaluated. Methods: In this controlled clinical trial, we included 68 normotensive diabetic type 2 patients. One group was treated with glibenclamide (36 patients) and another with repaglinide (32 patients), metformin was added when necessary. In both groups ABI, fasting glucose and lipid profile were evaluated at baseline and after 3 months follow-up. results: 43% female, mean age 52.66 years. 25 patients in each group received combination with metformin. The ABI with glibenclamida increased of 1.17 to 1.19 p=0.4764 and with repaglinide from 1.16 to 1.21 p= 0.1338, when comparing both groups, although the increase was higher with repaglinida, the difference was not significant, (p=0.0786). HbA1c decreased from 9.19% to 8.29% with glibenclamide, p=0.0733 and 10.71% to 7.74% with repaglinide, p=0.00001, when comparing both groups there was a significant difference in favor of repaglinide, p=0.0026. Conclusions: In this study we found that repaglinide achieved better control of HbA1c than glibenclamide, and that both drugs improved the ABI, although this improvement showed a trend to a further increase with repaglinide, it does not reach statistical significance. [ABSTRACT FROM AUTHOR]

Background: An increase in the cardiovascular risk (CVR) in patients with the HIV infection is being reported. The present paper analyzes the correlation between three different methods that consider the CVR in a group of patients with HIV infection, comparing the methods of Framingham, PROCAM and of the World Health Organization (WHO). Material and method: A cross-sectional, comparative and descriptive study was realised. The patients were taken care in 8 specialized centers in the attention of patients with HIV infection of four states of south-east of Mexico (Chiapas, Quintana Roo, Tabasco and Yucatan). The CVR to 10 years, was considered in each subject through of the three referred methods being classified in low (<10%), moderate (10-20%) and high (>20%) risk with the Framingham and PROCAM methods. For the WHO method the risk was classified in low (<10%), moderate (10-20%), high (20-30%) and very high (>30%) risk. Results: We studied 289 patients (35 (12%) women and 254 (88%) men). The average of age was of 39 (20-73) years. The time average to be diagnosed with the HIV infection was of 7±4.8 years. Two hundred thirty two patients (80%) were receiving HAART, the time average to receive HAART was of 4.5±4 years, among them, 169 (73%) received a protease inhibitor. The prevalence of patients with low, moderate and high CVR according to the method of Framingham was 84.4%, 10,7% and 4.8%, with PROCAM 93%, 3.8% and 3,1% and with the WHO 98%, 1,3% and 0.34%. Was not observed any patient with very high CVR (> 30%) with the method of the WHO. Conclusions: When the CVR -whatever the used method- is compared with the method of Framingham, this risk was overestimate in the population of patients infected by HIV. The predictive value of these three methods on the development of cardiovascular disease still needs well to be established in the population infected by HIV. Meanwhile, the estimation of CVR in these patients will have to be taken with precaution. [ABSTRACT FROM AUTHOR]

Background: The metabolic syndrome represents a clustering of several interrelated risk factors of metabolic origin that are thought to increase cardiovascular risk. It is still uncertain whether this clustering results from multiple underlying risk factors or whether it has a single cause. The evidence suggests that restricting sleep adversely affects metabolism. The restriction of sleep can damage glucose tolerance, alter levels of leptin and ghrelin increasing hunger and appetite, especially for foods with high carbohydrates content dense favouring the development of metabolic syndrome. Objective: To assess the relationship between hours of sleep, the components of the metabolic syndrome and the role of guard ABC, among residents of two health institutions. Methods: According to the criteria of the third report of the national cholesterol education program (NCEP-ATP III) designed a case-control study in two health institutions. 65 residents of second year or more, 33 with guards ABC Secretary of Health of the Government of Mexico City (SSDF) and 32 of specialties that do not have this complementary medical practice General Hospital of Mexico (HGM) for the period from March to May of 2008; was informed each resident, and after their acceptance was to collect information on the document, was given blood pressure, waist circumference, weight, height, BMI. Extraction fasting blood of least 8 hours to determine glucose levels, HDL cholesterol, triglycerides, and fasting insulin levels. Results: With less than five hours of sleep a day, as well as with more than eight, a higher susceptibility to have metabolic syndrome was found. Metabolic health status found in residents was: Obese BMI ≥ 27, the overall incidence was 40%, 54.5% and 25% in the group exposed and unexposed respectively with an odds ratio of 3.86 (95% CI 1.31 to 11.46) p= 0.01. Levels of triglycerides, with an odds ratio of 3.36 (95% CI 1.13 to 10.29) p= 0.02, hours of sleep, with an odds ratio of 2.82 (95% CI 0.97 to 8.33) p= 0.04; women with waist circumference, with an odds ratio of 18.0 (95% CI 2.25 to 158) p= 0.003, men with an odds ratio of 6.48 (95% CI 1.27 to 35.99) p= 0.02. Levels of HDL cholesterol women, an odds ratio of 1.33 (95% CI from 0.24 to 7.42) p= 1.00, men with an odds ratio of 1.38 (95%CI from 0.31 to 6.56) p= 0.02. Levels of insulin, an odds ratio of 4.80 (95% CI from 2.11 to 10.07) p= 0.05, HOMA an odds ratio of 5.54 (95% CI from 2.66 to 20.54) p= 0.12 Conclusion: The resident exposed to guards ABC has high incidence of obesity and metabolic syndrome, with an increased risk of 2.5 and 2.8 respectively. The sleep duration (= 5h) associated with the metabolic syndrome 1.8 greater risks in the exposed group; the associate hyperinsulinemia was 3.8 higher risks in the exposed group. We did not found direct relation between HOMA and guards ABC in this study. [ABSTRACT FROM AUTHOR]

Background: Both hypertension and type-2 diabetes are cardiovascular risk factors that produce endothelial dysfunction, which in turn decreases nitric oxide production and promotes albuminuria. Objective: To compare endothelial function in diabetic, hypertensive and normotensive patients, with health patients, and to correlate it with albuminuria degree. Patients and method: We included 80 type-2 diabetic patients (40 normotensive and 40 hypertensive), and 40 normotensive healthy patients, in whom endothelial function was measured using Griess method for detection of circulating nitrite levels, and 24-hrs albuminuria. Statistical analysis was performed with ANOVA, and coreelations with Spearman coefficient of correlation. Results: There was not meaningful difference between hypertensive (3.4 ± 0.1 Mmol/L) and normotensive diabetic patients (3.6 ± 0.3 Mmol/L). However, diabetic patients had significantly increased levels of nitrites when compared with healthy patients (5.7 ± 0. Mmol/L 4, p < 0.005). When nitrite values were correlated with 24-hrs albuminuria, we found that nitrites had an inverse correlation with albuminuria in both normotensive (R = -0.2) and hypertensive (R = -0.7) diabetic patients. Conclusions: Diabetic patients showed higher endothelial dysfunction than healthy patients, but it does not worse hypertension. This endothelial dysfunction had a correlation with 24-hrs albuminuria in diabetic patients, both normotensive and hypertensive. [ABSTRACT FROM AUTHOR]

Background: Antiretroviral therapy in HIV patients has caused lipid and glucose metabolism alterations. Objective: To compare prevalence of cardiovascular risk at 10 years over 10%, in a group of HIV-infected patients with HAART, and another without HAART. Patients and methods: A clinical-epidemiological, multicentre and comparative study was performed. Lipid profile and cardiovascular risk criteria were determined according ATP-III. Cardiovascular risk was calculated trough Framingham equation. Patients with a cardiovascular risk at 10 years over 10% were considered of high risk. When p value was lower than 0.05, it was considered statistically significant between both groups. Results: 256 HIV-infected adults patient were studied, 207 receiving HAART (group 1) and 49 without it (group 2). Prevalence of cardiovascular risk at 10 years above 10% was of 16% in patients of group 1, and of 12% in group 2. Average value calculated with Framingham equation was higher in group 1 (6.6 ± 5.6% vs 5.2 ± 5.0%, p = 0.02). Variables statistically meaningful for cardiovascular risk at 10 years above 10% were: smoking, age, male gender and non-HDL cholesterol. Conclusions: Prevalence of cardiovascular risk at 10 years higher than 10% was similar in both groups. Nevertheless, average of cardiovascular risk at 10 years was higher in group 1. Risk factors were: smoking, male gender in subjects over 45 years old and non-HDL cholesterol. Framingham equation could be a useful tool that will require more extensive studies to validate in this population group. [ABSTRACT FROM AUTHOR]