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Objective. To compare the usefulness for surveillance of the peer-reviewed literature on the prevalence of hypertension in Latin America and the Caribbean published from 2001 to 2010 with a previous study of the published literature from 1962 to 2000. Methods. A bibliographic search was conducted of publications from 2001 to 2010 that examined the prevalence of hypertension using MEDLINE and LILACS databases. The methodology of each paper was evaluated with the same critical appraisal tool used in the previous study. Results. A total of 81 papers were published from 2001 to 2010 on the prevalence of hypertension in Latin America and the Caribbean. Only 24 of these studies met the minimum methodologic criteria for evaluation. While the total number of studies published in the past 10 years exceeds the number published from 1962 to 2000, the percentage of studies that met the minimum methodologic criteria has not substantially increased. In addition to major methodologic shortcomings, less than 46% of the published studies reported rates of awareness, treatment, and control of hypertension. The hypertension prevalence estimates from the peer-reviewed literature range from 7% to 49%. These studies were primarily done in urban centers and are not evenly distributed throughout the region. Conclusions. The quality and geographic distribution of the published literature on the prevalence of hypertension in Latin America and the Caribbean are inadequate. Research resources and efforts should be directed in the future toward closing this gap. [ABSTRACT FROM AUTHOR]

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Given the fact that new guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) propose important changes in the definition of hypertension, from equal or greater than 140/90mmHg to equal or greater than 130/80mmHg, major debate has been generated about the diagnostic criteria and the treatment of high blood pressure (HBP). In addition, these guidelines recommend that in order to achieve control of hypertension the goal should be a reading lower than 130/80mmHg. These new figures will significantly increase the amount of individuals considered hypertensive, some of whom will need more medication to achieve the new goal. This paradigm has led to questioning the goal's clinical applicability given the enormous financial burden that would result from treating millions of new hypertensive patients. The academic validity of the AHA-ACC guidelines has also been questioned given the fact that the recommendations emerged basically from results obtained from a single study with important methodological differences compared to the majority of studies carried out previously. Furthermore, its outcomes are inconsistent with those of previous studies. This conflict has led to some scientific institutions, such as the Latin American Society of Hypertension (LASH), continuing to adhere to the previous recommendations., (Copyright © 2019 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introducción: La enfermedad cardiovascular (ECV) es la primera causa de mortalidad en el mundo y ocasiona alrededor del 30% de todas las muertes. En países con altos ingresos se observa un descenso de la mortalidad por ECV, mientras que en países con medianos y bajos ingresos existe un aumento con características epidémicas. Las proyecciones de la Organización Mundial de la Salud (OMS) indican que en las próximas tres décadas, la mortalidad por ECV se doblará a nivel global, fenómeno atribuible al aumento esperado en estos países. De hecho, el aumento en la mortalidad por ECV prevista para Latinoamérica en las próximas tres décadas alcanza el 140% (1). La identificación de factores de riesgo cardiovascular (FRCV) ha permitido predecir una proporción creciente del riesgo de un evento cardiovascular. Objetivo: Describir la situación de los factores de riesgo cardiovascular en Latinoamérica. Síntesis del contenido: El estudio INTER-HEART que incluyó 21,000 casos con infarto agudo de miocardio (IAM) y similar número de controles pareados en 52 países, con alrededor de 800 infartados colombianos demostró que nueve factores de riesgo prevenibles explican alrededor del 90% del riesgo atribuible a la población para la ocurrencia de un primer IAM (2). En América Latina la mayoría de la causalidad atribuible es dada, además del tabaquismo, por obesidad abdominal, dislipidemia, hipertensión arterial y diabetes mellitus tipo 2 (DM2), conjunto de alteraciones que conforman el denominado Síndrome Metabólico y que en Latinoamérica es de particular importancia por su alta prevalencia que llega a ser de más del 35% (3). El estudio INTERSTROKE (4) reportó que este conjunto de factores de riesgo fueron similares para accidente cerebro-vascular isquémico o hemorrágico, y además que en los pacientes sudamericanos la obesidad abdominal junto con la hipertensión y el tabaquismo fueron los FRCV más comunes. Conclusiones: Estos datos son relevantes para nuestra región dado el dramático incremento de sobrepeso y obesidad observado en las últimas décadas que ha llevado a que uno de cada dos adultos estén en sobrepeso u obesidad (5) y es bien conocido que el exceso de grasa corporal aumenta el riesgo de DM2 y ECV por inducir, entre otros mecanismos, un estado de resistencia a la insulina, de inflamación sistémica de bajo grado y por alterar la reactividad vascular (6-9). [ABSTRACT FROM AUTHOR]

Hypertension is a major risk factor for cardiovascular disease. Its prevalence is increasing worldwide, and is more common in low and middle-income countries. The effectiveness of hypertension treatment is determined by health cost, awareness, and patients' compliance with the treatment. People worldwide with an adequate control of hypertension correspond to a very small percentage in low and medium income countries as the Latin America ones. Between the causes to explain these are the low availability, affordability and adherence to treatment with multiple pills. It has been proposed that fixed dose combination therapy could improve the availability, affordability, adherence and control of hypertension. This article aims to review the evidence, showing that fixed dose combination can improve adherence, decrease health cost and improve control of hypertension. Improvement in hypertension control with fixed dose combination could make an important contribution to efforts to fight against the global cardiovascular morbidity and mortality., (Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.)

In the countries of Central America, South America and the Caribbean, there has been a dramatic rise in obesity, the metabolic syndrome, hypertension and other cardiovascular risk factors in the last few decades. Epidemiological evidence highlights a consistent correlation between obesity and hypertension, and the presence of obesity predisposes an individual to a greater risk of hypertension although the mechanisms remain unclear. Obesity and hypertension are two key drivers of the cardio-renal disease continuum, and patients with uncontrolled cardiovascular risk in their mid-life will likely have an increased risk of clinical cardiovascular and renal outcomes in old age. This article summarizes the current status for the prevalence and consequences of obesity and hypertension in Latin America, with the aim of initiating a call to action to all stakeholders for greater implementation of primary prevention strategies, particularly in the young., (Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)

The region of Latin America, which includes Central America, the Caribbean and South America, is one that is rapidly developing. Signified by socio-economic growth, transition and development over the last few decades, living standards in countries like Brazil and Mexico have improved dramatically, including improvements in education and health care. An important marker of socio-economic change has been the epidemiological shift in disease burden. Cardiovascular disease is now the leading cause of death in Latin America, and the drop in prevalence of infectious diseases has been accompanied by a rise in non-communicable diseases. Hypertension is the major risk factor driving the cardiovascular disease continuum. In this article we aim to discuss the epidemiological and management trends and patterns in hypertension that may be specific or more common to Latin-American populations - what we term 'Latin American characteristics' of hypertension - via a review of the recent literature. Recognizing that there may be a specific profile of hypertension for Latin-American patients may help to improve their treatment, with the ultimate goal to reduce their cardiovascular risk. We focus somewhat on the countries of Brazil, Mexico and Venezuela, the experience of which may reflect other Latin American countries that currently have less published data regarding epidemiology and management practices., (Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)