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Introduction: This article summarizes the clinical practice guide (CPG) for management of essential arterial hypertension in the Social Security of Peru (EsSalud). Objective: To provide evidence-based clinical recommendations for management of essential arterial hypertension in EsSalud. Methods: A guideline development group (GDG) was formed, which included specialist physicians and methodologists, who formulated clinical questions. Systematic searches of systematic reviews were conducted and - when deemed relevant - primary studies in PubMed during 2022. Evidence was selected to answer each of the proposed clinical questions. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GDG used the GRADE methodology to review the evidence and formulate recommendations, points of good clinical practice, and flowcharts. Finally, the CPG was approved with Resolution No. 109-IETSI-ESSALUD-2022. Results: The CPG addressed 6 clinical questions regarding management. Based on these questions, 14 recommendations were formulated (7 strong and 7 conditional), 2 points of good clinical practice, and 1 flow chart. Conclusion: Evidence-based recommendations were statement for the management of patients with essential arterial hypertension. [ABSTRACT FROM AUTHOR]

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RESUMEN Objetivo: Evaluar los valores de referencia de la dinámica circulatoria arterial ocular de los pacientes con hipertensión arterial esencial. Métodos: Se realizó un estudio descriptivo y transversal en 105 pacientes hipertensos y en un grupo de 33 sujetos no hipertensos, con edades comprendidas entre 18 y 60 años, sin antecedentes de padecer diabetes mellitus ni enfermedades oculares como glaucoma, o haber recibido tratamiento quirúrgico por catarata, hipertensión ocular u otras. A todos se les realizó la toma de la presión arterial sistémica, el examen clínico oftalmológico y el ultrasonido Doppler a color de carótida y de los vasos orbitarios. Resultados: Se encontró un predominio de mujeres de piel blanca, entre la cuarta y quinta década de la vida. Existió un incremento del pico de velocidad sistólica, la velocidad final diastólica y el índice de resistencia en la arteria oftálmica, que fue desde un rango normal en el grupo de los no hipertensos a valores promedios elevados en el grupo de hipertensos, los cuales fueron más altos en los casos descontrolados. No se encontraron modificaciones en el análisis de estos parámetros en las arterias centrales de la retina ni en las ciliares posteriores cortas. Conclusiones: En la casuística estudiada, el incremento del pico de la velocidad sistólica en la arteria oftálmica pudiera estar relacionado con áreas de obstrucción vascular localizadas o con vasoespasmo. Se encontró una asociación entre el descontrol de la presión arterial y los valores elevados del índice de resistencia en la arteria oftálmica.

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A therapeutic intervention to evaluate the effectiveness of using passiflora stint associated with the conventional treatment in 20 patients suffering from essential hypertension, who were assisted in a family doctor's office of Manzanillo Granma, was carried out from October, 2014 to April, 2015. The population was distributed in 2 groups: study and control. The first group was prescribed with passiflora stint combined with conventional medicines, according to associated diseases and personal risks, the second group received conventional medical treatment with the same requirements. An evaluation was carried out after 15 and 30 days to 6 months. There was a prevalence of sixty years and over patients (35.0%) and female sex. The treatment was effective in 42 members of the study group (70.0%) and 27 members of the control group (45.6). It was concluded that passiflora stint associated with conventional treatment was effective to control tension numbers. [ABSTRACT FROM AUTHOR]

Se presentaron algunos de los principales estudios y se discutieron resultados que confirman la relación entre el estrés oxidativo y la hipertensión arterial esencial, a partir de indicadores del daño oxidativo, de las defensas antioxidantes, así como de las respuestas de estos a algunos antioxidantes y a otros factores implicados en el origen del estrés oxidativo, que es un estado en el cual existe un desequilibrio entre las especies de alto poder oxidante y los sistemas de defensa antioxidante del organismo. En la actualidad, el estrés oxidativo aparece como una de las varias alteraciones metabólicas descritas en la hipertensión arterial esencial. Se ha demostrado que está implicado tanto en la disfunción endotelial como en la hipertrofia de las células musculares lisas vasculares, con fuertes evidencias de que un trastorno en la vasodilatación dependiente del endotelio pueda ser el fenómeno primarioSome of the main studies were presented and the results confirming the relation existing between oxidative stress and essential arterial hypertension were discussed, starting from oxidative damage indicators, from the antioxidant defenses, as well as from their responses to some antioxidants and to other factors involved in the origin of oxidative stress, which is a state where there is an imbalance among the species of high oxidizing power and the antioxidant defense systems of the organism. Nowadays, the oxidative stress appears as one of the various metabolic disorders described in essential arterial hypertension. It has been proved that it is involved both in the endothelial dysfunction and in the hypertrophy of vascular smooth muscular cells. There are strong evidences that a disorder in the vasodilation depending on the endothelium may be the primary phenomenon

Objetivo. Determinar la asociación entre apoyo familiar (AF) y apego al tratamiento de la hipertensión arterial esencial (HAS). Material y métodos. Estudio de casos y controles al que se integraron 80 sujetos con diagnóstico establecido de HAS, con 40 pacientes en cada grupo. Se consideró como casos a los pacientes con apego y como controles a los pacientes sin apego al tratamiento. El estudio se realizó de mayo a diciembre de 1999, en el Hospital Regional del IMSS, en la ciudad de Durango, Durango, México. La edad, género, duración de la HAS, escolaridad y estado civil fueron criterios de pareamiento. Las diferencias se establecieron con las pruebas ji cuadrada y t de student. Se calculó la razón de momios para estimar la fuerza de asociación. El diagnóstico de hipertensión arterial secundaria, o de otras enfermedades crónicas fueron criterios de exclusión. Resultados. No hubo diferencias entre los grupos respecto a las variables sociodemográficas, modalidad de tratamiento ni conocimiento que el enfermo tenía sobre su enfermedad. Tenían control de la presión arterial 31 (77.5%) pacientes con apego y 11 (27.5%) sin apego, p= 0.003. El AF se asoció de manera independiente con apego al tratamiento, RM 6.9, IC 95% 2.3-21.1. Conclusiones. El apego se vincula de forma significativa con el apoyo que los familiares otorgan al enfermo. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlObjective. To assess the relationship between family support and drug therapy compliance in essential hypertension. Material and methods. A case-control study was conducted between May and December 1999, at Mexican Institute of Social Security Regional Hospital in Durango, among 80 hypertensive subjects; 40 were cases and 40 controls. Cases were subjects who complied with drug therapy and controls were those who did not, matched by age, gender, schooling, hypertensive disease duration, and marital status. Differences were analyzed using the chi-squared test and Student's t test. Odds ratios were obtained to assess the strength of associations. Subjects diagnosed with secondary hypertension or other chronic diseases were excluded. Results. There were no differences in sociodemographic variables, therapy modality, and knowledge about hypertensive disease between cases and controls. Thirty-one (77.5%) compliant subjects, and 31 (77.5%) non-compliant subjects had arterial blood pressure values in normal ranges (p= 0.003). A strong and independent relationship between family support and therapy compliance was found (OR 6.9, 95% CI 2.3-21.1). Conclusions. Therapy compliance is strongly related with family support provided to the hypertensive patient. The English version of this paper is available at: http://www.insp.mx/salud/index.html

Objetivo. Determinar la asociación entre apoyo familiar (AF) y apego al tratamiento de la hipertensión arterial esencial (HAS). Material y métodos. Estudio de casos y controles al que se integraron 80 sujetos con diagnóstico establecido de HAS, con 40 pacientes en cada grupo. Se consideró como casos a los pacientes con apego y como controles a los pacientes sin apego al tratamiento. El estudio se realizó de mayo a diciembre de 1999, en el Hospital Regional del IMSS, en la ciudad de Durango, Durango, México. La edad, género, duración de la HAS, escolaridad y estado civil fueron criterios de pareamiento. Las diferencias se establecieron con las pruebas ji cuadrada y t de student. Se calculó la razón de momios para estimar la fuerza de asociación. El diagnóstico de hipertensión arterial secundaria, o de otras enfermedades crónicas fueron criterios de exclusión. Resultados. No hubo diferencias entre los grupos respecto a las variables sociodemográficas, modalidad de tratamiento ni conocimiento que el enfermo tenía sobre su enfermedad. Tenían control de la presión arterial 31 (77.5%) pacientes con apego y 11 (27.5%) sin apego, p= 0.003. El AF se asoció de manera independiente con apego al tratamiento, RM 6.9, IC 95% 2.3-21.1. Conclusiones. El apego se vincula de forma significativa con el apoyo que los familiares otorgan al enfermo. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

This work aims to conduct a review of articles published over the past 20 years about the psychosocial aspects associated with essential hypertension, from a gender perspective. The literature search was conducted through the databases PsycINFO, LILACS and Redalyc. The conclusions show that hypertension was traditionally considered a psychophysiological disorder which affects males. The approach to the psychosocial aspects associated with hypertension was biased by a male point of view. Currently, there are differences between men and women in the manifestation of factors such as the type A personality, psychosocial stress, coping, and the patient's representations about hypertension. These differences are probably determined by gender. [ABSTRACT FROM AUTHOR]

Introduction: In spite nearly 40% of the variability in blood pressure can be explained by genetic factors, the identification of genes associated to essential high blood pressure is difficult in populations where individuals have different genetic precedents; in these circumstances it is necessary to determinate whether the population is sub-structured because this can bias studies associated with this disease. Objectives: To determine the genetic structure of the population in Bucaramanga from genetic polymorphisms associated with the regulation of blood pressure: 448G>T, 679C>T y 1711C>T from the gene kinase 4 of the dopaminergic receptor linked to the protein G and Glu298Asp, -786T>C and the VNTR of the intron 4 of the gene of endothelial nitric oxide. Methodology: A sample of 552 unrelated individuals was studied through analysis of Restriction fragment length polymorphism. The allelic, haplotypic and genotypic frequencies were calculated, the Hardy-Weinberg equilibrium was determined and a molecular analysis of variance was performed to determine the genetic structure. Results: 38 Haplotypes were identified, with GCCTG4b as the most frequent (21.2%). The most diverse polymorphism was 448G>T with a frequency of 49.9% for heterozygous. The six polymorphisms were found in genetic equilibrium and genetic structure of populations was not evidenced (FST = 0,0038). Conclusion: The population studied does not present a genetic sub-structure and the polymorphisms analyzed were found in genetic equilibrium, this indicates that the population mixes randomly and there are no sub-groups capable of affecting the results of the association studies. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Se realizó un estudio exploratorio - descriptivo y se establecieron comparaciones entre un grupo de 25 sujetos normotensos y uno de 25 pacientes con hipertensión arterial esencial (HTA) para evaluar el estrés y el funcionamiento emocional en el segundo grupo. Se halló un predominio en los pacientes hipertensos de vivencias negativas que son experimentadas intensamente y altos niveles de vulnerabilidad al estrés; así como un predominio de moderada depresión y niveles de ansiedad rasgo y estado que oscilan entre medio y alto que distinguen a los pacientes con hipertensión arterial esencial del grupo de sujetos normotensos. Se ofrecieron recomendaciones referidas a la necesidad de una atención integral de estos pacientes.An exploratory descriptive study was conducted and comparisons were made between a group of 25 normotensive individuals and another group of 25 patients with essential arterial hypertension (AHT) aimed at evaluating the stress and emotional functioning in the second group. A predominance of intensive negative personal experiences that are and high levels of vulnerability to stress were observed in the hypertensive patients. A prevalence of moderate depression and levels of trait anxiety and anxiety state ranging from median to high distinguish patients with essential arterial hypertension from the group of normotensive subjects. Recommendations were made in relation to the need of provinding comprehensive care to these patients.

Background: Clinical observations suggest that the regular use of aspirin reduce the risk of ischemic stroke and Parkinson's disease. Methods: We report the use of aspirin and clonazepam into two patients with essential arterial hypertension (EAH) and aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) in a woman with type 2 diabetes mellitus (type 2 DM). Case report: Case 1, is a 65-year-old man with history of EAH, which was treated with captopril. On July 2000, he received aspirin and clonazepam as supplementary medication. Four years later, his blood pressure was normalized without antihypertensive medication. Case 2, was a 75-year-old woman who suffered of type 2 DM between 45 to 60 years of age. Moreover, since 55 to 75 years, she presented osteoarthritis. So then, since 55 to 60 years she received antidiabetic treatment, aspirin and NSAIDs. After 60 years of age, her glycemias were normal and without antidiabetic therapy. Case 3, is a 62-year-old woman who suffered from stress, sleep disorders and EAH, since ten years before her admission. From the first, she received only aspirin and clonazepam. At present, 11 months later, her blood pressure is normal. Conclusion: These clinical observations suggest that the regular use of aspirin may improve or normalize EAH and type 2 DM. [ABSTRACT FROM AUTHOR]

Objective: Non-alcoholic fatty liver is a chronic liver disease in which fat is deposited in the liver, causing an inflammation called non-alcoholic steatohepatitis (NASH), and fibrosis. NASH is associated with metabolic syndrome (MS) and other cardiovascular risk factors. The aim of this study was to analyse the epidemiological features of NASH within a hypertensive population, with a high prevalence of MS, and to determine the features related to NASH., Methods: The computerised records were collected from 3,473 patients from Mostoles University Hospital's Hypertension Unit in order to perform a retrospective, cross-sectional study. NASH was considered as ultrasound-detected fatty liver disease along with serum levels of alanine aminotransferase or aspartate aminotransferase 1.5 times above normal values, having ruled out other causes of liver disease: alcohol abuse, autoimmune hepatitis, drug toxicity, virus and hemochromatosis. A univariate, multivariate, and ANOVA analysis were performed to assess the effect of the studied features on the response of interest., Results: The cohort included 2,242 patients (51.3% men). NASH was present in 255 patients (11.4%) of whom 71% were men. MS was detected in 52.6% of patients (69.4% in the NASH group, and 50.5% in the non-NASH group, P=.001). Prevalence of type 2 diabetes mellitus was 11.5% (16.5% in the NASH group, and 10.8% in the non-NASH group, P=.01). In a multivariate analysis, waist circumference, MS, body mass index, type 2 diabetes mellitus, age, fasting serum insulin, and serum ferritin were associated with NASH. ANOVA revealed that NASH and transaminases were also significantly associated with components of metabolic syndrome., Conclusions: In the population studied, MS, type 2 diabetes mellitus, and several components of MS were independently associated with NASH. Therefore, NASH can be considered as the liver manifestation of MS in patients with arterial hypertension., (Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The endothelin system, for its vasoconstrictor action, is related to the development of essential hypertension (HTAe). The polymorphism analysis of their genes represents a new approach to the study of this disease. We propose to analyze the interaction between stages of essential hypertension (HTAe) and risk factors with polymorphisms 138ex1 ins/del A gene endothelin-1 (ET-1) and H323H receptor gene A ET-1 (ETRA)., Patients and Methods: We included 300 patients of both sexes, unrelated, who consecutively attended the clinic hypertension medical service. Each one underwent a complete physical examination, electrocardiogram, echocardiogram, and Rx thorax. The degree of severity of hypertension was determined in stages. The determination of polymorphisms was performed by amplification followed by cutting by specific restriction enzyme from DNA obtained from peripheral blood., Results: The 46% of patients had HTAe controlled, 17.6% had organ damage or cardiovascular, brain or kidney disease. It was observed that the 4A/4A carriers showed lower frequency of cardiovascular disease, kidney and brain (P<.032; 95% CI: 11.1-21.4). For H323H polymorphism, the evaluation by images showed a higher frequency of the dilations of left auricular (P=.02) and auricular fibrillation (P=.03) between the T/T carrier, a higher frequency of cardiomegaly was detected in C/C patients (P=.04)., Conclusion: The genotypes, 4A/4A of the ET-1 gene and the T/T from ETRA gene might be involved in worse outcome of cardiovascular damage. Their identification could help recognize subgroups of the hypertensive patients with different risk., (Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)