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- W2059547002 abstract "La hipertensión arterial (HTA) resistente requiere un abordaje global del riesgo cardiovascular. El objetivo del presente estudio ha sido analizar la agregación de factores de riesgo cardiovascular y la prevalencia de síndrome metabólico (SM) en una serie de sujetos con HTA resistente. Se incluyó de forma secuencial a 115 personas con HTA resistente, definida como un valor de presión arterial (PA) en consulta de 140/90 mmHg o mayor en tratamiento con 3 fármacos, uno de ellos diurético, durante un mínimo de 2 meses en buenos cumplidores. Se aplicó el protocolo de la Unidad de HTA: seguimiento de la PA de 24 h con un monitor Spacelabs 90202 o 90207, y ecocardiografía Doppler en modo M de buena calidad en 68 sujetos. Se consideró HTA seudorresistente cuando los valores de PA media diurna eran menores de 135/85 mmHg. La edad media (desviación estándar) fue de 61 (10) años y 50 pacientes (44%) eran varones. El valor medio de la PA en consulta fue de 166/95 (16/9) mmHg, y el de la PA diurna de 141/83 (15/12) mmHg. Tenían antecedentes familiares de enfermedad cardiovascular 88 sujetos (76,5%), de obesidad 64 (56%), de hipercolesterolemia 43 (37%), de concentración baja de colesterol unido a lipoproteínas de alta densidad 34 (30%), de sedentarismo 63 (55%) y de diabetes mellitus 32 (28%). La prevalencia de SM fue del 54%. Presentaban hipertrofia ventricular izquierda 49 pacientes (72%), lesiones de órgano diana 70 (61%) y un trastorno clínico asociado 44 (38%). En 31 casos (27%) se observó HTA seudorresistente; no se encontraron diferencias significativas en las distintas variables con los resistentes verdaderos. Los pacientes con HTA resistente en la consulta, independientemente de que tengan la PA ambulatoria controlada, presentan un riesgo muy elevado de experimentar un episodio cardiovascular, dada la importante agregación de factores de riesgo cardiovascular y la alta prevalencia de SM. El manejo de estos hipertensos requiere la optimización del tratamiento antihipertensivo, así como medidas o programas específicos del tratamiento de la obesidad y del sedentarismo. The aim of this study was to analyse the clustering of cardiovascular risk factors and the prevalence of metabolic syndrome (MS) in this sample of subjects with resistant hypertension (RH). One hundred and fifteen subjects with RH were sequentially included. RH was defined as a level of office blood pressure (BP) ≥ 140/90 mmHg in subjects treated with at least 3 antihypertensive drugs (one of them a diuretic) during at least 2 months and with good compliance. The usual protocol of the Hypertension Unit and ambulatory BP monitoring during 24 h was applied on all the subjects, and an echocardiogram with Doppler was performed on 68 of them. Subjects with a daytime BP < 135/85 mmHg were defined as pseudoresistant hypertensive. The mean age (standard deviation) was 61 (10) years, and 50 patients (44%) were males. The mean office BP was 166/95 (16/9) mmHg. The daytime BP was 141/83 (15/12) mmHg. Out of the patients, 88 (76.5%) had a family history of cardiovascular disease; 64 (56%) of obesity; 43 (37%) of hypercholesterolemia; 34 (30%) of low high-density lipoprotein cholesterol; 32 (28%) of diabetes mellitus; and 63 (55%) were sedentary. The prevalence of MS was 54%; target organ damage was found in 70 cases (61%), and 44 (38%) had other associated clinical conditions. Out of the subjects with echocardiography, 49 (72%) presented left ventricular hypertrophy. Pseudoresistant hypertension was found in 31 (27%). There were no significant differences in clinical variables between subjects with RH or psudoresistant hypertension. Patients with RH had high cardiovascular risk, independent of a good control of ambulatory BP, because of the high prevalence of cardiovascular risk factors and MS. An optimal antihypertensive treatment including specific programs for the control of obesity and a sedentary lifestyle are necessary in the management of these patients." @default.
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- W2059547002 date "2006-07-01" @default.
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- W2059547002 title "Agregación de factores de riesgo cardiovascular y de prevalencia de síndrome metabólico en personas con hipertensión arterial resistente" @default.
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- W2059547002 doi "https://doi.org/10.1157/13091263" @default.
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