First Brazilian Position on Resistant Hypertension

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May measurement month 2018: an analysis of blood pressure screening results from Brazil.

Hypertension is a pathology of high prevalence in the world. In Brazil, it is the main risk factor for the major cause of death in the country, coronary heart disease. The May Measurement Month Campaign in 2018 (MMM18) included a population with representation from all Brazilian states and reflects some of the characteristics of hypertension in Brazil. Questionnaire data were collected and three measures of blood pressure (BP) were performed. The sample consisted of 12 413 individuals, 59.1% were white, 51.3% were women. The average age was 54. ± 16.0 years. Diabetes was present in 11.6%, previous myocardial infarction in 5.9%, and previous stroke in 2.7%. Current smokers were 9.3% and 12.4% were regular drinkers. The average body mass index was 27.3 ± 4.5 kg/m2. After multiple imputations, 67.9% were hypertensive (>140/90 mmHg). Of the individuals who were not taking antihypertensive medication, 27.9% were hypertensive and of those taking antihypertensive medication, 40.3% were uncontrolled. Systolic BP increased with age. The MMM18 campaign demonstrated a large number of unknown hypertensives and a high rate of uncontrolled hypertension in Brazil, unfortunately in keeping with 2017 findings

Nastal čas prodloužit dobu expirace kryoprezervovaných alograftů srdečních chlopní

V současné době existuje velké množství umělých komerčních náhrad chlopní. Přesto jsou stále žádané a úspěšně transplantované kryoprezervované semilunární alografty srdečních chlopní (C-AHV). U těchto náhrad zatím není přesně definována doba expirace.Většina tkáňových bank používá pět let. Z fyziologického, funkčního a operačního pohledu představuje morfologie a mechanické vlastnosti aortálních a pulmonárních kořenů hlavní limitaci doby expirace C-AHV. Cílem této práce je podat přehled metod strukturní a mechanické analýzy tkání AHV, které jsou vhodné pro stanovení doby expirace. alograftů. Pro stanovení mikrostruktury je vhodná kvantitativní morfologie za použití stereologické testovací mřížky. Touto metodou lze snadno, efektivně a opakovatelně stanovit možství buněk a mezibuněčných komponent. Pro stanovení mechanických parametrů, jako Youngův modul pružnosti, mezní napětí a deformace, lze využít tahovou zkoušku. C-AHV jsou v různých tkáňových laboratořích připravovány podle různých protokolů. Je tedy nutné, aby každá laboratoř stanovila dobu expirace samostatně.Despite the wide choice of commercial heart valve prostheses, cryopreserved semilunar allograft heart valves (C-AHV) are required, and successfully transplanted in selected groups of patients. The expiration limit (EL) criteria have not been defined yet. Most Tissue Establishments (TE) use the EL of 5 years. From physiological, functional, and surgical point of view, the morphology and mechanical properties of aortic and pulmonary roots represent basic features limiting the EL of C-AHV. The aim of this work was to review methods of AHV tissue structural analysis and mechanical testing from the perspective of suitability for EL validation studies. Microscopic structure analysis of great arterial wall and semilunar leaflets tissue should clearly demonstrate cells as well as the extracellular matrix components by highly reproducible and specific histological staining procedures. Quantitative morphometry using stereological grids has proved to be effective, as the exact statistics was feasible. From mechanical testing methods, tensile test was the most suitable. Young’s moduli of elasticity, ultimate stress and strain were shown to represent most important AHV tissue mechanical characteristics, suitable for exact statistical analysis. C-AHV are prepared by many different protocols, so as each TE has to work out own EL for C-AHV