Características clínico-epidemiológicas de pacientes hipertensos en un Consultorio Médico de Santa Clara

High blood pressure is a chronic non-transmittable disease, which is also a risk factor for the development of other clinical conditions. The incidence of arterial hypertension in the Cuban population is high.Aim: to characterize the evolution of arterial hypertension in a Family Doctor's Office.Methods: an observational, descriptive and cross-sectional study was carried out at the Family Doctor's Office 17-19 in the municipality of Santa Clara. The study covered the months of January to March 2020. Of the 256 hypertensive patients, a sample of 52 was selected by a simple random method.Results: Males predominated (53.84 %), together with the age group between 40 and 49 years (28.84 %). A total of 63.46 % of the patients were white-skinned. 51.61% presented risk factors. The risk factors with the highest incidence were smoking, followed by obesity and sedentary lifestyle.Conclusions: the most affected hypertensive patients are male. Most patients have a family history of high blood pressure. Smoking is a high incidence risk factor in the hypertensive population.Introducción: la hipertensión arterial es una enfermedad crónica no transmisible, que a la vez constituye un factor de riesgo para el desarrollo de otras enfermedades. La incidencia de la hipertensión arterial en la población de Cuba es alta.Objetivo: caracterizar el comportamiento de la hipertensión arterial en un Consultorio Médico de Familia.Métodos: se realizó un estudio observacional, descriptivo y transversal en el Consultorio Médico de Familia 17-19 del municipio Santa Clara. El período de estudio comprendió los meses de enero a marzo del 2020. La población fue de 256 hipertensos y se escogió una muestra de 52 hipertensos por muestreo aleatorio simple.Resultados: predominó el sexo masculino (53,84 %), y el grupo de edad entre 40 y 49 años (28,84 %). El 63,46 % de los pacientes fueron de color de la piel blanca. El 51,61 % presentaron factores de riesgo. Los factores de riesgo de mayor incidencia fueron el tabaquismo, seguido por la obesidad y el sedentarismo.Conclusiones: los pacientes hipertensos más afectados son los del sexo masculino. La mayor parte de los pacientes tienen antecedentes familiares de hipertensión arterial. El tabaquismo es un factor de riesgo de alta incidencia en la población hipertensa

Comparing the Performance of Bread and Breakfast Cereals, Dairy, and Meat in Nutritionally Balanced and Sustainable Diets

Objective: To quantify the performance of food products in a sustainable diet based on the balance of their contribution to nutrient intake and environmental impact, within the context of the Dutch diet.Design: While fixing the quantity of a specific food group at different levels, optimized diets that met nutrient requirements and stayed as close as possible to the current Dutch diet were calculated, in order to understand its potential environmental impact and its nutritional quality. Bread & breakfast cereals, dairy, and meat were compared between 0 and 250% of current intake. Their performance is expressed in the relationship between the quantity of these food products and (1) the environmental impact of diets and (2) the nutrient balance of the diets.Setting: The Netherlands.Subjects: Women aged 31–50.Results: The amount of bread & breakfast cereals in the optimized diets were inversely correlated with their environmental impact. The nutrient balance of the optimized diets was maintained despite varying cereal content, with the expected improvement over the current diet. Increasing amounts of dairy in the optimized diet were associated with an increase in environmental impact and meat with a steep increase. The nutrient balance of optimized diets with varying dairy and meat contents was also maintained at high levels, even at 0% content.Conclusions: Bread and breakfast cereals are sources of nutrients with a better environmental performance compared to dairy or meat within the context of the Dutch diet. It is possible to optimize diets for environmental impact whilst maintaining a high nutrient balance

Reproducibility of ambulatory blood pressure monitoring in hemodialysis patients

Ambulatory blood pressure monitoring (ABPM) has been increasingly used in hemodialysis (HD) practice and research; however, no study has evaluated the reproducibility of ABPM in this population. To address this question, we performed 48-hour interdialytic ABPM on 21 HD patients (mean age, 53 ± 16 years; 7 women) on two different occasions 68 ± 34 days (range, 30 to 154 days) apart. To qualify for the protocol, patients had to be at the same dry weight and on the same vasoactive drug regimen at both monitoring periods. BP was analyzed according to three different methods: isolated pre-HD and post-HD values, average pre-HD and post-HD values for the five HD sessions surrounding each monitoring period, and 48-hour interdialytic ABPM. Reproducibility was determined by analysis of the SD of the differences (SDD) between the two monitoring periods and the coefficient of variation of each method of BP determination. Our results show better reproducibility of ABPM (SDD, 10.6/6.6 mm Hg; coefficient of variation, 7.5%/8.1%) compared with isolated pre-HD BP (SDD, 24.4/11.3 mm Hg; coefficient of variation, 16.7%/14.1%) or post-HD BP (SDD, 16.8/14.5 mm Hg; coefficient of variation, 11.7%/17.8%), and averaged pre-HD BP (SDD, 14.7/7.2 mm Hg; coefficient of variation, 10.1%/9.1%) or post-HD BP (SDD, 12.4/8.7 mm Hg; coefficient of variation, 8.9%/11.1%). The reproducibility of the decrease in BP during sleep was poor, with up to 43% of the subjects changing dipping category within or between interdialytic periods. We conclude that ABPM is the most accurate method to study BP in HD patients over time. However, variability is significant, and there is poor reproducibility of the nocturnal decline in BPFil: Peixoto, Aldo. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Santos, Sergio F.F. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Mendes, Roger. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Crowley, Susan. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Maldonado, Rafael. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Orias, Marcelo. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Mansoor, George A. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: White, William B. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentin

Implementação da Iniciativa HEARTS na Argentina: primeiros resultados

Cardiovascular diseases are the leading cause of mortality and morbidity in the Region of the Americas, and hypertension is one of the main risk factors. In 2018, Argentina began implementing the HEARTS Initiative in five primary health care centers, through the National Plan for the Prevention and Control of Arterial Hypertension. This study presents the impact its implementation has had on the indicators of effective coverage, treatment, combination therapy, and control. The HEARTS Initiative has multiple components; these include training health teams, reassigning tasks based on the transfer of clinical competencies, providing automatic and clinically validated blood pressure measurement devices, and using a single standardized treatment protocol. A longitudinal data model (generalized estimating equation analysis) was used, and the information from the five health centers was grouped using weighted averages according to the size of the population under coverage. Analysis of the results was stratified into two time periods delimited by the imposition of restrictions due to COVID-19. During the first period of 18 months, significant improvement was observed in treatment (5.9%; p<0.01) and combination therapy (13.4%; p<0.01), with no significant change in coverage (8.4%; p=0.87) and with a paradoxical decrease in control (−3.3%; p=0.02). When the period of restrictions was compared to the previous period, a generalized reduction was observed in all indicators, particularly coverage (−23.6%; p<0.01) and control (−12.5%; p<0.01). However, treatment and combination therapy levels remained above baseline values (1.7%; p<0.01 and 5.4%; p<0.01, respectively).Cardiovascular diseases are the leading cause of mortality and morbidity in the Region of the Americas, and hypertension is one of the main risk factors. In 2018, Argentina began implementing the HEARTS Initiative in five primary health care centers, through the National Plan for the Prevention and Control of Arterial Hypertension. This study presents the impact its implementation has had on the indicators of effective coverage, treatment, combination therapy, and control. The HEARTS Initiative has multiple components; these include training health teams, reassigning tasks based on the transfer of clinical competencies, providing automatic and clinically validated blood pressure measurement devices, and using a single standardized treatment protocol. A longitudinal data model (generalized estimating equation analysis) was used, and the information from the five health centers was grouped using weighted averages according to the size of the population under coverage. Analysis of the results was stratified into two time periods delimited by the imposition of restrictions due to COVID-19. During the first period of 18 months, significant improvement was observed in treatment (5.9%; p<0.01) and combination therapy (13.4%; p<0.01), with no significant change in coverage (8.4%; p=0.87) and with a paradoxical decrease in control (−3.3%; p=0.02). When the period of restrictions was compared to the previous period, a generalized reduction was observed in all indicators, particularly coverage (−23.6%; p<0.01) and control (−12.5%; p<0.01). However, treatment and combination therapy levels remained above baseline values (1.7%; p<0.01 and 5.4%; p<0.01, respectively).As doenças cardiovasculares são a principal causa de morbimortalidade, e a hipertensão, seu principal fator de risco. Em 2018, a Argentina começou a implementar a Iniciativa HEARTS em 5 centros de atenção primária à saúde por meio do Plano Nacional de Prevenção e Controle da Hipertensão Arterial. Este estudo apresenta o impacto de sua implementação nos indicadores de cobertura efetiva, tratamento, tratamento combinado e controle. A Iniciativa HEARTS inclui vários componentes. Entre eles, se destacam a capacitação das equipes de saúde, a reorganização das tarefas com base na transferência de competências clínicas, a disponibilização de aparelhos automáticos e clinicamente validados para aferição da pressão arterial e a utilização de um único protocolo padronizado de tratamento. Foi utilizado um modelo de equações de estimativas generalizadas para a análise de dados longitudinais, e as informações dos 5 centros de saúde foram agrupadas por meio de médias ponderadas de acordo com o tamanho da população coberta. A análise dos resultados foi estratificada em dois períodos de tempo delimitados pela irrupção das restrições em virtude da COVID-19. Durante os primeiros 18 meses, houve melhora significativa no tratamento (5,9%; p<0,01) e no tratamento combinado (13,4%; p<0,01), sem mudança significativa na cobertura (8,4%; p=0,87) e com uma diminuição paradoxal no controle (−3,3%; p=0,02). Durante as restrições e em relação ao período anterior, verificou-se redução generalizada em todos os indicadores, principalmente na cobertura (−23,6%; p<0,01) e no controle (−12,5%; p<0,01). No entanto, os níveis de tratamento e tratamento combinado persistiram acima dos valores basais (1,7%; p<0,01 e 5,4%; p<0,01, respectivamente).Fil: Rodriguez, Gonzalo. Organización Panamericana de la Salud; ArgentinaFil: Rosende, Andrés. Pan American Health Organization; Estados UnidosFil: Prado, Carolina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Cejas Mariño, Rubén. Ministerio de Salud. Departamento de Epidemiologia; ArgentinaFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: DiPette, Donald. University Of South Carolina; Estados UnidosFil: Orias, Marcelo. University of Yale; Estados UnidosFil: Giraldo Arcila, Gloria. Pan American Health Organization; Estados UnidosFil: Laspiur, Sebastián. Organización Panamericana de la Salud; Argentin

Table_1_Comparing the Performance of Bread and Breakfast Cereals, Dairy, and Meat in Nutritionally Balanced and Sustainable Diets.DOCX

<p>Objective: To quantify the performance of food products in a sustainable diet based on the balance of their contribution to nutrient intake and environmental impact, within the context of the Dutch diet.</p><p>Design: While fixing the quantity of a specific food group at different levels, optimized diets that met nutrient requirements and stayed as close as possible to the current Dutch diet were calculated, in order to understand its potential environmental impact and its nutritional quality. Bread & breakfast cereals, dairy, and meat were compared between 0 and 250% of current intake. Their performance is expressed in the relationship between the quantity of these food products and (1) the environmental impact of diets and (2) the nutrient balance of the diets.</p><p>Setting: The Netherlands.</p><p>Subjects: Women aged 31–50.</p><p>Results: The amount of bread & breakfast cereals in the optimized diets were inversely correlated with their environmental impact. The nutrient balance of the optimized diets was maintained despite varying cereal content, with the expected improvement over the current diet. Increasing amounts of dairy in the optimized diet were associated with an increase in environmental impact and meat with a steep increase. The nutrient balance of optimized diets with varying dairy and meat contents was also maintained at high levels, even at 0% content.</p><p>Conclusions: Bread and breakfast cereals are sources of nutrients with a better environmental performance compared to dairy or meat within the context of the Dutch diet. It is possible to optimize diets for environmental impact whilst maintaining a high nutrient balance.</p

High blood pressure 2016: why prevention and control are urgent and important. The World Hypertension League, International Society of Hypertension, World Stroke Organization, International Diabetes Foundation, International Council of Cardiovascular Prevention and Rehabilitation, International Society of Nephrology

No abstract available

2016 dietary salt fact sheet and call to action: the World Hypertension League, International Society of Hypertension, and the International Council of Cardiovascular Prevention and Rehabilitation

No abstract available