Navegando por Palavras-chave "arterial hypertension"
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- ItemSomente MetadadadosChildren with Chronic Renal Disease Undergoing Dialysis or Conservative Treatment-Differences in Structural and Functional Echocardiographic Parameters(Wiley-Blackwell, 2014-10-01) Scavarda, Valeska Tavares [UNIFESP]; Pinheiro, Aurelio Carvalho [UNIFESP]; Costa, Symone Damasceno [UNIFESP]; Andrade, Zelia Maria de [UNIFESP]; Abreu Carvalhaes, Joao Tomas de [UNIFESP]; Campos, Orlando [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Moises, Valdir Ambrosio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Cardiac disease frequently occurs in children with chronic kidney disease (CKD) undergoing dialysis (DI), but it is not well studied in patients undergoing conservative treatment (CT). the aim of our study was to use echocardiography to analyze and compare the cardiac involvement of children with CKD undergoing DI or CT. Methods: Seventy-one children with CKD were included; 41 undergoing DI and 30 undergoing CT. There were 33 controls. Measurements of arterial pressure and structural and functional echocardiographic variables were obtained; the children were followed up for 18 months. Tests of comparison and multiple regression were used; significant if P < 0.05. Results: Arterial hypertension (AH) was present in 37 of 71 (52%) children with CKD: 27 (65.8%) in DI and 10 (33.3%) in CT (X-2 = 8.7; P = 0.003). An abnormal left ventricular geometric pattern was present in 37/41 (90.3%) undergoing DI, 33 had left ventricular hypertrophy (LVH), and in 14/30 (46.7%) undergoing CT, 5 had LVH. Ejection fraction was normal in all groups; diastolic function alteration (DFA) occurred in 28/41 (68.3%) children on DI and in 10/30 (33.3%) on CT (X-2 = 9.2; P = 0.002). for children with CKD, DI (P = 0.002) and hypertension (P = 0.04) were associated with LVH; among those on DI, only AH was associated with LVH (P = 0.02). During the follow-up, 18 (43.9%) children undergoing DI had at least one cardiovascular event. Conclusion: Children with CKD undergoing CT had less cardiac involvement than those undergoing DI. LVH was associated with DI and AH in all children with CKD and with AH in those on DI.
- ItemAcesso aberto (Open Access)Effects of Sibutramine on the Treatment of Obesity in Patients with Arterial Hypertension(Sociedade Brasileira de Cardiologia - SBC, 2002-02-01) Faria, Alessandra Nunes [UNIFESP]; Ribeiro Filho, Fernando Flexa [UNIFESP]; Lerário, Daniel Diniz G. [UNIFESP]; Kohlmann, Narcia Elisa Bellucci [UNIFESP]; Ferreira, Sandra Roberta Gouvea [UNIFESP]; Zanella, Maria Teresa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To assess the effects of weight reduction with 10mg of sibutramine or placebo on blood pressure during 24 hours (ambulatory blood pressure monitoring), on left ventricular mass, and on antihypertensive therapy in 86 obese and hypertensive patients for 6 months. METHODS: The patients underwent echocardiography, ambulatory blood pressure monitoring, and measurement of the levels of hepatic enzymes prior to and after treatment with sibutramine or placebo. RESULTS: The group using sibutramine had a greater weight loss than that using placebo (6.7% versus 2.5%; p<0.001), an increase in heart rate (78.3±7.3 to 82±7.9 bpm; p=0.02), and a reduction in the left ventricular mass/height index (105±29.3 versus 96.6±28.58 g/m; p=0.002). Both groups showed similar increases in the levels of alkaline phosphatase and comparable adjustments in antihypertensive therapy; blood pressure, however, did not change. CONCLUSION: The use of sibutramine caused weight loss and a reduction in left ventricular mass in obese and hypertensive patients with no interference with blood pressure or with antihypertensive therapy.
- ItemAcesso aberto (Open Access)Estudo qualitativo da formação hipocampal de animais hipertensos com epilepsia(Academia Brasileira de Neurologia - ABNEURO, 2005-06-01) Scorza, Fulvio Alexandre [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Scorza, Carla Alessandra [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Mogi das Cruzes Universidade de Mogi das Cruzes Laboratório de Neurociências; Centro Universitário São CamiloThe aim of our study was to investigate the hippocampus and dentate gyrus neuropathological features of spontaneous hypertensive rats (SHR) with epilepsy. METHOD: Animals were randomly divided into 4 groups: control Wistar, Wistar with epilepsy, control SHR and SHR with epilepsy. The pilocarpine model of epilepsy was used in this experiement. After spontaneous recurrent seizures, all animals were perfused and their brains processed for histological analysis through Nissl and neo-Timm methods. RESULTS: In the Wistar rats with epilepsy we observed cell loss in hippocampal subfields CA1, CA3 and hilus of the dentate gyrus when compared with control animals. In the SHR with epilepsy we observed hippocampal formation atrophy with ventricular dilatation. No morphological alterations were observed in SHR and Wistar control rats. The neo-Timm staining of hippocampal formation has shown supragranular sprouting in Wistar and SHR with epilepsy. CONCLUSION: We found neuropathological alterations in hippocampal formation in Wistar with epilepsy and SHR with epilepsy, suggesting that epilepsy per se or associated to hypertention are able to cause neuronal damage.
- ItemSomente MetadadadosThe Gly482Ser polymorphism in the peroxisome proliferator-activated receptor-gamma coactivator-1 gene is associated with hypertension in type 2 diabetic men(Springer, 2004-11-01) Cheurfa, Nadir; Reis, André Fernandes [UNIFESP]; Dubois-Laforgue, Daniele; Bellanne-Chantelot, Christine; Timsit, José; Velho, Gilberto [UNIFESP]; Hop St Vincent de Paul; Universidade Federal de São Paulo (UNIFESP); Cochin Hosp; Hop St AntoineAims/hypothesis. Peroxisome proliferator-activated receptor-gamma coactivator-1 (PPARGC1) acts as a cofactor for several nuclear hormone receptors in many tissues and organs implicated in blood pressure regulation. Here, we assessed the association between the Gly482Ser variant of PPARGC1 and the arterial hypertension frequently found in subjects with type 2 diabetes.Methods. We studied a group of 479 men and 253 women with type 2 diabetes. Arterial hypertension was present in 70% of the men and in 73% of the women. Genotypes were examined by PCR restriction fragment length polymorphism. A logistic regression analysis was performed to assess the covariables associated with arterial hypertension.Results. There was an association between Ser allele homozygosis and arterial hypertension in type 2 diabetic men (odds ratio of 2.52 vs Gly allele homozygosis; 95% CI: 1.32-5.00; p=0.0064), but not in women. the prevalence of arterial hypertension in type 2 diabetic men was 77% vs 73% vs 67% for Ser-Ser, Gly-Ser and Gly-Gly carriers respectively (p=0.021). Age, BMI, the use of insulin, and triglyceride and creatinine levels were also independently associated with arterial hypertension in this cohort.Conclusions/interpretation. We have observed a sex-specific association between the PPARGC-1 gene Gly482Ser polymorphism and arterial hypertension in type 2 diabetic men. Further studies are needed to investigate the genetic, biochemical and pathophysiological basis of this allelic association.
- ItemSomente MetadadadosLaparoscopic treatment of type 2 diabetes mellitus for patients with a body mass index less than 35(Springer, 2008-03-01) DePaula, A. L.; Macedo, A. L. V.; Rassi, N.; Machado, C. A.; Schraibman, V. [UNIFESP]; Silva, L. Q.; Halpern, A.; Hosp Especialidades Ctr Med La Raza; Albert Einstein Hosp; Hosp Geral Goiania; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Background Type 2 diabetes mellitus (T2DM) is a common disease with numerous complications. Bariatric surgery is an efficient procedure for controlling T2DM in morbidly obese patients. in T2DM, the incretin effect is either greatly impaired or absent. This study aimed to evaluate the preliminary results from interposing a segment of ileum into the proximal jejunum associated with a sleeve or diverted sleeve gastrectomy to control T2DM in patients with a body mass index (BMI) less than 35 kg/m(2).Methods for this study, 39 patients (16 women and 23 men) underwent two laparoscopic procedures comprising different combinations of ileal interposition into the proximal jejunum via a sleeve or diverted sleeve gastrectomy. the mean age of these patients was 50.3 years (range, 36-66 years). the mean BMI was 30.1 kg/m(2) (range, 23.4-34.9 kg/m(2)). All the patients had a diagnosis of T2DM that had persisted for at least 3 years and evidence of stable treatment with oral hypoglycemic agents or insulin for at least 12 months. the mean duration of T2DM was 9.3 years (range, 3-22 years).Results the mean operative time was 185 min, and the median hospital stay was 4.3 days. Four major complications occurred in the short term (30-days), and the mortality rate was 2.6%. the mean postoperative follow-up period was 7 months (range, 4-16 months), and the mean percentage of weight loss was 22%. the mean postoperative BMI was 24.9 kg/m(2) (range, 18.9-31.7 kg/m2). An adequate glycemic control was achieved for 86.9% of the patients, and 13.1% had important improvement. the patients whose glycemia was not normalized were using a single oral hypoglycemic agent. No patient needed insulin therapy postoperatively. All the patients except experienced normalization of their cholesterol levels. Targeted triglycerides levels were achieved by 71% of the patients, and hypertension was controlled for 95.8%.Conclusions the laparoscopic ileal interposition via either a sleeve gastrectomy or diverted sleeve gastrectomy seems to be a promising procedure for the control of T2DM and the metabolic syndrome. A longer follow-up period is needed.
- ItemAcesso aberto (Open Access)Positive Association between Tinnitus and Arterial Hypertension(Frontiers Media Sa, 2016) Figueiredo, Ricardo Rodrigues [UNIFESP]; Azevedo, Andreia Aparecida [UNIFESP]; Penido, Norma de Oliveira [UNIFESP]Introduction: Tinnitus is the perception of noise in the absence of an external source and is considered by most authors as a multifactorial symptom. A systematic review concerning the association of tinnitus and systemic arterial hypertension retrieved suggestions of a positive association, but the articles included failed to perform a detailed analysis on the theme. Purpose: To analyze the presence of arterial hypertension in tinnitus and non-tinnitus patients, to analyze differences between tinnitus impact and psychoacoustic measurements in hypertensive and normotensive patients, and to evaluate the association between the presence of tinnitus and the diverse antihypertensive drugs employed. Materials and methods: This includes cross-sectional transversal study, comparing two groups of subjects (144 in the study group with tinnitus and 140 in the control group without tinnitus). Clinical, demographical, audiometrical, and psychoacoustics characteristics of the subjects were compared. Results: Hypertension prevalence in tinnitus subjects was 44.4% against 31.4% in subjects without tinnitus (p = 0.024). Positive associations with tinnitus were found with hypertension treatment with angiotensin-converting enzyme (ACE) inhibitors (p = 0.006), tiazidic diuretics (p < 0.0001), potassium-sparing diuretics (p = 0.016), and calcium channels blockers (p = 0.004). Conclusion: There is an association between tinnitus and arterial hypertension. This association is particularly strong in older patients. Hypertension treatment with diuretics, ACE inhibitors, and calcium channels blockers were more prevalent in tinnitus patients, suggesting that an eventual ototoxicity of these drugs may be involved in tinnitus pathophysiology, a hypothesis that should be evaluated in further studies.