Show simple item record

A WORD OF CAUTION ABOUT THE 2017 HYPERTENSION MANAGEMENT GUIDELINES

Consideraciones en torno a las Guías U.S.A. 2017 de hipertensión arterial.

dc.contributoren-US
dc.contributores-ES
dc.creatorFasce, Eduardo; Departamento de Educación Médica Facultad de Medicina Universidad de Concepción
dc.creatorZárate, Luis Hernán; Universidad de Chile
dc.creatorOrtiz, Liliana; Universidad de Concepción
dc.date2018-09-12
dc.date.accessioned2019-11-11T18:26:33Z
dc.date.available2019-11-11T18:26:33Z
dc.identifierhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/6838
dc.identifier.urihttps://revistaschilenas.uchile.cl/handle/2250/110722
dc.descriptionThe 2017 Guidelines on hypertension of the American College of Cardiology and American Heart Association, which proposed values of 130/80 mm Hg as the cutoff points for the onset of hypertension, aroused great interest. This recommendation is based in the SPRINT study (The Systolic Pressure Intervention Trial), which included hypertensive patients over 50 years of age, non-diabetic, without a history of stroke and with a low representation of subjects with a history of coronary artery disease (16%). A group with intensive anti-hypertensive therapy (pressure achieved 121.5 mm Hg) achieved a significantly lower cardiovascular risk as compared with a group with standard therapy (pressure achieved 134.6 mm Hg). The Guide proposes immediate pharmacological therapy in diabetic hypertensive patients, in those with stage 3 chronic kidney disease or with persistent albuminuria, and in patients with atherosclerotic disease. The Guideline does not include the management of isolated systolic hypertension of the elderly and did not consider studies that show an increased risk when pressure is reduced below 130/80 mm Hg in patients with coronary disease, peripheral vascular disease, diabetes mellitus or chronic renal failure. The new classification of hypertension would increase the number of hypertensive patients in our country by more than one million, would increase the risk associated with diastolic pressure reductions in older adults and ignores the evidence indicating a risk associated with reductions below 130/80 mm Hg in patients with diabetes, with chronic renal failure or with atherosclerotic disease. Therefore, it is advisable to maintain a threshold of 140/90 mm Hg and perform a careful and gradual management of blood pressure in the latter group of hypertensive patients.en-US
dc.descriptionThe 2017 Guidelines on hypertension of the American College of Cardiology and American Heart Association, which proposed values of 130/80 mm Hg as the cutoff points for the onset of hypertension, aroused great interest. This recommendation is based in the SPRINT study (The Systolic Pressure Intervention Trial), which included hypertensive patients over 50 years of age, non-diabetic, without a history of stroke and with a low representation of subjects with a history of coronary artery disease (16%). A group with intensive anti-hypertensive therapy (pressure achieved 121.5 mm Hg) achieved a significantly lower cardiovascular risk as compared with a group with standard therapy (pressure achieved 134.6 mm Hg). The Guide proposes immediate pharmacological therapy in diabetic hypertensive patients, in those with stage 3 chronic kidney disease or with persistent albuminuria, and in patients with atherosclerotic disease. The Guideline does not include the management of isolated systolic hypertension of the elderly and did not consider studies that show an increased risk when pressure is reduced below 130/80 mm Hg in patients with coronary disease, peripheral vascular disease, diabetes mellitus or chronic renal failure. The new classification of hypertension would increase the number of hypertensive patients in our country by more than one million, would increase the risk associated with diastolic pressure reductions in older adults and ignores the evidence indicating a risk associated with reductions below 130/80 mm Hg in patients with diabetes, with chronic renal failure or with atherosclerotic disease. Therefore, it is advisable to maintain a threshold of 140/90 mm Hg and perform a careful and gradual management of blood pressure in the latter group of hypertensive patients.es-ES
dc.formatapplication/pdf
dc.languagespa
dc.publisherRevista Médica de Chilees-ES
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/6838/4459
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/35513
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/35514
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/35515
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/35516
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/35517
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/35687
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/36401
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/36928
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/36929
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/6838/36930
dc.sourceRevista Médica de Chile; Vol. 146, núm. 11 (2018): NOVIEMBRE 2018es-ES
dc.source0034-9887
dc.subjectGuideline; Hypertension; Practice Guidelineen-US
dc.subjectGuideline; Hypertension; Practice Guidelinees-ES
dc.titleA WORD OF CAUTION ABOUT THE 2017 HYPERTENSION MANAGEMENT GUIDELINESen-US
dc.titleConsideraciones en torno a las Guías U.S.A. 2017 de hipertensión arterial.es-ES
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.typees-ES


This item appears in the following Collection(s)

Show simple item record