CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A HipertensÃo Arterial caracteriza-se como um dos principais problemas de saÃde pÃblica do mundo contemporÃneo por sua magnitude, risco e dificuldades no seu controle. A hipertensÃo arterial pode influenciar a sexualidade de maneira direta ou indireta. Este estudo do tipo descritivo teve como objetivos identificar, entre portadores de hipertensÃo arterial, de ambos os sexos, o perfil socioepidemiolÃgico e clÃnico, e a freqÃÃncia e os tipos das alteraÃÃes sexuais presentes nessa populaÃÃo. O estudo foi realizado no AmbulatÃrio de Cardiologia do Hospital UniversitÃrio Oswaldo Cruz (HUOC), considerado referÃncia em Cardiologia no RecifeâPE. Estudaram-se 114 adultos, sendo 39 homens e 75 mulheres, portadores de hipertensÃo arterial em tratamento ambulatorial, de maio a julho de 2004. Os dados foram obtidos por entrevista direta realizada pela pesquisadora, demonstram que a idade variou de 24 a 65 anos (mÃdia de 52,19 anos). Grande parcela (80,7%) eram casados. Quanto a escolaridade 64,9% informavam primeiro grau. A maioria professavam ser catÃlicos, com renda per capita variando de R$ 37,14 a R$ 1.300,00. Maior proporÃÃo encontravam-se classificados como nÃo-economicamente ativos e informavam tempo de diagnÃstico entre seis a 10 anos. Grande parcela fazia uso de drogas anti-hipertensiva entre um a cinco anos. Ao estudar interrupÃÃo do tratamento, as mulheres eram as menos aderentes. Ao analisar os hÃbitos saudÃveis de vida os hÃbitos desejÃveis compreenderam a reduÃÃo na ingestÃo de sal, reduÃÃo de peso, prÃtica de exercÃcios fÃsicos e lazer e hÃbitos nÃo desejÃveis, o consumo de cigarro de papel ou de palha e o consumo de bebidas alcoÃlicas, sendo que as mulheres informavam mais os hÃbitos saudÃveis do que os homens. JÃ, 55,7% do total dos hipertensos informavam ter apresentado alteraÃÃes na sua vida proveniente do diagnÃstico de hipertensÃo arterial. Quanto à avaliaÃÃo da existÃncia de alteraÃÃes sexuais nÃo foi observada diferenÃa estatisticamente significante entre os sexos (p = 0.3871). Entretanto, aquelas mais freqÃentes entre os homens eram a disfunÃÃo erÃtil, seguida pela inibiÃÃo do desejo, e as mulheres informavam mais a inibiÃÃo do desejo, seguida pela frigidez. Dentre as diferentes variÃveis estudadas mostraram significÃncia estatÃstica apenas as associaÃÃes: alteraÃÃo sexual versus situaÃÃo ocupacional e alteraÃÃo sexual versus existÃncia de atividade de lazer. Conclui-se, ao longo do estudo, que os hipertensos mostram caracterÃsticas semelhantes aos doentes do paÃs e apresentam alteraÃÃes na sexualidade advinda da prÃpria doenÃa ou do envelhecimento. Depreende-se que os indivÃduos que nÃo possuem lazer e nÃo trabalham, por se manterem ociosos, podem estar mais afetados pelas doenÃas, interferindo na saÃde sexual. / The arterial hypertension is characterized as one of the principal problems of public health of the contemporary world for your magnitude, risk and difficulties in your control. The arterial hypertension can influence the sexuality in way direct or indirect. This study of the descriptive type had as objectives to identify, among bearers of arterial hypertension, of both sexes, the profile partner-epidemiological and clinical, and frequency and the types of the present sexual alterations in that population. The study was accomplished at the clinic of cardiology of the Academicals Hospital Oswaldo Cruz (HUOC), considered reference in cardiology in Recife-PE 114 adults they were studied being, 39 men and 75 women, bearers of arterial hypertension in treatment ambulatory, of May to July of 2004. The data were obtained by direct interview accomplished by the researcher. The data demonstrate the age it varied from 24 to 65 years (52,19 year-old average) Great portion (80,7%) of the hypertensions they were married. With relationship to the education 64,9% informed first degree. Most professed to be Catholic, with per capita income varying from R$ 37,14 to R$ 1.300,00. Larger proportion of the hypertensions was classified as no-economically assets and they informed time of diagnosis among six to 10 years. Great portion made use of drugs anti-hypertensive among one to five years. When studying interruption of the treatment, the womem were the least adherent ones. When analyzing the healthy habits of life the desirable habits they understood the reduction in the ingestion of salt, weight reduction, practice of physical exercises and leisure and habits didnÂt want the consumption of paper cigarette or of straw and the consumption of drunk alcoholic, and the women informed more the healthy habits than the men. Already, 55,7% of the total of the hypertensions informed to have presented alterations in youÂre originating from life the diagnosis of arterial hypertension. With relationship to the evaluation of the existence of sexual alterations was not observed it differentiates significant statistically among the sexes (p= 0.3871). The more frequent sexual alterations among the men were the erectile dysfunctions, followed for the inhibition of the desire, and the women informed the inhibition of the desire, followed for the frigidity. Among the different studied variables they showed statistically significant, just to associations they will be alteration sexual versus occupacional situation and alteration sexual versus existence of leisure activity. It is concluded along the study that the hypertensions characteristics are shown similar to the patients of the country and they present alterations in the sexuality result of the own disease or of the aging. It is inferred that the individuals that donÂt possess leisure and they donÂt work, for if they maintain idle, they can be more affected by the diseases, interfering in the sexaul health.

Yes / Aberrant transforming growth factor-β (TGF-β) signaling activation is linked to pulmonary arterial hypertension (PAH). BMPR2 mutations perturb the balance between bone morphogenetic protein (BMP) and TGF-β pathways, leading to vascular remodeling, narrowing of the lumen of pulmonary vasculature, and clinical symptoms. This forum highlights the association of the TGF-β pathway with pathogenesis and therapeutic approaches. / Research carried out at Nasim laboratories is funded by GrowMedtech, the Royal Society, the Commonwealth Scholarship Commission (CSC) and the University of Bradford (UoB). N.S. is funded by the CSC and C.C.N. is partly funded by the UoB.

Background Pulmonary arterial hypertension (PAH) is a rare progressive disease with no known cure. Of various aetiologies, PAH in association with connective tissue disease (PAH-CTD) is the most rapidly progressive and difficult to treat. Management of PAH has evolved significantly in the past ten years since the introduction of oral therapies. Evidence for the efficacy of these agents outside randomised controlled trials is limited, but guidelines exist. Aim To measure the impact of first-line monotherapy with bosentan or sildenafil and the introduction of prescribing guidelines on outcomes in PAH-CTD. Methods Following a retrospective analysis of consecutive, incident, treatment-naive PAH-CTD cases identified by the ASPIRE registry, influences on outcome measures have been compared. First-line monotherapy episodes for 247 patients was analysed against four distinct endpoints: change in exercise capacity, WHO functional class, time on monotherapy and all-cause mortality. Results Treatment with bosentan or sildenafil resulted in clinical stability at 2 years for nearly 1/4 patients. No difference was identified between the groups in terms of either exercise capacity or WHO functional class. Sildenafil patients were found to remain on monotherapy longer than those prescribed bosentan. Patients prescribed sildenafil have improved survival over those treated with bosentan. Unexpected baseline differences in between groups may confound the results as the haemodynamics of the bosentan patients were more severe. Conclusions A significant number of patients with PAH-CTD remain clinically stable on monotherapy at 2 years. Both agents seem equally effective in this aggressive form of PAH. A novel endpoint “TOM” may be of value in future research assessing response to treatment.

No description available.

No description available.

Pulmonary arterial hypertension (PAH) can be caused by pathogenic variants in the gene bone morphogenetic protein receptor 2 (BMPR2). While BMPR2 protein expression levels are known to be reduced in the lung tissue of heritable PAH (HPAH) patients, a systematic study evaluating expression in more easily accessible blood samples and its clinical relevance is lacking. Thus, we analyzed the BMPR2 mRNA expression in idiopathic/HPAH patients and healthy controls in blood by quantitative polymerase chain reaction and protein expression by enzyme-linked immunosorbent assay. Clinical parameters included right heart catherization, echocardiography, six-minute walking test and laboratory tests. BMPR2 variant-carriers (n = 23) showed significantly lower BMPR2 mRNA expression in comparison to non-carriers (n = 56) and healthy controls (n = 30; p < 0.0001). No difference in BMPR2 protein expression was detected. Lower BMPR2 mRNA expression correlated significantly with greater systolic pulmonary artery pressure and pulmonary vascular resistance. Higher BMPR2 mRNA expression correlated with greater glomerular filtration rate, cardiac index and six-minute walking distance. We demonstrated the feasibility to assess BMPR2 expression in blood and, for the first time, that BMPR2 mRNA expression levels are significantly reduced in variant carriers and correlated with clinical parameters. Further studies may evaluate the usefulness of BMPR2 mRNA expression in blood as a new marker for disease severity.

Analysis of care in patients at risk for arterial hypertension in pharmacy IV. Author: Lada Kotlanová Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague Introduction and aim: Arterial hypertension (AH) belongs due to its pressure and atherosclerotic complications among very serious global health problems. The main goal of the therapy of AH is to prevent these complications, comprising early diagnosis and proper treatment plan. The aim of the study was to realize counselling in a pharmacy focused on clients with the risk of AH or already diagnosed AH. Metodology: Data were collected in a community pharmacy in Kralovice from September 2014 to January 2015. Prior to blood pressure measurement, the controlled interview was conducted with each client using special form which enabled to obtain important data from clients' history. Following data were obtained: socio-demographic characteristics of each client; their relationship to blood pressure measurement; risk factors of AH or atherosclerosis, respectively; disease history and use of drugs including food supplements. Results of blood pressure measurement, proposed intervention, or drug related problems were also subsequently recorded into the form thus...

Hypertension and nutrition: Fat-soluble vitamins A, D and E Weber J1 , Vlcek J1 , Suarez-Varella MM2 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic 2 Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of Valencia, Spain Arterial hypertension (AH) is a disease affecting population globally, and thus considered as a problem of public health and socioeconomic. Studies are trying to identify the connection between diet and the prevalence of arterial hypertension. Objective of the study was to determine possible association between an occurrence of AH and fat-soluble vitamins A, D and E intake. The nested, case-control population study investigation was grounded on database from the Spanish Hortega study, and performed on a random sample of 1,514 people (50.3 % women, 49.7 % men). From this sample we selected those aged ≥ 40 years old and untreated for hypertension and divided them into two groups: non-hypertensive (n = 429; 63.6 %) (controls), and newly diagnosed AH (n = 246; 36.4 %) (cases). Biochemical and anthropometric measurements, data on dietary intakes, education, socioeconomic status, place of residence, health habits, comorbidities, consumption of alcohol and tobacco were used for our...

Analysis of care in patients at risk for arterial hypertension in pharmacy III. Author: Petra Smíšková Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague Introduction: Arterial hypertension belongs to the most common diseases of cardiovascular system, not only in the Czech Republic. Therefore it is very important to focus on its prevention and early diagnostics before the stage of health complications shows up. Objectives: The aim of this thesis was to realize and evaluate consulting activities in pharmacy focused on patients who have high risks of arterial hypertension or have been already diagnosed with it. Methodology: Data were collected in a public pharmacy in Prague from the end of April 2013 until the beginning of April 2014. The actual blood pressure measurement was preceded by obtaining of answers to selected questions through controlled interview. Acquired statements were written into the printed forms. It was focused on particicipant's socio-demographic characteristics, his relationship to the blood pressure measurement; occurrence of risk factors of arterial hypertension, it means atherosclerosis; disease in the anamnesis and the usage of drugs including food supplements. The results of blood...

Background Pulmonary arterial hypertension (PAH) is a rare progressive disease with no known cure. Of various aetiologies, PAH in association with connective tissue disease (PAH-CTD) is the most rapidly progressive and difficult to treat. Management of PAH has evolved significantly in the past ten years since the introduction of oral therapies. Evidence for the efficacy of these agents outside randomised controlled trials is limited, but guidelines exist. Aim To measure the impact of first-line monotherapy with bosentan or sildenafil and the introduction of prescribing guidelines on outcomes in PAH-CTD. Methods Following a retrospective analysis of consecutive, incident, treatment-naive PAH-CTD cases identified by the ASPIRE registry, influences on outcome measures have been compared. First-line monotherapy episodes for 247 patients was analysed against four distinct endpoints: change in exercise capacity, WHO functional class, time on monotherapy and all-cause mortality. Results Treatment with bosentan or sildenafil resulted in clinical stability at 2 years for nearly 1/4 patients. No difference was identified between the groups in terms of either exercise capacity or WHO functional class. Sildenafil patients were found to remain on monotherapy longer than those prescribed bosentan. Patients prescribed sildenafil have improved survival over those treated with bosentan. Unexpected baseline differences in between groups may confound the results as the haemodynamics of the bosentan patients were more severe. Conclusions A significant number of patients with PAH-CTD remain clinically stable on monotherapy at 2 years. Both agents seem equally effective in this aggressive form of PAH. A novel endpoint “TOM” may be of value in future research assessing response to treatment.