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El presente trabajo de investigación es de tipo descriptivo, tiene como objetivo general determinar el nivel de conocimientos de los adultos mayores sobre prevención de hipertensión arterial en un centro de salud, Lima, 2014. La muestra estuvo conformada por 30 pacientes que no eran hipertensos a quienes se les aplicó un instrumento: entrevista para valorar su nivel de conocimientos sobre prevención en hipertensión arterial en adultos mayores. En lo que respecta a los resultados luego de procesarlos se obtuvó que la población adulta mayor, la mayoría son de sexo femenino con la que se trabajó la mayoría son de raza mestiza, mayormente tienen grado de instrucción primaria completa, tiene un mayor conocimiento de su peso y por último la mayoría conoce los valores de su presión arterial y que existe un mayor nivel de conocimiento de 80% (24) tienen un nivel de conocimiento medio y un menor nivel conocimiento de 6,6% (2) de un conocimiento bajo.

Objetivo General: determinar cuál es la asociación del Índice de Masa corporal y la circunferencia de cintura con la presión arterial en escolares de 6-11 años de dos I.E. Privadas del distrito de Santa Anita - Lima, 2016. Metodología: Es un estudio observacional tipo analítico de corte transversal, en un enfoque cuantitativo. La recolección de datos se hizo con la ayuda de una ficha de recolección de datos en la cual se obtuvo datos generales, medidas antropométricas y presión arterial de escolares de dos I.E. Privadas del distrito de Santa Anita - Lima, 2016. La muestra estuvo representada por 376 escolares de nivel primario, entre 6 - 11 años de edad cumplidos pertenecientes a los 2 colegios privados: Juan Espinoza Medrano y John Dalton. A todos ellos se les tomó el peso, la tala, la circunferencia de cintura y la presión arterial, y los datos obtenidos fueron analizados con las tablas de percentiles para cada variable respectivamente. Resultados: Se encontró una prevalencia de 23,4% de circunferencia de cintura aumentada (obesidad central), según el índice de masa corporal se encontró una prevalencia del 38% de obesidad y con respecto a la presión arterial, una prevalencia de 18,1% de hipertensión estadío 1 y 14,1% de hipertensión estadío 2. El aumento del índice de masa corporal es un factor de riesgo de hipertensión y prehipertensión arterial ya que se obtuvo un p= 0,000, OR = 8,329 (IC: 95%; inferior 4,858 y superior 14,282) y el aumento de la circunferencia de cintura es un factor de riesgo de hipertensión y prehipertensión arterial ya que se obtuvo un p= 0,000; OR = 7,003 (IC: 95%; inferior 3,671 y superior 13,360). Conclusión: Existe asociación entre el índice de masa corporal y la circunferencia de cintura con la presión arterial en escolares de 6 – 11 años de edad de dos instituciones educativas privadas del distrito de Santa Anita – Lima 2016, ambas variables son factores de riesgo para desarrollar hipertensión y prehipertensión arterial en la población estudiada.

La hipertensión arterial (HTA) es una de las enfermedades crónicas de mayor incidencia a nivel mundial que produce importante mortalidad y discapacidad. Objetivo: evaluar el efecto del uso de dispositivos de telefonía móvil en la adherencia al tratamiento de hipertensión arterial. Materiales y métodos: estudio de intervención cuasiexperimental, de antes y después; en el cual se entrevistó a pacientes que pertenecían a un programa ambulatorio de enfermedades crónicas, y se pidió llenar el cuestionario Martín-Bayarre-Grau para determinar su adherencia al tratamiento antihipertensivo antes y después de la intervención. Resultados: se realizó un análisis bivariado, en donde se comparó la variable adherencia al tratamiento antes y después de la intervención de los cuatro grupos del estudio; encontrándose solo una diferencia significativa en el grupo al cual se le enviaron 8 mensajes al mes (p= 0,011). También se comparó después de los 3 meses a los grupos sometidos a intervención versus el grupo control, hallándose una diferencia significativa en el grupo al cual se le enviaron 8 mensajes al mes (p= 0,022). Conclusiones: el uso de dispositivos móviles demostró mejorar la adherencia al tratamiento en la población de estudio, sobre todo en el grupo que recibió mayor frecuencia de mensajes de texto. / Tesis

Title: Analysis of Pharmacotherapy by patients with diagnosis of arterial hypertension Student: Vasiliki Kontou Tutor: Prof. RNDr. Jiri Vlcek, CSs Department of Social and Clinical Pharmacy, Charles University of Prague, Faculty of Pharmacy in Hradec Kralove Introduction: Arterial Hypertension (AH) is characterized by elevated blood pressure, which often leads to increased morbidity and mortality. AH divided into primary and secondary. Aim: In the theoretical part the aim is to analyse the etiopathogenesis, methods of diagnosis and the treatment strategies of arterial hypertension in the recent literature. In the experimental part the aim is to analyse the provisions of the above diagnosis of arterial hypertension. Method: During a six month period were collected 58 prescriptions with the diagnosis of arterial hypertension from a pharmacy that provided pharmaceutical care in the Greek village, Mytikas. Only one prescription for one patient was analysed. In the prescriptions were collected data on drugs, patients and physicians. Results: The pilot study included 58 prescriptions. Most patients were elderly, over 65 years old and 30% were in age 71 - 80 years. General practitioners prescribed 65% of the medical prescriptions. Most frequently prescribed ARBs with hydrochlorothiazide drugs (27%) and...

Mon projet porte d'une part sur le rôle de la voie TGF-b/Alk1 dans l’hypertension artérielle (HTAP) humaine et expérimentale. Le but est d’évaluer in vitro (i) l’expression du TGF-b et de ses récepteurs ALK1/Endogline dans les cellules endothéliales d’artères pulmonaires (CE-AP) de patients atteints d’HTAP idiopathique (HTAPi), (ii) les conséquence de l’activation de la voie TGF-b/ALK1 des CE-AP dans la synthèse de facteurs capables d’induire la prolifération des cellules musculaires lisses d’artères pulmonaires (CML-AP), (iii) identifier par une analyse protéomique différentielle la nature de ses facteurs paracrines, (iv) évaluer chez la souris la conséquence de la déficience en Endogline, co-récepteur de ALK1 sur le développement de l’hypertension artérielle pulmonaire. / My project relates to the role of the TGF-b/Alk1 pathway in human and experimental pulmobnary arterial hypertension (PAH). The goal is to evaluate in vitro (I) the expression of TGF-b and its receptors ALK1/Endoglin in pulmonary arterial endothelial (P-EC) of patients reached of idiopathic PAH (iPAH), (II) the consequence of the activation of the TGF-b/ALK1 pathway on the P-EC in the synthesis of factors able to induce the proliferation of the pulmonary arterial smooth muscle cell (PA-SMC), (III) to identify by a differential proteomic analysis the nature of its factors paracrines, (iv) to evaluate in the mouse the consequence of deficiency in Endoglin (co-receptor of ALK1) on the development of PAH.

Arterial variants, defined as atypical presentations of anatomy including aberrant origin, course, and branching pattern, are important to be aware of because of their effects in the clinical setting as well as their possible link to pathology. Much research has already been done focusing on specific arterial variants in a specific region in the body. However, more research is needed to determine if there is a relationship between arterial variants in different regions of the body. The purpose of this study is to examine the whole-body arterial system of body donors in order to assess if there is a relationship between the presence of arterial variants in one region of the body to the other. The entire arterial system of twenty-five formalin fixed body donors was examined for the presence of arterial variants. The data was separated into two main categories, central variants (e.g. arch of the aorta, unpaired abdominal aortic branches) and peripheral variants (e.g. upper and lower extremities). The relationship between the central and peripheral variants was determined using quantitative observation, specifically, by examining the percent frequency of cases where arterial variants were co-occurring. Of the body donors examined, all were found to have at least one arterial variant, with an average of 8.7 variants per body. Arterial variants were most commonly found in the foregut with prevalence of 80%, the midgut (68%), left subclavian (60%), right upper extremity (52%), and the left upper extremity (48%). Of the central arterial variants, a percent frequency of 20% was found for the arch of the aorta, 20% for the coronary artery, 12% for the hindgut, 28% for the right renal, and 28% for the left renal. For the peripheral variants, the percent frequencies were as follows: brain variants were 4%, right carotid 8%, left carotid 0%, right subclavian 28%, left upper extremity 40%, right suprarenal 24%, left suprarenal 12%, right phrenic 24%, left phrenic 12%, gonadal 4%, right iliac 40%, left iliac 32%, and right lower extremity 40%. Examination of the relationship between central variants and peripheral variants reveals that the most common arterial variants to occur in tandem in the sample were those of the variant foregut with variants of the left subclavian artery (52% of cases), the upper and lower extremities (36-44% and 40-44% of cases, respectively), and the right iliac artery (36% of cases). The most common central arterial variants to co-occur were the variants of the foregut and midgut observed in 64% of cases. The frequency of cases involving normal central anatomy and variant peripheral anatomy indicates that vascular variants in the periphery are likely unrelated to variants in the central body cavities. However, it does seem like there are “hot spots” for arterial variants to occur, including the foregut, midgut left subclavian artery, right and left upper extremities, the right iliac artery, and the right and left lower extremities. Although there was no discernable pattern found between vascular variants in the present study, that does not preclude the possibility that there is a significant relationship between certain vascular variants. Either way, the high prevalence of cases with multiple arterial variations suggests that they may be more likely to occur than previously thought.

O exercício resistido dinâmico é recomendado, em complemento ao aeróbico, para indivíduos hipertensos. O aumento da pressão arterial durante sua execução se faz, primordialmente, pelo aumento da resistência vascular periférica, porém o aumento do débito cardíaco também parece estar envolvido. A elevação da pressão arterial parece ser exacerbada em hipertensos não medicados. Entretanto, grande parte dos hipertensos está sob terapêutica medicamentosa e vários fazem uso de -bloqueadores, que reduzem o débito cardíaco pela diminuição da resposta taquicárdica e inotrópica à estimulação simpática. Assim, é possível supor que o uso de -bloqueadores reduza o aumento da pressão arterial nos exercícios resistidos. Porém, pelo nosso conhecimento, este efeito ainda não foi estudado. Assim, esta investigação teve por objetivo investigar o efeito do atenolol sobre a resposta da pressão arterial durante o exercício resistido de diferentes intensidades. Foram estudados 10 hipertensos essenciais com pressão arterial sistólica/diastólica sob placebo entre 140 e 160/90 e 105 mmHg. Os pacientes foram estudados após 6 semanas de uso de placebo e de atenolol, sendo que os indivíduos estavam cegos para a medicação. Em cada fase, os voluntários fizeram o exercício de extensão de joelhos na cadeira extensora até a exaustão, seguindo 3 protocolos realizados em ordem aleatória: a) uma série em 100% de 1RM (repetição máxima), b) três séries em 40% de 1RM e; c) três séries em 80% de 1RM. Antes, durante e após os exercícios, a pressão arterial foi medida diretamente na artéria radial. Os dados foram comparados pelo teste t student ou pela ANOVA de dois fatores para amostras repetidas. Quando necessário, foi utilizado o post-hoc de Newman-Keuls e aceito como significante o índice de P≤0,05. Verificou-se que o atenolol reduziu os valores absolutos atingidos pela pressão arterial sistólica durante a execução do exercício nas três intensidades (valores máximos: 100% = 186±4 vs. 215±7, 80% = 224±7 vs. 247±9 e 40% = 223±7 vs. 252±16, mmHg, P≤0,05). Além disso, ele reduziu o aumento desta pressão arterial na 1ª série do exercício nas 3 intensidades (100% = +38±5 vs. +54±9; 80% = +68±11 vs. +84±13 e 40% = +69±7 vs. +84±14, mmHg, P≤0,05). Em relação à pressão arterial diastólica, o atenolol diminuiu os valores máximos absolutos e o aumento desta pressão arterial (126±6 vs. 145±6 e +41±6 vs. +52±6, mmHg, P≤0,05) no exercício em 100% de 1RM, mas não a alterou nas demais intensidades. Dessa forma, é possível concluir que o atenolol foi eficaz em atenuar tanto o valor absoluto quanto a resposta da pressão arterial sistólica durante o exercício resistido de diferentes intensidades em hipertensos, conferindo-lhes uma certa proteção cardiovascular. Este achado reforça o conceito de que o aumento do débito cardíaco é um mecanismo importante para o aumento da pressão arterial sistólica durante este tipo de exercício / Dynamic resistance exercise is recommended in association to aerobic exercise for hypertensive patients. Blood pressure increase during this kind of exercise is mainly due to an increase in peripheral vascular resistance, however, an increase in cardiac output might also be involved. This blood pressure increase seems to be exacerbated in non-medicated hypertensives. Nevertheless, most of the hypertensives are taking medications, and some of them are receiving -blockers, which decreases cardiac output by the inhibition of sympathetic-induced increase on heart rate and cardiac contractility. Thus, -blockers might decrease blood pressure rise during resistance exercise which, to our knowledge, has not been studied yet. Hence, the aim of this study was to verify the effects of the selective -blocker atenolol on blood pressure increase during dynamic resistance exercise of different intensities. Ten essential hypertensives with systolic/diastolic blood pressures under placebo condition maintained among 140 and 160/90 and 105 mmHg were recruited. These volunteers were studied after 6 weeks of placebo and atenolol treatment, and they were blinded for the medication used. In each phase, the volunteers executed, in a random order, 3 protocols of knee extension exercise until fatigue: a) 1 set at 100% of 1 repetition maximum (1RM); b) 3 sets at 40% of 1RM; c) 3 sets at 80% of 1RM. Before, during and after the exercises, intra-arterial radial blood pressure was measured. Data were compared by paired student t-test and by two-way ANOVA for repeated measures. Newman-Keuls post-hoc test was applied when necessary. P≤0.05 was considered as significant. Atenolol decreased the absolute value achieved by systolic blood pressure during the exercise performed at the 3 intensities (maximum values: 100% = 186±4 vs. 215±7, 80%= 224±7 vs. 247±9 e 40% = 223±7 vs. 252±16, mmHg, P≤0.05). Moreover, atenolol also reduced systolic blood pressure increase in the first set of exercise at the 3 intensities (100% = +38±5 vs. +54±9; 80% = +68±11 vs. +84±13 e 40% = +69±7 vs. +84±14, mmHg, P≤0.05). In regard to diastolic blood pressure, atenolol decreased its absolute values and its increase during exercise performed at 100% of 1RM (126±6 vs. 145±6 e +41±6 vs. +52±6, mmHg, P≤0.05), but it did not change diastolic blood pressure at the other exercise intensities. In Conclusion, atenolol therapy was effective in reducing both, systolic blood pressure absolute values and increase during resistance exercise of different intensities in hypertensive subjects; given them some cardiovascular protection. This result enhances the belief that cardiac output increase is important for blood pressure enhancement during this kind of exercise

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