Detección de lesión de órgano diana y rigidez arterial mediante monitorización de la presión arterial en 24 horas y frecuencia cardiaca en pacientes hipertensos

[EN] Cardiovascular disease is the leading cause of morbidity and mortality in developed countries and high blood pressure is the main risk factor for its occurrence. It is responsible for 54 % of strokes and 47% of ischemic heart disease and a delay in diagnosis and treatment , leads to the appearance of lesions in target organs. The renal target organ injury is evaluated with serum creatinine , glomerular filtration rate or microalbuminuria ; heart with left ventricular hypertrophy and left ventricular mass ínidice and in the vascular structure is evaluated intima thickness media thickness and ankle -brachial index , or function with the speed of the pulse wave , pulse pressure , the ambulatory arterial stiffness index and indices of central and peripheral increase . Increased ambulatory arterial stiffness index is associated with an increased presence of vascular organ damage , heart and kidney in patients with hypertension regardless of whether or not to take antihypertensive drugs. Variability is an inherent characteristic of blood pressure. It can be obtained from ambulatory blood pressure monitoring in 24 hours. In hypertensive patients, tested both with the standard deviation and the coefficient of variation is associated with arterial stiffness assessed by the speed of the pulse wave . However, ambulatory blood pressure monitoring is more accessible in the clinic that the determination of the velocity of pulse wave , therefore , the evaluation of the variation in blood pressure (24 hours , day and night ) can be useful for assessing arterial stiffness. With respect to heart rate, there is no consensus on what value is beneficial . Variability is defined as the variation of the heart beat frequency in a time period and can be calculated , with the standard deviation and coefficient of variation , from the monitoring records ambulatory blood pressure . Both clinical and ambulatory heart rate and corresponding standard deviations , are inversely associated with markers of arterial stiffness , except with the pulse wave velocity , which has direct association . Elevated ambulatory heart rate and its variability , but not clinical , have been associated with decreased intima-media thickness of the carotid artery and increased glomerular filtration rate . However, this association disappeared after adjustment for age.

Author

• García García, Ángel

• Academic dissertations
• Internal medicine
• High blood pressure
• Tesis y disertaciones académicas
• Universidad de Salamanca (España)
• Medicina interna
• Hipertensión

Identifier

hdl:10366/122989

OAI identifier oai:identifier

oai:gredos.usal.es:10366/122989