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Curva j e hipertension arterial

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Curva j e hipertension arterial

  1. 1. CURVA J HIPERTENSION Argumentos en Contra ? Dr. Daniel Meneses Jefe Hemodinámica Hospital Metropolitano “Vivian Pellas” Managua. Nicaragua
  2. 2. APERTURA ESTABILIDAD
  3. 3. 0 mmHg Blood Pressure 200 mmHg CV Disease
  4. 4. 1 000 000 POR 14 AÑOS
  5. 5. All-cause mortality, CVD, and cancer mortality were highest in the low-DBP group (<75 mm Hg). Thus, comorbidities such as cancer and thus low weight and hypotension were the confounding factors that obscured the true relationship of BP and mortality.
  6. 6. HOTSlim Jim /NK/114/05/20041HypertensionOptimalTreatmentInternational StudyHypertensionOptimalTreatmentInternational StudyHOTHOTStudy resultsStudy results
  7. 7. 0 80 85 90 95 100 105 0 3 6 12 24 36 Final follow-up 74% 43% DBP mm Hg target 80 mm Hg 86% 73% 55% target 85 mm Hg target 90 mm Hg HOT - Target blood pressure is an achievable goal (% patients reaching target) 60% Hansson et al 1998 Months
  8. 8. Risk of a major cardiovascular event reduced by 30% in the HOT Study 0 5 10 15 20 25 30 105 100 95 90 85 % risk reduction Optimal DBP reduction in the HOT Study Hansson et al 1998 Achieved DBP mm Hg 80
  9. 9. Vaccarino V, Holford TR, Krumholz HM. Pulse pressure and risk for myocardial infarction and heart failure in the elderly. J Am Coll Cardiol 2000;36:130–8.
  10. 10. 1.LA CURVA J ESTA PRESENTE EN MUCHOS ESTUDIOS DE HIPERTENSION ARTERIAL RELACIONANDO MORTALIDAD CARDOVASCULAR CON PRESION DIASTOLICA 2. LA CURVA J ES MAS COMUN EN PACIENTES CON ENFERMEDAD ATEROSCLEROTICA AVANZADA 3. LA CAUSA DE ESTA CURVA ES AUN CONTROVERSIAL PORQUE LOS ESTUDIOS NO HAN SIDO DISEÑADOS EXPRESAMENTE PARA ESTUDIAR ESTA RELACION 4.DEBE BUSCARSE REDUCIR LA PRESION SISTOLICA DEBAJO DE 140 mmHg Y LA DIASTOLICA DEBAJO DE 90 mmHg EN LOS PACIENTES DE ALTO RIESGO SIN IR “ MAS BAJO MEJOR”

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