KeywordsCentral blood pressure hypertension risk factors evidence-based practice A B S T R A C T Background: Central blood pressure values and arterial stiffness have demonstrated to be a useful tool to stratify cardiovascular risk and also as a biomarker. A question that is still unanswered is if hypertension treatment guided by central blood pressure parameters will be even better to promote cardiovascular protection than peripheral one. Methods: With this proposition we have designed an open prospective multicentric randomized protocol to compare central (G1) and peripheral (G2) blood pressure targets during 1 year follow-up concerning target organ damage (carotid intima media thickness, left ventricular hypertrophy, microalbuminuria and pulse wave velocity). OMRON 1100 will be used to access peripheral and Mobil O'Graph to access central blood pressure and pulse wave velocity, TOSHIBA Xsario with longitudinal linear transdutor 7.5 MHz bidimensional mode B to access carotid and left ventricular parameters. Expected Results: This paper aims to describe methodological aspects concerning this research and we expect to find results to answer some open questions about hypertension treatment and cardiovascular protection.
RESUMOO transplante de Medula Óssea é marcado por uma série de empecilhos que interferem no número de doadores, precisando assim de intervenções. Assim, a Liga de Transplantes FM-UFG (LT-FMUFG) atua em campanhas abertas ao público, levando informações e esclarecendo dúvidas, buscando desconstruir mitos e apresentar uma visão humanitária da doação de órgãos. Contudo, com a pandemia do COVID-19 essas campanhas não ocorreram, impactando no número de doadores. Nesse sentido, faz necessário demonstrar os impactos causados pela pandemia no número de doadores de medula óssea. Para isso realizou-se estudo observacional longitudinal retrospectivo de dados secundários fornecidos pelo REDOME, os quais foram relacionados às atividades de extensão da LT-FMUFG. Observou-se um decréscimo de 40,4% e 31,2% no país e no estado de Goiás, respectivamente, em relação a 2019 nos cadastros de doadores de medula óssea. A pandemia influenciou essa redução ao criar um contexto de isolamento social e dificultar a realização de campanhas que conscientizem e incentivem as doações. É através de campanhas que a população consegue informações sobre o processo de doação e cadastro.
Objective: Identify from which PWV value, there is a greater possibility of identifying association with the presence of left ventricular hypertrophy (LVH), increased intima-media thickness (IMT) and presence of carotid plaque in hypertensive patients. Design and method: This is a cross-sectional study of 119 patients. ROC curves were performed for each cardiovascular biomarker. The analyses were performed considering the significance level of 0.05. Results: ROC curves were performed for each cardiovascular biomarker and the PWV values of 8.1m/s for LVH, 8.2m/s for increased IMT and 8.7 for the presence of carotid plaque were found, respectively. The PWV value of 8.2m/s identified the best parameter to find the three TOD outcomes. PWV above 8.2ms was associated with increased IMT (p = 0.004), with the presence of carotid plaque (p = 0.003) and with LVH (p<0.001). PWV above 8.2 showed greater sensitivity for IMT (AUC = 0.678, sensitivity 62.2), LVH (AUC = 0.717, sensitivity 87.2) and presence of plaque (AUC = 0.649, sensitivity 74.51) in the ROC curve. Conclusions: The 8.2m/s value is more sensitive in identifying the existence of cardiovascular biomarkers prematurely.
Objective:Objetive: The number of asymptomatic hypertensive patients who already have subclinical injuries in the early stages of hypertensive disease is high and, generally, they are not identified by the traditional evaluation model. The use of Pulse Wave Velocity (PWV) in addition to traditional cardiovascular risk factors can improve risk stratification. The present study intends to perform the reclassification of cardiovascular risk according to the median Pulse Wave Velocity (PWV) and correlate PWV with the intima-media thickness, with the left ventricular (LV) mass indexed and with microalbuminuria.Design and method:Design and method:Multicenter analytical cross-sectional study of patients undergoing measurement of central and peripheral blood pressure parameters between October/2018 and March/2019. Intima-media thickness (IMT) and presence of carotid plaque, left ventricular mass indexed and microalbuminuria were also evaluated. Fisher’s test was applied to verify the association of cardiovascular risk reclassification by median PWV. Spearman’s correlation was used to correlate PWV with intima-media thickness, presence or absence of carotid plaque, microalbuminuria and indexed left ventricular mass. A significance level of 5% was adopted.Results:Results:126 patients were evaluated, with a mean age of 60.58 ± 10.51 years and 87 (69.95%) are women. When reclassified, there was an increase in the frequency of patients who moved from medium to high risk (p<0.001). A weak and positive correlation was identified between PWV and LV mass indexed (r = 0.304, p < 0.001) and with IMT (r = 0.30, p < 0.001).Conclusions:Conclusions: The application of median PWV values is a simple and effective tool to reclassify intermediate-risk individuals to high-risk.
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