Frequency of hypertension in chronic Chagas' disease: retrospective clinical study

Gurgel, Cristina Brandt Friedrich Martin; Miguel, Armando; Mendes, Clayde Regina; Zerbini, Carolina Okada; Carcioni, Thiago Mussato

doi:10.1590/s0066-782x2003001400001

Cited by 14 publications

(13 citation statements)

References 4 publications

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“…Systemic arterial hypertension can affect about 30% of inhabitants in areas where Chagas' disease is endemic 11 and it may also compromise about 33% of Chagas' disease patients 12 . Chronic heart failure can affect 8% of patients with both conditions 12 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the six-minute walk test in patients with chronic heart failure associated with Chagas' disease and systemic arterial hypertension

Dourado

Bestetti

Cardinalli-Neto

et al. 2010

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: To evaluate physical capacity as determined by the six-minute walk test (6MWT) in patients with chronic heart failure due to Chagas' disease associated with systemic arterial hypertension (Chagas-SAH). METHODS: A total of 98 patients routinely followed at the Cardiomyopathy Outpatient Service were recruited. Of these, 60 (61%) were diagnosed with Chagas disease and 38 (39%) with Chagas-SAH. RESULTS: The distance walked during 6 min was 357.9 ±98 m for Chagas-SAH patients and 395.8 ± 121m for Chagas cardiomyopathy patients (p >0.05). In patients with Chagas-SAH, a negative correlation occurred between the 6MWT and the total score of the Minnesota Living with Heart Failure Questionnaire (r= -0.51; p=0.001). No other correlations were determined between 6MWT values and continuous variables in patients with Chagas-SAH. CONCLUSIONS: The results of the 6MWT in Chagas-SAH patients are similar to those verified in Chagas cardiomyopathy patients with chronic heart failure. Coexistence of SAH does not seem to affect the functional capacity of Chagas cardiomyopathy patients with chronic heart failure.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the six-minute walk test in patients with chronic heart failure associated with Chagas' disease and systemic arterial hypertension

Dourado

Bestetti

Cardinalli-Neto

et al. 2010

Rev. Soc. Bras. Med. Trop.

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“…Guariento et al aimed to define the association between Chagas disease and primary arterial hypertension and concluded that, when associated, cardiac compromise was more frequent and serious, this association being more prevalent in the elderly 17 . Gurgel et al retrospectively studied 225 hypertensive patients with Chagas' disease to verify the frequency of SAH in that group, and found similarity with the population in general 9 . In a clinical and anatomopathological study, Gurgel and Almeida also evaluated the frequency of SAH in patients with Chagas' disease, obtaining similar results to the previous study and concluding that the association of the 2 illnesses did not alter the natural history of either 8 .…”

Section: Ethical Considerationsmentioning

confidence: 97%

“…Overall variation in blood pressure before and after the exercise program, during wakefulness and sleep were described in Figures 1, 2, and 3, respectively. The damage to the autonomic nervous system stands out amongst the alterations described in chronic Chagas' heart disease, with a predominance of dysfunction of the parasympathetic system 14,15 , enabling sympathetic system activity, which could contribute to the development of arterial hypertension 8,9 . On the other hand, the action of physical exercise attenuating sympathetic activity 15,16 has been described, which make it necessary a study on the effect of physical exercise on the variation of blood pressure in this group of people.…”

Section: Ethical Considerationsmentioning

confidence: 99%

“…Some studies have shown elevated blood pressure levels in the population with Chagas' disease 18 , while other authors have shown that Chagas' disease patients seem to have the same propensity as the general population to develop arterial hypertension 8,9,19,20 ; still others, mainly in Argentina, have reported a decrease in blood pressure compared to the general population [21][22][23] . Ianni et al observed a group of 160 patients with the indeterminate form of Chagas' disease for up to 177 months, and reported that SAH was the most frequent cardiovascular illness 20 .…”

Section: Ethical Considerationsmentioning

confidence: 99%

“…The social cost is high as it is responsible for around 40% of cases of early retirement 7 . It is believed that its prevalence in patients with Chagas' disease is similar to that of the general population 8,9 , despite the neuronal damage associated with the illness, which is responsible for an imbalance in the autonomic nervous system, causing greater sympathetic activity that could influence the genesis of arterial hypertension 8,9 . With this theory in mind, research into the link between arterial hypertension and chronic Chagas' heart disease is considered relevant.…”

Section: Introductionmentioning

confidence: 99%

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Effects of an exercise program on blood pressure in patients with treated hypertension and chronic Chagas' heart disease

Oliveira

Sousa

Santos

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction: Previous studies describe an imbalance of the autonomic nervous system in Chagas' disease causing increased sympathetic activity, which could influence the genesis of hypertension. However, patients undergoing regular physical exercise could counteract this condition, considering that exercise causes physiological responses through autonomic and hemodynamic changes that positively affect the cardiovascular system. This study aimed to evaluate the effects of an exercise program on blood pressure in hypertensive patients with chronic Chagas' heart disease. Methods: We recruited 17 patients to a 24-week regular exercise program and used ambulatory blood pressure monitoring before and after training. We determined the differences in the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) from the beginning to the end of the study. Results: The blood pressures were evaluated in general and during periods of wakefulness and sleep, respectively: SBP (p = 0.34; 0.23; 0.85), DBP (p = 0.46; 0.44; 0.94) and MBP (p = 0.41; 0.30; 0.97). Conclusions: There was no statistically significant change in blood pressure after the 24-week exercise program; however, we concluded that physical training is safe for patients with chronic Chagas' disease, with no incidence of increase in blood pressure.

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Determination of the Th1, Th2, Th17, and Treg cytokine profile in patients with chronic Chagas heart disease and systemic arterial hypertension

Bestetti

Dellalibera-Joviliano

Lopes

et al. 2018

Heart Vessels

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Chronic Chagas heart disease (CCHD affects about 30% of patients with chronic Chagas disease (CCD). Systemic arterial hypertension (SAH) afflicts about 25% of patients with CCD. The association of CCHD with SAH (CCHD-SAH) predisposes patients to develop chronic heart failure. The role of cytokines in disease progression in patients with CCHD-SAH is unknown. Accordingly, the aim of this study was to evaluate the plasma levels of cytokines expressing the Th1, Th2, Th17 pattern, as well as Treg cytokines, TNF-alpha, IL-1β, IL-8, IL-7 in patients with SAH-CCHD to get insight into the immunomodulation process in patients with this condition. Fifteen patients with CCHD, 22 patients with CCHD-SAH, and 28 controls were studied. All patients underwent history-taking, physical examination, 12-lead resting ECG, chest X-ray, and Doppler-echocardiogram. Ten of 15 (66%) patients with CCHD, and 16 of 22 (73%) patients with CCHD-SAH had decreased left ventricular ejection fraction (p > 0.05). Cytokines levels were performed on plasma samples using the ELISA method. Overall, proinflammatory, anti-inflammatory, and regulatory cytokine levels were increased in patients with CCHD-SAH in comparison to patients with CCHD and controls. However, such a difference was higher regarding IL-2, IL-5, IL-17, IL-12, and TNF-alpha cytokine levels, respectively. Cytokine levels were higher in CCHD patients in comparison to controls. Patients with CCHD-SAH have increased plasma levels of pro-inflammatory, anti-inflammatory, and regulatory cytokines in comparison with CCHD patients, thus suggesting a higher level of immunomodulation in patients with CCHD-SAH.

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Frequency of hypertension in chronic Chagas' disease: retrospective clinical study

Abstract: Chagasic patients had a frequency of hypertension similar to that of the general population, and the clinical profile of the hypertensive chagasic patients seemed not to differ a lot from that of the chagasic patients.

Cited by 14 publications

References 4 publications

Evaluation of the six-minute walk test in patients with chronic heart failure associated with Chagas' disease and systemic arterial hypertension

Evaluation of the six-minute walk test in patients with chronic heart failure associated with Chagas' disease and systemic arterial hypertension

Effects of an exercise program on blood pressure in patients with treated hypertension and chronic Chagas' heart disease

Determination of the Th1, Th2, Th17, and Treg cytokine profile in patients with chronic Chagas heart disease and systemic arterial hypertension

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