Hipertensión arterial

Características Clínicas de Pacientes Hipertensos hospitalizados con y sin Enfermedad Cerebrovascular de 60 a 90 años en Quito, Ecuador: Estudio de Casos y Controles. Clinical Characteristics of hospitalized Hypertensive Patients with and without Stroke aged 60 to 90 years in Quito, Ecuador: A Case-Control Study.

Background: Stroke is the world’s second leading cause of death from disease, and disability-adjusted life years. The investment in management of a hospitalized stroke patient generates a high healthcare cost. In Ecuador it is the third leading cause of death. Hypertension is one of the most important factors in the stroke development. Patients with high blood pressure and stroke have a higher risk of complications, mortality and poor prognosis.

Objective: The present study aimed to identify which variables differ between hypertensive patients with stroke versus hypertensive patients without stroke, hospitalized, during 2017- 2020.

Methods: In a population of 96 cases and 57 controls, a retrospective analytical cohort study between two groups of patients was conducted.

Results: The variable education (primary education) was the most affected among cases (χ²=13.298; p=0.039). Patients with atrial fibrillation were significantly higher in the case group (χ²=7.31 p=0.007). Other variables like: sex, age, provenance, years lived with hypertension, smoking, type 2 diabetes mellitus, heart failure, hypercholesterolemia and anticoagulant therapy, showed no significant difference between the two groups.

Conclusions: Patients with complete primary education and atrial fibrillation had significant presence in hypertensive patients with stroke.

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Palabras clave: comorbilidades, enfermedad cerebrovascular, enfermedades cardiovasculares, Factores de riesgo, Hipertensión arterial, síndrome metabólico,

Keywords: Arterial hypertension, cardiovascular diseases, Comorbidity, metabolic syndrome, Risk factors, stroke,

Limited value of blood pressure levels in predicting white matter hyperintensities progression among community dwelling older adults living in a rural setting. Utilidad limitada de los niveles de presión arterial como predictor de progresión de hiperintensidades de sustancia blanca en adultos mayores que viven en un entorno rural

Introduction: This study aims to assess the impact of blood pressure (BP) on progression of white matter hyperintensities (WMH) of presumed vascular origin in community-dwelling older adults living in rural Ecuador.

Methods: Atahualpa residents aged ≥60 years receiving baseline and follow-up brain MRIs after a median of 6.5 years were included. Multilevel logistic regression models, which accounted for WMH severity at baseline, were fitted to assess the risk of WMH progression according to BP levels and other covariates.

Results: Analysis included 263 participants. WMH progression increased 3.45 times (95% C.I.: 1.94 – 4.96) among non-hypertensive individuals but 6.15 times (95% C.I.: 3.18 – 9.12) among those with arterial hypertension. However, overlapping of confidence intervals make such difference non-significant. Likewise, no differences in WMH progression were noticed when steady and pulsatile components of BP were used as independent variables.

Conclusions: High BP is not an independent predictor of WMH progression in the study population.