López CSM, Carranza MJ

Language: Spanish
References: 11
Page: 95-100
PDF size: 177.87 Kb.

ABSTRACT

Background: The appearance of the prehypertension group in the classification of the JNC-VII has been justified on the basis of not considering these subjects as normal but evaluating its cardiovascular risk in an integral way.
Objetive: To determine the clinical, metabolic and vascular characteristics of the prehypertensive (PH) subjects in comparison with normotensive (NT) ones.
Patients and method: Seventy-one PH and 83 NT were detected and they were featured for: sex, age, weight, height, BMI, record of cardiovascular risk factors, comorbidities and their treatments, clinical chemistry, fasting and postprandial glycemia, fasting insulin, lipid profile, microalbuminuria and waist perimeter. The insulin resistance was calculated by means of the Homeostatic Method Assessment (HOMA). They were measured with vascular ultrasound the carotid intima-media thickness to a centimeter of their bifurcation and the endothelial function was evaluated through measuring the caliber of the humeral artery before and after mechanic stimulation of the endothelium.
Results: Fourty-one percent of the PH and 34.6% of the NT were men, the main differences between PH and NT were: age 51.4±13.7 and 44.6±14.2, BMI 28.3±4.5 and 26.8±4.9, waist 95.8±10.9 and 89.7±12.6 cm, HOMA 3.51±2.1 and 2.6±2.2, uric acid 5.65±6.09 and 3.6±1.5 mg/dL, C-HDL 48.2±15.3 and 55.1±25.5 mg/dL, C-LDL 113.4±33.4 and 127.7±43 mg/dL, all significant ones (p ‹ 0.05). The PH regarding the NT had resistance to the insulin (RI) 65.2 vs 44.8%, hypertriglyceridemia 46 vs 41.7%, hypoalphalipoproteinemia 34 vs 29.4%, microalbuminuria 13.5 vs 10%, metabolic syndrome for the criteria of the NCEP 21.7 vs 13.7% all significant ones (p ‹ 0.05). The BMI was of 0.67 mm in PH and of 0.53 mm in NT (p ‹ 0.05), the endothelium-dependent dilation of the humeral was of 16.05% in PH and of 20.2% in NT (p ‹ 0.05).
Conclusions: The group of PH seems to be an interim statement in the road toward the diabetes mellitus and cardiovascular events via the metabolic syndrome, with RI and endothelial dysfunction.

REFERENCES

1. Expert Panel on Detection, Evaluation and Treatment of Highn Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP). Expert Panel on Detection, Evaluation and Treatment of High Cholesterol. JAMA 2001;285:2486-97.

2. Seven Report of the Joint Nacional Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Chobaniam AV, Bakris GL, Black HR, Cushman WC, et al and the National High Blood Pressure Education Program Coordinating Committee. Hypertension 2003;42:1206-52.

3. Beevers G, Lip GYH, O’Brien E. ABC of hypertension: Blood pressure measurement. BMJ 2001;322:1110-14.

4. Beevers G, Lip GYH, O’Brien E. ABC of hypertension: Blood pressure measurement. BMJ 2001;322:1167-70.

5. Mather KJ, Hunt AE, Steinberg HO, et al. Repeatability characteristics of simple indices of insulin resistance: implications for research applications. JCEM 2001;86:5457-64.

6. Pollex RL, Spende JD, House AA, Fenster A, et al. A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes. Cardiovasc Ultrasound 2005;3:15.

7. Correti MC, Anderson TJ, Benjamin EJ, et al. Guidelines for ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery. J Am Coll Cardiol 2002;39:257-65.

8. Grundy SM, Cleeman JI, Daniels SR, Donato KA, et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation published online Sep 12, 2005.

9. Velázquez-Monroy O, Rosas-Peralta M, Lara-Esqueda A, Pastelin-Hernández G, Grupo ENSA 2000, Sánchez-Castillo C y otros. Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: resultados finales de la Encuesta Nacional de Salud (ENSA) 2000. Arch Inst Cardiol Mex 2003;73(1):62-77.

10. Lara A, González A, Chassin OA, Arceo M, et al. Herramientas para predecir el riesgo de enfermedades crónicas no transmisibles: un análisis más del Estudio de las Seis Ciudades en México. Med Int Mex 2005;21:266-72.

11. Lemieux I, Pascot A, Couillard C, Lamarche B, et al. Hypertriglyceridemic waist: a marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men? Circulation 2000;102:179-84.