Are lead, cadmium and mercury risk factors for resistant hypertension?

Background: Lead (Pb), cadmium (Cd) and mercury (Hg) are toxic trace elements that represent a public health problem as risk factors for cardiovascular disease and hypertension (HT) and could also contribute to the development of resistant hypertension (rHT) AIMS: To compare the blood concentrations of Pb, Cd and Hg in subjects with resistant and non-resistant HT and to define whether there is a relationship between its levels and rHT.

Methods: Cross-sectional study. Subjects aged ≥ 21 to ≤ 80 years with a body mass index < 40 kg/m2 were recruited on a discretionary basis from October 2001 to October 2004 in a hypertension unit of a tertiary hospital amongst those sent to the hypertension unit by their family physician.

Laparoscopic adrenalectomy vs. radiofrequency ablation for the treatment of primary aldosteronism. A single center retrospective cohort analysis adjusted with propensity score.

Background: Laparoscopic adrenalectomy (LA) is the gold standard treatment for unilateral primary aldosteronism. However, satisfactory results have also been published with radiofrequency ablation (RFA). The aim of this study was to compare LA and RFA for the treatment of primary aldosteronism.

Health perception in menopausal women.

Aim: The aim of this study is to find whether the worsening of health perception was related to the menopausal (MNP) state or to its negative consequences on cardiometabolic risk factors (CMRF) and the presence of depression/anxiety.

Methods: In this study, 2,562 women, 1,357 (53%) MNP and 1,205 (47%) non-MNP, were analyzed. Blood pressure, heart rate, body mass index, waist circumference, and depression/anxiety screening using the Hospital Depression/Anxiety Scale (HADS) were measured.

Effect of intensive multifactorial treatment on vascular progenitor cells in hypertensive patients.

Background: Most hypertensive patients, despite a proper control of their cardiovascular risk factors, have cardiovascular complications, evidencing the importance of controlling and/or reversing target-organ damage. In this sense, endothelial dysfunction has been associated with the presence of cardiovascular risk factors and related cardiovascular outcomes. Since hypertension often clusters with other risk factors such as dyslipemia, diabetes and obesity, in this study we have investigated the effect of intensive multifactorial treatment on circulating vascular progenitor cell levels on high-risk hypertensive patients.

[Primary care evaluation of the hypertensive patient management in specialized care after derivation (DERIVA-2 Study)].

Introduction: To know the opinion/evaluation of the primary care physicians (PCPH) of the received information about patients that were attended in specialized care (SC).

Design: Cross-sectional study.

Location: Performed nationwide in primary care centers.

Primary aldosteronism and its various clinical scenarios.

Background: Primary aldosteronism is the most frequent endocrine cause of secondary hypertension. Aldosterone excess damages the cardiovascular system.

Objectives: We compared biochemical; morphological, and cardiovascular risk differences among hypokalemic and normokalemic primary aldosteronism.

[Evaluation of referral process of the hypertensive patient in Spain: DERIVA study].

Introduction: An adequate communication between levels of medical attention is the key point for optimal treatment and outcomes of the hypertensive population.

Aims: The aim of this study was to evaluate the adequacy of the hypertensive patients' derivation from Primary Care to Specialized Care. As secondary objectives, the information registered on the derivation report was assessed and concordance between derivation reason and final diagnosis was analysed.

Early predictors of gestational hypertension in a low-risk cohort. Results of a pilot study.

Objective: To determine if the clinical or biochemical markers used in pregnancy can be applied as early predictors of gestational hypertension.

Design: Prospective cohort study.

Population: 315 pregnant women referred from the Prenatal Diagnosis Unit between weeks 10-13 of pregnancy and followed up to the childbirth.

Hypertension caused by primary hyperaldosteronism: increased heart damage and cardiovascular risk.

Introduction And Objectives: Primary hyperaldosteronism is the most common cause of secondary hypertension. Elevated aldosterone levels cause heart damage and increase cardiovascular morbidity and mortality. Early diagnosis could change the course of this entity.

Association between urinary albumin excretion and both central and peripheral blood pressure in subjects with insulin resistance.

Background: Central blood pressure (cBP) predicts cardiovascular events. Regarding subclinical organ damage, the relationship between urinary albumin excretion (UAE) and cBP is rather unknown.

Objective: We aimed to determine whether cBP is related to UAE, and if this relationship is stronger than that observed with peripheral blood pressure (pBP).

Management of resistant arterial hypertension: role of spironolactone versus double blockade of the renin-angiotensin-aldosterone system.

Background: Currently there is no consensus regarding which add-on therapy to use in resistant hypertension. This study was designed to compare two treatment options, spironolactone (SPR) versus dual blockade of the renin-angiotensin-aldosterone system (RAAS).

Methods: Forty-two patients with true resistant hypertension were included in the study.

[Hypertension due to persistent hypokalemia: a complex case].

High grade of suspect must be present to diagnose some of the multiple causes of secondary blood hypertension. In the literature, there are reports that describe the coincidence of 2 different aetiologies of secondary hypertension in one patient, but both of endocrine origin. This one is the first time that a case with simultaneity of fibromuscular dysplasia and hyperaldosteronism in the same patient is described.