curva j e hipertension arterial
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CURVA J HIPERTENSION Argumentos en Contra ?
Dr. Daniel Meneses Jefe Hemodinámica
Hospital Metropolitano “Vivian Pellas”
Managua. Nicaragua
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APERTURA
ESTA
BIL
IDA
D
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0 mmHg Blood Pressure 200 mmHg
CV
Disease
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1 000 000 POR 14 AÑOS
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All-cause mortality, CVD, and cancer mortality were highest in the low-DBP group (<75 mm Hg). Thus, comorbidities such as cancer and thus low weight and hypotension were the confounding factors that obscured the true relationship of BP and mortality.
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HOT
Slim Jim /NK/1 14/05/20041
Hypertension
Optimal
TreatmentInternational Study
Hypertension
Optimal
TreatmentInternational Study
HOTHOT Study resultsStudy results
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0
80
85
90
95
100
105
0 3 6 12 24 36 Final follow-up
74%
43%
DBP mm Hg
target 80 mm Hg
86%
73%
55%
target 85 mm Hg
target 90 mm Hg
HOT - Target blood pressure is an achievable goal
(% patients reaching target)
60%
Hansson et al 1998
Months
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Risk of a major cardiovascular event reduced by 30% in the HOT Study
0
5
10
15
20
25
30
105 100 95 90 85
% risk reduction
Optimal DBP reduction in the HOT Study
Hansson et al 1998
Achieved DBP mm Hg 80
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Vaccarino V, Holford TR, Krumholz HM. Pulse pressure and risk for myocardial infarction and heart failure in the elderly. J Am Coll Cardiol 2000;36:130–8.
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1. LA CURVA J ESTA PRESENTE EN MUCHOS ESTUDIOS DE HIPERTENSION ARTERIAL RELACIONANDO MORTALIDAD CARDOVASCULAR CON PRESION DIASTOLICA
2. LA CURVA J ES MAS COMUN EN PACIENTES CON ENFERMEDAD
ATEROSCLEROTICA AVANZADA 3. LA CAUSA DE ESTA CURVA ES AUN CONTROVERSIAL PORQUE LOS ESTUDIOS
NO HAN SIDO DISEÑADOS EXPRESAMENTE PARA ESTUDIAR ESTA RELACION 4. DEBE BUSCARSE REDUCIR LA PRESION SISTOLICA DEBAJO DE 140 mmHg Y LA DIASTOLICA DEBAJO DE 90 mmHg EN LOS PACIENTES DE ALTO RIESGO SIN IR “ MAS BAJO MEJOR”
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