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      Consenso Paraguayo de Hipertensión Arterial 2015 Translated title: 2015 Paraguayan Consensus on Arterial Hypertension

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      Revista Virtual de la Sociedad Paraguaya de Medicina Interna
      Sociedad Paraguaya de Medicina Interna
      enfermedades cardiovasculares - epidemiología, hipertensión - diagnóstico, hipertensión inducida en el embarazo, hipertensión renal, diabetes mellitus tipo 2, insuficiencia cardiaca, antihipertensivos, estilo de vida, presión arterial, guía, Cardiovascular diseases - epidemiology, hypertension - diagnosis, hypertension, pregnancy-induced, hypertension, renal, diabetes mellitus, type 2, heart failure, antihypertensive agents, life style, arterial pressure, guideline

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          Abstract

          Este consenso fue ideado por el Director del Programa Nacional de Prevención Cardiovascular del M.S P. y B.S. (Paraguay) a raíz de que se necesitaba un documento actualizado que sirva como guía a los profesionales de la salud de todos los niveles de atención incluyendo a las diferentes especialidades, que tratan la hipertensión arterial y sus complicaciones agudas y crónicas. A través del convenio entre el Programa Nacional de Prevención Cardiovascular y la Sociedad Paraguaya de Cardiología de realizar actualizaciones de las Guías o documentos para difusión de manejo de patologías cardiovasculares y factores de riesgo asociados, se ha decidido elaborar y lanzar este material, que será utilizado como guía oficial en todo el territorio nacional. Con mesas de trabajo de varios días y la colaboración de representantes de sociedades científicas afines y asesores internacionales se ha logrado esta guía. Se presentan recomendaciones para facilitar el manejo de los pacientes con hipertensión arterial y sus complicaciones, con el propósito de disminuir la morbimortalidad cardiovascular. Han sido elaboradas según las evidencias científicas y conocimiento de expertos, con un enfoque práctico y sencillo. Todos los participantes aprobaron las decisiones finales. Los autores reconocen que la publicación y difusión de directrices serán siempre una guía práctica y que permitirá a los médicos ampliar los conocimientos con las recomendaciones propuestas, detectar precozmente el daño de órganos blancos y mejorar la calidad de vida de los pacientes hipertensos.

          Translated abstract

          This consensus was conceived by the Director of the National Program of Cardiovascular Prevention of the M.S P. y B.S. (Ministry of Public Health and Social Welfare, Paraguay) because an updated document was necessary as a guide for health professional of all care levels including different specialties that treat arterial hypertension and its acute and chronic complications. Through this consensus between the National Program of Cardiovascular Prevention and the Paraguayan Cardiology Society of updating Guides or documents for the dissemination of the management of cardiovascular pathologies and associated risk factors it was decided to elaborate and launch this material that will be used as an official guide in the national territory. This guide was achieved after working tables held during several days and the collaboration of representatives of related scientific societies and international advisers. Recommendations for facilitating the management of patients with arterial hypertension and its complications are presented in order to reduce the cardiovascular morbidity and mortality. They have been elaborated according to scientific evidence and knowledge of experts with a practical and simple approach. All the participants approved the final decisions. The authors recognize that the publications and dissemination of guidelines will always be a practical guide that will allow physicians to increase their knowledge with the proposed recommendation in order to early detect the damage of target organs and improve the quality of life of the hypertensive patients.

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          Most cited references54

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          ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.

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            Chronic kidney disease as a global public health problem: approaches and initiatives - a position statement from Kidney Disease Improving Global Outcomes.

            Chronic kidney disease (CKD) is increasingly recognized as a global public health problem. There is now convincing evidence that CKD can be detected using simple laboratory tests, and that treatment can prevent or delay complications of decreased kidney function, slow the progression of kidney disease, and reduce the risk of cardiovascular disease (CVD). Translating these advances to simple and applicable public health measures must be adopted as a goal worldwide. Understanding the relationship between CKD and other chronic diseases is important to developing a public health policy to improve outcomes. The 2004 Kidney Disease Improving Global Outcomes (KDIGO) Controversies Conference on 'Definition and Classification of Chronic Kidney Disease' represented an important endorsement of the Kidney Disease Outcome Quality Initiative definition and classification of CKD by the international community. The 2006 KDIGO Controversies Conference on CKD was convened to consider six major topics: (1) CKD classification, (2) CKD screening and surveillance, (3) public policy for CKD, (4) CVD and CVD risk factors as risk factors for development and progression of CKD, (5) association of CKD with chronic infections, and (6) association of CKD with cancer. This report contains the recommendations from the meeting. It has been reviewed by the conference participants and approved as position statement by the KDIGO Board of Directors. KDIGO will work in collaboration with international and national public health organizations to facilitate implementation of these recommendations.
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              Blood pressure and end-stage renal disease in men.

              End-stage renal disease in the United States creates a large burden for both individuals and society as a whole. Efforts to prevent the condition require an understanding of modifiable risk factors. We assessed the development of end-stage renal disease through 1990 in 332,544 men, 35 to 57 years of age, who were screened between 1973 and 1975 for entry into the Multiple Risk Factor Intervention Trial (MRFIT). We used data from the national registry for treated end-stage renal disease of the Health Care Financing Administration and from records on death from renal disease from the National Death Index and the Social Security Administration. During an average of 16 years of follow-up, 814 subjects either died of end-stage renal disease or were treated for that condition (15.6 cases per 100,000 person-years of observation). A strong, graded relation between both systolic and diastolic blood pressure and end-stage renal disease was identified, independent of associations between the disease and age, race, income, use of medication for diabetes mellitus, history of myocardial infarction, serum cholesterol concentration, and cigarette smoking. As compared with men with an optimal level of blood pressure (systolic pressure or = 210 mm Hg or diastolic pressure > or = 120 mm Hg) was 22.1 (P < 0.001). These relations were not due to end-stage renal disease that occurred soon after screening and, in the 12,866 screened men who entered the MRFIT study, were not changed by taking into account the base-line serum creatinine concentration and urinary protein excretion. The estimated risk of end-stage renal disease associated with elevations of systolic pressure was greater than that linked with elevations of diastolic pressure when both variables were considered together. Elevations of blood pressure are a strong independent risk factor for end-stage renal disease; interventions to prevent the disease need to emphasize the prevention and control of both high-normal and high blood pressure.
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                Author and article information

                Contributors
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                Journal
                spmi
                Revista Virtual de la Sociedad Paraguaya de Medicina Interna
                Rev. virtual Soc. Parag. Med. Int.
                Sociedad Paraguaya de Medicina Interna (Asunción, , Paraguay )
                2312-3893
                September 2016
                : 3
                : 2
                : 11-57
                Affiliations
                [07] orgnameHospital de Clínicas orgdiv1Departamento de Cardiología
                [06] orgnameInstituto de Previsión Social - Hospital Central orgdiv1Servicio de Medicina Interna
                [02] orgnameSociedad Latinoamericana de Hipertensión Arterial
                [10] orgnameSociedad Paraguaya de Diabetología
                [03] orgnameSociedad Paraguaya de Cardiología y Cirugía Cardiovascular
                [05] orgnameSociedad Paraguaya de Medicina Interna
                [08] orgnameMinisterio de Salud Pública y Bienestar Social orgdiv1Instituto Nacional de Nefrología
                [04] orgnameSociedad Paraguaya de Hipertensión Arterial
                [01] orgnameMinisterio de Salud Pública y Bienestar Social orgdiv1Programa Nacional de Prevención Cardiovascular
                [09] orgnameSociedad Paraguaya de Nefrología
                Article
                S2312-38932016000200002
                10.18004/rvspmi/2312-3893/2016.03(02)11-057
                faf1f353-4791-4e1e-8aaf-5b55abddd31b

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 26 July 2016
                : 12 May 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 86, Pages: 47
                Product

                SciELO Paraguay

                Categories
                Artículos Originales

                hipertensión inducida en el embarazo,arterial pressure,guideline,enfermedades cardiovasculares - epidemiología,hipertensión - diagnóstico,hipertensión renal,diabetes mellitus tipo 2,insuficiencia cardiaca,antihipertensivos,estilo de vida,presión arterial,guía,Cardiovascular diseases - epidemiology,hypertension - diagnosis,hypertension,pregnancy-induced,renal,diabetes mellitus,type 2,heart failure,antihypertensive agents,life style

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