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      La intolerancia a la glucosa aumenta el índice de masa ventricular izquierda y la distensibilidad arterial en un grupo de hipertensos leves de sexo masculino

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          Abstract

          Con la finalidad de evaluar si en un grupo de hipertensos de nivel I con intolerancia a la glucosa y obesidad abdominal, por lo cual reúnen criterios para diagnóstico de síndrome metabólico (SM), existe un índice de masa ventricular izquierda mayor y una alteración mayor de la distensibilidad arterial respecto de un grupo de hipertensos de nivel I con obesidad abdominal, no intolerantes a la glucosa y sin SM, en el presente trabajo se incluyeron 56 varones, de 51 ± 6 años, con hipertensión de nivel I, que se dividieron en dos grupos. Grupo A) 28 con SM: glucemia en ayunas >1,10 g/L y < 1,26 g/L o poscarga de glucemia >1,40 g/L y menor de 2,00 g/L, perímetro abdominal > 102 cm y PA ≥ 130 y/u / 85 mm Hg. Grupo B) 28 sin SM: el perímetro abdominal y la presión arterial eran similares al grupo A, pero con glucemias en ayunas < 1,10 g/L y poscarga < 1,40 g/L. Se midió el índice de masa ventricular izquierda (IMVI) por ecocardiografia bidimensional y distensibilidad arterial: velocidad de onda de pulso, onda refleja central (ORC) por Sphygmocor Conclusión La presencia de intolerancia a la glucosa en pacientes con hipertensión de nivel I se asocia con mayor masa ventricular izquierda y rigidez arterial que en los casos con el mismo nivel de hipertensión sin intolerancia a la glucosa.

          Translated abstract

          Glucose Intolerance Increases Left Ventricular Mass Index And Arterial Stiffness In Males with Mild Hypertension The aim of this study was to evaluate if a group of mild hypertensive males with glucose intolerance and central obesity, meeting metabolic syndrome (MS) criteria, presented greater left ventricular mass index and altered arterial compliance compared to a group of mild hypertensive males with central obesity but without glucose intolerance or MS. Fifty six male patients of 51±6 years of age were included and separated into two groups: A)28 with metabolic syndrome (ATP III): fasting blood sugar ≥1.10 g/l and < 1.26 g/ l or oral glucose tolerance test >1.40 g/l and < 2 g/l, waist circumference >102 cm and blood pressure ≥ 130/85 mmHg. B)28 patients without metabolic syndrome: fasting blood sugar < 1.10 g/l and oral glucose tolerance test < 1.40 g/l, and similar waist circumference and blood pressure as those in group A. Two-dimensional echocardiography was used to assess left ventricular mass index. Arterial compliance was measured by augmentation index and pulse wave velocity by Sphygmocor. Conclusion The association of mild hypertension and glucose intolerance leads to greater LVMI and arterial stiffness compared to non glucose intolerant hypertensive males.

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          Most cited references23

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          2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension.

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            Angiotensin receptor blockade improves arterial distensibility and reduces exercise-induced pressor responses in obese hypertensive patients with the metabolic syndrome.

            Patients with the metabolic syndrome have three or more of five cardiovascular risk factors and increased oxidative stress, arterial stiffness and pressor responses to exercise, which may contribute to their threefold greater risk for coronary heart disease. In addition to lowering basal blood pressure (BP), angiotensin receptor blockers (ARBs) may benefit metabolic syndrome patients by reducing oxidative stress, arterial stiffness, and pressor responses to exercise. Twelve patients, 7 women and 5 men, with the metabolic syndrome (aged 45 +/- 2 years, BP 145 +/- 5/85 +/- 2 mm Hg, waist girth 110 +/- 3 cm, triglycerides 186 +/- 23 mg/dL, HDL cholesterol 44 +/- 2 mg/dL, glucose 99 +/- 3 mg/dL) were studied off medications, while on modest sodium restriction ( approximately 100 mmol/d). Patients were randomized to the ARB losartan or placebo for 3 weeks then crossed over to the complement for 3 weeks. Studies were performed at the end of each phase following an overnight fast. Serum lipids and biomarkers of oxidative stress (F2-isoprostanes, thiobarbituric acid reacting substances) were unchanged by losartan, whereas large artery elasticity at rest, measured with the HDI PulseWave, increased from 13.6 +/- 0.7 on placebo to 16.2 +/- 1.1 mL/mm Hg on losartan, P <.05. Losartan lowered systolic BP pre-exercise from 142 +/- 3 to 131 +/- 3 mm Hg (P <.001) and systolic BP after 6 min of treadmill exercise from 192 +/- 6 to 169 +/- 5 mm Hg (P <.001). Losartan lowered systolic BP (-23 +/- 3 v -11 +/- 2 mm Hg, P <.05) and pulse pressure (-4 +/- 1 v -15 +/- 2 mm Hg, P <.05) more during exercise than rest. Losartan reduces the pressor response to exercise, perhaps by enhancing arterial compliance. In addition to lowering basal BP, angiotensin receptor blockade in patients with metabolic syndrome improves arterial compliance and reduces pressor reactivity to exercise.
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              Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rac
                Revista argentina de cardiología
                Rev. argent. cardiol.
                Sociedad Argentina de Cardiología (Ciudad Autónoma de Buenos Aires )
                1850-3748
                December 2005
                : 73
                : 6
                : 429-432
                Affiliations
                [1 ] Hospital General de Agudos Donación Francisco Santojanni Argentina
                [2 ] SAC Brazil
                Article
                S1850-37482005000600006
                fef8c73b-bbde-459c-8c2f-2f0db63a64f1

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Argentina

                Self URI (journal page): http://www.scielo.org.ar/scielo.php?script=sci_serial&pid=1850-3748&lng=en
                Categories
                CARDIAC & CARDIOVASCULAR SYSTEMS

                Cardiovascular Medicine
                Diabetes mellitus,Metabolism,Hypertension,Arteries,Compliance,Diabetes,Metabolismo,Hipertensión arterial,Distensibilidad arterial

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