RESUMEN

The sphincters failure is a part of NSAIDs-toxicity that can be accordingly counteracted. We used a safe stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419), LD1 not achieved, since successful in inflammatory bowel disease trials, and counteracts esophagitis, sphincters failure, gastrointestinal ulcer and skin ulcer, external and internal fistulas in rats, and particularly counteracts all NSAIDs-lesions. We assessed lower esophageal sphincter and pyloric sphincter pressure (cmH2O) in rats treated with various NSAIDs regimens, at corresponding time points, known to produce stomach, small intestine lesions, hepatotoxicity and encephalopathy. Assessment was after diclofenac (12.5 mg/kg, 40 mg/kg intraperitoneal challenge), ibuprofen (400 mg/day/kg intraperitoneally for 4 weeks), paracetamol (5.0 g/kg intraperitoneal challenge), aspirin (400 mg/kg intraperitoneally or intragastrically), celecoxib (0.5 mg/kg, 1.0 mg/kg intraperitoneally). BPC 157 (10 µg/kg, 10 ng/kg) was given immediately after NSAIDs (intraperitoneally or intragastrically) or given in drinking water. Regularly, in all control NSAIDs fall of pressure occurred in both sphincters rapidly and then persisted. By contrast, in all NSAIDs-rats that received BPC 157, initial fall of pressure was minimized and pressure values restored to normal values. All tested NSAIDs decrease pressure in both sphincters, whilst BPC 157 counteracts their effects and restored both sphincters function.

Asunto(s)

RESUMEN

INTRODUCTION: A low number of patients who are treated with antihypertensive drugs achieve therapeutic goals. Home blood pressure monitoring is an excellent tool for studying this population. OBJECTIVES: To determine the prevalence of patients with controlled and uncontrolled hypertension, as well as white-coat-effect and masked hypertension, and to evaluate the relationship with target organ damage in different groups. METHODS: Blood pressure readings were performed simultaneously in the clinic and in the home using the same validated oscillometric equipment on 83 hypertensive patients on treatment with 2 or more antihypertensive drugs. They were then classified into 4 groups according to the cut-off values of the clinic and home blood pressure measurements. Left ventricular mass index, carotid intima media thickness, and microalbuminuria as markers of target organ damage, were also evaluated. RESULTS: Controlled blood pressure was present in 32.5%, 30.2% had sustained hypertension. The white coat effect was seen in 26.5%, while 10.8% were masked uncontrolled hypertension. Left ventricular mass index was higher in patients with no ambulatory control compared to controlled patients, and carotid IMT was also higher too in uncontrolled and white coat effect groups than controlled patients. CONCLUSIONS: More than one third of our patients who were treated with 2 or more drugs were not properly controlled, and they had significantly greater target organ damage than controlled patients.

Asunto(s)

RESUMEN

Introducción: Pocos pacientes en tratamiento con fármacos antihipertensivos alcanzan metas terapéuticas. La monitorización domiciliaria de la presión arterial es una herramienta de gran utilidad y complemento en el estudio de esta población. Objetivo: Determinar la prevalencia de pacientes hipertensos ambulatorios sin control, con control, hipertensos con efecto de bata blanca e hipertensos enmascarados y evaluar lesión de órgano diana en los distintos grupos. Materiales y métodos: En 83 pacientes hipertensos bajo tratamiento con 2 o más fármacos antihipertensivos se registró en forma simultánea la presión arterial en consultorio y en domicilio con los mismos equipos oscilométricos validados. Luego se clasificaron en 4 grupos en función de los valores de corte de la presión arterial de consultorio y domiciliaria. También se evaluó el índice de masa ventricular izquierda, grosor íntima-media y microalbuminuria como marcadores de lesión de órgano diana. Resultados: El 32,5% fueron hipertensos sin control ambulatorio, el 30,2% hipertensos con control ambulatorio; se vio hipertensión con efecto de bata blanca en el 26,5%, mientras que el 10,8% tenían hipertensión enmascarada. El índice de masa ventricular izquierda fue mayor en los pacientes con hipertensión sin control ambulatorio con relación a los controlados y el GIM carotídeo fue mayor no solamente en los pacientes hipertensos sin control ambulatorio sino también en el grupo de hipertensos con efecto de bata blanca con respecto a los controlados. Conclusión: Más de un tercio de nuestros pacientes que se encontraban en tratamiento con 2 o más fármacos no estaban correctamente controlados y además presentaron mayor lesión de órgano diana que los pacientes controlados

Introduction: A low number of patients who are treated with antihypertensive drugs achieve therapeutic goals. Home blood pressure monitoring is an excellent tool for studying this population. Objectives: To determine the prevalence of patients with controlled and uncontrolled hypertension, as well as white-coat-effect and masked hypertension, and to evaluate the relationship with target organ damage in different groups. Methods: Blood pressure readings were performed simultaneously in the clinic and in the home using the same validated oscillometric equipment on 83 hypertensive patients on treatment with 2 or more antihypertensive drugs. They were then classified into 4 groups according to the cut-off values of the clinic and home blood pressure measurements. Left ventricular mass index, carotid intima media thickness, and microalbuminuria as markers of target organ damage, were also evaluated. Results: Controlled blood pressure was present in 32.5%, 30.2% had sustained hypertension. The white coat effect was seen in 26.5%, while 10.8% were masked uncontrolled hypertension. Left ventricular mass index was higher in patients with no ambulatory control compared to controlled patients, and carotid IMT was also higher too in uncontrolled and white coat effect groups than controlled patients. Conclusions: More than one third of our patients who were treated with 2 or more drugs were not properly controlled, and they had significantly greater target organ damage than controlled patients

Asunto(s)