RESUMO
Latin American hypertension guidelines, tailored to the needs of countries of Central and South America, should be applied and known by most Latin American physicians. The knowledge and implementation of the Guidelines is one of the greatest challenges of hypertension societies in Latin America such as the Central American and Caribbean Society of Arterial Hypertension (SCCH), the Latin American Society of Hypertension (LASH) and the Inter-American Society of Cardiology (SIAC). In 2020, the Inter-American Society of Cardiology (SIAC) published its position on the current Guidelines for Arterial Hypertension due to the need to standardize the evaluation, diagnosis, treatment and control of hypertension, establishing recommendations that should be adopted in all Latin American countries, aimed at optimizing the management of cardiovascular risk and achieving a substantial improvement in the reduction of cardiovascular events and mortality. This document intends to reinforce all proposals by the LASH guidelines and the position of the SIAC in relation to the therapeutic approach and pharmacological recommendations for patients with hypertension (HT), in order to achieve better HT control in the Central American and Caribbean area, and the consequently prognosis improvement of cardiovascular disease in the area.
Assuntos
Hipertensão , Humanos , Região do Caribe , América Central , Hipertensão/terapiaRESUMO
OBJECTIVE: To determine the predictors and prevalence of metabolic syndrome (MS) and the presence of vascular inflammation in apparently-normal children (10-15 years) of both sexes in Guayaquil, Ecuador. STUDY DESIGN AND METHODS: We included 395 apparently-healthy students from a middle-income school in a cross-sectional survey. Informed consent was obtained from students and parents. Anthropometric measurements including blood pressure (BP), body mass index (BMI) and waist-to-height ratio (WHtR), and blood tests were recorded. Vascular inflammation parameters were assessed. Percentiles of the different parameters were used, and MS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP-ATPIII). Waist circumference>P 75, blood pressure>P 90, glucose>100mg/dl, triglycerides>100mg/dl, HDL<45mg/dl. If 3 of the 5 criteria were present, this was considered MS. RESULTS: The mean age was 12 years (186 boys, 209 girls). The overall prevalence of MS was 9.37% (6.33% in girls, 3.04% in boys). Sustained hypertension was detected in 6.6% of children and pre-hypertension in 7.1%. Obesity was found in 1.8% of subjects, and overweight in 15.2%. Triglycerides has a RR 2.34 (1.97-2.76); HOMA index has a RR 1.97(1.62-2.40); HDL cholesterol has a RR 1.84(1.58-2.13); Insulin level has a RR 1.53(1.40-1.67) and interleukin 6 has RR 1.83(1.20-2.79). Serum glucose, total cholesterol and LDL-Cholesterol had no association with the metabolic syndrome. HDL-Cholesterol<45mg/dl and triglyceride>100mg/dl were present in 70% of subjects with MS. The WHtR threshold≥0.5 was 100% sensitive in both sexes (67% specificity in boys and 69% in girls). There were significant associations between the WHtR and pre-hypertension and sedentary lifestyle (P<0.001 and P<0.003 respectively). A WHtR value of ≥0.50 indicated a 2.2-fold increased risk of MS compared with normal WHtR, and normal weight. CONCLUSIONS: A WHtR≥0.5 was 100% sensitive in detecting MS in 10-15 year-old boys and girls in the normal or overweight range of the BMI. This assessment is a simple and practical tool for use in population-based studies of cardiovascular risk. When combined with pre-hypertension and a sedentary lifestyle, the WHtR is highly sensitive in predicting MS.
RESUMO
Este es un trabajo de investigación de tipo descriptivo que tienen como objetivo determinar las características socioeconómicas, políticas y culturales que podrían constituirse en determinantes de la salud, de las familias de Caporaya, Poquera y Londo y de esta manera buscar alternativas de solución, mediante la priorización de los problemas encontrados y subsecuentemente la realización de proyectos.Este trabajo se basa en los resultados obtenidos, de las familias entrevistadas mediante una encuesta socioeconómica política y cultural, aplicada al 100% de las familias de las comunidades de Caporaya, Poquera, Londo.
Assuntos
Medicina de Família e Comunidade , Relações Comunidade-InstituiçãoRESUMO
Diez años de Desarrollo Alternativo en Bolivia, tiene una raíz de noventa años con la firma del Primer Tratado Internacional sobre fiscalización de drogas, en la Haya - Holanda. Desde ese entonces, mucho se escrito sobre el asunto, gran parte de lo cual ha obedecido a políticas y estrategias de gobiernos interesados en mostrar su capacidad para decidir, sobre la manera de resolver problemas de interés común a la humanidad.