Decio mion jr - Academia.edu (original) (raw)
Papers by Decio mion jr
Arquivos Brasileiros de Cardiologia, 1998
![Research paper thumbnail of [Evaluation of hypertensive retinopathy through the oscillatory potentials of the electroretinogram]](https://attachments.academia-assets.com/38172872/thumbnails/1.jpg)
](Arquivos Brasileiros de Oftalmologia
To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretino... more To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretinogram (ERG) in hypertensive retinopathy. Forty-four patients (n=44) were submitted to clinical evaluation and subdivided in to 2 groups: hypertensives (HT) and normotensives (NT). The hypertensives patients were maintained under placebo during the period of the study. Soon afterwards, they were submitted to ophthalmological evaluation and accomplishment of ERG. Total field electroretinogram (ERG), with recording of the answers: scotopic, maximum scotopic, OP scotopic, photopic and flicker.For analysis of the OP answer the latency of the first 2 peaks and the average value of the width of the first 3 peaks of the compound of 3 consecutive answers, denominated Oscillatory Index (OI) were considered. The sample was composed of 44 patients, with a mean age of 51.55 +/- 7.2 range (34 to 68) years, 24 being females. Arterial hypertension affected 26 (59.1%) of the patients, while 18 (40.9%) wer...
Apesar dos conhecidos benefícios da terapia anti-hipertensiva na prevenção das complicações cardi... more Apesar dos conhecidos benefícios da terapia anti-hipertensiva na prevenção das complicações cardiovasculares da hipertensão arterial, o percentual de pacientes hipertensos que alcançam os alvos-terapêuticos é baixo. Como os atuais agentes anti-hipertensivos são eficazes em reduzir a pressão arterial, a baixa adesão à terapia medicamentosa é uma das principais razões do baixo percentual de controle destes pacientes. Significativas diferenças na adesão têm sido demonstradas quando do uso de diferentes classes de anti-hipertensivos, evidenciando melhor adesão às medicações com menor perfil de efeitos colaterais. Esta revisão enfoca trabalhos sobre a adesão ao valsartana, um antagonista dos receptores do tipo 1 da angiotensina II, comparativamente a outros anti-hipertensivos. Os trabalhos levantados na literatura apontaram maior índice de adesão e persistência a terapia anti-hipertensiva com o uso do valsartana, mesmo quando comparado com drogas reconhecidamente bem toleradas, como os inibidores da enzima de conversão da angiotensina e os antagonistas dos canais de cálcio, indicando assim, que a escolha da classe de anti-hipertensivo, influencia a adesão ao tratamento medicamentoso, sendo, portanto, uma forma de melhorar os índices de controle da hipertensão arterial.
![Research paper thumbnail of [Is ABPM indicated for all hypertensives and normotensives? Is supportive evidence available?]](https://attachments.academia-assets.com/44736583/thumbnails/1.jpg)
](Arquivos brasileiros de cardiologia, 2005
A MAPA é Indicada para Todo Hipertenso e Normotenso? Existem Evidências para tanto?
American journal of hypertension, 2007
Blood pressure control is the main influential variable in reducing microalbuminuria in patients ... more Blood pressure control is the main influential variable in reducing microalbuminuria in patients with type 2 diabetes. In this subanalysis of the Natrilix SR versus Enalapril Study in hypertensive Type 2 diabetics with micrOalbuminuRia (NESTOR) study, we have compared the effectiveness of indapamide sustained release (SR) and enalapril in reducing blood pressure and microalbuminuria in patients > or =65 years of age. Of the 570 hypertensive patients with type 2 diabetes and persistent microalbuminuria in the NESTOR study, 187 (33%) individuals > or =65 years of age were included in this analysis. Of these, 95 patients received indapamide SR 1.5 mg and 92 patients received enalapril 10 mg, taken once daily in both cases. Adjunctive amlodipine and/or atenolol was added if required. The urinary albumin-to-creatinine ratio decreased by 46% in the indapamide SR group and 47% in the enalapril group. Noninferiority of indapamide SR over enalapril was demonstrated (P = .0236; 35% limi...
Arquivos brasileiros de cardiologia, 2007
To evaluate whether procedures adopted by Brazilian physicians in the diagnosis and treatment of ... more To evaluate whether procedures adopted by Brazilian physicians in the diagnosis and treatment of hypertension are in compliance with those advocated by the IV Brazilian Hypertension Guidelines. Survey carried out by means of telephone interviews with Brazilian physicians. The survey featured application of a questionnaire aimed to assess receipt of and compliance with the guidelines, and to evaluate various aspects regarding the treatment of hypertensive patients. 68.3% of the respondents had received the guidelines and answered the questionnaire in full. The total sample consisted of 483 physicians--47% cardiologists, 31.7% internists, and 21.3% nephrologists. The survey showed high compliance with certain guideline topics such as more than one measurement at different times for the diagnosis of hypertension (94%), and providing guidance regarding lifestyle changes as a therapeutic strategy. As to arterial pressure levels used for diagnosis and therapeutic target, compliance with g...
Arquivos brasileiros de cardiologia, 2010
Little is known about the prevalence of hypertension in São Paulo, Brazil. To identify the preval... more Little is known about the prevalence of hypertension in São Paulo, Brazil. To identify the prevalence of self-reported hypertension in the city of São Paulo. There were 613 telephone interviews using directories of household land-lines. The sample was calculated with an estimated prevalence of hypertension in 20.0%. The prevalence of self-reported hypertension was 23.0% and 9.0% of respondents reported that the value of their last pressure measurement was greater than 140/90 mmHg, but they were unaware that they were hypertensive, with a total prevalence 32.0%. Hypertensive patients reported that: 89.0% were under treatment and 35.2% were controlled; 27.0% miss medical appointments; 16.2% stop taking drugs; 14.8% have a history of stroke; 27.8% had heart disease and 38.7% had hypercholesterolemia; 71.2% received advice to reduce salt, 64.6% to perform physical activity, 60.0% to lose weight loss and 26.2% to control stress; and 78.9% measured pressure regularly. There was a statisti...
Arquivos brasileiros de cardiologia, 2004
American Journal of Hypertension, 2005
high tertile, Chi-squareϭ7.95, pϭ0.02) with estimated 10-years CV risk : 30(15-40)%, 45(30-60)% a... more high tertile, Chi-squareϭ7.95, pϭ0.02) with estimated 10-years CV risk : 30(15-40)%, 45(30-60)% and 60(40-75)% respectively. Logistic analysis likewise demonstrated high independent prognostic significance of ABP. Odds ratio increased with each 10-mmHg change by 1.45(1.12-1.89) for 24-h SBP and 1.49(0.99-2.27) for 24-h DBP.
Clinics, 2010
Nery SS, Gomides RS, da Silva GV, Forjaz CLM, Mion Jr D, Tinucci T. Intra-arterial blood pressure... more Nery SS, Gomides RS, da Silva GV, Forjaz CLM, Mion Jr D, Tinucci T. Intra-arterial blood pressure response in hypertensive subjects during low-and high-intensity resistance exercise. Clinics. 2010;65(3):271-7.
Revista do Hospital das Clínicas, 2004
MION Jr. D et al. Hypertension in employees of a University General Hospital. Rev. Hosp. Clín. Fa... more MION Jr. D et al. Hypertension in employees of a University General Hospital. Rev. Hosp. Clín. Fac. Med. S. Paulo 59(6):329-336, 2004.
Clinics, 2009
Gusmão JL, Mion Jr. D, Pierin AMG. Health-related quality of life and blood pressure control in h... more Gusmão JL, Mion Jr. D, Pierin AMG. Health-related quality of life and blood pressure control in hypertensive patients with and without complications. Clinics. 2009;64 :619-28.
Recebido em 02/09/05 • Aceito em 13/10/05 PALAVRAS CHAVES combinação fi xa de antihipertensivos, ... more Recebido em 02/09/05 • Aceito em 13/10/05 PALAVRAS CHAVES combinação fi xa de antihipertensivos, anlodipino, losartana, efi cácia, tolerabilidade, metabolismo da glicose e lípides OBJECTIVE The LOTHAR study evaluated medium and long term (one year) effi cacy, tolerability and metabolic effects of the fi xed combination of amlodipine and losartan compared to amlodipine or losartan alone. METHODS Brazilian multicenter, randomized, double-blind and comparative trial performed with 198 patients in stage 1 and 2 essential hypertension.
Nephrology Dialysis Transplantation, 2009
It is not known if the adjustment of antihypertensive therapy based on home blood pressure monito... more It is not known if the adjustment of antihypertensive therapy based on home blood pressure monitoring (HBPM) can improve blood pressure (BP) control among haemodialysis patients. This is an open randomized clinical trial. Hypertensive patients on haemodialysis were randomized to have the antihypertensive therapy adjusted based on predialysis BP measurements or HBPM. Before and after 6 months of follow-up, patients were submitted to ambulatory blood pressure monitoring (ABPM) for 24 h, HBPM during 1 week and echocardiogram. A total of 34 and 31 patients completed the study in the HBPM and predialysis BP groups, respectively. At the end of study, the systolic (SBP) and diastolic (DBP) blood pressure during the interdialytic period measured by ABPM were significantly lower in the HBPM group in relation to the predialysis BP group (mean 24-h BP: 135 +/- 12 mmHg/76 +/- 7 mmHg versus 147 +/- 15 mmHg/79 +/- 8 mmHg; P < 0.05). In the HBPM analysis, the HBPM group showed a significant reduction only in SBP compared to the predialysis BP group (weekly mean: 144 +/- 21 mmHg versus 154 +/- 22 mmHg; P < 0.05). There were no differences between the HBPM and predialysis BP groups in relation to the left ventricular mass index at the end of the study (108 +/- 35 g/m(2) versus 110 +/- 33 g/m(2); P > 0.05). Decision making based on HBPM among haemodialysis patients has led to a better BP control during the interdialytic period in comparison with predialysis BP measurements. HBPM may be a useful adjuvant instrument for blood pressure control among haemodialysis patients.
Nephrology Dialysis Transplantation, 2011
Hypertension is highly prevalent among kidney transplantation recipients and considered as an imp... more Hypertension is highly prevalent among kidney transplantation recipients and considered as an important cardiovascular risk factor influencing patient survival and kidney graft survival. Aim. Compare the blood pressure (BP) control in kidney transplant patients through the use of home blood pressure monitoring (HBPM) is more comparable with the results of ambulatory blood pressure monitoring compared to the measurement of office blood pressure. From March 2008 to April 2009 prospectively were evaluated 183 kidney transplant recipients with time after transplantation between 1 and 10 years. Patients underwent three methods for measuring BP: office blood pressure measurement (oBP), HBPM and ambulatory blood pressure monitoring (ABPM). In total, 183 patients were evaluated, among them 94 were men (54%) and 89 women (46%). The average age was 50 ± 11 years. The average time of transplant was 57 ± 32 months. Ninety-nine patients received grafts from deceased donors (54%) and 84 were recipients of living donors (46%). When assessed using oBP, 56.3% presented with uncontrolled and 43.7% with adequate control of BP with an average of 138.9/82.3 ± 17.8/12.1 mmHg. However, when measured by HBPM, 55.2% of subjects were controlled and 44.8% presented with uncontrolled BP with an average of 131.1/78.5 ± 17.4/8.9 mmHg. Using the ABPM, we observed that 63.9% of subjects were controlled and 36.1% of patients presented uncontrolled BP with an average 128.8/80.5 ± 12.5/8.1 mmHg. We found that the two methods (oBP and HBPM) have a significant agreement, but the HBPM has a higher agreement that oBP, confirmed P = 0.026. We found that there is no symmetry in the data for both methods with McNemar test. The correlation index of Pearson linear methods for the ABPM with the other two methods were 0.494 for office measurement and 0.768 for HBPM, best value of HBPM with ABPM. Comparing the errors of the two methods by paired t-test, we obtained the descriptive level of 0.837. Looking at the receiver operating characteristic curve for BP measurements in each method, we observed that oBP is lower than those obtained by HBPM in relation to ABPM. We conclude that the results obtained with HBPM were closer to the ABPM results than those obtained with BP obtained at oBP, being more sensitive to detect poor control of hypertension in renal transplant recipients.
Hypertension, 2008
issue of Hypertension, Bankir et al 1 analyzed the data of 325 subjects divided into tertiles of ... more issue of Hypertension, Bankir et al 1 analyzed the data of 325 subjects divided into tertiles of the day:night ratio of urinary sodium excretion. Subjects in tertile 3 were qualified as "high daytime sodium excretors" because they excreted sodium at a rate that was 46% higher during daytime than during nighttime, whereas subjects in tertile 1 were "low daytime sodium excretors" and excreted 3 times less sodium during daytime than during nighttime. The nocturnal blood pressure (BP) dipping was significantly lower in tertile 1 than in other tertiles, especially for systolic BP. Thus, the authors suggested that the capacity to excrete sodium during daytime is the main determinant of nocturnal BP and dipping.
Blood Pressure Monitoring, 2005
Background Ambulatory blood pressure monitoring (ABPM) provides relevant data about blood pressur... more Background Ambulatory blood pressure monitoring (ABPM) provides relevant data about blood pressure over a 24-h period. The analysis of parameters to determine the blood pressure profile from these data is of great importance.
Blood Pressure Monitoring, 2004
Background It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is... more Background It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is erroneous for large arms.
Atherosclerosis, 2008
Background: Dietary salt restriction has been reported to adversely modify the plasma lipoprotein... more Background: Dietary salt restriction has been reported to adversely modify the plasma lipoprotein profile in hypertensive and in normotensive subjects. We investigated the effects of the low sodium intake (LSI) on the plasma lipoprotein profile and on inflammation and thrombosis biomarkers during the fasting and postprandial periods. Methods: Non-obese, non-treated hypertensive adults (n = 41) were fed strictly controlled diets. An initial week on a control diet (CD, Na = 160 mmol/day) was followed by 3 weeks on LSI (Na = 60 mmol/day). At admission and on the last day of each period, the 24-h ambulatory blood pressure was monitored and blood was drawn after an overnight fasting period and after a fat-rich test meal. Results: The dietary adherence was confirmed by 24-h urinary sodium excretion. Fasting triglyceride (TG), chylomicron-cholesterol, hsC-reactive protein (CRP), tumor necrosis factor-␣ (TNF-␣), interleukin-6 (IL-6) concentrations, renin activity, aldosterone, insulin, and homeostasis model assessment insulin resistance (HOMA-IR) values were higher, but non-esterified fatty acids (NEFA) were lower on LSI than on CD. For LSI, areas under the curve (AUC) of TG, chylomicron-cholesterol, apoB and the cholesterol/apoB ratio were increased, whereas AUC-NEFA was lowered. LSI did not modify body weight, hematocrit, fasting plasma cholesterol, glucose, adiponectin, leptin, fibrinogen and factor VII (FVII), and AUC of lipoprotein lipase and of lipoprotein remnants. Conclusion: LSI induced alterations in the plasma lipoproteins and in inflammatory markers that are common features of the metabolic syndrome.
Arquivos Brasileiros de Oftalmologia, 2008
Arquivos Brasileiros de Cardiologia, 1998
Arquivos Brasileiros de Oftalmologia
To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretino... more To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretinogram (ERG) in hypertensive retinopathy. Forty-four patients (n=44) were submitted to clinical evaluation and subdivided in to 2 groups: hypertensives (HT) and normotensives (NT). The hypertensives patients were maintained under placebo during the period of the study. Soon afterwards, they were submitted to ophthalmological evaluation and accomplishment of ERG. Total field electroretinogram (ERG), with recording of the answers: scotopic, maximum scotopic, OP scotopic, photopic and flicker.For analysis of the OP answer the latency of the first 2 peaks and the average value of the width of the first 3 peaks of the compound of 3 consecutive answers, denominated Oscillatory Index (OI) were considered. The sample was composed of 44 patients, with a mean age of 51.55 +/- 7.2 range (34 to 68) years, 24 being females. Arterial hypertension affected 26 (59.1%) of the patients, while 18 (40.9%) wer...
Apesar dos conhecidos benefícios da terapia anti-hipertensiva na prevenção das complicações cardi... more Apesar dos conhecidos benefícios da terapia anti-hipertensiva na prevenção das complicações cardiovasculares da hipertensão arterial, o percentual de pacientes hipertensos que alcançam os alvos-terapêuticos é baixo. Como os atuais agentes anti-hipertensivos são eficazes em reduzir a pressão arterial, a baixa adesão à terapia medicamentosa é uma das principais razões do baixo percentual de controle destes pacientes. Significativas diferenças na adesão têm sido demonstradas quando do uso de diferentes classes de anti-hipertensivos, evidenciando melhor adesão às medicações com menor perfil de efeitos colaterais. Esta revisão enfoca trabalhos sobre a adesão ao valsartana, um antagonista dos receptores do tipo 1 da angiotensina II, comparativamente a outros anti-hipertensivos. Os trabalhos levantados na literatura apontaram maior índice de adesão e persistência a terapia anti-hipertensiva com o uso do valsartana, mesmo quando comparado com drogas reconhecidamente bem toleradas, como os inibidores da enzima de conversão da angiotensina e os antagonistas dos canais de cálcio, indicando assim, que a escolha da classe de anti-hipertensivo, influencia a adesão ao tratamento medicamentoso, sendo, portanto, uma forma de melhorar os índices de controle da hipertensão arterial.
Arquivos brasileiros de cardiologia, 2005
A MAPA é Indicada para Todo Hipertenso e Normotenso? Existem Evidências para tanto?
American journal of hypertension, 2007
Blood pressure control is the main influential variable in reducing microalbuminuria in patients ... more Blood pressure control is the main influential variable in reducing microalbuminuria in patients with type 2 diabetes. In this subanalysis of the Natrilix SR versus Enalapril Study in hypertensive Type 2 diabetics with micrOalbuminuRia (NESTOR) study, we have compared the effectiveness of indapamide sustained release (SR) and enalapril in reducing blood pressure and microalbuminuria in patients > or =65 years of age. Of the 570 hypertensive patients with type 2 diabetes and persistent microalbuminuria in the NESTOR study, 187 (33%) individuals > or =65 years of age were included in this analysis. Of these, 95 patients received indapamide SR 1.5 mg and 92 patients received enalapril 10 mg, taken once daily in both cases. Adjunctive amlodipine and/or atenolol was added if required. The urinary albumin-to-creatinine ratio decreased by 46% in the indapamide SR group and 47% in the enalapril group. Noninferiority of indapamide SR over enalapril was demonstrated (P = .0236; 35% limi...
Arquivos brasileiros de cardiologia, 2007
To evaluate whether procedures adopted by Brazilian physicians in the diagnosis and treatment of ... more To evaluate whether procedures adopted by Brazilian physicians in the diagnosis and treatment of hypertension are in compliance with those advocated by the IV Brazilian Hypertension Guidelines. Survey carried out by means of telephone interviews with Brazilian physicians. The survey featured application of a questionnaire aimed to assess receipt of and compliance with the guidelines, and to evaluate various aspects regarding the treatment of hypertensive patients. 68.3% of the respondents had received the guidelines and answered the questionnaire in full. The total sample consisted of 483 physicians--47% cardiologists, 31.7% internists, and 21.3% nephrologists. The survey showed high compliance with certain guideline topics such as more than one measurement at different times for the diagnosis of hypertension (94%), and providing guidance regarding lifestyle changes as a therapeutic strategy. As to arterial pressure levels used for diagnosis and therapeutic target, compliance with g...
Arquivos brasileiros de cardiologia, 2010
Little is known about the prevalence of hypertension in São Paulo, Brazil. To identify the preval... more Little is known about the prevalence of hypertension in São Paulo, Brazil. To identify the prevalence of self-reported hypertension in the city of São Paulo. There were 613 telephone interviews using directories of household land-lines. The sample was calculated with an estimated prevalence of hypertension in 20.0%. The prevalence of self-reported hypertension was 23.0% and 9.0% of respondents reported that the value of their last pressure measurement was greater than 140/90 mmHg, but they were unaware that they were hypertensive, with a total prevalence 32.0%. Hypertensive patients reported that: 89.0% were under treatment and 35.2% were controlled; 27.0% miss medical appointments; 16.2% stop taking drugs; 14.8% have a history of stroke; 27.8% had heart disease and 38.7% had hypercholesterolemia; 71.2% received advice to reduce salt, 64.6% to perform physical activity, 60.0% to lose weight loss and 26.2% to control stress; and 78.9% measured pressure regularly. There was a statisti...
Arquivos brasileiros de cardiologia, 2004
American Journal of Hypertension, 2005
high tertile, Chi-squareϭ7.95, pϭ0.02) with estimated 10-years CV risk : 30(15-40)%, 45(30-60)% a... more high tertile, Chi-squareϭ7.95, pϭ0.02) with estimated 10-years CV risk : 30(15-40)%, 45(30-60)% and 60(40-75)% respectively. Logistic analysis likewise demonstrated high independent prognostic significance of ABP. Odds ratio increased with each 10-mmHg change by 1.45(1.12-1.89) for 24-h SBP and 1.49(0.99-2.27) for 24-h DBP.
Clinics, 2010
Nery SS, Gomides RS, da Silva GV, Forjaz CLM, Mion Jr D, Tinucci T. Intra-arterial blood pressure... more Nery SS, Gomides RS, da Silva GV, Forjaz CLM, Mion Jr D, Tinucci T. Intra-arterial blood pressure response in hypertensive subjects during low-and high-intensity resistance exercise. Clinics. 2010;65(3):271-7.
Revista do Hospital das Clínicas, 2004
MION Jr. D et al. Hypertension in employees of a University General Hospital. Rev. Hosp. Clín. Fa... more MION Jr. D et al. Hypertension in employees of a University General Hospital. Rev. Hosp. Clín. Fac. Med. S. Paulo 59(6):329-336, 2004.
Clinics, 2009
Gusmão JL, Mion Jr. D, Pierin AMG. Health-related quality of life and blood pressure control in h... more Gusmão JL, Mion Jr. D, Pierin AMG. Health-related quality of life and blood pressure control in hypertensive patients with and without complications. Clinics. 2009;64 :619-28.
Recebido em 02/09/05 • Aceito em 13/10/05 PALAVRAS CHAVES combinação fi xa de antihipertensivos, ... more Recebido em 02/09/05 • Aceito em 13/10/05 PALAVRAS CHAVES combinação fi xa de antihipertensivos, anlodipino, losartana, efi cácia, tolerabilidade, metabolismo da glicose e lípides OBJECTIVE The LOTHAR study evaluated medium and long term (one year) effi cacy, tolerability and metabolic effects of the fi xed combination of amlodipine and losartan compared to amlodipine or losartan alone. METHODS Brazilian multicenter, randomized, double-blind and comparative trial performed with 198 patients in stage 1 and 2 essential hypertension.
Nephrology Dialysis Transplantation, 2009
It is not known if the adjustment of antihypertensive therapy based on home blood pressure monito... more It is not known if the adjustment of antihypertensive therapy based on home blood pressure monitoring (HBPM) can improve blood pressure (BP) control among haemodialysis patients. This is an open randomized clinical trial. Hypertensive patients on haemodialysis were randomized to have the antihypertensive therapy adjusted based on predialysis BP measurements or HBPM. Before and after 6 months of follow-up, patients were submitted to ambulatory blood pressure monitoring (ABPM) for 24 h, HBPM during 1 week and echocardiogram. A total of 34 and 31 patients completed the study in the HBPM and predialysis BP groups, respectively. At the end of study, the systolic (SBP) and diastolic (DBP) blood pressure during the interdialytic period measured by ABPM were significantly lower in the HBPM group in relation to the predialysis BP group (mean 24-h BP: 135 +/- 12 mmHg/76 +/- 7 mmHg versus 147 +/- 15 mmHg/79 +/- 8 mmHg; P < 0.05). In the HBPM analysis, the HBPM group showed a significant reduction only in SBP compared to the predialysis BP group (weekly mean: 144 +/- 21 mmHg versus 154 +/- 22 mmHg; P < 0.05). There were no differences between the HBPM and predialysis BP groups in relation to the left ventricular mass index at the end of the study (108 +/- 35 g/m(2) versus 110 +/- 33 g/m(2); P > 0.05). Decision making based on HBPM among haemodialysis patients has led to a better BP control during the interdialytic period in comparison with predialysis BP measurements. HBPM may be a useful adjuvant instrument for blood pressure control among haemodialysis patients.
Nephrology Dialysis Transplantation, 2011
Hypertension is highly prevalent among kidney transplantation recipients and considered as an imp... more Hypertension is highly prevalent among kidney transplantation recipients and considered as an important cardiovascular risk factor influencing patient survival and kidney graft survival. Aim. Compare the blood pressure (BP) control in kidney transplant patients through the use of home blood pressure monitoring (HBPM) is more comparable with the results of ambulatory blood pressure monitoring compared to the measurement of office blood pressure. From March 2008 to April 2009 prospectively were evaluated 183 kidney transplant recipients with time after transplantation between 1 and 10 years. Patients underwent three methods for measuring BP: office blood pressure measurement (oBP), HBPM and ambulatory blood pressure monitoring (ABPM). In total, 183 patients were evaluated, among them 94 were men (54%) and 89 women (46%). The average age was 50 ± 11 years. The average time of transplant was 57 ± 32 months. Ninety-nine patients received grafts from deceased donors (54%) and 84 were recipients of living donors (46%). When assessed using oBP, 56.3% presented with uncontrolled and 43.7% with adequate control of BP with an average of 138.9/82.3 ± 17.8/12.1 mmHg. However, when measured by HBPM, 55.2% of subjects were controlled and 44.8% presented with uncontrolled BP with an average of 131.1/78.5 ± 17.4/8.9 mmHg. Using the ABPM, we observed that 63.9% of subjects were controlled and 36.1% of patients presented uncontrolled BP with an average 128.8/80.5 ± 12.5/8.1 mmHg. We found that the two methods (oBP and HBPM) have a significant agreement, but the HBPM has a higher agreement that oBP, confirmed P = 0.026. We found that there is no symmetry in the data for both methods with McNemar test. The correlation index of Pearson linear methods for the ABPM with the other two methods were 0.494 for office measurement and 0.768 for HBPM, best value of HBPM with ABPM. Comparing the errors of the two methods by paired t-test, we obtained the descriptive level of 0.837. Looking at the receiver operating characteristic curve for BP measurements in each method, we observed that oBP is lower than those obtained by HBPM in relation to ABPM. We conclude that the results obtained with HBPM were closer to the ABPM results than those obtained with BP obtained at oBP, being more sensitive to detect poor control of hypertension in renal transplant recipients.
Hypertension, 2008
issue of Hypertension, Bankir et al 1 analyzed the data of 325 subjects divided into tertiles of ... more issue of Hypertension, Bankir et al 1 analyzed the data of 325 subjects divided into tertiles of the day:night ratio of urinary sodium excretion. Subjects in tertile 3 were qualified as "high daytime sodium excretors" because they excreted sodium at a rate that was 46% higher during daytime than during nighttime, whereas subjects in tertile 1 were "low daytime sodium excretors" and excreted 3 times less sodium during daytime than during nighttime. The nocturnal blood pressure (BP) dipping was significantly lower in tertile 1 than in other tertiles, especially for systolic BP. Thus, the authors suggested that the capacity to excrete sodium during daytime is the main determinant of nocturnal BP and dipping.
Blood Pressure Monitoring, 2005
Background Ambulatory blood pressure monitoring (ABPM) provides relevant data about blood pressur... more Background Ambulatory blood pressure monitoring (ABPM) provides relevant data about blood pressure over a 24-h period. The analysis of parameters to determine the blood pressure profile from these data is of great importance.
Blood Pressure Monitoring, 2004
Background It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is... more Background It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is erroneous for large arms.
Atherosclerosis, 2008
Background: Dietary salt restriction has been reported to adversely modify the plasma lipoprotein... more Background: Dietary salt restriction has been reported to adversely modify the plasma lipoprotein profile in hypertensive and in normotensive subjects. We investigated the effects of the low sodium intake (LSI) on the plasma lipoprotein profile and on inflammation and thrombosis biomarkers during the fasting and postprandial periods. Methods: Non-obese, non-treated hypertensive adults (n = 41) were fed strictly controlled diets. An initial week on a control diet (CD, Na = 160 mmol/day) was followed by 3 weeks on LSI (Na = 60 mmol/day). At admission and on the last day of each period, the 24-h ambulatory blood pressure was monitored and blood was drawn after an overnight fasting period and after a fat-rich test meal. Results: The dietary adherence was confirmed by 24-h urinary sodium excretion. Fasting triglyceride (TG), chylomicron-cholesterol, hsC-reactive protein (CRP), tumor necrosis factor-␣ (TNF-␣), interleukin-6 (IL-6) concentrations, renin activity, aldosterone, insulin, and homeostasis model assessment insulin resistance (HOMA-IR) values were higher, but non-esterified fatty acids (NEFA) were lower on LSI than on CD. For LSI, areas under the curve (AUC) of TG, chylomicron-cholesterol, apoB and the cholesterol/apoB ratio were increased, whereas AUC-NEFA was lowered. LSI did not modify body weight, hematocrit, fasting plasma cholesterol, glucose, adiponectin, leptin, fibrinogen and factor VII (FVII), and AUC of lipoprotein lipase and of lipoprotein remnants. Conclusion: LSI induced alterations in the plasma lipoproteins and in inflammatory markers that are common features of the metabolic syndrome.
Arquivos Brasileiros de Oftalmologia, 2008