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hipertension arterial nomssa pdf. Quote. Postby Just» Tue Aug 28, am. Looking for hipertension arterial nomssa pdf. Epub Feb 1. PubMed PMID: 5: Lassalle M, Ayav C, Frimat L, Jacquelinet C, Couchoud C; Au Nom du Registre REIN. En nombre de la Asociación de Nefrología e Hipertensión Arterial de El Salvador (ANHAES). Prevalence. Proyecto de Norma Oficial Mexicana PROY-NOM SSA, Para la prevención, detección, diagnóstico, tratamiento y control de la hipertensión arterial sistémica, publicada en el Diario Oficial de la Task Force for the management of arterial hypertension of the European Society of [Epub ahead of print].
This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Hypertension and dyslipidemia exhibit an important clinical relationship because an increase in blood lipids yields an increase in blood pressure BP. A total of HT patients and normotensive individuals were included. The results showed significant associations in the HT group and HT subgroups classified as normolipemic and hyperlipemic. The alleles FABP2 p.
Subjects were dressed in light clothing and barefoot. Waist circumference WC was measured at the minimum circumference between the iliac crest and the rib cage. The samples were taken at 8 a. Before processing, the blood samples were centrifuged at x g for 3 min in a SOLBAT centrifuge at 4o C, and plasma was removed and analyzed immediately after collection.
Participants were divided into six groups of 32 women each. The components of each session included: introduction to the program, general approaches to selected topics nutrition, health, and psychology , social support and interrelation group dynamics, structured physical activity and closing remarks. Sessions Introduction During this phase the purpose of the study was reintroduced to the whole group and after signing the informed consent the participants' demographics, clinical data, and anthropometric measurements were taken.
General approaches to selected topics nutrition, health, and psychology Selected topics were explored in an interactive, dynamic manner. Some of the topics covered were the cardiovascular system, self-concept of body image, overweight and obesity, self-esteem, healthy diet, self-knowledge of one's strengths and weaknesses, acceptance of one's personality and lifestyles, the role and values of women in society, the importance of the role of women in society and the family, mental health, stress management, and self-empowerment.
Social support and inter-relation group dynamics In each session dynamic groups and inter-relation group dynamics were applied to reinforce each of the topics discussed and promote group cohesion, including questions and answers modules about individual barriers to lifestyle changes and group support. Music and leaflets were also used to support the sessions. Structured physical activity During the first six sessions, women were enrolled in low intensity aerobic exercise, each session was 30 minutes long; for the remaining seven sessions the women performed median impact aerobics, combined with anaerobic exercise, and these were also 30 minutes long.
Evaluation procedures Two weeks into the intervention an evaluation of the program was performed via a questionnaire assessing the participant's attitudes towards the intervention; and simultaneously the AF5 and PEPS-1 questionnaires were applied.
Anthropometric measurements and a blood sample for biochemical variables were also taken. Statistical analysis Anthropometric, biochemical, blood pressure, and AF-5 and PEPS-1 total scores for each dimension were examined to assess normality.
Paired two-tailed Student's t-tests were used to evaluate mean differences in pre and post intervention for all variables studied. Ethics approval The study was approved by the ethics committee of the Nutrition School of the Universidad de Ciencias y Artes de Chiapas, and the participants signed an informed consent form. Results Seven hundred and sixty two women attended the first meeting and agreed to participate in the study. However, only five hundred eighty six participants met the inclusion criteria for the study and had accurate data of anthropometric measurements, biochemistry, and the AF5 and PEPS-1 at the beginning of the study.
Mean age was The pre and post intervention percentage and remission of metabolic syndrome criteria are shown in table I. Discussion The first alarming observation of this study is the high prevalence of MS and its components. Additionally, among this group of women from rural Chiapas, with the specific characteristics of being very poor and with limited formal education, after a three month community intervention based on SS techniques and promoting changes in self-concept and lifestyles, significant changes were observed in several dimensions of the AF5 and PETS-1, as well as in MS and its components.
The high prevalence of MS among this population is consistent with the high prevalence of obesity among infant and toddler children from low income families in Mexico,11 and in low, middle and high SES middle school children living in Tuxtla, the largest city in the state of Chiapas. These results indicate the importance of intervention and evaluation programs targeting the entire Mexican population to prevent obesity and MS.
To our knowledge this is the first study that implemented a social support approach to women of rural areas, focusing on MS, self-concept, and healthy style profile. The results on the weight loss observed in this study are consistent with eight studies analyzed in a systematic review; however, those studies did not assessed all the components of MS and the AF5 and PEPS-1, and the interventions ranged from five to 24 months.
The strength of this study is the high number of participants from rural areas and the high number of participants with limited or no formal education, as well as this being a population living in very poor communities in Chiapas, the Mexican state with the lowest index of human development.
Furthermore, the low cost of the intervention based on the utilization of local resources from a public university and bachelors students of nutrition and the inclusion of a social support technique focusing on changes in self-concept, lifestyles, and MS are also important strengths. Limitations of this study include the short duration three months of the intervention, the wide range of the study participant's age, and the pre and posttest design.
Acknowledgments The authors declare no conflicts of interest. The authors thanks the student Anibal Aquino and the biochemist technical Adaly Rasgado, and all the students who participated in the interviewing and assessing process as well as the chemist who made the biochemical analysis, Ma. References 1. Summary of the Surgeon General's listening session: toward a national action plan on OW and obesity.
Obes Res ; 10 12 : Kirchengast Schober E. To be an immigrant: a risk factor for developing OW and obesity during childhood and adolescence?
J Biosoc Sci ; 38 5 The relation of gender, race and socioeconomic status to obesity and comorbidities in a sample of U. Int J Obes ; Lindstrom M, Sundquist K. The impact of country of birth and time in Sweden on OW and obesity. A population-based study. Scand J Publ Health ; 33 4 : Is migration to Canada associated with unhealthy weight gain?
OW and obesity among Canada's immigrants. Soc Sci Med ; 61 12 : J Immigr Minor Health ; 14 4 : The fattening burden of type 2 diabetes to Mexicans: projections from early growth to adulthood.
Diabetes Care ; 27 5 : JHCPU ; Secular change in height and weight of indigenous school children in Oaxaca, Mexico, between the s and Ann Hum Biol ; 38 6 : Epub Aug Asia Pacific J Clin Nutr ; 19 3 : Washington, DC. Furthermore, to estimate the relationships of the seven polymorphisms with hypertension and different dyslipidemias, multiple logistic regression models were generated.
A value of was considered statistically significant. The analyses were performed using SPSS v. Results 3. Genotypic and Allelic Frequencies The genotype and allele frequency distributions of the seven polymorphisms are shown in Table 1. All three possible genotypes were observed at each site and exhibited heterogeneous frequencies. The frequencies of the mutant genotypes of FABP2 p.
In both of the studied groups, the mutant alleles of LDLR c. Table 1: Frequencies of genotypic and allelic polymorphisms in hypertensive and normotensive subjects. Comparison of the genotypic and allelic frequencies between the groups revealed statistically significant differences only for the APOB p. EK polymorphism and , resp. Considering all of the HT patients not receiving drug treatment , the following significant associations with TC and TG were observed.
Subjects with the LPL p. A significant multiple linear regression model with the FABP2 p. Table 2: Distribution of dyslipidemias in hypertensive patients. Association analysis was performed in two subgroups of hypertensive patients, normolipemic without dyslipidemia and hyperlipemic with dyslipidemia Table 2.
Age variable was not significantly different between subgroups. Analysis of the two subgroups showed many significant results. The multiple linear regression models for each polymorphism and quantitative variable are presented in Table 4.
Table 4: Multiple linear regression models observed in normolipemic and hyperlipemic hypertensive patients. APOA5 p. APOB p. We detected one significant association in the normolipemic subgroup; the HT patients carrying the p. This polymorphism exhibited an association with three variables. TG and SBP levels were increased significantly in presence of the mutated allele p. Multiple Linear Regression Models In total, nine distinct multiple linear regression models with statistically significant differences were generated with genotypes and alleles data; in Table 4 , the results obtained with the alleles are shown.
An integrated model with two polymorphisms FABP2 p. The eight remaining models included only one polymorphism. The TG variable presented a greater number of significant models Table 4. Logistic Regression Models In this analysis, we observed two models. The first was observed for APOB p. Discussion Essential hypertension is a multifactorial disease with a strong genetic component; therefore, genes corresponding to different metabolic routes have been explored.
Because increased blood lipid levels are known to result in an increase in blood pressure, in the present work, we analyzed seven polymorphisms of genes involved in lipid metabolism in HT patients to examine their role in the development of essential hypertension and dyslipidemias.
It is important to note that when the association analysis was performed in the entire HT group, only a few significant results were observed. However, the analysis of the HT patients classified according to lipid levels revealed more significant associations between the polymorphisms and diverse variables.
Studies examining these polymorphisms in different populations have revealed heterogeneous results. A possible explanation is that these differences occur because most of the authors did not analyze the data by separating individuals according to dyslipidemia. EK, based on the presence of more heterozygotes in the HT group The analysis showed similar genotypic frequency distributions for the general population and NT individuals.
However, we observed significant differences between the general population and the HT group for three polymorphisms: the APOB p. SX Chinese and Caucasian populations [ 23 ]; similar to the results of the present study, the authors did not report significant differences in the genotypic and allelic frequency distribution. Distribution of Dyslipidemias in HT Patients In Mexico, dyslipidemias and essential hypertension are the most common risk factors for the development of cardiovascular disease in the general adult population [ 24 , 25 ].
Various reports have revealed that one of the most frequent dyslipidemias in the Mexican population is hypoalphalipoproteinemia, and similar results were obtained in this study. Although a clinical finding of hypoalphalipoproteinemia does not represent a health problem by itself, it is an important risk factor for developing cardiovascular disease and metabolic syndrome when associated with high TG and TC levels.
Furthermore, in patients with hypertension, several coincident biochemical alterations can increase cardiovascular risk and complicate hypertension management. In this study, the p. This association between high HDL-C levels and the p.
High TG levels associated with the p. This association was also reflected in the logistic regression analysis because, in the HT group, the p. In the present study, the p. However, the literature is inconsistent regarding whether the p. In this work we found a risk of developing hypertension conferred by p.
Thus, we suggest that the p. The FABP2 p. A55T polymorphism has been extensively studied and referenced in the literature. However, an association between the mutated allele and an increase in TG was observed in the HT patients and hyperlipemic subgroup and has been reported previously [ 31 , 32 ]. This association is consistent with the increase in fatty acid absorption found in individuals with the p.
Moreover, the studied groups in which this association had been observed also exhibit low HDL-C, as found in our patients with hypoalphalipoproteinemia. LDLR c. The c. One of the primary functions of hepatic lipase is to hydrolyze TG and phospholipids, and hepatic lipase is an important enzyme in HDL-C metabolism [ 14 ]. To our knowledge, this is the first study to analyze this polymorphism in HT patients and to assess its association with blood pressure.
It has been shown that the p. In the present work, in the HT and HT hyperlipemic groups, the p. Consistent with such results, the presence of the p. However, in healthy males and hypercholesterolemia patients, the mutated allele has been associated with low TC [ 16 ] and TG levels [ 35 ], respectively. Conclusions We highlight three important conclusions. EK polymorphism under the dominant model is associated with an increased risk for hypertension.
Total cholesterol is decreased in subjects with the LPL p. These findings indicate that polymorphisms of lipid metabolism genes modify systolic blood pressure and lipid levels and may be important for the development of essential hypertension and dyslipidemia in Mexican HT patients.
Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper. They would also like to thank Rogelio Troyo Sanroman for assistance with the statistical analysis.
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