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The uncertain beginnings and the “why” of this blog.

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If you want to see the spanish translation click here.

Back in 1998. I was doing my Residence in General Medicine in Santa Clara. Villa Clara. Cuba, it was noon and I was set out to see my last patient. He was a 10-year-old boy brought to the clinic by his mother. He looked like a bit overweight and reported intermittent headache for more than two days. Upon taking medical history, the only positive complain was a frontal headache lasting about an hour with no other accompanying symptom.

At physical examination, there was nothing relevant, in my opinion, to point out. I must confess that I was somewhat bewildered about the cause of the headache. However, I explained to the mother that this pain could be the result of multiple causes while I was ordering a routine checkup. The patient was prescribed pain killers and I advised the mother that if something new raised to go the nearest health center. At the stage, the patient was ready to leave the office I came up with the idea to measure his blood pressure (BP) and to my surprise, he had 140 mmHg of systolic blood pressure with 95 mmHg of diastolic blood pressure. Undoubtedly, that was the cause of the persistent headache. I said to myself: “this patient is hypertensive and he is only 11 years old, what should I do?” Continue reading “The uncertain beginnings and the “why” of this blog.”

Commentary: Left Ventricular Hypertrophy in Pediatric Hypertension: A Mini Review. I am very proud of this publication of mine.

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Left ventricular hypertrophy in pediatric hypertension. A new publication of mine stressing this important topic just published in the medical journal Frontiers in Pediatric (peer-reviewed journal with high impact. Click on the hyperlink)

Just awaiting for your comments.

Thanks,

Dr. Guillermo.

1-minute read. Aged cardiovascular system early in life. A new direction to act on. 

This post has been written by Dr. Guillermo Perez and represents his personal opinion on the topic. 

“A man is as old as his arteries”                                                                      

                                Thomas Sydenham. 

Vascular aging represents a progressive process involving biochemical, enzymatic, and cellular changes of the vascular tree.

In short, early vascular aging (EVA), is defined as a vascular damage inappropriate for age. Increased arterial stiffness, dilated elastic arteries of central type and impaired endothelial function are main aspects of this process.

EVA is common in patients with hypertension and increased burden of cardiovascular risk factors. Several studies have indicated that this process starts early in life and could be programmed during foetal life or influenced by adverse growth patterns in early postnatal life.

Determinants of EVA can be classified as prenatal and postnatal factors. Prenatal factors are related to mothers’ behavior regarding food, smoking, or alcohol consumption. Some of the genetic mutations from prenatal life seem to influence the development of EVA in children, by starting even from intrauterine life without having clinical or subclinical manifestations in childhood. Posnatal factors comprise the presence of known cardiovascular risk factors that might impact negatively over life speeding up the vascular aging.

Nowadays, the early recognition of the EVA process has become the target of many investigations seeking going ahead in the early identification of individuals at cardiovascular risk.

This is and will be the smartest way to act, it is time to detect the risk early in life. When it comes to cardiovascular risk, the earlier the better. Once the disease is in place, things may turn very unfavorable for the patient and often migh be late for an efective treatment.

Thus, we have another tool to work with, kowing how to use it is key. 

References

1- Nilsson P, Boutouyrie P, Cunha P. Early vascular ageing in translation a: from laboratory investigations to clinical applications in cardiovascular prevention. J Hypertens. 2013;(31):1517–1526.

2- Rana S, Pugh PC, Katz E, et al. Independent effects of early-life experience and trait aggression on cardiovascular function. Am J Physiol Regul Integr Comp Physiol. 2016;311(2):R272–R286.

 

 

Trending in the web. PURE Study Shakes Up Nutritional Field: Finds High Fat Intake Beneficial. Do you believe it?

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The new study of dietary habits in 135,000 people around the world found that high fat intake, including saturated fat, was associated with a reduced risk of mortality

Source: PURE Shakes Up Nutritional Field: Finds High Fat Intake Beneficial

1-minute read. Low school performance and arterial hypertension in children and adolescents. An overlooked link.

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This post has been written by Dr. Guillermo Alberto Perez Fernandez and represents his personal opinion on the topic.

September is already going on. In most countries, this month denotes the start of the academy year in the school system, thereby, I felt that this post would fit in well.

It has been addressed before on this blog the repercussions of arterial hypertension since early in life. However, there is an effect that most times is missed: the impact on the school performance in our children and adolescence.

Unlike some people might think, there is a connection.

Although it is well-known the influence of hypertension on several organs of the human body as kidney, heart and brain among others in adults. The impact on the brain since childhood has been barely described and most reports in the past were limited to gross neurologic events, such as facial palsy, seizure and stroke in children with malignant hypertension.

Nowadays, the medical community is focusing on the association of arterial hypertension and neurocognition since early in life.

Neurocognition: Any form of cognition (the mental process of thinking and understanding) that is associated with the functioning of one or more specific areas of the brain.

What has the medical community found out on this so far?

Children with newly diagnosed or untreated primary hypertension have decreased performance on neurocognitive measures of attention, learning, memory, and fine motor ability compared with those being normotensive regardless maternal education, race, ethnicity, age and sex.

Hypertension in early in life often clusters with other cardiovascular risk factors with further negative effects on cognition, including obstructive sleep apnea, metabolic syndrome, insulin resistance and hyperlipidemia (1,2)

Therefore, the impact of hypertension early in life on neurocognition is clear.

In addition, to make things more complicated, often the school environment may be stressful and challenging for some children which adds up stress to the equation; another variable proven to be strongly related with high blood pressure as I already published some time ago (3)

Then, my recommendation is this: check on any children or adolescent with a poor school performance. Hypertension might be backstage.

Thanks,

The author

References.

1- Lande, M.B., Kupferman, J.C., and Adams, H.R. Neurocognitive alterations in hypertensive children and adolescents. J Clin Hypertens (Greenwich). 2012; 14: 353–359.

2- Hooper SR. Risk Factors for Neurocognitive Functioning in Children with Autosomal Recessive Polycystic Kidney Disease. Front Pediatr. 2017 May 15;5:107.

3- Perez Fernández GA. Hipertensión arterial, estrés y rendimiento académico para la evaluación integral del adolescente hipertenso o en riesgo. Medicentro. 2011; 15(3). (Available at : http://www.medicentro.sld.cu/index.php/medicentro/article/view/238)

Long screen time and cardiovascular disease in children and adolescents. Social media and video games might be taking their toll.

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Whenever someone have asked me- What makes so difficult to approach and control arterial hypertension and its related health conditions?

My response is loud and clear: The complexity of the tangled skein we must deal with as health care providers.   

The problem is that there is a growing number of risk factors with a very complex interrelation.

Nowadays, another has been summed up to the list: the screen time or in other words, the time spent on social media, video games, watching television, music videos, advertising, etc.

It is not a secret that is increasingly rare to see kids and adolescents playing games outdoor unless these are part of the school program they belong to. Children are no longer playing hide-and-seek outside or reading a good hard-cover book. Instead, they’ve dived into a world of constant digital media through television, mobile devices and video games.

According to the latest statistics about the topic: Continue reading “Long screen time and cardiovascular disease in children and adolescents. Social media and video games might be taking their toll.”

Today’s Audio. Sodium intake might be killing the future. It will get your attention.

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Now our blog supports audio. Today you can listen to Dr. Bonita Falkner, chair of the International Pediatric Hypertension Association giving insigtful comments about this topic.

Thanks to Sheila Kay McIntyre on LinkedIn: “Today’s ShoutOutThursday Winners are 1 Guillermo Alberto Perez Fernandez…

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Today’s ShoutOutThursday Winners are 1 Guillermo Alberto Perez Fernandez  Cardiologist, Ph.D (read more about his fascinating Cardiovascular Health Article > https://lnkd.in/en4Ws2f  & under my latest comment! & 2 Melton McClanahan thank you for being such a valuable member of S.O.T, supporting so many with your positive comments, likes, re-posts & helpful articles! I want to Thank you 2 Great Men for all that you do for this Community!

Source: Sheila Kay McIntyre on LinkedIn: “Today’s ShoutOutThursday Winners are 1 Guillermo…