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

2017-10-18 14_53_16-Photos

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.

 

 

What if the human life span keeps increasing?

A post from a good blog I want to share with you.

Medicine and Serge Benhayon

by Rebecca Briant, Student and Receptionist, London, UK

The average life expectancy of humans is increasing at an unprecedented rate. Seen as one of the great achievements of the century, in the last 40 years alone it has risen by 10 years, and in 2011 life expectancy at birth was almost double what it was in 1841(1). But what will happen if our life span continues to increase, and how can we address the issues we will face?

As most people know, with age there comes a natural deterioration of the body. However, what we are already witnessing, and will see more of should trends continue to increase, is an unmanageable presence of chronic, multi-symptomatic conditions in our elderly and increasingly in younger people, which create a huge economic strain on the NHS. The annual cost of health and social care is far higher for elderly people, with more than…

View original post 1,181 more words

Red Bull beverage and high blood pressure in adolescents. Watch out ¡¡¡¡¡.

redThose who has drunk the energy beverage called Red Bull might be aware that its slogan since 1984 when it was first introduced into the Market is “Red Bull gives you wings”, meaning somehow that by consuming it you are freer.

To start with, briefly, I will tell you something that happened to me at my hospital in Cuba. It was a very exhausting day, and the last patient was a 16-aged male teenager who came in along with his parents which seemed to be very concerned for the lack of control of their child´s blood pressure despite the right measurements ordered to him over the past month when the diagnosis was made.

It was a moderate high blood pressure without known cardiovascular risk factors and all the tests indicated so far were within the normal range. The patient and his parents assured me that the non-pharmacological and pharmacological measurements are being carried out in good terms.

After a long chat where I could not find any insights related with this lack of blood pressure control, at last I asked him the following: Continue reading “Red Bull beverage and high blood pressure in adolescents. Watch out ¡¡¡¡¡.”

Escoge a los progenitores “sabiamente” y no serás hipertenso. ¿De quién es la culpa?

progValentín Fuster, uno de los padres de la cardiología moderna,  en la décimo sexta conferencia de Bethesda. EE.UU. en 1996, acerca del papel biológico de los factores de riesgo cardiovascular (FRC), emitió una interesante y no menos jocosa afirmación: “la mejor manera de evitar la aterosclerosis es “escoger” a los progenitores sabiamente”.

Según la literatura, los individuos con antecedentes patológicos familiares (APF) de FRC presentan cifras de presión arterial (PA) mayores que aquellos descendientes de familiares sin este riesgo; aseveración confirmada desde la edad pediátrica con tendencia a adquirir más relevancia posteriormente 1. Se plantea que cuando ambos padres son hipertensos, teóricamente el 50 % de los hijos heredará la condición; si uno solo lo es, la cifra desciende al 20 ó 30 %.

La contribución de la historia familiar de riesgo cardiovascular al exceso de riesgo es independiente del accionar de otros FRC y se ha relacionado con una serie de anormalidades, incluso desde la adolescencia, en individuos con APF de ECV, como son: hiperinsulinismo, resistencia a la insulina, intolerancia a la glucosa, disfunción endotelial, y alteraciones lipídicas y del metabolismo de las mitocondrias 1.

Solini y colaboradores 2, al medir las concentraciones séricas de selectina P, interleucina 6, metaloproteinasas 2 y 9 y el factor tisular inhibidor de las metaloproteinasas en sujetos con APF de ECV y sin este antecedente, llegan a la conclusión de que aquellos con una historia familiar positiva de ECV presentaron niveles de estas sustancias significativamente mayores, lo que sin dudas constituye un elemento indicativo de la presencia de aterosclerosis en los individuos con APF de ECV.

Vercoza y colaboradores 3 midieron por ultrasonografía de alta resolución el grosor de la íntima y la media de la arteria braquial entre niños en edad escolar, y encontraron asociaciones significativas entre dichos parámetros y la presencia de APF de ECV.

En opinión del autor, el presentar APF de ECV es un riesgo para el desarrollo de HTA; la distinción de cuál de los antecedentes es el más notable no es lo más significativo, si se tiene en cuenta que más del 50 % de los individuos poseen más de un APF de ECV; y que el patrón de herencia en este caso no es mendeliano, sino complejo. Lo trascendente aquí sería no dejar de pesquisar la existencia de una historia familiar de FRC.

Referencias Bibliográficas.

1-    Kones R. Recent advances in the management of chronic stable angina II. Anti-ischemic therapy, options for refractory angina, risk factor reduction, and revascularization. Vasc Health Risk Manag. 2010;6:749-74.

2-    A Solini, E Santini, A Passaro, S Madec and E Ferrannini. Family history of hypertension, anthropometric parameters and markers of early atherosclerosis in young healthy individuals. J Hum Hypertens 2009; 23:801–807.

3-    Verçoza AM, Baldisserotto M, de Los Santos CA, Poli-de-Figueiredo CE, d’Avila DO. Cardiovascular risk factors and carotid intima-media thickness in asymptomatic children. Pediatr Cardiol. 2009;30(8):1055-60.

Por favor “rate” esta entrada/Please rate this post

Cardiovascular disease and cancer. A madness?

images (1)Is it possible the existence of a bond between cardiovascular disease and cancer? This was one of the first questions aimed to my fellows at a briefing.

Really, I acknowledge that to figure a link is difficult. Yet, there is a connection. Different theories could explain such as relationship: Continue reading “Cardiovascular disease and cancer. A madness?”