Mecanismos de comorbilidad en hipertensión arterial

Shunchao Kou, Xueqing Li, Miguel Ángel Blanco Aspiazu

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Resumen

 

Introducción: La práctica asistencial muestra que la hipertensión arterial es una enfermedad que suele asociarse a otros problemas de salud, sin embargo, este aspecto no siempre se tiene en cuenta al elaborar guías de práctica clínica y protocolos de diagnóstico y tratamiento, así como en los ensayos clínicos.
Objetivo
: Fundamentar la necesidad de abordar la comorbilidad como fenómeno de la práctica clínica asistencial relevante para la investigación y la creación de guías de práctica clínica y protocolos de diagnóstico y tratamiento.
Material y Métodos
: Se realizó una revisión de fuentes bibliográficas que fueron localizadas mediante el motor de búsqueda Google Académico, biblioteca de los autores y la base de datos Scielo de la Biblioteca Virtual de Salud.
Resultados
: La asociación de la hipertensión y otros problemas de salud se manifiesta a nivel de la etiopatogenia, la fisiopatología y los efectos del tratamiento.
Conclusiones
: La comorbilidad es un fenómeno frecuente y aunque se trata de un problema complejo, existen fundamentos para su análisis desde los niveles etiopatogénico, fisiopatológico y terapéutico, lo que es imprescindible tomar en cuenta al elaborar y valorar normas de tratamiento e investigaciones sobre hipertensión arterial.

Palabras claves: Hipertensión arterial, comorbilidad, fisiopatología, mecanismo

Referencias

Bonet Gorbea M, Varona Pérez P. III Encuesta nacional de factores de riesgo y actividades preventivas de enfermedades no trasmisibles. Cuba 2010-2011. Editorial Ciencias Médicas 2014. [citado 10 Nov 2016] disponible en: http://www.bvs.sld.cu/libros/encuesta_nacional_riesgo/indicep.htm

MINSAP. Dirección de Registros médicos y estadísticas de salud. Anuario estadístico de salud. Cuba 2015. [citado 11 Nov 2016] Disponible en: www.sld.cu/sitios/dne/

Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013 Oct;31(10):1925-38.

Cowley AW, Nadeau JH, Baccarelli A, Berecek K, Fornage M, Gibbons GH, et al. Report of the National Heart, Lung, and Blood Institute Working Group on Epigenetics and Hypertension Hypertension. 2012;59: 1 - 7

Pamies Andreu E, Vallejo Maroto I, Carneado de la Fuente J. Factores genéticos en la hipertensión arterial. Hipertensión 2003;20(4):163-70.

Vlachopoulos C, Aznaouridis K, Stefanadis C. Clinical appraisal of arterial stiffness: the Argonauts in front of the Golden Fleece. Heart [Internet]. 2006 [citado 29 de Mar 2016];92:1544-50. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861258/.

Rodríguez-Gómez I, Baca Y, Moreno JM, Wangensteen R, Perez-Abud R, Payá JA, et al. Role of sympathetic tone in BSO-induced hypertension in mice.Am J Hypertens [Internet]. 2010 [citado 18 Dic 2010];23:882-8. Disponible en: http://ajh.oxfordjournals.org/content/23/8/882.full.

Julien C. Mental stress, hypertension and the baroreflex: what’s new? J Hypertens [Internet]. 2009 [citado 18 Dic 2010];27:31-3. Disponible en: http://journals.lww.com/jhypertension/Citation/2009/01000/Mental_stress,_hypertension_and_the_baroreflex_.8.aspx.

Campese VM. Oxidative stress and sympathetic activity in hypertension. Am J Hypertens [Internet]. 2010 [citado 19 de Dic 2015];23(5):456. Disponible en: http://ajh.oxfordjournals.org/content/23/5/456.full.pdf+html.

Milsted A, Underwood AC, Dunmire JU. Del Puerto HL, Martins AS, Ely DL, et al. Regulation of multiple renin–angiotensin system genes by Sry. J Hypertens [Internet]. 2010 [citado 25 Mar 2011]; 28:59-64. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897148/.

Fisher NDL, Williams GH. Hypertensive vascular disease. En: Kasper DI, Fauci A, Longo DI, Braunwald E, Hauser SI, Jameson JL, editors. Harrison’s Principles of Internal Medicine. New York: McGraw-Hill; 2006. p. 1463-81.

Mizuno Y, Jacob RF, Mason RP. Effects of calcium channel and renin–angiotensin system blockade on intravascular and neurohormonal mechanisms of hypertensive vascular disease. Am J Hypertens [Internet]. 2008 [citado 21 Mar 2016];21:1076-85. Disponible en: http://ajh.oxfordjournals.org/content/21/10/1076.full.

Sowers JR, Whaley-Connell, Epstein M. The emerging clinical implications of the role of aldosterone in the metabolic syndrome and resistant hypertension. Ann Intern Med [Internet]. 2009 [citado 21 Mar 2016];150(11):776-83. Disponible en: http://annals.org/article.aspx?articleid=744524.

Kim JA, Wei Y, Sowers JR. Role of mitochondrial dysfunction in insulin resistance. Circ Res [Internet]. 2008 [citado 26 Dic 2016]; 102:401-14. Disponible en: http://circres.ahajournals.org/content/102/4/401.full.

Lai TS, Curhan GC, Forman JP. Insulin resistance and risk of incident hypertension among men. J Clin Hypertens [Internet]. 2009 [citado 19 dic 2009];11(9):483-90. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139421/.

El-Atat F, McFarlane SI, Sowers JR. Diabetes, hypertension, and cardiovascular derangements: pathophysiology and management. Curr Hypertens Rep 2004; 6(3): 215–223.

Perlstein TS, Gumieniak O, Williams GH, Sparrow D, Vokonas PS, Gaziano M, et al. Uric acid and the development of hypertension: the Normative Aging Study. Hypertension. 2006;48:1031–6.

Luis M. Ruilope. Blood Pressure and Uric Acid in Diabetes Mellitus. The Journal of Clinical Hypertension 2014, 16 (4): 269.

Qaseem A, Wilt TJ, Rich R, Humphrey LL, Frost J, Forciea MA, et al. Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians. Ann Ann Intern Med. 2017 Jan 17. doi: 10.7326/P16-9030. [Epub ahead of print]

Zhu Y, Pandya BJ, Choi HK. Comorbidities of gout and hyperuricemia in the US general population—the National Health and Nutrition Examination Survey 2007-2008. Am J Med

Xu L, Wang S, Wang YX, Wang YS, Jonas JB. Prevalence of arterial hypertension in the adult population in rural and urban China: The Beijing Eye Study. Am J Hypertens [Internet]. 2008 [citado 27 Dic 2015];21(10):1117-23. Disponible en: http://ajh.oxfordjournals.org/content/21/10/1117.full.

Sun Z, Zheng L, Detrano R, Zhang X, Xu, Li J, Hu D. Risk of progression to hypertension in a rural chinese women population with prehypertension and normal blood pressure. Am J Hypertens [Internet]. 2010 [citado 10 Ene 2016];23(6):627-32. Disponible en: http://ajh.oxfordjournals.org/content/23/6/627.full.

Farsalinos K, Cibella F, Caponnetto P, Campagna D, Bhagwanji Morjaria J, Battaglia E, et al. Effect of continuous smoking reduction and abstinence on blood pressure and heart rate in smokers switching to electronic cigarettes. Intern Emerg Med. 2016 Feb;11(1):85-94.

Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2): S1-45.

Minami J, Ishimitsu T, Ohrui M, Matsuoka H. Association of smoking with aortic wave reflection and central systolic pressure and metabolic syndrome in normotensive Japanese men. Am J Hypertens [Internet]. 2009 [citado 20 Dic 2015];22(6):617-23. Disponible en: http://ajh.oxfordjournals.org/content/22/6/617.full.

Klatsky AL. Alcohol and cardiovascular mortality. Common sense and scientific Truth. J Am Coll Cardiol [Internet]. 2010[citado 18 Dic 2010]; 55(13):1336-8. Disponible en: http://www.sciencedirect.com/science/article/pii/S0735109710002731.

Simona Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G. Alcohol consumption and mortality in patients with cardiovascular disease. A meta-analysis.J Am Coll Cardiol [Internet]. 2010 [citado 18 Dic 2010];55(13):1339-47. Disponible en: http://www.sciencedirect.com/science/article/pii/S0735109710002408.

Pervichko E, Zinchenko Y. Postnonclassical Methodology in Clinical Psychology: Opportunities and Perspectives of Vygotsky-Luria School Open Journal of Social Sciences, 2014; 2: 90 – 5. http://dx.doi.org/10.4236/jss.2014.25018

Díez J, Frohlich ED. A translational approach to hypertensive heart disease. Hypertension[Internet]. 2010 [citado 29 Feb 2010];55:1-8. Disponible en: http://hyper.ahajournals.org/content/55/1/1

Vázquez H, Burdiat G, Alonso P, Sandoya E, Tejada J. Control del riesgo cardiovascular post internación en pacientes coronarios. Rev Urug Cardiol 2011; 26: 108-114.

Beaumont J, Arias T, López B, González A, Ravassa S, Hermida N et al. Avances en cardiopatía hipertensiva. Mecanismos de remodelado implicados en la transición de la hipertrofia a la insuficiencia cardiaca. Rev Esp Cardiol Supl. 2007; 7: 14F-21F.

González-Quevedo A, González-García S, Peña-Sánchez M, Menéndez-Saínz C, Fernández-Carriera R, Cordero-Einz A. Blood-Based Biomarkers Could Help Identify Subclinical Brain Damage Caused by Arterial Hypertension MEDICC Review. 2016; 18(1–2): 43 – 53.

González-García S, Hernández-Díaz Z, Quevedo-Sotolongo L, Peña-Sánchez M, Pino-Peña Y, Fernández-Carriera R, et al. Resistive cerebral blood fl ow as a potential marker of subclinical brain damage in essential hypertension. World J Cardiovasc Dis. 2014; 4(4): 169–78.

Longstreth WT, Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke. 1996; 27(8): 1274–82.

Céspedes Lantigua Luis Augusto, Morón Pinedo Déborah, Gomis Hernández Ride, Fernández Assán Ana, Prendes Lagos Elizabeth. Comportamiento del fenómeno dipper en una comunidad. Rev Cubana Med Gen Integr [Internet]. 2010 Dic [citado 2017 Abr 16] ; 26( 4 ): 624-635. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21252010000400005&lng=es.

Udani, S., Lazich, I. and Bakris, G.L. (2011) Epidemiology of Hypertensive Kidney Disease. Natural Review of Nephrology, 7, 11-21. http://dx.doi.org/10.1038/nrneph.2010.154

US Renal Data System (2011) USRDS. Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. National Institutes of Health, National In-stitute of Diabetes and Digestive and Kidney Diseases, Bethesda.

Sharma R, Kamalakar S, McCarthy E, Fields TA, Gupta K, Barua R, et al. Proteinuria in Hypertensive Nephropathy: A Review. Open Journal of Nephrology 2014, 4(2):

Appel LJ, Wright Jr, JT, Greene T, Agodoa LY, Astor BC. Bakris GL, et al. Intensive Blood-Pressure Control in Hypertensive Chronic Kidney Disease. New Engl J Med 2010; 363: 918 – 29.

Scialla, J.J., Appel, L.J., Astor, B.C., Miller 3rd, E.R., Beddhu, S., Woodward, M., et al. Net Endogenous Acid Production Is Associated with a Faster Decline in GFR in African Americans. Kidney International 2012; 82: 106 – 12. http://dx.doi.org/10.1038/ki.2012.82

Luyckx VA, Bertram JF. Brenner BM, Fall C, Hoy WE, Ozanne SE, et al. Effect of Fetal and Child Health on Kidney Development and Long-Term Risk of Hypertension and Kidney Disease. The Lancet. 2013; 382: 273 – 83. http://dx.doi.org/10.1016/S0140-6736(13)60311-6

Alfonso Guerra JP. Daño en órganos relacionados con la hipertensión arterial. Factores de riesgo modificables. En: Alfonso Guerra JP, Pérez Caballero MD, Hernández Cueto MJ, García Barreto D, editores. Hipertensión arterial en la atención primaria de salud. La Habana: Editorial Ciencias Médicas; 2009. p. 129-139.

Tomiyama H, Matsumoto C, Yamada J, Yoshida M, Odaira M, Shiina K, et al. Predictors of progression from prehypertension to hypertension in Japanese men. Am J Hypertens [Internet]. 2009 [citado 24 Feb 2010];22(6):630-6. Disponible en: http://ajh.oxfordjournals.org/content/22/6/630.full.

Mitaki S, Nagai A, Oguro H, Yamaguchi S. C-reactive protein levels are associated with cerebral small vessel-related lesions. Acta Neurol Scand. 2015 May 14. DOI: 10.1111/ane.12440. [Epub ahead of print]

Abe A, Nishiyama Y, Harada-Abe M, Okubo S, Ueda M, Mishina M, et al. Relative risk values of age, acrolein, IL-6 and CRP as markers of periventricular hyperintensities: a cross-sectional study. BMJ Open. 2014;4(8):e005598.

Shoamanesh A, Preis SR, Beiser AS, Vasan RS, Benjamin EJ, Kase CS, et al. Infl ammatory biomarkers, cerebral microbleeds, and small vessel disease. Framingham Heart Study. Neurology. 2015 Feb 24;84(8):825–32.

Grundy SM. Gamma-glutamyl transferase: another biomarker for metabolic syndrome and cardiovascular risk. Arterioscler Thromb Vasc Biol[Internet]. 2007[citado 14 Ene 2016]; 27:4-7. Disponible en: http://atvb.ahajournals.org/content/27/1/4.long.

Anker SD, von Haehling S. Inflammatory mediators in chronic heart failure: an overview. Heart [Internet]. 2004 [citado 14 Ene 2008];90:464-70. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768165/.

Shoamanesh A, Preis SR, Beiser AS, Vasan RS, Benjamin EJ, Kase CS, et al. Infl ammatory biomarkers, cerebral microbleeds, and small vessel disease. Framingham Heart Study. Neurology. 2015 Feb 24;84(8):825–32.

Abe A, Nishiyama Y, Harada-Abe M, Okubo S, Ueda M, Mishina M, et al. Relative risk values of age, acrolein, IL-6 and CRP as markers of periventricular hyperintensities: a cross-sectional study. BMJ Open. 2014;4(8):e005598.

Satizabal CL, Zhu YC, Mazoyer B, Dufouil C, Tzourio C. Circulating IL-6 and CRP are associated with MRI fi ndings in the elderly: the 3C-Dijon Study. Neurology. 2012 Mar 6;78(10):720-7. DOI: 10.1212/WNL.0b013e318248e50f. Epub 2012 Feb 22.

Dadu RT, Fornage M, Virani SS, Nambi V, Hoogeveen RC, Boerwinkle E, et al. Cardiovascular biomarkers and subclinical brain disease in the atherosclerosis risk in communities study. Stroke. 2013 Jul;44(7):1803–8.

Shoamanesh A, Preis SR, Beiser AS, Vasan RS, Benjamin EJ, Kase CS, et al. Infl ammatory biomarkers, cerebral microbleeds, and small vessel disease. Framingham Heart Study. Neurology. 2015 Feb 24;84(8):825–32.

Reinhard H, Garde E, Skimminge A, Åkeson P, Ramsøy TZ, Winther K, et al. Plasma NTproBNP and white matter hyperintensities in type 2 diabetic patients. Cardiovasc Diabetol. 2012 Oct 3;11:119. DOI: 10.1186/1475-2840-11-119.

Shoamanesh A, Preis SR, Beiser AS, Vasan RS, Benjamin EJ, Kase CS, et al. Infl ammatory biomarkers, cerebral microbleeds, and small vessel disease. Framingham Heart Study. Neurology. 2015 Feb 24;84(8):825–32.

Myat A, Redwood SR, Qureshi AC, Spertus JA, Williams B. Resistant hypertension. BMJ 2012;345:e7473

Rimoldi SF, Messerli FH, Chavez P, Stefanini GG, Scherrer U. Efficacy and Safety of Calcium Channel Blocker/Diuretics Combination Therapy in Hypertensive Patients: A Meta-Analysis. J Clin Hypertension. 2015; 17(3): 193 – 9.

Lund BC, Ernst ME. The Comparative Effectiveness of Hydrochlorothiazide and Chlorthalidone in an Observational Cohort of Veterans. The Journal of Clinical Hypertension 2012; 14(9): 623 – 9.

Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Rev Esp Cardiol (Engl Ed). 2016 Oct;69(10):939.

Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension. 2008;51:1403–19.

Bakris, G.L., Fonseca, V., Katholi, R.E., McGill, J.B., Messerli, F.H., Phillips, et al. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension. A randomized controlled trial. JAMA 2004; 292: 2227 – 36.

van Vark LC, Bertrand M, Akkerhuis KM, Brugts JJ, Fox K, Mourad J-J, Boersma E. Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of renin–angiotensin–aldosterone system inhibitors involving 158 998 patients. Eur Heart J 2012; 33 :2088–2097.

Rimoldi SF, Messerli FH, Chavez P, Stefanini GG, Scherrer U. Efficacy and Safety of Calcium Channel Blocker/Diuretics Combination Therapy in Hypertensive Patients: A Meta-Analysis. J Clin Hypertension. 2015; 17(3): 193 – 9.

Kjeldsen SE, Brunner HR, McInnes GT, Stolt P. Valsartan in the treatment of hypertension. Aging Health 2005; 1(1): 27 – 36.

Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG. et al Clinical Practice Guidelines for the Management of Hypertension in the Community A Statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens. 2014;16:14–26.

Sánchez MB, Armijo JA. Influencia de los factores genéticos y ambientales, la edad y el embarazo sobre la respuesta a los fármacos. En: Flores J, Armijo JA, Mediavilla A. Farmacología Humana. 6ta edición. Barcelona: Masson-SA; 2014. p. 121-55.

Gace H. Polifarmacia y morbilidad en adultos mayores. Rev Med Clin Condes. 2012; 23(1):31-5.

Sánchez MB, Armijo JA. Influencia de los factores genéticos y ambientales, la edad y el embarazo sobre la respuesta a los fármacos. En: Flores J, Armijo JA, Mediavilla A. Farmacología Humana. 6ta edición. Barcelona: Masson-SA; 2014. p. 121-55.

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