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2008, Número S2

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Arch Cardiol Mex 2008; 78 (S2)


Guías clínicas para la detección, prevención, diagnóstico y tratamiento de hipertensión arterial sistémica en México (2008)

Rosas M, Pastelín G, Vargas-Alarcón G, Martínez-Reding J, Lomelí C, Mendoza-González C, Lorenzo JA, Méndez A, Franco M, Sánchez-Lozada LG, Verdejo J, Sánchez N, Ruiz R, Férez-Santander SM, Attie F

Idioma: Español
Referencias bibliográficas: 134
Paginas: 5-57
Archivo PDF: 482.31 Kb.


RESUMEN

El Comité Institucional multidisciplinario de expertos en Hipertensión Arterial del Instituto Nacional de Cardiología presenta la actualización 2008 de sus "Guías y Recomendaciones" para la detección control y tratamiento de la Hipertensión Arterial Sistémica (HTAS). El abordaje pretende ser simple y práctico para todo aquel médico que tenga que enfrentar a las personas con HTAS, sin sacrificar desde luego, los conocimientos científicos de vanguardia. Estas guías están dirigidas a la población hipertensa de México. Se enfatiza la necesidad de medidas preventivas, la importancia del manejo no farmacológico, tales como nutrición, ejercicio y cambios en el estilo de vida, (que idealmente debe iniciarse desde edades muy tempranas) es crucial para la prevención clínica de cualquier enfermedad crónica esencial del adulto y la hipertensión no escapa a este aspecto. "Sólo si se sistematizan medidas de cambios en el estilo de vida robustos y continuos, con reforzamiento por parte de todos los organismos relacionados con la educación poblacional y el compromiso social habremos de confrontar de manera real y preventiva esta pandemia de enfermedades crónicas". En esta nueva edición de lineamientos se amplifica la información e importancia al respecto. La cardiología preventiva debe contribuir en vinculación multidisciplinaria. Basados principalmente en datos nacionales y lo informado en el resto del mundo, se propone un sistema propio de clasificación y estratificación de riesgo para las personas portadoras de HTAS, denominado HTM (Hipertensión Arterial en México) y tiene como finalidad siempre tener en mente que el abordaje de la HTAS es y será siempre multidisciplinario. El comité de expertos se dio a la tarea de revisar de manera crítica y exhaustiva, bajo los principios de la medicina basada en evidencia, la información más destacada vertida en la literatura médica nacional e internacional, con la finalidad de adecuar los conceptos y lineamientos para un mejor control y tratamiento de la HTAS en México. Una de las conclusiones más relevantes de este grupo de trabajo fue el reconocer que la HTAS no es un ente aislado, sino que, debe abordarse en el contexto de la prevalencia e interacción con otras ECEA así como de otros factores de riesgo tales como obesidad, diabetes, dislipidemia y tabaquismo entre otros. Se enfatiza la necesidad urgente de abordar de forma concatenada los diversos factores de riesgo cardiovascular, ya que independientemente de que comparten mecanismos fisiopatológicos comunes, su adecuada identificación y control afectará sin duda la historia natural del otro factor de riesgo concatenado. Por supuesto que a mayor participación de factores, mayor será el riesgo cardiovascular pero jamás se debe soslayar el peso específico que cada uno tiene sobre el riesgo cardiovascular global. En esta Segunda edición se amplifica de forma práctica el abordaje clínico ante la sospecha de HTAS tanto esencial como secundaria y se enfatiza la HTAS en la mujer con menopausia, y la hipertensión del embarazo. También se abordan algunos aspectos relacionados con las urgencias hipertensivas y otras situaciones especiales. Por primera vez aparecen en estas guías recomendaciones para el abordaje en niños y adolescentes.


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