2016, Número S1
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Rev Med Inst Mex Seguro Soc 2016; 54 (S1)
Tratamiento de la hipertensión arterial en la enfermedad renal crónica
Palomo-Piñón S, Rosas-Peralta M, Paniagua-Sierra JR
Idioma: Español
Referencias bibliográficas: 52
Paginas: 78-88
Archivo PDF: 306.25 Kb.
RESUMEN
La hipertensión arterial (HTA) es un síndrome cardiovascular
progresivo que es ocasionado por etiologías
complejas e interrelacionadas. Los marcadores tempranos
del síndrome frecuentemente están presentes
antes de que se eleve la presión arterial (PA); por lo
tanto, la HTA no puede ser solamente clasificada por
el umbral de elevación de la PA. Su progresión está
fuertemente asociada con anormalidades estructurales
y funcionales de la función cardiaca y vascular
que dañan el corazón, el riñón, el cerebro, los vasos
sanguíneos y otros órganos, y provocan morbilidad y
muerte prematuras. Así, la PA es solamente un biomarcador
de este síndrome cardiovascular, por lo que
es de mayor utilidad considerar los patrones individuales
de PA del enfermo en vez de un umbral de PA
único. El estudio y tratamiento de la HTA en la enfermedad
renal crónica (ERC) ha tenido avances, sobre
todo en la población en diálisis. El uso de tecnología
no invasiva para registrar la PA ha permitido reformar
la atención médica de los enfermos en cuanto al diagnóstico,
patrón circadiano, vigilancia clínica, prescripción
farmacológica, pronóstico y riesgo de eventos
cardiovasculares. La oportunidad en el diagnóstico y
tratamiento supone un retardo en la aparición de complicaciones
y en el inicio de la diálisis. El bloqueo del
sistema renina-angiotensina-aldosterona (SRAA), la
vigilancia periódica del peso seco en la población en
diálisis y las intervenciones para modificar el estilo de
vida son las maniobras con mayor impacto en la morbimortalidad
de los enfermos.
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