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  • SCImago Journal Rank (SJR):0,11
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doi: 10.1016/S1889-1837(06)71657-9
Detección de hipertrofia ventricular izquierda en adolescentes con hipertensión arterial esencial
Detection of left ventricular hypertrophy in adolescents with essential arterial hypertension
M. Ramírez Méndez,a, , F.L. Moreno-Martínezb, D. Torres Ruiza, C.G. Nieto Monteagudoa, C.M. Osorio Gómezb, A. Guevara Gonzálezc, A. González Díazb, R. González Chineab
a Hospital Universitario Celestino Hernández Robau. Santa Clara
b Cardiocentro Ernesto Che Guevara. Santa Clara
c Centro de Investigaciones sobre Longevidad, Envejecimiento y Salud (CITED). Ciudad de La Habana. Cuba
Recibido 09 noviembre 2005, Aceptado 07 septiembre 2006
Resumen
Introducción

La hipertensión arterial (HTA) constituye un problema de salud mundial y su riesgo depende de los órganos que sea capaz de dañar. La hipertrofia ventricular izquierda (HVI) define a un grupo de enfermos con alto riesgo de presentar complicaciones y, entre ellos, los adolescentes son también vulnerables. El objetivo de esta investigación fue detectar precozmente la presencia de HVI en adolescentes hipertensos para orientar el tratamiento y reducir las complicaciones.

Material y método

Se llevó a cabo un estudio de intervención, cuasiexperimental, longitudinal, prospectivo en 572 adolescentes hipertensos. Se realizó ecocardiograma al inicio de la investigación y se ajustó el tratamiento médico para comparar al año los resultados.

Resultados

Predominó el sexo masculino (73,3%) y el color de la piel negra (63,6%). El mayor porcentaje de pacientes (53,0%) presentaba HTA moderada. Sólo el 5,9 % de ellos aplicaba correctamente las medidas higiénico-dietéticas y las estrategias farmacológicas estaban subutilizadas. Al inicio del estudio, el 73,6% de los pacientes llevaban un tratamiento irregular y no lograban controlar su tensión arterial. Al año habíamos logrado controlar al 92% de los enfermos, se redujo la HVI y se mejoró la disfunción diastólica.

Conclusiones

Encontramos un gran número de adolescentes con HTA no controlada y muchos de ellos presentaban HVI (27,1 %) y alteraciones de la función diastólica (30,2%). Con el tratamiento adecuado logramos mejorar o normalizar dichas afecciones y logramos, además, controlar la tensión arterial. Mucho tienen que continuar haciendo los trabajadores de la Atención Primaria, pero el apoyo de la atención secundaria es vital para lograr los objetivos deseados.

Resumen
Introduction

Arterial hypertension (AHT) is a worldwide health problem and its risk depends on whether the organ can be harmed. Left ventricular hypertrophy (LVH) defines a group of patients at high risk of having complications and adolescents are also vulnerable. This research aimed to detect the presence of LVH early in hypertensive adolescents to orient treatment and reduce complications.

Material and methods

An intervention, quasi-experimental, longitudinal, prospective study was conducted in 572 hypertensive adolescents. An echocardiogram was performed at the onset of the investigation and the medical treatment was adjusted at one year to compare the results.

Results

There was predominance of male gender (73.3%) and black skin (63.6%). The largest percent of patients (53.0%) had moderate AHT. Only 5.9% of them correctly used hygienic-dietary measures and drug strategies were underused. At the onset of the study, 73.6 % of the patients had irregular treatment and did not achieve blood pressure control. At one year, we had achieved control in 92% of the patients, LVH was reduced and diastolic dysfunction improved.

Conclusions

We found a large number of adolescents with uncontrolled AHT and many had LVH (27.1%) and diastolic function alterations (30.2 %). With adequate treatment, we were able to improve or normalized these conditions and also achieved a control of blood pressure. The primary health care workers must continue working very much, however the support of secondary care is essential to achieve the objectives desired.

Palabras clave
hipertensión arterial, adolescencia, hipertrofia ventricular izquierda, diagnóstico
Key words
arterial hypertension, adolescence, left ventricular hypertrophy, diagnosis
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Correspondencia: Hemodinámica y Cardiología Intervencionista. Cardiocentro Ernesto Che Guevara. C./ Cuba, 610. 50200 Santa Clara. Villa Clara (Cuba).
Copyright © 2006. Sociedad Española de Hipertension-Liga Española para la Lucha de la Hipertensión Arterial (SEH-LELHA)