Hypertension: Vargas-Alarcón G

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, Anonymous00054. · Departamento de Cardiología Adultos III, Instituto Nacional de Cardiología "Ignacio Chávez", Tlalpan, México DF. · Arch Cardiol Mex. · Pubmed #18928127 No free full text.

Abstract: The multidisciplinary Institutional Committee of experts in Systemic Arterial Hypertension from the National Institute of Cardiology "Ignacio Chávez" presents its update (2008) of "Guidelines and Recommendations" for the early detection, control, treatment and prevention of Hypertension. The boarding tries to be simple and realistic for all that physicians whom have to face the hypertensive population in their clinical practice. The information is based in the most recent scientific evidence. These guides are principally directed to hypertensive population of emergent countries like Mexico. It is emphasized preventive health measures, the importance of the no pharmacological actions, such as good nutrition, exercise and changes in life style, (which ideally it must begin from very early ages). "We suggest that the changes in the style of life must be vigorous, continuous and systematized, with a real reinforcing by part of all the organisms related to the health education for all population (federal and private social organisms). It is the most important way to confront and prevent this pandemic of chronic diseases". In this new edition the authors amplifies the information and importance on the matter. The preventive cardiology must contribute in multidisciplinary entailment. Based mainly on national data and the international scientific publications, we developed our own system of classification and risk stratification for the carrying people with hypertension, Called HTM (Arterial Hypertension in Mexico) index. Its principal of purpose this index is to keep in mind that the current approach of hypertension must be always multidisciplinary. The institutional committee of experts reviewed with rigorous methodology under the principles of the evidence-based medicine, both, national and international medical literature, with the purpose of adapting the concepts and guidelines for a better control and treatment of hypertension in Mexico. This work group recognizes that hypertension is not an isolated disease; therefore its approach must be in the context of the prevalence and interaction with other cardiovascular risk factors such as obesity, diabetes, dislipidemia and smoking among others. The urgent necessity is emphasized to approach in a concatenated form the diverse cardiovascular risk factors, since independently of which they share common pathophysiological mechanisms, its suitable identification and control will affect without any doubt the natural history of the other concatenated risk factor. By all means that to greater participation of factors, greater it will be the global cardiovascular risk but never, however, the specific weight is due to avoid that each one has on the global cardiovascular risk. In this Second edition we try to amplify and give systematic forms for the clinical approach for the suspicion of secondary hypertension and we emphasizes that hypertension in the woman with or without menopause should be careful analyzed, and special recommendations are given for the hypertension in pregnancy. Also we have approached some aspects related to the hypertensive emergencies and other special situations. In this second version some recommendations are presented for boarding hypertension in children and adolescents.

Vargas-Alarcón G, Hernández-Pacheco G, Rodríguez-Pérez JM, Pérez-Hernández N, Pavón Z, Fragoso JM, Juarez-Cedillo T, Villarreal-Garza C, Granados J. · Department of Physiology, Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan 14080, México DF, México. · Hum Biol. · Pubmed #15018037 No free full text.

Abstract: The angiotensin-converting enzyme gene (ACE) insertion/deletion polymorphism was determined in 211 Mexican healthy individuals belonging to different Mexican ethnic groups (98 Mestizos, 64 Teenek, and 49 Nahuas). ACE polymorphism differed among Mexicans with a high frequency of the D allele and the D/D genotype in Mexican Mestizos. The D/D genotype was absent in Teenek and present in only one Nahua individual (2.0%). When comparisons were made, we observed that Caucasian, African, and Asian populations presented the highest frequencies of the D allele, whereas Amerindian (Teenek and Pima) and Australian Aboriginals showed the highest frequencies of the I allele. The distribution of I/D genotype was heterogeneous in all populations: Australian Aboriginals presented the lowest frequency (4.9%), whereas Nahuas presented the highest (73.4%). The present study shows the frequencies of a polymorphism not analyzed previously in Mexican populations and establishes that this polymorphism distinguishes the Amerindian populations of other groups. On the other hand, since ACE alleles have been associated with genetic susceptibility to developing cardiovascular diseases and hypertension, knowledge of the distribution of these alleles could help to define the true significance of ACE polymorphism as a genetic susceptibility marker in the Amerindian populations.

Vargas-Alarcón G, Flores-Domínguez C, Hernández-Pacheco G, Zuñiga J, Gamboa R, Soto ME, Granados J, Reyes PA. · Department of Physiology, Instituto Nacional de Cardiologia Ignacio Chávez, Mexico City, Mexico. · Clin Exp Rheumatol. · Pubmed #11491500 No free full text.

Abstract: OBJECTIVE: The aim of the present work was to study the association between HLA alleles and Takayasu's arteritis in Mexican Mestizo patients. METHODS: The study included 26 Mexican Mestizo patients with Takayasu's arteritis and 99 healthy unrelated individuals. HLA-A, -B and -DR alleles were determined by polymerase chain reaction PCR-SSP RESULTS: Increased gene frequencies were demonstrated for HLA-B15(p=0.009,pC=0.020,OR=3.24,EF=11.9%) and HLA-B52 (p=0.008, pC=0.027, OR=5.16, EF=7.7%), and a decreased frequency for the HLA-A24 allele in patients compared to normal controls (p=0.035, pC=NS, PF=11.1%). When HLA typing was correlated to clinicalfeatures in 24 cases, wefound an increasedfrequencies of HLA-DR14 in patients with systemic arterial hypertension (p=0.005, pC=0.004, OR=24.6, EF=38.3%) and HLA-A2 on patients with pulmonary involvement (p=0.034, pC=0.036, OR=3.67, EF=40.4%) when compared to patients without these clinical manifestations. CONCLUSION: These data confirm HLA-B52 as a relevant susceptibility allele for Takayasu's arteritis and suggest that HLA-B15 could be important as a marker of the disease in Mexican patients. Other class I and/or class II alleles could also be relevant as markers for the clinical features present in these patients.