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HIPERTENSIVAS
Raza negra.
La obesidad
Dislipidemia
Feocromocitoma
Hiperaldosteronismo primario
Enfermedad renovascular
El sndrome de Cushing
La Coartacin de la aorta
COMPLICACIONES
El aumento en el riesgo comienza cuando la presin arterial se
eleva por encima de 110/75 mmHg
Prevalence of hypertension in men (upper graph) and women (lower graph) according to age and race/ethnicity in
the United States from the NHAHES survey. Hypertension occurs earlier and more frequently in non-Hispanic
blacks. Data from Hajjar, I, Kotchen, TA. JAMA 2003; 290:199.
Cumulative absolute risk of CVD at five years
Cumulative absolute risk of cardiovascular disease (CVD) at five years according to systolic blood pressure and specified levels of
other risk factors. The reference category is a nondiabetic, nonsmoking 50 year-old woman with a serum total cholesterol (TC) of
154 mg/dL (4.0 mmol/L) and HDL-cholesterol of 62 mg/dL (1.6 mmol/L). The CVD risks are given for systolic blood pressure levels of
110, 130, 150, and 170 mmHg. In the other categories, the additional risk factors are added consecutively. As an example, the
diabetes category is a 50-year-old diabetic man who is a smoker and has a total cholesterol (TC) of 270 mg/dL (7 mmol/L) and HDL-
cholesterol of 39 mg/dL (1 mmol/L). Adapted from Jackson, R, Lawes, CM, Bennett, DA, et al, Lancet 2005; 365:434
Comparative Drug Trials in Patients with Hypertension
Algorithm for Management of Hypertension.
ACE denotes angiotensin-converting enzyme, ARB angiotensin-receptor
blocker, and DASH Dietary Approaches to Stop Hypertension.
Rates of Awareness, Treatment, and Control of High Blood Pressure in the United States
(19762004). High blood pressure is defined as a reading of 140/90 mm Hg or more for
persons between the ages of 18 and 74 years. Despite major improvements in blood-
pressure therapies in recent years, some 28% of Americans with hypertension do not know
they have the condition, 39% are receiving no therapy, and 65% have insufficient blood-
pressure control. Data are from Chobanian et al. and Cutler et al. NHANES denotes National
Health and Nutrition Examination Survey.
Risk Factors for Hypertension
Sites of Diuretic Action in the Nephron. The percentage of sodium reabsorbed in a given region is indicated in parentheses. "K+-sparing agents"
collectively refers to the epithelial sodium-channel inhibitors (e.g., amiloride and triamterene) and mineralocorticoid-receptor antagonists (e.g.,
spironolactone and eplerenone). Sodium is reabsorbed in the distal tubule and collecting ducts through an aldosterone-sensitive sodium channel
and by activation of an ATP-dependent sodiumpotassium pump. Through both mechanisms, potassium is secreted into the lumen to preserve
electroneutrality. Sodium-channel inhibitors preserve potassium by interfering with the sodiumpotassium pump, whereas mineralocorticoid-
receptor antagonists spare potassium through their inhibitory effect on aldosterone. NaHCO3 denotes sodium bicarbonate.
Potential Complications of Diuretics and Their Associated Mechanisms.
RAAS denotes the reninangiotensinaldosterone system.