Introduction:Inadequate blood pressure(BP)control is a significant challenge.Therapeutic decisions based on home blood pressure monitoring(HBPM)have been shown to lead to better blood pressure control compared to thos...Introduction:Inadequate blood pressure(BP)control is a significant challenge.Therapeutic decisions based on home blood pressure monitoring(HBPM)have been shown to lead to better blood pressure control compared to those based on office blood pressure(OBP)measurements alone.Objectives:To compare,over a five-year period,the annual BP control rates in hypertensive patients who were treated and monitored by the same cardiologists and who periodically used HBPM.Methodology:This was a multicenter study conducted with five cross-sectional analyses at annual intervals,with the first in 2019 and the last in 2023.OBP and HBPM measurements were performed according to current guidelines.Two cutoff points were considered for the analysis of BP control by OBP:<140/90 mmHg and<130/80 mmHg.For HBPM,the cutoff was<130/80 mmHg.Comparisons of quantitative variables between years were established using the t-test or chi-square test.A p-value<0.05 was considered significant.Results:A total of 8,890 individuals with a mean age of 63.3(±14.9)years were included,of whom 65.8%were women.A reduction in mean OBP values was observed between 2019-2020 and 2021-2022.There was also a reduction in the average number of antihypertensive medications used in 2020,with a mean of 1.99 medications taken that year.Compared to 2020,2022 showed an improvement in control rates for OBP<130/80 mmHg(31.5%vs.35.7%;p=0.008)and OBP<140/90 mmHg(58.7%vs.65.7%;p<0.001).Conclusion:Continuous monitoring by the same physician and the use of home measurement tools can lead to better BP control in hypertensive patients.展开更多
Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly with prevalence less than 0.01% in autopsy series. It can be found as an isolated anomaly, and the patient may be asymptomatic, but is often associa...Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly with prevalence less than 0.01% in autopsy series. It can be found as an isolated anomaly, and the patient may be asymptomatic, but is often associated with aortic insufficiency in 68% of the cases. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are currently used as a diagnostic and follow-up method for this anomaly. The objective of the present paper is through the clinical case report of a 60 year old patient submitted to surgical correction of QAV, to relate some clinical aspects of the disease and to discuss the anesthetic management for this group of patients, in addition, emphasizing the importance and the increasing use of the TEE in the intraoperative period in cardiac surgeries.展开更多
文摘Introduction:Inadequate blood pressure(BP)control is a significant challenge.Therapeutic decisions based on home blood pressure monitoring(HBPM)have been shown to lead to better blood pressure control compared to those based on office blood pressure(OBP)measurements alone.Objectives:To compare,over a five-year period,the annual BP control rates in hypertensive patients who were treated and monitored by the same cardiologists and who periodically used HBPM.Methodology:This was a multicenter study conducted with five cross-sectional analyses at annual intervals,with the first in 2019 and the last in 2023.OBP and HBPM measurements were performed according to current guidelines.Two cutoff points were considered for the analysis of BP control by OBP:<140/90 mmHg and<130/80 mmHg.For HBPM,the cutoff was<130/80 mmHg.Comparisons of quantitative variables between years were established using the t-test or chi-square test.A p-value<0.05 was considered significant.Results:A total of 8,890 individuals with a mean age of 63.3(±14.9)years were included,of whom 65.8%were women.A reduction in mean OBP values was observed between 2019-2020 and 2021-2022.There was also a reduction in the average number of antihypertensive medications used in 2020,with a mean of 1.99 medications taken that year.Compared to 2020,2022 showed an improvement in control rates for OBP<130/80 mmHg(31.5%vs.35.7%;p=0.008)and OBP<140/90 mmHg(58.7%vs.65.7%;p<0.001).Conclusion:Continuous monitoring by the same physician and the use of home measurement tools can lead to better BP control in hypertensive patients.
文摘Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly with prevalence less than 0.01% in autopsy series. It can be found as an isolated anomaly, and the patient may be asymptomatic, but is often associated with aortic insufficiency in 68% of the cases. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are currently used as a diagnostic and follow-up method for this anomaly. The objective of the present paper is through the clinical case report of a 60 year old patient submitted to surgical correction of QAV, to relate some clinical aspects of the disease and to discuss the anesthetic management for this group of patients, in addition, emphasizing the importance and the increasing use of the TEE in the intraoperative period in cardiac surgeries.
