{"id":76045,"date":"2018-03-09T23:21:23","date_gmt":"2018-03-09T23:21:23","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/patron-circadiano-de-la-presion-arterial-en-la-hipertension-arterial-refractaria-influencia-de-la-administracion-temporalizada-del-tratamiento\/"},"modified":"2018-03-09T23:21:23","modified_gmt":"2018-03-09T23:21:23","slug":"patron-circadiano-de-la-presion-arterial-en-la-hipertension-arterial-refractaria-influencia-de-la-administracion-temporalizada-del-tratamiento","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/patron-circadiano-de-la-presion-arterial-en-la-hipertension-arterial-refractaria-influencia-de-la-administracion-temporalizada-del-tratamiento\/","title":{"rendered":"Patr\u00f3n circadiano de la presi\u00f3n arterial en la hipertensi\u00f3n arterial refractaria: influencia de la administraci\u00f3n temporalizada del tratamiento."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Enrique Nieto Pol <\/strong><\/h2>\n<p>Con el desarrollo de la monitorizaci\u00f3n ambulatoria de la presi\u00f3n arterial (mapa), se ha podido profundizar en el conocimiento de la variabilidad de la misma, tanto en su componente intr\u00ednseco como en el perfil circadiano (actividad-descanso), lo que permite valorar su importancia cl\u00ednica en relaci\u00f3n con la morbimortalidad cardiovascular.  un descenso nocturno de la presi\u00f3n arterial (pa) igualo superior al1 0% de la pa sist\u00f3lica (pas) y pa diast\u00f3lica (pad) durante el d\u00eda, caracteriza el perfil dipper; por el contrar\u00edo, cuando no se produce dicho descenso, hablamos de perfil no-dipper. Diversos estudios sugieren que los sujetos no-dipper presentan una mayor lesi\u00f3n de los \u00f3rganos diana y una mayor morbimortalidad cardiovascular.  se considera hipertensi\u00f3n arterial resistente o refractaria (htar) a aquella hipertensi\u00f3n arterial (hta) cuyo r\u00e9gimen terap\u00e9utico incluye al menos tres f\u00e1rmacos antihipertensivos en dosis adecuadas y \u00e9ste no consigue reducir suficientemente la pas y pad -. En pacientes ancianos con hipertensi\u00f3n sist\u00f3lica aislada (hsa), se considera htar cuando las cifras de pas son&gt; 160 mmhg en la situaci\u00f3n terap\u00e9utica antes mencionada.  un alto porcentaje de pacientes con htar presentan alteraciones en el patr\u00f3n circadiano de la pa, con predominio del perfil no-dipper y el consiguiente aumento en el riesgo cardiovascular.  ante un paciente con htar, habitualmente se plantean tres opciones terap\u00e9uticas: en primer lugar, aumentar la dosis de los f\u00e1rmacos (si se estuviesen utilizando a dosis subterap\u00e9uticas), para alcanzar la m\u00e1xima eficacia terap\u00e9utica; en segundo lugar, cambios secuencia les de f\u00e1rmacos siempre con efecto sin\u00e9rgico; finalmente, la \u00faltima opci\u00f3n, es a\u00f1adir un cuarto f\u00e1rmaco antihipertensivo. Con este protocolo de actuaci\u00f3n en la htar, solar jente se consigue mejorar la eficacia antihipertensiva en un peque\u00f1o porcentaje de pacientes.  en el presente estudio se plantea una n<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Patr\u00f3n circadiano de la presi\u00f3n arterial en la hipertensi\u00f3n arterial refractaria: influencia de la administraci\u00f3n temporalizada del tratamiento.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Patr\u00f3n circadiano de la presi\u00f3n arterial en la hipertensi\u00f3n arterial refractaria: influencia de la administraci\u00f3n temporalizada del tratamiento. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Enrique Nieto Pol <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Santiago de compostela<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 28\/07\/2005<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Carlos Calvo Gomez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal:  Gonz\u00e1lez fuanatey Jos\u00e9 ramon <\/li>\n<li>salvador Pita fernandez (vocal)<\/li>\n<li>Manuel Igleisas diz (vocal)<\/li>\n<li>artemio Moj\u00f3n ojea (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Enrique Nieto Pol Con el desarrollo de la monitorizaci\u00f3n ambulatoria de la presi\u00f3n arterial (mapa), se ha [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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