[Factors associated with changes in microalbuminuria during antihypertensive treatment]

Prevalence and factors associated with non-adherence to therapy among partners of pregnant women with syphilis in a city of northeastern Brazil

BACKGROUND

One of the main difficulties faced in the prevention of the vertical transmission of syphilis is the inadequate treatment of pregnant women and their partners. The disease causes serious repercussions in infected newborns.

AIM

To evaluate the prevalence and factors associated with the therapeutic adhesion among partners of pregnant women with syphilis in a county in Northeastern Brazil.

METHODS

This is a descriptive, analytic, quantitative, cross-sectional study that was carried out through interviews with 46 pregnant women diagnosed with syphilis between 2017 and 2018 as well as with their partners. The interviews aimed at collecting data regarding sociodemographic characteristics, obstetric variables and information about syphilis, and partners’ related variables.

RESULTS

Our results showed that 73.91% of the partners did not undergo appropriate treatments, and obtaining negative results in syphilis tests was the main reason for the absence of therapies. The following factors were significantly associated with the lack of treatment among partners: Being a partner that is not the current mate of the pregnant woman, having a level of schooling inferior to 8 years [odds ratio (OR) = 10.28], and the pregnant woman undergoing up to two syphilis tests during the prenatal care (OR = 8.6). The study found a higher odds of absent treatment among partners if the pregnant woman is not white (OR = 13.88) or if the partner has less than 8 years of schooling (OR = 21.00) or has a monthly income of less than half the minimum wage (OR = 13.93).

CONCLUSION

The findings of this study show a high prevalence of partners that are not adequately treated for syphilis, a phenomenon that is strongly associated with socioeconomic factors.

Home blood pressure vs. clinic blood pressure measurement-based follow up in type ii diabetics: Effect on 24-h ambulatory BP and albuminuria. Randomised trial

BAKGROUND AND OBJECTIVE

To compare the efficacy of two strategies of blood pressure (BP) measurement-based follow-up in hypertension and albuminuria control.

PATIENTS AND METHODS

Multicentre, prospective, randomised, open trial with a parallel-group design. Nineteen primary care centres and a hospital clinic participated. Adult type 2 diabetics with systolic BP ≥140mmHg without relevant renal disease were randomised to one of two follow-up strategies: 1) standard follow up, with a clinic BP target <140/90mmHg and 2) self-monitoring home BP (SMHBP)-based follow up, with a BP target <135/85mmHg. Biochemical standard blood variables, albuminuria, and 24-h ambulatory BP monitoring were performed at entry, 12 and 24 months. The main outcome measurement was 24-h ambulatory systolic BP variation. Albuminuria change was analysed as a secondary outcome.

RESULTS

116 patients were analysed (mean age: 66.8 years). Mean systolic ambulatory 24- h BP change in two years was 3.9mmHg (95% CI 1.8-6.1). We did not find significant differences between both groups (p=0.706). Similarly, no differences were found when we compared other ambulatory BP values. Initial albuminuria was similar in both groups and did not significantly changed throughout the follow-up period.

CONCLUSION

In type 2 diabetics without relevant nephropathy a SMHBP- based follow up was equivalent to a standard clinic-based BP follow up in BP and albuminuria control.

[Prevalence of microalbuminuria and association with cardiovascular risk factors in a Spanish Mediterranean area]

BACKGROUND

The primary objective of this study was to know the prevalence of microalbuminuria (mAlb)in a general population from the Spanish Mediterranean area along with its association with other cardiovascular risk factors (CRF).

PATIENTS AND METHOD

We studied 99 consecutive patients who were classified in mAlb+ or mAlb-,depending on whether their mAlb was higher or lower than 30 mg/day,respectively.

RESULTS

Thirty-seven patients(9.3% of the general population) were mAlb positive. Twenty-one percent of them were males with hypertension. The presence of mAlb was positively correlated with age, systolic blood pressure,body mass index, waist-to-hip ratio, pulse pressure, HDL cholesterol,triglycerides, glycemia and serum creatinine. The level of mAlb was 12.9 (11.2) (mg/day) in non-hypertensive non diabetic individuals,while it was 14.1 (16.5) in diabetic non-hypertensive subjects, 22.5 (53,5) in hypertensive non-diabetic subjects and 27.7 (49.1)in diabetic individuals who were also hypertensive. Hypertension correlationed with the presence of mAlb with an odds ratio of 2.4 (CI 95%: 1.1-5.2)and the addition of a male gender increased the odds ratio to 3.8 (CI 95%: 1.8-8.1).

CONCLUSIONS

The prevalence of mAlb in the Spanish Mediterranean area appears to be low (9.3%),although it is especially high in hypertensive males with or without diabetes.