Alfonso Bryce

Consenso latino-americano de hipertensão em pacientes com diabetes tipo 2 e síndrome metabólica

The present document has been prepared by a group of experts, members of cardiology, endocrinology, internal medicine, nephrology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is a useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high-risk population, usually underestimated and undertreated. These recommendations result from presentations and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming knowledge, attitude and behavioural barriers, preventing both physicians and patients from effectively adhering to guideline recommendations. Arq Bras Endocrinol Metab. 2014;58(3):205-25

Consenso latinoamericano de hipertensión en pacientes con diabetes tipo 2 y síndrome metabólico

The present document has been prepared by a group of experts, members of Cardiology, Endocrinology, Internal Medicine, Nephrology and Diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high- risk population, usually underestimated and undertreated. These recommendations results from presentation and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming both physicians and patients from effectively adhering to guideline recommendations.

Atherogenic Dyslipidemia in Latin America: Prevalence, causes and treatment: Expert’s position paper made by The Latin American Academy for the Study of Lipids (ALALIP) Endorsed by the Inter-American Society of Cardiology (IASC), the South American Society of Cardiology (SSC), the Pan-American College of Endothelium (PACE), and the International Atherosclerosis Society (IAS)

La dislipidemia aterogenica (DA) es una entidad poco reconocida en las guias de practica clinica actuales. Debido a las frecuentes alteraciones lipidicas asociadas a esta anomalia metabolica en America Latina (AL), hemos organizado un grupo de expertos que ha adoptado el nombre de Asociacion Latinoamericana para el Estudio de Lipidos (ALALIP), para generar un documento en el que se analice la prevalencia en AL del perfil lipidico relacionado con esta afeccion y ofrecer recomendaciones practicas para su optimo diagnostico y tratamiento. Metodologia: Se selecciono un grupo de expertos regionales y, utilizando una metodologia Delphi modificada, se realizo una revision bibliografica exhaustiva, con enfasis en estudios o revisiones que tuvieran implicaciones para AL. Posteriormente se desarrollo una serie de preguntas clave sobre la epidemiologia, la fisiopatologia, el diagnostico y el tratamiento de la DA, que fueron discutidas por el grupo de expertos. Como convencion, las recomendaciones que tuvieron un 100% de aceptacion fueron consideradas unanimes; aquellas con al menos el 80% como para el consenso, y de desacuerdo, aquellas con menos del 80%. Resultados: Aunque no existe un estudio global sobre los factores de riesgo que se haya realizado sobre la base de una muestra representativa de toda la poblacion de AL, el analisis sistematico de las encuestas nacionales de salud y los estudios de cohortes regionales evidencian la alta prevalencia de las anormalidades lipidicas que definen la DA. La prevalencia de niveles bajos de colesterol de lipoproteinas de alta densidad (HDL-C) oscila entre el 34.1% (estudio CESCAS I) y el 53.3% (estudio LASO), con diferentes frecuencias entre hombres y mujeres y el punto de corte seleccionado. La prevalencia de trigliceridos elevados (TRG) varia de 25.5% (estudio LASO) a 31.2% (Encuesta Nacional de Salud de Chile) siendo siempre mas prevalente en..