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Abstract(s)
Introdução: As doenças cardiovasculares são a maior causa de morte a nível mundial, muitas vezes por complicação da hipertensão arterial. Observa-se uma alta prevalência da sua forma primária e baixas taxas de controlo devidas, na sua maioria, à adesão terapêutica insuficiente ou à prescrição subótima da medicação, baseada nos valores de pressão arterial, geralmente sem ter em conta o estado hemodinâmico do paciente. Neste trabalho explora-se a possibilidade da avaliação não-invasiva do estado hemodinâmico poder ser realizada através da bioimpedância torácica avaliando a sua eficácia e utilidade na escolha/titulação da terapêutica anti hipertensora.
Objetivos: Verificar se a bioimpedância torácica é um método fiável e analisar a sua utilidade na orientação do tratamento da hipertensão arterial.
Métodos: Pesquisa bibliográfica na base de dados Pubmed e uso de referências bibliográficas de artigos selecionados.
Resultados: 5 estudos validam a bioimpedância torácica como um método fiável na obtenção de dados hemodinâmicos quando comparados a métodos já utilizados na prática clínica. 7 estudos analisam a sua utilidade na orientação da terapia anti hipertensora em vários contextos, alguns em comparação com a abordagem empírica: todos eles mostram uma maior descida da pressão arterial, com taxas de controle superiores verificando-se maior recurso a politerapia. 3 estudos de caso mostram uma evolução favorável do estado hemodinâmico de pacientes com hipertensão arterial avaliados e tratados com recurso à bioimpedância torácica.
Conclusão: Esta análise sugere a bioimpedância torácica como um método fiável e útil na orientação terapêutica da hipertensão arterial com ganhos superiores aos da abordagem convencional, sem complicações atribuíveis à técnica, diminuição de efeitos adversos medicamentosos e com controle da pressão arterial na maior parte dos casos.
Introduction: Cardiovascular diseases are the most common cause of death worldwide, often as a complication of arterial hypertension. There is a high prevalence of its primary form and low control rates mostly given to a medication noncompliance or an inappropriate medical regimen, based only on the values of blood pressure, without accounting of the hemodynamic state of the patient. This work explores the possibility of a non-invasive evaluation of the hemodynamic state being realized by the use of thoracic bioimpedance, evaluating its accuracy and utility in the choice/titration of anti hypertensive treatment. Objective: Assess the reliability and utility of thoracic bioimpedance as a guide to anti hypertensive treatment prescription. Methods: Research of scientific articles in the Pubmed database and use of bibliographic references. Results: 5 studies validate thoracic bioimpedance as a reliable method for measure of hemodynamic data when compared to methods already used in clinical practice. 7 studies evaluate its utility in the choice of anti hypertensive medication in various contexts, some compare it to the empiric treatment: all of them show a higher reduction of blood pressure, higher control rates and a more frequent use of polytherapy. 3 case studies show a favorable evolution of the hemodynamic state of hypertensive patients when evaluated and treated with use of thoracic bioimpedance. Conclusion: This analysis suggests that thoracic bioimpedance is a reliable and useful method in guiding anti hypertensive therapy with better outcomes than the conventional treatment, without any complications given to this technique, reduction in adverse effects caused by medication and control of blood pressure in most cases.
Introduction: Cardiovascular diseases are the most common cause of death worldwide, often as a complication of arterial hypertension. There is a high prevalence of its primary form and low control rates mostly given to a medication noncompliance or an inappropriate medical regimen, based only on the values of blood pressure, without accounting of the hemodynamic state of the patient. This work explores the possibility of a non-invasive evaluation of the hemodynamic state being realized by the use of thoracic bioimpedance, evaluating its accuracy and utility in the choice/titration of anti hypertensive treatment. Objective: Assess the reliability and utility of thoracic bioimpedance as a guide to anti hypertensive treatment prescription. Methods: Research of scientific articles in the Pubmed database and use of bibliographic references. Results: 5 studies validate thoracic bioimpedance as a reliable method for measure of hemodynamic data when compared to methods already used in clinical practice. 7 studies evaluate its utility in the choice of anti hypertensive medication in various contexts, some compare it to the empiric treatment: all of them show a higher reduction of blood pressure, higher control rates and a more frequent use of polytherapy. 3 case studies show a favorable evolution of the hemodynamic state of hypertensive patients when evaluated and treated with use of thoracic bioimpedance. Conclusion: This analysis suggests that thoracic bioimpedance is a reliable and useful method in guiding anti hypertensive therapy with better outcomes than the conventional treatment, without any complications given to this technique, reduction in adverse effects caused by medication and control of blood pressure in most cases.
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Keywords
Bioimpedância Torácica Hemodinâmica Hipertensão Arterial Personalizada Terapia Anti Hipertensora