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Article ; Online: The Rationale for Using Fixed-Dose Combination Therapy in the Management of Hypertension in Colombia: A Narrative Review.

Molina de Salazar, Dora Inés / Coca, Antonio / Alcocer, Luis / Piskorz, Daniel

American journal of cardiovascular drugs : drugs, devices, and other interventions

2024 Volume 24, Issue 2, Page(s) 197–209

Abstract: Hypertension is a major risk factor for cardiovascular disease and the leading cause of death in Colombia. While the rate of hypertension awareness in Colombia is generally high, rates of treatment initiation, adherence, and blood pressure (BP) control ... ...

Abstract	Hypertension is a major risk factor for cardiovascular disease and the leading cause of death in Colombia. While the rate of hypertension awareness in Colombia is generally high, rates of treatment initiation, adherence, and blood pressure (BP) control are suboptimal. Major international hypertension guidelines recommend starting treatment with a combination of antihypertensive agents, and the use of a single-pill combination (SPC) to maximize adherence. In contrast, Colombian hypertension guidelines recommend starting treatment with diuretic monotherapy in most patients, and only initiating combination therapy in those with BP > 160/100 mmHg. Therefore, the aim of the current narrative review is to examine the rationale for using SPCs to treat hypertension in Colombia, in the context of the major issues for BP control there. There is evidence of widespread therapeutic inertia in hypertension management, particularly in primary care, in Colombia. Moreover, combination therapy, angiotensin-converting enzyme inhibitors, and long-acting calcium channel blockers, which are internationally recommended as first-line drug therapies, are underutilized there. Adherence to antihypertensive therapy is low in Colombia and may be enhanced by use of SPCs as well as better patient education and follow-up. While there are promising national initiatives to improve BP management, more needs to be done by individual physicians. Antihypertensive SPCs are available on the national essential medicines list and may help to overcome some of the problems with suboptimal adherence, therapeutic inertia, and low rates of BP control that contribute to the high cardiovascular death rate in Colombia.
MeSH term(s)	Humans ; Antihypertensive Agents/therapeutic use ; Colombia ; Hypertension/drug therapy ; Calcium Channel Blockers ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Blood Pressure ; Drug Therapy, Combination ; Drug Combinations
Chemical Substances	Antihypertensive Agents ; Calcium Channel Blockers ; Angiotensin-Converting Enzyme Inhibitors ; Drug Combinations
Language	English
Publishing date	2024-03-15
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2052547-3
ISSN	1179-187X ; 1175-3277
ISSN (online)	1179-187X
ISSN	1175-3277
DOI	10.1007/s40256-024-00634-8
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Article ; Online: Inhibidores de la enzima convertidora de angiotensina y bloqueadores de los receptores de angiotensina II

Dora Inés Molina / Tania Marcela Muñoz / Katterine Guevara

Revista Colombiana de Cardiología, Vol 27, Iss 3, Pp 132-

¿aumentan el riesgo de padecer COVID-19?

2020 Volume 136

Abstract: Resumen: Un nuevo coronavirus, llamado coronavirus 2 del síndrome respiratorio agudo severo (SARS-CoV-2), se descubrió en diciembre de 2019 en Wuhan, China; el virus se intensificó rápidamente y el 11 de marzo de 2020 la Organización Mundial de la Salud ... ...

Abstract	Resumen: Un nuevo coronavirus, llamado coronavirus 2 del síndrome respiratorio agudo severo (SARS-CoV-2), se descubrió en diciembre de 2019 en Wuhan, China; el virus se intensificó rápidamente y el 11 de marzo de 2020 la Organización Mundial de la Salud lo declaró pandemia.Los datos emergentes sugieren que los pacientes mayores con COVID-19 asociado a otras afecciones comórbidas, como diabetes, hipertensión, y enfermedades cardíacas y pulmonares, son, en particular, más susceptibles, en comparación con las poblaciones generales y tienen mayor mortalidad. Aún no está claro si esta mayor asociación de hipertensión arterial con COVID-19 y el mayor riesgo de mortalidad están directamente relacionados con la hipertensión arterial u otras comorbilidades asociadas, o con el tratamiento antihipertensivo.Si bien el mecanismo patogénico subyacente que une la hipertensión y la gravedad de la infección por COVID-19 aún no se ha dilucidado, se ha planteado la hipótesis de que la activación excesiva del sistema renina-angiotensina (RAS) podría contribuir a la progresión de la lesión pulmonar relacionada con COVID-19.La preocupación sobre si los bloqueadores del receptor de angiotensina II (BRA) y los inhibidores de la enzima convertidora de angiotensina (IECA) pueden tener efectos nocivos sobre la morbilidad y la mortalidad de los pacientes con COVID-19 se basa en la especulación de que estos medicamentos aumentarían la regulación de la enzima convertidora de angiotensina II (ACE2), un receptor para el SARS-CoV-2, que aumentaría la carga viral y la lesión pulmonar.Los estudios recientes concuerdan con las recomendaciones de las sociedades científicas que plantean evitar la suspensión o cambio de medicación antihipertensiva, pues no hay evidencia que muestre que estos puedan ser tomados como factores de riesgo para gravedad o mortalidad por COVID-19. Abstract: A new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in December 2019 in Wuhan, China; the virus escalated rapidly and on March 11, 2020, the World Health Organization declared it a pandemic.Emerging data suggests that older patients with COVID-19 associated with other comorbid conditions such as diabetes, hypertension, heart and lung diseases are particularly more susceptible, compared to general populations, and have higher mortality. It is not yet clear whether this increased association of high blood pressure with COVID-19 and the increased risk of mortality are directly related to high blood pressure or other associated comorbidities, or to antihypertensive treatment.Although the underlying pathogenic mechanism linking hypertension and severity of COVID-19 infection remains to be elucidated, it has been hypothesized that excessive activation of the renin-angiotensin system (RAS) could contribute to the progression of COVID-19 related lung injury.Concern about whether angiotensin II receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors may have deleterious effects on morbidity and mortality in patients with COVID-19 is based on speculation that these drugs would increase the regulation of angiotensin II converting enzyme (ACE2), a receptor for SARS-CoV-2, which would increase viral load and lung damage.Recent studies are consistent with the recommendations of scientific societies that propose avoiding the suspension or change of antihypertensive medication, as there is no evidence that shows that these can be taken as risk factors for severity or mortality from COVID-19.
Keywords	COVID-19 ; SARS-CoV-2 ; ACE2 ; BRA ; ACEI ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; covid19
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Inhibidores de la enzima convertidora de angiotensina y bloqueadores de los receptores de angiotensina II

Molina, Dora Inés / Muñoz, Tania Marcela / Guevara, Katterine

Revista Colombiana de Cardiología

¿aumentan el riesgo de padecer COVID-19?

2020 Volume 27, Issue 3, Page(s) 132–136

Keywords	Cardiology and Cardiovascular Medicine ; covid19
Language	Spanish
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2085912-0
ISSN	0120-5633
ISSN	0120-5633
DOI	10.1016/j.rccar.2020.05.003
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Article: Angiotensin converting enzyme inhibitors and angiotensin receptor blocker: do they increase the risk of COVID-19?/ Inhibidores de la enzima convertidora de angiotensina y bloqueadores de los receptores de angiotensina II: ¿aumentan el riesgo de padecer COVID-19?

Molina, Dora Inés / Muñoz, Tania Marcela / Guevara, Katterine

Rev. Colomb. Cardiol.

Abstract: A new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in December 2019 in Wuhan, China; the virus escalated rapidly and on March 11, 2020, the World Health Organization declared it a pandemic. Emerging ... ...

Abstract	A new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in December 2019 in Wuhan, China; the virus escalated rapidly and on March 11, 2020, the World Health Organization declared it a pandemic. Emerging data suggests that older patients with COVID-19 associated with other comorbid conditions such as diabetes, hypertension, heart and lung diseases are particularly more susceptible, compared to general populations, and have higher mortality. It is not yet clear whether this increased association of high blood pressure with COVID-19 and the increased risk of mortality are directly related to high blood pressure or other associated comorbidities, or to antihypertensive treatment. Although the underlying pathogenic mechanism linking hypertension and severity of COVID-19 infection remains to be elucidated, it has been hypothesized that excessive activation of the renin-angiotensin system (RAS) could contribute to the progression of COVID-19 related lung injury. Concern about whether angiotensin II receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors may have deleterious effects on morbidity and mortality in patients with COVID-19 is based on speculation that these drugs would increase the regulation of angiotensin II converting enzyme (ACE2), a receptor for SARS-CoV-2, which would increase viral load and lung damage. Recent studies are consistent with the recommendations of scientific societies that propose avoiding the suspension or change of antihypertensive medication, as there is no evidence that shows that these can be taken as risk factors for severity or mortality from COVID-19.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #597419
Database	COVID19

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Article ; Online: Blood pressure telemonitoring and telemedicine, a Latin America perspective.

Piskorz, Daniel / Alcocer, Luis / López Santi, Ricardo / Puente Barragán, Adriana / Múnera, Ana / Molina, Dora Inés / Galván Oseguera, Héctor / Barroso, Weimar Sebba / Palomo, Silvia / Díaz-Díaz, Enrique / Cardona-Muñoz, Ernesto / Wyss, Fernando / Ponte Negretti, Carlos / Rosas Peralta, Martín / Chávez Mendoza, Adolfo / Alvares López, Humberto / Patiño, Ernesto Peñaherrera / Guerra López, Arturo / Escudero, Xavier /

Enciso, José Manuel

Blood pressure

2023 Volume 32, Issue 1, Page(s) 2251586

Abstract: Purpose: To share a Latin-American perspective of the use of telemedicine, together with blood pressure measurements outside the medical office, as a potential contribution to improving access to the health system, diagnosis, adherence, and persistence ... ...

Abstract	Purpose: To share a Latin-American perspective of the use of telemedicine, together with blood pressure measurements outside the medical office, as a potential contribution to improving access to the health system, diagnosis, adherence, and persistence in hypertension treatment. Material and methods: A document settled by a Writing Group of Mexico Hypertension Experts Group, Interamerican Society of Hypertension, Epidemiology and Cardiovascular Prevention Council of the Interamerican Society of Cardiology, and National Cardiologist Association of Mexico. Results: In almost all Latin American countries, the health sector faces two fundamental challenges: (1) ensure equitable access to quality care services in a growing population that faces an increase in the prevalence of chronic diseases, and (2) optimise the growing costs of health services, maintaining equity, accessibility, universality, and quality. Telehealth proposes an innovative approach to patient management, especially for chronic conditions, intending to provide remote consultation, education, and follow-up to achieve measurements and goals. It is a tool that promises to improve access, empower the patient, and somehow influence their behaviour about lifestyle changes, improving prevention and reducing complications of hypertension. The clinical practitioner has seen increased evidence that the use of out-of-office blood pressure (BP) measurement and telemedicine are helpful tools to keep patients and physicians in contact and promote better pharmacological adherence and BP control. A survey carried out by medical and scientific institutions showed that practitioners are up-to-date with telemedicine, had internet access, and had hardware availability. Conclusions: A transcendent issue is the need to make the population aware of the benefits of taking blood pressure to avoid complications of hypertension, and in this scenario, promote the creation of teleconsultation mechanisms for the follow-up of patients diagnosed with hypertension.
MeSH term(s)	Humans ; Blood Pressure ; Latin America ; Telemedicine ; Remote Consultation ; Hypertension/diagnosis ; Hypertension/therapy
Language	English
Publishing date	2023-08-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1170048-8
ISSN	1651-1999 ; 1651-2480 ; 0803-7051 ; 0803-8023
ISSN (online)	1651-1999 ; 1651-2480
ISSN	0803-7051 ; 0803-8023
DOI	10.1080/08037051.2023.2251586
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Zs.A 3843: Show issues

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Article ; Online: Inhibidores de la enzima convertidora de angiotensina y antagonistas del receptor de angiotensina II: ¿Aumentan el riesgo de padecer COVID-19?

Molina, Dora Ines / Muñoz, Tania Marcela / Guevara, Katterine

Revista Colombiana de Cardiología

Abstract: Abstract A new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in December 2019 in Wuhan, China; the virus escalated rapidly and on March 11, 2020, the World Health Organization declared it a pandemic ... ...

Abstract	Abstract A new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in December 2019 in Wuhan, China; the virus escalated rapidly and on March 11, 2020, the World Health Organization declared it a pandemic.Emerging data suggests that older patients with COVID-19 associated with other comorbid conditions such as diabetes, hypertension, heart and lung diseases are particularly more susceptible, compared to general populations, and have higher mortality. It is not yet clear whether this increased association of high blood pressure with COVID-19 and the increased risk of mortality are directly related to high blood pressure or other associated comorbidities, or to antihypertensive treatment.Although the underlying pathogenic mechanism linking hypertension and severity of COVID-19 infection remains to be elucidated, it has been hypothesized that excessive activation of the renin-angiotensin system (RAS) could contribute to the progression of COVID-19 related lung injury.Concern about whether angiotensin II receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors may have deleterious effects on morbidity and mortality in patients with COVID-19 is based on speculation that these drugs would increase the regulation of angiotensin II converting enzyme (ACE2), a receptor for SARS-CoV-2, which would increase viral load and lung damage.Recent studies are consistent with the recommendations of scientific societies that propose avoiding the suspension or change of antihypertensive medication, as there is no evidence that shows that these can be taken as risk factors for severity or mortality from COVID-19.
Keywords	covid19
Publisher	Elsevier; PMC; WHO
Document type	Article ; Online
Note	WHO #Covidence: #597419
DOI	10.1016/j.rccar.2020.05.003
Database	COVID19

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Article: Association of time of breakfast and nighttime fasting duration with breast cancer risk in the multicase-control study in Spain.

Frontiers in nutrition

2022 Volume 9, Page(s) 941477

Abstract: Circadian nutritional behaviors, defined by the daily eating/fasting cycle, have been linked with breast cancer. This study aimed to further disentangle the association of nighttime fasting duration and time of breakfast with breast cancer risk. We ... ...

Abstract	Circadian nutritional behaviors, defined by the daily eating/fasting cycle, have been linked with breast cancer. This study aimed to further disentangle the association of nighttime fasting duration and time of breakfast with breast cancer risk. We analyzed data from 1,181 breast cancer cases and 1,326 population controls from the Spanish multicase-control study (MCC-Spain), 2008-2013. We collected circadian nutritional behaviors at mid-age
Language	English
Publishing date	2022-08-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2022.941477
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Article ; Online: The Association of Nighttime Fasting Duration and Prostate Cancer Risk: Results from the Multicase-Control (MCC) Study in Spain.

Palomar-Cros, Anna / Espinosa, Ana / Straif, Kurt / Pérez-Gómez, Beatriz / Papantoniou, Kyriaki / Gómez-Acebo, Inés / Molina-Barceló, Ana / Olmedo-Requena, Rocío / Alguacil, Juan / Fernández-Tardón, Guillermo / Casabonne, Delphine / Aragonés, Nuria / Castaño-Vinyals, Gemma / Pollán, Marina / Romaguera, Dora / Kogevinas, Manolis

Nutrients

2021 Volume 13, Issue 8

Abstract: Nighttime fasting has been inconclusively associated with a reduced risk of cancer. The purpose of this study was to investigate this association in relation to prostate cancer risk. We examined data from 607 prostate cancer cases and 848 population ... ...

Abstract	Nighttime fasting has been inconclusively associated with a reduced risk of cancer. The purpose of this study was to investigate this association in relation to prostate cancer risk. We examined data from 607 prostate cancer cases and 848 population controls who had never worked in night shift work from the Spanish multicase-control (MCC) study, 2008-2013. Through an interview, we collected circadian information on meal timing at mid-age. We estimated odds ratios (OR) and 95% confidence intervals (CI) with unconditional logistic regression. After controlling for time of breakfast, fasting for more than 11 h overnight (the median duration among controls) was associated with a reduced risk of prostate cancer compared to those fasting for 11 h or less (OR = 0.77, 95% 0.54-1.07). Combining a long nighttime fasting and an early breakfast was associated with a lower risk of prostate cancer compared to a short nighttime fasting and a late breakfast (OR = 0.54, 95% CI 0.27-1.04). This study suggests that a prolonged nighttime fasting duration and an early breakfast may be associated with a lower risk of prostate cancer. Findings should be interpreted cautiously and add to growing evidence on the importance of chrononutrition in relation to cancer risk.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Breakfast ; Case-Control Studies ; Circadian Rhythm ; Fasting ; Feeding Behavior ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prostatic Neoplasms/epidemiology ; Risk Factors ; Shift Work Schedule ; Spain/epidemiology ; Young Adult
Language	English
Publishing date	2021-07-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13082662
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Article ; Online: Impacto de la investigación clínica en el desarrollo de un país Impact of clinical research in the development of a country

Dora Inés Molina de salazar / Germán Camilo Giraldor

Acta Médica Colombiana, Vol 37, Iss 4, Pp 215-

2012 Volume 219

Abstract: Con la creciente aparición de centros de investigación por contratación en Colombia y Sur América, se hace necesario resaltar el por qué de esta situación y las ventajas que trae para cada país, tanto económicos como académicos, y el creciente interés de ...

Abstract	Con la creciente aparición de centros de investigación por contratación en Colombia y Sur América, se hace necesario resaltar el por qué de esta situación y las ventajas que trae para cada país, tanto económicos como académicos, y el creciente interés de la industria farmacéutica para llegar más a estos países, donde la cantidad de población, la calidad de la investigación y los costos han sido atractivos . En Colombia existen 108 centros de investigación, 53 afiliados a la Asociación Colombiana de Centros de Investigación; Diabetes y Endocrinología, los temas preferidos por los investigadores en Colombia. (Acta Med Colom 2012; 37: 215-219). With the increasing emergence of research centers though hiring in Colombia and South America, it is necessary to highlight the reason for this situation and the economic as well as academic benefits that it brings to each country, and the growing interest of the pharmaceutical industry to penetrate more in these countries where the number of people, the quality of research and the costs have been attractive. In Colombia there are 108 research centers, 53 of which are members of the Colombian Association of research centers, being Diabetes and Endocrinology the subjects preferred by researchers in Colombia. (Acta Med Colom 2012; 37: 215-219).
Keywords	investigación ; desarrollo económico ; industria farmacéutica ; estudios clínicos ; research ; economic development ; pharmaceutical ; clinical studies ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Spanish
Publishing date	2012-10-01T00:00:00Z
Publisher	Asociacion Colombiana de Medicina Interna
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dietary inflammatory index and prostate cancer risk: MCC-Spain study.

Lozano-Lorca, Macarena / Salcedo-Bellido, Inmaculada / Olmedo-Requena, Rocío / Castaño-Vinyals, Gemma / Amiano, Pilar / Shivappa, Nitin / Hébert, James R / Pérez-Gómez, Beatriz / Gracia-Lavedan, Esther / Gómez-Acebo, Inés / Molina-Barceló, Ana / Barrios-Rodríguez, Rocío / Alguacil, Juan / Fernández-Tardón, Guillermo / Aragonés, Nuria / Dierssen-Sotos, Trinidad / Romaguera, Dora / Pollán, Marina / Kogevinas, Manolis /

Jiménez-Moleón, José-Juan

Prostate cancer and prostatic diseases

2022 Volume 25, Issue 3, Page(s) 568–575

Abstract: Background: The etiology of prostate cancer (PCa) is not well-known, and the role of diet is not well established. We aimed to evaluate the role of the inflammatory power of the diet, measured by the Dietary Inflammatory Index (DII: Methodology: A ... ...

Abstract	Background: The etiology of prostate cancer (PCa) is not well-known, and the role of diet is not well established. We aimed to evaluate the role of the inflammatory power of the diet, measured by the Dietary Inflammatory Index (DII Methodology: A population-based multicase-control (MCC-Spain) study was conducted. Information was collected on sociodemographic characteristics, personal and family antecedents, and lifestyles, including diet from a Food Frequency Questionnaire. The inflammatory potential of the diet was assessed using the energy-adjusted Dietary Inflammatory Index (E-DII) based on 30 parameters (a higher score indicates a higher inflammatory capacity of the diet). Tertiles of E-DII were created using the cut-off points from the control group. The International Society of Urology Pathology (ISUP) was grouped as ISUP 1, ISUP 2, or ISUP 3-5. Unconditional logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between E-DII score and PCa risk. Results: A total of 928 PCa cases and 1278 population controls were included. Among PCa cases, the mean value of the E-DII score was 0.18 (SD: 1.9) vs. 0.07 (SD: 1.9) in the control group (p = 0.162). Cases with a more pro-inflammatory diet (3rd tertile) had the highest risk of PCa, aOR Conclusion: A positive association was observed between consuming a pro-inflammatory diet and PCa in the MCC-Spain population, specifically for an ISUP grade greater or equal than 2.
MeSH term(s)	Case-Control Studies ; Diet/adverse effects ; Humans ; Inflammation/complications ; Inflammation/epidemiology ; Male ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/etiology ; Prostatic Neoplasms/pathology ; Risk Factors ; Spain/epidemiology
Language	English
Publishing date	2022-04-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1419277-9
ISSN	1476-5608 ; 1365-7852
ISSN (online)	1476-5608
ISSN	1365-7852
DOI	10.1038/s41391-022-00532-7
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