Asociación entre el nivel de riesgo de eventos cardiovasculares medido por la escala de Framingham y el efecto "no dipper" del monitoreo ambulatorio de presión arterial, en pacientes de la cohorte Chicamocha

dc.contributorVillar Centeno, Juan Carlos
dc.contributorhttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000068519
dc.contributorhttps://scholar.google.es/citations?hl=es#user=nTlsWe0AAAAJ
dc.contributorhttps://orcid.org/0000-0002-7047-7299
dc.contributorhttps://www.scopus.com/authid/detail.uri?authorId=57193835436
dc.contributorhttps://www.researchgate.net/profile/Juan_Villar11
dc.contributorGrupo de Investigación en Cardiología Preventiva
dc.creatorBlanco Barrera, Néstor Fabián
dc.date.accessioned2020-06-26T19:59:56Z
dc.date.available2020-06-26T19:59:56Z
dc.date.created2020-06-26T19:59:56Z
dc.date.issued2017
dc.identifierhttp://hdl.handle.net/20.500.12749/1745
dc.identifierinstname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifierreponame:Repositorio Institucional UNAB
dc.description.abstractObjetivo: Se evaluó la relación entre el puntaje en la escala de Framingham de riesgo cardiovascular (EFRCV) y la condición “no dipper” (ND) por monitoreo ambulatorio de presión arterial (MAPA) en participantes de la cohorte CHICAMOCHA. Métodos: Estudio de corte transversal. Participantes clasificados como de mayor probabilidad de hipertensión arterial (HTA, n=269) o controles (n=39) en la visita de seguimiento (mediana 12 años) tuvieron MAPA para su adecuada clasificación. Se registró el puntaje en la EFRCV como variable independiente, además de las variables sociodemográficas y medidas antropométricas. Se describió el nivel de EFRCV en la población por terciles y se evaluó la relación entre ND (nuestra variable dependiente) y posibles variables de confusión. Basado en estos hallazgos se construyó un modelo de regresión logística para establecer la relación independiente entre ND y EFRCV. Resultados: Se encontró patrón ND en 200 (65%) participantes. En el análisis bivariado se identificó un patrón incremental de frecuencia de ND por niveles de EFRCV (57%, en el grupo de menor riesgo; 63% en el grupo intermedio y 74% en el de mayor riesgo, p=0.039). En el modelo de regresión logística (que incluyó los niveles de presión arterial como covariable) se encontró que la edad (OR= 1.06, IC 95% 1.02 -1.09 por cada año) y la obesidad (OR= 1.82, IC 95% 1.12- 2.95), pero no la EFRCV fueron independientemente asociadas con la condición ND. Conclusión: La mayoría de participantes fue clasificada como ND. Aun cuando se encontró un claro gradiente entre EFRCV y la condición ND, esta asociación está explicada por su relación con los niveles de presión arterial, que es un componente de la escala. Este hallazgo sugiere que la relación bien establecida entre la condición ND y los eventos cardiovasculares sea explicada por vías diferentes a las incluidas en la EFRCV.
dc.languagespa
dc.publisherUniversidad Autónoma de Bucaramanga UNAB
dc.publisherFacultad Ciencias de la Salud
dc.publisherEspecialización en Medicina Interna
dc.relationBlanco Barrera, Néstor Fabián (2017). Asociación entre el nivel de riesgo de eventos cardiovasculares medido por la escala de Framingham y el efecto "no dipper" del monitoreo ambulatorio de presión arterial, en pacientes de la cohorte Chicamocha. Floridablanca (Santander, Colombia) : Universidad Autónoma de Bucaramanga UNAB"
dc.relation1. Guía de práctica clínica. Hipertensión arterial primaria (HTA). 2013;
dc.relation2. Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, et al. CLINICIAN ’ S CORNER The Seventh Report of the Joint National Committee on Prevention , Detection , Evaluation , and Treatment. 2015;289(19):2560–73.
dc.relation3. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. Evidence-Based Guideline for the Management of High Blood Pressure in Adults. Jama [Internet]. 2013;1097(5):1–14. Available from: http://jama.jamanetwork.com/article.aspx?articleid=1791497%5Cnhttp://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2013.284427
dc.relation4. Siu AL, U.S. Preventive Services Task Force. Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med [Internet]. 2015 Nov 17 [cited 2016 Oct 24];163(10):778–86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26458123
dc.relation5. De Marco M, De Simone G, Roman MJ, Chinali M, Lee ET, Russell M, et al. Cardiovascular and Metabolic Predictors of Progression of Prehypertension into Hypertension: The Strong Heart Study.
dc.relation6. Boyko EJ, Shaw JE, Zimmet PZ, Chitson P, Tuomilehto J, Alberti KGMM. A prospective study of glycemia, body size, insulin resistance and the risk of hypertension in Mauritius. J Hypertens [Internet]. 2008 Sep [cited 2016 Oct 20];26(9):1742–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18698207
dc.relation7. Derhaschnig U, Testori C, Riedmueller E, Aschauer S, Wolzt M, Jilma B. Hypertensive emergencies are associated with elevated markers of inflammation, coagulation, platelet activation and fibrinolysis. J Hum Hypertens [Internet]. 2013 Jun [cited 2016 Oct 21];27(6):368–73. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23254594
dc.relation8. Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation [Internet]. American Heart Association, Inc.; 2008 Jun 24 [cited 2016 Oct 24];117(25):e510-26. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18574054
dc.relation9. Prkacin I, Balenovic D, Djermanovic-Dobrota V, Lukac I, Drazic P, Pranjic I-K. Resistant Hypertension and Chronotherapy. 2015;27(272):118–21.
dc.relation10. Mallick S, Kanthety R, Rahman M. Home Blood Pressure Monitoring in Clinical Practice: A Review. Am J Med [Internet]. 2009 Sep [cited 2016 Oct 24];122(9):803–10. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0002934309004100
dc.relation11. International Society for Chronobiology, American Association of Medical Chronobiology and Chronotherapeutics, Spanish Society of Applied Chronobiology, Chronotherapy, and Vascular Risk, Spanish Society of Atherosclerosis, Romanian Society of Internal Medicine, Hermida RC, et al. 2013 ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals. Chronobiol Int [Internet]. 2013 Apr [cited 2016 Oct 25];30(3):355–410. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23517220
dc.relation12. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for Blood Pressure Measurement in Humans and Experimental Animals. Circulation. 2005;111(5).
dc.relation13. Fagard RH, Van Den Broeke C, De Cort P. Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice. J Hum Hypertens [Internet]. 2005 Oct [cited 2016 Oct 25];19(10):801–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15959536
dc.relation14. Sega R, Facchetti R, Bombelli M, Cesana G, Corrao G, Grassi G, et al. Prognostic Value of Ambulatory and Home Blood Pressures Compared With Office Blood Pressure in the General Population. Circulation. 2005;111(14).
dc.relation15. Omboni S, Posokhov IN, Parati G, Avolio A, Rogoza AN, Kotovskaya Y V, et al. Vascular Health Assessment of The Hypertensive Patients (VASOTENS) Registry: Study Protocol of an International, Web-Based Telemonitoring Registry for Ambulatory Blood Pressure and Arterial Stiffness. JMIR Res Protoc [Internet]. JMIR Publications Inc.; 2016 Jun 29 [cited 2016 Oct 24];5(2):e137. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27358088
dc.relation16. White. Circadian variation of blood pressure: clinical relevance and implications for cardiovascular chronotherapeutics. Blood Press Monit [Internet]. 1997 Dec [cited 2016 Oct 21];2(1):47–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10234091
dc.relation17. Hermida RC, Ayala DE, Smolensky MH, Fernández JR, Mojón A, Portaluppi F. Sleep-time blood pressure: Unique sensitive prognostic marker of vascular risk and therapeutic target for prevention. Sleep Med Rev [Internet]. 2016 Apr [cited 2017 Feb 28]; Available from: http://linkinghub.elsevier.com/retrieve/pii/S1087079216300077
dc.relation18. Islam MS. Ambulatory Blood Pressure Monitoring in the Diagnosis and Treatment of Hypertension. 2016 [cited 2017 Feb 28]. Available from: http://link.springer.com/10.1007/5584_2016_177
dc.relation19. Coca A. Circadian rhythm and blood pressure control: physiological and pathophysiological factors. J Hypertens Suppl [Internet]. 1994 Jul [cited 2016 Oct 21];12(5):S13-21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7965281
dc.relation20. Salwa P, Gorczyca-Michta I, Kluk M, Dziubek K, Wożakowska-Kapłon B. Variability of circadian blood pressure profile during 24-hour ambulatory blood pressure monitoring in hypertensive patients. Kardiol Pol [Internet]. 2014 [cited 2016 Oct 21];72(5):432–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24526553
dc.relation21. Seguchi M, Wada H, Sakakura K, Nakagawa T, Ibe T, Ikeda N, et al. Circadian Variation of Acute Aortic Dissection. Int Heart J [Internet]. International Heart Journal Association; 2015 [cited 2016 Oct 24];56(3):324–8. Available from: https://www.jstage.jst.go.jp/article/ihj/56/3/56_14-328/_article
dc.relation22. Minamisawa M, Izawa A, Motoki H, Kashima Y, Hioki H, Abe N, et al. Prognostic Significance of Neuroadrenergic Dysfunction for Cardiovascular Events in Patients With Acute Myocardial Infarction. Circ J [Internet]. The Japanese Circulation Society; 2015 [cited 2016 Oct 25];79(10):2238–45. Available from: https://www.jstage.jst.go.jp/article/circj/79/10/79_CJ-15-0265/_article
dc.relation23. Hermida RC, Ayala DE, Mojón A, Fernández JR. Blunted Sleep-Time Relative Blood Pressure Decline Increases Cardiovascular Risk Independent of Blood Pressure Level—The “Normotensive Non-dipper” Paradox. Chronobiol Int [Internet]. 2013 Mar 5 [cited 2016 Oct 20];30(1–2):87–98. Available from: http://www.tandfonline.com/doi/full/10.3109/07420528.2012.701127
dc.relation24. Ozdemir E, Yildirimturk O, Cengiz B, Yurdakul S, Aytekin S. Evaluation of carotid intima-media thickness and aortic elasticity in patients with nondipper hypertension. Echocardiography [Internet]. 2014 May [cited 2016 Oct 25];31(5):663–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24219389
dc.relation25. Vasunta R-L, Kesäniemi YA, Ylitalo A, Ukkola O. Nondipping pattern and carotid atherosclerosis in a middle-aged population: OPERA Study. Am J Hypertens [Internet]. 2012 Jan [cited 2016 Oct 26];25(1):60–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21866184
dc.relation26. Kim S, Kim N-H, Kim YK, Yoo JH, Shin SN, Ko JS, et al. The Number of Endothelial Progenitor Cells is Decreased in Patients With Non-Dipper Hypertension. Korean Circ J [Internet]. The Korean Society of Cardiology; 2012 May [cited 2016 Oct 26];42(5):329–34. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22701498
dc.relation27. Cicek Y, Durakoglugil ME, Kocaman SA, Cetin M, Erdogan T, Dogan S, et al. Non-dipping pattern in untreated hypertensive patients is related to increased pulse wave velocity independent of raised nocturnal blood pressure. Blood Press [Internet]. 2013 Feb [cited 2016 Oct 26];22(1):34–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22783816
dc.relation28. Cuspidi C, Sala C, Tadic M, Rescaldani M, Grassi G, Mancia G. Non-Dipping Pattern and Subclinical Cardiac Damage in Untreated Hypertension: A Systematic Review and Meta-Analysis of Echocardiographic Studies. Am J Hypertens [Internet]. 2015 Dec [cited 2016 Oct 21];28(12):1392–402. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26108212
dc.relation29. Açar G, Bulut M, Arslan K, Alizade E, Ozkan B, Alici G, et al. Comparison of left atrial mechanical function in nondipper versus dipper hypertensive patients: a speckle tracking study. Echocardiography [Internet]. 2013 Feb [cited 2016 Oct 25];30(2):164–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23167459
dc.relation30. Coleman CT, Stowasser M, Jenkins C, Marwick TH, Sharman JE. Central hemodynamics and cardiovascular risk in nondippers. J Clin Hypertens (Greenwich) [Internet]. 2011 Aug [cited 2016 Oct 26];13(8):557–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21806765
dc.relation31. Sengul C, Cevik C, Ozveren O, Duman D, Eroglu E, Oduncu V, et al. Epicardial fat thickness is associated with non-dipper blood pressure pattern in patients with essential hypertension. Clin Exp Hypertens [Internet]. 2012 [cited 2016 Oct 26];34(3):165–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22008026
dc.relation32. Yan B, Peng L, Dong Q, Zheng F, Yang P, Sun L, et al. Reverse-dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension. Eur J Neurol [Internet]. 2015 Jun [cited 2016 Oct 24];22(6):1022–5. Available from: http://doi.wiley.com/10.1111/ene.12659
dc.relation33. Park J-H, Lee H-S, Kim JH, Lee J-H, Kim J, Choi SW. Reverse dipper and high night-time heart rate in acute stage of cerebral infarction are associated with increased mortality. J Stroke Cerebrovasc Dis [Internet]. [cited 2016 Oct 25];23(5):1171–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24268903
dc.relation34. Aksan G, İnci S, Nar G, Siğirci S, Gedikli Ö, Soylu K, et al. Serum neutrophıl gelatınase-assocıated lıpocalın levels in patients with non-dipper hypertension. Clin Invest Med [Internet]. 2015 Apr 8 [cited 2016 Oct 24];38(2):E53-62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25864997
dc.relation35. Ordu S, Ozhan H, Alemdar R, Yildirim H, Gungor A, Caglar SO, et al. Cystatin C levels in patients with dipper and nondipper hypertension. J Investig Med [Internet]. 2012 Apr [cited 2016 Oct 26];60(4):676–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22373662
dc.relation36. Nergiz B. The platelet-to-lymphocyte ratio as an inflammation marker in non-dipper hyper- tensive patients. Hippokratia. 2015;19(2):114–8.
dc.relation37. Surgit O, Erturk M, Akgul O, Pusuroglu H, Korkmaz AF, Isiksacan N, et al. Assessment of mean platelet volume and soluble CD40 ligand levels in patients with non-dipper hypertension, dippers and normotensives. Clin Exp Hypertens [Internet]. 2015 [cited 2016 Oct 24];37(1):70–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24866755
dc.relation38. Sunbul M, Sunbul EA, Kosker SD, Durmus E, Kivrak T, Ileri C, et al. Depression and anxiety are associated with abnormal nocturnal blood pressure fall in hypertensive patients. Clin Exp Hypertens [Internet]. 2014 [cited 2016 Oct 25];36(5):354–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24047218
dc.relation39. García-Ortiz L, Recio-Rodríguez JI, Puig-Ribera A, Lema-Bartolomé J, Ibáñez-Jalón E, González-Viejo N, et al. Blood pressure circadian pattern and physical exercise assessment by accelerometer and 7-day physical activity recall scale. Am J Hypertens [Internet]. 2014 May [cited 2016 Oct 25];27(5):665–73. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23975330
dc.relation40. Di Raimondo D, Tuttolomondo A, Miceli S, Milio G, Licata G, Pinto A. Aerobic physical activity based on fast walking does not alter blood pressure values in non-dipper essential hypertensives. Int Angiol [Internet]. 2012 Apr [cited 2016 Oct 26];31(2):142–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22466979
dc.relation41. Tekçe H, Kürşat S, Bahadır Çolak H, Aktaş G. Effects of nutritional parameters on nocturnal blood pressure in patients undergoing hemodialysis. Ren Fail [Internet]. 2013 Aug [cited 2016 Oct 25];35(7):946–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23815366
dc.relation42. Tutal E, Sayın B, Ertugrul DT, Ibis A, Sezer S, Ozdemir N. Is there a link between hyperuricemia, morning blood pressure surge, and non-dipping blood pressure pattern in metabolic syndrome patients? Int J Nephrol Renovasc Dis [Internet]. Dove Press; 2013 [cited 2016 Oct 25];6:71–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23662072
dc.relation43. Inal S, Karakoç MA, Kan E, Ebinç FA, Törüner FB, Aslan M. The effect of overt and subclinical hypothyroidism on the development of non-dipper blood pressure. Endokrynol Pol [Internet]. 2012 [cited 2016 Oct 26];63(2):97–103. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22538747
dc.relation44. Demir M, Günay T, Özmen G, Melek M. Relationship between vitamin D deficiency and nondipper hypertension. Clin Exp Hypertens [Internet]. 2013 [cited 2016 Oct 26];35(1):45–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22594967
dc.relation45. Hermida RC, Ayala DE, Smolensky MH, Fernández JR, Mojón A, Portaluppi F. Chronotherapy with conventional blood pressure medications improves management of hypertension and reduces cardiovascular and stroke risks. Hypertens Res [Internet]. 2016 May [cited 2016 Oct 21];39(5):277–92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26657008
dc.relation46. Hermida RC, Ayala DE, Mojón A, Smolensky MH, Portaluppi F, Fernández JR. Sleep-time ambulatory blood pressure as a novel therapeutic target for cardiovascular risk reduction. J Hum Hypertens [Internet]. 2014 Oct [cited 2016 Oct 25];28(10):567–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24500721
dc.relation47. Sousa F, Neves J, Ferreira R, Polonia J, Bastos JM. 1B.05: IN HYPERTENSION THE CHANGE FROM A NON-DIPPER TO A DIPPER PATTERN IS ASSOCIATED WITH A BETTER CARDIOVASCULAR PROGNOSIS THAN THE PERSISTENCE WITHIN THE NON-DIPPER PATTERN. J Hypertens [Internet]. 2015 Jun [cited 2016 Oct 21];33 Suppl 1:e6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26102868
dc.relation48. Sagarra-Tió M, Félez-Carrobé E, Baiget M, Félez J. Assessment of primary healthcare professionals’ management of hypertensive patients with riser pattern. Eur J Cardiovasc Nurs [Internet]. 2015 Feb [cited 2016 Oct 25];14(1):73–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24396114
dc.relation49. Hermida RC, Ayala DE, Smolensky MH, Mojón A, Fernández JR, Crespo JJ, et al. Chronotherapy improves blood pressure control and reduces vascular risk in CKD. Nat Rev Nephrol [Internet]. 2013 Jun [cited 2016 Oct 25];9(6):358–68. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23609565
dc.relation50. Kececi Savan D, Cengiz M, Yavuzer H, Yavuzer S, Sulu C, Doventas A, et al. Relation of ambulatory blood pressure measurement and cognitive functions in hypertensive elderly patients. Aging Clin Exp Res [Internet]. 2016 Aug [cited 2016 Oct 21];28(4):699–704. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26526029
dc.relation51. Wang C, Deng W-J, Gong W-Y, Zhang J, Zhang Q-Z, Ye ZC, et al. Nocturnal Hypertension Correlates Better With Target Organ Damage in Patients With Chronic Kidney Disease than a Nondipping Pattern. J Clin Hypertens (Greenwich) [Internet]. 2015 Oct [cited 2016 Oct 21];17(10):792–801. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26041362
dc.relation52. Akpinar I, Basar N, Sen N, Kisacik HL. Evaluation of biochemical, hematological,and thyroid function parameters in nondipper and dipper hypertensive patients. Wien Klin Wochenschr [Internet]. 2012 Jul 6 [cited 2017 Feb 28];124(13–14):439–43. Available from: http://link.springer.com/10.1007/s00508-012-0196-z
dc.relation53. Ríos MT, Domínguez-Sardiña M, Ayala DE, Gomara S, Sineiro E, Pousa L, et al. Prevalence and Clinical Characteristics of Isolated-Office and True Resistant Hypertension Determined by Ambulatory Blood Pressure Monitoring. Chronobiol Int [Internet]. 2013 Mar 19 [cited 2017 Feb 28];30(1–2):207–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23077975
dc.relation54. Ruiz ÁJ, Aschner PJ, Puerta MF, Alfonso-Cristancho R. Estudio IDEA (International Day for Evaluation of Abdominal Obesity): prevalencia de obesidad abdominal y factores de riesgo asociados en atención primaria en Colombia. Biomédica [Internet]. 2012 Jun 14 [cited 2017 Feb 28];32(4). Available from: http://www.revistabiomedica.org/index.php/biomedica/article/view/799
dc.relation55. Buendía R, Zambrano M, Díaz Á, Reino A, Ramírez J, Espinosa E. Puntos de corte de perímetro de cintura para el diagnóstico de obesidad abdominal en población colombiana usando bioimpedanciometría como estándar de referencia. Rev Colomb Cardiol. 2016;23(1):19–25.
dc.relation56. Lanas F, Avezum A, Bautista LE, Diaz R, Luna M, Islam S, et al. Risk factors for acute myocardial infarction in Latin America: the INTERHEART Latin American study. Circulation [Internet]. 2007 Mar 6 [cited 2017 Feb 28];115(9):1067–74. Available from: http://circ.ahajournals.org/cgi/doi/10.1161/CIRCULATIONAHA.106.633552
dc.relation57. Careaga M, Esmatjes E, Nuñez I, Molero J, Vidal J, Flores L. Effect of weight loss on abnormal 24-hour blood pressure patterns in severely obese patients. Surg Obes Relat Dis [Internet]. 2016 Nov [cited 2017 Feb 28];12(9):1719–24. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1550728915011168
dc.relation58. Yeboah J, McClelland RL, Polonsky TS, Burke GL, Sibley CT, O’Leary D, et al.Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA [Internet]. NIH Public Access; 2012 Aug 22 [cited 2017 Apr 25];308(8):788–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22910756
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dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia
dc.titleAsociación entre el nivel de riesgo de eventos cardiovasculares medido por la escala de Framingham y el efecto "no dipper" del monitoreo ambulatorio de presión arterial, en pacientes de la cohorte Chicamocha


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