José Juan Lozano-Nuevo

Instituto Politécnico Nacional, Ciudad de México, Mexico City, Mexico

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Publications (18)29.37 Total impact

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    ABSTRACT: Because hypertension and depression share common pathways, it is possible that each disease has an impact on the natural history of the other. To determinate whether depression influences blood pressure control in hypertensive patients. Forty hypertensive patients undergoing antihypertensive treatment, excluding beta-blockers and central-acting agents, self-measured their blood pressure several times a day for three days using a validated, commercially available device. All patients also completed the Zung Self-rating Depression Scale survey for depression. Associations between the results of the blood pressure and depression tests were determined using the Spearman correlation coefficient; RR was also measured. Of the 40 patients, 23 were depressed, and 21 of these 23 had poor control of their blood pressure. The RR for uncontrolled hypertension in depressed patients was 15.5. A significant correlation between systolic (r=0.713) and diastolic (r=0.52) blood pressure values and depression was found. Depression is common in patients with uncontrolled hypertension and may interfere with blood pressure control. Screening for depression in hypertensive patients is a simple and cost-effective tool that may improve outcomes.
    Full-text · Article · Dec 2013 · Experimental and clinical cardiology
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    ABSTRACT: Background: Almost all guidelines and recommendations for the treatment of pneumonia acquired in the community requiring hospitalization indicate as first line of treatment cephalosporins of third-generation and a macrolide, and emphasize that local antimicrobial resistance must be considered since fluoroquinolone such as levofloxacin or moxifloxacin can play an important role. Objective: To determine whether levofloxacin is as effective as conventional therapy with ceftriaxone plus clarithromycin for the management of the community-acquired pneumonia in hospital centers of Health Ministry of Mexico. Materials and method: An open-label randomized and controlled trial was performed in two hospitals of Mexico City. Sample size was calculated for a significance alpha < 0.05, comparing the response to two antibiotic regimens in the treatment of community-acquired pneumonia requiring hospitalization [group 1 (n=36), ceftriaxone plus clartithromycin, and group 2 (n=36) levofloxacin. Secondary objectives were to determine hospital mortality and the relationship of risk factor for treatment failure. Results: Statistical analysis did not show a statistically significant response (p < 0.114) for healing between the two treatment groups. There was not significant difference in mortality. It was determined as a risk factor for the lack of response to antibiotics having any sequel of neurological disease, and for the lack of response to levofloxacin, chronic alcoholism. Conclusions: Levofloxacin is as effective as ceftriaxone plus clarithromycin as initial antibiotic therapy in the management of community-acquired pneumonia.
    No preview · Article · Nov 2013 · Medicina Interna de Mexico
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    ABSTRACT: Background: Hypoadiponectinemia and hyperresistinemia are associated with cardiovascular disease. The increase in the carotid intima-media thickness (CIMT) assessed by B-mode ultrasound has been directly associated with increased risk of myocardial infarction and stroke. Objective: To evaluate the correlation between adipokine levels with CIMT in hypertensive type 2 diabetic patients. Methods: Serum levels of adiponectin and resistin levels were measured by ELISA in 30 type 2 diabetic patients with never-treated hypertension and in age-matched healthy controls. The CIMT (B-mode color imaging of extracranial carotid arteries using high-resolution ultrasound) was also obtained. The relationship between adipokine levels and the adiponectin/resistin index with the CIMT was assessed by the Pearson correlation coefficient test. Results: Adiponectin was lower (p < 0.05), and resistin higher (p < 0.01) in patients than in controls, CIMT correlated positively with resistin (R = 0.45, p < 0.02) and the adiponectin/resistin index (R = 0.58, p < 0.001), but not with adiponectin levels (r = -0.11, p > 0.1) in patients. Whereas only adiponectin levels correlated - negatively - with CIMT (r = -0.39, p < 0.02) in controls. Conclusion: Our results shown that the adiponectin/resistin index seems to be more strongly associated with atherosclerosis than adipokine levels, and may be used as a reliable marker of cardiovascular risk in type 2 diabetic hypertensive patients.
    Full-text · Article · May 2013 · Cardiology
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    ABSTRACT: Background: differentiating hemorrhagic from ischemic cerebral vascular disease (CVD) is the starting point for the treatment. The aim was to compare the diagnostic accuracy of the scales that differentiate hemorrhagic from ischemic stroke. Methods: we applied the scale of Siriraj Stroke Score (SSS) and Greek Stroke Score (GSS) to patients with stroke. The results were described as means and frequencies. For significant variables odds ratio was calculated. We calculated the validity of both scales compared to the head computed tomography. Results: ninety one patients had ischemic stroke and 28 were hemorrhagic. The mean systolic blood pressure in ischemic stroke was 138.94 mmHg (SD ± 26.90) and hemorrhagic was 165.55 mmHg (SD ± 36.40) p = 0.0007. The atherogenic index (AT) in ischemic stroke was 4.52 (SD ± 1.52) and in hemorrhagic was 4.84 (SD ± 2.01) p = 0.87. The specificity of the SSS for hemorrhagic stroke is 85.5 % and 96.7 % for the GSS. Conclusions: the GSS has a high specificity for hemorrhagic stroke.
    No preview · Article · Nov 2012 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Endothelial dysfunction is a common feature in type-2 diabetic patients and is associated with inflammation, increased levels of circulating soluble adhesion molecules and atherosclerosis. Insufficiency of tetrahydrobiopterin leads to uncoupling of the nitric oxide synthase enzyme an endothelial dysfunction. The aim of this study: was to evaluate if there is a relationship between the levels of circulating soluble adhesion molecules and the levels of biopterins in normotensive type-2 diabetic patients. Methods: We studied 30 normotensive type-2 diabetic patients in whom VCAM-1, ICAM-1 and E-selectin were measured by ELISA. Additionally, Biopterins were measured by reverse phase high performance liquid chromatography with fluorescence detection. The levels of circulating adhesion molecules and biopterins were correlated using the Spearman correlation coefficient test. Statistical analysis was performed with ANOVA. Results: We did not find any relationship between absolute values of biopterins and soluble adhesion molecules. However, we observed significant inverse correlations between the BH4/BH2 ratio and VCAM-1 (r= -0.65, p < 0.001) with ICAM-1 (r= -0.69, p < 0.001) and with E-selectin (r=-0.64 p < 0.001), Conclusion: Our data suggest that systemic levels of adhesion molecules have an inverse association with the BH4/BH2 ratio in type 2 diabetic normotensive patients.
    Full-text · Article · Apr 2012
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    ABSTRACT: Endothelial dysfunction, a common feature among hypertensive and type-2 diabetic patients, has been associated with inflammation and increased concentrations of serum soluble adhesion molecules and resistin, a monocyte-macrophage- and adipocyte-derived cytokine. To determine if there is a correlation between the serum concentrations of ICAM-1, VCAM-1, Eselectin and resistin in hypertensive type-2 diabetic patients. Thirty hypertensive type-2 diabetic patients were enrolled in the study. Serum ICAM-1, VCAM-1, E-selectin and resistin concentrations were determined by ELISA and correlated with the Spearman correlation coefficient. Results: The patients' serum resistin concentrations significantly correlated with VCAM-1 (r = 0.31, p= 0.05) concentrations but not with ICAM-1 (r = 0.29, p = >0.05) and E-selectin (r = 0.10, p = 0.24) concentrations. VCAM-1 and resistin may participate in the pathophysiology of vascular damage in hypertensive type-2 diabetic patients. Serum resistin concentrations may be a marker of endothelial dysfunction.
    Full-text · Article · Feb 2011
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    ABSTRACT: Background: Endothelial dysfunction, a common feature among hypertensive and type-2 diabetic patients, has been associated with inflammation and increased concentrations of serum soluble adhesion molecules and resistin, a monocyte-macrophage- and adipocyte-derived cytokine. The Aim of this Study: To determine if there is a correlation between the serum concentrations of ICAM-1, VCAM-1, Eselectin and resistin in hypertensive type-2 diabetic patients. Methods: Thirty hypertensive type-2 diabetic patients were enrolled in the study. Serum ICAM-1, VCAM-1, E-selectin and resistin concentrations were determined by ELISA and correlated with the Spearman correlation coefficient. Results: The patients' serum resistin concentrations significantly correlated with VCAM-1 (r = 0.31, p = 0.05) concentrations but not with ICAM-1 (r = 0.29, p = >0.05) and E-selectin (r = 0.10, p = 0.24) concentrations. Conclusion: VCAM-1 and resistin may participate in the pathophysiology of vascular damage in hypertensive type-2 diabetic patients. Serum resistin concentrations may be a marker of endothelial dysfunction.
    No preview · Article · Jan 2011 · Inflammation & Allergy - Drug Targets (Formerly ?Current Drug Targets - Inflammation & Allergy)
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    ABSTRACT: Endothelial dysfunction is a common feature in type-2 diabetic patients and is associated with inflammation, increased levels of circulating soluble adhesion molecules and atherosclerosis. The aim of this study was to evaluate the relationship between the levels of circulating soluble adhesion molecules and the degree of atherosclerosis in normotensive type-2 diabetic patients. We found significant correlations between ICAM-1 (r = 0.69, p < 0.001 95% IC 0.65 to 0.82) and VCAM-1 (r = 0.4, p < 0.03, 95% IC 0.65 to 0.82) levels and maximal carotid artery intimal-medial thickness, whereas no correlation was observed with E-selectin. We studied 30 normotensive type-2 diabetic patients in whom VCAM-1, ICAM-1 and E-selectin were measured by ELISA. Additionally, the intimal-medial thickness of both the common and internal carotid arteries was measured (B-mode ultrasound). The levels of circulating adhesion molecules and maximal carotid artery intimal-medial thicknesses were correlated using the Spearman correlation coefficient test. Statistical analysis was performed with ANOVA. Our results suggest that ICAM-1 and VCAM-1 are markers associated, and correlated with the degree of atherosclerosis in normotensive type-2 diabetic patients.
    Full-text · Article · Oct 2009 · Cell adhesion & migration
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    ABSTRACT: This paper sought to determine if the fixed-dose combination of trandolapril and verapamil is effective in the treatment of hypertensive obese patients resistant to monotherapy. Thirty-six hypertensive obese patients uncontrolled by monotherapy were given the combination of trandolapril-verapamil (2/180 mg) for 12 weeks. Before and after taking the drug, they self-measured their blood pressure. Patients experienced a significant reduction of blood pressure (from 178 +/- 18/100 +/- 12 mm Hg to 135 +/- 14/76 +/- 7 mm Hg, p < 0.001). Eighty percent of patients reached therapeutic goals; one patient suffered from headaches and one had constipation. it was determined that the combination of trandolapril-verapamil is effective and safe for the management of hypertension in obese patients uncontrolled by monotherapy.
    Full-text · Article · Oct 2006 · Clinical and Experimental Hypertension
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    ABSTRACT: About 70% of hypertensive patients need more than one drug to control their blood pressure (BP). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends a two-drug combination as initial drug therapy for patients with stage 2 hypertension. The aim of this study was to determine if a fixed-dose combination of trandolapril-verapamil is effective and safe in the treatment of stage 2 (moderate to severe) hypertension in hypertensive Mexican patients not controlled by monotherapy. Forty hypertensive patients with BP >160/100mm Hg despite >6 months of drug treatment were given the fixed-dose combination of trandolapril-verapamil (2mg/180mg) for 12 weeks. Before taking the drug, they measured their own blood pressure (self-measured BP [SMBP]) several times a day for 3 days using a validated Omrom HEM 713C BP measuring device. At the end of the 12-week treatment period, the patients performed a second series of SMBPs in the same way as before treatment. A washout period was not included because the patients did not have an adequate response to previous antihypertensive treatment. Antihypertensive control during the 3-day SMBP period was evaluated. Patients experienced a significant reduction in mean BP (from 180/100mm Hg to 135/78mm Hg; p < 0.001). Seventy-five percent of patients reached their therapeutic goals (BP <140/90mm Hg). The SMBP records showed that BP values were maintained throughout the entire 3 days. One patient experienced headache and one had constipation; no patients discontinued the treatment. A fixed-dose combination of trandolapril-verapamil seems to be an effective and safe option for the management of stage 2 hypertension in Mexican patients uncontrolled by monotherapy.
    No preview · Article · Jul 2005 · Clinical Drug Investigation
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    ABSTRACT: To compare the effect of fixed-dose trandolapril-verapamil (FDTV) with that of trandolapril on proteinuria in normotensive, type 2 diabetic patients. A total of 60 normotensive, type 2 diabetic patients with 24-h proteinuria >300 mg were randomly assigned to two groups for open-label treatment. One group received 2 mg trandolapril/180 mg verapamil FDTV once daily; the other group received 2 mg trandolapril once daily. Study drugs were administered for 6 months in both groups. Creatinine clearance and 24-h urinary protein excretion were measured at the beginning and the end of the study. Patients were evaluated monthly for blood pressure, fasting blood glucose level, heart rate, and adverse events. Statistical analysis was performed using ANOVA. Both groups experienced a statistically significant (P < 0.005) mean decrease in mean proteinuria from baseline: FDTV ([mean +/- SD] 1200 +/- 200 to 540 +/- 79 mg; P < 0.001) and trandolapril (1,105 +/- 212 to 750.9 +/- 134 mg; P < 0.005). A significantly greater reduction from baseline in proteinuria was observed in the FDTV group compared with the trandolapril group. Patients who received trandolapril experienced a statistically significant (P < 0.05) decrease in mean creatinine clearance (91.1 +/- 3.4 to 75.3 +/- 3 ml/min; P < 0.05) compared with patients who received FDTV (88.3 +/- 3.6 to 82.9 +/- 3.5 ml/min; P > 0.05). Final fasting blood glucose was significantly lower in the FDTV group (139 +/- 19) compared with the trandolapril group (154 +/- 22; P < 0.001). No significant differences were observed between the two groups in mean baseline or final measurements of blood pressure, mean heart rate, or frequency of adverse events. Our results suggest that FDTV is more effective than trandolapril in reducing proteinuria in normotensive, type 2 diabetic patients. This effect on proteinuria is not related with blood pressure reduction.
    Full-text · Article · Aug 2004 · Diabetes Care
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    ABSTRACT: Sixty patients with a hypertensive emergency (mean arterial pressure >130 mm Hg and evidence of target organ damage) were randomly divided into two groups of 30 patients each. Group A received 1.25 mg of isosorbide dinitrate aerosol upon arrival and a second dose 15 minutes later when the mean arterial pressure reduction was < 15%. Group B received a single 5 mg tablet of sublingual isosorbide dinitrate. Electrocardiography was performed in both groups prior to and 30 minutes after the medication. Blood pressure was monitored for 6 hours. Blood pressure in Group A patients decreased in an average time of 10 minutes from 191 +/- 12/122.3 +/- 5 to 151.5 +/- 9.2/93 +/- 4 mm Hg, p < 0.005. Mean arterial pressure decreased by 22.8%: 145 +/- 7 to 112 +/- 7.5 mm Hg, p < 0.005. No adverse effects occurred. Five patients in Group B did not respond; in the rest of the group blood pressure decreased 45 minutes after receiving the medication from 194 +/- 8/125 +/- 5.5 to 160 +/- 11/98 +/- 6 mm Hg; p < 0.005. Mean arterial pressure decreased by 20.1%: 148.3 +/- 12 to 118.6 +/- 9 mm Hg, p < 0.002; ten patients suffered headache. Three patients in Group A had a subepicardial lesion in the first electrocardiograph, which disappeared with the use of the aerosol. In Group B, electrocardiography results were normal. These results seem to indicate that isosorbide dinitrate aerosol is better than tablets for the treatment of patients with a hypertensive emergencies.
    No preview · Article · Mar 2001 · Angiology
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    ABSTRACT: Isosorbide dinitrate in spray form is an effective and safe option for the treatment of hypertensive emergencies. The aim of this study was to evaluate whether isosorbide dinitrate spray is as effective and safe as treatment in tablet form for the management of hypertensive emergencies in the elderly. Forty patients with hypertensive emergencies were randomly divided into two groups of 20 patients each. Group A received 1.25 mg isosorbide dinitrate aerosol upon arrival and a second dose 15 min later when mean systemic arterial pressure (MAP) reduction was <15% . Group B patients received a single 5 mg tablet of sublingual isosorbide dinitrate. Blood pressure in Group A patients decreased from 193 +/- 13/123 +/- 6.6 mmHg to 154 +/- 15/92.5 +/- 7.6 mmHg (p < 0.005), the reduction beginning 10 min after drug administration; no adverse effects were found. Two patients in Group B did not respond but for the other patients in this group blood pressure decreased from 197 +/- 10/121 +/- 7 to 154 +/- 11/90 +/- 4 mmHg, (p < 0.005), the reduction beginning 45 min after receiving the medication; 8 patients suffered headache. Our results indicate that isosorbide dinitrate aerosol is more effective than tablets for the treatment of elderly patients with hypertensive emergencies.
    No preview · Article · Feb 2000 · Blood Pressure
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    ABSTRACT: In this clinical trial, we assessed the effectiveness and safety of isosorbide dinitrate spray administered through the oral mucosa in 20 elderly patients (> 60 years old) with a hypertensive emergency (mean arterial pressure > 140 mmHg and target-organ damage). The patents were given a first dose of 1.25 mg of spray when they were admitted; a second dose was administered 15 min. later if the mean arterial pressure had not decreased by > 15%. An electrocardiogram (ECG) was done on every patient immediately prior and 30 min. after administering the medication. Three patients (15%) had a good response with one dose while 17 patients (85%) required a second dose. Thirty patients had a significant reduction in arterial blood pressure (193 +/- 91,123 +/- 5.4 to 154 + 7.1/92.5 + 6.2 mmHg p < 0.005) as well as of the mean arterial pressure (146.8 +/- B to 113 +/- 5 mmHg 23%, p < 0.005 > in a period of 30 min. No adverse effects, rebound hypertension nor severe hypotension were observed. These figures remained under control for 3 h. Both ECG, were normal. A reduction of 13.5% heart rate was obtained (p < 0.005). Our observations suggest that isosorbide dinitrate aerosol is an effective and safe alternative for the treatment of elderly patients with hypertensive emergencies.
    No preview · Article · Jan 2000 · Gaceta medica de Mexico
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    ABSTRACT: Nitric oxide donors have been used in the management of hypertensive emergencies (HE). Isosorbide dinitrate aerosol (ISA) is a nitric oxide fast-acting donor. The aim of this study is to compare the efficacy of ISA and nifedipine in the treatment of HE. Sixty adult patients with an HE were randomised to receive either ISA (2.5 mg) or nifedipine (10 mg). Patients were given an electrocardiogram (ECG) immediately prior, and 30 min after administering the medication. Blood pressure (BP) was measured every 5 min for the first 30 min, and then every 30 min for a period of 6 h. Blood pressure values for all patients in the ISA group decreased significantly (187 +/- 13/121 +/- 6 to 153 +/- 15/92.3 +/- 7.6 mmHg, P < 0.005). Two of the patients in this group had angor pectoris with evidence of subepicardial ischaemia as seen in the first ECG, both of which disappeared with the drug. Heart rate decreased by 14%. Similarly, all patients in the nifedipine group had significant decreases in BP (190 +/- 23/115 +/- 7 to 153 +/- 26/86 +/- 6 mm Hg, P < 0.005). Their first ECG was normal. Two patients suffered angor pectoris after nifedipine, with subepicardial ischaemia registering in the second ECG. Heart rate increased 11.9% in this group. During the follow-up period, no clinically significant side effects or cases of rebound hypertension were observed in the ISA group, whereas in the nifedipine group, eight patients reported having headaches and four others rebound hypertension. Our results show a favourable effect of ISA in the treatment of HE.
    Full-text · Article · Aug 1999 · Journal of Human Hypertension
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    ABSTRACT: In this study the authors assessed the effectiveness and safety of isosorbide dinitrate aerosol administered through the oral mucosa in 30 adult patients who presented with a hypertensive crisis (mean arterial pressure > 130 mm Hg and evidence of target organ damage). The patients were given a first dose of 1.25 mg of aerosol when they were admitted to the hospital; a second dose was administered 15 minutes later if the mean arterial pressure had not decreased by > 15%. An electrocardiogram (ECG) was obtained for every patient immediately prior to and 30 minutes after administration of the medication. Nine patients (30%) had a good response with one dose, whereas 21 patients (70%) required a second dose. All 30 patients had a significant reduction of the arterial blood pressure (187+/-13 / 121+/-6.6 to 153+/-15.3 / 92.3+/-7.6 mm Hg; p<0.005) as well as of the mean arterial pressure (136.6+/-8 to 109.5+/-7 mm Hg; p<0.005) in a period of 30 minutes. No adverse effects, rebound hypertension, or severe hypotension were observed. These figures remained under control for 6 hours. Two of the patients had angina pectoris at admission and their ECG showed subepicardial ischemia, both of which disappeared with the medication. A second ECG appeared normal. A reduction of 14% in heart rate was obtained (95+/-15 to 82+/-14 beats per minute; p<0.005). These observations suggest that isosorbide dinitrate aerosol is an effective and safe alternative for the treatment of patients with hypertensive crises.
    No preview · Article · Mar 1999 · Angiology
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    ABSTRACT: both, the ankle-brachial index < 0.9, and microalbuminuria are considered markers of endothelial dysfunction. Our objective was to evaluate if there is a correlation between the ankle-brachial index (ABI) and the degree of albuminuria in diabetic normotensive patients. we included 32 diabetic normotensive patients and measured their ABI, and their 24-h urinary albumin excretion by nephelometry; the ABI and albuminuria were correlated with the Spearman correlation coefficient. we did not find overall correlation between the ABI and albuminuria (r = 0.21, 95 % CI = -0.14-0.52, p = 0.12); However, when we measured the correlation of an ABI < 0.9 with any degree of albuminuria, we found a significant correlation (r = -0.32 ± 0.11, 95 % CI = 0.027 to -0.6, p = 0.03); and when the correlation of ABI with albuminuria > 300 mg, we also found a significant correlation (r = -0.45 ± 0.11, 95 % CI = -0.015 to -0.76, p = 0.3). our results suggest that ABI < 0.9 is a useful marker to estimate microalbuminuria in diabetic normotensive patients.
    No preview · Article · · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Adipocytokines are adipocyte-secreted peptides that are involved in the pathways that lead to insulin resistance, inflammation and the development of cardiovascular disease. Objective: To evaluate the levels of the adipocytokines resistin and adiponectin in normotensive and hypertensive diabetic patients. Material and methods: Clinical and transversal study; circulating levels of resistin and adiponectin were measured by ELISA (RyDSystems Minneapolis) in 80 type-2 diabetic patients (40 normotensive and 40 hypertensive naïve to antihypertensive therapy), and in 40 normotensive non-diabetic subjects. Statistical analysis was performed with ANOVA. Results: We found a non-significantly decreased levels of resistin in control group when compared with diabetic normotensive patients, (13.5 vs 16.7 ng/mL p > 0.05); however, the coexistence of hypertension increased significantly (25.9 ng/mL p < 0.005) those values. We also observed increased values of adiponectin in control group when compared with diabetic normotensive patients (9.6 vs 7.5 μg/mL, p<0.05), but the coexistence of hypertension did not modified those values significantly (7.4 μg/dL p>0.05). Conclusions: Diabetic patients have increased levels of resistin and lower values of adiponectin when compared with non diabetic subjects, coexistence of hypertension increase the levels of resistin but do not modified adiponectin values, this may explain why diabetic patients (hypertensive or not) had more complications than normotensive patients.
    No preview · Article · · Medicina Interna de Mexico

Publication Stats

98 Citations
29.37 Total Impact Points

Institutions

  • 2011
    • Instituto Politécnico Nacional
      Ciudad de México, Mexico City, Mexico
    • Center for Research and Advanced Studies of the National Polytechnic Institute
      Ciudad de México, The Federal District, Mexico
  • 2006
    • Hospital General de Mexico
      Ciudad de México, The Federal District, Mexico
  • 2000
    • Universidad Nacional Autónoma de México
      Ciudad de México, Mexico City, Mexico