El tratamiento crónico con extracto de fruta de juçara (Euterpe edulis) produce un efecto antihipertensivo y mejora la sensibilidad barorrefleja en ratas hipertensas espontâneas (SHR)
DOI:
https://doi.org/10.33448/rsd-v11i7.28995Palabras clave:
Antocianidinas; Antihipertensivo; Antioxidante; Açaí de la Mata Atlántica; Control de la presión arterial; Control de la presión refleja.Resumen
Introducción: Juçara açaí es una fruta brasileña con alta concentración de antocianidinas y excelentes propiedades antioxidantes. La correlación entre el estrés oxidativo, la hipertensión y el daño barorreflejo es conocido, sin embargo, los estudios previos que investigan el efecto de la pulpa de juçara en la hipertensión son escasos. Objetivo: El objetivo del presente estudio es investigar el efecto antihipertensivo de la pulpa del fruto de juçara (Euterpe edulis) en animales SHR, su capacidad antioxidante y la influencia del tratamiento en la sensibilidad barorrefleja. Metodología: El perfil químico se obtuvo por ESI(-)-FT-ICR-MS. Para los análisis biológicos, las ratas macho SHR se separaron en grupos: control (S) que recibió agua; captopril (SC) que recibió captopril (30 mg/kg) y el grupo juçara (SJ) que recibió pulpa de juçara (4,4 mL/kg). Todos los tratamientos se realizaron diariamente por vía oral (gavage) y se mantuvieron durante 8 semanas. La evaluación del barorreflejo se realizó mediante inyección en bolo de fenilefrina y nitroprusiato de sodio, y después del análisis hemodinámico, los corazones se recolectaron y congelaron (-80ºC) para análisis biomolecular (AOPP, TBARS, SOD y actividad de catalasa y expresión de proteínas). Resultados: Los tratamientos promovieron una reducción de la presión arterial (S: 163,3±2,2; SC: 154,0±0,6; SJ: 149,0±3,8 mmHg) y mejoraron la sensibilidad barorrefleja después de la activación con nitroprusiato de sodio. Además, se observó una reducción en los niveles de AOPP y un aumento en la actividad de las enzimas antioxidantes. Sin embargo, no se observaron cambios en la expresión de proteínas. Conclusión: Nuestros datos demuestran que la juçara puede promover beneficios cardiovasculares y se debe fomentar su consumo para prevenir la hipertensión arterial.
Citas
Aebi, H. (1984). Catalase in Vitro. Methods Enzymol. 105(1947): 121–126.
Ai, J., Liang, F., Zhou, H., Zhao, J., Wang, N., Zhu, S., & Yang, B. (2010). Mechanism of impaired baroreflex sensitivity in Wistar rats fed a high-fat and -carbohydrate diet. Br. J. Nutr. 104: 291–297. 10.1017/S0007114510000450.
Andrade, T.U., Santos, C.S., Busato, C.W., Medeiros, R.S., Abreu, R., & Moyse, M.R. (2008). Higher Physiological Doses of Nandrolone Decanoate Do Not Influence the Bezold-Jarish Reflex Control of Bradycardia. 39: 27–32. 10.1016/j.arcmed.2007.06.020.
Barroso, M.E.S., Oliveira, B.G., Pimentel, E.F., Pereira, P.M., Ruas, F.G., Andrade, T.U., Lenz, D., Scherer, R., Fronza, M., Ventura, J.A., Vaz, B.G., Kondratyuk, T.P., Romão, W., & Endringer, D.C. (2019). Phytochemical profile of genotypes of Euterpe edulis Martius – Juçara palm fruits. Food Res. Int. 116(21): 985–993. Elsevier. 10.1016/j.foodres.2018.09.036.
Batista, Â.G., Ferrari, A.S., Da Cunha, D.C., Da Silva, J.K., Cazarin, C.B.B., Correa, L.C., Prado, M.A., Carvalho-Silva, L.B. De, Esteves, E.A., & Maróstica Júnior, M.R. (2016). Polyphenols, antioxidants, and antimutagenic effects of Copaifera langsdorffii fruit. Food Chem. 197: 1153–1159. 10.1016/j.foodchem.2015.11.093.
Benjamin, E.J., Virani, S.S., Callaway, C.W., Chamberlain, A.M., Chang, A.R., Cheng, S., Chiuve, S.E., Cushman, M., Delling, F.N., Deo, R., De Ferranti, S.D., Ferguson, J.F., Fornage, M., Gillespie, C., Isasi, C.R., Jiménez, M.C., Jordan, L.C., Judd, S.E., Lackland, D., Lichtman, J.H., Lisabeth, L., Liu, S., Longenecker, C.T., Lutsey, P.L., MacKey, J.S., Matchar, D.B., Matsushita, K., Mussolino, M.E., Nasir, K., O’Flaherty, M., Palaniappan, L.P., Pandey, A., Pandey, D.K., Reeves, M.J., Ritchey, M.D., Rodriguez, C.J., Roth, G.A., Rosamond, W.D., Sampson, U.K.A., Satou, G.M., Shah, S.H., Spartano, N.L., Tirschwell, D.L., Tsao, C.W., Voeks, J.H., Willey, J.Z., Wilkins, J.T., Wu, J.H.Y., Alger, H.M., Wong, S.S., & Muntner, P. (2018). Heart disease and stroke statistics - 2018 update: A report from the American Heart Association. In Circulation. 10.1161/CIR.0000000000000558.
Bernardes, N.R., Heggdorne-Araújo, M., Borges, I.F.J.C., Almeida, F.M., Amaral, E.P., Lasunskaia, E.B., Muzitano, M.F., & Oliveira, D.B. (2014). Nitric oxide production, inhibitory, antioxidant and antimycobacterial activities of the fruits extract and flavonoid content of Schinus terebinthifolius. Brazilian J. Pharmacogn. 24(6): 644–650. Sociedade Brasileira de Farmacognosia. 10.1016/j.bjp.2014.10.012.
Bicudo, M.O.P., Ribani, R.H., & Beta, T. (2014). Anthocyanins, Phenolic Acids and Antioxidant Properties of Juçara Fruits (Euterpe edulis M.) Along the On-tree Ripening Process. Plant Foods Hum. Nutr. 69(2): 142–147. 10.1007/s11130-014-0406-0.
Borges, G. da S.C., Vieira, F.G.K., Copetti, C., Gonzaga, L.V., Zambiazi, R.C., Filho, J.M., & Fett, R. (2011). Chemical characterization, bioactive compounds, and antioxidant capacity of jussara (Euterpe edulis) fruit from the Atlantic Forest in southern Brazil. Food Res. Int. 44(7): 2128–2133. Elsevier B.V. 10.1016/j.foodres.2010.12.006.
Bradford, M.M. (1976). A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal. Biochem. 72(1–2): 248–254. 10.1016/0003-2697(76)90527-3.
Brasil. (2000). Intrução Normativa No 01, de 7 de janeiro de 2000. In DOU - Official Gazette. 10.1017/CBO9781107415324.004.
Brasil, G.A., Ronchi, S.N., Nascimento, A.M. do, de Lima, E.M., Romão, W., da Costa, H.B., Scherer, R., Ventura, J.A., Lenz, D., Bissoli, N.S., Endringer, D.C., & Andrade, T.U. de. (2014). Antihypertensive Effect of Carica papaya Via a Reduction in ACE Activity and Improved Baroreflex. Planta Med. 80(17): 1580–1587. 10.1055/s-0034-1383122.
Brito, E.S. de, Araújo, M.C.P. de, Alves, R.El., Carkeet, C., Clevidence, B.A., & Novotny, J. (2007). Anthocyanins present in selected tropical fruits: Acerola, jambolão, jussara, and guajiru. J. Agric. Food Chem. 55(23): 9389–9394. 10.1021/jf0715020.
Cardoso, A., de Liz, S., Rieger, D., Farah, A., Kunradi Vieira, F., Altenburg de Assis, M., & Di Pietro, P. (2018). An Update on the Biological Activities of Euterpe edulis (Juçara). Planta Med. 84(08): 487–499. 10.1055/s-0044-101624.
Cassidy, A. (2018). Berry anthocyanin intake and cardiovascular health. Mol. Aspects Med. 61: 76–82. Elsevier Ltd. 10.1016/j.mam.2017.05.002.
Cassidy, A., Bertoia, M., Chiuve, S., Flint, A., Forman, J., & Rimm, E.B. 2016. Habitual intake of anthocyanins and flavanones and risk of cardiovascular disease in men. Am. J. Clin. Nutr. 104(3): 587–594. 10.3945/ajcn.116.133132.
de Castro, C.A., Natali, A.J., Cardoso, L.M., Ferreira-Machado, A.B., Novello, A.A., da Silva, K.A., Tafuri, N.F., da Matta, S.L.P., Pedrosa, M.L., & Peluzio, M. do C.G. (2014). Aerobic exercise and not a diet supplemented with jussara açaí (Euterpe edulis Martius) alters hepatic oxidative and inflammatory biomarkers in ApoE-deficient mice. Br. J. Nutr. 112(03): 285–294. 10.1017/S000711451400083X.
Cheng, S.W.T., Swords, B.H., Kirk, K.A., & Berecek, K.H. (1989). Baroreflex function in lifetime—captopril-treated spontaneously hypertensive rats. Hypertension 13(1): 63–69. 10.1161/01.HYP.13.1.63.
Cordeiro, V.S., Carvalho, L.C., Bem, G.F. de, Costa, C.A., Souza, P.J.C., Souza, M.A. V, Rocha, V.N., Carvalho, J.J., Moura, R.S. de, & Resende, A.C. (2015). Euterpe oleracea Mart. extract prevents vascular remodeling and endothelial dysfunction in spontaneously hypertensive rats. Int. J. Appl. Res. Nat. Prod. 8(3): 6–16. Available from http://www.ijarnp.org/index.php/ijarnp/article/view/312.
Da Costa, C.A., Ognibene, D.T., Cordeiro, V.S.C., de Bem, G.F., Santos, I.B., Soares, R.A., Cunha, L.L. de M., Carvalho, L.C.R.M., de Moura, R.S., & Resende, A.C. 2017. Effect of Euterpe oleracea Mart. Seeds Extract on Chronic Ischemic Renal Injury in Renovascular Hypertensive Rats. J. Med. Food 00(0): jmf.2017.0011. 10.1089/jmf.2017.0011.
Cunha, T.S., Moura, M.J.C.S., Bermudes, C.F., Tanno, A.P., & Marcondes, F.K. 2005. Vascular Sensitivity to Phenylephrine in Rats Submitted to Anaerobic Training and Nandrolone Treatment. Hypertension 46(4): 1010–1015. 10.1161/01.HYP.0000174600.51515.e7.
El-Mas, M.M., Afify, E.A., Mohy El-Din, M.M., Omar, A.G., & Sharabi, F.M. (2001). Testosterone facilitates the baroreceptor control of reflex bradycardia: Role of cardiac sympathetic and parasympathetic components. J. Cardiovasc. Pharmacol. 38(5): 754–763. 10.1097/00005344-200111000-00012.
Fadden, J. Mac, Seoane, C.E., Paolinetti, V., Lima, A.D., Zanatta, R.A., Amêndola, D., Diaz, V.S., Martins, L.F., Sedrez, M., Maria, J., Foufre, L.C., Dereti, R., Miller, R., and De, E.C. (2008). Extração caseira de polpa de Juçara (Euterpe edullis Martius). In EMBRAPA. EMBRAPA.
Felzenszwalb, I., da Costa Marques, M.R., Mazzei, J.L., & Aiub, C.A.F. (2013). Toxicological evaluation of Euterpe edulis: A potential superfruit to be considered. Food Chem. Toxicol. 58: 536–544. 10.1016/j.fct.2013.05.029.
Freitas, R. de B., Melato, F.A., Oliveira, J.M. de, Bastos, D.S.S., Cardoso, R.M., Leite, J.P.V., and Lima, L.M. (2017). Euterpe edulis effects on cardiac and renal tissues of Wistar rats fed with cafeteria diet. Nutr. Hosp. 34(1): 186–192.
Gale, A.M., Kaur, R., and Baker, W.L. (2014). Hemodynamic and electrocardiographic effects of açaí berry in healthy volunteers: A randomized controlled trial. Int. J. Cardiol. 174(2): 421–423. Elsevier Ireland Ltd. 10.1016/j.ijcard.2014.04.036.
Garber, J.C., Barbee, R.W., Bielitzki, J.T., Clayton, L.A., Donovan, J.C., Hendriksen, C.F.M., Kohn, D.F., Lipman, N.S., Locke, P.A., Melcher, J., Quimby, F.W., Turner, P. V, Wood, G.A., & Wüebel, H. (2010). National Institute of Health: Guide for The Care and Use of Laboratory Animals. In 8th edition. The National Academies Press, Wasington D.C.
Gava, A.L., Balarini, C.M., Peotta, V.A., Abreu, G.R., Cabral, A.M., Vasquez, E.C., & Meyrelles, S.S. (2012). Baroreflex control of renal sympathetic nerve activity in mice with cardiac hypertrophy. Auton. Neurosci. Basic Clin. 170(1–2): 62–65. Elsevier B.V. 10.1016/j.autneu.2012.08.002.
Grans, C.F., Feriani, D.J., Abssamra, M.E.V., Rocha, L.Y., Carrozzi, N.M., Mostarda, C., Figueroa, D.M., Angelis, K. De, Irigoyen, M.C., & Rodrigues, B. (2014). Resistance Training After Myocardial Infarction in Rats: Its Role on Cardiac and Autonomic Function. Arq. Bras. Cardiol.: 60–68. 10.5935/abc.20140093.
Grassi, D., Desideri, G., Giosia, P.D., Feo, M.D., Fellini, E., Cheli, P., Ferri, L., & Ferri, C. (2013). Tea, flavonoids, and cardiovascular health: Endothelial protection. Am. J. Clin. Nutr. 98(6): 1660–1666. 10.3945/ajcn.113.058313.
Grassi, G., Trevano, F.Q., Seravalle, G., Scopelliti, F., & Mancia, G. (2006). Baroreflex Function in Hypertension: Consequences for Antihypertensive Therapy. Prog. Cardiovasc. Dis. 48(6): 407–415. 10.1016/j.pcad.2006.03.002.
Guzik, T.J., & Touyz, R.M. (2017). Oxidative Stress, Inflammation, and Vascular Aging in Hypertension. Hypertension 70(4): 660–667. 10.1161/HYPERTENSIONAHA.117.07802.
Head, G.A. (1995). Baroreflex and Cardiovascular Regulation in Hypertension. J. Cardiovasc. Pharmacol. 26 (Suppl.: S7–S16).
Heinrich, M., Dhanji, T., & Casselman, I. (2011). Açai (Euterpe oleracea Mart.) - A phytochemical and pharmacological assessment of the species’ health claims. Phytochem. Lett. 4(1): 10–21. Phytochemical Society of Europe. 10.1016/j.phytol.2010.11.005.
Hügel, H.M., Jackson, N., May, B., Zhang, A.L., & Xue, C.C. (2016). Polyphenol protection and treatment of hypertension. Phytomedicine 23(2): 220–231. 10.1016/j.phymed.2015.12.012.
Inácio, M.R.C., De Lima, K.M.G., Lopes, V.G., Pessoa, J.D.C., and De Almeida Teixeira, G.H. (2013). Total anthocyanin content determination in intact açaí (Euterpe oleracea Mart.) and palmitero-juçara (Euterpe edulis Mart.) fruit using near infrared spectroscopy (NIR) and multivariate calibration. Food Chem. 136(3–4): 1160–1164. 10.1016/j.foodchem.2012.09.046.
Judkins, C.P., Diep, H., Broughton, B.R.S., Mast, A.E., Hooker, E.U., Miller, A.A., Selemidis, S., Dusting, G.J., Sobey, C.G., & Drummond, G.R. (2010). Direct evidence of a role for Nox2 in superoxide production, reduced nitric oxide bioavailability, and early atherosclerotic plaque formation. Am. J. Physiol. Heart Circ. Physiol. 298(1): 24–32. 10.1152/ajpheart.00799.2009.
Kähkönen, M.P. & Heinonen, M. (2003). Antioxidant activity of anthocyanins and their aglycons. J. Agric. Food Chem. 51(3): 628–633. 10.1021/jf025551i.
Li, J., Kemp, B.A., Howell, N.L., Massey, J., Mińczuk, K., Huang, Q., Chordia, M.D., Jack Roy, R., Patrie, J.T., Davogustto, G.E., Kramer, C.M., Epstein, F.H., Carey, R.M., Taegtmeyer, H., Keller, S.R., & Kundu, B.K. (2019). Metabolic changes in spontaneously hypertensive rat hearts precede cardiac dysfunction and left ventricular hypertrophy. J. Am. Heart Assoc. 8(4). 10.1161/JAHA.118.010926.
Mancia, G., Parati, G., Pomidossi, G., Bertinieri, G., Buccino, N., Ferrari, A., Gregorini, L., Rupoli, L., & Zanchetti, A. (1982). Modification of Arterial Baroreflexes by Captopril in Essential Hypertension. Am. J. Cardiol. 49(mean 49): 1415–1419.
Mariz, S.R., Cerqueira, G.S., Araújo, W.C., Dantas, J.G., Ramalho, J.A., Palomaro, T. V., Duarte, J.C., dos Santos, H.B., Olveira, K., de Araújo, M.S.T., Diniz, M. de F.F.M., & de Medeiros, I.A. (2012). Chronic toxicologic study of the ethanolic extract of the aerial parts of Jatropha gossypiifolia in rats. Brazilian J. Pharmacogn. 22(3): 663–668. 10.1590/S0102-695X2012005000024.
Mengal, V., Silva, P.H.M., Tiradentes, R. V., Santuzzi, C.H., De Almeida, S.A., Sena, G.C., Bissoli, N.S., Abreu, G.R., & Gouvea, S.A. 2016. Aliskiren and l-arginine treatments restore depressed baroreflex sensitivity and decrease oxidative stress in renovascular hypertension rats. Hypertens. Res. 39(11): 769–776. Nature Publishing Group. 10.1038/hr.2016.61.
Meyrelles, S.S., Mauad, H., Mathias, S.C.B., Cabral, A.M., and Vasquez, E.C. (1998). Effects of myocardial hypertrophy on neural reflexes controlling cardiovascular function. J. Auton. Nerv. Syst. 73(2–3): 135–142. 10.1016/S0165-1838(98)00129-5.
Misra, H.P., & Fridovich, I. (1972). The Role of Superoxide Anion in the Autoxidation of Epinephrine and a Simple Assay for Superoxide Dismutase. J. Biol. Chem. 247(10): 3170–3175. 4623845.
Oparil, S., Acelajado, M.C., Bakris, G.L., Berlowitz, D.R., Cífková, R., Dominiczak, A.F., Grassi, G., Jordan, J., Poulter, N.R., Rodgers, A., & Whelton, P.K. (2018). Hypertension. Nat. Rev. Dis. Prim. 4. 10.1038/nrdp.2018.14.
Oxygen radicals, nitric oxide, and peroxynitrite: Redox pathways in molecular medicine [Biochemistry]. (n.d.). Proc. Natl. Acad. Sci. U. S. A. 10.1073/pnas.1804932115.
Panza, J.A., Casino, P.R., Badar, D.M., & Quyyumi, A.A. (1993). Effect of increased availability of endothelium-derived nitric oxide precursor on endothelium-dependent vascular relaxation in normal subjects and in patients with essential hypertension. Circulation 87(5): 1475–1481. 10.1161/01.CIR.87.5.1475.
Quilley, C.P., Chiba, S., Quilley, J., and McGiff, J.C. (1987). Aspirin enhances the antihypertensive effect of captopril in spontaneously hypertensive rats. Hypertension 10(3): 294–302. 10.1161/01.HYP.10.3.294.
Rababa’h, A.M., Guillory, A.N., Mustafa, R., & Hijjawi, T. (2018). Oxidative Stress and Cardiac Remodeling: An Updated Edge. Curr. Cardiol. Rev. 14(1): 53–59. 10.2174/1573403x14666180111145207.
Reagan-Shaw, S., Nihal, M., & Ahmad, N. (2008). Dose translation from animal to human studies revisited. FASEB J. 22(3): 659–661. 10.1096/fj.07-9574LSF.
dos Reis, L.C.R., Facco, E.M.P., Salvador, M., Flôres, S.H., & de Oliveira Rios, A. 2018. Antioxidant potential and physicochemical characterization of yellow, purple and orange passion fruit. J. Food Sci. Technol. 55(7): 2679–2691. 10.1007/s13197-018-3190-2.
Rodrigo, R., Gonzalez, J., & Paoletto, F. 2011. The role of oxidative stress in the pathophysiology of hypertension. Hypertens. Res. 34: 431–440. 10.1007/978-0-387-72347-1_4.
Schulz, M., Borges, G. da S.C., Gonzaga, L.V., Costa, A.C.O., & Fett, R. 2016. Juçara fruit (Euterpe edulis Mart.): Sustainable exploitation of a source of bioactive compounds. Food Res. Int. 89: 14–26. 10.1016/j.foodres.2016.07.027.
Schulz, M., Borges, G. da S.C., Gonzaga, L.V., Seraglio, S.K.T., Olivo, I.S., Azevedo, M.S., Nehring, P., de Gois, J.S., de Almeida, T.S., Vitali, L., Spudeit, D.A., Micke, G.A., Borges, D.L.G., & Fett, R. (2015). Chemical composition, bioactive compounds and antioxidant capacity of juçara fruit (Euterpe edulis Martius) during ripening. Food Res. Int. 77: 125–131. 10.1016/j.foodres.2015.08.006.
Tain, Y. & Huang, L. (2014). Restoration of Asymmetric Dimethylarginine – Nitric Oxide Balance to Prevent the Development of Hypertension. Inernational J. Mol. Sci. 15: 11773–11782. 10.3390/ijms150711773.
Tresserra-Rimbau, A., Lamuela-Raventos, R.M., & Moreno, J.J. (2018). Polyphenols, food and pharma. Current knowledge and directions for future research. Biochem. Pharmacol. 156: 186–195. 10.1016/j.bcp.2018.07.050.
Tsai, W.C., Lin, H.C., Lai, Y.R., Hsu, C.W., Huang, C.C., Wang, H.C., Su, C.M., Su, Y.J., Lin, W.C., Cheng, B.C., Chang, W.N., Lu, C.H., & Tsai, N.W. (2019). The Effect of Stroke Subtypes on Baroreceptor Sensitivity, a Predict for Acute Stroke Outcome. Biomed Res. Int. 2019. Hindawi. 10.1155/2019/7614828.
Udani, J.K., Singh, B.B., Singh, V.J., & Barrett, M.L. (2011). Effects of Açai (Euterpe oleracea Mart.) berry preparation on metabolic parameters in a healthy overweight population: A pilot study. Nutr. J. 10(1): 1–7. 10.1186/1475-2891-10-45.
do Vale, G.T. & Tirapelli, C.R. (2019). Are reactive oxygen species important mediators of vascular dysfunction? Curr. Hypertens. Rev. 15: 1–3. 10.2174/1573402115666190416153638.
Vasquez, E.C., Peotta, V.A. & Meyrelles, S.S. (2012). Cardiovascular Autonomic Imbalance and Baroreflex Dysfunction in the Apolipoprotein E -deficient Mouse. Cell. Physiol. Biochem. 900.
Vieira, G.S., Cavalcanti, R.N., Meireles, M.A.A., & Hubinger, M.D. (2013). Chemical and economic evaluation of natural antioxidant extracts obtained by ultrasound-assisted and agitated bed extraction from jussara pulp (Euterpe edulis). J. Food Eng. 119(2): 196–204. 10.1016/j.jfoodeng.2013.05.030.
Vignon-Zellweger, N., Relle, K., Rahnenführer, J., Schwab, K., Hocher, B., & Theuring, F. (2014). Endothelin-1 overexpression and endothelial nitric oxide synthase knock-out induce different pathological responses in the heart of male and female mice. Life Sci. 118(2): 219–225. The Authors. 10.1016/j.lfs.2013.12.003.
Virdis, A., Duranti, E. & Taddei, S. (2011). Oxidative Stress and Vascular Damage in Hypertension : Role of Angiotensin II. Int. J. Hypertens. 2011: 1–7. 10.4061/2011/916310.
Whelton, P.K., Carey, R.M., Aronow, W.S., Casey, D.E., Collins, K.J., Himmelfarb, C.D., DePalma, S.M., Gidding, S., Jamerson, K.A., Jones, D.W., MacLaughlin, E.J., Muntner, P., Ovbiagele, B., Smith, S.D., Spender, C.C., Stafford, R.S., Taler, S.J., & Thomas, R.J. (2018). Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension 71(6): E13–E115. 10.1161/HYP.0000000000000065.
Whelton, P.K., Carey, R.M., Aronow, W.S., Ovbiagele, B., Casey, D.E., Smith, S.C.D., Collins, K.J., Spencer, C.C., Himmelfarb, C.D., Stafford, R.S., DePalma, S.M., Taler, S.J., Gidding, S., Thomas, R.J., Jamerson, K.A., Williams, K.A., Jones, D.W., Williamson, J.D., MacLaughlin, E.J., Wright, J.T., Mauri, L., Casey Jr, D.E., KJ, C., C, D.H., SM, D., S, G., KA, J., DW, J., EJ, M., P, M., B, O., Jr, S.C.S.S., CC, S., RS, S., SJ, T., RJ, T., Sr, W.K., JD, W., Jr, W.J., Casey, D.E., Colins, K.J., Himmelfarb, C.D., DePalma, S.M., Gidding, S., Jamerson, K.A., Williams, K.A., MacLaughlin, E.J., Muntner, P., Ovbiagele, B., Jr, S.C.S.S., Spencer, C.C., Stafford, R.S., Taler, S.J., Thomas, R.J., Williams, K.A., Williamson, J.D., Jr, J.T.W., Collins, K.J., Himmelfarb, C.D., DePalma, S.M., Gidding, S., Jamerson, K.A., Jones, D.W., MacLaughlin, E.J., Muntner, P., Ovbiagele, B., Smith, S.C.D., Spender, C.C., Stafford, R.S., Taler, S.J., & Thomas, R.J. (2017). Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task force on Clinical Practice Guidelines. J. Am. Coll. Cardiol. 71(6): 283. 10.1161/HYP.0000000000000065/-/DC1.The.
WHO. 2013. World Health Day 2013 - Hypertension. A Glob. Br. Hypertens.: 9. 10.1136/bmj.1.4815.882-a.
WHO - World Health Organization. (2013). A global brief on Hypertension: Silent killer, global public health crisis. Edited ByWHO - World Health Organization. Geneva, Switzerland.
Witko-Sarsat, V., Friedlander, M., Capeillère-Blandin, C., Nguyen-Khoa, T., Nguyen, A.T., Zingraff, J., Jungers, P., & Descamps-Latscha, B. (1996). Advanced oxidation protein products as a novel marker of oxidative stress in uremia. Kidney Int. 49(5): 1304–1313. 10.1038/ki.1996.186.
Yamaguchi, K.K.D.L., Pereira, L.F.R., Lamarão, C.V., Lima, E.S., & Da Veiga-Junior, V.F. (2015). Amazon acai: Chemistry and biological activities: A review. In Food Chemistry. 10.1016/j.foodchem.2015.01.055.
Yuan, H., Ma, Q., Ye, L., & Piao, G. (2016). The traditional medicine and modern medicine from natural products. Molecules 21(5). 10.3390/molecules21050559.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2022 Augusto Altoé Puppin; Cristiane Lyrio da Silva; Silas Nascimento Ronchi; Mirian de Almeida Silva; Ewelyne Miranda de Lima; Bruno Gomes de Oliveira; Wanderson Romão; Nazaré Souza Bissoli; Tadeu Uggere de Andrade; Denise Coutinho Endringer; Girlandia Alexandre Brasil
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Los autores que publican en esta revista concuerdan con los siguientes términos:
1) Los autores mantienen los derechos de autor y conceden a la revista el derecho de primera publicación, con el trabajo simultáneamente licenciado bajo la Licencia Creative Commons Attribution que permite el compartir el trabajo con reconocimiento de la autoría y publicación inicial en esta revista.
2) Los autores tienen autorización para asumir contratos adicionales por separado, para distribución no exclusiva de la versión del trabajo publicada en esta revista (por ejemplo, publicar en repositorio institucional o como capítulo de libro), con reconocimiento de autoría y publicación inicial en esta revista.
3) Los autores tienen permiso y son estimulados a publicar y distribuir su trabajo en línea (por ejemplo, en repositorios institucionales o en su página personal) a cualquier punto antes o durante el proceso editorial, ya que esto puede generar cambios productivos, así como aumentar el impacto y la cita del trabajo publicado.
