<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2393-6797</journal-id>
<journal-title><![CDATA[Revista Uruguaya de Medicina Interna ]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Urug. Med. Int.]]></abbrev-journal-title>
<issn>2393-6797</issn>
<publisher>
<publisher-name><![CDATA[Sociedad de Medicina Interna del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2393-67972024000101306</article-id>
<article-id pub-id-type="doi">10.26445/09.01.9</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[La aplicación del saber médico. Hipertensión y daño cognitivo]]></article-title>
<article-title xml:lang="en"><![CDATA[The application of medical knowledge. Hypertension and cognitive impairment]]></article-title>
<article-title xml:lang="pt"><![CDATA[A aplicação do conhecimento médico. Hipertensão e comprometimento cognitivo]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[Viviana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Spósito]]></surname>
<given-names><![CDATA[Paola]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Llorens]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Más]]></surname>
<given-names><![CDATA[Valentina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivero]]></surname>
<given-names><![CDATA[María Noel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuba]]></surname>
<given-names><![CDATA[Ximena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Viviano]]></surname>
<given-names><![CDATA[Luciana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tregarthen]]></surname>
<given-names><![CDATA[Micaela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Facultad de Medicina. Unidad Académica Médica 3 Hospital Maciel]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>9</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S2393-67972024000101306&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S2393-67972024000101306&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S2393-67972024000101306&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[resumen está disponible en el texto completo]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage.  Methodology:  Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment.  Results:  222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect.  Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do.  Conclusions:  The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos.  Metodologia:  Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento.  Resultados:  Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico.  Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer.  Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hipertensión arterial]]></kwd>
<kwd lng="es"><![CDATA[Daño cognitivo]]></kwd>
<kwd lng="es"><![CDATA[Tests de screening cognitivo]]></kwd>
<kwd lng="es"><![CDATA[Práctica profesional]]></kwd>
<kwd lng="es"><![CDATA[Médicos]]></kwd>
<kwd lng="es"><![CDATA[
<kwd lng="en"><![CDATA[Hypertension]]></kwd>
<kwd lng="en"><![CDATA[Cognitive Dysfunction]]></kwd>
<kwd lng="en"><![CDATA[Cognitive Assessment Screening Instrument]]></kwd>
<kwd lng="en"><![CDATA[Professional Practice]]></kwd>
<kwd lng="en"><![CDATA[Physicians]]></kwd>
<kwd lng="pt"><![CDATA[Hipertensão arterial]]></kwd>
<kwd lng="pt"><![CDATA[Danos cognitivos]]></kwd>
<kwd lng="pt"><![CDATA[Testes de triagem cognitiva]]></kwd>
<kwd lng="pt"><![CDATA[Prática profissional]]></kwd>
<kwd lng="pt"><![CDATA[Médicos.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Uruguay]]></surname>
</name>
</person-group>
<source><![CDATA[Ministerio de Salud Pública.Interpelaciones y respuestas a las Enfermedades No Transmisibles en Uruguay: Documento de actualización sobre la situación de las ENT en Uruguay]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MSP]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Uruguay]]></surname>
</name>
</person-group>
<source><![CDATA[Ministerio de Salud Pública.Recomendaciones para el abordaje de la hipertensión arterial sistémica en el primer nivel de atención (Internet)]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MSP]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mancia]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Kreutz]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Brunström]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Burnier]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Grassi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Januszewicz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)]]></article-title>
<source><![CDATA[J Hypertens]]></source>
<year>2023</year>
<volume>41</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1874-2071</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vicario]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El cerebro y el daño neuropsiquiátrico de la hipertensión arterial]]></article-title>
<source><![CDATA[Hipertens. riesgo vasc]]></source>
<year>2014</year>
<volume>31</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>96-101</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="">
<source><![CDATA[]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<collab>Alzheimer's Disease International</collab>
<source><![CDATA[Informe Mundial sobre el Alzheimer 2019: Actitudes hacia la demencia. (Internet)]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Londres ]]></publisher-loc>
<publisher-name><![CDATA[ADI]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="">
<source><![CDATA[]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Almigbal]]></surname>
<given-names><![CDATA[TH]]></given-names>
</name>
<name>
<surname><![CDATA[Alzarah]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Aljanoubi]]></surname>
<given-names><![CDATA[FA]]></given-names>
</name>
<name>
<surname><![CDATA[Alhafez]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Aldawsari]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Alghadeer]]></surname>
<given-names><![CDATA[ZY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical Inertia in the Management of Type 2 Diabetes Mellitus A Systematic Review]]></article-title>
<source><![CDATA[Medicina (Kaunas)]]></source>
<year>2023</year>
<volume>59</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>182</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lázaro]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Murga]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Aguilar]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández-Presa]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Inercia terapéutica en el manejo extrahospitalario de la dislipemia en pacientes con cardiopatía isquémica Estudio Inercia]]></article-title>
<source><![CDATA[Rev Esp Cardiol]]></source>
<year>2010</year>
<volume>63</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1428-37</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gómez Doblas]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Padial]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Implementación de las guías de práctica clínica deseo o realidad. Algoritmo de decisión.]]></article-title>
<source><![CDATA[Clín investig arterioscler]]></source>
<year>2021</year>
<volume>33</volume>
<page-range>33-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="">
<source><![CDATA[]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Iadecola]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Yaffe]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Biller]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bratzke]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Faraci]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of Hypertension on Cognitive Function A Scientific Statement From the American Heart Association]]></article-title>
<collab>Gorelick PB et al</collab>
<source><![CDATA[Hypertension]]></source>
<year>2016</year>
<volume>68</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>e67-94</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="book">
<collab>Organización Mundial de la Salud.Organización Panamericana de la Salud</collab>
<source><![CDATA[Atención integrada para las personas mayores (ICOPE).Guía sobre la evaluación y los esquemas de atención centrados en la persona en la atención primaria de salud. (Internet)]]></source>
<year>2020</year>
<publisher-loc><![CDATA[Washington ]]></publisher-loc>
<publisher-name><![CDATA[OMS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="">
<source><![CDATA[]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="">
<source><![CDATA[]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="">
<source><![CDATA[]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gómez Doblas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Padial]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Implementación de las guías de práctica clínica deseo o realidad. Algoritmo de decisión]]></article-title>
<source><![CDATA[Clínica e Investigación en Arteriosclerosis]]></source>
<year>2021</year>
<volume>33</volume>
<page-range>33-9</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Shao]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Time to Clinical Benefit of Intensive Blood Pressure Lowering in Patients 60 Years and Older With Hypertension A Secondary Analysis of Randomized Clinical Trials]]></article-title>
<source><![CDATA[JAMA Intern Med]]></source>
<year>2022</year>
<volume>182</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>660-7</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[2018 ESC/ESH Guidelines for the management of arterial hypertension]]></article-title>
<source><![CDATA[Rev Esp Cardiol (Engl Ed)]]></source>
<year>2019</year>
<volume>72</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>160</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González-Montero]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Lara-Gallardo]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
</name>
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Modelos educativos en medicina y su evolución histórica]]></article-title>
<source><![CDATA[Rev Esp Med Quir]]></source>
<year>2015</year>
<volume>20</volume>
<page-range>256-65</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Witheridge]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ferns]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Scott-Smith]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Revisiting Miller&amp;apos;s pyramid in medical education the gap between traditional assessment and diagnostic reasoning]]></article-title>
<source><![CDATA[Int J Med Educ]]></source>
<year>2019</year>
<volume>10</volume>
<page-range>191-2</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
