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Objective: The study aims to compare the effectiveness of individual and group nutrition education methods in improving key anthropometric and biochemical markers in drug-treated, overweight-obese hypertensive adults., Methods: The randomized trial included 170 patients with pharmacologically well-controlled primary hypertension and body mass index (BMI) ≥ 25 kg/m 2 . For six months, the patients received six sessions, either one-to-one individual nutrition education (IE, n = 89) or group education (GE, n = 81), developed by dietitians. Anthropometric measurements, body composition, and fasting measures of biochemical parameters were obtained at baseline and after six months of intervention., Results: 150 patients completed the nutrition education program. The IE group significantly improved in many parameters compared to the GE group, including weight ( p < 0.001), waist circumference ( p < 0.001), BMI ( p < 0.001), systolic and diastolic blood pressure (BP) ( p < 0.001), fasting plasma glucose ( p = 0.011), oral glucose tolerance test (OGGT) ( p = 0.030), and insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR) ( p < 0.001). The groups did not differ in terms of total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) concentrations., Conclusion: Individual nutrition education is more effective than group education in terms of improving anthropometric and biochemical indices in overweight-obese hypertensive adults., Competing Interests: The authors declare no conflict of interest.

Background/aims: Benefits resulting from weight loss and dietary approaches to stop hypertension (DASH) diet in the treatment of arterial hypertension led to a search for a better therapy that would include psychological factors. The present study aimed to assess the relationship between the personality traits included in the Big Five personality traits and the effectiveness of treatment for weight loss in patients with essential hypertension and excessive body weight., Methods: The study involved 84 patients with essential hypertension, overweight or obesity, managed by a hypertensiologist. All patients underwent a 3-month diet treatment as part of the development process of an individualised eating plan that follows the principles of DASH diet and food education. Body mass index and DASH index were calculated before and after the therapy. NEO Five-Factor Inventory was applied to measure psychological variables., Results: The intervention led to a statistically significant increase of DASH index measured before and after treatment. There was a significant correlation between the increase of DASH index and gender. Patients presented higher intensity of openness to experience, extraversion, conscientiousness and lower levels of neuroticism and agreeableness compared to general population., Conclusion: The influence of psychological variables on the observed difference between men and women in DASH values and weight loss was not demonstrated., (© 2018 S. Karger AG, Basel.)

Background and Aim: The aim of the study was to assess the impact of individualised nutritional intervention based on the DASH diet (Dietary Approaches to Stop Hypertension) on the nutritional status, blood pressure, and selected biochemical parameters of obese/overweight patients with primary arterial hypertension., Methods: A total of 131 participants were randomised to the DASH intervention group (DIG; n = 69, 33 males) or the control group (CG; n = 62, 32 males). A three-month nutritional intervention was carried out in the DIG group, while the control group received only standard recommendations. Body weight, height, waist and hip circumference, body composition, blood pressure, serum glucose, and insulin and leptin concentrations were measured at the baseline and after the intervention., Results: Sixty-four (92.8%) participants in the intervention and 62 (100%) in the control group completed the study. In the DIG group a significant decrease in body mass, systolic and diastolic blood pressure, body fat content, fasting glucose, insulin, and leptin concentrations were observed in comparison to the control group (p < 0.05)., Conclusions: The DASH dietary intervention provides significant benefits to overweight/obese patients with primary hypertension.

Introduction: Hyperuricemia and gout are a growing health problem worldwide. Their etiology is complex, and usually caused by excessive production of uric acid and/or impaired excretion. Some drugs used in the treatment of high blood pressure furthermore increase the risk of hyperuricemia. An additional risk factor for hyperuricemia is obesity. Thus far, there is no consensus on the treatment of patients with asymptomatic hyperuricemia, despite a large number of studies conducted worldwide., The Aim: To evaluate the prevalence of hyperuricemia among patients with essential hypertension and obesity, pharmacologically treated with combination therapy., Material and Methods: A total of 109 obese patients (mean BMI=34.6±3.5 kg/m2) were included in this study, selected from the outpatients at the Clinic of Arterial Hypertension, the unit of the Cardinal Stefan Wyszyński Institute of Cardiology in Warsaw. Patients were treated with at least two antihypertensive drugs. Blood pressure, uric acid and insulin levels were measured among patients., Results: The average systolic blood pressure and diastolic blood pressure were of 131±5,9 and 84.6±3.6 mmHg respectively, the average uric acid level of 6.4±1.5 mg/dl, and the average level of insulin 17.6±11.0 mU/L. Hyperuricemia was found in 33 patients (27.5% of subjects). The uric acid level was significantly higher among men. A positive correlation between the serum uric acid concentration of serum insulin (r = 0.27, p <0.001), age (r = 0.21, p <0.002) and BMI patients (r = 0.26, p <0.002) has been shown. There were no significant differences in the concentration of uric acid among patients receiving multiple antihypertensive agents., Conclusion: The incidence of hyperuricemia demonstrated in this study confirms the findings of other authors and indicates a fairly common prevalence of this phenomenon among a population of patients with hypertension. Individually adjusted multidrug antihypertensive therapy does not seem to affect significantly the concentration of uric acid, but further research is needed in this respect.

Background: Iron deficiency may impair aerobic performance. This study aimed to determine whether treatment with intravenous iron (ferric carboxymaltose) would improve symptoms in patients who had heart failure, reduced left ventricular ejection fraction, and iron deficiency, either with or without anemia., Methods: We enrolled 459 patients with chronic heart failure of New York Heart Association (NYHA) functional class II or III, a left ventricular ejection fraction of 40% or less (for patients with NYHA class II) or 45% or less (for NYHA class III), iron deficiency (ferritin level <100 microg per liter or between 100 and 299 microg per liter, if the transferrin saturation was <20%), and a hemoglobin level of 95 to 135 g per liter. Patients were randomly assigned, in a 2:1 ratio, to receive 200 mg of intravenous iron (ferric carboxymaltose) or saline (placebo). The primary end points were the self-reported Patient Global Assessment and NYHA functional class, both at week 24. Secondary end points included the distance walked in 6 minutes and the health-related quality of life., Results: Among the patients receiving ferric carboxymaltose, 50% reported being much or moderately improved, as compared with 28% of patients receiving placebo, according to the Patient Global Assessment (odds ratio for improvement, 2.51; 95% confidence interval [CI], 1.75 to 3.61). Among the patients assigned to ferric carboxymaltose, 47% had an NYHA functional class I or II at week 24, as compared with 30% of patients assigned to placebo (odds ratio for improvement by one class, 2.40; 95% CI, 1.55 to 3.71). Results were similar in patients with anemia and those without anemia. Significant improvements were seen with ferric carboxymaltose in the distance on the 6-minute walk test and quality-of-life assessments. The rates of death, adverse events, and serious adverse events were similar in the two study groups., Conclusions: Treatment with intravenous ferric carboxymaltose in patients with chronic heart failure and iron deficiency, with or without anemia, improves symptoms, functional capacity, and quality of life; the side-effect profile is acceptable. (ClinicalTrials.gov number, NCT00520780)., (Copyright 2009 Massachusetts Medical Society)

Background: Arterial hypertension concerns about 40% of adult population in Poland. WOBASZ study shows that vast majority of hypertonics in Poland are treated unsuccessfully. The aim of study was to compare the effectiveness of hypertension treatment by specialist in different payment status outpatient clinics in 2 periods: 1996-2000 (A) and 2001-2006 (B)., Material and Methods: The received data is based on documentation of 1772 patients with essential hypertension (ntp) in three outpatient hypertension clinics: one public-PP and two private outpatient hypertension clinics (NP). Duration of treatment: 2-10 years (average 54 months). Two periods were compared: period A: 1996-2000 (679 patient) and period B: 2001-2006 (1093 patients). Every patient had blood pressure measured twice within approximately 1-2 minute interval in siting position after 15 minute rest. We used mean blood pressure from both measurements in our analysis., Results: Blood pressure lowering < 140/90 mmHg was reached in location PP with 79% patients in A and with 84.5% patients in period B. Blood pressure lowering < 140/90 mmHg was reached in location NP correspondingly with 99.5% patients and with 99.7% patients. Levels of hypertension were as follows: in P- no patients with hypertension 1.level in period A, 7% in period B while in NP 2.1% and 3.5% correspondingly. There was similar percentage of patients with hypertension 2.level in all clinics. Differences were observed in proportion of treated patients with hypertension 3.level. In NP.- more patients were treated in period B (24.7%) than in period A (10.8%) and more than in P (A: 4.2% B: 1.2%). Patients over 64 years old were mainly treated in PP. Young patients, especially during last five years, were treated in NP., Conclusions: 1. In public type of clinic the majority of treated patients with essential hypertension were over 64 years of age, in private clinics were in different age. 2. Treatment in private clinics was better than in public in patients with essential hypertension regardless of aging, gender and coexisting diabetes type 2 or complications of hypertension. 3. In public clinic hypertensive treatment during 2001-2006 was more effective than 5 year before but only in group of patients without complica tion hypertensive or coexisting diabetes type 2.

Unlabelled: 42 men, aged 19-35 years (mean 26.3), with mild or moderate essential hypertension (DBP 95-110 mmHg), were treated with telmisartan (40 mg or 80 mg ) once daily in the morning (6 and 7 a.m.) for at least 6 weeks and for next 6 weeks and after that administration time was changed to evening dose (6-7 p.m.) 24-hours ABPM (SpaceLabs) was performed in all patients on last day of each period. Obtained recordings were compared in different periods of time: 6.00 a.m. -10.59 p.m., 11.00 p.m-5.59 a.m., 2.00-5.59 a.m., 6.00-12.00 a.m, 3.00-7.00 p.m. The SBP values in all time intervals were comparable (differences statistically not significant). A statistically significant reduction of the DBP in the time interval 6:00-12:00 a.m. was found in patients treated with telmisartan in the morning. The heart rate of the patients who received telmisartan has not been affected by the treatment schedule and remained comparable., Conclusions: 1.) The time of the day administration does not affect the diurnal and night hypotensive efficacy of telmisartan. 2.) According to the results of this study, patients with the essential hypertension should receive telmisartan as monotherapy in the morning.

Unlabelled: Epidemiological studies shows high percent of hypertension cases are not covered as well as level of hypertension control is not satisfactory. The aim of this study was assessment of basic level of knowledge concerning hypertension in group of basic health care physicians., Material and Methods: 846 practice family physicians were included in this study. The questionnaire (own creation) was used for investigation. Before training course, four questions were asked to physicians about: 1/ Hypertension diagnosis in different age groups of people, 2/ Frequency of essential hypertension among of adult population, 3/ Blood pressure in first half period of normal pregnancy comparison to pre-pregnancy blood pressure, 4/ Groups of antihypertensive drugs certainly non administered in pregnancy period., Results: 14% responders correctly answered for first question, 19%for second question, 10%-for third and 6% for fourth question., Conclusions: 1. Investigated physicians presented low level of knowledge about hypertension. 2. It is necessary to elaborate more effective strategy for education of family physicians.

Background: The pathogenesis of essential hypertension (EH) is a complex multifactorial process. Little is known about the association between pregnancy and blood pressure fluctuation in women with EH. In this study we wanted to evaluate the relationship between the blood pressure (BP) and plasma renin activity (PRA) as well as serum and urine aldosterone (ALDO) levels in pregnant women with essential hypertension., Materials and Methods: We analyzed 84 pregnant women (97% primigravida) with EH aged 22-40 (mean 29.5 +/- 5.4) years and 60 healthy pregnant women aged 22-40 (mean 28.5 +/- 4.9) years. In women with EH, antihypertensive therapy was stopped immediately after pregnancy was confirmed. Patients with EH were divided to two groups: 1) with BP > or = 140/90 and 2) with BP > or = 140/90. PRA and ALDO as well as sodium and potassium excretion were measured three times in different periods of pregnancy: 8-12 weeks, 24-28 weeks, 34-38 weeks. In addition, both PRA and ALDO were analyzed in 4th month after delivery i.e. in the time, in which woman is reached hormonal and hemodynamic stability. PRA and ALDO were determined by RIA methods. BP was monitored by standardized method using mercury manometer., Results: PRA and ALDO concentrations in both: serum and urine were increased during pregnancy in all studied groups. No difference in kinetics of PRA and ALDO was stated between healthy pregnant women with EH. Increased was observed in women and during pregnancy. Statistically significant, the highest level of PRA was noted in fourth month after delivery in women with BP > 140/90. In this period, however, concentrations of ALDO in both serum and urine were the same in all examined women., Conclusion: 1. In women with EH and BP < 160/100 mm Hg during pregnancy PRA and concentration of ALDO in serum as well as ALDO excretion were the same as in healthy pregnancy women. 2. Reduction of blood pressure was observed in the group of women with the lowest PRA in fourth month after delivery. 3. PRA measured in women with EH may be a predictive parameter of BP during pregnancy.

This study compared the efficacy and tolerability of eplerenone and enalapril in 499 patients with stage 1 or 2 hypertension who were randomized to receive eplerenone or enalapril for 6 months in a 3-step titration-to-effect study. After 6 months, patients whose diastolic blood pressure (BP) was <90 mm Hg had their dosages down-titrated were followed for an additional 6 months. Diastolic BP was the primary end point. Eplerenone was as effective as enalapril in reducing both systolic BP (eplerenone, -14.5 mm Hg; enalapril, -12.7 mm Hg; p = 0.199) and diastolic BP (eplerenone, -11.2 mm Hg; enalapril, -11.3 mm Hg; p = 0.910) at 6 months. BP reductions at 12 months were also similar between groups (-16.5/-13.3 mm Hg for eplerenone, -14.8/-14.1 mm Hg for enalapril; p = 0.251 and 0.331, respectively). Withdrawal rates for adverse events (eplerenone 7.9%, enalapril 9.3% at 6 months) and treatment failures (eplerenone 23.3%, enalapril 22.8% at 6 months) were also equivalent. Approximately 2/3 of each group had normal BP with monotherapy treatment at 6 months. BP response was independent of renin levels in the eplerenone group, but not in the enalapril group. Both agents reduced albuminuria in patients who had an elevated value at baseline, with significantly greater improvement in patients treated with eplerenone versus enalapril (-61.5% vs -25.7%; p = 0.01). Both agents were similarly well tolerated, and there was no increased incidence of any sexual adverse events in the eplerenone group. Patients taking enalapril had a higher rate of cough. Both agents increased serum potassium levels, but <1% in each group reported adverse events from hyperkalemia. Eplerenone was as effective as enalapril as monotherapy in patients with stage 1 or 2 hypertension, was more effective in reducing albuminuria, and was well tolerated for 12 months.

I studied 84 pregnant women with mild to moderate essential hypertension, aged 22-40 (average of 29.5 + 5.4 years). After determination of pregnancy the existing hypertensive treatment has been stopped. Blood pressure measurements were performed twice every 3 minutes, with a mercury sphygmomanometer, at least 2 weeks after withdrawing hypertensive treatment, in a sitting position, on a left arm after 1 hour break. Among 84 women, the blood pressure of 36% ranged below 140/90 mm Hg at the end of 1 trimester. At the end of II trimester the percentage reached 54% and during the last trimester of pregnancy it has not changed significantly (52%). In the III trimester about 43% of all studied women showed the tendency of normalizing the blood pressure values to 135/85 mm Hg. Approximately 82% of women did not require pharmacological hypertensive treatment.

Unlabelled: I studied levels of blood pressure on 120 healthy primigravides aged between 22-40 years during physiological pregnancy. Blood pressure had been taken by standard methods (mercury sphygmomanometer). 60 of these women had a positive family history of hypertension and 60 pregnancies were with no family history of hypertension. Phase I of Korotkoff sound was used as the ausculatory criterion of systolic blood pressure and phase V was used as the criterion of diastolic blood pressure. The group of healthy pregnant women with a positive family history of hypertension presented statistically significantly higher values of systolic as well as diastolic blood pressure than the group of pregnancies with no family history of hypertension. The lowest systolic value has shown in the 6th month, diastolic in the 5th month of pregnancy and the highest values of both-were determined in the 9th month of pregnancy, Conclusion: Hypertension during pregnancy of healthy women is strongly influenced by their positive family history of hypertension.

The main purpose of this study is to estimate the influence of taking a number of placebo tablets to obtain hypotensive effects and some psychological parameters with essential hypertension. 197 patients (102F/95M) aged between 18-80 years (average age 52.3) with essential hypertension were included in the research in two outpatients clinics. The patients who participated in research, stayed for at least seven days without any pharmacological treatment. They had a diastolic pressure (DBP) between 95-114 mm Hg and systolic pressure (SBP) up to 200 mm Hg. 92 patients had taken one tablet a day and 105 patients had taken two tablets in the morning. This was before the placebo was included and two weeks after their blood pressure had been taken by standard methods (sphygmomanometer). They were monitored daily throughout the period using traditional methods and ABPM (SpaceLabs 90121). The patients completed two psychological tests. 97 records (52F/45M) qualified for statistical analysis (80% of measurements were undertaken properly, and the time between measurements was less than two hours). Psychological questionnaires were correctly completed by 92 patients. The visible results of decreasing systolic and diastolic value of blood pressure were obtained after using one (group 1) and two (group 2) placebo tablets. They were monitored by a standard method and recorded by ABPM. In group 1 SBP decreased from 164 +/- 11.4 mm Hg to 158 +/- 8.8 mm Hg (p < 0.01, on standard method) and from 149.5 +/- 17.8 to 144.5 +/- 8.3 mm Hg daily (p < 0.05, ABPM). DBP in this examined group decreased from 106.2 +/- 2.8 to 102 +/- 3.9 mm Hg (p < 0.01, stand. method), and from 103.2 +/- 2.6 to 98.6 +/- 1.2 mm Hg daily (p < 0.05, ABPM). In the second group SBP decreased from 169 +/- 12.8 to 157.6 +/- 17.9 mm Hg (p < 0.001, stand. method), and in ABPM from 148.5 +/- 15.8 to 139.6 +/- 16.2 mm Hg (p < 0.01). In this same group, DBP decreased from 104.4 +/- 2.6 to 98 +/- 3.4 mm hG (p < 0.001, stand. method), and from 107.4 +/- 5.8 mm Hg to 95.5 +/- 4.2 mm Hg-daily (p < 0.001, ABPM). There were no differences between heart rate in all groups of patients. In both groups there were significant statistical differences in negative symptoms, physical symptoms and anexity, but a more optimistic mood was observed by group 2. More effective hypertensive treatment was observed within the group which was treated with two placebo tablets. This group was characterized by more optimistic mood compared to the group which was treated with one placebo tablet a day.

The greatest belief that the group of patients with primary hypertension is heterogeneous and the progress which took place in the last few years in the research study concerning primary hypertension induced to recapitulation of the given data to asses the influence of the primary hypertension on the pregnant woman and the fetus. The study presented with clinical data claims that 50% of women with mild and moderate primary hypertension showed spontaneous reduction of blood pressure levels in the first months of pregnancy. The results should be taken under consideration when treating the hypertension. Simultaneously, at present the medicine does not posses the ability to indicate the type of hypertension which manifests itself in the second half of pregnancy, it is being proposed to monitor the evaluation of the renin-angiotensin-aldosterone system during pregnancy, as being helpful to the physician. All the study concerning the activity of the RAA system during pregnancy with the pregnancy induced hypertension showed remarkably lower growth levels with the gestational age unlike the pregnancy with the primary hypertension. The mild as well as moderate primary hypertension does not implicate any danger to the woman nor the fetus. But the simultaneous incidence of the pregnancy induced hypertension deteriorates the prognosis for both the woman and the fetus. The most sensitive prognostic factor for the pregnant woman with primary hypertension is the evaluation of the blood pressure levels in the first half of pregnancy. The study also covers the importance of the arterial hypertension family history among both healthy and those with primary hypertension pregnant women.

30 patients with primary mild to moderate hypertension (DBP 95-110 mm Hg) were treated with long acting diltiazem (120 or 240 mg) once daily in the morning (7.00-8.00 a.m.) for at least 3 weeks and after that the administration time was changed to evening dose (19.00-20.00 p.m.) for next 3 weeks. 24-hours ABPM was performed in all patients on the last day of each period. Obtained recordings were compared in different periods of time: total 24 hours, 6.00-23.00, 23.00-6.00, 4.30-8.00, 5.00-11.00, 20.00-2.00. Mean values of systolic and diastolic blood pressure, heart rate and pressure load (defined as percentage of records above 140/90 mm Hg in day and above 120/80 mm Hg at night) did not differ significantly between investigated dosage regimens. The evening administration of diltiazem did not produce greater decrease of BP at night than the morning dose. For this reason slow release formulation of diltiazem (oxycardil in doses of 120 to 240 mg) can be safely administered in the evening if needed.

The authors studied a sensory intensity response to sodium chloride (NaCl) and a sensory hedonic response to salt in suprathreshold concentrations in 120 healthy primigravidas (age: 20-40) during three trimesters of physiological pregnancy, and in 22 healthy nonpregnant women of the same age examined on the 7th or 8th day of the menstrual cycle. In all the periods covered by the study, pregnant women have manifested a tendency to a lower intensity response to all concentrations in comparison with nonpregnant women. The weakening of the response has become statistically significant in the second trimester--with respect to low concentrations, and at the final stage of pregnancy--with respect to medium concentrations. The sensory hedonic response in pregnant women has been increasing along with the age of the fetus. In comparison with the response of nonpregnant women, pregnant women have shown a tendency to the intensified response in all the periods covered by the study.

The aim of the study was the estimation of the lipid profile and prevalence of dyslipoproteinemia in patients with essential hypertension. The study group consisted of 108 outpatients (61 men and 47 women) with mild to moderate hypertension (HT), aged 35-64, who did not receive antihypertensive drugs for at least four weeks. The matched controls (MC) were randomly chosen for each HT patient from population of Warsaw inhabitants, covered by Pol-MONICA II screen. The concentrations of total cholesterol (CH) and triglycerides (TG) in serum and cholesterol in lipoprotein fractions and subfractions (LDL, HDL, HDL3) were measured by enzymatic methods. The levels of apolipoproteins (Apo A-I, Apo B) were estimated by immunoassay. Laboratory was under control of WHO-Lipid Reference Laboratory and CDC-NHLBI Lipid Standardization Program. In HT the concentration of cholesterol in LDL was significantly higher (p < 0.001) than in MC, both in men (by 15%) and in women (by 22%), but the concentrations of cholesterol in HDL and HDL3 and Apo A-I (in men only) were significantly lower (p < 0.001) in HT than in MC in men (by 21% and by 26%) as well in women (by 16% and by 25%). Also in HT group the mean levels of TG, CH and Apo B were higher than in MC, but these differences were significant only in TG level in men. In HT group the prevalence of normolipemia was twice lower than in MC (22% and 42%). Essential hypertension fractions is associated with abnormal levels of some lipoprotein fraction and with higher prevalence of hyperlipoproteinemia. The coexistence of both abnormalities may be particularly detrimental as important factor in the development of atherosclerosis.

A comparative studies on the effect of propranolol and acebutolol on blood pressure, cardiac function, blood serum lipids and lipoproteins were carried out in 48 patients with the primary hypertension double-blind method was applied. Tested drugs were given for 12 weeks. It was found, that both drugs are potent and comparable hypotensive agents normalizing blood pressure in the majority of treated patients. No significant difference in the effect on heart rate and adverse reactions has been noted. Acebutolol did not change lipid metabolism parameters whereas propranolol slightly but statistically significantly increased serum triglycerides.

Fourteen male patients with mild hypertension, aged between 20 and 46 years (mean = 32.4 years) measured their arterial blood pressure thrice daily for 6 weeks. Prior to and after this period psychological tests were carried out, including Gough's ACL test and Spielberger's STAI questionnaire. All patients underwent also Kraeplin's test under stress conditions twice during the experiment. It was found that there is significant correlation of personality response syndromes such as: need for acceptance, inferiority complex, need for success, trust to themselves, anger and some values of blood pressure. So-called personality syndrome related to hypertension was established. Psychophysiological picture accompanying emotional stress was discussed and relationship between blood pressure values (prior to and after emotional stress) and personality syndromes were defined.

Indapamide--a non-thiazide diuretic agent--was given to 28 patients with mild and moderate hypertension in a daily dose of 2.5 mg for 12 weeks. Statistically significant decrease in both systolic and diastolic blood pressure and complete normalization of the arterial blood pressure were achieved in 82% of the treated patients. Adverse reactions were mild and transient. However, low but statistically significant decrease in blood serum potassium and changes in the carbohydrate metabolism were seen. No significant effect of the-drug on lipid metabolism was found except the low but statistically significant increase in total cholesterol. Indapamide is an efficient and well tolerated hypotensive agent. However, biochemical indices should be checked up during the treatment due to the potential adverse reactions.

The aim of the study was to assess the usefulness of 24-hour blood pressure (BP) and heart rate (HR) monitoring in patients with "resistant" hypertension. 30 patients (44.1 +/- 9.9 years) with diastolic BP 100 mm Hg or more in spite of treatment with three or more antihypertensive drugs were studied. Ambulatory recording of BP and HR was performed by means of Del Mar Avionics monitoring system 9000. Mean recording time was 21.5 hours and mean number of measurements during one recording--56.7. Mean ambulatory systolic and diastolic BP values were significantly lower than mean value of three casual measurements (146.0 +/- 24.6 vs 171.5 +/- 21.2 mm Hg for systolic and 97.2 +/- 11.3 vs 110.4 +/- 7.5 mm Hg for diastolic BP p less than 0.01) In 14 (46.6%) systolic BP and in 10 patients (33.3%) diastolic BP were normal. The patients with normal and abnormal ambulatory BP recordings did not differ in regard to age and mean clinic BP levels. However, patients with abnormal ambulatory BP recordings were more often overweight and showed a greater frequency of left ventricular hypertrophy and family history of hypertension and its complications. The results of the study show that ambulatory BP monitoring may be of value in assessing the response to antihypertensive treatment in patients with so called resistant hypertension as judged on the basis of clinic pressure.

The aim of the study was to evaluate the usefulness of 24-hour automatic recording of blood pressure and cardiac rhythm in patients with borderline hypertension. The study was performed in 50 patients aged 38.8 +/- 13.1 using the Del Mar Avionics device. Mean time of recordings was 21.3 hours, and the mean number of blood pressure measurements per one patient was 52.4. Great fluctuations of systolic blood pressure (from 92.1 +/- 12.6 to 191 +/- 37.0 mm Hg) and diastolic one (from 57.3 +/- 11.4 to 118.9 +/- 13.8 mm Hg) were observed. Mean systolic blood pressure (125.6 +/- 10.6 mm Hg) was significantly lower than the mean value of last three ambulatory measurements (141.9 +/- 9.8; p less than 0.001). Also mean diastolic pressure was lower than that obtained in the out patient clinic (84.7 +/- 9.7 vs 91.9 +/- 3.2 mm Hg; p less than 0.001). Mean heart rate during the day was 86.2 +/- 10.7 and at night 69.7 +/- 10.5 beats per minute. Ventricular and/or supraventricular cardiac arrhythmias were observed in 14 (28%) of examined patients. Results of the study indicate, that 24-hour automatic blood pressure recording is the valuable method, affording possibilities for more precise estimation of blood pressure and its 24-hour fluctuations in patients with borderline hypertension.

The object of this study was to test taste responsiveness and taste preferences for NaCl in suprathreshold concentrations in hypertensive individuals. The investigations were carried out in 52 patients with essential hypertension (HT) and 46 normotensive (NT) control subjects. Two types of taste response were tested: (a) an intensity response, and (b) a hedonic (pleasantness) response to NaCl stimuli of 0.08-0.96% concentration. Intensity and hedonic responses were collected using an unstructured linear scale and a nine-point interval scale, respectively. The intensity slope for HT tended to be consistently flatter than the slope for NT. Lower intensity response was more pronounced in HT males. The hedonic responses of HT and NT subjects were split into three subgroups: 'up' (concentration increases, pleasantness increases), 'down' (concentration increases, pleasantness decreases), and 'up-and-down' (concentration increases, pleasantness--). Diversity of response was also observed in the control NT group. The conclusion was that essential hypertension seems to depress the intensity response to NaCl, especially in men, but the pattern of hedonic response to a growing concentration of NaCl is influenced by factors other than hypertension.