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Objective: Subjects with low birth weight and those born small for gestational age (SGA) have higher risk for hypertension, kidney disease and cardiovascular events as adults. Arterial stiffness (AS) is a marker of vascular ageing. Our aim was to analyse whether birth weight (BW) determines AS in young men. Design and Method: Normotensive non-treated, healthy adult men (n = 159 ; age 21.27 ± 0.9 years) were enrolled. Birth parameters were obtained from medical records. SGA was defined as BW under 10th percentile for gestational age and obesity as body mass index (BMI) > 25 kg/m2. Subjects were divided into the four groups: non-obese with normal BW (N = 55), obese with normal BW (N = 43), non-obese SGA (N = 40), obese SGA (N = 21). Blood pressure (BP) was measured with oscillometric device following ESH guidelines while aortic BP (SBPAO) and AS markers (pulse wave velocity (PWV), brachial and aortic augmentation index (AIxBR, AIxAO)) were determined using Arteriograph. Results: Overall, SGA subjects had higher brachial systolic BP (SBP) (p = 0.021) and HR (p = 0.003) values than those born with normal BW. However, there were no differences in PWV, AIxBR, AIxAO and SBPAO between subjects with SGA and normal BW(p > 0.05). When subjects were further divided according to the BMI, we found that SBP was the highest in obese SGA subjects (p = 0.035). Obese SGA had higher SBPAO and PP values than non-obese SGA (p = 0.017 ; p = 0.036, respectively) and non-obese subjects with normal BW (p = 0.027 ; p = 0.001, respectively). There were no significant correlations between BMI and AS markers in all subgroups. Conclusion: In young men, birth weight influences brachial SBP and HR, but according to our results it does not increase arterial stiffness determined with this technique. It might be concluded that higher values of SBP and HR observed in this group could be rather markers of hyperkinetic circulation than consequences of early vascular ageing. Obesity additionally affects BP values increasing even central SBP. SGA subjects should be informed about importance of life-style changes and monitored very closely.

Introduction: The prognostic value of heart rate (HR) for the development of hypertension and as an important cardiovascular risk factor is still neglected. Until now, there is no data on HR and its correlation with blood pressure (BP) in the Croatian general population. Subjects and methods: Of 1, 447 subjects enrolled in a nationwide survey (EH-UH study), 672 participants were eligible (302 men and 370 women) for further analyses (treated hypertensives and those with incomplete data were excluded). HR and BP were measured following ESH guidelines. The aim of the study was to determine HR values and analyse if there is a correlation between HR and BP in the general Croatian population. Results of this study show that men with high normal BP have a significantly higher HR than the men with optimal BP values (74.5 ; 95% CI 67.3–79.8 vs.72.2 ; 95% CI 66.9–78.0 ; p = 0.032), but they do not differ from the hypertensives (74.5 ; 95% CI 67.0–79.7 ; p > 0.05). In women, there is a significant difference in HR values among all normal BP categories and the hypertensive group (p = 0.003). HR is higher in men than in women appertaining to categories of optimal BP (72.2 ; 95% CI 66.9–78.0 vs.70.1 ; 95% CI 66.5– 73.6 ; p = 0.067) and stage 1 hypertension (p = 0.016). Subjects in stage 3 hypertension group have the highest values of HR (p = 0.004). A significant correlation was observed between HR and systolic and diastolic BP in the whole group (r=0.19 ; r=0.21, respectively ; p < 0.001) and in both genders. Conclusion: HR was higher in subjects with high normal than optimal BP, with the difference being more significant in men. In both genders, a statistically significant correlation between HR and BP was found. Our results confirmed previous studies showing that HR should be seriously considered from the beginning of the cardiorenal continuum.

To determine the characteristics of uncontrolled treated hypertensive patients enrolled in a Croatian nationwide survey

The relation of uric acid on cardiovascular risk has been reported. Our aim was to investigate whether mildly elevated UA influences the circadian blood pressure pattern in patients with newly diagnosed essential hypertension (EH). In this study, 103 previously untreated EH patients (60 M, 43 F, mean age: 37 ± 9.1 years) with normal renal function were enrolled. BP was measured using a mercury sphygmomanometer and a Spacelabs 90207 device. Patients with white-coat hypertension were excluded. There were 39% of patients with UA levels in the high normal range (310–360 μmol/1) (HUA) and 61% with UA < 310 μmol/1 (NUA). Significantly more men than women had HUA (63.5% vs. 7.6% ; p < 0.001). Patients in the HUA group had increased BMI, waist circumference (WC), and fasting blood glucose (p < 0.05). There were no differences in age, eGFR, sodium excretion and BP values. We did not observe any differences in dipping status, BPL, BP variability or heart rate between HUA and NUA patients. UA positively correlates with BMI and WC (r = 0.39 and r = 0.45, respectively ; p < 0.05), as well with daytime and nighttime systolic BP (r = 0.28 and r = 0.26, respectively ; p < 0.05). In multiple regression analysis, only BMI showed a significant impact on dipping status (ß = –0.576 ; p = 0.05) while UA had an impact on systolic BP variability (ß = 0.569 ; p = 0.011). Our results support clustering of risk factors in patients with increased UA levels. Correlation of UA with BP values might be due to altered vasoconstriction present even in patients with HUA.

Increased arterial stiffness has been shown to predict cardiovascular mortality. Recently, ambulatory arterial stiffness index was proposed as a new method.