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Objective:Smokers often hesitate quitting in fear of gaining weight. Smoking is a strong risk factor for coronary artery disease (CAD), while the respective risk of body weight is less clear. We studied the prognostic ability for CAD of different combinations of smoking habits and obesity status.Des

Left ventricular hypertrophy (LVH) conveys an increased risk of cardiovascular morbidity and mortality. We aimed to compare the prognostic value of daytime and nighttime blood pressure (BP) on the changes in LVH status in newly diagnosed hypertensive subjects. Three hundred and five hypertensive, nondiabetic subjects (mean age 51.1 ± 10.2 years, 190 men) were prospectively studied for a mean period of 42 ± 17 months. At baseline and last follow-up visit, all patients underwent office and ambulatory BP monitoring, as well as echocardiographic assessment. We defined the following: LVH development/LVH persistence as the new-onset LVH at the end of follow-up or the presence of LVH at both baseline and the end of follow-up; left ventricular mass index (LVMI) reduction as a decline in LVMI at the end of follow-up of ≥ 15% compared with the baseline value. Multivariate Cox regression analyses revealed that baseline nighttime systolic BP was a significant predictor of LVH development/LVH persistence during follow-up (hazard ratio=1.066, P=0.02), whereas baseline daytime systolic BP was not. Moreover, the reduction of nighttime systolic BP is related to an almost threefold increase in the probability of LVMI reduction, independently of daytime BP reduction. In conclusion, nighttime BP constitutes a better prognosticator of left ventricular mass alterations over time in treated essential hypertensive patients than does daytime BP.

Objective:Several studies have reported a small yet significant decrease in blood pressure (BP) with continuous positive airway pressure (CPAP) application in patients with obstructive sleep apnea (OSA). We investigated the long-term efficiency of CPAP in the management of hypertensive patients with

Objective: Beneficial effects of continuous positive airwaypressure (CPAP) on both blood pressure (BP) levels andvariability have been documented in patients withobstructive sleep apnoea (OSA). We investigated therelevant impact of different dosing times ofantihypertensive drugs beyond CPAP application.Methods: In this prospective, cross-over trial, we included41 patients with newly diagnosed hypertension and nevertreated OSA (apnoea-hypopnea index 15/h), withoutincreased daytime somnolence (Epworth Score designate the importance of improving circadian BP vari-10points). Patients first received treatment with valsartan orwith a fixed combination of amlodipine and valsartan in asingle morning dose for 8 weeks. In the following 8-weekperiod, patients received the same therapeutic regimen ina single evening dose. Office and ambulatory BP weremeasured at baseline and after each treatment period.Results: Compared with morning administration, eveningdosing induced a greater decrease in office SBP (by3.7 6.5mmHg, P¼0.001). The decrease in 24-h SBP/DBPwas significant and similar after morning and eveningdosing (-16.4 11/11.0 7.5 and -18.4 11/12.1 7.5mmHg, respectively, P