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The aim of the present work was to investigate intima media thickness (IMT) in healthy and in hypertensive adolescents and its influencing factors.103 hypertensive and 58 healthy adolescents were studied. IMT was measured in the common carotid artery using B-mode ultrasonography. Additionally, laboratory parameters (blood glucose, cholesterol, triglycerides, HDL- and LDL-cholesterols) and left ventricular mass indices were obtained.IMT in the common carotid artery was higher in hypertensive adolescents (means +/- SD: 0.55 +/- 0.11 mm) than in healthy control subjects (0.48 +/- 0.08 mm, p0.001). Similarly, a higher left ventricular mass index was measured in hypertensive (103.2 +/- 30.6 g/m(2)) than in healthy teenagers (91.1 +/- 25.2 g/m(2), p0.001). In general, IMT in adolescents was associated with age, weight, body mass index, left ventricular mass index and average systolic and diastolic blood pressure values of the subjects. By assessing the multivariate association between IMT and other factors, intima-media thickness was only associated with age and left ventricular mass index of the hypertensive subjects and was independent from all the investigated factors in normotensive controls.Our data suggest an ongoing target-organ damage in adolescent hypertension. These patients need to be subjected to early diagnostic methods, treatment and a regular follow-up, in order to avoid severe clinical manifestations of secondary target-organ damage due to hypertension.

The purpose of this study was to investigate cerebral arteriolar vasoreactivity function in preeclampsia. Preeclamptic (n = 26) and healthy pregnant (n = 22) women underwent transcranial Doppler sonography of the middle cerebral artery at rest and after 60 seconds of hyperventilation (HV). Systolic, diastolic, and mean blood flow velocities were recorded. The percentage change of the blood flow velocities after HV was calculated. Mean blood flow velocity of the middle cerebral artery was higher in preeclamptic women as compared with healthy pregnant women. No difference could be detected in percentage change of middle cerebral artery blood flow velocities after HV between the two groups. There is no evidence of a small-vessel vasoconstriction among preeclamptic patients. The role of vasoconstriction of the large cerebral arteries and vasodilation of the resistance arterioles, as well as a combination of these 2 pathomechanisms, in determining cerebral blood flow in preeclampsia and eclampsia should be investigated in further studies.

Aim of Study: Due to absorption of carbon dioxide and elevated intraabdominal pressure, pneumoperitoneum during laparoscopic cholecystectomy has potentially harmful intraoperative cardiovascular effects. Our aim was to test the usefulness of a non-invasive method for detecting these hemodynamic parameters. Methods: A total of 35 patients, with low anaesthesia risk (ASA 1 and 2) who underwent laparoscopic cholecystectomy were investigated using SphigmoCor arterial wave analyzing system. Conventional pneumoperitoneum was performed, insufflation using carbon dioxid to an intraabdominal pressure of 8–12 mmHg. We determined the estimated central aortic pressure, augmentation pressure, augmentation index, ejection duration and subendocardial viability ratio throughout the surgery. These parameters were recorded after induction of anaesthesia and during the inflation period of surgery. Results: A significant increase in mean arterial blood pressure (84.5±22.1 vs. 94.0±14.4 mmHg, p=0,04), aortic pulse pressure (29.5±9.2 vs. 32.7±11.5 mmHg, p=0.04), augmented pressure (5.9±4.1 vs. 11.0±6.9 mmHg, p

Background Symptomatic paroxysmal hypertension without significantly elevated catecholamine concentrations and with no evidence of an underlying adrenal tumor is known as pseudopheochromocytoma. Methods We describe the case of a female patient with paroxysmal hypertensive crises accompanied by headache, vertigo, tachycardia, nausea and altered mental status. Previously, she was treated for a longer period with alprazolam due to panic disorder. Causes of secondary hypertension were excluded. Neurological triggers (intracranial tumor, cerebral vascular lesions, hemorrhage, and epilepsy) could not be detected. Results Setting of the diagnosis of pseudopheochromocytoma treatment was initiated with alpha- and beta-blockers resulting in reduced frequency of symptoms. Alprazolam was restarted at a daily dose of 1 mg. The patient’s clinical condition improved rapidly and the dosage of alpha- and beta-blockers could be decreased. Conclusions We conclude that the withdrawal of an anxiolytic therapeutic regimen may generate sympathetic overdrive resulting in life-threatening paroxysmal malignant hypertension and secondary encephalopathy. We emphasize that pseudopheochromocytoma can be diagnosed only after exclusion of the secondary causes of hypertension. We highlight the importance of a psychopharmacological approach to this clinical entity.