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We have measured the blood pressure to 1500 children aged between 6 and 14 years by sphingomanometric method, using various cuffs according to the recommendations of the A.H.A. Systolic and diastolic pressure was taken and the average value and standard deviations were calculated for each age. On the ground of the values equal or higher than 97 degrees percentil was the presence of 99 subjects afflicted with not secondary hypertension. We noticed that blood pressure increases with the age, is independent of sex, but bears relationship to the presence of obesity (out of 72 obese subjects, 25 were afflicted with hypertension), of menarca (17 hypertensive menstruated out of 27) and of family hypertension (31 hypertensive parents out of 41 examined). Neither relation was found between children's hypertension and socio-economical level nor between hypertension and presence of pathological proteinuria.

In spite of the widespread use of intravenous urography and its extensive employment in the study of hypertension, there is still no unanimity of views as to its application in such pathology. 147 urographies belonging to 330 hypertense patients admitted to the Bari Medical Pathology Department between 1-1-1975 and 30-9-1977 have therefore been examined so as to assess its diagnostic value. Thereafter, the percentage of abnormalities found with urography were evaluated and compared with those in the population at large. Results stress on the one hand the higher incidence of renal ptosis and poly-cystic kidneys in the hypertense, and also highlight the possibility of revealing clinically silent diseases with this technique; on the other hand, many urographies (more than 50%) were useless and it is not always possible to diagnose certainly the presence of stenosis of the renal artery owing to the presence of false positives and negatives.

It is well recognized that the co-administration of some drugs to persons receiving digoxin results in an increase of serum digoxin levels: it occasionally precipitates digoxin toxicity. There are some possible mechanisms by which different drugs may increase serum glycoside levels: 1) by displacing digoxin from tissue binding sites, 2) by decreasing digoxin renal excretion, 3) by enhancing digoxin absorption, 4) by increasing the inhibition of the ATP-dependent pump. Combined administration of calcium antagonists and B-methyldigoxin is common in patients with heart diseases. Other Authors have found that the co-administration of these drugs with digoxin increases glycoside serum levels, without signs of intoxication. We have examined the effects of this combination on digitalis activity, by Rubidium 86 uptake in erythrocytes. Thirty patients aged 52 to 66 with congestive heart failure were studied. All of these had normal serum creatinine, blood urea and serum protein levels. These subjects received 0,20 mg of B-methyldigoxin daily for nine days; afterwards, ten of them were given in addition 320 mg of verapamil for seven days; the other ten received in addition 60 mg of nifedipine, for seven days; the remaining ten patients received in addition 320 mg of verapamil and 60 mg of nifedipine together, for seven days. Digoxin activity was measured on the eighth, ninth and sixteenth day of treatment by Rubidium 86 uptake in erythrocytes. The technique was that of Bertler. Means were compared with the t test, with the assumption of the equal variances in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Digoxin and Verapamil may often be used in association in heart diseases; we tested whether this coadministration increases digitalis activity. Ten patients with failing heart were given 0.10 mg of beta-methyldigoxin, twice a day, for nine days; then they received in addition 80 mg of Verapamil, four times a day, for seven days. Digoxin activity was measured on the eighth, ninth and 16th days of treatment by 86Rubidium uptake in erythrocytes. The steady-state concentration was 0.91 +/- 0.13 ng/ml; during the coadministration the concentration rose to 1.23 +/- 0.16 ng/ml (an increase of 35.12%). The change was significant (p less than 0.001). The mechanism of this increase is unknown: it is important that there exists an increase in digitalis activity and not only a haematic elevation.

Changes in arterial blood pressure and in thermographic values were evaluated in two groups of 15 hypertensive patients, each of which was treated, on a random basis, with a combination of atenolol plus chlorthalidone or a combination of labetalol plus chlorthalidone. Both combinations produced a statistically significant reduction in blood pressure values (p less than 0.01) with no changes in heart rate. Telethermographic investigations revealed the presence of hypothermia of the hands before treatment in all the hypertensive patients examined, but not in the control group (10 normal subjects with no vascular and/or hyperthermic disease). After one month of treatment, no changes in peripheral vascularization were observed in the group treated with atenolol plus chlorthalidone, except for 4 cases showing mild improvement, probably due to a reduction in peripheral resistance as a result of the treatment and to a consequent increase in blood flow in the area investigated. In the group treated with labetalol plus chlorthalidone, on the other hand, a substantial recovery of vascular flow was observed in 12 patients as a result of the treatment, while the remaining 3 patients showed a fair degree of improvement (2 degrees C). Both preparations lent themselves to simplified administration regimens with good patient compliance and no adverse reactions.

ECG traces from 60 children aged 10-14 yr with hypertension were examined to see whether this condition itself was enough to alter the parameters in a statistical comparison with the traces for 19 normotensive children of the same age. Some statistically significant differences were noted in: the deviation of the P wave axis, increased left ventricle activation time, frequency and QTc segment, presence of anticlockwise rotation on the longitudinal plane and junctional rhythms. These support the view that changes in these parameters is not dependent on the concomitance of other diseases, but due to hypertension itself.