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Purpose Time of drug administration may significantly influence its effect. The aim of the present study was to investigate the effect of ASA (administrated in the morning or in the evening) on the anti-hypertensive effect and diurnal blood pressure profile in the high-risk group of cardiovascular patients. Methods All patients (n = 114) had been diagnosed with coronary heart disease and arterial hypertension prior to the enrolment and had been treated with 75 mg per day of ASA in the morning. The patients were randomly assigned to one of the two study groups receiving 75 mg of ASA per day in a single antiplatelet therapy for 3 months in the morning (n = 58) or in the evening (n = 56). The control group (n = 61) consisted of patients with arterial hypertension but without coronary heart disease, not receiving ASA. In all the patients, during each visit, clinical blood pressure (BP) and ambulatory blood pressure measurements (ABPM) were performed. Results There was a significant reduction in 24-h BP and blood pressure at night in the ASA group evening group compared with the ASA morning group and the control group. Conclusions The present study demonstrated that compared with the use of ASA in the morning, its administration in the evening may lead to favourable drop in the ABPM and an improvement of the diurnal profile in the high-risk group of cardiovascular patients who are not naïve to ASA.

Background: Cardiovascular (CV) diseases remain a leading global cause of death. Lowering blood pressure (BP) reduces the risk of CV complications, especially stroke and acute coronary events, and it delays the progression of kidney disease. Adequate non-pharmacological treatment improves the effectiveness of the antihypertensive therapy. A Mediterranean diet with high content of vegetables (rich in tomatoes) is associated with a reduced CV risk. Aim: The main objective of the present study was to assess whether the addition of standardised tomato extract (STE) or acetylsalicylic acid (ASA) to standard antihypertensive therapy can improve BP control in patients with arterial hypertension (HT). Methods: The study involved 82 high-risk hypertensive patients. Patients with primary HT at high to a very high total CV risk were randomised in a blinded fashion to one of two groups, i.e. the ASA and STE group. The patients had two visits, a baseline visit and one after four weeks of treatment. In all the patients, during each visit, clinical BP and ambulatory BP measurements (ABPM) were performed. Platelet aggregation was determined using the VerifyNow analyser. Results: After four weeks of treatment in the STE group, there was a statistically significant reduction in 24-h systolic BP, diastolic BP, and mean arterial pressure values measured in ABPM (p < 0.001). After four weeks of treatment in the STE group there was a statistically significant reduction in pulse pressure (PP) during the daytime and during 24 h (p < 0.05). Interestingly, it was found that the use of STE in obese patients significantly decreased the day PP (p < 0.05). After four weeks of treatment in the ASA group there was no statistically significant reduction in BP values measured in ABPM. Conclusions: The results of this study show that the addition of STE to standard antihypertensive therapy improves BP control in hypertensive patients with high CV risk. This effect, together with the anti-aggregatory effect, may indicate the pleiotropic effect of tomato extract. This fact justifies further research into functional foods and gives new insights into STE as a food supplement that could have new therapeutic and prophylactic uses for the treatment of hypertensive patients with high CV risk and especially with obesity.

Apical hypertrophic cardiomyopathy (AHCM) is a rare form of hypertrophic cardiomyopathy, occasionally resulting in severe complications. The paper covers the etiology and pathogenesis of AHCM, different imaging methods and characteristic appearance of the disease in each of them. Echocardiography and cardiovascular magnetic resonance imaging (CMR) are known to be the most valuable imaging methods. Moreover, this review presents medical and surgical treatment, as well as the clinical course and prognosis. Despite possible morbid events the overall cardiovascular mortality rate of AHCM patients is low, and the prognosis is relatively optimistic.Kardiomiopatia koniuszkowa (AHCM) jest rzadką postacią kardiomiopatii przerostowej, która w niektórych przypadkach powoduje poważne komplikacje. Autorzy przedstawiają etiologię i patogenezę AHCM oraz różne techniki obrazowania pozwalające na ustalenie rozpoznania. Echokardiografia i magnetyczny rezonans jądrowy są najlepszymi metodami diagnostycznymi. Ponadto autorzy omawiają aktualne metody leczenia farmakologicznego i chirurgicznego, a także przebieg kliniczny i rokowanie. Pomimo występowania poważnych powikłań śmiertelność pacjentów z AHCM jest stosunkowo mała, a przebieg łagodny.

Although superficial vein thrombosis is commonly considered a rather minor condition, a number of studies indicate that its consequences can be much more severe. Since the introduction of Doppler ultrasonography to common diagnosis of venous diseases, the approach to threats associated with superficial vein thrombosis has changed, mainly in the context of venous thromboembolism. Superficial thrombosis in varicose veins must be differentiated from that occurring in patients without varicosities. In the former case, superficial vein thrombosis is usually caused by haemodynamic disorders (slower flow), while in the latter, it is caused by thrombophilia or inflammation, but it can also be a prodromal sign of cancer. Ultrasonography enables one to distinguish deep vein thrombosis caused by superficial vein thrombosis progression (by extension through perforator veins or the great/small saphenous vein ostium into the deep venous system) from deep vein thrombosis occurring at a certain distance from the site of superficial vein thrombosis. The authors emphasise that due to the possibility of concomitant deep vein thrombosis or pulmonary embolism, our attitude to the diagnostic process, potential complications and treatment of superficial vein thrombosis should be changed.

The obstructive sleep apnea (OSA) is highly associated with various significant cardiovascular outcomes such as resistant hypertension (RAH). Despite this, as of now the relationship between high night-time blood pressure (BP) and left ventricular hypertrophy (LVH) in patients with OSA and RAH is not fully understood. The aim of this study was to assess the influence of the addition of eplerenone to a standard antihypertensive therapy on parameters of 24-h ambulatory blood pressure measurement (ABPM) as well as on the results of echocardiography and polysomnography in patients with OSA and RAH. The patients were randomly assigned to one of the two study groups: the treatment group, receiving 50 mg/d eplerenone orally for 6 months (n = 51) and the control group, remaining on their standard antihypertensive therapy (n = 51). After that period, a significant reduction in the night-time BP parameters in the treatment group including an increased night blood pressure fall from 4.6 to 8.9% was noted. Additionally, the number of non-dipper patients was reduced by 45.1%. The treatment group also revealed a decrease in left ventricular hypertrophy and in the apnea&ndash, hypopnea index (AHI) with a positive correlation being observed between these two parameters. This study is the first to report the improvement of the circadian BP profile and the improvement of the left ventricle geometry in patients with OSA and RAH following the addition of selective mineralocorticoid receptor antagonists to antihypertensive therapy.

AKI is one of the most common yet underdiagnosed postoperative complications that can occur after any type of surgery. Contrast-induced nephropathy (CIN) is still poorly defined and due to a wide range of confounding individual variables, its risk is difficult to determine. CIN mainly affects patients with underlying chronic kidney disease, diabetes, sepsis, heart failure, acute coronary syndrome and cardiogenic shock. Further research is necessary to better understand pathophysiology of contrast-induced AKI and consequent implementation of effective prevention and therapeutic strategies. Although many therapies have been tested to avoid CIN, the only potent preventative strategy involves aggressive fluid administration and reduction of contrast volume. Regardless of surgical technique—open or endovascular—perioperative AKI is associated with significant morbidity, mortality and cost. Endovascular procedures always require administration of a contrast media, which may cause acute tubular necrosis or renal vascular embolization leading to renal ischemia and as a consequence, contribute to increased number of post-operative AKIs.

Obturacyjny bezdech senny (OSA) jest obecnie uwazany za jedną z najczestszych przyczyn nadciśnienia tetniczego opornego. Związek miedzy OSA i nadciśnieniem tetniczym opornym byl opisywany w wielu badaniach. W przebiegu OSA nadciśnienie tetnicze stwierdza sie u 37–56% chorych, a wśrod pacjentow z nadciśnieniem tetniczym opornym OSA wystepuje az u 70–85%. Do rozwoju nadciśnienia tetniczego opornego u osob z obturacyjnymi zaburzeniami oddychania podczas snu dochodzi prawdopodobnie przez wspoldzialanie kilku mechanizmow. Kluczową role odgrywa hipoksja, ktora doprowadza do aktywacji ukladu wspolczulnego, pobudzenia ukladu RAA, zwiekszonego stresu oksydacyjnego i wzrostu wydzielania endoteliny. Pobudzenie ukladu RAA i związane z tym podwyzszone stezenie angiotensyny II i aldosteronu generuje wzrost oporu naczyniowego, co w konsekwencji zwieksza obciązenie nastepcze serca. Wspolistnienie OSA zmniejsza skutecznośc terapii hipotensyjnej. W celu uzyskania kontroli ciśnienia tetniczego w tej grupie chorych konieczne jest rownoczesne stosowanie kilku lekow hipotensyjnych o zroznicowanym mechanizmie dzialania, w tym leku moczopednego.

Introduction Cardiovascular (CV) diseases remain a leading global cause of death. It has been proven that the use of acetylsalicylic acid (ASA) in secondary prevention reduces the CV risk, while the benefits of ASA in primary prevention have recently been debated. The aim of the study was to compare the antiplatelet effect of standardised tomato extract (STE) and ASA in hypertensive patients with high CV risk. Material and methods The study involved high-risk patients with arterial hypertension (AH) randomly assigned to one of two groups: group 1 included 33 patients receiving ASA and group 2 included 32 patients receiving STE. The platelet aggregation was determined using the VerifyNow analyser. Results After 4 weeks of ASA treatment in group 1, a statistically significant reduction in aspirin reaction units (ARU) was observed (p < 0.001). However, the obese subgroup using ASA (n = 18) did not reveal a significant decrease in ARU (p > 0.05). After 4 weeks of STE treatment in the obese subgroup (n = 14), significant declines in ARU by 8.6% (95% CI: –19.5 to –1.7%; p < 0.05) and in P2Y12 reaction units (PRU) by 7.5% (95% CI: –17.6 to 1.8%; p < 0.05) were observed. Conclusions The antiplatelet effect of STE in hypertensive patients may be weight dependent. The group with AH and obesity might have potentially benefitted from STE treatment.

A close causal relationship between cancer and venous thrombosis gives rise to questions about the effect of treatment modalities, in particular of the administered drugs, in patients with cancer-related venous thrombosis. An increased risk of chemotherapy-associated venous thromboembolism (VTE) has been well documented, while the effect of heparins used in VTE treatment on the disease course and prognosis in cancer patients has not been fully elucidated. This paper discusses the outcomes of the studies conducted so far investigating the role of heparins, in particular, low-molecular-weight heparins (LMWHs), in the prevention of thrombosis in cancer patients. It also focuses on such aspects of the treatment for cancer-associated VTE as treatment duration and drugs used. The paper summarizes the often discrepant results of long-term therapies with various LMWH products, emphasising that in this specific case the class effect is rather unlikely. It also presents the possible effects of heparins administered as part of cancer treatment, and points to the effects of LMWHs on cancer that are not related to an antithrombotic effect. On the 100th anniversary of heparin discovery, it can be said that heparin is irreversibly connected with thrombosis in the course of cancer.

INTRODUCTION Obstructive sleep apnea (OSA) is considered to be one of the major causes of resistant arterial hypertension (RAH). Apnea episodes cause hypoxia, which triggers the activation of the renin-angiotensin-aldosterone system. This leads to water retention and swelling in the neck region, exacerbating OSA symptoms. It is assumed that the use of eplerenone may reduce the swelling and thus alleviate the severity of OSA. OBJECTIVES We aimed to prospectively assess the impact of eplerenone on the severity of OSA and arterial stiffness in patients with RAH. PATIENTS AND METHODS The study included 31 patients with RAH and OSA. The exclusion criteria were as follows: secondary hypertension, myocardial infarction, stroke 6 months prior to the study, congestive heart failure, chronic kidney failure, alcohol or drug addiction, and active cancer. In all patients, the following tests were performed: blood pressure (BP) measurement (traditionally and using ambulatory BP measuring [ABPM]), applanation tonometry, polysomnography, and the apnea-hypopnea index (AHI) calculation. The tests were done before and after 3 months of eplerenone therapy. Patients received 50 mg of oral eplerenone daily, along with other hypertensive drugs. RESULTS The mean age of participants was 57.76 ±6.16 years. After 3 months of eplerenone therapy, we observed a significant reduction in the AHI, neck circumference, BP, aortic pulse wave, and arterial wall stiffness. There were significant correlations between the AHI and mean BP measured by ABPM and between the AHI and arterial stiffness parameters. CONCLUSIONS Our results provide evidence for the clinical significance of eplerenone, not only as an antihypertensive medication but also as a drug that may reduce the severity of OSA and arterial stiffness in patients with RAH and OSA.

J Clin Hypertens (Greenwich). 2012;14:701–710. ©2012 Wiley Periodicals, Inc. The authors aimed to determine the effect of the time of hypotensive drug administration on the progress of degenerative changes within the optic nerve in patients with hypertension and glaucoma. Two groups were included in the study: group A comprised patients-dippers taking drugs in the mornings, and group B comprised patients-nondippers taking drugs both in the mornings and in the evenings. After 6 months, group B showed significant drops in nocturnal diastolic blood pressure (BP) (month 1=73.27 mm Hg vs month 6=67.50 mm Hg), nocturnal mean BP (89.34 vs 84.65 mm Hg), and minimum diastolic BP (50.74 vs 44.03 mm Hg). Group B also showed significant reductions in nocturnal ocular perfusion pressure (43.0 vs 39.73), retinal nerve fiber layer thickness (131.31 vs 113.12 μm), and flow in the eye vessels. Taking hypotensive drugs in the evening may significantly decrease blood flow in the eye arteries, cause degenerative changes within the optic nerves, and result in greater loss in the field of vision.

As decreased bone mineral density (BMD) is a common problem in cystic fibrosis (CF) and milk products may have pivotal dietary role affecting BMD, we aimed to assess the potential influence of adult-type hypolactasia (ATH) and lactose malabsorption (LM) on BMD in adolescent and young adult patients. In 95 CF pancreatic-insufficient patients aged 10–25 years (without liver cirrhosis, steatosis and cholestasis, diabetes mellitus, systemic glucocorticoid therapy), lumbar BMD, the nutritional status, pulmonary function, vitamin D3 concentration, calcium intake and single-nucleotide polymorphism upstream of the lactase gene were assessed. In subjects with the −13910 C/C genotype predisposing to ATH, the presence of LM was determined with the use of a hydrogen–methane breath test (BT). BMD and calcium intake were significantly lower in patients with the C/C genotype (P

Introduction: Adult-type hypolactasia (ATH) is the most common enzyme deficiency in humans. Incomplete digestion of lactose may result in lactose malabsorption (LM) causing symptoms of lactose intolerance (LI). Aim: Determination the dose of lactose, administered as a single serving in the form of yogurt, that is tolerated by LI healthy young adults. Material and methods: All (10 young adults) subjects were homozygotes C/C at locus 13910 upstream of the LCT gene. The hydrogen-methane breath test (BT) was performed after a load of 400, 200 and 100 ml of yogurt (5 h). Clinical symptoms were assessed for 12 h. Results: Ingestion of 400 ml of yogurt brought about abnormal BT results in all examined individuals; consumption of 200 ml did so in two of ten subjects, while a load of 100 ml caused borderline hydrogen excretion in one individual. However, residual fermentation of lactose was observed for several hours in all subjects. All participants reported symptoms after the ingestion of 400 ml of yogurt and their severity was significantly higher than that observed after a load of 200 ml. After consuming 100 ml of yogurt, none of the examined individuals reported gastrointestinal symptoms. Conclusions: Subjective observation of clinical symptoms suggests that young adult LI may tolerate up to 200 ml of yogurt served in one meal. However, when considering the objective assessment of LM by BT, it seems that the dose served per meal definitely should not exceed 100 ml. Streszczenie Wstep: Hipolaktazja typu doroslych jest najczestszym niedoborem enzymatycznym wystepującym u ludzi. Niepelne trawienie laktozy moze prowadzic do zaburzen jej wchlaniania, co powoduje zespol objawow klinicznych określanych jako nietolerancja laktozy (NL). Cel: Określenie dawki laktozy podawanej jednorazowo w postaci jogurtu, tolerowanej przez zdrowe mlode osoby dorosle z NL. Material i metody: Badaniem objeto 10 mlodych doroslych z NL. Wszyscy badani byli homozygotami –13910 C/C w zakresie genu promotorowego laktazy. U kazdej osoby wykonano wodorowo-metanowy test oddechowy (TO) po obciązeniu 400, 200, 100 ml jogurtu (5 godzin). Objawy kliniczne oceniano przez 12 godzin po spozyciu kazdej dawki produktu. Wyniki: Nieprawidlowe wyniki TO wystepowaly u wszystkich badanych osob po spozyciu 400 ml, a u 2 spośrod 10 po spozyciu 200 ml jogurtu. Obciązenie dawką 100 ml skutkowalo graniczną wartością TO u 1 osoby. U wszystkich badanych stwierdzono resztkową fermentacje laktozy przez wiele godzin (mediana sumy wydalania wodoru i metanu w 240. min testu – 6,5 ppm). Wszyscy badani zglaszali objawy kliniczne po spozyciu 400 ml jogurtu. Ich nasilenie bylo istotnie wieksze niz obserwowane po obciązeniu 200 ml produktu. Dawka 100 ml jogurtu nie wywolala dolegliwości brzusznych ani zmiany konsystencji stolca u zadnej spośrod badanych osob. Wnioski: Subiektywna obserwacja objawow klinicznych sugeruje, ze mlodzi dorośli z NL mogą tolerowac do 200 ml jogurtu podawanego w jednym posilku. Uwzgledniając jednak obiektywną ocene zaburzen trawienia laktozy za pomocą TO, wydaje sie, ze jednorazowa dawka zdecydowanie nie powinna przekraczac 100 ml.

Introduction: A large portion of the world’s population undergoes a genetically programmed decrease in lactase synthesis and may experience symptoms of lactose intolerance (LI) after dairy consumption. Aim: The aim of the present study was to assess the effect of the same dose of lactose consumed by LI subjects in the form of different dairy products. Material and methods: Fifteen healthy young adults with LI were enrolled in the study. All subjects were symptomatic homozygotes –13910 C/C in the lactase promoter gene. The hydrogen-methane breath test was performed in each subject after a load of 400 ml of milk, kefir and yogurt. Clinical symptoms were assessed within the 12 h after each product consumption. Results: The excretion of gases was lower after ingestion of kefir and yogurt in comparison to milk. All examined subjects reported symptoms. After milk consumption, abdominal pain and intestinal rumbling were perceived as more severe. The number of stools was higher and their consistency was more liquid. Conclusions: Young adults with LI are not able to tolerate the typical dose of different dairy products as assessed by subjective and objective measures. The tolerance of kefir and yogurt is significantly better than that of milk. Streszczenie Wstep: U znacznej cześci ludności świata produkcja laktazy podlega genetycznie zaprogramowanej redukcji, co moze prowadzic do wystepowania objawow klinicznych nietolerancji laktozy (NL) po spozyciu produktow mlecznych. Cel: Ocena wplywu spozycia takiej samej dawki laktozy przez osoby z NL, podawanej w postaci roznych produktow mlecznych. Material i metody: Badaniem objeto 15 mlodych doroslych z objawową NL. Wszyscy badani byli homozygotami –13910 C/C w zakresie genu promotorowego dla laktazy. U kazdej osoby wykonano wodorowo-metanowy test oddechowy po obciązeniu 400 ml mleka, kefiru i jogurtu. Objawy kliniczne oceniano przez 12 godz. po spozyciu kazdego produktu. Wyniki: Wydalanie gazow bylo mniejsze po spozyciu kefiru i jogurtu niz mleka. Wszyscy badani zglaszali objawy kliniczne. Po spozyciu mleka bole brzucha i przelewania byly bardziej nasilone, stwierdzono wiekszą liczbe stolcow, a ich konsystencja byla bardziej plynna. Wnioski: Mlodzi dorośli z NL nie tolerują typowych porcji produktow mlecznych, co potwierdzono w ocenie subiektywnej i obiektywnej. Tolerancja kefiru i jogurtu jest znacząco lepsza niz mleka.

Purine metabolism reflects the exercise-induced muscle adaptations and training status. This study evaluated the utility of plasma hypoxanthine in the prediction of actual sport performance. We studied male athletes: 28 triathletes (21.4±2.9 years), 12 long-distance runners (23.2±1.9 years), 13 middle-distance runners (22.9±1.8 years) and 18 sprinters (22.0±2.7 years). Season-best race times were considered, achieved over standard triathlon, 5 000 m, 1 500 m and 100 m, respectively. Incremental treadmill test was administered to determine maximum and “threshold” oxygen uptake. Resting and post-exercise plasma concentrations of hypoxanthine, xanthine, uric acid and lactate were measured as well as resting erythrocyte hypoxanthine-guanine phosphoribosyltransferase activity. Simple and multiple regression analyses were used to identify significant contributors to the variance in performance. Hypoxanthine considered alone explained more variance in triathletes, long-distance runners, middle-distance runners and sprinters (r 2=0.81, 0.81, 0.88 and 0.78, respectively) than models based on aerobic capacity and lactate (R 2=0.51, 0.37, 0.59 and 0.31, respectively). Combining purine metabolites and cardiorespiratory variables resulted in the best prediction (R 2=0.86, 0.93, 0.93 and 0.91; r=0.93, 0.96, 0.96 and 0.95, respectively). In summary, hypoxanthine is a strong predictor of performance in highly trained athletes and its prediction ability is very high regardless of sport specialization, spanning the continuum from speed-power to endurance disciplines.

J Clin Hypertens (Greenwich). 2012;14:701–710. ©2012 Wiley Periodicals, Inc. The authors aimed to determine the effect of the time of hypotensive drug administration on the progress of degenerative changes within the optic nerve in patients with hypertension and glaucoma. Two groups were included in the study: group A comprised patients‐dippers taking drugs in the mornings, and group B comprised patients‐nondippers taking drugs both in the mornings and in the evenings. After 6 months, group B showed significant drops in nocturnal diastolic blood pressure (BP) (month 1=73.27 mm Hg vs month 6=67.50 mm Hg), nocturnal mean BP (89.34 vs 84.65 mm Hg), and minimum diastolic BP (50.74 vs 44.03 mm Hg). Group B also showed significant reductions in nocturnal ocular perfusion pressure (43.0 vs 39.73), retinal nerve fiber layer thickness (131.31 vs 113.12 μm), and flow in the eye vessels. Taking hypotensive drugs in the evening may significantly decrease blood flow in the eye arteries, cause degenerative changes within the optic nerves, and result in greater loss in the field of vision.

Many patients with glaucoma suffer from arterial hypertension (AH). It has been proved that both AH and low blood pressure (BP) at night are important vascular risk factors for primary open-angle glaucoma (POAG). The aims of this study were to assess the severity of pathological changes within the optic nerve and characteristics of blood flow in selected arteries of the eyeball and orbit in patients with POAG and controlled hypertension, in relation to the time of hypotensive drugs administration. Eighty-eight patients with POAG and treated, controlled hypertension were examined. The patients were divided into two subgroups, consisting of group A (n = 43), in whom hypotensive drugs were dosed only in the morning and group B (n = 45), in whom hypotensive drugs were also taken in the evening. In patients who were taking hypotensive drugs also in the evening (group B), there was a statistically significant lower mean perfusion pressure at night, a greater visual field loss and reduced amplitude of evoked potentials. Our analysis showed significantly worse changes in the parameters relating to the optic nerve in patients taking hypertensive medicines in the evening and also significantly lower perfusion pressures at night.

The number of body injuries keeps growing and that is mostly due to increasing number of car accidents. How to prevent thrombosis in such cases is still under discussion with the biggest issue being the proper timing. Most of the input to such discussion usually comes from extrapolating data from other studies, which is hardly of help for treatment of such group of patients. The authors focus on collection and analysis of most recent data and recommendations that are available in literature. They show that low-molecular-weight heparins are by far the most common, if not sole pharmacologic means of thromboembolism prevention in patients with numerous body injuries.

The aim of this study was to assess blood flow in the vessels of the eyeball and changes in the optic nerve in patients with arterial hypertension and primary open-angle glaucoma.The patients were divided into groups: 1 (night blood pressure, BP, fall, NBPF, not more than 10%; non-dippers); 2 (NBPF 10-15%, dippers) and 3 (NBPF15%; extreme dippers).In the group of dippers and extreme dippers, perfusion pressure was significantly lower than that in the non-dippers group, there was reduced thickness of the nerve fibers and a greater decrease in the visual field. Significant relationships between peak systolic, end-diastolic flow in the ophthalmic and central retinal arteries and night perfusion pressure, thickness of nerve fibers, and a loss of visual field were observed.In patients with glaucoma and well-controlled hypertension, a nocturnal BP fall of more than 10% is associated with a greater visual field defect and greater degeneration of the optic nerve fibers. Low minimum diastolic pressure and the level of nocturnal BP fall, but not the absolute value of average arterial BP at night, should be included in the group of specific risk factors in patients with hypertension and open-angle glaucoma. These findings also suggest avoiding excessive lowering of BP at night in this group.

The purpose of this study was to analyse prevalence of so called classical risk factors for VV in patients with this entity.Study consisted of three parts. In the first part the prevalence of risk factors in 130 men and 360 women with VV was compared. In the second part the prevalence of risk factor in 360 women with VV and 162 without VV was compared. In the third part the prevalence of risk factors in pregnant women with and without VV was compared. The age of patients in all groups was comparable. The results were statistically analyzed.There were no differences in prevalence of classical risk factors between men and women with VV. In non pregnant women positive family history (OR 2,27, p=0,018) and previous pregnancies (OR 2,05, p=0,046) were associated with presence of VV. Premenstrual aching of lower extremities and obesity were at the border of statistical significance, OR and p, 1,9 and 0,062 and 1,4 and 0,071, respectively. As many as 47% of pregnant women had VV. Positive family history (OR 2,27, p=0,018), previous pregnancies (OR 2,56, p=0,011) and premenstrual aching of lower extremities (OR 2,03, p=0,021) were associated with presence of VV. Remaining, so called classical risk factors such as oral contraceptive, working in a sitting or standing position or constipations were not associated with occurrence of VV.In conclusion, positive family history and previous pregnancies seem to be principal risk factors for VV in women.