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Introduction: The aim of this study was to assess the relations between plasma renin activity (PRA), serum aldosterone concentration (ALDO) and selected asymptomatic organ damage (AOD) indices in mild primary arterial hypertension (AH)., Material and Methods: We measured PRA, ALDO, and selected AOD indices (carotid-femoral pulse wave velocity (cfPWV), central aortic pulse pressure (cPP), estimated glomerular filtration rate (eGFR)) in 122 patients with untreated AH., Results: Patients with high PRA (≥ 0.65 ng/ml/h) were characterized by lower plasma sodium and aldosterone to renin ratio (ARR), higher ALDO, but a similar level of AOD indices compared to patients with low PRA. cfPWV ( p = 0.04) and cPP ( p = 0.019) increased with ARR, while eGFR decreased with ALDO ( p = 0.008). Only eGFR was independently correlated with ALDO. In subjects with simultaneously high PRA and ARR values, we found significantly higher cfPWV ( p = 0.02) and cPP ( p = 0.04) and lower eGFR ( p = 0.02) than in those with high PRA but low ARR values., Conclusions: Assessment of the influence of the renin-angiotensin-aldosterone system (RAAS) on AOD should include the relationship between renin and aldosterone. The PRA itself has no predictive value for AOD. More advanced arterial stiffness and renal impairment are associated with increased PRA and ARR. The RAAS activity might be useful in AOD prediction and hypertension severity assessment., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2018 Termedia & Banach.)

A 76-year old woman with a history of stage 3 arterial hypertension, paroxysmal atrial fibrillation, hypercholesterolemia and type 2 diabetes mellitus. Ventricular tachycardia was the first clinical manifestation of the disease. Echocardiography revealed hypertrophic cardiomyopathy with a high intraventricular gradient of 47 mmHg and midventricular obstruction at the level of the papillary muscles (the lumen of the left ventricle was 1-2 mm during systole). No ventricular aneurysm was found but the ventricle was elongated and dilated in the periapical part where systolic function was decreased but synchronized in time. Coronary angiograms showed no narrowing of coronary arteries. A single-chamber cardioverter-defibrillator (ICD, implantable cardioverter-defibrillator) was implanted to prevent sudden cardiac death. Modified-release metoprolol and amiodarone were administered in antiarrhythmic therapy. This case represents a rare kind of hypertrophic cardiomyopathy in an elderly woman which is characterized by midventricular obstruction.

Unlabelled: The aim of the study was to compare therapeutic effects of chosen antihypertensive drugs on arterial stiffness, shear stress in carotid arteries and metalloproteinases activity, moreover analysis of relationship of these variables in the course of treatment., Methods: 95 patients with essential arterial hypertension stage 1 or 2 were randomized to 6 months monotherapy with: quinapril, amlodipine, hydrochlorothiazide, losartan or bisoprolol. Each therapeutic group consisted of 19 patients (N=19). Before and then after 1, 3 and 6 months of treatment carotid-femoral pulse wave velocity (PWV) by using a Complior device, ultrasound of carotid arteries were performed. Blood samples for the measurement of whole blood viscosity were taken during each visit. Shear stress (SS) was calculated using measured variables: blood viscosity and velocity of blood flow. Serum concentration of metalloproteinase 3 (MMP-3) and plasma concentration of tissue inhibitor of metalloproteinase I (TIMP-1) were measured at the initial visit and after 6 months of treatment., Results: ANOVA for repeated measurements revealed for all groups significant decrease of PWV (ΔPWV) and MMP-3 (ΔMMP-3) concentration and increase of shear stress in carotid artery and TIMP-1 (ΔTIMP-1) concentration (p<0.05). No between groups differences appeared in above effects (p>0.05). The multiple regression analysis for the change of PWV (ΔPWV) in the study group considering all investigated variables at R2 = 0,27 revealed its significant relation to PWV at first visit, ΔTIMP-1, ΔMMP-3 and Δ shear stress counted for the maximum flow velocity in common carotid artery. Conclusion: Irrespectively of chosen drug we observed similar effect for PWV drop. Reduction of arterial stiffness as a result of antihypertensive therapy is strongly connected with shear stress increase that is secondary to blood flow velocity growth and changes in connective tissue metabolism.

The first reports about correlation between acute coronary syndromes and allergic reactions were originally published in 1950 and involved the use of penicillin. In 1991, Kounis and Zavras described the case of an allergic reaction which led to a myocardial infarction. Kounis syndrome is defined as an acute coronary syndrome which occurs during the course of an allergic reaction, and is caused by the contraction of the epicardial artery or the destabilization of the atherosclerotic plaque. Both of these processes are the consequence of a violent allergic reaction and the release of inflammatory markers such as histamine, proteolytic enzymes, and the products of arachidonic acid metabolism.