Circadian blood pressure profile in patients with active Cushing's disease and after long-term cure.

Hypertension is a major feature of Cushing's disease, with the attendant increase in the rate of cardiovascular events. The circadian blood pressure profile also impacts cardiovascular risk and a few studies have shown that patients with Cushing's syndrome do not present the expected nocturnal blood pressure decrease and, further, that this alteration persists in short-range disease remission. These studies were performed by conventional discontinuous ambulatory pressure monitoring, a technique not devoid of limitations.

A new method for assessing 24-h blood pressure variability after excluding the contribution of nocturnal blood pressure fall.

Objectives: To assess quantitatively the relationship between nocturnal blood pressure (BP) fall and 24-h BP variability; to propose a new method for computing 24-h BP variability, devoid of the contribution from nocturnal BP fall; and to verify the clinical value of this method.

Methods And Results: We analysed 3863 ambulatory BP recordings, and computed: (1) the standard deviation (SD) of 24-h BP directly from all individual readings and as a weighted mean of daytime and night-time SD (wSD); and (2) the size of nocturnal BP fall. Left ventricular mass index (LVMI) was assessed by echocardiography in 339 of the patients.

Assessment of long-term antihypertensive treatment by clinic and ambulatory blood pressure: data from the European Lacidipine Study on Atherosclerosis.

Objectives: Information on the features of long-term modifications of clinic and 24-h ambulatory blood pressure (ABP) by treatment is limited. The present study aimed to address this issue.

Methods: Ambulatory BP monitoring and clinic BP (CBP) measurements were performed at baseline and at yearly intervals over a 4-year follow-up period in 1523 hypertensives (56.

The impact of the degree of obesity on the discrepancies between office and ambulatory blood pressure values in youth.

Objectives: Obesity is an increasingly frequent problem among children and adolescents, and may lead to blood pressure (BP) increase. The aim of the present study was to assess the prevalence of hypertension, white-coat and masked hypertension in obese adolescents making systematic use of both office BP and 24-h ambulatory BP measurement. The impact of different degrees of obesity on BP and heart rate variability was also investigated.

[Current trends in the treatment of arterial hypertension].

Today's approach to the treatment of patients with arterial hypertension is no longer based solely on reducing high pressure values but forms part of a broader context designed to reduce the overall cardiovascular risk. The very decision of whether to begin anti-hypertensive treatment or not depends both on the degree of hypertension and on the presence or otherwis of other risk factors, organ damage or associated pathological conditions. The present paper summarises recent indications provided by the guidelines issued in 2003 by the European Society of Hypertension and the European Society of Cardiology.