[Specifics of using ambulatory blood pressure monitoring in the elderly].

Arterial hypertension is a chronic disease which represents a major risk factor for damage of cardiovascular system. Insufficient control of elevated blood pressure is associated with the development of target organ damage, increased cardiovascular morbidity and mortality with a adverse prognostic value. Using ambulatory blood pressure monitoring (ABPM) we can improve the overall management of elderly patients at which the prevalence of arterial hypertension is particularly high.

[Specifics of using ambulatory blood pressure monitoring in the elderly].

Unlabelled: Arterial hypertension is a chronic disease which represents a major risk factor for damage of cardiovascular system. Insufficient control of elevated blood pressure is associated with the development of target organ damage, in-creased cardiovascular morbidity and mortality with a adverse prognostic value. Using ambulatory blood pressure monitoring (ABPM) we can improve the overall management of elderly patients at which the prevalence of arterial hypertension is particularly high.

[Resistant hypertension in the elderly].

The issue of resistant hypertension is complex and from the clinical aspect very current, especially in the elderly. For the diagnosis of resistant hypertension in routine practice, ambulatory blood pressure monitoring is a proven method to distinguish it from the white coat hypertension. Fixed combinations of antihypertensive drugs helps to improve compliance not only in geriatric patients, but are also indicated in hypertensive patients with diabetes mellitus, metabolic syndrome, in patients with target organ damage, renal disease, coronary heart disease and post stroke conditions.

The Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) trial: outcomes in patients receiving monotherapy.

In the main Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) report, we investigated outcomes in 15 245 high-risk hypertensive subjects treated with valsartan- or amlodipine-based regimens. In this report, we analyzed outcomes in 7080 patients (46.4%) who, at the end of the initial drug adjustment period (6 months), remained on monotherapy.

Epinephrine producing pheochromocytoma. Is the secretory pattern decisive for the clinical manifestation?

Adrenal incidentalomas are becoming a major clinical problem, due to increasingly frequent radiological examinations. We present two cases of patients referred to our department with a finding of an unsuspected adrenal mass. Both of them were normotensive and without symptomatology typical for pheochromocytoma.

Retrospective analysis of patients clinical manifestations before and after pheochromocytoma surgery.

Main Purpose: A retrospective analysis of presurgical clinical picture and blood pressures of 34 patients with histologically verified pheochromocytoma. Assessment of clinical state, blood pressure and prognosis in the course of patients control hospitalizations from 2001 to 2002.

Patients And Methods: The study was designed as a synoptic one, based on a retrospective analysis of 34 patients records with histologically verified pheochromocytoma (26 women and 8 men).

[Clinical conditions imitating pheochromocytoma in diagnostic practice].

Serious predominantly diastolic treatment-resistant hypertension with unstable blood pressure values draws first contact physician's attention to a possibility of pheochromocytoma, although in some periods of disease blood pressure values of a patient can be normal or only slightly elevated. Clinical picture is sometimes atypical, can be overlooked or lead to a wrong diagnosis. The author brings forward atypical cases where pheochromocytoma emulates different disease or diseases with clinical pictures similar to that of pheochromocytoma.

Compliance and the therapeutic effect in patients with arterial hypertension.

Objective And Method: To analyse the therapeutic effect of treatment in patients monitored in our hypertension outpatient department and evaluation using questionnaires. To determine the influence of treatment effectiveness on the level of co-operation received from the patient. The effect of treatment was monitored by retrospective analysis of the medical records of 101 patients with essential hypertension.

Does diabetic autonomic neuropathy influence the clinical manifestations of reflux esophagitis?

Diabetic autonomic neuropathy is a common complication of diabetes mellitus and affects every segment of the gastrointestinal tract. Gastrointestinal problems tend to be more common and severe in diabetics compared with the nondiabetic population. In the literature, the prevalence of reflux esophagitis is not known.

The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial in Slovakia.

Objectives: We described the baseline characteristics of a cohort of patients who are a part of a large prospective study and compared with those characteristics of patients enrolled globally.

Background: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) is a double-blind, randomized, multinational, multicenter, prospective, parallel group study. The primary objective of VALUE trial is to assess the effect of the angiotensin II (AT1 receptor) antagonist valsartan on the reduction of cardiac morbidity and mortality in patients 50 years of age or older with essential hypertension and a high risk of cardiovascular events.

The effect of cardiovascular autonomic neuropathy on resting ECG in type 1 diabetic patients.

Background: Cardiovascular autonomic neuropathy (CAN) is a common complication of diabetes mellitus.

Aim: To assess the manifestations of CAN on ECG at rest.

Subjects And Methods: 100 type I diabetic patients, mean age 36.

Germline mutation of the RET proto-oncogene in members of Slovak families with multiple endocrine neoplasia 2.

Detection of mutations in RET proto-oncogene in Slovak families from different localities and of different ethnic origin with MEN 2 syndrome is reported. Despite the fact that the same mutation of RET oncogene was found in different family members, the latency period of tumor appearance and their pathogenicity differed substantially. In addition, also different phenotypes of the disease were expressed in various family members having the same RET gene mutation.

[Long-term treatment of combined hyperlipidemia with a combination of fluvastatin and fenofibrate].

The long-term efficacy and safety of fluvastatin monotherapy was compared with that of the combination of fluvastatin and fenofibrate in 104 patients with coronary heart disease and combined hyperlipidemia in an open, randomised, parallel group, clinical study of 78 weeks duration. Combined hyperlipidemia was defined as LDL-cholesterol 4.1 mmol/l and higher and triglycerides between 2.

[The role of home pressure monitoring in the treatment hypertension in the practice of general medicine].

Aim Of The Study: The aim of the study was to evaluate home blood pressure (BP) measurement using an OMRON HEM 706 device (including printout values) for the treatment of essential hypertension by a greater number of general practitioners and to establish the incidence of "white coat hypertension".

Methods: We compared home BP values, taken by the portable digital Omron HEM 706 device with casual BP values, measured during the course of a 6-month treatment of essential hypertension by the ACE inhibitor perindopril or a combination of perindopril and a diuretic (most frequently a low dose of hydrochlorothiazide) in 503 patients with mild to moderate essential hypertension. Czech and Slovak general practitioners participated in the study.

Passive smoking impairs endothelium-dependent relaxation of isolated rabbit arteries.

The aim of the present study was to examine the effect of prolonged passive smoking (lasting 3 weeks) on plasma catecholamine levels and reactivity of isolated rabbit arteries. Plasma noradrenaline, adrenaline and dopamine levels were determined radioenzymatically. Isolated rings of the thoracic aorta and carotid artery were suspended in organ chambers and connected to a force transducer for the recording of isometric tension.

Regression of left ventricular hypertrophy in hypertensive patients after 1 year of treatment with rilmenidine: a double-blind, randomized, controlled (versus nifedipine) study.

Objective: To assess the effect of 1-year treatment with rilmenidine, an oxazoline compound that exerts its antihypertensive effects through binding to imidazoline receptors in the brainstem, on left ventricular hypertrophy (LVH) secondary to essential, mild-to-moderate hypertension [supine diastolic blood pressure (DBP)95-115 mmHg].

Methods: We performed a double-blind, randomized, controlled (versus slow-release nifedipine) trial. Adjustment of treatment took place every month (M) between inclusion (MO) and an evaluation after 6 months (M6), then during M9 and after 1 year (M12) to achieve supine DBP values < or = 90 mmHg.

A 5-year follow-up of preventive approach to patients with essential hypertension.

We examined the effect of a 4-5 week spa programme consisting of hypertension control education, physical education and smoking cessation on a long-term risk factor control. Two hundred and twenty hypertensive males underwent a 1 month training programme. At the end of the month, improvement had occurred in blood pressure (BP), heart rate (HR) exercise capacity, degree of obesity and serum cholesterol and triglycerides.

Regression of left ventricular hypertrophy in patients with essential hypertension. Results of 6 month treatment with indapamide.

Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular morbidity in hypertensive patients. The effects of diuretics on LVH have raised controversies, but recent studies suggest that diuretics are able to reduce LVH in hypertensive patients, mainly through a reduction in ventricular diameter. The present multicenter open study was designed to test the effects of indapamide, a widely used nonthiazide diuretic, on LVH in patients with essential hypertension.

[Therapeutic approach in patients in hypertensive crisis].

The clinical picture of a hypertensive crisis is not determined only by the blood pressure reading but mainly by the associated symptoms of acute organ damage: neurological, cardiovascular and renal symptoms. The approach to the patient depends on the fact whether an emergency or urgent condition is involved. The authors review at first general principles of treatment of hypertensive crises.

[Treatment of hypertension with a fixed combination of bopindolol and chlorthalidone (Sandoretic)].

A multicentric, prospective, 16-week open study evaluated the effectivity and tolerance of the fixed combination of the beta-blocking agent bopindolol with the diuretic chlorthalidone--Sandoretic in 81 patients with mild to moderate hypertension. The combination of these two drugs is appropriate, since both drugs have long-term effects. Sandoretic induced a decrease of the mean sitting initial systolic blood pressure of 162.

[Detection of patients with pheochromocytoma using a cybernetic analysis method of the signs and symptoms of the disease].

The diagnosis of pheochromocytoma is established more frequently in recent years due to better diagnostic possibilities. The aim of this study was to determine whether it is possible to distinguish the diagnosis of pheochromocytoma from mild, moderate and severe hypertension by analysis of symptoms and signs of pheochromocytoma using mathematical methods such as the pattern recognizing procedure before investigation of catecholamines in serum and urine. We retrospectively analysed the presence or absence of 45 symptoms and signs of pheochromocytoma except for investigation of catecholamines in 20 randomly selected patients with mild hypertension (HT), 20 patients with moderate HT, 20 patients with severe HT, and 20 patients with known pheochromocytoma.

Tumours of the adrenal cortex.

The authors report their experience of 34 benign and 17 malignant tumours of the adrenal cortex. Both occurred more frequently in women (79.4% of cortical adenomas and 70.

[Problems posed by asymptomatic pheochromocytoma and malignant tumors of the adrenal medulla].

The authors analyse a group of 38 patients with a diagnosis of pheochromocytoma, in particular the topics of atypical symptomatology and malignancy. Three patients did not suffer from any subjective symptoms or other signs of pheochromocytoma ("incidentalomas"). Another three patients, although having giant tumours, only complained of atypical symptoms.