Atrial natriuretic peptide and 24 h blood pressure.

BACKGROUND: Atrial natriuretic peptide (ANP) is a hormone involved in the cardiovascular modulation of blood pressure and volume homeostasis. OBJECTIVE: To compare ANP levels in normotensives and hypertensives and to correlate ANP levels with ambulatory blood pressure parameters. METHODS: Plasma samples for ANP determination (using a double-antibody radioimmunoassay Kit) were obtained from 33 consecutive subjects (24 hypertensives, nine normotensives) who had rested supine for 30 min.

Ambulatory blood pressure, nocturnal blood pressure reduction and plasma catecholamines.

Objective And Design: Controversial data have been reported on plasma catecholamines in hypertensives. Aims of this study were to find whether 24-hour ambulatory blood pressure was correlated with circulating catecholamines and to investigate whether nocturnal blood pressure reduction was associated with baseline plasma catecholamines. Samples for catecholamine determination were obtained in 34 consecutive male subjects after a 30-minute rest and before ambulatory blood pressure monitoring.

Endogenous beta-endorphins in hypertension: correlation with 24-hour ambulatory blood pressure.

Objectives: The aims of this study were to determine whether hypertensive patients showed increased endogenous opioid tone and to find a possible correlation between beta-endorphin levels and 24-h ambulatory blood pressure. We also investigated whether circulating beta-endorphin levels were associated with pain perception at rest.

Background: Experimental studies suggest an involvement of the endogenous opioid system in cardiovascular control mechanisms.

Hyperinsulinemia, family history of hypertension, and essential hypertension.

The aim of this study was the evaluation of the relationships among hyperinsulinemia, a family history of hypertension, and essential hypertension. Insulin and C-peptide responses to an oral glucose load were studied in 175 lean normotensives (N) and untreated hypertensives (H) with (F+) and without (F-) a family history of hypertension: 30 NF-, 30 NF+, 45 HF-, and 70 HF+. The groups were comparable for age, sex, body mass index, and blood pressure.

Effect of sublingual nifedipine on left ventricular diastolic dysfunction in hypertensives: echo-Doppler study at rest and during handgrip.

Using digitized M-mode echocardiography, we evaluated the acute effect of nifedipine on left ventricular (LV) diastolic dysfunction in 30 untreated hypertensives, evaluated at rest and during handgrip, both before and 30' after nifedipine (20 mg sublingually). At rest, after nifedipine blood pressure and end-systolic wall stress significantly decreased and peak lengthening rate of LV diameter, peak thinning rate of LV posterior wall and Doppler E/A ratio increased. Before and after nifedipine handgrip induced significant increases of blood pressure, heart rate and end-systolic wall stress; diastolic parameters significantly decreased during basal handgrip and did not change during handgrip after nifedipine.

Effects of arithmetic mental stress test on hypertension-related hypalgesia.

Aim: Though hypertension-related hypalgesia has been described, little is known about possible variation of pain perception after mental stress. The aims of the present study were to determine (1) whether mental stress can influence pain perception in normotensive and hypertensive subjects and (2) whether blood pressure levels before pain evaluation can account for changes in pain sensitivity.

Patients And Methods: A pulpar test (graded increase in test current of 0-0.

Ambulatory blood pressure and left ventricular changes during antihypertensive treatment: perindopril versus isradipine.

Using digitized M-mode echocardiograms and 24-h ambulatory blood pressure (BP) monitoring, we compared the effects on left ventricle (LV) and BP of 6-month treatment with a calcium antagonist or an angiotensin-converting enzyme (ACE) inhibitor in 36 hypertensive patients with LV hypertrophy (group 1, 18 subjects treated with sustained-release isradipine; group 2, 18 subjects treated with perindopril). At the basal evaluation, the two groups had comparable BP and LV parameters. After treatment, both groups showed a similar and significant reduction in 24-h, day- and night-systolic and diastolic BP (SBP, DBP).

Twenty-four-hour noninvasive blood pressure monitoring and pain perception.

Although a hypertension-related hypalgesia has been described, the relation between pain perception and the 24-hour blood pressure trend is still unknown. The ambulatory blood pressure monitoring parameters and dental pain sensitivity were correlated in 67 male subjects. The pulpar test (graded increase of test current of 0 to 0.

Left ventricular anatomy and function in normotensive young adults with hypertensive parents. Study at rest and during handgrip.

Using digitized M-mode echocardiograms, we evaluated left ventricular (LV) anatomy and function at rest and during handgrip in 24 normotensive young adults with both parents hypertensive (HP+), each matched for age, sex, body weight, and body surface area with one normotensive adult with both parents normotensive (HP-). LV parameters were within the normal range in all HP+ and HP-. At rest, HP+ as compared to HP- had higher systolic and diastolic blood pressure (BP), septal and posterior wall thickness, and LV mass; LV diastolic diameter and end-systolic wall stress were similar in the two groups.

One-year antihypertensive treatment with amlodipine: effects on 24-hour blood pressure and left ventricular anatomy and function.

Using digitized M-mode echocardiograms and 24-hour noninvasive ambulatory blood pressure monitoring, we evaluated the effects of 1 year treatment with amlodipine on left ventricular morphology and function in 10 hypertensives with left ventricular hypertrophy. Echocardiograms and 24-hour blood pressure monitoring were performed after 3 weeks of wash-out and after 1 year of oral treatment with amlodipine (5 mg once daily). The therapy significantly lowered blood pressure, without changes in heart rate.

Effects of sustained-release isradipine on left ventricular anatomy and function in systemic hypertension.

With use of digitized M-mode echocardiograms and 24-hour noninvasive ambulatory blood pressure (BP) monitoring, the effects of chronic treatment with sustained-release isradipine on left ventricular (LV) morphology and function in hypertensive patients were evaluated. We selected 12 patients with LV hypertrophy and normal LV diastolic diameter. Echocardiograms and 24-hour BP monitoring were performed after 2 weeks of placebo and after 6 months of oral treatment with sustained-release isradipine (5 mg once daily).

Determinants of left ventricular function before and after regression of myocardial hypertrophy in hypertension.

Using digitized M-mode echocardiograms, we evaluated the determinants of left ventricular (LV) systolic and diastolic function in 30 hypertensives with LV hypertrophy (LV mass > 230 g and normal LV diastolic diameter), before (LV mass 319 +/- 26 g) and after normalization of LV mass (196 +/- 21 g) by antihypertensive treatment with angiotensin converting enzyme inhibitors. As a control group we selected 50 normal subjects. Using multiple regression analysis we studied the relative role of preload (LV end-diastolic diameter), afterload (end-systolic wall stress), inotropic state (systolic pressure/end-systolic LV diameter ratio), and LV mass on LV systolic (peak shortening rate of LV diameter) and diastolic function (peak lengthening rate of LV diameter).

Left ventricular function after reversal of myocardial hypertrophy in systemic hypertension, and response to acute increase of afterload by cold pressor test.

Using digitized M-mode echocardiography, the left ventricular (LV) response to acute increase in blood pressure after regression of myocardial hypertrophy due to an effective antihypertensive treatment was evaluated. Fifteen hypertensive patients with basal LV hypertrophy (LV mass greater than 230 g, and normal LV diastolic diameter) and normal LV mass after 3 to 4 months of treatment with angiotensin-converting enzyme inhibitors were selected for study. Subjects performed a cold pressor test before and after therapy.

Noninvasive assessment of the relationship between cardiac and autonomic function in diabetes.

In order to assess a possible relationship between left ventricular (LV) function and cardiac autonomic involvement in type-1 insulin dependent diabetes, we performed M-mode echocardiograms and autonomic function tests in 21 patients (mean age +/- SD, 38 +/- 11 years, range 18-55, 16 male and 5 female). In 7 patients and in 21 age-matched controls the echocardiogram was also recorded before and during handgrip. At rest, ventricular function abnormalities were found only in 4 subjects, and no significant correlation was found between echocardiographic parameters and autonomic function tests.

Influence of age and sex on left ventricular anatomy and function in normals.

Using digitized M-mode echograms, we evaluated the influence of sex on age-related changes of left ventricular (LV) anatomy and function in a normal population (75 males and 75 females, subdivided in age groups for each decade from 20 to 70 years). Aging is accompanied with an increase in septal and wall thickness in both males and females and in LV diameter only in males, with a progressive increase of LV mass more pronounced in males than in females. As regards LV function we found a progressive slowing of relaxation in females and of both contraction and relaxation in males, not related to changes in LV mass.

Double-blind comparison of perindopril and captopril in hypertension. Effects on left ventricular morphology and function.

Using digitized M-mode echocardiograms, we compared, in a double-blind study, the effects of 4 to 8 mg perindopril given once daily and 25 to 50 mg captopril given twice daily on the left ventricle (LV) in 20 hypertensive patients. Both treatments significantly (P less than .001) lowered blood pressure, reducing systemic vascular resistances.

Measuring left ventricular dimensions by conductance catheter in the rabbit.

A miniaturized (3.5 F), six-electrode conductance catheter was tested in 18 anaesthetized adult rabbits (weight 3.8-4.

[Factors influencing left ventricular function in arterial hypertension].

Using digitized M-mode echograms we evaluated the role of preload, afterload, inotropic state and left ventricular (LV) mass on LV systolic and diastolic function in 2 groups of hypertensive patients: Group 1: 25 subjects (18 men, mean age 48 +/- 6 years) with normal LV mass (less than 230 g); Group 2: 25 subjects (20 men, mean age 50 +/- 8 years) with LV hypertrophy (wall hypertrophy with normal LV diameter). As control group, we evaluated 50 normal subjects, matched for age, sex and body surface area with hypertensives. LV mass was significantly (p less than 0.

Optic nerve head drusen: histopathological considerations--clinical features.

The histopathological features made on 18 autopsies have proved that the optic nerve head drusen are calcified formations situated within the margins of the optic nerve head. It has been supposed that not only an aberrant axoplasmic transport, but also the presence of local factors, partly depending on the Bruch's membrane, can play a determining role in the pathogenesis of the optic disc drusen. A spongiotic edema gives us the histopathological equivalent of the clinical aspect of the optic disc with indistinct margins and lack of the central cup and furthermore gives us an explanation about the perimetric alterations pathogenesis.

Effect of enalapril on left ventricular mass and performance in essential hypertension.

The effect of enalapril on left ventricular (LV) morphology and function was studied in 12 hypertensive patients. The subjects were evaluated after 2 weeks of placebo and after 4 months of treatment with enalapril (20 or 40 mg once daily), using M-mode digitized echocardiograms. The drug reduced arterial blood pressure in all patients.

[Functional anatomy of the left ventricle in hypertensive subjects. Correlations with the clinical severity of hypertension].

Using computerized M-mode echocardiography we have investigated 58 hypertensive subjects in order to assess whether a correlation could be demonstrated between left ventricular changes induced by hypertension and age of the patients, the duration and severity of hypertension, and damage to other target organs. Various morphological changes of the left ventricle were detected: 14 patients (24%) had concentric hypertrophy of the left ventricle, 12 (20%) had asymmetric septal hypertrophy, 5 (8%) had dilated left ventricle without hypertrophy. Left ventricular mass was increased, when compared to normal controls in 24 patients (41%).

Improved left ventricular function after short-term treatment with fructose-1,6-diphosphate: echocardiographic study in chronic ischemic heart disease and idiopathic dilated cardiomyopathy.

The effect of fructose-1,6-diphosphate (FDP) on left ventricular function was assessed in seven patients with chronic ischemic heart disease and eight patients with idiopathic dilated cardiomyopathy. In a crossover study design each patient received 10 gm of FDP or saline placebo intravenously for three days. An M-mode echocardiographic assessment of left ventricular (LV) function was made before and after each treatment period.