[Where is the border between normal and abnormal blood pressure and what is the therapeutic goal in cardiovascular and renal diseases?].

Összefoglaló. Az irodalmi adatok arra utalnak, hogy a systolés vérnyomás értékének emelkedése már 110-115 Hgmm-től együtt jár az atherosclerosissal összefüggő elváltozások kialakulásával is és ezzel együtt a cardiovascularis és a renalis funkció romlásával. Az összefüggés exponenciális, de mértékét az életkor jelentősen befolyásolja.

[The combined effect of regular alcohol consumption and smoking on blood pressure and on the achievement of blood pressure target values in treated hypertensive patients].

Introduction: The combined effect of alcohol consumption and smoking on hypertension in hypertensive patients is still not completely clear, although both are known to be cardiovascular risk factors.

Aim: The aim of our study was to compare the blood pressure, the achievement of target blood pressure and heart rate of non-smokers and non-drinkers in the middle-aged hypertensive patients with those who smoke and drink regularly.

Method: From the database of the Hungarian Hypertension Registry, 12 615 patients (6341 men and 6274 women) aged 45-64 years were included in the current analysis, who self-reported smoking habit and alcohol consumption.

[The prevalence of smoking and gender differences according to the data of the national health screening program in 2010-2018].

The harmful effects represent an important public health problem in tha world. Our aim is to report and compare the results of screenings performed in Hungary's Comprehensive Health Screening Program 2010-2020-2030 (MÁESZ) with international data. During the 9-year continuous screening, we analyzed the data of 71 922 women and 60 934 men in the 18-80-year-old population and examined the occurrence of regular daily smokers.

[Measurement of blood pressure variability and the clinical value].

Authors have collected and analyzed literature data on blood pressure variability. They present the methods of blood pressure variability measurement, clinical value and relationships with target organ damages and risk of presence of cardiovascular events. They collect data about the prognostic value of blood pressure variability and the effects of different antihypertensive drugs on blood pressure variability.

[Hungarian Hypertension Registry].

Today, hypertension is considered endemic throughout the world. The number of individuals with high blood pressure and the increasing risk, morbidity and mortality caused by hypertension despite modern therapy do not decrease sufficiently. Hypertension has become a public health issue.

[Combined antihypertensive and antilipemic therapy as one of the pillars in the poly-pharmacologic preventive strategy for patients with high cardiovascular risk].

Hypertension is a highly prevalent disease and a strong risk factor for cardiovascular disease in industrialized countries in Europe and North America. About 40-50% of hypertensive patients have some other cardiovascular risk factors as smoking, dyslipidemia, glucose intolerance, metabolic syndrome and diabetes. The realization of optimal therapy of these patients is a difficult task, and reaching target blood pressure values is almost impossible by monotherapy.

[The real value of the transtelephonic ECG system in the clinical cardiological practice].

Authors demonstrate the basic concepts and the application possibilities of transtelephonic ECG system in the clinical cardiological practice. The basic element of the system is a hand-size transducer that is capable to send ECG signals--through any telephone network to the Analysing Center. The application of system is very successful in the acute coronary syndrome, angina pectoris, dangerous arrhythmias and for home controlling of cardiac patients.

Prevalence of metabolic syndrome estimated by International Diabetes Federation criteria in a Hungarian population.

Aims: In recent years, metabolic syndrome (MS) became a distinct pathological entity. MS is positively associated with cardiovascular mortality. The prevalence of MS is high and a continuing increase is expected.

[Diurnal changes in blood pressure and their consequences].

Author analyses the daily blood pressure and heart rate alterations due to circadian rhythm and their effects to development of dangerous clinical situations (sudden death, stroke, myocardial infarct, ischaemic episodes) in hypertension with or without ischemic heart disease. The most dangerous time-period is the morning hours, but serious problems are the sudden increases in blood pressure in any time of day as well. The daily changes in blood pressure (rise in blood pressure variability) are often associated with the alteration in heart rate (decrease in heart rate variability) and loss of dipp at night.

[Cardiovascular risk factors in essential hypertension].

Authors analysed the cardiovascular risk factors, their relationship to each other, the rate of multiple appearance in 1476 patients (774 men, 702 women) with essential hypertension. They produced a special questionnaire and risk factor analysing program for performing static and dynamic investigations on the base of international and domestic experiences. The data of their investigations verified, that the occurrence of obesity is very frequent and is associated with abnormal cholesterol and triglyceride values.

[Current status and possibilities of distant education in medicine].

Author analyses the concept and methods of distance education. The definition of distance education consist of geographic separation of the learner and the teacher, the high level of educational organisation, the use of modern technology for communication with interactivity. Before the widespread use of electronic communications for teaching and learning, the conventional method for distance education was the books and postal service.

[Captopril in the treatment of heart failure].

The author takes the characteristic hemodynamic features and neurohumoral factors associated with heart failure as the starting point for the discussion. He specifies fundamentals of the current strategies and goals of the management of heart failure. Treatment with vasodilatator and ACE inhibitors has paved novel way for treatment of heart failure, because it is not only able to alleviate the symptoms, but also to improve hemodynamic parameters and increase survival.

Testing the knowledge of postgraduate trainees in medicine: a multimedia software package.

1. TASK OF THE PROGRAM. The task of the program is to test the knowledge of applicants at the examination for specialists degrees.

Third generation electronic medical record knowledge based perspectives.

There is a need to develop better electronic medical records. One possible solution is to put more and more 'routine' medical knowledge into systems handling medical records. In this paper, we analyze the current state-of-the-art of knowledge-based medical record handling; we mainly consider the work of Rector et al.

[Antianginal effect of transdermal isosorbide dinitrate (multicenter study)].

Efficacy of transdermal isosorbid-dinitrate spray was investigated in 167 of 254 patients with stable angina pectoris. The transdermal application of isosorbid-dinitrate decreased successfully the number of anginal attacks and the sublingual nitroglycerin or isosorbid-dinitrate consumption. Very few side effects were observed and the patients well-being was good during treatment.

[Dual-chamber rate responsive cardiac pacing].

The authors describe in this report their first experience with the implantation of a rate responsive, dual chamber pacemaker. They emphasize the advantages of this type of pacemakers: the maintenance of AV-synchrony and the rate increase in response to exercise. Meanwhile they call attention on the complexity of the ECG interpretation.

Anti-anginal effect of Tenormin (atenolol).

The anti-anginal effect of Tenormin (atenolol) has been examined besides placebo control by single blind method in 20 patients with ischaemic heart disease, suffering from stable effort angina proved by coronarography. It has been observed that atenolol significantly decreases the weekly number of anginal attacks, and the amount of sublingual nitroglycerin consumption. It has been proved that atenolol successfully prevents the exercise-induced elevation of blood pressure and heart rate, increases exercise tolerance, decreases myocardial O2 consumption.

Comparative evaluation of the effect of balloon dilatation by exercise precordial mapping and exercise 201-thallium scintigraphy.

Precordial exercise electrocardiographic mapping and exercise 201-thallium scintigraphy were simultaneously used on sixteen patients before, shortly after and three months after percutaneous transluminal coronary angioplasty (PTCA) to evaluate the immediate and late results of the intervention. In spite of the limited number of observations, positive exercise precordial mapping and or a reversible 201-thallium perfusion defect after PTCA seem to be indicative of failure of balloon dilatation or of development of restenosis in a given coronary artery. "Reverse minimum", that is the minimum in the resting precordial map which disappears on exercise, may be a sign of segmental coronary artery occlusion and well functioning collateral supply.