Revelations about carotid body function through its pathological role in resistant hypertension.

Much recent attention has been given to the carotid body because of its potential role in cardiovascular disease states. One disease, neurogenic hypertension, characterised by excessive sympathetic activity, appears dependent on carotid body activity that may or may not be accompanied by sleep-disordered breathing. Herein, we review recent literature suggesting that the carotid body acquires tonicity in hypertension.

Updated ESH position paper on interventional therapy of resistant hypertension.

Out of the overall hypertensive population it is estimated that approximately 10% have treatment resistant hypertension (TRH). Percutaneous catheter-based transluminal renal ablation (renal denervation [RDN] by delivery of radiofrequency energy) has emerged as a new approach to achieve sustained blood pressure reduction in patients with TRH. This innovative interventional technique is now available across Europe for severe TRH for those patients in whom pharmacologic strategies and lifestyle changes have failed to control blood pressure below target (usually <140/90 mmHg).

Heart rate variability and functional outcome in ischemic stroke: a multiparameter approach.

Background And Purpose: Heart rate variability (HRV) as a measure of autonomic function might provide prognostic information in ischemic stroke. However, numerous difficulties are associated with HRV parameters assessment and interpretation, especially in short-term ECG recordings. For better understanding of derived HRV data and to avoid methodological bias we simultaneously recorded and analyzed heart rate, blood pressure and respiratory rate.

Early vascular ageing in translation: from laboratory investigations to clinical applications in cardiovascular prevention.

The ageing of the vascular tree is a fundamental reflection of biological ageing in general and a determinant of organ function. In the arterial wall this is characterized by a reduction in the elastin content, as well as by an increased content of collagen and its cross-linkages, leading to increased arterial stiffness and elevated central as well as brachial blood pressure, accompanied by increased SBP variability. In recent years a better understanding of these processes have led to the proposal of a condition named early vascular ageing (EVA) in patients with increased arterial stiffness for their age and sex.

Impact of obesity on cardiovascular health.

This review examines the impact of obesity on cardiovascular health. We will review first, relationship between obesity and hypertension. Second, we will describe obesity-related subclinical abnormalities in cardiovascular function and structure.

Clinical characteristics of patients with resistant hypertension: the RESIST-POL study.

Recent studies indicate that resistant hypertension (RHTN) is present in about 12% of the treated hypertensive population. However, patients with true RHTN (confirmed out of the office) have not been widely studied. We prospectively studied 204 patients (123 male, 81 female, mean age 48.

Relationship between heart rate variability, blood pressure and arterial wall properties during air and oxygen breathing in healthy subjects.

Previous studies reported that normobaric hyperoxia influences heart rate, arterial pressure, cardiac output and systemic vascular resistance, but the mechanisms underlying these changes are still not fully understood. Several factors are considered including degeneration of endothelium-derived nitric oxide by reactive oxygen species, the impact of oxygen-free radicals on tissues and alterations of autonomic nervous system function. Recently, new devices for the detailed non-invasive assessment of large and small arteries have been developed.

Smoking and obesity associated BDNF gene variance predicts total and cardiovascular mortality in smokers.

Objective: The brain derived neurotrophic factor (BDNF) locus has been implicated in psychiatric and substance related disorders. Recent genome-wide association studies (GWAS) have shown strong associations between single nucleotide polymorphisms in BDNF, smoking behaviour and high body mass index (BMI). Our aim was to test whether genetic BDNF variation alters the risk of smoking related morbidity and mortality.

The effects of statins on blood pressure in normotensive or hypertensive subjects--a meta-analysis of randomized controlled trials.

Objective: The aim of this meta-analysis was to investigate whether statin therapy is associated with blood pressure (BP)-lowering in patients with or without hypertension.

Background: The beneficial effects of statins on the cardiovascular system may in part be related to effects beyond lipid-lowering. It has been suggested that statins may reduce BP; however the available data are still ambiguous and often conflicting.

Recommendations for the management of patients with obstructive sleep apnoea and hypertension.

This article is aimed at addressing the current state-of-the-art in epidemiology, pathophysiology, diagnostic procedures and treatment options for appropriate management of obstructive sleep apnoea (OSA) in cardiovascular (in particular hypertensive) patients, as well as for the management of cardiovascular diseases (in particular arterial hypertension) in OSA patients. The present document is the result of work performed by a panel of experts participating in the European Union COST (Cooperation in Scientific and Technological research) Action B26 on OSA, with the endorsement of the European Respiratory Society and the European Society of Hypertension. In particular, these recommendations are aimed at reminding cardiovascular experts to consider the occurrence of sleep-related breathing disorders in patients with high blood pressure.

Effects of acute and long-term slow breathing exercise on muscle sympathetic nerve activity in untreated male patients with hypertension.

Objective: Acute slow breathing (SLOWB) affects sympathetic cardiovascular regulation, but its long-term effects are unknown. Using device-guided breathing we explored short-term and long-term SLOWB effects on blood pressure (BP), heart rate (HR) and muscle sympathetic nerve activity (MSNA) in essential hypertension.

Methods: We measured BP, HR and MSNA in 10 hypertensive individuals at rest, during laboratory stressors, before and after acute SLOWB, and 8 weeks after SLOWB exercise.

High-normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests.

Objective: High-normal blood pressure (BP) increases the risk of cardiovascular (CV) disease. The mechanisms underlying this increased risk are not clear. Sympathetic activation appears to be a potential mechanism linking high-normal BP to CV disease.

Pulse wave velocity is associated with early clinical outcome after ischemic stroke.

Background And Purposes: Pulse wave analysis (PWV), a marker of aortic stiffness, has independent predictive value for cardiovascular morbidity and mortality in both healthy and high-risk populations, especially fatal stroke, and for long-term functional stroke prognosis. Whether arterial stiffness and wave reflection are related to stroke in-hospital short-term outcome has never been demonstrated.

Methods: In a prospective study, we enrolled 134 patients with acute ischemic stroke, aged 63.

Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial.

Background: numerous reports have linked impaired kidney function to a higher risk of cardiovascular events and mortality. There are relatively few data relating to kidney function in the very elderly.

Methods: the Hypertension in the Very Elderly Trial (HYVET) was a randomised placebo-controlled trial of indapamide slow release 1.

ESH position paper: renal denervation - an interventional therapy of resistant hypertension.

Experts from the European Society of Hypertension prepared this position paper in order to summarize current evidence, unmet needs and practical recommendations on the application of percutaneous transluminal ablation of renal nerves [renal denervation (RDN)] as a novel therapeutic strategy for the treatment of resistant hypertension. The sympathetic nervous activation to the kidney and the sensory afferent signals to the central nervous system represent the targets of RND. Clinical studies have documented that catheter-based RDN decreases both efferent sympathetic and afferent sensory nerve traffic leading to clinically meaningful systolic and diastolic blood pressure (BP) reductions in patients with resistant hypertension.

Prevalence of left ventricular diastolic dysfunction in European populations based on cross-validated diagnostic thresholds.

Background: Different diagnostic criteria limit comparisons between populations in the prevalence of diastolic left ventricular (LV) dysfunction. We aimed to compare across populations age-specific echocardiographic criteria for diastolic LV dysfunction as well as their correlates and prevalence.

Methods: We measured the E and A peaks of transmitral blood flow by pulsed wave Doppler and the e' and a' peaks of mitral annular velocities by tissue Doppler imaging (TDI) in 2 cohorts randomly recruited in Belgium (n = 782; 51.