Racial differences in left ventricular mass among hypertensive Egyptians: results from the Egyptian national hypertension project [NHP]

In this study, LV measurements were obtained from the records of 103 black [B] and 1108 non-black [NB] hypertensive [SBP >/140 and/or DBP >/90 mmHg] Egyptians who received no treatment and were age and gender matched. In B cases, the mean age was 56 years, 39% of them were males. In NB cases, age was 54 years, 43.4% were males. Left ventricular mass [LVM] was corrected for body surface area [BSA] and LVM index [LVMI]. The results of echocardiographic survey study of hypertensive Egyptians revealed that black hypertensive Egyptians have similar or even less LVMI as compared with NB in spite of the higher levels of SBP and urinary NA excretion. Data did not support the notion that black race is at especially higher risk of developing LVH

Future of research in hypertension in developing countries

Major changes in the health profile of many developing countries are taking place. Life expectancy in these countries is increasing, and people are more exposed to diseases of old age like hypertension and cardiovascular diseases. Scientific research in the developing world including this area-is lagging behind. However, high-quality research can still be carried out in spite of the limited resources. This paper identifies the different material and psychological barriers to scientific research. Epidemiological and clinical research represent high priorities in hypertension research in developing countries, and international cooperation is essential to improve the understanding of hypertension

Effect of acute volume loading on diastolic function in hypertrophic cardiomyopathy

To evaluate left ventricular [LV] diastolic function in hypertrophic cardiomyopathy [HCM], we studied pulsed Doppler parameters, isovolumic relaxation time index [IVRT interval from minimum LV dimension to mitral valve opening] and LV end-diastolic volume and mass [using the area-length method and apical 4-chamber 2D-echocardiography]. Doppler indices included: E/A ratio, deceleration [Dec] and peak filling rate [PFR]. Measurements [mean +/- SE] were obtained in 16 patients with HCM, age 47 +/- 3y, and 8 normal subjects [46 +/- 3y, p NS] at rest and after a rapid IV infusion of IL saline. IVRT [msec] was significantly longer in HCM 58 = 6 compared to normal 40 +/- 6, P. However, resting Doppler measurements were not significantly different in HCM and normal groups, respectively E/A 0.9 +/- 0.07 vs 1.2 +/- 0.16 Dec 284 +/- 31 vs 330 +/- 50 cm/sec2, PER 449 +/- 72 vs 366 +/- 46 ml/sec. We divided the patients into 2 groups: HCM-A, n = 6, type III [Maron et al. classification] hypertrophy involving 2 segments of LV by 2D-echocardiography; HCM-B, n = 10, types I, II or apical hypertrophy involving

Improvement of left ventricular filling after short term captopril therapy in hypertensive patients

Left ventricular [LV] filling abnormalities were reported in hypertensives. To study the effect of treatment on these abnormalities we studied 12 untreated pts before [b] and after [a] short-term captopril therapy using echo-Doppler techniques. Results were compared to an age matched control group [c] of 10 individuals and are summarized in the following table: -HR [B/M]; 79 [5]; 77 [5]; 79 [5] - SBP MMHG; 126[10]; 157 [15]; 136 [10] - DBP [MMHG]; 83 [5]; 108 [12]; 83 [4] - MBP [MMHG]; 97 [6]; 125 [9]; 97 [6] - A/R RATIO; .59 [.11]; 1.1 [.21]; .59 [.11] - ACC CM-SEC2; 740 [160]; 562 [181]; 740 [161] - DEC CM-SEC2; 506 [121]; 309 [103]; 506 [121] - PFR M/SEC; 530 [134]; 437 [150]; 531 [134] - LVM GM; 205 [40]; 249 [64]; 205 [40]. R: early peak velocity. A.' late peak velocity, [A CC and DCC] acceleration and deceleration of early velocity wave, PFR: peak early filling rate computed as RX mitral annulus diameter. LVM = LV mass. Compared to CB showed a higher blood pressure, and LVM. [P < 01]. LV filling showed a higher A/R and a lower ACC and /DCC [p < 01]. After therapy there was improvement in A/R ratio and a drop in blood pressure. Other parameters did not change significantly. Drop in A/R ratio showed a correlation to the drop in DBP [6 = 0.55]. We conclude that captopril short term therapy has a potential for improving LV filling in hypertensive patients and that this improvement is related to the drop in DBP

Doppler pressure half-time and catheter pressure gradient half-time in the calculation of mitral valve area

The use of Doppler derived measurements in the assessment of mitral stenosis [MS.] was evaluated in 45 patients [pts] with rheumatic heart disease and the data were compared with that obtained by cardiac catheterization and direct measurement of the valve orifice area [MVA] at surgery. Results showed that Doppler derived measurements of MVA by pressure half-time method were of particular value in 24 pts in whom technically adequate cross-sectional images and MVA measurements were difficult to obtain.Eighteen of these cases [40%] had heavily calcified and disorganized valves and six pts [13%] had a poor acoustic window. The Doppler data were more accurate than standard two-dimensional measurements in 30 pts.[66%] with atrial fibrillation. The comparison with Gorlin's formula for catheter-derived MVA was poor, especially in the presence of mitral regurgitation or irregular rhythm. Excellent comparisons were obtained with a catheter-derived pressure half-time and surgical assessment of MVA. Thus, The Doppler examination proved to be an invaluable adjunct to a complete assessment of MVA and replaces the need for haemodynamic assessment in most pts with MS

Angiotensin infusion test in normo-and hypertensive subjects

The reactivity of vascular smooth muscles in thirty patients with both fixed essential and border line hypertension was studied and compared with fourteen normotensive control subjects. Angiotensin II infusion was given in a concentration of 1 mcg of 5% glucose at a rate of 0.01, then 0.02 mcg/kg/m with frequent recording of BP and heart rate

Tyramine test in normo and hypertensive subjects

The effect of sympathomimetic amine tyramine was studied in 19 patients with fixed essential and border line hypertension compared with 11 normotensive control subjects. After obtaining control measurements, tyramine solution was injected IV in doses of 1, 2 and 3 mg separated by at least nine-ten minutes