[Control of blood pressure morning surge in a lebanese hypertensive population]

The primary endpoint of this prospective clinical study is to ascertain the degree of blood pressure control in the early-morning hours after 8 weeks of treatment with telmisartan in hypertensive patients using home blood pressure measurements. Two hundred forty Lebanese patients with uncontrolled hypertension are enrolled in the study. The blood pressure is measured at the initial visit, then at week 4 of follow-up [optional visit] and after the 8 weeks period, by the physician at his office [with pulse rate] and by the patient at home in the morning. The blood pressure measured by the patient at home in the morning has a mean value of 129.7/79.1 mmhg, significantly less than 135/85 mmhg [P< 10[-5]], and it is reduced by 31.9/13.5 mmhg [P< 10[-5]]. At the physician's office, the reduction is 34.8/16 mmhg [P< 10[-5]. Heart rate is decreased by 4.7 +/- 0.5 bpm [P< 10[-5]. The drug was well tolerated. This study has demonstrated that Telmisartan, by his long half-life, protects the patients against the early-morning hours blood pressure surge, period during which coronary and cerebral events are the most frequent

[Balloon dilation of critical neonatal aortic stenosis: Early and midterm results]

We evaluated our immediate and midterm results of balloon dilation of critical valvular aortic stenosis in 15 consecutive neonates. Balloon dilation was attempted in 15 neonates at a mean age of 14 days. Three patients [20%] had associated left heart hypoplasia. Balloon dilation could be performed in 14 out of the 15 neonates [93.3%]. The average immediate maximal gradient reduction was 80 +/- 26%. The immediate mortality rate was nil, but 7 deaths [46%] occurred afterwards all not related to the dilation. Moderate to severe aortic regurgitation was noted in 7/14 [50%] of the dilated neonates but none has necessitated reintervention. At a mean follow-up of 11.5 months, survival and freedom of reintervention rates were respectively 40% and 50%. At last follow-up, 87.5% of the survivors were asymptomatic. This study confirms that dilation of aortic stenosis in neonates is effective, with encouraging immediate success but still disappointing short and midterm results