Vitamin D levels in white coat and sustained hypertension.

OBJECTIVE: The plasma levels of vitamin D in patients with white coat hypertension (WCHT) have not been studied previously. The aim of this study was to evaluate vitamin D levels in WCHT and compare with sustained hypertension (SHT) and with normotension (NT). PATIENTS AND METHODS: Fifty-three normotensive, 42 WCHT, and 59 SHT patients were recruited in this study. The participants were matched for age, sex, and BMI. The vitamin D levels were determined using the electrochemiluminescence immunoassay method. RESULTS: Plasma vitamin D levels were significantly lower in SHT than in the WCHT and NT groups (26.4±4.9, 34.3±3.6, and 36±5 ng/ml, respectively), and were similar in the WCHT and NT groups. There was a negative correlation between vitamin D levels and blood pressure parameters such as clinic systolic blood pressure (SBP), clinic diastolic blood pressure (DBP), 24-h SBP, 24-h DBP, daytime SBP, daytime DBP, night-time SBP, and night-time DBP (r=-0.554, -0.419, -0.629, -0.427, -0.559, -0.534, -0.607, -0.462, respectively, and all P<0.001) in the entire study group. Clinic SBP (B±SE=-0.97±0.037, P=0.009) and 24-h SBP (B±SE=-0.138±0.055, P=0.013) were identified as predictors for vitamin D levels in the entire study group. CONCLUSION: Our data show that sustained hypertensive patients have lower vitamin D levels than white coat hypertensive and normotensive individuals. White coat hypertensive patients without other cardiovascular risk factors have higher vitamin D levels than sustained hypertensive patients, suggesting that they have a lower cardiovascular risk.

Serum neurokinin B levels in newly diagnosed nondipper hypertensive patients.

OBJECTIVE: Cardiovascular diseases are more common in patients with nondipper hypertension (NDHT) compared with those with dipper hypertension (DHT). The aim of this study is to evaluate the serum neurokinin B levels in DHT and NDHT patients. METHODS: The study population included newly diagnosed hypertensive patients who were not under antihypertensive treatment. A total of 77 patients were evaluated with ambulatory blood pressure monitoring and divided into two groups: NDHT (n=42) and DHT (n=35). Plasma neurokinin B levels were measured using the ELISA method. RESULTS: Serum neurokinin B levels were significantly higher in the NDHT group compared with the DHT group [254 (180-888) and 207 (116-752) pg/ml, respectively; P=0.024]. There is a positive correlation between the mean night-time systolic blood pressure and plasma neurokinin levels (r=0.590; P<0.001). On regression analysis, neurokinin B level was only found to be related to the mean night-time systolic blood pressure (unstandardized ß=-22.02±9.59; P<0.001). CONCLUSION: Plasma neurokinin B level is higher in patients with NDHT, indicating an unfavorable cardiovascular prognosis. There is a need for further studies that search for the relation between serum neurokinin B levels and NDHT.

The spectrum of rheumatic heart disease in the southeastern Anatolia endemic region: results from 1900 patients.

BACKGROUND AND AIM OF THE STUDY: Rheumatic heart disease (RHD) continues to affect mainly young adults, and accounts for a major proportion of all cardiovascular diseases in the Southeastern Anatolia region, where the disease is still endemic. The study aim was to determine the echocardiographic profile of RHD in this region, from which no recent data are available. METHODS: In this retrospective study, transthoracic echocardiographic data acquired between June 2003 and January 2008 were reviewed. Information was gathered from the database of the authors' echocardiography laboratory, which included age, gender, clinical diagnosis and echocardiographic findings. In patients with more than one echocardiographic record, only the first echocardiographic data were included in the study. RESULTS: A first admission with full echocardiographic data of RHD was found in 1,900 cases among 43,900 subjects screened (4.3%). Of the 1,900 subjects, 537 (28%) were male (mean age: 39.7 +/- 15.7 years) and 1,363 (72%) were female (mean age: 41.3 +/- 13.7 years). There was no gender difference between mixed valvular lesions. Severe mitral stenosis (MS) was identified in 144 subjects. Males were affected more severely than females, provided that adjustments were made according to valve area < or =1 cm2 or >1 cm2. A total of 594 subjects had MS with a valve area < or =1.5 cm2. Severe aortic regurgitation (AR) (grade > or =3) was more common in males than in females. The echocardiographic scores showed 525 subjects (28%) to have mild, 1083 (57%) to have moderate, and 292 (15%) to have severe AR. Among a total of 1163 patients with MS, 385 (33%) had > or =0.5 cm nodular calcification on their valves. CONCLUSION: Currently, RHD remains an alarming and unresolved health problem in the Southeastern Anatolia region. While almost 75% of affected subjects were female, males were more severely affected. In addition, subjects were relatively old, and most were affected by mixed valvular disease of an advanced stage.