Blood pressure and arterial stiffness in patients with high sodium intake in relation to sodium handling and left ventricular diastolic dysfunction status.

In a population with high sodium consumption, we assessed relation between brachial and central blood pressures, elastic properties of large arteries, echocardiographic left ventricular diastolic function and sodium reabsorption as fractional urinary lithium excretion in proximal (FELi) and fractional sodium reabsorption in distal tubules assessed using the endogenous lithium clearance. Mean±s.d. age of 131 treated hypertensive patients (66 men and 65 women) was 61.9±7.5 years. We found significant interaction between left ventricular diastolic function and FELi with respect to the values of brachial blood pressure: systolic (SBP), diastolic (DBP) and mean blood pressure (MBP) (all PINT<0.03). In patients with FELi below the median value and impaired left ventricular diastolic function, the values of SBP (149.3 vs 132.5 mm Hg; P=0.005), DBP (85.1 vs 76.1 mm Hg; P=0.001), MBP (106.5 vs 94.9 mm Hg; P=0.001), central SBP (SBPC) (137.4 vs 122.0 mm Hg; P=0.01), central DBP (DBPC) (84.8 vs 76.0 mm Hg; P=0.003), central MBP (MBPC) (106.9 vs 95.9 mm Hg; P=0.007), aortic pulse wave augmentation (18.0 vs 13.5 mm Hg; P=0.03), pulse wave velocity (14.6 vs 12.5 m s(-1); P=0.02) and central aortic pulse wave augmentation index (155.7% vs 140.9%; P=0.01) were significantly higher than in patients with normal left ventricular diastolic function. Such relationships were not observed in the entire group and patients with FELi above the median value. In the hypertensive population with high sodium intake, increased sodium reabsorption in proximal tubules may affect blood pressure parameters and arterial wall damage, thus contributing to the development of left ventricular diastolic function impairment.

[The comparison of clinical effectiveness of perindopril and acebutolol in the primary hypertension treatment]. / Porównanie skutecznosci klinicznej perindoprilu i acebutololu w leczeniu pierwotnego nadcisnienia tetniczego.

Hypertension is one of the most important risk factors for ischaemic heart disease and stroke. The aim of our study was to assess the antihypertensive effect of angiotensine converting enzyme inhibitor (perindopril) versus beta blocker (acebutolol) in hypertensive patients. It was a double blind, placebo controlled study performed in the group of 31 patients (16 males, 15 females; mean age 46.6 +/- 8.7 years) with newly diagnosed (previously not treated) mild to moderate hypertension. Each patient in the wash-out period (two weeks) was given placebo and then was randomized to active treatment: perindopril (4 mg/day) or acebutolol (400 mg/day) for 3 weeks, following these drugs were cross matched (after one week wash out period). Blood pressure (BP) with mercury sphygmomanometer was measured three times: after 2 weeks of placebo treatment, after 3 weeks of perindopril and 3 weeks of acebutolol treatment. Both perindopril and acebutolol proved to be effective in monotherapy of hypertension. After 3 weeks of the treatment we observed BP systolic and diastolic normalization, but more patients had systolic BP normalization after perindopril treatment.

[Clinical evaluation of nitrates in exercise-induced angina]. / Ocena skutecznosci klinicznej nitratów w indukowanej wysilkiem dusznicy bolesnej.

Nitroglycerine (NTG) is still the most important angina relief drug. The aim of the study was to evaluate clinical effects and tolerance of sublingually nitroglycerine sub form Nitromint-spray in patients with exercise induced angina pectoris (AP) using treadmill electrocardiography stress test (EST). The study group consisted of 40 adults patients (mean age 57.4 +/- 10.08 years) hospitalised in our clinic with AP confirmed by clinically and electrocardiographically positive EST. Tests were performed using treadmill Marquette-Centra equipment, according to the modified Bruce protocol after 3 days wash-out period. On the fourth day two ESTs were performed: EST-0 and 30 minutes later EST-NTG after sublingual administration 0.8 mg of NTG. Among measured parameters after NTG exercise induced ST segment depression decline from 2.3 +/- 1.0 to 1.5 +/- 0.8 (p < 0.0001). EST after NTG became electrocardiographically negative in 11 patients. NTG increased workload, and time to angina pain oneset (p < 0.0001). Nitromint-spray proved to be clinically effective, well tolerated and easy to use.