Blood pressure and heart rate relationship in normotensive and hypertensive subjects.

A twenty-four-hour blood pressure (BP) monitoring was performed in 20 normotensive and 20 hypertensive subjects, matched by sex and age. Blood pressure and heart rate (HR) variability were evaluated both as absolute and percent standard deviation. In agreement with the literature no significant difference in HR and BP variability was observed between the two groups. The linear regression between HR and BP values was evaluated in both groups. The authors observed a significant difference in the relationship between these two cardiovascular variables between the two groups. In the hypertensive group the cardiovascular control of HR and BP showed a different relationship than in normotensive subjects, suggesting a different neurovegetative modulation.

The tilting cardiovascular response in orthostatic syncope.

159 patients with a previous discharge diagnosis of recurrent vasodepressor syncope associated with prolonged standing or other circumstance known to trigger the condition were examined in order to isolate the orthostatic form. 72 patients with a history of at least two episodes of loss of consciousness after standing still for at least 10' were selected for testing by head-up tilt. Those who showed signs or symptoms during the test were tested a further twice, the third time after atropine administration. This process resulted in the diagnosis of orthostatic vasodepressor syncope in 28 patients who presented both 1) a positive test associated with hypotension and bradycardia and 2) bradycardia-free hypotention on repetition of the test with atropine.

Detection of normotension, borderline and hypertension cutoffs in a population evaluated by non invasive blood pressure monitoring.

The 24-hour blood pressure (BP) average value in normotensive and hypertensive subjects is not defined. In 329 subjects three occasional blood pressure data were measured. The same day a non invasive 24-hour blood pressure monitoring was performed. The average of the occasional blood pressure and the average of the 24-hour blood pressure data were compared. In many cases the occasional blood pressure average was not strictly linked with the 24-hour blood pressure average. A statistical procedure (K-Means Cluster Analysis) was performed separately on occasional blood pressure values and on the hourly blood pressure average of the whole day. By this method three clusters of subjects were selected to evaluate the occasional and the 24-hour blood pressure cluster's cutoffs. The cluster's blood pressure cutoffs evaluated on occasional blood pressure values were not dissimilar from the blood pressure values suggested by literature for normotensive, borderline and hypertensive groups. The K-Means Clusters Analysis seems an interesting statistical method to research the subsets in a population evaluated by 24-hour blood pressure monitoring. We suggest that the 24-hour BP cutoffs evaluated in the three cluster groups may be considered as indicative for a clinical diagnosis of normotensive, borderline and hypertensive state.

The Valsalva maneuver in vasodepressor syncope.

In this work the authors propose the Valsalva maneuver as a diagnostic test in a group of patients shown, by anamnestic, physical, and instrumental criteria, to be affected by vasodepressor syncope. They studied the response of heart rate and baseline arterial pressure to the maneuver performed in passive orthostasis in 7 healthy volunteers and 24 patients. These patients showed a hypotensive response and a time of recovery to the initial values that was significantly longer than in the control group (p less than 0.01). The authors conclude that studying the response to the Valsalva maneuver can be useful in the diagnosis of vasodepressor syncope.

Homogeneous luminescence immunoassay for total estrogens in urine.

We describe an homogeneous luminescence immunoassay for "total" estrogens in enzymically hydrolyzed urine from nonpregnant women. The antiserum, raised against estriol-16,17- dihemisuccinate conjugated to bovine serum albumin, specifically bound the C-19 steroids carrying the estrogen-characteristic phenolic group. 17 beta-Estradiol conjugated with aminobutylethyl isoluminol was used to monitor the immunological reaction; this conjugate was stable for at least two years. Because binding to the antiserum markedly enhances the light-producing efficiency of the tracer, no separation of bound and free antigen is necessary. Results (microgram/24 h) by this method (y) correlated well (r = 0.958) with those by a conventional fluorometric (x) method (y = 2. 51x - 2.83). The sensitivity (detection limit) is 4 micrograms/L and the precision compares well with that of commonly used RIA methods. The method appears suited to large numbers of samples, as in menstrual cycle monitoring.

Effects of pharmacological doses of testosterone and dihydrotestosterone on the hypothalamic-pituitary axis function of Klinefelter patients.

Six patients affected by Klinefelter's syndrome (KS) were treated with testosterone propionate (TP) 100 mg im daily for 4 days and one month later the same patients received dihydrotestosterone propionate (DHTP) 100 mg im daily for 4 days. Plasma levels of LH, FSH, PRL, testosterone (T) and dihydrotestosterone (DHT) have been measured in these patients for 8 days during and after TP and DHTP treatment. TP administration reduced LH levels only transiently, while a more prolonged reduction was observed for FSH. DHTP administration produced a late and transient reduction of LH and a very late reduction of FSH. PRL levels increased significantly during and after TP administration. Our data suggest that in Klinefelter patients: i) DHT is less effective than T in suppressing gonadotropin concentrations, ii) the increased PRL levels observed during and after TP administration are not due to a pure androgenic effect, but are probably related to an increased conversion rate of T to estradiol.

A solid phase chemiluminescent immunoassay (LIA) for testosterone glicuronide in diluted urines.

A chemiluminescent immunoassay (LIA) method in solid phase for the measurement of testosterone 17 beta-D-glicuronide (TG) in diluted urine is described, which utilizes as tracer a TG-isoluminol conjugate (TG-ABEI). An IgG fraction of antiserum of TG-BSA, has been passively adsorbed to the walls of polystyrene tubes. After the binding reaction the coated tubes were washed with buffer and the measure of chemiluminescence reaction was performed at high pH. The assay was validated in terms of specificity, accuracy, sensitivity and precision. The values obtained by chemiluminescence immunoassay were compared with that obtained by the RIA method, and the two methods agreed well (r = 0.95, n = 28). The assay method offers the advantage of speed and does not involve the use of radioisotopes or of a centrifugation step. Preliminary results show that the mean 24 h urinary TG excretion in a group of hirsute women is higher than in the control group, and decreases after suppression with dexamethasone for 1 month of therapy.