Impact of milk yield on pharmacokinetics of six intramammary drugs - a population approach.

The aim of the research was an examination of potential impact of milk yield on the intercompartmental clearance - distribution clearance as well as determination of the variability of obtained pharmacokinetic parameters by the population approach using a two-compartmental structural model. Blood perfusion has a considerable impact on physiology of the udder and kinetics of drugs that are distributed in this organ. The research was performed on healthy Holstein- Friesian and Polish Black-White cows at the age of 4-10 years. Determination of antibiotics (ampicillin, amoxicillin, cefoperazone, penicillin G prokaine, cloxacillin, cefacetril) concentration was carried out after their every intramammary administration to one quarter of the udder. A population pharmacokinetic model was created to fit milk concentration data. General milk yield of a single cow was used as a variable. A population analysis was conducted using non-linear mixed-effect modeling. The impact of milk productivity was set solely by reference to intercompartmental clearance only in case of penicillin G, cloxacillin and ampicillin. It, has been found that milk yield, depending on a drug, influenced the distribution clearance of the drug to varying degrees. It means indirectly that increased perfusion of the udder has a different impact on drug distribution from the udder to the bloodstream.

Validation of relationship between milk resistance and daily yield of dairy cows.

PURPOSE: The reduced value of resistance (R) of milk (<167Ω) or increased conductivity (EC) >6.0 mS/cm indicate the growing number of ions in milk during the initial phase of mastitis. The aim of this study is to demonstrate a linear (verified by a validation procedure) dependency between R and mean daily yield (MDY), which could be used for current monitoring and forecasting of milk yield in dairy cow herds. Although the topic has frequently been examined, a validated model for prediction of MDY based on R has still not been presented. METHODS: Data from 118 dairy cows were analyzed in the study. The validation of model dependency R↔MDY was performed by the live-one-out method (LOO). RESULTS: The minimum geometrical/arithmetical mean of R milk was observed during the 1st month of lactation and was 53.40/254.86 Ω. However, the maximum geometrical/arithmetical mean of R milk was observed during the 7th month of lactation and has 189.62/574.51 Ω. The final model was described by the curve equation MDY = -04461 × R% + 51.58 where R% - percentage share of cows in a herd whose R oscillated within the limits 49.38-154.32 Ω. CONCLUSIONS: Complete predictivity of the model within the above mentioned limits ("prognostic range") was confirmed by the results of validation of the model. The developed model enables the efficiency of a herd at specified percentage share of cows of defined milk R value to be determined.

Temporal and spatiotemporal autocorrelation of daily concentrations of Alnus, Betula, and Corylus pollen in Poland.

The aim of the study was to determine the characteristics of temporal and space-time autocorrelation of pollen counts of Alnus, Betula, and Corylus in the air of eight cities in Poland. Daily average pollen concentrations were monitored over 8 years (2001-2005 and 2009-2011) using Hirst-designed volumetric spore traps. The spatial and temporal coherence of data was investigated using the autocorrelation and cross-correlation functions. The calculation and mathematical modelling of 61 correlograms were performed for up to 25 days back. The study revealed an association between temporal variations in Alnus, Betula, and Corylus pollen counts in Poland and three main groups of factors such as: (1) air mass exchange after the passage of a single weather front (30-40 % of pollen count variation); (2) long-lasting factors (50-60 %); and (3) random factors, including diurnal variations and measurements errors (10 %). These results can help to improve the quality of forecasting models.

Geographic and temporal variations in pollen exposure across Europe.

BACKGROUND: The EC-funded EuroPrevall project examined the prevalence of food allergy across Europe. A well-established factor in the occurrence of food allergy is primary sensitization to pollen. OBJECTIVE: To analyse geographic and temporal variations in pollen exposure, allowing the investigation of how these variations influence the prevalence and incidence of food allergies across Europe. METHODS: Airborne pollen data for two decades (1990-2009) were obtained from 13 monitoring sites located as close as possible to the EuroPrevall survey centres. Start dates, intensity and duration of Betulaceae, Oleaceae, Poaceae and Asteraceae pollen seasons were examined. Mean, slope of the regression, probability level (P) and dominant taxa (%) were calculated. Trends were considered significant at P < 0.05. RESULTS: On a European scale, Betulaceae, in particular Betula, is the most dominant pollen exposure, two folds higher than to Poaceae, and greater than five folds higher than to Oleaceae and Asteraceae. Only in Reykjavik, Madrid and Derby was Poaceae the dominant pollen, as was Oleaceae in Thessaloniki. Weed pollen (Asteraceae) was never dominant, exposure accounted for >10% of total pollen exposure only in Siauliai (Artemisia) and Legnano (Ambrosia). Consistent trends towards changing intensity or duration of exposure were not observed, possibly with the exception of (not significant) decreased exposure to Artemisia and increased exposure to Ambrosia. CONCLUSIONS: This is the first comprehensive study quantifying exposure to the major allergenic pollen families Betulaceae, Oleaceae, Poaceae and Asteraceae across Europe. These data can now be used for studies into patterns of sensitization and allergy to pollen and foods.

Aegilops-rye amphiploids and substitution rye used for introgression of genetic material into rye (Secale cereale L.).

The valuable genes of Aegilops biuncialis, Ae. ovata, Ae. kotschyi, and Ae. variabilis were transferred to rye, by crossing Aegilops-rye amphiploids with tetraploid and diploid substitution rye. The C-banded karyotype of the BC1 and BC2 generations of amphiploids with 4x substitution rye and BC1 with 2x substitution rye showed great variation in chromosome number and composition. In the BC1 generation of amphiploids with 4x and 2x substitution rye, seed set success rate and germination rate varied depending on origin. However, plant sterility in all cross combinations of amphiploids with 4x and 2x substitution rye resulted in their elimination from further experiments in the BC3 and BC2 generations, respectively. In backcrosses of 4x substitution rye with amphiploids Ae. variabilis × rye 4x, fertile 4x rye plants containing Aegilops chromatin were produced in the BC2 generation.

Association between IL-17F gene polymorphisms and susceptibility to and severity of rheumatoid arthritis (RA).

Interleukin-17F (IL-17F) is a novel proinflammatory cytokine. IL-17F gene is an excellent candidate for chronic inflammatory disease. We investigated the association between rheumatoid arthritis (RA) and His161Arg (7488A/G; rs763780) and Glu126Gly (7383A/G; rs2397084) polymorphism of IL-17F gene. The gene polymorphisms in 220 Polish patients with RA and 106 healthy subjects were amplified by polymerase chain reaction with restriction endonuclease mapping. Overall, the polymorphisms of the IL-17F gene were not correlated with susceptibility to RA in Polish population. However, the IL-17F His161Arg variant was associated with parameters of disease activity, such as number of tender joints, HAQ score or DAS-28-CRP. Moreover, our findings have shown that Glu126Gly IL-17F gene polymorphism may be correlated with longer disease duration in patients with RA. Our results for the first time showed the relationship between IL-17F gene polymorphisms and severity of RA.

Prevalence of allergy, patterns of allergic sensitization and allergy risk factors in rural and urban children.

BACKGROUND: We aimed to compare the prevalence of allergic diseases and sensitization in children living in urban and rural areas and to identify potential risk/protection factors associated with allergy. METHODS: School children 12-16 years old, from urban community (n = 201) and rural area (n = 203) were recruited. The data obtained by questionnaire were referred to doctors' diagnosis, skin prick tests (SPTs), and serum specific and total IgE assessment. RESULTS: The prevalence of allergic diseases in urban children was significantly higher as compared with rural children [asthma 16.42%vs 1.97% (P < 0.001) allergic rhinitis 38.81%vs 10.84% (P < 0.001)]. Positive SPTs to at least one allergen was found in 63.7% of urban and 22.7% rural children (P < 0.001). Significantly higher percentage of allergic rural than urban children were monosensitized or sensitized to 2-4 allergens, but almost a fourfold higher percentage of allergic urban children was found to be sensitized to five or more allergens (P < 0.0001). The history of frequent upper respiratory factor (URT) infections, antibiotic therapy, tonsiltectomy/adenoidectomy were positively associated with development of atopy and sensitization. CONCLUSION: Our findings confirm that residence of rural area is associated with a significant lower prevalence of allergic sensitization and symptoms in school children. Several risk and protective factors related to environment and style of life could be identified in both environments.

Risk factors for atherosclerosis in healthy employees-a multidisciplinary approach.

BACKGROUND: The aim of the study was to investigate the prevalence of early atherosclerosis in healthy workers and the relationship between classical, psychological, and immunological risk factors and atherosclerosis, as well as their predictive value. METHODS: One hundred healthy managers and 50 office workers aged 35-65 were studied. In all subjects, individual, family, and occupational stress/coping risk factors were evaluated, including plasma levels of biochemical (total cholesterol, LDL, HDL, TG, glucose) and inflammatory-immunological (aCL, anti-beta(2) GPI, oxLDL, HSP, HSCRP) parameters. Carotid artery intima-media thickness (IMT) and atherosclerotic plaques in carotid arteries were assessed with computer analysis of B-mode ultrasound images. RESULTS: In 107 persons (71%) no changes were found in ultrasound images and in 43 individuals (29%) the presence of plaque was shown. The mean IMT value was 0.0618+/-0.013 mm. Cross-domain analysis showed that core predictors for IMT were age, LDL level, smoking, and occupation (being a manager) (beta=0.33, 0.30, 0.23, and 0.20, respectively); the core predictors for plaque were age, total cholesterol level, and an occupational stressor home-work balance (Wald=7, 6.7, and 5.6, respectively). Immunological factors were not independent predictors. CONCLUSIONS: In atherosclerosis, not only traditional risk factors (age, lipid disorders, and lifestyle) but also occupational stress factors may play a role. Immunological factors do not seem to play a role in the development of atherosclerosis in a population of healthy workers. The interplay between occupational stress and atherosclerotic changes requires further investigation.

Arterial hypertension in Poland in 2002.

Arterial hypertension represents a serious medical, social and economic problem in Poland. Owing to a small number of studies concerning HT epidemiology in Poland and large differences in methodology, it is difficult to make an objective verification of the changes regarding principal parameters in our country within the last decade. Important programme for the assessment of the situation in our country is NATPOL PLUS, carried out in the year 2002 on a representative sample of 3051 adult Polish residents aged between 18 and 93 years, using the current diagnostic criteria for arterial hypertension (blood pressure readings obtained at three separate visits in cases of newly detected HT, different cuff sizes for different arm circumference, age range 18-93 years, rejection of first measurement during initial screening visit). Prevalence of HT in Poland is 29%, awareness-67%, and effectiveness of treatment-12%. This means that while HT affects about 8.4 million adult Poles, only 1 million of them get effective treatment. Moreover, as much as 8.7 million Poles have high normal blood pressure and they should apply active prevention. The awareness, detection and control of hypertension is much worse in men than in women. A series of NATPOL studies indicated over the period 1994-2002 a significant and rapid decrease in the awareness of one's own blood pressure among the adult Polish population, especially in small towns and villages, among less educated people, and in males.

Have rapid socioeconomic changes influenced awareness of blood pressure in Poland?

The aim of our study was to evaluate changes in awareness of blood pressure during transition into a market economy in Poland. Thus, in 1994, we conducted a cross-sectional survey based on a questionnaire interview on a sample of 2080 men (M) and women (F) aged 18 years and over. The subjects were selected from a Polish population by stratified and cluster random sampling with quotas by the Center for Social Research in Sopot. They were asked if they were aware of blood pressure. The results were analysed according to age, sex, education level, income and place of living. In September 1997 we carried out the same investigation on a new group of 1664 adults. In addition to the questionnaire, the blood pressure (three recordings at home) measurements were completed. The interviewers were well-trained medical students. Awareness of blood pressure has declined (P < 0.001) from 71% in 1994 to 65.5% in 1997. The highest decrease in awareness of blood pressure was observed among less educated people, as well as among people living in smaller cities and villages. The overall prevalence of hypertension was 25.9% by 'older' WHO criteria (BP > or =160/95 mm Hg or taking antihypertensive medication) and 44.5% by JNC VI criteria (BP > or =140/90 mm Hg or taking antihypertensive medication). Forty-six percent of hypertensive subjects classified by JNC VI criteria were previously known to be hypertensives and 54% were newly detected (F: 39%, M: 69%). Low awareness of blood pressure in Poland is the crucial factor of insufficient detectability of hypertension. Decline of awareness of blood pressure being the most significant among people representing lower social status, emphasises the need for urgent preventive measures.

Family with Li-Fraumeni syndrome and no evidence of a germline mutation of the p53 gene or chromosomal aberrations.

Li-Fraumeni syndrome is a rare autosomal, dominant trait of diverse types of cancers in children and young adults, with a predominance of soft tissue sarcomas, osteosarcomas, brain tumours, adrenocortical and breast carcinomas, as well as leukaemias. We present a family with an unusual cancer history fulfilling the criteria of Li-Fraumeni syndrome. Mutational analysis of the p53 gene in constitutional DNA of several affected members of the family did not show any germline p53 defect. Cytogenetic studies did not reveal any structural aberrations.

Screening for germline p53 mutations in pediatric and adult patients of high-risk groups in Poland.

Germline mutations of the p53 gene lead to cell transformation in various tissues. Such a complex cancer phenotype makes it difficult to recognize the carriers of the defective allele. Several studies undertaken to identify high-risk groups found germline p53 mutations in familial cancer aggregations and in patients with multiple tumors. We screened 189 pediatric and 48 adult patients. The high-risk groups comprised 41 patients with a family history of cancer and 35 with multiple neoplasms. Furthermore, 124 tumors were screened for somatic mutations. p53 exons 2 to 11 were analyzed by polymerase chain reaction and single strand conformation polymorphism (PCR-SSCP) followed by direct sequencing of abnormal DNA fragments. No germline p53 mutations were found and somatic mutations were detected in 5 of 59 sarcomas, globally, in 8 of 124 tumors. In conclusion, in Poland, p53 alterations do not seem very important for the predisposition to malignancy and development of sarcomas.

[CAPD treatment in children with renal amyloidosis]. / Leczenie dializa otrzewnowa dzieci z amyloidoza nerek.

The aim of the study was to summarize the experience in the treatment of chronic renal failure due to secondary amyloidosis in the course of juvenile rheumatoid arthritis. Fourteen children aged 7.5-17.7 years were treated with dialysis; 12 with CAPD, 2 with HD. Our results indicate that CAPD is a proper dialysis technique for children with amyloidosis, despite a high rate of complications in early period of CAPD, such as: bleeding, leaks, hernias, and impaired wound healing.

The release of eosinophil chemotactic activity and eosinophil chemokinesis inhibitory activity by mononuclear cells from atopic asthmatic and non-atopic subjects.

The goal of our study was to assess the chemotactic activity for eosinophils (ECA) and neutrophils (NCA) and histamine releasing activity (HRA) in crude supernatants of mononuclear cells in monosensitized atopic asthmatics and healthy controls. Chemotactic activity for ECA and neutrophils was measured in supernatants of cultured mononuclear cells with modified Boyden's chamber and HRA was assessed on healthy donor basophils. With respect to ECA generation two distinct subgroups of subjects were distinguished: releasers [ECA (+)] and non-releasers [ECA (-)]. In atopic and non-atopic ECA (+) the mean ECA index was 3.78 +/- 0.49 and 2.47 +/- 0.27 respectively (P > 0.05). Supernatants from the remaining subjects (seven of 22 atopic and five of 11 non-atopic) did not express ECA, but revealed significant inhibitory activity for chemokinesis of eosinophils (mean chemotactic index 0.25 +/- 0.16 and 0.48 +/- 0.22 for atopic and non-atopic non-releasers respectively). Stimulation with antigen of MNC from atopic and with PHA from non-atopic ECA (-) restored cells ability to release ECA. Sephadex gel chromatography revealed that supernatants of MNC contained chemotactic and chemokinesis inhibitory activity in different fractions. The spontaneous productions of NCA and HRA by mononuclear cells was similar in ECA releasers and non-releasers, although the HRA was higher following stimulation with PHA in the non-atopic ECA (+) subgroup. Our study demonstrated, for the first time, that MNC are capable of generating not only chemotactic activity but also chemokinesis inhibitory activity for eosinophils.

Headache in patients with mild to moderate hypertension is generally not associated with simultaneous blood pressure elevation.

OBJECTIVE: Although headache is regarded a symptom of hypertension, its relation to blood pressure, especially in mild and moderate hypertension, is not clear. Thus, the aim of the study was to investigate whether headache in patients with mild to moderate hypertension may be attributed to simultaneous elevations in blood pressure. DESIGN AND METHODS: Ambulatory blood pressure monitoring (ABPM) was performed in patients (mean age 48 +/- 10 years, n = 150, 92 men, 58 women) classified, according to their office blood pressure, as stage 1 -2 hypertensives (JNC VI). Headache periods were recorded in patients' diaries. RESULTS: Headaches were generally not directly associated with blood pressure elevations in the studied group of stage 1-2 hypertensive patients because (i) blood pressure values from headache periods were not significantly higher than those from headache-free periods; (ii) blood pressure values directly preceding the pain were not significantly different from values at the beginning of headache; and (iii) in the vast majority of hypertensives, their maximal blood pressure values were recorded during headache-free periods. Moreover, in some instances, patients who showed maximal ABPM values during headache had relatively high blood pressure, i.e. > or = 180/110 mmHg. CONCLUSIONS: Our results did not support the opinion that headache experienced by stage 1-2 hypertensives was generally caused by simultaneous elevation in blood pressure. The direct mechanisms of headache in hypertension, as well as the relation between increments in blood pressure above 180/110 mmHg and headache, need further investigations.

[Evaluation of reproducibility of plethysmographic indices according to body posture, choice of forearm and method of measurement]. / Ocena powtarzalnosci wskazników pletyzmograficznych w zaleznosci od pozycji ciala, wyboru badanej konczyny oraz metody pomiaru.

The aim of the study was the analysis of the influence: a) body position (sitting vs. supine), b) choice of the arm (dominant vs. nondominant), c) variant of the method (classic vs. automatic) on plethysmographic indices describing forearm blood flow repeatability (arterial inflow--AI, fast blood flow--FBF, venous outflow VO, venous capacitance--VC). The study group included subjective healthy men, aged from 22 to 60 years. Individuals with body mass index (BMI) > 35 kg/m2 or treated pharmacologically weren't been included into examination. The indices of the forearm blood flow were calculated from the plethysmographic curve using the graphic technique: venous capacitance (VC), arterial inflow (AI), fast blood flow (FBF) and venous outflow (VO). We used relative repeatability coefficient (RRC) and coefficient of variation (CV) for assessing repeatability of obtained parameters. Repeatability of plethysmographic indices was better in supine position than in sitting one. RRC was respectively for supine vs. sitting position for VO: 0.41 vs. 0.68, for VC: 0.42 vs. 0.52 and for AI: 0.57 vs. 0.65. Plethysmographic indices VO, VC, AI were characterised by better repeatability when the exams were performed on the dominant arm. RRC was respectively for dominant vs. nondominant arm for VO: 0.68 vs. 0.71, for VC: 0.52 vs. 0.64 and for AI: 0.65 vs. 0.71. Coefficient of variation of arterial inflow assessed by conventional, automatic and by fast inflow was respectively 20%, 23% and 17%. The long-term repeatability of FBF estimated by RRC was 0.76 whereas CV yielded 17%. The same coefficient of variation was obtained when short-term repeatability was estimated-mean value CV was 17%, after rejection extremal values 11%. In conclusion the best repeatability was obtained when measurements were performed with automatic variant of method, in supine position, on dominant arm.

Nasal reactivity to capsaicin in patients with seasonal allergic rhinitis during and after the pollen season.

BACKGROUND: We aimed to study the participation of neurogenic mechanisms in nasal allergic inflammation by assessing the effect of neurogenic stimulation on the secretory and cellular responses of nasal mucosa in patients with allergic rhinitis. METHODS: A group of patients suffering from seasonal allergic rhinitis was challenged intranasally with incremental doses of capsaicin (0.3, 3, 12 microg) during and after the pollen season. Clinical symptoms after provocations were monitored, and unilateral nasal lavages were obtained. The nasal lavage fluid (NAL) was assayed for concentration of total protein, albumin, lactoferrin, and number of leukocytes, following by differential count. RESULTS: Capsaicin challenge during the pollen season produced greater congestion (P < 0.01) and rhinorrhea (P < 0.05) than after the season. The intensity of burning sensation (pain) was similar on both occasions. Capsaicin failed to increase albumin content in NAL both during and after the season. Total protein was increased only after the highest dose of capsaicin (P < 0.03) after the season. The number of eosinophils in basal lavages was higher during the season. During the season, the total number of leukocytes at least doubled in 7/12 patients and the percentage of eosinophils increased in 6/12 patients after the capsaicin challenge. CONCLUSIONS: Our study demonstrated that during the symptomatic period the nasal mucosa of allergic patients is more susceptible to neurogenic stimulation, showing enhanced secretory and inflammatory (cellular) responses.

Heritability of plasma leptin levels: a twin study.

OBJECTIVE: To examine the influence of genetic factors on plasma leptin levels. SUBJECTS AND METHODS: We measured plasma leptin levels, body mass index and body fat distribution in healthy young female monozygotic (n = 19) and dizygotic (n = 14) twins. The twin zygosity was verified by determination of short tandem repeat and amplified fragment length polymorphism systems. The genetic analysis included analysis of variance-based and maximum likelihood-based methods. RESULTS: Plasma leptin levels were correlated significantly with body mass index (r = 0.59, P < 0.001), waist circumference (r = 0.54, P < 0.001) and hip circumference (r = 0.63, P < 0.001), but not with age (r = -0.17) or the waist:hip ratio (r = 0.02). The heritability estimates derived from intraclass correlations were significant for body mass index (P = 0.001), waist circumference (P = 0.004), hip circumference (P = 0.01) and plasma leptin levels (P = 0.005), but not for the waist:hip ratio (P = 0.22). In the maximum likelihood-based path analysis, heritability was estimated at 79% for body mass index and at 73% for plasma leptin levels. After adjustment for body mass index, the heritability estimate for leptin levels from the model-fitting approach was 55%. CONCLUSIONS: Genetic factors are major determinants of plasma leptin levels in humans and may account for as much as half of the variance in leptin levels.

[Pharmacotherapy of arterial hypertension and pharmacoeconomic aspects of hypotensive therapy in elderly patients in Poland]. / Leczenie farmakologiczne nadcisnienia tetniczego oraz wybrane aspekty farmakoekonomiczne terapii hipotensyjnej u chorych w starszym wieku w Polsce.

The aim of our study was to examine the use of pharmacological therapy and to evaluate the economical aspects of treating hypertension (HT) in elderly patients in Poland. Two hundred and sixty eight elderly persons (147 females, 121 males; mean age: 72.2 +/- 6.0 years) were selected from Polish population by stratified and cluster random sampling with quotas. BP measurement was performed 3 times every 2 minutes at respondents home. In the questionnaire, awareness of HT was assessed. Prevalence of hypertension among subjects aged 65 years and over by JNC VI criteria (SAP > or = 140 mm Hg, DAP > or = 90 mm Hg or hypotensive therapy) was 74%. Awareness of HT was equal to 61%. Eleven percent of all hypertensives were well controlled. Among hypertensives, 71% took prescribed antihypertensive drugs on a regular basis. Patients with HT were taking the following antihypertensive drugs: diuretics 16%, diuretics and reserpine 20%, beta-blockers 19%, ACE inhibitors 53%, calcium antagonists 30%, and other 3%. Newer drugs were prescribed in 7%, and multi-source (generic) products in 93%. The average cost of treatment with one drug was 147 PLN (37.5 USD) per year (newer drugs: 413 PLN; multi-source product 126 PLN). Assuming those data and number of elderly people in Poland (4.335 mln), we estimated that 3.208 mln of subjects have had hypertension according to JNC VI criteria. Only 1.957 mln of patients with HT have been detected and only 0.353 mln of hypertensives have been well controlled. The approximate global cost of antihypertensive drugs per year in elderly patients in Poland has been equal to 285 mln PLN (72.8 mln USD). In hypothetical situation with optimal (100%) detection and control of HT the global cost by the actual rate of regularity in taking drugs would increase to 569 mln PLN (145.3 mln USD). The prevalence of HT in elderly people in Poland is very high. In elderly hypertensives ACE inhibitors are used most often. More than 90% of prescribed drugs are multi-source products. An optimal improvement of HT detection and control would cause a two-fold augmentation of the costs of pharmacological therapy.

[The influence of 5-week relaxation therapy on arterial blood pressure in patients with borderline hypertension]. / Wplyw 5-tygodniowej terapii relaksacyjnej na wysokosc cisnienia tetniczego u chorych na nadcisnienie tetnicze graniczne.

The present study was performed to evaluate the influence of 5-week relaxation therapy on office and ambulatory blood pressure in young borderline hypertensives. Thirty patients were studied. The office blood pressure decreased significantly after 5 weeks of relaxation therapy (P < 0.001 for both systolic and diastolic blood pressure). Ambulatory monitoring revealed only a slight decrease of 24-hour blood pressure (P = 0.02). Our results indicate limited efficacy of relaxation therapy in treatment of borderline hypertensives.