Primary aldosteronism: Higher volume load, cardiac output and arterial stiffness than in essential hypertension.

BACKGROUND: The diagnostics of primary aldosteronism (PA) are usually carried out in patients taking antihypertensive medications. We compared haemodynamics between medicated PA, medicated essential hypertension (EH), never-medicated EH and normotensive controls (n = 130 in all groups). METHODS: The hypertensive groups were matched for age (53 years), sex (84 male/46 female) and body mass index (BMI) (30 kg m-2 ); normotensive controls had similar sex distribution (age 48 years, BMI 27 kg m-2 ). Haemodynamics were recorded using whole-body impedance cardiography and radial pulse wave analysis, and the results were adjusted as appropriate. Radial blood pressure recordings were calibrated by brachial blood pressure measurements from the contralateral arm. RESULTS: Radial and aortic systolic and diastolic blood pressure was similar in PA and never-medicated EH, and higher than in medicated EH and normotensive controls (P ≤ 0.001 for all comparisons). Extracellular water balance was ~ 4% higher in PA than in all other groups (P < 0.05 for all), whilst cardiac output was ~ 8% higher in PA than in medicated EH (P = 0.012). Systemic vascular resistance and augmentation index were similarly increased in PA and both EH groups when compared with controls. Pulse wave velocity was higher in PA and never-medicated EH than in medicated EH and normotensive controls (P ≤ 0.033 for all comparisons). CONCLUSIONS: Medicated PA patients presented with corresponding systemic vascular resistance and wave reflection, but higher extracellular water volume, cardiac output and arterial stiffness than medicated EH patients. Whether the systematic evaluation of these features would benefit the clinical diagnostics of PA remains to be studied in future.

Seed Village Program: A Practical Approach for Combating Malnutrition and Nutritional Security in an Arid Zone.

Despite implementation of the organized seed program, there exists an alarming gap between the demand and supply of quality seeds. The immediate increase in the productivity and production of these crops can be achieved by a higher distribution of quality seeds of high-yielding varieties. In this context, the concept of a seed village is gaining momentum. Bearing the above facts in mind, Krishi Vigyan Kendra (KVK), Central Arid Zone Research Institute (CAZRI), Pali, India, introduced the seed village program to selected villages in the year 2018 to 2019. Under this initiative, quality seeds of improved varieties of prominent local crops were distributed by the KVK to the identified farmers in the area as per an annual program. A number of training sessions on seed production technology were also arranged for technology empowerment of the participating farmers in the seed villages, and they were also trained for isolation distance, sowing techniques, seed treatment, off-type plant, and other agronomic practices. The farmers used these quality seeds and undertook their own seed multiplication within the operational area, which showed a considerable spread of improved varieties in nearby villages. For wheat, from an initial start of 10 farmers the variety spread to 8 villages covering 17 ha of area. For barley, the varietal spread was observed in 10 villages covering an area of 20 ha. In the case of chickpea, the variety spread to an area of 19 ha, with mustard the spread included 8 villages covering an area of 30 ha, with green gram the spread included 7 villages covering an area of 15 ha, and in the case of sesame the spread included 9 villages covering an area of 33 ha. Thus, there is vast scope to produce quality seeds in most crops for which the seed village concept is a practical approach and needs to be promoted to facilitate the production and timely distribution of quality seeds of desired varieties at the village level.