Noninvasive detection of vascular dysfunction in alcoholic patients.

Vasodilation is impaired in various conditions, such as hypercholesterolemia and tobacco use. We evaluated brachial artery flow-mediated vasodilation (FMD) after blood pressure (BP) cuff occlusion using high-resolution B-mode ultrasound in 20 alcoholics, without any coexisting conditions such as smoking, hypertension, or cholesterolemia, after a 3-month period of abstinence. They were compared with a control group of 20 alcohol-free healthy subjects. We measured the diameter of the brachial artery under baseline conditions, during reactive hyperemia (with increased flow causing endothelium-dependent dilatation), and after administration of sublingual glyceryl trinitrate (GTN), an endothelium-independent dilator. We performed an echocardiographic study (Esaote Au3) according to guidelines of the American Society of Echocardiography to assess left ventricular mass (LVM), wall thickness, systolic stress, and diastolic function changes. FMD (% diameter change) was significantly less in the alcoholic patients than in the controls (6.03+/-3.67 v 13.7+/-4.65; P < .05), whereas no difference was noted after GTN administration (13.7+/-7.97 v 16.0+/-5.12, P = NS). Echocardiographic study showed no differences between the study group for LVM, wall thickness, and systolic stress; diastolic function expressed as E/A ratio inversion was significantly impaired. These data demonstrate an impairment of endothelial-dependent vasodilatation in chronic alcohol abusers, which may contribute to the excess prevalence of cardiovascular diseases in these individuals.

Effect of alcohol consumption versus abstinence on 24-h blood pressure profile in normotensive alcoholic patients.

The aim of this study was to evaluate 24-h ambulatory blood pressure monitoring in 15 male alcoholic normotensive subjects during alcohol consumption and following an abstinence phase and the effects of alcohol consumption compared with a period of 1 week of abstinence. The average 24-h BP was not different, but the diurnal pattern showed a fall in systolic BP early (06:00 to noon; P < .005) and late (18:00 to 22:00; P < .002) in the day during abstinence. BP variability was increased during the alcohol phase (P < .05). This study showed that 1 week of abstinence does not influence 24-h BP levels in normotensive subjects, but alters the diurnal pattern, characterized by a fall in systolic BP and increased BP variability.

Physical exercise and hypertension. New insights and clinical implications.

In the last few years, the role of habitual physical activity in blood pressure regulation and in the prevention and treatment of mild hypertension has stimulated general interest. Both experimental and observational studies seem to show that physical exercise has a lowering effect on blood pressure. Some longitudinal training studies supplied data regarding the possibility of using physical training in the treatment of hypertensive patients. The mechanisms responsible for lower blood pressure induced by physical training are still unknown; however, the benefits from physical training last only as long as individuals continue to engage in regular physical activity.

Blood pressure and isometric exercise. Correlation with anthropometric data and electrolyte urinary excretion in two groups of trained and untrained young men.

Blood pressure (BP) and heart rate (HR) at rest and at the third minute of hand grip exercise (HG), body weight (W), height (H), body index (BI), triceps skinfold (TS), arm circumference (AC), and 24-hour excretion of Na, K, and creatinine were measured in two groups of 50 males 18 to 21 years of age. The subjects were divided in two groups depending on their physical activity. Group 1 included 50 trained subjects who had been regularly engaging in dynamic exercise for at least one month (four one-hour sessions a week); Group 2 included 50 untrained subjects. In Group 1 there was no significant correlation among systolic blood pressure (SBP) and anthropometric data at rest, but it was significantly correlated during HG with W, H, BI, and AC. In Group 2, SBP was significantly correlated only with W and BI at rest, with W, H, BI, and AC during HG. Diastolic blood pressure (DBP) was well correlated, both at rest and during HG, with anthropometric data in both groups studied. No correlation was found between BP and urinary excretion of electrolytes. The BP values appeared to be slightly lower in Group 1 than the ones in Group 2, both at rest and during HG (P less than .05). No significant difference was found in any of the other parameters considered. Our data seem to confirm that regular physical exercise may have a moderate lowering effect on BP both at rest and during exercise; this is independent of any concomitant weight loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthropometric data, urinary sodium excretion, and isometric exercise in epidemiological study of arterial hypertension.

Relationships between cardiovascular response to isometric exercise, anthropometric data, and urinary sodium excretion were examined a group of 80 young males aged 19.7 +/- 1.3 years. Diastolic blood pressure (DBP) was well correlated with the anthropometric data both at rest and during hand grip (HG). During hand grip even the systolic blood pressure (SBP) was correlated with height, arm circumference, body weight, and body index. There was no significant correlation between urinary excretion of sodium and BP. The correlation between SBP and some anthropometric measures found during hand grip but not at rest suggests that the sympathetic nervous system may play a role in determining a relationship between excessive body weight and blood pressure increase.

Anthropometric data, urinary electrolytes excretion, and blood pressure in adolescents.

Relationships between arterial pressure, age, sex, anthropometric measurements, body fat, and urinary excretion of electrolytes were examined in a group of 120 adolescents from 11 to 14 years of age. Body weight and triceps skinfold thickness are two variables that have the highest correlation with arterial pressure levels, especially among girls. Only a slight correlation was found between urinary excretion of sodium and arterial hypertension. The apparent contradiction between positive correlation of fat percent and arterial pressure and the negative correlation between urinary excretion of sodium and arterial pressure can possibly be explained by the low sodium content of the diet of the subjects studied. Their typical Mediterranean diet was abundant in fresh food, mainly based on carbohydrates (macaroni, bread, vegetables), rather than conserved foods in which salt plays an important role in the conservation process (butter, bacon, salad, etc.), typical of the continental diet.