Determinants of Weight Status and Body, Health and Life Satisfaction in Young Adults.

Health behaviors include behavioral patterns and habits that relate to health maintenance, restoration and improvement. They do not only affect the physical condition; they are also associated with life satisfaction. In our study, we focused on young adulthood, a specific lifespan period for establishing long-term health behavior patterns. The aim of the present study was to investigate depressive symptoms, lifestyle and eating behaviors and delineate their associations with overweight/obesity and body, health and life satisfaction in young adults in Poland. We enrolled 800 students (81.4% females and 18.6% males). Diet, physical activity, depressive symptoms, eating behaviors and body, health and life satisfaction were assessed. Multivariate logistic regression models were employed. Almost half of the participants in our study had at least mild symptoms of depression. Symptoms of depression significantly reduced the odds of satisfaction with body, health and life, whereas physical activity increased them. Overweight/obesity significantly reduced the odds of body and health satisfaction. In women, a history of depression and emotional eating increased the odds of being overweight/obese. The results of our study may contribute to the development of educational programs and intervention strategies for young adults.

C-Reactive Protein and Albumin Levels as Useful Tools for Predicting In-Hospital Outcomes in Polish Nonagenarians.

Purpose: The admissions of nonagenarians to internal medicine wards are rising. The aim of this study was to analyse the causes of ward admission and blood and renal parameters as potential mortality predictors in this age group. Patients and Methods: Out of 1140 patients, 111 nonagenarians aged 90+ admitted to the Internal Medicine Ward in one general hospital in Poznan in 2019 were studied. Medical records of these patients were analysed to find factors attributable to the hospitalisation. Results: The leading causes of admission were infections and cardiovascular diseases, and the main causes of death were cardiovascular diseases. Elevated C-reactive protein (CRP) level was a statistically significant death predictor. Equally, decreased albumin level was found to be a mortality predictor. No such relationships were obtained for haematological or renal parameters. Conclusion: Our study uniquely analysed a relatively large group of hospitalised nonagenarians and identified those who need particular attention in the ward by identifying those with the highest risk of death. CRP and albumin levels may serve as useful indicators of in-hospital mortality in this age group.

Effect of COVID-19 on Blood Pressure Profile and Oxygen Pulse during and after the Cardiopulmonary Exercise Test in Healthy Adults.

Several reports have shown the impact of COVID-19 history on exercise capacity. This study compared the blood pressure (BP) response and oxygen pulse (O2 pulse) characteristics in normotensive patients with and without a history of COVID-19 during the cardiopulmonary exercise test (CPET) and post-exercise recovery. This cross-sectional study involved 130 healthy Caucasian adult volunteers (71 participants with a history of COVID-19). All patients underwent the CPET with blood pressure measurements during exercise and post-exercise recovery. The post-COVID group had significantly higher systolic, diastolic, and mean blood pressure after 9 min of recovery and achieved a significantly lower max O2 pulse (2.02 mL/beat on average) than the controls. It should be noted that the COVID group tended to have higher blood pressure values in all steps, with no differences in heart rate, pulse pressure, and saturation at any step. The COVID-19 outbreak was associated with a higher blood pressure response, significantly, in post-exercise recovery, a lower maximum O2 pulse, and a lower maximum load achievement. Future studies are needed to determine if these abnormalities during the CPET and the blood pressure variation have prognostic value.

The Effect of 75 Grams of Glucose during OGTT on Plasma Markers of Lipid and Lipoprotein Peroxidation, Oxidized LDL and Thiobarbituric Acid Reactive Substances, in People with Increased Body Mass.

Obesity, currently defined as a disease, is associated with a number of metabolic disorders, and oxidative stress is discussed as the link between them. The aim of this study was to analyze the plasma markers reflecting oxidative modification of lipids and lipoproteins, oxidized LDL (oxLDL) and thiobarbituric acid reactive substances (TBARS), under the influence of the 75 g of oral glucose during oral glucose tolerance test (OGTT), in patients with increased body mass. One hundred twenty individuals of both genders (46 women and 74 men) aged 26 to 75 years with increased body mass (BMI > 25 kg/m2) were recruited for the study. OGTT was performed in each of the qualified persons, and glycemia, insulinemia, and concentrations of oxLDL and TBARS were measured fasting and at 120 min of OGTT. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to assess the degree of insulin resistance (IR). In order to assess the changes of the investigated parameters under the influence of 75 g glucose, the index ROGTT = [120']/[0'] was calculated to obtain oxLDL-ROGTT and TBARS-ROGTT. The statistical analysis was performed in the entire study population and subsequent groups from H1 to H4, defined by HOMA-IR quartiles. In the entire study population and the subgroups, oxidative stress markers changed during OGTT. From H1 to H4 group, increasing oxLDL and TBARS were observed both in the fasting state and at 120 min of OGTT, and the oxLDL-ROGTT index decreased from the H2 to the H4 group. The intensification of IR in people with increased body mass may predispose them to enhanced oxidative modification of lipoproteins. Individual reduction in the concentration of oxLDL during OGTT, in reference to fasting value (decreased oxLDL-ROGTT), suggests increased uptake of modified lipoproteins by scavenger receptor-presenting cells or increased migration to the vascular wall.

Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction.

Background: The efficacy of interventions in ST-segment elevation myocardial infarction (STEMI) assessed by a decrease in inpatient mortality in Poland is very high. However, a rise in mortality rate is recorded within 3 years of the discharge from the intervention centre. In order to reduce out-of-hospital mortality, the treatment should be continued with cardiac rehabilitation after hospitalization. The aim of this retrospective study was to evaluate the effect of cardiac rehabilitation on exercise capacity increase patients with STEMI with regard to their age, gender, Body Mass Index (BMI), ejection fraction (EF), concomitant diabetes and nicotine dependence. The effectiveness of cardiac rehabilitation was assessed by exercise ECG (electrocardiogram) stress test or the 6-min walk test, prior to and after cardiac rehabilitation completion. Methods: The study group included 100 randomly selected patients undergoing cardiac rehabilitation after STEMI, aged 40-75 years, with BMI ≤ 40 kg/m2, with controlled arterial hypertension, without anemia and any pulmonary comorbidities. Results: The study patients' exercise capacity was observed to have increased significantly (+1 metabolic equivalent (MET) in exercise ECG stress test and +75.4 m in the 6-min walk test) regardless of their gender, age, BMI and nicotine dependence. Conclusions: This study proved that every patient with STEMI could benefit from cardiac rehabilitation. Nicotine-dependents, males, patients aged ≤55 and those with reduced EF (<50%) were found to have benefitted most substantially.

Urinary tract infections in postmenopausal women with type 2 diabetes: clinical correlates and quinolone susceptibility.

INTRODUCTION Diabetes mellitus and the postmenopausal period are associated with increased risk of urinary tract infections (UTIs) in women. However, data on UTIs in postmenopausal diabetic women are scarce. OBJECTIVES The aim of this study was to determine the prevalence of UTIs in postmenopausal women with type 2 diabetes mellitus, identify the potential risk factors, describe the causative pathogens, and assess their susceptibility to quinolones.  PATIENTS AND METHODS Patients were interviewed, examined, and had their hospital records analyzed. An uncontaminated midstream urine sample was collected and cultured in selective or enriched media. Colony­forming units were counted and susceptibility to quinolones was assessed. Univariate and multivariate logistic regression models were built.  RESULTS Forty women were included in this prospective cross­sectional study; their median age was 64 years (range, 52-84 years). UTIs occurred in 37.5% of the patients. The major implicated pathogens were Escherichia coli (66.7%) and enterococci (20%; most often Enterococcus faecalis). Most of the pathogens (93.8%) were susceptible to all tested quinolones. Patients with UTIs had a significantly lower glomerular filtration rate (P = 0.008) and higher comorbidity index (P = 0.01) compared with patients with sterile urine. Microangiopathic complications, including retinopathy and nephropathy, were identified as independent risk factor for UTIs (adjusted odds ratio, 3.5; 95% CI, 1.2-5.5; P = 0.006). The other clinical correlates of UTIs were urinary incontinence, hyperlipidemia, and microalbuminuria. CONCLUSIONS Postmenopausal diabetic patients with microangiopathy are at high risk of UTIs and therefore should be educated and vigilantly monitored. Attention should also be paid to urinary incontinence, hyperlipidemia, and microalbuminuria as other risk factors for UTIs. Quinolones are an attractive treatment option in this group of patients in Poland.

The impact of high­density lipoprotein on oxidant-antioxidant balance in healthy elderly people.

INTRODUCTION    There is an inverse relationship between high­density lipoprotein cholesterol (HDL-C) levels and the risk of atherosclerosis. OBJECTIVES    The aim of the present study was to assess the oxidant-antioxidant balance in elderly people with different concentrations of HDL-C. PATIENTS AND METHODS    A total of 541 people aged 60 years or older were examined, of whom 90 individuals with no acute or severe chronic disorders had their waist circumference, body mass index, percentage of body fat, and blood pressure measured. Fasting and 120­minute glycemia was determined in an oral glucose tolerance test, following which 15 patients with type 2 diabetes were excluded. Fasting plasma levels of lipids, total antioxidant status, and thiobarbituric acid-reacting substances (TBARS), as well ast the activity of erythrocyte superoxide dismutase 1 (SOD­1) were assessed. Based on HDL-C levels, participants were divided into the high HDL­C group (≥40.0 mg/dl and ≥50.0 mg/dl for men and women, respectively; n = 50) and the low HDL­C group (<40.0 mg/dl and <50.0 mg/dl for men and women, respectively; n = 25). RESULTS    The groups did not differ in terms of age, blood pressure, body mass index, percentage of body fat, and glucose concentration. The high HDL­C group had lower waist circumference (P <0.02) and lower triglyceride concentrations (P <0.00001). Increased TBARS levels (P <0.0005) was observed in the low HDL­C group. There were no differences in SOD­1 activity and total antioxidant status between the groups. CONCLUSIONS    HDL-C levels, which are known to reflect the antiatherogenic activity of HDL, including antioxidant properties, may indicate increasing oxidative stress in healthy elderly individuals.

Impact of administration of folic acid on selected indicators of inflammation in patients with primary arterial hypertension.

The results of epidemiological and clinical tests have shown that in patients with primary arterial hypertension, a chronic mild inflammation develops. The purpose of the study was to determine whether administration of folic acid to patients with primary arterial hypertension influences concentrations of indicators of inflammation: hsCRP, sICAM-1 and sVCAM-1. MATERIAL AND METHODS: The examination was carried out in 41 patients with primary arterial hypertension, aged 19-65 (21 men and 20 women), without complications of hypertension and/or coexisting diseases. The examined patients were administered 15 mg of folic acid once a day for 45 days. Before and after administration of folic acid, concentrations of folic acid, homocysteine, hsCRP, sICAM-1 and sVCAM-1 in serum were assessed. Concentrations of folic acid and homocysteine were determined using the immunoenzymatic method (Abbott) on an AxSYM analyzer. The level of C-reactive protein (CRP) was determined with an ultra-sensitive turbidimetric assay on a Dimension analyzer (Siemens). Next, concentrations of adhesion particles sICAM-1 and sVCAM-1 were assessed with the ELISA technique (R&D). RESULTS: After the administration of folic acid in patients with primary arterial hypertension, a significant decrease in median concentrations of homocysteine in blood was observed. Simultaneously, the median hsCRP, ICAM-1 and VCAM-1 concentrations in serum in patients with primary arterial hypertension were significantly reduced. CONSLUSIONS: Administration of folic acid to persons with primary arterial hypertension in a dose of 15 mg/ day for 45 days caused a decrease in the concentration of homocysteine in serum. That could indirectly result in the decrease in concentrations of the indicators of inflammation (hsCRP, ICAM-1 and VCAM-1), as it is apparent from previous studies that hyperhomocysteinemia stimulates the synthesis of CRP and the expression of adhesion molecules.

[The analysis of the influence of short term physical effort on selected endothelial function parameters and blood vessels stiffness features among young and healthy men]. / Analiza wplywu krótkotrwalego wysilku fizycznego na wybrane parametry funkcji sródblonka naczyniowego oraz sztywnosc naczyn krwionosnych u mlodych i zdrowych mezczyzn.

UNLABELLED: Endothelium dysfunction is well established factor contributing to the development of atheroslerotic plaque. It is characterized by, among other, impaired vasodilatation and increased expression of adhesion molecules. The aim of the study was to estimate changes of serum selectin levels and blood vessels stiffness under the influence of short term physical effort in young healthy men characterized by various lifestyles. MATERIAL AND METHODS: The study was performed on 28 healthy men aged 22 to 34. The study involved personal interview, electrocardiography, treadmill exercise test, non-invasive endothelial function assessment (using PulseTrace PCA 2) and collecting blood samples for serum E-, L- and P-selectin measurement. The given population was divided into smoking and non-smoking groups, as well as into groups with different level of physical activity assessed according to the International Physical Activity Questionnaire. RESULTS: In regard to serum selectin levels under the influence of short term physical effort E-selectin concentration didn't change significantly in any group, P-selectin level was lower in non-smoking group (p < 0.01) and in group with vigorous physical activity (p < 0.005), L-selectin level decreased in non-smokers (p < 0.005) and in groups taking moderate (p < 0.05) and vigorous exercise (p < 0.05). Baseline SI (stiffness index) value differed significantly between smoking and nonsmoking groups (p < 0.005). SI value didn't change significantly under effort in any group. RI (reflection index) value in measurements made after physical effort was significantly lower in each of examined groups, but decrease was better marked among non-smokers (p < 0.005) than in smokers (p < 0.05). CONCLUSIONS: The study revealed that individuals who undertake physical activity regularly, benefit from each single physical effort, because of decrease in serum concentration of proinflammatory molecules such as L-selectin and P-selectin. Short term physical effort does not influence the level of selectins in smokers. Smokers are characterized by increased arterial stiffness compared to nonsmokers. Short term physical effort leads to peripheral vasodilatation, expressed by decreasing RI value, but vasodilatation effect does not appear in smokers. It seems that pulse contour analysis obtained by finger photopletysmography may be treated as method of endothelium function screening among healthy men with the presence of atherogenesis modifiable risk factors.

Economic aspects of hypertension treatment in Poland.

INTRODUCTION: The aim of this study was to assess the costs associated with mild hypertension (HTN) in Poland and to compare the costs of 3-year ambulatory care for those diagnosed with mild HTN (group A) and those diagnosed with mild HTN and comorbidities (group B). MATERIAL AND METHODS: The researchers undertook a retrospective study of a group of 120 patients treated for 3 years (2006-2008) (60%, n = 72 women and 40%, n = 48 men), taking into account the broadest possible social perspective. Medical and non-medical direct costs as well as indirect costs were calculated. RESULTS: The total costs of the 3-year pharmacotherapy in group A equalled 49,985.65 EUR, or 833.09 EUR per patient, whereas in group B the costs were twice as high: 105,691.55 EUR in total or 1,761.53 EUR per patient. Indirect costs for group A patients totalled 3,468.80 EUR (578.13 EUR per patient) and 4,579.20 EUR for group B patients (572.40 EUR per patient). Total direct costs (medical and non-medical) and indirect costs for group B patients were much higher, amounting to 130,228.14 EUR and 2,666.55 EUR per patient, which was double the costs in group A, where costs were 74,184.96 EUR and 1,756.73 EUR per patient. CONCLUSIONS: The costs of HTN treatment in Poland are very high and are growing, like in other countries. Potential solutions include developing better patientdoctor communication to improve compliance, and increasing the chances of more effective and less expensive therapy by prescribing cheaper generic drugs, limiting polypharmacy and improving availability of novel therapeutic methods.

Primary systemic amyloidosis as a real diagnostic challenge - case study.

Primary amyloidosis (AL) is a rare variety of plasma cell dyscrasia, the diagnosis of which is often difficult to establish. Pathogenesis of amyloidosis involves extracellular deposition of insoluble protein fibrils in tissues, leading to insufficiency of affected organs. According to various sources, mean survival rate of patients with primary amyloidosis ranges from 12 to 24 months, making primary amyloidosis a disease with a very poor prognosis. Survival rate is significantly lowered in case of cardiac manifestation of amyloidosis (about 6 months survival in untreated patients). In recent years a considerable progress in AL treatment has been observed. Nowadays we are able not only to delay progression of amyloidosis, but also to improve the function of the affected organs. Unfortunately as first signs and symptoms of AL are usually nonspecific, the diagnosis of AL is often delayed, resulting in late introduction of optimal therapy. There are many diagnostic tests which can be used in diagnostic process of amyloidosis, i.e. electrophoresis, serum and urine immunofixation or affected organs and bone marrow biopsy. On establishing the diagnosis in a patient with suspected amyloidosis it should be remembered that particular diagnostic methods vary considerably in sensitivity. The aim of this paper is to present a case report of a 27-year-old patient with primary amyloidosis focusing on diagnostic aspect of this condition. On the basis of this case, the authors would like to emphasize the value of precise diagnostic process, with immunological techniques playing undoubtedly a crucial role.

Influence of hypertension, obesity and nicotine abuse on quantitative and qualitative changes in acute-phase proteins in patients with essential hypertension.

BACKGROUND: Hypertension is a powerful risk factor for cardiovascular disease and frequently occurs in conjunction with obesity. Accumulative evidence suggests a link between inflammation and hypertension. The aim of study was to evaluate whether blood pressure, obesity and smoking may influence acute-phase response. MATERIAL/METHODS: Ninety-two patients with essential hypertension and 75 healthy volunteers as a control group were studied. In all subjects assessment of hsCRP, alpha1-acid glycoprotein (AGP), alpha1-antichymotrypsin, transferrin, alpha1-antitrypsin, and C3 and C4 complement were performed. Evaluation of glycosylation profile and reactivity coefficient (RC) for AGP was done by means of affinity immunoelectrophoresis with concanavalin A as a ligand. RESULTS: When compared to the controls, hypertensive subjects presented significantly higher hsCRP concentrations and lower transferrin level. Hypertensive patients had elevated AGP-AC. The intensification of the inflammatory reaction was greater in the subgroup of hypertensive patients smoking cigarettes. In obese hypertensives, elevated serum C3 complement level was found. CONCLUSIONS: We conclude that arterial hypertension may evoke the acute-phase response in humans. Markers of acute-phase response are particularly strongly expressed in smokers. Serum C 3 complement, but not other APPs, is elevated in hypertension coexisting with obesity.

The way of serum chromium utilization may contribute to cardiovascular risk factors in centrally obese persons.

INTRODUCTION: Obesity-related disturbances are considered to be risk factors for cardiovascular disease (CVD). Chromium is shown to improve carbohydrate and lipid metabolism. Conflicting data on effects of chromium supplementation in humans are published. The aim of the study was to assess the concentrations of serum chromium during the 75-g oral glucose tolerance test (OGTT) in obese persons. MATERIAL AND METHODS: Fourty-eight centrally obese Caucasians, apparently healthy, using neither special diet nor mineral supplementation, were enrolled in the study. During the OGTT, 0-min and 120-min concentrations of plasma glucose (G 0', G 120'), serum insulin (Ins 0', Ins 120') and chromium (Cr 0', Cr 120') were determined. Plasma lipids, apolipoproteins A and B, and serum uric acid were measured at 0 min only. For parameters assessed during the OGTT, the difference D = [(120' concentration) - (0' concentration)] was calculated. Contradictory tendencies of Cr 120' were observed; thus the difference of serum chromium concentrations, DCr = [(Cr 120') - (Cr 0')], was used to establish the positive DCr group with DCr > 0 (PosDCr: n= 24; 9 male/15 female) and the negative DCr group with DCr < 0 (NegDCr: n= 24; 8 male/16 female). RESULTS: The studied groups were comparable as far as their metabolic parameters are concerned, except higher G 120' (p= 0.043) and DG (p = 0.048), and lower Cr 120' (p < 0.000), which were observed in the NegDCr group. The NegDCr persons showed inverse correlations between Cr 0' and systolic and diastolic blood pressure. CONCLUSIONS: We suggest that the studied centrally obese persons differed in chromium metabolism. In subjects "consuming" Cr during the OGTT, chromium status may be associated with increased risk for CVD.

Serum adiponectin concentrations and their relationship with plasma lipids in obese diabetic and non-diabetic Caucasians.

OBJECTIVES: Adiponectin is a novel plasma protein produced exclusively in adipocytes. Despite early data, its relationship with obesity and diabetes has been recently questioned. Since plasma lipids influence diabetes and obesity, of concern is whether any associations between plasma lipids and adiponectin exist. DESIGN AND METHODS: The aim of this study was to measure adiponectin levels and to investigate their associations with plasma cholesterol fractions and triglycerides in 73 obese non-diabetic subjects (44 women and 29 men), and 43 obese diabetic subjects (28 women and 15 men), aged 52.7+/-11.2 and 53.1+/-11 years, respectively, and matched for age, sex and BMI. The WHO definitions of obesity and diabetes were used. Adiponectin was determined by an enzyme-linked immunosorbent assay. RESULTS: No correlations between adiponectin and total and LDL cholesterol levels were shown (for the whole cohort: r=0.0130; p=0.8899, and r=0.0807; p=0.3958, respectively). A positive correlation between HDL cholesterol levels and adiponectin occured predominantly in obese women without diabetes (r=0.4531; p=0.0023), resulting in an overall statistical trend in the whole cohort (r=0.2243; p=0.0164). A negative correlation between serum adiponectin and triglycerides was found (r=-0.3413; p=0.0002). CONCLUSION: Adiponectin correlated only with TG and partially with HDL but not with LDL and total cholesterol in the study group of obese diabetic and obese non diabetic subjects. In view of these results we suggest that the role of adiponectin in human metabolism is unclear and merits further investigation.

[Assessment of blood pressure and endothelin-1 plasma concentration in young, hypertensive patients after treatment with angiotensin converting enzyme inhibitor]. / Ocena cisnienia tetniczego i stezenia endoteliny 1 u mlodych chorych na nadcisnienie tetnicze poddanych leczeniu inhibitorem konwertazy angiotensyny.

BACKGROUND: Endothelin (ET) is the strongest endogenic substance causing vasoconstriction. The aim of this study was to assess the influence of ACEI therapy on serum concentration of ET-1 plasma activity in young patients with essential mild-to-moderate hypertension. DESIGN AND METHODS: 19 persons with essential mild-to-moderate hypertension were enrolled into study (14 male and 5 female). The average age of this group was 17.6+/-1.4 years. The patients were untreated or there was a 7 day wash out period. The blood pressure and serum concentration of ET-1 plasma were measured before enrolling and after 6 weeks of trandolapril (2 mg per day) therapy. The concentration of endothelin-1 was measured using RIA methods. RESULTS: In analyzed group there was a significant both SBP and DBP lowering after the ACEI therapy. SBP was reduced from 142.6+/-9.7 to 129.3+/-8.4 mmHg (p<0.003), DBP from 85.7+/-6.9 to 79.8+/-8.6 mmHg (p<0.01). The average serum concentration of endothelin-1 was: before treatment 9.33+/-1.9 fmol/ml and after therapy 8.96+/-2.2 fmol/ml. CONCLUSION: The treatment with ACEI drug (trandolapil) induced the significant decrease of SBP and DBP in young hypertensives. 6-weeks trandolapril therapy was associated with the reduction of serum concentration of ET-1, but not statistically significant.

[Hypotensive effectiveness of therapy combined enalapril and nitrendipine and influence on the quality of life]. / Skutecznosc hipotensyjna oraz wplyw na jakosc zycia skojarzonej terapii enalaprilem oraz nitrendypina.

UNLABELLED: It has been proved that effectiveness of monotherapy in mild hypertension is about 50%; in the other half of patients the dose of previously used drug should be increased or combined therapy should be recommended. THE AIM OF THE STUDY was to compare treatment with angiotensin convertase enzyme inhibitor--ACE-I (enalapril 10 mg bid--group 1) to therapy with ACE-I combined with calcium antagonist (enalapril 5 mg bid + nitrendipine 20 mg qd--group 2). MATERIAL AND METHODS: In a prospective, open, randomised crossover study we assessed 44 hypertensive subjects (17 women, 27 men), aged 35-69 years (mean age 48.6 years) with poorly controlled hypertension treated with enalapril 5 mg twice daily. Mean initial systolic blood pressure was 150.8 < or = 9.9 mmHg, diastolic 94.7 +/- 5.3 mmHg respectively. The influence of the treatment regimen on the quality of life (QoL) was estimated by a questionnaire. RESULTS: The effectiveness of both used procedures did not differ statistically--in both groups mean blood pressure reduction was similar (14/8 mmHg in 4 weeks), also percentage of patients with well controlled hypertension (about 50%) did not differ significantly. In the group with changes regimen from monotherapy to combined therapy the improvement of systolic blood pressure was found to be statistically significant (p<0.05); in the case of combined therapy replaced with monotherapy such an improvement was not observed. In the subgroup with the isolated systolic hypertension combined therapy was considerably more effective. The improvement of QoL was noted in both groups, mainly in the initial phase of the study. CONCLUSION: In mild hypertension ACE-I and calcium antagonist combination is effective in blood pressure reduction and in the improvement of the quality of life. Nitrendipine in a dose 20 mg in an once daily regimen is a potent and safe hypotensive agent, particularly in isolated systolic hypertension.

[The effect of analysed hypotensive drugs on certain metabolic parameters]. / Wplyw analizowanych leków hipotensyjnych na wybrane parametry metaboliczne.

The aim of this study was to assess the influence of 3 hypotensive drugs on the metabolic disorders: dyslipidemia, insulin resistance, hyperuricemia. There were 39 patients aged 20-55, with mild-to-moderate essential hypertension. The patients with other serious diseases or treated earlier with cholesterol or uric acid lowering drugs were excluded. Patients were divided into 3 groups, each was treated during 8 weeks with one drug: gr 1--trandolapril (T), gr 2--felodipine ER (F), gr 3--rilmenidine (R). Glucose and insulin in oral glucose tolerance test, I/G proportion, serum lipids and uric acid were tested before and after therapy. The therapy did not influence lipid parameters: LDL, HDL, triglyceride. In the T group there could be observed a significant reduction of total cholesterol value. Examined drugs did not induce changes in serum carbohydrate. The significant reduction of serum uric acid could be observed only after F therapy. Analysed drugs are very useful in therapy of hypertension with metabolic disorders.

[Urinary albumin excretion in patients with essential hypertension and impaired glucose tolerance]. / Ocena wydalania albumin z moczem u chorych z nadcisnieniem tetniczym oraz uposledzona tolerancja glukozy.

The objective of this study was to evaluate the urinary albumin excretion and plasma biochemistry in patients with essential hypertension and impaired glucose tolerance. We studied 82 untreated patients (35 women and 47 men, mean aged 41 +/- 13) with mild to moderate hypertension. Body mass index (BMI) for study subjects was 29.1 +/- 5.0 kg/m2 and mean office blood pressure at entry was 152/97 mmHg. After an oral glucose tolerance test (OGTT) glucose, group was divided into impaired glucose tolerant (n = 16; IGT) and normoglycemic (n = 66; NormGLU) subgroups; patients with diabetes were excluded. 24-hour urinary albumin excretion (UAE) was estimated by the radioimmunoassay during two separate days. The median UAE in the IGT group was 16.0 +/- 28.6 mg/day and in NormGLU group 7.2 +/- 10.7 mg (p < 0.01). The prevalence of microalbuminuria was higher in IGT group (37 vs 18%). In the IGT subgroup total cholesterol, triglycerides and systolic blood pressure were higher. The presence of impaired glucose tolerance in hypertensive patients is correlated with increased urinary albumin excretion, which indicates significant role of metabolic disorders in inducing microalbuminuria.

[Evaluation of acute phase proteins in hypertensive and obese patients]. / Ocena stezen bialek ostrej fazy u osób z nadcisnieniem tetniczym i otyloscia prosta.

UNLABELLED: The inflammatory process contributes to the development of atherosclerotic changes. The aim of this study was to evaluate concentrations of selected acute phase proteins (APP) and their glycosylation profile in hypertensive subjects. 92 hypertensive patients (53 men and 39 women, average age 45.1 yrs) were recruited to the study. Hypertension was proved to be essential, mild to moderate (mean blood pressure values were 141/87 mmHg). The control group comprised 75 healthy persons in comparable age. In all subjects assessment of C-reactive protein (CRP), alpha 1-acid glycoprotein (AGP), alpha 1-antichimotripsin (ACT), transferrin, alpha 1-antitripsin (rocket immunoelectrophoresis method) and C3c and C4c complement fractions (radial immunoelectrophoresis according to Mancini) were performed. Evaluation of glycosylation profile and reactivity coefficient (RC) for AGP were done by means of affinity immunoelectrophoresis with concanavalin A as a ligand (according to Bøg-Hansen). When compared to the control group hypertensive subjects had significantly higher C-reactive protein and interleukin 6 concentrations. Level of transferrin (negative APP--decreasing in the course of the inflammatory process) was statistically lower in the studied group. Hypertensive patients were also found to have elevated AGP-AC values proving acute character of the inflammatory reaction. The intensification of the inflammatory reaction was greater in the subgroup of hypertensive patients with unsatisfactory control of blood pressure. CONCLUSIONS: 1. Hypertension may evoke the acute phase reaction. 2. Quantitative and qualitative changes in acute phase proteins observed in hypertension prove that hypertension itself is an acute inflammatory condition. 3. Markers of acute phase response are particularly strongly expressed in smokers and subjects with insufficient control of blood pressure. The most probable factor leading to the enhanced acute phase response in hypertension is interleukin 6.

[Circadian rhythm and variability of blood pressure and target organ damage in essential hypertension]. / Rytm dobowy i zmiennosc cisnienia a powiklania narzadowe u chorych z nadcisnieniem tetniczym samoistnym.

The aim of this study was to evaluate the influence of blood pressure variability and circadian rhythm on left ventricular mass and urinary albumin excretion rate (UAE) in patients with essential hypertension. 82 untreated patients (35 women and 47 men; mean age 41.1 +/- 13.7) were recruited to this study. Mean office blood pressure at entry was 152/97 mmHg. Ambulatory blood pressure monitoring (ABPM) was performed using an Medilog ABP recorder (Oxford). Blood pressure variability was estimated as the standard deviation (SD) of systolic and diastolic ambulatory blood pressure. Urinary albumin excretion (UAE) was estimated by the radioimmunoassay during two separate days. Echocardiography was used to measure left ventricular mass and left ventricular mass index (LVMI). The median urinary albumin excretion for the whole group was 8.2 mg/day; in 18 patients (21.9%) microalbuminuria was present. Left ventricular mass index in a whole group was 109.1 g/m2; in 23 subjects (28.0%) left ventricular hypertrophy (LVH) was found. Patients with microalbuminuria as well as with left ventricular hypertrophy had higher office and 24 hour ambulatory systolic and diastolic blood pressure and higher systolic blood pressure variability. During ABPM 18 patients with absent nocturnal fall in blood pressure (non-dippers) were found; they did not display more frequent prevalence of target organ damage. Increased 24-hour blood pressure variability present in hypertensive subjects with both microalbuminuria and left ventricular hypertrophy may suggest that this phenomenon plays role in development of target organ damage.