Target organ damage and ambulatory blood pressure in stage I hypertension. The Hypertension and Ambulatory Recording Venetia Study.

According to recent international guidelines the decision on whether to treat young subjects during the early phase of hypertension should be based not only on their office blood pressure but also on their ambulatory blood pressure and whether target organ damage has occurred. Few data on the prevalence of hypertensive complications in young subjects with mild hypertension are available. In the Hypertension and Ambulatory Recording Venetia Study (HARVEST), a multicenter trial conducted in northeast Italy, the percentage of young borderline-to-mild hypertensive subjects with echocardiographic left ventricular hypertrophy was 4.5% and the percentage with concentric remodeling was 4%. Clear differences in cardiac size and geometric adjustment to ambulatory systolic pressure between the two sexes were found. The impact of blood pressure on the walls of the left ventricle and on the left ventricular mass was remarkable in women but weak in men. The assessment of left ventricular systolic function confirmed that many young mild hypertensive subjects have an increased ejective performance. The left ventricular contractility evaluated by midwall measurement was, however, found to be depressed in 9.2% of the HARVEST participants. Their left ventricular diastolic function was similar to that of 50 normotensive controls. The prevalence of microalbuminuria [albumin excretion rate (AER) > 30 mg/24 h) was 6.1%, only slightly higher than that found by other authors among normotensive subjects and much lower than that observed among patients with more severe hypertension. For our stage I hypertensives, however, the AER was correlated to the 24 h blood pressure with high statistical significance, whereas we found no relationship between the AER and left ventricular mass index either for all of the subjects taken together or for the men and women considered separately. The results suggest that renal and cardiac involvement do not occur in parallel during the initial phase of hypertension.

Immunoheterogeneity of serum calcitonin in heroin addicts.

Serum calcitonin (CT) concentrations were determined in 96 heroin addicts. CT levels were assayed by radioimmunological method employing two antisera, one vs. the 17-32 fraction (IMN) of the human CT, the other vs. the 11-32 fraction (B7). In heroin addicts the CT mean values were significantly higher (P less than 0.001) than in normal subjects (141 +/- 16.0 and 292 +/- 21.7 pg/ml with IMN-antiserum and with B7-antiserum, respectively, in heroin addicts; 64 +/- 7.8 and 189 +/- 21.7 pg/ml in controls). Serum CT levels assayed with B7-antiserum were notably higher (P less than 0.001) both in controls and in heroin addicts. Our results draw attention to the heterogeneity of high ICT values found in heroin addicts.