[Influence of hormone replacement therapy on the quality of life in postmenopausal women with hypertension]. / Wplyw hormonalnej terapii zastepczej na jakosc zycia kobiet z pierwotnym nadcisnieniem tetniczym w okresie pomenopauzalnym.

AIM: The effect of hormone replacement therapy (HRT) on the quality of life in women with hypertension is still not clear. Thus, the aim of the study was to assess the effect of hormone replacement therapy on quality of life in postmenopausal women with essential hypertension by using a battery of standardized questionnaires. MATERIAL AND METHODS: The study population consisted of 53 women (mean age 50.9 +/- 6.3 years) with mild and moderate essential hypertension (mean duration 6.4 +/- 6.4 years). The postmenopausal status was defined as the absence of menstrual blood loss during > 6 months and blood estradiol concentration < 50 pg/ml, accompanied by follicle-stimulating hormone (FSH) levels > 21 U/I. Twenty seven women were blindly randomised to transdermal hormone replacement therapy (HRT) and received 17-beta-estradiol and noretisterone acetate, TTS. Twenty six women were randomly selected as controls. The subjects were evaluated at baseline (after 2 weeks' wash-out from hypotensive drug period) and after three months of HRT using self-administered standardized quality of life questionnaires: the Psychological General Well-being Index (PGWB) and the Subjective Symptoms Assessment Profile (SSA-P). RESULTS: No differences were found in blood pressure values, heart rate, body mass index and distribution of body fat tissue between women receiving HRT and controls at baseline and after 3 months of follow-up. There were no significant differences in the baseline total PGWB score as well as in its subscale between two groups. Similarly, the frequency and intensity of subjective symptoms assessed by SSA-profile were the same in both groups at baseline. After 3 months, a significant improvement in PGWB total score was observed in women receiving HRT. This effect was due to improvement in anxiety, positive well-being and vitality. Moreover, emotional distress, symptoms of flushing, sweating and trembling hands also diminished and sexual capacity improved in women treated with HRT. CONCLUSION: A three-month hormone replacement therapy in hypertensive postmenopausal women slightly improves the general well-being, seems to decrease emotional tension, increase sexual capacity and markedly relieves some vasomotor symptoms.

Aortic pulse wave velocity in young normotensives with a family history of hypertension.

OBJECTIVE: To assess the effect of selected clinical and biochemical parameters, with particular consideration of familial hypertension, on the pulse wave velocity (PWV) in young normotensives. SUBJECTS AND METHODS: Seventy voluntary students were enrolled (mean age 22.3+/-2.1 years), 39 men and 31 women, with normal blood pressure. A history was obtained with respect to diabetes mellitus, ischaemic heart disease, lipid disorders and arterial hypertension in the family. The subjects were subdivided into two groups: those with (n = 33) and without (n = 37) a family history of arterial hypertension, and blood pressure and heart rate were measured three times and total cholesterol and its subfractions determined in plasma. The carotid to femoral PWV was measured using an automatic computerized recorder and analysed by the Complior program. RESULTS: The subjects with a family history of arterial hypertension had higher blood pressure levels (systolic and diastolic blood pressure, pulse pressure and mean arterial pressure), as well as mean body mass index and low-density lipoprotein (LDL) cholesterol. The PWV in this group did not differ from that in the subjects without a family history of arterial hypertension (9.69+/-2.8 versus 9.32+/-2.0). However, the PWV was significantly higher in males than females (10.62+/-2.2 versus 7.86+/-1.13, P < 0.0001) and there was a significant positive correlation between male gender and PWV. CONCLUSIONS: Familial arterial hypertension does not significantly affect aortic stiffness in terms of PWV. Male gender in this population of young healthy subjects is one of the most important factors associated with central arterial stiffness.

[Characteristics of personality structure and neurotic disturbances in patients with primary arterial hypertension]. / Charakterystyka struktury osobowosci oraz zaburzen nerwicowych u chorych z pierwotnym nadcisnieniem tetniczym.

The aim of this study was to measure the prevalence of neuroses in an examined group of patients and to determine specific personality profiles in the group of men and women with primary arterial hypertension with or without coexisting neurosis. Data were collected from a group of 93 out-patients with primary arterial hypertension of the I and II degree according to WHO (51 men, mean age 47.9 years and 42 women, mean age 44.4 years). All subjects had secondary or university education. Neurotic disturbances were determined by the symptom check-list (version "S") and estimation of the personality structure was performed by the Cattell 16 Personality Factors test. The prevalence of neurotic syndromes was 33% in men and 45% in women. We have found a higher frequency of neuroses than in the population, in both men and women with primary arterial hypertension, who have had secondary education. Factor F- (desurgency) was dominant in the male group (p < 0.01) and factors: A+, I+, O+, Q4+, B-, C-, E-, F-, N-, Q1- were predominant in the female group. The subjects with primary arterial hypertension, but without neurosis were characterised by the following personality factors: men by A+, B+, F- Q2- and women by A+ and I+. Moreover affectothymia (A+) was more frequent in men than in women. The personality structure of men with primary arterial hypertension and concomitant neurosis was characterised by the following 16 PF test factors: C- (low ego strength) and O+ (to be apprehensive/guilt-proneness). Neurotic personality structure in women was described by the following 16 PF test factors: B- (less intelligent), C- (low ego strength), E- (submissiveness), F- (desurgency, sober), N- (artlessness, simple-minded), O+ (apprehensive/guilt-proneness) and Q4+ (high ergic tension). It is important, that the 16 PF test profile was different, both in hypertensive men and women and both with or without the presence of neurotic syndromes. This fact and the prevalence of neurosis among hypertensives should be taken into consideration in the psychologic approach and contemporary treatment of primary arterial hypertension.