Systemic sclerosis is not associated with clinical or ambulatory blood pressure.

BACKGROUND: Raynaud's phenomenon is often the first symptom and occurs eventually in more than 95% of patients with systemic sclerosis (SSc). Angiographic studies disclose narrowing and obstruction of the digital arteries, which on autopsy histologic study show prominent subintimal connective tissue proliferation without inflammation, as well as adventitial fibrosis. It is also known that primary cardiac problems include pericarditis, left ventricular or biventricular failure, serious supraventricular or ventricular arrhythmias emerge in patients with SSc. It is not known if these patients present hypertension or hypotension and which parameter of the ambulatory blood pressure may influence such a disease course. METHODS: A total of 85 subjects underwent clinical blood pressure (BP) readings, 24-hour ambulatory BP monitoring, left ventricular assessment by echocardiography and measurement of intima media thickness (IMT) of the right-left internal carotid arteries (RICA and LICA) and right-left common carotid arteries (RCCA and LCCA). The population consisted of 40 subjects with SSc according to the criteria of the American College of Rheumatology (SCL-group) who were not receiving any antihypertensive treatment and 45 healthy volunteers (control group). The two groups did not differ in age. RESULTS: Clinical systolic and diastolic blood pressure, clinical heart rate, mean 24 h systolic blood pressure, SD systolic blood pressure, mean 24 h diastolic blood pressure, SD 24 h diastolic blood pressure, mean 24 h heart rate, SD 24 h heart rate, pulse pressure 24 h, serum glucose, cholesterol, triglycerides, HDL, LDL, creatinine, urea, potassium and natrium did not statistically significant differ between the two groups. Furthermore, the left ventricular mass/BSA and IMT of both carotid arteries did not show a statistically significant difference between the groups. CONCLUSION: Systemic sclerosis is not associated with clinical blood pressure or the parameter of 24 h blood pressure monitoring.

Autonomic nervous system responses to personal stressful events in patients with acute myocardial infarction. Preliminary results.

BACKGROUND: Life events specific for each individual may influence the onset of acute myocardial infarction (AMI), and we wondered whether recall of such events elicits autonomic nervous system responses in patients. METHODS: Thirty-one subjects with AMI, which occurred about 1 month previously (study group), and 22 healthy subjects were interviewed. Whenever the presence of a stressful event was found within the last 2 months before AMI onset, a key phrase of the event was isolated. Each subject was faced with 20 written key sentences (including his/her own sentence if detected) at random order, for 40 s each. At the same time the heart rate (HR) and the galvanic skin response (GSR) were continuously recorded. Pearson r correlations, chi 2 and t tests were employed for comparisons between study and control group as well as within each group. RESULTS: A recent exacerbating event was detected in 30/31 AMI patients and in 0/22 healthy subjects. For the 30 AMI patients the values of HR following the sentence of the suspected event, specific for each patient, were statistically significantly higher than the mean values of HR following the remaining 19 'neutral' statements. The same significant difference appeared with regard to GSR values. The mean values of the AMI patients for the 19 neutral statements did not differ significantly from those of the healthy subjects for the 20 neutral statements, either for HR or GSR. CONCLUSIONS: Findings suggest that recall of personal stressful events elicited autonomic nervous system responses in AMI patients and, therefore, events with personal significance are related to coronary disease onset.

Hyperlipidemia and presence of thyroid autoantibodies in girls with Turner's syndrome or mosaic variance.

OBJECTIVE: The investigation of differences in the medical status between girls with Turner's syndrome or mosaic variance and healthy girls of the same age. In addition, the existence of differences between those persons with full Turner's syndrome and those with mosaic variance were examined. The influence of the treatment was also of concern because a number of the subjects in the study group were being treated with hormones (estrogen and progestin). Investigation concerned cardiovascular abnormalities, bone age, and lipid and hormonal profiles of the participating persons. PARTICIPANTS: Girls came to the hospital with problems in their menstrual cycles. Genetic control (karyotyping) took place. Each patient with symptoms of Turner's syndrome or mosaic variance was included in the study group. Every third patient with no symptoms of the syndromes and near the same age were included in the control group. METHODS: Stratification was made according to the body mass index of the participating persons. Nonparametric tests were used for the analysis. RESULTS: Differences were detected in the levels of cholesterol, low-density lipoproteins (LDLs), high-density lipoproteins (HDLs), and triglycerides, and were increased in the study group. Presence of thyroid autoantibodies, antithyreo-globulin-antibodies (AASTs) and antimicrosomatic antibodies (AASMs), was observed in the study group. In addition, differences were observed in HDL levels between persons with full Turner's syndrome and those with mosaic variance. Finally, significant difference was observed in the level of triglycerides and in the presence of AASTs and AASMs in treated and untreated persons with mosaic variance. CONCLUSIONS: Metabolic, genetic, eating or autoimmune mechanisms are suspected.

Effects of group psychosocial intervention on coronary risk factors.

The purpose of this study was to investigate whether a psychosocial intervention approach aimed at resolving psychological conflicts could reduce the severity of risk factors for post-acute myocardial infarction patients. Twenty-three patients with a recent myocardial infarction participated in a group psychosocial intervention program which lasted 1 year. Twenty other patients with recent myocardial infarction served as controls. Patients form both groups had regular clinical and laboratory follow-up as well as medication. Mean values for seven risk factors of coronary heart disease (smoking, S; body weight, W; serum cholesterol, C; triglycerides, T; systolic and diastolic blood pressure, SBP, DBP; serum uric acid, U) were compared between the two groups in the 1st, 3rd, 6th and 12th months of the follow-up. The maximal mean improvements of the study versus the control group were as follows: W: -2.82 vs. -1.05 kg; C: -56.04 vs. -6.25 mg/dl; T: -20.61 vs. -2.4 mg/dl; U: -0.57 vs. -0.9 mg/dl; S at 1 year -55.5 vs. -10%. It is concluded that group psychosocial intervention with post-acute myocardial infarction patients considerably reduces some coronary-disease risk factors.