INTROduCTION An important factor influencing the perception of health-related quality of life (HRQoL) is the presence of chronic diseases, especially polymorbidity. However, little is known about how concurrent chronic diseases influence the HRQoL of hypertensive patients. ObjECTIvEs The primary aim of the study was to assess the relationship between comorbidities and different aspects of HRQoL in a large unselected cohort of patients undergoing treatment for hypertension. PATIENTs ANd mEThOds A questionnaire-based study was conducted by 832 primary care physicians in a group of 12,525 unselected patients treated for hypertension for at least 3 months. HRQoL was evaluated using the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). REsuLTs Coexisting diseases were reported in 7986 patients (63.8%). Significantly lower HRQoL values were associated with coexisting diseases, especially obstructive respiratory disease, degenerative disc disease, radiculopathy, coronary artery disease, heart failure, stroke, diabetes, epilepsy, neurotic disorders, and mood disorders. The HRQoL of hypertensive patients decreased significantly with age and duration of antihypertensive therapy (>2 years). HRQoL values were higher for men and participants with higher education and lower for participants who were obese or had visceral obesity. Antihypertensive therapy was effective in 25.4% of the participants. CONCLusIONs Chronic diseases concomitant with arterial hypertension negatively affect all dimensions of the HRQoL.

SummaryBackgroundDry cough is a common cause for the discontinuation of ramipril treatment. The aim of this pharmacoepidemiological study was to assess the incidence of ramipril-related cough among the Polish population and to characterize patients at risk of experiencing the adverse effect of cough during ramipril treatment.Material/MethodsThis was a prospective observational study involving 10,380 patients treated with ramipril for a period of no longer than 8 weeks, consisting of 3 visits: baseline, first follow-up (after 4–8 weeks) and second follow-up visit (after 4–8 weeks of cessation of ramipril, conducted only for evaluating coughing patients).ResultsThe incidence of ramipril-related cough was 7.1%. Logistic regression analysis identified female sex (OR=1.35), cigarette smoking (OR=2.50), chronic obstructive pulmonary disease (OR=1.70), asthma (OR=1.60) and previous history of tuberculosis (OR=6.20) to be significantly and independently associated with the onset of ramipril-related cough.Coughing subsided within a period of 2–20 days after ramipril was discontinued. In all patients reporting the appearance of cough within the first 5 days after therapy initiation, the adverse effect subsided after therapy discontinuation. If cough appeared within 6–10 days, it subsided after discontinuation in 81.6% of subjects. Cough persisted in 30.4% of those reporting later onset.Conclusions1. Female sex, cigarette smoking, COPD, asthma, and previous history of tuberculosis increase the risk of ramipril-related cough. 2. The later the cough occurs during treatment, the less often the drug is the causative agent and the cough and also less likely to disappear after discontinuation of ramipril.

Background: Thoracic surgery often demands separation of ventilation between the lungs. It is achieved with double-lumen tubes (DLTs), video double-lumen tubes (VDLTs) or bronchial blockers. We tested the hypothesis that intubation with the VivaSight double-lumen tube would be easier and faster than with a standard DLT.Methods: Seventy-one adult patients undergoing thoracic procedures that required general anaesthesia and one-lung ventilation (OLV) were enrolled in this randomized, prospective study. Patients were randomly assigned to procedure of intubation with a standard DLT or VDLT. The collected data included: patients' demographics, surgery information, anthropometric tests used for difficult intubation prediction, specifics of intubation procedure, tube placement, fiberoptic bronchoscopy (FOB) use, lung separation, trachea temperature, and reported complications of intubation.Results: For DLTs compared to video-double lumen tubes, intubation time was significantly longer (125 vs. 44 s; P<0.001), intubation graded harder (P<0.05) and FOB use was more prevalent [8 (20.5%) vs. 0; P<0.05]. Conclusions:The use of VDLTs when compared with standard-double lumen tubes offers reduced intubation time and is relatively easier. Also, the reduced need for fibreoptic bronchoscopy may improve the cost-effectiveness of VDLT use. In addition, constant visualization of the airways during the procedure allows to quickly correct or even prevent the tube malposition.Trial Registration: The study was registered in the ClinicalTrials.gov registry, ID: NCT04101734.

IntroductIon Visceral adipose tissue is the main source of circulating proinflammatory adipokine, visfatin/nicotinamide phosphoribosyltransferase (visfatin/NAMPT), whose role in the pathogenesis of metabolic syndrome (MS) components such as hypertension and carbohydrate and lipid disturbances is still uncertain, due to commonly used low specific C-terminal immunoassays to determine visfatin/ NAMPT levels.objectIves The aim of the study was to assess the association between the occurrence of MS components and circulating visfatin/NAMPT levels in elderly population.PAtIents And methods The analysis included 2174 elderly participants of the PolSenior study without heart failure, severe chronic kidney disease, cancer, and malnutrition. MS was defined according to the modified International Diabetes Federation criteria. Plasma visfatin/NAMPT concentrations were measured by a highly specific enzyme-linked immunosorbent assay. Additionally, high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), and insulin levels were assessed, and the homeostasis model assessment for insulin resistance was calculated.results Women were diagnosed with MS more often than men (71.2% vs 56.8%; P <0.001) and had a greater prevalence of all MS components except for type 2 diabetes. Women with MS had higher concentrations of hsCRP and IL-6 than those without MS. Visfatin/NAMPT concentrations were higher in women with MS than in those without MS (1.06 ng/ml [0.65-1.87] vs 0.85 ng/ml [0.54-1.40]; P <0.001), but no differences were observed in men (0.97 ng/ml [0.59-1.61] vs 0.90 ng/ml [0.56-1.60], respectively; P = 0.5). In women, there was a stronger association between the number of components of MS and increased plasma visfatin/NAMPT levels than in men.conclusIons Plasma visfatin/NAMPT levels are increased only in elderly women with MS. It is difficult to distinguish the components of MS specifically associated with increased visfatin/NAMPT levels. 403assay (ELISA) kits in plasma samples of a large group of elderly subjects, participants of the PolSenior study, 18 may provide new data on the role of visfatin/NAMPT in MS. In our recently published study, we have shown that plasma visfatin/NAMPT levels are associated with age, systemic microinflammation, and IR regardless of sex, and with nutritional status only in women. 19 The aim of the present study was to assess the association between the number and type of MS components and circulating plasma visfatin/ NAMPT levels in elderly population.PAtIents And methods study design and setting This substudy was based on 2733 banked samples from the PolSenior study 18 stored at -70°C. The PolSenior study conducted in the years 2008 and 2011 recruited 6 age cohorts of a similar size (65-69 years, 70-74 years, 75-79 years, 80-84 years, 85-89 years, and ≥90 years). Trained nurses visited a total of 4979 participants 3 times to conduct a questionnaire survey, comprehensive geriatric assessment, and body mass, height, waist circumference, and blood pressure (BP) measurements. In addi...

year survival of patients with chronic systolic heart failure... 543 INTROduCTION Despite advances in the diagnosis and treatment of coronary artery disease and arterial hypertension, the incidence and prevalence of chronic systolic heart failure (CHF) are still on the rise. 1-3 In people aged from 35 to 64 years, arterial hypertension causes a 4-fold increase in the risk of CHF; in elderly patients, the increase is 2-fold. 4,5 Disorders of the circadian rhythm of arterial pressure, such as the absence of night-time dip, are associated with a 2-fold increase in CHF risk. 6 Hypertension leads to left ventricular (LV) overload and to alterations in cardiac structure and function, referred to as hypertensive heart disease. 7,8 The left ventricle adapts its size and shape to an increased afterload, which requires a greater energy input so as to maintain its cardiac output. Macro-and microangiopathy-related ischemia as well as fibrosis additionally impair the ventricular function. Excessive activation of the neurohormonal system maintains the faulty cycle of remodeling, thereby causing further pro-AbsTRACT INTROduCTION Despite advances in medicine, chronic systolic heart failure (CHF) due to hypertension still constitutes a serious clinical challenge. ObjECTIvEs The aim of the study was to determine risk mortality factors in a 3-year follow-up of patients with CHF due to hypertension. PATIENTs ANd mEThOds The study involved 140 consecutive stable inpatients with CHF (left ventricular end diastolic diameter >57 mm; left ventricular ejection fraction [LVEF] <40%), without epicardial artery stenosis (>30% vessel lumen), significant heart defect, diabetes, neoplastic, disease, or chronic kidney disease, with a minimum 5-year history of hypertension, and administration of angiotensin-converting enzyme inhibitors (or angiotensin II receptor antagonists), β-adrenolytics, spironolactone and furosemide for 3 or more months. The follow-up began on admission to the hospital after laboratory tests, resting electrocardiogram and echocardiogram, six-minute walk test, coronarography, and endomyocardial biopsy. Late follow-up data was obtained from the follow-up visits or by telephone. REsuLTs The analysis involved 130 of 140 patients aged 47.8 ±7.9 years. The 3-year mortality rate was 18.5%. Independent risk factors for death were LVEF (hazard ratio [HR], 0.881; 95% confidence interval [CI], 0.797-0.975,