BackgroundStudies showed that long-standing smokers have stiffer arteries at rest. However, the effect of smoking on the ability of the vascular system to respond to increased demands (physical stress) has not been studied. The purpose of this study was to estimate the effect of smoking on arterial stiffness and subendocardial viability ratio, at rest and after acute exercise in young healthy individuals.Methods/ResultsHealthy light smokers (n = 24, pack-years = 2.9) and non-smokers (n = 53) underwent pulse wave analysis and carotid-femoral pulse wave velocity measurements at rest, and 2, 5, 10, and 15 minutes following an exercise test to exhaustion. Smokers were tested, 1) after 12h abstinence from smoking (chronic condition) and 2) immediately after smoking one cigarette (acute condition). At rest, chronic smokers had higher augmentation index and lower aortic pulse pressure than non-smokers, while subendocardial viability ratio was not significantly different. Acute smoking increased resting augmentation index and decreased subendocardial viability ratio compared with non-smokers, and decreased subendocardial viability ratio compared with the chronic condition. After exercise, subendocardial viability ratio was lower, and augmentation index and aortic pulse pressure were higher in non-smokers than smokers in the chronic and acute conditions. cfPWV rate of recovery of was greater in non-smokers than chronic smokers after exercise. Non-smokers were also able to achieve higher workloads than smokers in both conditions.ConclusionChronic and acute smoking appears to diminish the vascular response to physical stress. This can be seen as an impaired ‘vascular reserve’ or a blunted ability of the blood vessels to accommodate the changes required to achieve higher workloads. These changes were noted before changes in arterial stiffness or subendocardial viability ratio occurred at rest. Even light smoking in young healthy individuals appears to have harmful effects on vascular function, affecting the ability of the vascular bed to respond to increased demands.

OCP use was associated with significant increases in aortic and peripheral blood pressures, but not with increased arterial stiffness. Given the widespread OCP use, future longitudinal studies are needed to confirm our findings and assess the long-term effect of OCPs on arterial stiffness and hemodynamics.

"Surgical stress response" is tissue damage postsurgery, leading to a systemic response (inflammation, sympathetic upregulation, and release of vasoactive chemicals), which is typically measured by C-reactive protein (CRP). We assessed arterial stiffness and heart rate variability (HRV)-additional parameters reflecting autonomic and vascular functions-in this response and their potential associations with postoperative complications. In 47 participants undergoing abdominal surgery, CRP, arterial stiffness, and HRV were measured pre- and postoperatively (days 1 and 2). C-reactive protein was significantly higher postoperatively in participants experiencing complications but not preoperatively. Compared to participants without complications, those with complications had increased HRV and pnn50 (time domain) and tendency toward increasing low-frequency/high-frequency ratio (frequency domain) on postoperative day 2. Therefore, time and frequency domain HRV parameters show perioperative changes in relation to complication development. These findings suggest the applicability of this noninvasive technology to a variety of abdominal operations. Larger studies need to confirm these findings.

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BACKGROUND: Consumption of 1-2 alcoholic beverages daily has been associated with a lower risk of cardiovascular disease and all-cause mortality in middle-aged and older adults. Central blood pressure has emerged as a better predictor of cardiovascular risk than peripheral blood pressure. However, the effects of habitual alcohol consumption on central blood pressure particularly in young adults, who are among the largest consumers of alcohol in North America, have yet to be investigated. OBJECTIVE: We aimed to study the effect of alcohol consumption on central and peripheral blood pressure, and arterial stiffness in young adults. DESIGN: Cross-sectional observational study. MAIN MEASURES: Using a standardized questionnaire, alcohol consumption (drinks/week) was queried; participants were classified as non-(< 2), light (2-6), moderate (women 7-9, men 7-14), and heavy drinkers (women > 9, men > 14). Central blood pressure and arterial stiffness were measured using applanation tonometry. KEY RESULTS: We recruited 153 healthy, non-smoking, non-obese individuals. We found a U-shaped effect of alcohol consumption on blood pressure. Light drinkers had significantly lower central systolic and mean arterial blood pressure, but not peripheral blood pressure when compared to non-and moderate/heavy drinkers (P < 0.05). No significant associations with arterial stiffness parameters were noted. CONCLUSIONS: A U-shaped relationship was found between alcohol consumption and central and mean arterial blood pressure in young individuals, which importantly, was shifted towards lower levels of alcohol consumption than currently suggested. This is the first study, to our knowledge, that examines the effect of alcohol consumption on central blood pressure and arterial stiffness exclusively in young individuals. Prospective studies are needed to confirm the relationships observed herein.

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OBJECTIVES:To evaluate the level of compliance with antihypertensive medication among Greek hypertensive patients. Furthermore, to investigate the possible association between non-compliance and patient profile as well as specific drug categories. METHODS: A total of 2700 hypertensive patients participated and 2662 were analyzed in the study. The duration of the study was 9 months. Information was collected on different antihypertensive drug categories along with epidemiological data. Morisky scale was used in order to measure compliance. RESULTS: A total of 57.5% of the responders were male (1530 patients) and 1130 were female. Average age of responders was 63 years and average duration of hypertension was 8.6 years. 63.1% of the study population was found to be compliant with their antihypertensive treatment (regardless of the type of antihypertensive treatment the patient was receiving). From the Morisky scale, 36.2% of patients answered that they sometimes forget to take their medication, 44.9% said that they were sometimes careless when it comes to taking their medicine, 26.9% that when they feel better they forget to take their medicine and 18.4% of the study population answered that when they feel worse, they relate this to their medication and discontinue taking it. The factors found to influence compliance were the level of education, the occupational status and the financial status of the patient as well as the existence of conforming diseases such as duslipidemia and diabetes. CONCLUSIONS: About four out of ten hypertensive patients fail to comply with their prescribed treatment, increasing the possibility of poor control of their condition. This may be an important obstacle in the assessment of the efficacy of any pharmaceutical therapy and may influence the overall health levels of the patients, since poorly controlled blood pressure may lead to the development of more serious conditions as Congestive Heart Failure and Coronary Heart Disease.