This is the first demonstration from a large database that not only average 24 h PP and SBP values, but also 24 h BP fluctuations, are associated with, and possibly determinants of, the alterations of large artery structure in hypertension.

No abstract

Chronic alcohol exposure can affect the osteoblastic activity and the proliferation and differentiation of cells due to its toxic effect, which can affect negatively bone repair and bone microarchitecture. The aim of this study was to evaluate the effects of chronic use of 20% alcohol on rats regarding osteoblastic differentiation, extrinsic and intrinsic properties of the tibia, and hepatic and renal morphology. Wistar rats were divided into three groups (n = 9) in accordance with a 24-week diet. After euthanasia, kidneys, liver, and tibias were removed for analysis and femurs mesenchymal cells were collected. The results showed that chronic use of 20% alcohol influenced neither the alkaline phosphatase production nor total protein (p > 0.05) in rats, with similar formation of nodules in all groups (p > 0.05). However, significant changes in the liver and kidneys and adverse effects on the mechanical properties of the tibia were observed. According to the results, it can be concluded that the chronic use of alcohol for 24 weeks had no negative influence on the activity and differentiation of osteoblasts, but the mechanical properties of the tibia were impaired and the organs responsible for metabolism and excretion were also affected due to the consumption of alcohol.

The aim of this study was to evaluate the effects of chronic treatment with lacidipine on blood pressure, heart rate and double product during and immediately after physical effort in mild to moderate hypertensive patients. This was a single-center, randomized, double-blind, crossover, placebo-controlled clinical trial. Eighteen hypertensive patients (56% males, median age 53 years) were randomized to lacidipine 4 mg o.i.d. followed by placebo or to placebo followed by lacidipine 4 mg o.i.d. Lacidipine compared with placebo exerted a significant antihypertensive effect, lowering SBP and DBP both at baseline and either during or after exercise test. The average incremental changes of SBP and DBP between pre-exercise stage and maximal effort did not show any significant differences between treatments. HR during treatment with lacidipine was higher than during treatment with placebo both at rest and after exercise, but at maximal effort, HR was not different from placebo. The average values of DP at maximal effort, and during recovery, did not show any significant differences. Lacidipine 4 mg was effective in lowering blood pressure and in maintaining its antihypertensive effect throughout and after physical exercise, without enhancing double product value, which is an indirect index of myocardial oxygen consumption.

Objective:Smoking is a well recognised cardiovascular risk factor in hypertensive subjects, being associated Abstract with an increase in sympathetic activation, impaired endothelial function and, ultimately, an excess of morbidity and mortality. The antihypertensive class of choice in hypertensive smokers has not been clearly established. Design and study participants: After a cross-sectional pilot study conducted in more than 3000 hypertensive patients (37.5% of whom were smokers), we conducted a 6-month prospective study in 4219 hypertensive smokers. The aim of the study was to explore the association between antihypertensive treatment (with a focus on β-blockers), blood pressure (BP) control and overall cardiovascular risk reduction in such patients. Results: Chronic treatment with a β-blocker-containing compared with a non-β-blocker-containing antihypertensive regimen was associated with significantly better BP control both at baseline and after a 6-month follow-up period. This resulted in a lower 10-year projected cardiovascular risk, a lower incidence of cardiovascular events and reduced hospitalisation rates compared with patients receiving a non-β-blockercontaining regimen. Conclusions: More prospective, randomised, controlled studies are needed to further test the hypothesis that β-blockers are the treatment of choice for hypertensive smokers.Hypertension is a well known cause of cardiovascular compliof evaluating and treating concomitant diseases or hypertensionassociated risk factors such as diabetes, dyslipidaemia, left vencations, including heart failure, myocardial infarction, aortic aneutricular hypertrophy and smoking. [3] Cigarette smoking especially rysm rupture, stroke, eclampsia, coronary artery disease and is known to markedly increase the risk of myocardial infarction in chronic kidney failure, which carry a high socioeconomic burboth men and women, [4] particularly in hypertensive subjects. The den. [1,2] During the past 25 years, it has been well established that detrimental effects of smoking in hypertensive patients may be antihypertensive medications have beneficial effects, not only in due to both an additive increase in sympathetic activation and lowering blood pressure (BP) per se, but also in reducing hyperfurther disruption of peripheral endothelial function. tension-associated detrimental effects on target organs such as the heart, brain, kidney and blood vessels. Nevertheless, patients with To date, a relatively low level of attention has been paid to hypertension still have a higher incidence of cardiovascular discigarette smoking in hypertensive patients, compared with other ease compared with normotensive individuals. This can be attribconcomitant risk factors such as diabetes or left ventricular hyperuted to (i) the difficulty in normalising BP levels in the majority of trophy. [5,6] This is in spite of the fact that epidemiological data hypertensive patients; and (ii) the low awareness of the importance have confirmed that hypertensive smokers are at a higher risk of