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Experimental models suggest that endothelin-1 (ET-1) has a significant role in the pathogenesis of cyclosporin A (CyA)-induced hypertension. However, its serum levels evaluated in different studies, including patients who received solid organ transplants, exhibited controversial results. Our study population consisted of 43 renal transplant patients: 33 were taking CyA as a component of their immunosuppressive regimen (CyA group) and 10 that were not taking CyA (control group). Baseline laboratory data, blood pressure and ET-1 levels were taken at baseline and 3 and 4 h after the ingestion of CyA. In the control group samples were collected in the corresponding periods of time. Blood pressure was significantly higher in the CyA group (mean blood pressure: 101.2 +/- 9.5 vs. 91.1 +/- 10.7 mmHg; p < 0.001), who also presented higher serum creatinine (1.2 +/- 0.28 vs. 0.97 +/- 0.13 mg/dL; p < 0.001) and ET-1 levels. In the CyA group an ET-1 peak was evident by the third hour after CyA ingestion that showed its maximum concentration after 1-2 h; the control group exhibited significantly lower levels of ET-1 (p = 0.044). ET-1 levels compared between patients with and without hypertension showed a non-statistically significant difference (1.54 +/- 0.76 vs. 1.27 +/- 0.62 ng/mL; p = 0.27, respectively). In conclusion, in the present study chronic CyA ingestion was associated with higher blood pressure and plasma ET-1 levels.

Coronary calcification was highly prevalent in these uraemic patients on chronic haemodialysis. A correlation was evidenced between CaCs and advanced age, but severity of the CAC score did not have an impact on 2-year mortality of this cohort.

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Urinary calcium excretion has been reported to be diminished in preeclampsia. The objective of the present study was to determine urinary calcium excretion in pregnant patients with chronic arterial hypertension (CAH) and preeclampsia (PE), and in normotensive patients (N). Forty-four pregnant patients (gestational age, 20-42 weeks; 18 CAH, 17 PE, 9 N) were evaluated for calciuria, proteinuria, plasma uric acid and blood pressure. Patients with PE (82 ± 15.1 mg/ 24 h) showed significantly lower calciuria (P<0.05) than the group with CAH (147 ± 24.9 mg/24 h) and the N group (317 ± 86.0 mg/24 h) (P<0.05, Student t-test). Plasma uric acid was significantly higher in the PE group (6.1 ± 0.38 mg/dl) than the CAH group (5.0 ± 0.33 mg/ dl; P<0.05), which also presented higher proteinuria levels, although the difference was not statistically significant. Diastolic and systolic blood pressure did not differ between the PE (164 ± 105 mmHg) and CAH (164 ± 107 mmHg) groups. Calciuria was significantly lower in the group with preeclampsia than in the group with chronic arterial hypertension. We conclude that calciuria can be a further factor for identifying preeclampsia.

We s t u d i e d 3 7 n u l l i p a r o u s women w i t h l a t e -o n s e t g e s t a t i o n a l h y p e r t e n s i o n a n d s i g n i f i c a n t p r o t e i n u r i a , w i t h a d i a s t o l i c b l o o d p r e s s u r e o f 1 1 0 mmHg o r h i g h e r . T h e y w e r e r a n d o m l y a s s i g n e d t o r e c e i v e i n t r a v e n o u s h y d r a l a z i n e ( 5 ou 1 0 mg) p l u s a n o r a l p l a c e b o ; o r o r a l n i f e d i p i n e ( 1 0 o r 2 0 mg) p l u s an i n t r a v e n o u s p l a c e b o , w i t h t h e g o a l o f m a i n t a i n i n g d i a s t o l i c b l o o d p r e s s u r e a t o r b e l o w 1 0 0 mmHg. A l l d r u g s w e r e a d m i n i s t e r e d i n a d o u b l e -b l i n d f a s h i o n . H y d r a l a z i n e d e c r e a s e d m e a n a r t e r i a l p r e s s u r e f r o m 1 3 6 * mmHg t o 1 0 6 k 7 mmHg, w h i l e n i f e d i p i n e d e c r e a s e d i t f r o m 1 3 5 * 8 mmHg t o 1 0 9 * 1 0 nunHg. The i n c i d e n c e of a d v e r s e m a t e r n a l a n d f e t a l e f f e c t s w e r e s i m i l a r i n t h e t w o t r e a t m e n t g r o u p s . T h i s r a n d o m i z e d t r i a l c o n t a i n e d a l i m i t e d n u m b e r o f s u b j e c t s a n d , t h e r e f o r e , d i d n o t h a v e t h e s t a t i s t i c a l p o w e r t o d e t e c t s m a l l d i f f e r e n c e s b e t w e e n h y d r a l a z i n e a n d n i f e d i p i n e . H o w e v e r , w e h a v e d e m o n s t r a t e d t h a t a t r i a l o f d r u g t h e r a p i e s f o r a c u t e h y p e r t e n s i o n i n p r e g n a n c y c a n b e s u c c e s s f u l l y b l i n d e d , a n d t h i s a p p r o a c h w o u l d b e v a l u a b l e i n a l a r g e r s t u d y c o m p a r i n g t h e t r e a t m e n t r e g i m e n s a d d r e s s e d h e r e .