1. Changes in blood pressure during the normal menstrual cycle are not well documented, and previous studies have given conflicting results. 2. Thirty normotensive women and ten mildly hypertensive women measured their blood pressure at home each morning for 6 weeks, under standardized conditions, using a UA-751 semi-automatic sphygmomanometer. All had normal menstrual cycles and subjects entered the study at difference phases of the cycle. 3. Blood pressure was higher at the onset of menstruation than at most other phases of the cycle (systolic blood pressure, P < 0.05; diastolic blood pressure, P < 0.001). Adjusted diastolic blood pressure was higher in the follicular than in the luteal phase (mean difference 1.23 mmHg, P < 0.001). Similarly, blood pressure was lower during days 17–26 than during the remainder of the cycle (adjusted mean difference in systolic blood pressure −0.65 mmHg, P = 0.07; adjusted mean difference in diastolic blood pressure − 1.19 mmHg, P < 0.001). 4. Similar patterns were seen in normotensive and hypertensive subjects, and changes in plasma 17β-oestradiol and progesterone concentrations were also similar in the two groups.

Although epidemiological findings support a role for vitamin K status in the improvement of bone indices in adult patients with Crohn's disease (CD), this needs to be confirmed in double-blind, randomised controlled trials (RCT) with phylloquinone (vitamin K 1 ). By conducting two RCT, the present study aimed to first establish whether supplementation with 1000 mg of phylloquinone daily near-maximally suppresses the percentage of undercarboxylated osteocalcin in serum (%ucOC; marker of vitamin K status) in adult patients with CD currently in remission as it does in healthy adults and second determine the effect of supplementation with phylloquinone at this dose for 12 months on the indices of bone turnover and bone mass. The initial dose-ranging RCT was conducted in adult patients with CD (n 10 per group) using 0 (placebo), 1000 or 2000 mg of phylloquinone daily for 2 weeks. In the main RCT, the effect of placebo v. 1000mg vitamin K/d (both coadministered with Ca (500 mg/d) and vitamin D 3 (10 mg/d)) for 12 months (n 43 per group) on the biochemical indices of bone turnover (determined by enzyme immunoassay) and bone mass (determined by dual-energy X-ray absorptiometry) were investigated. At baseline, the mean %ucOC was 47 %, and this was suppressed upon supplementation with 1000 mg of phylloquinone daily (281 %; P,0·01) and not suppressed further by 2000 mg of phylloquinone daily. Compared with the placebo, supplementation with 1000 mg of phylloquinone daily for 12 months had no significant effect (P.0·1) on bone turnover markers or on the bone mass of the lumbar spine or femur, but modestly increased (P,0·05) the bone mass of the total radius. Despite near maximal suppression of serum %ucOC, supplementation with 1000 mg of phylloquinone daily (with Ca and vitamin D 3 ) had no effect on the indices of bone health in adult CD patients with likely vitamin K insufficiency.Key words: Phylloquinone (vitamin K 1 ): Percentage of undercarboxylated osteocalcin: Bone health indices: Intervention studies: Crohn's disease Osteopaenia and osteoporosis are common conditions among patients with Crohn's disease (CD) (1,2) . Bone loss resulting from these conditions is a major risk factor for osteoporotic fractures of the spine, wrist and hip (3) , which can have a deleterious effect on the quality of life of patients with CD, especially in young patients who have a normal life expectancy. Although the pathogenesis of osteopaenia and osteoporosis in CD is likely to be multifactorial, the existence of nutritional inadequacies of Ca and vitamin D in these patients has been implicated (4 -9) .The prevalence of vitamin K deficiency in patients with chronic gastrointestinal disorders has been known for some time (10) . The concentration of undercarboxylated osteocalcin (ucOC) and the percentage of osteocalcin present in an undercarboxylated state (%ucOC) are markers of diminished vitamin K nutritive status (11) . Adult patients with CD, even those in remission and not taking high-dose steroids, have been shown to have hi...

The prevalence of hypertension was investigated in a systematically chosen sample of patients attending a diabetic clinic. One hundred ninety-one patients were classified as Type 1 (insulin-dependent), 183 were classified as Type 2 (non-insulin-dependent) and 12 were deemed unclassifiable. Two hundred fifty-five control subjects attending non-medical out-patient clinics were also examined under similar conditions. Hypertension was significantly (p less than 0.001) more common among Type 2 patients (38%) than among Type 1 patients (15%) or control subjects (16%). The difference between Type 2 patients and control subjects, but not between Type 2 and Type 1 patients, persisted when the influences of age and body mass index were controlled. We also investigated the prevalence of hypertension among the siblings of the hypertensive patients identified, together with a matched normotensive group. One hundred eighty-eight siblings were examined and historical details were obtained for a further 451 siblings. When age and body mass index were controlled for in examined siblings, the risk of hypertension was greater in those with a hypertensive proband than in those with a normotensive proband, in the control (p less than 0.06) and Type 1 (p less than 0.02) groups.(ABSTRACT TRUNCATED AT 250 WORDS)