SUMMARY Systemic, renal and splanchnic hemodynamics, intravascular volume, circulating catecholamine levels and plasma renin activity were compared in 39 patients with borderline hypertension and 28 normotensive subjects, who were less than 5% (n = 42, lean patients) or more than 40% overweight (n = 25, obese patients). Lean borderline hypertensive patients had greater cardiac output (p < 0.05), heart rate (p < 0.01) and renal blood flow (p < 0.05); cardiopulmonary redistribution of intravascular volume (p < 0.05); and higher circulating norepinephrine levels (p < 0.05). Obese normotensive subjects also showed an increased cardiac output (p < 0.005), stroke volume (p < 0.01), left ventricular stroke work (p < 0.05), and renal blood flow (p < 0.05) (but not respective indexes), but intravascular volume was expanded (p < 0.05) without redistribution and circulating catecholamine levels were normal. Obese borderline hypertensive patients had hemodynamic characteristics similar to those of obese normotensive subjects except for an increased peripheral resistance (p < 0.05). The data indicate that although both populations have an increased cardiac output, the lean borderline hypertensive patients have signs of enhanced adrenergic activity as evidenced by higher circulating catecholamine levels and heart rate with blood volume translocation to the cardiopulmonary circulation. In contrast, the obese subjects (whether normotensive or borderline hypertensive), who also have increased cardiac output, seem to have normal adrenergic activity and an expanded intravascular volume without cardiopulmonary redistribution.YOUNG PATIENTS with borderline blood pressure values are at least three times more likely to develop established essential hypertension as age-matched normotensive subjects.'1 2 Elevated resting cardiac output and heart rate have been identified as predictors for the development of essential hypertension into a state with more persistently elevated arterial pressure and periph-

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in this pediatric population, renal function at second transplant was an independent predictor of mortality (p Ͻ 0.05). Conclusion: In contrast to adult experience, mechanical ventilation at time of second transplant was not a predictor for mortality in pediatric lung re-transplantation. Instead, renal insufficiency was the unique predictor of mortality in this pediatric population. Based on these findings, we have adopted creatinine clearance Ͻ50ml/min/m 2 as a contraindication for pediatric lung re-transplantation.

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