Introduction:The aim of the study was to evaluate clinical and biochemical differences between patients with low-renin and high-renin primary arterial hypertension (AH), mainly in reference to serum lipids, and to identify factors determining lipid concentrations.Materials and methods:In untreated patients with AH stage 1 we measured plasma renin activity (PRA) and subdivided the group into low-renin (PRA < 0.65 ng/mL/h) and high-renin (PRA ⩾ 0.65 ng/mL/h) AH. We compared office and 24-h ambulatory blood pressure, serum aldosterone, lipids and selected biochemical parameters between subgroups. Factors determining lipid concentration in both subgroups were assessed in regression analysis.Results:Patients with high-renin hypertension (N = 58) were characterized by higher heart rate (p = 0.04), lower serum sodium (p < 0.01) and aldosterone-to-renin ratio (p < 0.01), and significantly higher serum aldosterone (p = 0.03), albumin (p < 0.01), total protein (p < 0.01), total cholesterol (p = 0.01) and low-density lipoprotein cholesterol (LDL-C) (p = 0.04) than low-renin subjects (N = 39). In univariate linear regression, only PRA in the low-renin group was in a positive relationship with LDL-C (R2 = 0.15, β = 1.53 and p = 0.013); this association remained significant after adjustment for age, sex, and serum albumin and aldosterone concentrations.Conclusions:Higher serum levels of total and LDL-C characterized high-renin subjects, but the association between LDL-C level and PRA existed only in low-renin primary AH.
Objective: The aim of the study was to establish mechanisms of ischemic type, painless ST segment depression in nine patients with nonobstructive hypertrophic cardiomyopathy (HC) treated effectively by verapamil.Methods: Simultaneous 24-hour Holter and blood pressure monitoring (measurements every 15 minutes) was performed to determine approximate indices of myocardial oxygen demand (double product), myocardial oxygen supply (diastolic blood pressure), and ST segment level during each minute when blood pressure measurements were obtained. According to ST segment level, all recordings were divided into four subgroups (one without and three with gradually increasing magnitude of ST segment depression) in which average double product and diastolic blood pressure were calculated.Results: Increasing ST segment depression coincided with gradual rises in double product indicating increasing myocardial oxygen consumption. Diastolic blood pressure was low in the group without ST segment deviation whereas it was significantly higher only in groups with ST segment depression of more than 2 mm.Conclusion: Verapamil-induced, excessive fail of diastolic blood pressure was not associated with exacerbating ST segment depression. On the other hand, occasionally verapamil insufficiently prevented increases of double product, which coincided with the prescence of painless ST segment hypertrophic cardiomyopathy; painless myocardial ischemia; verapamil depression episodes.
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