We investigated the e¡ect of testosterone (T) on tumor necrosis factor-K K (TNF-K K)-induced expression of vascular cell adhesion molecule-1 (VCAM-1) in human aortic endothelial cells. Incubation of these cells with T resulted in a dose-dependent reduction in the expression, with this reduction completely abolished by a selective androgen receptor blocker. Electrophoretic mobility shift assay demonstrated that T inhibited TNF-K Kinduced activation of the transcriptional nuclear factor-U UB, which is critical for the inducible expression of VCAM-1, probably through the suppression of the nuclear translocation. Our results may suggest an inhibitory e¡ect of T on atherogenesis, providing a novel insight into the consideration of the pathogenesis of atherosclerosis.

OBJECTIVE -To assess the prognostic role of ambulatory 24-h pulse pressure (PP) on various vascular events in relatively young type 2 diabetic subjects under 60 years of age.RESEARCH DESIGN AND METHODS -In this prospective study, 237 type 2 diabetic subjects without any history of vascular complications were analyzed. After excluding 9 dropout subjects, 228 subjects (mean age, 46 years; 69% men; mean follow-up period, 100 months) entered the study.RESULTS -Distribution of 24-h PP for all subjects showed left skewed data, indicating that there may be a diabetic subgroup that had a wide PP. Therefore, further analysis was performed by stratifying the diabetic subjects by quartile of 24-h PP. Outcomes for the widest quartile (n ϭ 58; cut point ϭ 53.3 mmHg) was then compared with those from the other narrower quartiles (n ϭ 170). In the diabetic subjects with a wide PP, cardiovascular events occurred more frequently than those in the diabetic subjects with a narrow one (20.7 vs. 4.1%; P Ͻ 0.001), resulting in the significant difference in the cumulative incidence of cardiovascular events (P Ͻ 0.001, log-rank test), but not cerebrovascular events, between the two subgroups. The Cox model revealed that a wide 24-h PP at baseline independently predicted subsequent cardiovascular events but not cerebrovascular events. By contrast, only duration of diabetes was the risk factor for cerebrovascular events.CONCLUSIONS -This study showed that a wide 24-h PP is predictive for cardiovascular events in relatively young diabetic subjects. Diabetes Care 28:102-107, 2005T here is now increasing evidence that wide pulse pressure (PP), which is an indicator of large arterial stiffness, is an independent predictor for cardiovascular disease in elderly subjects with essential hypertension (1,2). A prognostic role for PP has been extended to an unselected general population, including relatively young aged (3,4) and normotensive subjects (5). Furthermore, the Atherosclerosis Risk in Communities study (6) and the Hoorn study (7) demonstrated that type 2 diabetic subjects have stiffer arteries than individuals with normal glucose tolerance, which was confirmed using ambulatory 24-h monitoring of PP by van Dijk et al. (8). Recently, Domanski et al. (9) and Miyagi et al. (10) pointed out that a cardiovascular risk in subjects with a wide PP increased with the presence of diabetes. On the other hand, previous studies suggest that in subjects with essential hypertension, ambulatory PP not only correlates with organ damage (11) but also independently predicts cardiovascular events more precisely than clinic PP does (12,13). However, there is little information concerning PP of relatively young type 2 diabetic subjects, and the predictive value of ambulatory 24-h PP among these subjects has not been previously reported.The aim of this present study was to assess a prognostic role of ambulatory 24-h PP on various vascular events in type 2 diabetic subjects Ͻ60 years of age.RESEARCH DESIGN AND METHODS -The blood pressure (BP) monitoring progra...

We describe a 17-year-old hypertensive man with a left abdominal mass on the computed tomographic scan. Radiologic studies revealed a large tumor near the left renal hilus, resulting in renal compression and displacement toward the posterolateral abdominal cavity. Aortography excluded stenosis of the renal arterial vessels. Plasma and urinary catecholamines were normal and plasma renin activity (PRA) was high. The left renal vein renin was 2.1-fold higher than the right one. After resecting the tumor including the left kidney and adrenal, high blood pressure and elevated PRA returned to normal. Histologically, the tumor was a paraganglioma, and the affected kidney showed hyperplasia of the juxtaglomerular apparatus. Thus, the hypertension in our patient was probably due to renal ischemia extrinsically compressed by a non-functioning retroperitoneal paraganglioma (Page kidney).

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Renovascular hypertension in two sisters, aged 22 and 20, respectively, has been described. Renal artery stenoses were observed unilaterally in the elder patient and bilaterally in the younger one. In both patients, the functional significance of unilateral stenosis of the renal artery was documented by the renal vein renin ratio between the affected side and the contralateral or less affected side. High blood pressure and elevated plasma renin activity have been normalized with a unilateral revascularization in the elder patient, and with the treatment of propranolol in the younger one. The histological examination of the stenotic renal artery in the elder patient showed a finding comparable to the perimedial fibroplasia in Harrison and McCormack’s classification of idiopathic fibromuscular stenosis.