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Abstract-We aimed to investigate for the first time the blood pressure (BP)-lowering effect of renal sympathetic denervation (RDN) versus clinically adjusted drug treatment in true treatment-resistant hypertension (TRH) after excluding patients with confounding poor drug adherence. Patients with apparent TRH (n=65) were referred for RDN, and those with secondary and spurious hypertension (n=26) were excluded. TRH was defined as office systolic BP (SBP) >140 mm Hg, despite maximally tolerated doses of ≥3 antihypertensive drugs including a diuretic. In addition, ambulatory daytime SBP >135 mm Hg after witnessed intake of antihypertensive drugs was required, after which 20 patients had normalized BP and were excluded. Patients with true TRH were randomized and underwent RDN (n=9) performed with Symplicity Catheter System versus clinically adjusted drug treatment (n=10

High intake of fruits and vegetables is associated with reduced cardiovascular risk. A number of fruits and vegetables are rich in anthocyanins, which constitute a subgroup of the flavonoids. Anthocyanins have demonstrated anti-inflammatory and anti-oxidative properties, and anthocyanin-rich interventions have indicated beneficial effects on blood pressure and other cardiovascular risk factors. We assessed whether a purified anthocyanin supplement improves cardiovascular metabolic risk factors and markers of inflammation and oxidative stress in prehypertensive participants, and whether plasma polyphenols are increased 1-3 h following intake. In all, 31 men between 35-51 years with screening blood pressure >140/90 mm Hg without anti-hypertensive or lipid-lowering medication, were randomized in a double-blinded crossover study to placebo versus 640 mg anthocyanins daily. Treatment durations were 4 weeks with a 4-week washout. High-density lipoprotein (HDL)-cholesterol and blood glucose were significantly higher after anthocyanin versus placebo treatment (P=0.043 and P=0.024, respectively). No effects were observed on inflammation or oxidative stress in vivo, except for von Willebrand factor, which was higher in the anthocyanin period (P=0.007). Several plasma polyphenols increased significantly 1-3 h following anthocyanin intake. The present study strengthens the evidence that anthocyanins may increase HDL-cholesterol levels, and this is demonstrated for the first time in prehypertensive and non-dyslipidemic men. However, no other beneficial effects in the short term were found on pathophysiological markers of cardiovascular disease.

Background: Skin conductance (SC) as a measure of emotional state or arousal may be a tool for monitoring surgical stress in anaesthesia. When an outgoing sympathetic nervous burst occurs to the skin, the palmar and plantar sweat glands are filled up, and the SC increases before the sweat is removed and the SC decreases. This creates a SC fluctuation. The purpose of this study was to measure SC during laparoscopic cholecystectomy with propofol and remifentanil anesthaesia and to evaluate whether number and amplitude of SC fluctuations correlate with perioperative stress monitoring. Methods: Eleven patients were studied nine times before, during and after anaesthesia. SC was compared to changes in stress measures such as blood pressure, heart rate, norepinephrine and epinephrine levels. SC was also compared to changes in Bispectral index (BIS). Results: The blood pressure, epinephrine levels and norepinephrine levels were positively correlated with both the number (P Ͻ 0.001) and amplitude (P Ͻ 0.01) of the SC fluctu-

Abstract-Baroreceptor reflex sensitivity (BRS) has been found lower and heart rate variability (HRV) parasympathetic markers have been found higher in healthy women than in healthy men. Thus, in the present study we hypothesized gender differences in the autonomic function among hypertensive subjects. Forty-one hypertensive patients and 34 normotensive subjects, age 53Ϯ1 years, were examined. Four weeks after cessation of antihypertensive therapy, HRV was assessed in 24-hour Holter ECGs, and BRS was calculated with the transfer technique. A t test was performed after log transformation of spectral values. Resting blood pressure and heart rate in the hypertensive and the normotensive groups were 150Ϯ2/100Ϯ1 (meanϮSEM) and 121Ϯ2/81Ϯ1 mm Hg, respectively, and 68Ϯ1 and 60Ϯ1 bpm, respectively (PϽ0.0005). Compared with normotensive controls, hypertensive patients had lower total power (1224Ϯ116 versus 1797Ϯ241 ms 2 ; Pϭ0.03), lower low frequency power (550Ϯ57 versus 813Ϯ115 ms 2 ; Pϭ0.04), lower high frequency power (141Ϯ23 versus 215Ϯ38 ms 2 ; Pϭ0.06), lower root mean square successive difference (28.7Ϯ2.7 versus 35.7Ϯ3.0 ms; Pϭ0.03), and PNN50 (4.9Ϯ0.6% versus 9.8Ϯ1.5%; Pϭ0.003). BRS was also lower in the hypertensive subjects (7.6Ϯ0.6 versus 10.4Ϯ0.8 ms/mm Hg; Pϭ0.005). When comparing the same parameters between normotensive subjects and hypertensive subjects within the same gender group, we found significant reduction (PϽ0.05) only within the female group. The difference in BRS within the female group was twice that within the male group. Stepwise multiple regression analysis revealed gender, age, HDL cholesterol, and blood pressure as independent explanatory variables of BRS and HRV. Our results suggest that gender is an important determinant of BRS and HRV. Autonomic function parameters were especially impaired in hypertensive women compared with hypertensive men. Key Words: hypertension Ⅲ gender Ⅲ baroreflex Ⅲ catecholamines Ⅲ heart rate T he autonomic nervous system plays a crucial role in blood pressure (BP) and heart rate (HR) control and may thus be an important pathophysiological factor in the development of hypertension. There have been numerous studies on plasma catecholamines in essential hypertension, 1 most of which have shown increased levels in hypertensive subjects. Moreover, disturbed autonomic HR and BP control has been demonstrated in several studies by means of HR variability (HRV) and baroreceptor reflex sensitivity (BRS). [2][3][4][5][6][7][8][9][10] HRV, which estimates the tonic HR control, 11-13 is generally reduced (standard deviation of all R-R intervals [SDNN] and total power [energy in the heart period spectrum between 0.0033 and 0.40 Hz] [TP]) in hypertensive patients. 2,4 -6 Markers of sympathetic predominance are increased in some 3 but not all studies. 4 -6 BRS, which estimates the reflex vagal HR control, 11-13 is reduced in hypertensive subjects. 6 -10 Both BRS and HRV parameters (except low frequency power [energy in the heart period spectrum between 0.04 and 0.15 Hz] [LF]/h...