Both BEI and BRS convey prognostic information that may have clinical implications for patients with cardiovascular diseases in general.

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We conclude that BEI, which is markedly reduced in hypertensive patients with CRF, may convey information on arterial baroreflex function that is complementary to BRS.

Patients with CRF (chronic renal failure) are at increased risk of cardiovascular diseases, and 60% of cardiovascular mortality in CRF is attributed to sudden death. Various abnormalities in myocardial repolarization are associated with the risk of ventricular arrhythmia. The aim of this study was to evaluate an index of temporal myocardial repolarization lability, the temporal QTVI (QT variability index), in patients with CRF. ECGs were recorded in 153 patients with CRF on haemodialysis (n=67), continuous ambulatory peritoneal dialysis (n=43) or conservative treatment (n=43) during 30 min of rest. QTVI was calculated as the logarithm of the ratio between the variances of the normalized QT and RR intervals. Age-matched healthy subjects (n=39) were examined for comparison. QTVI was increased by 47% in CRF patients compared with healthy subjects (-0.82+/-0.56 compared with -1.54+/-0.27 respectively; P<0.01). QTVI did not differ among patients on dialysis or conservative treatment, whereas QTVI was elevated further in patients with diabetes compared with non-diabetic CRF patients (-0.56+/-0.54 compared with -0.94+/-0.52 respectively; P<0.01). In a multiple linear regression analysis, diabetes and a history of coronary artery disease were the only independent predictors of QTVI in the CRF population. The present study demonstrates that elevated QTVI in patients with CRF is associated with diabetes and coronary disease. The present findings are important given that repolarization instability may predispose to ventricular arrhythmia and sudden death, events that occur frequently in CRF patients.

Many peri-and post-menopausal women also report depression and other psychological problems, which may be attributed to exogenous factors, but also to hormonal changes.8Most of these symptoms and changes around menopause may be ameliorated or completely cured by oestrogen replacement therapy (ERT), which should be combined with progestagen therapy to avoid hyperstimulation of the endometrium and risk of endometrial carcinoma.9 Combined treatment, usually called hormone replacement therapy (HRT), leads to vaginal bleeding, which makes some women abandon the treatment. Other women are prevented from undergoing ERT for medical reasons. Therefore there is a need for alternative treatments. There are relatively few pharmacological alternatives to ERT/HRT. Lifestyle factors such as regular physical activity affect many metabolic changes and symptoms of the climacteric,"0 including mental status as well as vasomotor symptoms.1' In fact, most metabolic changes correlated to the decrease in sex steroids around menopause are affected by exercise in the same direction as by oestrogens, but exercise also has some unique effects. Studies have shown that physically active women have a higher maximal oxygen uptake"-6 and a decreased risk of cardiovascular disease and death.'7 0 Exercise has beneficial effects on weight,...4 lipoprotein metabolism,2 2 blood pressure,... and glucose tolerance.'0" Furthermore, exercise increases bone mass and prevents bone loss3436 and also benefits balance,37 which should decrease the risk of falls and fractures. Fewer physically active women were found to have moderate to severe hot flushes after menopause than age matched women from a control group.38 Physical activity also exerts mental effects reducing both anxiety and physiological arousal,39 has definite relaxing effects,40 and appears to be an efficient treatment for mild to moderate depression.4' 42During the past few decades the number of competitive sports available to women has increased as has women's general leisure time for physical activity.43 Women may even have increased their activity levels more than men, and this also includes older women.4' The mean age of joggers has been found to increase, perhaps the result of a cohort phenomenon.44 Although interest in physical activity is growing, only 7-8% of women and men in the US aged 18-65 years were found to take part in regular physical exercise that involved large muscle groups for at least 60% of the