Alexandros Tsakiris

Female sexual dysfunction in essential hypertension: a common problem being uncovered.

Objectives Female sexual dysfunction (FSD) is increasingly attracting more scientific and public interest, and represents a poorly investigated issue in patients with essential hypertension. We evaluated the prevalence of sexual dysfunction in hypertensive women compared with normotensive women according to age, hypertension severity, hypertension duration, and antihypertensive treatment. Methods The study population consisted of consecutive, sexually active women attending an outpatient hypertension clinic. The Female Sexual Function Index (FSFI questionnaire) was used to evaluate FSD. Univariate and multivariate analyses were used to evaluate predictors of FSD. Results Four hundred and seventeen women were studied. From them, 216 women had arterial hypertension (136 treated, 80 untreated) and 201 were normotensive. Sexual dysfunction was found in 42.1% of hypertensive women compared with 19.4% of normotensive women (odds ratio, 3.2; 95% confidence interval, 1.9–4.7; P < 0.001). Systolic blood pressure levels were significantly related to FSFI score (r = −0.67, P < 0.001). Successful control of hypertension was related to lower prevalence of FSD. Increasing age (β = −0.187, P = 0.001), increasing systolic blood pressure (β = −0.687, P < 0.001), and β-blocker administration (β = −0.162, P = 0.001) were significant predictors of sexual dysfunction in this patient population. Conclusions FSD is more prevalent in women with essential hypertension compared with women with normal blood pressure, and its prevalence declines with adequate blood pressure control. Adequate control of hypertension with medication not affecting sexual function can have a great impact on the quality of life of hypertensive patients. Physicians should recognize and properly manage FSD in hypertensive women.

Impact of the Metabolic Syndrome on Atrial Size in Patients With New-Onset Atrial Fibrillation

Atrial fibrillation (AF) is the most common arrhythmia, and it is strongly related to atrial enlargement. Metabolic syndrome (MetSyn) is associated with increased cardiovascular morbility and mortality. However, the impact of the MetSyn on cardiac arrhythmias is poorly elucidated. The aim of this study was to compare atrial dimensions in patients suffering from nonvalvular paroxysmal AF, with and without MetSyn, trying to identify structural differences that could favor the occurrence of this arrhythmia. The study population consisted of 60 patients who presented with at least 1 episode of paroxysmal AF. From these, 26 patients fulfilled the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) definition of MetSyn, while the remaining 34 patients did not. Left atrial size was assessed by 2-dimensional echocardiography. Patients with MetSyn had a mean atrial size of 46.2 ∓4.3 mm and those without MetSyn had a mean atrial size of 41.6 ∓1.9 mm, p<0.011. MetSyn may favor the occurrence of paroxysmal AF by increasing atrial size. This concept deserves more research.

Microalbuminuria is determined by systolic and pulse pressure over a 12-year period and related to peripheral artery disease in normotensive and hypertensive subjects : The three areas study in greece (TAS-GR)

Microalbuminuria and peripheral artery disease represent 2 different forms of target organ damage due to raised blood pressure. The aim of this study was to investigate the association between blood pressure with microalbuminuria and the appearance of peripheral artery disease after more than a decade, and moreover, to address whether any relationship exists between microalbuminuria and peripheral disease in a Greek Caucasian population. In 1990, 635 normal subjects were examined and their blood pressure was recorded. Nine and 12 years later, subjects were reexamined and 361 of them (57%) were available at last visit for the determination of microalbuminuria and ankle-arm index. Microalbuminuria was detected in 35/361 (9.7%) and peripheral artery disease in 89/361 (24.7%). Both conditions were statistically correlated with pulse and systolic blood pressure at all time points during the 12-year follow-up period, while the relationship with diastolic and mean arterial pressure existed only for baseline values and was then abolished. Microalbuminuria was statistically correlated to peripheral artery disease (r =-0.460, p=0.0001). Blood pressure levels seemed to predict the appearance of microalbuminuria and peripheral disease after 12 years. Microvasculature and macro-vasculature abnormalities (microalbuminuria and peripheral disease, respectively) showed a significant relationship, suggesting a common pathogenetic mechanism.

Effect of obesity on atrial size in older women with non-valvular paroxysmal atrial fibrillation

Background and aims: Atrial fibrillation (AF) typically prevails on male sex in all decades of life. Thus, prevalence rate of AF in older women is elevated, mainly due to their longer survival. The aim of this study was to evaluate the effect that obesity has on atria dimensions of older women with paroxysmal atrial fibrillation (PAF). Methods: The study population consisted of older women who were admitted to our cardiology department due to an episode of PAF and cardioverted to sinus rhythm within 48 hours. A total of 48 patients were included and divided in two groups according the presence (30) or the absence (18) of obesity, considering obesity as a body mass index (BMI) greater or equal to 30 kg/cm2. Results: Obese women had a mean atrial size of 45.1±3.9 mm and non-obese women had a mean atrial size of 39.8±2.6 mm, p<0.001. BMI was positively correlated with atrial enlargement in a statistically significant way even after multiple adjustments. Conclusions: Among the elderly female population with an episode of PAF, obese women seem to have greater risk for the perpetuation and the stabilization of this arrhythmia due to the enlargement of their atrial size.