R. De Toni

Relationship between albumin excretion rate, ambulatory blood pressure and left ventricular hypertrophy in mild hypertension

Objective To study the relationship of urinary albumin excretion to ambulatory blood pressure and other cardiovascular risk factors in borderline to mild hypertension. Patients and methods We studied 779 patients with borderline to mild hypertension (mean±SEM age 33±0.3 years; mean±SEM office blood pressure 146±0.4/94±0.2 mmHg) at 17 hypertension clinics in northeast Italy. Office and 24-h blood pressures were recorded with simultaneous urine collection for albumin measurement. In 510 subjects, left ventricular mass was measured by echocardiography. Results Subjects with overt (>30 mg/24 h) and borderline (16–29 mg/24 h) microalbuminuria had similar 24-h blood pressure levels, higher than those in the subjects without microalbuminuria. In the univariate and multiple regression analyses the albumin excretion rate was closely correlated with 24-h systolic blood pressure and not related to age, body mass index, metabolic parameters, lifestyle factors and degree of left ventricular hypertrophy. Conclusions Borderline values of urinary albumin excretion (16–29 mg/24 h) may be clinically relevant in subjects with borderline to mild hypertension. Renal and cardiac damage do not develop in parallel in the initial phases of hypertension.

FAST HEART RATE AS PREDICTOR OF OVERWEIGHT IN SUBJECTS SCREENED FOR STAGE 1 HYPERTENSION: PP.34.354

Objective: Increased sympathetic activity has been found to predict body weight (BW) gain. We did a prospective study to investigate whether clinic heart rate (HR) and 24 h ambulatory HR assessed at baseline and changes in heart rate during follow-up were independent predictors of subsequent increase in BW. Design and Methods: The study was conducted in a cohort of 1008 white stage 1 hypertensive subjects from the HARVEST never treated for hypertension and followed-up for an average of 7 years. Clinic heart rate was the average of 6 readings. Ambulatory heart rate was obtained in 701 subjects. Data were adjusted for baseline body mass index, blood pressure, age, gender, physical activity habits, parental hypertension, cigarette smoking, and alcohol consumption. Results: At the baseline, clinic heart rate was 74.7 ± 9.7 bpm and body mass index was 25.4 ± 3.4 Kg/m2. During the follow-up BW increased by 2.1 ± 7.2 Kg. Both clinic HR (p = 0.005) and 24 h HR (p = 0.02) were significant predictors of BW gain. Also changes in HR measured in the clinic (p = 0.005) or with 24 h recording (p = 0.004) during the follow-up were independent associates of BW gain. In multivariable Cox regression, baseline body mass index (p < 0.001), male gender (p < 0.001), systolic blood pressure (p = 0.01), baseline clinic HR (p = 0.02) and follow-up changes in clinic HR (p < 0.001) were independent predictors of overweight at the end of the follow-up. Subjects with persistent tachycardia (heart rate > = 80 bpm) but not transient tachycardia had a 40% increase in the adjusted risk of overweight in comparison with subjects with normal heart rate (p = 0.02). In the subgroup of subjects with ambulatory HR data, clinic HR remained a significant predictor of subsequent BW gain (p = 0.008) whereas 24 h HR was excluded from the model. Conclusions: Baseline clinic HR and HR changes during the follow-up are independent predictors of BW gain in young persons screened for stage 1 hypertension suggesting that sympathetic nervous system activity may play a role in the development of obesity in hypertension.

SYSTOLIC AND DIASTOLIC BLOOD PRESSURE AND THEIR INTERACTION AFTER MYOCARDIAL INFARCTION AND LONG TERM MORTALITY: PP.22.365

Conclusion: highest and lowest BP values during follow-up after AMI, and chiefly their interaction are associated to higher 10-year mortality.

Cognitive effects of long-term interferon treatment for chronic viral hepatitis

No systematic investigation of the cognitive effects of interferon (IFN) therapy in patients with chronic viral hepatitis has been reported. We have conducted a study to assess the cognitive and neurophysiological effects of alpha-IFN.