Impact of cardiac transplantation in 24 hours circadian blood pressure and heart rate profile.

OBJECTIVE: The aim of the present study was to evaluate 24 hours blood pressure (BP) and heart rate changes as well as 24-hour circadian BP rhythm of cardiac transplant recipients. METHODS: Twenty-five transplant recipients and twenty-five healthy volunteers underwent 24-hour ambulatory BP monitoring. Parameters of 24-hour ambulatory BP monitoring (24-h/daytime/nightime systolic, diastolic BP, pulse pressure, and heart rate) were determined in all patients. RESULTS: Clinic systolic/diastolic BP, mean 24-h systolic/diastolic BP, mean daytime systolic/diastolic BP, mean nighttime systolic/diastolic BP, and mean 24-h/daytime/nighttime heart rate were significantly higher in transplant recipients than in control group subjects. Standard deviations of 24-h/daytime/nighttime heart rates were significantly lower in transplant recipients. Dippers were 48% of the control and only 12% of the transplantation group. CONCLUSIONS: Cardiac transplant recipients had increased ambulatory BP. They also had increased 24-h/daytime/nighttime heart rate and decreased heart rate variability. Also, diminished nocturnal decrease of BP was found in transplant recipients.

Increased prevalence of Chlamydophila pneumoniae but not Epstein-Barr antibodies in essential hypertensives.

Conflicting data exist regarding the relationship between Chlamydophila pneunoniae (C. pneumoniae) and hypertension. In this study, both C. pneumoniae IgG and IgA titres and Epstein-Barr virus antibody levels were measured in 146 sustained hypertensives defined by 24 h ambulatory blood pressure monitoring (ABPM) and 54 normotensives. C. pneumoniae antibodies were measured by microimmunofluorescence test. IgG > or = 80 and IgA > or = 40 were defined as elevated antibody titres. Epstein-Barr antibodies were measured in order to investigate whether a possible association exists between hypertension and other, similarly widespread in the general population, intracellular microorganisms. All participants underwent casual blood pressure (BP) readings and 24 h ABPM. Subjects having mean 24 h systolic/diastolic ambulatory BP>125/80 mmHg, with or without antihypertensive medication were defined as hypertensives. Controls were free of any history or clinical evidence of hypertension, cardiovascular or pulmonary disease. Of the total participants, 77 hypertensives (52.7%) and 10 normotensives (18.5%) had IgA titres > or = 40 (crosstabs P < 0.000), whereas 76 hypertensives (52.1%) and 15 normotensives (27.8%) had IgG titres > or = 80, (crosstabs P < 0.002). No difference was found in Epstein-Barr antibodies, between hypertensives and normotensives. In conclusion, C. pneumoniae, but not Epstein-Barr, antibody levels were found significantly higher in sustained hypertensives, suggesting high frequency of chronic C. pneumoniae, infections in this specific group of patients.

Systemic sclerosis is not associated with clinical or ambulatory blood pressure.

BACKGROUND: Raynaud's phenomenon is often the first symptom and occurs eventually in more than 95% of patients with systemic sclerosis (SSc). Angiographic studies disclose narrowing and obstruction of the digital arteries, which on autopsy histologic study show prominent subintimal connective tissue proliferation without inflammation, as well as adventitial fibrosis. It is also known that primary cardiac problems include pericarditis, left ventricular or biventricular failure, serious supraventricular or ventricular arrhythmias emerge in patients with SSc. It is not known if these patients present hypertension or hypotension and which parameter of the ambulatory blood pressure may influence such a disease course. METHODS: A total of 85 subjects underwent clinical blood pressure (BP) readings, 24-hour ambulatory BP monitoring, left ventricular assessment by echocardiography and measurement of intima media thickness (IMT) of the right-left internal carotid arteries (RICA and LICA) and right-left common carotid arteries (RCCA and LCCA). The population consisted of 40 subjects with SSc according to the criteria of the American College of Rheumatology (SCL-group) who were not receiving any antihypertensive treatment and 45 healthy volunteers (control group). The two groups did not differ in age. RESULTS: Clinical systolic and diastolic blood pressure, clinical heart rate, mean 24 h systolic blood pressure, SD systolic blood pressure, mean 24 h diastolic blood pressure, SD 24 h diastolic blood pressure, mean 24 h heart rate, SD 24 h heart rate, pulse pressure 24 h, serum glucose, cholesterol, triglycerides, HDL, LDL, creatinine, urea, potassium and natrium did not statistically significant differ between the two groups. Furthermore, the left ventricular mass/BSA and IMT of both carotid arteries did not show a statistically significant difference between the groups. CONCLUSION: Systemic sclerosis is not associated with clinical blood pressure or the parameter of 24 h blood pressure monitoring.