Digital plethysmography and arginine metabolism in prehypertension: effect of nebivolol therapy.

Prehypertension is an important phenotype for cardiovascular risk and development of established hypertension. To better understand the early circulatory changes in this group, the authors studied 34 patients with prehypertension (blood pressure 120-139/80-89 mm Hg) using digital plethysmography for measurement of blood flow and reactive hyperemic index (RHI). Arterial augmentation index (AI) was also measured. Because prehypertension is associated with endothelial dysfunction and decreased availability of nitric oxide (NO), indices of arginine metabolism (l-arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine, and l-citrulline) were measured. Nebivolol (5 mg/d), a vasodilating ß1 -antagonist with ß3 -agonist activity, was studied in a double-blind fashion for 8 weeks. Nebivolol increases the bioavailability of NO. Prehypertension was associated with normal RHI and baseline digital blood flow. AI was abnormal and associated with diastolic blood pressure. ADMA concentration was increased at baseline. After 8 weeks of nebivolol therapy, RHI, ADMA, symmetric dimethylarginine, and AI showed no significant change, but digital blood flow and l-citrulline levels were significantly increased. Prehypertension is associated with increased ADMA and evidence of increased arterial stiffness and preserved RHI. Nebivolol therapy is associated with digital vasodilation and increased NO production, as depicted by increased levels of l-citruline and mean digital blood flow.

Nonlinear surface waves in left-handed materials.

We study both linear and nonlinear surface waves localized at the interface separating a left-handed (LH) medium (i.e., a medium with both negative dielectric permittivity and negative magnetic permeability) and a conventional [or right-handed (RH)] dielectric medium. We demonstrate that the interface can support both TE- and TM-polarized surface waves-surface polaritons, and we study their properties. We describe the intensity-dependent properties of nonlinear surface waves in three different cases, i.e., when both the LH and RH media are nonlinear and when either of the media is nonlinear. In the case when both media are nonlinear, we find two types of nonlinear surface waves, one with the maximum amplitude at the interface, and the other one with two humps. In the case when one medium is nonlinear, only one type of surface wave exists, which has the maximum electric field at the interface, unlike waves in right-handed materials where the surface-wave maximum is usually shifted into a self-focusing nonlinear medium. We discuss the possibility of tuning the wave group velocity in both the linear and nonlinear cases, and show that group-velocity dispersion, which leads to pulse broadening, can be balanced by the nonlinearity of the media, so resulting in soliton propagation.