The effect of nebivolol and ramipril on selected biochemical parameters, arterial stiffness, and circadian profile of blood pressure in young men with primary hypertension: A 12-week prospective randomized, open-label study trial.

BACKGROUND: The pleiotropic effects of hypotensive drugs should always be taken into consideration. There is limited data on the effect of such drugs on reducing global cardiovascular risk in young hypertensives. The aim of this study was to evaluate the effect of nebivolol and ramipril on biochemical parameters, arterial stiffness, and circadian profile of blood pressure (BP) in young men undergoing treatment for hypertension (HT). METHODS: A total of 80 patients aged 16 to 28 years of age with grade 1 HT were enrolled into the prospective randomized, open-label trial. They were randomized to receive 5 mg of nebivolol or 5 mg of ramipril, daily. Arterial stiffness index (SI), the circadian profile of BP registered in ambulatory blood pressure monitoring (ABPM), and biochemical parameters-including lipid profile, insulinemia, glycemia, and high sensitivity C-reactive protein (hsCRP) levels-were evaluated before and after the twelve-week period. RESULTS: After the treatment period, we observed significant decreases in both ABPM systolic blood pressure (SBP) in group of nebivolol (P = .0007) and ramipril (P = .0001) and in ABPM diastolic blood pressure (DBP) in group of nebivolol (P = .0018) and ramipril (P = .0006). Reductions in the nondippers percentage were found in group of nebivolol and ramipril (P = .0077, P = .0001 respectively). Ramipril treatment resulted in a significant plausible modification in high-density lipoprotein (HDL) (P = .0390), glucose (P = .0213), and hsCRP (P = .0053) concentrations, as well as decreased SI (P = .0009) value, while nebivolol treatment showed no such benefits. CONCLUSIONS: Despite the similar hypotensive effect of nebivolol and ramipril, ramipril seems to possess better clinical potential in reducing cardiovascular risk in young men with HT.

The effect of orlistat versus metformin on body composition and insulin resistance in obese premenopausal women: 3-month randomized prospective open-label study.

INTRODUCTION: Our aim was to evaluate the effects of metformin and orlistat on body composition and glucose-insulin homeostasis in obese premenopausal women. MATERIAL AND METHODS: Seventy-three obese premenopausal Caucasian women aged 32.4 ±8.3 years were treated with either metformin (1000 mg/day; n = 37) or orlistat (360 mg/day; n = 36). Anthropometric parameters were measured using dual-energy X-ray absorptiometry. Glucose tolerance, using the oral glucose tolerance test; insulin resistance, using the homeostasis model assessment (HOMA-IR); and insulin sensitivity, using the Matsuda insulin sensitivity index (ISI Matsuda), were assessed at the commencement of the study and after 3 months. RESULTS: Those treated with orlistat showed greater weight loss (-9.4 ±2.3 vs. -4.9 ±1.3 kg, p < 0.05) and decrease of fat mass (-5.4 ±3.0 vs. -3.5 ±0.7 kg, p < 0.05) than those treated with metformin. The percentage of android and gynoid fat deposits was reduced in both groups; however, a greater decrease in android fat was observed in those treated with metformin. Improvement in ISI Matsuda and post-load insulin were similar in both groups. High initial post-load insulin and low ISI Matsuda corresponded with reductions in total fat, trunk fat, and waist circumference in both groups, and a decrease in android fat in those treated with metformin. CONCLUSIONS: Orlistat treatment resulted in greater weight loss and improvement in body composition; metformin treatment resulted in a reduction of android fat. Both drugs produced a comparable improvement in insulin/glucose homeostasis. Overall, insulin-resistant women showed improvement with treatment, irrespective of which drug was used.

Impact of 25-hydroxyvitamin D, free and bioavailable fractions of vitamin D, and vitamin D binding protein levels on metabolic syndrome components.

INTRODUCTION: Various forms of vitamin D and factors involved in their metabolism can play a role in the etiopathogenesis of metabolic disorders. This paper aims to define the relationship between concentration of the hydroxylated form of vitamin D (25(OH)D), the fraction of free and bioavailable vitamin D, and of vitamin D binding protein (VDBP) levels on the one hand and the prevalence of metabolic syndrome components on the other. MATERIAL AND METHODS: The studies were conducted on 79 people, including 52 with metabolic syndrome (MetS+) and 27 without it (MetS-). Biochemical measurements (lipid profile, glycemia, 25(OH)D, VDBP, albumin, calcium, parathyroid hormone) were performed, concentration of free and bioavailable vitamin D was mathematically calculated, and anthropometric and blood pressure measurements were taken. RESULTS: The mean ± SD concentration of 25(OH)D among MetS+ individuals (41.90 ±13.12 nmol/l) was lower (p < 0.0001) than among the MetS- group (66.09 ±18.02 nmol/l). Differences between groups were observed in relation to medians/means of concentrations of free and bioavailable vitamin D (p < 0.0001) but not in the case of VDBP. In the entire study population, 25(OH)D correlated with all metabolic syndrome components, whereas its free and bioavailable fraction correlated with particular components of the syndrome. In the MetS+ group, VDBP concentration negatively correlated with body mass index (p = 0.037) and levels of diastolic pressure (p = 0.022). In the case of the MetS- group, the free fraction of vitamin D negatively correlated with triglyceridemia (p = 0.049). CONCLUSIONS: The evaluation of various forms of vitamin D and VDBP in different population groups seems to have significant clinical value in evaluating the prevalence of metabolic disorders.

Concentrations of omentin and vaspin versus insulin resistance in obese individuals.

INTRODUCTION: Omentin and vaspin are adipokines manifesting a potentially protective action against obesity-associated metabolic disturbances. AIM: Evaluation of relationship between serum concentrations of omentin and vaspin on one hand and indices of insulin resistance and anthropometric parameters in obese individuals on the other. MATERIAL AND METHODS: The studies were conducted on 64 individuals. The investigated group (37 obese patients) included the subgroup with normal glucose tolerance (NGT) and with abnormal glucose tolerance (AGT). The control group (n=27) included healthy individuals with normal body weight. In all participants anthropometric analyses and biochemical tests, including estimation of omentin and vaspin concentrations were performed, and insulin resistance by HOMA-IR was evaluated. RESULTS: Concentrations of examined adipokines manifested no significant differences between the examined groups. Median values of the index defining ratio between studied adipokine and degree of insulin resistance, i.e. omentin/HOMA-IR, proved to be different in the investigated and the control group while no such difference could be noted in cases of vaspin/HOMA-IR indices. In the studied population a negative relationship was detected between serum concentration of omentin and systolic blood pressure (p<0.04). Values of omentin/HOMA-IR index manifested a correlation with values of most anthropometric parameters (p<0.0001), blood pressure (p<0.0001) concentrations of TG (p<000.1) and HDL (p<0.0001), ISIbasal (p<0.00001), ISIgly (p<0.0001), Quicki (p<0.00001) and fasting insulinaemia (p<0.00001). In the case of vaspin/HOMA-IR index only its positive relationship with HDL concentration was noted (p<0.05). CONCLUSION: In context of date of correlation, multiple regression and values of area of under receiver operating characteristics curve omentin, as compared to vaspin, seems to provide a better predictor of insulin resistance in obese individuals.

Effects of endurance and endurance-strength exercise on biochemical parameters of liver function in women with abdominal obesity.

INTRODUCTION: Obesity is a risk factor of nonalcoholic fatty liver disease. Although the standard therapy for obesity involves physical exercise, well-planned studies of the changes in liver function in response to different exercise intensities in obese subjects are scarce. The aim of the present study was to examine a question of how does exercise mode affect the liver function. MATERIAL AND METHODS: 44 women with abdominal obesity were randomized into two exercise groups: endurance (group A) and endurance-strength (group B). Women in each group exercised for 60min 3 times/week for a 3-month period. Markers of liver function: serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), alkaline phosphatase (ALP) activities, and bilirubin levels were quantified. RESULTS: We found significant differences in ALT (p<0.01) and AST (p<0.05) activities between group A and B after training exercise. Blood ALT and AST tended to decrease in group B, increase in group A. Significant reduction in serum GGT level after exercise in both groups was observed (p<0.001, group A; p<0.01, group B). Neither endurance nor endurance-strength exercise led to changes in serum ALP activity and total or direct bilirubin level. However, endurance-strength training resulted in significant decreases in serum indirect bilirubin (p<0.05). Strong positive correlations between serum indirect bilirubin and body mass (r=0.615; p=0.0085) and BMI (r=0.576; p=0.0154) were found after endurance-strength exercise (group B). CONCLUSION: The mode of exercise does matter: endurance-strength exercise led to a greater improvement, compared to endurance exercise, in the liver function in women with abdominal obesity.

Effects of the lercanidipine-enalapril combination vs. the corresponding monotherapies on home blood pressure in hypertension: evidence from a large database.

OBJECTIVE: To compare a combination of a dihydropyridine calcium-channel blocker with an angiotensin converting enzyme inhibitor vs. monotherapy with one or the other drug and placebo for their effects on home blood pressure (HBP). METHODS: After a 2-week placebo wash-out, patients with an elevated office blood pressure (BP) (diastolic 100-109 and systolic <180 mmHg) and HBP (diastolic ≥85 mmHg) were randomized double-blind to a 10-week treatment with placebo, lercanidipine, 10 or 20 mg daily, enalapril, 10 or 20 mg daily, or the four possible combinations. In addition to office BP, HBP was self-measured via a validated semiautomatic device twice in the morning and twice in the evening during the 7 days before randomization and at the end of treatment. Baseline and treatment HBP values were separately averaged for each day, morning, evening or the whole monitoring period, excluding the first day. Day-by-day HBP variability was defined as the SD or the variation coefficient of the daily BP averages. RESULTS: Eight hundred and fifty-four patients with valid HBP recordings at baseline and at the end of treatment were analyzed (intention-to-treat population). From the baseline value (147.0±11.6 mmHg) systolic/diastolic HBP showed a small reduction (average baseline-adjusted change: -1.8/-1.6 mmHg) with placebo, a more marked significant fall with monotherapies (-8.8/-5.9 mmHg, P < 0.001/<0.001 vs. placebo) and even more with combination treatment (11.6/-7.6 mmHg, P < 0.001/ < 0.001 vs. placebo and P < 0.01/ < 0.05 vs. monotherapy). A similar pattern was observed for each of the days of the BP self-monitoring period as well as for either morning or evening values, although the difference between mono and combination treatment appeared to be consistently significant for the morning values only. Day-by-day systolic BP-SD was unaffected by placebo and slightly reduced by drug treatments, with no, however, significant changes in SBP-variation coefficient. Baseline and end of treatment HBP values showed a limited correlation with office BP values, this being particularly the case for treatment-induced changes (correlation coefficients: 0.37 for systolic and 0.45 for diastolic BP). CONCLUSION: This large HBP database shows that the lercanidipine-enalapril combination lowers HBP more effectively than the corresponding monotherapies and placebo, and that this greater effect is consistent between days. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01093807.

The effect of L-arginine and ascorbic acid on the visceral fat and the concentrations of metalloproteinases 2 and 9 in high-fat-diet rats.

INTRODUCTION: L-arginine (L-arg) and vitamin C supplementation may decrease fat accumulation and have a favourable effect on carbohydrate metabolism. This is partly caused by matrix metalloproteinases (MMPs), which are involved in adipocyte development and remodelling. Our study evaluated the effects of L-arg and vitamin C supplementation on the content of visceral fat (VF%), activity of MMPs, and insulin resistance (IR) in rats fed a high-fat diet (HFD). MATERIAL AND METHODS: The experiment was performed using 48 Wistar rats divided into four groups: Group 1 was fed a standard diet, Group 2 a HFD, Group 3 a HFD supplemented with L-arg (A), and Group 4 a HFD supplemented with L-arg and vitamin C (AC). The animals were euthanized after six weeks. The concentrations of serum glucose, insulin, MMP-2, and MMP-9, as well as IR by Homeostatic Model Assessment (HOMA) and VF% were measured. RESULTS: Statistically significant increases in VF%, MMP-2, MMP-9, insulin, and HOMA-IR levels were observed in the HFD group when compared to the control group. A smaller increase in VF%, insulin, and HOMA-IR was seen in Group 3 (A) and 4 (AC). L-arg supplementation protected against increases in MMP-2 and MMP-9 in Group 3 (A) and 4 (AC). CONCLUSIONS: L-arginine could protect from an increase in visceral fat through a change in the activity of MMPs and amelioration of insulin sensitivity in rats fed a HFD. The addition of vitamin C did not improve the effects of L-arginine supplementation.

Effect of L-arginine supplementation on insulin resistance and serum adiponectin concentration in rats with fat diet.

OBJECT: The purpose of this study was to determine whether supplementation with L-arginine, a substrate used in the production of nitric oxide, had an effect on adiponectin concentration in rats fed a high-fat diet. The influence of L-arginine on insulin resistance was also evaluated. MATERIALS AND METHODS: The experiment was performed using 36 Wistar rats divided into three groups: group 1 was fed a standard diet, group 2 a high-fat (HF) diet, group 3 a HF diet supplemented with L-arginine. After 42 days, serum levels of lipids, glucose, insulin, NO, and adiponectin were measured. Insulin resistance (IR) was estimated by the Homeostasis Model Assessment (HOMA). RESULTS: Body mass was equal in all 3 groups, at the beginning as well as at the end of the study, however, in group 2 the amount of visceral fat was greater after 42 days. In group 3, there was a tendency for visceral fat to decrease. An increase in cholesterol, triglycerides, insulin and HOMA-IR, as well as a decrease in NO and adiponectin were seen in group 2, while in group 3, L-arginine supplementation ameliorated these disturbances. CONCLUSIONS: Our study shows that L-arginine supplementation in rats fed a HF diet is associated with an increase in insulin sensitivity. Our findings suggest that the underlying mechanism could be at least partially related to an increase in adiponectin concentration.

Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity.

AIMS: To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. METHODS: 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. RESULTS: Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. CONCLUSION: Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity.

[The analysis of the influence of short term physical effort on selected endothelial function parameters and blood vessels stiffness features among young and healthy men]. / Analiza wplywu krótkotrwalego wysilku fizycznego na wybrane parametry funkcji sródblonka naczyniowego oraz sztywnosc naczyn krwionosnych u mlodych i zdrowych mezczyzn.

UNLABELLED: Endothelium dysfunction is well established factor contributing to the development of atheroslerotic plaque. It is characterized by, among other, impaired vasodilatation and increased expression of adhesion molecules. The aim of the study was to estimate changes of serum selectin levels and blood vessels stiffness under the influence of short term physical effort in young healthy men characterized by various lifestyles. MATERIAL AND METHODS: The study was performed on 28 healthy men aged 22 to 34. The study involved personal interview, electrocardiography, treadmill exercise test, non-invasive endothelial function assessment (using PulseTrace PCA 2) and collecting blood samples for serum E-, L- and P-selectin measurement. The given population was divided into smoking and non-smoking groups, as well as into groups with different level of physical activity assessed according to the International Physical Activity Questionnaire. RESULTS: In regard to serum selectin levels under the influence of short term physical effort E-selectin concentration didn't change significantly in any group, P-selectin level was lower in non-smoking group (p < 0.01) and in group with vigorous physical activity (p < 0.005), L-selectin level decreased in non-smokers (p < 0.005) and in groups taking moderate (p < 0.05) and vigorous exercise (p < 0.05). Baseline SI (stiffness index) value differed significantly between smoking and nonsmoking groups (p < 0.005). SI value didn't change significantly under effort in any group. RI (reflection index) value in measurements made after physical effort was significantly lower in each of examined groups, but decrease was better marked among non-smokers (p < 0.005) than in smokers (p < 0.05). CONCLUSIONS: The study revealed that individuals who undertake physical activity regularly, benefit from each single physical effort, because of decrease in serum concentration of proinflammatory molecules such as L-selectin and P-selectin. Short term physical effort does not influence the level of selectins in smokers. Smokers are characterized by increased arterial stiffness compared to nonsmokers. Short term physical effort leads to peripheral vasodilatation, expressed by decreasing RI value, but vasodilatation effect does not appear in smokers. It seems that pulse contour analysis obtained by finger photopletysmography may be treated as method of endothelium function screening among healthy men with the presence of atherogenesis modifiable risk factors.

Effects on office and home blood pressure of the lercanidipine-enalapril combination in patients with Stage 2 hypertension: a European randomized, controlled clinical trial.

OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of combinations of lercanidipine (L) and enalapril (E) at different doses on office and home blood pressure (BP) in patients with Stage 2 hypertension. STUDY DESIGN: This was a randomized, double-blind, placebo-controlled, factorial study conducted in 100 centres from seven countries. Patients with office DBP 100-109 mmHg and home DBP at least 85 mmHg at the end of a 2-week placebo run-in period were randomized to a 10-week treatment with placebo, L (10 or 20 mg), E (10 or 20 mg) or the four L-E combinations. The efficacy parameters were office DBP at trough (primary), SBP at trough and home SBP and DBP. Office BP was measured at each visit in both the sitting and the standing position, while home BP was measured twice in the morning and twice in the evening for at least 3 days before treatment and at study end. Safety parameters included adverse events, laboratory tests and 12-lead ECG. RESULTS: A total of 1039 patients were randomized (48% men, mean age 54 years, mean BMI 30 kg/m, 40% obese patients). Baseline BP was similar in all groups and lower for home than for office values (149/95 and 159/103 mmHg, respectively). A marked placebo effect was observed on office but not on home BP. Combination therapy was superior to placebo at all doses for both office and home BP. The greatest effect was observed in the L20/E20 group, in which the SBP/DBP fall amounted to -19.2/-15.2 and -13.2/-7.5 mmHg for sitting office and home BP, respectively. Similar reductions were observed on standing office BP. The L20/E20 combination was associated with less cough, palpitations and leg oedema than monotherapies, with no increased rate of dizziness or hypotension. CONCLUSION: In Stage 2 hypertension, a fixed-dose combination of L and E ensures a control of both office and out-of-office BP, with a favourable tolerability profile.

[Effect of physical exercise on endothelial function, indicators of inflammation and oxidative stress]. / Wplyw wysilku fizycznego na funkcje sródblonka, wskazniki stanu zapalnego i stresu oksydacyjnego.

Endothelium plays an important role in regulation of the activity of inflammation and oxidative stress. Numerous studies have shown that physical training affects endothelial function. It is proven that regular physical activity reduces the seventy of inflammation and the risk of cardiovascular events. Changes observed in effect of physical activity include increase in production of nitric oxide (NO), a decrease of plaque volume, a decrease in vascular wall viscosity and an increase in diastolic coronary perfusion. It has been shown that exercise reduces cardiovascular risk in subjects with diabetes, metabolic syndrome, coronary heart disease and hypertension, as well as in healthy people. In above populations the benefits result from improved endothelial function. It has been proven that regular physical activity improves enzymatic antioxidant systems and the immune response. It is a result of the stimulating effect of muscle tissue micro-injuries and recruitment of various cell types of the inflammatory response and their migration deeper into the tissues. The biggest changes in the immune response are observed in prolonged aerobic exercise. Physical activity has a significant impact on endothelial function, intensity of inflammatory processes and exponents of oxidative stress. There is a need for further researches, in particular in order to determine the optimal model of training.

Changes in mineral status are associated with improvements in insulin sensitivity in obese patients following L-arginine supplementation.

PURPOSE: The aim of this study is to evaluate the long-term influence of L-arginine intake on mineral concentration in patients with obesity and to assess the changes in lipid serum levels, fat content, and insulin resistance that result. METHODS: A randomized double-blind placebo-controlled study was conducted. 88 obese patients were randomly assigned to receive either 9 g of L-arginine or placebo daily, for 6 months. At baseline and after 6 months, selected anthropometrical measurements and blood biochemical analyses were performed and mineral levels were assessed. To assess insulin sensitivity, the gold-standard euglycemic clamp methodology was used. RESULTS: We found that 6 months of L-arginine supplementation resulted in significant increases in insulin sensitivity (Δ1.1 mg/kg/min, P < 0.01) and zinc levels (Δ1.5 µmol/L, P < 0.001). Moreover, a positive correlation between the change in zinc concentration in serum and the change in insulin sensitivity was observed (R = 0.80, P < 0.01). In the group of patients treated with L-arginine, a negative correlation between the change in zinc concentration in serum and the change in body fat content was noted (R = -0.38, P < 0.05). CONCLUSIONS: L-Arginine supplementation affects zinc status in obese patients. One beneficial influence is related to the improvements in insulin sensitivity.

Primary systemic amyloidosis as a real diagnostic challenge - case study.

Primary amyloidosis (AL) is a rare variety of plasma cell dyscrasia, the diagnosis of which is often difficult to establish. Pathogenesis of amyloidosis involves extracellular deposition of insoluble protein fibrils in tissues, leading to insufficiency of affected organs. According to various sources, mean survival rate of patients with primary amyloidosis ranges from 12 to 24 months, making primary amyloidosis a disease with a very poor prognosis. Survival rate is significantly lowered in case of cardiac manifestation of amyloidosis (about 6 months survival in untreated patients). In recent years a considerable progress in AL treatment has been observed. Nowadays we are able not only to delay progression of amyloidosis, but also to improve the function of the affected organs. Unfortunately as first signs and symptoms of AL are usually nonspecific, the diagnosis of AL is often delayed, resulting in late introduction of optimal therapy. There are many diagnostic tests which can be used in diagnostic process of amyloidosis, i.e. electrophoresis, serum and urine immunofixation or affected organs and bone marrow biopsy. On establishing the diagnosis in a patient with suspected amyloidosis it should be remembered that particular diagnostic methods vary considerably in sensitivity. The aim of this paper is to present a case report of a 27-year-old patient with primary amyloidosis focusing on diagnostic aspect of this condition. On the basis of this case, the authors would like to emphasize the value of precise diagnostic process, with immunological techniques playing undoubtedly a crucial role.

The effects of L-arginine, alone and combined with vitamin C, on mineral status in relation to its antidiabetic, anti-inflammatory, and antioxidant properties in male rats on a high-fat diet.

The aim of this study was to evaluate the influence of the intake of L-arginine alone and of L-arginine with vitamin C on mineral concentration in rats fed with a high-fat diet, and to assess the lipid glucose, insulin, and total antioxidant status (TAS) and tumor necrosis factor (TNF) alpha serum levels that result. Wistar rats were assigned to groups fed with either a standard control diet (C), a diet high in fat (FD), a diet high in fat with L-arginine, or a diet high in fat with L-arginine and vitamin C. After 6 weeks, the length and weight of the rats were measured, and the animals were euthanized. The liver, spleen, kidneys, pancreas, heart, and gonads were collected, as were blood samples. The total serum cholesterol, triglyceride, fasting glucose, insulin, TAS, and TNF alpha levels were measured. The tissue calcium, magnesium, iron, zinc, and copper concentrations were determined. It was found that L-arginine supplementation diminished the effect of the modified diet on the concentration of iron in the liver and spleen and of copper in heart. At the same time, it was observed that L-arginine supplementation reduced the effect of the high-fat diet on insulin, TNF alpha, and TAS. The combination of L-arginine and vitamin C produced a similar effect on the mineral levels in the tissues as did L-arginine used alone. Moreover, positive correlations between serum insulin and iron in the liver, between TNF alpha and iron in the liver, and between TNF alpha and copper in the heart were observed. The level of TAS in serum was inversely correlated with the copper level in the heart and the iron level in the liver. We concluded that the beneficial influence of L-arginine on insulin, TAS, and TNF alpha serum level is associated with changes in the iron and copper status in rats fed with a high-fat diet. No synergistic effect of L-arginine and vitamin C in the biochemical parameters or in the mineral status in rats fed with the modified diet was observed.

An assessment of dietary intake and state of nutritional in hypertensive patients from rural and urban areas of Greater Poland.

The aim of this study was to determine the nutritional factors connected with the prevalence of hypertension in rural and urban areas of Greater Poland. The study consisted of 308 people aged 35-62, with essential hypertension but without any other coexisting disorders. The studied group consisted of 154 residents of Poznan (79 women and 75 men) and 152 inhabitants of rural areas in Greater Poland (78 women and 74 men). Participants were randomly assigned to the study. Nutritional state assessment was based on Body Mass Index (BMI) and body fat percentage. Dietary intake were assessed with a 24-hour nutritional survey from 3 consecutive days. Analysis of anthropometric examination results showed a large prevalence of obesity in the studied group. Moreover people living in rural areas had a significantly higher BMI and body fat percentage than those living in a city. It has been proved that the patients with hypertension consume food with an excess of fat and a shortage of fibre, antioxidant vitamins, potassium, calcium and magnesium. The total food rations of rural dwellers consisted of larger amounts of fat, cholesterol and vitamin A compared to those of city dwellers. Present studies have shown incorrect dietary intake among patients with hypertension, often related to the coexistence of overweight and obesity. Obtained results indicate significantly worse eating habits and state of nutrition among rural inhabitants.

Green tea extract reduces blood pressure, inflammatory biomarkers, and oxidative stress and improves parameters associated with insulin resistance in obese, hypertensive patients.

Green tea (GT) consumption is known to be associated with enhanced cardiovascular and metabolic health. The purpose of this study is to examine the hypothesis that supplementation with GT alters insulin resistance and associated cardiovascular risk factors in obese, hypertensive patients. In a double-blind, placebo-controlled trial, 56 obese, hypertensive subjects were randomized to receive a daily supplement of 1 capsule that contained either 379 mg of GT extract (GTE) or a matching placebo, for 3 months. At baseline and after 3 months of treatment, the anthropometric parameters, blood pressure, plasma lipid levels, glucose levels, creatinine levels, tumor necrosis factor α levels, C-reactive protein levels, total antioxidant status, and insulin levels were assessed. Insulin resistance was evaluated according to the homeostasis model assessment-insulin resistance protocol. After 3 months of supplementation, both systolic and diastolic blood pressures had significantly decreased in the GTE group as compared with the placebo group (P < .01). Considerable (P < .01) reductions in fasting serum glucose and insulin levels and insulin resistance were observed in the GTE group when compared with the placebo group. Serum tumor necrosis factor α and C-reactive protein were significantly lower, whereas total antioxidant status increased in the GTE group compared with the placebo (P < .05). Supplementation also contributed to significant (P < .05) decreases in the total and low-density lipoprotein cholesterol and triglycerides, but an increase in high-density lipoprotein cholesterol. In conclusion, daily supplementation with 379 mg of GTE favorably influences blood pressure, insulin resistance, inflammation and oxidative stress, and lipid profile in patients with obesity-related hypertension.