A questionnaire-based, multicenter registry of resistant and pseudo-resistant arterial

Introduction: Hypertensive patients with poor blood pressure (BP) control are commonly referred to tertiary centers with a diagnosis of resistant hypertension (RH). The aim of the study was to identify the causes of insufficient BP control and to assess the incidence of true resistant hypertension. Material and Methods: We ran a questionnaire-based, multicenter study (10 high volume tertiary centers in Poland) of patients referred with an initial diagnosis of RH. Only patients with ABPM-confirmed uncontrolled hypertension (systolic ≥140 mmHg and/or diastolic ≥90mmHg despite maximal doses of ≥3 medications, including a diuretic) were included. We assessed the causes of non-optimal BP control, a proportion of patients with excluded secondary hypertension, and the burden of hypertension-related complications. Results: We analyzed 124 patients aged 41-88, with a history of hypertension of 17.5±9 years. 90% of them had developed systemic complications, the most common being LV hypertrophy (73.4%) and LV diastolic dysfunction (63.4%). In only 47% all major causes of secondary hypertension were excluded. In 90.3% of subjects, at least one factor affecting BP control was identified. The most frequent factors were medication noncompliance (52.4%), metabolic syndrome (43.6%) excessive sodium intake (66.1%) and chronic administration of non-steroid anti-inflammatory drugs (40%). The incidence of real resistant hypertension was only 4.8%. Conclusions: Among patients referred with uncontrolled hypertension, the incidence of real resistant hypertension is small. A majority of these patients have multiple factors potentially responsible for poor BP control, the most common being medication non-adherence, use of drugs increasing BP, excessive salt intake and metabolic syndrome.

[Thermography in cardiology]. / Termowizja jako metoda diagnostyczna stosowana w kardiologii.

Thermography is a diagnostic method which is totally non-invasive, painless and safe for both a patient and a diagnostician. It enables to define the physiological condition of the examined tissues or organs basing on the emission of the infrared radiation. Thermography examination has its application in almost every branch of medicine. For a few years in cardiology, there has been an intensive research on introducing the new methods of identifying the high risk atherosclerotic plaques which is largely based on evaluating the degree of escalation of the inflammation process within the atherosclerotic changes. Thanks to applying thermography within the vessels, it is possible to measure the temperature of the wall of the vessel in order to detect the high risk atherosclerotic plaques and evaluate the potential risk of occurrence of the acute coronary syndrome.

[Thermography in medical diagnostics]. / Termowizja jako metoda diagnostyczna stosowana w medycynie.

Measuring the body temperature belongs to the oldest and the most frequently performed diagnostic examination. Current technical progress enables for measurment of body temperature on its surface not only in one particular place, but in lots of different places at the same time and it can also be done from some distance. Invisible for the eye temperature dispersion, which is presented in the form of thermographic photographs, is becoming more popular in medical diagnostics. Thermography is a totally non-invasive, painless and safe for both the patient and the diagnostician examining. The method allows for defining the physiological condition of the tissues or organs on the basis of emitted ultrared radiation.