Echocardiographic evaluation of children with and without family history of essential hypertension.

A family history of hypertension is considered a risk factor for developing hypertension. We studied two groups of normotensive children (aged 14 years): one comprising 14 subjects with family history of hypertension, the other comprising 15 subjects without family history of hypertension. Children were comparable with respect to age, weight, height, body surface area, heart rate, and arterial blood pressure. M-mode echocardiography demonstrated higher interventricular septum/posterior wall ratio in progeny of hypertensive subjects. Interestingly, all the parameters evaluated were within the normal limits. Our data suggest that a certain degree of cardiac changes is present in children with positive family history of hypertension, though further studies are needed before considering these findings predictive of future essential hypertension.

Assessment of optimal dose of diuretic associated with fixed dose of beta-blocking: a new experimental model based on multiple sampling of blood pressure performed by self-measurements.

A new experimental model is presented for determining the optimum dose of 3 different doses (13 mg, 25 mg, 37 mg per day) of hydrochlorothiazide employed to enhance hypotensive effect of 200 mg/day of metoprolol in human hypertension. The model takes into account the circadian variability of blood pressure as sinusoidal function and wash-out effect as a linear trend so as to compensate for bias due to normal temporal variability.

The maternal 24-h blood pressure (BP) profile as a predictor of fetal distress.

No mention is made of any aspect of BP bioperiodicity, among current clinical criteria for diagnosing pregnancy-related hypertension. The abnormal BP, based on a single unqualified measurement, is accepted and utilized as a clinical feature to identify pregnancy at risk. Systolic, diastolic and mean arterial blood pressure were measured every 15 min for 24 h in 5 women (2 non pregnant clinically healthy subjects, 1 clinically healthy subject in her third trimester of pregnancy, 1 presenting mild and 1 severe toxiemia, also in their third trimester of pregnancy) by an automated BP recording apparatus (Dynamap). All variables, analyzed by the single cosinor method, exhibited statistically significant circadian rhythms. A high amplitude could nullify the time-unqualified usual range. The change in circadian amplitude precedes an overt mesor hypertension and constitutes a tool for earlier detection of fetal distress.

A modified bladder washout test to improve diagnostic results in chronic urinary tract infections.

Bladder washout (BWO) and antibody-coated bacteria (ACB) tests were performed on 25 patients with radiological and/or clinical evidence of chronic upper urinary tract infection (UTI) and 12 patients with asymptomatic bacteriuria. Using a traditional single-washout procedure, the BWO test gave equivocal results in many cases of chronic pyelonephritis; this seemed mainly due to the lack of complete bladder sterilization. A modified procedure, including double sterilization and irrigation, biochemical typing of isolated bacteria, and evaluation of temporal pattern of bacteriuria recurrence, was then introduced. Although preliminary results of the modified BWO test demonstrated a general improvement in the diagnosis of the infection site, it seemed rather difficult, at least in chronic UTI, to establish localizing criteria based on definite numeric changes in bacterial counts after washout.