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

Carotid artery intima-media thickness could predict the presence of coronary artery lesions

The purpose of the present study was to examine whether intima-media thickness (IMT) predicts the presence of the coronary artery lesions independent of other risk factors including clinic blood pressure (BP), parameters of 24-h ambulatory BP monitoring, body mass index, serum cholesterol. and glucose levels. The study population consisted of 390 consecutive subjects who had recently under-one coronary arteriography; 51 subjects with no measurable lesions in their coronary arteries (control group) and 339 subjects with coronary artery lesions (coronary artery disease [CAD] group). Mean IMT of the common carotid artery (MCCA) and internal carotid artery (MICA) were significantly higher in subjects with CAD compare control subjects (P <.0001). Carotid IMT could predict the presence of coronary artery lesions independently of clinic or ambulatory BP values, BMI, serum cholesterol, and glucose levels (P <.01). Carotid IMT predicted the presence of significant coronary artery lesions with cutoff values 0.85 and 0.80 for MICA and MCCA, respectively. The IMT Could be a clinical useful test for the presence of significant coronary artery lesions. (c) 2005 American Journal of Hypertension, Ltd

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 greater than or equal to 80 and IgA greater than or equal to 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 anti hypertensive 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 greater than or equal to 40 (crosstabs P < 0.000), whereas 76 hypertensives (52.1%) and 15 normotensives (27.8%) had IgG titres greater than or equal to 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

Chlamydia pneumponiae and Epstein-Barr antibodies are not associated with carotid thickness: The effect of hypertension

Background: To examine the relationship between Chlamydia pneumoniae (C pneumoniae) seropositivity and carotid intima-media thickness (IMT) in three selected groups: 1) hypertensives; 2) white coat hypertensives; and 3) normotensives. Epstein-Barr antibodies were also measured. Methods: The 340 participants underwent 24-h ambulatory blood pressure (BP) monitoring, clinic BP measurements, ultrasound carotid measurements, and serologic analysis (microimmunofluorescence and ELISA). Results: Significant differences in IMT were found between the three groups, regarding both mean internal carotid artery (MICA) and mean common carotid artery (MCCA) (one-way ANOVA). In all three groups, no association was found between the carotid IMT and the C. pneumoniae or Epstein-Barr seropositivity. Conclusions: When the effect of BP is isolated, there is no association between C. pneumoniae antibody levels and carotid IMT

High prevalence of Chlamydia pneumoniae antibodies in white-coat hypertensives

Previous studies have linked essential sustained hypertension with Chlamydia pneumoniae (C pneumoniae) and changes in intima-media thickness (IMT) of carotid arteries. The aim of this study was to examine if similar associations exist in subjects with white-coat hypertension. C pneumoniae IgA and IgG antibody titers were measured in 125 patients with white-coat hypertension and 54 normotensives. All participants underwent a 24 h ambulatory blood pressure (BP) monitoring, clinic BP readings and common-internal carotid artery IMT measurements. Seventy subjects of the white-coat group (56%) and 15 of the control group (27.8%) had IgG titers greater than or equal to 80 (crosstabs; P < 0.001). IgA titers were elevated in 75 subjects of the white-coat group (60%) and 10 (18.5%) of the control group (crosstabs; P < 0.001). The IMT of the carotid arteries in the white-coat group was significantly higher than that of the normotensive group (t-test; P < 0.001 and P < 0.001, respectively). In contrast, carotid IMT did not differ between C pneumoniae-seropositive and C pneumoniae-seronegative groups concerning both IgG and IgA antibody titers. Our findings suggest that both C pneumoniae antibody titers and carotid IMT were increased in subjects with white-coat hypertension. The preceding associations strengthen prior evidence in favor of the opinion that white-coat hypertension is not an innocent phenomenon. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved