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Background: Evidences suggest that central hemodynamics indexes are independent predictors of future cardiovascular events and all-cause mortality. Multiple factors have been pointed to have potential influence on central aortic function: height, heart rate, left ventricular ejection duration and blood pressure level. Data related to the influence of gender and postmenopausal status on aortic wave form reflection is scarce. Methods: In a cross sectional study, 122 hypertensive patients (52 men and 70 women) were studied. Hypertension was defined as blood pressure (BP) levels ≥140/90 mmHg or use of antihypertensive drugs. Central arterial pressure, augmentation index (AIx) and augmentation index normalized to 75bpm (Alx75) were obtained using applanation tonometry. Menopause and postmenopause history were accessed by a direct questionnaire. Postmenopause was defined as at least one year since last menstruation. Patients were paired by age, gender and menopausal status and 4 groups were compared: group 1 (young men, ≤ 48y), group 2 (young women, ≤4 8y), group 3 (older men, > 48y) and group 4 (older women, > 48y). Results: Height and weight were significantly lower in women than in men at the same age. Conversely, Alx (32.7±9.8% vs. 20.1±11.7%, p Conclusion: Women patients had both higher reflected aortic pressure wave form and central blood pressure indexes and these findings were worsened by the menopausal status.

Background: Cognitive impairment and elevated arterial stiffness are described in patients with arterial hypertension(AH), but its correlations are not well studied. Objectives: To study the cognitive function at different domains and arterial properties in patients with AH stage 1 to 3 compared to normotensives and to evaluate the correlations between these variables. Methods: We evaluated 221 subjects, 71 normotensives (52±14yrs,47%male,65%white) and 150 patients with stage 1-3 AH (52±12yrs,45%male,70%white) under treatment. The global cognitive function was assessed by Mini Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA). There was done a validated comprehensive battery of neuropsychological tests(NPE) assessed the following main cognitive areas: memory, language, visuospatial ability, executive function, attention. Pulse wave velocity(PWV) was measured by Complior® device. Carotid properties were assessed by radiofrequency ultrasound(WTS®). Central arterial pressure and augmentation index (AIx) were obtained using applanation tonometry(Sphygmocor®). Results: Mean BP of the normotensive group (122.1±8/76.7±7mmHg) was significantly lower than hypertensive patients (135.2±13/83.3±10 and 149.9±29/91.5±16mmHg). Severe HTN group had worse performance in cognitive evaluation either by MMSE (26.8±2.1 vs 27.4±2.1 vs. 28.0±2.0, p=0.004) or MoCA test (23.4±3.7 vs. 24.9±2.8 vs. 25.5±3.2, p Conclusions: Cognitive impairment at different domains was more frequent in patients with different stages of AH. Arterial functional and structural properties were diversely associated with cognitive performance at different domains

Left ventricle remodeling is a common consequence of uncontrolled hypertension. Hypertension treatment including renin-angiotensin-aldosterone system inhibition and beta-blockers offers cardiac protection. Carvedilol uses in cardiomyopathy from different etiology have shown good results in left ventricle reverse remodeling. There is a lack of information regarding carvedilol use in hypertensive cardiomyopathy. The main objective in this study was to evaluate the use of carvedilol in hypertensive patients with reduced left ventricle ejection fraction. We evaluate 98 subjects with reduced left ventricle ejection fraction (55 years age, 59 males, 64 white, 34 nonwhite) before and after at least six months of carvedilol use. Clinical data, laboratory tests, and echocardiogram were evaluated at least 6 months before and after carvedilol was added to the treatment. Other causes of cardiomyopathy, including coronary artery disease, were excluded. A hundred percent of patients was taking diuretic and renin-angiotensin-aldosterone system inhibitors. Twenty eight percent were using statins, 19% were using antidiabetic drugs, and 29% were taking digoxin. Blood pressure and heart rate (144/92 mmHg, 84 bpm) decreased significantly after (130/82 mmHg, 70 bpm) carvedilol treatment. Ejection fraction improved in 68.5% patients. Let ventricle diastolic diameter decreased from 62 to 56 mm, left ventricle systolic diameter decreased from 53 to 42 mm, left ventricle mass index decreased from 145 to 129 g/m 2 , left ventricle relative posterior wall increased from 0.32 to 0.36. Carvedilol, in addition to antihypertensive drugs, showed improvement in hemodynamic parameters, and in echocardiographic structural and functional parameters in hypertensive cardiomyopathy patients.