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Background: In this study we compared the arterial characteristics and blood pressure (BP) of normotensive offspring of two normotensive parents (OFF/NT) and normotensive offspring who had at least one hypertensive parent (OFF/HT). Methods: A total of 174 OFF/HT (17 to 40 years of age) and 59 OFF/NT (16 to 34 years) were recruited in Cracow, Poland (n = 138) and Pilsen, Czech Republic (n = 95). Peripheral pulse pressure (PPp) was determined from conventional and 24-h ambulatory BP. A SphygmoCor device was used to measure the central (CAIx) and peripheral (PAIx) systolic augmentation indexes, central pulse pressure (PPc), and the aortic pulse wave velocity (PWV). In multivariate analyses family clusters and significant covariates were accounted for. Results: The OFF/HT had higher (.14 < P < .0007) conventional BP and PPp on conventional BP measurement (121/75 v 114/71 mm Hg and 46 v 42 mm Hg) as well as on 24-h ambulatory monitoring (118/70 v 114/67 mm Hg and 48 v 47 mm Hg). OFF/HT, compared with OFF/NT, also had higher (.05 < P < .0008) PPc (28 v 26 mm Hg), PAIx (54.7% v 44.9%), CAIx (108.8% v 99.8%), and PWV (7.4 v 6.6 m/sec). However, complex adjustment including mean arterial pressure and age removed the differences between the offspring in the PAIx, CAIx, and PWV. Conclusions: Large-artery properties are altered in OFF/HT compared with OFF/NT. The findings from this cross-sectional study suggest that the alterations in arterial function in subjects with a family history of hypertension are determined mainly by an increased BP and age-related hemodynamic changes. [Copyright &y& Elsevier]

Background: Numerous studies based on assessment of lithium clearance demonstrated higher sodium reabsorption in renal proximal tubules in individuals with hypertension, overweight, obesity, metabolic syndrome, or diabetes., Aims: We aimed to assess the influence of angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin-II-receptor antagonists (ARB) treatment on sodium handling., Methods: In a sample of 351Caucasian subjects without diuretic treatment with prevailing sodium consumption, we studied associations between renal sodium reabsorption in proximal (FPRNa) and distal (FDRNa) tubules assessed by endogenous lithium clearance and daily sodium intake measured by 24-hour excretion of sodium (UNaV), in the context of obesity and long-term treatment with ACE-I or ARB., Results: In the entire study population, we found a strong negative association between FPRNa and ACE-I/ARB treatment (b = -19.5; SE = 4.9; P <0.001). Subjects with FPRNa above the median value showed a significant adverse association between FPRNa and age (b = -0.06; SE = 0.02; P = 0.003), with no association with ACE-I/ARB treatment (P = 0.68). In contrast, in subjects with FPRNa below the median value, we found a strongly significant adverse relationship between FPRNa and ACE-I/ARB treatment (b = -30.4; SE = 8.60; P <0.001), with no association with age (P = 0.32)., Conclusions: ACE-I/ARB long-term treatment modulates FPRNa in the group with lower reabsorption, but not in that with higher than median value for the entire study population.

Introduction: Although the differences between central and peripheral blood pressure (BP) values have been known for decades, the consequences of decision making based on peripheral rather than central BP have only recently been recognized. Recently, a U-shaped relation between sodium intake and cardiovascular risk has been suggested., Objectives: The aim of the study was to evaluate the relationship between intima-media thickness (IMT) and central and peripheral BP as well as the effect of 24-hour urinary sodium excretion on this relationship., Patients and Methods: The study included 182 subjects (mean age, 37.3 ±14.0 years, 92 men and 90 women) who were members of families randomly selected from one of the gminas (administrative regions) in southern Poland. In all patients, peripheral and central BP (using applanation tonometry), IMT, and 24-hour sodium excretion were measured., Results: Hypertension was observed in 44.5% of the participants. The mean urinary sodium excretion was 243 ±81 mmol/d. IMT was significantly more correlated with central pulse pressure (PP) compared with peripheral PP (r = 0.54 vs r = 0.27; P <0.01). After multivariate adjustments, IMT remained significantly related to central systolic BP and central and peripheral PP. When the study group was divided according to the tertiles of sodium excretion, central PP was related to IMT only in the second and third tertiles. When the study group was divided according to sex and sex-specific median values of sodium excretion, IMT was associated with central PP only in subjects with sodium excretion exceeding the median values (both in men and women)., Conclusions: IMT is more correlated with central than with peripheral BP. The association between IMT and central PP may be modulated by sodium intake. This hypothesis should be tested in larger studies.

The aim of the study was to evaluate the repeatability of flow microcirculation measurements by laser doppler flowmetry (Periflix, firm Perimed, Sweden). Measurements of right forearm skin perfusion were performed twice in 3-4 day intervals in 40 healthy subject aged 39.5 +/- 18.3. Two independent investigators analysed the results. Pearson correlation and analysis ac. Bland and Altman (Lancet 1986, 1, 307-310) were performed during comparing results obtained in the same studied persons and by the investigators. There was a high correlation between the compared results performed on the same subjects within a few days interval, especially between the results for post-occlusive congestion reaction in basic temperature (r = 0.64-0.72) and the results for congestion reaction at a temperature of 44 degrees C (r = 0.5-0.56). High correlation values (r = 0.8-0.95) were also observed when comparing both investigators' evaluations. Repeatability evaluation using Bland and Altman analysis was poorer, especially for values observed in resting conditions and for some values observed after stimulation with both investigators (2.5-10% of results were out of interval: mean +/- 2SD). The results show good repeatability of microcirculation flow measurements, especially under stimulation.

Degenerative changes of elastin, increase of collagen fibres, proliferation of muscle cells and impairment in endothelium function occurs in the vessel wall with ageing, in hypertensive and others diseases. Early changes are potentially reversible. Atherosclerosis is a late stage of pathologies occurring in the arterial wall in response to various factors. The present paper describes current knowledge on mechanisms of arterial wall remodelling. The authors define basic indices of arterial compliance and describe several physiological and pathological factors which occur play the main role in process of arterial wall remodelling. A chapter is devoted to the effects of increased arterial stiffness on heart pathology and clinical implications of measuring these parameters.

Assessment of the pulse character is one of the earliest recorded medical skills, but objective recordings of pulse waveform emerged only in the nineteenth century. This technique fell into disuse with the advent of the sphygmomanometer, but interest has recently been rekindled with the introduction of computer technology and high fidelity applanation tonometry. Sphygmocardiography is a non-invasive and accurate technology which utilizes tonometric analysis of the radial or carotid artery pulse wave and measurement of peripheral arterial blood pressure to derive a central arterial pulse wave, central arterial blood pressure and related indices. In clinical studies pulse wave analysis is a highly reproducible method and easy to apply. This measure provides important information about arterial stiffness and heart-vascular interactions. This technique may provides better cardiovascular risk assessment associated with increased arterial stiffness and allow treatment to be targeted to those most in need.