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Abstract: A population-based study was conducted among women over the age of 70 years with complaints of uncomplicated urinary tract infections (UTIs). The positive predictive value of the nitrite test alone or in combination with the leukocyte esterase test ranged between 83% and 99%. The nitrofurantoin prescription rate decreased whereas fluoroquinolone and amoxicillin/clavulanic acid prescriptions increased with increasing age. The aetiology of infection was age-dependent. Escherichia coli was the most commonly isolated uropathogen, followed by Proteus mirabilis and Klebsiella pneumoniae. For these uropathogens, the lowest susceptibility percentages were found for amoxicillin, trimethoprim and co-trimoxazole. As trimethoprim susceptibility reached ∼75%, it may be advisable not to use this as a first-choice agent in the treatment of uncomplicated UTIs in the elderly. [Copyright &y& Elsevier]

Background: Multimorbidity is a growing problem. The number and complexity of (non-)pharmaceutical treatments create a great burden for patients. Treatment burden refers to the perception of the weight of these treatments, and is associated with multimorbidity. Measurement of treatment burden is of great value for optimizing treatment and health-related outcomes., Objective: We aim to translate and validate the Multimorbidity Treatment Burden Questionnaire (MTBQ) for use in the Dutch population with multimorbidity and explore the level of treatment burden., Methods: Translating the MTBQ into Dutch included forward-backward translation, piloting, and cognitive interviewing (n = 8). Psychometric properties of the questionnaire were assessed in a cross-sectional study of patients with multimorbidity recruited from a panel in the Netherlands (n = 959). We examined item properties, dimensionality, internal consistency reliability, and construct validity. The level of treatment burden in the population was assessed., Results: The mean age among 959 participants with multimorbidity was 69.9 (17-96) years. Median global NL-MTBQ score was 3.85 (interquartile range 0-9.62), representing low treatment burden. Significant floor effects were found for all 13 items of the instrument. Factor analysis supported a single-factor structure. The NL-MTBQ had high internal consistency (α = 0.845), and provided good evidence on the construct validity of the scale., Conclusion: The Dutch version of the 13-item MTBQ is a single-structured, valid, and compact patient-reported outcome measure to assess treatment burden in primary care patients with multimorbidity. It could identify patients experiencing high treatment burden, with great potential to enhance shared decision-making and offer additional support., (© The Author(s) 2023. Published by Oxford University Press.)

Background: Treatment burden is an emerging concept in health care literature. It can complicate the patients' condition and perhaps result in poor adherence to treatment, which is linked to worse clinical outcomes. However, until now there is no definition for treatment burden recognized by all stakeholders. This review was prepared in order to find what available definitions for treatment burden are present in the literature., Methods: A systematic review of the literature was prepared looking for definitions of treatment burden in adult patients. Articles about adults aged 18 years or older from both genders with one or more medical conditions that contained a (new) definition of treatment burden were included. The search approach consisted of conventional systematic review database searching of multiple resources including Embase, Medline, PsycINFO, and CINAHL. Two independent reviewers screened the titles and abstracts, and full papers., Results: The searches resulted in 8045 records, of which 16 articles were included. Based on quality appraisal criteria, we decided that two definitions had better evaluations than the rest of the definitions, the first one defining it as the impact of the 'work of being a patient' on functioning and well-being, the second as the actions and resources they devote to their healthcare., Conclusion: We consider the definition concentrating on actions and resources patients devote to their healthcare, including difficulty, time, and out-of-pocket costs dedicated to the healthcare tasks such as adhering to medications, dietary recommendations, and self-monitoring as the one probably comprising most domains of Treatment Burden that we have found in our search in the existing literature. However, adding even more domains to this definition and differentiating explicitly between patient's perception and caregiver's perception in the definition could in our opinion result in an improved definition. Also patients' evaluation of this definition is commendable., (© 2020 The Authors.)

Background: Physicians and other healthcare professionals involved in the care of patients with multimorbidity should consider the problems these patients experience in managing their own conditions. However, treatment burden from the patient's perspective has been poorly explored, even though this might hamper treatment adherence., Objective: The present study examined the experiences of patients with multimorbidity in primary care in the Netherlands and Belgium using semi-structured interviews, with special attention to the daily life domains of treatment burden., Design: Individual interviews gathering qualitative data to explore the treatment burden experienced by patients with multimorbidity in primary care. Twenty-two patients agreed to participate: seven men and fifteen women. The recorded interviews were transcribed verbatim and evaluated using thematic content analysis., Results: The patients reported numerous aspects of treatment burden they experienced in various domains of their daily lives. These topics were categorized into four daily life domains of burden: organization of care, medication, patient's role, and impact on daily life (including the involvement of caregivers)., Conclusions: The findings indicate that primary care patients with multimorbidity report treatment burden in several domains of their daily lives, not restricted to medical issues, such as side effects of medication. Some issues, such as those related to organization of care, seem easily modifiable. Further research is required focusing on special factors of treatment burden as experienced by patients with multimorbidity, and the implications for treatment adherence, especially in European settings, as little information is currently available., Competing Interests: The authors declare no conflicts of interest.

Background: To ensure true patient-centered care, the urgency of patient participation in research is increasingly recognized. This study takes this one step further and reports on patient participation in describing patients' needs for improving quality of care in the context of research priorities - a challenging partnership with patients in research as we yet lack experience in the Netherlands., Objectives: 1) To illustrate the process of describing patients' needs in the context of research priorities for patients with blood cancer (multiple myeloma or Waldenstrom's disease) with the purpose to improve the quality of health care. 2) To describe the experienced needs in the context of research priorities in the patients., Methods: Following the Dialogue Model, we first established a balanced project group and agreed on the study protocol, followed by the actual data collection of which the most important steps included: individual interviews and focus groups with purposeful samples of patients, a questionnaire that was sent to all members of the patient organization (n=1,782), and a dialogue meeting with patients to prioritize the final issues., Results: 1) Ten interviews and two focus groups were successfully conducted. Response rate on the questionnaire averaged 44%. 2) Main research topics: improved information on all aspects of disease and treatment, involving patients in decision making, organization of care and the burden of neuropathy., Discussion: Given the process of data collection we believe that the patients' needs for quality of care improvements in the context of research priorities that were described are valid and representative. The novelty of this approach was that patients themselves contacted researchers to assess the patients' priorities in a scientific and reliable way., (Copyright © 2016. Published by Elsevier GmbH.)

This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

Objective: To document family medicine research in the 25 EGPRN member countries in 2010., Design: Semi-structured survey with open-ended questions., Setting: Academic family medicine in 23 European countries, Israel, and Turkey., Subjects: 25 EGPRN national representatives., Main Outcome Measures: Demographics of the general population and family medicine. Assessments, opinions, and suggestions., Results: EGPRN has represented family medicine for almost half a billion people and > 300,000 general practitioners (GPs). Turkey had the largest number of family medicine departments and highest density of GPs, 2.1/1000 people, Belgium had 1.7, Austria 1.6, and France 1.5. Lowest GP density was reported from Israel 0.17, Greece 0.18, and Slovenia 0.4 GPs per 1000 people. Family medicine research networks were reported by 22 of 25 and undergraduate family medicine research education in 20 of the 25 member countries, and in 10 countries students were required to do research projects. Postgraduate family medicine research was reported by 18 of the member countries. Open-ended responses showed that EGPRN meetings promoted stimulating and interesting research questions such as comparative studies of chronic pain management, sleep disorders, elderly care, healthy lifestyle promotion, mental health, clinical competence, and appropriateness of specialist referrals. Many respondents reported a lack of interest in family medicine research related to poor incentives and low family medicine status in general and among medical students in particular. It was suggested that EGPRN exert political lobbying for family medicine research., Conclusion: Since 1974, EGPRN organizes biannual conferences that unite and promote primary care practice, clinical research and academic family medicine in 25 member countries.

The prevalence of asthma in children has increased in the last decades, and gender-specific differences in asthma development have recently been suggested. The present study investigates whether gender differences are present in a population of young children (0-2 yr) with a high risk for the development of asthma on the basis of the presence of asthma in first-degree relative(s). The study was performed on 222 children (118 boys, 104 girls) with a familial predisposition of asthma, which received standardized recommendations to reduce exposure to allergens (dust mite, pets and food allergens) and to passive smoking. Health outcome (wheezing episodes and shortness of breath) and compliance with allergen-reducing measures were studied by means of multiple regression analyses. Boys suffered more from asthma-like complaints than girls, as diagnosed by the general practitioner (32% vs. 18%, respectively, p = 0.023). Compliance with intervention measures was similar for boys and girls for most allergens, but food allergen reduction was better applied for girls: duration of exclusive breastfeeding was longer in girls (median 9 wk vs. 4 wk, p = 0.009). Further analysis showed that 4 wk of longer breastfeeding reduced the number of wheezing episodes and shortness of breath in boys by 19% and 15%, respectively, but not in girls, suggesting sex as an effect modifier in the relationship between breastfeeding and asthma-like symptoms. The present findings indicate that application and effects of prevention strategies for children with a high risk for developing asthma might be gender-specific and suggest a special importance of breastfeeding boys.

Objectives: Epidemiological studies indicate that acute uncomplicated urinary tract infections (UTI) in women can be successfully treated with short treatment regimens. However, the findings from the literature do not match experiences in daily practice., Methods: A randomised, controlled trial evaluating the microbiological and clinical (self-reported) cure rates of a three-day vs. five-day treatment regimen with trimethoprim for UTI in women., Results: No statistically significant difference in bacteriological cure rate was found between the three-day and five-day regimen. One day after the shorter regimen 44% of women considered themselves as 'not-recovered' due to persistence of the symptoms compared with 35% after the five-day treatment (p > 0.05). Three days after therapy these percentages were 30 and 25% respectively., Conclusion: The relatively high percentage of persistent symptoms one day after the three-day regimen might be responsible for general practitioners believing that short regimens are not successful. It is therefore advisable that if urine samples are controlled to wait at least three days after finishing treatment.

The aim of this prospective population-based study was to systematically define a cluster of diagnostic items which can assist in the early identification and classification of epileptic and non-epileptic seizures. A cohort of patients aged > or =14 years, suspected with a first epileptic seizure, were included in this study. A team of neurologists evaluated and classified all cases. Diagnostic items for epileptic and non-epileptic seizures were identified using logistic regression analysis. Three hundred and fifty cases entered this study. Distinctive features for epileptic seizures were postictal confusion (OR 0.09), an epileptiform EEG pattern (OR 0.02), and abnormal neuroimaging findings (OR 0.07), whereas for non-epileptic seizures of organic origin there was a history of hypertension (OR 7.5), and provoking factors (OR 13.4) such as exercise and warmth. Diagnostic items for seizures of non-organic origin were a history of febrile seizures (OR 5.8), treatment by a psychologist or psychiatrist (OR 9.1), and presentiment of the seizure (OR 3.7) such as a feeling of choking and palpitations. A separate analysis for the patients who were systematically investigated provided some additional diagnostic items for the different subgroups of patients. For instance, back arching during the seizure for the patients with seizures of non-organic origin and female sex for the patients with non-epileptic seizures of organic origin.

Purpose: To evaluate the methodology of incidence studies of epilepsy and unprovoked seizures and to assess the value of their findings by summarizing their results., Methods: A Medline literature search from January 1966 to December 1999 was conducted. In each selected study, key methodologic items such as case definition and study design were evaluated. Furthermore, a quantitative meta-analysis of the incidence data was performed., Results: Forty incidence studies met the inclusion criteria. There was considerable heterogeneity in study methodology, and the methodologic quality score was generally low. The median incidence rate of epilepsy and unprovoked seizures was 47.4 and 56 per 100,000, respectively. The age-specific incidence of epilepsy was high in those aged 60 years or older, but was highest in childhood. Males had a slightly higher incidence of epilepsy (median, 50.7/100,000) than did females (median, 46.2/100,000), and partial seizures seemed to occur more often than generalized seizures. Developing countries had a higher incidence rate of epilepsy (median, 68.7/100,000) than did industrialized countries (median, 43.4/100,000). Similar results were found for unprovoked seizures. The incidence of epilepsy over time appears to decrease in children, whereas it increases in the elderly., Conclusions: The age-specific incidence of epilepsy showed a bimodal distribution with the highest peak in childhood. No definitive conclusions could be reached for the incidence of unprovoked seizures and other specific incidence rates of epilepsy. More incidence studies with an adequate study methodology are needed to explore geographic variations and time trends of the incidence of epilepsy and unprovoked seizures.

Gender-related differences for disorders of consciousness other than true epilepsy usually point to a larger number of women suffering especially from non-epileptic attacks or pseudoseizures. Recently, sexual abuse has been suggested as a possible cause for this increased prevalence in women. It has, however, not been very clear if women have a different phenomenology of these type of seizures from men. In the present study, patients' cases as published in the literature are analysed in a detailed way, using a working classification by Betts et al to look for gender-specificity. Of the 62 cases, 76% concern women and 24% men; a percentage comparable to those published elsewhere. Ages range from 14 to 77 years-of-age, but 89% of patients are younger than 40. Sexual abuse was proven in 18 cases, all women. The phenomenology of the attacks was divided into tonic-clonic type and complex partial type of attack, or a combination of the two. Also, special types of attacks (swoons, tantrums, abreactive attacks and forthright simulation) were looked for. Males tended to suffer especially from tonic-clonic type seizures (80% of cases), while in women as many tonic-clonic type as complex partial type attacks were observed. Special types of attacks were observed at the same frequency in both sexes. The group of sexual abuse victims did not differ from the total group of women in this respect. The clinically more impressive nature of a tonic-clonic-type attack, that is more easily suspected to be 'real', might make this type of seizure a more male form of acting out. A prospective study on the incidence and phenomenology of pseudo-epileptic seizures in the general population is suggested to answer the new questions raised in this survey.

Objective: Arterial distensibility (DC) and compliance (CC) are vessel wall properties of large arteries that can be measured non-invasively with a custom made vessel wall movement detector system (VWMDS). This study investigated the reproducibility of this device in 10 volunteers., Methods: To investigate intraobserver intrasession and intraobserver intersession variability, arterial diameter (D) and relative change in diameter during the heart cycle (delta D/D) were measured in the elastic common carotid artery, and in the muscular femoral and brachial arteries. Interobserver intrasession variability was examined in common carotid artery by two observers, while interobserver variability on the same image was assessed for common carotid and femoral arteries. Variability was expressed as the coefficient of variation., Results: For common carotid artery, intraobserver intrasession variability was 7.9(SEM 1.6)% (delta D/D), 4.5(1.1)% (D), 8.3(1.3)% (DC), and 9.1(2.6)% (CC), respectively. In femoral artery it was 12.4(2.2)% (delta D/D), 2.7(0.6)% (DC), 13.4(2.2)% (DC), and 12.5(2.1)% (CC). For brachial artery it was 13.4(2.8)% (delta D/D), 2.5(0.5)% (D), 16.1(2.5)% (DC), and 15.6(2.6)% (CC). Intraobserver intersession variability was comparable to intraobserver intrasession variability for all vessels. Interobserver intrasession variability for common carotid artery was 11.3(2.6)% (delta D/D) and 8.6(1.9)% (D), but was larger for DC and CC. Interobserver variability on the same image was < 5% for common carotid and femoral arteries., Conclusions: In conclusion, the vessel wall movement detector system has a good technical reproducibility. Intraobserver intrasession and intersession variability are comparable, and are larger in muscular arteries. This might be due to a larger variation in tone of these arteries, which are under permanent neurohumoral control. Interobserver intrasession variability was larger than intraobserver variability and might be influenced by differences in observers' skill and spontaneous variation in vessel wall properties.

Aim: To determine whether there are inhomogeneities in arterial wall distensibility with age and hypertension., Background: It has been known for some years that arteries lose their elasticity with increasing age and that they are less distensible in subjects with established and borderline hypertension than in age-matched controls., Results of Data Analysis: In the carotid artery changes in arterial wall properties are not homogeneously distributed along the bifurcation. Both in older subjects and in those with borderline hypertension the loss of distensibility is most pronounced in the carotid artery bulb, while in borderline hypertensives the proximal part of the bulb, where the baroreceptors are predominantly located, is more affected than other parts of the bulb. The loss of distensibility in the bulb may explain the diminished baroreceptor sensitivity observed in older subjects. The pronounced involvement of the proximal part of the bulb in the decreased distensibility in borderline hypertensives suggests that local stiffening, probably leading to disturbed baroreceptor sensitivity, may contribute to the development of hypertension in these patients. The pattern of inhomogeneities in wall distensibility in borderline hypertensives at a relatively young age (average 38 years) is similar to that seen in older normotensive subjects (average age 57 years), supporting the idea that arteries age faster in hypertensives than in normotensives., Conclusion: In management of the borderline hypertensive patient, consideration should be given to preventing early ageing of the arterial wall rather than following arterial blood pressure.

The compliance of large arteries (for instance the carotid and femoral artery) can be non-invasively assessed with a vessel wall moving detector system, based upon phase tracking of the radio frequency signals generated by the arterial wall. A good compliance enables large arteries to manage the systolic flow jet from the heart more adequately, and has been suggested to protect these vessels from atherosclerosis. Arterial compliance has been found to be diminished in hypertensive subjects, even at an early stage of the disease. Antihypertensive treatment might restore compliance, depending on the drugs used. More recently, local stiffening of vessels and inhomogeneities in local distensibility have been observed in the carotid artery bifurcation of borderline hypertensives, and the time-dependent variation in local distensibility and compliance has been studied.

Atherosclerosis is an important cause of cardiovascular morbidity and mortality. A good arterial compliance has been suggested to protect large vessels from atherosclerosis. Arterial compliance is diminished in patients with essential hypertension. The influence of verapamil (calcium-antagonist) and nebivolol (beta-adrenoceptor antagonist) on the vessel-wall properties of the common carotid artery were investigated. The two drugs improved compliance of the common carotid artery. Results from other studies on arterial compliance and antihypertensive drugs are also discussed.

The effect of chronic administration of verapamil, following a double-blind, crossover protocol, on the distensibility and cross-sectional compliance of the common carotid artery was investigated in 19 patients with essential hypertension. Distensibility was significantly increased during verapamil treatment as compared to placebo for both left and right common carotid artery (p less than 0.01 and p less than 0.05, respectively). The cross-sectional compliance was significantly increased during verapamil treatment for the right common carotid artery (p less than 0.05). For the left common carotid artery, the difference did not reach the level of significance (p = 0.16). The common carotid artery diameter and the arterial pulse pressure were not significantly different during verapamil treatment as compared with placebo. The results of this study indicate that chronic treatment with verapamil increases distensibility and cross-sectional compliance of the common carotid artery in hypertensive subjects. These improvements have to be considered as changes in arterial wall properties because no significant differences in pulse pressure and diameter could be detected between the verapamil and placebo periods. Improved arterial wall properties could result in a better management of the flow jet from the heart, and might protect the patients from atherosclerotic complications of hypertension.

In the present study the criteria of spectral broadening used in pulsed Doppler systems to diagnose minor disease in the cervical carotid arteries were evaluated in relation to the size of the sample volume. For this purpose the Doppler audio spectra as recorded in asymptomatic volunteers with an ATL Duplex scanner (relatively large sample volume) and a multi-gate pulsed Doppler system (relatively small sample volume) were compared with each other. The volunteers, randomly selected from the population registers, varied in age from 20-69 yr. Only in the common carotid artery at younger age, were normal spectra recorded, especially with the multi-gate system. In the internal carotid artery the number of spectra, supposed to be associated with low grade stenosis, increased significantly, especially when recorded with the Duplex scanner. More pronounced spectral broadening was found when the spectra were recorded distally in this artery. In the cervical carotid arteries normal spectra were found only when sampled in the middle of the bloodstream. These findings indicate that for the detection of vascular lesions in the cervical carotid arteries at an early stage of the disease on the basis of spectral broadening, small sample volumes and sampling in the centre of the vessel are required.

Basically two principles have to be distinguished in ultrasonic imaging of arteries. In velocity imaging blood flow velocities are visualized with continuous wave or pulsed Doppler devices. In pulsed echo-systems artery wall structures are visualized by picking up echoes reflected by the vessel walls. Velocity imaging is mainly used to localize the site of velocity sampling which is of importance in screening the carotid artery bifurcation and in follow-up studies. Although promising results have been obtained in diagnosing atherosclerotic lesions with echo-imaging systems, these systems have their limitations. To improve the diagnostic accuracy these systems should be combined with a single- or multi-gate pulsed Doppler system.

The vessel wall properties of the common carotid artery were noninvasively studied in 109 normotensive, presumed normal male and female volunteers of various ages (20-69 y) with the use of a multi-gate pulsed Doppler system. This system allows the on-line recording of velocity profiles and the relative changes in carotid artery diameter during the cardiac cycle (delta d/d). From the width of these profiles the systolic internal diameter (d) of the carotid artery can be determined. With the use of d, the maximal increase in delta d/d during systole and the pulse pressure, as measured in the brachial artery (delta p), the distensibility coefficient and the cross-sectional compliance were calculated. Both distensibility and cross-sectional compliance were significantly lower in females than in males, irrespective of age. This likely results from a stiffer arterial wall behavior in females, because the relative increase in vessel diameter during the cardiac cycle is lower in females than in males, despite the fact that their pulse pressure values are not significantly different. The carotid artery diameters were similar in men and women. The findings in the present study indicate that the common carotid artery is stiffer in females than in males of comparable age. Therefore, sex-dependent differences have to be considered in the interpretation of arterial distensibility and cross-sectional compliance.

The vessel wall properties of the common carotid artery were studied noninvasively in normotensive and borderline hypertensive male volunteers of various ages with the use of a multi-gate pulsed Doppler system. In the younger age group (20-35 y) both distensibility and cross-sectional compliance were significantly less in the borderline hypertensive group. In the older borderline hypertensive subjects (50-69 y) distensibility (p less than 0.05) and cross-sectional compliance (p = 0.06) were also less than in the control subjects. The reduced distensibility and cross-sectional compliance likely result from a decrease in arterial wall elasticity because the relative increase in common carotid artery diameter during systole is diminished in borderline hypertensives, despite the fact that their pulse pressure is similar to or higher than that in control subjects. The less pronounced differences in vessel wall properties between borderline hypertensive and normotensive volunteers in the older age group may be a consequence of the changes in these properties with age, partly masking the alterations due to borderline hypertension. Since the stiffer behavior of the common carotid artery in borderline hypertensives is associated with relatively slight changes in blood pressure, the question can be raised whether the alterations in arterial wall properties are really a result of the elevated arterial blood pressure; these alterations might develop independent of the blood pressure elevation.

Changes in distensibility and cross-sectional compliance of the common carotid artery with age were studied in 80 presumed healthy volunteers, varying in age between 20 and 69 y. The distensibility was assessed from the relative increase in arterial diameter during systole normalized with respect to the arterial pulse pressure. The cross-sectional compliance was obtained by multiplying the distensibility by the arterial diameter. The relative diameter changes of the common carotid artery during the cardiac cycle were recorded on-line with a high resolution multigate pulsed Doppler system. The arterial diameter was assessed from the width of the velocity profiles which can also be recorded on-line with this system. Arterial pulse pressure was determined from brachial artery cuff blood pressure measurements. Both distensibility and cross-sectional compliance of the common carotid artery decreased linearly with age, starting in the third age decade. The reduction in the latter parameter was less pronounced, probably as a consequence of an increase in arterial diameter with age.

The effects of verapamil (a calcium antagonist) and nebivolol (a novel, selective beta 1-adrenoceptor blocker) on carotid artery distensibility and cross-sectional compliance were studied non-invasively in hypertensive patients with the use of a high-resolution multigate pulsed Doppler system. Arm blood pressure measurements were made with an automated device (Dinamap). After a 4-week washout period, 19 patients (aged 21-73 years) with essential hypertension entered a double-blind randomized placebo-controlled crossover study with 120 mg verapamil or placebo three times a day for 4 weeks. After the administration of verapamil, carotid artery distensibility and cross-sectional compliance were significantly larger (P less than 0.05) than after placebo. Using the same protocol, 29 patients (aged 25-70 years) were given 5 mg nebivolol or placebo once a day for 4 weeks. After the administration of nebivolol, carotid artery distensibility and cross-sectional compliance were significantly larger (P less than 0.05) than after placebo. In both studies no significant differences in diameter and pulse pressure were found between placebo and verapamil or nebivolol. Blood pressure was decreased similarly with both verapamil and nebivolol. These results indicate that both verapamil and nebivolol favourably influence carotid artery distensibility and cross-sectional compliance of the common carotid artery, resulting in a better management of the systolic pressure pulse. The improved carotid artery distensibility may help to protect the patient against atherosclerotic complications of hypertension.