539hypertensive action of ketanserin is thus characterised by a favourable haemodynamic profile. The observation that ketanserin lowered not only systemic arterial pressure but also cardiac filling pressures suggests that this balanced vasodilatation may be of particular interest for the treatment of congestive heart failure. Indeed, a favourable response to ketanserin in this condition has been reported recently."' 5-HT not only acts as a direct vasoconstrictor, but it also amplifies the vasoconstrictor responses to agents such as noradrenaline and angiotensin II.2 5-HT is released by aggregating platelets in atherosclerotic arteries, which are abnormally responsive to this amine.'2 Ketanserin antagonises not only the direct vasoconstrictor effect of 5-HT but also its amplifying effects on other vasoactive substances.5 These mechanisms may all be implicated in the haemodynamic effects of 5-HT2 receptor blockade by ketanserin. This compound is thus a new therapeutic tool for investigating the role of 5-HT in the pathogenesis of various forms of hypertension. Experience so far warrants further assessment of its place in the management of hypertension.We thank Dr J Symocns of Janssen Pharmaceutica for generous supplies of ketanserin. Sodium-potassium cotransport activity is thought to be defective in essential hypertension and could be a useful genetic marker for susceptibility to essential hypertension. In this study cotransport activity in subjects with hypertension was compared with that in normotensive controls. The effects of ethnic differences, environment, and antihypertensive drugs were also studied. Mean cotransport activity was lower in hypertensive subjects than in controls of the same ethnic groups. There was, however, a large overlap between controls and hypertensive subjects. No ethnic or environmental influences were found. The large overlap found suggests that sodium-potassium cotransport activity is not a useful genetic marker in essential hypertension. References

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This monitoring catheter enabled the assessment of the functional state of the dynamic cardiomyoplasty and allowed a synchronization to the heart cycle. It will promote understanding and might help to avoid muscle damage in dynamic cardiomyoplasty for an improved outcome of the surgical treatment of end-stage heart failure.