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Objective: In HT, both arterial elasticity of the central arteries (C1) and of the distal circulation (C2) has been reported to be reduced and this condition favours the development of other cardiovascular diseases. Diastolic dysfunction (DD) identifies hypertensives with high cardiovascular risk independent of LV mass and BP level. Several studies have shown that the extent of diastolic function's impairment could be interdependent on the level of arterial elasticities’ alteration. PURPOSE: To evaluate the correlation between the elasticity of large and small arteries and DD Design and method: Arterial elasticity indices (C1, C2) were derived from pulse wave analysis based on a modified Windkessel model in 101 hypertensive subjects, (mean age 51.08 ± 0.79 yrs; 48.51% of men, SBP/DBP: 202.49 ± 7.41/106.7 ± 5.54 mmHg, BMI- 29.38 ± 0.22 kg/m2), without other co-morbidities. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE)were performed at baseline and after 6, 12- months period of treatment. DD patterns were appreciated according to ASE/EACVI 2016 guidelines. Altered arterial elasticity was considered for C1 < 10 ml/mm Hg × 10, C2 < 6 ml/mm Hg × 1. Correlation analysis was performed using Pearson's test. The correlation coefficient was considered weak at < 0.3, medium-0.3–0.7 and strong > 0.7–1.0. Statistical significance was appreciated at a P-value < 0.05 and highly significant at a P-value < 0.001 Results: Diastolic dysfunction and C1 and C2 indices demonstrated a statistically significant correlation (p < 0.001). More advanced patterns of diastolic dysfunction were associated with higher C1 and C2 abnormalities (Tab. 1,). Conclusions: Diastolic dysfunction is associated with arterial elasticity's alteration, and this association appears to have a particularly strong relationship with the extent of diastolic function's impairment. The more advanced patterns of diastolic dysfunction occurred, the stronger is the interdependence with arterial elasticity abnormalities.

Objective: Comparative evaluation of the impact of renal denervation versus pharmacological treatment with sympathetic nervous system (SNS) blockers on blood pressure variability in patients with resistant hypertension. Design and method: 75 patients with resistant hypertension without comorbidities after a 3-week standardized treatment with Losartan, Amlodipine and Indapamide and confirmation of their resistance were randomized into three groups, depending on medication supplimented to the previously administred: group I M - selective I1-imidazoline agonist Moxonidine, group II B – cardioselective beta-blocker Bisoprolol, group III D – renal artery denervation (RDN). Blood pressure variability assessed by ambulatory blood pressure monitoring (ABPM) were determined at baseline, 3 and 6 months follow-up. Results: The media/day and media/night systolic blood pressure (SBP) variability increased at the baseline in all three groups was reduced statistically significant from 3 months of monitoring, reaching the maximum effect towards the end of the study, when its normal values were recorded in all observational groups. Although treatment group supplimented with Moxonidine demonstrated an effect superior to that with Bisoprolol, and RDN - superiority to both, all three schemes had an authentic dynamics in improving SBP at 6 months of evaluation (p < 0,001) (Fig.1). The evolution of diastolic blood pressure (DBP) media/day and media/night variability noted a beneficial effect, starting with 3 months, the improvement of this parameter being maintained until the end of the study. Although the reduction of DBP variability was statistically authentic in all three groups at all stages of evaluation, the Bisoprolol treatment group noted a smaller effect in improving this parameter, the higher net effect being manifested by the RDN patients group (p < 0,001) (Fig.2). Conclusions: RDN in patients with resistant hypertension reduced statistically significant SBP and DBP variability starting with 3 months of follow-up and reaching maximum effect at the end of the study, simultaneously demonstrating superiority over treatment with SNS blockers.

Objective: To evaluate the effect of valsartan, eprosartan or losartan on LVH and NT-proBNP levels in patients with hypertension and preserved ejection fraction Design and method: This is randomized, prospective and double-blind study involved 154 hypertensive patients (56,5% men; mean age 53,6 ± 0,5 years) with concentric LVH remodeling (LV mass > 115 g/m2 and 95 g/m2 in men and women, respectively), which were eligible criterions to randomize to receive medication into three groups: valsartan (n = 48), eprosartan (n = 54), losartan (n = 52) over a follow-up period of 24 months. Echocardiography, ambulatory blood pressure monitoring and NT-proBNP assessments were performed at baseline and after 24 months treatment. Results: Despite similar effects on ambulatory blood pressure levels, significant differences on LV mass index were found between valsartan, eprosartan and losartan treatment (mean decrease 27.0 g/m2 vs 35 g/m2 and 24.0 g/m2, respectively, p < 0,001), and there was positive correlation of changes in ambulatory systolic blood pressure with LV mass index (r = 0,5; p < 0,001). Eprosartan-based therapy induced a greater reduction in NT-proBNP levels (-45,6%, p < 0,001) from baseline than in the valsartan (-28,9%, p < 0,01) and losartan group (- 26,5%,, p < 0,01). Conclusions: The findings of this study showed that all three agents progressively reduced LVH, but the reduction was significantly greater in the eprosartan group. Additionally, eprosartan was associated with a greater reduction of NT-proBNP levels.

Over the years, time has given us a whole series of novelties in the fi eld of natural medicine, which have managed to truly prove their value and keep up to date. Th e application of apitherapy has been known since ancient times and today the interest in this branch of natural medicine is growing worldwide. Among bee products, with an indisputable value is also propolis, which is currently widely studied, and as a result is the subject of multiple therapeutic uses based on evidence. Research in the fi eld of propolis preparations has expanded considerably and is of major medical and pharmaceutical interest. Propolis is an excellent anti-infl ammatory, healing and epithelializing, hepatoprotective, immuno-biostimulator, capillary tonic and tissue regenerator. It is remarkable that, due to its complexity and compositional variability, propolis retains its full antimicrobial capacity, unlike synthetic antibiotics, which bacteria develop resistance over time, requiring the periodic introduction of new antibiotics. Th e study on obtaining and analyzing propolis extracts, by determining the total polyphenolic and antioxidant activity, by scavenging method of the free radical DPPH, is an important premise for the use and development of new pharmaceutical forms containing propolis for multiple curative-prophylactic uses based on local raw materials.