A hypertensive response to exercise (HRE) is frequently observed in individuals without hypertension or other cardiovascular disease. However, mechanisms and clinical implication of HRE is not fully elucidated. Endothelial dysfunction and increased stiffness of large artery contribute to development of HRE. From neurohormonal aspects, excess stimulation of sympathetic nervous system and augmented rise of angiotensin II seems to be important mechanism in HRE. Increasing evidences indicates that a HRE is associated with functional and structural abnormalities of left ventricle, especially when accompanied by increased central blood pressure. A HRE harbors prognostic significance in future development of hypertension and increased cardiovascular events, particularly if a HRE is documented in moderate intensity of exercise. As supported by previous studies, a HRE is not a benign phenomenon, however, currently, whether to treat a HRE is controversial with uncertain treatment strategy. Considering underlying mechanisms, angiotensin receptor blockers and beta blockers can be suggested in individuals with HRE, however, evidences for efficacy and outcomes of treatment of HRE in individuals without hypertension is scarce and therefore warrants further studies.

No abstract

No abstract

use of AP, to varying degrees. 5-7 In the elderly, degenerative valve disease, diabetes, and cancer have become the major risk factors for IE. 1 A recent study reported that patients with colorectal, lung, or prostate cancer had a substantially higher incidence of IE than did non-cancer patients. 8 Furthermore, a recent study showed an association between invasive procedures and the development of IE. 9 Cancer patients may constitute a special risk group for the development of IE because they are often subjected to invasive procedures. 10 However, little is known regarding the incidence, provoking factors, and outcomes of IE in patients with cancer. Moreover, it is unclear whether the same principles for AP can be applied in cancer patients. The aims of this study were to determine the clinical characteristics and outcomes of IE patients with cancer and to compare them with IE patients without cancer. Methods The study protocol was approved by the Institutional I nfective endocarditis (IE) is an uncommon but lifethreatening disease. 1 Despite advances in diagnosis, antimicrobial therapy, surgical techniques, and management of complications, the 1-year mortality rate of patients with IE is almost 30%. 1,2 Recent studies have shown remarkable changes in the epidemiological and clinical features of IE. In the past, IE mainly occurred in the younger population (30-40 years old), and the most common pathogen was the viridans group Streptococcus, which is part of the normal oral flora. 3 However, the incidence of IE has recently increased in patients aged more than 50 years, and the most common bacterial organism is now Staphylococcus aureus. 3,4 Transient bacteremia is known to be a precursor to the development of IE. 5 Therefore, oral antibiotic prophylaxis (AP) has been recommended for patients at risk of developing IE who are undergoing a dental procedure. However,