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Transthoracic CFR correlated significantly with well-established noninvasive predictors of atherosclerosis, and we suggest that it can be used as a surrogate for coronary atherosclerosis.

5Uric acid (UA) is independently associated with the emergence of hypertension. Nocturnal nondipping pattern of hypertension is associated with a greater risk of cardiovascular, renal, and cerebrovascular complications than dippers. The aim of the present study was to evaluate the relationship between the circadian blood pressure rhythm and UA level in patients with newly diagnosed essential hypertension. The study included 112 essential hypertensive patients and 50 healthy controls. The hypertensive patients were divided into two groups according to the results of 24-hour ambulatory blood pressure monitoring, including 60 dippers (35 men, 25 women; mean age, 52.6AE15.8 years) and 52 nondippers (29 men, 23 women; mean age, 55.9AE13.2 years). Nondippers had significantly higher serum UA levels than the dippers and controls (5.8AE0.8, 5.1AE0.9 and 4.2AE0.9 mg ⁄ dL, respectively; P<.001). Serum high-sensitivity C-reactive protein levels were also significantly higher in the nondipper group than the other groups (P<.001) and significantly correlated with serum UA (r=0.358, P<.001). Multivariate logistic regression analysis revealed an independent positive association between serum UA levels and nondipper pattern (odds ratio, 2.28; 95% confidence interval, 1.33-3.94; P=.003). Serum UA is strongly and independently associated with the nondipper circadian pattern in essential hypertension. J Clin Hypertens (Greenwich). 2013; 15:7-13. Ó2012 Wiley Periodicals, Inc.

Background-Elevated serum bilirubin concentrations protect against atherosclerotic diseases; however, it is not clear whether higher serum bilirubin concentrations in physiological ranges work in favor of the cardiovascular system in younger persons with no cardiovascular risk factors. Accordingly, we investigated the effects of high, intermediate, and low serum bilirubin concentrations on coronary flow reserve (CFR). Methods and Results-Fifty-two healthy subjects with hyperbilirubinemia (total bilirubin 1.43Ϯ0.33 mg/dL; mean age 35.9Ϯ7.3), 55 subjects with intermediate bilirubin level (total bilirubin: 0.69Ϯ0.11 mg/dL; mean age: 36.4Ϯ6.8), and 53 healthy subjects with hypobilirubinemia (total bilirubin 0.37Ϯ0.08 mg/dL; mean age, 37.6Ϯ6.6) were studied. Transthoracic second harmonic Doppler echocardiography examination was performed using an Acuson Sequoia C256 Echocardiography System. Coronary diastolic peak flow velocities were measured at baseline and after dipyridamole infusion (0.84 mg/kg over 6 minutes). CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocities. Demographic features, coronary risk factors, echocardiographic measurements, and biochemical measurements were similar among the 3 groups, except high-sensitivity C-reactive protein (hsCRP