Objective: In the present study, the importance of the pulse pressure amplitude as a marker of the risk of myocardial infarction (MI) is discussed. Methods:The 88 survivors of myocardial infarction were evaluated and a group of 106 healthy people is used as controls. The biomarkers: total cholesterol, HDL -cholesterol, serum triglycerides and LDL -cholesterol is measured with biochemical analyzer "Cobas Integra 400 (Roche)". ANOVA analysis is performed and multivariate analyses are conducted with multiple logistic regression methods. Results:The mean systolic blood pressure is significantly higher in MI participants. The relation between odds and pulse pressure amplitude, according to obtained models, indicates increasing of odds when the value of pulse pressure amplitude is greater. The p-value for overall model fit statistic is from 8.2173×10-5 to 0.0026 for different models and it is evidence that pulse pressure amplitude is a marker for MI risk. In the simplest model only pulse pressure amplitude is included as predictor variable whereas pulse pressure amplitude, sex and smoking are included in the most complex model. Results show that for a given pulse pressure amplitude odds of MI are significantly greater for men than for women. Expected increase of odds for the pulse pressure amplitude increase with 0.1 is obtained. Conclusions:The studies prove that pulse pressure amplitude is a marker of myocardial infarction risk. When the pulse pressure amplitude is used for risk level evaluation at least sex should be taken into account. Obtained results show that increased pulse pressure amplitude is greater risk for men than for women.

Background Metabolic syndrome (MetS), a risk factor for many vascular conditions, may be a prodromal manifestation of vascular cognitive impairment. Diagnosing early stages of cerebrovascular pathology can lead to prevention and delay of the progression of pathological conditions such as vascular cognitive impairment. Methods The objective of the study was to investigate new biomarkers for early diagnosis of MetS and cognitive decline as a follow-up. A cardiological, neuropsychological and neurological study was conducted among 75 Bulgarian participants. Beta amyloid in the blood, procalcitonin (PCT), NT-proBNP as predictors of cognitive impairment in patients with metabolic syndrome were identified. Clinical, anthropometric, biochemical, neuropsychological, cognitive and statistical data processing. Plasma amyloid beta (Aβ) levels, procalcitonin, NT-proBNP in MetS were investigated in participants with MetS and in group of healthy people. Results In the present study, plasma levels of Aβ42 and Aβ40 were found to be reduced in MetS participants. Procalcitonin concentration was significantly higher in males than in females. NT-proBNP was significantly higher in females than in males (p < 0.001). Regression analysis showed a positive relationship between NT-proBNP and systolic blood pressure (p < 0.001) and fasting blood glucose (p < 0.05). An inverse relation between NT-proBNP and diastolic blood pressure, waist circumference, triglycerides, HDL- and LDL cholesterol was found. Conclusions There was a positive association between PCT levels, decreased levels of Aβ42 and Aβ40, as well as elevated NT-proBNP and cognitive impairment in people with MetC. A concentration of NT-proBNP of 60 pg / ml or greater could be an indicator of metabolic abnormalities and early cognitive decline. Key messages Metabolic syndrome may be a prodromal manifestation of vascular cognitive impairment. The use of new biomarkers for diagnosis can lead to preventing and slowing the progression of complications associated with MetS.

Background: Obesity blunts the association of cfPWV with BP, at least in youth. We assessed the impact of BMI in the relationship between carotid artery function (CAF) and central BP. Methods: Stiffness index (b), Elastic modulus (Ep), Arterial Compliance (AC) and local PWV (PWVb) were measured at the common carotid arteries by echo-tracking (Aloka prosound alpha 10), and central BP was assessed with the SphygmoCor device. Patients were classified into 3 groups according to BMI (<25 normal weight; !25-<30 overweight; !30 obesity). Linear regression models, Pearson's correlation coefficient and ANCOVA models (age, gender, heart rate and central PP as covariates) were performed. Results: 222 patients (mean age 42.8 AE 14.2 years; 93 (42%) women; mean BMI 26.6 AE 4.4; 139 (62.6%) hypertensives, 104 (74.8%) under treatment). BMI categories: 85 (38.3%) normal weight, 88 (39.6) overweight, 49 (22.1%) obesity. Age, HR ,central PP showed significant positive association with CAF parameters. BMI categories and gender were not significantly associated with CAF parameters, except for overweight with PWVb (p-value 0.02). There was no significant difference in b, Ep, AC and PWVb between BMI groups after adjusting by covariates. Pearson's correlation coefficient between central SBP and CAF parameters was significantly lower if BMI!25 (â: 0.46, 0.19, 0.13; Ep: 0.69, 0.43, 0.3; AC: -0.48, -0.37, -0.31; PWVâ: 0.66, 0.48, 0.36 for normal weight, overweight and obesity, respectively; p-value for overweight<0.001, p-value for obesity<0.05). Conclusions: BMI categories are not closely related to CAF. BMI might blunt the increment of CAF parameters with rising central BP.

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