Despite the fact that it is known that hypertension may be associated to early atherosclerosis manifestations, few data are to date available on the relationship between early carotid abnormalities and left ventricular diastolic dysfunction. To address this issue, 142 hypertensive patients (64 females and 78 males) younger than 55 years, at the first diagnosis of mild-tomoderate essential hypertension (WHO/ISH criteria), were selected from a database consisting of 3541 subjects referred to ultrasound cardiovascular laboratory in the last 5 years. Carotid intima-media thickness (IMT) was detected by high-resolution vascular ultrasound and left ventricular structure and function by the use of Doppler echocardiography. According to carotid IMT values, all patients were subgrouped into two groups consisting of 89 (62.6%) pts with IMT X1 mm (A) and 53 (37.4%) pts with IMT o1 mm (B). Our results show that isovolumic relaxation time (IVRT), deceleration time of E velocity (EDT) and left ventricular relative wall thickness (LV-RWT) were significantly (Po0.05) higher in group A (IVRT 112 7 8.9 ms; EDT 288 7 21.8 ms; LV-RWT 0.40 7 0.08) than in group B (IVRT 92.3 7 4.6 ms; EDT 203.3 7 27.01 ms; LV-RWT 0.37 7 0.06). Moreover, the prevalence of left ventricular hypertrophy (LVH) was significantly (Po0.01) higher in group A (30/89; 33.7%) than in group B (8/53; 15%). A positive correlation (Po0.001) between IMT, EDT and IVRT was found only in hypertensives without LVH. These results are consistent with the indication that IMT evaluation has to be recommended both in hypertensive patients with LVH and in those without LVH, but with left ventricular diastolic dysfunction. This approach might improve the prognostic stratification of hypertensive subjects and it might be suitable to recognize the subset of patients at a higher risk of cardiovascular disease or events early.

This study has been designed to evaluate the relationship among transforming growth factor b1 (TGFb1) and some measurements of diastolic function in a population of hypertensive subjects with normal left ventricular ejection fraction. We studied 67 hypertensive outpatients who according to their BMI levels were subdivided into three groups: lean (L), overweight (OW) and obese (OB) hypertensives (HT). Circulating TGFb1 and M-and B-mode echocardiography was determined. All hypertensives were further subgrouped, according to European Society of Cardiology Guidelines, into two subsets of patients with normal diastolic function or with diastolic dysfunction. Prevalence of left ventricular hypertrophy (LVH) was determined in all the groups. TGFb1, left ventricular mass (LVM), LVM/h 2.7 , E-wave deceleration time and isovolumic relaxation time (IVRT) were significantly (Po0.005) higher and E/A velocity ratio was significantly (Po0.05) lower in OW-HT and OB-HT than in L-HT. Prevalence of LVH was significantly higher (Po0.03) in group OB-HT than in L-HT. TGFb1 (Po0.004), LVM/h 2.7 (Po0.001) and prevalence of LVH were (Po0.01) significantly higher in hypertensives with diastolic dysfunction than hypertensives with normal diastolic function. TGFb1 levels were positively correlated with BMI (r ¼ 0.60; Po0.0001), LVM/h 2.7 (r ¼ 0.28; Po0.03), IVRT (r ¼ 0.30; Po0.02) and negatively with E/A ratio (r ¼ À0.38; Po0.002) in all HT. Multiple regression analysis indicated that TGFb1, BMI and IVRT were independently related to E/A ratio explaining 71% of its variability (r ¼ 0.84; Po0.0001). This relationship was independent of LVH, age and HR suggesting that TGFb1 overproduction may be considered a pathophysiological mechanism in the development of left ventricular filling abnormalities in obesity-associated hypertension.

The data obtained suggest that in patients without evidence of gastric phase III of MMC the prevalence of H. pylori colonization is significantly (P = 0.032) higher.

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Introduction:The flow-mediated vasodilatation (FMD) of the brachial artery can provide a reliable measure of endothelial function. A decrease in FMD is presently considered a sensitive index of cardiovascular risk. Aging and hypertension "per se" are among the major cardiovascular risk factors in the general population. Therefore the aim of this study was to compare the effect of aging and hypertension on flow mediated dilatation. Methods: We studied five young normotensives (YNT), five young hypertensives (YHT), five elderly normotensives (ENT) and five elderly hypertensives (EHT) All hypertensives were affected by WHO Class I hypertension. The internal diameter of the brachial artery ("leading edge to leading edge") was continuously monitored and recorded and the peak FMD variation was then evaluated off-line with a dedicated software (FMD Studio Institute of Clinical Physiology CNR Pisa; Ghiadoni et al). The measurement of the carotid intima -media (IMT) thickness was obtained semi-automatically with a dedicated software (Math' Lab Paris) by off-line evaluation of the far-wall of both common carotid arteries (4-7 MHz Linear transducer using a Simens Sequoia Paragon 512 and recorded. as the frozen images). Endothelium-dependent FMD was compared with endothelium-independent vasodilatation following sublingual nitroglycerin administration (natispray 0,3 mg) [see Results: Both hypertension and aging lead to a decrease in endothelial function (FMD) but the hypertensive disease causes a greater reduction; endothelial dysfunction was accompanied by an increase in IMT. Conclusions: Despite the small sample of subjects investigated the differences were consistent in both groups.