THE CIRCADIAN ALTERATIONS OF BLOOD PRESSURE IN PATIENTS WITH SECONDARY HYPERTENSION

Objective To study the pattern of circadian blood pressure changes in patients with se-condary hypertension. Methods The 24h ambulatory blood pressure monitoring was performed in 80 patients with secondary hypertension (SH) including primary aldosteronism in 44, pheochromocytoma in 11, renovas-cular hypertension in 10, renoparenchymal hypertension in 15 and compared with 80 patients with essential hy-pertension (EH) matched by age and sex. Results The diurnal rhythm in patients with SH was different from that of patients with EU. The diurnal curves in SU and EU was overlapped in daytime and separated from each other at nighttime. The nocturnal blood pressure fall was less and average blood pressure at nighttime was higher in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure loading and non-dipper phenomenon were much more frequently seen in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure/daytime blood pressure ratio was significantly higher in patients with SH than that in patients with Eli (P <0. 01). Conclusion The non-invasive 24h ambulatory blood pressure monitoring may be a useful method in screening for

Relation Between Night Urinary Free Cortisol and Hypertension in Youth

Objectives To study the relation between night urinary free cortisol (UFC) excretion and hypertension in youth. Methods Night urinary free cortisol excretion and blood pressure & its related factor were measured in 188 young people. Results In young men with hypertension the 8 h's night UFC excretion was significantly higher than that in the group with normal blood pressure 21. 57±6. 28μg/8 h vs 10. 54 ± 5. 46 μg/8 h ( P < 0. 05) . In a group of young people with positive family history of hypertension, the night UFC excretion was much higher than that in the group with negative family history of hypertension. Men excrete much more night UFC than women (12. 73 ± 5. 85 μg/8 h vs 7. 80 ± 4. 15 μg/8 h, P < 0. 05). Conclusions There is an association between hypertension and high 8h's night UFC excretion; furthermore, there is gender difference in night UFC excretion.

Acute responses to inhalation of Iloprost in patients with pulmonary hypertension

Background Iloprost has been used to test acute pulmonary vasoreactivity in idiopathic pulmonary arterial hypertension （PAH）. We aimed to investigate the acute hemodynamic and oxygenation responses and tolerability to 20 pg aerosolized Iloprost in Chinese patients with pulmonary hypertension. Methods Between March 2005 and May 2010, 212 pulmonary hypertension patients inhaled a single dose of 20 pg Iloprost over 10-15 minutes for vasoreactivity testing. The acute hemodynamic and oxygenation responses and adverse events were recorded. Results Iloprost decreased total pulmonary resistance （（1747±918） dyn.s-cm-5 vs. （1581±937） dyn.s.cm-5, P 〈0.001）, increased stroke volume （（45.0±22.1） ml vs. （47.0±24.2） ml, P=0.002）, and cardiac output （（3.7±1.7） L/ml vs. （3.9±1.9） L/min, P=0.009）. Heart rate and systemic vascular resistance remained stable during inhalation. However, systemic arterial blood oxygen saturation fell slightly （（91.0±6.8）% vs. （90.3±6.7）%, P=0.002）. Pulmonary and systemic arterial blood pressures declined within 1-3 minutes after inhalation initiation and reached their lowest levels within 10-15 minutes. Idiopathic PAH responded more favorably than pulmonary hypertension due to other causes （P 〈0.001） and patients with less severe pulmonary hypertension have better responses to Iloprost. No adverse events requiring medical care or leading to termination of inhalation occurred. Conclusions Inhalation of 20 pg Iloprost showed potent and selective pulmonary hemodynamic effects and was well tolerated in the Chinese pulmonary hypertension patients. Patients with idiopathic PAH and less severe pulmonary hypertension responded more favorably to inhalation of Iloprost.