Vasilios Kotsis

The measurement of carotid artery intima-media thickness in children and adolescents has attracted a great deal of research and clinical interest in recent years, because it can provide evidence that early arterial lesions are already present in asymptomatic subjects who have risk factors for cardiovascular disease. The aim of the present study was to investigate possible correlations between parameters of 24-hour ambulatory blood pressure monitoring (ABPM) and carotid artery intima-media thickness in obese and nonobese children and adolescents. We studied 128 children and adolescents who were referred for investigation for possible hypertension. All participants in the study underwent ABPM and ultrasound measurement of the intima-media thickness of the common and internal carotid arteries. Obesity was defined as a body mass index (BMI) the 95th percentile for age and sex. Carotid artery intima-media thickness was significantly greater in obese than in non-obese children and adolescents. Linear correlations were observed between common and internal carotid artery intima-media thickness and the BMI percentile, the BMI z score, and parameters from ABPM. Multifactorial analysis of covariance showed that obesity and age were correlated with mean carotid artery intima-media thickness, independently of sex and values of clinic blood pressure and ABPM. Obese children and adolescents have greater carotid artery intima-media thickness than nonobese subjects, independently of blood pressure. These findings suggest a possible role for childhood obesity in the early onset of carotid artery atherosclerosis.

To investigate predictors of left ventricular mass corrected for height2.7 (LVMI) and left ventricular hypertrophy in patients who were found to be normotensive with both office and 24-h ambulatory blood pressure (BP) measurements. A total of 805 consecutive patients were analyzed. All patients underwent office BP measurements, 24-h ambulatory BP monitoring, laboratory measurements for cardiovascular risk factors and echocardiography. Individuals with both office and ambulatory normotension were characterized as true normotensive. LVMI was found to be 34.5 ± 10.9 g/m2.7 in normal-weight patients and 48.7 ± 13.0 g/m2.7 in obese patients (P 2.7 Obesity may represent a significant cardiovascular risk factor even in normotensive individuals. Other predictors of LVMI were ageing and daytime PP.

Background. In this study we investigated (i) the prevalence of white coat hypertension (WCH) and masked hypertension (MH) in patients who had never be

To examine differences between hypothyroid patients and healthy volunteers in 24-h ambulatory blood pressure parameters. The study population consisted of 100 individuals who were recently diagnosed for hypothyroidism. These patients had never been treated before with antihypertensive treatment or received drugs for hypothyroidism. All participants underwent 24-h ambulatory blood pressure monitoring. The control group consisted of 100 healthy volunteers matched one to one for gender and age with the hypothyroid participants. Clinic systolic and diastolic blood pressures were significantly higher in patients with hypothyroidism compared with volunteers. The mean 24-h systolic blood pressure and 24-h pulse pressure were significantly higher in patients with hypothyroidism compared with volunteers. The 24-h systolic blood pressure variability was also significantly higher in patients with hypothyroidism. Fasting serum cholesterol tended to be higher in patients with hypothyroidism compared with volunteers but the difference was not statistically significant, while fasting serum triglycerides were significantly higher. Body mass index was also significantly higher in patients with hypothyroidism. These findings indicate that hypothyroidism may be an important predictor of higher mean 24-h systolic blood pressure, 24-h pulse pressure and 24-h systolic blood pressure variability, parameters of ambulatory blood pressure monitoring that have been previously associated with higher cardiovascular target organ damage.

Objective: To explore differences in intima media thickness (IMT) of the carotid arteries induced by differences in BMI.Research Methods and Procedures: Data from 3173 consecutive subjects, who were referred to our Hypertension Center from 1998 to 2004, were reviewed. Criteria for patients to be considered for further analysis included no past or concurrent antihypertensive medication, no concurrent medication with the potential to raise blood pressure (BP) (e.g., prednisone), and no clinical signs or laboratory evidence of secondary causes of hypertension. Our population was divided into four groups according to NIH criteria for obesity: underweight, normal weight, overweight, and obese. BMI, mean IMT of internal carotid arteries, and 24‐hour BP values were available for all subjects. Five hundred thirty six subjects of the four groups, matched for age, gender, and mean 24‐hour BP values, were included in the analysis.Results: Mean IMT of internal carotid arteries was increased with increasing BMI. Mean IMT was significantly higher in obese subjects compared with normal‐weight (p < 0.01) and underweight (p < 0.001) subjects. Mean IMT was significantly higher in overweight subjects compared with normal‐weight ones (p < 0.05). Furthermore, multivariate regression analysis in obese subjects revealed that fasting serum glucose was independently associated with IMT.Discussion: Obesity may be an important factor for carotid atherosclerosis, and at least some of the effects of obesity are independent of the BP levels. Fasting serum glucose levels in obese subjects may play an important role in carotid atherosclerosis.