Objective To investigate (1) whether or not irbesartan can relieve endothelial dysfunction of essential hypertension; (2) which of fosinopril and irbesartan is better in relieving the endothelial dysfunction in essential hypertension, especially for the elderly . Methods Sixty-two elderly patients with essential hypertension were divided into two groups: fosinopril group and irbesartan group. After 3 months treatment, the effect of drugs on BP and the endothelium-dependent relaxation(EDR) of brachial artery (BA) with high resolution ultrasound examination were analyzed, meanwhile the plasma levels of NO、ET-1 and vWF were assessed. Results Fosinopril and irbesartan groups had a similar (P

Diabetic retinopathy (DR) is one of the most common causes of visual impairment and blindness in diabetic patients.It is particularly important to set up simpler,safer,non-invasive and highly effective methods for diagnosis as well as monitoring DR.A variety of new fundus imaging techniques show great advantages in early diagnosis,treatment and monitoring of DR in recent years,The main characteristics of wide-field scanning laser imaging system is achieving a large range of retinal image in a single photograph and without mydriasis.It provides several options for color images,FFA and FAF,which satisfy to detect the retina,choroid and vascular structure.Multi spectral fundus imaging system is suitable for DR screening,because it is able to recognize the typical characteristics of DR,such as microaneurysms,hemorrhage and exudation,and is non-invasive and convenient.OCT angiography is a quantitative examination that provides foveal avascular zone area,macular blood flow density,which provides strong evidence for DR diagnosis.The improvement of these new techniques will help us to build up a personalized evaluation system of DR.

OBJECTIVETo analyze the correlation between mitral regurgitation grading and left ventricular ejection fraction in elderly patients (>60 years of age) in a 2-year follow-up.

METHODSA total of 455 patients with the diagnosis of at least mild mitral regurgitation by echocardiography were divided into ischemic mitral regurgitation (IMR) group and non-ischemic regurgitation (NIMR) group. The patients were followed up with echocardiography every 6 months and the data were analyzed at the end of 24 months.

RESULTSMitral regurgitation grade was inversely correlated with left ventricular ejection fraction (LVEF). Patients with moderate and severe IMR had a lower LVEF than those with NIMR (P<0.05). After adjustment for age, sex, body mass index, high blood pressure, diabetes, atrial fibrillation and cardiomyopathy, the mean LVEF at 2 years was lowered by 2.7% (1.4%-4.1%), 2.7% (1.3%-4.0%), and 5.2% (3.5%-6.9%) in mild, moderate and severe IMR patients, respectively (P<0.04), and by 3.2% (1.6%-4.8%), and 3.0% (1.4%-4.5%), and 1.7%(-0.5%-3.9%) in mild, moderate and severe NIMR patients (P=0.30).

CONCLUSIONThe mean LVEF in IMR patients is significantly lowered compared to that in NIMR patients. The grade of mitral regurgitation is inversely correlated with the regurgitation area in IMR patients. Stratified management might help improve LVEF in severe IMR patients.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Mitral Valve Insufficiency ; Stroke Volume ; Ventricular Dysfunction, Left ; physiopathology

Objective:To study the effect of lifestyle intervention and Irbesartan intervention on vascular endothelial function in elderly people with prehypertension.Methods:Seventy elderly people with prehypertension were randomly divided into the lifestyle intervention group and the Irbesartan intervention group.After one year of intervention, the level of cyclic endothelial microparticles(EMPs)and brachial-ankle pulse wave conduction velocity(baPWV)before and after the intervention were compared between the two groups.Results:There were significant differences in levels of circulating EMPs[(1 946±234)/μl vs.(1 745±416)/μl, t=2.530, P=0.011]and baPWV[(1 653±172)cm/s vs.(1 511±230)cm/s, t=2.448, P=0.017]before and after one year of lifestyle intervention.There were also significant differences in levels of circulating EMPs[(19 507±146)/μl vs.(1 446±286)/μl, t=3.340, P=0.002]and baPWV[(1 639±165)cm/s vs.(1 361±211)cm/s, t=3.156, P=0.005]before and after one year of Irbesartan intervention and between the lifestyle intervention group and the Irbesartan intervention group after one year( t=2.238 and 2.475, P<0.05). Conclusions:Lifestyle intervention and Irbesartan intervention have protective effects on vascular endothelial function and delay the initiation and progression of atherosclerosis in elderly people with prehypertension, and irbesartan intervention is more effective than lifestyle intervention.