Lege Artis Medicinae

[Day-to-day blood pressure variability measured with home monitoring for the verification of succesful antihypertensive therapy]

KÉKES Ede, PAKSY András, KISS István

JUNE 01, 2015

Lege Artis Medicinae - 2015;25(04-05)

[The value of „day-to-day” blood pressure variability based on home blood pressure measurements for demonstrating of successful antihypertensive treatment. Authors analyzed the effect of antihypertensive therapy on the blood pressure variability by day-to-day method based on home pressure measurements in a large number of hypertensive patients. During the four months observation period the mean blood pressure values were significantly decreased and the parameters of blood pressure variability were decreased as well, they reached the level of normal variability. The nowadays expected „double target values” has given us hope that we can successfully prevent the organ damages due to high blood pressure. The effects of some „drug family” and the drug-combinations to the blood pressure variability were analyzed. The RAS inhibitors (ACEI and ARB) reduced significantly the blood pressure variability, the ARB drugs more effectively. The ACEI agents combined with calcium antagonists or third-generation beta-blockers increased the normalization of blood pressure variability. Such effects were not observed with the ARB agents. Authors suggested the use of their method in every day practice. The guidelines also recommend this method.]



Further articles in this publication

Lege Artis Medicinae

[Survey on the dietary habits of children between the age of 4-10]

KISS-TÓTH Bernadett, BÍRÓ Lajos

[INTRODUCTION - The prevalence of overweightness and obesity among children is increasing in Hungary, while the inadequate or excessive intake of some nutrients is also representative. Keeping these inappropriate lifestyle habits in adulthood could significantly worsen the health status of the rising generation. METHOD - The sample is representative for the 4-10 year old children of Budapest and Kecskemét city. The dietary assessment was executed, using the internationally accepted 3 day dietary record method. Body mass index was also calculated from the measured body weight and height, creating BMI categories according to the Cole methodology. RESULTS - The ratio of overweightness and obesity resulted in 21% (19% for the 4-6 year old, 24% for the 7-10 year old), while 13% of them belonged to the underweight category. The nutritional problems, identified by adults, like the excessive fat intake, its inappropriate composition, the high sodium-, low calcium- and vitamin D intake already appears in the early stages of life. CONCLUSION - The results prove, that the education for healthy nutrition among children is in high priority, in which all stakeholders, like the parents, the governmental and non-governmental organisations, the educational institutes as well as the food industry plays an important role. ]

Lege Artis Medicinae

[The Sixth Sense of China – Paintings of Qi Baishi ]

NAGY Zsuzsanna

Lege Artis Medicinae

[The changing face of carrier choice: Chances and opportunities in Hungary]


[BACKGROUND - In the 21st century, medicine has changed. As a part of this transformation we observe the phenomenon of deprofessionalisation, change of the recruitment and alteration of the carrier motivation. METHODS - The quantitative study included 733 medical students of four Medical Universities in Hungary. Data for the qualitative study was collected from interviews of 45 medical students. RESULTS - Both research methods confirmed the changing of the medical profession. Besides, the number of medical school applicants are decreasing, and the number of women students are increasing. The impact of the doctor parents showed a decrease. Students reported late carrier choice and that they don’t become exclusively clinicians. The most important factor of carrier choice is altruism, but scientific interest and controllable lifestyle also appears as a motivation factor. CONCLUSIONS - Results suggest challenge of the „feminization of medical profession”. The medical curriculum and the conditions of work environment need to respond to these „metamorphoses”.]

Lege Artis Medicinae

[Ethical Considerations of Organ and Tissue Transplant Part 1 ]


Lege Artis Medicinae

[Use of surgical checklists to improve the patient safety]


[In the millennium working groups were formed in several countries to create and implement control- or checklists to reduce the mortality rate and complications during surgical care. The research revealed that the use of checklists improved patient safety, reduced mortality and complication rate, and several additional positive effects were identified. The checklists improved teamwork and the communication in the surgery team. The starting financial and time costs of using checklist are low, and the maintaining costs are minimal. On the other hand, checklists result significant financial savings. These savings primarily are the costs of malpractice lawsuits and the costs of treatment complications. To ensure patient safety multiple checklists were developed. By the literature data three checklists are the most detailed and widely used: the World Health Organiza­tion’s checklist, the Universal Protocol and the Surgical Patient Safety System. Common characteristics are that they significantly reduce the complications and the mortality rate, improve patient safety, teamwork and communication. The main differences are in the using and timing. In this publication we present the most typical and used checklists, their advantages and possible disadvantages, and finally we give an overview of the examples of the Hungarian experience.]

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[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

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JÁRAI Zoltán, ÁCS Tamás, FARSANG Csaba

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Lege Artis Medicinae



[Stroke is a highly prevalent disorder worldwide; it is the third main cause of death and the leading cause of severe disability. Recent data showed that 72-86% of cerebrovascular disorders are of ischaemic type. Arterial hypertension is the most prevalent risk factor for both haemorrhagic and ischaemic stroke, it is present in approximately 70% of cases. All forms of hypertension, isolated systolic or diastolic and combined hypertension increase stroke risk about 3-4 times and the relationship with systolic blood pressure may even be stronger than with diastolic blood pressure. Hypertension is very common after acute stroke. In this phase the cerebral autoregulation is disturbed in the region of focal brain ischaemia or haemorrhage such that cerebral blood flow is directly dependent on systemic blood pressure. It is therefore essential to avoid systemic hypotension in acute stroke patients and the reduction of high blood pressure may lower cerebral blood flow in the ischemic penumbra. Evidence from clinical data shows that control of blood pressure leads to lower risk of first or reccurent stroke and patients have shown beneficial effects especially of ACE inhibitors and diuretics. In the PROGRESS study both hypertensive and non-hypertensive cerebrovascular patients benefited from antihypertensive therapy. Previous results suggests that there may be additional beneficial effects of the ACEinhibitor therapy not related to blood pressure lowering in the prevention of stroke.]

Lege Artis Medicinae

[Antihypertensive therapy in patients with COPD 699 - The significance of nebivolol]


[The occurrence of hypertension associated with chronic obstructive pulmonary disease (COPD) is increasing. Recognising COPD is important in order to choose the appropriate antihypertensive drugs. Antihypertensive drugs that can be used to treat patients with hypertension and COPD include diuretics, ACE-inhibitors, angiotensine receptor blockers (AT1 receptor antagonists) and calcium antagonists, as well as cardioselective beta blockers, as these drugs decrease total and cardiovascular mortality. Of these agents, the importance of the most cardioselective one, nebivolol should be stressed, as this drug has no clinically significant effect on parameters of respiratory function, and, through its additional effects (namely by increasing the synthesis of NO), it has a beneficial effect on COPD-related deterioration of respiratory functions, haemodynamic alterations (cor pulmonale) and local factors that participate in the respiratory inflammation and endothelial dysfunction.]