High normal blood pressure (BP; 130–139/85–89mm Hg) is related with increased cardiovascular (CV) risk compared to normal BP (120–129/80–84mm Hg) or/and optimal BP (<120/80mm Hg). Low apelin plasma levels have been associated with arterial hypertension and atherosclerosis, while high visfatin plasma levels may promote vascular inflammation and atherosclerotic plaque destabilization and have been evaluated as a marker for identifying stages of essential hypertension. We sought to compare the apelin and visfatin plasma levels between subjects with high normal BP and subjects with normal or optimal BP matched for age, gender, smoking, and body mass index (BMI). Twenty-five subjects with high normal BP (office BP 136±3/88±2mm Hg, age 57±4 years, 76% males, 32% smokers, BMI 24.0±1.7kg/m ² ) and 35 subjects with normal or optimal BP (office BP 118±2/78±2mm Hg, age 55±7 years, 63% males, 29% smokers, BMI 23.2±1.4kg/m ² ) were studied. The apelin and visfatin plasma levels were determined with the enzyme-linked immunosorbent assay. Compared to normal or optimal BP subjects, apelin levels were significantly lower (205±108 vs. 325±152 pg/ml, P < 0.001) and visfatin levels significantly higher (11.0±2.0 vs. 7.2±0.9ng/ml, P = 0.002) in high normal BP subjects. No significant differences were found between the 2 groups ( P = NS) regarding the basic clinical characteristics, the glycemic/lipid profile, and the renal function parameters. The emerging, from the present study, data raise the hypothesis that lower apelin and higher visfatin plasma levels in high normal BP subjects compared to normal or optimal BP individuals could partially explain the higher CV risk of the high normal BP group.

Objectives. Mitral valve prolapse (MVP) is a known cause for false positive exercise test (ET). The purpose of this study was to establish additional electrocardiographic criteria to distinguish the false positive exercise results in patients with MVP.Methods. We studied 218 consecutive patients ( years, 103 males) with MVP (according to echocardiographic study), and positive treadmill ET was performed due to multiple cardiovascular risk factors or angina-like symptoms. A coronary angiography was performed to detect coronary artery disease (CAD).Results. From 218 patients, 90 (group A) presented with normal coronary arteries according to the angiography (false positive ET) while the rest 128 (group B) presented with CAD. ST-segment depression in hyperventilation phase was present in 54 patients of group A (60%) while only in 14 patients of group B (11%), .Conclusions. Presence of ST-segment depression in hyperventilation phase favors a false positive ET in patients with MVP.