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PubMed2000

CA 125 measurement and ultrasonography in borderline tumors of the ovary.

OBJECTIVES: Our goal was to perform an analysis of ultrasonographic characteristics and CA 125 levels in ovarian tumors of borderline malignancy. STUDY DESIGN: We performed a retrospective analysis of CA 125 levels and ultrasonographic parameters in 91 patients with borderline tumors. RESULTS: Serous tumors of borderline malignancy were associated with elevated CA 125 levels in 75% of patients before surgery (mean, 156 IU/mL) compared with 30% of mucinous tumors (mean, 28 IU/mL; P =.004). CA 125 was elevated in 35% of stage IA serous tumors (mean, 67 IU/mL) compared with 89% of tumors with spread beyond the ovary (mean, 259 IU/mL; P =.001). Mucinous tumors tended to be bigger (13.1 +/- 7 cm) on ultrasonography than serous tumors (9.3 +/- 6.2 cm, P =.016). Mucinous tumors were multilocular in half the patients and contained papillations in 40% of the patients. Serous tumors were multilocular in 30% of the patients but presented with solid or papillary patterns in 78% of the patients (P =.001). A resistance index of <0.4 was found in 36% of mucinous tumors and half the cases of serous tumors. In 13% of patients, ultrasonographic characteristics were compatible with a simple cyst only, including 1 patient with microinvasion and 1 patient with stage IIIB disease. Sensitivity of gray-scale ultrasonography was 87%, that of CA 125 measurement was 62%, and that of flow was 55%. At least 1 diagnostic test result was abnormal in 93% of patients, 2 were abnormal in 69% of patients, and all 3 were abnormal in 21% of patients. CONCLUSIONS: A high proportion of borderline tumors of the ovary, particularly of the serous type, were associated with elevated CA 125 levels and abnormal ultrasonographic characteristics, although some tumors presented as simple cysts.

Adolescent↗
PubMed1994

p53 expression in ovarian borderline tumors and stage I carcinomas.

Seventy-nine ovarian serous and mucinous borderline tumors, 36 stage I carcinomas and 39 stage II-IV carcinomas were studied for p53 protein accumulation with monoclonal antibody PAb1801.p53 protein was expressed in 14% of borderline tumors, 36% of stage I carcinomas, and 64% of higher stage carcinomas. All immunopositive carcinomas accumulated p53 protein in the primary tumor, and 95% of them showed concordance in staining among different tissue blocks. A difference in frequency of p53 protein accumulation between stage I and higher stage serous carcinomas was not statistically significant. p53 positivity was associated with microinvasion, microcarcinoma and coexistent carcinoma in mucinous borderline tumors (P = .025). An association between p53 protein expression and poor tumor differentiation in Stage I carcinomas as statistically significant (P = .03). p53 positivity was observed in a poorly differentiated endometrioid carcinoma as well as in adjacent benign endometriotic tissue. These results suggest that p53 abnormalities may be early events in ovarian cancer, possibly contributing to malignant transformation of some borderline tumors, endometriosis and other carcinoma precursors.

Adenocarcinoma, Mucinous↗
PubMed1989

Reduced cardiovascular efficiency and increased reactivity during exercise in borderline and established hypertension.

In this study, exercise capacity was evaluated in patients with borderline and established, uncomplicated, essential hypertension as compared to normal subjects. To this aim, the response of blood pressure, heart rate and cardiac work to a multi-stage exercise test was investigated by analyzing the results of linear regression fitting of cardiovascular parameters (ie, heart rate, systolic blood pressure and rate-pressure product (RPP)) versus time of exercise. Compared to normal patients, both essential and borderline hypertensive patients had a shorter average duration of exercise test (ie, a decreased exercise capacity), always negative for transient myocardial ischemia. This was in spite of a mild increment of maximal RPP (+19% and +10% v normal patients, respectively). Reduction of exercise duration in borderline and established hypertensive patients was related to the higher RPP at rest (+26% and +56% related to normal patients, respectively) and to the steeper slopes (rates of increment) of heart rate systolic pressure and RPP during exercise. Interestingly, in the overall population of normal and hypertensive subjects, the slopes of heart rate and RPP were directly correlated with basal blood pressure. In conclusion, these data indicate a decreased exercise tolerance in both established and borderline hypertensive patients without documented myocardial ischemia. This abnormality, which appears to be due to a disproportional increment during exercise not only of systolic pressure but also of heart rate, could reflect abnormalities in the autonomic control of heart function.

Adult↗
PubMed1993

Noninvasive ambulatory 24 h blood pressures and basal blood pressures predict development of sustained hypertension from a borderline state.

A sample of 143 male borderline hypertensives aged 35 to 45, screened from a population cohort, were subjected to psychological stress, static work, and ambulatory 24 h blood pressure (BP) monitoring to assess the predictive power of BP reactivity in the development of established hypertension. After 1 year, a follow-up showed that 21 subjects (14.7%) had developed established hypertension (causal diastolic (D) BP > or = 95 mm Hg), 25 subjects (15.7%) had become normotensive (causal DBP < 85 mm Hg), and 97 (67.8%) remained within the borderline range (causal DBP 85 to 94 mm Hg). Those who developed established hypertension had considerably higher initial basal resting blood pressures than those who remained borderline: systolic (S) BP 134.2 +/- 12.5 v 127.6 +/- 10.7 mm Hg, P < .05 and DBP 86.8 +/- 7.9 v 80.4 +/- 7.0 mm Hg, P < .01. They had also somewhat higher BP values during mental arithmetic exercises and hand-grip work (peak DBP 101.1 +/- 8.8 v 96.8 +/- 8.7 mm Hg, P < .05, and 131.4 +/- 14.8 v 123.5 +/- 12.9 mm Hg, P < .05, respectively). Those subjects who developed established hypertension had significantly higher 24 h mean blood pressures than those who remained borderline (24 h SBP 133.3 +/- 11.4 v 126.0 +/- 10.1 mm Hg, P < .01, and DBP 84.7 +/- 5.7 v 81.6 +/- 6.8 mm Hg, P < .05). This difference was attributed mainly to the differences found during daytime (07:00 to 19:00) hours but was also found to be nominally dependent upon those found during nighttime (01:00 to 07:00) hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Laparoscopic management of borderline ovarian tumors: results of a French multicenter study.

BACKGROUND: Laparoscopy in the management of women with borderline ovarian tumors remains controversial. We therefore evaluated the adequacy of initial laparoscopic staging according to FIGO guidelines, by comparison with laparotomy. PATIENTS AND METHODS: In a French retrospective multicenter study of 358 women with borderline ovarian tumors, we compared epidemiological characteristics, sonographic findings, serum tumor marker levels, and surgical and histological parameters between women undergoing laparoscopy and women undergoing laparotomy. RESULTS: One hundred and forty-nine (41.6%) of the 358 women underwent laparoscopy. Mean age, mean gestity and parity, and mean tumor size were higher in the laparotomy group. Forty-two women (28.2%) underwent laparoconversion, mainly for suspected ovarian cancer or large tumor volume. Conservative treatment and cyst rupture were more frequent in the laparoscopy group than in the laparoconversion and laparotomy groups (P < 0.0001). The rate of complete staging was lower in the laparoscopy group than in the laparoconversion and laparotomy groups (P < 0.0001), with no difference between these latter two groups. No difference in the recurrence rate was noted between the groups, but a higher recurrence rate was observed after conservative treatment (P < 0.001). CONCLUSIONS: Laparoscopic management of borderline ovarian tumors is associated with a higher rate of cyst rupture and incomplete staging. Recurrence was more frequent after conservative treatment. Whatever the surgical route, the rate of complete initial staging was low, emphasizing the need to respect treatment guidelines for borderline ovarian tumors.

Adolescent↗
PubMed1981

Baroreflex responsiveness in borderline hypertensives: a study with neostigmine.

The baroreflex response to changes in transmural pressure throughout the arterial tree or limited to the carotid sinus was evaluated in ten borderline hypertensives and compared with that observed in ten normal subjects and in ten established hypertensives. Baroreceptor sensitivity was tested by evaluating both heart rate response to phenylephrine-induced increase in arterial pressure and heart rate and blood pressure changes induced by increased neck tissue pressure by means of a neck chamber. The heart rate response to phenylephrine (evaluated by the regression of the R-R interval versus the systolic blood pressure) was depressed both in borderline and established hypertensives as compared with controls. Similarly, the heart rate and the pressor response to increased neck tissue pressure were depressed in both groups of hypertensives. In borderline, but not in established hypertensives, neostigmine administration improved consistently the pressor baroreflex response to increased neck tissue pressure and the heart rate reflex response to both the employed stimuli. These findings indicate that a reduced parasympathetic activity is one of the components involved in the altered baroreflex sensitivity in borderline hypertensives.

Adult↗
PubMed1991

Risk factors for epithelial ovarian tumours of borderline malignancy.

A case-control study was conducted on 91 cases with histologically-confirmed borderline ovarian tumours and 237 control subjects in hospital for acute non-gynaecological, hormonal or neoplastic disease. Women reporting three or more births, compared to nulliparae, had a relative risk (RR) estimate of 0.6, but this finding was not statistically significant (95% confidence interval (CI): 0.2-1.4). The risk of borderline tumours increased, although not significantly, with later age at first birth: compared to women reporting first birth at age 24 or before, the RRs were 1.3 and 1.7 in those reporting respectively their first birth at age 25-29 and 30 years or more. No significant relationship emerged between borderline ovarian cancer and age at menarche, menopausal status and lifelong menstrual pattern. Cases tended to report a later age at menopause than controls, but the trend in risk was not statistically significant. Nine cases (9.9%) and 68 controls (24.9%) reported oral contraceptive use: compared with never users the multivariate RR for ever users was 0.3, and the risk dropped with duration of use to 0.2 in users for two years or more (chi 2 (1) trend = 12.70, p less than 0.001). This study provides epidemiological evidence of a pathogenetic continuum between borderline and invasive ovarian tumours.

Adult↗
PubMed1987

Family history of diabetes and cardiovascular disease risk factors and mortality among euglycemic, borderline hyperglycemic, and diabetic adults.

In a prospective population-based study begun in 1972 in Rancho Bernardo, California, the association of cardiovascular disease risk factors, at baseline, with a family history of diabetes and subsequent death from cardiovascular disease was investigated among 3,081 euglycemic, 1,290 borderline hyperglycemic, and 347 diabetic adults between 20 and 79 years of age. The main difference in risk factor distribution was in diabetic men and women 20-49 years of age, of whom those with a family history of diabetes were older and had higher levels of fasting plasma cholesterol and triglyceride. In addition, in all age-sex-diabetes status groups, those with a family history of diabetes included a greater proportion with a family history of heart attack. In five out of 12 groups, the association was statistically significant. Significant independent predictors of cardiovascular disease mortality in euglycemic and borderline hyperglycemic adults were age, sex, cholesterol, and systolic blood pressure, while fasting plasma glucose was a significant predictor in euglycemic adults only. Family history of heart attack was significantly associated with cardiovascular disease mortality in euglycemic and borderline hyperglycemic adults. Family history of diabetes was not significantly associated with mortality risk in any of the three groups, but the risk followed an increasing trend from euglycemic (0.89) to borderline hyperglycemic (1.17) to diabetic (1.31) adults.

Adult↗
PubMed1979

Is borderline a distinct entity?

There is no agreement in American psychiatry as to whether borderline should be regarded as a distinct entity. A review of the major viewpoints in the field reveals that borderline is variously used to designate: (1) a clinical disorder distinguishable by behavioral criteria; (2) a milder form of schizophrenia; (3) a nonspecific term encompassing several atypical affective disorders; (4) a psychostructural distinction. When the St. Louis approach to diagnostic validity is used as a guideline, the conclusion reached is that available data do not weigh conclusively for or against borderline's status as an independent entity. In particular, borderline, as defined by several investigators, appears distinct from schizophrenia, but requires further delimitation from the affective disorders.

Adjustment Disorders↗
PubMed1979

Justification for separating schizotypal and borderline personality disorders.

Siever and Gunderson (1979) have questioned the decision to separate Schizotypal Personality Disorder from Borderline Personality Disorder in DSM-III. The justification for this separation rests not on genetic evidence, but rather on the relative independence of the behavioral characteristics of two dimensions that up to now have both been referred to with the appellation "borderline." We believe that this separation provides the tools with which investigators may usefully study the interaction of genetic and environmental factors as they relate to personality and the major psychiatric disorders. The benefits of this separation are already apparent in that research investigators are now using two terms to describe different phenomena, when previously they were using the single term borderline. Proposed diagnostic criteria for Schizotypal Personality Disorder and Borderline Personality Disorder are appended.

Chronic Disease↗
PubMed1999

Ovarian serous borderline tumors with micropapillary and cribriform patterns: a study of 40 cases and comparison with 44 cases without these patterns.

A group of investigators have proposed that the presence of micropapillary or cribriform patterns within ovarian serous tumors diagnosed as borderline according to World Health Organization (WHO) criteria identifies a subset of these neoplasms that are apt to be associated with invasive peritoneal implants and therefore should be designated as "micropapillary carcinoma." The authors of the current article identified 40 serous borderline tumors that showed one or both of these patterns, using the earlier investigators' published criteria for so-called micropapillary carcinoma, and compared them with 44 tumors that lacked these patterns (controls). Twenty-six patients with micropapillary tumors were aged 21 to 76 years (mean 38); 11 with cribriform tumors were aged 34 to 79 years (mean 60); and 3 with tumors having both patterns were aged 21 to 58 years (mean 38); the control patients were aged 22 to 83 years (mean 54). An advanced stage, bilaterality, and ovarian surface growth were features of the "micropapillary" tumors more often than of the control tumors. Except for a postoperative death related to sepsis, all 11 patients with Stage I tumors with either or both patterns who were followed until their death, or for at least 5 years (mean 7.9 years), survived without evidence of disease; a twelfth patient had a recent removal of recurrent pelvic tumor at 2.8 years and was alive at 3.3 years. Six of the eight patients with Stage II or III tumors with either or both patterns who were followed for at least 5 years (mean 7.5 years) survived disease-free. No deaths from tumor or progressive recurrences occurred in 27 control cases with 5-14 (mean 7.9) years of follow-up data. The two tumor-related deaths in the entire series, one from a micropapillary tumor and one from a cribriform tumor, occurred in patients who had Stage III tumors with invasive peritoneal implants. No patient with "micropapillary" tumors and noninvasive implants had progressive disease. Two women with "micropapillary" tumors and two control subjects had stable recurrent tumor or a newly developed tumor in a contralateral ovary that had been spared during the initial operation. Our findings confirm those of previous investigators that noninvasive serous tumors with a micropapillary or cribriform pattern or both patterns may be accompanied by invasive peritoneal implants more often than tumors without such patterns and that in such cases the disease is likely to be progressive and fatal. Since so-called micropapillary carcinomas lack obvious stromal invasion within the ovary, and their prognosis when they spread to the peritoneum is much closer to that associated with typical Stage II and III serous borderline tumors than to that associated with similarly staged serous carcinomas, the authors believe that this newly described category of tumors should remain as a subset within the borderline category, with a notation that their prognosis is poor if they are associated with invasive peritoneal implants.

Adult↗
PubMed2002

Serous borderline tumors of the ovary: a long-term follow-up study of 137 cases, including 18 with a micropapillary pattern and 20 with microinvasion.

The natural history of serous borderline tumors (SBTs) of the ovary varies considerably. A group of investigators have proposed that a small subset of SBTs with a micropapillary architecture and an allegedly higher incidence of invasive peritoneal implants should be designated "micropapillary serous carcinomas." Based on the overall favorable prognosis of the nonmicropapillary SBTs, these investigators have recommended abandoning the borderline category of serous tumors, restricting them to benign (benign and typical SBTs) and malignant types; other investigators, however, are in favor of retaining the original grouping, designating borderline tumors with a micropapillary pattern as such instead of designating them carcinomas. We have reviewed the clinicopathologic records of 137 patients with ovarian SBTs and obtained follow-up information on 106 of them ranging from 1 to 18 years (mean 7 years). Of the 21 patients with stage I tumors who had conservative surgical treatment, only two (9.5%) were subsequently found to have tumor in the contralateral ovary. Both were successfully managed by reoperation alone. Forty-five stage I patients had procedures that included bilateral oophorectomy, and two of them (4.4%) had a pelvic recurrence, which was fatal in one patient (whose tumor had been understaged) and occurred on multiple occasions in the other patient, finally transforming into invasive carcinoma; that patient survived. Of the 45 stage II-IV patients, only the six (13%) with invasive implants had an unfavorable outcome: three died of tumor (from 7 to 9.3 years), and the other three were alive with progressive disease from 5 to 10 years. Solid epithelial nests or small papillae surrounded by clefts and micropapillary architecture were found more often in invasive than in noninvasive implants. However, the only feature specifically associated with a poor outcome was obvious destructive invasion of the underlying tissue. Among the 137 SBTs, we identified 18 cases of serous borderline tumors with a micropapillary pattern (SBT-MP) (so-called "micropapillary carcinoma") and 20 cases of SBT with microinvasion (SBT-Minv) (three of which were also micropapillary). We compared the two groups of tumors with the remaining 102 cases of typical SBTs (which lacked micropapillary pattern and microinvasion). Of the 17 patients with SBT-MP and follow-up data, only the one patient with invasive implants had an unfavorable outcome; similarly, of the two patients with SBT-Minv and an unfavorable outcome, one had invasive implants and the other had been incompletely staged. SBTs have a very favorable prognosis, but complete surgical staging and prolonged follow-up are advised because pelvic recurrence and occasionally transformation to invasive carcinoma may occur. Designation of SBTs as "atypical proliferative tumors" is not recommended because it discourages complete surgical staging and follow-up. Advanced stage tumors with noninvasive implants are common, characteristically behave in a benign fashion, and can be safely treated conservatively. The rare SBTs associated with invasive implants are almost always fatal. SBT-MP and SBT-Minv are much closer in their biologic behavior to SBTs than to serous carcinomas. The micropapillary pattern alone does not imply an unfavorable prognosis; only micropapillary tumors associated with invasive implants behave aggressively.

Adolescent↗
PubMed2003

Borderline ovarian tumours: a review of the recent literature.

PURPOSE OF REVIEW: Borderline tumors of the ovary are seen commonly in obstetrics and gynecology practices. This review will outline the most recent information regarding the epidemiology, molecular pathogenesis, pathology, and clinical management of these tumors. RECENT FINDINGS: In the past, borderline ovarian tumors and invasive ovarian cancer were studied together, under the presumption that they represent a continuum of disease. This view is coming into question based on both epidemiological and molecular biological studies. Pathologists are increasingly able to identify poor prognostic histological features. This has not yet been translated into improved non-surgical therapy. Surgical management to excise all visible tumor remains the cornerstone of therapy. Because borderline ovarian tumors often occur in reproductive-age women, fertility is an important issue. Conservative surgery is safe in carefully selected patients. SUMMARY: Our growing understanding of the relatively benign natural history of borderline ovarian tumors has allowed us to be more conservative in their surgical management, preserving fertility in many young women. A few women will be affected by a more virulent form of the disease with the potential to recur and cause death. The pathological features that identify patients with a poor prognosis are progressively being elucidated. Surgery remains the most effective therapy for these patients. Effective non-surgical therapies have yet to be identified. Hopefully, as molecular biological studies continue to expand our understanding of this disease as probably a separate carcinogenic process from invasive ovarian cancer, we will be able to employ this knowledge to design novel adjuvant therapies.

Adult↗
PubMed1985

The prognostic value of morphometry in ovarian epithelial tumors of borderline malignancy.

A fully "blind" morphometric analysis was made of 20 ovarian epithelial tumors; 18 of these were of borderline malignancy, one was a well-differentiated adenocarcinoma and one had been categorized as "borderline? malignant?" Morphometry correctly identified the adenocarcinoma, which had proved fatal, and the two tumors of borderline malignancy that had directly led to the patients' deaths, as having a "poor" prognosis. One tumor thought to have a "poor" prognosis was associated with long-term survival, but the patient had received chemotherapy. All the patients whose tumors were morphometrically graded as having a "good" prognosis were alive and tumor-free at intervals ranging from 4 to 14 years. It is concluded that the predictive prognostic power of morphometry, when applied to ovarian epithelial tumors of borderline malignancy, is greater than that of unaided light microscopy.

Adenocarcinoma, Mucinous↗
PubMed1993

Flow cytometry and AgNORs in benign, borderline, and malignant mucinous and serous tumours of the ovary.

We performed flow cytometry and AgNOR counts on 117 serous and mucinous ovarian tumours, comprising 56 cystadenomas, 21 borderline tumours, and 40 cystadenocarcinomas. DNA aneuploidy was present in one cystadenoma and in 11% of mucinous and 46% of serous cystadenocarcinomas. All borderline tumours were DNA diploid. Major and minor FIGO stages and flow cytometrically determined DNA ploidy and DNA index were prognostically significant. Age, histological type (serous versus mucinous), flow cytometric proliferative index, and AgNOR counts were not predictive of survival. Cystadenomas and borderline tumours had lower rates of proliferation than cystadenocarcinomas. AgNORs correlated with DNA ploidy and proliferative index. Borderline tumours showed elevated AgNOR numbers despite low proliferative indices and universal DNA diploidy, suggesting that AgNOR numbers may be related to nuclear events other than proliferation and DNA ploidy.

Adult↗
PubMed2003

Advanced-stage serous borderline tumors of the ovary: a clinicopathological study of 49 cases.

There is controversy about patient outcomes and pathological parameters of prognostic significance in patients with stage II or stage III ovarian serous borderline tumors. Forty-nine cases of stage II and III ovarian serous borderline tumors were identified on review of the medical records at Vancouver Hospital and British Columbia Cancer Agency for the period from 1979 to 1996. Pathological features assessed included presence of micropapillary architecture, tumor cell DNA content (ploidy), and characteristics of the extraovarian implants, including invasiveness and mitotic activity. Clinical follow-up information (3-17 years of follow-up) was obtained for 48 patients. Fifteen patients had stage II tumors and 34 had stage III tumors. Fourteen patients experienced tumor recurrence 1 to 8 (mean 3.5) years after presentation and of these, six patients died of disease (2, 3, 4, 7, 10, and 11 years after presentation). Patients with gross residual disease, as assessed by the surgeon, more frequently experienced a recurrence compared with patients without gross residual disease, but this difference did not reach statistical significance (0.05<p<0.1). The patients who died of disease all had stage III tumors. Patients with invasive implants had a significantly worse outcome than patients with noninvasive implants (p<0.005). Other pathological features (ploidy, micropapillary architecture, invasiveness of implants, mitotic activity of implants) were not significantly predictive of tumor recurrence or death. No single pathological feature or combination of features was present in all patients who subsequently died of disease. In conclusion, the prognosis for patients with advanced-stage serous borderline tumors in this population-based study is very favorable, with only six patients ultimately dying of progressive disease. The combination of stage (stage III) and invasiveness of extraovarian implants identifies a small subset of patients with advanced-stage serous borderline tumors with a significantly worse prognosis, who may benefit from adjuvant therapy.

Combined Modality Therapy↗
PubMed1988

Twenty-four hour ambulatory intra-arterial blood pressure in normotensive and borderline hypertensive subjects.

A number of studies have shown that blood pressure values obtained by ambulatory monitoring are lower than those obtained in the doctor's office by cuff readings. However, there is still no suitable information on 'normal' 24-h ambulatory blood pressure values. In 19 normotensive and 13 borderline hypertensive subjects, defined by repeated office blood pressure measurements, we recorded intra-arterial blood pressure under ambulatory conditions for 24 h (Oxford method) in order (1) to assess the 24-h blood pressure values of normal subjects, and (2) to compare their 24-h blood pressure values with those of borderline hypertensive patients. In the normotensive subjects systolic, diastolic and mean ambulatory blood pressure values over 24 h were significantly lower than the corresponding office values, the differences being -15.0, -22.1 and -17.9 mmHg, respectively. In the borderline hypertensives 24-h ambulatory blood pressure was significantly lower than office readings. On average, the 24-h mean blood pressure of normotensive subjects was significantly lower than that of borderline patients (P less than 0.01). However, individual 24-h blood pressure values showed a considerable overlap. Thus, (1) ambulatory blood pressure values just below 140/90 mmHg do not necessarily mean that the blood pressure is in the normal range, the mean 24-h blood pressure of true normotensive subjects being much lower; (2) ambulatory blood pressure monitoring in patients with high office blood pressure readings may help to identify subjects whose 24-h mean values are indistinguishable from those of normotensives. However, the clinical relevance of these findings in the diagnosis of hypertension has to be validated by prospective clinical trials.

Adult↗
PubMed1989

Early arterial modifications in young patients with borderline hypertension.

Pulse wave velocity, used as an indicator of arterial distensibility, was recorded in 123 young male subjects, 63 untreated patients with borderline hypertension and 60 control subjects. The measurement was made with a continuous Doppler unit coupled to an ECG. In both groups mean age was similar, but mean arterial pressure was increased in borderline hypertensive compared with control patients. In comparison with controls, borderline hypertensives showed an increased pulse wave velocity. A significant correlation was observed between mean arterial pressure and pulse wave velocity in both populations, but the two regression lines were significantly different (covariance analysis). This result suggests that pulse wave velocity modifications in borderline hypertensives are not solely due to the elevated pressure, but also reflect structural or functional changes in the arterial tree.

Adolescent↗