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Cardiovascular disease remains the leading cause of death worldwide. In this review, we briefly summarize new insights on the modulation of genetic cardiovascular risk by host factors such as sex and age and lifestyle factors such as salt intake. As phenotypes (genotypes) of interest, we considered left ventricular structure and function (ADD1 Gly460Trp; AGTR2 G1675A; ACE D/I), the incidence of heart failure (ADD1 Gly460Trp), heart rate variability (CYP11B2 C-344T; AGTR1 A1166C), carotid distensibility (IL6 G-174C), and serum lipid levels (APOE ɛ 2/ ɛ 3/ ɛ 4; APOA1 A 75G). In each case, the associations with the genetic cardiovascular risk factor were modulated by sex, age, sodium intake, or a combination thereof. These interactions highlight that genetic risk factors and phenotype-genotype associations can only be interpreted within their ecogenetic context. Perhaps a better understanding of these phenomena will lead researchers to target in a more specific way the pathophysiologic mechanisms operating within each individual. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate risk pattern and mortality in a general population epidemiologic study performed by a staff of hypertension specialists working as the "good father of a family," with lifestyle and therapeutic advice and instrumental measurements. Mortality among the study population (n=856) during the 4-y study was compared with that recorded in the general population during the 4-y period before the study; those who refused to participate in the study were also recorded (n=280). Among study subjects, blood pressure decreased by 3.6/3.5 mm Hg (P<.01/P<.0001), serum total cholesterol by 3.8% (P<.0001), and low-density lipoprotein cholesterol by 10.9% (P<.01); awareness of hypertension increased by 87% (P<.0001); 20% of hypercholesterolemic patients (P<.01) and 28% of diabetic patients (P<.001) were identified; and 40% of hypertensive patients (P<.0001) were treated. Overall 4-y mortality was 12.5% in study subjects, 36.6% in renitent subjects (P<.0001 vs enrolled), and 19.9% during the period preceding the study (P<.0001 vs enrolled); cardiovascular mortality rates were 5.8%, 18.6% (P<.0001), and 11.4% (P<.0001), respectively. In particular, the frequency of fatal stroke was 0.06%, 3.8% (P<.0001), and 2.5% (P<.0001), respectively, and that of fatal coronary events was 3.4%, 7.5% (P<.0001), and 4.6% (P<.0001), respectively. In conclusion, when an epidemiologic professional staff member approaches patients in a manner similar to that of the "good father of a family," a better risk pattern and lower mortality rates (particularly cerebrovascular and coronary) are seen in those who are receptive to the care provided; those who decide not to participate in health care opportunities do not benefit. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate risk pattern and mortality in a general population epidemiologic study performed by a staff of hypertension specialists working as the“good father of a family”, with lifestyle and therapeutic advice and instrumental measurements. Mortality among the study population (n=856) during the 4-y study was compared with that recorded in the general population during the 4-y period before the study; those who refused to participate in the study were also recorded (n=280). Among study subjects, blood pressure decreased by 3.6/3.5 mm Hg ( P < .01/ P < .0001), serum total cholesterol by 3.8% ( P < .0001), and low-density lipoprotein cholesterol by 10.9% ( P < .01); awareness of hypertension increased by 87% ( P < .0001); 20% of hypercholesterolemic patients ( P < .01) and 28% of diabetic patients ( P < .001) were identified; and 40% of hypertensive patients ( P < .0001) were treated. Overall 4-y mortality was 12.5% in study subjects, 36.6% in renitent subjects ( P < .0001 vs enrolled), and 19.9% during the period preceding the study ( P < .0001 vs enrolled); cardiovascular mortality rates were 5.8%, 18.6% ( P < .0001), and 11.4% ( P < .0001), respectively. In particular, the frequency of fatal stroke was 0.06%, 3.8% ( P < .0001), and 2.5% ( P < .0001), respectively, and that of fatal coronary events was 3.4%, 7.5% ( P < .0001), and 4.6% ( P < .0001), respectively. In conclusion, when an epidemiologic professional staff member approaches patients in a manner similar to that of the “good father of a family”, a better risk pattern and lower mortality rates (particularly cerebrovascular and coronary) are seen in those who are receptive to the care provided; those who decide not to participate in health care opportunities do not benefit. [ABSTRACT FROM AUTHOR]

Manidipine and lercanidipine are considered effective and safe in the treatment of chronic arterial hypertension and are equipotent in reducing blood pressure (BP) levels. Their main side effect is ankle-foot edema. After a 2-week placebo run-in period, these 2 drugs were compared in a controlled parallel-group study lasting 3 months, involving 53 patients with mild-to-moderate essential hypertension (26 assigned to manidipine and 27 to lercanidipine). At the end of the active treatment period, BP was significantly reduced in comparison with the end of the placebo phase in both the manidipine and the lercanidipine groups, without significant differences between the 2 drugs. Daytime BP was significantly reduced by 5.5%/5.6% with manidipine and by 3.8%/6.6% with lercanidipine, while smaller reductions were seen at nighttime. The smoothness index was the same with both drugs. Unlike lercanidipine, manidipine significantly reduced both basal (-30%) and minimal vascular resistance (-39%), qualifying it as a potent vasodilator. Despite vasodilation, heart rate was not increased but was even slightly reduced by treatment. Ankle-foot edema was observed with both drugs but was less pronounced with manidipine, probably because of greater postcapillary dilatation. In conclusion, manidipine and lercanidipine are both effective and safe in mild-to-moderate essential hypertension, although the former seems to have a more favorable tolerability profile than the latter. [ABSTRACT FROM AUTHOR]

Manidipine and lercanidipine are considered effective and safe in the treatment of chronic arterial hypertension and are equipotent in reducing blood pressure (BP) levels. Their main side effect is ankle-foot edema. After a 2-week placebo runin period, these 2 drugs were compared in a controlled parallel-group study lasting 3 months, involving 53 patients with mild-to-moderate essential hypertension (26 assigned to manidipine and 27 to lercanidipine). At the end of the active treatment period, BP was significantly reduced in comparison with the end of the placebo phase in both the manidipine and the lercanidipine groups, without significant differences between the 2 drugs. Daytime BP was significantly reduced by 5.5%/5.6% with manidipine and by 3.8%/6.6% with lercanidipine, while smaller reductions were seen at nighttime. The smoothness index was the same with both drugs. Unlike lercanidipine, manidipine significantly reduced both basal (-30%) and minimal vascular resistance (-39%), qualifying it as a potent vasodilator. Despite vasodilation, heart rate was not increased but was even slightly reduced by treatment. Ankle-foot edema was observed with both drugs but was less pronounced with manidipine, probably because of greater postcapillary dilatation. In conclusion, manidipine and lercanidipine are both effective and safe in mild-to-moderate essential hypertension, although the former seems to have a more favorable tolerability profile than the latter. [ABSTRACT FROM AUTHOR]