122 results on '"Alli, C"'
Search Results
102. Dealing with hypertension in general practice. General implications of an Italian point of view. Several hundred Italian general practitioners who collaborated in the clinical and epidemiological projects.
- Author
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Tognoni G, Avanzini F, Alli C, and Colombo F
- Subjects
- Aged, Family Practice, Feasibility Studies, Female, Humans, Italy epidemiology, Male, Prevalence, Randomized Controlled Trials as Topic, Antihypertensive Agents therapeutic use, Hypertension epidemiology, Hypertension prevention & control, Practice Patterns, Physicians'
- Published
- 1999
103. Hypertension Optimal Treatment (HOT) trial.
- Author
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Avanzini F, Marchioli R, Alli C, and Tognoni G
- Subjects
- Blood Pressure drug effects, Follow-Up Studies, Humans, Hypertension physiopathology, Myocardial Infarction complications, Myocardial Infarction prevention & control, Myocardial Ischemia complications, Myocardial Ischemia prevention & control, Reproducibility of Results, Antihypertensive Agents therapeutic use, Hypertension drug therapy
- Published
- 1998
- Full Text
- View/download PDF
104. Control of hypertension in Italy: results of the "Study on Antihypertensive Treatment in General Practice (STAP)". Physicians Taking Part in STAP.
- Author
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Avanzini F, Alli C, Colombo P, Corsetti A, Colombo F, and Tognoni G
- Subjects
- Aged, Antihypertensive Agents adverse effects, Blood Pressure drug effects, Chi-Square Distribution, Family Practice statistics & numerical data, Female, Humans, Hypertension physiopathology, Italy, Male, Middle Aged, Patient Compliance statistics & numerical data, Antihypertensive Agents therapeutic use, Hypertension drug therapy
- Abstract
Background: Various epidemiological surveys from different countries have documented the unsatisfactory control of arterial hypertension. The aim of this study was to assess the current status of treatment and control of hypertension in Italy., Methods: A random sample of general practitioners (GP) working in several Aziende Sanitarie Locali (Local health offices-ASL) throughout Italy were invited to take part in the study. Each doctor had to recruit a random sample of 15-20 hypertensive patients receiving antihypertensive drugs among those attending his/her office for any reason. A standard medical history, specifically oriented to hypertension and its pharmacological treatment, was taken for each patient. Three blood pressure (BP) measurements were made, with the patient seated for at least 5 minutes, using an accurate automatic device (A&D UA-732), and the mean was taken as each patient's BP., Results: A total of 73 GPs (17% of the invited sample), working in 14 Italian ASL (six in the north of the country, four in the center and four in the south and islands), agreed to participate in the study. They recruited an average of 17 patients each, for a total of 1204 hypertensive subjects (663 women and 541 men) 633 of whom were 65 years old or more, mean age 64 +/- 11 years, range 25-94 years. More than half (56%) had been taking antihypertensive drugs for at least five years; 42% were taking one drug, 40% two, 16% three and 2% four drugs. Respectively, 63% and 23% had systolic BP (SBP) > or = 140 and > or = 160 mmHg; 28% and 14% had diastolic BP (DBP) > or = 90 and 95 mmHg. In 71%, BP was < 160/95 mmHg, but only 33% had BP lower than 140/90 mmHg. BP control was similar in males and females, but worse in the elderly. Nine percent of patients complained of symptomatic side effects, usually mild. Only 8% admitted to poor compliance with the antihypertensive therapy, and their BP was significantly less well controlled., Conclusions: Control of BP in patients receiving antihypertensive drugs is still far from optimal in Italy, just as in other countries. This situation seems more related to the fact that doctors do not tackle the problem aggressively, than to the patients' degree of compliance with therapy.
- Published
- 1998
105. [Guidelines for the treatment of arterial hypertension: evidence, consensus and gray areas].
- Author
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Alli C and Avanzini F
- Subjects
- Blood Pressure drug effects, Humans, Research, Antihypertensive Agents therapeutic use, Evidence-Based Medicine, Hypertension drug therapy, Practice Guidelines as Topic
- Published
- 1997
106. [Post-infarction arterial hypertension: more benefits or more risks of the antihypertensive treatment?].
- Author
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Avanzini F and Alli C
- Subjects
- Aged, Antihypertensive Agents adverse effects, Coronary Disease drug therapy, Data Interpretation, Statistical, Female, Follow-Up Studies, Humans, Hypertension mortality, Male, Myocardial Infarction drug therapy, Myocardial Infarction mortality, Prognosis, Randomized Controlled Trials as Topic, Research, Risk Factors, Time Factors, Antihypertensive Agents therapeutic use, Hypertension drug therapy, Myocardial Infarction complications
- Published
- 1997
107. Albuminuria and transferrinuria in essential hypertension. Effects of antihypertensive therapy.
- Author
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Alli C, Lombardo M, Zanni D, Agrati AM, Cassani M, and Granata S
- Subjects
- Adult, Albuminuria complications, Amlodipine pharmacology, Amlodipine therapeutic use, Angiotensin-Converting Enzyme Inhibitors pharmacology, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Antihypertensive Agents pharmacology, Blood Pressure Monitoring, Ambulatory, Calcium Channel Blockers pharmacology, Calcium Channel Blockers therapeutic use, Female, Fosinopril pharmacology, Fosinopril therapeutic use, Humans, Hypertension complications, Hypertension urine, Male, Middle Aged, Prospective Studies, Regression Analysis, Albuminuria diagnosis, Antihypertensive Agents therapeutic use, Blood Pressure drug effects, Hypertension drug therapy, Transferrin urine
- Abstract
The objectives of this study were to evaluate the effects of an ACE inhibitor (fosinopril) and a calcium antagonist (amlodipine) on the urinary albumin and transferrin excretion and their relationship to the blood pressure in essential hypertension. Twenty-four never-treated patients (mean age, 46.4 +/- 8.9 years) with a diastolic blood pressure between 90 and 114 mm Hg and normal renal function, randomly received amlodipine or fosinopril and, if the diastolic blood pressure was not normalized, doxazosin was added to the therapy. Twenty-four-hour ambulatory blood pressure monitoring and 24-h urine collection for albumin and transferrin measurements were performed before and after 3 and 6 months of therapy. Diastolic blood pressure was normalized in 23 patients (96%). Before treatment, microalbuminuria was present in 50% of patients. In the amlodipine and fosinopril group, antihypertensive therapy significantly decreased blood pressure and, only in the fosinopril group, albuminuria. Transferrinuria did not change significantly in both groups. Fosinopril lowered albuminuria in all patients, whereas amlodipine only in half of patients. Albuminuria, but not transferrinuria, was significantly correlated to the ambulatory blood pressure. This correlation was more pronounced for systolic than for diastolic pressure. In essential hypertensive patients with normal renal function, a high prevalence of microalbuminuria can be observed. Albuminuria appears to correlate with ambulatory blood pressure, particularly with systolic pressure. Intrarenal hemodynamic changes seem to play a more important role than systemic blood pressure decrease in the reduction of albuminuria. Transferrinuria does not seem a useful marker to follow-up nondiabetic hypertensive patients with early signs of glomerular dysfunction.
- Published
- 1996
- Full Text
- View/download PDF
108. Randomised clinical trials in general practice: lessons from a failure.
- Author
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Tognoni G, Alli C, Avanzini F, Bettelli G, Colombo F, Corso R, Marchioli R, and Zussino A
- Subjects
- Aged, Antihypertensive Agents therapeutic use, Attitude of Health Personnel, Clinical Protocols, Humans, Italy, Physician-Patient Relations, Family Practice, Hypertension drug therapy, Randomized Controlled Trials as Topic methods
- Published
- 1991
- Full Text
- View/download PDF
109. Effects of a screening program for hypertension in a community.
- Author
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Radice M, Alli C, Avanzini F, Di Tullio M, Guiducci D, Mariotti G, and Taioli E
- Subjects
- Adult, Blood Pressure physiology, Female, Humans, Hypertension physiopathology, Hypertension prevention & control, Hypertension psychology, Italy epidemiology, Male, Middle Aged, Prevalence, Risk Factors, Time Factors, Antihypertensive Agents therapeutic use, Attitude of Health Personnel, Attitude to Health, Hypertension epidemiology, Mass Screening
- Abstract
The effect of a population screening for hypertension was assessed through a subsequent survey performed 1 year later. All the hypertensives identified at the first visit (239 subjects, 15.6% of the whole screened population) were invited for a re-examination: the adhesion rate was 84.5%. After the screening, a high proportion of subjects (74.7%) had contacted their physicians because of their blood pressure. The most common advice physicians gave was to have further measurements of blood pressure (72.8%). Laboratory tests were prescribed in 62 patients (41.1%), but a complete assessment of a target organ damage was carried out in few cases (1.9%). Only 19.5% of patients started a course of treatment during the year following the screening and no more than one-third of those with moderate to severe hypertension. Out of the 176 subjects showing other cardiovascular risk factors at the screening, only 12 reported they had modified their habits 1 year later. Our results suggest that a screening for hypertension, when performed without any liaison with other medical facilities, seems to have a poor impact on physicians' and patients' attitudes towards hypertension.
- Published
- 1991
110. [Association between arterial pressure and other cardiovascular risk factors in adolescence].
- Author
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Radice M, Alberti D, Alli C, Avanzini F, Decarli A, Di Tullio M, Mariotti G, Taioli E, and Zussino A
- Subjects
- Female, Humans, Hypertension prevention & control, Italy, Male, Mass Screening, Risk, Adolescent, Blood Pressure
- Abstract
A screening for hypertension and other cardiovascular risk factors was carried out during 1981 in a population of 1142 subjects (675 males and 467 females) aged 14-18 years. Aim of the study was to analyze the distribution of blood pressure values and of variables possibly associated with hypertension in a population of adolescents. The mean value of systolic blood pressure was higher in males than in females, slightly increasing with age in males and decreasing in females. The diastolic blood pressure was similar, and increased with age in both sexes. The prevalence of individuals with systolic blood pressure greater than or equal to 140 mmHg resulted of 16.1% in males and of 5.6% in females; the prevalence of adolescents with diastolic blood pressure greater than or equal to 90 mmHg was much lower, being of 2.5% and 1.5% respectively. The average value of heart rate was higher in females and decreased with age in both sexes. Males showed significantly greater height and weight, but the body mass index was nearly equal in the two sexes; females had thicker skinfolds. All these variables only in males were clearly associated with age. Among anamnestic variables, only smoking habits, alcohol consumption and physical activity were significantly different in the two sexes. A positive family history for hypertension was present in 31.4% of the adolescents in whom an objective assessment was possible. In both sexes the systolic blood pressure appeared significantly related to heart rate, body weight, body mass index and skinfold thickness.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1985
111. [Therapy of arterial hypertension: benefits and risks].
- Author
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Di Tullio M, Taioli E, and Alli C
- Subjects
- Adult, Aged, Combined Modality Therapy, Diuretics therapeutic use, Female, Humans, Male, Middle Aged, Antihypertensive Agents therapeutic use, Diet, Sodium-Restricted, Hypertension therapy
- Published
- 1984
112. [M-mode echocardiogram in adolescents genetically predisposed to develop hypertension].
- Author
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Radice M, Alli C, Avanzini F, Di Tullio M, Mariotti G, Taioli E, Zussino A, and Folli G
- Subjects
- Adolescent, Humans, Male, Risk, Echocardiography, Heart physiopathology, Hypertension genetics
- Published
- 1983
113. [Behavior of blood pressure during exercise in adolescents at various risks of developing hypertension].
- Author
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Radice M, Alberti D, Alli C, Avanzini F, Di Tullio M, Mariottì G, Taioli E, Zussino A, and Folli G
- Subjects
- Adolescent, Exercise Test, Humans, Hypertension genetics, Male, Risk, Blood Pressure, Hypertension etiology, Physical Exertion
- Published
- 1984
114. Assessment of ventricular function in arterial hypertension with radionuclide ventriculography.
- Author
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Radice M, Albertini A, Alli C, Canciani C, Di Tullio M, Manzini M, Mariotti G, Salmoirago E, Taioli E, and Zatta G
- Subjects
- Adult, Aged, Echocardiography, Female, Heart physiopathology, Humans, Hypertension physiopathology, Male, Middle Aged, Myocardial Contraction, Radionuclide Imaging, Stroke Volume, Systole, Heart diagnostic imaging, Hypertension diagnostic imaging
- Abstract
Diastolic function of the left ventricle was assessed in 29 untreated patients with mild to moderate hypertension and in 21 normotensive control subjects using gated radionuclide ventriculography. In hypertensive patients, the time to peak filling rate was significantly longer (p less than 0.01) than that in control subjects, and first-third filling fraction and peak filling rate were significantly reduced (p less than 0.001). The ejection fraction and peak ejection rate were also significantly reduced in hypertensive patients (p less than 0.001). No relation was observed between diastolic functional impairment and age, cardiac hypertrophy, or severity of hypertension. Thus, early impairment of ventricular filling is present in hypertension, even in young patients without evidence of cardiac hypertrophy.
- Published
- 1988
- Full Text
- View/download PDF
115. Awareness, treatment, and control of hypertension in the elderly in a general practice experience. Study Group on Hypertension in the Elderly.
- Author
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Avanzini F, Alli C, Bettelli G, Colombo F, Conforti L, Devoto MA, di Tullio M, Marchioli R, Mariotti G, and Pirone F
- Subjects
- Aged, Cohort Studies, Cross-Sectional Studies, Family Practice, Female, Humans, Hypertension diagnosis, Hypertension therapy, Italy, Male, Prospective Studies, Quality of Health Care, Hypertension epidemiology
- Abstract
In 3858 ambulatory elderly people (age greater than or equal to 65 years) prevalence of hypertension was 67.8%. The hypertensive status was unknown to both the doctor and the patient in 21.4% of cases. More than 90% of known hypertensives were treated, but hypertension could be considered as controlled in less than 30% of them.
- Published
- 1989
- Full Text
- View/download PDF
116. Left ventricular structure and function in normotensive adolescents with a genetic predisposition to hypertension.
- Author
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Radice M, Alli C, Avanzini F, Di Tullio M, Mariotti G, Taioli E, Zussino A, and Folli G
- Subjects
- Adolescent, Adult, Disease Susceptibility, Echocardiography, Heart physiology, Heart physiopathology, Heart Ventricles, Humans, Hypertension etiology, Hypertension pathology, Hypertension physiopathology, Male, Myocardium pathology, Heart anatomy & histology, Hypertension genetics
- Abstract
It has been suggested that the heart plays an active role in the pathogenesis of arterial hypertension. If this is true, there must be early cardiac involvement in young normotensive subjects who develop hypertension later in life and differences in cardiac morphology or function may exist between young normotensive subjects with different risks of developing hypertension. M-mode echocardiography was performed in 51 normotensive male adolescents with at least one hypertensive parent (SHT). These subjects were compared with 55 normotensive sons of normotensive parents (SNT) and with 25 adolescents with borderline hypertension (BH). Control groups were matched for sex and age. The following morphologic parameters were significantly greater in the SHT group than in the SNT group: interventricular septum (0.54 +/- 0.08 vs 0.49 +/- 0.09 cm/m2; p less than 0.01) and posterior wall (0.54 +/- 0.11 vs 0.50 +/- 0.08 cm/m2; p less than 0.05) thickness, left ventricular mass (125.0 +/- 29.1 vs 109.2 +/- 25.4 gm/m2; p less than 0.005), and cross-sectional area (9.9 +/- 1.8 vs 8.9 +/- 1.6 cm2/m2; p less than 0.005). No significant differences between SHT and BH subjects were observed. Excursion of left ventricular posterior wall was significantly higher in the BH group. No differences were observed between SHT and SNT subjects. These data show that the same kinds of changes in cardiac morphology are present in normotensive subjects with a family history of hypertension and in subjects with borderline hypertension, suggesting that cardiac involvement may precede elevation of blood pressure.
- Published
- 1986
- Full Text
- View/download PDF
117. [Echocardiographic evaluation of the left ventricular morphology and function in adolescents with mild arterial hypertension].
- Author
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Radice M, Alli C, Avanzini F, Di Tullio M, Mariotti G, Taioli E, and Zussino A
- Subjects
- Adolescent, Cardiac Output, Cardiomegaly etiology, Cardiomegaly physiopathology, Humans, Hypertension physiopathology, Male, Cardiomegaly pathology, Echocardiography, Hypertension pathology
- Abstract
A few studies have been carried out in humans on the morphology and function of the cardiovascular system in the early phases of hypertension. Furthermore, the data which have been provided are controversal and, in particular, a hyperkinetic status has been found only by some authors. For this reason, we planned to study the type and degree of cardiac involvement in 25 male adolescents with mild hypertension, by means of M-mode echocardiography. The control group consisted of 100 normotensive males matched for age and sex. The following indices of left ventricular hypertrophy were significantly higher in cases than in controls: posterior wall thickness (10.4 +/- 1.0 vs 9.1 +/- 1.7 mm; p less than 0.001), cross sectional area (18.3 +/- 2.7 vs 16.6 +/- 3.2 cm2; p less than 0.02) and left ventricular mass (230.9 +/- 46.7 vs 206.2 +/- 54.0 g; p less than 0.05). After normalizing for body surface area, only posterior wall thickness was still significantly greater in cases (5.7 +/- 0.6 vs 5.2 +/- 1.0 mm/m2; p less than 0.01). Among the indices of left ventricular function, only the posterior wall excursion was significantly greater in mild hypertensives than in controls. Our data do not confirm the existence of a hyperkinetic status in subjects with mild hypertension. The type of morphological alterations we found and their modest correlation to blood pressure suggest that factors besides an increased afterload are involved in the development of left ventricular hypertrophy.
- Published
- 1985
118. Antihypertensive treatment of the elderly in general practice.
- Author
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Villella M, Devoto MA, Avanzini F, Alli C, Bettelli G, Colombo F, Di Tullio M, Marchioli R, Mariotti G, and Radice M
- Subjects
- Aged, Aged, 80 and over, Antihypertensive Agents administration & dosage, Diuretics therapeutic use, Drug Administration Schedule, Female, Humans, Male, Pilot Projects, Sympatholytics therapeutic use, Antihypertensive Agents therapeutic use, Hypertension drug therapy
- Abstract
In order to assess the antihypertensive care received by the elderly, where clear therapeutic guidelines are lacking, a population of 3,858 aged over 64 years was studied. Data were derived from a large Italian 'Study on Blood Pressure in the Elderly', carried out in general practice. Over 90% of the 2,059 known hypertensive patients were receiving drug treatment, with no age or sex-related differences. A single drug was prescribed to 50.2% of treated patients; only 5.5% were receiving three or more drugs. Diuretics and older sympatholytic agents were by far the most frequently prescribed categories, with four drugs (hydrochlorothiazide, amiloride, methyldopa and chlorthalidone) accounting for over 50% of all prescriptions. Low-dosage treatment schedules were frequently used, often associated with less-often-than-daily drug administration. Our study shows that physicians' attitudes to the treatment of arterial hypertension in the elderly are fairly uniform, with treatment of all subjects but with low drug dosages.
- Published
- 1989
119. [Relations between pressure overload and early signs of cardiac involvement in arterial hypertension].
- Author
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Radice M, Alli C, Di Tullio M, Guiducci D, Mariotti G, Salmoirago E, and Taioli E
- Subjects
- Adolescent, Adult, Echocardiography, Exercise Test, Humans, Middle Aged, Blood Pressure, Heart physiopathology, Hypertension physiopathology, Physical Exertion
- Abstract
In arterial hypertension the indexes of left ventricular hypertrophy are not related to resting blood pressure, whereas a positive association with exercise blood pressure has been observed. It has not been investigated a possible relationship between response to stress and left ventricular diastolic function, the latter being early involved in arterial hypertension even before the development of ventricular hypertrophy. The present study was aimed at assessing a possible relationship between blood pressure response to dynamic exercise and index of left ventricular mass, systolic and diastolic function in a group of untreated hypertensives. fourty hypertensives aged 16-56 years were studied, 27 with mild hypertension and 13 with moderate or severe hypertension. The control group consisted of 23 normotensive healthy subjects, aged 14-40 years. All the subjects underwent a maximum-graded bicycle exercise in the supine position and a M-mode echocardiogram under the B-mode drive. Average values of the indexes of ventricular hypertrophy and of systolic function were overlapping in the 3 groups. Significant differences were observed in the indexes of diastolic function; with regard to normatensive controls, hypertensive subjects showed an increase in isovolumic relaxation time and rapid filling time, a decrease of isovolumic and rapid filling rates and a reduction of mitral valve closing and opening velocities.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1989
120. [Usefulness of exertion tests in the evaluation of the effectiveness of antihypertensive therapy].
- Author
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Radice M, Alli C, Avanzini F, Canciani C, Castelli MR, Di Tullio M, Giudici V, Manzini M, Mariotti G, and Salmoirago E
- Subjects
- Adult, Evaluation Studies as Topic, Female, Humans, Hypertension physiopathology, Male, Blood Pressure, Exercise Test, Hypertension therapy
- Abstract
Aim of this study was to assess the reliability of blood pressure (BP) response to exercise compared with the occasional BP measurements in evaluating the efficacy of an antihypertensive therapy. We have studied 40 subjects (22 M, 18 F mean age 33.3 +/- 6.6) with essential hypertension (19 with mild hypertension, 8 with moderate hypertension, 13 with severe hypertension). Every patient underwent a maximum graded exercise test in the supine position on a bicycle ergometer before starting the antihypertensive treatment. An exercise test was repeated with the same procedure after resting BP had been normalized for at least six months. Both systolic and diastolic BP at peak exercise were significantly reduced (systolic BP from 212.13 +/- 25.79 mmHg to 194.38 +/- 21.58 mmHg; diastolic BP from 128.00 +/- 16.52 to 114.1 +/- 11.02 mmHg) during the second test. An excessive BP increase (above the 95% confidence limits of the BP response to exercise in a group of normotensives) was observed in 32 subjects during the first test. A "hypertensive" response to stress persisted in 13 subjects during the second test even if the resting BP values were normalized. Our data support the value of stress testing in both the evaluation of the hypertensive patient and the assessment of the individual response to treatment.
- Published
- 1987
121. [Isolated systolic hypertension in the elderly].
- Author
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Avanzini F, Alli C, Bettelli G, Di Tullio M, Marchioli R, and Tognoni G
- Subjects
- Aged, Humans, Hypertension complications, Hypertension epidemiology, Hypertension physiopathology, Risk Factors, Systole, Antihypertensive Agents therapeutic use, Hypertension drug therapy
- Abstract
Isolated systolic hypertension (ISH) is a very common condition in the elderly, even more than diastolic hypertension. Several studies indicate that ISH is a considerable cardiovascular risk factor in the elderly but the benefit of antihypertensive treatment has not been proved. Data in the literature on prevalence, pathophysiology, prognostic meaning and treatment of ISH are critically reviewed.
- Published
- 1989
122. [Index of left ventricular hypertrophy in adolescents genetically predisposed to the development of arterial hypertension].
- Author
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Radice M, Alli C, Avanzini F, Di Tullio M, Mariotti G, Taioli E, and Zussino A
- Subjects
- Adolescent, Electrocardiography, Humans, Hypertension physiopathology, Cardiomegaly pathology, Hypertension genetics
- Abstract
Experimental studies on strains of normotensive rats genetically prone to hypertension and investigations on humans with borderline hypertension have shown an early involvement of the heart, mainly consisting in a trend to ventricular hypertrophy. To assess whether such alterations may preceed or follow the elevation of blood pressure, subjects who will develop hypertension, but whose blood pressure is currently normal must be studied. For this reason, we studied by means of M-mode echocardiography 51 normotensive males aged 14-19 years with family history for hypertension (at least one hypertensive parent; SHT). Fifty-five normotensive subjects with both normotensive parents (SNT), matched for sex and age, were the controls. Average values of the following parameters were significantly higher in SHT than in SNT subjects: interventricular septum (5.4 +/- 0.8 versus 4.9 +/- 0.9 mm/m2; p less than 0.01) and posterior wall (5.4 +/- 1.1 versus 5.0 +/- 0.8 mm/m2; p less than 0.05) thickness, left ventricular mass (125.0 +/- 29.1 versus 109.2 +/- 25.4 g/m2; p less than 0.005) and cross sectional area (10.0 +/- 1.8 versus 8.9 +/- 1.6 cm2/m2; p less than 0.005). No significant difference between the two groups was observed in the indexes of left ventricular function. The existence of alterations of cardiac morphology in normotensive adolescents with genetic risk of hypertension shows that the cardiac involvement may preceed the development of high blood pressure.
- Published
- 1985
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