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1. Prevalence, Clustering, and Current Management of Cardiovascular Risk Factors Upon First Referral to Hypertension Specialists: the APPROACH Study

Author

Del Pinto, R, Agabiti Rosei, C, Di Guardo, A, Giannattasio, C, Izzo, R, Mazza, A, Pucci, G, Sarzani, R, Tocci, G, Veglio, F, Volpe, M, Grassi, G, Muiesan, M, Ferri, C, Del Pinto R, Agabiti Rosei C, Di Guardo A, Giannattasio C, Izzo R, Mazza A, Pucci G, Sarzani R, Tocci G, Veglio F, Volpe M, Grassi G, Muiesan ML, Ferri C, Del Pinto, R, Agabiti Rosei, C, Di Guardo, A, Giannattasio, C, Izzo, R, Mazza, A, Pucci, G, Sarzani, R, Tocci, G, Veglio, F, Volpe, M, Grassi, G, Muiesan, M, Ferri, C, Del Pinto R, Agabiti Rosei C, Di Guardo A, Giannattasio C, Izzo R, Mazza A, Pucci G, Sarzani R, Tocci G, Veglio F, Volpe M, Grassi G, Muiesan ML, and Ferri C

Abstract

Introduction: Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. Methods: Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022-2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. Results: A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3 years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3 mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. Conclusions: In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies.

Published
2024

2. May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a Nationwide Survey

Author

Del Pinto, R, Agabiti Rosei, C, Borghi, C, Cipollini, F, Cottone, S, De Giorgi, G, Di Guardo, A, Dugnani, M, Fabris, B, Giannattasio, C, Giacchetti, G, Minuz, P, Mulè, G, Nazzaro, P, Parati, G, Rattazzi, M, Saladini, F, Salvetti, M, Sarzani, R, Savoia, C, Tocci, G, Veglio, F, Volpe, M, Vulpis, V, Baldini, G, Ferri, C, Muiesan, M, Del Pinto R., Agabiti Rosei C., Borghi C., Cipollini F., Cottone S., De Giorgi G. A., Di Guardo A., Dugnani M., Fabris B., Giannattasio C., Giacchetti G., Minuz P., Mulè G., Nazzaro P., Parati G., Rattazzi M., Saladini F., Salvetti M., Sarzani R., Savoia C., Tocci G., Veglio F., Volpe M., Vulpis V., Baldini G., Ferri C., Muiesan M. L., Del Pinto, R, Agabiti Rosei, C, Borghi, C, Cipollini, F, Cottone, S, De Giorgi, G, Di Guardo, A, Dugnani, M, Fabris, B, Giannattasio, C, Giacchetti, G, Minuz, P, Mulè, G, Nazzaro, P, Parati, G, Rattazzi, M, Saladini, F, Salvetti, M, Sarzani, R, Savoia, C, Tocci, G, Veglio, F, Volpe, M, Vulpis, V, Baldini, G, Ferri, C, Muiesan, M, Del Pinto R., Agabiti Rosei C., Borghi C., Cipollini F., Cottone S., De Giorgi G. A., Di Guardo A., Dugnani M., Fabris B., Giannattasio C., Giacchetti G., Minuz P., Mulè G., Nazzaro P., Parati G., Rattazzi M., Saladini F., Salvetti M., Sarzani R., Savoia C., Tocci G., Veglio F., Volpe M., Vulpis V., Baldini G., Ferri C., and Muiesan M. L.

Abstract

Introduction: Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients' side, and therapeutic inertia on physicians' side. Methods: During the global BP screening campaign "May Measure Month" (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures. Results: A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About half of participants were sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension. Most were not on a fixed-dose combination of antihypertensive drugs and did not regularly measure BP at home. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%). Conclusions: This survey identified a remarkable degree of therapeutic inertia and poor patients' involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to identify areas of unsatisfactory management of hypertension, to increase risk factors' awareness in the population with the final purpose of reducing cardiovascular risk.

Published
2024

4. Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Author

Agabiti Rosei, C, Paini, A, Buso, G, Maloberti, A, Giannattasio, C, Salvetti, M, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Masulli, M, Mazza, A, Mengozzi, A, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Virdis, A, Muiesan, M, Borghi, C, Agabiti Rosei, Claudia, Paini, Anna, Buso, Giacomo, Maloberti, Alessandro, Giannattasio, Cristina, Salvetti, Massimo, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo Francesco Giuseppe, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, D'Elia, Lanfranco, Desideri, Giovambattista, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Masulli, Maria, Mazza, Alberto, Mengozzi, Alessandro, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Virdis, Agostino, Muiesan, Maria Lorenza, Borghi, Claudio, Agabiti Rosei, C, Paini, A, Buso, G, Maloberti, A, Giannattasio, C, Salvetti, M, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Masulli, M, Mazza, A, Mengozzi, A, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Virdis, A, Muiesan, M, Borghi, C, Agabiti Rosei, Claudia, Paini, Anna, Buso, Giacomo, Maloberti, Alessandro, Giannattasio, Cristina, Salvetti, Massimo, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo Francesco Giuseppe, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, D'Elia, Lanfranco, Desideri, Giovambattista, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Masulli, Maria, Mazza, Alberto, Mengozzi, Alessandro, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Virdis, Agostino, Muiesan, Maria Lorenza, and Borghi, Claudio

Abstract

High levels of serum uric acid (SUA) and triglycerides (TG) might promote high-cardiovascular-risk phenotypes, including subclinical atherosclerosis. An interaction between plaques xanthine oxidase (XO) expression, SUA, and HDL-C has been recently postulated. Subjects from the URic acid Right for heArt Health (URRAH) study with carotid ultrasound and without previous cardiovascular diseases (CVD) (n = 6209), followed over 20 years, were included in the analysis. Hypertriglyceridemia (hTG) was defined as TG ≥ 150 mg/dL. Higher levels of SUA (hSUA) were defined as ≥5.6 mg/dL in men and 5.1 mg/dL in women. A carotid plaque was identified in 1742 subjects (28%). SUA and TG predicted carotid plaque (HR 1.09 [1.04-1.27], p < 0.001 and HR 1.25 [1.09-1.45], p < 0.001) in the whole population, independently of age, sex, diabetes, systolic blood pressure, HDL and LDL cholesterol and treatment. Four different groups were identified (normal SUA and TG, hSUA and normal TG, normal SUA and hTG, hSUA and hTG). The prevalence of plaque was progressively greater in subjects with normal SUA and TG (23%), hSUA and normal TG (31%), normal SUA and hTG (34%), and hSUA and hTG (38%) (Chi-square, 0.0001). Logistic regression analysis showed that hSUA and normal TG [HR 1.159 (1.002 to 1.341); p = 0.001], normal SUA and hTG [HR 1.305 (1.057 to 1.611); p = 0.001], and the combination of hUA and hTG [HR 1.539 (1.274 to 1.859); p = 0.001] were associated with a higher risk of plaque. Our findings demonstrate that SUA is independently associated with the presence of carotid plaque and suggest that the combination of hyperuricemia and hypertriglyceridemia is a stronger determinant of carotid plaque than hSUA or hTG taken as single risk factors. The association between SUA and CVD events may be explained in part by a direct association of UA with carotid plaques.

Published
2024

5. Mechanisms of Vascular Inflammation and Potential Therapeutic Targets: A Position Paper From the ESH Working Group on Small Arteries

Author

Rios, F, de Ciuceis, C, Georgiopoulos, G, Lazaridis, A, Nosalski, R, Pavlidis, G, Tual-Chalot, S, Agabiti-Rosei, C, Camargo, L, Dąbrowska, E, Quarti-Trevano, F, Hellmann, M, Masi, S, Lopreiato, M, Mavraganis, G, Mengozzi, A, Montezano, A, Stavropoulos, K, Winklewski, P, Wolf, J, Costantino, S, Doumas, M, Gkaliagkousi, E, Grassi, G, Guzik, T, Ikonomidis, I, Narkiewicz, K, Paneni, F, Rizzoni, D, Stamatelopoulos, K, Stellos, K, Taddei, S, Touyz, R, Virdis, A, Rios, Francisco J., de Ciuceis, Carolina, Georgiopoulos, Georgios, Lazaridis, Antonios, Nosalski, Ryszard, Pavlidis, George, Tual-Chalot, Simon, Agabiti-Rosei, Claudia, Camargo, Livia L., Dąbrowska, Edyta, Quarti-Trevano, Fosca, Hellmann, Marcin, Masi, Stefano, Lopreiato, Mariarosaria, Mavraganis, Georgios, Mengozzi, Alessandro, Montezano, Augusto C., Stavropoulos, Konstantinos, Winklewski, Pawel J., Wolf, Jacek, Costantino, Sarah, Doumas, Michael, Gkaliagkousi, Eugenia, Grassi, Guido, Guzik, Tomasz J., Ikonomidis, Ignatios, Narkiewicz, Krzysztof, Paneni, Francesco, Rizzoni, Damiano, Stamatelopoulos, Kimon, Stellos, Konstantinos, Taddei, Stefano, Touyz, Rhian M, Virdis, Agostino, Rios, F, de Ciuceis, C, Georgiopoulos, G, Lazaridis, A, Nosalski, R, Pavlidis, G, Tual-Chalot, S, Agabiti-Rosei, C, Camargo, L, Dąbrowska, E, Quarti-Trevano, F, Hellmann, M, Masi, S, Lopreiato, M, Mavraganis, G, Mengozzi, A, Montezano, A, Stavropoulos, K, Winklewski, P, Wolf, J, Costantino, S, Doumas, M, Gkaliagkousi, E, Grassi, G, Guzik, T, Ikonomidis, I, Narkiewicz, K, Paneni, F, Rizzoni, D, Stamatelopoulos, K, Stellos, K, Taddei, S, Touyz, R, Virdis, A, Rios, Francisco J., de Ciuceis, Carolina, Georgiopoulos, Georgios, Lazaridis, Antonios, Nosalski, Ryszard, Pavlidis, George, Tual-Chalot, Simon, Agabiti-Rosei, Claudia, Camargo, Livia L., Dąbrowska, Edyta, Quarti-Trevano, Fosca, Hellmann, Marcin, Masi, Stefano, Lopreiato, Mariarosaria, Mavraganis, Georgios, Mengozzi, Alessandro, Montezano, Augusto C., Stavropoulos, Konstantinos, Winklewski, Pawel J., Wolf, Jacek, Costantino, Sarah, Doumas, Michael, Gkaliagkousi, Eugenia, Grassi, Guido, Guzik, Tomasz J., Ikonomidis, Ignatios, Narkiewicz, Krzysztof, Paneni, Francesco, Rizzoni, Damiano, Stamatelopoulos, Kimon, Stellos, Konstantinos, Taddei, Stefano, Touyz, Rhian M, and Virdis, Agostino

Abstract

Inflammatory responses in small vessels play an important role in the development of cardiovascular diseases, including hypertension, stroke, and small vessel disease. This involves various complex molecular processes including oxidative stress, inflammasome activation, immune-mediated responses, and protein misfolding, which together contribute to microvascular damage. In addition, epigenetic factors, including DNA methylation, histone modifications, and microRNAs influence vascular inflammation and injury. These phenomena may be acquired during the aging process or due to environmental factors. Activation of proinflammatory signaling pathways and molecular events induce low-grade and chronic inflammation with consequent cardiovascular damage. Identifying mechanism-specific targets might provide opportunities in the development of novel therapeutic approaches. Monoclonal antibodies targeting inflammatory cytokines and epigenetic drugs, show promise in reducing microvascular inflammation and associated cardiovascular diseases. In this article, we provide a comprehensive discussion of the complex mechanisms underlying microvascular inflammation and offer insights into innovative therapeutic strategies that may ameliorate vascular injury in cardiovascular disease.

Published
2024

6. Serum uric acid and left ventricular mass index independently predict cardiovascular mortality: The uric acid right for heart health (URRAH) project

Author

Muiesan, M, Agabiti Rosei, C, Paini, A, Casiglia, E, Cirillo, M, Grassi, G, Iaccarino, G, Mallamaci, F, Maloberti, A, Mazza, A, Mengozzi, A, Palatini, P, Parati, G, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tikhonoff, V, Tocci, G, Borghi, C, Angeli, F, Barbagallo, C, Bombelli, M, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, P, Dell'Oro, R, Medica, C, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Giannattasio, C, Lippa, L, Masi, S, Masulli, M, Nazzaro, P, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Ungar, A, Verdecchia, P, Viazzi, F, Virdis, A, Volpe, M, Muiesan M. L., Agabiti Rosei C., Paini A., Casiglia E., Cirillo M., Grassi G., Iaccarino G., Mallamaci F., Maloberti A., Mazza A., Mengozzi A., Palatini P., Parati G., Reboldi G., Rivasi G., Russo E., Salvetti M., Tikhonoff V., Tocci G., Borghi C., Angeli F., Barbagallo C. M., Bombelli M., Cianci R., Ciccarelli M., Cicero A. F. G., Cirillo P., Dell'Oro R., Medica C., D'Elia L., Desideri G., Ferri C., Galletti F., Gesualdo L., Giannattasio C., Lippa L., Masi S., Masulli M., Nazzaro P., Pontremoli R., Quarti-Trevano F., Rattazzi M., Ungar A., Verdecchia P., Viazzi F., Virdis A., Volpe M., Muiesan, M, Agabiti Rosei, C, Paini, A, Casiglia, E, Cirillo, M, Grassi, G, Iaccarino, G, Mallamaci, F, Maloberti, A, Mazza, A, Mengozzi, A, Palatini, P, Parati, G, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tikhonoff, V, Tocci, G, Borghi, C, Angeli, F, Barbagallo, C, Bombelli, M, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, P, Dell'Oro, R, Medica, C, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Giannattasio, C, Lippa, L, Masi, S, Masulli, M, Nazzaro, P, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Ungar, A, Verdecchia, P, Viazzi, F, Virdis, A, Volpe, M, Muiesan M. L., Agabiti Rosei C., Paini A., Casiglia E., Cirillo M., Grassi G., Iaccarino G., Mallamaci F., Maloberti A., Mazza A., Mengozzi A., Palatini P., Parati G., Reboldi G., Rivasi G., Russo E., Salvetti M., Tikhonoff V., Tocci G., Borghi C., Angeli F., Barbagallo C. M., Bombelli M., Cianci R., Ciccarelli M., Cicero A. F. G., Cirillo P., Dell'Oro R., Medica C., D'Elia L., Desideri G., Ferri C., Galletti F., Gesualdo L., Giannattasio C., Lippa L., Masi S., Masulli M., Nazzaro P., Pontremoli R., Quarti-Trevano F., Rattazzi M., Ungar A., Verdecchia P., Viazzi F., Virdis A., and Volpe M.

Abstract

Unlabelled: A relationship between serum uric acid (SUA) and cardiovascular (CV) events has been documented in the Uric Acid Right for Heart Health (URRAH) study. Aim: of this study was to investigate the association between SUA and left ventricular mass index (LVMI) and whether SUA and LVMI or their combination may predict the incidence of CV death. Methods: Subjects with echocardiographic measurement of LVMI included in the URRAH study (n=10733) were part of this analysis. LV hypertrophy (LVH) was defined as LVMI > 95 g/m2 in women and 115 g/m2 in men. Results: A significant association between SUA and LVMI was observed in multiple regression analysis in men: beta 0,095, F 5.47, P< 0.001 and women: beta 0,069, F 4.36, P<0.001. During follow-up 319 CV deaths occurred. Kaplan-Meier curves showed a significantly poorer survival rate in subjects with higher SUA (> 5.6 mg/dl in men and 5.1 mg/dl in women) and LVH (log-rank chi-square 298.105; P<0.0001). At multivariate Cox regression analysis in women LVH alone and the combination of higher SUA and LVH but not hyperuricemia alone, were associated with a higher risk of CV death, while in men hyperuricemia without LVH, LVH without hyperuricemia and their combination were all associated with a higher incidence of CV death. Conclusions: Our findings demonstrate that SUA is independently associated with LVMI and suggest that the combination of hyperuricemia with LVH is an independent and powerful predictor for CV death both in men and women.

Published
2023

7. Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension

Author

Grassi, G, Del Pinto, R, Agabiti Rosei, C, Agnoletti, D, Borghi, C, Cicero, A, De Ciuceis, C, Desideri, G, Grassi, D, Muiesan, M, Paini, A, Salvetti, M, Tocci, G, Veglio, F, Volpe, M, Ferri, C, Grassi G., Del Pinto R., Agabiti Rosei C., Agnoletti D., Borghi C., Cicero A. F. G., De Ciuceis C., Desideri G., Grassi D., Muiesan M. L., Paini A., Salvetti M., Tocci G., Veglio F., Volpe M., Ferri C., Grassi, G, Del Pinto, R, Agabiti Rosei, C, Agnoletti, D, Borghi, C, Cicero, A, De Ciuceis, C, Desideri, G, Grassi, D, Muiesan, M, Paini, A, Salvetti, M, Tocci, G, Veglio, F, Volpe, M, Ferri, C, Grassi G., Del Pinto R., Agabiti Rosei C., Agnoletti D., Borghi C., Cicero A. F. G., De Ciuceis C., Desideri G., Grassi D., Muiesan M. L., Paini A., Salvetti M., Tocci G., Veglio F., Volpe M., and Ferri C.

Abstract

The primary and secondary prevention strategies of atherosclerotic cardiovascular disease (ASCVD) largely rely on the management of arterial hypertension and hypercholesterolemia, two major risk factors possibly linked in pathophysiological terms by the renin-angiotensin system activation and that often coexist in the same patient synergistically increasing cardiovascular risk. The classic pharmacologic armamentarium to reduce hypercholesterolemia has been based in the last two decades on statins, ezetimibe, and bile acid sequestrants. More recently numerous novel, additive resources targeting different pathways in LDL cholesterol metabolism have emerged. They include drugs targeting the proprotein convertase subtilisin/kexin type 9 (PCSK9) (inhibitory antibodies; small-interfering RNAs), the angiopoietin-like protein 3 (inhibitory antibodies), and the ATP-citrate lyase (the inhibitory oral prodrug, bempedoic acid), with PCSK9 inhibitors and bempedoic acid already approved for clinical use. With the potential of at least halving LDL cholesterol levels faster and more effectively with the addition of ezetimibe than with high-intensity statin alone, and even more with the addition of the novel available drugs, this document endorsed by the Italian Society of Hypertension proposes a novel paradigm for the treatment of the hypertensive patient with hypercholesterolemia at high and very high ASCVD risk. Our proposal is based on the use as a first-line of a preferably fixed combination of lipid-lowering drugs, under the motto “Our goal: achieve control. No setback: combine and check”.

Published
2022

8. The importance of microvascular inflammation in ageing and age-related diseases: a position paper from the ESH working group on small arteries, section of microvascular inflammation

Author

Mengozzi, A, de Ciuceis, C, Dell'Oro, R, Georgiopoulos, G, Lazaridis, A, Nosalski, R, Pavlidis, G, Tual-Chalot, S, Agabiti-Rosei, C, Anyfanti, P, Camargo, L, Dąbrowska, E, Quarti-Trevano, F, Hellmann, M, Masi, S, Mavraganis, G, Montezano, A, Rios, F, Winklewski, P, Wolf, J, Costantino, S, Gkaliagkousi, E, Grassi, G, Guzik, T, Ikonomidis, I, Narkiewicz, K, Paneni, F, Rizzoni, D, Stamatelopoulos, K, Stellos, K, Taddei, S, Touyz, R, Triantafyllou, A, Virdis, A, Mengozzi, Alessandro, de Ciuceis, Carolina, Dell'oro, Raffaella, Georgiopoulos, Georgios, Lazaridis, Antonios, Nosalski, Ryszard, Pavlidis, George, Tual-Chalot, Simon, Agabiti-Rosei, Claudia, Anyfanti, Panagiota, Camargo, Livia L, Dąbrowska, Edyta, Quarti-Trevano, Fosca, Hellmann, Marcin, Masi, Stefano, Mavraganis, Georgios, Montezano, Augusto C, Rios, Francesco J, Winklewski, Pawel J, Wolf, Jacek, Costantino, Sarah, Gkaliagkousi, Eugenia, Grassi, Guido, Guzik, Tomasz J, Ikonomidis, Ignatios, Narkiewicz, Krzysztof, Paneni, Francesco, Rizzoni, Damiano, Stamatelopoulos, Kimon, Stellos, Konstantinos, Taddei, Stefano, Touyz, Rhian M, Triantafyllou, Areti, Virdis, Agostino, Mengozzi, A, de Ciuceis, C, Dell'Oro, R, Georgiopoulos, G, Lazaridis, A, Nosalski, R, Pavlidis, G, Tual-Chalot, S, Agabiti-Rosei, C, Anyfanti, P, Camargo, L, Dąbrowska, E, Quarti-Trevano, F, Hellmann, M, Masi, S, Mavraganis, G, Montezano, A, Rios, F, Winklewski, P, Wolf, J, Costantino, S, Gkaliagkousi, E, Grassi, G, Guzik, T, Ikonomidis, I, Narkiewicz, K, Paneni, F, Rizzoni, D, Stamatelopoulos, K, Stellos, K, Taddei, S, Touyz, R, Triantafyllou, A, Virdis, A, Mengozzi, Alessandro, de Ciuceis, Carolina, Dell'oro, Raffaella, Georgiopoulos, Georgios, Lazaridis, Antonios, Nosalski, Ryszard, Pavlidis, George, Tual-Chalot, Simon, Agabiti-Rosei, Claudia, Anyfanti, Panagiota, Camargo, Livia L, Dąbrowska, Edyta, Quarti-Trevano, Fosca, Hellmann, Marcin, Masi, Stefano, Mavraganis, Georgios, Montezano, Augusto C, Rios, Francesco J, Winklewski, Pawel J, Wolf, Jacek, Costantino, Sarah, Gkaliagkousi, Eugenia, Grassi, Guido, Guzik, Tomasz J, Ikonomidis, Ignatios, Narkiewicz, Krzysztof, Paneni, Francesco, Rizzoni, Damiano, Stamatelopoulos, Kimon, Stellos, Konstantinos, Taddei, Stefano, Touyz, Rhian M, Triantafyllou, Areti, and Virdis, Agostino

Abstract

Microcirculation is pervasive and orchestrates a profound regulatory cross-talk with the surrounding tissue and organs. Similarly, it is one of the earliest biological systems targeted by environmental stressors and consequently involved in the development and progression of ageing and age-related disease. Microvascular dysfunction, if not targeted, leads to a steady derangement of the phenotype, which cumulates comorbidities and eventually results in a nonrescuable, very high-cardiovascular risk. Along the broad spectrum of pathologies, both shared and distinct molecular pathways and pathophysiological alteration are involved in the disruption of microvascular homeostasis, all pointing to microvascular inflammation as the putative primary culprit. This position paper explores the presence and the detrimental contribution of microvascular inflammation across the whole spectrum of chronic age-related diseases, which characterise the 21st-century healthcare landscape. The manuscript aims to strongly affirm the centrality of microvascular inflammation by recapitulating the current evidence and providing a clear synoptic view of the whole cardiometabolic derangement. Indeed, there is an urgent need for further mechanistic exploration to identify clear, very early or disease-specific molecular targets to provide an effective therapeutic strategy against the otherwise unstoppable rising prevalence of age-related diseases.

Published
2023

9. Prevalence of Cardiovascular Risk Factors and Related Medical and Lifestyle Interventions Among Italian Cardiovascular Specialists: A Proof-of-Concept Study

Author

Agabiti Rosei, C, Del Pinto, R, Grassi, G, Muiesan, M, Ferri, C, Agabiti Rosei, Claudia, Del Pinto, Rita, Grassi, Guido, Muiesan, Maria Lorenza, Ferri, Claudio, Agabiti Rosei, C, Del Pinto, R, Grassi, G, Muiesan, M, Ferri, C, Agabiti Rosei, Claudia, Del Pinto, Rita, Grassi, Guido, Muiesan, Maria Lorenza, and Ferri, Claudio

Abstract

Introduction: Physicians and researchers in the cardiovascular field are constantly engaged in the promotion of guidelines-directed preventive measures, but whether they are themselves adherent to the same recommendations was only sporadically examined. Aim: To assess awareness of self-exposure to cardiovascular risk factors and related management among cardiovascular specialists. Methods: During the National Conference of the Italian Society of Hypertension (October 2022), a pilot observational study on consecutive volunteer cardiovascular specialists was conducted. Participants underwent standard sitting and standing blood pressure (BP) measurements and answered a questionnaire regarding modifiable/non modifiable cardiovascular risk factors and related treatments. Based on self-declarations and actual measurements, BP was classified as optimal, normal, high-normal BP, and new hypertension in untreated participants, and as treated/untreated pre-existing hypertension. Controlled hypertension was defined as BP < 140/90 mmHg; age-adjusted lower targets were also applied, according to guidelines. Results: In total, 62 participants (30 F, mean age 43.2 ± 14.8 years) were enrolled; 79% reported regular physical activity; 53% of women and 38% of men were on a low-salt diet. After smoke (19.4%), dyslipidemia was the second most common risk factor (17.7%), often occurring with high BP (26.3%) and left untreated (36.7%). Pre-existing hypertension (11.3%) was often uncontrolled (57.1%) and associated with non-adherence to guidelines-directed lifestyle recommendations. About one in 12 participants was unaware of having high measured BP values. Conclusions: Despite the specific professional exposure, a margin for improvement in self cardiovascular risk factors awareness and management remains in this exploratory sample of cardiovascular specialists. This pilot research anticipates forthcoming, larger studies during national and international conferences.

Published
2023

12. POSSIBLE ROLE OF THE SPLEEN IN THE DEVELOPMENT OF HYPERTENSION IN HUMANS

Author

De Ciuceis, C., primary, Nardin, M., additional, Rossini, C., additional, Coschignano, M., additional, Brami, V., additional, Agabiti Rosei, C., additional, Salvetti, M., additional, Paini, A., additional, Caletti, S., additional, Chiarini, G., additional, Piacentini, N., additional, Porteri, E., additional, Rossi, G., additional, Tiberio, G., additional, Muiesan, M.L., additional, and Rizzoni, D., additional

Published
2019
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13. Central blood pressure assessment using 24-hour brachial pulse wave analysis

Author

Muiesan ML, Salvetti M, Bertacchini F, Agabiti-Rosei C, Maruelli G, Colonetti E, and Paini A

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, central aortic pressure, arterial hypertension cardiovascular risk, lcsh:RC666-701, blood pressure ambulatory monitoring
Abstract

Maria Lorenza Muiesan, Massimo Salvetti, Fabio Bertacchini, Claudia Agabiti-Rosei, Giulia Maruelli, Efrem Colonetti, Anna Paini Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy Abstract: This review describes the use of central blood pressure (BP) measurements during ambulatory monitoring, using noninvasive devices. The principles of measuring central BP by applanation tonometry and by oscillometry are reported, and information on device validation studies is described. The pathophysiological basis for the differences between brachial and aortic pressure is discussed. The currently available methods for central aortic pressure measurement are relatively accurate, and their use has important clinical implications, such as improving diagnostic and prognostic stratification of hypertension and providing a more accurate assessment of the effect of treatment on BP. Keywords: aortic blood pressure measurements, ambulatory monitoring, pulse wave analysis

Published
2014

26. P464Clinic and 24 hours blood pressure values are strictly related to dimensions of the ascending aorta in a general population

Author

Salvetti, M., primary, Paini, A., additional, Bertacchini, F., additional, Stassaldi, D., additional, Agabiti Rosei, C., additional, Aggiusti, C.Q., additional, Maruelli, G., additional, Rubagotti, G., additional, Verzeri, L., additional, Sacca', G., additional, Agabiti-Rosei, E., additional, and Muiesan, M.L., additional

Published
2017
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27. P141 COMPARISON BETWEEN TECHNIQUES OF EVALUATION MICROVASCULAR MORPHOLOGY: THE GOLD-STANDARD LOCALLY INVASIVE MICROMYOGRAPHY VS. THREE NON-INVASIVE TECHNIQUES. PRELIMINARY DATA

Author

De Ciuceis, C., primary, Caletti, S., primary, Coschignano, M.A., primary, Rossini, C., primary, Duse, S., primary, Docchio, F., primary, Pasinetti, S., primary, Zambonardi, F., primary, Semeraro, F., primary, Sansoni, G., primary, Agabiti Rosei, C., primary, Pileri, P., primary, Agabiti Rosei, E., primary, and Rizzoni, D., primary

Published
2017
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29. Relationship between media to lumen ratio of subcutaneous small arteries and wall to lumen ratio of retinal arterioles evaluated non invasively by scanning laser Doppler flowmetry

Author

Rizzoni, D, Porteri, E, De Ciuceis, C, La Boria, E, Duse, S, Semeraro, F, Costagliola, Ciro, Sebastiani, A, Danzi, P, Tiberio, Gam, Giulini, Sm, Agabiti Rosei, C, Sarkar, A, Avanzi, D, Agabiti Rosei, E., Rizzoni, D, Porteri, E, De Ciuceis, C, La Boria, E, Duse, S, Semeraro, F, Costagliola, Ciro, Sebastiani, A, Danzi, P, Tiberio, Gam, Giulini, Sm, Agabiti Rosei, C, Sarkar, A, Avanzi, D, and Agabiti Rosei, E.

Subjects
Vascular biology Microcirculation Remodeling
Published
2011

31. [OP.1B.09] RELATIONSHIP BETWEEN CHA2DS2-VASC SCORE AND PRECLINICAL CARDIOVASCULAR ORGAN DAMAGE IN A GENERAL POPULATION IN NORTHERN ITALY

Author

Agabiti Rosei E, G. Rubagotti, Agabiti Rosei C, Anna Paini, Carlo Aggiusti, M. Salvetti, G. Maruelli, Fabio Bertacchini, and M.L. Muiesan

Subjects
medicine.medical_specialty, education.field_of_study, Physiology, business.industry, Population, Northern italy, Surgery, Organ damage, Internal medicine, CHA2DS2–VASc score, Internal Medicine, Medicine, Cardiology and Cardiovascular Medicine, business, education
Published
2016

35. PP.27.13

Author

Salvetti, M., primary, Paini, A., additional, Agabiti-Rosei, C., additional, Bertacchini, F., additional, Maruelli, G., additional, Colonetti, E., additional, Donini, C., additional, Germano, R., additional, Casella, E., additional, Agabiti-Rosei, E., additional, and Muiesan, M., additional

Published
2015
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47. 3.5 EFFECT OF SHORT-TERM TREATMENT WITH LERCANIDIPINE ON CIRCULATING ENDOTHELIAL PROGENITOR CELLS AND STRUCTURAL ALTERATIONS IN RETINAL ARTERIOLES

Author

De Ciuceis, C., primary, Rossini, C., primary, La Boria, E., primary, Duse, S., primary, Semeraro, F., primary, Agabiti Rosei, C., primary, Airò, P., primary, Scarsi, M., primary, Tincani, A., primary, Muiesan, M.L., primary, Paini, A., primary, Salvetti, M., primary, Porteri, E., primary, Agabiti Rosei, E., primary, and Rizzoni, D., primary

Published
2012
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49. CIRCULATING INDICES OF INFLAMMATION/OXIDATIVE STRESS IN NORMOTENSIVE AND HYPERTENSIVE OBESE PATIENTS

Author

De Ciuceis, C., primary, Pilu, A., additional, Porteri, E., additional, La Boria, E., additional, Corbellini, C., additional, Boari, G. E.M., additional, Mittempergher, F., additional, Di Betta, E., additional, Casella, C., additional, Agabiti Rosei, C., additional, Ruggeri, G., additional, Rizzoni, D., additional, and Agabiti Rosei, E., additional

Published
2011
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50. RESISTANT HYPERTENSION IN A GENERAL POPULATION IN NORTHERN ITALY: PREVALENCE, ASSOCIATED CARDIOVASCULAR RISK FACTORS AND TARGET ORGAN DAMAGE

Author

Salvetti, M., primary, Muiesan, M. L., additional, Paini, A., additional, Agabiti Rosei, C., additional, Aggiusti, C., additional, Bertacchini, F., additional, Stassaldi, D., additional, Beschi, F., additional, Cobelli, S., additional, Rubagotti, G., additional, Monteduro, C., additional, Castellano, M., additional, and Agabiti Rosei, E., additional

Published
2011
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