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1. Blood pressure and metabolic profile after surgical menopause: comparison with fertile and naturally-menopausal women

Author: Casiglia, E, Ginocchio, G, Tikhonoff, V, D’Este, D, Mazza, A, Pizziol, A, Pavei, A, Ambrosio, GB, Piccoli, A, and Pessina, AC
Published: 2000
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2. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial

Author: Trimarco, THE TELMISARTAN RANDOMISED ASSESSMENT STUDY IN ACE INTOLERANT SUBJECTS WITH CARDIOVASCULAR DISEASE TRANSCEND INVESTIGATORS Italy: B., Verdecchia, P., Maggioni, A., Achilli, A., Agabiti Rosei, E., Ambrosio, Gb, Bentivoglio, M., Branzi, A., Chersevani, D., Chiariello, M., Cirrincione, V., Dembech, C., Ferrari, R., Gattobigio, R., Giovannini, E., Lauro, R., Lembo, Giuseppe, Moretti, L., Pancaldi, L., Pede, S., Pettinati, G., Reboldi, G., Ricci, R., Rosiello, G., Rozza, F., Sardone, Mg, Tavazzi, L., Terrosu, P., Venco, A., Vetrano, A., and Volpe, Massimo
Subjects: Male, medicine.medical_specialty, Angiotensin-Converting Enzyme Inhibitors, Kaplan-Meier Estimate, Klinikai orvostudományok, Placebo, Benzoates, law.invention, Randomized controlled trial, law, Internal medicine, medicine, Humans, Single-Blind Method, Telmisartan, Myocardial infarction, Angioedema, Stroke, Aged, Intention-to-treat analysis, biology, business.industry, Angiotensin-converting enzyme, Orvostudományok, General Medicine, medicine.disease, ACE inibitori, AT1 bloccanti, trial clinico, Candesartan, Cough, Therapeutic Equivalency, Cardiovascular Diseases, Anesthesia, biology.protein, Benzimidazoles, Female, Hypotension, business, Risk Reduction Behavior, Follow-Up Studies, medicine.drug
Abstract: BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors reduce major cardiovascular events, but are not tolerated by about 20% of patients. We therefore assessed whether the angiotensin-receptor blocker telmisartan would be effective in patients intolerant to ACE inhibitors with cardiovascular disease or diabetes with end-organ damage. METHODS: After a 3-week run-in period, 5926 patients, many of whom were receiving concomitant proven therapies, were randomised to receive telmisartan 80 mg/day (n=2954) or placebo (n=2972) by use of a central automated randomisation system. Randomisation was stratified by hospital. The primary outcome was the composite of cardiovascular death, myocardial infarction, stroke, or hospitalisation for heart failure. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00153101. FINDINGS: The median duration of follow-up was 56 (IQR 51-64) months. All randomised patients were included in the efficacy analyses. Mean blood pressure was lower in the telmisartan group than in the placebo group throughout the study (weighted mean difference between groups 4.0/2.2 [SD 19.6/12.0] mm Hg). 465 (15.7%) patients experienced the primary outcome in the telmisartan group compared with 504 (17.0%) in the placebo group (hazard ratio 0.92, 95% CI 0.81-1.05, p=0.216). One of the secondary outcomes-a composite of cardiovascular death, myocardial infarction, or stroke-occurred in 384 (13.0%) patients on telmisartan compared with 440 (14.8%) on placebo (0.87, 0.76-1.00, p=0.048 unadjusted; p=0.068 after adjustment for multiplicity of comparisons and overlap with primary outcome). 894 (30.3%) patients receiving telmisartan were hospitalised for a cardiovascular reason, compared with 980 (33.0%) on placebo (relative risk 0.92, 95% CI 0.85-0.99; p=0.025). Fewer patients permanently discontinued study medication in the telmisartan group than in the placebo group (639 [21.6%] vs 705 [23.8%]; p=0.055); the most common reason for permanent discontinuation was hypotensive symptoms (29 [0.98%] in the telmisartan group vs 16 [0.54%] in the placebo group). INTERPRETATION: Telmisartan was well tolerated in patients unable to tolerate ACE inhibitors. Although the drug had no significant effect on the primary outcome of this study, which included hospitalisations for heart failure, it modestly reduced the risk of the composite outcome of cardiovascular death, myocardial infarction, or stroke. FUNDING: Boehringer Ingelheim.
Published: 2008
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3. Eplerenone in patients with systolic heart failure and mild symptoms

Author: Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H, Vincent J, Pocock SJ, Pitt B, Drexler H, McMurray J, Remme WJ, Cornel JH, Hildebrandt P, Hradec J, Mareev V, Reddy KS, Sindone A, Martinez F, Alonso Garcia A, Wilhelmsen L, Dargie HJ, Tavazzi L, Pocock S, Leizorovic A, Collier T, Nul DR, Serra JL, Thierer JM, Cross DB, Sindone AP, Singh BB, Boreux JL, Charlier FP, Dendale P, De Keulenaer G, Marchandise B, Marechal P, Marenne F, Mieghem WV, Van Dorpe AC, Vanhaecke J, Arnold JM, Dion D, Huynh T, Kouz SM, Lepage S, McKelvie RS, O'Meara E, Proulx G, Sauve C, Aschermann M, Brecka D, Filipovsky J, Groch L, Jerabek O, Jokl I, Linkova H, Motovska Z, Munz J, Penicka M, Rucka D, Mid JS, Spacek R, Spinar J, Stipal R, Vojacek J, Attali P, Bonneau A, Bousser JP, Dutoit L, Funck F, Galinier MP, Gibelin P, Hautefeuille BD, Hittinger L, Jobic Y, Jourdain P, Komajda M, Maupas E, Olive T, Philias A, Roul G, Rouleau F, Trochu JN, Boehm M, Bruch L, Engelhardt H, Erbs S, Foerster A, Franz N, Hambrecht R, Heuer H, Krueger U, Landmesser U, Leischik R, Mitrovic V, Moehlenkamp S, Monti J, Mueller Ehmsen J, Oezcelik C, Philipp S, Pieske B, Roehnisch JU, Schunkert H, Schwinger R, Wachter R, Willenbrock R, Winkelmann BR, Winkler R, Wollert KC, Adamopoulos S, Kalikazaros I, Karavidas A, Karvounis H, Kremastinos D, Manolis AJ, Nanas I, Sotirellos K, Vasiliadis K, Zaboulis C, Lee S, Yu CM, Czibok C, Édes I, Forster T, Preda I, Simon K, Takacs J, Zámolyi K, Bhagavatula KS, Chockalingam K, Desai N, Iyengar SS, Jayadev SM, Mullasari AS, Sathe SP, Sinha N, Vadagenalli PS, Wander GS, McDonald KM, Nash P, Vaughan CJ, Agostoni P, Ambrosio GB, Bittolo Bon G, Boffa G, Cacciavillani L, Capucci A, Chiariello M, Cirrincione V, Gensini GF, Masini F, Modena MG, Monte I, Rosano GM, Senni M, Sinagra G, Tamburino C, Terrosu P, Villani GQ, Volterrani M, Chae SC, Ha CW, Ha JW, Shin JH, Bayram Llamas E, Calvillo JC, Cruz Diaz A, Delgado Leal L, Estrada Gomez MM, Kosturakis D, Petersen Aranguren F, Velasco Sanchez RG, Daniëls MC, Dirkali A, Dunselman PH, de Kluiver EP, Kragten JA, Lok DJ, Maas AH, Michels HR, Nicastia DM, Stoel I, de Swart JB, Thijssen HJ, Van Kempen LH, Voors AA, Willems FF, Dluzniewski M, Gaciong Z, Kawecka Jaszcz K, Jozwa R, Korewicki J, Krzeminska Pakula M, Kurowski M, Ogorek M, Pempera M, Rynkiewicz A, Ujda M, Wierzchowiecki M, Abreu Á, Andrade A, Carrageta M, Fonseca C, Franco F, Gil VM, Lousada N, Mendonca C, Moreira I, Padua FP, Providência L, Cardoso JC, Trabulo M, Aroutyunov GP, Gindin K, Karpov YB, Kostenko VA, Nikitin YP, Obraztsova GI, Shilkina NP, Shlyakhto EV, Skvortsov A, Ding ZP, Yeo DP, Ambrovicova V, Gaspar L, Goncalvesova E, Kycina P, Litvinova J, Mikes Z, Murin J, Poliacik P, Uhliar R, Lloyd EA, Marx D, Naidoo DP, Prozesky HW, Sliwa Hahnle K, Theron H, Anguita M, De Teresa E, Galve E, Juanatey JR, Orbe PM, Vida M, Ahremark U, Andersson B, Axelsson U, Berglund S, Boman K, Dahlstrom U, Fu M, Holm Orndahl L, Johansson A, Lindgren M, Nemeczek C, Prantare H, Roussine V, Stehn G, Stenberg A, Vasko P, Bazylevych A, Dyadyk OI, Dzyak GV, Girina OM, Ignatenko GA, Kononenko LG, Kubyshkin VF, Kuryata OV, Parkhomenko AN, Perepelytsya MV, Pertseva TO, Popik GS, Rishko MV, Sakharchuk II, Tseluyko VI, Tykhonova SA, Vizir V, Voronkov LG, Al Khaja N, Almahmeed WA, Bazargani N, Adgey AA, Al Mohammad A, Banerjee P, Barlow M, Bridges AB, Brooks N, Connolly EC, Denvir MA, Egdell RM, Kardos A, Keeling PJ, Khokhar AA, Senior R, Williams SG, Anand IS, Anderson JL, Berk MR, Bertolet BD, Bisognano JD, Blonder RD, Breburda CS, Canaday DB, Capodilupo RC, Choiunard MD, Colucci WS, Dahiya RJ, Dunlap SH, Essandoh LK, Flores AR, Henderson DA, Herzog WR Jr, Katz RJ, Kosinski EJ, Labin IN, Lally FL, Lash JA, McGrew FA 3rd, Mohiuddin SM, Moraes D, Murali SC, Nallasivan M, Philbin E, Prabhu S, Primack DS, Ramani R, Rawitscher D, Sangrigoli R, Schamalfuss CM, Stoletniy L, Strong MH, Thadani U, Treasure CB 2nd, Vicari RM, Vogel CD, Wlsh MN, Wencker D, Wilson SA, Winkel E, Wiseman AH, Zoiopoulos LY, Mancebo JR, Mendoza I, Waich S.T., PERRONE FILARDI, PASQUALE, Zannad, F, Mcmurray, Jj, Krum, H, van Veldhuisen, Dj, Swedberg, K, Shi, H, Vincent, J, Pocock, Sj, Pitt, B, Drexler, H, Mcmurray, J, Remme, Wj, Cornel, Jh, Hildebrandt, P, Hradec, J, Mareev, V, Reddy, K, Sindone, A, Martinez, F, Alonso Garcia, A, Wilhelmsen, L, Dargie, Hj, Tavazzi, L, Pocock, S, Leizorovic, A, Collier, T, Nul, Dr, Serra, Jl, Thierer, Jm, Cross, Db, Sindone, Ap, Singh, Bb, Boreux, Jl, Charlier, Fp, Dendale, P, De Keulenaer, G, Marchandise, B, Marechal, P, Marenne, F, Mieghem, Wv, Van Dorpe, Ac, Vanhaecke, J, Arnold, Jm, Dion, D, Huynh, T, Kouz, Sm, Lepage, S, Mckelvie, R, O'Meara, E, Proulx, G, Sauve, C, Aschermann, M, Brecka, D, Filipovsky, J, Groch, L, Jerabek, O, Jokl, I, Linkova, H, Motovska, Z, Munz, J, Penicka, M, Rucka, D, Mid, J, Spacek, R, Spinar, J, Stipal, R, Vojacek, J, Attali, P, Bonneau, A, Bousser, Jp, Dutoit, L, Funck, F, Galinier, Mp, Gibelin, P, Hautefeuille, Bd, Hittinger, L, Jobic, Y, Jourdain, P, Komajda, M, Maupas, E, Olive, T, Philias, A, Roul, G, Rouleau, F, Trochu, Jn, Boehm, M, Bruch, L, Engelhardt, H, Erbs, S, Foerster, A, Franz, N, Hambrecht, R, Heuer, H, Krueger, U, Landmesser, U, Leischik, R, Mitrovic, V, Moehlenkamp, S, Monti, J, Mueller Ehmsen, J, Oezcelik, C, Philipp, S, Pieske, B, Roehnisch, Ju, Schunkert, H, Schwinger, R, Wachter, R, Willenbrock, R, Winkelmann, Br, Winkler, R, Wollert, Kc, Adamopoulos, S, Kalikazaros, I, Karavidas, A, Karvounis, H, Kremastinos, D, Manolis, Aj, Nanas, I, Sotirellos, K, Vasiliadis, K, Zaboulis, C, Lee, S, Yu, Cm, Czibok, C, Édes, I, Forster, T, Preda, I, Simon, K, Takacs, J, Zámolyi, K, Bhagavatula, K, Chockalingam, K, Desai, N, Iyengar, S, Jayadev, Sm, Mullasari, A, Sathe, Sp, Sinha, N, Vadagenalli, P, Wander, G, Mcdonald, Km, Nash, P, Vaughan, Cj, Agostoni, P, Ambrosio, Gb, Bittolo Bon, G, Boffa, G, Cacciavillani, L, Capucci, A, Chiariello, M, Cirrincione, V, Gensini, Gf, Masini, F, Modena, Mg, Monte, I, PERRONE FILARDI, Pasquale, Rosano, Gm, Senni, M, Sinagra, G, Tamburino, C, Terrosu, P, Villani, Gq, Volterrani, M, Chae, Sc, Ha, Cw, Ha, Jw, Shin, Jh, Bayram Llamas, E, Calvillo, Jc, Cruz Diaz, A, Delgado Leal, L, Estrada Gomez, Mm, Kosturakis, D, Petersen Aranguren, F, Velasco Sanchez, Rg, Daniëls, Mc, Dirkali, A, Dunselman, Ph, de Kluiver, Ep, Kragten, Ja, Lok, Dj, Maas, Ah, Michels, Hr, Nicastia, Dm, Stoel, I, de Swart, Jb, Thijssen, Hj, Van Kempen, Lh, Voors, Aa, Willems, Ff, Dluzniewski, M, Gaciong, Z, Kawecka Jaszcz, K, Jozwa, R, Korewicki, J, Krzeminska Pakula, M, Kurowski, M, Ogorek, M, Pempera, M, Rynkiewicz, A, Ujda, M, Wierzchowiecki, M, Abreu, Á, Andrade, A, Carrageta, M, Fonseca, C, Franco, F, Gil, Vm, Lousada, N, Mendonca, C, Moreira, I, Padua, Fp, Providência, L, Cardoso, Jc, Trabulo, M, Aroutyunov, Gp, Gindin, K, Karpov, Yb, Kostenko, Va, Nikitin, Yp, Obraztsova, Gi, Shilkina, Np, Shlyakhto, Ev, Skvortsov, A, Ding, Zp, Yeo, Dp, Ambrovicova, V, Gaspar, L, Goncalvesova, E, Kycina, P, Litvinova, J, Mikes, Z, Murin, J, Poliacik, P, Uhliar, R, Lloyd, Ea, Marx, D, Naidoo, Dp, Prozesky, Hw, Sliwa Hahnle, K, Theron, H, Anguita, M, De Teresa, E, Galve, E, Juanatey, Jr, Orbe, Pm, Vida, M, Ahremark, U, Andersson, B, Axelsson, U, Berglund, S, Boman, K, Dahlstrom, U, Fu, M, Holm Orndahl, L, Johansson, A, Lindgren, M, Nemeczek, C, Prantare, H, Roussine, V, Stehn, G, Stenberg, A, Vasko, P, Bazylevych, A, Dyadyk, Oi, Dzyak, Gv, Girina, Om, Ignatenko, Ga, Kononenko, Lg, Kubyshkin, Vf, Kuryata, Ov, Parkhomenko, An, Perepelytsya, Mv, Pertseva, To, Popik, G, Rishko, Mv, Sakharchuk, Ii, Tseluyko, Vi, Tykhonova, Sa, Vizir, V, Voronkov, Lg, Al Khaja, N, Almahmeed, Wa, Bazargani, N, Adgey, Aa, Al Mohammad, A, Banerjee, P, Barlow, M, Bridges, Ab, Brooks, N, Connolly, Ec, Denvir, Ma, Egdell, Rm, Kardos, A, Keeling, Pj, Khokhar, Aa, Senior, R, Williams, Sg, Anand, I, Anderson, Jl, Berk, Mr, Bertolet, Bd, Bisognano, Jd, Blonder, Rd, Breburda, C, Canaday, Db, Capodilupo, Rc, Choiunard, Md, Colucci, W, Dahiya, Rj, Dunlap, Sh, Essandoh, Lk, Flores, Ar, Henderson, Da, Herzog WR, Jr, Katz, Rj, Kosinski, Ej, Labin, In, Lally, Fl, Lash, Ja, McGrew FA, 3rd, Mohiuddin, Sm, Moraes, D, Murali, Sc, Nallasivan, M, Philbin, E, Prabhu, S, Primack, D, Ramani, R, Rawitscher, D, Sangrigoli, R, Schamalfuss, Cm, Stoletniy, L, Strong, Mh, Thadani, U, Treasure CB, 2nd, Vicari, Rm, Vogel, Cd, Wlsh, Mn, Wencker, D, Wilson, Sa, Winkel, E, Wiseman, Ah, Zoiopoulos, Ly, Mancebo, Jr, Mendoza, I, and Waich, S. T.
Published: 2011

4. EUROASPIRE III. Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries

Author: Kotseva, K., Wood D, De Backer G, De Bacquer D, Pyörälä K, Reiner, Željko, Keil U, EUROASPIRE Study Group. Collaborators: Pyörälä K, Ambrosio GB, Cokkinos D, Deckers JW, Dzerve V, Fraz Z, Gaita D, Gotcheva N, Graham I, Kotseva K, Laucevicius A, Lehto S, McGregor K, Nicolaides P, Oganov R, Ostör E, Pajak A, Simon J, Tokgözoğlu L, De Velasco J, Jenning C, Xenikaki D, Winnicki J, Manini M, Bramley C, Boulle C, Taylor C, Sundvall J, Lund L, De Sutter J, Piessens V, Van den Abbeele H, Dierickx E, Muylaert P, Present L, Braeckman M, Bruggeman H, Debackere P, Heytens S, Deleu K, Behaeghe P, Van De Wiele J, Van Aelst F, Taragola H, Spenninck E, Verkinderen B, Van Baeveghem S, De Waele B, De Waele C, Calis B, Schiettecatte V, Vermaercke C, Willems S, Van Imschoot K, De Vriese M, Maudens P, Maudens F, Georgiev B, Kastamanov R, Toneva K, Pavlov T, Stoev I, Alexandrov A, Miladinov A, Valterova A, Bergman-Marković, Biserka, Vinter-Repalust, Nevenka, Cerovečki Nekić, Venija, Soldo, Dragan, Petriček, Goranka, Ožvačić Adžić, Zlata, Marijić Gordana, Saloranta P, Savolainen J, Helminen EE, Heidrich J, Prugger C, Wellmann J, Neiteler G, Kalic M, Siebert E, Brand-Herrmann SM, Telgmann R, Barth F, Berger U, Briefs HJ, Degener L, Friedewald W, Heinemann-Vechtel O, Hüning U, Kalbfleisch C, Krösmann M, Neugebauer U, Noack KH, Richter-Millers B, Schuster A, Wahle K, Vanuzzo D, Mirolo R, Pilotto L, Zamaro G, Adinolfi V, Da Porto M, Gubiani M, Canciani L, Hansone S, Gozite A, Liepa L, Veze I, Putane L, Ecina V, Aija Rubine I, Rozkova N, Bricina N, Erglis A, Kawecka-Jaszcz K, Wolfshaut-Wolak R, Jankowski P, Windak A, Krzysztoń J, Makowiec-Dyrda M, Giza B, Sadek-Ratajewicz J, Sobalski T, Korman, Tomislav, Pop M, Buzulica C, Cicala C, Nicoara M, Zarici I, Iurciuc M, Iurciuc S, Roman C, Gavruta M, Breteanu L, Avram CA, Sarau CA, Avram C, Craciun L, Fras Z, Fras-Stefan T, Dovc M, Celan-Lucu B, Kralj S, Jurkovic G, Fonda A, Bercic MM, Maiques A, Mendez G, Buigues C, Montero N, Amoraga A, Bonet Y, Cuevas R, Torres Y, De Vries H, Koul B, Fellowes D, Sleight C, Purwar R, Harrison M, Saini S, Walton I, Thomas S, Igbanoi J, Bello F, Elgamel V, and Kudyba M.
Subjects: Male, medicine.medical_specialty, Epidemiology, Cross-sectional study, medicine.medical_treatment, General Practice, MEDLINE, Risk Assessment, Asymptomatic, Risk Factors, Diabetes mellitus, Environmental health, EUROASPIRE, guidelines, primary prevention, Preventive Health Services, Weight Loss, Diabetes Mellitus, medicine, Humans, Hypoglycemic Agents, Practice Patterns, Physicians', Antihypertensive Agents, Aged, Dyslipidemias, Hypolipidemic Agents, Retrospective Studies, Asymptomatic Diseases, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, Europe, Cross-Sectional Studies, Treatment Outcome, Cardiovascular Diseases, Health Care Surveys, Hypertension, Practice Guidelines as Topic, Physical therapy, Smoking cessation, Female, Smoking Cessation, Guideline Adherence, medicine.symptom, Cardiology and Cardiovascular Medicine, Risk assessment, business, Risk Reduction Behavior
Abstract: Objective was to determine whether the 2003 Joint European Societies' guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been followed in general practice. Design was Cross-sectional survey. The EUROASPIRE survey was carried out in 2006-2007 in 66 general practices in 12 European countries. Patients without a history of coronary or other atherosclerotic disease either started on antihypertensive and/or lipid-lowering and/or antidiabetes treatments were identified retrospectively, interviewed and examined at least 6 months after the start of medication. Four thousand, three hundred and sixty-six high- risk individuals (57.7% females) were interviewed (participation rate 76.7%). Overall, 16.9% smoked cigarettes, 43.5% had body mass index ≥30 kg/m, 70.8% had blood pressure ≥140/90 mmHg (≥130/80 in people with diabetes mellitus), 66.4% had total cholesterol ≥5.0 mmol/l (≥4.5 mmol/l in people with diabetes) and 30.2% reported a history of diabetes. The risk factor control was very poor, with only 26.3% of patients using antihypertensive medication achieving the blood pressure goal, 30.6% of patients on lipid-lowering medication achieving the total cholesterol goal and 39.9% of patients with self-reported diabetes having haemoglobin A1c ≤6.1%. The use of blood pressure- lowering medication in people with hypertension was: β-blockers 34.1%, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers 60.8%, calcium channel blockers 26.3%, diuretics 36.9%. Statins were prescribed in 47.0% of people with hypercholesterolemia. About 22.0% of all patients were on aspirin or other antiplatelet medication. The EUROASPIRE III survey in general practice shows that the lifestyle of people being treated as high cardiovascular risk is a major cause of concern with persistent smoking and high prevalence of both obesity and central obesity. Blood pressure, lipid and glucose control are completely inadequate with most patients not achieving the targets defined in the prevention guidelines. Primary prevention needs a systematic, comprehensive, multidisciplinary approach, which addresses lifestyle and risk factor management by general practitioners, nurses and other allied health professionals, and a health care system which invests in prevention.
Published: 2010
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5. Residual thrombosis on ultrasonography to guide the duration of anticoagulation in patients with deep venous thrombosis: a randomized trial

Author: Prandoni, P, Prins, Mh, Lensing, Aw, Ghirarduzzi, A, Ageno, W, Imberti, D, Scannapieco, G, Ambrosio, Gb, Pesavento, R, Cuppini, S, Quintavalla, R, Agnelli, Giancarlo, and Aesopus, Investigators
Published: 2009

6. Role of body mass index in the prediction of all cause mortality in over 62000 men and women. The Italian RIFLE Pooling Project

Author: SECCARECCIA F, LANTI M, MENOTTI A, SCANGA M, THE RIFLE RESEARCH GROUP, FARCHI G, CONTI S, MARENCO G, FALCHERO M, FERRARIO M, CESANA GC, TENCONI MT, MUSSI A, DOBRILLA G, DE PETRIS G, ANGELINI GP, OCKOLICSANYI L, TOSO S, AMBROSIO GB, BITTOLO BON G, ALESSANDRINI P, FERUGLIO GA, VANUZZO D, CARULLI N, SALVIOLI GF, GADDI A, D'ADDARO S, ALVISI V, BUZZELLI GP, GIACCHI M, LAURENZI M, SPAGNOLO A, RICCI G, ANTONINI R, ANGELICO F, LALLONI L, ATTILI AF, URBINATI GC, GIAMPAOLI S, MANCINI M, PANICO S, FARINARO E, ALBANO O, MISCIAGNA G, MUNTONI S, STABILINI L, AVELLONE G, DI GARBO G., DEVOTI, Gabriele, Seccareccia, F, Lanti, M, Menotti, A, Scanga, M, THE RIFLE RESEARCH, Group, Farchi, G, Conti, S, Marenco, G, Falchero, M, Ferrario, M, Cesana, Gc, Tenconi, Mt, Mussi, A, Devoti, Gabriele, Dobrilla, G, DE PETRIS, G, Angelini, Gp, Ockolicsanyi, L, Toso, S, Ambrosio, Gb, BITTOLO BON, G, Alessandrini, P, Feruglio, Ga, Vanuzzo, D, Carulli, N, Salvioli, Gf, Gaddi, A, D'Addaro, S, Alvisi, V, Buzzelli, Gp, Giacchi, M, Laurenzi, M, Spagnolo, A, Ricci, G, Antonini, R, Angelico, F, Lalloni, L, Attili, Af, Urbinati, Gc, Giampaoli, S, Mancini, M, Panico, S, Farinaro, E, Albano, O, Misciagna, G, Muntoni, S, Stabilini, L, Avellone, G, and DI GARBO, G.
Published: 1998

7. Prevalence of type 2 diabetes among patients with hypertension under the care of 30 Italian clinics of hypertension: results of the (Iper)tensione and (dia)bete study

Author: Lonati, C, Morganti, A, Comarella, L, Mancia, G, Zanchetti, A, IPERDIA STUDY GROUP (ABATE, G, AGABITI ROSEI, E, Ambrosio, Gb, Ambrosioni, E, Bellini, G, Cavatorta, A, Cerasola, G, Cereda, Ug, DE DIVITIIS, O, Ferrari, A, Lechi, A, Leonetti, G, Martines, C, Nami, R, Pagani, M, Palatini, P, Pasotti, C, Pirrelli, A, Portaluppi, F, Rappelli, A, Salvetti, A, Santucci, A, Vanuzzo, D, Veglio, Franco, Venco, A, Volpe, M., LONATI C, MORGANTI A, COMARELLA L, MANCIA G, ZANCHETTI A, CERASOLA G, and THE IPERDIA STUDY GROUP
Subjects: Blood Glucose, Male, medicine.medical_specialty, hypertension, Physiology, Blood Pressure, diabetes, prevalence, Type 2 diabetes, Ambulatory Care Facilities, Cohort Studies, chemistry.chemical_compound, Risk Factors, Internal medicine, Diabetes mellitus, Prevalence, Internal Medicine, medicine, Humans, Outpatient clinic, Aged, Creatinine, Glucose tolerance test, Diabete di tipo 2, ipertensione arteriosa, medicine.diagnostic_test, business.industry, Glucose Tolerance Test, Middle Aged, medicine.disease, Blood pressure, Endocrinology, Diabetes Mellitus, Type 2, Italy, chemistry, Female, Microalbuminuria, Cardiology and Cardiovascular Medicine, business, Cohort study
Abstract: BACKGROUND AND PURPOSE Hypertension is known to be highly prevalent among patients with diabetes and associated with an increased risk of cardiovascular damage. In contrast, relatively few investigations have addressed the prevalence of diabetes among patients with hypertension. The purpose of the present study was to examine the prevalence of type 2 diabetes, the effectiveness of hypertension and diabetes control and the association with other cardiovascular risk factors and previous cardiovascular diseases in a cohort of patients with hypertension referred to 30 hospital outpatient clinics for the treatment of hypertension. METHODS AND PATIENTS Patients were considered as having diabetes if they were already on an antidiabetic treatment either with diet or medications. All other patients had fasting plasma glucose measured on two separate occasions and were classified as having diabetes if both values were at least 140 mg/dl (7.8 mmol/l) and as not having diabetes if both values were less than 110 mg/dl (6.1 mmol/l). In patients with a single determination of at least 110 mg/dl, the final diagnosis of diabetes was established according to the result of an oral glucose tolerance test. A secondary definition of diabetes was also used, that is two fasting plasma glucose values of at least 126 mg/dl (7.0 mmol/l). In all patients, serum total, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, fasting serum triglycerides, serum creatinine and urinary albumin were also evaluated. RESULTS AND CONCLUSION Among the 1397 recruited patients, 242 (17.3%) were diagnosed as having diabetes according to the primary definition and 244 (17.5%) according to the secondary definition. In 195 out of the 242 (14%), the diagnosis was already known whereas, in the remaining 47 (3.3%), it was made de novo. In 61.4% of those already having diabetes, plasma glucose was at least 140 mg/dl (7.8 mmol/l), whereas only in 8.4% of them was it less than 110 mg/dl (6.1 mmol/l). Patients with diabetes were older, heavier and with a greater familiar predisposition. Patients with diabetes had higher values of systolic blood pressure than individuals without diabetes (150 +/- 17 vs. 144 +/- 16 mmHg, respectively; P < 0.001), lower high-density lipoprotein cholesterol and higher triglycerides and microalbuminuria. Overall, among patients with hypertension and diabetes, only 3% had blood pressure and HbA1c within the recommended limits. The prevalence of previous cardiovascular disorders was two to three times higher than among individuals without diabetes.
Published: 2008

8. Diabetes and coronary risk factors. Relative risk for single factors and aggregation of more factors in a general population sample from northern Italy

Author: Ambrosio Gb, Maria Gioia Stefanini, Paolo Zanchi, Sergio Zamboni, Laura Dissegna, Domenico Fedele, Marina Vanin, Simone Tasso, and Piero Spandri
Subjects: Adult, Male, Rural Population, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Blood Pressure, Coronary Disease, Body Mass Index, Diabetes Complications, chemistry.chemical_compound, Sex Factors, Endocrinology, Risk Factors, Diabetes mellitus, Internal medicine, Epidemiology, Internal Medicine, medicine, Humans, Triglycerides, Cholesterol, business.industry, Smoking, Age Factors, Coronary risk factors, General Medicine, Middle Aged, medicine.disease, Northern italy, Blood pressure, Italy, chemistry, Relative risk, Female, business, Body mass index
Abstract: In the course of a general population survey in Mirano (Venice), Northern Italy, a random sample of 1,903 subjects (50.1% men) aged 20-59 was examined. Fifty-five were diabetic (fasting plasma glucose greater than or equal to 140 mg/dl or diagnosed by a physician) and 1,670 non-diabetic subjects (fasting plasma glucose below 110 mg/dl). In this paper an assessment was made on the more frequent occurrence of coronary risk factors (serum cholesterol and triglycerides, body mass index (BMI), systolic blood pressure, cigarette smoking) and, in particular, of their aggregation in diabetic patients as compared to non-diabetic controls. The occurrence of any one of the coronary risk factors studied was more frequent in diabetic subjects and significantly so for triglyceridemia in both sexes and for systolic blood pressure and BMI in men. The aggregation of two or more risk factors was also more frequent in diabetic subjects than controls. Finally, the combined score of coronary risk as calculated by multiple logistic function showed higher values for diabetic subjects. These results confirm the need for a systematic search for coronary risk factors in diabetic subjects in order to prevent cardiovascular complications.
Published: 1990
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9. Electrocardiographic Minnesota Code findings predicting short-term mortality in asymptomatic subjects. The Italian RIFLE Pooling Project (Risk Factors and Life Expectancy)

Author: MENOTTI A, SECCARECCIA F, THE RIFLE RESEARCH GROUP, LANTI M, FARCHI G, CONTI S, DIMA F, SCANGA M, MARENCO G, FALCHERO M, FERRARIO M, CESANA GC, TENCONI MT, LADDOMADA MS, DOBRILLA G, DE PETRIS G, ANGELINI GP, OCKOLICSANYI L, TOSO S, AMBROSIO GB, BITTOLO BON G, ALESSANDRINI P, FERUGLIO GA, VANUZZO D, CARULLI N, SALVIOLI GF, GADDI A, D'ADDATO S, ALVISI V, BUZZELLI GP, GIACCHI M, LAURENZI M, SPAGNOLO A, RICCI G, ANTONINI R, ANGELICO F, LALLONI L, ATTILI AF, URBINATI GC, GIAMPAOLI S, MANCINI M, PANICO S, FARINARO E, ALBANO O, MISCIAGNA G, MUNTONI S, STABILINI L, AVELLONE G, DI GARBO G. ., DEVOTI, Gabriele, Menotti, A, Seccareccia, F, THE RIFLE RESEARCH, Group, Lanti, M, Farchi, G, Conti, S, Dima, F, Scanga, M, Marenco, G, Falchero, M, Ferrario, M, Cesana, Gc, Tenconi, Mt, Laddomada, M, Devoti, Gabriele, Dobrilla, G, DE PETRIS, G, Angelini, Gp, Ockolicsanyi, L, Toso, S, Ambrosio, Gb, BITTOLO BON, G, Alessandrini, P, Feruglio, Ga, Vanuzzo, D, Carulli, N, Salvioli, Gf, Gaddi, A, D'Addato, S, Alvisi, V, Buzzelli, Gp, Giacchi, M, Laurenzi, M, Spagnolo, A, Ricci, G, Antonini, R, Angelico, F, Lalloni, L, Attili, Af, Urbinati, Gc, Giampaoli, S, Mancini, M, Panico, S, Farinaro, E, Albano, O, Misciagna, G, Muntoni, S, Stabilini, L, Avellone, G, and DI GARBO, G. .
Published: 1997

10. Syndrome X: prevalence in a large population-based study

Author: LIU J, TREVISAN M, MENOTTI A, THE RIFLE RESEARCH GROUP, LANTI M, FARCHI G, CONTI S, SECCARECCIA F, DIMA F, SCANGA M, MARENCO G, FALCHERO M, FERRARIO M, CESANA GC, TENCONI MT, LADDOMADA MS, DOBRILLA G, DE PETRIS G, ANGELINI GP, OCKOLICSANYI L, TOSO S, AMBROSIO GB, BITTOLO BON G, ALESSANDRINI P, FERUGLIO GA, VANUZZO D, CARULLI N, SALVIOLI GF, GADDI A, D'ADDARO S, ALVISI V, BUZZELLI GP, GIACCHI M, LAURENZI M, SPAGNOLO A, RICCI G, ANTONINI R, ANGELICO F, LALLONI L, ATTILI AF, URBINATI GC, GIAMPAOLI S, MANCINI M, PANICO S, FARINARO E, ALBANO O, MISCIAGNA G, MUNTONI S, STABILINI L, AVELLONE G, DI GARBO G. ., DEVOTI, Gabriele, Liu, J, Trevisan, M, Menotti, A, THE RIFLE RESEARCH, Group, Lanti, M, Farchi, G, Conti, S, Seccareccia, F, Dima, F, Scanga, M, Marenco, G, Falchero, M, Ferrario, M, Cesana, Gc, Tenconi, Mt, Laddomada, M, Devoti, Gabriele, Dobrilla, G, DE PETRIS, G, Angelini, Gp, Ockolicsanyi, L, Toso, S, Ambrosio, Gb, BITTOLO BON, G, Alessandrini, P, Feruglio, Ga, Vanuzzo, D, Carulli, N, Salvioli, Gf, Gaddi, A, D'Addaro, S, Alvisi, V, Buzzelli, Gp, Giacchi, M, Laurenzi, M, Spagnolo, A, Ricci, G, Antonini, R, Angelico, F, Lalloni, L, Attili, Af, Urbinati, Gc, Giampaoli, S, Mancini, M, Panico, S, Farinaro, E, Albano, O, Misciagna, G, Muntoni, S, Stabilini, L, Avellone, G, and DI GARBO, G. .
Published: 1997

11. Mean levels and distributions of some cardiovascular risk factors in Italy in the 1970's and the 1980's. The Italian RIFLE Pooling Project. Risk Factors and Life Expectancy

Author: MENOTTI A, SECCARECCIA F, LANTI M, THE RIFLE PROJECT RESEARCH GROUP, FARCHI G, CONTI S, DIMA F, SCANGA M, MARENCO G, FALCHERO M, IDEO G, PODDA M, FERRARIO M, CESANA GC, TENCONI MT, MUSSI A, DOBRILLA G, DE PETRIS G, ANGELINI GP, OCKOLICSANYI L, TOSO S, AMBROSIO GB, BITTOLO BON G, ALESSANDRINI P, FERUGLIO GA, VANUZZO D, CARULLI N, SALVIOLI GF, GADDI A, D'ADDARO S, ALVISI V, BUZZELLI GP, GIACCHI M, LAURENZI M, SPAGNOLO A, RICCI G, ANTONINI R, ANGELICO F, LALLONI L, ATTILI AF, URBINATI GC, GIAMPAOLI S, MANCINI M, PANICO S, FARINARO E, ALBANO O, MISCIAGNA G, MUNTONI S, STABILINI L, AVELLONE G, DI GARBO G. ., DEVOTI, Gabriele, Menotti, A, Seccareccia, F, Lanti, M, THE RIFLE PROJECT RESEARCH, Group, Farchi, G, Conti, S, Dima, F, Scanga, M, Marenco, G, Falchero, M, Ideo, G, Podda, M, Ferrario, M, Cesana, Gc, Tenconi, Mt, Mussi, A, Devoti, Gabriele, Dobrilla, G, DE PETRIS, G, Angelini, Gp, Ockolicsanyi, L, Toso, S, Ambrosio, Gb, BITTOLO BON, G, Alessandrini, P, Feruglio, Ga, Vanuzzo, D, Carulli, N, Salvioli, Gf, Gaddi, A, D'Addaro, S, Alvisi, V, Buzzelli, Gp, Giacchi, M, Laurenzi, M, Spagnolo, A, Ricci, G, Antonini, R, Angelico, F, Lalloni, L, Attili, Af, Urbinati, Gc, Giampaoli, S, Mancini, M, Panico, S, Farinaro, E, Albano, O, Misciagna, G, Muntoni, S, Stabilini, L, Avellone, G, and DI GARBO, G. .
Published: 1995

12. The prediction of coronary heart disease mortality as a function of major risk factors in over 30000 men in the Italian RIFLE Pooling Project. A comparison with the MRFIT primary screenees

Author: MENOTTI A, FARCHI G, SECCARECCIA F, THE RIFLE RESEARCH GROUP, CONTI S, GIAMPAOLI S, LANTI M, MARIOTTI S, SCANGA M, MARENCO G, FALCHERO M, IDEO G, PODDA M, FERRARIO M, CESANA GC, TENCONI MT, LADDOMADA MS, DOBRILLA G, DE PETRIS G, ANGELINI GP, OCKOLICSANYI L, TOSO S, AMBROSIO GB, BITTOLO BON G, ALESSANDRINI P, FERUGLIO GA, VANUZZO D, CARULLI N, SALVIOLI GF, GADDI A, D'ADDARO S, ALVISI V, BUZZELLI GP, GIACCHI M, LAURENZI M, SPAGNOLO A, RICCI G, ANTONINI R, ANGELICO F, LALLONI L, ATTILI AF, URBINATI GC, MANCINI M, PANICO S, FARINARO E, ALBANO O, MISCIAGNA G, MUNTONI S, STABILINI L, AVELLONE G, DI GARBO G. ., DEVOTI, Gabriele, Menotti, A, Farchi, G, Seccareccia, F, THE RIFLE RESEARCH, Group, Conti, S, Giampaoli, S, Lanti, M, Mariotti, S, Scanga, M, Marenco, G, Falchero, M, Ideo, G, Podda, M, Ferrario, M, Cesana, Gc, Tenconi, Mt, Laddomada, M, Devoti, Gabriele, Dobrilla, G, DE PETRIS, G, Angelini, Gp, Ockolicsanyi, L, Toso, S, Ambrosio, Gb, BITTOLO BON, G, Alessandrini, P, Feruglio, Ga, Vanuzzo, D, Carulli, N, Salvioli, Gf, Gaddi, A, D'Addaro, S, Alvisi, V, Buzzelli, Gp, Giacchi, M, Laurenzi, M, Spagnolo, A, Ricci, G, Antonini, R, Angelico, F, Lalloni, L, Attili, Af, Urbinati, Gc, Mancini, M, Panico, S, Farinaro, E, Albano, O, Misciagna, G, Muntoni, S, Stabilini, L, Avellone, G, and DI GARBO, G. .
Published: 1994

13. Extensive screening for occult malignant disease in idiopathic venous thromboembolism: a prospective randomized clinical trial

Author: Piccioli, A, Lensing, Awa, Prins, Mh, Falanga, A, Scannapieco, Gl, Ieran, M, Cigolini, M, Ambrosio, Gb, Monreal, M, Girolami, A, Prandoni, P, Girolami, B, Bernardi, E, Bagatella, P, Marchiori, A, Marchetti, M, Vignoli, A, Doria, S, Parisi, R, Bortoluzzi, C, Paolicelli, Mi, Filippi, F, Baggio, Elda, and Lipari, Giovanni
Subjects: venous thromboembolism, cancer, Deep venous thrombosis
Published: 2004

14. Presentation of the RIFLE Project Risk Factors and Life Expectancy

Author: THE RIFLE RESEARCH GROUP, MENOTTI A, FARCHI G, CONTI S, GIAMPAOLI S, LANTI M, MARIOTTI S, SCANGA M, SECCARECCIA F, SPAGNOLO A, VERDECCHIA A, DI CARLO G, DIMA F, MARENCO G, FALCHERO M, IDEO G, PODDA M, FERRARIO M, CESANA GC, TENCONI MT, LADDOMADA MS, DOBRILLA G, DE PETRIS G, ANGELINI GP, OCKOLICSANYI L, TOSO S, AMBROSIO GB, TASSO S, BITTOLO BON G, ALESSANDRINI P, FERUGLIO GA, VANUZZO D, CARULLI N, SALVIOLI GF, GADDI A, D'ADDATO S, DESCOVICH GC, DORMI A, BARBARA L, ALVISI V, BUZZELLI GP, GIACCHI M, LAURENZI M, RICCI G, ANTONINI R, ANGELICO F, LALLONI L, ATTILI AF, URBINATI GC, MANCINI M, PANICO S, FARINARO E, ALBANO O, MISCIAGNA G, MUNTONI S, STABILINI L, AVELLONE G, DI GARBO G. ., DEVOTI, Gabriele, THE RIFLE RESEARCH, Group, Menotti, A, Farchi, G, Conti, S, Giampaoli, S, Lanti, M, Mariotti, S, Scanga, M, Seccareccia, F, Spagnolo, A, Verdecchia, A, DI CARLO, G, Dima, F, Marenco, G, Falchero, M, Ideo, G, Podda, M, Ferrario, M, Cesana, Gc, Tenconi, Mt, Laddomada, M, Devoti, Gabriele, Dobrilla, G, DE PETRIS, G, Angelini, Gp, Ockolicsanyi, L, Toso, S, Ambrosio, Gb, Tasso, S, BITTOLO BON, G, Alessandrini, P, Feruglio, Ga, Vanuzzo, D, Carulli, N, Salvioli, Gf, Gaddi, A, D'Addato, S, Descovich, Gc, Dormi, A, Barbara, L, Alvisi, V, Buzzelli, Gp, Giacchi, M, Laurenzi, M, Ricci, G, Antonini, R, Angelico, F, Lalloni, L, Attili, Af, Urbinati, Gc, Mancini, M, Panico, S, Farinaro, E, Albano, O, Misciagna, G, Muntoni, S, Stabilini, L, Avellone, G, and DI GARBO, G. .
Published: 1993

15. Incidence of cancer after a first episode of idiopathic venous thromboembolism treated with 3 months or 1 year of oral anticoagulation

Author: Taliani, Mr, Agnelli, G, Prandoni, Paolo, Becattini, C, Moia, M, Bazzan, M, Ageno, W, Tomasi, C, Guazzaloca, G, Ambrosio, Gb, Bertoldi, A, Salvi, R, Poggio, R, and Silingardi, M.
Published: 2003

16. Blood pressure and metabolic profile after surgical menopause: comparison with fertile and naturally-menopausal women

Author: Andrea Pavei, Ambrosio Gb, Antonio Piccoli, Achille C. Pessina, Edoardo Casiglia, A Pizziol, G Ginocchio, Valérie Tikhonoff, Daniele D'Este, and Alberto Mazza
Subjects: Adult, Blood Glucose, medicine.medical_specialty, Adolescent, Ovariectomy, Population, Blood Pressure, Coronary artery disease, Surgical Menopause, Internal Medicine, Humans, Medicine, Longitudinal Studies, Myocardial infarction, Risk factor, education, Gynecology, education.field_of_study, business.industry, Obstetrics, Incidence (epidemiology), Middle Aged, Prognosis, medicine.disease, Lipids, Menopause, Cross-Sectional Studies, Blood pressure, Female, business, Follow-Up Studies
Abstract: In 1978 a random sample (367 men and 568 women aged 18-65 years) taken from the general population of a north-eastern Italian town was screened for cardiovascular risk; 16 years later, the women were invited to a second screening. Three groups were identified at the initial screening (fertile, naturally menopausal and surgically menopausal) and four in the longitudinal study (137 remained fertile during the whole study, 205 became naturally menopausal, 56 were ovariectomised and 127 were already going through the menopause). The protocol included a questionnaire, blood pressure (BP) measurement, and blood exams. Continuous variables were adjusted for confounders. Systolic BP, prevalence of hypertension, cholesterol, glycaemia and uricaemia were similar, whereas diastolic and triglycerides (TG) were lower in surgically-menopausal than in fertile women (P0.001). No significant difference in 16 years' variation from baseline was observed between the four groups, although women who remained fertile showed the smallest increases. In particular, neither systolic or diastolic BP increases differed between the women who were oophorectimised and those who remained fertile. 'Fertile status' was rejected from the logistic equation of incidence of hypertension, and 'age of menopause' was also rejected when this analysis was repeated in ovariectomised women. New coronary artery disease (angina pectoris or myocardial infarction) was observed in one ovariectomised woman, in three naturally menopausal, and in 13 already menopausal women which seemed to reflect the age trend. No new cases were observed in women who remained fertile. In conclusion, in Italian women surgical menopause, similarly to natural menopause, is devoid of any negative prognostic effect. Journal of Human Hypertension (2000) 14, 799-805
Published: 2000

17. PRESENTATION OF THE RIFLE PROJECT RISK-FACTORS AND LIFE EXPECTANCY

Author: Menotti, A., Farchi, G., Conti, S., Giampaoli, S., Lanti, M., Mariotti, S., Scanga, M., Seccareccia, F., Spagnolo, A., Verdecchia, A., Dicarlo, G., Dima, F., Marenco, G., Falchero, M., Ideo, G., Caspani, B., Podda, M., Zuin, M., Ferrario, M., Cesana, Gc, Devito, G., Sega, R., Tenconi, Mt, Laddomada, Ms, Devoti, G., Dobrilla, G., Depetris, G., Angelini, Gp, Okolicsanyi, L., Toso, S., Nassuato, G., Passera, D., Ambrosio, Gb, Tasso, S., Bittolobon, G., Moro, E., Alessandrini, P., Soldan, S., Feruglio, Ga, Vanuzzo, D., Pilotto, L., Carulli, N., Loria, P., Dilengite, M., Bozzoli, M., Salvioli, Gf, Lugli, R., Gaddi, A., Sangiorgi, Z., Daddato, S., Minardi, A., Descovich, Gc, Dormi, A., Barbara, L., Festi, D., Alvisi, V., Balhous, W., Buzzelli, Gp, Giusti, A., Giacchi, M., Fatighenti, D., Giotti, M., Laurenzi, M., Ricci, G., Bucci, A., Antonini, R., Pacioni, F., Angelico, F., Delben, M., Lalloni, L., Azzarri, L., Ricci, P., Attili, Fa, Desantis, A., Urbinati, Gc, Fazio, S., Pannozzo, F., Sotis, Gl, Righetti, Gm, Mancini, M., Farinaro, E., Panico, S., Trevisan, M., Krogh, V., Jossa, F., Celentano, E., Rocco Galasso, Albano, O., Palasciano, G., Misciagna, G., Guerra, V., Muntoni, S., Pintus, P., Podda, E., Stabilini, M., Frulio, T., Brotzu, G., Pulina, S., Trudu, A., Sanna, A., Baule, Gm, Avellone, G., and Digarbo, V.
Subjects: RISK FACTORS, LIFE EXPECTANCY, MORTALITY, PREDICTION
Published: 1993

18. Effects induced by olive oil-rich diet on erythrocytes membrane lipids and sodium-potassium transports in postmenopausal hypertensive women

Author: S. Ferrari, Roberto Corrocher, Alberto Gandini, Ambrosio Gb, Antonella Bassi, Patrizia Guarini, Domenico Girelli, Oliviero Olivieri, D. Piccolo, and Antonio Pagnan
Subjects: medicine.medical_specialty, Cell Membrane Permeability, Chromatography, Gas, Diet therapy, Endocrinology, Diabetes and Metabolism, Membrane lipids, Blood Pressure, Lithium, chemistry.chemical_compound, Membrane Lipids, Endocrinology, Dietary Fats, Unsaturated, Internal medicine, medicine, Humans, Plant Oils, Na+/K+-ATPase, Olive Oil, Unsaturated fatty acid, chemistry.chemical_classification, Erythrocyte Membrane, Fatty Acids, Sodium, Fatty acid, Middle Aged, Diet, Oleic acid, chemistry, Hypertension, Potassium, Female, Sodium-Potassium-Exchanging ATPase, Cation transport, Polyunsaturated fatty acid
Abstract: Since we have observed that mo-nounsaturated fatty acids (MUFA) enriched diet modifies red cell membrane lipids and cation transport systems in normotensive subjects, we similarly evaluated a group of hypertensive patients undergoing an analogous dietary modification. In a group of 18 moderately hypertensive women, the diet was supplemented for two months with olive oil (about 45 g/day), which replaced an equal amount of seasoning fats. Before and after this period, red cell fatty acid composition was evaluated by gas-chromatography in order to verify diet compliance: a significant increase in oleic acid was observed, while the content of saturated and polyunsaturated fatty acids remained unchanged. After olive oil, maximal rates of Na-K pump (5580±329 vs 6995±390, plt;0.001) and Na-K cotransport ( Na-COT 544±52 vs 877±46, plt;0.001: K-COT 790±76 vs 1176±66, plt;0.001), cell Na content (9.58+0.4 vs 10.61 ±0.6, plt;0.03) and passive permeability for Na (936±74 vs 1836±102, plt;0.001 ) rose significantly. Although the reduction in maximal rate of the Li-Na CT after olive oil was not significant, it was the only cation transport parameter being correlated with the variations of membrane lipids, namely negatively with UFA (r=-0.528, plt;0.05) and positively with SFA (r=0.482, plt;0.005). The change in maximal rate of Li-Na CT was also correlated with the variation of systolic and diastolic BP (r=0.50, plt;0.03). No changes in membrane lipid composition and ion transport systems were observed in a group of 13 control patients kept on usual diet over the same period. Thus, olive oil supplementation affects the lipid composition of the cell membrane in hypertension. This change is in turn associated with a modification of membrane transport activity; in addition a significant reduction of blood pressure is obtained.
Published: 1992

19. Diabetes mellitus and lifestyle in a north Italian population

Author: Simone Tasso, Sergio Zamboni, Marina Vanin, Ambrosio Gb, Laura Riva, and Domenico Fedele
Subjects: Adult, Rural Population, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, Physical activity, General Medicine, Middle Aged, medicine.disease, Italian population, Environmental agent, Body Mass Index, Endocrinology, Drinking habits, Italy, Environmental health, Diabetes mellitus, Epidemiology, Internal Medicine, medicine, Diabetes Mellitus, Prevalence, Humans, business, Life Style
Abstract: The prevalence of diabetes mellitus shows an enormous variability between different countries and even within the same country [l-4]. While part of these differences can be accounted for by a number of different methodological factors, they also reflect real genetic and environmental dtierences. ‘Diabetes Epidemiology Research International’ has recently emphasized the latter, stating that ‘the challenge for the next decade is to track down the environmental agent(s) because this is likely to be the best strategy for preventing diabetes’ [ 51. This is a formidable task in which epidemiological investigation can demonstrably provide a major contribution. In Italy wide dilferences have been reported in the rate of occurrence of some diseases according to latitude and hence
Published: 1990

20. Blood pressure control and knowledge of target blood pressure in coronary patients across Europe: results from the EUROASPIRE III survey.

Author: Prugger C, Keil U, Wellmann J, de Bacquer D, de Backer G, Ambrosio GB, Reiner Z, Gaita D, Wood D, Kotseva K, Heidrich J, and EUROASPIRE III Study Group
Published: 2011
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21. Residual thrombosis on ultrasonography to guide the duration of anticoagulation in patients with deep venous thrombosis: a randomized trial.

Author: Prandoni P, Prins MH, Lensing AW, Ghirarduzzi A, Ageno W, Imberti D, Scannapieco G, Ambrosio GB, Pesavento R, Cuppini S, Quintavalla R, Agnelli G, AESOPUS Investigators, Prandoni, Paolo, Prins, Martin H, Lensing, Anthonie W A, Ghirarduzzi, Angelo, Ageno, Walter, Imberti, Davide, and Scannapieco, Gianluigi
Abstract: Background: The optimal duration of oral anticoagulant therapy in patients with deep venous thrombosis (DVT) of the lower extremities remains uncertain.Objective: To assess whether tailoring the duration of anticoagulation on the basis of the persistence of residual thrombi on ultrasonography reduces the rate of recurrent venous thromboembolism (VTE) compared with the administration of conventional fixed-duration treatment in adults with proximal DVT.Design: Parallel, randomized trial from 1999 to 2006. Trained physicians who assessed outcomes were blinded to patient assignment status, but patients and providers were not.Setting: 9 university or hospital centers in Italy.Patients: 538 consecutive outpatients with a first episode of acute proximal DVT at completion of an uneventful 3-month period of anticoagulation.Intervention: Patients were randomly assigned (stratified by center and secondary vs. unprovoked DVT by using a computer-generated list that was accessible only to a trial nurse) to fixed-duration anticoagulation (no further anticoagulation for secondary thrombosis and an extra 3 months for unprovoked thrombosis) or flexible-duration, ultrasonography-guided anticoagulation (no further anticoagulation in patients with recanalized veins and continued anticoagulation in all other patients for up to 9 months for secondary DVT and up to 21 months for unprovoked thrombosis). For the primary outcome assessment, 530 patients completed the trial.Measurements: The rate of confirmed recurrent VTE during 33 months of follow-up.Results: Overall, 46 (17.2%) of 268 patients allocated to fixed-duration anticoagulation and 32 (11.9%) of 270 patients allocated to flexible-duration anticoagulation developed recurrent VTE (adjusted hazard ratio [HR], 0.64 [95% CI, 0.39 to 0.99]). For patients with unprovoked DVT, the adjusted HR was 0.61 (CI, 0.36 to 1.02) and 0.81 (CI, 0.32 to 2.06) for those with secondary DVT. Major bleeding occurred in 2 (0.7%) patients in the fixed-duration group and 4 (1.5%) patients in the flexible-duration group (P = 0.67).Limitations: The trial lacked a double-blind design. The sample size was not powered to detect differences in bleeding between groups and to detect effectiveness of the intervention in the subgroups of patients with unprovoked and secondary DVT. Patients with previous thromboembolism, permanent risk factors for thrombosis, and thrombophilic abnormalities other than factor V Leiden and prothrombin mutation were excluded.Conclusion: Tailoring the duration of anticoagulation on the basis of ultrasonography findings reduces the rate of recurrent VTE in adults with proximal DVT.Primary Funding Source: None. [ABSTRACT FROM AUTHOR]
Published: 2009
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22. Blood pressure is insufficiently controlled in European patients with established coronary heart disease.

Author: Boersma E, Keil U, De Bacquer D, De Backer G, Pyörälä K, Poldermans D, Leprotti C, Pilotto L, de Swart E, Deckers JW, Heidrich J, Sans S, Kotseva K, Wood D, Ambrosio GB, EUROASPIRE I and II Study Groups, Boersma, Eric, Keil, Ulrich, De Bacquer, Dirk, and De Backer, Guy
Published: 2003
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23. 90012096 Effects induced by olive oil-rich diet on erythrocytes membrane lipids and sodium-potassium transports in postmenopausal hypertensive women

Author: A. Bassi, Antonio Pagnan, P. Guarini, D. Piccolo, Oliviero Olivieri, S. Ferrari, Ambrosio Gb, Alberto Gandini, Domenico Girelli, and R. Corrocher
Subjects: Biochemistry, chemistry, business.industry, Sodium, Potassium, Erythrocytes membrane, Obstetrics and Gynecology, chemistry.chemical_element, Medicine, Food science, business, General Biochemistry, Genetics and Molecular Biology, Olive oil
Published: 1993
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24. Isolated Systolic Hypertension in the Community. Data From a Population Survey and Hypertension Register in Northern Italy

Author: Pilotto L, Ambrosio Gb, Dal Palù C, and Sergio Zamboni
Subjects: Adult, Male, medicine.medical_specialty, Pediatrics, Systole, Systolic hypertension, Population, Diastole, Diastolic Hypertension, Prehypertension, Internal medicine, Heart rate, Internal Medicine, medicine, Humans, Registries, education, education.field_of_study, business.industry, Smoking, Middle Aged, medicine.disease, Cross-Sectional Studies, Blood pressure, Italy, Hypertension, Female, business, Body mass index
Abstract: In the Region Veneto, north-eastern Italy, a survey of three random samples of population aged 20-64 has been made during the initial phase of the international cooperative pilot project called "Community Control Programme of Hypertension", promoted by World Health Organization. 15,187 subjects were examined (47.2% males). The prevalence of "isolated" systolic hypertension (ISH: "casual" blood pressure at or above 160 for systolic readings and below 95 for diastolic) was 6.2%, that of "isolated" diastolic (IDH) 9% and that of "simultaneous" systolic diastolic hypertension (SDH) 15.5%. ISH had an awareness rate of 29.4% and a treatment rate of 10.6%, which is less than for SDH but more than IDH. Analysis of the Hypertension Register set up in one of the three areas showed no important differences in heart rate, Body Mass Index, serum sodium or potassium, B.U.N. and total cholesterol between the different forms of hypertension. The assessment of coronary risk by means of Multiple Logistic Function yielded similar figures for ISH and SDH in males, higher figure for SDH in females. Electrocardiographic changes of left ventricular hypertrophy and of ischaemia were more frequent among subjects with ISH than those with SDH and IDH. It is concluded that ISH is present in a substantial proportion of the population and carries with it no less risk of cardiovascular complications than the other forms of hypertension.
Published: 1982
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25. Precursors of atherosclerosis in children: The Cittadella study. Follow-up and tracking of total serum cholesterol, triglycerides, and blood glucose

Author: Paolo Mormino, Franco Cappelletti, Enrico Barbieri, Pietro Maiolino, Antonio Pagnan, Ambrosio Gb, Cesare Dal Palù, Mario Vincenzi, and Licia Gerin
Subjects: Blood Glucose, Male, Risk, Percentile, medicine.medical_specialty, Adolescent, Arteriosclerosis, Epidemiology, Statistics as Topic, Age groups, Total cholesterol, Internal medicine, medicine, Humans, Longitudinal Studies, Oral glucose, Child, Triglycerides, Serum cholesterol, business.industry, Age Factors, Public Health, Environmental and Occupational Health, Northern italy, Cholesterol, Endocrinology, Italy, Female, business, Follow-Up Studies
Abstract: As part of a WHO project, precursors of atherosclerosis in children, a survey was made in Cittadella, a town in Northern Italy. Four hundred and eight children (49.7% males) aged 6, 9, 12, and 15 were examined and a blood sample for total cholesterol (TC), triglycerides (TG), and blood glucose (BG) was drawn one hour after an oral glucose load of 50 g. The same procedure was performed in the same subjects 3 years later. The mean values of TC in the age groups 6, 9, 12, and 15 were 155.2, 176.1, 191.5, 170.5 mg/dl, respectively. TG values were 54.4, 53.1, 55.8, 62.2 mg/dl and BG, 108.3, 85.2, 92.1, 97.4 mg/dl, respectively. A marked fall of TC at reexamination was found in initial age groups of 12 and 15. BG levels fell significantly only in those subjects initially examined at age 6, while TG showed a longitudinal increase in all age groups, though more markedly in the younger ones. Different body composition, and possibly a secular trend, might explain these findings. The tracking analysis showed that serum TC tends to maintain its percentile with increasing age in contrast to serum TG and BG tracking which was less consistent, suggesting the influence of factors other than those affecting changes in TC.
Published: 1982
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26. Hypertension and Neuroticism

Author: Paolo Santonastaso, Sergio Zamboni, Graziano Canton, and Ambrosio Gb
Subjects: Adult, Male, medicine.medical_specialty, Neurotic Disorders, Age and sex, medicine, Humans, Psychological testing, Hypertension diagnosis, Psychiatry, Applied Psychology, Depression (differential diagnoses), Psychological Tests, General Medicine, Awareness, Middle Aged, medicine.disease, Neuroticism, Psychiatry and Mental health, Clinical Psychology, Hypertension, Anxiety, Female, medicine.symptom, Psychology, Somatization, Stress, Psychological, Clinical psychology
Abstract: 324 normo- and hypertensive subjects were investigated for neurotic symptoms during outpatient screening for arterial hypertension. The patients were randomly selected and subdivided into three groups: 'new' hypertensives, 'old' hypertensives and normotensives. Neurotic symptoms were evaluated using the Kellner and Sheffield Symptom Rating Test. The mean values thus obtained were adjusted using covariance analysis, with age and sex as the covariants. The 'new' hypertensives scored significantly lower for total neuroticism, depression and inadequacy than the normotensives. They also differed from the 'old' hypertensives, scoring significantly lower for total neuroticism, anxiety, somatization and inadequacy. However, no differences were revealed between the 'old' hypertensives and the normotensives. The significance and implications of these psychological differences are discussed.
Published: 1984
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27. Olive-oil-enriched diet: effect on serum lipoprotein levels and biliary cholesterol saturation

Author: Ambrosio Gb, A Bonanome, Antonio Pagnan, Maurizio Muraca, Scipione Martini, Giovannella Baggio, S Ferrari, P. Guarini, D. Piccolo, and A Opportuno
Subjects: Adult, Male, medicine.medical_specialty, Apolipoprotein B, Lipoproteins, Medicine (miscellaneous), chemistry.chemical_compound, Dietary Fats, Unsaturated, Internal medicine, medicine, Bile, Humans, Plant Oils, Olive Oil, Apolipoproteins A, chemistry.chemical_classification, Nutrition and Dietetics, Apolipoprotein A-I, biology, Cholesterol, Gallbladder, Cholesterol, HDL, Cholesterol, LDL, Metabolism, medicine.anatomical_structure, Endocrinology, chemistry, biology.protein, lipids (amino acids, peptides, and proteins), Saturation (chemistry), Lipoprotein, Olive oil, Polyunsaturated fatty acid
Abstract: The effect of diet enriched with a monounsaturated fatty acid (olive oil) on serum lipoproteins, biliary cholesterol saturation index, and gallbladder motility compared with a standard low-fat diet was evaluated in 11 young volunteers admitted to a metabolic ward. A significant decrease of mean total cholesterol (-9.5%), total apo B (-7.4%), LDL cholesterol (-12.2%), and total triglycerides (-25.5%) was observed after the olive-oil-enriched diet. Total HDL- and HDL-subfractions-cholesterol levels as well as serum apo A-I mean levels remained unchanged. Cholesterol saturation index of the bile and fasting and after-meal gallbladder volumes were unaffected by the enriched diet as compared with the low-fat diet. Olive oil may be a natural fat that can be used for the control of plasma and LDL cholesterol as a valid alternative to polyunsaturated fatty acids.
Published: 1988
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28. Captopril in elderly hypertensive patients

Author: Gianfranco Botta, Sergio Zamboni, and Ambrosio Gb
Subjects: medicine.medical_specialty, business.industry, Physical fitness, Captopril, General Medicine, Surgery, Regimen, Mood, Blood pressure, Hydrochlorothiazide, Mean blood pressure, Quality of life, Anesthesia, medicine, business, medicine.drug
Abstract: In this study, 953 patients (48 percent men) more than 60 years old with mild to moderate hypertension (class I or II) were included. After a two-week wash-out period, a starting dosage of captopril--12.5 mg twice a day--was given. Patients were examined after one and three weeks and, subsequently, at monthly intervals for a total period of four months. The dosage was adjusted to a maximum of 50 mg twice a day plus, when needed, 25 mg of hydrochlorothiazide per day. Thirty-two patients were lost to follow-up, 10 withdrew because of inadequate control of blood pressure, and only 21 (2 percent) dropped out because of side effects. Mean blood pressure decreased from 184/104 to 152/87 mm Hg. The lowest dosage (25 mg a day) was sufficient to control blood pressure in 15 percent of patients, 31 percent needed 50 mg a day, and 24 percent required 100 mg a day. Hydrochlorothiazide was added to the captopril regimen in 30 percent. No substantial changes in biochemical variables or electrocardiographic results were observed. "Quality of life" (judged as physical fitness, positive well being, mood, and sexual desire) remarkably improved.
Published: 1988
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29. Comportamento di di tipo A e caratteristiche psicologiche dell'iperteso in trattamento antiipertensivo

Author: Zotti, Am, Ambroso, G, Ambrosio, Gb, Vidotto, Giulio, and DAL PALU`, C.
Published: 1989

30. Blood pressure and its spontaneous variations in a northern Italian population

Author: Bugaro L, Ambrosio Gb, C. Dal Palù, Sergio Zamboni, Gabaldo S, and R. Pigato
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Time Factors, business.industry, Community control, Blood Pressure, General Medicine, Middle Aged, Italian population, Blood pressure, Italy, Internal medicine, Regression toward the mean, Cohort, Hypertension, medicine, Cardiology, Humans, Female, business
Abstract: 1. Blood pressure has been measured in a random sample of 5852 subjects (both sexes, 20–64 years old). The prevalence of hypertension (blood pressure ≥ 160 mmHg and/or 95 mmHg; 150 mmHg and/or 90 mmHg under the age of 30 years) was 29·5%. 2. In a cohort of 972 detected hypertensive subjects, longitudinal changes (2 and 5 months after the initial examination) were evaluated. The phenomenon of regression toward the mean value was evident. 3. The implications of the variability of blood pressure in a community control programme of hypertension are discussed.
Published: 1976

31. Relationship between body weight and blood pressure and some metabolic parameters in psoriatic patients

Author: Antonio Pagnan, S. Padovan, P. Bertoli, Andrea Peserico, Roberto Cipriani, Ambrosio Gb, Zanetti G, C. Veller Fornasa, and Sergio Zamboni
Subjects: Adult, Blood Glucose, Male, medicine.medical_specialty, Population, Blood Pressure, Dermatology, Overweight, Body weight, chemistry.chemical_compound, Psoriasis, Internal medicine, medicine, Humans, education, Triglycerides, education.field_of_study, business.industry, Body Weight, Middle Aged, medicine.disease, Control subjects, Uric Acid, Endocrinology, Blood pressure, Cholesterol, Normal weight, chemistry, Uric acid, Female, medicine.symptom, business
Abstract: summary The relationship between body weight and blood pressure, total serum cholesterol, triglycerides, uric acid and glucose was investigated in 203 psoriatic patients in comparison with 904 healthy controls. In the psoriatic patients, these parameters were clearly related to their body weight. Those psoriatic patients of normal weight exhibited lower mean values of all the parameters compared with overweight psoriatic patients while they did not differ from control subjects of normal weight. Our results suggest that only overweight psoriatic patients exhibit the metabolic abnormalities frequently reported in the literature, while psoriatic patients of normal weight do not differ from the general population in this respect.
Published: 1988

32. Dietary behaviuor in psoriatic patients

Author: Zamboni, S, Zanetti, G, Grosso, G, Ambrosio, Gb, Gozzetti, S, and PESERICO STECCHINI NEGRI DE SALVI, Andrea
Published: 1989

33. Spontaneous changes in very high blood pressure after admission to the hospital and their relation to target organ involvement

Author: Cesare Dal Palù, Sergio Zamboni, Ambrosio Gb, and Renata Pigato
Subjects: Adult, Male, medicine.medical_specialty, Ambulatory blood pressure, Time Factors, Diastole, Prehypertension, Internal medicine, Medicine, Humans, Pharmacology (medical), Intensive care medicine, Antihypertensive Agents, Aged, business.industry, Diagnostic Tests, Routine, Body Weight, Blood Pressure Determination, Middle Aged, Myocardial Contraction, Blood pressure, Hypertension, Cardiology, Regression Analysis, Female, sense organs, Cardiology and Cardiovascular Medicine, business, Target organ
Abstract: Spontaneous changes in blood pressure (BP) over a week after admission to the hospital were investigated in 127 patients admitted with diastolic BP at or above 120 mm Hg. Average BP decreased from 205/129 at admission to 174/110 on the 8th day. Regression analysis showed highly significant negative slopes which were related to initial levels but not to the presence or type of target organ involvement. After 1 week, 66% of the subjects attained a diastolic BP lower than 120 mm Hg. More remarkably, 36% attained values lower than 105 mm Hg: 33% of these had BP values less than 95 mm Hg. While not ruling out the importance of very high BP readings, it is concluded that they do not necessarily represent any pattern of either fixed or severe hypertension nor imply a need for urgent antihypertensive treatment.
Published: 1982

34. Effects of an olive-oil-rich diet on erythrocyte membrane lipid composition and cation transport systems

Author: Ambrosio Gb, Oliviero Olivieri, S. Ferrari, Roberto Corrocher, D. Piccolo, Antonio Pagnan, Giovannella Baggio, Patrizia Guarini, Antonella Bassi, and Aldo Opportuno
Subjects: Adult, Male, Phospholipid, Biological Transport, Active, Reference range, Lithium, chemistry.chemical_compound, Dietary Fats, Unsaturated, Humans, Plant Oils, Food science, Olive Oil, chemistry.chemical_classification, Chemistry, Cholesterol, Erythrocyte Membrane, Fatty Acids, Sodium, General Medicine, Lipids, Oleic acid, Membrane, Saturated fatty acid, Potassium, Sodium-Potassium-Exchanging ATPase, Cation transport, Polyunsaturated fatty acid
Abstract: 1. In this study we sought to test the possibility that an olive-oil-rich diet might influence the membrane lipid composition and cation transport mechanisms in erythrocytes. 2. To this end, 11 normotensive normolipidaemic healthy volunteers were given a standard relatively low fat diet (28% of total energy) for 3 weeks, followed by a high fat (38% of total energy), olive-oil (100 g/day)-enriched diet for the 3 subsequent weeks, in a metabolic ward. The two diets contained the same amount of cholesterol (400 mg), and the polyunsaturated fatty acid/saturated fatty acid ratio was similar and comparatively low (0.35 on the standard vs 0.36 on the olive oil diet). 3. At the end of the study the lipid composition of the erythrocyte membranes showed the following changes: the oleic acid content increased by 15.7% and the amount of saturated fatty acid decreased by 3.2%. The polyunsaturated fatty acid content tended to decrease, while the polyunsaturated fatty acid/saturated fatty acid ratio did not change significantly. The cholesterol/phospholipid molar ratio increased significantly by 7.8%, still remaining within the reference range. 4. At the same time, the mean values of the maximum rates of the cation fluxes mediated by the Na+-K+ pump, and by Na+-K+ co-transport rose significantly, while the maximal rate of Na+-Li+ countertransport showed a non-significant trend towards lower values. 5. Urinary excretion of Na+ and K+, body weight and blood pressure did not change significantly.
Published: 1989

35. Links among lipids artherosclerosis and hypertension

Author: Pagnan, A., Corrocher, Roberto, Ambrosio, Gb, Piccolo, D., and Dal Palù, C.
Published: 1989

36. Olive-oil-enriched diet: effect on serum lipoprotein levels and biliary cholesterol saturation

Author: Baggio, G, primary, Pagnan, A, additional, Muraca, M, additional, Martini, S, additional, Opportuno, A, additional, Bonanome, A, additional, Ambrosio, GB, additional, Ferrari, S, additional, Guarini, P, additional, and Piccolo, D, additional
Published: 1988
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37. Residual risk of cardiovascular mortality in patients with coronary heart disease: the EUROASPIRE risk categories.

Author: De Bacquer D, Dallongeville J, Kotseva K, Cooney MT, Pajak A, Deckers JW, Mayer O, Vanuzzo D, Lehto S, Fras Z, Östor E, Ambrosio GB, De Backer G, Wood D, Keil U, Sans S, Graham I, and Pyörälä K
Subjects: Aged, Cardiovascular Diseases diagnosis, Cardiovascular Diseases mortality, Cohort Studies, Europe epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Risk Factors, Coronary Disease diagnosis, Coronary Disease mortality
Abstract: Background: The EUROASPIRE I, II and III surveys revealed high prevalences of modifiable risk factors in the high priority group of coronary patients all over Europe. The potential to further reduce coronary heart disease (CHD) morbidity and mortality rates is still considerable. We report here on the relative risk of cardiovascular disease (CVD) death associated with common modifiable risk factor levels based on the mortality follow-up of patients participating in the first two EUROASPIRE surveys. We also present a novel simple risk classification system (ERC) that can be used in the management of patients with existing CHD., Methods: The study cohort consisted of a consecutive sample of CHD patients aged ≤ 70 years from 12 European countries. Baseline data gathered in 1995-2000 through standardized methods, were linked to cardiovascular mortality in 5216 patients according to an accelerated failure time model., Results: During 28,143 person-years of follow-up, 332 patients died from cardiovascular disease denoting a CVD mortality risk of 12.3 per 1000 person-years in men and 10.2 per 1000 person-years in women. In multivariate analysis, fasting glucose, total cholesterol and smoking emerged as the strongest independent modifiable predictors of cardiovascular mortality., Conclusions: The results of the mortality follow-up of the EUROASPIRE I and II CHD patients emphasize the continuing risk from elevated glucose and total cholesterol levels and underline the importance of smoking cessation in secondary prevention. The ERC risk tool that we developed may prove helpful to obtain these goals in the setting of secondary prevention., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
Published: 2013
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38. Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment.

Author: Santamaria MG, Agnelli G, Taliani MR, Prandoni P, Moia M, Bazzan M, Guazzaloca G, Ageno W, Bertoldi A, Silingardi M, Tomasi C, and Ambrosio GB
Subjects: Aged, Female, Genetic Predisposition to Disease, Humans, Incidence, Male, Middle Aged, Prevalence, Recurrence, Retrospective Studies, Thromboembolism epidemiology, Thromboembolism prevention & control, Thrombophilia diagnosis, Thrombophilia drug therapy, Venous Thrombosis epidemiology, Venous Thrombosis prevention & control, Anticoagulants therapeutic use, Thromboembolism etiology, Thrombophilia complications, Thrombophilia epidemiology, Venous Thrombosis etiology
Abstract: Introduction: Whether patients with hereditary or acquired thrombophilia have an increased risk for recurrence of venous thromboembolism (deep vein thrombosis and/or pulmonary embolism) is still controversial. The aim of this study was to evaluate the incidence of recurrence of venous thromboembolism in patients with and without thrombophilic abnormalities treated with standardized anticoagulant treatment., Material and Methods: Database was from a prospective multicenter randomized study aimed at evaluating the long-term clinical benefit of extending to 1 year the 3-month oral anticoagulant treatment after a first episode of idiopathic proximal deep vein thrombosis. The screening for thrombophilia included antithrombin, protein C, protein S deficiencies, resistance to activated protein C and/or factor V R506Q mutation, the mutation 20210GA of the prothrombin gene, hyperhomocysteinemia and antiphospholipid antibodies. The diagnosis of venous thromboembolism recurrence was done by objective tests and adjudicated by a panel unaware of the results of the thrombophilia screening., Results: A screening for thrombophilic abnormalities was performed in 195 patients. Twenty of 57 (35.1%) thrombophilic patients experienced a recurrence of venous thromboembolism as compared with 29 of 138 (21.0%) patients without thrombophilia (HR=1.78, 95% CI 1.002-3.140, p=0.046). The difference in VTE recurrence between patients with and without thrombophilia was accounted for by those who received 3 months of oral anticoagulation (HR=3.21, 95% CI 1.349-7.616, p=0.008). No difference between thrombophilic and non-thrombophilic patients was observed in the time interval from the index episode to recurrent venous thromboembolism (29.1+/-23.9 and 30.6+/-19.8 months, respectively)., Conclusions: Thrombophilic abnormalities are associated with an increased risk of venous thromboembolism recurrence. The role of thrombophilia in the long-term management of venous thromboembolism should be addressed in prospective management studies.
Published: 2005
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39. Extensive screening for occult malignant disease in idiopathic venous thromboembolism: a prospective randomized clinical trial.

Author: Piccioli A, Lensing AW, Prins MH, Falanga A, Scannapieco GL, Ieran M, Cigolini M, Ambrosio GB, Monreal M, Girolami A, and Prandoni P
Subjects: Adult, Aged, Aged, 80 and over, Early Diagnosis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms complications, Neoplasms mortality, Prognosis, Treatment Outcome, Mass Screening methods, Neoplasms diagnosis, Thromboembolism etiology, Venous Thrombosis etiology
Abstract: Patients with symptomatic idiopathic venous thromboembolism and apparently cancer-free have an approximate 10% incidence of subsequent cancer. Apparently cancer-free patients with acute idiopathic venous thromboembolism were randomized to either the strategy of extensive screening for occult cancer or to no further testing. Patients had a 2-year follow-up period. Of the 201 patients, 99 were allocated to the extensive screening group and 102 to the control group. In 13 (13.1%) patients, the extensive screening identified occult cancer. In the extensive screening group, a single (1.0%) malignancy became apparent during follow-up, whereas in the control group a total of 10 (9.8%) malignancies became symptomatic [relative risk, 9.7 (95% CI, 1.3-36.8; P < 0.01]. Overall, malignancies identified in the extensive screening group were at an earlier stage and the mean delay to diagnosis was reduced from 11.6 to 1.0 months (P < 0.001). Cancer-related mortality during the 2 years follow-up period occurred in two (2.0%) of the 99 patients of the extensive screening group vs. four (3.9%) of the 102 control patients [absolute difference, 1.9% (95% CI, -5.5-10.9)]. Although early detection of occult cancers may be associated with improved treatment possibilities, it is uncertain whether this improves the prognosis.
Published: 2004
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40. Current presentation and management of heart failure in cardiology and internal medicine hospital units: a tale of two worlds--the TEMISTOCLE study.

Author: Di Lenarda A, Scherillo M, Maggioni AP, Acquarone N, Ambrosio GB, Annicchiarico M, Bellis P, Bellotti P, De Maria R, Lavecchia R, Lucci D, Mathieu G, Opasich C, Porcu M, Tavazzi L, and Cafiero M
Subjects: Adrenergic beta-Antagonists therapeutic use, Aged, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Coronary Care Units statistics & numerical data, Cross-Sectional Studies, Female, Follow-Up Studies, Heart Failure mortality, Hospital Mortality, Humans, Internal Medicine statistics & numerical data, Length of Stay statistics & numerical data, Male, Prospective Studies, Treatment Outcome, Heart Failure diagnosis, Heart Failure drug therapy
Abstract: Background: The purpose pf the current article is to describe the clinical profile, use of resources, management and outcome in a population of real-world inpatients with heart failure., Methods and Results: With a prospective, cross-sectional survey on acute hospital admissions, we evaluated the overall and provider-related differences in patient characteristics, diagnostic work-up, treatment and inhospital outcome of 2127 patients with heart failure admitted to 167 cardiology departments and 250 internal medicine departments between February 14 and 25, 2000. Patients admitted to cardiology units were younger (56.3% >70 years vs 76.2%, P <.0001), had more severe symptoms (NYHA IV 35% vs 29%, P =.00014), and more often underwent evaluation of ventricular function (89.3% vs 54.8%, P <.0001) and coronary angiography (7.5% vs 0.9%, P <.0001) than those admitted to medical units. Moreover, they were more often prescribed beta-blockers (17.8% vs 8.7%, P <.0001). However, prescription of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers (78.7% vs 81.5%, P = not significant [NS]) and inhospital mortality (5.2% vs 5.9%, P = NS) were similar. A 6-month follow-up visit was performed in 56.4% of cases (68.2% of cardiology vs 49.4% of medicine patients, P <.0001); 6-month readmission (43.7% vs 45.4%, P = NS) and mortality (13.9% vs 16.7%, P = NS) rates were similar., Conclusions: Patients with heart failure admitted to cardiology and internal medicine units represent 2 clearly different populations. In both groups, diagnostic procedures and evidence-based treatments, such as beta-blockers, appeared to be underused, and there was a lack of structured follow-up, as well as a poor 6-month prognosis.
Published: 2003
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41. Incidence of cancer after a first episode of idiopathic venous thromboembolism treated with 3 months or 1 year of oral anticoagulation.

Author: Taliani MR, Agnelli G, Prandoni P, Becattini C, Moia M, Bazzan M, Ageno W, Tomasi C, Guazzaloca G, Ambrosio GB, Bertoldi A, Salvi R, Poggio R, and Silingardi M
Subjects: Administration, Oral, Adult, Aged, Aged, 80 and over, Female, Humans, Incidence, Male, Middle Aged, Models, Statistical, Neoplasms chemically induced, Pulmonary Embolism complications, Risk, Thromboembolism complications, Time Factors, Treatment Outcome, Anticoagulants administration & dosage, Anticoagulants adverse effects, Neoplasms etiology, Pulmonary Embolism drug therapy, Thromboembolism drug therapy
Abstract: Background: A prolonged treatment with oral anticoagulants has been claimed to reduce the incidence of newly diagnosed cancer in the long-term follow-up of patients with venous thromboembolism., Objectives: In a multicenter prospective study we assessed the incidence of newly diagnosed clinically overt cancer in patients with a first episode of idiopathic venous thromboembolism (VTE) treated with oral anticoagulants for 3 months or 1 year., Patients and Methods: Consecutive patients with an idiopathic venous thromboembolism who had completed 3 months of oral anticoagulant therapy without having a recurrence, bleeding or newly diagnosed cancer were randomized to discontinue oral anticoagulant therapy or to continue it for nine additional months. Idiopathic venous thromboembolism was defined as thrombosis occurring in the absence of known cancer, known thrombophilia, or temporary risk factors for venous thromboembolism. All patients were followed up for at least 1 year after randomization., Results: A total of 429 patients, 265 patients with DVT and 164 with PE, were followed up for an average of 43.7 months after randomization. A newly diagnosed cancer occurred in 32 patients (7.5%), 13 (6.2%) of the 210 patients treated for 3 months and 19 (8.7%) of the 219 patients treated for 1 year (RR = 0.71, 95% confidence interval 0.36-1.41)., Conclusions: The incidence of newly diagnosed clinically overt cancer is not reduced in patients with idiopathic venous thromboembolism treated with 1-year anticoagulant treatment compared with patients treated for 3 months.
Published: 2003
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42. Apoptosis and changes in contractile protein pattern in the skeletal muscle in heart failure.

Author: Vescovo G, Ambrosio GB, and Dalla Libera L
Subjects: Angiotensin Receptor Antagonists, Animals, Biphenyl Compounds therapeutic use, Disease Models, Animal, Heart Failure blood, Heart Failure chemically induced, Heart Failure metabolism, Humans, Irbesartan, Monocrotaline toxicity, Muscle, Skeletal metabolism, Muscular Atrophy metabolism, Muscular Atrophy pathology, Myosin Heavy Chains metabolism, Rats, Sphingosine blood, Tetrazoles therapeutic use, Tumor Necrosis Factor-alpha analysis, Apoptosis, Contractile Proteins metabolism, Heart Failure pathology, Muscle, Skeletal pathology
Abstract: Chronic heart failure is characterized as a clinical disorder by exercise intolerance. There are two factors that are independently responsible for the reduced exercise capacity: (a) a shift from myosin heavy chain 1 (MHC1) to MHC2a and MHC2b and (b) muscle atrophy. We have demonstrated, both in experimental models of heart failure and in man, that the more severe the heart failure, the greater the magnitude of skeletal muscle apoptosis. In the monocrotaline treated rat, that develops a severe right-sided heart failure, the increased number of apoptotic nuclei was paralleled by increasing levels of circulating TNFalpha. In agreement with some recent observations showing that sphingolipids can mediate programmed cell death, we found that in animals with heart failure and high number of apoptotic nuclei, circulating levels of sphingosine were significantly increased. In a study conducted in patients with heart failure we found a correlation between exercise capacity limitation and skeletal myocytes apoptosis. There was also a correlation between degree of muscle atrophy and magnitude of apoptosis. The shift in MHCs, although with a different mechanism, is also responsible for the reduced exercise capacity in these patients. In fact there is a strong correlation between indices of severity of CHF and MHC composition. Muscle fatigue, appears earlier in patients that have a greater skeletal muscle expression of 'fast' MHCs. We have also demonstrated that MHCs shift and apoptosis can be prevented by using angiotensin II converting enzyme inhibitors and angiotensin II receptor blockers.
Published: 2001
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43. Potential for cholesterol lowering in secondary prevention of coronary heart disease in europe: findings from EUROASPIRE study. European Action on Secondary Prevention through Intervention to Reduce Events.

Author: Vanuzzo D, Pilotto L, Ambrosio GB, Pyörälä K, Lehto S, De Bacquer D, De Backer G, and Wood D
Subjects: Aged, Coronary Disease blood, Coronary Disease epidemiology, Europe epidemiology, Female, Humans, Male, Middle Aged, Risk Factors, Coronary Disease prevention & control, Hypolipidemic Agents administration & dosage, Lipids blood
Abstract: We have examined the potential for cholesterol lowering in secondary prevention of coronary heart disease based on data from the European Action on Secondary Prevention through Intervention to Reduce Events (EUROASPIRE) study carried out in 1995-1996 in nine European centres (Czech Republic, Finland, France, Germany, Hungary, Italy, The Netherlands, Slovenia and Spain). Consecutive patients aged < or = 70 years in four diagnostic categories--coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, acute myocardial infarction, and acute myocardial ischaemia without infarction--were identified from hospital records and invited for an interview and risk factor assessment at least 6 months after hospital admission. Plasma lipid measurements were carried out in a central laboratory. Combining patients from all centres and diagnostic categories (n = 2749) the medians (interquartile ranges) for plasma lipids were: total cholesterol 5.36 (4.76-6.03) mmol/l, high density lipoprotein (HDL) cholesterol 1.19 (1.01-1.42) mmol/l, triglycerides 1.55 (1.15-2.24) mmol/l, and low density lipoprotein (LDL) cholesterol 3.32 (2.76-3.91) mmol/l. Only 33% of the patients received lipid-lowering drugs. If the therapeutic goal given in the 1998 European recommendations, total cholesterol < 5.0 mmol/l, were applied, 67% of these patients would have needed an intensified cholesterol-lowering action, and with an even stricter goal, total cholesterol < 4.5 mmol/l, this proportion would have been as high as 84%.
Published: 2000
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44. Apoptosis in the skeletal muscle of patients with heart failure: investigation of clinical and biochemical changes.

Author: Vescovo G, Volterrani M, Zennaro R, Sandri M, Ceconi C, Lorusso R, Ferrari R, Ambrosio GB, and Dalla Libera L
Subjects: Adult, Aged, Blotting, Western, Case-Control Studies, Caspase 3, Caspases metabolism, Exercise Tolerance, Heart Failure metabolism, Heart Failure pathology, Humans, In Situ Nick-End Labeling, Male, Middle Aged, Muscle Fatigue, Muscle Fibers, Skeletal pathology, Muscle, Skeletal metabolism, Muscle, Skeletal pathology, Muscular Atrophy metabolism, Muscular Atrophy pathology, Muscular Atrophy physiopathology, Myosin Heavy Chains metabolism, Oxygen Consumption, Proto-Oncogene Proteins c-bcl-2 metabolism, Regression Analysis, Ubiquitins metabolism, Apoptosis, Heart Failure physiopathology, Muscle, Skeletal physiopathology
Abstract: Objective: To investigate the contribution of apoptosis in the development of the skeletal myopathy in chronic heart failure., Design: The electrophoretic pattern of myosin heavy chains (MHC), fibre cross sectional area, number of in situ nick end labelling (TUNEL) positive apoptotic myocyte nuclei, and the tissue levels of caspase-3, Bcl-2, and ubiquitin were determined in biopsies taken from the vastus lateralis muscle. The study involved nine patients with severe chronic heart failure caused by ischaemic heart disease and hibernating myocardium and five controls., Results: In chronic heart failure patients the vastus lateralis showed a significant increase of MHC(2a) and MHC(2b) and a greater degree of fibre atrophy, as demonstrated by the decreased cross sectional area. There was also an increased number of TUNEL positive apoptotic myocyte nuclei. Tissue concentrations of Bcl-2 were decreased, while those of caspase-3 and ubiquitin were increased. Peak oxygen consumption (VO(2)) was negatively correlated with the number of TUNEL positive nuclei and the fibre cross sectional area. There was a correlation between the number of apoptotic nuclei and the fibre cross sectional area, but no correlation between myosin heavy chains and number of apoptotic nuclei., Conclusions: Myocyte apoptosis occurs in the skeletal muscle of patients with chronic heart failure, and its magnitude is associated with the severity of exercise capacity limitation and the degree of muscle atrophy. Muscle atrophy contributes to the limitation of exercise capacity, together with the increased synthesis of fast, more fatiguable myosin heavy chains.
Published: 2000
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45. [Atherogenic risk factors in patients with obliterative arteriopathy of the legs].

Author: Scannapieco G, Parisi R, Bortoluzzi C, Doria S, Puato M, and Ambrosio GB
Subjects: Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Risk Factors, Arteriosclerosis etiology, Leg blood supply, Peripheral Vascular Diseases etiology
Published: 1999

46. Heart failure: a skeletal muscle disorder?

Author: Vescovo G, Ambrosio GB, and Dalla Libera L
Subjects: Apoptosis, Chronic Disease, Exercise Tolerance, Heart Failure metabolism, Heart Failure physiopathology, Humans, Muscle, Skeletal, Muscular Atrophy pathology, Myosin Heavy Chains metabolism, Heart Failure etiology, Muscular Atrophy complications
Published: 1999

47. Apoptosis and atrophy in rat slow skeletal muscles in chronic heart failure.

Author: Libera LD, Zennaro R, Sandri M, Ambrosio GB, and Vescovo G
Subjects: Animals, Atrophy, Blotting, Western, Body Weight, Caspase 3, Caspases analysis, Cell Nucleus pathology, Chronic Disease, Heart Failure chemically induced, Hypertension, Pulmonary chemically induced, Hypertrophy, Right Ventricular chemically induced, Hypertrophy, Right Ventricular pathology, In Situ Nick-End Labeling, Male, Monocrotaline, Muscle Fibers, Slow-Twitch chemistry, Muscle Fibers, Slow-Twitch enzymology, Muscle, Skeletal chemistry, Muscle, Skeletal enzymology, Myosin Heavy Chains analysis, Proto-Oncogene Proteins c-bcl-2 analysis, Rats, Rats, Sprague-Dawley, Ubiquitins analysis, Apoptosis physiology, Heart Failure pathology, Muscle Fibers, Slow-Twitch pathology, Muscle, Skeletal pathology
Abstract: Congestive heart failure is characterized by a skeletal muscle myopathy with muscle bulk loss. The mechanisms responsible for these changes are not clear at present. We have investigated the role of apoptosis in the rat "slow" soleus muscle during the development of heart failure, which was induced by injection of monocrotaline (30 mg/kg). We looked at the time course of apoptosis by studying six animals at each of the following time points: 0, 17, 24, and 30 days. We found a decreased expression of the antiapoptotic protein Bcl-2, which was accompanied by a rise of proapoptotic caspase-3. Ubiquitin levels did not change. DNA nick-end labeling showed an increased number of apoptotic nuclei both in myofibers and interstitial cells when heart failure occurred. At variance with previous observations in the fast-twitch tibialis anterior muscle in the same animals, in which tumor necrosis factor-alpha (TNF-alpha) increased at the time that apoptosis occurred, the magnitude of apoptosis is lower in soleus muscle and there is no appearance of muscle atrophy. In soleus muscle, apoptosis is accompanied by activation of the caspase-3 system. There is no activation of the TNF-alpha- and ubiquitin-dependent protein waste. In conclusion, slow muscles are less prone to develop apoptosis than fast muscles. Muscle atrophy appears earlier in these latter ones.
Published: 1999
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48. Exercise capacity and skeletal muscle myosin heavy chains in CHF.

Author: Vescovo G, Dalla Libera L, Leprotti C, and Ambrosio GB
Subjects: Animals, Chronic Disease, Heart Failure etiology, Humans, Muscle Fibers, Skeletal physiology, Muscular Atrophy etiology, Muscular Atrophy physiopathology, Exercise Tolerance physiology, Heart Failure physiopathology, Muscle, Skeletal physiopathology, Myosin Heavy Chains physiology
Published: 1999

49. Apoptosis of skeletal muscle myofibers and interstitial cells in experimental heart failure.

Author: Vescovo G, Zennaro R, Sandri M, Carraro U, Leprotti C, Ceconi C, Ambrosio GB, and Dalla Libera L
Subjects: Animals, Connective Tissue Cells pathology, Heart Failure metabolism, In Situ Nick-End Labeling, Male, Muscle, Skeletal metabolism, Proto-Oncogene Proteins biosynthesis, Proto-Oncogene Proteins c-bcl-2 biosynthesis, Rats, Rats, Sprague-Dawley, bcl-2-Associated X Protein, Apoptosis, Heart Failure pathology, Muscle, Skeletal pathology
Abstract: Unlabelled: Congestive heart failure (CHF) is characterized by a limb skeletal muscle myopathy with shift from the slow aerobic, fatigue resistant fibers, to the fast, anaerobic ones, and muscle bulk loss. Apoptosis (A) has been recently demonstrated to play a role in several cardiovascular diseases., Aim of the Study: we have investigated the role of A in the skeletal muscle of the hindlimbs in an experimental model of CHF., Animals and Methods: CHF was induced in 7 males 80-100 g Sprague-Dawley rats with 30 mg/kg monocrotaline. Five age and diet matched controls were also studied. The time course of A was also studied in additional animals at day 0, 17, 24 and 30 days., Results: At day 27 the electrophoretic analysis of myosin heavy chains (MHCs) demonstrated in the CHF rats the occurrence of a myopathy, with disappearance of slow MHC1 in the Tibialis Anterior (TA), and a significant shift from the slow to the fast isoforms in the soleus and EDL. With in situ DNA nick-end labelling (TUNEL) we found in the TA of CHF animals a significantly higher number of TUNEL positive nuclei (0.43 +/- 0.24 v 0.08 +/- 0.02, P<0.02 and TUNEL positive myonuclei (0.031 +/- 0.012 v 0.0025 +/- 0.005, P<0.02). The time course of A showed a progressive rise in interstitial and myocyte A, accompanied by a drop in fibers cross-sectional area and muscle weight/body weight, that came out to be significant at 30 days. Western blot showed a lower expression of Bcl-2 at 27 days and a further drop at 30 days in the CHF rats. Double staining for TUNEL and antibody against anti-MHC2a and anti MHC2b + 2x showed that A occurs non-selectively in all the myofiber types. BetaANP and Right Ventricle Mass/Volume (RVM/V) correlated significantly with total apoptotic nuclei., Conclusions: In CHF myofibers A can lead to muscle atrophy. Endothelial cells A may produce an imbalance in myofibres nutrition with relative ischemia that triggers the preferential synthesis of fast anaerobic myosin as an adaptive mechanism or alternatively induce myofibres death.
Published: 1998
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50. Improved exercise tolerance after losartan and enalapril in heart failure: correlation with changes in skeletal muscle myosin heavy chain composition.

Author: Vescovo G, Dalla Libera L, Serafini F, Leprotti C, Facchin L, Volterrani M, Ceconi C, and Ambrosio GB
Subjects: Angiotensin II antagonists & inhibitors, Heart Failure physiopathology, Humans, Male, Middle Aged, Muscle, Skeletal metabolism, Myosin Heavy Chains metabolism, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Antihypertensive Agents therapeutic use, Enalapril therapeutic use, Exercise Tolerance drug effects, Heart Failure drug therapy, Losartan therapeutic use
Abstract: Background: In congestive heart failure, fatigue-resistant, oxidative, slow type I fibers are decreased in leg skeletal muscle, contributing to exercise capacity (EC) limitation. The mechanisms by which ACE inhibitors and AII antagonists improve EC is still unclear. We tested the hypothesis that improvement in EC is related to changes in skeletal muscle composition toward type I fibers., Methods and Results: Eight patients with congestive heart failure, NYHA classes I through IV, were treated for 6 months with enalapril (E) 20 mg/d, and another 8 with losartan (L) 50 mg/d. EC was assessed with maximal cardiopulmonary exercise testing at baseline and after treatment. Myosin heavy chain (MHC) composition of the gastrocnemius was studied after electrophoretic separation of slow MHC1, fast oxidative MHC2a, and fast glycolytic MHC2b isoforms from needle microbiopsies obtained at baseline and after 6 months. EC improved in both groups. Peak V(O2) increased from 21.0+/-4.7 to 27.6+/-4.3 mL . kg-1 . min -1 (P=0.011) in the L group and from 17.5+/-5.0 to 25.0+/-5.5 mL . kg-1 . min -1 (P=0.014) in the E group. Similarly, ventilatory threshold changed from 15.0+/-4.0 to 19.9+/-4.9 mL (P=0. 049) with L and from 12.0+/-1.9 to 15.4+/-3.5 mL (P=0.039) with E. MCH1 increased from 61.2+/-11.2% to 75.4+/-7.6% with L (P=0.012) and from 60.6+/-13.1% to 80.1+/-10.9% (P=0.006) with E. Similarly, MHC2a decreased from 21.20+/-9.5% to 12.9+/-4.4% (P=0.05) with L and from 19.9+/-7.8% to 11.8+/-7.9% (P=0.06) with E. MHC2b changed from 17. 5+/-6.5% to 11.7+/-5.2% (P=0.07) with L and from 19.5+/-6.4% to 8. 1+/-4.6% (P=0.0015) with E. There was a significant correlation between net changes in MHC1 and absolute changes in peak V(O2) (r2=0.29, P=0.029) and a trend to significance for MHC2a and 2b., Conclusions: Six months' treatment with L and with E produces an improvement in EC of similar magnitude. These changes are accompanied by a reshift of MHCs of leg skeletal muscle toward the slow, more fatigue-resistant isoforms. Magnitude of MHC1 changes correlates with the net peak V(O2) gain, which suggests that improved EC may be caused by favorable biochemical changes occurring in the skeletal muscle.
Published: 1998
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