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1. Morning blood pressure surge: pathophysiology, clinical relevance and therapeutic aspects

Author: Bilo G, Grillo A, Guida V, and Parati G
Subjects: morning blood pressure surge, ambulatory blood pressure monitoring, cardiovascular risk, blood pressure variability, Internal medicine, RC31-1245
Abstract: Grzegorz Bilo,1,2 Andrea Grillo,1,2 Valentina Guida,1,2 Gianfranco Parati1,2 1Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; 2Cardiology Unit, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy Abstract: Morning hours are the period of the day characterized by the highest incidence of major cardiovascular events including myocardial infarction, sudden death or stroke. They are also characterized by important neurohormonal changes, in particular, the activation of sympathetic nervous system which usually leads to a rapid increase in blood pressure (BP), known as morning blood pressure surge (MBPS). It was hypothesized that excessive MBPS may be causally involved in the pathogenesis of cardiovascular events occurring in the morning by inducing hemodynamic stress. A number of studies support an independent relationship of MBPS with organ damage, cerebrovascular complications and mortality, although some heterogeneity exists in the available evidence. This may be due to ethnic differences, methodological issues and the confounding relationship of MBPS with other features of 24-hour BP profile, such as nocturnal dipping or BP variability. Several studies are also available dealing with treatment effects on MBPS and indicating the importance of long-acting antihypertensive drugs in this regard. This paper provides an overview of pathophysiologic, methodological, prognostic and therapeutic aspects related to MBPS. Keywords: morning blood pressure surge, ambulatory blood pressure monitoring, cardiovascular risk, blood pressure variability
Published: 2018

2. Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney

Author: Halimi, J, Sarafidis, P, Azizi, M, Bilo, G, Burkard, T, Bursztyn, M, Camafort, M, Chapman, N, Cottone, S, de Backer, T, Deinum, J, Delmotte, P, Dorobantu, M, Doumas, M, Dusing, R, Duly-Bouhanick, B, Fauvel, J, Fesler, P, Gaciong, Z, Gkaliagkousi, E, Gordin, D, Grassi, G, Grassos, C, Guerrot, D, Huart, J, Izzo, R, Jaén Águila, F, Járai, Z, Kahan, T, Kantola, I, Kociánová, E, Limbourg, F, Lopez-Sublet, M, Mallamaci, F, Manolis, A, Marketou, M, Mayer, G, Mazza, A, Macintyre, I, Mourad, J, Muiesan, M, Nasr, E, Nilsson, P, Oliveras, A, Ormezzano, O, Paixão-Dias, V, Papadakis, I, Papadopoulos, D, Perl, S, Polónia, J, Pontremoli, R, Pucci, G, Robles, N, Rubin, S, Ruilope, L, Rump, L, Saeed, S, Sanidas, E, Sarzani, R, Schmieder, R, Silhol, F, Sokolovic, S, Solbu, M, Soucek, M, Stergiou, G, Sudano, I, Tabbalat, R, Tengiz, I, Triantafyllidi, H, Tsioufis, K, Václavík, J, van der Giet, M, der Niepen, P, Veglio, F, Venzin, R, Viigimaa, M, Weber, T, Widimsky, J, Wuerzner, G, Zelveian, P, Zebekakis, P, Lueders, S, Persu, A, Kreutz, R, Vogt, L, Halimi JM, Sarafidis P, Azizi M, Bilo G, Burkard T, Bursztyn M, Camafort M, Chapman N, Cottone S, de Backer T, Deinum J, Delmotte P, Dorobantu M, Doumas M, Dusing R, Duly-Bouhanick B, Fauvel JP, Fesler P, Gaciong Z, Gkaliagkousi E, Gordin D, Grassi G, Grassos C, Guerrot D, Huart J, Izzo R, Jaén Águila F, Járai Z, Kahan T, Kantola I, Kociánová E, Limbourg F, Lopez-Sublet M, Mallamaci F, Manolis A, Marketou M, Mayer G, Mazza A, MacIntyre I, Mourad JJ, Muiesan ML, Nasr E, Nilsson P, Oliveras A, Ormezzano O, Paixão-Dias V, Papadakis I, Papadopoulos D, Perl S, Polónia J, Pontremoli R, Pucci G, Robles NR, Rubin S, Ruilope LM, Rump LC, Saeed S, Sanidas E, Sarzani R, Schmieder R, Silhol F, Sokolovic S, Solbu M, Soucek M, Stergiou G, Sudano I, Tabbalat R, Tengiz I, Triantafyllidi H, Tsioufis K, Václavík J, van der Giet M, der Niepen PV, Veglio F, Venzin R, Viigimaa M, Weber T, Widimsky J, Wuerzner G, Zelveian P, Zebekakis P, Lueders S, Persu A, Kreutz R, Vogt L., Halimi, J, Sarafidis, P, Azizi, M, Bilo, G, Burkard, T, Bursztyn, M, Camafort, M, Chapman, N, Cottone, S, de Backer, T, Deinum, J, Delmotte, P, Dorobantu, M, Doumas, M, Dusing, R, Duly-Bouhanick, B, Fauvel, J, Fesler, P, Gaciong, Z, Gkaliagkousi, E, Gordin, D, Grassi, G, Grassos, C, Guerrot, D, Huart, J, Izzo, R, Jaén Águila, F, Járai, Z, Kahan, T, Kantola, I, Kociánová, E, Limbourg, F, Lopez-Sublet, M, Mallamaci, F, Manolis, A, Marketou, M, Mayer, G, Mazza, A, Macintyre, I, Mourad, J, Muiesan, M, Nasr, E, Nilsson, P, Oliveras, A, Ormezzano, O, Paixão-Dias, V, Papadakis, I, Papadopoulos, D, Perl, S, Polónia, J, Pontremoli, R, Pucci, G, Robles, N, Rubin, S, Ruilope, L, Rump, L, Saeed, S, Sanidas, E, Sarzani, R, Schmieder, R, Silhol, F, Sokolovic, S, Solbu, M, Soucek, M, Stergiou, G, Sudano, I, Tabbalat, R, Tengiz, I, Triantafyllidi, H, Tsioufis, K, Václavík, J, van der Giet, M, der Niepen, P, Veglio, F, Venzin, R, Viigimaa, M, Weber, T, Widimsky, J, Wuerzner, G, Zelveian, P, Zebekakis, P, Lueders, S, Persu, A, Kreutz, R, Vogt, L, Halimi JM, Sarafidis P, Azizi M, Bilo G, Burkard T, Bursztyn M, Camafort M, Chapman N, Cottone S, de Backer T, Deinum J, Delmotte P, Dorobantu M, Doumas M, Dusing R, Duly-Bouhanick B, Fauvel JP, Fesler P, Gaciong Z, Gkaliagkousi E, Gordin D, Grassi G, Grassos C, Guerrot D, Huart J, Izzo R, Jaén Águila F, Járai Z, Kahan T, Kantola I, Kociánová E, Limbourg F, Lopez-Sublet M, Mallamaci F, Manolis A, Marketou M, Mayer G, Mazza A, MacIntyre I, Mourad JJ, Muiesan ML, Nasr E, Nilsson P, Oliveras A, Ormezzano O, Paixão-Dias V, Papadakis I, Papadopoulos D, Perl S, Polónia J, Pontremoli R, Pucci G, Robles NR, Rubin S, Ruilope LM, Rump LC, Saeed S, Sanidas E, Sarzani R, Schmieder R, Silhol F, Sokolovic S, Solbu M, Soucek M, Stergiou G, Sudano I, Tabbalat R, Tengiz I, Triantafyllidi H, Tsioufis K, Václavík J, van der Giet M, der Niepen PV, Veglio F, Venzin R, Viigimaa M, Weber T, Widimsky J, Wuerzner G, Zelveian P, Zebekakis P, Lueders S, Persu A, Kreutz R, and Vogt L.
Abstract: Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70–95%]) than MRA (20% [10–30%]), SGLT2i (30% [20–50%]) or (GLP1-RA (10% [5–15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15–40%) vs 18% [10%–25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5–5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers’ dosage reduction was the usual management.
Published: 2024

3. Screening and management of hypertensive patients with chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. A pilot survey based on questionnaire

Author: Halimi, J, Sarafidis, P, Azizi, M, Bilo, G, Burkard, T, Bursztyn, M, Camafort, M, Chapman, N, Cottone, S, de Backer, T, Deinum, J, Delmotte, P, Dorobantu, M, Doumas, M, Dusing, R, Duly-Bouhanick, B, Fauvel, J, Fesler, P, Gaciong, Z, Gkaliagkousi, E, Gordin, D, Grassi, G, Grassos, C, Guerrot, D, Huart, J, Izzo, R, Águila, F, Járai, Z, Kahan, T, Kantola, I, Kociánová, E, Limbourg, F, Lopez-Sublet, M, Mallamaci, F, Manolis, A, Marketou, M, Mayer, G, Mazza, A, Macintyre, I, Mourad, J, Muiesan, M, Nasr, E, Nilsson, P, Oliveras, A, Ormezzano, O, Paixão-Dias, V, Papadakis, I, Papadopoulos, D, Perl, S, Polónia, J, Pontremoli, R, Pucci, G, Robles, N, Rubin, S, Ruilope, L, Rump, L, Saeed, S, Sanidas, E, Sarzani, R, Schmieder, R, Silhol, F, Sokolovic, S, Solbu, M, Soucek, M, Stergiou, G, Sudano, I, Tabbalat, R, Tengiz, I, Triantafyllidi, H, Tsioufis, K, Václavík, J, van der Giet, M, Van der Niepen, P, Veglio, F, Venzin, R, Viigimaa, M, Weber, T, Widimsky, J, Wuerzner, G, Zelveian, P, Zebekakis, P, Lueders, S, Persu, A, Kreutz, R, Vogt, L, Halimi JM, Sarafidis P, Azizi M, Bilo G, Burkard T, Bursztyn M, Camafort M, Chapman N, Cottone S, de Backer T, Deinum J, Delmotte P, Dorobantu M, Doumas M, Dusing R, Duly-Bouhanick B, Fauvel JP, Fesler P, Gaciong Z, Gkaliagkousi E, Gordin D, Grassi G, Grassos C, Guerrot D, Huart J, Izzo R, Águila FJ, Járai Z, Kahan T, Kantola I, Kociánová E, Limbourg FP, Lopez-Sublet M, Mallamaci F, Manolis A, Marketou M, Mayer G, Mazza A, MacIntyre IM, Mourad JJ, Muiesan ML, Nasr E, Nilsson P, Oliveras A, Ormezzano O, Paixão-Dias V, Papadakis I, Papadopoulos D, Perl S, Polónia J, Pontremoli R, Pucci G, Robles NR, Rubin S, Ruilope LM, Rump LC, Saeed S, Sanidas E, Sarzani R, Schmieder R, Silhol F, Sokolovic S, Solbu M, Soucek M, Stergiou G, Sudano I, Tabbalat R, Tengiz I, Triantafyllidi H, Tsioufis K, Václavík J, van der Giet M, Van der Niepen P, Veglio F, Venzin RM, Viigimaa M, Weber T, Widimsky J, Wuerzner G, Zelveian P, Zebekakis P, Lueders S, Persu A, Kreutz R, Vogt L, Halimi, J, Sarafidis, P, Azizi, M, Bilo, G, Burkard, T, Bursztyn, M, Camafort, M, Chapman, N, Cottone, S, de Backer, T, Deinum, J, Delmotte, P, Dorobantu, M, Doumas, M, Dusing, R, Duly-Bouhanick, B, Fauvel, J, Fesler, P, Gaciong, Z, Gkaliagkousi, E, Gordin, D, Grassi, G, Grassos, C, Guerrot, D, Huart, J, Izzo, R, Águila, F, Járai, Z, Kahan, T, Kantola, I, Kociánová, E, Limbourg, F, Lopez-Sublet, M, Mallamaci, F, Manolis, A, Marketou, M, Mayer, G, Mazza, A, Macintyre, I, Mourad, J, Muiesan, M, Nasr, E, Nilsson, P, Oliveras, A, Ormezzano, O, Paixão-Dias, V, Papadakis, I, Papadopoulos, D, Perl, S, Polónia, J, Pontremoli, R, Pucci, G, Robles, N, Rubin, S, Ruilope, L, Rump, L, Saeed, S, Sanidas, E, Sarzani, R, Schmieder, R, Silhol, F, Sokolovic, S, Solbu, M, Soucek, M, Stergiou, G, Sudano, I, Tabbalat, R, Tengiz, I, Triantafyllidi, H, Tsioufis, K, Václavík, J, van der Giet, M, Van der Niepen, P, Veglio, F, Venzin, R, Viigimaa, M, Weber, T, Widimsky, J, Wuerzner, G, Zelveian, P, Zebekakis, P, Lueders, S, Persu, A, Kreutz, R, Vogt, L, Halimi JM, Sarafidis P, Azizi M, Bilo G, Burkard T, Bursztyn M, Camafort M, Chapman N, Cottone S, de Backer T, Deinum J, Delmotte P, Dorobantu M, Doumas M, Dusing R, Duly-Bouhanick B, Fauvel JP, Fesler P, Gaciong Z, Gkaliagkousi E, Gordin D, Grassi G, Grassos C, Guerrot D, Huart J, Izzo R, Águila FJ, Járai Z, Kahan T, Kantola I, Kociánová E, Limbourg FP, Lopez-Sublet M, Mallamaci F, Manolis A, Marketou M, Mayer G, Mazza A, MacIntyre IM, Mourad JJ, Muiesan ML, Nasr E, Nilsson P, Oliveras A, Ormezzano O, Paixão-Dias V, Papadakis I, Papadopoulos D, Perl S, Polónia J, Pontremoli R, Pucci G, Robles NR, Rubin S, Ruilope LM, Rump LC, Saeed S, Sanidas E, Sarzani R, Schmieder R, Silhol F, Sokolovic S, Solbu M, Soucek M, Stergiou G, Sudano I, Tabbalat R, Tengiz I, Triantafyllidi H, Tsioufis K, Václavík J, van der Giet M, Van der Niepen P, Veglio F, Venzin RM, Viigimaa M, Weber T, Widimsky J, Wuerzner G, Zelveian P, Zebekakis P, Lueders S, Persu A, Kreutz R, and Vogt L
Abstract: Objective: Real-life management of hypertensive patients with chronic kidney disease (CKD) is unclear. Methods: A survey was conducted in 2023 by the European Society of Hypertension (ESH) to assess management of CKD patients referred to ESH-Hypertension Excellence Centres (ESH-ECs) at first referral visit. The questionnaire contained 64 questions with which ESH-ECs representatives were asked to estimate preexisting CKD management quality. Results: Overall, 88 ESH-ECs from 27 countries participated (fully completed surveys: 66/88 [75.0%]). ESH-ECs reported that 28% (median, interquartile range: 15-50%) had preexisting CKD, with 10% of them (5-30%) previously referred to a nephrologist, while 30% (15-40%) had resistant hypertension. The reported rate of previous recent (<6 months) estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) testing were 80% (50-95%) and 30% (15-50%), respectively. The reported use of renin-angiotensin system blockers was 80% (70-90%). When a nephrologist was part of the ESH-EC teams the reported rates SGLT2 inhibitors (27.5% [20-40%] vs. 15% [10-25], P = 0.003), GLP1-RA (10% [10-20%] vs. 5% [5-10%], P = 0.003) and mineralocorticoid receptor antagonists (20% [10-30%] vs. 15% [10-20%], P = 0.05) use were greater as compared to ESH-ECs without nephrologist participation. The rate of reported resistant hypertension, recent eGFR and UACR results and management of CKD patients prior to referral varied widely across countries. Conclusions: Our estimation indicates deficits regarding CKD screening, use of nephroprotective drugs and referral to nephrologists before referral to ESH-ECs but results varied widely across countries. This information can be used to build specific programs to improve care in hypertensives with CKD.
Published: 2024

4. The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study)

Author: Ostrowska, A, Wojciechowska, W, Rajzer, M, Weber, T, Bursztyn, M, Persu, A, Stergiou, G, Kiełbasa, G, Chrostowska, M, Doumas, M, Parati, G, Bilo, G, Grassi, G, Mancia, G, Januszewicz, A, Kreutz, R, Narkiewicz, K, Dubiela, A, Imprialos, K, Stavropoulos, K, de Freminville, J, Azizi, M, Cunha, P, Lewandowski, J, Strzelczyk, J, Wuerzner, G, Gosk-Przybyłek, M, Szwęch, E, Prejbisz, A, Van der Niepen, P, Kahan, T, Jekell, A, Spaak, J, Tsioufis, K, Ehret, G, Doroszko, A, Kubalski, P, Polonia, J, Styczkiewicz, K, Styczkiewicz, M, Mazur, S, Veglio, F, Rabbia, F, Eula, E, Águila, F, Sarzani, R, Spannella, F, Jarai, Z, Papadopoulos, D, Sublet, M, Grassos, C, Kahrimanidis, I, Gkaliagkousi, E, Triantafyllou, A, Grodzicki, T, Wizner, B, Seweryn, A, Moczulska, B, Ntineri, A, Robles, N, Widmiski, J, Zbroch, E, Ostrowska, Aleksandra, Wojciechowska, Wiktoria, Rajzer, Marek, Weber, Thomas, Bursztyn, Michael, Persu, Alexandre, Stergiou, George, Kiełbasa, Grzegorz, Chrostowska, Marzena, Doumas, Michaelis, Parati, Gianfranco, Bilo, Grzegorz, Grassi, Guido, Mancia, Giuseppe, Januszewicz, Andrzej, Kreutz, Reinhold, Narkiewicz, Krzysztof, Dubiela, Andżelina, Imprialos, Konstantinos, Stavropoulos, Konstantinos, de Freminville, Jean-Baptiste, Azizi, Michel, Cunha, Pedro Guimarães, Lewandowski, Jacek, Strzelczyk, Jakub, Wuerzner, Gregoire, Gosk-Przybyłek, Maria, Szwęch, Elżbieta, Prejbisz, Aleksander, Van der Niepen, Patricia, Kahan, Thomas, Jekell, Andreas, Spaak, Jonas, Tsioufis, Konstantinos, Ehret, Georg, Doroszko, Adrian, Kubalski, Piotr, Polonia, Jorge, Styczkiewicz, Katarzyna, Styczkiewicz, Marek, Mazur, Stanisław, Veglio, Franco, Rabbia, Franco, Eula, Elisabetta, Águila, Fernando Jaen, Sarzani, Riccardo, Spannella, Francesco, Jarai, Zoltan, Papadopoulos, Dimitrios, Sublet, Marilucy Lopez –, Grassos, Charalampos, Kahrimanidis, Ioannis, Gkaliagkousi, Eugenia, Triantafyllou, Areti, Grodzicki, Tomasz, Wizner, Barbara, Seweryn, Aleksandra, Moczulska, Beata, Ntineri, Angeliki, Robles, Nicolas Roberto, Widmiski, Jiri, Zbroch, Edyta, Ostrowska, A, Wojciechowska, W, Rajzer, M, Weber, T, Bursztyn, M, Persu, A, Stergiou, G, Kiełbasa, G, Chrostowska, M, Doumas, M, Parati, G, Bilo, G, Grassi, G, Mancia, G, Januszewicz, A, Kreutz, R, Narkiewicz, K, Dubiela, A, Imprialos, K, Stavropoulos, K, de Freminville, J, Azizi, M, Cunha, P, Lewandowski, J, Strzelczyk, J, Wuerzner, G, Gosk-Przybyłek, M, Szwęch, E, Prejbisz, A, Van der Niepen, P, Kahan, T, Jekell, A, Spaak, J, Tsioufis, K, Ehret, G, Doroszko, A, Kubalski, P, Polonia, J, Styczkiewicz, K, Styczkiewicz, M, Mazur, S, Veglio, F, Rabbia, F, Eula, E, Águila, F, Sarzani, R, Spannella, F, Jarai, Z, Papadopoulos, D, Sublet, M, Grassos, C, Kahrimanidis, I, Gkaliagkousi, E, Triantafyllou, A, Grodzicki, T, Wizner, B, Seweryn, A, Moczulska, B, Ntineri, A, Robles, N, Widmiski, J, Zbroch, E, Ostrowska, Aleksandra, Wojciechowska, Wiktoria, Rajzer, Marek, Weber, Thomas, Bursztyn, Michael, Persu, Alexandre, Stergiou, George, Kiełbasa, Grzegorz, Chrostowska, Marzena, Doumas, Michaelis, Parati, Gianfranco, Bilo, Grzegorz, Grassi, Guido, Mancia, Giuseppe, Januszewicz, Andrzej, Kreutz, Reinhold, Narkiewicz, Krzysztof, Dubiela, Andżelina, Imprialos, Konstantinos, Stavropoulos, Konstantinos, de Freminville, Jean-Baptiste, Azizi, Michel, Cunha, Pedro Guimarães, Lewandowski, Jacek, Strzelczyk, Jakub, Wuerzner, Gregoire, Gosk-Przybyłek, Maria, Szwęch, Elżbieta, Prejbisz, Aleksander, Van der Niepen, Patricia, Kahan, Thomas, Jekell, Andreas, Spaak, Jonas, Tsioufis, Konstantinos, Ehret, Georg, Doroszko, Adrian, Kubalski, Piotr, Polonia, Jorge, Styczkiewicz, Katarzyna, Styczkiewicz, Marek, Mazur, Stanisław, Veglio, Franco, Rabbia, Franco, Eula, Elisabetta, Águila, Fernando Jaen, Sarzani, Riccardo, Spannella, Francesco, Jarai, Zoltan, Papadopoulos, Dimitrios, Sublet, Marilucy Lopez –, Grassos, Charalampos, Kahrimanidis, Ioannis, Gkaliagkousi, Eugenia, Triantafyllou, Areti, Grodzicki, Tomasz, Wizner, Barbara, Seweryn, Aleksandra, Moczulska, Beata, Ntineri, Angeliki, Robles, Nicolas Roberto, Widmiski, Jiri, and Zbroch, Edyta
Published: 2024

5. The impact of the COVID-19 pandemic on blood pressure control in patients with treated hypertension-results of the European Society of Hypertension Study (ESH ABPM COVID-19 Study)

Author: Wojciechowska, W, Rajzer, M, Kreutz, R, Weber, T, Bursztyn, M, Persu, A, Stergiou, G, Parati, G, Bilo, G, Pac, A, Grassi, G, Mancia, G, Januszewicz, A, Wojciechowska, Wiktoria, Rajzer, Marek, Kreutz, Reinhold, Weber, Thomas, Bursztyn, Michael, Persu, Alexandre, Stergiou, George, Parati, Gianfranco, Bilo, Grzegorz, Pac, Agnieszka, Grassi, Guido, Mancia, Giuseppe, Januszewicz, Andrzej, Wojciechowska, W, Rajzer, M, Kreutz, R, Weber, T, Bursztyn, M, Persu, A, Stergiou, G, Parati, G, Bilo, G, Pac, A, Grassi, G, Mancia, G, Januszewicz, A, Wojciechowska, Wiktoria, Rajzer, Marek, Kreutz, Reinhold, Weber, Thomas, Bursztyn, Michael, Persu, Alexandre, Stergiou, George, Parati, Gianfranco, Bilo, Grzegorz, Pac, Agnieszka, Grassi, Guido, Mancia, Giuseppe, and Januszewicz, Andrzej
Abstract: Background: We aimed to determine the influence of coronavirus disease 2019 (COVID-19) pandemic on blood pressure (BP) control assessed by ambulatory blood pressure monitoring (ABPM). Methods: Office BP and ABPM data from two visits conducted within a 9-15 months interval were collected from patients treated for hypertension. In the prepandemic group, both visits took place before, while in the pandemic group, Visit-1 was done before and Visit-2 during the pandemic period. Results: Of 1811 collected patients 191 were excluded because they did not meet the required ABPM time frames. Thus, the study comprised 704 patients from the pandemic and 916 from the prepandemic group. Groups did not differ in sex, age, duration of hypertension, frequency of first line antihypertensive drug use and mean 24 h BP on Visit-1. The prevalence of sustained uncontrolled hypertension was similar in both groups. On Visit-2 mean 24 h BP, daytime and nighttime systolic BP and diastolic BP were higher in the pandemic compared to the prepandemic group (P < 0.034). The prevalence of sustained uncontrolled hypertension on Visit-2 was higher in the pandemic than in the prepandemic group [0.29 (95% confidence interval (95% CI): 0.26-0.33) vs. 0.25 (95% CI: 0.22-0.28), P < 0.037]. In multivariable adjusted analyses a significant difference in BP visit-to-visit change was observed, with a more profound decline in BP between visits in the prepandemic group. Conclusions: This study using ABPM indicates a negative impact of the COVID-19 pandemic on BP control. It emphasizes the need of developing strategies to maintain BP control during a pandemic such as the one induced by COVID-19.
Published: 2024

6. Assessment and management of exaggerated blood pressure response to standing and orthostatic hypertension: consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability

Author: Palatini, P, Kollias, A, Saladini, F, Asmar, R, Bilo, G, Kyriakoulis, K, Parati, G, Stergiou, G, Grassi, G, Kreutz, R, Mancia, G, Jordan, J, Biaggioni, I, de la Sierra, A, Kyriakoulis, KG, Stergiou, GS, Palatini, P, Kollias, A, Saladini, F, Asmar, R, Bilo, G, Kyriakoulis, K, Parati, G, Stergiou, G, Grassi, G, Kreutz, R, Mancia, G, Jordan, J, Biaggioni, I, de la Sierra, A, Kyriakoulis, KG, and Stergiou, GS
Abstract: Recent evidence suggests that an exaggerated blood pressure (BP) response to standing (ERTS) is associated with an increased risk of adverse outcomes, both in young and old individuals. In addition, ERTS has been shown to be an independent predictor of masked hypertension. In the vast majority of studies reporting on the prognostic value of orthostatic hypertension (OHT), the definition was based only on systolic office BP measurements. This consensus statement provides recommendations on the assessment and management of individuals with ERTS and/or OHT. ERTS is defined as an orthostatic increase in SBP at least 20 mmHg and OHT as an ERTS with standing SBP at least 140 mmHg. This statement recommends a standardized methodology to assess ERTS, by considering body and arm position, and the number and timing of BP measurements. ERTS/OHT should be confirmed in a second visit, to account for its limited reproducibility. The second assessment should evaluate BP changes from the supine to the standing posture. Ambulatory BP monitoring is recommended in most individuals with ERTS/OHT, especially if they have high-normal seated office BP. Implementation of lifestyle changes and close follow-up are recommended in individuals with ERTS/OHT and normotensive seated office BP. Whether antihypertensive treatment should be administered in the latter is unknown. Hypertensive patients with ERTS/OHT should be managed as any other hypertensive patient. Standardized standing BP measurement should be implemented in future epidemiological and interventional studies.
Published: 2024

7. Impact of oscillometric measurement artefacts in ambulatory blood pressure monitoring on estimates of average blood pressure and of its variability: A pilot study

Author: Bothe, T, Bilo, G, Parati, G, Haberl, R, Pilz, N, Patzak, A, Bothe T. L., Bilo G., Parati G., Haberl R., Pilz N., Patzak A., Bothe, T, Bilo, G, Parati, G, Haberl, R, Pilz, N, Patzak, A, Bothe T. L., Bilo G., Parati G., Haberl R., Pilz N., and Patzak A.
Abstract: Objective:Ambulatory blood pressure monitoring (ABPM) plays an important role in the diagnosis of hypertension. However, methodological factors and the measurement conditions affect the results and may lead to incorrect classification of the patient. We performed a pilot study to evaluate the impact of oscillometric measurement artefacts on ABPM-derived variables.Methods:Four classes of artefacts have been detected: motor activity artefacts, cuff errors, cardiovascular arousals, and arrhythmias. The data consisted of uncorrected measurements (all data), corrected measurements (all artefact free data), and artefact affected data.Results:A total of 30 individuals (9 female/21 male), aged between 36 and 86 years, mean: 65.5 (standard deviation: 9.5) were included in the study. The average blood pressure (BP) was higher in artefacts-affected measurements compared the artefact-free measurements both for systolic (4.6 mmHg) and diastolic (1.3 mmHg) measurements. Further, artefact-affected systolic BP (SBP) was 6.4 mmHg higher than artefact-free measurements during daytime. Nocturnal measurements showed no artefact-depended differences. Individual comparisons yielded that 23% of the participants crossed the threshold for BP classification for either 24-h, daytime or nocturnal hypertension when comparing uncorrected and artefact-free measurements. Dipping classification changed within 24% of participants. BP variability was 21 and 12% higher for SPB and DBP, respectively, during daytime. These differences were even higher (27% for SBP and 21% for DPB) during night-time.Conclusion:The study reveals that measurement artefacts are frequently present during cuff-based ABPM and do relevantly affect measurement outcome. Exclusion of measurement artefacts is a promising approach to improving cuff-based ABPM accuracy.
Published: 2023

8. Rationale and design of the CV-PREVITAL study: an Italian multiple cohort randomised controlled trial investigating innovative digital strategies in primary cardiovascular prevention

Author: Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., Protti G., Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., and Protti G.
Abstract: Introduction Prevention of cardiovascular disease (CVD) is of key importance in reducing morbidity, disability and mortality worldwide. Observational studies suggest that digital health interventions can be an effective strategy to reduce cardiovascular (CV) risk. However, evidence from large randomised clinical trials is lacking. Methods and analysis The CV-PREVITAL study is a multicentre, prospective, randomised, controlled, open-label interventional trial designed to compare the effectiveness of an educational and motivational mobile health (mHealth) intervention versus usual care in reducing CV risk. The intervention aims at improving diet, physical activity, sleep quality, psycho-behavioural aspects, as well as promoting smoking cessation and adherence to pharmacological treatment for CV risk factors. The trial aims to enrol approximately 80 000 subjects without overt CVDs referring to general practitioners' offices, community pharmacies or clinics of Scientific Institute for Research, Hospitalization and Health Care (Italian acronym IRCCS) affiliated with the Italian Cardiology Network. All participants are evaluated at baseline and after 12 months to assess the effectiveness of the intervention on short-term endpoints, namely improvement in CV risk score and reduction of major CV risk factors. Beyond the funded life of the study, a long-term (7 years) follow-up is also planned to assess the effectiveness of the intervention on the incidence of major adverse CV events. A series of ancillary studies designed to evaluate the effect of the mHealth intervention on additional risk biomarkers are also performed. Ethics and dissemination This study received ethics approval from the ethics committee of the coordinating centre (Monzino Cardiology Center; R1256/20-CCM 1319) and from all other relevant IRBs and ethics committees. Findings are disseminated through scientific meetings and peer-reviewed journals and via social media. Partners are informed about the study's
Published: 2023

9. Requirements for design and function of blood pressure measuring devices used for the management of hypertension: Consensus Statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability and STRIDE BP

Author: Stergiou, G, Parati, G, Kollias, A, Schutte, A, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Filipovsky, J, Head, G, Kario, K, Kyriakoulis, K, Mancia, G, Manios, E, Menti, A, Mcmanus, R, Mihailidou, A, Muntner, P, Niiranen, T, Ohkubo, T, Omboni, S, Protogerou, A, Saladini, F, Sharman, J, Shennan, A, Shimbo, D, Topouchian, J, Wang, J, O'Brien, E, Palatini, P, Stergiou G. S., Parati G., Kollias A., Schutte A. E., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Filipovsky J., Head G., Kario K., Kyriakoulis K. G., Mancia G., Manios E., Menti A., McManus R. J., Mihailidou A. S., Muntner P., Niiranen T., Ohkubo T., Omboni S., Protogerou A., Saladini F., Sharman J., Shennan A., Shimbo D., Topouchian J., Wang J., O'Brien E., Palatini P., Stergiou, G, Parati, G, Kollias, A, Schutte, A, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Filipovsky, J, Head, G, Kario, K, Kyriakoulis, K, Mancia, G, Manios, E, Menti, A, Mcmanus, R, Mihailidou, A, Muntner, P, Niiranen, T, Ohkubo, T, Omboni, S, Protogerou, A, Saladini, F, Sharman, J, Shennan, A, Shimbo, D, Topouchian, J, Wang, J, O'Brien, E, Palatini, P, Stergiou G. S., Parati G., Kollias A., Schutte A. E., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Filipovsky J., Head G., Kario K., Kyriakoulis K. G., Mancia G., Manios E., Menti A., McManus R. J., Mihailidou A. S., Muntner P., Niiranen T., Ohkubo T., Omboni S., Protogerou A., Saladini F., Sharman J., Shennan A., Shimbo D., Topouchian J., Wang J., O'Brien E., and Palatini P.
Abstract: Objective:To develop scientific consensus recommendations for the optimal design and functions of different types of blood pressure (BP) measuring devices used in clinical practice for the detection, management, and long-term follow-up of hypertension.Methods:A scientific consensus meeting was performed by the European Society of Hypertension (ESH) Working Group on BP Monitoring and Cardiovascular Variability and STRIDE BP (Science and Technology for Regional Innovation and Development in Europe) during the 2022 Scientific Meeting of the ESH in Athens, Greece. Manufacturers were also invited to provide their feedback on BP device design and development. Thirty-one international experts in clinical hypertension and BP monitoring contributed to the development of consensus recommendations on the optimal design of BP devices.Statement:International consensus was reached on the requirements for the design and features of five types of BP monitors, including office (or clinic) BP monitors, ambulatory BP monitors, home BP monitors, home BP telemonitors, and kiosk BP monitors for public spaces. For each device type "essential" requirements (must have), and "optional" ones (may have) are presented, as well as additional comments on the optimal device design and features.Conclusions:These consensus recommendations aim at providing manufacturers of BP devices with the requirements that are considered mandatory, or optional, by clinical experts involved in the detection and management of hypertension. They are also directed to administrative healthcare personnel involved in the provision and purchase of BP devices so that they can recommend the most appropriate ones.
Published: 2023

10. Ambulatory blood pressure monitoring in treated patients with hypertension in the COVID-19 pandemic - The study of European society of hypertension (ESH ABPM COVID-19 study)

Author: Wojciechowska, W, Rajzer, M, Weber, T, Prejbisz, A, Dobrowolski, P, Ostrowska, A, Bilo, G, Mancia, G, Kreutz, R, Januszewicz, A, Wojciechowska W., Rajzer M., Weber T., Prejbisz A., Dobrowolski P., Ostrowska A., Bilo G., Mancia G., Kreutz R., Januszewicz A., Wojciechowska, W, Rajzer, M, Weber, T, Prejbisz, A, Dobrowolski, P, Ostrowska, A, Bilo, G, Mancia, G, Kreutz, R, Januszewicz, A, Wojciechowska W., Rajzer M., Weber T., Prejbisz A., Dobrowolski P., Ostrowska A., Bilo G., Mancia G., Kreutz R., and Januszewicz A.
Abstract: Purpose: The coronavirus disease 2019 (COVID-19) pandemic and the subsequent lockdown profoundly affected almost all aspects of daily life including health services worldwide. The established risk factors for increased blood pressure (BP) and hypertension may also demonstrate significant changes during the pandemic. This study aims to determine the impact of the COVID-19 pandemic on BP control and BP phenotypes as assessed with 24-hour ambulatory BP monitoring (ABPM). Materials and Methods: This is a multi-centre, observational, retrospective and comparative study involving Excellence Centres of the European Society of Hypertension across Europe. Along with clinical data and office BP, ABPM recordings will be collected in adult patients with treated arterial hypertension. There will be two groups in the study: Group 1 will consist of participants who have undergone two ABPM recordings - the second one occurring during the COVID-19 pandemic, i.e. after March 2020, and the first one 9–15 months prior to the second. Participants in Group 2 will have two repeated ABPM recordings - both performed before the pandemic within a similar 9–15 month interval between the recordings. Within each group, we will analyse and compare BP variables and phenotypes (including averaged daytime and night-time BP, BP variability, dipper and non-dipper status, white-coat and masked hypertension) between the two respective ABPM recordings and compare these changes between the two groups. The target sample size will amount to least 590 participants in each of the study groups, which means a total of at least 2360 ABPM recordings overall. Expected outcomes: As a result, we expect to identify the impact of a COVID-19 pandemic on blood pressure control and the quality of medical care in order to develop the strategy to control cardiovascular risk factors during unpredictable global events.
Published: 2023

11. Effect of Continuous Positive Airway Pressure on Glucose and Lipid Profiles in Patients With Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author: Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, Fava, C, Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., Fava C., Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, Fava, C, Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., and Fava C.
Abstract: Background and aim: Continuous Positive Airway Pressure (CPAP) is the most effective therapy for symptomatic obstructive sleep apnoea (OSA). However, uncertainty remains about the effectiveness of CPAP in improving OSA-related metabolic dysregulation. This meta-analysis of randomized controlled trials (RCTs) aimed to investigate whether CPAP, compared to other control treatments, could improve glucose or lipid metabolism in OSA patients. Methods: Relevant articles were searched in three different databases (MEDLINE, EMBASE and Web of Science) from inception to 6th Feb 2022 through specific search terms and selection criteria. Results: From a total of 5553 articles, 31 RCTs were included. CPAP modestly improved insulin sensitivity as determined by mean fasting plasma insulin and Homeostasis Model Assessment of Insulin Resistance reduction of 1.33 mU/L and 0.287, respectively. In subgroup analyses pre-diabetic/type 2 diabetic patients as well as those with sleepy OSA showed a greater response to CPAP. Regarding lipid metabolism, CPAP was associated with a mean total cholesterol reduction of 0.064 mmol/L. In subgroup analyses, the benefit was higher in patients that showed more severe OSA and oxygen desaturations at the baseline sleep study as well as in younger and obese subjects. Neither glycated haemoglobin nor triglycerides, HDL- and LDL-cholesterol were reduced by CPAP. Conclusion: CPAP treatment may improve insulin sensitivity and total cholesterol levels in OSA patients but with low effect size. Our results suggest that CPAP does not substantially improve metabolic derangements in an unselected OSA population, but the effect may be higher in specific subgroups of OSA patients.
Published: 2023

12. Blood pressure variability: methodological aspects, clinical relevance and practical indications for management - a European Society of Hypertension position paper ∗

Author: Parati, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Castiglioni, P, Stergiou, G, Mancia, G, Asayama, K, Asmar, R, Avolio, A, Caiani, E, De La Sierra, A, Dolan, E, Grillo, A, Guzik, P, Hoshide, S, Head, G, Imai, Y, Juhanoja, E, Kahan, T, Kario, K, Kotsis, V, Kreutz, R, Kyriakoulis, K, Li, Y, Manios, E, Mihailidou, A, Modesti, P, Omboni, S, Palatini, P, Persu, A, Protogerou, A, Saladini, F, Salvi, P, Sarafidis, P, Torlasco, C, Veglio, F, Vlachopoulos, C, Zhang, Y, Parati G., Bilo G., Kollias A., Pengo M., Ochoa J. E., Castiglioni P., Stergiou G. S., Mancia G., Asayama K., Asmar R., Avolio A., Caiani E. G., De La Sierra A., Dolan E., Grillo A., Guzik P., Hoshide S., Head G. A., Imai Y., Juhanoja E., Kahan T., Kario K., Kotsis V., Kreutz R., Kyriakoulis K. G., Li Y., Manios E., Mihailidou A. S., Modesti P. A., Omboni S., Palatini P., Persu A., Protogerou A. D., Saladini F., Salvi P., Sarafidis P., Torlasco C., Veglio F., Vlachopoulos C., Zhang Y., Parati, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Castiglioni, P, Stergiou, G, Mancia, G, Asayama, K, Asmar, R, Avolio, A, Caiani, E, De La Sierra, A, Dolan, E, Grillo, A, Guzik, P, Hoshide, S, Head, G, Imai, Y, Juhanoja, E, Kahan, T, Kario, K, Kotsis, V, Kreutz, R, Kyriakoulis, K, Li, Y, Manios, E, Mihailidou, A, Modesti, P, Omboni, S, Palatini, P, Persu, A, Protogerou, A, Saladini, F, Salvi, P, Sarafidis, P, Torlasco, C, Veglio, F, Vlachopoulos, C, Zhang, Y, Parati G., Bilo G., Kollias A., Pengo M., Ochoa J. E., Castiglioni P., Stergiou G. S., Mancia G., Asayama K., Asmar R., Avolio A., Caiani E. G., De La Sierra A., Dolan E., Grillo A., Guzik P., Hoshide S., Head G. A., Imai Y., Juhanoja E., Kahan T., Kario K., Kotsis V., Kreutz R., Kyriakoulis K. G., Li Y., Manios E., Mihailidou A. S., Modesti P. A., Omboni S., Palatini P., Persu A., Protogerou A. D., Saladini F., Salvi P., Sarafidis P., Torlasco C., Veglio F., Vlachopoulos C., and Zhang Y.
Abstract: Blood pressure is not a static parameter, but rather undergoes continuous fluctuations over time, as a result of the interaction between environmental and behavioural factors on one side and intrinsic cardiovascular regulatory mechanisms on the other side. Increased blood pressure variability (BPV) may indicate an impaired cardiovascular regulation and may represent a cardiovascular risk factor itself, having been associated with increased all-cause and cardiovascular mortality, stroke, coronary artery disease, heart failure, end-stage renal disease, and dementia incidence. Nonetheless, BPV was considered only a research issue in previous hypertension management guidelines, because the available evidence on its clinical relevance presents several gaps and is based on heterogeneous studies with limited standardization of methods for BPV assessment.The aim of this position paper, with contributions from members of the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability and from a number of international experts, is to summarize the available evidence in the field of BPV assessment methodology and clinical applications and to provide practical indications on how to measure and interpret BPV in research and clinical settings based on currently available data. Pending issues and clinical and methodological recommendations supported by available evidence are also reported. The information provided by this paper should contribute to a better standardization of future studies on BPV, but should also provide clinicians with some indications on how BPV can be managed based on currently available data.
Published: 2023

13. Nocturnal BP Profile Predicts CPAP Effect on BP in Patients With OSA and Resistant Hypertension

Author: Pengo, M, Oscullo, G, Gomez-Olivas, J, Bilo, G, Parati, G, Martinez-Garcia, M, Pengo M. F., Oscullo G., Gomez-Olivas J. D., Bilo G., Parati G., Martinez-Garcia M. A., Pengo, M, Oscullo, G, Gomez-Olivas, J, Bilo, G, Parati, G, Martinez-Garcia, M, Pengo M. F., Oscullo G., Gomez-Olivas J. D., Bilo G., Parati G., and Martinez-Garcia M. A.
Published: 2023

14. Effect of Continuous Positive Airway Pressure on Glucose and Lipid Profiles in Patients With Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author: Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., Fava C., Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, and Fava, C
Subjects: OSA, Pulmonary and Respiratory Medicine, Glucose level, CPAP, Insulin resistance, Meta-analysi, Lipids level
Abstract: Background and aim: Continuous Positive Airway Pressure (CPAP) is the most effective therapy for symptomatic obstructive sleep apnoea (OSA). However, uncertainty remains about the effectiveness of CPAP in improving OSA-related metabolic dysregulation. This meta-analysis of randomized controlled trials (RCTs) aimed to investigate whether CPAP, compared to other control treatments, could improve glucose or lipid metabolism in OSA patients. Methods: Relevant articles were searched in three different databases (MEDLINE, EMBASE and Web of Science) from inception to 6th Feb 2022 through specific search terms and selection criteria. Results: From a total of 5553 articles, 31 RCTs were included. CPAP modestly improved insulin sensitivity as determined by mean fasting plasma insulin and Homeostasis Model Assessment of Insulin Resistance reduction of 1.33 mU/L and 0.287, respectively. In subgroup analyses pre-diabetic/type 2 diabetic patients as well as those with sleepy OSA showed a greater response to CPAP. Regarding lipid metabolism, CPAP was associated with a mean total cholesterol reduction of 0.064 mmol/L. In subgroup analyses, the benefit was higher in patients that showed more severe OSA and oxygen desaturations at the baseline sleep study as well as in younger and obese subjects. Neither glycated haemoglobin nor triglycerides, HDL- and LDL-cholesterol were reduced by CPAP. Conclusion: CPAP treatment may improve insulin sensitivity and total cholesterol levels in OSA patients but with low effect size. Our results suggest that CPAP does not substantially improve metabolic derangements in an unselected OSA population, but the effect may be higher in specific subgroups of OSA patients.
Published: 2023

15. Time to rethink the management of underlying sleep disturbances in nondippers?

Author: Pengo, Martino F., Bilo, G., Lombardi, C., and Parati, G.
Published: 2020
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16. Cardiac Autonomic Modulation and Response to Sub-Maximal Exercise in Chilean Hypertensive Miners

Author: Lang, M, Mendt, S, Paez, V, Gunga, H, Bilo, G, Merati, G, Parati, G, Maggioni, M, Lang M., Mendt S., Paez V., Gunga H. -C., Bilo G., Merati G., Parati G., Maggioni M. A., Lang, M, Mendt, S, Paez, V, Gunga, H, Bilo, G, Merati, G, Parati, G, Maggioni, M, Lang M., Mendt S., Paez V., Gunga H. -C., Bilo G., Merati G., Parati G., and Maggioni M. A.
Abstract: Cardiac autonomic modulation in workers exposed to chronic intermittent hypoxia (CIH) has been poorly studied, especially considering hypertensive ones. Heart rate variability (HRV) has been proven as valuable tool to assess cardiac autonomic modulation under different conditions. The aim of this study is to investigate the cardiac autonomic response related to submaximal exercise (i.e., six-minute walk test, 6MWT) in hypertensive (HT, n = 9) and non-hypertensive (NT, n = 10) workers exposed for > 2 years to CIH. Participants worked on 7-on 7-off days shift between high altitude (HA: > 4.200 m asl) and sea level (SL: < 500 m asl). Data were recorded with electrocardiography (ECG) at morning upon awakening (10 min supine, baseline), then at rest before and after (5 min sitting, pre and post) the 6MWT, performed respectively on the first day of their work shift at HA, and after the second day of SL sojourn. Heart rate was higher at HA in both groups for each measurement (p < 0.01). Parasympathetic indices of HRV were lower in both groups at HA, either in time domain (RMSSD, p < 0.01) and in frequency domain (log HF, p < 0.01), independently from measurement’s time. HRV indices in non-linear domain supported the decrease of vagal tone at HA and showed a reduced signal’s complexity. ECG derived respiration frequency (EDR) was higher at HA in both groups (p < 0.01) with interaction group x altitude (p = 0.012), i.e., higher EDR in HT with respect to NT. No significant difference was found in 6MWT distance regarding altitude for both groups, whereas HT covered a shorter 6MWT distance compared to NT (p < 0.05), both at HA and SL. Besides, conventional arm-cuff blood pressure and oxygen blood saturation values (recorded before, at the end and after 5-min recovery from 6MWT), reported differences related to HA only. HA is the main factor affecting cardiac autonomic modulation, independently from hypertension. However, presence of hypertension was asso
Published: 2022

17. The rationale, protocol and preliminary results of the ESH ABPM COVID-19 study

Author: Wojciechowska, W, Rajzer, M, Weber, T, Prejbis, A, Dobrowolski, P, Ostrowska, A, Bilo, G, Mancia, G, Kreutz, R, Januszewicz, A, Wojciechowska W., Rajzer M., Weber T., Prejbis A., Dobrowolski P., Ostrowska A., Bilo G., Mancia G., Kreutz R., Januszewicz A., Wojciechowska, W, Rajzer, M, Weber, T, Prejbis, A, Dobrowolski, P, Ostrowska, A, Bilo, G, Mancia, G, Kreutz, R, Januszewicz, A, Wojciechowska W., Rajzer M., Weber T., Prejbis A., Dobrowolski P., Ostrowska A., Bilo G., Mancia G., Kreutz R., and Januszewicz A.
Published: 2022

18. New answers to an old question: how many office blood pressure measurements are needed?

Author: Bilo, G, Pengo, M, Parati, G, Bilo G., Pengo M., Parati G., Bilo, G, Pengo, M, Parati, G, Bilo G., Pengo M., and Parati G.
Published: 2022

19. Association between hypotension during 24 h ambulatory blood pressure monitoring and reflex syncope: the SynABPM 1 study

Author: Rivasi, G, Groppelli, A, Brignole, M, Soranna, D, Zambon, A, Bilo, G, Pengo, M, Sharad, B, Hamrefors, V, Rafanelli, M, Testa, G, Rice, C, Kenny, R, Sutton, R, Ungar, A, Fedorowski, A, Parati, G, Rivasi G., Groppelli A., Brignole M., Soranna D., Zambon A., Bilo G., Pengo M., Sharad B., Hamrefors V., Rafanelli M., Testa G. D., Rice C., Kenny R. A., Sutton R., Ungar A., Fedorowski A., Parati G., Rivasi, G, Groppelli, A, Brignole, M, Soranna, D, Zambon, A, Bilo, G, Pengo, M, Sharad, B, Hamrefors, V, Rafanelli, M, Testa, G, Rice, C, Kenny, R, Sutton, R, Ungar, A, Fedorowski, A, Parati, G, Rivasi G., Groppelli A., Brignole M., Soranna D., Zambon A., Bilo G., Pengo M., Sharad B., Hamrefors V., Rafanelli M., Testa G. D., Rice C., Kenny R. A., Sutton R., Ungar A., Fedorowski A., and Parati G.
Abstract: Aims: Diagnostic criteria for ambulatory blood pressure monitoring (ABPM) in patients with suspected reflex syncope are lacking. The study hypothesis was that patients with reflex syncope have a higher prevalence of systolic blood pressure (SBP) drops on ABPM. Methods and results: ABPM data from reflex syncope patients and controls, matched by average 24h SBP, age, sex, and hypertension were compared. Patients with constitutional hypotension, orthostatic hypotension, and predominant cardioinhibition during carotid sinus massage or prolonged electrocardiogram monitoring or competing causes of syncope were excluded. Daytime and nighttime SBP drops (<110, 100, 90, 80mmHg) were assessed. Findings were validated in an independent sample. In the derivation sample, daytime SBP drops were significantly more common in 158 syncope patients than 329 controls. One or more daytime drops <90mmHg achieved 91% specificity and 32% sensitivity [odds ratio (OR) 4.6, P < 0.001]. Two or more daytime drops <100mmHg achieved 84% specificity and 40% sensitivity (OR 3.5, P = 0.001). Results were confirmed in the validation sample of 164 syncope patients and 164 controls: one or more daytime SBP drops <90mmHg achieved 94% specificity and 29% sensitivity (OR 6.2, P < 0.001), while two or more daytime SBP drops <100mmHg achieved 83% specificity and 35% sensitivity (OR 2.6, P < 0.001) Conclusion: SBP drops during ABPM are more common in reflex syncope patients than in controls. Cut-off values that may be applied in clinical practice are defined. This study expands the current indications for ABPM to patients with reflex syncope.
Published: 2022

20. Effects of uric acid-lowering therapy in patients with essential arterial hypertension

Author: Gruszka, K, Drozdz, T, Wojciechowska, W, Jankowski, P, Terlecki, M, Bijak, M, Hering, D, Bilo, G, Drozdz, D, Rajzer, M, Gruszka K., Drozdz T., Wojciechowska W., Jankowski P., Terlecki M., Bijak M., Hering D., Bilo G., Drozdz D., Rajzer M., Gruszka, K, Drozdz, T, Wojciechowska, W, Jankowski, P, Terlecki, M, Bijak, M, Hering, D, Bilo, G, Drozdz, D, Rajzer, M, Gruszka K., Drozdz T., Wojciechowska W., Jankowski P., Terlecki M., Bijak M., Hering D., Bilo G., Drozdz D., and Rajzer M.
Abstract: Objectives Asymptomatic hyperuricemia (AHU) is elevated serum uric acid (UA) without symptoms. This study aimed to determine the effects of AHU treatment with allopurinol on selected hypertension-mediated organ damage (HMOD) indices in patients with uncomplicated essential arterial hypertension (AH). Methods Patients aged 30-70 years with AHU and AH grade 1-2 with adequate blood pressure (BP) control, without previous urate-lowering therapy (ULT), were divided into two groups: (a) ULT (receiving allopurinol) and (b) control (age- and sex-matched patients without ULT). Both received a UA-lowering diet. BP (office, 24 h and central), echocardiographic parameters, carotid intima-media thickness (IMT) and lab tests [high-sensitivity C-reactive protein (hs-CRP)] were measured at baseline and at 6 months follow-up. Results Of 100 participants, 87 (44 ULT, 43 controls) completed the study. At 6 months follow-up, there was a greater reduction in serum UA concentration in the ULT group than in the control group. Patients receiving allopurinol had significant reductions in office systolic and diastolic BP, central systolic BP, pulse pressure, IMT (0.773 ± 0.121 vs. 0.752 ± 0.13 mm, P = 0.044) and hs-CRP (3.36 ± 2.73 vs. 2.74 ± 1.91 mg/L, P = 0.028) compared to controls. Multivariate regression analysis revealed the independent relationship between reduction in IMT and UA lowering (P < 0.026). Conclusion In patients with AH and AHU, treatment with allopurinol leads to improvement in BP control and reduction in HMOD intensity, in particular IMT. The decrease in hs-CRP concentration associated with ULT may have a beneficial effect on a patient's long-term prognosis.
Published: 2022

21. Nocturnal hypoxemia, blood pressure, vascular status and chronic mountain sickness in the highest city in the world

Author: Perger, E, Baillieul, S, Esteve, F, Pichon, A, Bilo, G, Soranna, D, Doutreleau, S, Savina, Y, Ulliel-Roche, M, Brugniaux, J, Stauffer, E, Oberholzer, L, Howe, C, Hannco, I, Lombardi, C, Tamisier, R, Pepin, J, Verges, S, Parati, G, Perger E., Baillieul S., Esteve F., Pichon A., Bilo G., Soranna D., Doutreleau S., Savina Y., Ulliel-Roche M., Brugniaux J. V., Stauffer E., Oberholzer L., Howe C., Hannco I., Lombardi C., Tamisier R., Pepin J. -L., Verges S., Parati G., Perger, E, Baillieul, S, Esteve, F, Pichon, A, Bilo, G, Soranna, D, Doutreleau, S, Savina, Y, Ulliel-Roche, M, Brugniaux, J, Stauffer, E, Oberholzer, L, Howe, C, Hannco, I, Lombardi, C, Tamisier, R, Pepin, J, Verges, S, Parati, G, Perger E., Baillieul S., Esteve F., Pichon A., Bilo G., Soranna D., Doutreleau S., Savina Y., Ulliel-Roche M., Brugniaux J. V., Stauffer E., Oberholzer L., Howe C., Hannco I., Lombardi C., Tamisier R., Pepin J. -L., Verges S., and Parati G.
Abstract: Introduction: Chronic mountain sickness (CMS) is a condition characterized by excessive erythrocytosis in response to chronic hypobaric hypoxia. CMS frequently triggers cardiorespiratory diseases such as pulmonary hypertension and right or left heart failure. Ambient hypoxia might be further amplified night-time by intermittent hypoxia related to sleep-disordered breathing (SDB) so that sleep disturbance may be an important feature of CMS. Our aim was to characterize in a cross-sectional study nocturnal hypoxaemia, SDB, blood pressure (BP), arterial stiffness and carotid intima-media thickness (CIMT) in highlanders living at extreme altitude. Methods: Men aged 18 to 55 years were prospectively recruited. Home sleep apnoea test, questionnaires (short-form health survey; Montreal cognitive assessment; Pittsburgh Sleep Questionnaire Index and the Insomnia severity index), 24-h ambulatory BP monitoring, CIMT and arterial stiffness were evaluated in 3 groups: i) Andean lowlanders (sea-level); ii) highlanders living at 3,800 m and iii) highlanders living at 5,100 m. Analyses were conducted in sub-groups according to 1) CMS severity 2) healthy subjects living at the three different altitude. Results: Ninety-two males were evaluated at their living altitudes. Among the 54 highlanders living at 5,100 m, subjects with CMS showed lower mean nocturnal oxygen saturation (SpO2), SpO2 nadir, lower pulse wave velocity and higher nocturnal BP variability than those with no-CMS. Lower nocturnal SpO2 nadir was associated with higher CMS severity (ß= −0.14, p=.009). Among the 55 healthy subjects, healthy highlanders at 5,100 m were characterized by lower scores on quality of life and sleep quality scales and lower mean SpO2 compared to lowlanders. Conclusions: Lower nocturnal SpO2 and higher nocturnal BP variability are associated with CMS severity in individuals living permanently at high altitude. The role of lower SpO2 and higher nocturnal BP variability in the cardiovascular progre
Published: 2022

22. Did nocturia, in hypertension, correlate with dipping status?

Author: Croce, A, primary, Parazzoli, C, additional, Pengo, M, additional, Rosa, D, additional, Bilo, G, additional, Chiodini, I, additional, and Parati, G F, additional
Published: 2023
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23. Psychometric Properties of a Brief Version of the Perception of Risk of Heart Disease Scale in an Italian Sample

Author: Rosa, D, Pengo, M, Adorni, R, Bilo, G, Parati, G, Steca, P, Pengo, MF, Rosa, D, Pengo, M, Adorni, R, Bilo, G, Parati, G, Steca, P, and Pengo, MF
Abstract: Introduction: The number of Italian citizens unaware of their risk of cardiovascular disease it is still very high. Aim: This study aimed to translate and preliminarily validate a brief Italian version of the Perception of Risk of Heart Disease Scale (PRHDS). Methods: PRHDS was culturally adapted to the Italian context. Then, the scale was administered to 772 healthy adults. By randomly dividing the sample into two subsamples, we tested the scale dimensionality through Exploratory Factor Analysis (EFA) followed by Confirmatory Factor Analysis (CFA). Finally, we evaluated internal consistency. Results: Psychometric properties of the scale were appropriate. EFA and CFA evidenced a unidimensional structure of a brief version of the scale, composed of six items. Internal consistency was adequate. Conclusions: Italian version of the brief PRHDS is a promising self-report questionnaire to measure cardiovascular risk perception among Italian adults.
Published: 2023

24. THE IMPACT OF COVID-19 PANDEMIC ON BLOOD PRESSURE CONTROL IN PATIENTS WITH TREATED HYPERTENSION. RESULTS OF EUROPEAN SOCIETY OF HYPERTENSION STUDY (ESH ABPM COVID-19 STUDY)

Author: Wojciechowska, W, Rajzer, M, Weber, T, Chrostowska, M, Doumas, M, De Fréminville, J, Lewandowski, J, Wuerzner, G, Gosk-Przybylek, M, Parati, G, Van Der Niepen, P, Kahan, T, Bursztyn, M, Persu, A, Stergiou, G, Bilo, G, Grassi, G, Mancia, G, Kreutz, R, Januszewicz, A, De Fréminville, JB, Stergiou, GS, Wojciechowska, W, Rajzer, M, Weber, T, Chrostowska, M, Doumas, M, De Fréminville, J, Lewandowski, J, Wuerzner, G, Gosk-Przybylek, M, Parati, G, Van Der Niepen, P, Kahan, T, Bursztyn, M, Persu, A, Stergiou, G, Bilo, G, Grassi, G, Mancia, G, Kreutz, R, Januszewicz, A, De Fréminville, JB, and Stergiou, GS
Published: 2023

25. GARFIELD-AF: risk profiles, treatment patterns and 2-year outcomes in patients with atrial fibrillation in Germany, Austria and Switzerland (DACH) compared to 32 countries in other regions worldwide

Author: Sylvia, H, John A, C, Darius, H, Jan, S, Saverio, V, Karen, P, Marianne, B, Sebastian, S, Frank, M, Gloria, K, Kakkar, A, Bassand, J, John Camm, A, Fitzmaurice, D, Fox, K, Gersh, B, Goldhaber, S, Goto, S, Haas, S, Hacke, W, Mantovani, L, Misselwitz, F, Pieper, K, Turpie, A, van Eickels, M, Verheugt, F, Gersh, K, Lucas Luciardi Harry Gibbs, H, Brodmann, M, Cools, F, Carlos Pereira Barretto, A, Connolly, S, Eikelboom, J, Corbalan, R, Jing, Z, Jansky, P, Dalsgaard Nielsen, J, Ragy, H, Raatikainen, P, Le Heuzey, J, Keltai, M, Pal Singh Sawhney, J, Agnelli, G, Ambrosio, G, Koretsune, Y, Jerjes Sánchez Díaz, C, Ten Cate, H, Atar, D, Stepinska, J, Panchenko, E, Wei Lim, T, Jacobson, B, Oh, S, Viñolas, X, Rosenqvist, M, Steffel, J, Angchaisuksiri, P, Oto, A, Parkhomenko, A, Al Mahmeed, W, Hu Kangning Chen, D, Zhao, Y, Zhang, H, Chen, J, Cao, S, Wang, D, Yang, Y, Li, W, Li, H, Yin, Y, Tao, G, Yang, P, Chen, Y, He, S, Wang, Y, Fu, G, Li, X, Wu, T, Cheng, X, Yan, X, Zhao, R, Chen, M, Xiong, L, Chen, P, Jiao, Y, Guo, Y, Xue, L, Yang, Z, Jadhavm Raghava Sarma, P, Kulkarni, G, Chandwani, P, Atulbhai Pothiwala, R, Padinhare Purayil, M, Chawla, K, Annasaheb Kothiwale, V, Raghuraman, B, Madan Vijan, V, Sawhney, J, Bantwal, G, Khan, A, Meena, R, Chopada, M, Abraham, S, Bisne, V, Vijayaraghavan, G, Roy, D, Durgaprasad, R, Ravi Shankar, A, Kumar, S, Jain, D, Bhargava, K, Kumar, V, Madappa Nagamalesh, U, Kumar Rajput, R, Koretsune Seishu Kanamori, Y, Yamamoto, K, Kumagai, K, Katsuda, Y, Yoshida, K, Toyota, F, Mizuno, Y, Misumi, I, Noguchi, H, Ando, S, Suetsugu, T, Minamoto, M, Oda, H, Adachi, S, Chiba, K, Norita, H, Tsuruta, M, Koyanagi, T, Ando, H, Higashi, T, Okada, M, Azakami, S, Komaki, S, Kumeda, K, Murayama, T, Matsumura, J, Oba, Y, Sonoda, R, Goto, K, Minoda, K, Haraguchi, Y, Suefuji, H, Miyagi, H, Kato, H, Nakamura, T, Nandate, H, Zaitsu, R, Fujiura, Y, Yoshimura, A, Numata, H, Ogawa, J, Kamogawa, Y, Murakami, K, Wakasa, Y, Yamasawa, M, Maekawa, H, Abe, S, Kihara, H, Tsunoda, S, Saito, K, Tachibana, H, Oba, I, Kuwahata, T, Higa, S, Gushiken, M, Eto, T, Chibana, H, Fujisawa, K, Shiga, Y, Sumi, H, Nagatomo, T, Atsuchi, Y, Nagoshi, T, Sanno, K, Hoshino, F, Yokota, N, Kameko, M, Tabuchi, T, Ishizawa, M, Ikeda, D, Seto, T, Iwao, T, Ishioka, N, Oshiro, K, Tsuchida, K, Hatori, Y, Takeuchi, M, Takezawa, H, Nagano, S, Iwaki, M, Nakamura, Y, Miyamoto, N, Taguchi, T, Ashida, K, Yoshizawa, N, Agata, J, Matsukawa, S, Arasaki, O, Fukuoka, S, Murakami, H, Mishima, K, Hata, Y, Sakuma, I, Obunai, K, Takamura, I, Akutsu, M, Unoki, T, Go, Y, Ikemura, M, Morii, S, Marusaki, S, Doi, H, Tanaka, M, Kusumoto, T, Kakinoki, S, Ogurusu, C, Murata, K, Shimoyama, M, Nakatsuka, M, Kitami, Y, Oyama, R, Ageta, M, Mita, T, Nagao, K, Mito, T, Minami, J, Abe, M, Fujii, M, Okawa, M, Fujito, T, Taniguchi, T, Ko, T, Kubo, H, Imamaki, M, Akiyama, M, Ueda, T, Odakura, H, Inagaki, M, Katsube, Y, Nakata, A, Tomimoto, S, Shibuya, M, Nakano, M, Ito, K, Matsuta, M, Ishiguro, M, Minagawa, T, Wada, M, Mukawa, H, Mizuguchi, M, Okuda, F, Kimura, T, Taga, K, Techigawara, M, Igarashi, M, Watanabe, H, Seo, T, Hiramitsu, S, Hosokawa, H, Hoshiai, M, Hibino, M, Miyagawa, K, Horie, H, Sugishita, N, Soma, A, Neya, K, Yoshida, T, Akahane, K, Takanaka, C, Matsui, S, Kanda, H, Kaneko, M, Nagasaka, S, Taguchi, A, Toru, S, Miyashita, A, Sasaguri, H, Nariyama, J, Hatsuno, T, Iwase, T, Sato, K, Kawai, K, Kotani, T, Tsuji, T, Sakai, H, Nishino, K, Ikeda, K, Maeda, K, Shinozuka, T, Inoue, T, Kawakami, K, Kitazumi, H, Takagi, T, Hamaoka, M, Kojima, J, Sasaki, A, Tsuchiya, Y, Betsuyaku, T, Higuchi, K, Honda, M, Hasegawa, K, Baba, T, Mineoi, K, Koeda, T, Hirasawa, K, Kumazaki, T, Nakagomi, A, Otaki, E, Shindo, T, Hirayama, H, Sugimoto, C, Yamagishi, T, Mizuguchi, I, Sezaki, K, Niwa, I, Takenaka, K, Iiji, O, Taya, K, Kitazawa, H, Ueda, S, Kakuda, H, Ono, T, Oriso, S, Kamata, J, Nanke, T, Maeda, I, Matsuura, Y, Teragawa, H, Maruyama, Y, Takei, K, Kito, T, Asano, H, Matsushita, K, Nakamura, M, 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Connolly, John Eikelboom, Ramon Corbalan, Zhi-Cheng Jing, Petr Jansky, Jørn Dalsgaard Nielsen, Hany Ragy, Pekka Raatikainen, Jean-Yves Le Heuzey, Harald Darius, Matyas Keltai, Jitendra Pal Singh Sawhney, Giancarlo Agnelli, Giuseppe Ambrosio, Yukihiro Koretsune, Carlos Jerjes Sánchez Díaz, Hugo Ten Cate, Dan Atar, Janina Stepinska, Elizaveta Panchenko, Toon Wei Lim, Barry Jacobson, Seil Oh, Xavier Viñolas, Marten Rosenqvist, Jan Steffel, Pantep Angchaisuksiri, Ali Oto, Alex Parkhomenko, Wael Al Mahmeed, David Fitzmaurice, Dayi Hu Kangning Chen, Yusheng Zhao, Huaiqin Zhang, Jiyan Chen, Shiping Cao, Daowen Wang, Yuejin Yang, Weihua Li, Hui Li, Yuehui Yin, Guizhou Tao, Ping Yang, Yingmin Chen, Shenghu He, Yong Wang, Guosheng Fu, Xin Li, Tongguo Wu, Xiaoshu Cheng, Xiaowei Yan, Ruiping Zhao, Moshui Chen, Longgen Xiong, Ping Chen, Yang Jiao, Ying Guo, Li Xue, Zhiming Yang, Praveen Jadhavm Raghava Sarma, Govind Kulkarni, Prakash Chandwani, Rasesh Atulbhai Pothiwala, Mohanan Padinhare Purayil, Kamaldeep Chawla, Veerappa Annasaheb Kothiwale, Bagirath Raghuraman, Vinod Madan Vijan, Jitendra Sawhney, Ganapathi Bantwal, Aziz Khan, Ramdhan Meena, Manojkumar Chopada, Sunitha Abraham, Vikas Bisne, Govindan Vijayaraghavan, Debabrata Roy, Rajashekhar Durgaprasad, A. 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Ravi Shankar, Sunil Kumar, Dinesh Jain, Kartikeya Bhargava, Vinay Kumar, Udigala Madappa Nagamalesh, Rajeeve Kumar Rajput, Yukihiro Koretsune Seishu Kanamori, Kenichi Yamamoto, Koichiro Kumagai, Yosuke Katsuda, Keiki Yoshida, Fumitoshi Toyota, Yuji Mizuno, Ikuo Misumi, Hiroo Noguchi, Shinichi Ando, Tetsuro Suetsugu, Masahiro Minamoto, Hiroyuki Oda, Susumu Adachi, Kei Chiba, Hiroaki Norita, Makoto Tsuruta, Takeshi Koyanagi, Kunihiko Yamamoto, Hiroshi Ando, Takayuki Higashi, Megumi Okada, Shiro Azakami, Shinichiro Komaki, Kenshi Kumeda, Takashi Murayama, Jun Matsumura, Yurika Oba, Ryuji Sonoda, Kazuo Goto, Kotaro Minoda, Yoshikuni Haraguchi, Hisakazu Suefuji, Hiroo Miyagi, Hitoshi Kato, Tsugihiro Nakamura, Tadashi Nakamura, Hidekazu Nandate, Ryuji Zaitsu, Yoshihisa Fujiura, Akira Yoshimura, Hiroyuki Numata, Jun Ogawa, Yasuyuki Kamogawa, Kinshiro Murakami, Yutaka Wakasa, Masanori Yamasawa, Hiromitsu Maekawa, Sumihisa Abe, Hajime Kihara, Satoru Tsunoda, Katsumi Saito, Hiroki Tachibana, Ichiro Oba, Takashi Kuwahata, Satoshi Higa, Masamichi Gushiken, Takuma Eto, Hidetoshi Chibana, Kazuaki Fujisawa, Yuhei Shiga, Hirokuni Sumi, Toshihisa Nagatomo, Yoshihiko Atsuchi, Toshiro Nagoshi, Kazuhisa Sanno, Fumihiro Hoshino, Naoto Yokota, Masahiro Kameko, Toshifumi Tabuchi, Munesumi Ishizawa, Yoshitake Fujiura, Daisuke Ikeda, Taku Seto, Tetsu Iwao, Norio Ishioka, Koichi Oshiro, Keizo Tsuchida, Yutaka Hatori, Motoshi Takeuchi, Hiroto Takezawa, Shinjiro Nagano, Masaaki Iwaki, Yuichiro Nakamura, Naomasa Miyamoto, Toshifumi Taguchi, Ko Ashida, Naoto Yoshizawa, Jun Agata, Seishiro Matsukawa, Osamu Arasaki, Shuji Fukuoka, Hirofumi Murakami, Kazuya Mishima, Yoshiki Hata, Ichiro Sakuma, Kotaro Obunai, Ichiro Takamura, Mitsuyuki Akutsu, Toshihide Unoki, Yoshinori Go, Makoto Ikemura, Shoji Morii, Shigeru Marusaki, Hideo Doi, Mitsuru Tanaka, Takaaki Kusumoto, Shigeo Kakinoki, Chiga Ogurusu, Kazuya Murata, Masaki Shimoyama, Masami Nakatsuka, Yutaka Kitami, Yoichi Nakamura, Hiroshi Oda, Rikimaru Oyama, Masato Ageta, Teruaki Mita, Kazuhiko Nagao, Takafumi Mito, Junichi Minami, Mitsunori Abe, Masako Fujii, Makoto Okawa, Tsuneo Fujito, Toshiya Taniguchi, Tenei Ko, Hiroshi Kubo, Mizuho Imamaki, Masahiro Akiyama, Takashi Ueda, Hironori Odakura, Masahiko Inagaki, Yoshiki Katsube, Atsuyuki Nakata, Shinobu Tomimoto, Mitsuhiro Shibuya, Masayuki Nakano, Kenichiro Ito, Masahiro Matsuta, Motoyuki Ishiguro, Taro Minagawa, Masamichi Wada, Hiroaki Mukawa, Masato Mizuguchi, Fumio Okuda, Teruaki Kimura, Kuniaki Taga, Masaaki Techigawara, Morio Igarashi, Hiroshi Watanabe, Toshihiko Seo, Shinya Hiramitsu, Hiroaki Hosokawa, Mitsumoto Hoshiai, Michitaka Hibino, Koichi Miyagawa, Hideki Horie, Nobuyoshi Sugishita, Yukio Shiga, Akira Soma, Kazuo Neya, Tetsuro Yoshida, Kunio Akahane, Sen Adachi, Chiei Takanaka, Saori Matsui, Hirofumi Kanda, Masanori Kaneko, Shiro Nagasaka, Atsushi Taguchi, Shuta Toru, Kazuyuki Saito, Akiko Miyashita, Hiroki Sasaguri, Jin Nariyama, Taketo Hatsuno, Takash Iwase, Kazuki Sato, Kazuya Kawai, Tomobumi Kotani, Tsuyoshi Tsuji, Hirosumi Sakai, Kiyoshi Nishino, Kenichi Ikeda, Kazuo Maeda, Tomohiro Shinozuka, Takeshi Inoue, Koichi Kawakami, Hiromichi Kitazumi, Tsutomu Takagi, Mamoru Hamaoka, Jisho Kojima, Akitoshi Sasaki, Yoshihiro Tsuchiya, Tetsuo Betsuyaku, Koji Higuchi, Masaaki Honda, Koichi Hasegawa, Takao Baba, Kazuaki Mineoi, Toshihiko Koeda, Kunihiko Hirasawa, Toshihide Kumazaki, Akira Nakagomi, Eiji Otaki, Takashi Shindo, Hiroyoshi Hirayama, Chikako Sugimoto, Takashi Yamagishi, Ichiro Mizuguchi, Kazunori Sezaki, Isamu Niwa, Ken Takenaka, Osamu Iiji, Koichi Taya, Hitoshi Kitazawa, samu Ueda, Hirokazu Kakuda, Takuya Ono, Seizo Oriso, Junya Kamata, Toshihiko Nanke, Itaru Maeda, Yoshifusa Matsuura, Hiroki Teragawa, Yasuyuki Maruyama, Kazuo Takei, Hajime Horie, Tetsutaro Kito, Hiroshi Asano, Koji Matsushita, Masaichi Nakamura, Takashi Washizuka, Tomoki Yoshida, Masato Sawano, Shinichi Arima, Hidekazu Arai, Hisanori Shinohara, Hiroyuki Takai, Nobufusa Furukawa, Akira Ota, Kentaro Yamamoto, Kenji Aoki, Taku Yamamoto, Takeaki Kasai, Shunji Suzuki, Shu Suzuki, Nitaro Shibata, Masayuki Watanabe, Yosuke Nishihata, Toru Arino, Masaki Okuyama, Tetsushi Wakiyama, Tomoko Kato, Yasuo Sasagawa, Takeshi Tana, Yoshihito Hayashi, Shinichi Hirota, Yukihiko Abe, Yoshihiro Saito, Hirohide Uchiyama, Hiroshi Takeda, Hiroshi Ono, Shuichi Tohyo, Naoto Hanazono, Seiichi Miyajima, Hisashi Shimono, Takuma Aoyama, Yasunobu Shozawa, Yawara Niijima, Osamu Murai, Hideko Inaba, Katsumasa Nomura, Masatsugu Nozoe, Kazuo Suzuki, Toshiyuki Furukawa, Toshihiko Shiraiwa, Nobuhisa Ito, Shunichi Nagai, Kiyoharu Sato, Shiro Nakahara, Yujin Shimoyama, Naoko Ohara, Teruhiko Kozuka, Hideaki Okita, Masato Endo, Tsutomu Goto, Makoto Hirose, Emiko Nagata, Noriyuki Nakanishi, Toshizumi Mori, Shuichi Seki, Katsuhiro Okamoto, Osamu Moriai, Yoko Emura, Tsuyoshi Fukuda, Haruhiko Date, Shuichi Kawakami, Sho Nagai, Yuya Ueyama, Tetsuro Fudo, Mitsuru Imaizumi, Takuo Ogawa, Shunsuke Take, Hideo Ikeda, Hiroaki Nishioka, Norihiko Sakamoto, Kiyomitsu Ikeoka, Nobuo Wakaki, Masatake Abe, Junji Doiuchi, Tetsuya Kira, Masato Tada, Ken Tsuzaki, Naoya Miura, Yasuaki Fujisawa, Wataru Furumoto, Susumu Suzuki, Akinori Fujisawa, Ryosai Nakamura, Hiroyasu Komatsu, Rei Fujiki, Shuichi Kawano, Keijiro Nishizawa, Yoji Kato, Junya Azuma, Kiyoshi Yasui, Toshio Amano, Yasuhiro Sekine, Tatsuo Honzawa, Yuichiro Koshibu, Yasuhide Sakamoto, Yukihiro Seta, Shingo Miyaguchi, Kojuro Morishita, Yasuko Samejima, Toyoshi Sasaki, Fumiko Iseki, Toshiyuki Kobayashi, Hiroshi Kano, Jaeyoung Kim, Hiroshi Yamaguchi, Yoichi Takagi, Yoko Onuki Pearce, Yasuyuki Suzuki, Takayuki Fukui, Toru Nakayama, Hideaki Kanai, Yoshiyuki Kawano, Tetsuji Ino, Hironori Miyoshi, Yasufumi Miyamoto, Masahito Shigekiyo, Shimato Ono, Yutaka Okamoto, Satoshi Ubukata, Kojiro Kodera, Tatsuo Oriuchi, Naoki Matsumoto, Koichi Inagaki, Atsushi Iseki, Tomohiro Yoshida, Toshihiro Goda, Tsukasa Katsuki, Atsushi Sato, Etsuo Mori, Toshio Tsubokura, Hiroshi Shudo, Shunichi Fujimoto, Tomohiro Katsuya, Yoshiyuki Furukawa, Hiroshi Hosokawa, Jun Narumi, Kiichiro Yamamoto, Masaki Owari, Takuya Inakura, Takafumi Anno, Kazuyuki Shirakawa, Chi Keong Ching Toon Wei Lim, David Foo, Kelvin Wong, Tan Yuyang, Seil Oh Hui Nam Park, Woo-Shik Kim, HyeYoung Lee, Sung-Won Jang, Dae Hyeok Kim, Jun Kim, DongRyeol Ryu, Jaemin Shim, Dae-Kyeong Kim, Dong Ju Choi, Yong Seog Oh, Myeong-Chan Cho, Hack-Lyoung Kim, Hui-Kyung Jeon, Dong-Gu Shin, Sang Weon Park, Hoon Ki Park, Sang-Jin Han, Jung Hoon Sung, Hyung-Wook Park, Gi-Byoung Nam, Young Keun On, Hong Euy Lim, JaeJin Kwak, Tae-Joon Cha, Taek Jong Hong, Seong Hoon Park, Jung Han Yoon, Nam-Ho Kim, Kee-Sik Kim, Byung Chun Jung, Gyo-Seung Hwang, Chong-Jin Kim, Sakda Rungaramsin Peerapat Katekangplu, Porames Khunrong, Thanita Bunyapipat, Wanwarang Wongcharoen, Pinij Kaewsuwanna, Khanchai Siriwattana, Waraporn Tiyanon, Supalerk Pattanaprichakul, Khanchit Likittanasombat, Doungrat Cholsaringkarl, Warangkana Boonyapisit, Sirichai Cheewatanakornkul, Songkwan Silaruks, Pisit Hutayanon, Seksan Chawanadelert, Pairoj Chattranukulchai, Boonsert Chatlaong, Yingsak Santanakorn, Khompiya Kanokphatcharakun, Piya Mongkolwongroj, Sasivimon Jai-Aue, Ongkarn Komson, Armagan Altun Ali Aydinlar, Ramazan Topsakal, Zeki Ongen, Sadik Acikel, Durmus Yildiray Sahin, Ozcan Yilmaz, Mehmet Birhan Yilmaz, Hasan Pekdemir, Mesut Demir, Murat Sucu, Levent Sahiner, Murat Ersanli, Ertugrul Okuyan, Dursun Aras, Florencia Rolandi Adrian Cesar Ingaramo, Gustavo Alberto Sambadaro, Vanina Fernandez Caputi, Hector Luciardi, Sofia Graciela Berman, Pablo Dragotto, Andres Javier Kleiban, Nestor Centurion, Rodolfo Andres Ahuad Guerrero, Leonel Adalberto Di Paola, Ricardo Dario Dran, Javier Egido, Matias Jose Fosco, Victor Alfredo Sinisi, Luis Rodolfo Cartasegna, Oscar Gomez Vilamajo, Jose Luis Ramos, Sonia Sassone, Gerardo Zapata, Diego Conde, Guillermo Giacomi, Alberto Alfredo Fernandez, Mario Alberto Berli, Fabian Ferroni, Dário Celestino Sobral Filho Jefferson Jaber, Luciana Vidal Armaganijan, Costantino Roberto Frack Costantini, André Steffens, Weimar Kunz Sebba Barroso de Souzaem, João David de Souza Neto, José Márcio Ribeiro, Marcelo Silveira Teixeira, Paulo Rossi, Leonardo Pires, Daniel Moreira, José Carlos Moura Jorge, Adalberto Menezes Lorga Filho, Luiz Bodanese, Marcelo Westerlund Montera, Carlos Henrique Del Carlo, Jamil Abdalla Saad, Fernando Augusto Alves da Costa, Renato Lopes, Gilson Roberto de Araújo, Euler Roberto Manenti, Jose Francisco Kerr Saraiva, João Carlos Ferreira Braga, Alexandre Negri, Carlos Moncada, Dalton Precoma, Fernando Roquette, Gilmar Reis, Roberto Álvaro Ramos Filho, Estêvão Lanna Figueiredo, Roberto Vieira Botelho, Cláudio Munhoz da Fontoura Tavares, Helius Carlos Finimundi, Adriano Kochi, César Cássio Broilo França, Fábio Alban, Guido Bernardo Aranha Rosito, João Batista de Moura Xavier Moraes Junior, Rogério Tadeu Tumelero, Lilia Maia, Roberto Simões de Almeida, Ney Carter do Carmo Borges, Luís Gustavo Gomes Ferreira, Ramón Corbalán Benjamin Aleck Joseh Stockins Fernandez, Humberto Montecinos, Fernando Lanas, Martín Larico Gómez, Carlos Astudillo, Carlos Conejeros, Patricio Marin Cuevas, Alejandro Forero, Claudio Bugueño Gutiérrez, Juan Aguilar, Sergio Potthoff Cardenas, German Eggers, Cesar Houzvic, Carlos Rey, Germán Arriagada, Gustavo Charme Vilches, Carlos Jerjes Sanchez Diaz Jesus Jaime Illescas Diaz, Raul Leal Cantu, Maria Guadalupe Ramos Zavala, Ricardo Cabrera Jardines, Nilda Espinola Zavaleta, Enrique Lopez Rosas, Guillermo Antonio Llamas Esperón, Gerardo Pozas, Ernesto Cardona Muñoz, Norberto Matadamas Hernandez, Adolfo Leyva Rendon, Norberto Garcia Hernandez, Manuel de los Rios Ibarra, Luis Ramon Virgen Carrillo, David Lopez Villezca, Carlos Hernandez Herrera, Juan Jose Lopez Prieto, Rodolfo Gaona Rodriguez, Efrain Villeda Espinosa, David Flores Martinez, Jose Velasco Barcena, Omar Fierro Fierro, Ignacio Rodriguez Briones, Jose Luis Leiva Pons, Humberto Alvarez Lopez, Rafael Olvera Ruiz, Carlos Gerardo Cantu Brito, Eduardo Julian Jose Roberto Chuquiure Valenzuela, Roxana Reyes Sanchez, Alberto Esteban Bazzoni Ruiz, Oscar Martin Lopez Ruiz, Roberto Arriaga Nava, Jesus David Morales Cerda, Pedro Fajardo Campos, Mario Benavides Gonzalez, Marianne Brodmann Kurt Lenz, Claus Hagn, Johannes Foechterle, Heinz Drexel, Kurt Huber, Andrea Podczeck-Schweighofer, Michael Winkler, Bruno Schneeweiss, Alfons Gegenhuber, Wilfried Lang, Sabine Eichinger-Hasenauer, Peter Kaserer, Josef Sykora, Heribert Rasch, Bernhard Strohmer, Luc Capiau Geert Vervoort, Bart Wollaert, Geert Hollanders, Jan Vercammen, Dirk Faes, Yohan Balthazar, Marc Delforge, Olivier Xhaet, Harry Striekwold, John Thoeng, Kurt Hermans, Georges Mairesse, Wim Anné, Ivan Blankoff, Michel Beutels, Stefan Verstraete, Peter Vandergoten, Philippe Purnode, Pascal Godart, Tim Boussy, Philippe Desfontaines, Alex Heyse, Joeri Voet, Axel De Wolf, Eva Zidkova Petr Jansky, Rudolf Spacek, Vilma Machova, Ondrej Ludka, Josef Olsr, Lubos Kotik, Blazej Racz, Richard Ferkl, Jan Hubac, Ilja Kotik, Zdenek Monhart, Hana Burianova, Ondrej Jerabek, Jana Pisova, Iveta Petrova, Vratislav Dedek, Michaela Honkova, Petr Podrazil, Petr Reichert, Jindrich Spinar, Miroslav Novak, Vaclav Durdil, Katarina Plocova, Jiri Lastuvka, Jørn Nielsen Steen Husted, Helena Dominguez, Ulrik Hintze, Søren Rasmussen, Næstved Sygehus, Arne Bremmelgaard, John Markenvard, Jan Børger, Jorgen Solgaard, Ebbe Eriksen, Thomas Løkkegaard, Michael Bruun, Jacob Mertz, Morten Schou, Michael Olsen, Pekka Raatikainen Carmela Viitanen, Franck Paganelli Joël Ohayon, Frédéric Casassus, Michel Galinier, Yannick Gottwalles, Philippe Loiselet, Jean-Joseph Muller, Mohamed Bassel Koujan, André Marquand, Sylvain Destrac, Olivier Piot, Nicolas Delarche, Jean-Pierre Cebron, Maxime Guenoun, Dominique Guedj-Meynier, A. 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Lokesh, Mathieu Zuber, Pierre Amarenco, Emmanuel Ellie, James Kadouch, Pierre-Yves Fournier, Jean-Pierre Huberman, Nestor Lemaire, Gilles Rodier, Xavier Vandamme, Igor Sibon, Jean-Philippe Neau, Marie Hélène Mahagne, Antoine Mielot, Marc Bonnefoy, Jean-Baptiste Churet, Vincent Navarre, Frederic Sellem, Gilles Monniot, Jean-Paul Boyes, Bernard Doucet, Michel Martelet, Désiré Obadia, Bernard Crousillat, Joseph Mouallem, Etienne Bearez, Jean Philippe Brugnaux, Alain Fedorowsky, Pierre Nazeyrollas, Jean-Baptiste Berneau, Frédéric Chemin, Sebastien Schellong Harald Darius, Georg Koeniger, Andreas Kopf, Uwe Gerbaulet, Bernd-Thomas Kellner, Thomas Schaefer, Jan Purr, Enno Eißfeller, Heinz-Dieter Zauzig, Peter Riegel, Christoph Axthelm, Gerd-Ulrich Heinz, Holger Menke, Andreas Pustelnik, Stefan Zutz, Wolfgang Eder, Guenter Rehling, Dirk Glatzel, Norbert Ludwig, Petra Sandow, Henning Wiswedel, Cosmas Wildenauer, Steffen Schoen, Toralf Schwarz, Adyeri Babyesiza, Maximilian Kropp, Hans-Hermann Zimny, Friedhelm Kahl, Andreas Caspar, Sabine Omankowsky, Torsten Laessig, Hermann-Josef Hartmann, Gunter Lehmann, Hans-Walter Bindig, Gunter Hergdt, Dietrich Reimer, Joachim Hauk, Holger Michel, Praxis Dres. 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H. Ruiter, Andreas Lucassen, Henk Adriaansen, Maarten Bongaerts, Mathijs Pieterse, Coen van Guldener, Johannes Herrman, S. H. K. P. R. Nierop, Pieter Hoogslag, Walter Hermans, B. E. Groenemeijer, W. Terpstra, Cees Buiks, L. V. A. 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Martini Leone Maria Cristina, G, Tiraferri, E, Santoro, R, Testa, S, Di Minno, G, Moia, M, Maria Caimi, T, Tessitori, M, Cappelli, R, Poli, D, Quintavalla, R, Cosmi, F, Fanelli, R, Oriana, V, Reggio, R, Santi, R, Pancaldi, L, De Cristofaro, R, Guazzaloca, G, De Blasio, A, Salerno Uriate, J, Lillo, F, Maria Pogliani, E, Bilo, G, Accogli, M, Mariani, A, Feola, M, Raisaro, A, Fattore, L, Mauric, A, Germini, F, Tedeschi, L, Settimi, M, Nicoli, S, Ricciarini, P, Argena, A, Ronchini, P, Bulla, C, Tradati, F, Volpe, M, D’Avino, M, Grazia Bongiorni, M, Severi, S, Capucci, A, Lodigiani, C, Salomone, E, Serviddio, G, Tondo, C, Golino, P, Mazzone, C, Iacopino, S, Ruiter, H, Lucassen, A, Adriaansen, H, Bongaerts, M, Pieterse, M, van Guldener, C, Herrman, J, Nierop, S, Hoogslag, P, Hermans, W, Groenemeijer, B, Terpstra, W, Buiks, C, Boersma, L, Berge Per Anton Sirnes, E, Gjertsen, E, Hole, T, Erga, K, Hallaråker, A, Skjelvan, G, Østrem, A, Ghezai, B, Svilaas, A, Christersson, P, Øien, T, Høegh Henrichsen, S, Erik Otterstad, J, Berg-Johansen, J, Stepinska Andrzej Gieroba, J, Biedrzycka, M, Ogorek, M, Wozakowska-Kaplon, B, Loboz-Grudzien, K, Jaroslaw, Supinski, W, Kuzniar, J, Zaluska, R, Hiczkiewicz, J, Swiatkowska-Byczynska, L, Kucharski, L, Gruchala, M, Minc, P, Olszewski, M, Kania, G, Krzciuk, M, Lajkowski, Z, Ostrowska-Pomian, B, Lewczuk, J, Zinka, E, Karczmarczyk, A, Chmielnicka-Pruszczynska, M, Wozniak-Skowerska, I, Opolski, G, Bronisz, M, Glanowska, G, Ruszkowski, P, Skonieczny, G, Sciborski, R, Okopien, B, Kukla, P, Galbas, K, Cymerman, K, Jurowiecki, J, Miekus, P, Myszka, W, Mazur, S, Lysek, R, Baszak, J, Rusicka-Piekarz, T, Raczak, G, Domanska, E, Nessler, J, Lesnik, J, Eltishcheva Roman Libis, V, Kamalov, G, Belenky, D, Egorova, L, Khokhlov, A, Yakupov, E, Zateyshchikov, D, Barbarash, O, Miller, O, Mazur, E, Zrazhevskiy, K, Novikova, T, Moiseeva, Y, Polkanova, E, Sobolev, K, Rossovskaya, M, Shapovalova, Y, Kolesnikova, A, Nikolaev, K, Zemlianskaia, O, Zateyshchikova, A, Kostenko, V, Popov, S, Poltavskaya, M, Edin, A, Aleksandrova Oksana Drapkina, E, Vishnevsky, A, Nagibovich, O, Chizhov, P, Rachkova, S, Sergeev, M, Kurylo, B, Ushakov, A, Vinolas Pere Alvarez Garcia, X, Fernanda Lopez Fernandez, M, Tercedor Sanchez, L, Tranche Iparraguirre, S, Toran Monserrat, P, Marquez Contreras, E, Isart Rafecas, J, Motero Carrasco, J, Garcia Pavia, P, Gomez Pajuelo, C, Miguel Rincon Diaz, L, Fernando Iglesias Alonso, L, Grande Ruiz, A, Merce Klein, J, Ramon Gonzalez Juanatey, J, Monte Collado, I, Palacin Piquero, H, Brotons Cuixart, C, Fernandez Escobar, E, i Llibre, J, Corros Vicente, C, Vida Gutierrez, M, Epelde Gonzalo, F, Alexandre Almeida Fernandez, C, Martinez Navarro, E, Jose Montero Alia, J, Barreda Gonzalez, M, Angels Moleiro Oliva, M, Iglesias Sanmartin, J, Jimenez Gonzalez, M, del Mar Rodriguez Alvarez, M, Herreros Melenchon, J, Ripoll Vera, T, Jimenez Navarro, M, Vazquez Caamano, M, Fe Arcocha Torres, M, Marcos Gomez, G, Iniguez Romo, A, Angel Prieto Diaz, M, Rosenqvist Alexander Wirdby, M, Centrumkliniken, Lindén, J, Henriksson, K, Elmersson, M, Egilsson, A, Börjesson, U, Svärd, G, Liu, B, Lindh, A, Olsson, L, Gustavsson, M, Andersson, L, Benson, L, Bothin, C, Hajimirsadeghi, A, Martinsson, B, Ericsson, M, Ohlsson, Å, Lindvall, H, Svensson, P, Thörne, K, Händel, H, Platonov, P, Bernsten, F, Timberg, I, Crisby, M, Karlsson, J, Andersson, A, Malmqvist, L, Engdahl, J, Thulin, J, Hot-Bjelak, A, Jensen, S, Stalby, P, Steffel Johann Debrunner, J, Beer, J, Shah, D, Rudyk Vira Tseluyko, I, Karpenko, O, Zhurba, S, Kraiz, I, Parkhomenko, O, Kupnovytska, I, Seredyuk, N, Mostovoy, Y, Ushakov, O, Koval, O, Kovalskiy, I, Svyshchenko, Y, Sychov, O, Stanislavchuk, M, Yagensky, A, Tykhonova, S, Fushtey, I, Murdoch Naresh Chauhan, W, Goodwin, D, Lumley, L, Patel, R, Saunders, P, Wong, B, Cameron, A, Patel, N, Jhittay, P, Ross, A, Kainth, M, Ladha, K, Douglas, K, Pickavance, G, Mcdonnell, J, Handscombe, L, Gooding, T, Wagner, H, Cumberlidge, Bradshaw, C, Bromham, C, Jones, K, Suryani, S, Coates, R, Sarai, B, Willcock, W, Sircar, S, Cairns, J, Gilliand, A, Bilas, R, Strieder, E, Hutchinson, P, Wakeman, A, Stokes, M, Kirby, G, Vishwanathan, B, Bird, N, Evans, P, Clark, M, Bisatt, J, Litchfield, J, Fisher, E, Fooks, T, Kelsall, R, Paul, N, Alborough, E, Aziz, M, Ramesh, C, Wilson, P, Franklin, S, Fairhead, S, Thompson, J, Chowan, H, Taylor, G, Tragen, D, Parfitt, M, Seamark, C, Paul, C, Richardson, M, Jefferies, A, Sharp, H, Jones, H, Giles, C, Bramley, M, Williams, P, Aldegather, J, Wetherell, S, Lumb, W, Scouller, F, Macey, N, Rogers, S, Stipp, Y, West, R, Pinney, P, Wadeson, P, Matthews, J, Pandya, P, Gallagher, A, Railton, T, Davies, E, Mcclure, J, Jacobs, M, Hutton, C, Thompson, R, Sinha, B, Butter, K, Barrow, S, Little, H, Russell, D, Choudhary, U, Haq, I, Ainsworth, P, Jones, C, Weeks, P, Eden, J, Gibbons, L, Glencross, J, Macleod, A, Poland, K, Mulolland, C, Warke, A, Conn, P, Burns, D, Smith, R, Kamath, R, Webster, J, Hodgins, I, Vercoe, S, Roome, P, Pinnock, H, Patel, J, Ali, A, Hart, N, Davies, R, De-Sousa, N, Neden, C, Danielsen, M, Sharma, P, Galloway, S, Hawkins, C, Oliver, R, Aylward, M, Pattni, M, Irvine, G, Ahmad, S, Rothwell, C, Choudhary, F, Khalaque, S, Short, S, Peters, S, Coulson, W, Roberts, N, Butler Steven Coates, A, Ward, B, Jackson, D, Walton, S, Shepherd, D, Wong, T, Boon, M, Deacon, M, Cornelius, D, Davies, S, Frankel, B, Hargreaves, N, Choi, H, Sumner, J, Myhill, T, Estifanos, S, Geatch, D, Wilkinson, J, Veale, R, Forshaw, K, Hirst, R, Zaman, K, Liley, C, Wastling, R, Mceleny, P, Beattie, A, Cooke, P, Wong, M, Pugsley, M, Dooldeniya, C, Rogers, G, Bennett, J, Jacobs, P, Muvva, R, Adam, M, Fox, R, Thomas, N, Cartwright, S, Reed, R, Randfield, S, A’Court, C, Flynn, A, Halpin, A, Dobson, S, Lomax, L, Nadaph, M, Munro, I, Goram, J, Stoddart, H, Simmons, P, Shewring, J, Bowen-Simpkins, E, Rickenbach, M, Blenkhorn Bhuwanendu Singh, A, Astridge, P, van Gaal, W, Abhayaratna, W, Thomson, P, Lehman, R, Kilian, J, Coulshed, D, Catanchin, A, Colquhoun, D, Kiat, H, Eccleston, D, French, J, Ayres, B, Blombery, P, Phan, T, Rogers, J, O’Donnell, D, Cheol Bae, S, Gibbs, H, Carroll, P, Starmer, G, Arstall, M, Binnekamp, M, Lee, A, Eikelboom Robert Luton, J, Gupta, M, Shekhar Pandey, A, Cheung, S, Leader, R, Beaudry, P, Ayala-Paredes, F, Berlingieri, J, Heath, J, Poirier, G, du Preez, M, Schweitzer, B, Nadeau, R, Dhillon, R, Hruczkowski, T, Lavoie, A, Parkash, R, Cha, J, Coutu, B, Macdonald, P, Ramjattan, B, Bonet, J, Vizel, S, Angaran, P, Fikry, S, Mowafy Azza Katta, A, Tawfik, M, Nawar, M, Sobhy, M, Kamal Abou Seif, S, Khairy, T, Abd El-Aziz, A, Taha, N, Reda, A, Elbahry, A, Setiha, M, Gamal El Din, M, Elkhadem, M, El-Etreby, A, Kettles Junaid Bayat, D, Siebert, H, Horak, A, Kelfkens, Y, Garda, R, Pillay, T, Guerra, M, van Zyl, L, Theron, H, Murray, A, Louw, R, Greyling, D, Mntla, P, Ismail, S, Ahmed, F, Engelbrecht, J, Maharajh, S, Oosthuysen, W, Loghdey, R, Ueckermann, V, AlAl Mahmeed AbdullahNaeemi, W, Yousef, G, Bazargani, N, Alomairi, M, Maruthanayagam, R, Singh, R, Naguib, A, Ibrahim, M, Agrawal, A, Nathani, M, Esheiba, E, Wassef, A, Gupta, R, Cox Scott Beach, M, Duffy, P, Falkowski, S, Ferrick, K, Franco, M, Michael Kutayli, W, Quick, A, Sharma, N, Wilson, V, Miller, S, Alberts, M, Blumberg, E, Canosa, R, Gutowski, T, Ison, R, Garcia, J, Mullen, P, Noveck, H, Rama, P, Reddy, R, Williams, M, Nishijima, D, Ferdinand, K, Haque, I, Mendelson, R, Pitta, S, Theodoro, D, Treasure, C, Moustafa, M, Cader, C, Pharr, W, Oropallo, A, Platt, G, Gujral, J, Welker, J, Koura, F, Haas, Sylvia, Camm, John A, Harald, Darius, Steffel, Jan, Virdone, Saverio, Pieper, Karen, Brodmann, Marianne, Schellong, Sebastian, Misselwitz, Frank, Kayani, Gloria, Ajay K. Kakkar, Jean-Pierre Bassand, A. John Camm, David A. Fitzmaurice, Keith A. A. Fox, Bernard J. Gersh, Samuel Z. Goldhaber, Shinya Goto, Sylvia Haas, Werner Hacke, Lorenzo G. Mantovani, Frank Misselwitz, Karen S. Pieper, Alexander G. G. Turpie, Martin van Eickels, Freek W. A. Verheugt, Keith A. A. Fox Bernard J. Gersh, Hector Lucas Luciardi Harry Gibbs, Marianne Brodmann, Frank Cools, Antonio Carlos Pereira Barretto, Stuart J. Connolly, John Eikelboom, Ramon Corbalan, Zhi-Cheng Jing, Petr Jansky, Jørn Dalsgaard Nielsen, Hany Ragy, Pekka Raatikainen, Jean-Yves Le Heuzey, Harald Darius, Matyas Keltai, Jitendra Pal Singh Sawhney, Giancarlo Agnelli, Giuseppe Ambrosio, Yukihiro Koretsune, Carlos Jerjes Sánchez Díaz, Hugo Ten Cate, Dan Atar, Janina Stepinska, Elizaveta Panchenko, Toon Wei Lim, Barry Jacobson, Seil Oh, Xavier Viñolas, Marten Rosenqvist, Jan Steffel, Pantep Angchaisuksiri, Ali Oto, Alex Parkhomenko, Wael Al Mahmeed, David Fitzmaurice, Dayi Hu Kangning Chen, Yusheng Zhao, Huaiqin Zhang, Jiyan Chen, Shiping Cao, Daowen Wang, Yuejin Yang, Weihua Li, Hui Li, Yuehui Yin, Guizhou Tao, Ping Yang, Yingmin Chen, Shenghu He, Yong Wang, Guosheng Fu, Xin Li, Tongguo Wu, Xiaoshu Cheng, Xiaowei Yan, Ruiping Zhao, Moshui Chen, Longgen Xiong, Ping Chen, Yang Jiao, Ying Guo, Li Xue, Zhiming Yang, Praveen Jadhavm Raghava Sarma, Govind Kulkarni, Prakash Chandwani, Rasesh Atulbhai Pothiwala, Mohanan Padinhare Purayil, Kamaldeep Chawla, Veerappa Annasaheb Kothiwale, Bagirath Raghuraman, Vinod Madan Vijan, Jitendra Sawhney, Ganapathi Bantwal, Aziz Khan, Ramdhan Meena, Manojkumar Chopada, Sunitha Abraham, Vikas Bisne, Govindan Vijayaraghavan, Debabrata Roy, Rajashekhar Durgaprasad, A. G. Ravi Shankar, Sunil Kumar, Dinesh Jain, Kartikeya Bhargava, Vinay Kumar, Udigala Madappa Nagamalesh, Rajeeve Kumar Rajput, Yukihiro Koretsune Seishu Kanamori, Kenichi Yamamoto, Koichiro Kumagai, Yosuke Katsuda, Keiki Yoshida, Fumitoshi Toyota, Yuji Mizuno, Ikuo Misumi, Hiroo Noguchi, Shinichi Ando, Tetsuro Suetsugu, Masahiro Minamoto, Hiroyuki Oda, Susumu Adachi, Kei Chiba, Hiroaki Norita, Makoto Tsuruta, Takeshi Koyanagi, Kunihiko Yamamoto, Hiroshi Ando, Takayuki Higashi, Megumi Okada, Shiro Azakami, Shinichiro Komaki, Kenshi Kumeda, Takashi Murayama, Jun Matsumura, Yurika Oba, Ryuji Sonoda, Kazuo Goto, Kotaro Minoda, Yoshikuni Haraguchi, Hisakazu Suefuji, Hiroo Miyagi, Hitoshi Kato, Tsugihiro Nakamura, Tadashi Nakamura, Hidekazu Nandate, Ryuji Zaitsu, Yoshihisa Fujiura, Akira Yoshimura, Hiroyuki Numata, Jun Ogawa, Yasuyuki Kamogawa, Kinshiro Murakami, Yutaka Wakasa, Masanori Yamasawa, Hiromitsu Maekawa, Sumihisa Abe, Hajime Kihara, Satoru Tsunoda, Katsumi Saito, Hiroki Tachibana, Ichiro Oba, Takashi Kuwahata, Satoshi Higa, Masamichi Gushiken, Takuma Eto, Hidetoshi Chibana, Kazuaki Fujisawa, Yuhei Shiga, Hirokuni Sumi, Toshihisa Nagatomo, Yoshihiko Atsuchi, Toshiro Nagoshi, Kazuhisa Sanno, Fumihiro Hoshino, Naoto Yokota, Masahiro Kameko, Toshifumi Tabuchi, Munesumi Ishizawa, Yoshitake Fujiura, Daisuke Ikeda, Taku Seto, Tetsu Iwao, Norio Ishioka, Koichi Oshiro, Keizo Tsuchida, Yutaka Hatori, Motoshi Takeuchi, Hiroto Takezawa, Shinjiro Nagano, Masaaki Iwaki, Yuichiro Nakamura, Naomasa Miyamoto, Toshifumi Taguchi, Ko Ashida, Naoto Yoshizawa, Jun Agata, Seishiro Matsukawa, Osamu Arasaki, Shuji Fukuoka, Hirofumi Murakami, Kazuya Mishima, Yoshiki Hata, Ichiro Sakuma, Kotaro Obunai, Ichiro Takamura, Mitsuyuki Akutsu, Toshihide Unoki, Yoshinori Go, Makoto Ikemura, Shoji Morii, Shigeru Marusaki, Hideo Doi, Mitsuru Tanaka, Takaaki Kusumoto, Shigeo Kakinoki, Chiga Ogurusu, Kazuya Murata, Masaki Shimoyama, Masami Nakatsuka, Yutaka Kitami, Yoichi Nakamura, Hiroshi Oda, Rikimaru Oyama, Masato Ageta, Teruaki Mita, Kazuhiko Nagao, Takafumi Mito, Junichi Minami, Mitsunori Abe, Masako Fujii, Makoto Okawa, Tsuneo Fujito, Toshiya Taniguchi, Tenei Ko, Hiroshi Kubo, Mizuho Imamaki, Masahiro Akiyama, Takashi Ueda, Hironori Odakura, Masahiko Inagaki, Yoshiki Katsube, Atsuyuki Nakata, Shinobu Tomimoto, Mitsuhiro Shibuya, Masayuki Nakano, Kenichiro Ito, Masahiro Matsuta, Motoyuki Ishiguro, Taro Minagawa, Masamichi Wada, Hiroaki Mukawa, Masato Mizuguchi, Fumio Okuda, Teruaki Kimura, Kuniaki Taga, Masaaki Techigawara, Morio Igarashi, Hiroshi Watanabe, Toshihiko Seo, Shinya Hiramitsu, Hiroaki Hosokawa, Mitsumoto Hoshiai, Michitaka Hibino, Koichi Miyagawa, Hideki Horie, Nobuyoshi Sugishita, Yukio Shiga, Akira Soma, Kazuo Neya, Tetsuro Yoshida, Kunio Akahane, Sen Adachi, Chiei Takanaka, Saori Matsui, Hirofumi Kanda, Masanori Kaneko, Shiro Nagasaka, Atsushi Taguchi, Shuta Toru, Kazuyuki Saito, Akiko Miyashita, Hiroki Sasaguri, Jin Nariyama, Taketo Hatsuno, Takash Iwase, Kazuki Sato, Kazuya Kawai, Tomobumi Kotani, Tsuyoshi Tsuji, Hirosumi Sakai, Kiyoshi Nishino, Kenichi Ikeda, Kazuo Maeda, Tomohiro Shinozuka, Takeshi Inoue, Koichi Kawakami, Hiromichi Kitazumi, Tsutomu Takagi, Mamoru Hamaoka, Jisho Kojima, Akitoshi Sasaki, Yoshihiro Tsuchiya, Tetsuo Betsuyaku, Koji Higuchi, Masaaki Honda, Koichi Hasegawa, Takao Baba, Kazuaki Mineoi, Toshihiko Koeda, Kunihiko Hirasawa, Toshihide Kumazaki, Akira Nakagomi, Eiji Otaki, Takashi Shindo, Hiroyoshi Hirayama, Chikako Sugimoto, Takashi Yamagishi, Ichiro Mizuguchi, Kazunori Sezaki, Isamu Niwa, Ken Takenaka, Osamu Iiji, Koichi Taya, Hitoshi Kitazawa, samu Ueda, Hirokazu Kakuda, Takuya Ono, Seizo Oriso, Junya Kamata, Toshihiko Nanke, Itaru Maeda, Yoshifusa Matsuura, Hiroki Teragawa, Yasuyuki Maruyama, Kazuo Takei, Hajime Horie, Tetsutaro Kito, Hiroshi Asano, Koji Matsushita, Masaichi Nakamura, Takashi Washizuka, Tomoki Yoshida, Masato Sawano, Shinichi Arima, Hidekazu Arai, Hisanori Shinohara, Hiroyuki Takai, Nobufusa Furukawa, Akira Ota, Kentaro Yamamoto, Kenji Aoki, Taku Yamamoto, Takeaki Kasai, Shunji Suzuki, Shu Suzuki, Nitaro Shibata, Masayuki Watanabe, Yosuke Nishihata, Toru Arino, Masaki Okuyama, Tetsushi Wakiyama, Tomoko Kato, Yasuo Sasagawa, Takeshi Tana, Yoshihito Hayashi, Shinichi Hirota, Yukihiko Abe, Yoshihiro Saito, Hirohide Uchiyama, Hiroshi Takeda, Hiroshi Ono, Shuichi Tohyo, Naoto Hanazono, Seiichi Miyajima, Hisashi Shimono, Takuma Aoyama, Yasunobu Shozawa, Yawara Niijima, Osamu Murai, Hideko Inaba, Katsumasa Nomura, Masatsugu Nozoe, Kazuo Suzuki, Toshiyuki Furukawa, Toshihiko Shiraiwa, Nobuhisa Ito, Shunichi Nagai, Kiyoharu Sato, Shiro Nakahara, Yujin Shimoyama, Naoko Ohara, Teruhiko Kozuka, Hideaki Okita, Masato Endo, Tsutomu Goto, Makoto Hirose, Emiko Nagata, Noriyuki Nakanishi, Toshizumi Mori, Shuichi Seki, Katsuhiro Okamoto, Osamu Moriai, Yoko Emura, Tsuyoshi Fukuda, Haruhiko Date, Shuichi Kawakami, Sho Nagai, Yuya Ueyama, Tetsuro Fudo, Mitsuru Imaizumi, Takuo Ogawa, Shunsuke Take, Hideo Ikeda, Hiroaki Nishioka, Norihiko Sakamoto, Kiyomitsu Ikeoka, Nobuo Wakaki, Masatake Abe, Junji Doiuchi, Tetsuya Kira, Masato Tada, Ken Tsuzaki, Naoya Miura, Yasuaki Fujisawa, Wataru Furumoto, Susumu Suzuki, Akinori Fujisawa, Ryosai Nakamura, Hiroyasu Komatsu, Rei Fujiki, Shuichi Kawano, Keijiro Nishizawa, Yoji Kato, Junya Azuma, Kiyoshi Yasui, Toshio Amano, Yasuhiro Sekine, Tatsuo Honzawa, Yuichiro Koshibu, Yasuhide Sakamoto, Yukihiro Seta, Shingo Miyaguchi, Kojuro Morishita, Yasuko Samejima, Toyoshi Sasaki, Fumiko Iseki, Toshiyuki Kobayashi, Hiroshi Kano, Jaeyoung Kim, Hiroshi Yamaguchi, Yoichi Takagi, Yoko Onuki Pearce, Yasuyuki Suzuki, Takayuki Fukui, Toru Nakayama, Hideaki Kanai, Yoshiyuki Kawano, Tetsuji Ino, Hironori Miyoshi, Yasufumi Miyamoto, Masahito Shigekiyo, Shimato Ono, Yutaka Okamoto, Satoshi Ubukata, Kojiro Kodera, Tatsuo Oriuchi, Naoki Matsumoto, Koichi Inagaki, Atsushi Iseki, Tomohiro Yoshida, Toshihiro Goda, Tsukasa Katsuki, Atsushi Sato, Etsuo Mori, Toshio Tsubokura, Hiroshi Shudo, Shunichi Fujimoto, Tomohiro Katsuya, Yoshiyuki Furukawa, Hiroshi Hosokawa, Jun Narumi, Kiichiro Yamamoto, Masaki Owari, Takuya Inakura, Takafumi Anno, Kazuyuki Shirakawa, Chi Keong Ching Toon Wei Lim, David Foo, Kelvin Wong, Tan Yuyang, Seil Oh Hui Nam Park, Woo-Shik Kim, HyeYoung Lee, Sung-Won Jang, Dae Hyeok Kim, Jun Kim, DongRyeol Ryu, Jaemin Shim, Dae-Kyeong Kim, Dong Ju Choi, Yong Seog Oh, Myeong-Chan Cho, Hack-Lyoung Kim, Hui-Kyung Jeon, Dong-Gu Shin, Sang Weon Park, Hoon Ki Park, Sang-Jin Han, Jung Hoon Sung, Hyung-Wook Park, Gi-Byoung Nam, Young Keun On, Hong Euy Lim, JaeJin Kwak, Tae-Joon Cha, Taek Jong Hong, Seong Hoon Park, Jung Han Yoon, Nam-Ho Kim, Kee-Sik Kim, Byung Chun Jung, Gyo-Seung Hwang, Chong-Jin Kim, Sakda Rungaramsin Peerapat Katekangplu, Porames Khunrong, Thanita Bunyapipat, Wanwarang Wongcharoen, Pinij Kaewsuwanna, Khanchai Siriwattana, Waraporn Tiyanon, Supalerk Pattanaprichakul, Khanchit Likittanasombat, Doungrat Cholsaringkarl, Warangkana Boonyapisit, Sirichai Cheewatanakornkul, Songkwan Silaruks, Pisit Hutayanon, Seksan Chawanadelert, Pairoj Chattranukulchai, Boonsert Chatlaong, Yingsak Santanakorn, Khompiya Kanokphatcharakun, Piya Mongkolwongroj, Sasivimon Jai-Aue, Ongkarn Komson, Armagan Altun Ali Aydinlar, Ramazan Topsakal, Zeki Ongen, Sadik Acikel, Durmus Yildiray Sahin, Ozcan Yilmaz, Mehmet Birhan Yilmaz, Hasan Pekdemir, Mesut Demir, Murat Sucu, Levent Sahiner, Murat Ersanli, Ertugrul Okuyan, Dursun Aras, Florencia Rolandi Adrian Cesar Ingaramo, Gustavo Alberto Sambadaro, Vanina Fernandez Caputi, Hector Luciardi, Sofia Graciela Berman, Pablo Dragotto, Andres Javier Kleiban, Nestor Centurion, Rodolfo Andres Ahuad Guerrero, Leonel Adalberto Di Paola, Ricardo Dario Dran, Javier Egido, Matias Jose Fosco, Victor Alfredo Sinisi, Luis Rodolfo Cartasegna, Oscar Gomez Vilamajo, Jose Luis Ramos, Sonia Sassone, Gerardo Zapata, Diego Conde, Guillermo Giacomi, Alberto Alfredo Fernandez, Mario Alberto Berli, Fabian Ferroni, Dário Celestino Sobral Filho Jefferson Jaber, Luciana Vidal Armaganijan, Costantino Roberto Frack Costantini, André Steffens, Weimar Kunz Sebba Barroso de Souzaem, João David de Souza Neto, José Márcio Ribeiro, Marcelo Silveira Teixeira, Paulo Rossi, Leonardo Pires, Daniel Moreira, José Carlos Moura Jorge, Adalberto Menezes Lorga Filho, Luiz Bodanese, Marcelo Westerlund Montera, Carlos Henrique Del Carlo, Jamil Abdalla Saad, Fernando Augusto Alves da Costa, Renato Lopes, Gilson Roberto de Araújo, Euler Roberto Manenti, Jose Francisco Kerr Saraiva, João Carlos Ferreira Braga, Alexandre Negri, Carlos Moncada, Dalton Precoma, Fernando Roquette, Gilmar Reis, Roberto Álvaro Ramos Filho, Estêvão Lanna Figueiredo, Roberto Vieira Botelho, Cláudio Munhoz da Fontoura Tavares, Helius Carlos Finimundi, Adriano Kochi, César Cássio Broilo França, Fábio Alban, Guido Bernardo Aranha Rosito, João Batista de Moura Xavier Moraes Junior, Rogério Tadeu Tumelero, Lilia Maia, Roberto Simões de Almeida, Ney Carter do Carmo Borges, Luís Gustavo Gomes Ferreira, Ramón Corbalán Benjamin Aleck Joseh Stockins Fernandez, Humberto Montecinos, Fernando Lanas, Martín Larico Gómez, Carlos Astudillo, Carlos Conejeros, Patricio Marin Cuevas, Alejandro Forero, Claudio Bugueño Gutiérrez, Juan Aguilar, Sergio Potthoff Cardenas, German Eggers, Cesar Houzvic, Carlos Rey, Germán Arriagada, Gustavo Charme Vilches, Carlos Jerjes Sanchez Diaz Jesus Jaime Illescas Diaz, Raul Leal Cantu, Maria Guadalupe Ramos Zavala, Ricardo Cabrera Jardines, Nilda Espinola Zavaleta, Enrique Lopez Rosas, Guillermo Antonio Llamas Esperón, Gerardo Pozas, Ernesto Cardona Muñoz, Norberto Matadamas Hernandez, Adolfo Leyva Rendon, Norberto Garcia Hernandez, Manuel de los Rios Ibarra, Luis Ramon Virgen Carrillo, David Lopez Villezca, Carlos Hernandez Herrera, Juan Jose Lopez Prieto, Rodolfo Gaona Rodriguez, Efrain Villeda Espinosa, David Flores Martinez, Jose Velasco Barcena, Omar Fierro Fierro, Ignacio Rodriguez Briones, Jose Luis Leiva Pons, Humberto Alvarez Lopez, Rafael Olvera Ruiz, Carlos Gerardo Cantu Brito, Eduardo Julian Jose Roberto Chuquiure Valenzuela, Roxana Reyes Sanchez, Alberto Esteban Bazzoni Ruiz, Oscar Martin Lopez Ruiz, Roberto Arriaga Nava, Jesus David Morales Cerda, Pedro Fajardo Campos, Mario Benavides Gonzalez, Marianne Brodmann Kurt Lenz, Claus Hagn, Johannes Foechterle, Heinz Drexel, Kurt Huber, Andrea Podczeck-Schweighofer, Michael Winkler, Bruno Schneeweiss, Alfons Gegenhuber, Wilfried Lang, Sabine Eichinger-Hasenauer, Peter Kaserer, Josef Sykora, Heribert Rasch, Bernhard Strohmer, Luc Capiau Geert Vervoort, Bart Wollaert, Geert Hollanders, Jan Vercammen, Dirk Faes, Yohan Balthazar, Marc Delforge, Olivier Xhaet, Harry Striekwold, John Thoeng, Kurt Hermans, Georges Mairesse, Wim Anné, Ivan Blankoff, Michel Beutels, Stefan Verstraete, Peter Vandergoten, Philippe Purnode, Pascal Godart, Tim Boussy, Philippe Desfontaines, Alex Heyse, Joeri Voet, Axel De Wolf, Eva Zidkova Petr Jansky, Rudolf Spacek, Vilma Machova, Ondrej Ludka, Josef Olsr, Lubos Kotik, Blazej Racz, Richard Ferkl, Jan Hubac, Ilja Kotik, Zdenek Monhart, Hana Burianova, Ondrej Jerabek, Jana Pisova, Iveta Petrova, Vratislav Dedek, Michaela Honkova, Petr Podrazil, Petr Reichert, Jindrich Spinar, Miroslav Novak, Vaclav Durdil, Katarina Plocova, Jiri Lastuvka, Jørn Nielsen Steen Husted, Helena Dominguez, Ulrik Hintze, Søren Rasmussen, Næstved Sygehus, Arne Bremmelgaard, John Markenvard, Jan Børger, Jorgen Solgaard, Ebbe Eriksen, Thomas Løkkegaard, Michael Bruun, Jacob Mertz, Morten Schou, Michael Olsen, Pekka Raatikainen Carmela Viitanen, Franck Paganelli Joël Ohayon, Frédéric Casassus, Michel Galinier, Yannick Gottwalles, Philippe Loiselet, Jean-Joseph Muller, Mohamed Bassel Koujan, André Marquand, Sylvain Destrac, Olivier Piot, Nicolas Delarche, Jean-Pierre Cebron, Maxime Guenoun, Dominique Guedj-Meynier, A. G. Lokesh, Mathieu Zuber, Pierre Amarenco, Emmanuel Ellie, James Kadouch, Pierre-Yves Fournier, Jean-Pierre Huberman, Nestor Lemaire, Gilles Rodier, Xavier Vandamme, Igor Sibon, Jean-Philippe Neau, Marie Hélène Mahagne, Antoine Mielot, Marc Bonnefoy, Jean-Baptiste Churet, Vincent Navarre, Frederic Sellem, Gilles Monniot, Jean-Paul Boyes, Bernard Doucet, Michel Martelet, Désiré Obadia, Bernard Crousillat, Joseph Mouallem, Etienne Bearez, Jean Philippe Brugnaux, Alain Fedorowsky, Pierre Nazeyrollas, Jean-Baptiste Berneau, Frédéric Chemin, Sebastien Schellong Harald Darius, Georg Koeniger, Andreas Kopf, Uwe Gerbaulet, Bernd-Thomas Kellner, Thomas Schaefer, Jan Purr, Enno Eißfeller, Heinz-Dieter Zauzig, Peter Riegel, Christoph Axthelm, Gerd-Ulrich Heinz, Holger Menke, Andreas Pustelnik, Stefan Zutz, Wolfgang Eder, Guenter Rehling, Dirk Glatzel, Norbert Ludwig, Petra Sandow, Henning Wiswedel, Cosmas Wildenauer, Steffen Schoen, Toralf Schwarz, Adyeri Babyesiza, Maximilian Kropp, Hans-Hermann Zimny, Friedhelm Kahl, Andreas Caspar, Sabine Omankowsky, Torsten Laessig, Hermann-Josef Hartmann, Gunter Lehmann, Hans-Walter Bindig, Gunter Hergdt, Dietrich Reimer, Joachim Hauk, Holger Michel, Praxis Dres. Werner Erdle, Wilfried Dorsch, Janna Dshabrailov, Karl-Albrecht Rapp, Reinhold Vormann, Thomas Mueller, Peter Mayer, Uwe Horstmeier, Volker Eissing, Heinz Hey, Heinz Leuchtgens, Volker Lilienweiss, Heiner Mueller, Christian Schubert, Herrmann Lauer, Thomas Buchner, Gunter Brauer, Susanne Kamin, Karsten Mueller, Sylvia Baumbach, Muwafeg Abdel-Qader, Hans-Holger Ebert, Carsten Schwencke, Peter Bernhardt, Laszlo Karolyi, Britta Sievers, Wilhelm Haverkamp, Jens-Uwe Roehnisch, Andras Vertes Gabor Szantai, Andras Matoltsy, Nikosz Kanakaridisz, Zoltan Boda, Erno Kis, Balazs Gaszner, Ferenc Juhasz, Gizella Juhasz, Sandor Kancz, Zoltan Laszlo, Zsolt May, Bela Merkely, Ebrahim Noori, Tamas Habon, Peter Polgar, Gabriella Szalai, Sandor Vangel, Andras Nagy, Gabriella Engelthaler, Judit Ferenczi, Mihaly Egyutt, Giuliana Martini Leone Maria Cristina, Eros Tiraferri, Rita Santoro, Sophie Testa, Giovanni Di Minno, Marco Moia, Teresa Maria Caimi, Maria Tessitori, Roberto Cappelli, Daniela Poli, Roberto Quintavalla, Franco Cosmi, Raffaele Fanelli, Vincenzo Oriana, Raffaele Reggio, Roberto Santi, Leonardo Pancaldi, Raimondo De Cristofaro, Giuliana Guazzaloca, Angelo De Blasio, Jorge Salerno Uriate, Flavia Lillo, Enrico Maria Pogliani, Grzegorz Bilo, Michele Accogli, Antonio Mariani, Mauro Feola, Arturo Raisaro, Luciano Fattore, Andrea Mauric, Fabrizio Germini, Luca Tedeschi, Maria Settimi, Sergio Nicoli, Paolo Ricciarini, Antonio Argena, Paolo Ronchini, Claudio Bulla, Filippo Tradati, Massimo Volpe, Maria D’Avino, Maria Grazia Bongiorni, Silva Severi, Alessandro Capucci, Corrado Lodigiani, Enrico Salomone, Gaetano Serviddio, Claudio Tondo, Paolo Golino, Carmine Mazzone, Saverio Iacopino, Hugo ten Cate J. H. Ruiter, Andreas Lucassen, Henk Adriaansen, Maarten Bongaerts, Mathijs Pieterse, Coen van Guldener, Johannes Herrman, S. H. K. P. R. Nierop, Pieter Hoogslag, Walter Hermans, B. E. Groenemeijer, W. Terpstra, Cees Buiks, L. V. A. Boersma, Eivind Berge Per Anton Sirnes, Erik Gjertsen, Torstein Hole, Knut Erga, Arne Hallaråker, Gunnar Skjelvan, Anders Østrem, Beraki Ghezai, Arne Svilaas, Peter Christersson, Torbjørn Øien, Svein Høegh Henrichsen, Jan Erik Otterstad, Jan Berg-Johansen, Janina Stepinska Andrzej Gieroba, Malgorzata Biedrzycka, Michal Ogorek, Beata Wozakowska-Kaplon, Krystyna Loboz-Grudzien, Wieslaw Supinski, Jerzy Kuzniar, Roman Zaluska, Jaroslaw Hiczkiewicz, Lucyna Swiatkowska-Byczynska, Lech Kucharski, Marcin Gruchala, Piotr Minc, Maciej Olszewski, Grzegorz Kania, Malgorzata Krzciuk, Zbigniew Lajkowski, Bozenna Ostrowska-Pomian, Jerzy Lewczuk, Elzbieta Zinka, Agnieszka Karczmarczyk, Malgorzata Chmielnicka-Pruszczynska, Iwona Wozniak-Skowerska, Grzegorz Opolski, Marek Bronisz, Marcin Ogorek, Grazyna Glanowska, Piotr Ruszkowski, Grzegorz Skonieczny, Ryszard Sciborski, Boguslaw Okopien, Piotr Kukla, Krzysztof Galbas, Krzysztof Cymerman, Jaroslaw Jurowiecki, Pawel Miekus, Waldemar Myszka, Stanislaw Mazur, Roman Lysek, Jacek Baszak, Teresa Rusicka-Piekarz, Grzegorz Raczak, Ewa Domanska, Jadwiga Nessler, Jozef Lesnik, Vera Eltishcheva Roman Libis, Gadel Kamalov, Dmitry Belenky, Liudmila Egorova, Alexander Khokhlov, Eduard Yakupov, Dmitry Zateyshchikov, Olga Barbarash, Olga Miller, Evgeniy Mazur, Konstantin Zrazhevskiy, Tatyana Novikova, Yulia Moiseeva, Elena Polkanova, Konstantin Sobolev, Maria Rossovskaya, Yulia Shapovalova, Alla Kolesnikova, Konstantin Nikolaev, Oksana Zemlianskaia, Anna Zateyshchikova, Victor Kostenko, Sergey Popov, Maria Poltavskaya, Anton Edin, Elena Aleksandrova Oksana Drapkina, Alexander Vishnevsky, Oleg Nagibovich, Petr Chizhov, Svetlana Rachkova, Mikhail Sergeev, Borys Kurylo, Alexey Ushakov, Xavier Vinolas Pere Alvarez Garcia, Maria Fernanda Lopez Fernandez, Luis Tercedor Sanchez, Salvador Tranche Iparraguirre, Pere Toran Monserrat, Emilio Marquez Contreras, Jordi Isart Rafecas, Juan Motero Carrasco, Pablo Garcia Pavia, Casimiro Gomez Pajuelo, Luis Miguel Rincon Diaz, Luis Fernando Iglesias Alonso, Angel Grande Ruiz, Jordi Merce Klein, Jose Ramon Gonzalez Juanatey, Ines Monte Collado, Herminia Palacin Piquero, Carles Brotons Cuixart, Esther Fernandez Escobar, Joan Bayo i Llibre, Cecilia Corros Vicente, Manuel Vida Gutierrez, Francisco Epelde Gonzalo, Carlos Alexandre Almeida Fernandez, Encarnacion Martinez Navarro, Juan Jose Montero Alia, Maria Barreda Gonzalez, Maria Angels Moleiro Oliva, Jose Iglesias Sanmartin, Mercedes Jimenez Gonzalez, Maria del Mar Rodriguez Alvarez, Juan Herreros Melenchon, Tomas Ripoll Vera, Manuel Jimenez Navarro, Maria Vazquez Caamano, Maria Fe Arcocha Torres, Gonzalo Marcos Gomez, Andres Iniguez Romo, Miguel Angel Prieto Diaz, Mårten Rosenqvist Alexander Wirdby, Jan Lindén, Kerstin Henriksson, Micael Elmersson, Arnor Egilsson, Ulf Börjesson, Gunnar Svärd, Bo Liu, Anders Lindh, Lars-Bertil Olsson, Mikael Gustavsson, Lars Andersson, Lars Benson, Claes Bothin, Ali Hajimirsadeghi, Björn Martinsson, Marianne Ericsson, Åke Ohlsson, Håkan Lindvall, Peter Svensson, Katarina Thörne, Hans Händel, Pyotr Platonov, Fredrik Bernsten, Ingar Timberg, Milita Crisby, Jan-Erik Karlsson, Agneta Andersson, Lennart Malmqvist, Johan Engdahl, Jörgen Thulin, Aida Hot-Bjelak, Steen Jensen, Per Stalby, Jan Steffel Johann Debrunner, Juerg H. Beer, Dipen Shah, Iurii Rudyk Vira Tseluyko, Oleksandr Karpenko, Svitlana Zhurba, Igor Kraiz, Oleksandr Parkhomenko, Iryna Kupnovytska, Nestor Seredyuk, Yuriy Mostovoy, Oleksiy Ushakov, Olena Koval, Igor Kovalskiy, Yevgeniya Svyshchenko, Oleg Sychov, Mykola Stanislavchuk, Andriy Yagensky, Susanna Tykhonova, Ivan Fushtey, Will Murdoch Naresh Chauhan, Daryl Goodwin, Louise Lumley, Ramila Patel, Philip Saunders, Bennett Wong, Alex Cameron, Niranjan Patel, P. Jhittay, Andrew Ross, M. S. Kainth, Karim Ladha, Kevin Douglas, Gill Pickavance, Joanna McDonnell, Laura Handscombe, Trevor Gooding, Helga Wagner, Colin Bradshaw, Catherine Bromham, Kevin Jones, Shoeb Suryani, Richard Coates, Bhupinder Sarai, W. Willcock, S. Sircar, John Cairns, A. Gilliand, Roman Bilas, E. Strieder, Peter Hutchinson, Anne Wakeman, Michael Stokes, Graham Kirby, Bhaskhar Vishwanathan, Nigel Bird, Paul Evans, M. Clark, John Bisatt, Jennifer Litchfield, E. Fisher, Tim Fooks, Richard Kelsall, Neil Paul, Elizabeth Alborough, Michael Aziz, C. Ramesh, Pete Wilson, Simon Franklin, Sue Fairhead, Julian Thompson, Hasan Chowan, Gary Taylor, Dawn Tragen, Matt Parfitt, Claire Seamark, Carolyn Paul, Mark Richardson, Angus Jefferies, Helen Sharp, Hywel Jones, Claire Giles, Matthew Bramley, Philip Williams, Jehad Aldegather, Simon Wetherell, William Lumb, Phil Evans, Frances Scouller, Neil Macey, Stephen Rogers, Yvette Stipp, Richard West, Philip Pinney, Paul Wadeson, John Matthews, Preeti Pandya, Andrew Gallagher, T. Railton, Emyr Davies, Jonathan McClure, Marc Jacobs, Claire Hutton, R. Thompson, Bijoy Sinha, Keith Butter, Susan Barrow, Helen Little, David Russell, Ulka Choudhary, Ikram Haq, Paul Ainsworth, Claire Jones, Phil Weeks, Jane Eden, Lisa Gibbons, Janet Glencross, Alison MacLeod, K. Poland, Conor Mulolland, A. Warke, Paul Conn, D. Burns, R. Smith, R. Kamath, Jonathan Webster, Ian Hodgins, Stephen Vercoe, Paul Roome, Hilary Pinnock, Jayesh Patel, Amar Ali, Nigel Hart, Richard Davies, Nigel De-Sousa, Catherine Neden, Mark Danielsen, Purnima Sharma, Sophia Galloway, Charlotte Hawkins, Raife Oliver, Martin Aylward, Mira Pattni, Gordon Irvine, Shahid Ahmad, Catherine Rothwell, Fiaz Choudhary, Sabrina Khalaque, Stephanie Short, Sharon Peters, Warwick Coulson, Neil Roberts, Amy Butler Steven Coates, Ben Ward, Daniel Jackson, Steve Walton, Diane Shepherd, Toh Wong, Mark Boon, Melanie Deacon, David Cornelius, Sarah Davies, Ben Frankel, Nick Hargreaves, Henry Choi, Jon Sumner, Tim Myhill, Salah Estifanos, Diane Geatch, Justin Wilkinson, Richard Veale, Karen Forshaw, Rob Hirst, Kashif Zaman, Catherine Liley, Rebecca Wastling, Paul McEleny, Andre Beattie, Philip Cooke, Mike Wong, Mark Pugsley, Chaminda Dooldeniya, Greg Rogers, James Bennett, Polly Jacobs, Rajesh Muvva, Matthew Adam, Robin Fox, Nicolas Thomas, Simon Cartwright, Rory Reed, Simon Randfield, Christine A’Court, Ann Flynn, Andrew Halpin, Simon Dobson, Louise Lomax, Minnal Nadaph, Iain Munro, Jane Goram, Helen Stoddart, Phil Simmons, John Shewring, Emma Bowen-Simpkins, Mark Rickenbach, Adam Blenkhorn Bhuwanendu Singh, Penny Astridge, William van Gaal, Walter Abhayaratna, Philip Thomson, Ron Lehman, Jens Kilian, David Coulshed, Andrei Catanchin, David Colquhoun, Hosen Kiat, David Eccleston, John French, Bronte Ayres, Peter Blombery, Thanh Phan, James Rogers, David O’Donnell, Sang Cheol Bae, Harry Gibbs, Patrick Carroll, Greg Starmer, Margaret Arstall, Maurits Binnekamp, Astin Lee, John Eikelboom Robert Luton, Milan Gupta, Amritanshu Shekhar Pandey, Stephen Cheung, Rolland Leader, Philippe Beaudry, Félix Ayala-Paredes, Joseph Berlingieri, John Heath, Germain Poirier, Miranda du Preez, Bradley Schweitzer, Reginald Nadeau, Ripple Dhillon, Tomasz Hruczkowski, Andrea Lavoie, Ratika Parkash, James Cha, Benoit Coutu, Paul MacDonald, Brian Ramjattan, Jorge Bonet, Saul Vizel, Paul Angaran, Sameh Fikry, Ahmed Mowafy Azza Katta, Mazen Tawfik, Moustafa Nawar, Mohamed Sobhy, Seif Kamal Abou Seif, Tarek Khairy, Ahmed Abd El-Aziz, Nasser Taha, Ashraf Reda, Atef Elbahry, Mohamed Setiha, Mohamed Gamal El Din, Magdi Elkhadem, Adel El-Etreby, David Kettles Junaid Bayat, Heidi Siebert, Adrian Horak, Ynez Kelfkens, Riaz Garda, Thayabran Pillay, Michele Guerra, Louis van Zyl, Hendrik Theron, Andrew Murray, Rikus Louw, Deon Greyling, Pindile Mntla, Siddique Ismail, Fayzal Ahmed, Johannes Engelbrecht, Shambu Maharajh, Wessel Oosthuysen, Rehana Loghdey, Veronica Ueckermann, Wael AlAl Mahmeed AbdullahNaeemi, Ghazi Yousef, Nooshin Bazargani, Munther AlOmairi, Rajan Maruthanayagam, Rupesh Singh, Ahmed Naguib, Mohamed Ibrahim, Amrish Agrawal, Mukesh Nathani, Ehab M. Esheiba, Adel Wassef, Rajeev Gupta, Michael Cox Scott Beach, Peter Duffy, Stephen Falkowski, Kevin Ferrick, Miguel Franco, W. Michael Kutayli, Annette Quick, Niraj Sharma, Vance Wilson, Stephen Miller, Mark Alberts, Edwin Blumberg, Roddy Canosa, Ted Gutowski, Rodney Ison, Jorge Garcia, Paul Mullen, Howard Noveck, Pamela Rama, Rajneesh Reddy, Marcus Williams, Daniel Nishijima, Keith Ferdinand, Ihsan Haque, Robert Mendelson, Sridevi Pitta, Daniel Theodoro, Charles Treasure, Moustafa Moustafa, Cas Cader, Walter Pharr, Alisha Oropallo, George Platt, Jaspal Gujral, James Welker, and Firas Koura
Abstract: Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is a worldwide non-interventional study of stroke prevention in patients with non-valvular AF. Methods and results: 52,080 patients with newly diagnosed AF were prospectively enrolled from 2010 to 2016. 4121 (7.9%) of these patients were recruited in DACH [Germany (n = 3567), Austria (n = 465) and Switzerland (n = 89) combined], and 47,959 patients were from 32 countries in other regions worldwide (ORW). Hypertension was most prevalent in DACH and ORW (85.3% and 75.6%, respectively). Diabetes, hypercholesterolaemia, carotid occlusive disease and vascular disease were more prevalent in DACH patients vs ORW (27.6%, 49.4%, 5.8% and 29.0% vs 21.7%, 40.9%, 2.8% and 24.5%). The use of non-vitamin K antagonist oral anticoagulants (NOACs) increased more in DACH over time. Management of vitamin K antagonists was suboptimal in DACH and ORW (time in therapeutic range of INR ≥ 65% in 44.6% and 44.4% of patients or ≥ 70% in 36.9% and 36.0% of patients, respectively). Adjusted rates of cardiovascular mortality and MI/ACS were higher in DACH while non-haemorrhagic stroke/systemic embolism was lower after 2-year follow-up. Conclusions: Similarities and dissimilarities in AF management and clinical outcomes are seen in DACH and ORW. The increased use of NOAC was associated with a mismatch of risk-adapted anticoagulation (over-and-undertreatment) in DACH. Suboptimal control of INR requires educational activities in both regional groups. Higher rates of cardiovascular death in DACH may reflect the higher risk profile of these patients and lower rates of non-haemorrhagic stroke could be associated with increased NOAC use. Graphical abstract: [Figure not available: see fulltext.].
Published: 2023

26. GREATER VARIABILITY IN DIASTOLIC- THAN SYSTOLIC AMBULATORY BLOOD PRESSURE IS ASSOCIATED WITH HIGH RISK FOR CARDIOVASCULAR MORTALITY WITHIN 5 YEARS IN SUBJECTS OVER 50 YEARS OF AGE

Author: Gavish, B., Bilo, G., Dolan, E., O’brien, E., and Parati, G.
Published: 2019
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27. THE IMPACT OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURE VARIABILITY ON MORTALITY IS MODIFIED BY AGEING. DATA FROM THE DUBLIN OUTCOME STUDY

Author: Bilo, G., Dolan, E., O’Brien, E., Facchetti, R., Soranna, D., Zambon, A., Mancia, G., and Parati, G.
Published: 2019
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28. BLOOD PRESSURE EFFECTS OF OBSTRUCTIVE SLEEP APNEA TREATMENT BY CONTINUOUS POSITIVE AIRWAY PRESSURE: SYSTEMATIC REVIEW, METAANALYSIS AND EVALUATION OF PHENOTYPES PREDICTING RESPONSE

Author: Pengo, M., Soranna, D., Giontella, A., Perger, E., Schwarz, E.I., Lombardi, C., Bilo, G., Zambon, A., Steier, J., Minuz, P., Parati, G., and Fava, C.
Published: 2019
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29. RELATIONSHIP BETWEEN SLEEP BREATHING PATTERNS AND BLOOD PRESSURE CHANGES DURING ACUTE HIGH ALTITUDE EXPOSURE. DATA FROM HIGHCARE STUDIES

Author: Dehò, G., Bilo, G., Lombardi, C., Soranna, D., Zambon, A., Faini, A., and Parati, G.
Published: 2019
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30. Blood pressure response in miners exposed to chronic intermittent hypoxia in Chile

Author: Lang, M, Paez, V, Maj, G, Silva-Urra, J, Labarca-Valenzuela, C, Caravita, S, Faini, A, Cantuarias, J, Perez, O, Bilo, G, Parati, G, Lang M., Paez V., Maj G., Silva-Urra J., Labarca-Valenzuela C., Caravita S., Faini A., Cantuarias J., Perez O., Bilo G., Parati G., Lang, M, Paez, V, Maj, G, Silva-Urra, J, Labarca-Valenzuela, C, Caravita, S, Faini, A, Cantuarias, J, Perez, O, Bilo, G, Parati, G, Lang M., Paez V., Maj G., Silva-Urra J., Labarca-Valenzuela C., Caravita S., Faini A., Cantuarias J., Perez O., Bilo G., and Parati G.
Abstract: Introduction: Limited information is available on blood pressure (BP) behavior in workers exposed to chronic intermittent hypoxia (CIH), and even less is known regarding effects of CIH on 24-h ambulatory BP in those affected by arterial hypertension at sea level (SL). The aims of this study were to assess clinic and 24-h ambulatory BP at SL and at high altitude (HA; 3,870 m above SL) in workers exposed to CIH, and to compare BP response to HA exposure between normotensive and hypertensive workers. Methods: Nineteen normotensive and 18 pharmacologically treated hypertensive miners acclimatized to CIH were included, whose work was organized according to a “7 days-on−7 days-off” shift pattern between SL and HA. All measurements were performed on the second and seventh day of their HA shift and after the second day of SL sojourn. Results: Compared to SL, 24-h systolic BP (SBP) and diastolic BP (DBP) increased at HA [+14.7 ± 12.6 mmHg (p < 0.001) and +8.7 ± 7.2 mmHg (p < 0.001), respectively], and SBP nocturnal fall decreased consistently (−4.1 ± 9.8%; p < 0.05) in all participants, with hypertensives showing higher nocturnal DBP than normotensives (p < 0.05) despite the current therapy. Also, heart rate (HR) nocturnal fall tended to be reduced at HA. In addition, the 24-h SBP/DBP hypertension threshold of ≥130/80 mmHg was exceeded by 39% of workers at SL and by 89% at HA. Clinic HR, SBP, and DBP were significantly higher on the second day of work at HA compared with SL, the increase being more pronounced for SBP in hypertensives (p < 0.05) and accompanied by, on average, mild altitude sickness in both groups. These symptoms and the values of all cardiovascular variables decreased on the seventh day at HA (p < 0.05) regardless of CIH exposure duration. Conclusion: Long history of work at HA according to scheduled CIH did not prevent the occurrence of acute cardiovascular changes at HA during the first days of exposure. The BP response to HA tended to be
Published: 2021

31. Current challenges for hypertension management: From better hypertension diagnosis to improved patients' adherence and blood pressure control

Author: Parati, G, Lombardi, C, Pengo, M, Bilo, G, Ochoa, J, Parati G., Lombardi C., Pengo M., Bilo G., Ochoa J. E., Parati, G, Lombardi, C, Pengo, M, Bilo, G, Ochoa, J, Parati G., Lombardi C., Pengo M., Bilo G., and Ochoa J. E.
Abstract: Hypertension control still remains a largely unmet challenge for public health systems. Despite the progress in blood pressure (BP) measurement techniques, and the availability of effective and safe antihypertensive drugs, a large number of hypertensive patients are not properly identified, and a significant proportion of those who receive antihypertensive treatment fail to achieve satisfactory control of their BP levels. It is thus not surprising that hypertension is still a major contributor to disease burden and disability worlwide, even in developed countries. This paper will address current challenges in hypertension management and potential strategies for an improvement in this field. In its first part relevant issues related to hypertension diagnosis will be addressed, in particular how to improve identification of sustained BP elevation and specific BP phenotypes such as white coat and masked hypertension trough the combined use of office and out-of-office BP monitoring techniques. In its second part focus will be on how to improve achievement of hypertension control in treated patients by optimization and simplification of medication regimens, including more efficient selection and titration of antihypertensive drugs and their combinations, aimed at achieving a more consistent 24hBP control; and by favoring a more active patients' and physicians' involvement in hypertension management also through BP telemonitoring and mobile health technologies.
Published: 2021

32. Blood pressure and high altitude: physiological response and clinical management [Presión arterial y altitud: respuestas fisiológicas y manejo clínico]

Author: Lang, M, Bilo, G, Caravita, S, Parati, G, Lang M., Bilo G., Caravita S., Parati G., Lang, M, Bilo, G, Caravita, S, Parati, G, Lang M., Bilo G., Caravita S., and Parati G.
Abstract: High altitude is an extreme environment that challenges human beings exposed because of work, recreational activities, or habitat. Exposure to hypobaric hypoxia results in physiological adaptations in response to the geography and the associated extreme environmental conditions. These acclimatization responses can be diverse and result from evolutionary changes and comorbidities. In this context, this review aims to identify the available evidence on the effects of high altitude on blood pressure-from the physiological to clinical aspects at rest and during exercise-and the underlying mechanisms and possible clinical implications of acute and chronic intermittent hypoxia., La gran altitud es un ambiente extremo que impone fuertes desafíos para el ser humano que se expone por actividades laborales, recreativas o que vive en esta condición. La exposición a hipoxia hipobárica genera una serie de adaptaciones fisiológicas dadas por el entorno geográfico y las condiciones ambientales extremas asociadas. Estas respuestas de aclimatación pueden ser heterogéneas, siendo el resultado de cambios evolutivos y de la existencia de comorbilidades o patologías asociadas. En este contexto, el objetivo de este artículo es identificar la evidencia científica acerca de los efectos de la altitud geográfica en la presión arterial, desde los aspectos fisiológicos a las implicaciones clínicas en reposo y ejercicio. Asimismo, se abordan los mecanismos subyacentes y las posibles implicaciones clínicas en hipoxia aguda e hipoxia intermitente crónica.
Published: 2021

33. The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure [El proyecto ANDANTE: un metanálisis a nivel mundial de datos individuales sobre el efecto del tratamiento de la apnea del sueño en la presión arterial]

Author: Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, Zambra, G, Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., Zambra G., Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, Zambra, G, Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., and Zambra G.
Published: 2021

34. PREDICTIVE POWER OF 24-HOUR AMBULATORY PULSE PRESSURE COMPONENTS FOR CARDIOVASCULAR MORTALITY IN DIFFERENT AGE AND HEART RATE STRATA DERIVED FROM DATA OF DUBLIN OUTCOME STUDY

Author: Gavish, B., Bilo, G., Dolan, E., O’Brien, E., and Parati, G.
Published: 2018
Full Text: View/download PDF

35. Time to rethink the management of underlying sleep disturbances in nondippers?

Author: Pengo, M, Bilo, G, Lombardi, C, Parati, G, Pengo M. F., Bilo G., Lombardi C., Parati G., Pengo, M, Bilo, G, Lombardi, C, Parati, G, Pengo M. F., Bilo G., Lombardi C., and Parati G.
Published: 2020

36. Seasonal variation in blood pressure: Evidence, consensus and recommendations for clinical practice. Consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability

Author: Stergiou, G, Palatini, P, Modesti, P, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Head, G, Kario, K, Kollias, A, Manios, E, Mihailidou, A, Myers, M, Niiranen, T, Ohkubo, T, Protogerou, A, Wang, J, O'Brien, E, Parati, G, Stergiou G. S., Palatini P., Modesti P. A., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Head G., Kario K., Kollias A., Manios E., Mihailidou A. S., Myers M., Niiranen T., Ohkubo T., Protogerou A., Wang J., O'Brien E., Parati G., Stergiou, G, Palatini, P, Modesti, P, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Head, G, Kario, K, Kollias, A, Manios, E, Mihailidou, A, Myers, M, Niiranen, T, Ohkubo, T, Protogerou, A, Wang, J, O'Brien, E, Parati, G, Stergiou G. S., Palatini P., Modesti P. A., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Head G., Kario K., Kollias A., Manios E., Mihailidou A. S., Myers M., Niiranen T., Ohkubo T., Protogerou A., Wang J., O'Brien E., and Parati G.
Abstract: Blood pressure (BP) exhibits seasonal variation with lower levels at higher environmental temperatures and higher at lower temperatures. This is a global phenomenon affecting both sexes, all age groups, normotensive individuals, and hypertensive patients. In treated hypertensive patients it may result in excessive BP decline in summer, or rise in winter, possibly deserving treatment modification. This Consensus Statement by the European Society of Hypertension Working Group on BP Monitoring and Cardiovascular Variability provides a review of the evidence on the seasonal BP variation regarding its epidemiology, pathophysiology, relevance, magnitude, and the findings using different measurement methods. Consensus recommendations are provided for health professionals on how to evaluate the seasonal BP changes in treated hypertensive patients and when treatment modification might be justified. (i) In treated hypertensive patients symptoms appearing with temperature rise and suggesting overtreatment must be investigated for possible excessive BP drop due to seasonal variation. On the other hand, a BP rise during cold weather, might be due to seasonal variation. (ii) The seasonal BP changes should be confirmed by repeated office measurements; preferably with home or ambulatory BP monitoring. Other reasons for BP change must be excluded. (iii) Similar issues might appear in people traveling from cold to hot places, or the reverse. (iv) BP levels below the recommended treatment goal should be considered for possible down-titration, particularly if there are symptoms suggesting overtreatment. SBP less than 110 mmHg requires consideration for treatment down-titration, even in asymptomatic patients. Further research is needed on the optimal management of the seasonal BP changes.
Published: 2020

37. Office and Ambulatory Arterial Hypertension in Highlanders: HIGHCARE-ANDES Highlanders Study

Author: Bilo, G, Acone, L, Anza-Ramire, C, Macarlupu, J, Soranna, D, Zambon, A, Vizcardo-Galindo, G, Pengo, M, Villafuerte, F, Parati, G, Bilo G., Acone L., Anza-Ramire C., MacArlupu J. L., Soranna D., Zambon A., Vizcardo-Galindo G., Pengo M. F., Villafuerte F. C., Parati G., Bilo, G, Acone, L, Anza-Ramire, C, Macarlupu, J, Soranna, D, Zambon, A, Vizcardo-Galindo, G, Pengo, M, Villafuerte, F, Parati, G, Bilo G., Acone L., Anza-Ramire C., MacArlupu J. L., Soranna D., Zambon A., Vizcardo-Galindo G., Pengo M. F., Villafuerte F. C., and Parati G.
Abstract: Millions of people worldwide live at high altitude, being chronically exposed to hypobaric hypoxia. Hypertension is a major cardiovascular risk factor but data on its prevalence and determinants in highlanders are limited, and systematic studies with ambulatory blood pressure monitoring are not available. Aim of this study was to assess the prevalence of clinic and ambulatory hypertension and the associated factors in a sample of Andean highlanders. Hypertension prevalence and phenotypes were assessed with office and ambulatory blood pressure measurement in a sample of adults living in Cerro de Pasco, Peru (altitude 4340 m). Basic clinical data, blood oxygen saturation, hematocrit, and Qinghai Chronic Mountain Sickness score were obtained. Participants were classified according to the presence of excessive erythrocytosis and chronic mountain sickness diagnosis. Data of 289 participants (143 women, 146 men, mean age 38.3 years) were analyzed. Office hypertension was present in 20 (7%) participants, while ambulatory hypertension was found in 58 (20%) participants. Masked hypertension was common (15%), and white coat hypertension was rare (2%). Among participants with ambulatory hypertension, the most prevalent phenotypes included isolated nocturnal hypertension, isolated diastolic hypertension, and systodiastolic hypertension. Ambulatory hypertension was associated with male gender, age, overweight/obesity, 24-hour heart rate, and excessive erythrocytosis. Prevalence of hypertension among Andean highlanders may be significantly underestimated when based on conventional blood pressure measurements, due to the high prevalence of masked hypertension. In highlanders, ambulatory hypertension may be independently associated with excessive erythrocytosis.
Published: 2020

38. Obstructive sleep apnoea treatment and blood pressure: Which phenotypes predict a response? A systematic review and meta-analysis

Author: Pengo, M, Soranna, D, Giontella, A, Perger, E, Mattaliano, P, Schwarz, E, Lombardi, C, Bilo, G, Zambon, A, Steier, J, Parati, G, Minuz, P, Fava, C, Pengo M. F., Soranna D., Giontella A., Perger E., Mattaliano P., Schwarz E. I., Lombardi C., Bilo G., Zambon A., Steier J., Parati G., Minuz P., Fava C., Pengo, M, Soranna, D, Giontella, A, Perger, E, Mattaliano, P, Schwarz, E, Lombardi, C, Bilo, G, Zambon, A, Steier, J, Parati, G, Minuz, P, Fava, C, Pengo M. F., Soranna D., Giontella A., Perger E., Mattaliano P., Schwarz E. I., Lombardi C., Bilo G., Zambon A., Steier J., Parati G., Minuz P., and Fava C.
Abstract: The treatment for obstructive sleep apnoea (OSA) with continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs) is associated with blood pressure (BP) reduction; however, the overall effect is modest. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effect of such treatments on BP was to identify subgroups of patients who respond best to treatment. The article search was performed in three different databases with specific search terms and selection criteria. From 2289 articles, we included 68 RCTs that compared CPAP or MADs with either passive or active treatment. When all the studies were pooled together, CPAP and MADs were associated with a mean BP reduction of 2.09 (95% CI 2.78-1.40) mmHg for systolic BP and 1.92 (95% CI 2.40-1.43) mmHg for diastolic BP and 1.27 (95% CI 2.34-0.20) mmHg for systolic BP and 1.11 (95% CI 1.82-0.41) mmHg for diastolic BP, respectively. The subgroups of patients who showed a greater response were those aged <60 years (systolic BP 2.93 mmHg), with uncontrolled BP at baseline (systolic BP 4.14 mmHg) and with severe oxygen desaturations (minimum arterial oxygen saturation measured by pulse oximetry <77%) at baseline (24-h systolic BP 7.57 mmHg). Although this meta-analysis shows that the expected reduction of BP by CPAP/MADs is modest, it identifies specific characteristics that may predict a pronounced benefit from CPAP in terms of BP control. These findings should be interpreted with caution; however, they are particularly important in identifying potential phenotypes associated with BP reduction in patients treated for OSA.
Published: 2020

39. Home blood pressure during COVID-19-related lockdown in patients with hypertension

Author: Pengo, M, Albini, F, Guglielmi, G, Mollica, C, Soranna, D, Zambra, G, Zambon, A, Bilo, G, Parati, G, Pengo, M, Albini, F, Guglielmi, G, Mollica, C, Soranna, D, Zambra, G, Zambon, A, Bilo, G, and Parati, G
Published: 2022

40. [OP.1C.05] DIFFERENT PROGNOSTIC RELEVANCE OF 24-HOUR SYSTOLIC AND DIASTOLIC BLOOD PRESSURE VARIABILITY IN DIFFERENT AGE STRATA. DUBLIN OUTCOME STUDY

Author: Bilo, G., Dolan, E., Facchetti, R., O’Brien, E., and Parati, G.
Published: 2017
Full Text: View/download PDF

41. Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic

Author: Kreutz R, Dobrowolski P, Prejbisz A, Algharably E, Bilo G, Creutzig F, Grassi G, Kotsis V, Lovic D, Lurbe E, Modesti P, Pappaccogli M, Parati G, Persu A, Polonia J, Rajzer M, de Timary P, Weber T, Weisser B, Tsioufis K, Mancia G, Januszewicz A, European Society of Hypertension COVID-19 Task Force Review, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de psychiatrie adulte, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Kreutz, R, Dobrowolski, P, Prejbisz, A, Algharably, E, Bilo, G, Creutzig, F, Grassi, G, Kotsis, V, Lovic, D, Lurbe, E, Modesti, P, Pappaccogli, M, Parati, G, Persu, A, Polonia, J, Rajzer, M, de Timary, P, Weber, T, Weisser, B, Tsioufis, K, Mancia, G, and Januszewicz, A
Subjects: Psychologic stress, Coronavirus disease 2019 (COVID-19), Physiology, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Pandemic, Internal Medicine, Humans, Medicine, 030212 general & internal medicine, Risk factor, Life Style, Pandemics, Socioeconomic status, cardiovascular risk, coronavirus disease 2019, diet, environmental, hypertension, life style, psychological, salt, severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, business.industry, Smoking, COVID-19, Diurnal rhythms, Lifestyle factors, Blood pressure, Socioeconomic Factors, Hypertension, business, Cardiology and Cardiovascular Medicine, Stress, Psychological
Abstract: SUMMARY: The coronavirus disease 2019 (COVID-19) pandemic considerably affects health, wellbeing, social, economic and other aspects of daily life. The impact of COVID-19 on blood pressure (BP) control and hypertension remains insufficiently explored. We therefore provide a comprehensive review of the potential changes in lifestyle factors and behaviours as well as environmental changes likely to influence BP control and cardiovascular risk during the pandemic. This includes the impact on physical activity, dietary patterns, alcohol consumption and the resulting consequences, for example increases in body weight. Other risk factors for increases in BP and cardiovascular risk such as smoking, emotional/psychologic stress, changes in sleep patterns and diurnal rhythms may also exhibit significant changes in addition to novel factors such as air pollution and environmental noise. We also highlight potential preventive measures to improve BP control because hypertension is the leading preventable risk factor for worldwide health during and beyond the COVID-19 pandemic.
Published: 2021

42. Blood pressure and high altitude: physiological response and clinical management [Presión arterial y altitud: respuestas fisiológicas y manejo clínico]

Author: Lang M., Bilo G., Caravita S., Parati G., Lang, M, Bilo, G, Caravita, S, and Parati, G
Subjects: hypertension, hypoxia, blood pressure, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, altitude
Abstract: High altitude is an extreme environment that challenges human beings exposed because of work, recreational activities, or habitat. Exposure to hypobaric hypoxia results in physiological adaptations in response to the geography and the associated extreme environmental conditions. These acclimatization responses can be diverse and result from evolutionary changes and comorbidities. In this context, this review aims to identify the available evidence on the effects of high altitude on blood pressure-from the physiological to clinical aspects at rest and during exercise-and the underlying mechanisms and possible clinical implications of acute and chronic intermittent hypoxia. La gran altitud es un ambiente extremo que impone fuertes desafíos para el ser humano que se expone por actividades laborales, recreativas o que vive en esta condición. La exposición a hipoxia hipobárica genera una serie de adaptaciones fisiológicas dadas por el entorno geográfico y las condiciones ambientales extremas asociadas. Estas respuestas de aclimatación pueden ser heterogéneas, siendo el resultado de cambios evolutivos y de la existencia de comorbilidades o patologías asociadas. En este contexto, el objetivo de este artículo es identificar la evidencia científica acerca de los efectos de la altitud geográfica en la presión arterial, desde los aspectos fisiológicos a las implicaciones clínicas en reposo y ejercicio. Asimismo, se abordan los mecanismos subyacentes y las posibles implicaciones clínicas en hipoxia aguda e hipoxia intermitente crónica.
Published: 2021

43. The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure [El proyecto ANDANTE: un metanálisis a nivel mundial de datos individuales sobre el efecto del tratamiento de la apnea del sueño en la presión arterial]

Author: Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., Zambra G., Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, and Zambra, G
Subjects: hypertension, blood pressure, sleep apnea
Published: 2021

44. White Coat and Masked Hypertension in Chronic Kidney Disease: Importance of the Difference Between Office and Out-of-Office Blood Pressure Measurements

Author: Parati, G, Ochoa, J, Bilo, G, Parati G., Ochoa J. E., Bilo G., Parati, G, Ochoa, J, Bilo, G, Parati G., Ochoa J. E., and Bilo G.
Published: 2019

45. Cardiac autonomic regulation in patients undergoing pulmonary vein isolation for atrial fibrillation

Author: Styczkiewicz, K, Spadacini, G, Tritto, M, Perego, G, Facchini, M, Bilo, G, Kawecka-Jaszcz, K, Czarnecka, D, Malfatto, G, Parati, G, Styczkiewicz K., Spadacini G., Tritto M., Perego G. B., Facchini M., Bilo G., Kawecka-Jaszcz K., Czarnecka D., Malfatto G., Parati G., Styczkiewicz, K, Spadacini, G, Tritto, M, Perego, G, Facchini, M, Bilo, G, Kawecka-Jaszcz, K, Czarnecka, D, Malfatto, G, Parati, G, Styczkiewicz K., Spadacini G., Tritto M., Perego G. B., Facchini M., Bilo G., Kawecka-Jaszcz K., Czarnecka D., Malfatto G., and Parati G.
Abstract: Aims Ablation procedures for the treatment of atrial fibrillation lead to changes in autonomic heart control; however, there are insufficient data on the possible association of these changes with atrial fibrillation recurrence. The study aim was to assess the effects of pulmonary vein isolation (PVI) on cardiac autonomic modulation and atrial fibrillation recurrence. Methods We screened 52 patients with atrial fibrillation referred for PVI, of whom 20 patients met inclusion and exclusion criteria, and were enrolled in the study and followed over 6 months. Beat-to-beat blood pressure monitoring was performed 1–2 days before PVI, 1 and 6 months after PVI. We estimated pulse interval variability and spontaneous baroreflex sensitivity (BRS) both in the time and frequency domains, and performed the Valsalva manoeuvre assessing the Valsalva ratio. Results During 6 months after PVI, atrial fibrillation recurrence was observed in six patients. One month after PVI, pulse interval variability and BRS (sequence method) significantly decreased in all patients, returning to preintervention values by 6 months. Patients without atrial fibrillation recurrence at 1 month showed a transient reduction in pulse interval variability (frequency domain) and in BRS (both methods) in contrast to those with atrial fibrillation recurrence. A significant decrease in the Valsalva ratio observed at 1 month was maintained at 6 months after PVI in both groups. Conclusion Successful PVI may lead to transient autonomic alterations reflected by a reduction in pulse interval variability and BRS, with more prolonged changes in the Valsalva ratio. The efficacy of PVI in preventing atrial fibrillation recurrence seems to be related to transient parasympathetic atrial denervation.
Published: 2019

46. Blood pressure at high altitude: Physiology and clinical implications

Author: Bilo, G, Caravita, S, Torlasco, C, Parati, G, Bilo G., Caravita S., Torlasco C., Parati G., Bilo, G, Caravita, S, Torlasco, C, Parati, G, Bilo G., Caravita S., Torlasco C., and Parati G.
Abstract: High altitude is a fascinating model of hypoxia effects on the human body, but it is also an extreme environment that directly influences millions of people who either travel to high altitude locations or live there permanently. A significant progress has been made over the past decades in the understanding of physiological background of responses to altitude, and recently, a number of studies regarding clinical aspects of high-altitude exposure have been published. In particular, more is known about the changes in systemic blood pressure (BP) in individuals exposed to high altitude as well as on the effects of antihypertensive drugs in this setting. The present article provides an overview of principal physiological and clinical aspects related to systemic BP control and its changes at high altitude, mainly during the acute exposure. The evidence on BP changes at rest and during exercise is discussed, as well as the underlying mechanisms and possible clinical implications.
Published: 2019

47. Home blood pressure monitoring: methodology, clinical relevance, and practical application. A 2021 position paper by the European Society of Hypertension. Working Group on Blood Pressure Monitoring and Cardiovascular Variability

Author: Parati, G, Stergiou, G, Bilo,G, McManus, R, and Hypertension, Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of
Abstract: The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments which have occurred over the past twenty years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH.
Published: 2021

48. Effects of insomnia and restless legs syndrome on sleep arterial blood pressure: A systematic review and meta-analysis

Author: Maiolino, G, Bisogni, V, Soranna, D, Pengo, M, Pucci, G, Vettor, R, Fava, C, Colussi, G, Bilo, G, Lombardi, C, Parati, G, Rossi, G, Silvani, A, Colussi, GL, Rossi, GP, Maiolino, G, Bisogni, V, Soranna, D, Pengo, M, Pucci, G, Vettor, R, Fava, C, Colussi, G, Bilo, G, Lombardi, C, Parati, G, Rossi, G, Silvani, A, Colussi, GL, and Rossi, GP
Abstract: Hypertension and blunted blood pressure (BP) dipping during nighttime sleep are associated with increased cardiovascular risk. Chronic insomnia and restless legs syndrome (RLS) may affect the 24-h BP profile. We systematically reviewed the association of insomnia and RLS with BP values during nighttime sleep and the relative BP dipping pattern. We searched relevant articles in any language with selection criteria including enrolment of subjects with insomnia or RLS and with obstructive sleep apnea comorbidity assessment. Of the 872 studies originally retrieved, seven were selected. Four studies enrolled subjects with insomnia. One study relied on sleep diaries to classify nighttime sleep BP, whereas three relied only on clock time. At meta-analysis, subjects with insomnia displayed an attenuated dipping of systolic BP (−2.00%; 95% confidence interval (CI): −3.61 - −0.39%) and diastolic BP (−1.58%; 95% CI: −2.66 ̶ −0.49%) during nighttime sleep compared to controls. Three studies enrolled subjects with RLS. One study relied on polysomnography to classify nighttime sleep BP, whereas two relied only on clock time. Subjects with RLS showed increases in nighttime sleep systolic BP (5.61 mm Hg, 95% CI 0.13̶–11.09 mm Hg) compared to controls. In conclusion, the limited available data suggest that insomnia and RLS are both associated with altered BP control during nighttime sleep. There is need for more clinical studies to confirm these findings, specifically focusing on measurements of BP during objectively defined sleep, on causal roles of leg movements during sleep and alterations in sleep architecture, and on implications for cardiovascular risk. Prospero acknowledgement of number: CRD42020217947.
Published: 2021

49. Time to recognize continuous positive airway pressure as a blood pressure-lowering treatment in patients with obstructive sleep apnoea and resistant hypertension?

Author: Pengo, M, Lombardi, C, Bilo, G, Parati, G, Pengo, M, Lombardi, C, Bilo, G, and Parati, G
Published: 2021

50. The Association Between Chronic Hepatitis B, Chronic Hepatitis C, Sustained Liver Damage, and Features of Increased Cardiovascular Risk

Author: Czepiel, J, Rajzer, M, Bilo, G, Parati, G, Biesiada, G, Cibor, D, Pitera, E, Wolkow, P, Michalak, M, Garlicki, A, Czepiel, J, Rajzer, M, Bilo, G, Parati, G, Biesiada, G, Cibor, D, Pitera, E, Wolkow, P, Michalak, M, and Garlicki, A
Abstract: It is thought that chronic liver disease affects a person’s risk of cardiovascular disease (CVD) development. The aim of this study was to assess the effect of Chronic Hepatitis B (HBV) infection, Chronic Hepatitis C (HCV) infection, and liver damage on cardiovascular risk and selected vascular parameters contributing to CVD risk. This case-control study included a group of 114 patients composed of 34 patients with HBV, 35 patients with HCV, and 45 patients as the control group. Cardiovascular risk was assessed by analyzing classic risk factors, and the SCORE system. The following arterial properties were analyzed using applanation tonometry with SphygmoCor Vx technology: central systolic blood pressure (cSBP), central pulse pressure, augmentation pressure, augmentation index, and carotid-femoral pulse wave velocity (PWV). Asymmetric dimethyloarginine (ADMA) blood levels were analyzed using ELISA as a marker of vascular function. In a univariable analysis we found no significant differences between the hepatitis B, hepatitis C, and control groups in terms of PWV (respectively: median 7.2 [Q25-Q75 6.4-8.5], 7.3 [6.9-8.7], 7.8 [6.5-8.9]), cSBP (115 [109-126], 118 [107-123], 116 [107-129]), ADMA (0.52 [0.47-0.60], 0.53 [0.45-0.62], 0.58 [0.51-0.63]), SCORE (0 [0-1], 0 [0-2], 0 [0-2]). No significant differences in cardiovascular variables were observed between cirrhotic and non-cirrhotic patients. A multivariable analysis confirmed the above findings. (PWV, p=0.29; cSBP, p=0.26; ADMA, p=0.19). We concluded that chronic hepatitis B or C was not independently associated with an adverse cardiovascular risk profile nor with an unfavorable pattern of vascular parameters contributing to CVD risk in our study population, even in the case of liver cirrhosis. The same was true for blood ADMA levels.
Published: 2021

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