Blood Pressure and Metabolic Effect of a Combination of Lercanidipine with Different Antihypertensive Drugs in Clinical Practice

The aim of this study is to assess the blood pressure (BP) and metabolic effects of lercanidipine when combined with other classes of first-line antihypertensive drugs in day-to-day clinical practice. For this study, we consecutively enrolled 162 patients with uncomplicated primary hypertension, who are partial responders to the treatment with lercanidipine over a period of 24 months. Patients were then allocated to the combination of lercanidipine (10–20 mg/day) with β-blockers, diuretics, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers according to compelling indications (if any) and/or suggestions of European Society of Hypertension–European Society of Cardiology (ESH–ESC) guidelines. All the enrolled patients completed the study and no adverse drug reaction was registered during the research period. The association of a second drug with lercanidipine determined an additional BP decrease of either systolic BP or diastolic BP independently from the type of drug added (P always 0.05). Conversely, a significant decrease in fasting plasma glucose and serum levels of triglycerides has been observed in patients where lercanidipine has been combined with an angiotensin-converting enzyme inhibitor or an angiotensin-II receptor blocker. In conclusion, in our study we observed that lercanidipine-based protocols are well tolerated and efficacious in reducing BP. Moreover, the association of lercanidipine with renin–angiotensin system blockers is also associated with significant improvements in triglycerides and fasting plasma glucose

5.26 Left Ventricular Hypertrophy Prevalence by Different Left Ventricular Mass Indexes

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Rischio cardiovascolare e disturbi ipertensivi della gravidanza: follow-up a 10 anni.

Razionale. La comparsa di disordini ipertensivi in gravidanza costituisce una evenienza relativamente comune, potendo interessare circa un 10% di tutte le gravidanze e fino al 20% delle prime gravidanze, con un trend in crescita. Un numero crescente di studi ha segnalato in queste pazienti un aumento del rischio cardiovascolare a lungo termine. Disegno dello studio e metodi. La ricerca \ue8 stata condotta sulla base di un disegno osservazionale caso-controllo valutando a distanza di 10 anni dal parto 90 donne: 50 donne nelle quali 10 anni prima era stata posta diagnosi di un disordine ipertensivo in gravidanza (32 PIH, 28 PE) e 30 controlli con gravindanza nornale 10 anni prima. Risultati. Nessuna delle pazienti ha riferito eventi CV negli ultimi 10 anni (numero limitato di soggetti arruolato nello studio, donne in una fascia di et\ue0 ancora giovane) ma analizzando i dati sulla pressione arteriosa abbiamo rilevato come le pazienti con pregressa PIH non solo presentassero valori pressori sistolici pi\uf9 elevati (p<0.05 vs PE e C) ma anche come ben il 40% di essei a distanza di 10 anni dalla gravidanza avesse sviluppato una ipertensione cronica. Conclusioni. I risultati del nostro studio incoraggiano a proseguire il follow-up delle donne con disturbi ipertensivi in gravidanza e suggerisco di considerare con maggiore attenzione ili rischio cardiovascolare a lungo termine di questa popolazione di donne in quanto l'espletamento del parto sembra non porre fine ai rischi materni nel lungo periodo

Effects of a Combined Nutraceutical on Lipid Pattern, Glucose Metabolism and Inflammatory Parameters in Moderately Hypercholesterolemic Subjects: A Double-blind, Cross-over, Randomized Clinical Trial

Background: There is an increasing interest for combined nutraceuticals that can act on several points of lipid and glucose metabolism with preventive purposes. However, the simple assemblage of nutraceuticals with potentially additive mechanism of action need to be clinically tested. Methods: To assess the effects of a combination of nutraceuticals based on artichoke, red yeast rice, banaba, and coenzyme Q10, we performed a double bind, cross-over designed trial versus placebo in 30 adults with LDL cholesterol suboptimal in primary prevention of cardiovascular disease. After a period of 3 weeks of dietary habits correction, patients began a period of 6 weeks of treatment with nutraceutical or placebo, followed by 2 weeks of washout and finally 6 weeks in cross-over. Data related to lipid pattern, insulin resistance, renal function, liver and CPK have been obtained at each visit. Results: In particular, the after the nutraceutical treatment the enrolled patients experienced a significant improvement in total cholesterol (-13.6 %), LDL-C (-18.2 %), non-HDL-C (-15 %), glutamic oxaloacetic transaminase (-10 %), glutamate-pyruvate transaminase (-30.9 %), and hs-CRP (-18.2 %) versus placebo. No changes have been observed in the other investigated parameters in both groups. Conclusions: The tested combination of nutraceuticals has shown clinical efficacy in the reduction of total cholesterol, non-HDL, LDL and triglycerides, while improving the level of liver transaminases and high sensitivity C-reactive protein. Further confirmation are needed to verify these observations on the middle and long term with a larger number of subject

La compromissione della funzione renale in un campione di popolazione generale: dati del Brisighella Heart Study.

Background. La compromissione della funzione renale \ue8 una frequente condizione clinica,che risulta in una aumentata incidenza e prevalenza di malattia renale. Lo scopo dello studio \ue8 quello di indagare i determinanti del deterioramento della funzione renale in un campione di popolazione generale. Metodi. Il Brisighella Heart Study \ue8 uno studio longitudinale, prospettico, di popolazione coinvolgente 2939 soggetti arruolati in modo casuale, di et\ue0 compresa fra i 14 e 84 anni, senza patologia cardiovascolare all\u2019arruolamento, residenti in una citt\ue0 rurale del nord Italia, Brisighella. Da questa coorte storica, seguita dal 1972 abbiamo selezionato 694 soggetti (50% uomini) che presentassero un rilievo di informazioni cliniche/laboratoristiche sia nel 2004 (et\ue0 media 61\ub112 anni) sia nel 2008 (et\ue0 media 65\ub112 anni). Risultati. Rispetto al 2004, nel 2008 i soggetti presentavano un pi\uf9 elevato giro di vita (94\ub112 vs. 92\ub112 cm, p<0.001), ridotta frequenza cardiaca (64\ub110 vs. 72\ub110 bpm, p<0.0001), pi\uf9 bassi livelli livelli di colesterolo totale, colesterolo HDL e LDL (rispettivamente 211\ub139 vs 224\ub141 mg/dl, p<0.0001, 46\ub111 vs 52\ub113 mg/dl, p<0.0001, 142\ub138 vs. 147\ub137 mg/dl, p<0.01), uricemia pi\uf9 elevata (5.3\ub11.6 vs. 4.7mg/dl, p<0.0001), un lieve incremento della velocit\ue0 di filtrazione glomerulare (76\ub115 vs. 75\ub114, p=0.03). La pressione arteriosa sistolica e diastolica era sovrapponibile. La regressione multipla mirata ad investigare i determinanti della velocit\ue0 di filtrazione glomerulare nel 2008 ha mostrato che i livelli di colesterolo totale (beta=0.06, p=0.04) e la pressione arteriosa sistolica (beta=0.08, p=0.01) nel 2004 significativi determinanti negativi, dopo aggiustamento per la velocit\ue0 di filtrazione glomerulare al baseline. Conclusioni. Abbiamo mostrato che, nonostante simili od addirittura pi\uf9 elevati livelli di filtrazione glomerulare dopo un follow-up di 4 anni, in una popolazione rurale erano i livelli di colesterolo totale e la pressione arteriosa

LIPID-LOWERING AND ANTI-INFLAMMATORY EFFECTS OF OMEGA 3 ETHYL ESTERS AND KRILL OIL: A RANDOMIZED, CROSS-OVER, CLINICAL TRIAL

Objective: The aim of our study was to comparatively evaluate the short-term lipid-lowering efficacy of krill oil and purified Omega 3 ethyl esters PUFAs in mildly overweight hypertriglyceridemic subjects. Design and method: This double blind, randomized clinical trial was carried out in 25 moderately hypertriglyceridemic subjects (TG = 150 - 500 mg/dL). After 4 weeks of diet and physical activity, patients were allocated to treatment with an indistinguishable pill containing Omega 3 ethyl ester PUFAs 2000 mg/die vs. Krill oil 500 mg/die to be assumed once a day. After 4 weeks of treatment, patients were asked to observe a 2-week wash-out period, and they were then assigned to the alternative treatment for a further period of 4 weeks. Results: Although both PUFA sources were able to improve TG plasma levels, esterified omega 3 PUFAs were more efficacious than Krill oil (p &lt; 0.05). Nonetheless, only Krill oil treatment was able to significantly improve HDL-C and apoAI level, both compared to baseline (p &lt; 0.05) and end of treatment with esterified Omega 3 PUFAs (p &lt; 0.05) values. Both treatments were able to significantly reduce hsCRP levels from the baseline (p &lt; 0.05), but Krill oil improved it more efficaciously than esterified omega 3 PUFAs (p &lt; 0.05). Conclusions: Krill oil has lipid-lowering effects comparable with those obtained through a 4 time higher dose of purified Omega 3 ethyl esters PUFAs in mildly overweight hypertriglyceridemic subjects, while more efficaciously reducing hsCRP