ISSN:1120-9879    

出版商:ADIS    

年代:2004

数据来源: ADIS

ISSN:1120-9879    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

AimThe aim of the present observational study was to evaluate the level of cardiovascular risk in a population of hypertensive patients referred to cardiologists or physicians working in outpatient hypertension clinical centres.Population1000 specialists in cardiology or physicians working in hypertension centres distributed throughout Italy enrolled 20 consecutive hypertensive patients, aged ≥60 years, in two distinct periods: ten patients were included during the month of March 2003, while ten patients were included in June 2003.EndpointThe primary endpoint was the evolution of the cardiovascular risk distribution in hypertensive patients and the level of control of hypertension and dyslipidaemia in an unselected outpatient population.

ISSN:1120-9879    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

Impaired endothelial function due to reduced nitric oxide availability secondary to an augmented production of oxidative stress has been associated with an increased risk of cardiovascular events in patients with coronary artery disease. Therefore, improvement of endothelial function through antioxidant therapy might be an important therapeutic approach for the prevention of cardiovascular morbidity and mortality. Available evidence indicates that acute high-dose ascorbic acid (vitamin C) improves endothelial function in high-risk patients. In contrast, results from clinical trials on the effect of long-term antioxidant therapy are contradictory. This discrepancy could be due to different experimental designs, vascular areas, diseases, range of doses and concomitant drugs utilised. The possibility that antioxidant vitamins can reduce cardiovascular damage and prevent cardiovascular events has been investigated in several studies. While observational studies suggested an inverse relationship between antioxidant vitamin intake and progression of atherosclerotic lesions, controlled clinical studies showed no effect of antioxidant vitamins on post-percutaneous transluminal coronary angioplasty stenting restenosis, coronary and carotid atherosclerotic lesions. Controlled studies evaluating the effect of antioxidant vitamins, in particular tocopherol (vitamin E), on cardiovascular events showed no beneficial effect in six of eight trials, although data concerning both the presence or absence of benefit in particular patients and the type of cardiovascular events were discordant. Overall, while these data indicated that at this time antioxidant vitamins are not to be recommended for the prevention of cardiovascular events, they did not contradict the hypothesis that antioxidant therapy should still be considered an important tool for prevention-regression of atherosclerosis and prevention of cardiovascular events. However, this potential benefit needs to be confirmed by future controlled clinical studies using new antioxidant substances with optimal pharmacokinetics and pharmacodynamics, in order to achieve high bioavailability and a documented dose-dependent antioxidant effect.

ISSN:1120-9879    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

In spite of a significant improvement in the control of numerous predisposing risk factors, cardiovascular disease (CVD) remains a major health problem and a common cause of death and disability in our Western societies. A genetic predisposition to CVD has been documented in both animal models and in humans. However, a precise definition of the genetic factors responsible for common forms of CVD is still lacking, mainly because of its complex nature, the confounding presence of other predisposing risk factors, and the genetic heterogeneity of human populations.Linkage studies in experimental crossbred rats and candidate gene testing in human populations represent two of the most widely used approaches for the analysis of the genetic basis of common forms of CVD. On the one hand, the use of animal models has highlighted several potential candidates, whereas controversial findings have been provided by the enormous amount of polymorphisms/association studies.The recent introduction of intermediate disease phenotypes has led to a reductionist approach that may significantly contribute to achieve the discovery of important information on the genetics of CVD.

ISSN:1120-9879    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

Hypertension is one of the most common medical problems in industrialised societies and represents a major risk factor for cardiovascular morbidity and mortality. Most of the complications from hypertension occur in patients with mild hypertension in whom atherosclerotic disease, especially in coronary arteries, is more frequent.As recently suggested in European Society of Cardiology–European Society of Hypertension (ESC/ESH) Guidelines for Management of Hypertension, diagnostic procedures in patients with hypertension are aimed at the following: (i) establishing blood pressure levels (and consequently grade of hypertension); (ii) identifying possible secondary causes of hypertension according to rational algorithms; and (iii) evaluating the overall cardiovascular risk by identifying other risk factors, target organ damage and concomitant diseases or accompanying clinical conditions.Epidemiological data have shown a close relationship between atherosclerotic changes in the carotid artery (such as intima media thickness and plaques) and an increased risk of infarction and/or cerebrovascular disease. These observations have recently prompted increasing interest in investigating alterations in the carotid artery wall in patients with hypertension or in patients with other cardiovascular conditions.Measurements of the intima-media complex can also be used as relevant intermediate endpoints of antihypertensive treatment trials. In fact, it is important to establish the effectiveness of therapy administered by quantifying progression/regression of target organ damage using intermediate phenotypes of cardiovascular disease, and thus not only through the evaluation of blood pressure reduction.In this article, we briefly review the impact of the presence of vascular lesions on natural history and risk stratification in patients with hypertension, as well as the effects of therapeutic control of the vascular lesions and regression, in order to sustain systematic evaluation of the arterial tree in hypertension.

ISSN:1120-9879    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

To help the reader keep up-to-date with the very latest developments in experimental and clinical research, this section of the journal aims to provide the reader with information selected by the journal sponsors regarding emerging clinical evidence on their compounds, new areas of research interest, and any other topic which might be potentially relevant to the reader.

ISSN:1120-9879    

出版商:ADIS    

年代:2004

数据来源: ADIS