1,721,549 research outputs found
Application for recognition as a fellow in medical angiology vascular medicine of the international union of angiology
No full textEpidemiology of critical limb ischaemia : north Italian data
No full textOBJECTIVES: We confronted the difficult problem of obtaining accurate epidemiological data on critical leg ischaemia. METHODS: Three different approaches were used. 1) A prospective study, over a total period of 7 years, on the incidence of critical leg ischaemia in 200 patients suffering from claudication and in 190 controls. 2) A prospective study, over a period of 3 months, on critical leg ischaemia hospitalization in a sample of hospitals located in a Region of Northern Italy (Lombardy). 3) Encoding the amputations performed in the hospitals in two regions of Northern Italy: for 6 months in Lombardy and for 2 years in Emilia Romagna. RESULTS: The data obtained through the three different methodological approaches provided results that were substantially equivalent in order of magnitude. The incidence in the population aged > 45 years turned out to be 450/million/year for critical leg ischaemia and 112/million/year for amputations. In the sample of hospitals in Lombardy, the incidence in the population aged > 45 years was 652/million/year for critical leg ischaemia and 160/million/year for amputations. The incidence of amputations in Lombardy and Emilia Romagna in the population aged > 45 years was 577/million/year for critical leg ischaemia and 172/million/year for amputations in Lombardy and 530/million/year for critical leg ischaemia and 154/million/year for amputations in Emilia Romagna. CONCLUSION: The results indicate an incidence of critical leg ischaemia and amputations lower than expected in the samples studied. It is known that Italy is a country with one of the highest rates of "cardiovascular protection". Therefore, genetic and dietary factors probably play an important role also in the development of critical leg ischaemia and in the consequent incidence of amputations
Lipid profile during antihypertensive treatment. The SLIP Study Group. Study on Lipids with Isoptin Press
No full textSome antihypertensive drugs adversely affect the plasma lipid profile, and this has to be taken into account when choosing treatment for hypertension because it may offset the beneficial blood pressure-lowering effect of these agents. In this study, the long term effects of verapamil sustained release (SR) 240mg daily and enalapril 20mg daily on plasma lipid levels were investigated in 931 patients with mild to moderate hypertension. Patients whose blood pressure was not effectively lowered after at least 1 month of monotherapy had either enalapril 20mg once daily added to their verapamil treatment or hydrochlorothiazide 12.5mg once daily added to their enalapril treatment. Blood pressure and lipid profile were assessed before and after 6 months of treatment. Of 864 evaluable patients, 563 patients (65.1%) were successfully treated with monotherapy and 220 patients (25.5%) required combination therapy. A total of 81 patients withdrew from the trial. Systolic and diastolic blood pressure were significantly reduced by treatment with either verapamil or enalapril, and heart rate was reduced slightly, but significantly, by both treatments. Total cholesterol, triglycerides and low density lipoprotein were significantly reduced by both treatments. High density lipoprotein levels were significantly increased in verapamil recipients, but not in enalapril recipients. Adverse effects occurred in 37 (3.9%) patients receiving verapamil SR and 25 (2.7%) patients receiving enalapril. In conclusion, long term treatment with the antihypertensive agents verapamil and enalapril, alone or in combination regimens, significantly improved the plasma lipid profile. Verapamil SR had the most beneficial effect on plasma lipid levels
Endoteline e patologie umane
No full textEndothelins are substances produced by the endothelium that have a vasoconstrictive effect. From a functional point of view, endothelins can be considered the physiological antagonists of various different substances that have a vasodilatative effect, and they contribute, together with the latter, towards cotrolling the vascular tone. Interest in these sustances has further increased following the discovery of their involvement in various different diseases in man. This review considers first of all the structure, biosynthesis and activity of endothelins. Then the role of these substances in hypertension and other diseases, including atherosclerosis, cerebrovascular diseases, peripheral vascular disease and other pathological conditions linked with hypertension is discussed. In the conclusion, the widespread nature of the action of endothelins in many tissues and in a wide range of pathological conditions is mentioned
A multicenter study of doxazosin in the treatment of patients with mild or moderate essential hypertension and concomitant intermittent claudication
No full textThis study assessed the efficacy and safety of once-daily doxazosin in the treatment of patients (n = 19) with mild or moderate essential hypertension (sitting diastolic blood pressure [DBP] 95 to 114 mm Hg) and concomitant intermittent claudication (Doppler ankle/arm ratio of less than 0.80 and walking tolerance of less than 700 m on the treadmill). After 14 weeks of treatment with doxazosin, a significant (p less than 0.05) reduction in systolic blood pressure and DBP was observed. Mean blood pressures were reduced from 170/100 mm Hg at baseline to 161/93 mm Hg at the end of treatment. Minor changes in heart rate occurred, which with continued treatment were not statistically significant from baseline. In 12 of 16 (75.0%) efficacy-evaluable patients blood pressure was normalized (DBP to less than or equal to 90 mm Hg with an greater than or equal to 5 mm Hg reduction from baseline) with a mean daily dose of 7.6 mg/day. Doxazosin improved the hypertension severity category in 13 of 16 (81.3%) patients. The blood pressure ratios between both the thighs and arms and ankles and arms showed no statistically significant changes after treatment with doxazosin. Thigh blood flow at rest and the reactive hyperemia after 3 minutes of arterial occlusion did not change statistically. There was a tendency for pain-free distance to improve. Laboratory data were not significantly changed after treatment with doxazosin. Of the 19 patients studied, 5 reported mild or moderate side effects that were either tolerated or disappeared with continued treatment. No patient had therapy withdrawn and no patient required a dose reduction
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