Panminerva medica
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The second half of the last century was characterized by intense research in the field of arterial hypertension and related therapies. These studies showed that the management of arterial hypertension requires a robust coordination with close integration of the "health care systems" and "health care professionals." In 1998, the healthcare organization named "Campania Salute Network" was set up at the Federico II University, Naples, Italy. The Campania Salute Network involves 23 outpatient hypertensive clinics distributed in different community hospitals of the Regione Campania's area, 60 randomly selected general practitioners uniformly distributed in the same area, and the Hypertension Clinic of the Federico II University (coordinating center). ⋯ Campania Salute Network is also a powerful tool for the clinical and translational research with more 15,000 hypertensive patients followed for more than 15 years. This database allowed, in prospetic, large scale studies, to identify the hemodiminamic and metabolic determinants of hypertension mediated organ damage and major cardiovascular events. The experience of Campania Salute Netwiork indicates that the creation of large databases from real life experiences becomes an indispensable condition also for artificial intelligence which, in the near future, thanks to scientific knowledge, the availability of particularly advanced hardware and software, will also be able to transform the management of arterial hypertension.
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The Vobarno Study represents the first observational study aimed to assess in a general population sample the relationship between parameters of cardiac and vascular structure (and function) and blood pressure values, measured in the clinic and during the 24 hours. In the frame of The Vobarno Study blood samples for hematochemistry and DNA extraction, clinic and 24-hour blood pressure measurements, cardiac and carotid ultrasound, and aortic stiffness were measured in all subjects, living in a small town (Vobarno) between Brescia and the Garda Lake (Italy), and randomly selected from electoral roles. ⋯ This will allow to update the information related to cardiovascular morbidity and mortality in the study cohort. The present paper will report the results of some analyses performed, exploring epidemiological and clinical aspects of target organ damage.
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The Gubbio Population Study (Gubbio Study) is a prospective epidemiological study carried out on the resident population of the city of Gubbio, Perugia, Italy. The study's objectives were both of public health nature (the control and awareness of hypertension), and experimental (the role of electrolyte handling at the cellular membrane level and its relation to hypertension). Additional objectives were addressed during the 30+ year activity of the study, in particular the role of kidney dysfunction. ⋯ The data are of relevance to Public Health and to experimental medicine alike and vouch to the importance of the control of risk factors at the community level.
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Among the observational studies performed in the area of blood pressure measurements in the population the "Pressioni Arteriose Monitorate E Loro Associazioni" (PAMELA) investigation represents a unique research for several reasons. The PAMELA study combines clinic, home and 24-hour blood pressure measurements in all participants, which were representative of the general population. Examination included metabolic variables, allowing us to determine the interrelationships between blood pressure and metabolic profile. ⋯ Finally, PAMELA represents one of the few studies with a prolonged follow-up, the last survey being completed three years ago, and data collected are under analysis. This will allow to update the information related to cardiovascular morbidity and mortality in the study cohort. The present paper provided an overview of the various scientific contributions of the PAMELA study to the epidemiology, pathophysiology and clinical aspects of hypertension and hypertension related cardiovascular risk.