[Effects of two Sicilian red wines on some cardiovascular risk factors]. / Effetto di due vini rossi siciliani su alcuni fattori di rischio cardiovascolare.

BACKGROUND: The aim of this study was to evaluate whether Sicilian red wine consumption is associated with a lower cardiovascular risk. METHODS: Forty-eight subjects of both sexes (age range 35-65 years) nondrinkers or rarely drinkers of moderate red wine intake were selected. Subjects were divided into two groups (group A and group B), assigned to receive with a crossover design 250 ml/die (during the meals) of one of two types of Sicilian red wines (Nero d'Avola and Etna Torrepalino respectively). At all visits (-15 days, basal, +4 and +8 weeks) the following parameters were measured: blood glucose, total cholesterol and triglycerides (by enzyme kit methods, Boehringer Mannheim, Milan, Italy), HDL cholesterol (by selective precipitation with dextran-magnesium chloride), LDL cholesterol (by calculation with the Friedewald formula), LDL/HDL ratio, apolipoproteins A1 and B (by radial immunodiffusion, Behring Institute, Scoppito, Italy), lipoprotein(a) (ELISA, Technoclone, Vienna, Austria), plasma C-reactive protein (high-sensitivity, Dade Behring, Marburg, Germany), D-dimer (Turbiquant, Dade Behring), factor VII (coagulant activity, Dade Behring), plasminogen activator inhibitor antigen (ELISA), tissue-type plasminogen activator antigen (ELISA), fibrinogen (coagulant), oxidized LDL antibody (ELISA), total plasma antioxidant capacity (FRAP method). RESULTS: At the end of the red wine intake period, HDL cholesterol was significantly increased (p < 0.01) and the LDL/HDL ratio was significantly decreased (p < 0.05) in both study groups, while apolipoprotein A1 was significantly increased (p < 0.05) only in group A. In both group A and group B fibrinogen (p < 0.01 and p < 0.005, respectively), factor VII (p < 0.01 and p < 0.05, respectively), plasma C-reactive protein (p < 0.005 and p < 0.05, respectively) and oxidized LDL antibody (p < 0.05) were significantly decreased, while tissue-type plasminogen activator (p < 0.005), plasminogen activator inhibitor (p < 0.005) and total plasma antioxidant capacity (p < 0.005) were significantly increased. CONCLUSIONS: Our results show a positive effect of these Sicilian red wines on many risk factors, suggesting a moderate consumption of red wine in the adult population as a component of the Mediterranean diet.

Elevated plasma total homocysteine in centenarians.

Homocysteine (Hcy) is a sulfur-containing metabolite of methionine and is an emerging independent risk factor for atherosclerosis. Previous studies have shown that age, gender, renal function and folic acid intake are the main factors influencing total plasma Hcy levels in humans. A unique approach to the science of human longevity is the natural model of centenarians. The objective of this study was to verify whether the previously determined risk factors for atherosclerosis and atherosclerosis-related diseases change with age and, finally, to establish the vitamin nutritional status role. We studied 54 centenarians (14 males and 40 females) aged between 100-107 years (mean age 102.6+/-1.8 years) living in Sicily (Italy), recruited via the Registry Office, and compared them with three control groups composed of subjects with different age ranges. Total plasma Hcy, folate, vitamin B12 and pyridoxal phosphate (PLP) levels were compared between the groups by the Student's t test. The comparison between centenarians and <65-year old, randomly selected individuals showed that in centenarians the mean value of serum creatinine levels was 18 micromol/l (p=0.000) higher, the mean total Hcy value was 22 micromol/l higher (p=0.000), the mean PLP value was 17.9 nmol/l lower (p=0.000), the mean folate level was 2.1 nmol/l lower (p<0.001) and vitamin B12 was 70.5 pmol/l lower (p=0.000). The comparison between centenarians and >65-year old, randomly selected individuals showed that in centenarians the mean value of serum creatinine levels was 8 micromol/l higher (p=0.037), the mean total Hcy value was 11.6 micromol/l higher (p=0.000) and the mean PLP value was 4.2 nmol/l higher (p=0.000). It seems that centenarians are protected by some mechanism (maybe genetic) that allows them a long survival despite the high value of homocysteinemia. On the other hand, it can by hypothesized that good vitamin intake is essential to live over 100 years.

Central obesity and hypertensive renal disease: association between higher levels of BMI, circulating transforming growth factor beta1 and urinary albumin excretion.

OBJECTIVE: In this study, the relationship between circulating transforming growth factor beta1 (TGFbeta1) and urinary albumin excretion (UAE) has been investigated in non-obese and central obese hypertensive patients. DESIGN AND PATIENTS: Fifty-eight consecutive hypertensive outpatients both lean and with central obesity were enrolled and divided in three groups, according to their body mass index (BMI) values. Group A: 16 lean hypertensives (men with BMI < 25 kg/m2 and women with BMI < 24.7 kg/m2); Group B: 16 overweight hypertensives (men with BMI > or = 25 kg/m2 and < 30 kg/m2 and women with BMI > 24.7 kg/m2 and < 27.3 kg/m2); Group C: 26 obese hypertensives (men with BMI > or = 30 kg/m2 and women with BMI > or = 27.3 kg/m2). MEASURES: In all patients, UAE, by immunonephelometric assay, circulating TGFbeta1 by a solid-phase specific sandwich enzyme-linked immunosorbent assay (ELISA) technique, blood urea nitrogen (BUN) and creatinine, by routine laboratory methods, were determined. In addition, left ventricular telediastolic internal diameter (LVIDd), interventricular septum diastolic (IVSTd), posterior wall thickness (PWT), total and normalized to height2.7 left ventricular mass (LVM, LVM/h2.7), relative wall thickness (RWT) and left ventricular ejection fraction (EF) by M-B Mode echocardiography were calculated. RESULTS: Overweight and obese hypertensives had significantly (p < 0.05) higher BMI, waist-hip ratio (WHR), UAE and TGFbeta1 than lean hypertensives. Obese hypertensives had significantly (p < 0.05) higher total and indexed LVM values than lean hypertensives. Obese hypertensives had significantly (p < 0.05) higher BMI, UAE and TGFbeta1 than overweight hypertensives. In all subjects, TGFbeta1 correlated directly with BMI (r = 0.52; p < 0.0001), WHR (r = 0.48; p < 0.003), MBP (r = 0.31; p < 0.02) and UAE (r = 0.57; p < 0.0001). Multiple regression analysis indicated that BMI, MBP and UAE were able to explain the 47.9% TGFbeta1 variability (r = 0.69; p < 0.0001), and that TGFbeta1 was the best predictor of UAE changes (r = 0.60; p < 0.0001). CONCLUSION: Our data suggest that TGFbeta1 levels are positively associated with BMI, MBP and UAE in hypertensive subjects. This also indicates that TGFbeta1 overproduction might be considered a pathophysiology mechanism of progressive renal function impairment in obese hypertensives.

Effects of losartan and delapril on the fibrinolytic system in patients with mild to moderate hypertension.

BACKGROUND AND OBJECTIVES: Angiotensin-converting enzyme (ACE) probably influences the fibrinolytic system at a central point by converting angiotensin I to angiotensin II, which increases plasminogen activator inhibitor-1 (PAI-1) activity. This effect appears to be mediated in humans via the angiotensin II type 1 (AT(1)) receptor. The objective of this study was to evaluate, in patients with mild to moderate hypertension, the change in tissue plasminogen activator (t-PA) and PAI-1 plasma levels after treatment with an AT(1)-receptor blocker (losartan 50 mg/day) or an ACE inhibitor (delapril 60 mg/day). PATIENTS AND METHODS: 30 hypertensive patients and 15 controls were enrolled. Essential hypertension was established by a medical history, physical examination and the absence of clinical findings suggestive of a secondary form of hypertension. Preliminary investigations, routine biochemical tests (including clearance of creatinine and oral glucose tolerance test), chest x-ray, standard and 24-hour ECG monitoring, M- and B-mode echocardiography and fundus oculi examinations were performed. No patients had previously received ACE inhibitors or AT(1)-receptor blockers. After a 14-day run-in period with placebo, patients were randomised in a double-blind fashion into two groups: 15 patients were randomised to losartan 50 mg/day (group 1), 15 patients were randomised to delapril 60 mg/day (group 2), and 15 healthy subjects were used as controls (group 3). Plasma PAI-1 and t-PA antigen were determined by enzyme-linked immunosorbent assay and a photometric method at the end of the run-in period and after 6 months of treatment. RESULTS: There were no significant differences among the three groups regarding age, sex, body mass index and smoking. After 6 months, both groups of patients showed a reduction in blood pressure values. The losartan group did not demonstrate significant changes in PAI-1 levels (96.52 +/- 23.73 and 99.89 +/- 22.18 mug/L, pre- and post-treatment, respectively) or in t-PA antigen levels (26.17 +/- 6.18 and 27.32 +/- 5.91 mug/L, pre- and post-treatment, respectively). The delapril group showed no significant changes in PAI-1 levels (97.73 +/- 25.75 and 86.12 +/- 13.12 mug/L, pre- and post-treatment, respectively), but did show a statistically significant difference (p < 0.005) in t-PA antigen levels (25.71 +/- 6.40 and 32.24 +/- 5.31 mug/L, pre- and post-treatment, respectively). The losartan group demonstrated significantly higher post-treatment PAI-1 values than the delapril group (p = 0.048). CONCLUSION: The study showed that losartan does not affect fibrinolytic parameters, while delapril resulted in an insignificant reduction in PAI-1 and a significant increase in t-PA levels. Further studies are clearly required in order to establish whether these different effects on the fibrinolytic system between ACE inhibitors and AT(1)-receptor blockers may have clinical relevance.