Target organ damage and ambulatory blood pressure in stage I hypertension. The Hypertension and Ambulatory Recording Venetia Study.

According to recent international guidelines the decision on whether to treat young subjects during the early phase of hypertension should be based not only on their office blood pressure but also on their ambulatory blood pressure and whether target organ damage has occurred. Few data on the prevalence of hypertensive complications in young subjects with mild hypertension are available. In the Hypertension and Ambulatory Recording Venetia Study (HARVEST), a multicenter trial conducted in northeast Italy, the percentage of young borderline-to-mild hypertensive subjects with echocardiographic left ventricular hypertrophy was 4.5% and the percentage with concentric remodeling was 4%. Clear differences in cardiac size and geometric adjustment to ambulatory systolic pressure between the two sexes were found. The impact of blood pressure on the walls of the left ventricle and on the left ventricular mass was remarkable in women but weak in men. The assessment of left ventricular systolic function confirmed that many young mild hypertensive subjects have an increased ejective performance. The left ventricular contractility evaluated by midwall measurement was, however, found to be depressed in 9.2% of the HARVEST participants. Their left ventricular diastolic function was similar to that of 50 normotensive controls. The prevalence of microalbuminuria [albumin excretion rate (AER) > 30 mg/24 h) was 6.1%, only slightly higher than that found by other authors among normotensive subjects and much lower than that observed among patients with more severe hypertension. For our stage I hypertensives, however, the AER was correlated to the 24 h blood pressure with high statistical significance, whereas we found no relationship between the AER and left ventricular mass index either for all of the subjects taken together or for the men and women considered separately. The results suggest that renal and cardiac involvement do not occur in parallel during the initial phase of hypertension.

Prevalence and clinical correlates of microalbuminuria in stage I hypertension. Results from the Hypertension and Ambulatory Recording Venetia Study (HARVEST Study).

The objective of the present study was to examine the association between albumin excretion rate (AER) and office and ambulatory blood pressures (BP), and other recognized cardiovascular risk factors in stage I hypertension. The study was carried out in 870 never-treated 18- to 45-year-old hypertensives (628 men, 242 women). Office and ambulatory BP, 24-h urinary collection for AER assessment, and echocardiographic left ventricular mass (n = 587) were obtained. AER was similar in men and women (12.3 v 12.5 mg/24 h) and was unrelated to age and body mass index. In 85.2% of the subjects, AER was < 16 mg/24 h, in 8.3% it was between 16 and 29 mg/24 h (borderline microalbuminuria), and in 6.1% it was >or= 30 mg/24 h (overt microalbuminuria). Office systolic BP was not different in the three groups, whereas 24-h systolic BP was higher in the subjects with microalbuminuria than in those with normal AER (P < .0001) and was similar in the two microalbuminuric groups. Office and 24-h diastolic BPs were higher in the subjects with overt microalbuminuria than in those with normal AER. Left ventricular mass was correlated to systolic (P < .0001) and diastolic (P = .01) 24-h BP, but was unrelated to AER. Family history for hypertension, smoking, coffee and alcohol intake, and physical activity habits did not influence AER. In a logistic regression analysis, 24-h systolic BP emerged as the only determinant of microalbuminuria (P < .0001). In conclusion, these results indicate that borderline levels of microalbuminuria may also be clinically relevant in stage I hypertension. Overweight and lifestyle factors do not appear to influence AER in these patients. Finally, the lack of correlation between AER and left ventricular mass suggests that renal and cardiac involvement do not occur in a parallel fashion in the initial phase of hypertension.

[Pordenone study: HDL-cholesterol and obesity indexes in the young]. / Studio di Pordenone: HDL-colesterolo e indici di obesità nei giovani.

BACKGROUND: In 1987, ten years after the first observation, we performed the follow-up of the subjects included in the "Pordenone Study on the precursors of atherosclerosis in childhood". METHODS: The anthropometric, biologic and anamnestic indicators of coronary risk were evaluated. The W.H.O. protocol was always used. 439 (90%) subjects underwent reexamination, (234 males and 205 females between 18 and 26 years). HDL cholesterol, tricipital and subscapular skinfold thickness, weight and height were evaluated. The aim of our study was to find possible correlations between obesity indexes and HDL cholesterol values. RESULTS: We found that HDL cholesterol levels are lower in males compared to females and that differences exist below and over the 80 degrees percentile of BMI. Obese subjects have lower HDL cholesterol levels in both sexes. Females with android obesity (subjects with subscapular skinfold thickness values over 80 degrees percentile) had low HDL cholesterol values. CONCLUSIONS: Because of this inverse correlation between HDL cholesterol and coronary risk, and because young obese generally have low HDL cholesterol levels, we believe that the study of coronary risk factors is also useful starting from this age in overweight subjects. This will be useful for preventive purposes. Particular attention must be given to young girls with android obesity.

[The Pordenone study on the precursors of atherosclosis in childhood. A 10-year follow-up. Cigarette smoking]. / Studio di Pordenone sui precursori dell'aterosclerosi nell'infanzia. Follow-up dopo dieci anni. Il fumo di sigaretta.

We have studied smoking habit in the sample enrolled in the ten year follow-up of the "Pordenone Study on the Precursors of Atherosclerosis in Childhood". The response rate at ten year follow-up was very high (about 90%). Prevalence of smoking is 45.1% among males and 25.6% among females. Males and females aged 23 present a prevalence of smokers higher than the other groups while the group aged 26 smoke less. Males began to smoke at 16.4 years, females at 16.7. Mean daily consumption is 12.6 cigarettes among males, and 5.0 among females. Juvenile experimentation with cigarettes and juvenile smoking habit are strong predictors to smoke ten years later; while parental smoking behaviour is not so influential. Therefore we conclude that smoking habit acquired in youngs has a high probability to be maintained in adults, remarking the importance of planning a preventive intervention as early as possible.

[Results of diet treatment in 100 adult obese patients after 1-year follow-up]. / Risultati del trattamento dietetico in cento pazienti adulti obesi dopo un anno di "follow-up".

One hundred overweight adult patients were subjected to a hypocaloric diet with periodic controls during a one year observation period. During the first 4 months, 98% of the patients adhered to the dietary regimen, with an initial mean percentage loss of body weight of 9.3% for the females and 8.9% for the males. The weight loss was more conspicuous during the first two months of the diet therapy and in patients with an initially higher BMI. With time, the rate of drop-out from the diet therapy increased, which resulted in a follow-up of 49% and 87% of cases at 6 and 12 months respectively, with no significant differences between the two sexes. The drop-out phenomenon resulted to be more frequent in patients with an initially lower BMI.

Deficiency, transposition, and duplication of one 15q region may be alternatively associated with Prader-Willi (or a similar) syndrome. Analysis of seven cases after varying ascertainment.

Seven patients are described who have some or all of the symptoms of Prader-Willi syndrome. They were ascertained by varying criteria starting either from the clinical picture or from the identification of a chromosome abnormality involving the proximal portion of the long arm of chromosome 15. The chromosome abnormalities consisted of two balanced translocations (15;18 and 8;15), three unbalanced ones (15;18, 15;19, and 9;15), and one interstitial deletion of bands 15q11 and q12. The seventh case had an unidentified extra chromosome. These data and a review of the literature led to the conclusion that deficiency, transposition, and even duplication of the region(s) 15q11-q13 may all result in a syndrome which is identifiable with or similar to the Prader-Willi syndrome.

[Precursors of atherosclerosis in childhood: Pordenone study. Transverse and longitudinal study of arterial blood pressure (BP) in a group of boys and adolescents (author's transl)]. / Precursori dell'arteriosclerosi nell'infanzia: studio di Pordenone. Primi risultati concernenti il comportamento "trasversale" e "longitudinale" della pressione arteriosa in un gruppo di bambini ed adolescenti.

Mean systolic BP values gradually and significantly increase from the infancy to the adolescence. On the contrary, diastolic BP does not change significantly. No sex differences were found for mean values of both systolic and diastolic BP. The results of the longitudinal study (two years follow-up) have shown, for the two sexes, a significant increase in the systolic BP values, which parallels the ponderal growth. In particular, the greatest increment of the values was observed in the triennium 12-14 year, that is around the puberty.

[Study of the precursors of atherosclerosis in childhood: the Pordenone study. Longitudinal behaviour of total cholesterol and serum triglycerides in school children (author's transl)]. / Precursori dell'arteriosclerosi nell'infanzia: studio di Pordenone. Comportamento "longitudinale" ["two years follow-up"] del colesterolo totale e dei trigliceridi del siero in una casistica scolare di bambini ed adolescenti.

In a total number of approximately 500 school-children, belonging to a suburban area around Pordenone (Northern Italy), aged 6-9-12-15, we have performed a two years follow-up on serum TC and TG. As for serum TC, a progressive decrease of mean TC levels at the two rescreenings was observed. We cannot explain such trend, unless we admit that some dietary modification has been introduced in the families, although no dietary advices were given. However the observed decrease of the TC levels, makes clear that a single serum TC determination is not sufficient in order to define the lipid profile of a given subject. Unlike TC, serum TG tend to increase with the age. The "longitudinal" behavior of TC and TG is similar for both males and females.

[Values of plasma testosterone in infancy and adolescence]. / Valori del testosterone plasmatico nella infanzia ed adolescenza.

We have performed a research to establish the normal values of the plasmatic testosterone among 111 pupils, of both sexes, from 7 to 16 years attending our provincial schools. As we expected, the greatest increase of the plasmatic testosterone, in comparison with the previous ages, has been found in the group of the 13 years old females of the same age is more restrained, even if it's significative. By this way we could know the physiological values of the plasmatic testosterone in the children and adolescents of our population.

[Precursors of arteriosclerosis in childhood. Protocol and firsts results concerning plasma lipids and carbohydrate tolerance in 520 school children at Pordenone (Italy) (author's transl)]. / Precursori dell'arteriosclerosi nell'infanzia. Protocollo di studio e primi risultati concernenti i lipidi plasmatici e la tolleranza ai carboidrati in un gruppo di bambini ed adolescenti de Pordenone.

The cardiological centers of Pordenone and Cittadella (Italy) organized by the Institute of Clinica Medica II of Padua University, have carried out a study on the "Precursors of arteriosclerosis in children", according to a WHO protocol. In this paper some results of the Pordenone study are reported, concerning serum cholesterol (TC), triglycerides (TG) and blood glucose 1 h after 1 g/Kg glucose per os. 520 school children, males and females, aged 6, 9, 12, 15 years, entered the study. Mean serum TC resulted significantly higher at age 12 as compared to the other age classes. Serum TG progressively increased with age. Mean serum TC and TG in our italian children and adolescents were silimar to those reported in studies from other countries. Blood glucose resulted significantly higher in children than in adolescents. The distribution of the blood glucose values was bimodal. After having arbitrarily fixed cut-off points for serum TC, TG and blood glucose, the prevalence of hyperlipidemia and hyperglycemia was determined. The prevalence figures have shown that at the pediatric age it is possible to identify subjects at "risk" of developing arteriosclerosis.

[Epidemiology of group A beta-hemolytic streptococcus in the school population of Pordenone Province]. / Epidemiologia dello streptococco beta-emolitico di gruppo A, nella popolazione scolare della Provincia di Pordenone.

During the winter months of 1976-1977, our group carried out an epidemiological study in the school population aged 7 years and 10 years respectively, living in the towns of Pasiano (pop. 6,389) and Zoppola (pop. 7,383) in the province of Pordenone. The aim of the study was to determine the incidence of individuals in the school-age group having group A beta haemolitic streptococcus in the pharynx. The results of the study showed a high incidence of children with a positive throat swad. Of the 284 scholars examined, 107 (45.7% of the entire population examined) were carriers, in the pharynx, of group A beta haemolytic streptococcus.