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Biomedical subjects

M Santonastaso

Publications and source records attributed to M Santonastaso.

22 records · Page 2Linked to original sources

Factors affecting ambulatory blood pressure reproducibility. Results of the HARVEST Trial. Hypertension and Ambulatory Recording Venetia Study.

To assess the reproducibility of ambulatory blood pressure, we recorded 24-hour blood pressure twice 3 months apart in 508 hypertensive subjects participating in the HARVEST trial using a noninvasive technique. Blood pressure was measured every 10 minutes during the daytime and 30 minutes during the nighttime. Reproducibility was better for ambulatory than for office blood pressure. It was greater for 24-hour than for daytime blood pressure and lowest for nighttime blood pressure. The reproducibility of blood pressure variability (standard deviation) was poorer than that of the average values. A small but significant decrease in average daytime blood pressure (-0.8/-1.0 mm Hg) and virtually no change in nighttime blood pressure (+0.5/+0.1 mm Hg) were observed at repeat recording. Reducing the sampling rate by 50% caused only a small impairment of the reproducibility indexes of both the average values and variability. Blood pressure reduction was greater during the first and last hours of the recordings, indicating an effect of the hospital environment on the between-monitoring difference. Changes in body weight (-0.7 kg, P = .006, at repeat recording) were related to those of 24-hour diastolic blood pressure (P < .05). In conclusion, patient reaction to medical environment and changes of body weight seem to account for most of the change in 24-hour blood pressure that occurs over a 3-month period.

Adolescent↗

[Alcohol consumption, arterial pressure and metabolic parameters in a population of borderline hypertension subjects. The results of the HARVEST Multicenter Study. Hypertension and Ambulatory Recording Venetia Study].

In 544 borderline to mild hypertensive subjects (mean age 33.5 +/- 8.6 years) participating in the HARVEST trial the relationship between alcohol consumption, blood pressure levels and several clinical parameters was examined. Subjects were divided into 3 groups according to whether they did not drink (Group 1, n = 171) or their daily alcohol intake was < 50 g (Group 2, n = 184) or > 50 g (Group 3, n = 54). In the 409 men alcohol consumption was related to age (p < 0.0001), body weight (p < 0.05) and coffee consumption (p < 0.0001). Group 3 drinkers were also more sedentary than the 2 other groups (p < 0.05). Both office (p < 0.001) and 24-hour (p < 0.001) diastolic blood pressure were greater in the drinkers than in the non drinkers, while no difference was observed in systolic blood pressure. Twenty-four-hour heart rate was higher in Group 3, but urinary catecholamines were similar in the 3 groups of men. Blood glucose (p < 0.001), total cholesterol (p = 0.001) and triglyceride (p < 0.005) were related to alcohol consumption, while HDL-cholesterol was not different in the 3 groups. Albumin excretion rate and uricemia were also unrelated to alcohol intake. In the 135 women a similar alcohol-related trend was observed for office diastolic blood pressure and for the metabolic parameters. In conclusion, the results of the present study confirm the association between alcohol consumption and blood pressure levels, which was apparent also within a population of borderline to mild hypertensive subjects and stress the role of alcohol in determining an abnormality of the metabolic parameters.

Adolescent↗

[Acute adrenal failure due to adrenal hemorrhagic necrosis secondary to heparin-induced thrombocytopenia].

The authors describe a clinical case with a peculiar sequence of unhealthy events. An operated by osteotomy woman presented a deep venous thrombosis of lever lower extremity with following pulmonary embolism. The patient was treated with heparin. After 5 days, the patient showed a thrombocytopenia, that was not determined by an immune mechanism. The heparin was stopped and the thrombocythemia returned to normal values. But the patient still presented somnolence, asthenia and hypotension. The tests of adrenocortical function showed below normal values. The abdominal CAT showed haemorrhagic necrosis of the suprarenal glands.

Acute Disease↗

Thrombocytopenic purpura during therapy with simvastatin.

The authors describe a case of very serious thrombocytopenic purpura occurring in a diabetic and hyperlipidemic woman during therapy with simvastatin, an HMG-CoA reductase inhibitor drug. Interruption of the medical treatment produced a prompt reversal of the thrombocytic attack: one year later the patient's platelet count remains within the normal range. The authors have not found other reports in the medical literature of similar serious reactions during therapy with an HMG-CoA reductase inhibiting substance; nevertheless, a causal nexus is hypothesized but not argued in this case, since further studies will be needed before this connection can be established.

Diabetes Mellitus, Type 2↗