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Biomedical subjects

M Trevisan

Publications and source records attributed to M Trevisan.

At least 145 records · Page 8Linked to original sources

INTERSALT in Italy: findings and community health implications.

In INTERSALT, an international cooperative study on electrolytes and blood pressure, significant associations were found, in the pooled data for 52 centres, between systolic BP and sodium (Na) excretion, body mass index (BMI), high alcohol intake and low potassium (K) excretion. We have assessed the status of the four Italian centres (Mirano, Gubbio, Bassiano, Naples) on these variables. The four centres examined a total of 794 men and women aged 20-59 years. Combined values were similar to overall INTERSALT levels for daily Na excretion (170 mmol) and BMI (25 kg/m2). The Italian centres had slightly higher potassium excretions (57 vs. 55 mmol/day), a higher prevalence of drinkers and a greater average alcohol consumption. Participants were divided into those below or above median levels of Na, K, BMI, and by alcohol intake (below or above 300 ml/week). Both systolic BP and diastolic BP were found to be lower in the more favourable stratum, for each variable. When all four factors were combined, those below median Na excretion and BMI, above median K, and with alcohol intake less than 300 ml/week had age-adjusted systolic BP 7.5 mmHg lower than those with less favourable levels of all four variables. The difference in adjusted diastolic BP was 4.3 mmHg. The data indicate the potential for lower population average BP with improved lifestyles.

Alcohol Drinking↗

Consumption of olive oil, butter, and vegetable oils and coronary heart disease risk factors. The Research Group ATS-RF2 of the Italian National Research Council.

The cross-sectional association between consumption of various fats (eg, butter, olive oil, and vegetable oil) and risk factors for coronary heart disease was analyzed in a sample of 4903 Italian men and women 20 to 59 years of age. The intake of fats was ascertained by an interviewer-administered questionnaire. Increased consumption of butter was associated with significantly higher blood pressure and serum cholesterol and glucose levels for men; in women only the association with glucose reached statistical significance. In both sexes consumption of olive oil and vegetable oil was inversely associated with serum cholesterol and glucose levels and systolic blood pressure. These findings were adjusted for confounding effects of other risk factors for cardiovascular disease. These cross-sectional findings from a large population sample suggest that consumption of butter may detrimentally affect coronary risk factors, while polyunsaturated and monounsaturated fats may be associated with a lower coronary risk profile.

Adult↗

Diet and coronary heart disease risk factors in a population with varied intake. The Research Group ATS-RF2 of The Italian National Research Council.

The relationship between consumption of foods high in saturated fats and cholesterol and a number of coronary heart disease risk factors (blood pressure, serum glucose, serum cholesterol, and triglycerides) was analyzed in a large sample (4,917) of Italian men and women, ages 20-59 years. The dietary habits of the participants were ascertained with a food frequency questionnaire. Intake of atherogenic foods (foods high in cholesterol and saturated fats) was evaluated for each participant. In both sexes, systolic blood pressure, serum glucose, and serum cholesterol increased with higher consumption of atherogenic foods. These findings were independent of any possible confounding effect of age, adiposity, alcohol intake, and cigarette smoking. The present article confirms previous findings that consumption of foods high in saturated fats and cholesterol is associated with an increased risk for atherosclerosis.

Adult↗

Improvement of oncology education at the University of Washington School of Medicine, 1984-1988.

In 1984, performance on the National Board of Medical Examiners (NBME) examination by medical students from the University of Washington School of Medicine was significantly lower in clinical oncology, pathology, surgery, and oncology-related subjects than was their performance in other subjects (p = .002) and inversely proportional to the degree of oncology-relatedness of the material examined. Moreover, their performance on oncology-related questions was significantly lower than the national average (p less than .001). The curriculum committee thus initiated a review of the oncology content in the curriculum of the school of medicine and implemented a two-year plan in 1984-1986 to improve the perceived deficiencies. During the year the two-year intervention was completed, reevaluation demonstrated evidence that substantial improvement had occurred in oncology performance by the students, relative to their performance in non-oncology subjects (p less than .05) and to the national average. Performance on the non-oncology items was unchanged. The authors conclude that oncology education and performance of the students was significantly improved within two years, after instituting the short-term plan to enhance cancer education in the medical school, the improvement in oncology did not occur at the expense of a reduction in performance in non-oncology subjects, and the improved performance in oncology by the students enhanced their overall performance on the NBME examination.

Academic Medical Centers↗

Sodium-lithium countertransport and systolic blood pressure response to exercise.

This study examined the relationship between erythrocyte sodium-stimulated lithium countertransport (Na-Li CT) and systolic blood pressure (SBP) response to exercise in 22 white normotensive men (mean age 40.6 years) completing a submaximal (85% of target heart rate) graded exercise tolerance test. These men were assessed to be at risk of hypertension on the basis of a high normal diastolic blood pressure (DBP; 80-89 mmHg), being overweight and having a rapid resting pulse rate. Na-Li CT was positively and significantly associated with the maximal SBP reached during exercise (P less than 0.01) and the lowest SBP achieved during post-exercise supine rest (P less than 0.01). The relationship with resting blood pressure was not significant. Standing DBP was the only resting blood pressure measurement significantly associated with Na-Li CT (P less than 0.05). We found an association between Na-Li CT, a membrane sodium transport system associated with blood pressure and hypertension, and the maximal SBP reached during exercise, a blood pressure measurement predictive of future hypertension, in people with normotensive resting blood pressure. This suggests that altered membrane sodium transport may occur before the establishment of hypertension, and supports the possibility that Na-Li CT may be a risk factor for this disease.

Adult↗

Multiple risk factors in hypertension: results from the Gubbio study.

The association between hypertension and a number of cardiovascular disease risk factors was assessed in the large population sample of Gubbio, a town in central Italy that dates back to medieval times. The data confirm those of previous studies showing that hypertension is strongly associated with other metabolic abnormalities, such as markedly overweight subjects, hyperuricaemia, hyperglycaemia, hypercholesterolaemia, that may be related to the aetiopathogenesis of high blood pressure and, in addition, compound the risk of major clinical cardiovascular events in people with hypertension. The findings are therefore relevant for prevention strategies. In addition, the association between erythrocyte sodium-stimulated lithium countertransport and hypertension is being studied.

Adult↗

Is Italy losing the "Mediterranean advantage?" Report on the Gubbio population study: cardiovascular risk factors at baseline. Gubbio Collaborative Study Group.

The coronary heart disease mortality rate in Italy--lower than in many other industrialized countries--has changed little in the last 20 years, whereas in the United States, a major decline in deaths resulting from coronary heart disease has occurred. These differing trends have reduced considerably the gap between the two countries in coronary mortality rates. Several recent population studies in Italy have found a change in the previously more favorable risk factor profile. In the northern hill town of Gubbio, studied in 1983-1985, median serum cholesterol level of men ages 40-59 was 223 mg/dl, considerably higher than was found in the 1960 Italian population samples of the Seven Countries Study (197-206 mg/dl). In the earlier study, the cholesterol levels in the Italian men who were still mainly consuming the traditional Mediterranean diet were 30-40 mg/dl lower than in the U.S. sample. The 1980 Gubbio levels, however, were at least as high as those of their U.S. contemporaries. Cigarette smoking was much higher among the middle-aged men of Gubbio than among a similar U.S. population sample (56% vs 36%). Hypertension prevalence was high, and several risk factors for hypertension--obesity, high salt intake, and alcohol--were common in the Gubbio as well as in other recent Italian population studies. The changing coronary risk profile in Italy, which now includes higher population levels of serum cholesterol as well as the other major coronary heart disease risk factors of cigarette smoking and hypertension, threatens to reduce markedly the "Mediterranean advantage" enjoyed by Italy in the past.

Adult↗

Erythrocyte sodium/lithium countertransport and renal lithium clearance in a random sample of untreated middle-aged men.

1. It has been proposed that the enhanced erythrocyte Na+/Li+ countertransport observed in many patients with essential hypertension could be a marker of abnormal renal proximal tubular function. We thus investigated the relationship of blood pressure and Na+/Li+ countertransport to an index of proximal tubular function such as renal Li+ clearance. 2. The study was carried out in a sample of 299 untreated male subjects (aged 21-59 years) randomly selected from a population at work. Na+/Li+ countertransport was measured in a representative sub-group of 176 men. 3. We did not detect statistically significant correlation of either blood pressure or Na+/Li+ countertransport (Vmax) with fractional excretion of Li+, while confirming the existence of a significant continuous association of blood pressure and body mass index with Na+/Li+ countertransport (P less than 0.01). 4. A sub-sample of 57 participants belonging to the lowest or the highest quintiles of Na+/Li+ countertransport distribution repeated the Li+ clearance study after moderate Na+ restriction. 5. Although fractional excretions of Na+ and Li+ were reduced on the low Na+ diet (both P less than 0.001), they did not differ significantly between groups. 6. Our results are at variance with the findings of a recent case-control study in a young age group and suggest that further studies are necessary before a conclusion can be drawn as to the suitability of Na+/Li+ countertransport as a marker of Na+ reabsorption in the renal proximal tubule.

Adult↗

Red blood cell sodium-lithium countertransport, blood pressure, and uric acid metabolism in untreated healthy men.

The relationship of red blood cell (RBC) Na/Li countertransport to the renal handling of lithium and uric acid was investigated in a sample of 176 untreated men. Subjects in the upper quintile of the Na/Li countertransport distribution (n = 40), compared to those in the two lower quintiles (n = 72), had higher serum uric acid levels (0.34 +/- 0.06 v 0.29 +/- 0.05 mmol/L, P less than 0.001) and systolic blood pressure (131 +/- 19 v 123 +/- 16 mm Hg, P less than 0.02) and slightly lower fractional excretion of uric acid (7.5 +/- 1.5 v 8.4 +/- 2.6%, P less than 0.08). The lithium fractional excretion was not significantly related to either blood pressure or RBC Na/Li countertransport. The altered uric acid metabolism in individuals with high RBC Na/Li countertransport could be the expression of an abnormality of renal tubular function.

Biological Transport↗

Altered renal tubular function in men with high erythrocyte sodium-lithium countertransport.

The renal fractional excretion of uric acid was determined for both a habitual diet and an NaCl-restricted diet in two groups of untreated subjects with low (117-207 mumol per litre of cells per h) and high (373-598 mumol per litre of cells per h) erythrocyte Na-Li countertransport identified in a population-based survey of middle-aged male workers. The group with high Na-Li countertransport had a higher mean blood pressure (P less than 0.05); this group also had a significantly reduced fractional excretion of uric acid with the NaCl-restricted diet even after adjustment for the difference in blood pressure (P less than 0.03). These findings are compatible with an abnormality in kidney tubular function and possibly in the renal handling of sodium in subjects with elevated erythrocyte Na-Li countertransport.

Biological Transport↗

Sodium-lithium countertransport and blood pressure: the Gubbio Population Study.

The relation of red blood cell sodium-stimulated lithium countertransport to blood pressure (BP) and prevalence of hypertension was assessed in univariate and multivariate analyses for 2,748 men and women aged 25-74 years who participated in the baseline examination of the Gubbio Population Study in north central Italy. Since age-specific countertransport values were consistently higher for men than women, all analyses were done for men and women separately. In simple correlation analyses, countertransport was significantly related to systolic and diastolic BP in both sexes (r values 0.107-0.163). In age-adjusted analyses, countertransport was significantly related to BP level of both men and women not receiving antihypertensive treatment; mean levels were high for hypertensive persons receiving antihypertensive therapy compared with normotensive persons. Age-adjusted prevalence rates of hypertension were progressively higher for both sexes in successively higher quintiles of countertransport, almost twice as high for those in the highest quintile compared with those in the lowest quintile. Correspondingly, age-adjusted logistic regression analyses showed countertransport to be related significantly to prevalence of hypertension for both men and women (p less than 0.001). Since age, body mass index, plasma total cholesterol, uric acid, glucose, urinary sodium/potassium excretion, pulse, and (for men) daily alcohol intake also were significantly correlated with BP, and in some instances with countertransport, relation of countertransport to BP was also assessed in multivariate analyses with control for these variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Calcium binding capacity of erythrocyte membrane in human hypertension.

The cell membrane calcium binding capacity of genetically hypertensive rats is reduced when measured in the presence of the submicromolar calcium concentrations proper of intracellular environment. The present work, performed as an ancillary study to an epidemiological survey on an entire population, aimed to investigate the existence of a similar abnormality in human hypertension. Calcium binding to the erythrocyte membrane was measured in clinically healthy normotensive (n = 12) and hypertensive individuals (n = 24). For this purpose, a filtration technique was used, based on the determination of 45Ca bound to the erythrocyte membrane in the presence of free calcium concentrations (40 nmol/l and 1 mumol/l), which are similar to those of the intracellular environment. The intra-assay technical error was determined on 35 duplicate samples and, when expressed as percent of the mean, was 24.1 at the 40 nmol/l concentration and 16.8 at the 1 mumol/l concentration. Membranes of untreated hypertensive patients, at both calcium concentrations, bound significantly less calcium than the control group. Treated and untreated hypertensive individuals had comparable values of membrane calcium binding capacity. Membranes of the treated hypertensive group bound less calcium than those of the normotensive group at both calcium concentrations, but the difference was statistically significant only in the presence of 40 nmol/l free calcium. A significant positive correlation was observed between the calcium binding capacity at 40 nmol/l concentration and that at 1 mumol/l in the treated and untreated hypertensive groups (r = 0.73 and 0.75, respectively; 0.51 for the normotensive group). These findings support the hypothesis that a cell membrane abnormality is detectable in some hypertensive patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Blood pressure and intracellular ion transport in childhood.

The available data on the association between the cellular handling of sodium and high BP indicate that alteration of these parameters could be linked to the level of high BP. Limited data are available with regard to the association between BP and these aspects of the intracellular ion metabolism in childhood. The study of intracellular ion metabolism in children could help clarify the pathogenesis and etiology of essential hypertension by providing an opportunity to study this relationship before the effects of possible determinants of adult BP (ie, age, body weight, diet, physical activity) affect ion transport and modify its effect on BP. Specifically, familial predisposition to hypertension, growth and maturation, and the various components of body size need to be studied further to determine their role in the relationship between Na-Li CT and RBC Na and BP. Better understanding of this complex association could help elucidate the pathophysiology of essential hypertension.

Biological Transport↗

Leisure time physical activity and blood pressure in schoolchildren.

The relation between blood pressure and habitual physical activity during leisure time was investigated in a random sample of 272 sixth grade schoolchildren (mean age, 11.3 years) who entered secondary school in 1983 in Marano di Napoli, a suburb of Naples, Italy. Blood pressure, pulse rate, and anthropometry were measured with standardized techniques. Physical activity was evaluated by a questionnaire outlining four levels of physical activity during leisure time. The study provided evidence that a low level of physical activity during leisure time in 11-year-old children is associated with higher systolic blood pressure independent of sex, age, and adiposity. These findings may be relevant to programs of primary prevention of arterial hypertension in early life.

Anthropometry↗

Calcium-rich foods and blood pressure: findings from the Italian National Research Council Study (the Nine Communities Study).

The present report analyzes the relation between different categories of consumption of varied calcium-rich foods and blood pressure in a population sample of 5,049 Italian men and women aged 20-59, examined between November 1978 and May 1979. The consumption pattern of the various foods was estimated with the use of a food frequency questionnaire. The findings are consistent with an inverse association between whole milk consumption and systolic, but not diastolic, blood pressure. Daily consumption of cheese, on the other hand, is not associated with reduced blood pressure levels. The possibility of an adverse effect of the high saturated fats and sodium content on blood pressure that could counteract the beneficial effect of calcium is discussed. Daily skim milk consumption is surprisingly associated with higher systolic, but not diastolic, pressure, compared with infrequent consumption. The possibility of these findings being the result of pre-existing health problems leading to the selection of skim milk over whole milk is discussed. Daily consumption of legumes is associated with lower systolic pressure than infrequent consumption, but the differences do not reach statistical significance, probably because of limited statistical power. These associations are similar in both males and females.

Adult↗

Red blood cell Na content, Na, Li-countertransport, family history of hypertension and blood pressure in school children.

This study focuses on the relationship between some aspects of intra-erythrocytic sodium metabolism (intra-erythrocytic Na content, Na,Li-countertransport), blood pressure, and family history of hypertension, in a group of 84 randomly selected school children (45 males, 39 females). Na,Li-countertransport was significantly related to both systolic blood pressure (SBP) and diastolic blood pressure (DBP) only in boys at the univariate level, but both of these associations lost statistical significance after the possible confounding role of weight and height were taken into consideration. In both sexes, participants with a family history of hypertension had similar values of both intra-erythrocytic Na content and Na,Li-countertransport to participants with no family history. We conclude that family history of hypertension does not seem to play an important role in the determination of either intra-erythrocytic Na content or Na,Li-countertransport at this age. Although the positive association between Na,Li-countertransport and blood pressure observed in adult males is already present in childhood, this probably is still, at least in part, dependent upon body size.

Biological Transport, Active↗

Hypertension, non-insulin-dependent diabetes, and intracellular sodium metabolism.

The present study was designed to investigate whether non-insulin-dependent diabetic hypertensive patients exhibit abnormalities in intracellular sodium metabolism similar to those described for essential hypertensive patients. Both normotensive and hypertensive non-insulin-dependent diabetic patients had similar average values of both Na+-Li+ countertransport and Na+-K+ cotransport compared with nondiabetic controls. Within the group of diabetic patients, hypertensive patients did not exhibit any abnormalities in either of the sodium transport pathways studied. The possible implications of these findings are addressed.

Biological Transport, Active↗