Panminerva medica
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The Brisighella Heart Study (BHS) is a long-term, prospective, population-based longitudinal study on 2939 randomly selected residents of the town of Brisighella, in Emilia-Romagna, Italy. Upon enrollment in 1972, no participant had any cardiovascular disease, 1491 participants were men and 1448 women, and the age span was 14 to 84 years. The observational phase of the study contributed to the evidence of a strong pathophysiological association between hypercholesterolemia and hypertension. ⋯ Currently, the BHS staff is planning its 11th four-yearly population survey in 2022. Today, the study is moving from an epidemiological perspective to a translational approach, involving advanced biomolecular analyses, genetic tests, and functional vascular investigations. This review aims to summarize the main findings of the first 50 years of BHS research and spot the latest developments and future perspectives of this remarkable Italian cardiovascular study.
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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 Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) Study is a prospective registry of morbidity and mortality in initially untreated patients with essential hypertension whose initial diagnostic evaluation included 24-hour ambulatory blood pressure (ABP) monitoring according to a standardized protocol. The present article summarizes the main results of the PIUMA Study. The PIUMA Study is conducted in three hospitals in Umbria, Italy. ⋯ The PIUMA Study provided the first ever evidence of the prognostic value of: 1) 24-hour ambulatory blood pressure monitoring; and 2) regression of echocardiographic left ventricular hypertrophy in hypertensive patients. The PIUMA Registry gave us an enormous opportunity for investigating several pathophysiologic, diagnostic and therapeutic aspects related to management of hypertensive patients. Some of our studies have been mentioned in several hypertension guidelines to support some specific statements.