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2. Renin-Angiotensin-system inhibitors and all-cause mortality in patients with COVID-19: A systematic review and meta-Analysis of observational studies

Author

Bavishi, C, Whelton, P, Mancia, G, Corrao, G, Messerli, F, Bavishi C., Whelton P. K., Mancia G., Corrao G., Messerli F. H., Bavishi, C, Whelton, P, Mancia, G, Corrao, G, Messerli, F, Bavishi C., Whelton P. K., Mancia G., Corrao G., and Messerli F. H.

Abstract

Aims:We sought to evaluate the association of angiotensin-converting-enzyme inhibitors (ACEI) or AT1 blockers (ARB) therapy with clinical outcomes in patients with coronavirus disease 2019 (COVID-19).Methods and results:Electronic databases were searched to identify published studies that reported clinical outcomes in patients with COVID-19 who were or were not taking an ACEI/ARB. We studied all-cause mortality and/or severe disease outcomes. Fully adjusted effect estimates from individual studies were pooled using a random-effects model. In total, 34 (31 cohort-based and three case-control) studies met our eligibility criteria. Due to the inherent differences between cohort and case-control studies, we did not combine results of these studies but used them to identify the consistency of their results. The 31 cohort studies provided outcome data for 87 951 patients with COVID-19, of whom 22 383/83 963 (26.7%) were on ACEI/ARB therapy. In pooled analysis, we found no association between the use of ACEI/ARB and all-cause mortality/severe disease [relative risk: 0.94, 95% confidence interval (CI): 0.86-1.03, I2 = 57%, P = 0.20] or occurrence of severe disease (relative risk: 0.93, 95% CI: 0.74-1.17, I2 = 56%, P = 0.55). Analysis of three population-based case-control studies identified no significant association between ACEI/ARB (pooled odds ratio: 1.00, 95% CI: 0.81-1.23, I2 = 0, P = 0.98) and all-cause mortality/severe disease. In 13 of the 31 cohort studies as well as in three case-control studies that reported outcomes separately for ACEI and ARB, there was no differential effect for mortality/severe disease outcomes.Conclusion:In patients with COVID-19, we found no association between ACEI/ARB treatment and mortality/severe disease. ACEI/ARB should not be discontinued, unless clinically indicated.

Published
2021

5. Salt and cardiovascular disease: Insufficient evidence to recommend low sodium intake

Author

O'Donnell, M, Mente, A, Alderman, M, Brady, A, Diaz, R, Gupta, R, Lopez-Jaramillo, P, Luft, F, Luscher, T, Mancia, G, Mann, J, Mccarron, D, Mckee, M, Messerli, F, Moore, L, Narula, J, Oparil, S, Packer, M, Prabhakaran, D, Schutte, A, Sliwa, K, Staessen, J, Yancy, C, Yusuf, S, O'Donnell M., Mente A., Alderman M. H., Brady A. J. B., Diaz R., Gupta R., Lopez-Jaramillo P., Luft F. C., Luscher T. F., Mancia G., Mann J. F. E., McCarron D., McKee M., Messerli F. H., Moore L. L., Narula J., Oparil S., Packer M., Prabhakaran D., Schutte A., Sliwa K., Staessen J. A., Yancy C., Yusuf S., O'Donnell, M, Mente, A, Alderman, M, Brady, A, Diaz, R, Gupta, R, Lopez-Jaramillo, P, Luft, F, Luscher, T, Mancia, G, Mann, J, Mccarron, D, Mckee, M, Messerli, F, Moore, L, Narula, J, Oparil, S, Packer, M, Prabhakaran, D, Schutte, A, Sliwa, K, Staessen, J, Yancy, C, Yusuf, S, O'Donnell M., Mente A., Alderman M. H., Brady A. J. B., Diaz R., Gupta R., Lopez-Jaramillo P., Luft F. C., Luscher T. F., Mancia G., Mann J. F. E., McCarron D., McKee M., Messerli F. H., Moore L. L., Narula J., Oparil S., Packer M., Prabhakaran D., Schutte A., Sliwa K., Staessen J. A., Yancy C., and Yusuf S.

Abstract

Several blood pressure guidelines recommend low sodium intake (<2.3 g/day, 100 mmol, 5.8 g/day of salt) for the entire population, on the premise that reductions in sodium intake, irrespective of the levels, will lower blood pressure, and, in turn, reduce cardiovascular disease occurrence. These guidelines have been developed without effective interventions to achieve sustained low sodium intake in free-living individuals, without a feasible method to estimate sodium intake reliably in individuals, and without high-quality evidence that low sodium intake reduces cardiovascular events (compared with moderate intake). In this review, we examine whether the recommendation for low sodium intake, reached by current guideline panels, is supported by robust evidence. Our review provides a counterpoint to the current recommendation for low sodium intake and suggests that a specific low sodium intake target (e.g. <2.3 g/day) for individuals may be unfeasible, of uncertain effect on other dietary factors and of unproven effectiveness in reducing cardiovascular disease. We contend that current evidence, despite methodological limitations, suggests that most of the world's population consume a moderate range of dietary sodium (2.3-4.6g/day; 1-2 teaspoons of salt) that is not associated with increased cardiovascular risk, and that the risk of cardiovascular disease increases when sodium intakes exceed 5 g/day. While current evidence has limitations, and there are differences of opinion in interpretation of existing evidence, it is reasonable, based upon observational studies, to suggest a population-level mean target of <5 g/day in populations with mean sodium intake of >5 g/day, while awaiting the results of large randomized controlled trials of sodium reduction on incidence of cardiovascular events and mortality.

Published
2020

8. UROCORTIN 2 - A PROTECTIVE EFFECT IN HYPERTENSION?

Author

DZIEZA-GRUDNIK, A., SIGA, O., WALCZEWSKA, J., WIZNER, B., WOLKOW, P. P., MESSERLI, F. H., and GRODZICKI, T.

Abstract

Urocortin 2, an endogenous selective ligand for the corticotropin-releasing hormone receptor type 2, has been suggested to exert cardioprotective effects. We analyzed the possible relationship between the level of Ucn2 and specific indicators of cardiovascular risk factors in patients with untreated hypertension and in healthy subjects. Sixty seven subjects were recruited: 38 with newly diagnosed treatment-naïve hypertension (with no pharmacological treatment - HT group) and 29 healthy subjects without hypertension (nHT group). We evaluated ambulatory blood pressure monitoring, Ucn2 levels and metabolic indices. Multivariable regression analyses were performed to assess the effects of gender, age, and Ucn2 levels on metabolic indices or blood pressure (BP) level. Log of Ucn2 levels were higher in healthy subjects than in hypertensive patients (2.44±0.7 versus 2.09±0.66, p<0.05) and correlated inversely with 24-hour diastolic blood pressure, and both night-time systolic and diastolic blood pressure regardless of age and gender (R2=0.06; R2=0.06; R2=0.052; respectively). Furthermore, Ucn2 levels inversely correlated with cholesterol and low-density cholesterol (LDL) concentrations in healthy subjects only. Ucn2 was independently related to total cholesterol (but not to LDL) regardless of age, gender and the presence of hypertension (R2=0.18). However, we did not find any relationship between urocortin 2, body mass index or waist-hip ratio as well as parameters of glucose metabolism. Our data indicates that higher levels of urocortin 2 are related to more favorable lipid profiles and lower blood pressure. [ABSTRACT FROM AUTHOR]

Published
2023
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13. 2018 ESC/ESH guidelines for the diagnosis and treatment of arterial hypertension: The Task Force for the Diagnosis and Treatment of Arterial Hypertension of the European Society of Cardiology (ESC) and of the European Society of Hypertension (ESH)

Author

Williams, B, Mancia, G, Spiering, W, Rosei, E, Azizi, M, Burnier, M, Clement, D, Coca, A, De Simone, G, Dominiczak, A, Kahan, T, Mahfoud, F, Redon, J, Ruilope, L, Zanchetti, A, Kerins, M, Kjeldsen, S, Kreutz, R, Laurent, S, Lip, G, Mcmanus, R, Narkiewicz, K, Ruschitzka, F, Schmieder, R, Shlyakhto, E, Tsioufis, C, Aboyans, V, Desormais, I, De Backer, G, Heagerty, A, Agewall, S, Bochud, M, Borghi, C, Boutouyrie, P, Brguljan, J, Bueno, H, Caiani, E, Carlberg, B, Chapman, N, Cifkova, R, Cleland, J, Collet, J, Coman, I, De Leeuw, P, Delgado, V, Dendale, P, Diener, H, Dorobantu, M, Fagard, R, Farsang, C, Ferrini, M, Graham, I, Grassi, G, Haller, H, Richard Hobbs, F, Jelakovic, B, Jennings, C, Katus, H, Kroon, A, Leclercq, C, Lovic, D, Lurbe, E, Manolis, A, Mcdonagh, T, Messerli, F, Muiesan, M, Nixdorff, U, Olsen, M, Parati, G, Perk, J, Piepoli, M, Polonia, J, Ponikowski, P, Richter, D, Rimoldi, S, Roffi, M, Sattar, N, Seferovic, P, Simpson, I, Sousa-Uva, M, Stanton, A, Van De Borne, P, Vardas, P, Volpe, M, Wassmann, S, Windecker, S, Zamorano, J, Williams B., Mancia G., Spiering W., Rosei E. A., Azizi M., Burnier M., Clement D. L., Coca A., De Simone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S. E., Kreutz R., Laurent S., Lip G. Y. H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R. E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I., De Backer G., Heagerty A. M., Agewall S., Bochud M., Borghi C., Boutouyrie P., Brguljan J., Bueno H., Caiani E. G., Carlberg B., Chapman N., Cifkova R., Cleland J. G. F., Collet J. -P., Coman I. M., De Leeuw P. W., Delgado V., Dendale P., Diener H. -C., Dorobantu M., Fagard R., Farsang C., Ferrini M., Graham I. M., Grassi G., Haller H., Richard Hobbs F. D., Jelakovic B., Jennings C., Katus H. A., Kroon A. A., Leclercq C., Lovic D., Lurbe E., Manolis A. J., McDonagh T. A., Messerli F., Muiesan M. L., Nixdorff U., Olsen M. H., Parati G., Perk J., Piepoli M. F., Polonia J., Ponikowski P., Richter D. J., Rimoldi S. F., Roffi M., Sattar N., Seferovic P. M., Simpson I. A., Sousa-Uva M., Stanton A. V., Van De Borne P., Vardas P., Volpe M., Wassmann S., Windecker S., Zamorano J. L., Williams, B, Mancia, G, Spiering, W, Rosei, E, Azizi, M, Burnier, M, Clement, D, Coca, A, De Simone, G, Dominiczak, A, Kahan, T, Mahfoud, F, Redon, J, Ruilope, L, Zanchetti, A, Kerins, M, Kjeldsen, S, Kreutz, R, Laurent, S, Lip, G, Mcmanus, R, Narkiewicz, K, Ruschitzka, F, Schmieder, R, Shlyakhto, E, Tsioufis, C, Aboyans, V, Desormais, I, De Backer, G, Heagerty, A, Agewall, S, Bochud, M, Borghi, C, Boutouyrie, P, Brguljan, J, Bueno, H, Caiani, E, Carlberg, B, Chapman, N, Cifkova, R, Cleland, J, Collet, J, Coman, I, De Leeuw, P, Delgado, V, Dendale, P, Diener, H, Dorobantu, M, Fagard, R, Farsang, C, Ferrini, M, Graham, I, Grassi, G, Haller, H, Richard Hobbs, F, Jelakovic, B, Jennings, C, Katus, H, Kroon, A, Leclercq, C, Lovic, D, Lurbe, E, Manolis, A, Mcdonagh, T, Messerli, F, Muiesan, M, Nixdorff, U, Olsen, M, Parati, G, Perk, J, Piepoli, M, Polonia, J, Ponikowski, P, Richter, D, Rimoldi, S, Roffi, M, Sattar, N, Seferovic, P, Simpson, I, Sousa-Uva, M, Stanton, A, Van De Borne, P, Vardas, P, Volpe, M, Wassmann, S, Windecker, S, Zamorano, J, Williams B., Mancia G., Spiering W., Rosei E. A., Azizi M., Burnier M., Clement D. L., Coca A., De Simone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S. E., Kreutz R., Laurent S., Lip G. Y. H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R. E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I., De Backer G., Heagerty A. M., Agewall S., Bochud M., Borghi C., Boutouyrie P., Brguljan J., Bueno H., Caiani E. G., Carlberg B., Chapman N., Cifkova R., Cleland J. G. F., Collet J. -P., Coman I. M., De Leeuw P. W., Delgado V., Dendale P., Diener H. -C., Dorobantu M., Fagard R., Farsang C., Ferrini M., Graham I. M., Grassi G., Haller H., Richard Hobbs F. D., Jelakovic B., Jennings C., Katus H. A., Kroon A. A., Leclercq C., Lovic D., Lurbe E., Manolis A. J., McDonagh T. A., Messerli F., Muiesan M. L., Nixdorff U., Olsen M. H., Parati G., Perk J., Piepoli M. F., Polonia J., Ponikowski P., Richter D. J., Rimoldi S. F., Roffi M., Sattar N., Seferovic P. M., Simpson I. A., Sousa-Uva M., Stanton A. V., Van De Borne P., Vardas P., Volpe M., Wassmann S., Windecker S., and Zamorano J. L.

Published
2018

23. 2018 ESC/ESH guidelines for the diagnosis and treatment of arterial hypertension: The Task Force for the Diagnosis and Treatment of Arterial Hypertension of the European Society of Cardiology (ESC) and of the European Society of Hypertension (ESH)

Author

Williams B., Mancia G., Spiering W., Rosei E. A., Azizi M., Burnier M., Clement D. L., Coca A., De Simone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S. E., Kreutz R., Laurent S., Lip G. Y. H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R. E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I., De Backer G., Heagerty A. M., Agewall S., Bochud M., Borghi C., Boutouyrie P., Brguljan J., Bueno H., Caiani E. G., Carlberg B., Chapman N., Cifkova R., Cleland J. G. F., Collet J. -P., Coman I. M., De Leeuw P. W., Delgado V., Dendale P., Diener H. -C., Dorobantu M., Fagard R., Farsang C., Ferrini M., Graham I. M., Grassi G., Haller H., Richard Hobbs F. D., Jelakovic B., Jennings C., Katus H. A., Kroon A. A., Leclercq C., Lovic D., Lurbe E., Manolis A. J., McDonagh T. A., Messerli F., Muiesan M. L., Nixdorff U., Olsen M. H., Parati G., Perk J., Piepoli M. F., Polonia J., Ponikowski P., Richter D. J., Rimoldi S. F., Roffi M., Sattar N., Seferovic P. M., Simpson I. A., Sousa-Uva M., Stanton A. V., Van De Borne P., Vardas P., Volpe M., Wassmann S., Windecker S., Zamorano J. L., Williams, B, Mancia, G, Spiering, W, Rosei, E, Azizi, M, Burnier, M, Clement, D, Coca, A, De Simone, G, Dominiczak, A, Kahan, T, Mahfoud, F, Redon, J, Ruilope, L, Zanchetti, A, Kerins, M, Kjeldsen, S, Kreutz, R, Laurent, S, Lip, G, Mcmanus, R, Narkiewicz, K, Ruschitzka, F, Schmieder, R, Shlyakhto, E, Tsioufis, C, Aboyans, V, Desormais, I, De Backer, G, Heagerty, A, Agewall, S, Bochud, M, Borghi, C, Boutouyrie, P, Brguljan, J, Bueno, H, Caiani, E, Carlberg, B, Chapman, N, Cifkova, R, Cleland, J, Collet, J, Coman, I, De Leeuw, P, Delgado, V, Dendale, P, Diener, H, Dorobantu, M, Fagard, R, Farsang, C, Ferrini, M, Graham, I, Grassi, G, Haller, H, Richard Hobbs, F, Jelakovic, B, Jennings, C, Katus, H, Kroon, A, Leclercq, C, Lovic, D, Lurbe, E, Manolis, A, Mcdonagh, T, Messerli, F, Muiesan, M, Nixdorff, U, Olsen, M, Parati, G, Perk, J, Piepoli, M, Polonia, J, Ponikowski, P, Richter, D, Rimoldi, S, Roffi, M, Sattar, N, Seferovic, P, Simpson, I, Sousa-Uva, M, Stanton, A, Van De Borne, P, Vardas, P, Volpe, M, Wassmann, S, Windecker, S, and Zamorano, J

Subjects
diagnosis and treatment of arterial hypertension
Published
2018

29. Expertise: No Longer a Sine Qua Non for Guideline Authors?

Author

Messerli, F, Hofstetter, L, Agabiti Rosei, E, Burnier, M, Elliott, W, Franklin, S, Grodzicki, T, Kario, K, Kjeldsen, S, Kostis, J, Laurent, S, Leenen, F, Lund Johansen, P, Mancia, G, Narkiewicz, K, Papademetriou, V, Parati, G, Poulter, N, Redon, J, Rimoldi, S, Ruilope, L, Schiffrin, E, Schmieder, R, Schwartz, A, Sever, P, Sowers, J, Staessen, J, Wang, J, Weber, M, Williams, B, MANCIA, GIUSEPPE, PARATI, GIANFRANCO, Williams, B., Messerli, F, Hofstetter, L, Agabiti Rosei, E, Burnier, M, Elliott, W, Franklin, S, Grodzicki, T, Kario, K, Kjeldsen, S, Kostis, J, Laurent, S, Leenen, F, Lund Johansen, P, Mancia, G, Narkiewicz, K, Papademetriou, V, Parati, G, Poulter, N, Redon, J, Rimoldi, S, Ruilope, L, Schiffrin, E, Schmieder, R, Schwartz, A, Sever, P, Sowers, J, Staessen, J, Wang, J, Weber, M, Williams, B, MANCIA, GIUSEPPE, PARATI, GIANFRANCO, and Williams, B.

Published
2017

30. Reply

Author

Messerli, F, Hofstetter, L, Agabiti Rosei, E, Burnier, M, Elliott, W, Franklin, S, Grodzicki, T, Kario, K, Kjeldsen, S, Kostis, J, Laurent, S, Leenen, F, de Leeuw, P, Lund Johansen, P, Mancia, G, Narkiewicz, K, Papademetriou, V, Parati, G, Poulter, N, Redon, J, Rimoldi, S, Ruilope, L, Schiffrin, E, Schmieder, R, Schwartz, A, Sever, P, Sowers, J, Staessen, J, Wang, J, Weber, M, Williams, B, Williams, B., MANCIA, GIUSEPPE, PARATI, GIANFRANCO, Messerli, F, Hofstetter, L, Agabiti Rosei, E, Burnier, M, Elliott, W, Franklin, S, Grodzicki, T, Kario, K, Kjeldsen, S, Kostis, J, Laurent, S, Leenen, F, de Leeuw, P, Lund Johansen, P, Mancia, G, Narkiewicz, K, Papademetriou, V, Parati, G, Poulter, N, Redon, J, Rimoldi, S, Ruilope, L, Schiffrin, E, Schmieder, R, Schwartz, A, Sever, P, Sowers, J, Staessen, J, Wang, J, Weber, M, Williams, B, Williams, B., MANCIA, GIUSEPPE, and PARATI, GIANFRANCO

Published
2017

31. Correction: Effects of verapamil SR and atenolol on 24-Hour blood pressure and heart rate in hypertension patients with coronary artery disease: An international verapamil SR-trandolapril ambulatory monitoring substudy

Author

Denardo, S, Gong, Y, Cooper-DeHoff, R, Farsang, C, Keltai, M, Szirmai, L, Messerli, F, Bavry, A, Handberg, E, Mancia, G, Pepine, C, Denardo, Scott J., Gong, Yan, Cooper-DeHoff, Rhonda M., Farsang, Csaba, Keltai, Matyas, Szirmai, L�szl�, Messerli, Franz H., Bavry, Anthony A., Handberg, Eileen M., Mancia, Giuseppe, Pepine, Carl J., Denardo, S, Gong, Y, Cooper-DeHoff, R, Farsang, C, Keltai, M, Szirmai, L, Messerli, F, Bavry, A, Handberg, E, Mancia, G, Pepine, C, Denardo, Scott J., Gong, Yan, Cooper-DeHoff, Rhonda M., Farsang, Csaba, Keltai, Matyas, Szirmai, L�szl�, Messerli, Franz H., Bavry, Anthony A., Handberg, Eileen M., Mancia, Giuseppe, and Pepine, Carl J.

Abstract

This corrects the article DOI: 10.1371/journal.pone.0122726

Published
2016

32. Correction: Effects of verapamil SR and atenolol on 24-Hour blood pressure and heart rate in hypertension patients with coronary artery disease: An international verapamil SR-trandolapril ambulatory monitoring substudy

Author

Denardo, Scott J., Denardo, S, Gong, Y, Cooper-DeHoff, R, Farsang, C, Keltai, M, Szirmai, L, Messerli, F, Bavry, A, Handberg, E, Mancia, G, Pepine, C, Denardo, Scott J., Gong, Yan, Cooper-DeHoff, Rhonda M., Farsang, Csaba, Keltai, Matyas, Szirmai, Lï¿1⁄2szlï¿1⁄2, Messerli, Franz H., Bavry, Anthony A., Handberg, Eileen M., Mancia, Giuseppe, Pepine, Carl J., Denardo, Scott J., Denardo, S, Gong, Y, Cooper-DeHoff, R, Farsang, C, Keltai, M, Szirmai, L, Messerli, F, Bavry, A, Handberg, E, Mancia, G, Pepine, C, Denardo, Scott J., Gong, Yan, Cooper-DeHoff, Rhonda M., Farsang, Csaba, Keltai, Matyas, Szirmai, Lï¿1⁄2szlï¿1⁄2, Messerli, Franz H., Bavry, Anthony A., Handberg, Eileen M., Mancia, Giuseppe, and Pepine, Carl J.

Abstract

This corrects the article DOI: 10.1371/journal.pone.0122726

Published
2016

33. No evidence for a J-shaped curve in treated hypertensive patients with increased cardiovascular risk: The VALUE trial

Author

Kjeldsen, S, Berge, E, Bangalore, S, Messerli, F, Mancia, G, Holzhauer, B, Hua, T, Zappe, D, Zanchetti, A, Weber, M, Julius, S, Kjeldsen, SE, Messerli, FH, Hua, TA, Weber, MA., Kjeldsen, S, Berge, E, Bangalore, S, Messerli, F, Mancia, G, Holzhauer, B, Hua, T, Zappe, D, Zanchetti, A, Weber, M, Julius, S, Kjeldsen, SE, Messerli, FH, Hua, TA, and Weber, MA.

Abstract

Previous studies have debated the notion that low blood pressure (BP) during treatment, particularly diastolic (DBP), is associated with increased risk of cardiovascular disease. We evaluated the impact of low BP on cardiovascular outcomes in a high-risk population of 15,244 hypertensive patients, almost half of whom had a history of coronary artery disease (CAD). In the prospective Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, patients were randomized to valsartan or amlodipine regimens and followed for 4.2 years (mean) with no difference in the primary cardiovascular endpoint. A Cox proportional hazards model was used to evaluate the relationship between average on-treatment BP and clinical outcomes. The relationship between BP and cardiovascular events was adjusted for age, gender and body mass index, and baseline qualifying risk factors and diseases (smoking, high total cholesterol, diabetes mellitus, proteinuria, CAD, previous stroke and left ventricular hypertrophy). DBP ≥ 90 mmHg, compared with < 90 mmHg, was associated with increased incidence of the primary cardiovascular endpoint (all cardiac events); however, DBP < 70 mmHg, compared with ≥ 70 mmHg, was not associated with increased incidence after covariate adjustment (no J-shaped curve). Similar results were observed for death, myocardial infarction (MI), heart failure and stroke, considered separately. Nadir for MI was at DBP of 76 mmHg and for stroke 60 mmHg. The ratio of MI to stroke increased with lower DBP. In CAD patients the MI to stroke ratio was more pronounced than in patients without CAD but there was no significant J-curve in either group. Systolic BP ≥ 150 but not < 130 mmHg, compared with 130-149 mmHg, similarly was associated with increased risk for primary outcome. In conclusion, patients in BP strata ≥ 150/90 mmHg, but not patients in BP strata < 130/70 mmHg, were at increased risk for adverse outcomes in this hypertensive, high-risk population. Although benefit in p

Published
2016

35. Wie kann‘s laufen? Beispiel I

Author

Messerli, F

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Vom Ereignis zur Krise – Erfahrungsbericht aus der Flugsicherung 2002 kollidierten über Süddeutschland zwei Verkehrsflugzeuge auf der Reiseflughöhe und stürzten in der Nähe der Stadt Überlingen ab. Zum Zeitpunkt des Unfalls war die Schweizer Flugsicherung für[for full text, please go to the a.m. URL], 15. Fachtagung Luftrettung

Published
2013
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37. Effects of verapamil SR and atenolol on 24-hour blood pressure and heart rate in hypertension patients with coronary artery disease: An international verapamil SR-trandolapril ambulatory monitoring substudy

Author

Denardo, S, Gong, Y, Cooper-Dehoff, R, Farsang, C, Keltai, M, Szirmai, L, Messerli, F, Bavry, A, Handberg, E, Mancia, G, Pepine, C, Denardo, Scott J., Gong, Yan, Cooper-Dehoff, Rhonda M., Farsang, Csaba, Keltai, Matyas, Szirmai, László, Messerli, Franz H., Bavry, Anthony A., Handberg, Eileen M., Mancia, Giuseppe, Pepine, Carl J., Denardo, S, Gong, Y, Cooper-Dehoff, R, Farsang, C, Keltai, M, Szirmai, L, Messerli, F, Bavry, A, Handberg, E, Mancia, G, Pepine, C, Denardo, Scott J., Gong, Yan, Cooper-Dehoff, Rhonda M., Farsang, Csaba, Keltai, Matyas, Szirmai, László, Messerli, Franz H., Bavry, Anthony A., Handberg, Eileen M., Mancia, Giuseppe, and Pepine, Carl J.

Abstract

Elevated nighttime blood pressure (BP) and heart rate (HR), increased BP and HR variability, and altered diurnal variations of BP and HR (nighttime dipping and morning surge) in patients with systemic hypertension are each associated with increased adverse cardiovascular events. However, there are no reports on the effect of hypertension treatment on these important hemodynamic parameters in the growing population of hypertensive patients with atherosclerotic coronary artery disease (CAD). This was a pre-specified subgroup analysis of the INternational VErapamil SR-Trandolapril STudy (INVEST), which involved 22,576 clinically stable patients aged >50 years with hypertension and CAD randomized to either verapamil SR-oratenolol-based hypertension treatment strategies. The subgroup consisted of 117 patients undergoing 24-hour ambulatory monitoring at baseline and after 1 year of treatment. Hourly systolic and diastolic BP (SBP and DBP) decreased after 1 year for both verapamil SR- and atenolol-based treatment strategies compared with baseline (P<0.0001). Atenolol also decreased hourly HR (P<0.0001). Both treatment strategies decreased SBP variability (weighted standard deviation: P = 0.012 and 0.021, respectively). Compared with verapamil SR, atenolol also increased the prevalence of BP and HR nighttime dipping among prior non-dippers (BP: OR = 3.37; 95% CI: 1.26-8.97; P = 0.015; HR: OR = 4.06; 95% CI: 1.35-12.17; P = 0.012) and blunted HR morning surge (+2.8 vs. +4.5 beats/min/hr; P = 0.019). Both verapamil SR- and especially atenolol-based strategies resulted in favorable changes in ambulatory monitoring parameters that have been previously associated with increased adverse cardiovascular events.

Published
2015

38. LIST OF CONTRIBUTORS AND DISCUSSANTS

Author

Aiyer, M.S., primary, Albert, A., additional, Alexander, R.W., additional, Anderson, H.J., additional, Aubert, M., additional, Aurbach, G.D., additional, Baker, H.W.G., additional, Bardin, C.W., additional, Bartke, A., additional, Bartter, F.C., additional, Bennett, P.H., additional, Bernstein, R.S., additional, Bitensky, L., additional, Boucher, R., additional, Bourne, H., additional, Braunstein, G.D., additional, Bravo, E.L., additional, Bremner, W.J., additional, Brown, E.M., additional, Brunton, L.L., additional, Burger, H.G., additional, Burrow, G.N., additional, Campbell, G.T., additional, Caron, M.G., additional, Carter, A.C., additional, Chatterton, R.T., additional, Chayen, J., additional, Coffino, P., additional, Cohen, S.L., additional, Constantopoulos, G., additional, Daly, J.R., additional, de Kretser, D.M., additional, DiGirolamo, M., additional, Dillmann, W.H., additional, Dominguez, O.V., additional, Duax, W.L., additional, Dulmanis, A., additional, Earll, J.M., additional, Eddie, L.W., additional, Edelman, I.S., additional, Edgren, R.A., additional, Faiman, C., additional, Fakunding, J.L., additional, Friedrich, U., additional, Friesen, H.G., additional, Frisch, R.E., additional, Frohman, L.A., additional, Furth, J., additional, Ganten, D., additional, Gardner, J.D., additional, Gehring, U., additional, Geller, J., additional, Gendrich, R., additional, Genest, J., additional, George, J.M., additional, Gill, J.R., additional, Gilman, A.G., additional, Goodman, H.M., additional, Gross, G., additional, Grumbach, M., additional, Hembree, W., additional, Hochman, J., additional, Huckins, C., additional, Hudson, B., additional, Insel, P.A., additional, Jacobs, L.S., additional, Jewelewicz, R., additional, Kaplan, S., additional, Kennedy, T., additional, Kenny, A.D., additional, Keogh, E.J., additional, Kirschner, M.A., additional, Knobil, E., additional, Koerner, D., additional, Kowal, J., additional, Krieger, D.T., additional, Kuchel, O., additional, Kulin, H.E., additional, LeCompte, P.M., additional, Lee, V.W.K., additional, Lefkowitz, R.J., additional, Lemaire, I., additional, Lequin, R.M., additional, Limbird, L.E., additional, Lin, Y.C., additional, Lindner, H.R., additional, Lipsett, M.B., additional, Little, B., additional, Loveridge, N., additional, McArthur, J.W., additional, McKenzie, J.M., additional, Maguire, M.E., additional, Martin, J.B., additional, Means, A.R., additional, Melby, J.C., additional, Melmon, K.L., additional, Messerli, F., additional, Mickey, J.V., additional, Miller, M., additional, Montoya, E., additional, Mukherjee, C., additional, Murphy, B.E.P., additional, Naftolin, F., additional, Niswender, G.D., additional, Nowaczynski, W., additional, Nureddin, A., additional, Odell, W.D., additional, Oliver, J.T., additional, Oppenheimer, J.H., additional, O'Riordan, J.L.H., additional, Orr, J., additional, Osathanondh, R., additional, Papkoff, H., additional, Parsons, J.A., additional, Pasqualini, J.R., additional, Paulsen, C.A., additional, Pearlman, W.H., additional, Pearson, O.H., additional, Perón, F.G., additional, Plotnikoff, N.P., additional, Raiti, S., additional, Ramaley, J.A., additional, Rayford, P.L., additional, Renaud, L., additional, Rennie, G.C., additional, Rice, B.F., additional, Rodbard, D., additional, Rodgers, C.H., additional, Rohrer, D.C., additional, Rojo-Ortega, J.M., additional, Rosemberg, E., additional, Rosenqvist, U., additional, Ross, G.T., additional, Rushford, N.B., additional, Ryan, R.J., additional, Saffran, M., additional, Sairam, M.R., additional, Samuels, H.H., additional, Santen, R.J., additional, Schwartz, H.L., additional, Schwartz, N.B., additional, Segaloff, A., additional, Sherins, R.J., additional, Sherman, M.R., additional, Sibley, C.H., additional, Spiegel, A.M., additional, Stampfer, M.R., additional, Steinetz, B.G., additional, Sterling, K., additional, Surks, M.I., additional, Swerdloff, R.S., additional, Swislocki, N.I., additional, Tate, R., additional, Tindall, D.J., additional, Tomkins, G.S., additional, Vaitukaitis, J.L., additional, Van Arsdale, P.M., additional, Vitale, R., additional, Waldhäusl, W., additional, Weeks, C.M., additional, Weisz, J., additional, White, W.F., additional, Wiklund, R.A., additional, Wilber, J.F., additional, Williams, L.T., additional, Winter, J., additional, and Yamamoto, K.R., additional

Published
1976
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39. Is the angiotensin II Type 2 receptor cerebroprotective?

Author

Fournier, A., Achard, J.M., Boutitie, Florent, Mazouz, H., Mansour, J., Oprisiu, R., Fernandez, L., Messerli, F., Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2004

41. International expert consensus statement: percutaneous transluminal renal denervation for the treatment of resistant hypertension

Author

Schlaich, M, Schmieder, R, Bakris, G, Blankestijn, P, Böhm, M, Campese, V, Francis, D, Grassi, G, Hering, D, Katholi, R, Kjeldsen, S, Krum, H, Mahfoud, F, Mancia, G, Messerli, F, Narkiewicz, K, Parati, G, Rocha Singh, K, Ruilope, L, Rump, L, Sica, D, Sobotka, P, Tsioufis, C, Vonend, O, Weber, M, Williams, B, Zeller, T, Esler, M, Schlaich, MP, Schmieder, RE, Blankestijn, PJ, Campese, VM, Francis, DP, GRASSI, GUIDO, MANCIA, GIUSEPPE, Messerli, FH, PARATI, GIANFRANCO, Rocha Singh, KJ, Ruilope, LM, Rump, LC, Sica, DA, Sobotka, PA, Weber, MA, Esler, MD, Schlaich, M, Schmieder, R, Bakris, G, Blankestijn, P, Böhm, M, Campese, V, Francis, D, Grassi, G, Hering, D, Katholi, R, Kjeldsen, S, Krum, H, Mahfoud, F, Mancia, G, Messerli, F, Narkiewicz, K, Parati, G, Rocha Singh, K, Ruilope, L, Rump, L, Sica, D, Sobotka, P, Tsioufis, C, Vonend, O, Weber, M, Williams, B, Zeller, T, Esler, M, Schlaich, MP, Schmieder, RE, Blankestijn, PJ, Campese, VM, Francis, DP, GRASSI, GUIDO, MANCIA, GIUSEPPE, Messerli, FH, PARATI, GIANFRANCO, Rocha Singh, KJ, Ruilope, LM, Rump, LC, Sica, DA, Sobotka, PA, Weber, MA, and Esler, MD

Abstract

Catheter-based radiofrequency ablation technology to disrupt both efferent and afferent renal nerves has recently been introduced to clinical medicine after the demonstration of significant systolic and diastolic blood pressure reductions. Clinical trial data available thus far have been obtained primarily in patients with resistant hypertension, defined as standardized systolic clinic blood pressure ≥160 mm Hg (or ≥150 mm Hg in patients with type 2 diabetes) despite appropriate pharmacologic treatment with at least 3 antihypertensive drugs, including a diuretic agent. Accordingly, these criteria and blood pressure thresholds should be borne in mind when selecting patients for renal nerve ablation. Secondary forms of hypertension and pseudoresistance, such as nonadherence to medication, intolerance of medication, and white coat hypertension, should have been ruled out, and 24-h ambulatory blood pressure monitoring is mandatory in this context. Because there are theoretical concerns with regard to renal safety, selected patients should have preserved renal function, with an estimated glomerular filtration rate ≥45 ml/min/1.73 m(2). Optimal periprocedural management of volume status and medication regimens at specialized and experienced centers equipped with adequate infrastructure to cope with potential procedural complications will minimize potential patient risks. Long-term safety and efficacy data are limited to 3 years of follow-up in small patient cohorts, so efforts to monitor treated patients are crucial to define the long-term performance of the procedure. Although renal nerve ablation could have beneficial effects in other conditions characterized by elevated renal sympathetic nerve activity, its potential use for such indications should currently be limited to formal research studies of its safety and efficacy.

Published
2013

42. Facts and fallacies of blood pressure control in recent trials: implications in the management of patients with hypertension

Author

Zanchetti, A, Mancia, G, Black, H, Oparil, S, Waeber, B, Schmieder, R, Bakris, G, Messerli, F, Kjeldsen, S, Ruilope, M, Black, HR, Schmieder, RE, Bakris, GL, Messerli, FH, Kjeldsen, SE, Ruilope, M., MANCIA, GIUSEPPE, Zanchetti, A, Mancia, G, Black, H, Oparil, S, Waeber, B, Schmieder, R, Bakris, G, Messerli, F, Kjeldsen, S, Ruilope, M, Black, HR, Schmieder, RE, Bakris, GL, Messerli, FH, Kjeldsen, SE, Ruilope, M., and MANCIA, GIUSEPPE

Abstract

A large body of clinical trial data indicates that a given difference in blood pressure (BP), as measured in the clinic, results in a given difference in outcome. This correlation underpins current US and European guidelines for the management of hypertension. However, findings fromrecent comparative trials may appear inconsistent with a fixed relationship between BP lowering and outcome benefit, at least at all BP ranges, at all levels of total cardiovascular risk and with all drug combinations. We review the findings of six of these recent trials and conclude that their complex design precludes a simple interpretation, that several important questions remain unanswered and that direct evidence - particularly in support of lowering systolic BP below 140 or 130mmHg - is urgently needed. © 2009 Wolters Kluwer Health.

Published
2009

43. Pulse pressure and risk of cardiovascular outcomes in patients with hypertension and coronary artery disease: an INternational VErapamil SR-trandopril STudy (INVEST) analysis

Author

Bangalore, S, Messerli, F, Franklin, S, Mancia, G, Champion, A, Pepine, C, Messerli, FH, Franklin, SS, Pepine, CJ, MANCIA, GIUSEPPE, Bangalore, S, Messerli, F, Franklin, S, Mancia, G, Champion, A, Pepine, C, Messerli, FH, Franklin, SS, Pepine, CJ, and MANCIA, GIUSEPPE

Abstract

AimThe purpose of this study was to assess the relationship between pulse pressure (PP) and cardiovascular outcomes in a large, elderly, coronary artery disease (CAD) population with hypertension, and compare the predictive power of PP with other blood pressure measures.Methods and resultsIn INternational VErapamil-trandolapril STudy, 22 576 CAD patients with hypertension (mean age 66 years) were randomized to verapamil-SR or atenolol-based strategies and followed for 2.7 years (mean). Primary outcome (PO) was time to first occurrence of death (all-cause), non-fatal myocardial infarction (MI), or non-fatal stroke. Mean follow-up PP was summarized by 5 mmHg subgroups for association with incidence of PO. Stepwise Cox proportional hazards models were used to estimate adjusted relative hazard ratios (HR) for the risk of PO with follow-up PP as a continuous variable, with linear and quadratic terms. Similar models were constructed for follow-up systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressures (MAP). A -2 log-likelihood statistic was used to assess the predictive power of PP compared with SBP, DBP, and MAP. For follow-up PP, the incidence and adjusted HR for the PO formed a J- or U-shaped curve. After adjusting for baseline covariates, both linear and quadratic terms for PP were significant (P < 0.0001 for both), with a nadir of 54 mmHg (bootstrapping 95 CI 42-60 mmHg). Similar quadratic relationships were found between PP and all-cause mortality or MI; the relationship between PP and stroke was linear. Pulse pressure was a predictor of PO even after including SBP (P = 0.007 linear term) or DBP (P < 0.0001 for both linear and quadratic terms) or MAP (P < 0.01 for both liner and quadratic terms) in the model. Using -2 log-likelihood differences, SBP (-2 log-likelihood difference 77.1 vs. 7.3 for PP), DBP (-2 log-likelihood difference 138.5 vs. 44.6 for PP), and MAP (-2 log-likelihood difference 125.0 vs. 13.4 for PP) were stronger

Published
2009

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