The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Alberto Zanchetti - One of the best experts on this subject based on the ideXlab platform.
-
prevalence and incidence of the metabolic syndrome in the european Lacidipine study on atherosclerosis elsa and its relation with carotid intima media thickness
Journal of Hypertension, 2007Co-Authors: Alberto Zanchetti, Micheal Hennig, Hansjoerg Baurecht, Rong Tang, Cesare Cuspidi, Stefano Carugo, Giuseppe ManciaAbstract:BackgroundThe European Lacidipine Study on Atherosclerosis (ELSA) randomized 2334 hypertensive patients to either the lipophilic calcium antagonist Lacidipine or the β-blocker atenolol for 4 years. About 35% of subjects in both groups received additional hydrochlorothiazide (12.5–25 mg/day). The pat
-
assessment of long term antihypertensive treatment by clinic and ambulatory blood pressure data from the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2007Co-Authors: Giuseppe Mancia, Gianfranco Parati, M Hennig, Hansjorg Baurecht, Grzegorz Bilo, A Maronati, Stefano Omboni, Alberto ZanchettiAbstract:Objectives Information on the features of long-term modifications of clinic and 24-h ambulatory blood pressure (ABP) by treatment is limited. The present study aimed to address this issue. Methods Ambulatory BP monitoring and clinic BP (CBP) measurements were performed at baseline and at yearly intervals over a 4-year follow-up period in 1523 hypertensives (56.1 ± 7.6 years) randomized to treatment with Lacidipine or atenolol in the European Lacidipine Study on Atherosclerosis (ELSA). Results CBP was always greater than ABP, while reductions in all BP values (greater for CBP than for ABP) were on average maintained throughout 4 years, CBP changes showing limited relationship with ABP changes (r = 0.14–0.27). BP reductions by treatment during daytime and night-time were correlated (r = 0.63–0.73). BP normalization was achieved in a greater percentage of patients for CBP (41.7%) than for ABP (25.3%), with systolic BP control being always less common than diastolic BP control. BP normalization was more frequent at single yearly visits than throughout the 4 years. Twenty-four-hour BP variability was reduced by treatment over 4 years in absolute but not in normalized units. Conclusions The present study provides the best evidence available on long-term effect of antihypertensive treatment on both ABP and CBP. On average, ABP was sustainedly reduced by treatment throughout the follow-up period, but 24-h BP was more difficult to control than CBP. In several patients, ABP control was unstable between visits, the percentage of patients under control over 4 years being much less than that of those controlled at each year. Treatment induced a reduction in absolute but not in normalized BP variability estimates. This has clinical implications because of the prognostic importance of ABP mean values and variability.
-
carotid wall composition in hypertensive patients after 4 year treatment with Lacidipine or atenolol an echoreflectivity study
Journal of Hypertension, 2005Co-Authors: Roberta Paliotti, Rong Tang, Giuseppe Mancia, Michele M Ciulla, M Hennig, Gene M Bond, F Magrini, Alberto ZanchettiAbstract:OBJECTIVE: In the European Lacidipine Study on Atherosclerosis (ELSA), against a similar antihypertensive effect, a significantly greater effect of Lacidipine was found on carotid intima-media thickness (IMT) progression, indicating a specific anti-atherosclerotic effect of Lacidipine. However, not only the extent but also the composition of an atherosclerotic plaque is a determinant of subsequent events. DESIGN AND METHODS: Among the 2334 patients enrolled in ELSA, 420 with 4-year treatment were chosen, videodensitometric analysis of their ultrasound carotid scan was performed and the maximum wall lesion (Tmax) was classified as lipidic, fibrolipidic and fibrotic by means of software previously validated against histology. Of the 420 patients, 244 had scans suitable for videodensitometry. RESULTS: Excellent reproducibility of videodensitometry analysis was found using the Bland-Altman and other methods. At baseline, ELSA hypertensive patients had predominantly fibrolipidic walls (70%), with an echoreflectivity indicating a mean collagen content of 25%. After 4 years of antihypertensive treatment, little change in the frequency distribution of carotid lesions (fibrolipidic 73%) was found, with no significant differences between patients randomized to Lacidipine or atenolol. CONCLUSIONS: Our study provides previously unavailable information that carotid wall composition changes to an extremely small extent during 4-year effective blood pressure lowering. With Lacidipine, stable composition is associated with a lower IMT progression than with atenolol.
-
quality control of b mode ultrasonic measurement of carotid artery intima media thickness the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2005Co-Authors: Rong Tang, Giuseppe Mancia, M Hennig, Gene M Bond, Regina Hollweck, Alberto ZanchettiAbstract:BackgroundThe European Lacidipine Study of Atherosclerosis (ELSA) was a prospective, randomized, double-blind, multinational interventional trial using B-mode ultrasound measurement of carotid intima–media thickness (IMT) in 2259 hypertensive individuals. ELSA showed that 4-year treatment with the c
-
different relation between 24 h blood pressure and distensibility at different peripheral arteries data from the european Lacidipine study on atherosclerosis elsa
Journal of Hypertension, 2005Co-Authors: Cristina Giannattasio, M Hennig, J L Reid, Regina Hollweck, M Failla, S Laurent, Jean Michel Mallion, Michel E Safar, Gene Bond, Alberto ZanchettiAbstract:INTRODUCTION: The European Lacidipine Study on Atherosclerosis (ELSA) has been planned to investigate the effect of reduction in office and ambulatory blood pressure by Lacidipine versus atenolol on carotid artery wall thickness in mild to moderate essential hypertensive patients with no metabolic abnormalities. One prespecified sub-study of ELSA focused on measurements of arterial distensibility in the carotid as well as in the radial artery to determine the relationship of functional arterial properties with office versus ambulatory blood pressure (BP) values as well as the correspondence between functional and structural arterial alterations. METHODS: The sub-study was conducted on 124 patients recruited in four centres (Monza-Milan, Paris, Grenoble and Glasgow). BP was measured both by a mercury sphygmomanometer and by 24-h ambulatory monitoring. Common carotid artery wall thickness was measured by certified sonographers as described in the main study. Common carotid and radial artery distensibility wereobtained by echotracking techniques, which allowed to relate changes in arterial diameter with systo-diastolic BP changes. RESULTS: Carotid artery wall distensibility showed (1) a negative correlation with office and more so 24-h average systolic BP (r = -0.45 and -0.58, P< 0.008 and 0.001) but not with office or 24-h diastolic BP) and (2) a negative correlation with the corresponding wall thickness (r = -0.47, P< 0.005). In contrast, at the radial artery level distensibility and thickness showed no correlation with each other and with BP. Carotid (but not radial) artery distensibility also correlated with ambulatory systolic BP variability but the correlation was lost after adjustment for age and mean BP values. CONCLUSION: These data suggest that stiffening of large elastic artery is reflected more by ambulatory than office BP elevations, systolic BP being much more important than diastolic. Alterations of large elastic arteries function is related to structural wall changes. Functional and structural properties of middle-size muscle arteries are independent of BP.
Giuseppe Mancia - One of the best experts on this subject based on the ideXlab platform.
-
serum uric acid and resistance to antihypertensive treatment data from the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2019Co-Authors: Michele Bombelli, Cesare Cuspidi, Giuseppe Mancia, Mario Macchiarulo, Rita Facchetti, Davide Maggiolini, Gianfranco Parati, Guido GrassiAbstract:Aim:Whether increased serum uric acid (SUA) favours resistance to antihypertensive drugs is not clear.Methods:The European Lacidipine Study on Atherosclerosis (ELSA) was a randomized, double-blind, multicenter trial comparing the effects of a 4-year treatment with either Lacidipine or atenolol on pr
-
prevalence and incidence of the metabolic syndrome in the european Lacidipine study on atherosclerosis elsa and its relation with carotid intima media thickness
Journal of Hypertension, 2007Co-Authors: Alberto Zanchetti, Micheal Hennig, Hansjoerg Baurecht, Rong Tang, Cesare Cuspidi, Stefano Carugo, Giuseppe ManciaAbstract:BackgroundThe European Lacidipine Study on Atherosclerosis (ELSA) randomized 2334 hypertensive patients to either the lipophilic calcium antagonist Lacidipine or the β-blocker atenolol for 4 years. About 35% of subjects in both groups received additional hydrochlorothiazide (12.5–25 mg/day). The pat
-
assessment of long term antihypertensive treatment by clinic and ambulatory blood pressure data from the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2007Co-Authors: Giuseppe Mancia, Gianfranco Parati, M Hennig, Hansjorg Baurecht, Grzegorz Bilo, A Maronati, Stefano Omboni, Alberto ZanchettiAbstract:Objectives Information on the features of long-term modifications of clinic and 24-h ambulatory blood pressure (ABP) by treatment is limited. The present study aimed to address this issue. Methods Ambulatory BP monitoring and clinic BP (CBP) measurements were performed at baseline and at yearly intervals over a 4-year follow-up period in 1523 hypertensives (56.1 ± 7.6 years) randomized to treatment with Lacidipine or atenolol in the European Lacidipine Study on Atherosclerosis (ELSA). Results CBP was always greater than ABP, while reductions in all BP values (greater for CBP than for ABP) were on average maintained throughout 4 years, CBP changes showing limited relationship with ABP changes (r = 0.14–0.27). BP reductions by treatment during daytime and night-time were correlated (r = 0.63–0.73). BP normalization was achieved in a greater percentage of patients for CBP (41.7%) than for ABP (25.3%), with systolic BP control being always less common than diastolic BP control. BP normalization was more frequent at single yearly visits than throughout the 4 years. Twenty-four-hour BP variability was reduced by treatment over 4 years in absolute but not in normalized units. Conclusions The present study provides the best evidence available on long-term effect of antihypertensive treatment on both ABP and CBP. On average, ABP was sustainedly reduced by treatment throughout the follow-up period, but 24-h BP was more difficult to control than CBP. In several patients, ABP control was unstable between visits, the percentage of patients under control over 4 years being much less than that of those controlled at each year. Treatment induced a reduction in absolute but not in normalized BP variability estimates. This has clinical implications because of the prognostic importance of ABP mean values and variability.
-
carotid wall composition in hypertensive patients after 4 year treatment with Lacidipine or atenolol an echoreflectivity study
Journal of Hypertension, 2005Co-Authors: Roberta Paliotti, Rong Tang, Giuseppe Mancia, Michele M Ciulla, M Hennig, Gene M Bond, F Magrini, Alberto ZanchettiAbstract:OBJECTIVE: In the European Lacidipine Study on Atherosclerosis (ELSA), against a similar antihypertensive effect, a significantly greater effect of Lacidipine was found on carotid intima-media thickness (IMT) progression, indicating a specific anti-atherosclerotic effect of Lacidipine. However, not only the extent but also the composition of an atherosclerotic plaque is a determinant of subsequent events. DESIGN AND METHODS: Among the 2334 patients enrolled in ELSA, 420 with 4-year treatment were chosen, videodensitometric analysis of their ultrasound carotid scan was performed and the maximum wall lesion (Tmax) was classified as lipidic, fibrolipidic and fibrotic by means of software previously validated against histology. Of the 420 patients, 244 had scans suitable for videodensitometry. RESULTS: Excellent reproducibility of videodensitometry analysis was found using the Bland-Altman and other methods. At baseline, ELSA hypertensive patients had predominantly fibrolipidic walls (70%), with an echoreflectivity indicating a mean collagen content of 25%. After 4 years of antihypertensive treatment, little change in the frequency distribution of carotid lesions (fibrolipidic 73%) was found, with no significant differences between patients randomized to Lacidipine or atenolol. CONCLUSIONS: Our study provides previously unavailable information that carotid wall composition changes to an extremely small extent during 4-year effective blood pressure lowering. With Lacidipine, stable composition is associated with a lower IMT progression than with atenolol.
-
quality control of b mode ultrasonic measurement of carotid artery intima media thickness the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2005Co-Authors: Rong Tang, Giuseppe Mancia, M Hennig, Gene M Bond, Regina Hollweck, Alberto ZanchettiAbstract:BackgroundThe European Lacidipine Study of Atherosclerosis (ELSA) was a prospective, randomized, double-blind, multinational interventional trial using B-mode ultrasound measurement of carotid intima–media thickness (IMT) in 2259 hypertensive individuals. ELSA showed that 4-year treatment with the c
Theophile Godfraind - One of the best experts on this subject based on the ideXlab platform.
-
effects of amlodipine and Lacidipine on cardiac remodelling and renin production in salt loaded stroke prone hypertensive rats
British Journal of Pharmacology, 2001Co-Authors: Jan Kyselovic, Maurice Wibo, Peter Krenek, Theophile GodfraindAbstract:1. Calcium channel blockers (CCBs) are anti-hypertensive drugs that are usually considered to act mainly as vasodilators. We investigated the relation between the reduction of blood pressure evoked by two long-acting CCBs and their protective effect against cardiac and renal damage in salt-loaded stroke-prone spontaneously hypertensive rats (SHRSP). 2. SHRSP were exposed to high dietary salt intake (1% NaCl in drinking solution) from 8 to 14 weeks of age, with or without amlodipine or Lacidipine at three dosage regimens producing similar effects on blood pressure. 3. The lowest dosages of both drugs had non-significant effects on blood pressure but inhibited the paradoxical increases in plasma renin activity (PRA) and in renin mRNA in kidney that were found in salt-loaded SHRSP. The lowest dosage of Lacidipine (but not of amlodipine) restored the physiological downregulation of renin production by high salt and reduced left ventricular hypertrophy and mRNA levels of atrial natriuretic factor and transforming growth factor-beta1. 4. The intermediate dosages reduced blood pressure and PRA in a comparable manner, but cardiac hypertrophy was more reduced by Lacidipine than by amlodipine. 5. Although the highest doses exhibited a further action on blood pressure, they had no additional effect on cardiac hypertrophy, and they increased PRA and kidney levels of renin mRNA even more than in the absence of drug treatment. 6. We conclude that reduction of blood pressure is not the sole mechanism involved in the prevention of cardiac remodelling by CCBs, and that protection against kidney damage and excessive renin production by low and intermediate dosages of these drugs contributes to their beneficial cardiovascular effects.
-
Lacidipine prevents endothelial dysfunction in salt loaded stroke prone hypertensive rats
Hypertension, 2001Co-Authors: Peter Krenek, Jan Kyselovic, Nicole Morel, Maurice Wibo, Salvatore Salomone, Theophile GodfraindAbstract:Endothelium-dependent vasorelaxation is defective in hypertensive rats, especially in conduit arteries. In the stroke-prone spontaneously hypertensive rat, impaired endothelium-dependent vasorelaxation appears to contribute to the pathogenesis of stroke independent of blood pressure. Because treatment with Lacidipine, a long-acting calcium channel blocker, protects against stroke and cardiovascular remodeling in this model, we investigated the effect of this treatment on endothelium-dependent vasorelaxation in the aorta. Stroke-prone rats were exposed to a salt-rich diet (1% NaCl in drinking water) with or without Lacidipine (1 mg. kg(-1). d(-1)) for 6 weeks. A high-sodium diet (1) increased systolic blood pressure, aortic weight, and wall thickness and plasma renin activity (P<0.05); (2) markedly reduced nitric oxide (NO)-mediated, endothelium-dependent relaxation of aortic rings to acetylcholine and the sensitivity to the relaxing effect of S-nitroso-N-acetylpenicillamine, an NO donor (P<0.001); and (3) induced an elevation of preproendothelin-1 mRNA levels in aortic tissue (P<0.01) without affecting endothelial NO synthase mRNA levels. Lacidipine treatment prevented the salt-dependent functional and structural alterations of the aorta, including the overexpression of the preproendothelin-1 gene, and increased endothelial NO synthase mRNA levels in aortic tissue (P<0.01). In conclusion, Lacidipine protects stroke-prone hypertensive rats against the impairment of endothelium-dependent vasorelaxation evoked by a salt-rich diet, and this effect may contribute to its beneficial effect against end-organ damage and stroke.
-
carvedilol and Lacidipine prevent cardiac hypertrophy and endothelin 1 gene overexpression after aortic banding
Hypertension, 1999Co-Authors: Pierreemmanuel Massart, Jan Kyselovic, Theophile Godfraind, Julian Donckier, Guy R Heyndrickx, Maurice WiboAbstract:Carvedilol and Lacidipine have been shown to exert cardioprotective effects in rat models of chronic hypertension. We investigated their effects in an acute model of pressure overload produced by suprarenal aortic constriction, in which enhanced myocardial production of endothelin-1 could play a crucial role. In the absence of drug treatment, after 1 week, aortic banding provoked an increase in carotid pressure associated with left ventricular hypertrophy (29%; P<0.01). These changes were accompanied by increased myocardial expression of preproendothelin-1 (2.5 times; P<0.05) and skeletal alpha-actin (3.6 times; P<0.05), but the expression of cardiac alpha-actin was not modified. Oral administration of carvedilol at a dose of 30 mg. kg(-1). d(-1) to rats with aortic banding normalized carotid pressure and left ventricular weight as well as preproendothelin-1 and skeletal alpha-actin gene expression. Carvedilol at a lower dose (7.5 mg x kg(-1) x d(-1)) and Lacidipine 1 mg x kg(-1) x d(-1) had only moderate and nonsignificant effects on carotid pressure but largely prevented left ventricular hypertrophy (P<0.01) and preproendothelin-1 overexpression (P<0.05). Labetalol (60 mg x kg(-1) x d(-1)) tended to exert similar effects but insignificantly. These results show that the antihypertrophic properties of carvedilol and Lacidipine are partly independent of their antihypertensive effects and may be related to their ability to blunt myocardial preproendothelin-1 overexpression. Moreover, carvedilol at a dose of 7.5 mg x kg(-1) x d(-1) did not prevent myocardial overexpression of skeletal alpha-actin, which suggests that, in this model, reexpression of a fetal gene can be activated by pressure overload independently of cardiac hypertrophy.
-
prevention of salt dependent cardiac remodeling and enhanced gene expression in stroke prone hypertensive rats by the long acting calcium channel blocker Lacidipine
Journal of Hypertension, 1998Co-Authors: Jan Kyselovic, Nicole Morel, Maurice Wibo, Theophile GodfraindAbstract:OBJECTIVE: To analyze the effect of the long-acting calcium channel blocker Lacidipine on cardiovascular remodeling induced by salt loading in a genetic model of hypertension. DESIGN: We examined the influence of threshold doses of Lacidipine, with little blood-pressure lowering effect, on cardiac weight and gene expression in stroke-prone spontaneously hypertensive rats (SHRSP). METHODS: SHRSPs (8-week-old) were randomly allocated to four groups: control, salt-loaded SHRSP and salt-loaded SHRSP treated with Lacidipine at 0.3 and 1 mg/kg per day. Systolic blood pressure was measured by the tail-cuff method. At the end of 6 weeks of treatment, ventricles were collected and weighed. Ventricular messenger RNA was extracted and subjected to Northern blot analysis. RESULTS: Lacidipine (0.3 mg/kg per day) not only prevented the salt-dependent cardiac hypertrophy and the slight increase in systolic blood pressure induced by salt, but also prevented, largely or completely, salt-dependent increases in ventricular levels of several gene products: skeletal and cardiac alpha-actin, beta-myosin heavy chain (beta-MHC), type I collagen, long-lasting (L)-type calcium channel and preproendothelin-1. At a higher dose of 1 mg/kg per day, Lacidipine further decreased systolic blood pressure below the level of control SHRSP, completely prevented salt-dependent overexpression of the beta-MHC gene and markedly attenuated salt-dependent overexpression of the transforming growth factor-beta1 gene. CONCLUSIONS: Lacidipine prevents the cardiac remodeling and enhanced gene expression induced by salt loading in SHRSP at doses that only minimally affect the high systolic blood pressure.
-
action of the calcium channel blocker Lacidipine on cardiac hypertrophy and endothelin 1 gene expression in stroke prone hypertensive rats
British Journal of Pharmacology, 1996Co-Authors: Olivier Feron, Salvatore Salomone, Theophile GodfraindAbstract:1. The tissue-protective effects of calcium channel blockers in hypertension are not well dissociated from their effect on systolic blood pressure (SBP). We have previously shown that Lacidipine, a dihydropyridine-type calcium antagonist, reduced the cardiac hypertrophy and the cardiac endothelin-1 (ET-1) gene overexpression occurring in salt-loaded stroke-prone spontaneously hypertensive rats (SL-SHRSP), an effect occurring without systolic blood pressure (SBP) change. In the present study, we have examined whether this action was dose-related and if it could be associated with ET receptor changes. The action of Lacidipine was also examined in control SHRSP and in Wistar Kyoto rats (WKY). 2. The daily dose of 0.3 mg kg-1 Lacidipine which did not lower SBP but significantly prevented ventricle hypertrophy and cardiac preproET-1-mRNA expression in SL-SHRSP was inactive in control SHRSP. With the higher dose of Lacidipine (1 mg kg-1 day-1), we observed a further reduction of cardiac hypertrophy and of ET-1 gene expression in SL-SHRSP and a significant effect on those parameters in control SHRSP but only a small reduction of SBP in both groups. 3. In WKY, salt loading did not induce change in SBP or increase of cardiac ET-1 gene expression and ventricle mass. In these normotensive rats, Lacidipine (1 mg kg-1 day-1) did not modulate the basal preproET-1-mRNA expression and did not affect SBP or heart weight. 4. The maximum binding capacity (Bmax) and the dissociation constant (KD) of [125I]-ET-1 binding and the relative proportion of low- and high-affinity binding sites for ET-3 were not significantly affected by salt loading or Lacidipine treatment in SHRSP. 5. These results show that Lacidipine exerted a dose-related inhibition of ventricle hypertrophy and preproET-1-mRNA expression in SHRSP and indicate that this effect was unrelated to SBP changes. The dose-dependency of this inhibition suggests that salt-induced cardiac hypertrophy could be related to ET-1 gene overexpression. The results further show that ET receptor changes are not involved in the pathophysiological process studied here.
M Hennig - One of the best experts on this subject based on the ideXlab platform.
-
assessment of long term antihypertensive treatment by clinic and ambulatory blood pressure data from the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2007Co-Authors: Giuseppe Mancia, Gianfranco Parati, M Hennig, Hansjorg Baurecht, Grzegorz Bilo, A Maronati, Stefano Omboni, Alberto ZanchettiAbstract:Objectives Information on the features of long-term modifications of clinic and 24-h ambulatory blood pressure (ABP) by treatment is limited. The present study aimed to address this issue. Methods Ambulatory BP monitoring and clinic BP (CBP) measurements were performed at baseline and at yearly intervals over a 4-year follow-up period in 1523 hypertensives (56.1 ± 7.6 years) randomized to treatment with Lacidipine or atenolol in the European Lacidipine Study on Atherosclerosis (ELSA). Results CBP was always greater than ABP, while reductions in all BP values (greater for CBP than for ABP) were on average maintained throughout 4 years, CBP changes showing limited relationship with ABP changes (r = 0.14–0.27). BP reductions by treatment during daytime and night-time were correlated (r = 0.63–0.73). BP normalization was achieved in a greater percentage of patients for CBP (41.7%) than for ABP (25.3%), with systolic BP control being always less common than diastolic BP control. BP normalization was more frequent at single yearly visits than throughout the 4 years. Twenty-four-hour BP variability was reduced by treatment over 4 years in absolute but not in normalized units. Conclusions The present study provides the best evidence available on long-term effect of antihypertensive treatment on both ABP and CBP. On average, ABP was sustainedly reduced by treatment throughout the follow-up period, but 24-h BP was more difficult to control than CBP. In several patients, ABP control was unstable between visits, the percentage of patients under control over 4 years being much less than that of those controlled at each year. Treatment induced a reduction in absolute but not in normalized BP variability estimates. This has clinical implications because of the prognostic importance of ABP mean values and variability.
-
carotid wall composition in hypertensive patients after 4 year treatment with Lacidipine or atenolol an echoreflectivity study
Journal of Hypertension, 2005Co-Authors: Roberta Paliotti, Rong Tang, Giuseppe Mancia, Michele M Ciulla, M Hennig, Gene M Bond, F Magrini, Alberto ZanchettiAbstract:OBJECTIVE: In the European Lacidipine Study on Atherosclerosis (ELSA), against a similar antihypertensive effect, a significantly greater effect of Lacidipine was found on carotid intima-media thickness (IMT) progression, indicating a specific anti-atherosclerotic effect of Lacidipine. However, not only the extent but also the composition of an atherosclerotic plaque is a determinant of subsequent events. DESIGN AND METHODS: Among the 2334 patients enrolled in ELSA, 420 with 4-year treatment were chosen, videodensitometric analysis of their ultrasound carotid scan was performed and the maximum wall lesion (Tmax) was classified as lipidic, fibrolipidic and fibrotic by means of software previously validated against histology. Of the 420 patients, 244 had scans suitable for videodensitometry. RESULTS: Excellent reproducibility of videodensitometry analysis was found using the Bland-Altman and other methods. At baseline, ELSA hypertensive patients had predominantly fibrolipidic walls (70%), with an echoreflectivity indicating a mean collagen content of 25%. After 4 years of antihypertensive treatment, little change in the frequency distribution of carotid lesions (fibrolipidic 73%) was found, with no significant differences between patients randomized to Lacidipine or atenolol. CONCLUSIONS: Our study provides previously unavailable information that carotid wall composition changes to an extremely small extent during 4-year effective blood pressure lowering. With Lacidipine, stable composition is associated with a lower IMT progression than with atenolol.
-
quality control of b mode ultrasonic measurement of carotid artery intima media thickness the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2005Co-Authors: Rong Tang, Giuseppe Mancia, M Hennig, Gene M Bond, Regina Hollweck, Alberto ZanchettiAbstract:BackgroundThe European Lacidipine Study of Atherosclerosis (ELSA) was a prospective, randomized, double-blind, multinational interventional trial using B-mode ultrasound measurement of carotid intima–media thickness (IMT) in 2259 hypertensive individuals. ELSA showed that 4-year treatment with the c
-
cardiac structural and functional changes during long term antihypertensive treatment with Lacidipine and atenolol in the european Lacidipine study on atherosclerosis elsa
Journal of Hypertension, 2005Co-Authors: Enrico Agabitirosei, Bruno Trimarco, Rong Tang, Gianfranco Parati, M Hennig, J L Reid, Maria Lorenza Muiesan, Antonio Salvetti, Hansjorg Baurecht, Giuseppe ManciaAbstract:ObjectivesTo evaluate and correlate the effects of long-term antihypertensive treatment on left ventricular (LV) mass and carotid structural changes in a large group of essential hypertensive patients, participating in the European Lacidipine Study on Atherosclerosis (ELSA).DesignIn four (Brescia, G
-
different relation between 24 h blood pressure and distensibility at different peripheral arteries data from the european Lacidipine study on atherosclerosis elsa
Journal of Hypertension, 2005Co-Authors: Cristina Giannattasio, M Hennig, J L Reid, Regina Hollweck, M Failla, S Laurent, Jean Michel Mallion, Michel E Safar, Gene Bond, Alberto ZanchettiAbstract:INTRODUCTION: The European Lacidipine Study on Atherosclerosis (ELSA) has been planned to investigate the effect of reduction in office and ambulatory blood pressure by Lacidipine versus atenolol on carotid artery wall thickness in mild to moderate essential hypertensive patients with no metabolic abnormalities. One prespecified sub-study of ELSA focused on measurements of arterial distensibility in the carotid as well as in the radial artery to determine the relationship of functional arterial properties with office versus ambulatory blood pressure (BP) values as well as the correspondence between functional and structural arterial alterations. METHODS: The sub-study was conducted on 124 patients recruited in four centres (Monza-Milan, Paris, Grenoble and Glasgow). BP was measured both by a mercury sphygmomanometer and by 24-h ambulatory monitoring. Common carotid artery wall thickness was measured by certified sonographers as described in the main study. Common carotid and radial artery distensibility wereobtained by echotracking techniques, which allowed to relate changes in arterial diameter with systo-diastolic BP changes. RESULTS: Carotid artery wall distensibility showed (1) a negative correlation with office and more so 24-h average systolic BP (r = -0.45 and -0.58, P< 0.008 and 0.001) but not with office or 24-h diastolic BP) and (2) a negative correlation with the corresponding wall thickness (r = -0.47, P< 0.005). In contrast, at the radial artery level distensibility and thickness showed no correlation with each other and with BP. Carotid (but not radial) artery distensibility also correlated with ambulatory systolic BP variability but the correlation was lost after adjustment for age and mean BP values. CONCLUSION: These data suggest that stiffening of large elastic artery is reflected more by ambulatory than office BP elevations, systolic BP being much more important than diastolic. Alterations of large elastic arteries function is related to structural wall changes. Functional and structural properties of middle-size muscle arteries are independent of BP.
Rong Tang - One of the best experts on this subject based on the ideXlab platform.
-
prevalence and incidence of the metabolic syndrome in the european Lacidipine study on atherosclerosis elsa and its relation with carotid intima media thickness
Journal of Hypertension, 2007Co-Authors: Alberto Zanchetti, Micheal Hennig, Hansjoerg Baurecht, Rong Tang, Cesare Cuspidi, Stefano Carugo, Giuseppe ManciaAbstract:BackgroundThe European Lacidipine Study on Atherosclerosis (ELSA) randomized 2334 hypertensive patients to either the lipophilic calcium antagonist Lacidipine or the β-blocker atenolol for 4 years. About 35% of subjects in both groups received additional hydrochlorothiazide (12.5–25 mg/day). The pat
-
carotid wall composition in hypertensive patients after 4 year treatment with Lacidipine or atenolol an echoreflectivity study
Journal of Hypertension, 2005Co-Authors: Roberta Paliotti, Rong Tang, Giuseppe Mancia, Michele M Ciulla, M Hennig, Gene M Bond, F Magrini, Alberto ZanchettiAbstract:OBJECTIVE: In the European Lacidipine Study on Atherosclerosis (ELSA), against a similar antihypertensive effect, a significantly greater effect of Lacidipine was found on carotid intima-media thickness (IMT) progression, indicating a specific anti-atherosclerotic effect of Lacidipine. However, not only the extent but also the composition of an atherosclerotic plaque is a determinant of subsequent events. DESIGN AND METHODS: Among the 2334 patients enrolled in ELSA, 420 with 4-year treatment were chosen, videodensitometric analysis of their ultrasound carotid scan was performed and the maximum wall lesion (Tmax) was classified as lipidic, fibrolipidic and fibrotic by means of software previously validated against histology. Of the 420 patients, 244 had scans suitable for videodensitometry. RESULTS: Excellent reproducibility of videodensitometry analysis was found using the Bland-Altman and other methods. At baseline, ELSA hypertensive patients had predominantly fibrolipidic walls (70%), with an echoreflectivity indicating a mean collagen content of 25%. After 4 years of antihypertensive treatment, little change in the frequency distribution of carotid lesions (fibrolipidic 73%) was found, with no significant differences between patients randomized to Lacidipine or atenolol. CONCLUSIONS: Our study provides previously unavailable information that carotid wall composition changes to an extremely small extent during 4-year effective blood pressure lowering. With Lacidipine, stable composition is associated with a lower IMT progression than with atenolol.
-
quality control of b mode ultrasonic measurement of carotid artery intima media thickness the european Lacidipine study on atherosclerosis
Journal of Hypertension, 2005Co-Authors: Rong Tang, Giuseppe Mancia, M Hennig, Gene M Bond, Regina Hollweck, Alberto ZanchettiAbstract:BackgroundThe European Lacidipine Study of Atherosclerosis (ELSA) was a prospective, randomized, double-blind, multinational interventional trial using B-mode ultrasound measurement of carotid intima–media thickness (IMT) in 2259 hypertensive individuals. ELSA showed that 4-year treatment with the c
-
cardiac structural and functional changes during long term antihypertensive treatment with Lacidipine and atenolol in the european Lacidipine study on atherosclerosis elsa
Journal of Hypertension, 2005Co-Authors: Enrico Agabitirosei, Bruno Trimarco, Rong Tang, Gianfranco Parati, M Hennig, J L Reid, Maria Lorenza Muiesan, Antonio Salvetti, Hansjorg Baurecht, Giuseppe ManciaAbstract:ObjectivesTo evaluate and correlate the effects of long-term antihypertensive treatment on left ventricular (LV) mass and carotid structural changes in a large group of essential hypertensive patients, participating in the European Lacidipine Study on Atherosclerosis (ELSA).DesignIn four (Brescia, G
-
absolute and relative changes in carotid intima media thickness and atherosclerotic plaques during long term antihypertensive treatment further results of the european Lacidipine study on atherosclerosis elsa
Journal of Hypertension, 2004Co-Authors: Alberto Zanchetti, Rong Tang, Giuseppe Mancia, M Hennig, Gene M Bond, Regina Hollweck, Lothar Eckes, Dino MicheliAbstract:BACKGROUND: In ELSA, a randomized, double-blind trial in 2334 hypertensives, 4-year antihypertensive treatment with Lacidipine slowed down progression of carotid atherosclerosis significantly more than atenolol treatment. To avoid bias, the primary outcome was measured blindly at study-end on a randomized sequence of scans, but measurements were limited to the four far walls of common carotids and bifurcations (CBMmax) and to one of each couple of duplicate scans recorded yearly. OBJECTIVES AND METHODS: Secondary outcomes included measurements made on all duplicate scans of both near and far walls, not only of common carotids and bifurcations, but also of internal carotids (12 walls). These measurements were made blindly during the 4-year study, shortly after recording. To avoid possible readers' drift or bias, 250 duplicate baseline scans were re-read at yearly intervals (longitudinal on-line quality control) and a correction factor calculated. RESULTS: Measurements during the 4-year study showed a trend toward decreased values, with the Lacidipine effect significantly greater than the atenolol one. A trend toward lower values was also observed in the longitudinal quality control of baseline scans. After applying a correction factor calculated from this longitudinal control, all measurements no longer decreased with time, but significantly increased, with progression being significantly smaller in Lacidipine than in atenolol patients. Corrected values were quite similar to those calculated on measurements carried out at study-end. CONCLUSION: The relative benefit of Lacidipine over atenolol could be measured precisely by reading scans either during the study or at study-end. However, absolute treatment-related changes (progression versus regression) cannot safely be judged by readings made during along-term study, unless a longitudinal quality control of readings is performed.
