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Biomedical subjects

A Menotti

Publications and source records attributed to A Menotti.

At least 19 recordsLinked to original sources
PubMed1995

Twenty-five year mortality from coronary heart disease and its prediction in two Croatian cohorts of middle-aged men.

Two cohorts of men aged 40-59 in geographically defined areas of Croatia, former Yugoslavia, were enrolled in 1958 and cardiovascular risk factors were measured. The cohort of Dalmatia, on the Adriatic coast, was made up of 671 men (participation rate 98%), that of Slavonia, in the inland plain, of 696 men (participation rate 91%). Similar examinations were repeated 5 and 10 years after the entry one. A complete follow-up for vital status and causes of death was run for 25 years. Death rates in 25 years from coronary heart disease (CHD) were 90 per 1000 in Dalmatia and 148 per 1000 in Slavonia where also all other major causes of death and all-cause mortality rates were higher (642 vs 465 per 1000 in 25 years). Univariate and multivariate analysis relating ten risk factors to CHD mortality, showed that age and systolic blood pressure were significant predictors in Dalmatia; age, subscapular skinfold and body mass index (inverse) in Slavonia; and age, systolic blood pressure and subscapular skinfold in a multivariate model with lumped cohorts, where dummy variables identifying cohorts indicated a large unexplained extra-risk in Slavonia. In the pooled analysis cigarette smoking and serum cholesterol carried non significant coefficients. Blood pressure change in the first 10 years of follow-up added predictivity to a model exploring the delayed CHD morality occurring between year 10 and 25 of follow-up. Among the base-line measurements only serum cholesterol was significantly different between the two groups (188 mg/dl in Dalmatia and 199 mg/dl in Slavonia).(ABSTRACT TRUNCATED AT 250 WORDS)

Cohort Studies↗
PubMed1995

Normal behaviour of circulatory parameters during exercise. Reference values for heart rate and systemic blood pressure. The ECCIS Project data. Epidemiologia e Clinica della Cardiopatia Ischemica Silente.

The study of simultaneous variations in heart rate (HR) and systemic blood pressure is of great interest in ergometric practice complementing the analysis of the ST segment by ECG. This paper examines data proceeding from 500 consecutive, normal, exercise stress tests with the aim of offering reference values on the step-by-step behaviour of HR, systolic and diastolic blood pressure (SBP, DBP) during exercise in a normal population. The sample comes from a large epidemiological study (ECCIS Project) conducted on 4842 healthy, working men, aged 40-59, which proposes to identify, by a 3 stage procedure, subjects with totally asymptomatic coronary artery disease (type I silent ischemia). A further aim of our paper is to examine the influence of some physiological variables (age, height, weight, body mass index, resting HR, SBP and DBP) on the response to effort of HR, SBP and DBP; reciprocal HR/SBP adjustment during exercise; maximal attained workload and recovery time. Due to a preliminary observation that the rate of step-by-step increase in HR and SBP is inversely related to total duration, the population was split into 4 groups according to exercise tolerance (defined by maximal attained workload) to elaborate reference values. Furthermore our data demonstrate that: 1) SBP increases more rapidly with respect to HR for older and heavier subjects; 2) Exercise tolerance is inversely related to age, baseline HR and SBP, and directly related to weight and height; 3) return to baseline conditions, during recovery, is quicker for subjects with better exercise tolerance and lower baseline HR, SBP and weight.

Adult↗
PubMed1992

Association of selected social, environmental and constitutional factors to blood lead levels in men aged 55-75 years.

Blood lead (B-Pb) levels were determined in 1802 out of 1856 non-occupationally exposed men aged 55-75 years living in the Rome area who participated, between 1989 and 1990, in an epidemiological survey for coronary heart disease (New Risk Factors Project). The median B-Pb level was 113 micrograms/l (10th-90th centiles: 74-180 micrograms/l) and only 0.7 per cent (n = 14) of the subjects had B-Pb values higher than 300 micrograms/l. B-Pb levels were significantly and positively associated to alcohol consumption. Moderate and heavy drinkers had median B-Pb level of 143 micrograms/l (10th-90th centiles: 92-233) and 165 micrograms/l (10th-90th centiles: 102-285) respectively, whereas non-drinkers had a median B-Pb level of 96 micrograms/l (10th-90th centiles: 66-143). The influence of smoking habits was less relevant. Subjects who never smoked and subjects smoking more than 20 cigarettes daily had median B-Pb levels of 103 and 133 micrograms/l, respectively. Individuals classified as habitual car-drivers had slightly higher Pb levels than non-drivers. Subjects classified as manual workers had higher B-Pb levels in comparison with non-manual workers and retired subjects. B-Pb levels were directly related to HDL-cholesterol (HDL-C, r = 0.2252) and gamma-glutamyltransferase (gamma-GT, r = 0.2207) serum levels. The alleged alcohol consumption was more related to B-Pb level (r = 0.3848) than to serum level of HDL-C (r = 0.2474) or gamma-GT (r = 0.2469). A significant correlation (r = 0.2409) also existed between B-Pb and blood cadmium levels (B-Cd). Subjects with a low Gaensler ratio, an index of respiratory function, had higher B-Pb levels. In multiple regression analyses alcohol intake was the most important predictor of B-Pb level, explaining more (14.27%) of the total variance than did B-Cd (4.98%), HDL-C (1.89%), driving habits (1.46%), gamma-GT (1.09%), skinfold thickness (0.96%), and Gaensler index (0.38%). The risk ratio of having B-Pb level higher than 180 micrograms/l (90th centile of B-Pb distribution in our subjects) was 5.3 (95% CI: 2.7-10.4) for drinkers versus non-drinkers and 1.9 (95% CI: 1.2-3.1) for current smokers versus subjects who had never smoked. B-Pb was, at least in our subjects, a more specific and sensitive objective index of alcohol consumption than gamma-GT and HDL-C.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1992

The prediction of coronary heart disease in different population samples.

Two population samples of men aged 46-65 years were examined for the measurement of some cardiovascular risk factors and followed up for 6.5 years. The two groups were: 1) 3338 men belonging to occupational groups examined in Rome (ROG) in 1979-81 and 2) 1543 men belonging to two demographic samples of rural areas located in northern and central Italy (IRA) examined in 1965. In men free from previous myocardial infarction the rate of fatal coronary events was 18.0 in the ROG group and 17.5 per 1000 in the IRA group. Five established risk factors (age, systolic blood pressure, serum cholesterol, cigarette consumption and body mass index) were used in a multivariate model for predicting coronary deaths. The coefficients of the multiple logistic function were similar in the two populations group. However, when the IRA coefficients were applied to the ROG factors, they predicted 43 events instead of 58 (under-estimation of 26%; p < 0.05), whereas the ROG coefficients predicted 31 events instead of 26 in the IRA sample (over-estimation of 19%; p = n.s.). A model which included the pool of the two populations and a dummy-variable for the identification of each of them, suggested that being a member of the ROG group is accompained, everything else being equal, by an extra risk of 26%.

Coronary Disease↗
PubMed1992

Predicting all causes mortality in the general population as a function of blood pressure and smoking habits measured in population samples: a pilot study. Research Group ATS-RF2.

Nine population samples of mean aged 40-59, for a total of 1777 individuals drawn from nine health units, were examined in 1978-79 for the measurement of some risk factors possibly related to total mortality. The analysis evaluated the possible relationship between blood pressure levels and smoking habits measured in the population samples and the official death rates covering the period 1980-82 in the health units from which the samples were drawn. The analysis was conducted in a direct way but also by the help of a risk function linking blood pressure and smoking habits as obtained from another Italian population sample. The cograduation test between mean blood pressure in the nine areas and total mortality was 0.58 (linear correlation 0.57); the cograduation test was -0.70 for non-smokers, 0.62 for ex-smokers, 0.50 for present smokers (linear correlation of -0.27, 0.29 and 0.14 respectively). The death rates estimated by the risk function (Cox model) tended to overestimate the death rates from 5 to 64% (average 36.3%). The cograduation test between expected and observed death rates was 0.56 (linear correlation coefficient 0.66). Some limitations of this pilot study are largely explained by the small size of the sample and by the need to use a risk function provided by another population sample.

Adult↗
PubMed1992

Alcohol and mortality in the Italian rural cohorts of the Seven Countries Study.

The relation of alcohol consumption to mortality is examined using the data of the Italian rural cohorts of the Seven Countries Study, a prospective investigation of factors related to cardiovascular disease (CVD). The present analysis includes 1536 men aged 45-64, whose dietary habits and food consumption, including alcoholic beverages, were measured in 1965. Of them, 463 men died in a follow-up period of 15 years. The analysis shows a J-shaped relationship between alcohol consumption, expressed as percentage of total daily energy intake, and both overall mortality and cardiovascular mortality; this J-shaped relationship is evident even after adjusting for age, cigarette smoking and occupation. The inverse relationship for consumption of small quantities of alcohol, which is represented by the left side of the J-curve, is no longer significant when all men with previous cardiovascular manifestations are excluded from the analysis, yet it is never completely eliminated.

Alcohol Drinking↗
PubMed1992

Trends in coronary risk factors in Italy. Responsible Investigators of the RF2, OB43 and MICOL Research Groups.

Three large-scale epidemiological surveys covering some major coronary risk factors were conducted in Italy in population samples of men and women aged 30-59 years. The first survey was carried out in 1978-1979 (RF2 study; nine samples in eight regions; 2561 men and 2912 women); the second in 1983-1984 (OB43 study; nine samples in the same eight regions; 2267 men and 2398 women); and the third one in 1985-1987 (MICOL study; 18 samples in 10 regions; 14,411 men and 12,611 women). Time trends in mean age standardized risk factors levels showed slight but systematic decreases in blood pressure, cigarette smoking (only in men), and body mass index (only in women); whereas no substantial changes were observed in serum cholesterol levels. The combined multiple coronary risk estimated by a model produced in a previous study, showed a decline between 1978-1979 and 1983-1984 of 5.5% in men and 13.4% in women. These changes were compared with the official coronary death rates between 1984 and 1987 in the whole country and in the regions where the samples were located. The expected/observed ratio computed in different ways ranged from 0.54 to 0.88 for men and was over 1 for women. Changes in the levels of major risk factors and changes in coronary mortality seem biologically coherent at least in men.

Adult↗
PubMed1992

Prognostic role of flow cytometry in superficial bladder cancer.

Prognostic factors in superficial transitional cell carcinoma of the bladder were assessed with histopathological and flow cytometry analysis in a series of 61 patients operated transurethrally between 1988 and 1990. In particular, we evaluated the usefulness of flow cytometry in order to identify patients who require a more accurate clinical follow-up or a more aggressive therapy. A multivariate analysis was done in 61 cases, considering patient age and sex, stage, grade and number of lesions (unifocal or multifocal), post-TUR therapy (therapy or not), and DNA ploidy (diploid/aneuploid). DNA pattern and number of recurrences were determinant for selecting risk cases for progression.

Carcinoma, Transitional Cell↗
PubMed1992

Effect of propionyl-L-carnitine on experimental induced cardiomyopathy in rats.

The purpose of this study is to evaluate the ability of propionyl-L-carnitine, a carnitine derivative to prevent cardiac dysfunction induced by erucic acid and streptozotocin treatment in rats. Rats were fed for 10 days with normal or 10% erucic-acid-enriched diet with or without propionyl-L-carnitine injected intraperitoneally (1 mM/kg daily). Another group of rats was injected for 8-10 weeks with streptozotocin (65 mg/kg) with or without propionyl-L-carnitine intraperitoneally injected at the same dosage. Thereafter the animals were sacrificed and the hearts isolated and perfused aerobically. When isovolumic measurements of left ventricular function were applied, there was no difference in mechanical activity between treated and control hearts. On the contrary, when pressure-volume curves were determined in the paced hearts, the pressure developed by hearts from erucic acid-treated or diabetic rats was reduced. Propionyl-L-carnitine always produced positive inotropy. This was true for the control-saline treated rats that received the drug, as well as for the hearts isolated from cardiomyopathic animals. These data suggest that propionyl-L-carnitine, when given chronically, is able to overcome myocardial dysfunction caused either from erucic acid treatment or diabetes.

Animals↗
PubMed1992

[Prevalence of some cardiovascular risk factors in a sample of the aged population].

The distribution of some cardiovascular risk factors in a cohort of elderly population is reported. The study population consisted of 427 males aged 71-91, examined in 1991 and belonging to the Italian rural section of the Seven Countries Study on Cardiovascular Diseases. Systolic blood pressure shows an increasing trend with age, with mean levels greater than 160 mmHg in each quinquennium, while the prevalence of hypertension ranges between 60 and 75%. Other risk factors considered such as serum cholesterol, triglycerides, weight, height and smoking habit show decreasing levels with ageing. This trend is clear also for fasting glucose from the age group 76-80.

Age Factors↗
PubMed1992

Physical activity, physical fitness and mortality in a sample of middle aged men followed-up 25 years.

One-thousand-seven-hundred-twelve men aged 40-59, representing two demographic samples of rural areas in Northern and Central Italy, were examined in 1960 and then followed-up for 25 years. Total mortality and coronary mortality were related to the entry measurements of physical activity at work, estimated in three levels by a simple questionnaire and to four possible indicators of physical fitness, ie resting heart rate, the circumference of the right arm cleaned from the contribution of skin and subcutaneous fat, vital capacity and forced expiratory volume in 3/4 sec, the latter two adjusted by height. The four indicators of fitness and the score of physical activity were somewhat related each other in the expected direction. Both all causes and coronary mortality were indirectly related to the score of physical activity. The relative risk for age adjusted rates of sedentary vs heavy workers was 1.23 for all causes of death, and 1.72 for coronary deaths. Direct univariate relationships were found between resting heart rate and mortality (for both all causes and coronary deaths) whereas indirect relationships were found for arm circumference and the two indicators of respiratory function. The age adjusted relative risks between the upper and the bottom quartile of the distribution were, for all causes of death, 0.75 for vital capacity, 0.68 for forced expiratory volume 1.32 for heart rate, and 0.84 for arm circumference. The correspondent relative risks for coronary deaths were 0.71, 0.65, 1.23 and 1.02 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Demography and public health: the complexity of interventions in women].

Some considerations on age distribution of the Italian population, in particular women, are reported; after 40, they are the majority. Problems of ageing and their quality of life constitute a large interest of future research. Cardiovascular diseases are more frequent with ageing for both, males and females; the differences, found in middle age males and females, suggest the possible protective role of feminine sexual hormones. Trials, which include hormone replacement therapy in women after menopause, are conducted for the possible influence on cardiovascular diseases, on osteoporosis and on thrombogenic factors.

Adult↗
PubMed1992

[Epidemiology and risk factors for cardiovascular diseases in women].

Some Italian data on frequencies of cardiovascular diseases in women are reported. Recent data, published by ISTAT (1987), record that diseases of the circulatory system represent 50% of all deaths and cardiovascular events happen over 75. Mortality rates for cardiovascular diseases, aged 0-74, are lower than in men of the same age group. Coronary and cerebrovascular events recorded by the MONICA register in the Area Latina are lower in women than in men with a ratio of 3:1 and 3:2 respectively. Fatality rate is higher in women than in men. Incidence rate of definite coronary events assessed by population samples is 2.2 per 1000 per year in women aged 40-69. On cardiovascular risk factors few Italian data are published. Some data from American studies reported for women the prediction of risk factors, such as serum cholesterol, blood pressure, and smoking habit; an independent role is played by diabetes and obesity.

Cardiovascular Diseases↗
PubMed1992

Multivariate prediction of coronary deaths in a 10 year follow-up of an Italian occupational male cohort.

3395 men aged 46-65 belonging to occupational groups in Rome were examined in 1980 for the measurement of a number of potential coronary risk factors and of other personal characteristics. They represented the 76.5% of the enrolled roster. In 2853 men free from previous major coronary events and with all the measurements available, 98 died from CHD in the next 10 years. The multivariate analysis performed by the Cox model showed the significant predictive role of age, systolic blood pressure, non-HDL cholesterol, blood glucose and heart rate. The relative risk (for a distance of 2 standard deviations from the mean) was of 2.3, 2.1, 1.4, 1.7 and 1.4 respectively. Smoking habits, body mass index, xanthelasma, leisure physical activity, serum triglycerides, uric acid and a stress score did not contribute to the prediction of coronary deaths. HDL cholesterol produced a negative but not significant coefficient. As compared to the previously available Italian risk functions the role of non-HDL cholesterol and of blood glucose represents the most remarkable contribution.

Cohort Studies↗
PubMed1992

[Obesity and mortality. Italian epidemiologic data].

The relationship of indicators of obesity, such as the body mass index (BMI) and the skinfold thickness in some areas (SKIN) to all causes mortality have been analyzed in three italian epidemiological studies. They are the Seven Countries Study--italian areas conducted on 2480 men at entry and followed-up for 25 years; the Brisighella study conducted on 1123 men and 1100 women aged 30-69 and followed-up for 15 years; and the NFR study in Rome conducted on 3395 men aged 46-66 and followed-up of 6.5 years. The univariate analysis concerning the BMI for various age groups, the two sexes, and variable periods of follow-up has almost systematically showed a parabolic inverted J shaped relationship with minimal levels of risk for BMI values of 27-29 units. However this was not the case for the women group and for the oldest men where no clear relationship was found. The analysis concerning the SKIN provided similar but less clear-cut results. The multivariate analysis has confirmed the parabolic relationship of BMI to all causes mortality even in the presence of other 4-5 covariates. The left branch of risk is higher than the right one and its slope could be reduced, although not completely, by the exclusion of heavy smokers, of those who died within the first 5 years of follow-up, of those who were carriers of severe diseases at entry examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Short term changes in cardiovascular risk factors in the Di.S.Co. Intervention Project. Research Group of the DI.S.Co. Project.

The Di.S.Co. Project--Sezze District Community Control--is aimed at achieving in the general population the prevention of chronic diseases through community intervention. Two areas are enrolled, one for intervention (25,706 subjects) and one for reference (12,655 subjects). In 1983 the first survey was conducted on a sample of males and females aged 20-69, and some risk factors for cardiovascular diseases were measured. In 1986 a second screening was conducted on the same sample examined in 1983 and in a new one to evaluate the effect of community treatment during the three-year intervention. The main net differences obtained in the treatment area against controls (by the paired analysis), adjusted by the initial levels of the risk factors considered, were: in males body mass index: -1.3% and number of cigarettes smoked per day: -5.1%; in females systolic blood pressure: -2.1%, body mass index: -3.2% and number of cigarettes smoked per day: -34.4%. The theoretical probability of death from atherosclerotic cardiovascular diseases in 25 years was estimated by the multiple logistic function and in three years it increased by 1% in males, while for females it decreased by 6.5%.

Adult↗
PubMed1991

Serum selenium and precursors of cardiovascular risk factors in adolescents.

The aim of this study was to determine, in a population of Italian adolescents, the association of serum selenium levels with precursors of biochemical and anthropometric variables known as being among the major risk factors for cardiovascular diseases in the adult population. The following measurements were taken in a school sample of 627 adolescents (aged 12-13 years); serum selenium, total cholesterol, high density lipoprotein cholesterol, non-HDL cholesterol, height, weight, body mass index, systolic blood pressure and diastolic blood pressure. The serum selenium levels were slightly higher in males (83.1 +/- 10.1 micrograms/l) than in females (81.7 +/- 11.0 micrograms/l), but the difference was not statistically significant. Serum selenium was positively correlated with total cholesterol, diastolic blood pressure and HDL cholesterol in both sexes; moreover it was positively correlated with non-HDL cholesterol and negatively correlated with height in males only.

Adolescent↗