Biomedical subjects

Annachiara Nuzzo

Publications and source records attributed to Annachiara Nuzzo.

3 recordsLinked to original sources

PubMed2005

Endothelial-dependent vasodilation and incidence of type 2 diabetes in a population of healthy postmenopausal women.

OBJECTIVE: Both postmenopausal state and diabetes are associated with endothelial dysfunction and are well-known risk factors for atherosclerosis. However, the relationship of endothelium-dependent vasodilation and diabetes has never been prospectively evaluated. This study provided the opportunity to assess the association between endothelial vasodilation function and the incidence of diabetes in a cohort of apparently healthy postmenopausal women. RESEARCH DESIGN AND METHODS: We conducted a prospective cohort study that began in 1997 with 840 apparently healthy, nonobese, postmenopausal women, aged 53 +/- 6 years, initially with normal glucose tolerance at the oral glucose tolerance test. All participants were followed up for a mean period of 3.9 +/- 0.7 years (range 0.5-6.9). Endothelial function was measured as flow-mediated dilation (FMD) of the brachial artery, using high-resolution ultrasound. RESULTS: There were no significant differences in demographic, blood pressure, and biochemical profiles among each tertile group at baseline or at follow-up review. During follow-up, 102 women developed type 2 diabetes. The adjusted relative risk (RR) for women with FMD </=4.3 (lowest tertile) was 5.87 (95% CI 4.34-8.10) versus women with FMD >/=5.6 (highest tertile reference). Each 1-unit decrease of FMD was associated with a significant 32% (22-48%) increase in the multiple-adjusted RR of incident diabetes. CONCLUSIONS: These prospective data indicate a significant increase in the RR of diabetes with each unit decrease of FMD. This could suggest that an impaired endothelial function may play a fundamental role in diabetogenesis in postmenopausal women.

Blood Glucose↗

PubMed2004

Flow-mediated vasodilation and the risk of developing hypertension in healthy postmenopausal women.

OBJECTIVES: This study provided the opportunity to assess the relationship between endothelial vasomotor function and incidence of hypertension in a cohort of postmenopausal women. BACKGROUND: Both menopause and hypertension are associated with endothelial dysfunction and are well-known risk factors for atherosclerotic-related disease. METHODS: We conducted a prospective cohort study that began in 1996 on 952 apparently healthy postmenopausal women, age 53 +/- 5 years (range 44 to 60 years), with initially normal levels of blood pressure and no history of hypertension. All participants were followed up for a mean period of 3.6 +/- 0.7 years (range 0.5 to 6.9 years). Endothelial function was measured as flow-mediated dilation of the brachial artery using high-resolution ultrasound. RESULTS: During follow-up 112 women developed hypertension. The adjusted relative risk for women with flow-mediated dilation of 3.5 or less (lowest quartile) was 5.77 (95% confidence interval 4.34 to 8.10) versus women with flow-mediated dilation of 5.5 or greater (highest quartile, referent). Each one-unit decrease of flow-mediated dilation was associated with a significant 16% (95% confidence interval 12% to 33%) increase in the multiple-adjusted relative risk of incident hypertension. CONCLUSIONS: These prospective data indicate a significant increase in the relative risk of hypertension with each unit decrease of flow-mediated dilation that is independent of age and baseline systolic and diastolic pressure values. This could suggest that an impaired endothelial vasomotor function precedes and predicts the future development of hypertension in postmenopausal women.

Adult↗

PubMed2003

Gender differences in diagnostic procedures.

This review examines the contribution of the literature to the controversial issue of diagnostic procedures in women affected by coronary artery disease (CAD), on which a large number of papers have been published. It has been reported that cerebro- and cardiovascular diseases represent the first cause of death in the New as well as in the Old World, Italy included. Some studies are conditioned by bias; one of these is the Framingham study, in which angina was reported and defined only clinically and for a relatively young age range, as a benign condition in women. Angiographic studies, such as the CASS, considered a super elected group of women referred to the hemodynamic laboratory for chest pain, which in the female gender often has atypical characteristics. In our opinion, it is mandatory to take into account: 1) what chest pain really means in women; 2) the fact that there are gender differences: women have a different biological and hormonal status, lifestyle, and perception of the disease; 3) that there is a different approach of the physicians to a woman with possible or suspected CAD. We suggest, therefore, a more peculiar and individualized diagnostic approach to women suspected as having CAD. This approach should also take the pre-test probability of disease into consideration. The first investigational step we recommend is the exercise ECG test; should this be unfeasible or not interpretable, an imaging and/or pharmacological stress test is advisable. In case of positive first test results, coronary angiography should be performed.

Aged↗