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S Zamboni

Publications and source records attributed to S Zamboni.

At least 55 records · Page 3Linked to original sources

Psychological effects of hypertension labelling during a community survey. A two-year follow-up.

The possibility that subjects examined during a population screening programme may develop psychological disturbances as a consequence of being labelled as hypertensives has been investigated. The Symptom Rating Test (SRT) for the assessment of neurotic symptoms was completed by 210 screenees. Aware hypertensives were excluded from the study. It was subsequently found that 81 subjects had raised BP (systolic greater than or equal to 160 or diastolic greater than or equal to 95 mmHg; group 1), and 129 subjects were 'normotensive' (group 2). The total SRT score was significantly higher in group 2 than in group 1. After screening, all subjects were returned to their GPs, and 82% of them were re-examined 2 years later. SRT scores were significantly lower than the initial ones in both groups. At re-examination 35% of 'hypertensives', were found to have 'normal' BP values. The SRT scores of these falsely-labelled subjects were similar to those of the subjects found still to be hypertensive. These findings suggest that subjects with raised BP at screening have lower neuroticism scores than normotensives. More importantly still, hypertension labelling, whether 'true' or 'false', does not have any negative long-term psychological consequences.

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[Using a structural alternative (non-medical) in the "capillary" screening of arterial hypertension in a community. Means of intervention and evaluation in preventive cardiology].

A "Community Control Programme of Hypertension" has been implemented in a Northern Italian population as part of an international co-operative pilot project promoted by World Health Organization. The programme was planned to last five years. Three years after the start we performed what we called a "capillary" screening in the community involved in the project. In fact a team of physicians and medical students moved about in the villages of the area where extemporary ambulances were set up with the aim of identifying new hypertensives, evaluating the state of the control of hypertension as compared with the situation at the outset of the study and, more generally, as a means of strengthening the ties between the project organization and the community. In doing so we also evaluated the feasibility of an alternative approach, based upon the cooperation with an organization outside the health service system, namely the Catholic Church, to achieve the set aims in a very religious population as ours. The parish priests of the villages did eagerly cooperate with our work both in the form of propaganda and in making available the parish buildings in which the ambulances were set up. We examined 1306 subjects (47.3% males), of whom 39.5% were hypertensives ("casual" blood pressure at or above 160 or 95 or treated). Of all the hypertensives, 28.6% were new hypertensives ("unaware"), 45.3% were being treated and 13.7% had a blood pressure lower than 160/95 mmHg while under treatment "effectively treated"); 16%, though, had blood pressure values at or above 200 or 120 mmHg. The state of control of hypertension was better in women and with increasing age. As compared with the findings at the outset of the study, 27,6% more "aware", 23.9% more treated and 9.6% more "effectively treated" hypertensives were found. Using the support of an alternative (non-medical) organization in a programme of preventive medicine in the community has proved to be, in our experience, a feasible, valuable and very cheap approach.

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Treatment of hypertension: the community approach.

A long term project to improve the treatment of hypertension in a community is described. The results to date indicate that intervention can improve the proportion of hypertensives treated and the adequacy of such treatment. The final analysis of the project will include a comparison with a reference community and assessment of the impact of intervention on cardiovascular mortality.

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Spontaneous changes in very high blood pressure after admission to the hospital and their relation to target organ involvement.

Spontaneous changes in blood pressure (BP) over a week after admission to the hospital were investigated in 127 patients admitted with diastolic BP at or above 120 mm Hg. Average BP decreased from 205/129 at admission to 174/110 on the 8th day. Regression analysis showed highly significant negative slopes which were related to initial levels but not to the presence or type of target organ involvement. After 1 week, 66% of the subjects attained a diastolic BP lower than 120 mm Hg. More remarkably, 36% attained values lower than 105 mm Hg: 33% of these had BP values less than 95 mm Hg. While not ruling out the importance of very high BP readings, it is concluded that they do not necessarily represent any pattern of either fixed or severe hypertension nor imply a need for urgent antihypertensive treatment.

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Isolated systolic hypertension in the community. Data from a population survey and hypertension register in Northern Italy.

In the Region Veneto, north-eastern Italy, a survey of three random samples of population aged 20-64 has been made during the initial phase of the international cooperative pilot project called "Community Control Programme of Hypertension", promoted by World Health Organization. 15,187 subjects were examined (47.2% males). The prevalence of "isolated" systolic hypertension (ISH: "casual" blood pressure at or above 160 for systolic readings and below 95 for diastolic) was 6.2%, that of "isolated" diastolic (IDH) 9% and that of "simultaneous" systolic diastolic hypertension (SDH) 15.5%. ISH had an awareness rate of 29.4% and a treatment rate of 10.6%, which is less than for SDH but more than IDH. Analysis of the Hypertension Register set up in one of the three areas showed no important differences in heart rate, Body Mass Index, serum sodium or potassium, B.U.N. and total cholesterol between the different forms of hypertension. The assessment of coronary risk by means of Multiple Logistic Function yielded similar figures for ISH and SDH in males, higher figure for SDH in females. Electrocardiographic changes of left ventricular hypertrophy and of ischaemia were more frequent among subjects with ISH than those with SDH and IDH. It is concluded that ISH is present in a substantial proportion of the population and carries with it no less risk of cardiovascular complications than the other forms of hypertension.

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[Prevalence of arterial hypertension in the community. Experience of the province of Veneto].

In the context of a W.H.O. Community Control Program of Hypertension, 15.187 subjects aged 20-64 years were examined in three distinct areas of the Veneto region: Camposampiero (Padua), Valdagno (Vicenza) and Mirano (Venice). The prevalence of hypertension was evaluated according to W.H.O. criteria. The prevalence of the three forms of hypertension "systolic only", "diastolic only" and "systo-diastolic together", the difference according to sex and the correlation with age were also calculated. In particular the correlation with age was evaluated in four arbitrary classes of relative weight. The mean prevalence of hypertension into the three samples was 30.7%. The most common form was "systo-diastolic together" (15.5%). The prevalence of hypertension was higher in males and increased with age in both sexes. A positive association between the prevalence of hypertension and the age was observed in all the three classes of relative weight. This association was more noticeable in the classes of a higher relative weight. The association between weight and prevalence of hypertension is discussed in view of a primary prevention of hypertension. The results obtained clearly show the extent of the effort involved in order to control hypertension in the community.

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[Screening of hypertension in a community. Data from the "Camposampiero Project" (author's transl)].

During the initial phase of the international "Community Control Programme of Hypertension" sponsored by W.H.O., and carried out in Italy by the Clinica Medica II of the University of Padua, a random sample of 5852 subjects was screened (11% of the whole population). The response rate was of 75.3%; the prevalence rate of hypertension (160 or 95), based on casual blood pressure readings, was 29.5%. Measures of the control of hypertension and other relevant results are: a 35.6% of all hypertensives were aware of their condition, and of these 41% were under treatment. Effective treatment of hypertension was seen in one 12.3% of all treated hypertensives (values lower than 16/95), while 14.2% of all hypertensives had values at or above 200 (systolic) or 120 (diastolic). 98.2% of all hypertensives were not under effective control. As a whole, control of hypertension was better in women and in elderly patients.

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Blood pressure and its spontaneous variations in a northern Italian population.

1. Blood pressure has been measured in a random sample of 5852 subjects (both sexes, 20-64 years old). The prevalence of hypertension (blood pressure greater than or equal to 160 mmHg and/or 95 mmHg; 150 mmHg and/or 90 mmHg under the age of 30 years) was 29-5%. 2. In a cohort of 972 detected hypertensive subjects, longitudinal changes (2 and 5 months after the initial examination) were evaluated. The phenomenon of regression toward the mean value was evident. 3. The implications of the variability of blood pressure in a community control programme of hypertension are discussed.

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Diabetes and coronary risk factors, relative risk for single factors and aggregation of more factors in a general population sample from northern Italy.

In the course of a general population survey in Mirano (Venice), Northern Italy, a random sample of 1,903 subjects (50.1% men) aged 20-59 was examined. Fifty-five were diabetic (fasting plasma glucose greater than or equal to 140 mg/dl or diagnosed by a physician) and 1,670 non-diabetic subjects (fasting plasma glucose below 110 mg/dl). In this paper an assessment was made on the more frequent occurrence of coronary risk factors (serum cholesterol and triglycerides, body mass index (BMI), systolic blood pressure, cigarette smoking) and, in particular, of their aggregation in diabetic patients as compared to non-diabetic controls. The occurrence of any one of the coronary risk factors studied was more frequent in diabetic subjects and significantly so for triglyceridemia in both sexes and for systolic blood pressure and BMI in men. The aggregation of two or more risk factors was also more frequent in diabetic subjects than controls. Finally, the combined score of coronary risk as calculated by multiple logistic function showed higher values for diabetic subjects. These results confirm the need for a systematic search for coronary risk factors in diabetic subjects in order to prevent cardiovascular complications.

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