Haemorheological components in the pre-geriatric and geriatric age range in a randomly selected Western Sicily population sample (Casteldaccia study)

{Received 24.8.1992; accepted 7.12.1992} On a randomly selected western Sicily population sample (Casteldac­ cia Study: 600 subjects; 300 males and 300 females) of an age range from 40 to 79 years, were determined: Haematocrit (Htc) , blood vi­ scosity, plasma viscosity, filterability of whole blood and fibrinogen. Par­ ticipation was 97%, being 582 subjects (M = 287, F = 295). All the parameters measured showed a progressive increase with age and si­ gnificant differences were found between male and female subjects: Htc and blood viscosity were higher in male subjects (p < 0.01), while plasma viscosity, whole blood filterability and fibrinogen were higher in female subjects (p < 0.05). In …

Non lipid, dose-dependent effects of pravastatin treatment on hemostatic system and inflammatory response

Objectives: The aim of the present study was to evaluate the effects of pravastatin treatment on lipid, inflammation, and coagulation parameters in patients suffering from myocardial infarction with or without carotid atherosclerotic lesions (groups 1 and 2, respectively). Methods: In the first phase of the study, a cross-sectional comparison of lipid, inflammation, and coagulation parameters was performed between the patients and the control group (group 3). Highly significant differences in these parameters were observed, especially in group 1. In the second phase of the study, we assessed the effects of a persistent reduction in cholesterol synthesis induced by increasing doses of pravas…

Improvement of fibrinolysis and plasma lipoprotein levels induced by gemfibrozil in hypertriglyceridemia.

A randomized double-blind study was carried out with gemfibrozil (600 mg b.i.d.) vs placebo in 20 patients (twelve males and eight females, age 52 +/- 3 years, BMI 24.2 +/- 0.4) suffering from primary hypertriglyceridemia (Fredrickson's type IV). Each group was treated for a 12 week period with gemfibrozil (n = 10) or placebo (n = 10) patients) in a double-blind fashion. Total cholesterol, HDL-cholesterol (HDL-C) and its subfractions (HDL2-C and HDL3-C), blood glucose, Apolipoproteins A1 and B, fibrinogen, plasminogen, factor VII, t-PA:Ag and PAI activity pre- and post-venous occlusion (VO) were determined. In the gemfibrozil-treated group a significant decrease of total cholesterol and tri…

Hemostatic function in young subjects with central obesity: relationship with left ventricular function.

This study was designed to evaluate coagulation and fibrinolysis activity and their relationship with left ventricular function in young obese subjects with central fat distribution. We assessed coagulation and fibrinolysis activity by evaluation of factor VII activity, fibrinogen and plasminogen, plasminogen activator inhibitor (PAI), and tissue plasminogen activator antigen basally (tPA1) and after venous occlusion (tPA2). These measures were evaluated in young (< 40 years) obese subjects with central fat distribution (n = 19) and in comparable lean subjects (n = 20). Blood glucose, triglycerides, total and high-density lipoprotein (HDL) cholesterol, apolipoprotein (apo) A1 and apo B, fas…

Sulfinpyrazone and platelet function in hypertensive patients

Elevated plasma total homocysteine in centenarians

Homocysteine (Hcy) is a sulfur-containing metabolite of methionine and is an emerging independent risk factor for atherosclerosis. Previous studies have shown that age, gender, renal function and folic acid intake are the main factors influencing total plasma Hcy levels in humans. A unique approach to the science of human longevity is the natural model of centenarians. The objective of this study was to verify whether the previously determined risk factors for atherosclerosis and atherosclerosis-related diseases change with age and, finally, to establish the vitamin nutritional status role. We studied 54 centenarians (14 males and 40 females) aged between 100-107 years (mean age 102.6+/-1.8…

Indium-111 Oxine Platelets Survival In Patients Suffering Of Cardiac And Cerebral Arteriosclerosis

Cross-over study on effects of Mediterranean diet in two randomly selected population samples

Abstract Two randomly selected population samples in Western Sicily, one rural (n = 40) and one urban (n = 40), were studied to evaluate the impact of dietary intervention on lipid, coagulative and fibrinolytic parameters. The two groups received the diets in a cross-over design with the following sequences: (a) baseline period; (b) 8-week dietary intervention period; (c) 8-week return to the original diet. During (a) and (c) all subjects consumed their usual diet. During the dietary intervention period (b), the rural sample consumed the urban sample's diet, while the urban sample consumed the rural sample's diet (the so-called “Mediterranean diet”). At baseline, after 8 weeks' dietary inte…

Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE project

Effect of moderate Sicilian red wines comsuption on inflammatory biomarkers of atherosclerosis

Increased thrombin generation and complement activation in patients with type IIA hyperlipoproteinemia: effects of simvastatin treatment

Abstract The aim of this study was to demonstrate the existence of increased thrombin generation and complement activation in patients with type IIa primary hyperlipoproteinemia, but no signs of atherosclerotic vascular disease and to assess the effects of simvastatin treatment in these patients. We studied 40 patients with type IIa primary hyperlipoproteinemia and 40 healthy subjects matched for sex, age, body mass index, and smoking status. The study was divided into two phases. In the first phase, a cross-sectional comparison of lipid and hemostatic patterns was performed between patients and controls. In the second phase, we assessed the effect of a persistent reduction in cholesterol s…

Different effects of losartan and delapril on plasma PAI-1 levels in patients with mild to moderate hypertension

ACE probably influences the fibrinolytic system at acentral point by converting angiotensin I to angiotensin II,which increases PAI-1 activity. This effect appears to bemediated via the AT1-receptor in humans. The RAAS mayalso contribute to a reduction in t-PA production by degra-dation of bradykinin, since the latter increases the release ofprostacyclin, nitric oxide, and t-PA from endothelial cells.Accordingly, ACE inhibitors not only influence the fibrino-lytic system by a reduction of PAI-1 activity but also byincreasing t-PA activity [1–3]. However, few studies haveanalysed the effects of AT1-R antagonists on t-PA and PAI-1plasma levels and the in vivo effects of AT1-R antagonistson th…

Inhibition of thromboxane biosynthesis by triflusal in type 2 diabetes mellitus.

Abstract Triflusal is an antiplatelet drug related to aspirin, with different pharmacological properties and a lower haemorrhagic risk. We aimed at comparing their effects on platelet and endothelial activation in type 2 diabetes mellitus (T2DM). In a randomized, double-blind, parallel group study, we compared the effects of three daily regimens (300, 600, and 900mg) of triflusal, and aspirin (100mg/day) on urinary 11-dehydro-thromboxane (TX)B 2 , index of in vivo platelet activation, ex vivo platelet function using the analyzer PFA-100, plasma von Willebrand factor (vWF), P-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and serum nitrite a…

Platelet Activity and Blood Lipid Changes in Diabetes Mellitus

An altered platelet function can often be found in diabetes mellitus (2, 3, 4, 10, 13, 16, 17, 23, 24). Several studies have pointed towards an increased sensitivity of platelets to ADP induced aggregation (3, 6, 23) in diabetic patients; this phenomenon can also be found in diabetics without apparent vasculopathy and in subjects with altered glucose tolerance (3, 23).

Antica saggezza contadina e realtà moderna: il vino rosso ed i suoi benefici effetti sulla salute

Effects of heparin treatment on hemostatic abnormalities in obese non-insulin-dependent diabetic patients.

This study was conducted to identify the mechanisms responsible for coagulative and fibrinolytic alterations and to study the effects of a short-term treatment with low-dose heparin on hemostatic abnormalities in obese non-insulin-dependent diabetes mellitus (NIDDM) patients. Four groups of age- and sex-matched patients were studied: (1) lean nondiabetic subjects (n = 30) with a body mass index (BMI) less than 25 kg/m2 (lean control subjects), (2) obese nondiabetic subjects (n = 30) with a BMI greater than 30 kg/m2 (obese control subjects), (3) lean NIDDM patients (n = 30), and (4) obese NIDDM patients (n = 30). All subjects were tested on the following parameters: fibrinogen, factor VII, p…

Relationship between body fat distribution and blood disorders in patients with visceral obesity with and without diabetes mellitus

Effects of moderate consumption of sicilian red wines on some cardiovascular risk factors

Effetto di due vini rossi siciliani su alcuni fattori di rischio cardiovascolare

Background. The aim of this study was to evaluate whether Sicilian red wine consumption is associated with a lower cardiovascular risk. Methods. Forty-eight subjects of both sexes (age range 35-65 years) nondrinkers or rarely drinkers of moderate red wine intake were selected. Subjects were divided into two groups (group A and group B), assigned to receive with a crossover design 250 ml/die (during the meals) of one of two types of Sicilian red wines (Nero d’Avola and Etna Torrepalino respectively). At all visits (-15 days, basal, +4 and +8 weeks) the following parameters were measured: blood glucose, total cholesterol and triglycerides (by enzyme kit methods, Boehringer Mannheim, Milan, It…

Immunoinflammatory activation during the acute phase of lacunar and non-lacunar ischemic stroke: Association with time of onset and diabetic state

Several studies have stressed the involvement of inflammation in the pathophysiology of acute brain ischemia, but the role of immunoinflammatory activation in diabetic stroke patients has not yet been fully evaluated. The aim of our study was to evaluate immunoinflammatory activation of acute phase of stroke in relation to time of symptoms onset, diabetic state and diagnostic subtype. We enrolled 60 patients (32 diabetics; 28 non- diabetics) with acute ischemic stroke and 123 subjects without acute ischemic stroke, and measured levels of IL-1β, TNF-α, IL-6, IL-10, E-selectin, P-selectin, sICAM-1, sVCAM-1, VWF, 24–72 h and 7–10 days after stroke onset; TPA, PAI-1 plasma levels at 24–72h. Ou…

Effects of moderate Sicilian red wine consumption on inflammatory biomarkers of atherosclerosis.

Objective: The aim of the study is to evaluate the effect of moderate Sicilian red wine consumption on cardiovascular risk factors and, in particular, on some inflammatory biomarkers. Methods: A total of 48 subjects of both sexes who were nondrinkers or rare drinkers of moderate red wine were selected and randomly subdivided into two groups assigned to receive with a crossover design a Sicilian red wine (Nero d’Avola or Etna Torrepalino) during meals: Group A (n ¼ 24), in whom the diet was supplemented for 4 weeks with 250 ml/day of red wine, followed by 4 weeks when they returned to their usual wine intake; and Group B (n ¼ 24), in whom the usual wine intake was maintained for 4 weeks, fol…

Efficacia della associazione Atorvastatina e n-3 PUFA in pazienti affetti da dislipidemia combinata e ad alto rischio di eventi cardiovascolari

Changes induced by pravastatin treatment on hemostatic and fibrinolytic patterns in patients with type IIb hyperlipoproteinemia

Abstract A randomized, double-blind, parallel-group study of pravastatin versus placebo was carried out for 24 weeks in 20 patients with type IIb primary hyperlipoproteinemia. Total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, blood glucose, apolipoproteins (apo) A1 and B, and lipoprotein (a) (Lp[a]) levels were determined. A venous occlusion test was also performed in all patients. Pre- and postvenous occlusion tests were determined: tissue plasminogen activator antigen (t-PA[Ag]), plasminogen activator inhibitor (PAI) activity, factor VII, fibrinogen, plasminogen, and hematocrit. Compared with placebo, pravastatin signi…

Coagulation, fibrinolysis and haemorheology in premenopausal obese women with different body fat distribution

Recently waist/hip ratio (WHR), a marker of body fat distribution, has been described as a risk factor for cardiovascular disease (CVD). The aim of the present study was to evaluate the influence of body fat distribution on metabolic, haemostatic and haemorheological pattern in premenopausal obese women with different WHR. Fourty premenopausal obese women were subdivided into two groups, matched for age and body mass index (BMI): 20 women with abdominal obesity (WHR = 0.94 +/- 0.02) and 20 women with peripheral obesity (WHR = 0.77 +/- 0.03). Twenty nonobese women were recruited as control group. The abdominal obesity group had significantly higher blood glucose, triglycerides, total cholest…

Effects of sorbinicate and nicotinic acid on blood viscosity, red cell deformation and platelet function

Summary Nicotinic acid (NA) and a retard derivative, sorbinicate, were investigated for their effects on blood rheology and platelet function, after oral administration, in two groups of patients with lower limb atherosclerosis obliterans — the second group having diabetes also. Red cell deformation and blood plasma viscosity were studied in the nondiabetic group (single dose of NA, 100 mg, and sorbinicate, 400 mg); release of platelet malondialdehyde (MDA) (single dose of NA, 100 mg, and sorbinicate, 800 mg), and the platelet regeneration time (before and after sorbinicate 400 mg × 3/die for 7 days) were studied in the diabetic group. Both drugs induced a significant improvement in red cel…

Effects of Losartan and Delapril on the Fibrinolytic System in Patients with Mild to Moderate Hypertension

Background and objectives: Angiotensin-converting enzyme (ACE) probably influences the fibrinolytic system at a central point by converting angiotensin I to angiotensin II, which increases plasminogen activator inhibitor-1 (PAI-1) activity. This effect appears to be mediated in humans via the angiotensin II type 1 (AT1) receptor. The objective of this study was to evaluate, in patients with mild to moderate hypertension, the change in tissue plasminogen activator (t-PA) and PAI-1 plasma levels after treatment with an AT1-receptor blocker (losartan 50 mg/day) or an ACE inhibitor (delapril 60 mg/day). Patients and methods: 30 hypertensive patients and 15 controls were enrolled. Essential hype…

Atherosclerosis in females patients with rheumatoid arthritis; a two years follow-up.

Central obesity and hypertensive renal disease: association between higher levels of BMI, circulating transforming growth factor beta1 and urinary albumin excretion.

OBJECTIVE: In this study, the relationship between circulating transforming growth factor beta1 (TGFbeta1) and urinary albumin excretion (UAE) has been investigated in non-obese and central obese hypertensive patients. DESIGN AND PATIENTS: Fifty-eight consecutive hypertensive outpatients both lean and with central obesity were enrolled and divided in three groups, according to their body mass index (BMI) values. Group A: 16 lean hypertensives (men with BMI or = 25 kg/m2 and 24.7 kg/m2 and or = 30 kg/m2 and women with BMI > or = 27.3 kg/m2). MEASURES: In all patients, UAE, by immunonephelometric assay, circulating TGFbeta1 by a solid-phase specific sandwich enzyme-linked immunosorbent assay …

One-year atorvastatin treatment in hypercholesterolemic patients with or without carotid artery disease.

Aim. Statins are the drugs of choice in heterozygous familial hypercholesterolemia (FH), which has a high risk of premature cardiovascular events including myocardial infarction, stroke, and surgical revascularization. Methods. A 1-year open-label study was conducted to test the efficacy and tolerability of Atorvastatin titrated to the target, in proven FH patients and to evaluate certain inflammatory parameters. One hundred and two FH patients (44 men and 58 women; mean age 58.7±3.6 years) were included in the study. After evaluation using the B-mode duplex scanning system of extracranial carotid arteries, the patients were divided into groups: Group 1 (15 men, 25 women) with carotid plaqu…

Haemostatic and fibrinolytic abnormalities in obese patients and in patients with type 2 diabetes with metabolic syndrome

Importance of adjustment of haemorheological and haemocoagulative components in the medical treatment of arteriosclerosis obliterans of the lower limbs

Fibrinolysis in hypertriglyceridaemic subjects in response to venous occlusion.

We have measured various fibrinolytic and coagulation parameters (t-PA antigen, PAI, fibrinogen, plasminogen and factor VII) before and after 10 min of venous occlusion in 20 hypertryglyceridaemic subjects (twelve males and eight females, age 38 +/- 4 years, body mass index 23 +/- 1.5) and 20 healthy normal subjects, matched for sex (twelve males and eight females), age (37 +/- 3.5 years) and body mass index (22.8 +/- 1.4). At rest, t-PA:Ag, PAI, fibrinogen, plasminogen and factor VII were significantly (P < 0.005) higher in hypertriglyceridaemic subjects than in normal controls. After venous occlusion, the increase in all parameters except t-PA:Ag was more marked in the patient group than …

Long-term anti-tumour necrosis factor therapy reverses the progression of carotid intima–media thickness in female patients with active rheumatoid arthritis

The objective of the study is to evaluate the effect of TNF inhibition on carotid thickness over a 2-year period. 144 women with RA diagnosed according to ACR criteria, without clinical evidence of cardiac and/or vascular disease were enrolled and compared with 78 matched controls. All patients received methotrexate (15–20 mg weekly) for 3 months. Responders (n = 79) continued to be treated with methotrexate, non-responders (n = 40) moved to methotrexate plus a TNF alpha antagonist. Echosonographic studies of carotids were obtained before and after 2-year follow-up. A significant decrease of ca-IMT was observed in anti-TNF-treated patients (P < 0.001); on the other hand, no significant vari…

Left ventricular filling abnormalities and obesity-associated hypertension: relationship with overproduction of circulating transforming growth factor β1

This study has been designed to evaluate the relationship among transforming growth factor beta1 (TGFbeta1) and some measurements of diastolic function in a population of hypertensive subjects with normal left ventricular ejection fraction. We studied 67 hypertensive outpatients who according to their BMI levels were subdivided into three groups: lean (L), overweight (OW) and obese (OB) hypertensives (HT). Circulating TGFbeta1 and M- and B-mode echocardiography was determined. All hypertensives were further subgrouped, according to European Society of Cardiology Guidelines, into two subsets of patients with normal diastolic function or with diastolic dysfunction. Prevalence of left ventricu…

Effect of gemfibrozil treatment on fibrinolysis system in patients with hypertriglyceridemia

Abstract The effect of gemfibrozil on lipidic, coagulative, and fibrinolytic pattern was studied in 20 patients with primary type IV hyperlipoproteinemia. After a 4-week stabilization period during which administration of lipid-lowering drugs was stopped and an isocaloric diet (20% protein, 30% fat, and 50% carbohydrates) was prescribed, 20 patients (12 men and 8 women; mean age, 38 ± 4 years; body mass index, 23.4 ± 1.5) suffering from primary hypertriglyceridemia were included in this study and treated for a 12-week period with gemfibrozil (600 mg BID). Every 4 weeks the following parameters were checked: glycemia, triglycerides, total cholesterol, high density lipoprotein-cholesterol, to…

Hemostatic Alterations in Peripheral Arteriopathies

The most common cause of obliterative disease in limb arteries is slowly progressive arteriosclerosis which is eventually superimposed by thrombosis.

Double-blind, crossover study of the clinical efficacy and the hemorheological effects of pentoxifylline in patients with occlusive arterial disease of the lower limbs.

The effect of a 3 month daily administration of 800 mg pentoxifylline (Trental 400 bds) or placebo was assessed under double blind crossover design in 18 patients (12 males and 6 females) with peripheral occlusive arterial disease in respect of painfree walking distance and various hemorheological and hemostasiological variables, platelet aggregation, serum cholesterol and triglycerides. In first treatment period walking distance significantly increased with pentoxifylline by 46% from baseline 121 ± 15 m and by 4% with placebo from baseline 134 ± 18 m. Pentoxifylline administration furthermore yielded significant decrease in whole blood and plasma viscosity and significant increase in eryt…

Atherosclerosis in female patients with rheumatoid arthritis; a two years follow-up