Papers by Claudio Pascale
Italian Journal of Medicine, 2013
Cardiovascular clinics, 1981
ABSTRACT. A review on the effects of ageing on cardiovascular function, with special reference to... more ABSTRACT. A review on the effects of ageing on cardiovascular function, with special reference to high blood pressure (BP), is given in this seminar. In most western populations the diastolic and especially the systolic BP increases with age in both sexes and this has been ...
PLoS ONE, 2014
Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral... more Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure $220 mmHg and/or diastolic blood pressure $120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p,0.001). Even among known hypertensive patients, a larger proportion of men than women reported not taking antihypertensive drug (12.6% among men and 9.4% among women (p,0.001). Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.
Journal of Cardiovascular Pharmacology, 1994
This study estimated the efficacy of sublingual nifedipine 10 mg vs. sublingual lacidipine 4 mg i... more This study estimated the efficacy of sublingual nifedipine 10 mg vs. sublingual lacidipine 4 mg in the management of hypertensive crises. We studied 40 patients with diastolic blood pressure > or = 120 mm Hg, who were divided into two groups of 20. Blood pressure and heart rate were assessed in the recumbent position before treatment and after 30, 120, and 240 min. Comparison of the effectiveness of these drugs was analyzed by Student's t test. Both drugs tested revealed a statistically significant hypotensive effect on diastolic and systolic blood pressure, and few side effects. Compared with lacidipine, nifedipine had a greater hypotensive effect on diastolic and systolic blood pressure in the first 30 min and on the diastolic blood pressure after the first 120 min. However, the hypotensive effect of lacidipine is statistically significant. After 4 h, both drugs showed a similar efficacy without significant statistical variations. We concluded that in the management of hypertensive crises the use of each of these drugs can have a particular range: nifedipine can be used when a pronounced and rapid blood pressure decrement is necessary, whereas lacidipine can be used when a more gradual effect is preferable.
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Papers by Claudio Pascale