Skip to main content
Erschienen in: Current Hypertension Reports 3/2013

01.06.2013 | Therapeutic Trials (G Mancia, Section Editor)

The Pamela Study: Main Findings and Perspectives

verfasst von: Michele Bombelli, Elena Toso, Maria Peronio, Danilo Fodri, Marco Volpe, Gianmaria Brambilla, Rita Facchetti, Roberto Sega, Guido Grassi, Giuseppe Mancia

Erschienen in: Current Hypertension Reports | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

PAMELA (Pressioni Arteriose Monitorate E Loro Associazioni) is an epidemiological study, originally designed to determine the normality of home and ambulatory blood pressure values. The study was performed on 3,200 subjects, aged 25 to 74 years, randomly selected from the general population of Monza (Milan, Italy). In the study context we performed clinical, home and ambulatory blood pressure measurements, echocardiographic assessment of cardiac structure and function as well as laboratory examinations (glucose and lipids). Personal and family histories were collected. The same procedures were repeated 10 years later. During a 12-year follow-up, the incident cardiovascular events were validated. Cardiovascular and all-cause fatal events were collected for a 16-year follow-up. This article will review the main results of the PAMELA study, with particular emphasis on (1) the prognostic value of the different blood pressure measurements, (2) the relationships between metabolic variables and blood pressure and (3) the clinical relevance and prognostic importance of left ventricular mass values and alterations.
Literatur
1.
Zurück zum Zitat Cesana G, De Vito G, Ferrario M, et al. Ambulatory blood pressure normalcy: the PAMELA Study. J Hypertens Suppl. 1991;9:S17–23.PubMed Cesana G, De Vito G, Ferrario M, et al. Ambulatory blood pressure normalcy: the PAMELA Study. J Hypertens Suppl. 1991;9:S17–23.PubMed
2.
Zurück zum Zitat Manual of international statistical classification of diseases, injuries and causes of death, IXth revision. Geneva: WHO; 1977. Manual of international statistical classification of diseases, injuries and causes of death, IXth revision. Geneva: WHO; 1977.
3.
Zurück zum Zitat •• Mancia G, Sega R, Bravi C, et al. Ambulatory blood pressure normality: results from the PAMELA study. J Hypertens. 1995;13:1377–90. This is one of the first studies reporting normality values for 24-h ambulatory blood pressure values in the general population. •• Mancia G, Sega R, Bravi C, et al. Ambulatory blood pressure normality: results from the PAMELA study. J Hypertens. 1995;13:1377–90. This is one of the first studies reporting normality values for 24-h ambulatory blood pressure values in the general population.
4.
Zurück zum Zitat Sega R, Cesana G, Milesi C, et al. Ambulatory and home blood pressure normality in the elderly: data from the PAMELA population. Hypertension. 1997;30:1–6.PubMedCrossRef Sega R, Cesana G, Milesi C, et al. Ambulatory and home blood pressure normality in the elderly: data from the PAMELA population. Hypertension. 1997;30:1–6.PubMedCrossRef
5.
Zurück zum Zitat Sega R, Facchetti R, Bombelli M, et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation. 2005;111:1777–83.PubMedCrossRef Sega R, Facchetti R, Bombelli M, et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation. 2005;111:1777–83.PubMedCrossRef
6.
Zurück zum Zitat Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87.PubMedCrossRef Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87.PubMedCrossRef
7.
Zurück zum Zitat Sega R, Trocino G, Lanzarotti A, et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: Data from the general population (Pressione Arteriose Monitorate E Loro Associazioni [PAMELA] Study). Circulation. 2001;104(12):1385–92.PubMedCrossRef Sega R, Trocino G, Lanzarotti A, et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: Data from the general population (Pressione Arteriose Monitorate E Loro Associazioni [PAMELA] Study). Circulation. 2001;104(12):1385–92.PubMedCrossRef
8.
Zurück zum Zitat •• Mancia G, Bombelli M, Facchetti R, et al. Long-term risk of sustained hypertension in white-coat or masked hypertension. Hypertension. 2009;54:226–32. The article provides evidence of the increased risk of white-coat and masked hypertension to develop a sustained hypertension and suggests that these conditions are not innocent from the prognostic point of view. •• Mancia G, Bombelli M, Facchetti R, et al. Long-term risk of sustained hypertension in white-coat or masked hypertension. Hypertension. 2009;54:226–32. The article provides evidence of the increased risk of white-coat and masked hypertension to develop a sustained hypertension and suggests that these conditions are not innocent from the prognostic point of view.
9.
Zurück zum Zitat • Mancia G, Bombelli M, Facchetti R, et al. Increased long-term risk of new-onset diabetes mellitus in white-coat and masked hypertension. J Hypertens. 2009;27:1672–8. The article documents an increased risk of white-coat and masked hypertension to develop a condition of deranged glucose metabolism and suggests the importance of out-of-office blood pressure measurement in the prognostic stratification of hypertensive subjects. • Mancia G, Bombelli M, Facchetti R, et al. Increased long-term risk of new-onset diabetes mellitus in white-coat and masked hypertension. J Hypertens. 2009;27:1672–8. The article documents an increased risk of white-coat and masked hypertension to develop a condition of deranged glucose metabolism and suggests the importance of out-of-office blood pressure measurement in the prognostic stratification of hypertensive subjects.
10.
Zurück zum Zitat Mancia G, Facchetti R, Bombelli M, et al. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006;47:846–53.PubMedCrossRef Mancia G, Facchetti R, Bombelli M, et al. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006;47:846–53.PubMedCrossRef
11.
Zurück zum Zitat Mancia G, Facchetti R, Bombelli M, et al. Relationship of office, home, and ambulatory blood pressure to blood glucose and lipid variables in the PAMELA population. Hypertension. 2005;45:1072–7.PubMedCrossRef Mancia G, Facchetti R, Bombelli M, et al. Relationship of office, home, and ambulatory blood pressure to blood glucose and lipid variables in the PAMELA population. Hypertension. 2005;45:1072–7.PubMedCrossRef
12.
Zurück zum Zitat Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–7.CrossRef Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–7.CrossRef
13.
Zurück zum Zitat Mancia G, Bombelli M, Corrao G, et al. Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis. Hypertension. 2007;49:40–7.PubMedCrossRef Mancia G, Bombelli M, Corrao G, et al. Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis. Hypertension. 2007;49:40–7.PubMedCrossRef
14.
Zurück zum Zitat Mancia G, Bombelli M, Facchetti R, et al. Long-term risk of diabetes, hypertension and left ventricular hypertrophy associated with the metabolic syndrome in a general population. J Hypertens. 2008;26:1602–11.PubMedCrossRef Mancia G, Bombelli M, Facchetti R, et al. Long-term risk of diabetes, hypertension and left ventricular hypertrophy associated with the metabolic syndrome in a general population. J Hypertens. 2008;26:1602–11.PubMedCrossRef
15.
Zurück zum Zitat Grundy SM, Brewer HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Arterioscler Thromb Vasc Biol. 2004;24:e13–8.PubMedCrossRef Grundy SM, Brewer HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Arterioscler Thromb Vasc Biol. 2004;24:e13–8.PubMedCrossRef
16.
Zurück zum Zitat Alberti KG, Zimmet PZ, Shaw JE. The metabolic syndrome: a new worldwide definition from the International Diabetes Federation consensus. Lancet. 2005;366:1059–62.PubMedCrossRef Alberti KG, Zimmet PZ, Shaw JE. The metabolic syndrome: a new worldwide definition from the International Diabetes Federation consensus. Lancet. 2005;366:1059–62.PubMedCrossRef
17.
Zurück zum Zitat Mancia G, Bombelli M, Facchetti R, et al. Impact of different definitions of the metabolic syndrome on the prevalence of organ damage, cardiometabolic risk and cardiovascular events. J Hypertens. 2010;28:999–1006.PubMedCrossRef Mancia G, Bombelli M, Facchetti R, et al. Impact of different definitions of the metabolic syndrome on the prevalence of organ damage, cardiometabolic risk and cardiovascular events. J Hypertens. 2010;28:999–1006.PubMedCrossRef
18.
Zurück zum Zitat Bombelli M, Facchetti R, Fodri D, et al. Impact of body mass index and waist circumference on the cardiovascular risk and all-cause death in a general population: Data from the PAMELA study. Nutr Metab Cardiovasc Dis. 2013, In press. Bombelli M, Facchetti R, Fodri D, et al. Impact of body mass index and waist circumference on the cardiovascular risk and all-cause death in a general population: Data from the PAMELA study. Nutr Metab Cardiovasc Dis. 2013, In press.
19.
Zurück zum Zitat Bombelli M, Facchetti R, Sega R, et al. Impact of body mass index and waist circumference on the long-term risk of diabetes mellitus, hypertension, and cardiac organ damage. Hypertension. 2011;58:1029–35.PubMedCrossRef Bombelli M, Facchetti R, Sega R, et al. Impact of body mass index and waist circumference on the long-term risk of diabetes mellitus, hypertension, and cardiac organ damage. Hypertension. 2011;58:1029–35.PubMedCrossRef
20.
Zurück zum Zitat Levy D, Garrison RJ, Savage DD, et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990;322:1561–6.PubMedCrossRef Levy D, Garrison RJ, Savage DD, et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990;322:1561–6.PubMedCrossRef
21.
Zurück zum Zitat Bombelli M, Facchetti R, Carugo S, et al. Left ventricular hypertrophy increases cardiovascular risk independently of in-office and out-of-office blood pressure values. J Hypertens. 2009;27:2458–64.PubMedCrossRef Bombelli M, Facchetti R, Carugo S, et al. Left ventricular hypertrophy increases cardiovascular risk independently of in-office and out-of-office blood pressure values. J Hypertens. 2009;27:2458–64.PubMedCrossRef
22.
Zurück zum Zitat Poppe KK, Edgerton Bachmann M, Triggs CM, et al. Geographic variations in left ventricular mass and left ventricular mass index: a systematic review. J Hum Hypertens. 2012;26:420–9.PubMedCrossRef Poppe KK, Edgerton Bachmann M, Triggs CM, et al. Geographic variations in left ventricular mass and left ventricular mass index: a systematic review. J Hum Hypertens. 2012;26:420–9.PubMedCrossRef
23.
Zurück zum Zitat • Cuspidi C, Facchetti R, Sala C. Normal values of left-ventricular mass: echocardiographic findings from the PAMELA study. J Hypertens. 2012;30:997–1003. This is the first study deriving the normalcy values of left ventricular mass from the mean values of a healthy population, without the confounding influence of overweight, obesity, diabetes mellitus, and clinical and out-of-office hypertension. • Cuspidi C, Facchetti R, Sala C. Normal values of left-ventricular mass: echocardiographic findings from the PAMELA study. J Hypertens. 2012;30:997–1003. This is the first study deriving the normalcy values of left ventricular mass from the mean values of a healthy population, without the confounding influence of overweight, obesity, diabetes mellitus, and clinical and out-of-office hypertension.
24.
Zurück zum Zitat Wild PS, Sinning CR, Roth A, et al. Distribution and categorization of left ventricular measurements in the general population. Results from the population-based Gutenberg heart study. Circ Cardiovasc Imaging. 2010;3:604–13.PubMedCrossRef Wild PS, Sinning CR, Roth A, et al. Distribution and categorization of left ventricular measurements in the general population. Results from the population-based Gutenberg heart study. Circ Cardiovasc Imaging. 2010;3:604–13.PubMedCrossRef
25.
Zurück zum Zitat Lang RM, Bierig M, Devereux RB, et al. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.PubMedCrossRef Lang RM, Bierig M, Devereux RB, et al. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.PubMedCrossRef
Metadaten
Titel
The Pamela Study: Main Findings and Perspectives
verfasst von
Michele Bombelli
Elena Toso
Maria Peronio
Danilo Fodri
Marco Volpe
Gianmaria Brambilla
Rita Facchetti
Roberto Sega
Guido Grassi
Giuseppe Mancia
Publikationsdatum
01.06.2013
Verlag
Current Science Inc.
Erschienen in
Current Hypertension Reports / Ausgabe 3/2013
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-013-0348-1

Weitere Artikel der Ausgabe 3/2013

Current Hypertension Reports 3/2013 Zur Ausgabe

Hypertension and Obesity (E Reisin, Section Editor)

Obesity and Metabolic Syndrome in Kidney Transplantation

Hypertension and Obesity (E Reisin, Section Editor)

Animal Models in Obesity and Hypertension

Blood Pressure Monitoring and Management (J Redon, Section Editor)

Ambulatory Blood Pressure in Stroke and Cognitive Dysfunction

Therapeutic Trials (G Mancia, Section Editor)

Heart Rate and the Cardiometabolic Risk

Hypertension and Obesity (E Reisin, Section Editor)

Exercise Training and Cardiometabolic Diseases: Focus on the Vascular System

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.