Ilaria Figliuzzi
Sapienza University of Rome
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Featured researches published by Ilaria Figliuzzi.
International Journal of Cardiology | 2017
Giuliano Tocci; Ilaria Figliuzzi; Vivianne Presta; Nadia Attalla El Halabieh; Barbara Citoni; Roberta Coluccia; Allegra Battistoni; Andrea Ferrucci; Massimo Volpe
INTRODUCTION Global cardiovascular (CV) risk stratification is recommended in all outpatients. Risk score charts, however, do not include markers of organ damage (OD). AIM To evaluate the potential added value of including different markers of subclinical OD to US Framingham, European SCORE and Italian Cuore risk score calculators. METHODS We prospectively evaluated adult outpatients, who underwent blood pressure (BP) assessment and global CV risk stratification. The following OD markers were considered: 1) cardiac OD: electrocardiographic) or echocardiographic left ventricular (LV) hypertrophy; 2) vascular OD: carotid atherosclerotic plaque; 3) renal OD: reduced estimated glomerular filtration rate or creatinine clearance. Different risk score calculators were applied for comparisons. RESULTS We included an overall population sample of 1979 outpatients (44.0% female, age 57.2±13.0years, BMI 26,6±4,4kg/m2, clinic systolic/diastolic BP 145.4±18.3/85.8±10.7mmHg), among whom 117 (5.9%) presented cardiac, 161 (8.1%) vascular, and 117 (5.9%) renal OD. US Framingham, European SCORE and Italian Cuore risk scores were all significantly raised in patients with than in those without OD. A trend toward increase for US Framingham CVD death, European ESC and Italian Cuore scores was observed according to degree of all markers of OD. Among these, reduced ClCr and eGFR showed high sensitivity and specificity to identify high risk individuals. CONCLUSIONS Presence of cardiac, vascular or renal OD is associated with higher risk scores, independently by the types of calculators, age and gender classes. OD detection should be included in CV risk stratification in order to improve diagnostic, prognostic and therapeutic processes.
Journal of Clinical Hypertension | 2018
Giuliano Tocci; Vivianne Presta; Ilaria Figliuzzi; Nadia Attalla El Halabieh; Allegra Battistoni; Roberta Coluccia; Michela D'Agostino; Andrea Ferrucci; Massimo Volpe
The aim of this study was to analyze prevalence and clinical outcomes of the following clinical conditions: normotension (NT; clinic BP < 140/90 mm Hg; 24‐hour BP < 130/80 mm Hg), white‐coat hypertension (WCHT; clinic BP ≥ 140 and/or ≥90 mm Hg; 24‐hour BP < 130/80 mm Hg), masked hypertension (MHT; clinic BP < 140/90 mm Hg; 24‐hour BP ≥ 130 and/or ≥80 mm Hg), and sustained hypertension (SHT; clinic BP ≥ 140 and/or ≥90 mm Hg; 24‐hour BP ≥ 130 and/or ≥80 mm Hg) in a large cohort of adult untreated individuals. Systematic research throughout the medical database of Regione Lazio (Italy) was performed to estimate incidence of myocardial infarction (MI), stroke, and hospitalizations for HT and heart failure (HF). Among a total study sample of 2209 outpatients, 377 (17.1%) had NT, 351 (15.9%) had WCHT, 149 (6.7%) had MHT, and 1332 had (60.3%) SHT. During an average follow‐up of 120.1 ± 73.9 months, WCHT was associated with increased risk of hospitalization for HT (OR 95% CI: 1.927 [1.233‐3.013]; P = .04) and HF (OR 95% CI: 3.449 [1.321‐9.007]; P = .011). MHT was associated with an increased risk of MI (OR 95% CI: 5.062 [2.218‐11.550]; P < .001), hospitalization for HT (OR 95% CI: 2.553 [1.446‐4.508]; P = .001), and for HF (OR 95% CI: 4.214 [1.449‐12.249]; P = .008). These effects remained statistically significant event after corrections for confounding factors including age, BMI, gender, smoking, dyslipidaemia, diabetes, and presence of antihypertensive therapies.
Journal of Hypertension | 2017
Giuliano Tocci; Vivianne Presta; Barbara Citoni; Ilaria Figliuzzi; Roberta Coluccia; Allegra Battistoni; M. Beatrice Musumeci; Luciano De Biase; Andrea Ferrucci; Massimo Volpe
Introduction: Assumption of lipid-lowering drugs, mostly statins, is recommended at bed-time and evidence demonstrated a strong and independent correlation between night-time blood pressure (BP) and increased risk of cardiovascular events. Aim: To evaluate the effects of statins on night-time BP levels. Methods: We analysed data derived from a large cohort of adult individuals, who consecutively underwent home, clinic and ambulatory BP monitoring at our Unit. All BP measurements were performed and BP thresholds were set according to recommendations from European guidelines. Study population was stratified according to statin use. Results: We included an overall sample of 5634 adult individuals (women 48.9%, age 60.5 ± 11.6 years, BMI 27.0 ± 4.6 kg/m2, clinic BP 144.3 ± 18.4/90.9 ± 12.4 mmHg, 24-h BP 130.7 ± 13.4/79.0 ± 9.7 mmHg), among whom 17.3% received and 82.7% did not received statins. Treated outpatients were older, had higher BMI and prevalence of risk factors and comorbidities than those who were untreated (P < 0.001 for all). Patients treated with statins showed lower DBP levels at all BP measurements, including night-time (67.3 ± 9.4 vs. 70.9 ± 9.7 mmHg; P < 0.001) periods, than those observed in untreated patients. Also, statin use resulted an independent factor associated with 24-h [odds ratio (95% confidence interval): 1.513(1.295–1.767); P < 0.001] and night-time [odds ratio (95% confidence interval): 1.357(1.161–1.587); P < 0.001] BP control, even after adjusting for age, sex, BMI, diabetes, number of antihypertensive drugs (model 1) or presence/absence of antihypertensive treatment (model 2). Conclusion: Statin use was associated with significantly lower DBP levels. These effects were independently observed, even after correction for cardiovascular risk factors and comorbidities, as well as number of antihypertensive drugs.
Clinical Cardiology | 2018
Ilaria Figliuzzi; Vivianne Presta; Barbara Citoni; Francesca Miceli; Francesca Simonelli; Allegra Battistoni; Roberta Coluccia; Andrea Ferrucci; Massimo Volpe; Giuliano Tocci
Pharmacological therapy in patients at high cardiovascular (CV) risk should be tailored to achieve recommended therapeutic targets.
Journal of Clinical Hypertension | 2018
Vivianne Presta; Ilaria Figliuzzi; Barbara Citoni; Francesca Miceli; Allegra Battistoni; Maria Beatrice Musumeci; Roberta Coluccia; Luciano De Biase; Andrea Ferrucci; Massimo Volpe; Giuliano Tocci
We previously demonstrated lower diastolic blood pressure (BP) levels under statin therapy in adult individuals who consecutively underwent 24‐hour ambulatory BP monitoring and compared their levels to untreated outpatients. Here we evaluated systolic/diastolic BP levels according to different statin types and dosages. 987 patients (47.5% female, age 66.0 ± 10.1 years, BMI 27.7 ± 4.6 kg/m2, clinic BP 146.9 ± 19.4/86.1 ± 12.1 mm Hg, 24‐hour BP 129.2 ± 14.4/74.9 ± 9.2 mm Hg) were stratified into 4 groups: 291 (29.5%) on simvastatin 10‐80 mg/d, 341 (34.5%) on atorvastatin 10‐80 mg/d, 187 (18.9%) on rosuvastatin 5‐40 mg/d, and 168 (17.0%) on other statins. There were no significant BP differences among patients treated by various statin types and dosages, except in lower clinic (P = .007) and daytime (P = .013) diastolic BP in patients treated with simvastatin and atorvastatin compared to other statins. Favorable effects of statins on systolic/diastolic BP levels seem to be independent of types or dosages, thus suggesting a potential class effect of these drugs.
Journal of Clinical Hypertension | 2018
Vivianne Presta; Ilaria Figliuzzi; Michela D'Agostino; Barbara Citoni; Francesca Miceli; Francesca Simonelli; Roberta Coluccia; Maria Beatrice Musumeci; Andrea Ferrucci; Massimo Volpe; Giuliano Tocci
Masked hypertension (MHT) is characterized by normal clinic and above normal 24‐hour ambulatory blood pressure (BP) levels. We evaluated clinical characteristics and CV outcomes of different nocturnal patterns of MHT. We analyzed data derived from a large cohort of adult individuals, who consecutively underwent home, clinic, and ambulatory BP monitoring at our Hypertension Unit between January 2007 and December 2016. MHT was defined as clinic BP <140/90 mm Hg and 24‐hour BP ≥ 130/80 mm Hg, and stratified into three groups according to dipping status: (a) dippers, (b) nondippers, and (c) reverse dippers. From an overall sample of 6695 individuals, we selected 2628 (46.2%) adult untreated individuals, among whom 153 (5.0%) had MHT. In this group, 67 (43.8%) were nondippers, 65 (42.5%) dippers, and 21 (13.7%) reverse dippers. No significant differences were found among groups regarding demographics, clinical characteristics, and prevalence of risk factors, excluding older age in reverse dippers compared to other groups (P < 0.001). Systolic BP levels were significantly higher in reverse dippers than in other groups at both 24‐hour (135.6 ± 8.5 vs 130.4 ± 6.0 vs 128.2 ± 6.8 mm Hg, respectively; P < 0.001) and nighttime periods (138.2 ± 9.1 vs 125.0 ± 6.3 vs 114.5 ± 7.7 mm Hg; P < 0.001). Reverse dipping was associated with a significantly higher risk of stroke, even after correction for age, gender, BMI, dyslipidemia, and diabetes (OR 18.660; 95% IC [1.056‐33.813]; P = 0.046). MHT with reverse dipping status was associated with higher burden of BP and relatively high risk of stroke compared to both dipping and nondipping profiles, although a limited number of CV outcomes have been recorded during the follow‐up.
Annual Review of Physiology | 2017
Giuliano Tocci; Ilaria Figliuzzi
Control of hypertension still remains an unresolved clinical problem. Despite marked improvement in both diagnostic opportunities and availability of integrated and well-tolerated antihypertensive drug therapies, several reports have independently and consistently showed a relatively high prevalence of the disease (ranging between 25 and 35%) and persistently low rates of blood pressure control (about 35–45%) [1–3]. This, of course, may have potentially harmful consequences for the sustainability of Health Care Systems, since hypertension is the most common cardiovascular risk factor in the general population, and it is responsible for the vast majority of cardiovascular morbidity and mortality, worldwide [4]. Indeed, hypertension-related clinical conditions, including coronary artery disease, stroke, renal failure, congestive heart failure and other metabolic abnormalities (mostly diabetes), heavily affect quality of life and markedly impact on costs related to complex pharmacological therapies and hospitalizations. In addition, the progressively increasing incidence of other cardiovascular and metabolic risk factors, such as smoking, obesity, dyslipidaemia, and metabolic syndrome, and the wide-spread adoption of unhealthy habits (e.g. sedentary life, unbalanced diet, physical and mental stress) further promote the risk of developing sustained blood pressure rise and accelerate the progression of hypertension-related atherosclerotic diseases. On the basis of these considerations, closer attention might be devoted by physicians and health care providers for implementing strategies aimed at preventing the development and improving awareness of hypertension, respectively. Evidence demonstrated that the first step for reducing the burden of a given disease, namely hypertension, in a setting of clinical practice should be an appraisal on prevalence, awareness, treatment and control rates of this clinical condition. With these purposes, numerous observational studies and epidemiological registries have been progressively made available during the last decades in various countries, worldwide. Information obtained from these analyses are of potential clinical relevance, since they can be effectively implemented by recommendations derived from international guidelines, in order to improve the clinical management and achieve the recommended blood pressure targets. In particular, recent studies have demonstrated that the implementation of rational and effective therapeutic regimes, mostly based on combination therapies, may promote higher rates of blood pressure control also in the setting of real practice [5–7]. In this issue of High Blood Pressure and Cardiovascular Prevention, Kiselev and co-authors reported a detailed and comprehensive analysis of clinical factors that may have potential impact on the achievement of the blood pressure goals in a large sample of adult individuals with hypertension in the Ivanovo, Russia [8]. This study is part of the larger Russian Registry of Hypertension, Coronary Artery Disease and Chronic Heart Failure, which is a retrospective, continuous, nation-wide, web-based registry. The present analysis involved about 1,037,000 individuals, predominantly female (about 55%), representing about 2.7% of the whole Russian population and about 4.2% of & Giuliano Tocci [email protected]
International Journal of Cardiology | 2018
Giuliano Tocci; Vivianne Presta; Ilaria Figliuzzi; Massimo Volpe
Annual Review of Physiology | 2018
Giuliano Tocci; Ilaria Figliuzzi; Vivianne Presta; Francesca Miceli; Barbara Citoni; Roberta Coluccia; Maria Beatrice Musumeci; Andrea Ferrucci; Massimo Volpe
American Journal of Hypertension | 2018
Giuliano Tocci; Vivianne Presta; Ilaria Figliuzzi; Francesca Miceli; Barbara Citoni; Roberta Coluccia; Anna Paini; Massimo Salvetti; Andrea Ferrucci; Maria Lorenza Muiesan; Massimo Volpe