Browsing by Author "Omboni, Stefano"
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- ItemAngiotensin Receptor Blockers Versus Angiotensin Converting Enzyme Inhibitors for the Treatment of Arterial Hypertension and the Role of Olmesartan.(0000-00-00) Omboni, Stefano; Volpe, MassimoBlood pressure lowering by all classes of antihypertensive drugs is accompanied by significant reductions of stroke and major cardiovascular CV events Drugs acting on the renin angiotensin aldosterone system such as angiotensin converting enzyme inhibitors ACEIs and angiotensin receptor blockers ARBs showed similar benefit on major CV events to other antihypertensive medications In real world practice ARBs reduced by 10 the incidence of CV mortality non fatal myocardial infarction non fatal stroke and provided superior protection against CV events than ACEIs in high risk patients Despite similar antihypertensive properties and a favourable safety profile for both ACEIs and ARBs evidence indicates that patients treated with ARBs have lower rates of withdrawal for adverse events and greater persistence to therapy than those treated with ACEIs Among ARBs olmesartan is one of the latest generation compounds introduced in clinical practice for treating hypertension head to head comparative trials suggest that the efficacy of olmesartan is superior to that of commonly prescribed ACEIs ramipril and perindopril The drug administered as a monotherapy or in combination with a dihydropyridine calcium channel blocker or a thiazide diuretic has proved to be effective in maintaining blood pressure stability over 24 h with a favourable safety profile and low discontinuation rates These properties are pivotal for considering olmesartan as a useful antihypertensive agent especially for high risk patients e g elderly diabetics patients with metabolic syndrome Funding Article preparation and open access fee were funded by Menarini International Operations Luxembourg S A M I O L
- ItemAntihypertensive effect of zofenopril plus hydrochlorothiazide versus zofenopril monotherapy in patients with essential hypertension according to their cardiovascular risk level: A post hoc analysis.(2014-04-02) Malacco, Ettore; Omboni, Stefano; ,International guidelines recommend the use of angiotensin converting enzyme inhibitors possibly in combination with other antihypertensive drugs to treat hypertension with associated risk factors
- ItemEffects of the concomitant administration of xanthine oxidase inhibitors with zofenopril or other ACE-inhibitors in post-myocardial infarction patients: a meta-analysis of individual data of four randomized,...(0000-00-00) Borghi, Claudio; Omboni, Stefano; Reggiardo, Giorgio; Bacchelli, Stefano; Esposti, Daniela Degli; Ambrosioni, Ettore; ,BACKGROUND Oxidative stress is increased in hyperuricemic patients with acute myocardial infarction AMI Use of sulfhydryl ACE inhibitors ACEIs such as zofenopril or captopril plus xanthine oxidase inhibitors XOIs may potentially result in enhanced antioxidant effects and improved survival OBJECTIVE We verified the benefit of such combination in a randomly stratified sample of 525 of the 3630 post AMI patients of the four randomized prospective SMILE Survival of Myocardial Infarction Long term Evaluation studies METHODS One hundred sixty five 31 4 patients were treated with XOIs 79 under zofenopril 86 placebo lisinopril or ramipril whereas 360 were not 192 zofenopril 168 placebo or other ACEIs In these four groups we separately estimated the 1 year combined risk of major cardiovascular events MACE death or hospitalization for cardiovascular causes RESULTS MACE occurred in 10 1 of patients receiving zofenopril XOIs in 18 6 receiving placebo or other ACEIs XOIs in 13 5 receiving zofenopril without XOIs and in 22 0 receiving placebo or other ACEIs but no XOIs p 0 034 across groups Rate of survival free from MACE was significantly larger under treatment with zofenopril XOIs than with other ACEIs with no XOIs hazard ratio 2 29 1 06 4 91 p 0 034 A non significant trend for superiority of zofenopril XOIs combination was observed vs zofenopril alone 1 19 0 54 2 64 p 0 669 or vs placebo or other ACEIs XOIs 1 82 0 78 4 26 p 0 169 CONCLUSIONS Our retrospective analysis suggests an improved survival free from MACE in post AMI patients treated with a combination of an urate lowering drug with antioxidant activity and an ACEI with best effects observed with zofenopril
- ItemEffects of treatment with zofenopril in men and women with acute myocardial infarction: gender analysis of the SMILE Program.(2014-11-04) Franconi, Flavia; Omboni, Stefano; Ambrosioni, Ettore; Reggiardo, Giorgio; Campesi, Ilaria; Borghi, ClaudioThe SMILE studies proved the prognostic benefit of zofenopril vs placebo or other ACE inhibitors ACEIs in post acute myocardial infarction AMI In this retrospective pooled analysis of these studies we assessed whether the zofenopril effect is influenced by gender
- ItemEffects on 24-hour blood pressure variability of ace-inhibition and calcium channel blockade as monotherapy or in combination.(0000-00-00) Parati, Gianfranco; Castiglioni, Paolo; Omboni, Stefano; Faini, AndreaCardiovascular events in hypertensives are associated with elevated average blood pressure BP and higher short term BP variability V but little is known on treatment effects on BPV and on how to assess changes in short term BPV Aim of our study was to address the methodology of short term BPV assessment and its reduction by Lercanidipine L or Enalapril E and their combination through analysis of 24 hour ambulatory BP recordings from two studies including subjects of different age Study 1 64 middle age hypertensives 52 9 9 5 yrs received L and E s i d at 10 mg L10 E10 or 20 mg doses L20 E20 for 8 weeks Study 2 66 elderly hypertensives 65 5 4 7 yrs received placebo L10 E20 and L10 E20 s i d for 4 weeks In middle age subjects both L and E decreased mean BP and at the highest dose also short term BPV In elderly subjects L10 alone or in combination with E20 reduced BPV Treatment induced reductions in BP levels and BPV were uncorrelated Different methods for short term BPV assessment did not always provide superimposable results in the elderly Our study supports a better reduction of BPV by L in the elderly and by E L combination at any age suggesting BPV reduction to be independent from reduction in average BP
- ItemEfficacy and Safety of Zofenopril Versus Ramipril in the Treatment of Myocardial Infarction and Heart Failure: A Review of the Published and Unpublished Data of the Randomized Double-Blind SMILE-4 Stu...(0000-00-00) Borghi, Claudio; Omboni, Stefano; Novo, Salvatore; Vinereanu, Dragos; Ambrosio, Giuseppe; Ambrosioni, EttoreZofenopril is a lipophilic sulfhydryl group containing angiotensin converting enzyme ACE inhibitor characterized by wide tissue distribution long duration of action and pleiotropic effects on endothelial dysfunction Its clinical efficacy and safety have been described in the four randomized controlled trials of the SMILE program which globally enrolled more than 3600 patients in post acute myocardial infarction AMI setting The SMILE 4 study specifically selected patients with left ventricular dysfunction at admission and compared the effects of zofenopril or ramipril in combination with acetylsalicylic acid ASA Zofenopril demonstrated its superiority over ramipril in reducing the combined occurrence of death or hospitalization for cardiovascular causes both in the overall population included in the original study and in subgroups of patients at highest risk namely hypertensive and diabetic subjects The effects of the early treatment with zofenopril were sustained over time and after 5 years of follow up zofenopril increased the survival likelihood and reduced the hospitalization rate Compared to ramipril zofenopril was cost effective with a number to treat of 13 and an incremental cost effectiveness ratio ICER of 2125 45 euros for any additional event prevented Furthermore in real world settings zofenopril decreased the risk of death in patients with heart failure particularly in men and in subjects older than 76 years or with ejection fraction lower than 54 These results support the early use of zofenopril immediately after AMI even in the presence of comorbidities and its maintenance over time to reduce the risk of heart failure FUNDING Menarini International Operations Luxembourg S A
- ItemEfficacy Of Zofenopril Alone Or In Combination With Hydrochlorothiazide In Patients With Kidney Dysfunction.(0000-00-00) Omboni, Stefano; Borghi, ClaudioHypertension and kidney disease often coexist further increasing the risk of future cardiovascular events Treatment of hypertensive adults with an angiotensin converting enzyme inhibitor in case of concomitant kidney disease may slow disease progression The third generation liphophilic angiotensin converting enzyme inhibitor zofenopril administered alone or combined with a thiazide diuretic has proved to be effective in lowering blood pressure in hypertensive patients and to reduce the risk of fatal and non fatal events in post acute myocardial infarction and heart failure In almost three hundred hypertensive patients with kidney impairment zofenopril administered for 12 weeks showed a similar blood pressure lowering effect irrespective of the stage of the disease with larger effects in combination with a thiazide diuretic particularly in patients with slightly or moderately impaired kidney function In animal models zofenopril produced a significant and long lasting inhibition of kidney angiotensin converting enzyme inhibitor and prevented kidney morphological and functional alterations following kidney ischemia reperfusion injury Treatment of hypertensive patients for 18 weeks with a combination of zofenopril 30 mg and hydrochlorothiazide 12 5 mg resulted in a reduction in albumin creatinine ratio of 8 4 mg g 49 6 reduction from baseline values and no changes in glomerular filtration rate variations in line with those obtained in the control group treated with a combination of irbesartan 150 mg and hydrochlorothiazide 12 5 mg Thus some preliminary evidence exists to support that relatively long term treatment with the angiotensin converting enzyme inhibitor zofenopril alone or combined with hydrochlorothiazide is effective in controlling blood pressure and may confer some kidney protection due to ACE inhibition properties
- ItemEfficacy of zofenopril in combination with amlodipine in patients with acute myocardial infarction: a pooled individual patient data analysis of four randomized, double-blind, controlled, prospective ...(0000-00-00) Borghi, Claudio; Omboni, Stefano; Reggiardo, Giorgio; Bacchelli, Stefano; Degli Esposti, Daniela; Ambrosioni, Ettore; ,OBJECTIVE In the four SMILE Survival of Myocardial Infarction Long Term Evaluation studies early administration of zofenopril in acute myocardial infarction AMI showed beneficial effects as compared to placebo and other angiotensin converting enzyme inhibitors ACEIs We investigated whether the concomitant administration of the dihydropyridine calcium channel blocker amlodipine may improve zofenopril efficacy to prevent cardiovascular events in post AMI patients METHODS This was a post hoc analysis of pooled individual patient data from the four large randomized SMILE studies The primary endpoint was the 1 year combined occurrence of death or hospitalization for cardiovascular causes RESULTS 3488 patients were considered 303 8 7 treated with concomitant amlodipine Baseline systolic blood pressure and prevalence of metabolic syndrome were higher in amlodipine treated patients The 1 year occurrence of major cardiovascular outcomes was significantly reduced in patients receiving concomitant treatment with amlodipine hazard ratio HR and 95 confidence interval CI 0 66 95 CI 0 44 0 98 p 0 039 After accounting for treatment with amlodipine the risk of cardiovascular events was significantly reduced with zofenopril compared to placebo HR and 95 CI 0 78 0 63 0 97 p 0 026 Among ACEI treated patients the zofenopril plus amlodipine combination reduced the risk of cardiovascular events by 38 compared to the combination of other ACEIs plus amlodipine HR and 95 CI 0 76 0 61 0 94 p 0 013 The prognostic benefit of concomitant treatment with zofenopril plus amlodipine was independent from blood pressure lowering CONCLUSIONS Zofenopril had a positive impact on prognosis in post AMI patients compared to other ACEIs Concomitant administration of amlodipine may help to reduce the risk of cardiovascular events at 1 year
- ItemEfficacy of zofenopril in combination with thiazide diuretics in patients with acute myocardial infarction: a pooled individual data analysis of four randomized, double-blind, controlled, prospective ...(0000-00-00) Borghi, Claudio; Omboni, Stefano; Reggiardo, Giorgio; Bacchelli, Stefano; Esposti, Daniela Degli; Ambrosioni, EttoreBackground In the Survival of Myocardial Infarction Long Term Evaluation SMILE studies early administration of zofenopril after acute myocardial infarction AMI was prognostically beneficial as compared to placebo and other angiotensin converting enzyme inhibitors ACEIs such as lisinopril and ramipril Here we investigated whether zofenopril efficacy could be affected by a concomitant use of thiazide diuretics TDs Methods This was a post hoc analysis of pooled individual patient data from the SMILE studies Patients treated with other diuretics than TDs were excluded The primary study endpoint was the 1 year combined occurrence of death or hospitalization for CV causes with or without TD Results Among 2 995 patients 263 8 8 were treated with a combination including a TD TD whereas 2 732 91 2 were not treated with any diuretic TD Proportions of subjects who were treated with TD were equally distributed p 0 774 within the placebo zofenopril and other ACEIs groups The 1 year risk of major cardiovascular events was similar in TD 18 3 and TD 16 8 patients hazard ratio HR 1 04 95 CI 0 74 1 45 p 0 838 After stratifying per concomitant treatment and TD the 1 year risk of CV events was significantly lower with zofenopril than with placebo HR 0 70 95 CI 0 55 0 88 p 0 002 and other ACEIs HR 0 58 95 CI 0 46 0 74 p 0 0001 Treatment with ACEIs and TD as concomitant therapy was associated with a larger blood pressure BP reduction p 0 0001 for systolic BP and p 0 045 for diastolic BP Conclusion In post AMI patients zofenopril maintained its positive impact on prognosis compared to placebo or other ACEIs regardless concomitant TD administration In this setting TD shows advantages in managing the most difficult hypertensive patients
- ItemHas the time come for self-management of blood pressure and antihypertensive medications by patients?(0000-00-00) Omboni, Stefano
- ItemManagement of arterial hypertension with angiotensin receptor blockers: current evidence and the role of olmesartan.(0000-00-00) Omboni, Stefano; Volpe, MassimoElevated blood pressure BP is a major determinant of morbidity and mortality burden related to cardio metabolic risk Current guidelines indicate that controlling and lowering BP promotes cardiovascular CV risk reduction Among antihypertensive agents angiotensin receptor blockers ARBs are characterized by an efficacy profile equivalent to other antihypertensive agents and are provided with excellent tolerability profile and low discontinuation rates during chronic treatments Moreover CV outcomes are reduced by ARBs Olmesartan is a long lasting ARB which proved to achieve a comparable or more effective action in lowering BP when compared with other ARBs Olmesartan in fact displayed a larger and more sustained antihypertensive effect over the 24 hours with a buffering effect on short term BP variability These are important features which differentiate olmesartan from the other principles of the same class and that may help to control the increased CV risk in presence of high BP variability Olmesartan shows similar benefits as other ARBs in terms of all cause and CV mortality and a favourable tolerability profile Combination of olmesartan with long lasting calcium channel blockers and thiazide diuretics represents a rational and effective therapy Thus ARBs including olmesartan represent one of the most effective and safe treatment for patients with arterial hypertension This article is protected by copyright All rights reserved
- ItemMASked-unconTrolled hypERtension management based on office BP or on ambulatory blood pressure measurement (MASTER) Study: a randomised controlled trial protocol.(0000-00-00) Parati, Gianfranco; Agabiti-Rosei, Enrico; Bakris, George L; Bilo, Grzegorz; Branzi, Giovanna; Cecchi, Franco; Chrostowska, Marzena; de la Sierra, Alejandro; Domenech, Monica; Dorobantu, Maria; Faria, Thays; Huo, Yong; Jelaković, Bojan; Kahan, Thomas; Konradi, Alexandra; Laurent, Stéphane; Li, Nanfang; Madan, Kushal; Mancia, Giuseppe; McManus, Richard J; Modesti, Pietro Amedeo; Ochoa, Juan Eugenio; Octavio, José Andrés; Omboni, Stefano; Palatini, Paolo; Park, Jeong Bae; Pellegrini, Dario; Perl, Sabine; Podoleanu, Cristian; Pucci, Giacomo; Redon, Josep; Renna, Nicolas; Rhee, Moo Yong; Rodilla Sala, Enrique; Sanchez, Ramiro; Schmieder, Roland; Soranna, Davide; Stergiou, George; Stojanovic, Milos; Tsioufis, Konstantinos; Valsecchi, Maria Grazia; Veglio, Franco; Waisman, Gabriel Dario; Wang, Ji Guang; Wijnmaalen, Paulina; Zambon, Antonella; Zanchetti, Alberto; Zhang, YuqingINTRODUCTION Masked uncontrolled hypertension MUCH carries an increased risk of cardiovascular CV complications and can be identified through combined use of office O and ambulatory A blood pressure BP monitoring M in treated patients However it is still debated whether the information carried by ABPM should be considered for MUCH management Aim of the MASked unconTrolled hypERtension management based on OBP or on ambulatory blood pressure measurement MASTER Study is to assess the impact on outcome of MUCH management based on OBPM or ABPM METHODS AND ANALYSIS MASTER is a 4 year prospective randomised open label blinded endpoint investigation A total of 1240 treated hypertensive patients from about 40 secondary care clinical centres worldwide will be included upon confirming presence of MUCH repeated on treatment OBP Under140 90 mm Hg and at least one of the following daytime ABP 135 85 mm Hg night time ABP 120 70 mm Hg 24 hour ABP 130 80 mm Hg and will be randomised to a management strategy based on OBPM group 1 or on ABPM group 2 Patients in group 1 will have OBP measured at 0 3 6 12 18 24 30 36 42 and 48 months and taken as a guide for treatment ABPM will be performed at randomisation and at 12 24 36 and 48 months but will not be used to take treatment decisions Patients randomised to group 2 will have ABPM performed at randomisation and all scheduled visits as a guide to antihypertensive treatment The effects of MUCH management strategy based on ABPM or on OBPM on CV and renal intermediate outcomes changing left ventricular mass and microalbuminuria coprimary outcomes at 1 year and on CV events at 4 years and on changes in BP related variables will be assessed ETHICS AND DISSEMINATION MASTER study protocol has received approval by the ethical review board of Istituto Auxologico Italiano The procedures set out in this protocol are in accordance with principles of Declaration of Helsinki and Good Clinical Practice guidelines Results will be published in accordance with the CONSORT statement in a peer reviewed scientific journal TRIAL REGISTRATION NUMBER NCT02804074 Pre results
- ItemOlmesartan vs. ramipril in elderly hypertensive patients: review of data from two published randomized, double-blind studies.(2014-03-11) Omboni, Stefano; Malacco, Ettore; Mallion, Jean-Michel; Fabrizzi, Paolo; Volpe, MassimoHypertension is a frequent condition among individuals over 65 years of age worldwide and is one of the most important risk factors for cardiovascular CV disease Effective drug treatment of elderly hypertensives is usually associated with a marked reduction in CV morbidity and mortality Among the different classes of antihypertensive agents angiotensin receptor blockers ARBs and ACE inhibitors are supposed to provide the best efficacy in lowering blood pressure BP and protecting target organ damage while featuring a good tolerability profile However up to date few randomized clinical studies have directly compared the activity and safety of ARBs and ACE inhibitors in elderly hypertensive patients Aim of this review of published and unpublished pooled data from two recent randomized double blind controlled trials is to offer a comprehensive head to head comparison of the antihypertensive efficacy of the ARB olmesartan medoxomil vs the ACE inhibitor ramipril in a large study population including more than 1 400 hypertensive subjects aged 65 89 years with mild to moderate essential hypertension The efficacy of the two drugs was separately evaluated in subgroups of patients classified according to the presence of metabolic syndrome reduced renal function CV risk level gender class of age type of arterial hypertension and previous antihypertensive treatments Olmesartan showed a greater efficacy than ramipril both in terms of clinic BP reduction and rate normalization Olmesartan appeared significantly superior to ramipril in providing a more homogeneous and long lasting 24 h BP control and maintaining an effective antihypertensive action in the last 6 h period from drug intake In subgroups of patients with additional clinical conditions olmesartan gave comparable and in some cases greater BP responses than those achieved with the ACE inhibitor The incidence of adverse events was similar for both drugs Olmesartan may thus represent an effective alternative to ACE inhibitors among first line drug treatments for hypertension in older people
- ItemThe pharmacist and the management of arterial hypertension: the role of blood pressure monitoring and telemonitoring.(2015-01-20) Omboni, Stefano; Sala, ElisaRandomized controlled trials have documented that a team of health care professionals which includes a physician a nurse and a community pharmacist may improve the benefit and adherence of anti hypertensive therapy If such a health care model relies on blood pressure telemonitoring it can promote a stronger relationship between health care professionals and patients and further improve BP control of hypertension The major benefit of this collaborative approach is to center the patient s management in a tailored way providing comprehensive and preventive care based on health information technologies In this review the authors summarize recent clinical studies that evaluate the role of the community pharmacist in BP measurements and in hypertension screening and control The authors also describe the advantages of using blood pressure telemonitoring in home and ambulatory settings to evaluate potential alternatives to primary care in hypertension management
- ItemPhysician-pharmacist collaborative practice and telehealth may transform hypertension management.(0000-00-00) Omboni, Stefano; Tenti, Mauro; Coronetti, ClaudioCommunity pharmacists play a crucial role in hypertension management and their intervention mainly including education medication monitoring and reviewing blood pressure BP measurement and cardiovascular risk factors tracking have proved to enhance BP control and adherence to antihypertensive treatment A multidisciplinary collaborative approach with the referring physician and a patient centered model of care have been proved to be particularly effective for improving control of hypertension and promoting patients health The inclusion of telehealth in such model the so called telepharmacy may expand the reach of the pharmacist s intervention and provide pharmacy operations and patient care at a distance with further benefits for hypertensive patients and their managing physicians Very few randomized controlled studies have evaluated the clinical efficacy of the implementation of telepharmacy services in the management of hypertension with the strongest evidence limited to physician pharmacist collaborative interventions based on home BP telemonitoring plus patient education on lifestyle drug therapy and cardiovascular risk factors control The results of these trials documented a benefit of telehealth mainly in terms of improvement of BP control consequent to antihypertensive medication intensification and optimization Although promising these results need to be corroborated through larger prospective and long term studies which should also evaluate additional long term benefits of telepharmacy services in hypertension management
- ItemSimultaneous double arm automated blood pressure measurement for the screening of subjects with potential vascular disease: a community study.(0000-00-00) Omboni, Stefano; Verberk, Willem JPURPOSE Hypertension guidelines recommend measuring blood pressure BP on both arms since an abnormal inter arm difference IAD in BP is associated with an increased risk of vascular abnormalities and cardiovascular CV disease We tested whether an automatic oscillometric BP monitor allowing simultaneous both arm BP measurement might be effective for screening of subjects with potential vascular disease MATERIALS AND METHODS 220 consecutive subjects from an unselected sample of individuals of a small Italian community were screened using an automated upper arm electronic BP monitor Microlife WatchBP Office Seated BP was measured in triplicate at 1 min interval Demographic and clinical data were collected prior to any BP measurement An average IAD difference 20 mmHg for systolic S and or 10 mmHg for diastolic D BP was considered abnormal RESULTS In 9 subjects 4 1 an abnormal IAD was found with lower BPs measured in the non dominant arm 147 28 78 9 vs 154 15 92 11 mmHg dominant pUnder 01 Subjects with a significant IAD were significantly older 71 8 vs 57 15 years p 005 had a greater body mass index BMI 32 7 vs 25 4 kg m2 p 0001 higher BP levels 154 15 92 11 vs 133 18 80 10 mmHg p 001 and were more likely to report obesity 56 vs 13 p 001 a history of hypertension 67 vs 35 p 044 or cardiovascular disease 33 vs 10 p 034 than subjects with normal IAD In a multivariate analysis a higher BMI odds ratio 95 confidence interval 1 29 1 11 1 51 and SBP 1 06 1 01 1 10 were significantly associated with a larger risk of an abnormal IAD p 001 and p 012 respectively CONCLUSIONS An abnormal IAD in BP is associated with a larger prevalence of CV risk factors and CV disease Our study confirms that simultaneous both arm BP measurement must always be accomplished in subjects at risk for or with established CV disease
- ItemTelepharmacy for the management of cardiovascular patients in the community.(0000-00-00) Omboni, Stefano; Tenti, MauroTelepharmacy is devised to provide pharmacy operations and patient care at a distance and to expand access to healthcare enhance patients safety and improve patient outcomes A variety of technologies models of care and interventions are used to develop and provide telepharmacy services serving diversified populations with different pathological conditions including cardiovascular diseases Unfortunately very few randomized controlled studies have evaluated the clinical efficacy of the implementation of telepharmacy services in the management of various cardiovascular conditions with the strongest evidence being limited to telemonitoring studies in the areas of hypertension and diabetes Although the clinical efficacy of telepharmacy and its cost effectiveness are far from being fully proved the inclusion of telepharmacy services in healthcare models may offer the unique opportunity to increase access to screening and improve care of cardiovascular conditions
- ItemValidation of the Omron M5-I, R5-I and HEM-907 automated blood pressure monitors in elderly individuals according to the International Protocol of the European Society of Hypertension.(2007-07-12) Omboni, Stefano; Riva, Isabella; Giglio, Alessia; Caldara, Gianluca; Groppelli, Antonella; Parati, GianfrancoThis study aimed at verifying the accuracy of three automated electronic oscillometric blood pressure measuring devices namely Omron M5 I home use upper arm monitor R5 I home use wrist monitor and HEM 907 professional use upper arm monitor according to the European Society of Hypertension International Protocol in elderly individuals
- ItemA working definition of white-coat hypertension must include nocturnal blood pressure.(0000-00-00) Omboni, Stefano