The Pamela Study: Main Findings and Perspectives
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THERAPEUTIC TRIALS (G MANCIA, SECTION EDITOR)
The Pamela Study: Main Findings and Perspectives Michele Bombelli & Elena Toso & Maria Peronio & Danilo Fodri & Marco Volpe & Gianmaria Brambilla & Rita Facchetti & Roberto Sega & Guido Grassi & Giuseppe Mancia
Published online: 23 April 2013 # Springer Science+Business Media New York 2013
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. Keywords Clinical blood pressure . Home blood pressure . Ambulatory blood pressure . White-coat hypertension . Masked hypertension . Blood glucose . Metabolic syndrome . Body mass index . Waist circumference . Left ventricular mass index M. Bombelli (*) : E. Toso : M. Peronio : D. Fodri : M. Volpe : G. Brambilla : R. Facchetti : R. Sega : G. Grassi : G. Mancia Clinica Medica, Department of Health Sciences, University of Milano-Bicocca, S. Gerardo Hospital, via Pergolesi, 20052 Monza, Milan, Italy e-mail: [email protected] G. Grassi IRCCS Multimedica, Sesto San Giovanni, Milan, Italy
Introduction PAMELA (Pressioni Arteriose Monitorate E Loro Associazioni) is an epidemiological study, designed with the original purpose of determining the normal values of blood pressure (BP) selfmeasured at home and during a 24-h period via ambulatory BP recordings. The study started in 1990 and was performed on a large sample of subjects representative of the general population of Monza (northeastern outskirt of Milan, Italy) for gender and decades of ages. A total of 3,200 subjects were recruited, and 2,054 (64 %) agreed to take part in the study. The study methods have been described extensively elsewhere [1]. Briefly, for each subject, we collected several variables: clinical BP (by mercury sphygmomanometer), home BP (twice a day, by a semiautomatic oscillometric validated device), ambulatory BP (by an automatic and validated device, automatic measurements every 20 min), biochemical metabolic variables (serum lipid and glucose profile), anthropometric variables (body mass index
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