The Pamela Study: Old and New Findings

Michele      Bombelli; Guido      Grassi; Danilo      Fodri; Gianmaria      Brambilla; Rita      Facchetti; Roberto      Sega; Giuseppe      Mancia

Abstract

The paper will review the contribution of the PAMELA Research Project to the epidemiology, pathophysiology and treatment of hypertension and hypertension-related cardiometabolic disease. This will be firstly done by examining the results of the PAMELA studies planned and performed in the past 20 years aimed at defining normality values for home and ambulatory blood pressure values as well as at determining precise figures for blood pressure control, taking into account different blood pressure measurements. It will also be done by taking into account different “weight” of clinic, home and ambulatory blood pressure values in determining end-organ damage and in assessing the capability of the different pressures to reflect the regression of target organ damage induced by antihypertensive drug treatment. The review will finally address three further issues of major clinical relevance, i.e. the definition and clinical implication of “white-coat” and “masked” hypertension, the prognostic significance over the long-term period of alterations in home and ambulatory blood pressures as compared to the clinic ones and finally the close relationships between blood pressure and metabolic alterations, including metabolic syndrome.

Keywords: Ambulatory blood pressure, home blood pressure, clinic blood pressure, blood pressure normality, blood pressure control, end organ damage, metabolic syndrome, HDL cholesterol, mercury sphygmomanometer, antihypertensive therapy, prognostic impact