Paolo Palatini

Paolo Palatini
University of Padua | UNIPD · Department of Medicine DIMED

Professor of Medicine

About

790
Publications
105,734
Reads
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34,923
Citations
Additional affiliations
January 2008 - December 2011
Università degli Studi di Milano-Bicocca
January 2003 - December 2004
University of Milan
Position
  • Università degli studi di Milano
Education
July 1996 - October 1999
University of Michigan
Field of study
  • Hypertension

Publications

Publications (790)
Article
Full-text available
Background Insulin resistance (IR) and serum uric acid (SUA) are closely interconnected: SUA contributes to adversely affects the insulin signaling pathway and contributes to IR, while IR is a known predictor for the development of hyperuricemia. The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio has been proposed as an eas...
Article
Kiosk devices for unsupervised self-measurement of blood pressure (BP) are being used in public spaces and healthcare settings in several countries. This statement by the European Society of Hypertension (ESH) Working Group on BP Monitoring and Cardiovascular Variability provides a review of the published evidence on kiosk BP devices and consensus...
Preprint
Full-text available
Background Insulin resistance (IR) and serum uric acid (SUA) are closely interconnected: SUA contributes to adversely affects the insulin signaling pathway and contributing to IR, while IR is a known predictor for the development of hyperuricemia. The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio has been proposed as an ea...
Article
Full-text available
Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is recognized as a reference tool for accurately diagnosing hypertension. Until a few years ago, this technique was restricted to use by specialists. Recently, however, due to the need for wider availability and thanks to technological innovation, simplification of analysis processes, and...
Article
Objective To investigate the reproducibility of ambulatory BP sub-periods and nocturnal dipping phenotypes assessed twice 3 months apart in young-to-middle-age untreated individuals screened for stage 1 hypertension. Design and methods We investigated 1096, 18-to-45-year old participants from the HARVEST. Their office BP was 145.8 ± 10.4/93.7 ± 5....
Article
Background and Objective The accuracy of blood pressure (BP) monitors is essential for an accurate diagnosis, yet few devices have been validated using an established protocol. This study assessed the published evidence on validation studies of BP monitors. Methods STRIDE BP (www.stridebp.org) performs periodic systematic PubMed searches to identi...
Article
Background and Objective Validated automated upper-arm cuff blood pressure (BP) measuring devices are currently recommended for BP measurement. However, a validated BP device in the general population may be inaccurate in pregnant women. Thus, separate validation studies are required in pregnant women with normal BP, hypertension, and preeclampsia....
Article
Background and Objective Blood pressure (BP) measurement in public spaces using kiosk devices may be useful in improving hypertension awareness and control. Validation studies of kiosk devices using an established protocol are necessary prior to their use. Methods A PubMed search was performed using the following algorithm: (kiosk OR “public space...
Article
Background and Objective Properly validated automated upper-arm cuff blood pressure (BP) measuring devices are currently recommended for office, home, and ambulatory BP measurement. However, the validation of BP devices in children presents additional challenges, necessitating separate studies. This study assessed the evidence on accurate automated...
Article
Full-text available
The objective of this study was to investigate the longitudinal association of metabolically healthy overweight/obese adults with major adverse cardiovascular events (MACE) and the effect of LDL-cholesterol levels on this association. This study was conducted with 15,904 participants from the URRAH study grouped according to BMI and metabolic statu...
Article
Objective Tyg index, a surrogate marker of insulin resistance, was shown to be a predictor of development of metabolic syndrome (MS) among diabetes patients and general population while the predictive value among young hypertensives is less known. The aim of the present study was to investigate the predictive capacity of tyg index for incident MS a...
Article
Objective Night-time blood pressure (BP) assessed with ambulatory monitoring has a greater prognostic value than daytime BP but whether this is due to night-time hypertension being more reproducible than daytime hypertension is unclear. The aim of the study was to investigate the reproducibility of ambulatory BP subperiods and nocturnal dipping phe...
Article
Objective The triglyceride-glucose index (TYG), a surrogate marker of insulin resistance, was shown to be associated with an increased risk of cardiovascular events among people with diabetes or the metabolic syndrome, while its prognostic capacity among young hypertensives is less explored. The aim of the present study was to investigate the role...
Article
Objective The clinical significance of metabolically healthy overweight/obesity (OwOb) is controversial. One main issue not yet resolved is whether a healthy metabolic status is stable or just temporary. Conversion to a metabolically unhealthy phenotype may imply a considerable increase in cardiovascular risk. Aim of the present study was to determ...
Article
Full-text available
Purpose Recently, a novel index [the triglyceride-glucose (TyG) index]) was considered a surrogate marker of insulin resistance (IR); in addition, it was estimated to be a better expression of IR than widely used tools. Few and heterogeneous data are available on the relationship between this index and mortality risk in non-Asian populations. There...
Article
Full-text available
Several studies have detected a direct association between serum uric acid (SUA) and cardiovascular (CV) risk. In consideration that SUA largely depends on kidney function, some studies explored the role of the serum creatinine (sCr)-normalized SUA (SUA/sCr) ratio in different settings. Previously, the URRAH (URic acid Right for heArt Health) Study...
Article
Recent evidence suggests that an exaggerated blood pressure (BP) response to standing (ERTS) is associated with an increased risk of adverse outcomes, both in young and old individuals. In addition, ERTS has been shown to be an independent predictor of masked hypertension. In the vast majority of studies reporting on the prognostic value of orthost...
Article
Objective To determine the accuracy of the KOROT P3 Accurate (previously InBody BPBIO480KV) monitor, an automated auscultatory blood pressure (BP) measuring device developed for professional use, in people with extra-large arms according to the ISO81060-2 2018 protocol. Methods The KOROT P3 Accurate was tested in 37 subjects with upper-arm circumf...
Article
Full-text available
Background Despite longstanding epidemiologic data on the association between increased serum triglycerides and cardiovascular events, the exact level at which risk begins to rise is unclear. The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension has conceived a protocol aimed at searching for the prognostic c...
Article
Full-text available
Background: Whether healthy metabolic status is stable or only temporary is still controversial. The aim of the present study was to determine the frequency of the transition from metabolically healthy to metabolically unhealthy status, or vice versa, over the long term. Methods: We examined 970 individuals of 18 to 45 years of age. The participant...
Article
Full-text available
The 2023 hypertension guidelines of the European Society of Hypertension (ESH) have been published in the December issue of the official Journal of the Society (Journal of Hypertension),1 where they are freely available online. Compared to the guidelines published 5 years ago,2 the new guidelines address issues never or only marginally addressed be...
Article
Full-text available
The relationship between Serum Uric Acid (UA) and Cardiovascular (CV) diseases has already been extensively evaluated, and it was found to be an independent predictor of all-cause and cardiovascular mortality but also acute coronary syndrome, stroke and heart failure. Similarly, also many papers have been published on the association between UA and...
Preprint
Full-text available
Background: Despite longstanding epidemiologic data on the association between increased serum triglycerides (TG) and cardiovascular (CV) events, the exact level at which risk begins to rise is unclear. The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension has conceived a protocol aimed at searching for the p...
Article
Full-text available
Document Reviewers Luis Alcocer (Mexico), Christina Antza (Greece), Mustafa Arici (Turkey), Eduardo Barbosa (Brazil), Adel Berbari (Lebanon), Luís Bronze (Portugal), John Chalmers (Australia), Tine De Backer (Belgium), Alejandro de la Sierra (Spain), Kyriakos Dimitriadis (Greece), Dorota Drozdz (Poland), Béatrice Duly-Bouhanick (France), Brent M. E...
Article
Objective: To develop scientific consensus recommendations for the optimal design and functions of different types of blood pressure (BP) measuring devices used in clinical practice for the detection, management, and long-term follow-up of hypertension. Methods: A scientific consensus meeting was performed by the European Society of Hypertension...
Article
Background: There is intense effort to develop cuffless blood pressure (BP) measuring devices, and several are already on the market claiming that they provide accurate measurements. These devices are heterogeneous in measurement principle, intended use, functions, and calibration, and have special accuracy issues requiring different validation th...
Article
Background Microalbuminuria is one of the earliest biomarkers of kidney injury that reflects an endothelial dysfunction with increased glomerular permeability and it is independently associated with adverse outcomes in several clinical situations. Methods To evaluate the very long–term prognostic yield of baseline microalbuminuria in patients with...
Article
Full-text available
Purpose: To investigate the prevalence of orthostatic hypertension and the association of the blood pressure (BP) level, supine BP decline, and white-coat effect with the orthostatic pressor response. Methods: We studied 1275 young-to-middle-age individuals with stage-1 hypertension. Orthostatic response was assessed three times over a 3 month p...
Article
Full-text available
Aim: To evaluate the association of alcohol and smoking combined with cardiovascular and renal events and investigate whether moderate and heavy alcohol consumption have a different impact on this association. Methods: The study was conducted in 1208 young-to-middle-age stage 1 hypertensive patients. Subjects were classified into three categorie...
Article
Full-text available
Unlabelled: A relationship between serum uric acid (SUA) and cardiovascular (CV) events has been documented in the Uric Acid Right for Heart Health (URRAH) study. Aim: of this study was to investigate the association between SUA and left ventricular mass index (LVMI) and whether SUA and LVMI or their combination may predict the incidence of CV d...
Article
To determine the accuracy of the Hingmed DBP-01P monitor for clinical automatic blood pressure (BP) measurement according to the International Organization for Standardization (ISO) 81060-2 2018 protocol. The DBP-01P was tested in 85 subjects from the general population (mean age, 69.9 years; 43 men) using a wide-range cuff for arm circumferences f...
Article
Full-text available
High serum uric acid (SUA) and triglyceride (TG) levels might promote high-cardiovascular risk phenotypes across the cardiometabolic spectrum. However, SUA predictive power in the presence of normal and high TG levels has never been investigated. We included 8124 patients from the URic acid Right for heArt Health (URRAH) study cohort who were follo...
Article
Objective: Recommendations about the dimensions of the reference cuff for device validations in people with arm size >42 cm are still unavailable. The aim of this study was to identify the criteria for an appropriate reference cuff for validation studies in people with upper arm circumference between 43 and 50 cm. Methods: In 20 adults with uppe...
Article
Blood pressure is not a static parameter, but rather undergoes continuous fluctuations over time, as a result of the interaction between environmental and behavioural factors on one side and intrinsic cardiovascular regulatory mechanisms on the other side. Increased blood pressure variability (BPV) may indicate an impaired cardiovascular regulation...
Article
Full-text available
(1) Aim. The aim of the study was to investigate the reproducibility of white-coat hypertension (WCH) and its predictive capacity for hypertension needing antihypertensive treatment (HT) in young to middle-age subjects. (2) Methods. We investigated 1096 subjects from the HARVEST. Office and 24 h blood pressures (BP) were measured at baseline and af...
Article
Full-text available
Background and Aims Whether the association between very high HDL-cholesterol levels and cardiovascular mortality (CVM) is modulated by some facilitating factors is unclear. Aim of the study was to investigate whether the risk of CVM associated with very high HDL-cholesterol is increased in subjects with hyperuricemia. Methods and Results Multivar...
Article
Background: Microalbuminuria is associated with adverse outcome in acute coronary syndrome (ACS) patients. Methods: To evaluate the very long-term association between microalbuminuria during ACS and the overall mortality and causes of death, we prospectively studied 579 ACS patients admitted to three Italian hospitals. The baseline albumin-to-creat...
Article
Full-text available
Objective: In the frame of the Uric Acid Right for Heart Health (URRAH) study, a nationwide multicenter study involving adult participants recruited on a regional community basis from all the territory of Italy under the patronage of the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension, we searched for the...
Article
Full-text available
Aim. To assess the effect of leisure time versus vigorous long-term dynamic physical activity (PA) on carotid stiffness in normotensive versus hypertensive subjects. Methods. The study was conducted on 120 leisure-time exercisers and 120 competitive athletes. One hundred and twenty sedentary subjects served as controls. In addition, participants we...
Chapter
Sedentary habits leading to obesity and metabolic disturbances are responsible for the rise in the prevalence of hypertension among adolescents and young individuals. Regular aerobic exercise has been shown to reduce blood pressure (BP) in resting conditions and BP reactivity to stressors, and to improve all components of the metabolic syndrome. Be...
Chapter
Haemodynamic changes caused by exercise in human beings have been studied almost exclusively during laboratory tests. However, blood pressure (BP) recordings performed “in the field” have shown that the BP behaviour during real sports activities can hardly be reproduced with the use of laboratory testing. When dynamic exercise is performed using pr...
Article
Objective: The pathophysiologic mechanisms of masked hypertension are still debated. The aim of this study was to investigate whether the blood pressure response to standing is a determinant of masked hypertension in young individuals. Design and methods: We studied 1078 individuals (mean age 33.2 ± 8.5 years) with stage-1 untreated hypertension...
Article
Full-text available
Background: Many cuffless blood pressure (BP) measuring devices are currently on the market claiming that they provide accurate BP measurements. These technologies have considerable potential to improve the awareness, treatment, and management of hypertension. However, recent guidelines by the European Society of Hypertension do not recommend cuff...
Article
Objective: Systemic arterial hypertension is the main risk factor for the development of heart failure with preserved ejection fraction (HFpEF). The aim of this study was to assess the right heart-pulmonary circulation unit response to exercise doppler echocardiography (EDE) in patients with hypertension in order to evaluate the capacity of EDE to...
Article
Objective: Previous research showed that elevated systolic blood pressure (SBP) reaction to standing (RS), a condition that may be accompanied by sympathoadrenergic hyperactivity, is a predictor of cardiovascular events. This might be due to the influence of RS on ambulatory BP (ABP). Thus, we investigated whether RS is a determinant of ABP and if...
Article
Objective: The pathophysiologic mechanisms of masked hypertension are still debated. The aim of this study was to clarify the role of the blood pressure (BP) response to the upright posture as a potential mechanism for the development of masked hypertension in young subjects screened for stage 1 hypertension. Design and method: We studied 1078 y...
Article
Objective: A relationship between serum uric acid(UA)and CV events has been documented in the URRAH study.The association between UA and left ventricular mass index(LVMI)has been investigated with heterogeneous results.Aim of this study was to investigate the association between UA and LVMI and whether UA and LVMI or they combination may predict t...
Article
Objective: Little information is available on the accuracy of oscillometric devices for the measurement of heart rate (HR) and on whether the device performance may depend on the level of pulse pressure or HR. Our aim was to determine whether these variables can influence the accuracy of an oscillometric device for the measurement of HR during res...
Article
Objective: Whether impaired arterial elasticity in stage 1 hypertension can be brought back to normal by antihypertensive treatment is unknown. Aim of this study was to evaluate the impact of long-term well-controlled blood pressure (BP) on carotid artery elasticity and endothelial function in stage 1 hypertensive patients at low cardiovascular ri...
Article
Objective: Searching for a prognostic cut-off value of triglycerides (TG) in predicting cardiovascular (CV) outcome in a large regional-based Italian database of men and women. Design and method: A nationwide multicentre database collects data on subjects aged 18 to 95 years recruited on a regional community basis from all the territory of Italy...
Article
Objective: Published evidence has shown that tronco-conical cuffs improve BP measurement accuracy in obese subjects. However, the exact shape of these cuffs according to arm size has not been established. The aim of the present study was to investigate the anthropometric characteristics of the upper arm in a large population in order to identify t...
Article
Objective: The prognostic significance of orthostatic hypertension (BP) in young individuals is still controversial. This study aims to evaluate the association of hyperreactivity to standing with major adverse cardiovascular and renal events (MACE) in a cohort of young-to-middle-age subjects. Design and method: This investigation was performed...
Article
The prognostic significance and the mechanisms of blood pressure (BP) hyperreactivity to standing remain controversial. This study aims to evaluate the association of orthostatic hyperreactivity with major adverse cardiovascular and renal events in a cohort of young hypertensive subjects. We studied 1207 untreated subjects screened for stage I hype...
Article
Objective: The role of increased blood pressure (BP) variability and a blunted day-night BP drop is still debated, particularly in young hypertensive subjects. We investigated the contribution of BP variability and day-night BP changes combined to cardiovascular events in initially untreated young hypertensive individuals. Methods: We selected 1...
Article
Objective The URRAH (URic acid Right for heArt Health) Study has identified cut-off values of serum uric acid (SUA) predictive of total mortality at 4.7 mg/dl, and cardiovascular (CV) mortality at 5.6 mg/dl. Our aim was to validate these SUA thresholds in people with diabetes. Methods The URRAH subpopulation of people with diabetes was studied. Al...
Article
Background Published evidence has shown that tronco-conical cuffs improve BP measurement accuracy in subjects with obesity. However, the exact shape of these cuffs according to arm size is unknown. The aim of the present study was to investigate the anthropometric characteristics of the arm in a large population in order to identify the appropriate...
Article
Full-text available
Background: Systemic arterial hypertension (HTN) is the main risk factor for the development of heart failure with preserved ejection fraction (HFpEF). The aim of the study was was to assess the trends in PASP, E/E' and TAPSE during exercise Doppler echocardiography (EDE) in hypertensive (HTN) patients vs. healthy subjects stratified by age. Meth...
Article
Objectives: In older individuals, the role of serum uric acid (SUA) as risk factor for mortality is debated. This study investigated the association of SUA with all-cause and cardiovascular (CV) mortality in older adults participating in the large multicentre observational uric acid right for heart health (URRAH) study. Methods: Eight thousand U...
Article
Full-text available
The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension conceived and designed an ad hoc study aimed at searching for prognostic cut-off values of serum uric acid (SUA) in predicting combined (fatal and non-fatal) cerebrovascular (CBV) events in the whole database. The URic acid Right for heArt Health study is...
Article
Full-text available
Background: Serum uric acid predicts the onset and progression of kidney disease, and the occurrence of cardiovascular and all-cause mortality. Nevertheless, it is unclear which is the appropriate definition of hyperuricemia in presence of chronic kidney disease (CKD). Our goal was to study the independent impact of uric acid and CKD on mortality....
Article
Objective: Whether oscillometric devices provide accurate measurements of heart rate (HR) is not known. Our aim was to determine the accuracy of an oscillometric device for the measurement of HR during rest and exercise. Methods: The Microlife WatchBP O3, a monitor previously validated for blood pressure measurement, was tested in 36 individuals...
Article
Full-text available
Whether impaired arterial elasticity in stage 1 hypertension can be brought back to normal by antihypertensive treatment is unknown. Aim of this study was to evaluate the impact of long-term well-controlled blood pressure (BP) on carotid artery elasticity and endothelial function in stage 1 hypertensive patients. We studied 40 middle-age hypertensi...
Article
The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a r...
Article
Full-text available
Introduction Serum uric acid (SUA) has been depicted as a contributory causal factor in metabolic syndrome (MS), which in turn, portends unfavourable prognosis. Aim We assessed the prognostic role of SUA in patients with and without MS. Methods We used data from the multicentre Uric Acid Right for Heart Health study and considered cardiovascular...
Article
Full-text available
Aortic valve stenosis (AS) shares similarities with the atherosclerotic process but little is known about the effect of the mechanical properties of large arteries on outcome in patients with AS. The aims of this study were (1) to determine the relationship between indexes of carotid stiffness/compliance and the severity of AS and (2) to identify w...
Article
Objective The prognostic significance of different hypertension subtypes in youth is still debated. The aim of the study was to investigate baseline clinical and haemodynamic characteristics and blood pressure (BP) time-course in young subjects with systolic hypertension compared to other hypertension subtypes. Design and method We investigated 12...
Article
Objective STRIDE BP has systematically reviewed PubMed publications reporting validation data of BP measuring devices using an established protocol. Lists of accurate devices for clinical use are available on the STRIDE BP website (www.stridebp.org) and are circulated to hypertension societies. This report presents the results of the STRIDE BP revi...
Article
Objective Ambulatory blood pressure (ABP) monitoring (ABPM) is currently performed for stratification of risk in hypertension. However, in clinical practice interest is focused on average ABP whereas little attention is paid to other ABPM parameters. Previous data have been obtained mainly from populations including elderly individuals, while littl...
Article
Objective Rectangular (cylindrical) cuffs and bladders are currently used for blood pressure (BP) measurement at the upper arm. However, large arms have a conical shape which make cylindrical cuffs potentially unsuitable. Aim of this study was to study the shape of the arm in people with severe obesity and to investigate the effect of the shape of...
Article
Objective Hyperuricemia can be both determined by overproduction (due to xanthine oxidase hyperactivity) or renal hypoexcretion. In this latter case, also diuretic use (particularly hydrochlorotiazhide) can be involved. While the relationship between hyperuricemia and CardioVascular (CV) events has been definitively linked in many studies, data on...
Article
Objective To determine the accuracy of the Microlife WatchBP O3 monitor for ambulatory blood pressure measurement according to the new ISO81060–2 2018 protocol. Design and method The WatchBP O3 model is an oscillometric fully automatic device for blood pressure measurement at the upper arm. The device accuracy was first tested in 97 subjects from...
Article
Full-text available
Background Hyperuricemia is commonly observed in patients with chronic kidney disease (CKD). However, a better understanding of the relationship among uric acid (UA) values, glomerular filtration rate (GFR) and albuminuria may shed light on the mechanisms underlying the excess of cardiovascular mortality associated with both chronic kidney disease...
Article
Collaborators: Lucas Aparicio (Argentina), Kei Asayama (Japan), Roland Asmar (France), Grzegorz Bilo (Italy), Jean-Marc Boivin (France), Alejandro de la Sierra (Spain), Eamon Dolan (Ireland), Jan Filipovsky (Czech Republic), Geoffrey Head (Australia), Yutaka Imai (Japan), Kazuomi Kario (Japan), Anastasios Kollias (Greece), Efstathios Manios (Greec...
Article
Aims Whether the association between uric acid (UA) and cardiovascular disease is influenced by some facilitating factors is unclear. The aim of this study was to investigate whether the risk of cardiovascular mortality (CVM) associated with elevated UA was modulated by the level of resting heart rate (HR). Methods and results Multivariable Cox...