Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Hypertension Reports
Published in: Current Hypertension Reports 3/2013

01-06-2013 | Therapeutic Trials (G Mancia, Section Editor)

The Pamela Study: Main Findings and Perspectives

Authors: Michele Bombelli, Elena Toso, Maria Peronio, Danilo Fodri, Marco Volpe, Gianmaria Brambilla, Rita Facchetti, Roberto Sega, Guido Grassi, Giuseppe Mancia

Published in: Current Hypertension Reports | Issue 3/2013

Login to get access

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.
Literature
1.
Cesana G, De Vito G, Ferrario M, et al. Ambulatory blood pressure normalcy: the PAMELA Study. J Hypertens Suppl. 1991;9:S17–23.PubMed
2.
Manual of international statistical classification of diseases, injuries and causes of death, IXth revision. Geneva: WHO; 1977.
3.
•• Mancia G, Sega R, Bravi C, et al. Ambulatory blood pressure normality: results from the PAMELA study. J Hypertens. 1995;13:1377–90. This is one of the first studies reporting normality values for 24-h ambulatory blood pressure values in the general population.
4.
Sega R, Cesana G, Milesi C, et al. Ambulatory and home blood pressure normality in the elderly: data from the PAMELA population. Hypertension. 1997;30:1–6.PubMedCrossRef
5.
Sega R, Facchetti R, Bombelli M, et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation. 2005;111:1777–83.PubMedCrossRef
6.
Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87.PubMedCrossRef
7.
Sega R, Trocino G, Lanzarotti A, et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: Data from the general population (Pressione Arteriose Monitorate E Loro Associazioni [PAMELA] Study). Circulation. 2001;104(12):1385–92.PubMedCrossRef
8.
•• Mancia G, Bombelli M, Facchetti R, et al. Long-term risk of sustained hypertension in white-coat or masked hypertension. Hypertension. 2009;54:226–32. The article provides evidence of the increased risk of white-coat and masked hypertension to develop a sustained hypertension and suggests that these conditions are not innocent from the prognostic point of view.
9.
• Mancia G, Bombelli M, Facchetti R, et al. Increased long-term risk of new-onset diabetes mellitus in white-coat and masked hypertension. J Hypertens. 2009;27:1672–8. The article documents an increased risk of white-coat and masked hypertension to develop a condition of deranged glucose metabolism and suggests the importance of out-of-office blood pressure measurement in the prognostic stratification of hypertensive subjects.
10.
Mancia G, Facchetti R, Bombelli M, et al. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006;47:846–53.PubMedCrossRef
11.
Mancia G, Facchetti R, Bombelli M, et al. Relationship of office, home, and ambulatory blood pressure to blood glucose and lipid variables in the PAMELA population. Hypertension. 2005;45:1072–7.PubMedCrossRef
12.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–7.CrossRef
13.
Mancia G, Bombelli M, Corrao G, et al. Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis. Hypertension. 2007;49:40–7.PubMedCrossRef
14.
Mancia G, Bombelli M, Facchetti R, et al. Long-term risk of diabetes, hypertension and left ventricular hypertrophy associated with the metabolic syndrome in a general population. J Hypertens. 2008;26:1602–11.PubMedCrossRef
15.
Grundy SM, Brewer HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Arterioscler Thromb Vasc Biol. 2004;24:e13–8.PubMedCrossRef
16.
Alberti KG, Zimmet PZ, Shaw JE. The metabolic syndrome: a new worldwide definition from the International Diabetes Federation consensus. Lancet. 2005;366:1059–62.PubMedCrossRef
17.
Mancia G, Bombelli M, Facchetti R, et al. Impact of different definitions of the metabolic syndrome on the prevalence of organ damage, cardiometabolic risk and cardiovascular events. J Hypertens. 2010;28:999–1006.PubMedCrossRef
18.
Bombelli M, Facchetti R, Fodri D, et al. Impact of body mass index and waist circumference on the cardiovascular risk and all-cause death in a general population: Data from the PAMELA study. Nutr Metab Cardiovasc Dis. 2013, In press.
19.
Bombelli M, Facchetti R, Sega R, et al. Impact of body mass index and waist circumference on the long-term risk of diabetes mellitus, hypertension, and cardiac organ damage. Hypertension. 2011;58:1029–35.PubMedCrossRef
20.
Levy D, Garrison RJ, Savage DD, et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990;322:1561–6.PubMedCrossRef
21.
Bombelli M, Facchetti R, Carugo S, et al. Left ventricular hypertrophy increases cardiovascular risk independently of in-office and out-of-office blood pressure values. J Hypertens. 2009;27:2458–64.PubMedCrossRef
22.
Poppe KK, Edgerton Bachmann M, Triggs CM, et al. Geographic variations in left ventricular mass and left ventricular mass index: a systematic review. J Hum Hypertens. 2012;26:420–9.PubMedCrossRef
23.
• Cuspidi C, Facchetti R, Sala C. Normal values of left-ventricular mass: echocardiographic findings from the PAMELA study. J Hypertens. 2012;30:997–1003. This is the first study deriving the normalcy values of left ventricular mass from the mean values of a healthy population, without the confounding influence of overweight, obesity, diabetes mellitus, and clinical and out-of-office hypertension.
24.
Wild PS, Sinning CR, Roth A, et al. Distribution and categorization of left ventricular measurements in the general population. Results from the population-based Gutenberg heart study. Circ Cardiovasc Imaging. 2010;3:604–13.PubMedCrossRef
25.
Lang RM, Bierig M, Devereux RB, et al. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.PubMedCrossRef
Metadata
Title
The Pamela Study: Main Findings and Perspectives
Authors
Michele Bombelli
Elena Toso
Maria Peronio
Danilo Fodri
Marco Volpe
Gianmaria Brambilla
Rita Facchetti
Roberto Sega
Guido Grassi
Giuseppe Mancia
Publication date
01-06-2013
Publisher
Current Science Inc.
Published in
Current Hypertension Reports / Issue 3/2013
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-013-0348-1

Other articles of this Issue 3/2013

Current Hypertension Reports 3/2013 Go to the issue

Hypertension and Obesity (E Reisin, Section Editor)

Treatment of Obesity-Related Hypertension in Children and Adolescents

Blood Pressure Monitoring and Management (J Redon, Section Editor)

Ambulatory Blood Pressure in Stroke and Cognitive Dysfunction

Invited Commentary

High Blood Pressure: The Leading Global Burden of Disease Risk Factor and the Need for Worldwide Prevention Programs

Hypertension and Obesity (E Reisin, Section Editor)

Pharmacologic Treatment Options for Obesity: What Is Old Is New Again

Therapeutic Trials (G Mancia, Section Editor)

Role of Ambulatory Blood Pressure Monitoring in Resistant Hypertension

Hypertension and Obesity (E Reisin, Section Editor)

Exercise Training and Cardiometabolic Diseases: Focus on the Vascular System
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits