Hypertension Cohort Study in Northeast Italy

One-hundred-twenty-eight consecutive patients with grade 1/grade 2 essential hypertension who presented at the outpatient service of our Clinic from January 2019 to December 2019 were included in a cross-sectional study. Patients seen at the Clinic are white, live in the North-East of Italy, and are representative of the hypertensive population of this regional territory (34 (link)). An automatic tool equipped with appropriately sized cuffs (Omron M6, OMRON Healthcare Co., Kyoto, Japan) was used to measure blood pressure in patients who had been supine for at least 15 min, obtaining 3 consecutive readings. According to current guidelines (35 (link)), diagnosis of hypertension was done after measurements obtained in at least 3 separate visits. Exclusion criteria were predefined as follows: age younger than 18 or older than 80 years; body mass index (BMI) greater than 35 kg/m²; pregnancy; secondary hypertension; 24-h creatinine clearance lower than 30 ml/min/1,73 m²; diabetes; use of lipid-lowering, antiplatelet, anticoagulant drugs and any type of drugs that could interfere with the hemostatic system; history of recent illness and acute or chronic inflammatory conditions; history of cerebrovascular, ischemic heart, or peripheral artery disease. Causes of secondary hypertension were ruled out according to current guidelines (35 (link)) after clinical, biochemical (urine analysis, creatinine clearance, plasma aldosterone, renin, and cortisol, free urinary cortisol and epinephrine, norepinephrine, and dopamine) and instrumental tests (ECG, echocardiography, renal ultrasound, and renal angio-CT and adrenal CT scan when indicated) (36 (link)). Diabetes was excluded by measurement of fasting blood glucose and glycated hemoglobin, and by a standard oral glucose tolerance test (37 (link)). Smokers were defined if they smoked for more than 5 years and did not quit more than 1 year before examination. Ethanol consumption (grams/day) was assessed by a standardized questionnaire (38 (link)). The leisure physical activity of all patients was estimated by a questionnaire, and patients that practiced at least 3 h of aerobic exercise in a week were defined as physically active. The study was conducted following the statements of the Declaration of Helsinki and was approved by the Institutional Review Board. All patients gave their informed consent.