Beyond risk factors (2), in the war against Atherosclerosis.
Sirs,
L.Hooper et al. (1), in their otherwise fascinating research to assess the
long term effects of advice to restrict dietary sodium in adults with and
without hypertension, consider unfortunately that sodium metabolism is the
same in general population, a part from blood pressure value. Moreover,
their conclusion is really over-simplified interpretation of
atherosclerosis and its complications: “Intensive interventions, unsuited
to primary care or population prevention programmes, provide only small
reductions in blood pressure and sodium excretion, and effects on deaths
and cardiovascular events are unclear. Advice to reduce sodium intake may
help people on antihypertensive drugs to stop their medication while
maintaining good blood pressure control”.
Firstly, in a 45-year-long
clinical experience, independently of its possible adverse effect on small
arterioles, according to Hammersem, i.e., resistance vessel (2), primarily
in skeletal muscles, abnormality of sodium metabolism involves exclusively
individual with an inherited mitochondrial cytopatology, I named
Congenital Acidosic Enzyme-Metabolic Histangiopathy, conditio sine qua non
of the most severe human diseases (See site HONCode, N° 233736, http://digilander.libero.it/semeioticabiofisica, “Congenital Acidosic
Enzyme-Metabolic Histangiopathy” (CAEMH) and “Biophysical-Semeiotic
Constitution”).
Secondly, mortality, cardiovascular events, blood
pressure a.s.o. are problems impossible to resolve, now-a-days, for who is
unfortunately speaking about “only” well-known risk factors.
As I wrote in
a previous letter (“Beyond risk factors”, 28 June 2002), we must go
beyond such risk factors to prevent morbidity and mortality due to
arteriosclerosis. Primary Prevention of the most common and dangerous
human pathologies, including malignancies, depends clearly by easy and
rapid bed-side detecting individuals, even apparently healthy, but at
"real" risk, i.e. involved by well-defined biophysical-semeiotic
constitution(s), assessed clinically in “quantitative” way (3). In order
to define clinically a “particular” constitution, based always on CAEMH
(4,5,6), which does not exclude at all the presence of other(s), of
course, it is necessary to think over the current possibility of gathering
at the bed -side biophysical-semeiotic data, rich of biological and
molecular-biological information on the various human organs, tissues and
biological systems, so that doctor can describe numerous types of
biophysical-semeiotic constitutions, even from the “quantitative” point of
view. I agree, therefore, completely with Pete Hayden’s compelling
hypothesis
(See excellent and intriguing site www.amyloiddiabetes.com) about the
urgent necessity to find new ways in the war against the mortality and
morbidity, also in young people, due to ATS, even in total absence of the
over 300 (too much, in my opinion) risk factors.
1) Hooper L., Bartlett h., Smith GD., and Ebrahim S., Systematic
review of long term effects of advice to reduce dietary salt in adults.
BMJ 2002;325:628 ( 21 September )
2) Curri S. B., Le microangiopatie, a cura di Inverni della Beffa, Arte
Grafica S.p.A. Verona, 1986.
3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of
Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta
Med. Medit. 5, 141, 1989.
4) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica
condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz.
Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28
Settembre-1 Ottobre, Bellagio, 1983.
5) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X
Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7
Novembre, 1981,Siena
Rapid Response:
Beyond risk factors (2), in the war against Atherosclerosis.
Sirs,
L.Hooper et al. (1), in their otherwise fascinating research to assess the
long term effects of advice to restrict dietary sodium in adults with and
without hypertension, consider unfortunately that sodium metabolism is the
same in general population, a part from blood pressure value. Moreover,
their conclusion is really over-simplified interpretation of
atherosclerosis and its complications: “Intensive interventions, unsuited
to primary care or population prevention programmes, provide only small
reductions in blood pressure and sodium excretion, and effects on deaths
and cardiovascular events are unclear. Advice to reduce sodium intake may
help people on antihypertensive drugs to stop their medication while
maintaining good blood pressure control”.
Firstly, in a 45-year-long
clinical experience, independently of its possible adverse effect on small
arterioles, according to Hammersem, i.e., resistance vessel (2), primarily
in skeletal muscles, abnormality of sodium metabolism involves exclusively
individual with an inherited mitochondrial cytopatology, I named
Congenital Acidosic Enzyme-Metabolic Histangiopathy, conditio sine qua non
of the most severe human diseases (See site HONCode, N° 233736,
http://digilander.libero.it/semeioticabiofisica, “Congenital Acidosic
Enzyme-Metabolic Histangiopathy” (CAEMH) and “Biophysical-Semeiotic
Constitution”).
Secondly, mortality, cardiovascular events, blood
pressure a.s.o. are problems impossible to resolve, now-a-days, for who is
unfortunately speaking about “only” well-known risk factors.
As I wrote in
a previous letter (“Beyond risk factors”, 28 June 2002), we must go
beyond such risk factors to prevent morbidity and mortality due to
arteriosclerosis. Primary Prevention of the most common and dangerous
human pathologies, including malignancies, depends clearly by easy and
rapid bed-side detecting individuals, even apparently healthy, but at
"real" risk, i.e. involved by well-defined biophysical-semeiotic
constitution(s), assessed clinically in “quantitative” way (3). In order
to define clinically a “particular” constitution, based always on CAEMH
(4,5,6), which does not exclude at all the presence of other(s), of
course, it is necessary to think over the current possibility of gathering
at the bed -side biophysical-semeiotic data, rich of biological and
molecular-biological information on the various human organs, tissues and
biological systems, so that doctor can describe numerous types of
biophysical-semeiotic constitutions, even from the “quantitative” point of
view. I agree, therefore, completely with Pete Hayden’s compelling
hypothesis
(See excellent and intriguing site www.amyloiddiabetes.com) about the
urgent necessity to find new ways in the war against the mortality and
morbidity, also in young people, due to ATS, even in total absence of the
over 300 (too much, in my opinion) risk factors.
1) Hooper L., Bartlett h., Smith GD., and Ebrahim S., Systematic
review of long term effects of advice to reduce dietary salt in adults.
BMJ 2002;325:628 ( 21 September )
2) Curri S. B., Le microangiopatie, a cura di Inverni della Beffa, Arte
Grafica S.p.A. Verona, 1986.
3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of
Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta
Med. Medit. 5, 141, 1989.
4) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica
condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz.
Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28
Settembre-1 Ottobre, Bellagio, 1983.
5) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X
Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7
Novembre, 1981,Siena
6) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz
Med. It. – Asch. Sci, Med. 144, 423,1985 (Infotrieve).
Competing interests: No competing interests