Abstract The May Measurement Month (MMM) campaign was conducted in Italy in 2023 to raise awareness of raised blood pressure (BP). Adults aged ≥ 18 years were recruited through convenience sampling. Three seated BP readings were taken on each participant, and a questionnaire collected information on demographics, lifestyle factors, and comorbidities. Hypertension was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or being on BP-lowering medication. Controlled BP was defined as being on BP-lowering medication with a BP <140/90 mmHg. Multiple imputation was used to estimate missing BP readings. In total, 2492 were screened, with a mean age of 58.7 years and 52.6% were female. Their mean BP was 128.4/77.8 mmHg. Globally, 1260 participants (50.6%) had hypertension, of whom 946 (75.1%) were aware, and 885 (70.2%) were on antihypertensive medication. Among treated individuals, 64.3% had controlled BP; of all participants with hypertension, 45.2% had controlled BP. The MMM campaign in Italy identified a substantial number of participants with untreated or inadequately treated hypertension and a high prevalence of lifestyle-related cardiometabolic risk factors. Awareness-raising campaigns that educate and empower patients are essential for effective cardiovascular prevention.

Background and Objectives: Dysbiosis of the oral–gut axis is related to several extraintestinal inflammatory diseases, including endometriosis. This study aims to assess the microbial landscape and pathogenic potential of distinct biological niches during endometriosis. Materials and Methods: A microbiome meta-analysis was conducted on 182 metagenomic sequences (79 of fecal and 103 of vaginal origin) from women with and without endometriosis. Fecal and vaginal microbial diversity, differential abundance, and functional analysis based on disease status were assessed. Random forest, gradient boosting, and generalized linear modeling were used to predict endometriosis based on differentially enriched bacteria. Results: Only intestinal microbes displayed distinctive taxonomic and functional characteristics in women with endometriosis compared to control women. Taxonomic differences were quantified using the microbial endometriosis index (MEI), which effectively distinguished between individuals with and without the disease. The observed functional enrichment pointed to proinflammatory pathways previously related to endometriosis development. Conclusions: Dysbiosis in the oral–gut microbial community appears to play a prevalent role in endometriosis. Our findings pave the ground for future studies exploring the potential mechanistic involvement of the oral–gut axis in disease pathogenesis.

Introduction:Chronic periodontitis is linked to systemic inflammation and cardiovascular risk, yet the temporal trajectory and magnitude of systemic cytokine reduction following nonsurgical-periodontal-therapy (NSPT) remain underexplored. We conducted a meta-analysis and spline-based meta-regression to assess whether intensive NSPT, compared to standard therapy, produces sustained reductions in circulating TNF-α, IL-1β, IL-6 and high-sensitivity C-reactive protein (hs-CRP). Methods:We systematically searched major databases for interventional studies published until January 2024 comparing intensive vs. standard NSPT on inflammatory markers. Using a custom R pipeline, standardized mean differences (SMDs), 95% confidence intervals (Cis) heterogeneity (I²) and stratified analyses by phenotype (e.g., smoking, diabetes) and time were performed. A spline-based mixed-effects meta-regression explored temporal dynamics of inflammatory reduction in the intensive group. Results:From 216 observations (14,374 paired values), intensive NSPT led to significantly greater reductions in TNF-α (SMD -0.59, 95% CI -1.02 to -0.16; P=0.008), IL-6 (SMD -0.20, 95% CI -0.39 to -0.00; P=0.046) and hs-CRP (SMD -1.17, 95% CI -2.18 to -0.16; P=0.024) compared to standard therapy. IL-1β showed a near-significant reduction (SMD -4.14, P=0.052). Standard therapy was paradoxically associated with greater CRP reduction (SMD -0.30, P=0.001). Age, tooth count and year of publication moderated effects. Early benefits emerged within 3 months for TNF-α and 6 months for IL-1β. Although no strong nonlinear time-response was confirmed (QM = 4.23, P=0.2372),a potential rebound in cytokine suppression was suggested. The overall anti-inflammatory effect remained significant. Discussion:Intensive NSPT reduces systemic inflammation particularly in younger, non-smoking individuals. The potential rebound in inflammatory markers underscores the need for longitudinal studies but, supports the systemic immunoregulatory effect of periodontal therapy. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier CDR42024503063.

Introduction Cardiovascular diseases (CVD) represent the leading cause of morbidity and mortality for women worldwide, yet they are often unaware of this heavy burden. AimTo assess cardiovascular risk awareness among Italian women. Methods Following World Heart Day 2023, a cardiovascular prevention campaign was conducted in Italian pharmacies to evaluate the effectiveness of screening activities offered by pharmacies and raise awareness of cardiovascular health status among Italian women. Cardiovascular risk profile and perception of CVD burden relative to other common female-specific diseases were assessed. Blood pressure (BP) measurement and ECG recording were performed. Results A total of 1510 women (84.7% < 70 years), enrolled at 91 pharmacies, were included. The most prevalent cardiovascular risk factor was sedentary lifestyle (57.9%), followed by overweight/obesity (44.3%), hypercholesterolemia (37.9%), hypertension (31.3%), family history of early CVD (28.7%), smoking (20.6%), and diabetes (5%). CVD and/or kidney disease were uncommon (3.6%), but 1 in 4 women was classified as being at increased cardiovascular risk, and 47.5% had some type of ECG abnormalities, requiring further assessments in 18% cases. Less than 1 in 3 women was aware of the burden represented by CVD, being the majority mostly concerned with breast cancer and osteoporosis as potential health threats. Conclusions The burden of cardiovascular risk factors is high, and the perception of related health threat is low among the examined sample of Italian women, supporting the urgent need to raise awareness of CVD in women as a major health issue and to undertake effective, tailored preventive strategies to reduce such risk in a timely fashion.

INTRODUCTION:Bempedoic acid can interfere with creatinine excretion, thereby potentially altering the calculation of glomerular filtration rate (eGFR), but is not known to have an effect on cystatin C metabolism. AIM:The aim of this pilot observational study was to assess the impact of 3-months bempedoic acid treatment on renal function assessed by serum creatinine and cystatin C. METHODS:Consecutive hypercholesterolemic outpatients with indication to be started on bempedoic acid and available serum creatinine and cystatin C levels were enrolled. Follow-up (45-90 days) renal function markers were assessed. Lipid profile, uric acid levels, and CRP levels were also recorded. RESULTS:Bempedoic acid reduced LDL-c and total cholesterol levels by day 45. No changes were observed in HDL-c, triglycerides, Lp(a), serum creatinine, eGFRcr, BUN, uric acid, or CRP levels throughout the study. The sensitivity analysis on individuals with complete data for cystatin C during follow-up (42%) confirmed the overall observations, while also showing neutral effects of bempedoic acid eGFRcys and eGFRcr-cys. CONCLUSIONS:Three-months administration of bempedoic acid did not affect cystatin C levels. Adequately powered studies are needed to test these findings and, ultimately, the renal safety of bempedoic acid.

Objective: Most individuals have little awareness of their health status and do not engage in prevention measures to reduce the risk of future cardiovascular diseases (CVD. We conducted an observational study to assess the prevalence of common cardiometabolic risk factors and modifiable lifestyle measures in the general population. Design and method: During an awareness-raising educational campaign for cardiovascular prevention (October 10th, 2023), a cross-sectional study on consecutive volunteer individuals was conducted. Participants self-presented at local sites and accepted to undergo standard blood pressure (BP) measurement with automated devices and to complete a questionnaire on self-reported demographic and clinical features and lifestyle habits. Open seminars were held to educate on cardiovascular risk factors and related non-pharmacological preventive measures (including diet, physical exercise, smoking cessation). As part of the prevention of peripheral artery disease (PAD), participants received education on how to perform arterial pulses autopalpation. Here, stratification based on self-reported symptoms suggestive of PAD is reported. Descriptive analysis was performed with R. Results: A total of 160 participants took part in the survey, of whom 154 (113 F; mean age 38.5(18.7) years; 83.3% <=70 years) with no PAD symptoms. Their mean BP was 120/3(14.2)/76.2/(11.5) mmHg. Of them, 16.7% had DM2, 40% had hypertension, 50% had hypercholesterolemia, 49.3% were current/former smokers; 67% reported to exercise >=150’/week; 9.1% never/rarely consumed vegetables/fruit. Only 3.7% participants (mean age 56.5(15.5) years) declared symptoms compatible with PAD. Their mean BP was 145(18.7)/89.6(5) mmHg; 83.3% reported having hypertension, diabetes, high cholesterol, and/or never or rarely eating vegetables/fruits; 50% were smokers; 33.3% were sedentary; approximately 4 in 5 had measured their BP in the previous month. All participants were educated on the prevention of common cardiometabolic risk factors and self-examination of peripheral pulses. Conclusions: In the examined relatively young sample of the general population, cardiometabolic risk factors were common in individuals with and without symptoms of PAD, and lifestyle habits could be largely improved. Awareness-raising educational campaign represent a powerful opportunity for health empowerment.

Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022–2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. A total of 255 individuals were included, 40.2

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide with a high socioeconomic burden. Increasing evidence supports a convincing connection with increased cardiovascular risk of periodontal diseases (PD), a group of widespread, debilitating, and costly dysbiotic relapsing-remitting inflammatory diseases of the tissues supporting the teeth. Herein, we ensembled the best available evidence on the connection between CVDs and PD to review the recently emerging concept of the latter as a non-traditional risk factor for CVDs. We focused on oral dysbiosis, inflammation-associated molecular and cellular mechanisms, and epigenetic changes as potential causative links between PD and CVDs. The available evidence on the effects of periodontal treatment on cardiovascular risk factors and diseases was also described.

Objective: By affecting approximately 45% of the world's population, hypertension is the main risk factor for cardiovascular diseases (CVD). Of note, only half of hypertensive patients manage to have good blood pressure (BP) control. Relevant reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients’ side, and therapeutic inertia on physicians’ side. Design and method: During the global BP screening campaign “May Measure Month” (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults >= 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures. Results: A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About one in two participants was sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension; not being on a fixed-dose combination of antihypertensive drugs and not measuring their BP at home were common features in this setting. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%). Conclusions: This survey identified a certain degree of therapeutic inertia and poor patients’ involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to increase risk factors awareness to reduce CV risk.

Abstract IL-33 is a pleiotropic cytokine known to possess dichotomous roles during gut health and disease. We previously described that IL-33 promotes epithelial restitution/repair in otherwise healthy (C57BL/6) mice that have been challenged with dextran sodium sulphate (DSS) to induce acute colitis, with the end result of efficient resolution of inflammation. However, in SAMP1/YitFc (SAMP) mice that spontaneously develop Crohn’s disease (CD)-like ileitis, elevated IL-33 levels persist as disease progresses, perpetuating chronic gut inflammation and severe fibrosis. While IL-33 has been implicated in the development of inflammation-associated fibrosis, the precise mechanism(s) by which this occurs remains unclear. The aim of this study was to determine IL-33-dependent events leading to intestinal fibrosis in ileitis-prone SAMP mice. Our results show IHC co-localization of IL-33 with fibrotic lesions, specifically in cells morphologically-consistent with both macrophages and subepithelial myofibroblasts (SEMFs). Bulk RNA-Seq analysis of the human SEMF cell line, CCD-18Co, stimulated +/- IL-33 identifies one of the highest-expressing transcripts as SERPINE1, encoding for plasminogen activator inhibitor-1 (PAI-1), which has previously been reported as highly-enriched in IBD patients with active disease that do not respond to anti-TNF therapy. Analysis of publicly-available scRNA-Seq data confirms the increased expression of SERPINE1 in IBD patients that localizes to mesenchymal cell populations. Of note, robust upregulation of SERPINE1 is detected in activated fibroblasts from involved vs. non-involved areas of CD patients. Furthermore, spatial transcriptomics of SAMP ilea reveal a progressive and concomitant increase in both Il33 and Serpine1, with strong clusterization compared to healthy AKR controls, particularly during later time points when fibrosis is evident. Currently, results are pending on the treatment of SAMP mice with the PAI-1 inhibitor, MDI-2268, to determine its direct effect(s) on the development of inflammation-associated intestinal fibrosis. Taken together, these findings suggest IL-33-dependent regulation of Serpine1/PAI-1 that promotes intestinal fibrosis, commonly observed in CD patients, and may provide a novel target to treat IBD patients with fibrostenoic disease.

Sex is an often overlooked, yet compulsory, biological variable when performing biomedical research. Periodontitis is a common yet progressively debilitating chronic inflammatory disorder affecting the tissues supporting teeth that ultimately leads to tooth loss if left untreated. The incidence of periodontitis is sex biased, with increased prevalence in males compared with females but with unknown etiology. We performed a sex-specific meta-analysis using publicly available oral microbiome data from different sampling sites of patients with periodontitis and periodontally healthy controls; sex balance was established for each periodontal health condition. Our results show sex-based diversity in oral biofilms of individuals with periodontitis but not in their saliva, with increased abundance of several periodontal pathogens in subgingival plaques from females compared with males. We devised a quantitative measure, uniquely defined as the Microsexome Index (MSI), which indicates that sexual dimorphism in subgingival bacterial composition is a distinct feature of reduced microbial diversity during periodontitis but not under healthy conditions. In addition, we found that smoking exacerbates microsexome diversity in supragingival biofilms, particularly during periodontitis. Taken together, we provide insights regarding sex-based diversity in periodontitis, a disease with multiorgan associations, and provide the rationale for further mechanistic, diagnostic, and therapeutic studies.

Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients’ side, and therapeutic inertia on physicians’ side. During the global BP screening campaign “May Measure Month” (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures. A total of 1612 participants (mean age 60.0±15.41 years; 44.7

Objective: Physicians and researchers in the cardiovascular (CV) field are constantly engaged in the promotion of guidelines-directed preventive measures, but whether they are themselves adherent to the same recommendations was only sporadically assessed. Design and method: During the annual meeting of the Italian Society of Hypertension (SIIA, October 2022) and the European Society of Hypertension (ESH, June 2023), an observational study on consecutive volunteer health professionals was conducted. Participants underwent three standard sitting and two standing (1-3 minutes) blood pressure (BP) measurements and answered a questionnaire regarding demographic features, modifiable/non-modifiable CV risk factors and related treatments. Hypertension was defined as BP > 140 and/or 90 mmHg or as a pre-existing diagnosis. Orthostatic hypotension was defined as a decrease of systolic BP > 20 mmHg or of diastolic BP > 10 mmHg; orthostatic hypertension was defined as an increase of systolic BP > 20 mmHg or of diastolic BP > 11 mmHg. Results: In total, 62 participants from SIIA 2022 (30F, mean age 43.2±14.8 years) and 129 participants from ESH 2023 (65F, mean age 36,6±12.5 years) were enrolled; 49 participants were non-Italian (26 F e 23 M). 80,1% reported regular physical activity; and only 22.5% were on a low-salt diet. Dyslipidemia was the most common risk factor (13.1%), but only 56% participants were on a statin; 9.3% had high BP, of whom 83.3% were unaware; 1.6% and 16.4% had orthostatic hypo- and hypertension, respectively. No significant differences were found regarding the degree of physical activity between Italian or non-Italian participants. Italian women were more often on a low-salt diet than non-Italian women (31% vs 4% p=0.005). Conclusions: Despite the specific professional involvement, self-awareness and management of CV risk factors can be improved in the examined exploratory, international sample of health professionals.

Obesity is a chronic, multifactorial disease characterized by persistent low-grade tissue and systemic inflammation. Fat accumulation in adipose tissue (AT) leads to stress and dysfunctional adipocytes, along with the infiltration of immune cells, which initiates and sustains inflammation. Neutrophils are the first immune cells to infiltrate AT during high-fat diet (HFD)-induced obesity. Emerging evidence suggests that the formation and release of neutrophil extracellular traps (NETs) play a significant role in the progression of obesity and related diseases. Additionally, obesity is associated with an imbalance in gut microbiota and increased intestinal barrier permeability, resulting in the translocation of live bacteria, bacterial deoxyribonucleic acid (DNA), lipopolysaccharides (LPS), and pro-inflammatory cytokines into the bloodstream and AT, thereby contributing to metabolic inflammation. Recent research has also shown that short-chain fatty acids (SCFAs), produced by gut microbiota, can influence various functions of neutrophils, including their activation, migration, and the generation of inflammatory mediators. This review comprehensively summarizes recent advancements in understanding the role of neutrophils and NET formation in the pathophysiology of obesity and related disorders while also focusing on updated potential therapeutic approaches targeting NETs based on studies conducted in humans and animal models.

Physicians and researchers in the cardiovascular field are constantly engaged in the promotion of guidelines-directed preventive measures, but whether they are themselves adherent to the same recommendations was only sporadically examined. To assess awareness of self-exposure to cardiovascular risk factors and related management among cardiovascular specialists. During the National Conference of the Italian Society of Hypertension (October 2022), a pilot observational study on consecutive volunteer cardiovascular specialists was conducted. Participants underwent standard sitting and standing blood pressure (BP) measurements and answered a questionnaire regarding modifiable/non modifiable cardiovascular risk factors and related treatments. Based on self-declarations and actual measurements, BP was classified as optimal, normal, high-normal BP, and new hypertension in untreated participants, and as treated/untreated pre-existing hypertension. Controlled hypertension was defined as BP < 140/90 mmHg; age-adjusted lower targets were also applied, according to guidelines. In total, 62 participants (30 F, mean age 43.2 ± 14.8 years) were enrolled; 79

Arterial hypertension (AH) and periodontitis are among the most common non-communicable chronic diseases worldwide. Besides sharing common risk factors, an increasing body of evidence supports an independent association between the two conditions, with low-grade systemic inflammation acting as the plausible biological link with increased cardiovascular risk. In 2021, the Italian Society of Arterial Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) have joined forces and published a joint report on the relationships between AH and periodontitis, reviewing the existing scientific evidence and underlining the need to increase awareness of the strong connection between the two conditions and promote treatment strategies for the control of gums inflammation in patients with AH. The current document extends the previous joint report, providing clinical practical guidelines aimed to support clinicians in the management of patients who suffer from or are at risk of being affected by both conditions. These recommendations are based on careful consideration of the available evidence as well as of the current guidelines on the management of periodontitis and AH and are supported by SIIA and SIdP.