Evangelismos State General Hospital

Athens, Greece

Evangelismos State General Hospital

Athens, Greece
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Gouveri E.T.,Evangelismos State General Hospital | Tzavara C.,National and Kapodistrian University of Athens | Drakopanagiotakis F.,Evangelismos State General Hospital | Tsaoussoglou M.,Evangelismos State General Hospital | And 3 more authors.
Nutrition in Clinical Practice | Year: 2011

Background: Previous studies demonstrated the beneficial impact of the Mediterranean diet (MedDiet) on metabolic syndrome (MetS). The aim of this study was to retrospectively investigate the association between MedDiet and MetS in a representative sample of the Athenian population in the early 1980s, when MetS had not been established as an entity yet. Methods: In a cross-sectional epidemiologic survey of cardiovascular disease (CVD), 2,074 randomly selected adults were examined: 900 men and 1,174 women (age, 46.9 ± 14.9 years). MetS was defined according to criteria of the National Cholesterol Education Program-Adult Treatment Panel III. A validated questionnaire concerning nutrition habits was administered, and MedDiet was assessed according to guidelines of the Division of Nutrition/Epidemiology, Athens University Medical School. Results: Overall, 1,023 participants (49.3%) followed MedDiet (47.3% men, 52.0% women, P =.033) with similar rates across age groups (P =.337). MetS was diagnosed in 24.0% of those following MedDiet, compared with 27.9% of those not following it (P =.041). Participants with CVD or diabetes mellitus were less likely to follow MedDiet (43% vs 50%, P =.009). Multivariate analysis revealed that MedDiet is associated with a 20% reduction in MetS (odds ratio = 0.80, 95% confidence interval = 0.65-0.98), after adjustment for age, gender, smoking, light physical activity, serum levels of low-density lipoprotein cholesterol and I-glutamyl transferase, diabetes mellitus, CVD, family history of hypertension, and/or hyperlipidemia. Conclusions: Results indicate that adherence to MedDiet may attenuate the prevalence of MetS and, consequently, the increasing burden of diabetes mellitus and CVD, especially in urban populations. © 2011 The American Society for Parenteral and Enteral Nutrition.


Sialvera T.E.,Agricultural University of Athens | Pounis G.D.,Agricultural University of Athens | Koutelidakis A.E.,Agricultural University of Athens | Richter D.J.,Athens Euroclinic | And 6 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2012

Background and aims: Several studies have observed a hypocholesterolemic effect of plant sterols in hypercholesterolemic patients on a balanced diet. The aim of this study was to examine the effect of phytosterol supplementation on risk factors of coronary artery disease in metabolic syndrome patients on a Westernized type diet. Methods and results: In a randomized placebo-controlled design 108 patients with metabolic syndrome were assigned to consume either 2 plant sterol-enriched yogurt mini drink which provided 4 g phytosterols per day, or a yogurt beverage without phytosterols (control). The duration of the study was 2 months and the patients in both groups followed their habitual westernized type diet and recording it on food diaries. Blood samples were drawn at baseline and after 2 months of intervention. After 2 months supplementation with phytosterols, a significant reduction in total cholesterol, LDL-cholesterol, small and dense LDL (sdLDL) levels, as well as, apoB and triglycerides concentrations were observed in the intervention group (P < 0.05) compared to the control group. In addition, phytosterol supplementation lowered serum total cholesterol by 15.9%, LDL-cholesterol by 20.3% and triglyceride levels by 19.1% (P = 0.02, P < 0.001 and P < 0.001, respectively), although the patients kept their habitual westernized type diet. No differences were observed in HDL cholesterol, apoA1, glucose, C-reactive protein, fibrinogen levels and blood pressure. Conclusions: Phytosterol supplementation improves risk factors of coronary artery disease even if the diet is a westernized type. © 2011 Elsevier B.V.


Sialvera T.-E.,Agricultural University of Athens | Koutelidakis A.E.,Agricultural University of Athens | Richter D.J.,Athens Euroclinic | Yfanti G.,Evangelismos State General Hospital | And 5 more authors.
International Journal of Food Sciences and Nutrition | Year: 2013

Several studies have observed decreased levels of lipophilic antioxidants after supplementation with phytosterols and stanols. The aim of this study was to examine the effect of phytosterol supplementation on plasma total antioxidant capacity in patients with metabolic syndrome. In a parallel arm, randomized placebo-controlled design, 108 patients with metabolic syndrome were assigned to consume yogurt beverage which provided 4 g of phytosterols per day or yogurt beverage without phytosterols. The duration of the study was 2 months and the patients in both groups followed their habitual westernized type diet. Blood samples were drawn at baseline and after 2 months, and the total antioxidant capacity of plasma was measured using the ferric reducing antioxidant power of plasma and oxygen radical absorbance capacity assays. After 2 months of intervention, plasma total antioxidant capacity did not differ between and within the intervention and the control groups. Phytosterol supplementation does not affect plasma antioxidant status. © 2012 Informa UK, Ltd.


Andreadis E.A.,Evangelismos State General Hospital | Sfakianakis M.E.,Evangelismos State General Hospital | Tsourous G.I.,Evangelismos State General Hospital | Georgiopoulos D.X.,Evangelismos State General Hospital | And 7 more authors.
International Angiology | Year: 2010

Aim. Arterial stiffness, assessed by ambulatory arterial stiffness index (AASI), is an independent predictor of cardiovascular disease (CVD) mortality in hypertensives. However, it is unclear whether certain antihypertensive drugs are conducive to the reduction in CVD morbidity and mortality through their beneficial effect on arterial stiffness. Therefore, we compared the effect of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on AASI in a hypertensive population. Methods. We studied 188 individuals with newly-diagnosed essential hypertension without organ damage or CVD. AASI was calculated from twenty-four-hour ambulatory blood pressure monitoring (ABPM) readings at baseline and after twelve weeks of antihypertensive treatment. Therapy was initiated with a low-dose of CCB (group A) or ARB (group B). After six weeks, subjects with poor office blood pressure (BP) control were further randomized to high-dose monotherapy (CCB in group C or ARB in group D) or low-dose combination therapy (CCB plus ARB, group E). Results. Groups A and B showed similar reductions in systolic and diastolic BP (r=-0.12, P=0.92 and r=-0.07, P=0.58 in group A and r=-0.06, P=0.67 and r=-0.04, P=0.73 in group B, respectively). However, only subjects in group B achieved significant AASI decrease (P<0.001). Similarly, subjects in groups C, D and E also displayed a comparable BP reduction, but only those in group E attained significant AASI decrease (P=0.001). Conclusion. ARB treatment, either as low-dose monotherapy or in combination with a CCB in hypertensives who do not achieve BP control with monotherapy, has a beneficial effect on arterial stiffness. As arterial stiffness is an important modifiable risk factor, our findings highlight the value of ARBs beyond their BP lowering properties.


Gouveri E.,Evangelismos State General Hospital | Papanas N.,Democritus University of Thrace | Marakomichelakis G.,Evangelismos State General Hospital | Tzavara C.,Evangelismos State General Hospital | And 3 more authors.
International Angiology | Year: 2013

Aim. Previous studies have estimated the sensitivity, specificity and predictive value of non-invasive methods for the detection of peripheral arterial disease (PAD). The aim of our study was to evaluate the performance of non-invasive diagnostic tools and more specifically ankle-brachial index (ABI) at rest and after exercise for the detection of PAD in an epidemiological survey conducted in Greece. Methods. Overall, a representative sample of 2089 adults (911 men and 1178 women), 18-90 years old (mean age 46.88+14.98 years) living in the greater Athens area, participated in the study. For the detection of intermittent claudication, the Rose questionnaire (RQ) was used. Moreover, physical examination (PE) of the lower extremities was performed, ABI both at rest and after exercise was measured. Results. Thirty subjects were diagnosed with PAD, corresponding to a prevalence of 1.43%. Sensitivity and specificity of RQ, PE, ABI at rest and one minute after stress test were 53.33%, 66.67%, 100%, 64.71% and 98.79%, 97.77%, 99.81%, 94.94%, respectively. The combination of RQ with PE and ABI at rest yielded a 41.18% sensitivity, but a very high specificity (100%) and positive predictive value (100%). Conclusion. ABI at rest detected PAD in the epidemiological setting, and its combination with RQ and PE attained a very high specificity. Intermittent claudication and physical examination, while easier to evaluate, were considerably less sensitive. Finally, inclusion of postexercise ABI did not increase sensitivity which leads to the conclusion that this diagnostic tool is not needed for the detection of PAD in large epidemiological surveys.


PubMed | Evangelismos State General Hospital
Type: Journal Article | Journal: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition | Year: 2011

Previous studies demonstrated the beneficial impact of the Mediterranean diet (MedDiet) on metabolic syndrome (MetS). The aim of this study was to retrospectively investigate the association between MedDiet and MetS in a representative sample of the Athenian population in the early 1980s, when MetS had not been established as an entity yet.In a cross-sectional epidemiologic survey of cardiovascular disease (CVD), 2,074 randomly selected adults were examined: 900 men and 1,174 women (age, 46.9 14.9 years). MetS was defined according to criteria of the National Cholesterol Education Program-Adult Treatment Panel III. A validated questionnaire concerning nutrition habits was administered, and MedDiet was assessed according to guidelines of the Division of Nutrition/Epidemiology, Athens University Medical School.Overall, 1,023 participants (49.3%) followed MedDiet (47.3% men, 52.0% women, P = .033) with similar rates across age groups (P = .337). MetS was diagnosed in 24.0% of those following MedDiet, compared with 27.9% of those not following it (P = .041). Participants with CVD or diabetes mellitus were less likely to follow MedDiet (43% vs 50%, P = .009). Multivariate analysis revealed that MedDiet is associated with a 20% reduction in MetS (odds ratio = 0.80, 95% confidence interval = 0.65-0.98), after adjustment for age, gender, smoking, light physical activity, serum levels of low-density lipoprotein cholesterol and -glutamyl transferase, diabetes mellitus, CVD, family history of hypertension, and/or hyperlipidemia.Results indicate that adherence to MedDiet may attenuate the prevalence of MetS and, consequently, the increasing burden of diabetes mellitus and CVD, especially in urban populations.

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