bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECTS OF DIABETES ON CLINICAL OUTCOMES OF PSORIATIC PATIENTS WITH CORONARY ARTERY DISEASE
Authors: Zhao Lin , Sun Lin , Yang Kunqi , Zeng Yan , Zhou Xianliang , Yang Weixian
Published: June 2023

Objective:

Psoriasis is associated with a heightened prevalence of cardiovascular risk factors, including diabetes. However, it is not clear whether diabetes will cause differences on clinical outcomes of psoriatic patients who have already suffered from coronary artery disease.

Design and method:

We conducted a retrospective cohort study of consecutive psoriatic patients with coronary artery disease between January 2017 and May 2022 in our hospital. The clinical records, laboratory measurements and coronary angiography reports were collected, and comparisons were made between patients with and without diabetes. The Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between diabetes and major adverse cardiovascular events (MACEs).

Results:

Of the 307 participants, 147 patients had diabetes. Individuals with diabetes were more prone to be with hypertension (p = 0.045), history of stroke (p = 0.041) and peripheral vascular disease (p = 0.043). The levels of low-density lipoprotein cholesterol (p = 0.039), uric acid (p = 0.013) and homocysteine (p = 0.006) were higher in the non-diabetes group. Patients with diabetes were more likely to have lesions in the right coronary artery than those without diabetes(p = 0.03). After the mean follow-up of 35.32 ± 18.61 months, MACEs were more prone to occur in diabetes group than non-diabetes group (30.0% vs. 19.2%, p = 0.032). Kaplan-Meier estimates showed the same trend. The COX regression analysis showed that diabetes [hazard ratio (HR) = 1.661, 95% confidence interval (95%CI): 1.025–2.692, p = 0.039] was positively associated with an increased risk of MACEs. In the subgroup analysis, diabetes was associated with the occurrence of MACEs especially in men (p = 0.008) and in patients without chronic kidney disease(p = 0.021).

Conclusions:

In psoriatic patients with coronary artery disease, patients with diabetes were more likely to have lesions in the right coronary artery and diabetes can independently predict MACEs, especially in men and in patients without chronic kidney disease. To reduce the cardiovascular disease risk associated with diabetes, it is vital to increase awareness of the condition among these patients.
POLYGENIC SCORES TOGETHER WITH COMMON RISK FACTORS ARE INFORMATIVE PREDICTORS OF METABOLIC HEALTH
Authors: Timasheva Yanina , Balkhiyarova Zhanna , Avzaletdinova Diana , Morugova Tatiana , Korytina Gulnaz , Prokopenko Inga , Kochetova Olga
Published: June 2023

Objective:

Type 2 diabetes (T2D) is a complex metabolic disorder influenced by various genetic, behavioural, and environmental factors, with ageing and obesity most prominently contributing to its development. Our aim was to examine an association between common variants in genes implicated in the development of T2D, and evaluate the predictive value of polygenic scores and other risk factors.

Design and method:

We tested associations between 13 established genetic variants and T2D in 1371 study participants from the Volga-Ural region of Eurasian continent, and evaluated the prognostic ability of the model containing polygenic scores for the variants associated with T2D in our dataset, alone and in combination with other risk factors, such as age and sex.

Results:

Using logistic regression analysis, we found associations with T2D for the CCL20 rs6749704 (OR = 1.68, PFDR = 3.40 × 10-5), CCR5 rs333 (OR = 1.99, PFDR = 0.033), ADIPOQ rs17366743 (OR = 3.17, PFDR = 2.64 × 10-4), TCF7L2 rs114758349 (OR = 1.77, PFDR = 9.37 × 10-5), and CCL2 rs1024611 (OR = 1.38, PFDR = 0.033) polymorphisms. We showed that the most informative prognostic model included weighted polygenic scores for these five loci, and non-genetic factors such as age and sex (AUC 85.8%, 95%CI 83.7%-87.8%).

Conclusions:

The five variants associated with T2D in people from the Volga-Ural region are linked to inflammation (CCR5, CCL2, CCL20) and glucose metabolism regulation (TCF7L, ADIPOQ2). Further studies in independent groups of T2D patients should validate the prognostic value of the model and further elucidate the molecular mechanisms of the disease development.

Figure 1. Receiver operator characteristic (ROC) curves visualising the predictive prognostic ability abilities of the models to predict type 2 diabetes: A. model constructed using the unweighted polygenic score calculated for the five genetic variants associated with type 2 diabetes in our study; B. model constructed using the weighted polygenic score; C. model constructed using the unweighted polygenic score in combination with age and sex; D. model constructed using the weighted polygenic score in combination with age and sex polygenic scores for type 2 diabetes.

This research was funded by THE MINISTRY OF SCIENCE AND HIGHER EDUCATION OF RUSSIAN FEDERATION, grant number 075-15-2021-595; RUSSIAN SCIENCE FOUNDATION, grant number 22-25-00010.
EFFECTIVENESS OF TREATMENT OF COMBINED PATHOLOGY OF DIABETES MELLITUS AND MULTIDRUG-RESISTANCE TUBERCULOSIS
Authors: Semianiv Ihor , Todoriko Liliia , Semianiv Marianna , Sukholitky Yuriy
Published: June 2023

Objective:

The objective of the study is a comprehensive retrospective assessment of the prevalence, features, course of treatment of diabetes mellitus and multidrug-resistant tuberculosis.

Design and method:

Our study is based on an analysis of statistical data obtained from a retrospective study of 762 case histories and cases of MDR-TB in the register of tuberculosis patients in different regions of Ukraine for 2016-2020.

Results:

Depending on the type of TB case in our patients, we found that in both groups of the study the recurrence of TB prevailed – 49 cases (55.7%) against TB 39 cases (44.3%) of people in the main group; 363 cases (53.9%) against 311 (46.1%) in the control group (p <0.05).

The rate of successful treatment in gr.2 is probably higher than in gr. 1 (64.7% vs. 61.4%; (p <0.05)). However, a more significant probable difference is characterized by the treatment rate, which in the main group is 27.3% versus 40.3% in the control group (almost 2 times; p <0.05). The rate of ineffective treatment, which in patients with comorbidity was 27.3% (almost every third patient) against 17.6% in group 2 is also important for scientists and practitioners.

Conclusions:

There is a clear tendency to increase the combined pathology and chemoresistance in the structure of the incidence of tuberculosis, the proportion of recurrences of tuberculosis in the presence of diabetes mellitus. The pulmonary tuberculosis developed significantly more often in middle-aged patients with type 2 diabetes mellitus with moderate and severe states, the subcompensated form, with a complicated course.
MYOCARDIAL REDUCTION OF SYMPATHETIC ACTIVITY IS INVOLVED IN THE ANTIFIBROTIC AND ANTIHYPERTROPHIC EFFECTS OF SGLT2 INHIBITION IN ANGIOTENSIN II-DEPENDENT HYPERTENSION
Authors: Castoldi Giovanna , Carletti Raffaella , Ippolito Silvia , Colzani Massimiliano , Perseghin Gianluca , Zerbini Gianpaolo , Zatti Giovanni , Gioia Cira Di
Published: June 2023

Objective:

The beneficial myocardial effects of SGLT2 inhibitors, a new class of antidiabetic drugs, have been described not only in diabetic patients, but also in heart diseases not associated with diabetes. The positive effects of these drugs go beyond glycemic control and involve multiple mechanisms.

In the present study we investigate whether the cardioprotective effects of empagliflozin, a SGLT2 inhibitor, may be dependent on myocardial sympathetic activity in experimental model of angiotensin II-dependent hypertension.

Design and method:

Experiments were performed in Sprague Dawley rats (n = 26) followed for 4 weeks and divided in the following groups: a) Angiotensin II-treated group (Ang II, 200 ng/kg/min, osmotic minipumps s.c, n = 7); b) Ang II +Empagliflozin-treated group (Empa, 10 mg/kg/day, per os, n = 6); c) control group (physiological saline s.c., n = 7); d) Control+Empagliflozin-treated group (n = 6). Systolic blood pressure was measured by tail cuff method. At the end of the experimental period myocardial interstitial fibrosis (Sirius Red staining) and myocardial hypertrophy were measured by histomorphometric analysis. Myocardial tyrosine hydroxylase expression, used as marker of sympathetic activity, was measured by immunohistochemistry.

Results:

Ang II caused a significant increase of blood pressure (p<0.0001), myocardial interstitial fibrosis (p<0.01), hypertrophy (p<0.01), and tyrosine hydroxylase expression (p<0.01) as compared to control groups. Empagliflozin treatment did not modify blood glucose in the different groups of rats. Empagliflozin administration did not modify the increase in blood pressure in Ang II treated rats, but prevented the development of myocardial fibrosis, hypertrophy, and tyrosine hydroxylase over-expression.

Conclusions:

These data demonstrate that in Ang II dependent hypertension Empagliflozin administration prevented the onset of myocardial fibrosis and hypertrophy through the reduction of local sympathetic activity. This effect is independent on the modulation of blood pressure and blood glucose levels.
EFFECT OF LOW DOSE ALLOPURINOL ON GLYCEMIC CONTROL AND GLYCEMIC VARIABILITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A CROSS-SECTIONAL STUDY
Authors: Manal Mohammed Alem
Published: June 2023

Objective:

Type 2 diabetes mellitus (DM), gout, and asymptomatic hyperuricemia are inter-connected pathologies. Glycemic control (GC), involving a range of treatments is central to the management of DM, whereas allopurinol continues to be the most widely recommended urate lowering agent. Allopurinol has been shown to possess anti-oxidant properties: this study explores the potential effect of allopurinol on glucose homeostasis.

Design and method:

This is an observational study with a cross-sectional design performed on patients with type 2 diabetes mellitus (DM), recruited from centers in Saudi Arabia. Patients were divided into two groups; allopurinol users; (for gout or asymptomatic hyperuricemia) and a matching disease control group. Patient demographics, co-morbid conditions, biochemical tests, and pharmacological treatments were extracted from electronic records to investigate the effect of allopurinol therapy on Glycemic control (GC), as assessed by glycated haemoglobin (HbA1cas primary endpoint), and on parameters of glycaemic variability (GV) (secondary endpoints).

Results:

A total of 194 patients with type 2 DM were recruited (97 in both groups). The two groups were matched for age, sex, and duration of DM:mean age: 59.4 years, 73% males, and 122 months in the allopurinol group vs 59.6 years, 73% males, and 113 months in the control group. Antidiabetic medications were matched between the two groups. In the allopurinol group, it was prescribed with a daily dose of 100 mg, for 77% of the patients, with median duration of 39.5 months. HbA1c values were; 6.90% (6.20, 7.80) in the allopurinol group vs 7.30% (6.60, 8.40) in the control group (P = 0.010). Parameters of GV were calculated from 3 consecutive fasting blood sugar (FBS) readings: variability independent of the mean (VIM) was 0.140 in the allopurinol group vs 0.987 in the control group (P<0.001).

Conclusions:

Concomitant low-dose allopurinol therapy in patients with type 2 DM was associated with modest but significant improvements in GC and GV.
SCREENING RATES FOR PRIMARY ALDOSTERONISM ARE UNSATISFACTORY EVEN IN HYPERTENSION EXCELLENCE CENTERS. A CALL FOR COMPULSORY SCREENING FOR ALL HYPERTENSIVE PATIENTS
Authors: Leiba Adi , Seged-German Hadassah , Rappoport Vladimir , Sofer Shelly , Leiba Ronit , Katzir Zeev , Hausmann Michael , Korman Avital Angel
Published: June 2023

Objective:

The Endocrine Society guidelines recommend screening for primary aldosteronism (PA) in high risk hypertensive patients. These include patients with sustained blood pressure (BP) above 150/100 mmHg, patients with resistant hypertension (HTN), hypertensive patients with spontaneous or diuretic-induced hypokalemia, adrenal incidentaloma, sleep apnea, family history of early onset HTN or cerebrovascular accident at a young age and all hypertensive first-degree relatives of patients with PA.

Even though guidelines are clear and screening is simple, compliance rates among clinicians are extremely low ranging between 0.1% to 2.7%. This results in underdiagnosis of early disease, leading to an enormous extra-burden of advanced chronic kidney disease, heart failure, atrial fibrillation, and stroke.

We aimed to examine the screening rate, according to the abovementioned guidelines, at our recently recognized Hypertension Excellence Center in Assuta Ashdod University Hospital.

Design and method:

A retrospective cohort study. We analyzed all hypertensive patients, eligible for screening between 01/18 and 12/20.

We calculated screening rates and in univariate and multivariate regression analyses, looked at parameters that influence screening.

Results:

Of 661 patients over 18 years of age with HTN, 218 patients (33%) met the Endocrine Society guidelines for PA screening. However only 46 of them (21.1%), were referred for screening. A multivariate regression analysis, demonstrated that advanced age and male gender were associated with lower rates of screening referral. Odds ratio for age was 0.945 for every year (95% CI 0.915-0.975).

Conclusions:

A 21% screening rate in a Hypertension Excellence Center, although higher than prior published studies, suggests that many cases of PA are likely missed, more often in elderly population in whom adrenal micro as well as macronodular-hyperplasia is extremely common and can be the cause of secondary HTN.

We therefore advocate for PA screening at least once of all hypertensive patients, preferably before the patient is started on multiple anti-hypertensive medications. This should be done regardless of patients’ age and gender, as the absolute risk for cardiovascular events in both hypertensive and PA patients increases with rising age, and treatment with mineralocorticoid receptor antagonists can be lifesaving.
AUTOREACTIVE T CELLS TO ANGIOTENSIN II TYPE 1 RECEPTOR IN SALT-DEPENDENT HYPERTENSION DUE TO PRIMARY ALDOSTERONISM
Authors: Scarpa Riccardo , Piazza Maria , Caroccia Brasilina , Carraro Samuela , Torresan Francesca , Iacobone Maurizio , Vianello Fabrizio , Cinetto Francesco , Agostini Carlo , Seccia Teresa Maria , Rossi Gian Paolo
Published: June 2023

Objective:

Compelling evidence suggested a role of acquired immunity in hypertension and hypertension-mediated organ damage (HMOD), but its pathogenic role is still unknown. Primary Aldosteronism (PA), the paradigm of salt-dependent hypertension, is characterised by a more prominent HMOD than primary hypertension and by high titer of autoantibodies against the angiotensin type-1 receptor (AT1R). As T cells are broadly recognised as HMOD-mediators we investigated: 1) the presence of AT1R-autoreactive T cells in PA; 2) aldosterone rapid and chronic effect on AT1R-autoreactive T lymphocytes; 3) the presence and functional role of aldosterone receptors on T lymphocytes.

Design and Methods: The presence of AT1R-autoreactive T cells in 11 PA patients was investigated by flow cytometry after stimulation with pool of peptides spanning the full length of AT1R. The expression of mineralocorticoid receptor (MR) and G Protein-Coupled Estrogen Receptor (GPER) on T cells was tested by measuring mRNA copy number and immunoblotting from healthy donors and PA patients. PBMCs from PA patients were exposed to aldosterone 10-10 M with or without MR antagonist (canrenone) and GPER agonist (G1) and antagonist (G36). We evaluated the effect of aldosterone on CD8+ T cells by measuring IFN? release with flow cytometry.

Results:

PA patients were found to have CD8+ AT1R-autoreactive T cells after activation of PBMC with AT1R peptides. MR and GPER were detected both at mRNA and protein level in CD4+ and CD8+ T cells with the following rank of expression GR>MR>>GPER. Aldosterone significantly increased IFN? release in CD8+ T-cell both under chronic and acute stimulation. Chronic exposure to aldosterone increased IFN-? production by CD8+ T cells by acting via the MR, as it was prevented (p<0.004) by canrenone, while the rapid aldosterone action was MR and GPER mediated, as it was reduced by canrenone (p<0.003), but also by G36 (p<0.02), and mimicked by G1.

Conclusion: These results showed the presence of AT1R-autoreactive T cells in patients with PA and demonstrates that, upon of MR and GPER receptor stimulation with aldosterone, AT1-R specific CD8+ T cells undergo profound changes that mediated a strong cytotoxic response towards AT1-R-expressing organs.
TRANSCRIPTOMIC ANALYSIS OF URINARY EXTRACELLULAR VESICLES IN HYPERTENSIVE PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Mango Gabriele , Castagna Annalisa , Veneri Mariangela , Ambrosani Francesca , Begali Francesca , Spillere Carlotta , Pattini Patrizia , Santis Domenica De , Brazzarola Paolo , Friso Simonetta , Olivieri Oliviero , Pizzolo Francesca
Published: June 2023

Objective:

To perform transcriptomic analysis of RNA samples extracted from urinary extracellular vesicles (uEVs) of patients with primary aldosteronism (PA), subtype aldosterone-producing adenoma (APA), before and after adrenalectomy, and patients with essential hypertension (EH). Then, to compare the differentially expressed genes (DEGs) for evaluating gene expression differences between PA and EH, and PA before and after adrenalectomy.

Design and method:

Urinary extracellular vesicles were isolated using a commercially available precipitating reagent and differential centrifugations. RNA libraries were prepared according to the TruSeq Stranded Total RNA protocol and sequenced by NextSeq System (Illumina).

Results:

Gene set enrichment analysis on DEGs in 5 patients with PA compared to 8 EH subjects revealed several significantly overrepresented classes of transcripts, including ion binding, sodium ion transmembrane transport and collagen-containing extracellular matrix. Among the more interesting genes, we found some associated to the activity of voltage-dependent ion channels (CACNA2D1, CACNA2D4, CACNG2, SCN3A, SCN5A, SCN9A, SCN11A). Moreover, in order to identify potentially aldosterone-regulated genes, we focused on DEGs in common between the comparisons APA pre-surgery vs EH and APA pre surgery vs APA post-surgery. We found, among DEGs shared across these two groups, some transcripts involved in the regulation of extracellular matrix remodeling and Phosphoinositide 3-kinases pathway (CST3, EPHB2, ITGA5, PIK3R2).

Conclusions:

This study contributes to a more precise characterization of the molecular mechanisms underlying PA. To our knowledge, this is the first transcriptomic study on uEVs from patients with PA and EH, confirming evidence found in other studies on different tissues (biological fluids and adrenal tissue). Our results suggest that the mRNA content of these vesicles may reflect the pathophysiological processes occurring in the urinary tract and especially in the kidney.
RISK OF ENDOTHELIAL DYSFUNCTION AND CAROTID ARTERIES INTIMA MEDIA THICKNESS DEPENDING ON GUANINE NUCLEOTIDE-BINDING PROTEIN BETA-3 AND ENDOTHELIAL NITRIC OXIDE SYNTHASE GENES’ PO
Authors: Sydorchuk Andrii , Voroniuk Ksenia , Sydorchuk Larysa , Dzhuriak Valentina , Sydorchuk Ruslan , Gutnitska Adelina , Iftoda Oksana
Published: June 2023

Objective:

Endothelial dysfunction (ED) is an initial step to vascular insufficiency, atherosclerosis. The study is aimed to clarify the risk of ED and carotid arteries (CA) intima media thickness (IMT) changes depending on guanine-nucleotide-binding-protein-beta-3 (GNB3, rs5443) and endothelial-nitric-oxide-synthase (NOS3, rs2070744) genes’ polymorphisms in essential arterial hypertension (EAH).

Design and method:

One-hundred EAH patients with target-organ damage, moderate/high/very high cardiovascular risk were involved in the case-control study: 79.0% females, 21.0% males, mean age 59.87±8.02; disease duration 6-25 years. Control - 48 practically healthy persons . GNB3 (rs5443) and NOS3 (rs2070744) genes’ polymorphisms examined in Real-Time-PCR. Soluble-Vascular-Cell-Adhesion-Molecule (sVCAM-1), total NO-metabolites (NO2-/NO3-), transcriptional activity of NOS3 gene, Endothelium-Dependent-Flow-Mediated-Dilation of the Brachial Artery (FMD BA) and carotid IMT were studied.

Results:

Severe EAH course (SBP/DBP>160>100 mmHg) is associated with the structural changes of the CA (IMT>0.9 mm) increasing the likelihood more than 3.5 times [OR 95%CI:1.28-10.23; p = 0.012], atherosclerotic plaques on the CA – 4 and 3.5 times as much [OR 95%CI:1.18-13.59; p = 0.018 and 1.23-10.71; p = 0.014], and decreased NOS3 gene transcriptional activity by the mRNA level (<0.5 U) – threefold [OR 95%CI: 1.0-9.66; p = 0.042]). Moderate/severe ED enhance the risk of severe EAH 3-5.5 times [OR 95%CI:1.13-9.34; p = 0.025 and 1.96-14.45; p<0.001]. C-allele of NOS3 (rs2070744) gene elevates the risk of atherosclerotic lesion in CA 3.5 times [OR 95%CI:1.24-11.20; p = 0.019 and 1.22-10.18; p = 0.018], ED – by decrease of total NO metabolites (<25 μmol/l) and sVCAM-1 growth (>1050 ng/ml) almost 12 and 4 times [OR 95%CI: 1.23-112.7; p = 0.023 and 1.24-11.20; p = 0.019]. C-allele of NOS3 gene heighten the probability of low NOS3 gene expression by mRNA level (<0.5 U) 69 times [OR95%CI:17,72-520,0; p<0,001]. Minor T-allele (rs5443) increases the risk of CA changes by IMT (>0,9 mm) threefold [OR 95%CI:1.09-7.74; p = 0.027], CA atherosclerotic plaques – almost 10 and 5 times [OR 95%CI:2.55-38.0; p<0.001 and 1.61-13.27; p = 0.003]. T-allele of GNB3 gene enhances the probability of high sVCAM-1 (>1050 ng/ml) threefold [OR 95%CI:1.06-9.59; p = 0.032].

Conclusions:

C-allele of NOS3 (rs2070744) gene contributes more to ED risk elevation. T-allele of GNB3 (rs5443) gene increases the risk of the carotid arteries structural changes.
VASCULAR REMODELING AND FIBROSIS INDEXES IN NAFLD SUBJECTS
Authors: Rosson Marco , Grillo Andrea , Barbato Vincenzo , Pierro Giuliano Di , Rovina Matteo , Zorat Francesca , Comar Consuelo , Fabris Bruno , Puato Massimo
Published: June 2023

Objective:

Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem and is related to an increased burden of cardiovascular disease.

Aim of the study: to assess the relation between non-invasive scoring systems for liver fibrosis (Fibrosis-4 Index and NAFLD Fibrosis Score) and structural and functional vascular properties in NAFLD patients.

Design and method:

The study enrolled 30 consecutive patients (mean age 64±13, BMI 29.3±6.1 kg/m2, male 60%) who underwent hepatological evaluation in our department. Atherosclerotic burden was evaluated by B-mode ultrasound in each carotid artery segment (common, bulb, internal), bilaterally, and expressed as mean of carotid intima-media thickness (mean-IMT) and mean of maximum IMT (M-MAX), right common carotid artery distensibility and stiffness (CardioVascular Suite 4, Quipu, Italy). Aortic stiffness was measured by applanation tonometry (PulsePen DiaTecne, Italy) and was expressed as carotid-femoral pulse wave velocity (PWV).

Results:

In our cohort vascular properties were: carotid mean-IMT 0.83±0.15 mm, M-MAX 0.98±0.17 mm, carotid distensibility 18.8±8.3 10-3/kPa, and carotid compliance CC 0.88±0.40 mm2/kPa. We found a significant correlation between NAFLD Fibrosis Score and PWV (mean PWV = 10.9±2.9m/s; Fibrosis Score = -0.97±1.80; R = 0.422, p = 0.020), which remained significant after adjustment for mean arterial blood pressure and sex (p = 0.017). No correlation was found between carotid ultrasound parameters and fibrosis scores.

Conclusions:

In NAFLD patients, our preliminary observation shows a correlation between a liver fibrosis score and PWV, an established marker of aortic stiffness, while no correlation was observed with carotid atherosclerosis markers. This vascular remodeling phenotype needs to be confirmed in a larger population.
ENDOTHELIAL FUNCTION, AS ASSESSED BY FLOW MEDIATED DILATION AND ASYMMETRIC DIMETHYLARGININE IS IMPAIRED IN NEWLY DIAGNOSED TYPE 2 DIABETES MELLITUS
Authors: Nikolaidou Barbara , Anyfanti Panagiota , Lazaridis Antonios , Gavriilaki Eleni , Dolgyras Panagiotis , Mastrogiannis Konstantinos , Kavelidou Maryanthe , Triantafyllou Areti , Doumas Michalis , Gkaliagkousi Eugenia
Published: June 2023

Objective:

Endothelial dysfunction precedes the onset of clinically detectable atherosclerosis diabetes mellitus in type 2 (T2DM) and contributes significantly to the development of vascular complications and mortality. The aim of the present study was to investigate the endothelial function in patients with a recent diagnosis of T2DM.

Design and method:

We studied patients with newly diagnosed T2DM (<6 months from diagnosis) that did not receive antidiabetic treatment (except for metformin) and otherwise healthy individuals matched for age and blood pressure (BP). We recorded somatometric, BP (office and 24-hour) and hematological (lipids, renal function, fasting glucose, HBA1c) data. We also calculate the 10-year atherosclerotic cardiovascular risk (ASCVD risk score). We determined endothelial dysfunction with 2 methods: Asymmetric Dimethylarginine (ADMA) by ELISA (enzyme-linked immunosorbent assay) and the gold standard non-invasive method Flow Mediated Dilation (FMD).

Results:

Ninety subjects were studied, 33 patients with T2DM and 57 controls. Twenty T2DM patients were enrolled within 1 month from diagnosis, while the rest 13 had been diagnosed 3.69±2.14 months before. Similarly, 16 (48.48%) had received metformin for a median of 3 (interquartile range 18) weeks. T2DM showed significantly impaired FMD [4.68 (4.58)% versus 7.85 (7)%, (p = 0.012)] and higher ADMA [0.926±0.569 μmol/l versus 0.468 (0.27) μmol/l, (p = 0.032)], compared to controls. There was also an independent association of T2DM and FMD (Beta = -0.278, p = 0.012). Results were similar in the sub-group analysis of patients without hypertension. In this cohort, FMD lower than 7.5% was able to predict T2DM diagnosis with 87.5% sensitivity and 70.8% specificity.

Conclusions:

Patients with a very recent diagnosis of T2DM show impaired endothelial function as demonstrated by FMD and ADMA findings. This assessment highlights the early severe, damaging effect of hyperglycemia on the endothelium, emphasizing the need for early detection and management.
HIGH SERUM TRIMETHYLAMINE N-OXIDE LEVEL IS ASSOCIATED WITH ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH HYPERTENSION
Authors: Hsiao Chien-Hao , Yang Chiu-Fen , Wang Ji-Hung , Hsu Bang-Gee
Published: June 2023

Objective:

Trimethylamine N-oxide (TMAO) is a metabolite derived from gut microbial metabolism and dietary intake and plays important roles in cardiovascular disease pathogenesis. Endothelial dysfunction is associated with risk factors of cardiovascular disease in patients with hypertension. The present study aimed to determine the correlation between serum TMAO and endothelial function, measured by vascular reactivity index (VRI) in patients with hypertension.

Design and method:

The present study collected fasting blood samples from 110 patients with hypertension. Serum TMAO levels were determination of by high-performance liquid chromatography–mass spectrometry. The endothelial function and VRI values were measured using digital thermal monitoring test, and VRI values of >2.0, 1.0–1.9 and <1.0 indicated good, intermediate and poor vascular reactivity, respectively.

Results:

Ten hypertensive patients (9.1%) were categorized as poor vascular reactivity (VRI < 1.0), 57 hypertensive patients (51.8%) were categorized as intermediate vascular reactivity (1.0 < VRI < 2.0), and 43 hypertensive patients had good vascular reactivity. Older age (P = 0.010), higher levels of serum total cholesterol (TCH, P = 0.007), low-density lipoprotein cholesterol (LDL-C, P = 0.009), and TMAO levels (P < 0.001) were associated with poor vascular reactivity. Furthermore, after multivariable forward stepwise linear regression analysis noted that logarithmically transformed serum level of TMAO (log-TMAO, adjusted R2 change = 0.274, P < 0.001) was significantly and independently associated with VRI values in hypertensive patients. Compared with good vascular reactivity index, patients with vascular reactivity dysfunction (intermediate vascular reactivity and poor vascular reactivity; odds ratio (OR) = 1.100; 95% confidence interval (CI) = 1.047–1.155; P < 0.001) or poor vascular reactivity (OR = 1.580, 95% CI = 1.002–2.492, P = 0.049) also noted TMAO was positively associated with poor vascular reactivity after multivariate logistic regression analysis.

Conclusions:

Serum TMAO levels were negatively associated with VRI and associated with endothelial dysfunction in patients with hypertension.
PREVALENCE OF SUBCLINICAL ATHEROSCLEROSIS IN YOUNG HYPERTENSIVES
Authors: Gragera Fernando
Published: June 2023

Objective:

Evaluate the structure and arterial function in young hypertensive patients and determine the prevalence increase of EIM and atherosclerotic plaques: degree, location, total burden and its relation with pulse wave velocity.

Design and method:

An observational study was carried out transversally, at a population between 20 and 50 years old. The arterial evaluation has been done with a transductor lineal of 10MHZ ultrasound scanner. Measurement of endothelial function was performed by flow-mediated vasodilatation in the humeral artery. Continuous variables are presented as medium and standard deviation percentages. The comparation of variables between groups were carried on with T students. To compare the distribution of categorical variables, Chi square was operated. Pearson's correlation coefficient was used for the relation between VOP and other continuous numerical variables. A P<0.05 was considered significant.

Results:

Between September of 2020 and December of 2021, 150 patients were studied, 35 of which were comprehended from 20 to 50 years of age inclusive. The age was 43,3 years (from 25 to 50 years), 19 were male (59%) and 13 were female (39%). The body mass index was 29.9 +- 4.86 (21-39.4) with a prevalence of overweight of 22% (7 patients) and obesity of 47% (15 patients). 14 patients (44%) dyslipidemia, 1 patient (3%) Diabetes mellitus, 2 patients (6,3%) hypothyroidism, 2 patients (6.3%) cerebral vascular accident and 2 patients (6.3%) active smoking. Among all patients, 87,5% of them (28 patients) presented in at least one arterial territory EIM equal or higher to percentile 75. Atherosclerotic plaque was observed in 12 patients (37,5%) Endothelial function was decreased in 16 patients (50%) and pulse wave velocity was abnormal in 4 patients (12.5%). Cardiovascular risk was estimated in 10 years according to Framingham; 84.3% (27 patients) showed a low risk and plaque in 42% (8 patients). The 15.6% (5 patients) showed intermediate risk and plaque in 80% (4 patients).

Conclusions:

The prevalence of subclinical atherosclerosis in young hypertensive patients with low and moderate risk is high, has very poor correlation with risk scores, and has a clear correlation with alterations in arterial function.
ASSOCIATION OF METABOLIC SYNDROME AND HYPERTENSION IN A MOROCCAN POPULATION
Authors: Zahidi Hatim Amine , Badaoui Karim , Haboub Meryem , Arous Salim , Bennouna El Ghali , Drighil Abdenasser , Azzouzi Leila , Habbal Rachida
Published: June 2023

Objective:

The metabolic syndrome (MS) is an emerging entity that groups together several metabolic abnormalities in the same individual that predispose to cardiovascular risk. However, among hypertensive patients, cardiovascular diseases are the main cause of mortality, and the prevalence of MS is not well known. We aim to estimate the prevalence of MS and its associated factors in a sample of patients with hypertension.

Design and method:

A cross-sectional study including 352 patients with arterial hypertension (> 20 years), The following measurements were performed: blood pressure; Body mass index (BMI); Plasma glucose and lipid levels. Blood pressure criteria was mean systolic blood pressure > 140 mmHg and/or diastolic arterial pressure > 90 mmHg; and the diagnosis of metabolic syndrome was retained according to WHO criteria and NCEP-ATP III criteria.

Results:

352 hypertensive patients, 76 % of whom were women, with a mean age of 60 ± 10 years were analyzed.

The prevalence of metabolic syndrome was 71%, mainly in women. Central obesity was the most frequent component of metabolic syndrome, accounting for 74% of patients (17% of men and 83% of women). Among the other components, low HDL-C was present in 63 % (22% of men and 78% of women), hyperglycemia in 70 % (16% of men and 84% of women), and high triglycerides in 67% (21% of men and 79% of women).

Conclusions:

The prevalence of metabolic syndrome is high in patients with hypertension. This underscores the importance of routine screening of hypertensive patients for other risk factors for cardiovascular disease.
BLOOD PRESSURE AND CARDIOVASCULAR RISK IN RELATION TO BIRTH WEIGHT AND URINARY SODIUM: AN INDIVIDUAL-PARTICIPANT META-ANALYSIS OF EUROPEAN FAMILY-BASED POPULATION STUDIES
Authors: Yu Yuling , Moliterno Paula , An Dewei , Raaijmakers Anke , Martens Dries , Stolarz-Skrzypek Katarzyna , Tikhonoff Valérie , Malyutina Sofia , Casiglia Edoardo , Chori Babangida , Filipovský Jan , Rajzer Marek , Allegaert Karel , Kawecka-Jaszcz Kalina , Verhamme Peter , Nawrot Tim , Staessen Jan , Boggia José
Published: June 2023

Objective:

While the relation of salt intake with blood pressure (BP) is linear, it is U shaped for mortality and cardiovascular disease (CVD). This individual-participant meta-analysis explored whether the relation of hypertension, death or CVD with 24 h urinary sodium excretion (UVNA) or sodium-to-potassium (UNAK) ratio was modified by birth weight (BW).

Design and method:

Families were randomly enrolled in the Flemish Study on Genes, Environment and Health Outcomes (1985-2004) and the European Project on Genes in Hypertension (1999-2001). Categories of BW, UVNA and UNAK (< = 2500, >2500-4000, >4000 g; <2.3, 2.3-4.6 and >4.6 g; and <1, 1-2, >2, respectively) were coded using deviation-from-mean coding and analyzed by Kaplan-Meier survival functions and linear and Cox regression.

Results:

The study population was subdivided into the Outcome (n = 1945), Hypertension (n = 1460) and BP cohorts (n = 1039) to analyze the incidence of mortality and cardiovascular endpoints, hypertension and BP changes as function of UVNA changes. The prevalence of low/medium/high BW in the Outcome Cohort was 5.8/84.5/9.7%. Over 16.7 years (median), rates were 4.9%, 8.0% and 27.1% for mortality, CVD and hypertension, respectively, but were not associated with BW. Multivariable-adjusted hazard ratios were not significant for any endpoint in any of the BW, UVNA and UNAK strata. Adult body weight tracked with BW (P<0.0001). The partial r in the low BW group associating changes from baseline to follow-up in UVNA and systolic BP was 0.68 (P = 0.023), but not significant in other BW groups.

Conclusions:

This study did not substantiate its prior hypothesis, but showed tracking of adult with birth weight and suggest that low BW increases salt sensitivity.
ASSOCIATIONS BETWEEN ADHERENCE TO THE MEDITERRANEAN DIET AND 24-HOUR PULSE WAVE VELOCITY IN HYPERTENSIVE PATIENTS
Authors: Kolak Ela , Radic Josipa , Vuckovic Marijana , Gelemanovic Andrea , Dogas Hana , Nenadic Dora Bucan , Radic Mislav
Published: June 2023

Objective:

A Mediterranean diet (MeDi) is characterized by high consumption of plant-based food and fish, moderate consumption of red wine, and low intake of red and processed meat, and is associated with improvement in cardiometabolic risk factors. Arterial stiffness measured by pulse wave velocity (PWV) is considered a predictor of cardiovascular events, but the association between dietary intake according to MeDi and arterial stiffness is not yet clear. The aim of this study was to determine possible associations between MeDi adherence and PWV in patients with arterial hypertension (AH).

Design and method:

This study included 420 participants with AH of which 50.2% were women, with an overall median age of 63.5 years (IQR = 17.3). To assess 24-hour PWV parameter, a 24-hour ambulatory blood pressure monitor IEM Mobil-O-Graph based on the oscillometry was used. In order to determine adherence to the MeDi, a validated Mediterranean Diet Serving Score (MDSS) questionnaire was used. For every participant, data about comorbidities was collected from their medical records combined with their self reports.

Results:

Adherence to the MeDi defined as MDSS score >14 was found in 6.4% of participants. The mean value of 24-hour PWV was 9.08±1.88 m/s. Significant differences in PWV value were not found among high adherence, medium adherence and low adherence to MeDi. Positive predictors of 24-hour PWV were older age (beta = 0.128, p<0.001), presence of chronic kidney disease (beta = 0.312, p<0.001) and adherence to the legumes intake recommendation (beta = 0.169, p = 0.037), while the negative predictor was adherence to the dairy intake recommendation (beta = -0.174, p = 0.024).

Conclusions:

Exceptionally low adherence to the principles of the MeDi was noticed in hypertensive patients, with dairy and legumes suggested as predictors of 24-hour PWV. This suggests a need for structural nutritional intervention to increase adherence to the MeDi in order to decrease and reduce cardiovascular risk in this population of patients.
RELATIONSHIP BETWEEN BLOOD PRESSURE AND LDL-C CONTROL AND PATIENT-REPORTED OUTCOMES: A CROSS-SECTIONAL EPIDEMIOLOGICAL STUDY IN ROMANIA (SNAPSHOT-1)
Authors: Vinereanu Dragos , Vittos Oana , Ciobanu Andreea , Dolofan Bogdan , Trambitas Nicoleta , Johnson Neil , Tanasescu Rodica , Guja Cristian
Published: June 2023

Objective:

To assess correlation between patient reported outcomes (PRO: socio-economic factors, depression level, and treatment adherence) and control of blood pressure (BP) and LDL-cholesterol (LDL-C).

Design and method:

This cross-sectional, observational, multicenter, epidemiological (SNAPSHOT-1) study included 2469 hypertensive patients with dyslipidemia, from outpatient clinics, recruited by cardiologists, diabetologists and general practitioners. Patients completed a three-part questionnaire including: (1) questions on socio-economic factors (education, marital status, working status, socio-professional category, incomes, and physical activity); (2) Patient Health Questionnaire (PHQ-9) (Depression scale); and (3) Hill-Bone Medication Adherence Scale (HBMAS) for hypertension and dyslipidemia (according to scoring guide, patients were considered as adherent if they answered “none of the time” or “some of the time” to specific questions). The correlations between PRO and control status and those between self-reported adherence and other PRO were assessed by logistic regression models (including variables with p-value<0.2 in univariate analyses on top of age, gender, and ethnicity).

Results:

Study population included 40.9% men, aged 65.0±10.0 years. Half of patients had depression symptoms (53.3%). The majority of patients self-reported being adherent to their hypertension (91.8%) and dyslipidemia (89.6%) treatments. Socio-economic factors are described in Table 1.

Patients with higher socio-professional category (managerial), without depression symptoms, and good adherence to treatment were more likely to have their BP controlled. Patients with good adherence to treatment were more likely to have their LDL-C controlled (Table 2).

Patients with higher socio-professional category, not married/not in relationship, physically active, and without depression symptoms were more likely to be adherent to antihypertensive treatment. Patients not married/not in relationship, physically active, and without depression symptoms were more likely to be adherent to lipid-lowering treatment. Higher education highly correlated with adherence to antihypertensive treatment (Table 3).

Conclusions:

Patient reported outcomes (PRO) correlate with BP and LDL-C control. Self-reported adherence to treatment also correlates with some socio-economic factors and with depression level. Thus, relevance of PRO assessment in routine clinical practice in patients with hypertension and dyslipidemia needs to be further evaluated.
D-DIMER AS AN ASSOCIATED FACTOR FOR LONG-TERM MORTALITY IN PATIENTS WITH ACUTE SEVERE HYPERTENSION
Authors: Kim Byung Sik , Shin Jeong-Hun , Shin Jinho
Published: June 2023

Objective:

D-dimer, which serve as a marker of thrombotic events, was associated with poor outcome in various cardiovascular disease. However, there are no study on its prognostic implication in acute severe hypertension. This study aimed to investigate the association between D-dimer and long-term mortality in patients with acute severe hypertension visiting the emergency department.

Design and method:

This observational study included patients with acute severe hypertension who visited emergency department between 2016 and 2019. Acute severe hypertension was defined as systolic blood pressure > = 180 mmHg or diastolic blood pressure > = 100 mmHg. Among the 10219 patient, 4203 patients who performed assay for D-dimer were analyzed. Patients were categorized into tertiles according to D-dimer levels upon admission to the emergency department.

Results:

Among the 4203 patients with acute severe hypertension, 3.2% in the first (lowest) tertile, 17.7% in the second tertile, and 44.8% in the third (highest) tertile of D-dimer died up to 3-years. After adjusting for confounding variables, third tertile of D-dimer group (hazard ratio 8.105; 95% confidence interval, 5.799–11.327) and second tertile of D-dimer group (hazard ratio 3.234; 95% confidence interval, 2.298–4.550) showed significantly higher risk of 3-year all-cause mortality than first tertile of D-dimer group.

Conclusions:

D-dimer may be a useful marker for identifying high-risk group at risk of mortality in patients with acute severe hypertension visiting emergency department.
ARTERIAL HYPERTENSION IN RURAL AND NON-RURAL POPULATIONS OF A CITY IN THE NORTHERN ARGENTINE REPUBLIC IN THE YEAR 2022
Authors: Romano Jose René , Rajha Jorge Miguel
Published: June 2023

Objective:

to evaluate the prevalence of arterial hypertension and characteristics of how, why and when they are consulted in rural and non-rural populations of north argentine.

Design and method:

The study was carried out in 4 towns in the province of Formosa, a province in the north of the Argentine Republic, located 512, 354, 162 and 103 km away from the capital city of that province and in a hospital in the capital. It was done in all the cases in public institutions and the patients used as controls were patients not derived from rural areas treated in the capital. During the year 2022. A survey was carried out and pressure taking with validated tensiometers and in the recommended conditions. The data They were analyzed by the STatistix program.

Results:

Of 1034 patients attended, a random sample of 20% of said population was taken and a similar sample in the city, it was observed in the rural sample a mean age of 48 years, 52% male, blood pressure (BP) systolic ( S) mean 145 and diastolic (D) 83, and with AHT 51.1% S and 39.3% D. 24% of the patients attended consulted for HBP. They presented HTA 180/110 or more: 10%. 3% were referred for presenting signs of target organ damage. Those from the city: average age 39 years, consulted for HTA 42%. The average BP S 141 D 85. Hypertensive patients in the consultation 43% S and 35% D. In rural areas 8.75% of autochthonous aboriginal race that increased over time with the number of cares (1 patient to 5 to 6 patients).

Conclusions:

The differences with patients who consult in the city of age to which they consult, the degree of control of hypertensive patients and the number of patients known to be hypertensive and consultation for control were demonstrated, therefore, it was possible to attend to special populations, in this Aboriginal case and measure variables in them. It is expected in the future to evaluate the utility at the population level of these services.
CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF PATIENTS WITH LIPITENSION: RESULTS FROM THE LARGEST RETROSPECTIVE EMR STUDY FROM INDIA
Authors: Natarajan Vidhya , Dalal Jamshed , Chandra Praveen , Ponde Chandrashekhar , Hazra Prakash , Kumar Viveka , Bhalla Neeraj , Naqvi Mujtaba , Gaurav Kumar , Dhanaki Gauri , Rathod Rahul , Kotak Bhavesh
Published: June 2023

Objective:

Common end-organ manifestations of hypertension and dyslipidemia predispose patients to develop cardiovascular diseases (CVD). The data on coexistent hypertension and dyslipidemia (lipitension) in India is scarce. In patients with lipitension CVD risk is amplified, therefore necessitating better understanding of their current clinical characteristics and treatment gaps.

Design and method:

This was an EMR based, retrospective, multicenter, cross sectional, database study to evaluate the demographic and clinical profile of adult patients with age more than 18 years having coexistent hypertension and dyslipidemia in India. Data of patients with Type 1 Diabetes Mellitus, Familial Hypercholesterolemia and pregnant females were excluded.

Results:

Data of 6722173 (6.7 million approx.) patients with age more than or equal to 18 years registered in EMR from January 2021 to December 2021 was extracted from the EMR database. Out of these patients, 38343 cases (0.57%) were found to have lipitension. Mean age was noted to be 54.71 years and 55.5% of them were males. The mean BMI of the patients was 28.3 kg/m2, and 76% of patients had an above normal BMI (>24.99). The mean SBP and DBP in mmHg were noted to be 139.98 and 85.47, respectively. Only 8% and 18.7% of patients had a normal SBP and normal DBP, respectively. The mean in mg/dl (% non-optimal control) of LDL, total cholesterol, triglycerides and VLDL was 124.2 (89.2), 195.1 (46.6), 176.8 (56.1) and 27.4 (40.7), respectively. The mean HDL was 46.69 mg/dl and optimal HDL of >60 mg/dl was noted in 11% of patients. Beta blockers (20.2%) and combination of anti-hypertensive with diuretics (14.5%) were most used for hypertension. Statins in combination with other medicines were used in 33.3% of patients and 41.7% were on statins alone.

Conclusions:

The findings suggests that control of lipitension in India is inadequate despite current therapy being offered, this puts patients at a higher risk for early-onset CVD. Hence, there is an urgent need to create awareness and optimize management of lipitension.