bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P307: Renal Natural Killer Cell Activation and Mitochondrial Oxidative Stress; New Mechanisms in AT1-AA Mediated Hypertensive Pregnancy
Authors: Cunningham Mark W , Vaka Venkata , McMaster Kristen , Ibrahim Tarek , Cornelius Denise , Amaral Lorena , Campbell Nathan , Wallukat Gerd , McDuffy Shyanne , Usry Nathan , Dechend Ralph , LaMarca Babbette
Published: December 2018

Women with preeclampsia (PE) have increased blood pressure (MAP), natural killer (NK) cells, reactive oxygen species (ROS), and agonistic autoantibodies to the angiotensin II type 1 receptor (AT1-AA). AT1-AA’s administered to pregnant rodents produces a well-accepted model of PE. However, the role of NK cells and mitochondrial reactive oxygen species (mtROS) in AT1-AA mediated hypertension during pregnancy is unknown. We hypothesize that AT1-AA induced model of PE will exhibit elevated MAP, NK cells, and mtROS; while inhibition of the AT1-AA binding to the AT1R would be preventative. Pregnant rats were divided into 3 groups: normal pregnant (NP) (n=5), NP + AT1-AA infused (NP + AT1-AA) (n= 10), and NP + AT1-AA + AT1-AA inhibitory peptide (NP + AT1-AA + ‘n7AAc’) (n=8). Day 13, rats were surgically administered mini-pumps with either AT1-AA or AT1-AA+‘n7AAc’. Day 19, tissue and blood was collected. MAP was elevated in AT1-AA vs. NP (119±1 vs. 102±2 mmHg, p<0.05) and was prevented by ‘n7AAc’ (108±3). There was a 6 fold increase in renal activated NK cells in AT1-AA vs .NP (1.2±0.4 vs. 0.2±0.1 % Gated, p=0.05) and a return to NP levels in AT1-AA +‘n7AAc’ (0.1±0.1 % Gated). Renal mtROS (317±49 vs. 101±13 % Fold, p<0.05) was elevated with AT1-AA vs NP and was decreased in AT1-AA +‘n7AAc’ (128±16, p<0.05). AT1-AA’s infused into pregnant rats increased MAP, NK cells, and mtROS which were prevented by AT1-AA inhibition, thus highlighting new mechanisms of AT1-AA and the importance of drug therapy targeted to AT1-AAs in hypertensive pregnancies.
Research Supported by NIH grants HL78147, HL51971, and HD067541 awarded to BL. DC is supported by NIH grant HL130456 and the American Heart Association 16SDG27520000.
Abstract P308: Differential VEGF-Dependent Induction of sFlt-1 From Vascular Endothelial and Placental Cells
Authors: Chapman Heather , Eddy Adrian C , Bidwell Gene L , George Eric M
Published: December 2018

Preeclampsia is a disorder of pregnancy characterized by new-onset hypertension and maternal endothelial dysfunction. Although the origins of the disease are unclear, it is believed that placental hypoxia/ischemia leads to the release of soluble factors which cause the maternal syndrome. The best characterized factor elevated in PE is soluble fms-like Tyrosine Kinase-1 (sFlt-1), a soluble splice variant of the VEGFR1 receptor which acts as a decoy receptor; and thus a VEGFA antagonist. Overproduction of this protein is believed to be a major contributor to the maternal endothelial dysfunction, causing much speculation that VEGF supplementation could be an effective supplementation could be an effective therapy. Recently we described a VEGFA chimera therapy (ELP-VEGFA) which alleviated the hypertension associated with placental ischemia in a rodent model, but also led to a dramatic increase in maternal circulating sFlt-1. Here we tested the hypothesis that chimeric VEGF would significantly increase sFlt-1 production from placental tissue in vitro. Surprisingly, there was no effect of ELP-VEGF on sFlt-1 production in either BeWo placental trophoblasts or in rodent placental tissue explants at either the mRNA or protein level. Instead, we found that vascular endothelial cells (HUVECs) responded robustly to ELP-VEGFA at the protein (6593 ± 199 vs 14547 ± 364 pg/ml, p<0.05) and mRNA (100 ± 2 vs 401 ± 3.6%, p<0.05) levels. This effect was unique to ELP-VEGFA as ELP-based proteins based on the VEGF family members VEGFB or PlGF had no effect on sFlt-1 production from either placental or endothelial cells. Finally, we found that 24hr post-administration of ELP-VEGF, pregnant rats demonstrated a trend for increased sFlt-1 mRNA in aorta (83 ± 7 vs 225 ± 63 AU, p<0.05) but no increase in placental tissue. These data suggest that therapeutic peptides based on either VEGFB or PlGF could have significantly improved safety profiles over those based on the VEGFA sequence. Furthermore, it raises questions about the origin of much sFlt-1 protein in preeclamptic patients.
Abstract P312: The Impact of Arterial Hypertension in Maternal and Perinatal Outcomes in Pregnancies With Takayasu Arteritis
Authors: Bortolotto Luiz , Bortolotto Maria R , Codarin Rodrigo R , Gomes Tiago J , Testa Carolina B , Francisco Rossana P , Zugaib Marcelo
Published: December 2018

Objectives:
To describe the clinical features, obstetric and perinatal outcomes of pregnancies in patients diagnosed Takayasu arteritis associated to arterial hypertension.

Methods:
A retrospective, observational and descriptive study evaluating pregnant patients at a Brazilian tertiary hospital between the years 2002 and 2016 that had been diagnosed with Takayasu arteritis (TA) based on the modified Ishikawa criteria. Arterial hypertension (AH) previous to pregnancies was considered as BP≥ 140/90 mmHg or under treatment. The variables considered for analysis were clinical characteristics, diagnostic criteria, obstetrics and perinatal outcomes of these pregnancies.

Results:
Twenty-nine pregnancies in 24 patients were followed in the period. Hypertension was detected in 20 patients (83.3%). The most prevalent angiographic criteria were injury in the abdominal aorta, found in 15 women (62.5%). Angiographic classification type 5 was the most common feature. Aside from two drop-outs that were not followed up, the pregnancies resulted in 25 live births. Five (20%) of the newborns were classified as small for gestational age and eight (32%) were premature, most of them in patients with AH. Eighteen deliveries (69.2%) were caesarean sections and the main anesthetic method was the combined spinal-epidural. Preeclampsia was the main maternal complication, present in five cases, all of them with previous diagnosis of AH. There were no acute cardiovascular complications during pregnancy related to underlying disease. The only fetal death in this study was an abortion after judicial authorization by lethal fetal malformation.

Conclusion:
In general, patients with TA had a good perinatal outcomes despite of severity of disease. Hypertension is highly prevalent and is related to major reported obstetric and perinatal complications, such as preeclampsia, prematurity and newborns that are small for gestational age.
Abstract P319: Effects on Cardiac Output, Arterial Stiffness and Blood Pressure of Sacubyrtil + Valsartan in Hypertensive Patients With Heart Failure Whose Previously Received Ace Inhibitors or Arb + Diuretics. Prospective Study and Follow-up to 24 Weeks
Authors: Cabrera-Sole Ricardo , Turpin Lucas Caridad , Urrego Rivera Liliana , Nuñez Galdamez Ana , Garcia Ruiz Santiago , Stephan Luekpe Erik , Aguilera Saldaña Manuel
Published: December 2018

Introduction:
Hypertension (HTA), is behind a high percentage of patients with left ventricle dysfunction (LVHF) and the recent use of sacubitril + valsartan (ARNi), has revolutionized the treatment of heart failure. In hypertensive patients with LVHF, the use of this combination has been especially useful for clinical improvement and better control of blood pressure figures, however, we have little information about the effect of them on arterial stiffness (AS) and cardiac output (CO), for what we present the following work.

Objectives:
to evaluate the effect of ARNi on AS,CO and antihypertensive response in hypertensive patients with heart failure, who previously received ACE inhibitors or ARB.

Material and Methods:
we studied 48 patients (P) with LVHF from those we selected 38 P ( 68 ± 8 years old, 30 men) who had hypertension and were receiving ACEI or ARB alone or with diuretics for treatment. After discontinuing the previous treatment, ARNi was started until the tolerated dose and in all P had been done before introducing this drug and at 24 ± 2 weeks, a 24-hour ambulatory blood pressure study , and we measured the augmentation index (AI), pulse wave velocity (PWV), and CO non-invasively by means a MobilOgraph © device.The results were compared and exposed in the following table:

Results:

*means p value less than 0.05.

Conclusions:
use of ARNi, significantly improves the control of HTA as well as the AS, and CO of hypertensive patients with LVHF. There was also a tendency towards improvement, of the PWV, without reaching significant level, probably due to the number of patients studied, which provides more data of better prognosis to use ARNi in this group of patients.
Abstract P322: Different Responses To Intrarenomedullary Infusion of Anandamidevs. PF-3845 Reveal Additional Mechanisms Of Pressure-lowering And Diuresis-stimulation By Renomedullary FAAH Inhibition
Authors: Ahmad Ashfaq , Dempsey Sara K , Daneva Zdravka , Li Ningjun , Li Pin-Lan , Ritter Joseph K
Published: December 2018

The fatty acyl ethanolamides comprise a group of lipids having biological activities consistent with multiple mechanisms of blood pressure-lowering, including vasodepressor, diuretic and natriuretic, and sympatholytic activities. One of these, N-arachidonoylethanolamide (anandamide, AEA), is an agonist at cannabinoid type 1 receptors (CB1) and is enriched in the renal medulla together with two of its metabolizing enzymes, fatty acyl amide hydrolase (FAAH) and cyclooxygenase-2 (COX-2). The purpose of the present study was to characterize and compare the effects of AEA with those of a selective FAAH inhibitor, PF-3845, on blood pressure and urine excretion parameters after intramedullary infusion into the outer medulla of anesthetized C57BL/6 (WT) or FAAH knockout (KO) mice. Intramedullary infusion of PF-3845 into WT mice stimulated UV but had a delayed MAP-lowering effect. Homozygous FAAH KO mice were refractory to intramedullary PF-3845- induced changes in MAP but UV was still increased. Both the MAP and UV responses to intramedullary PF-3845 in C57BL/6J mice were diminished by pretreatment with the cannabinoid type 1 receptor (CB1)-selective antagonist but not COX2-selective inhibitor. In contrast, intramedullary AEA treatment stimulated UV to similar extents in WT and FAAH KO mice but had no effect on MAP. The increase in UV by AEA was blocked by pretreatment with CB1 antagonist and COX-2 inhibitor. These data indicate fundamental differences in mechanisms of blood pressure-lowering by a FAAH inhibitor vs. AEA.
Abstract P327: Real-Time Analysis of Blood Glucose Dynamics by a Glucose Telemetry System in Canagliflozin-Treated Diabetic Mice
Authors: Satou Ryousuke , Woods T Cooper , Miyata Kayoko , Katsurada Akemi , Dugas Courtney M , Klingenberg Natasha C , Navar L. Gabriel
Published: December 2018

SGLT2 inhibitors lower blood glucose (BG) levels and have the potential to reduce cardiovascular and renal complications of type 2 diabetes mellitus (T2DM). Since BG levels can vary significantly during a treatment regime, hemoglobin A1c is often utilized as a stable indicator of BG status but dynamic measurements of BG may provide greater insights. A blood glucose telemetry systems was used to investigate BG dynamics in canagliflozin (CANA, an SGLT inhibitor)-treated T2DM mice. Male New Zealand Obese mice were fed a high fat diet to induce diabetes. When the mice exhibited a BG of ~350 mg/dl, the mice were treated with vehicle for 5 days followed by 10 mg/kg/day CANA for 5 days by daily oral gavage (single dosing/day). BG levels were monitored continuously via implanted telemetry devices. Chronic treatment (6 weeks) was also performed to investigate blood pressure monitored by a telemetry system and to assess kidney injury. During vehicle treatment for 5 days, BG levels in the mice averaged 336.7 mg/dl. Lower BG levels during early morning compared to night time (active time) were observed during vehicle treatment. BG levels demonstrated a large variation over 24 hours during the vehicle treatment (maximum minus minimum BG: 368.5 mg/dl on day 5). CANA rapidly reduced BG levels within 3 hours following treatment (214.8±25.4 mg/dl), and the lowered BG was sustained until the next dosing. The average 24-hour BG was gradually suppressed during the CANA treatment reaching 170.1 mg/dl on the last day of CANA treatment. Moreover, CANA reduced the variation of BG (maximum minus minimum BG: 214.8 mg/dl on day 5 of CANA treatment). In mice receiving chronic treatment, CANA started lowering systolic blood pressure on week 2 and significant suppression was observed on week 6 (vehicle: 157.9±2.2 vs. CANA: 124.7±7.6 mmHg). The development of kidney injury, especially renal tubular fibrosis and inflammation, was attenuated by CANA. These findings demonstrate that CANA treatment results in rapid and sustained reductions of both BG levels and BG variability which precede the reduction of blood pressure. The temporal dissociation between the lowering of BG and of arterial pressure levels by CANA suggests hyperglycemia-induced factors mediate the development of hypertension in T2DM.
Abstract P328: Effect of Sitagliptin on the Hemodynamic and Metabolic Response to a Mixed Meal in Individuals With Type 2 Diabetes and Hypertension
Authors: Wilson Jessica R , Kerman Scott J , Nian Hui , Hubers Scott , Brown Nancy J
Published: December 2018

Dipeptidyl peptidase IV (DPP4) inhibitors such as sitagliptin are anti-diabetes drugs that may also have cardiovascular effects. We tested the hypothesis that there is an interactive effect between sitagliptin and angiotensin-converting enzyme (ACE) inhibition on blood pressure (SBP, DBP, MAP) and heart rate (HR) after a meal. We enrolled 52 type 2 diabetics (T2DM) with hypertension. The mean age was 56.1±10.2 years. 58.5% were men, 28.3% were black and 67.9% were white. Individuals were randomized to one of three BP agents: ramipril 10mg/d, valsartan 320mg/d [a renin-angiotensin-aldosterone system (RAAS) inhibiting drug without enzyme activity], and amlodipine 10mg/d (a RAAS-independent control) for 15 weeks. On the 5
th
, 10
th
, and 15
th
week of anti-hypertensive therapy each participant underwent one-week crossover treatment with sitagliptin 100 mg/d + placebo, placebo + placebo, and sitagliptin + aprepitant 80 mg/d (a substance P receptor blocker, as DPP4 and ACE degrade substance P). On the last day of each treatment, participants were given a mixed meal (712 calories: 45% from fat, 33% carbohydrate, 22% protein).

There was no difference in pre-prandial BP among the three crossover treatments. Following the meal, SBP (p=0.002) and MAP (p<0.001) were significantly decreased during either DPP4 inhibitor crossover treatment compared to placebo. In particular, in patients treated with an ACE inhibitor, post-prandial SBP (0.015) and MAP (p=0.021) were lower during DPP4 inhibition. This was true after controlling for significant effects of race (p=0.002) and gender (p=0.0007). Post-prandial HR was not affected by DPP4 inhibition during ACE inhibition. The effect of DPP4 inhibition on fasting glucose but not on postprandial glucose differed among anti-hypertensive treatment groups. DPP4 inhibition decreased the formation of PYY3-36 from PYY following the meal.

There is an interactive effect between DPP4 inhibition and anti-hypertensive therapy on post-prandial BP and metabolic parameters.
Abstract P329: Ankle Brachial Index Profile in a Diabetic Population With High Risk of Cardiovascular Disease
Authors: de Freitas Bernardo P , Saraiva Beatriz G , Peçanha Laura M , Wolff Andressa Regina d , Coimbra Bruno V , Brustolin Fernando R , de Castro Nicole C , da Costa Odara , Garcia Renan A , Dal Pai Maria C , Garcia Caroline C , da Costa Lilian S
Published: December 2018

Introduction:
The Ankle Brachial Index (ABI) is a noninvasive and effective measure in the evaluation of peripheral vascular disease, also being indicative of atherosclerosis. This measure is based on the ratio of ankle systolic pressure values to ipsilateral arm systolic pressure. ABI values below 0.90 are considered risk factors for coronary and cerebrovascular diseases and for the presence of high cardiovascular risk.

Objective:
To describe the ABI and risk factors (RF) of participants in a cross-sectional sample of diabetic and hypertensive patients at high cardiovascular risk.

Method:
After analyzing a group of 147 high-risk cardiovascular patients, 25.9% of hypertensive diabetic patients (n = 38) were selected for ABI and the demographic profile analysis, related to the presence of brain and/or cardiovascular events (CVD). To evaluate the project, a cross-sectional descriptive analysis of data collected through questionnaires and anthropometric evaluation was used

Results:
Of the 38 subjects (57.9% women), with a mean age of 63 ± 9 years, other RF history were found: physical inactivity (73.7%); dyslipidemia (63.2%); family history of cardiovascular diseases (60.5%); reports of previous cardiovascular events, myocardial infarction and / or stroke (71.1%); overweight (34.2%); obesity (36.8%) and smoking (7.9%). When comparing the ITB values found in the subgroup with CVD (n = 27) and without CVD (n = 11), we observed values of 1.00 (0.73-1.25) x 1.02 (0.68- 1.13), respectively, with significant difference between the groups by the chi-square Monte Carlo analysis (p 0.13), although with a small analysis sample.

Conclusion:
In a population with a high cardiovascular profile, with multiple risk factors, the assessment of ABI was a risk marker in the presence of previous CVD, and should be a method to be encouraged in daily clinical practice as a possible marker of cardiovascular risk in the diabetic population.
Abstract P330: Alterations in Maternal Heart during Diabetic Rat Pregnancy
Authors: Schuette Till , Golic Michaela , Kraeker Kristin , Haase Nadine , Herse Florian , Alenina Natalia , Mueller Dominik N , Bader Michael , Schupp Michael , Dechend Ralf
Published: December 2018

Introduction:
Pregnancy is an enormous challenge for the maternal cardiovascular system. Women with pre-gestational cardiovascular impairments face an increased risk for developing pathological pregnancies. Diabetes affects cardiovascular function already in the non-pregnant state. We aimed at evaluating the influence of pre-gestational diabetes on heart morphology and gene expression using a transgenic rat.

Methods:
We generated a pre-gestational hyperglycemic condition in transgenic rats (Tet29) by applying doxycycline, which induces a knock down of the insulin receptor via RNA interference in this strain. Wildtype Sprague-Dawley (SD) rats receiving doxycycline served as a control. Heart analysis was performed on day 21 of pregnancy (with appearance of a vaginal plug being pregnancy day 1). Gene expression levels were measured by qRT-PCR. Heart and body weight were obtained and analyzed.

Results:
Tet29 rats were hyperglycemic throughout pregnancy (blood glucose of 487±24 mg/dl vs. 95±5 md/dl in SD rats) and had a lower body weight in comparison to SD rats at the end of pregnancy (402.3±9.0 g vs. 471.3±12.0 g). Hearts of diabetic Tet29 rats were smaller (absolutely and relatively, regarding body weight), in comparison to SD rats at the end of pregnancy (0.60±0.02 g vs. 0.87±0.02 g; 0.150±0.005 vs. 0.186±0.004, respectively). Expression of inflammation markers MCP1 (1.34±0.20 vs. 0.47±0.13) and TNFα (1.76±0.30 vs. 0.48±0.15) was higher in diabetic hearts. Additionally, the expression of the fibrosis markers CTGF (1.83±0.98 vs. 0.18±0.04) and NGAL (1.30±0.55 vs. 0.41±0.22) was elevated in diabetic hearts, whereas the markers fibronectin (0.74±0.07 vs. 1.23±0.29) and collagen 1 (0.45±0.08 vs. 2.04±0.55) were decreased.

Discussion:
Diabetic pregnant Tet29 rats reveal an altered morphology and gene expression profile in the heart. This phenotype does not fit in a classical category of heart diseases. Further studies such as echocardiography and follow-up analysis in postpartum life are necessary to elucidate possible functional changes.
Abstract P331: Transition From Pre-Diabetes To Diabetes Is Associated With Worsening Of Cardiac Autonomic Neuropathy: Reversal By Anti-Diabetic Drugs
Authors: Bakkar Nour , Mougharbil Nahed , Fares Souha , Zouein Fouad A , El-Yazbi Ahmed F
Published: December 2018

Cardiac autonomic neuropathy (CAN) occurs early in the course of diabetes leading to significant cardiovascular mortality and morbidity. Manifested as impaired heart rate variability (HRV) and baroreflex sensitivity (BRS), CAN represents an independent risk predictor of cardiac mortality. CAN development is linked to hyperglycemia; however, current understanding extends cardiovascular risk to pre-diabetic patients with slight glycemic changes. Here, we assessed the incidence and manifestation of CAN in a rat model of metabolic challenge prior to and after the development of diabetes. Rats were fed a hypercaloric (HC) diet (4.035 KCal/g vs. 3 KCal/g for control rats) composed of: weight (calories) 18.06 % fat (38.68%), 15.8% protein (15.66%), and 46.13% carbohydrates (45.73%). Stable fasting hyperglycemia developed by 16 weeks of feeding. The pre-diabetic stage was associated with signs of perivascular and epicardiac adipose inflammation (4- and 40- fold increase in IL-1β and TGF-β and 2-fold increase in NK-κB expression; and macrophage infiltration) and increased brainstem oxidative stress accompanied with impairment of HRV (total power decrease from 3098 ± 233 to 89 ± 88μs
2
) and the parasympathetic arm of the baroreflex (slope decrease from -1.02 ± 0.12 to -0.34 ± 0.04). These abnormalities were reversed upon treatment with non-hypoglycemic doses of either metformin or pioglitazone or upon lowering the rat caloric intake. On the other hand, after progression to diabetes, the autonomic deficit progressed to the sympathetic arm of the baroreflex (Slope reduction from -0.35 ± 0.02 to -0.09 ± 0.03). The same hypoglycemic doses of metformin and pioglitazone failed to reverse the impaired HRV and BRS. Whereas, reduction of hyperglycemia to control levels by insulin was only capable of reversing the sympathetic impairment (BRS slope of -0.28 ± 0.04). Our present results outline a framework for sequential involvement of different detrimental mechanisms in the course of metabolic disease leading to differential impact on cardiac autonomic control. Furthermore, our findings emphasize the value of early intervention with antidiabetic drugs with potential protective pleiotropic effects.
Abstract P335: Effect of Aerobic Walking Exercise on Cardiovascular Health in Non-Ambulatory Stroke Survivors, a Pilot Study
Authors: Alqahtani Abdulfattah S , Alajam Ramzi A , Eickmeyer Sarah , Liu Wen
Published: December 2018

Background:
Most of rehabilitation interventions in stroke rehabilitation are designed with a focus on improving the impaired sensorimotor function. However, around 75% of stroke survivors are prone to having cardiovascular diseases, the main cause of death in stroke survivors. Much less efforts have been made on how to control risks of cardiovascular diseases. Furthermore, past studies of aerobic exercise have involved only stroke survivors who could walk independently. Stroke survivors who were unable to walk were greatly ignored in past studies that measured risk of cardiovascular diseases. In this project, we examined the effect of aerobic walking exercise on cardiovascular risk factors in non-ambulatory stroke survivors using a treadmill and body weight support system.

Methods:
So far, we have completed a low intensity walking exercise program with body weight support system (30 minutes/session; three sessions/week for eight weeks) in three ischemic stroke survivors (two males, mean age 60.3±17.6 years). Blood pressure (BP) and resting heart rate (RHR) were measured pre- and post-intervention.

Results:
Pre- and post-intervention systolic BP decreased from 151.3±17.2 mmHg to 137.3±27.6 mmHg; diastolic BP decreased from 95±14.4 mmHg to 86±8.6 mmHg; RHR decreased from 74±19.3 beats/minute to 68±20.2 beats/minute, respectively.

Conclusion:
This is an ongoing study, and we are still recruiting study participants. The current results are promising and suggest that the aerobic walking exercise may decrease BP and RHR in non-ambulatory stroke survivors.
Abstract P354: Performance of Different Oscillometric Blood Pressure Algorithms in Patients with Chronic Kidney Disease
Authors: Ringrose Jennifer S , Smith Kevan , Jalali Afrooz , Khinda Harsimran , Wirzba Isaac , Eche-Ameh Hannah , Bello Aminu K , Braam Branko , Padwal Raj
Published: December 2018

Objective:
The extent to which different oscillometric blood pressure (BP) algorithms differ in how they derive BP in patients with chronic kidney disease (CKD) is unknown. We compared the performance of three different oscillometric algorithms against a known oscillometric reference standard in this patient population.

Methods:
Thirty intermittent hemodialysis (HD) patients and 30 stage 3 CKD (CKD) patients were recruited from a quaternary care, academic hospital in Edmonton, Canada. In random order, three sequential readings with an Omron HEM 907XL device and three sequential readings with a laptop-driven oscillometric device capable of detecting and recording oscillometric waveforms were obtained 30 seconds apart. The mean of each three reading set was used for analyses. Oscillometric algorithms (two fixed-ratio and one slope- based) were applied to the raw oscillometric data to derive BP. Paired t-tests were used to assess for statistical significance at the 0.05 level.

Results:
Mean age was 63.4 ± 16.3 y (HD group) and 65.9 ± 10.7 y (CKD group); percent female was 37% (HD) and 47% (CKD); mean BMI was 28.3 kg/m
2
(HD) and 30.3 kg/m
2
(CKD). Over 80% of participants in each group had hypertension. BP comparisons are summarized in Table 1.

Conclusions:
Varying the type of oscillometric algorithm results in markedly different systolic BP estimates in patients with CKD. The fixed-ratio algorithm produced results most comparable to the Omron device. These findings help clarify why different devices using different algorithms produce different results in patients with CKD.
Abstract P360: Potential Need for Expanded Clinical- and Community-based Pharmacologic Treatment and Lifestyle Modification Services Under the 2017 Hypertension Guideline
Authors: Wozniak Gregory , Ritchey Matthew , Gillespie Cathleen , Shay Christina , Thompson-Paul Angela , Loustalot Fleetwood , Hong Yuling
Published: December 2018

Objective:
Describe the effects of the 2017 Hypertension Guideline (HTN GL) compared to JNC-7 guideline on recommended blood pressure (BP) treatment status among US adults and identify the potential need for expanded clinical- and community-based BP management services.

Methods:
Analyze data from 2011-2014 National Health and Nutrition Examination Survey, with analytic sample of 10,031 aged ≥18 years.

Results:
The new HTN GL reclassifies 32.3 million US adults as newly hypertensive and recommends BP-related treatment for 133.7 million adults, including 4.9 million newly recommended pharmacologic therapy and 50.5 million newly recommended lifestyle modifications alone. An estimated 1.1 million adults newly recommended to initiate pharmacologic treatment and 20.6 million adults newly recommended lifestyle modification alone report not having established healthcare linkages. Application of the new HTN GL affects some groups significantly more than others in being reclassified as having hypertension or being newly recommended to initiate BP treatment. This includes adults aged 18-64 years and males, two groups who historically have limited access to or low utilization of healthcare services for hypertension management. In addition, 3.6 million of the 4.9 million US adults who are newly recommended pharmacologic treatment and 36.4 million of the 50.5 million of those newly recommended lifestyle modification alone, are overweight or obese.

Conclusions:
The new HTN GL results in millions of additional US adults being recommended for lifestyle modification to manage their BP and a smaller proportion for pharmaceutical treatment. With many of those individuals not having established linkages to healthcare, these results can aid in translating the new HTN GL into clinical practice and public health programs necessary to meet the increased demand for services. Expanded clinical and public health resources are likely to be required to manage the additional millions of US adults recommended to newly initiate pharmacologic treatment and/or lifestyle modification, including many who previously had only limited healthcare system interaction. Community-based prevention strategies can aid in addressing this added burden on the health care system.
Abstract P370: The Efficacy of Fixed Combination Lisinopril and Hydrochlorothiazide in Obese Hypertensive Women
Authors: Stojanov Vesna , Radivojevic Nenad , Paunovic Katarina , Jakovljevic Branko
Published: December 2018

Objectives:
The aim was to assess the effects of lisinopril combined with hydrochlorthiazide on blood pressure of hypertensive women with normal weight, overweight and obesity.

Methods:
The study comprised 454 hypertensive women, aged 61.50±10.64 years. All patients were treated with fixed combination of 20 mg lisinopril and 12.5 mg hydrochlorthiazide. Body mass index (BMI) was calculated from body weight divided by squared body height. Normal weight was defined as BMI from 18.5 to 24.9 kg/m
2
, overweight as BMI from 25.0 to 29.9 kg/m
2
and obesity as BMI exceeding 30 kg/m
2
. Blood pressure (BP) was measured by an oscillometric device at the beginning of the study, and after three months of therapy. The differences between the groups were tested with one-way ANOVA. The differences from baseline values were tested with Student’s t test for paired samples.

Results:
At the beginning of the study 124 women (27.9%) had normal weight, 217 women (48.8%) were overweight, and 104 (23.4%) were obese. All three groups of women had similar systolic (SBP) and diastolic pressures (DBP) at the beginning of the study as well as at the end of the study. Mean BMI remained stable during three months of antihypertensive therapy. Mean SBP for all patients at the beginning of the study was 161.90±13.26 mmHg, mean DBP was 97.48±8.78 mmHg. After three months of therapy, all women reduced their SBP significantly (mean decrease from baseline = 28.48±12.67 mmHg), as well as their DBP (mean decrease from baseline = 15.48±8.84 mmHg). The average decrease in SBP and DBP during therapy was similar among women with normal weight, overweight and obesity. Women with normal weight reduced their SBP by 29.61±12.33 mmHg, in comparison to overweight women (28.42±11.89 mmHg), and to obese women (26.54±12.74 mmHg), but the difference was not statistically significant.

Conclusion:
Three-month therapy with lisinopril and hydrochlorthiazide is equally effective in hypertensive women with normal weight, overweight and obesity.
Abstract P380: Inverse Circadian Pattern in the Renal Generation of Tumor Necrosis Factor-Alpha (TNFå) and Angiotensinogen (AGT) in Salt-Sensitive Hypertension (SSH) Induced by Angiotensin II (AngII) in Mice
Authors: Castillo Alexander , Khan Nadia , Shindler Isabella , Navar L.Gabriel , Majid Dewan S
Published: December 2018

Individuals with SSH show a non-dipping blood pressure (BP) during the inactive night period, a phenomenon which is significantly associated with enhanced cardiovascular morbidity and mortality. However, the pathophysiological mechanism for this phenomenon is not yet clearly understood. Chronic AngII administration in mice (reversed circadian rhythm) induced SSH with an increase in intra-renal AGT formation, a response that was exaggerated in TNFα receptor type 1 (TNFR1) knockout mice, indicating that renal AGT formation is suppressed by TNFR1 activation by TNFα. The present study examined the hypothesis that AngII-induced TNFα formation follows a circadian pattern with increases during the active period compared to the inactive period, that facilitates less AGT formation during the active period. Experiments were performed in mice chronically treated with or without AngII (25 ng/min; osmotic mini-pump) + high salt (4% NaCl) intake for 4 weeks that increased BP from 90±2 to 108±3 mmHg (tail-cuff method). Circadian rhythm in urinary parameters was assessed by 12 hour collections of urine using metabolic cages during the active night period (7PM to 7AM) and the inactive day period (7 AM to 7 PM). In normal mice (n=6), urinary excretion of TNFα (uTNFα) was higher (0.5±0.2 vs 0.13±0.08 pg/hour) but urinary excretion of AGT (uAGT) was lower (0.28±0.18 vs 0.46±0.14 ng/hour) during the active period compared to that during the inactive period. This inverse relationship between uTNFα and uAGT was exaggerated in AngII+HS treated mice (n=6). From the baseline (0 week) to the 2nd and 4
th
week period, there were marked incremental changes in uTNFα during active periods (0.68±0.20 to 14.2±5.4 and 44.6±14.6 pg/hour) which were less during inactive periods (0.73±0.48 to 10.3±3.3 and 12.1±4.7 pg/hour). Interestingly, uAGT changed minimally during active periods (0.21±0.14 to 0.05±0.04 and 1.42±0.97 ng/hour) but increased significantly during inactive periods (0.32±0.14 to 1.57±0.71 and 3.98±1.67 ng/hour). These data suggest that an increase in TNFα generation suppresses intra-renal AGT formation during active periods but this phenomenon is inversed during inactive periods. The increase in AGT during the inactive period could lead to a non-dipping BP pattern in SSH.
Abstract P382: The Role of Atrial Natriuretic Peptide in Cardiac Damage During Salt Sensitive Hypertension
Authors: Ilatovskaya Daria , Winsor Kristen , Zietara Adrian , Paterson Mark , Levchenko Vladislav , Kriegel Alison , Staruschenko Alexander
Published: December 2018

Atrial natriuretic peptide (ANP), encoded by the
Nppa
gene, is an osmoregulatory hormone that promotes salt excretion. GWAS identified
Nppa
to be associated with hypertension; some studies suggest varying ANP levels as an indicator of salt-sensitivity. The aim of the current project was to assess the effects of ANP deficiency on cardiac damage and function using a knockout of
Nppa
in the Dahl Salt-Sensitive (SS) rat background (SS
NPPA-/-
). A combination of in vivo techniques with ex vivo and biochemical methods were used to test the role of ANP in the development of SS hypertension in male and female rats. IHC analysis was employed to quantify tissue damage; echocardiography was used to test heart function. SS
NPPA-/-
rats demonstrated higher blood pressure compared to SS controls when fed a high salt (HS, 4% NaCl) diet: on day 21 of diet MAP was 185.8 ± 9 mmHg in SS
NPPA-/-
rats compared to 144.6 ± 4 mmHg in SS controls. Heart rate was found to be on average 40 bpm lower in SS
NPPA-/-
rats until day 8 of the HS challenge, when it rose up to the rate of wild type counterparts and continued to decline at the same pace. SS
NPPA-/-
rats showed exacerbated kidney damage, reduced diuresis and lower sodium excretion when fed a HS diet. SS
NPPA-/-
rats exhibited intensified cardiac damage compared to SS controls, as demonstrated by heart to body weight ratio after HS (3.9 ± 0.13 in wild type vs 5.5 ± 0.09 in KO rats), elevated cardiac fibrosis (up to 6% of fibrotic cardiac tissue area in SS
NPPA-/-
vs less than 3% in wild types), and a significantly increased cardiac vessel media thickness. Fibrosis and heart hypertrophy were attenuated in female rats. Echocardiography revealed that although SS
NPPA-/-
rats show heart remodeling, ejection fraction is preserved and they do not exhibit heart failure. Chronic i.v. infusion of ANP in SS rats (100 ng/kg/day) attenuated the HS-induced increase in blood pressure and renal damage, and resulted in less cardiac hypertrophy and fibrosis (1% fibrosis in ANP-infused animals vs 3% in vehicle-treated group). Therefore, ANP deficiency aggravates SS hypertension and cardiac damage; further work is needed to reveal if ANP deficiency causes heart failure of a HF/PEF phenotype, and what the interplay between heart and kidney is in this setting.
Abstract P383: High Sodium Intake is Independently Associated with Subclinical Hypercortisolism in Hypertensive Patients
Authors: Rossitto Giacomo , Maiolino Giuseppe , Lerco Silvia , Bisogni Valeria , Cesari Maurizio , Ceolotto Giulio , Touyz Rhian M , Pinato Alessio , Plebani Mario , Rossi Gian Paolo , Delles Christian
Published: December 2018

The widely accepted notion of an increase in water intake to compensate for a similar increase in salt consumption has recently been challenged by evidence of long-term renal and metabolic mechanisms favouring endogenous water accrual and body fluid preservation. A glucocorticoid-driven catabolic state is instrumental to this aim and is prevented by increased food intake in rodents. Demonstration of these mechanisms in large human populations is lacking and their relevance for cardiovascular disease is therefore unknown. We explored the association between sodium intake (estimated by 24h urine sodium excretion; USE) and 24h urinary free cortisol (UFC) in 145 patients screened for secondary causes of hypertension in a tertiary referral centre, after washout from drugs affecting the renin-angiotensin-aldosterone system (63 males, 43.3%; age, 48 [38-56] years; BMI, 27.1 [24.3-31.0] kg/m
2
). USE was directly associated with UFC (Spearman’s rho=0.407, p<0.001), as well as male gender (r=0.381, p<0.001), BMI (r=0.243, p=0.006), creatinine clearance (r=0.637, p<0.001) and, borderline, to plasma glucose (r=0.268, p=0.065). Importantly, UFC increased across classes of sodium intake (Low < 2.3g/d, Medium 2.3-5g/d and High > 5g/d) in lean and overweight groups (n=41, ANOVA p = 0.005 and n= 49, ANOVA p < 0.001, respectively), but not in obese subjects (n=35; p = 0.083). Linear regression analysis showed that (square root-transformed) USE was the strongest explanatory variable for UFC after correction for age, gender, BMI, eGFR and aldosterone:renin ratio (β = 0.04, p < 0.0005). A regression model that also included (Log-transformed) BMI as a surrogate of excess food intake (β = -0.51, p = 0.042), explained 23% of UFC variability in the cohort. We conclude that sodium intake, as estimated by USE, is an independent predictor of subclinical hypercortisolism in lean and overweight but possibly not in obese subjects. These data, in a population at increased cardiovascular risk, suggest a link between sodium intake and subclinical metabolic derangement, which could further add to the overall risk profile.
Abstract P385: The Enhanced Antihypertensive Effect by a Combination Diet of Allium Bakeri and Capsaicin in 2-Kidney, 1-Clip Renovascular Hypertensive Rats
Authors: Kurihara Nobutaka , Segawa Yukiko , Maruyama Saki , Osera Tomoko , Hashimoto Hiroko
Published: December 2018

Objective:
Allicin contained in Allium Bakeri (AB) , a transient receptor potential (TRP) vanilloid type-1 (TRPV1) and TRP ankyrin-1 (TRPA1) agonist, increases phosphorylated (p-) endothelial nitric oxide synthase (eNOS). Another TRPV1 agonist, capsaicin (CAP), causes a vasodilatory effect through the increment of p-eNOS. We recently demonstrated the alleviation of blood pressure (BP) elevation by each intake of AB and CAP in 2-kidney, 1-clip (2K1C) hypertensive rats. AB is often used with red hot chili pepper containing CAP in the Japanese cuisine. We hypothesized that a combination diet of AB and CAP enhances the antihypertensive effect compared with each diet. In this study, to test the hypothesis, we investigated the interactive effects of dietary AB and CAP on BP, as well as the p-eNOS/eNOS in the protein expression of aorta, in 2K1C rats.

Method:
Male Sprague-Dawley rats (6wks) were treated with sham operation (SHAM) or clipping the left renal artery (2K1C). After surgery, SHAM rats received a control diet (CTL), and 2K1C rats received CTL, a diet with 1% (10 of 1,000, w/w) freeze-dried AB powder, with 0.006% (60 of 1,000,000, w/w) CAP or with both (AB+CAP) for 6 weeks. The systolic BP (SBP) was measured by a tail-cuff method once per week. At the end of protocol, rats were euthanized and the thoracic aortas were collected for extracting the protein. The p-eNOS/eNOS in the protein expression in aorta was evaluated by Western blotting.

Result:
Analysis of variance showed that SBP was significantly higher in 2K1C-CTL than SHAM-CTL through the protocol (123±2.3 vs 165±3.2 mmHg,
p
< 0.05, at 6 weeks after the surgery). SBP was lower in 2K1C-AB and -CAP in 2K1C-CTL (151±2.4 and 139±3.7 vs 165±3.2,
p
< 0.05, each). Compared with 2K1C-AB and -CAP, a significant reduction in SBP was observed in 2K1C-AB+CAP (135±3.1, at 6 weeks) throughout the procedure (
p
< 0.05). The p-eNOS/eNOS was tended to be enhanced in 2K1C-AB and -CAP, but not in 2K1C-AB+CAP, compared to 2K1C-CTL.

Conclusion:
A combination diet of AB and CAP may enhance antihypertensive effects compared with each diet of AB and CAP, in 2K1C rats. Although the increase in eNOS phosphorylation may participate in the mechanism of the antihypertensive effects by each diet of AB and CAP, it may not do in that of their combined effect.
Abstract P393: Sex Modifies the Longitudinal Association of Adiposity With Left Ventricular Hypertrophy Among Children With Chronic Kidney Disease
Authors: Brady Tammy M , Roem Jennifer , Cox Christopher , Schneider Michael , Wilson Amy , Furth Susan , Warady Bradley , Mitsnefes Mark
Published: December 2018

Objective:
Adiposity, not blood pressure (BP), is associated with left ventricular hypertrophy (LVH) among hypertensive children without chronic kidney disease (CKD). We aimed to determine the longitudinal association of BMI z-score with LVH and left ventricular mass index (LVMI) among children with CKD.

Methods:
696 participants of the Chronic Kidney Disease in Children study with echocardiography results who contributed a total of 1,300 visits were included. Mixed models, adjusting for repeated visits with a random subject effect, were used to determine the longitudinal association of body mass index (BMI) z-score with LVMI and LVH (LVMI> age-sex specific 95
th
%ile). Models were adjusted for age, sex, race, systolic and diastolic BP z-score, glomerular diagnosis, time with CKD, glomerular filtration rate and calcium*phosphorus product and accounted for informative censoring.

Results:
Baseline characteristics are in the table. Among females, a 1 unit increase in BMI z-score was associated with an 8.5% increase in LVMI and 3.4 greater odds of LVH, whereas with boys, a 1 unit increase in BMI z-score was associated with a 5.2% increase in LVMI and a 1.4 greater odds of LVH (p<0.05 for all).

Conclusions:
Among children with mild-moderate CKD, adiposity is independently associated with LVMI and LVH over time. This association is greater among females, a finding that may have future clinical and research implications.
Abstract P403: Mortality of Hypertensive Men is Affected by Pneumonia and Lung Cancer
Authors: Shen Yuechun , Li Xinchun , Li Jun
Published: December 2018

Background:
Both morbidity and mortality of hypertension are high. Whether pneumonia and lung cancer affect the mortality of men with hypertension is not well studied. The aim of the study was to study the association between pneumonia/lung cancer and the mortality among male individuals with hypertension.

Methods:
A cross-sectional study was performed on hypertensive men, who admitted into our hospital and lived in eligible downtown areas prior to admission. Variety statistical analyses were performed, including logistic regression to assess the association between pneumonia/lung cancer and the mortality.

Results:
14354 patients were enrolled. Mean age of them was 68.9±12.4 year old (y) and dead ones was 75.9±9.5y. The hospitalized mortality was 5.9%, which was increased with age: the mortality of group ≦49y, 50-59y, 60-69y, 70-79y, 80-89y and ≧90y was 0.7%, 2.2%, 2.9%, 7.1%, 11.1% and 16.6% respectively. The increased mortality was significantly positively correlated with the prevalence of pneumonia in different age,
P
<0.05, r=0.99. Pneumonia was prone to involved in men with older age and severer organ damage by hypertension. Similar to traditional risks coronary heart disease and stroke, pneumonia and lung cancer were also significantly associated with the mortality. OR (95% CI) for pneumonia and lung cancer were 6.18 (4.35-8.78) and 1.55 (1.14-2.11) respectively.

Conclusions:
The study provides evidence that pneumonia and lung cancer significantly affect mortality of hypertensive men in downtown areas, bringing alert that in order to reduce the mortality of hypertension in mordent life, theses lung diseases should be prevented and treated intensively.

Key Words:
hypertension, hospitalized mortality, pneumonia, lung cancer
Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Katsanos Konstantinos , Spiliopoulos Stavros , Kitrou Panagiotis , Krokidis Miltiadis , Karnabatidis Dimitrios
Published: December 2018

Background

Several randomized controlled trials (
RCT
s) have already shown that paclitaxel‐coated balloons and stents significantly reduce the rates of vessel restenosis and target lesion revascularization after lower extremity interventions.

Methods and Results

A systematic review and meta‐analysis of
RCT
s investigating paclitaxel‐coated devices in the femoral and/or popliteal arteries was performed. The primary safety measure was all‐cause patient death. Risk ratios and risk differences were pooled with a random effects model. In all, 28
RCT
s with 4663 patients (89% intermittent claudication) were analyzed. All‐cause patient death at 1 year (28
RCT
s with 4432 cases) was similar between paclitaxel‐coated devices and control arms (2.3% versus 2.3% crude risk of death; risk ratio, 1.08; 95% CI, 0.72–1.61). All‐cause death at 2 years (12
RCT
s with 2316 cases) was significantly increased in the case of paclitaxel versus control (7.2% versus 3.8% crude risk of death; risk ratio, 1.68; 95%
CI,
1.15–2.47; —number‐needed‐to‐harm, 29 patients [95%
CI
, 19–59]). All‐cause death up to 5 years (3
RCT
s with 863 cases) increased further in the case of paclitaxel (14.7% versus 8.1% crude risk of death; risk ratio, 1.93; 95%
CI
, 1.27–2.93; —number‐needed‐to‐harm, 14 patients [95%
CI
, 9–32]). Meta‐regression showed a significant relationship between exposure to paclitaxel (dose‐time product) and absolute risk of death (0.4±0.1% excess risk of death per paclitaxel mg‐year;
P
<0.001). Trial sequential analysis excluded false‐positive findings with 99% certainty (2‐sided α, 1.0%).

Conclusions

There is increased risk of death following application of paclitaxel‐coated balloons and stents in the femoropopliteal artery of the lower limbs. Further investigations are urgently warranted.

Clinical Trial Registration

URL
:
www.crd.york.ac.uk/PROSPERO
. Unique identifier:
CRD
42018099447.
Systematic ambiguity in the well-established model system insect Scathophaga stercoraria (Diptera: Scathophagidae): sister species S. soror revealed by molecular evidence
Authors: BERNASCONI MARCO VALERIO , BERGER DAVID , BLANCKENHORN WOLF U.
Published: December 2018

Even for well-established insect model systems, such as the yellow dung fly Scathophaga stercoraria (Linnaeus) (Diptera: Scathophagidae), there may be hidden systematic ambiguities that require clarification. Dung flies from the Afrotropical Region have been considered (i) as con-specific and not different from all the other Holarctic Scathophaga stercoraria; (ii) as a local and peculiar African subspecies of S. stercoraria (Scathophaga stercoraria soror Wiedemann), or (iii) as a separate valid species (Scathophaga soror Wiedemann). Our study represents an attempt, based on mitochondrial (COI, 12S, and 16S), nuclear (ITS2) as well as microsatellite markers, to clarify this problem. Results strongly suggest that S. soror is a separate taxon from S. stercoraria. Due to the importance of S. stercoraria as a model system for studies in ecology, behaviour and evolution, the systematic position of S. soror (relative to S. stercoraria) is not solely of interest for systematists, but for evolutionary ecologists as well.