bluuebunny/crossref_metadata_2025 huggingface dataset:
HEART RATE AT OFFICE VISIT AND LONG-TERM CARDIOVASCULAR EVENTS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Jaeho Byeon , Choo Eun-Ho , Chang Kiyuk
Published: June 2023

Objective:

Elevated heart rate at admission or discharge is known to be associated with poor cardiovascular outcomes in patients with acute myocardial infarction (AMI). The association between averaged heart rate at office and cardiovascular outcomes in patients with AMI has been studied scarcely. We investigated the relationship of heart rate at office with long-term cardiovascular outcomes in AMI.

Design and method:

We analyzed a total of 7,840 patients with heart rate measured at least 3 times after hospital discharge between January 2004 and April 2015 from COREA-AMI registry. The values of heart rate measured at office visit were averaged and categorized into four groups by quartiles (<68, 68-74, 74-80, and >80 beats per minute). The primary end point was a composite of cardiovascular death, myocardial infarction, and ischemic stroke.

Results:

During a median of 5.7-year follow up, major adverse cardiovascular events (MACE) affected 1,357(17.3%) patients. The averaged heart rate of higher than 80 beat per minute (b.p.m) was associated with an increased incidence of primary outcomes compared to the averaged heart rate of 68-74 b.p.m as reference. (Adjusted hazard ratio 1.37, 95% CI 1.19-1.58, p<0.0001) Increased heart rate of 1 b.p.m was an independent predictor of MACE (Adjusted hazard ratio 1.025, 95% CI 1.02-1.03, p<0.001). When dichotomized into < 74 or > 74 b.p.m, lower averaged heart rate was not associated with incidence of primary outcomes in patients with LV systolic dysfunction in contrast to those without LV systolic dysfunction.

Conclusions:

Elevated averaged heart rate at office visit after AMI was associated with increased risk of cardiovascular outcomes.
MARKED INCREASES IN PROXIMAL AORTIC CHARACTERISTIC IMPEDANCE AND HENCE FORWARD WAVE PRESSURES BEYOND BRACHIAL BLOOD PRESSURE IN ANGIOGRAPHIC PROVEN CORONARY ARTERY DISEASE
Authors: Peterson Vernice , Els Danelle , Fernandes Daniel Da Silva , Kinsey Jamie -Leigh , Santos Claudia Dos , Sadiq Eitzaz , Naran Ravi , Monareng Taalib , Abdool-Carrim Talib , Cassimjee Ismail , Modi Girish , Norton Gavin , Woodiwiss Angela , Peters Ferande
Published: June 2023

Objective:

Although indexes of aortic stiffness increase the risk for coronary artery disease (CAD), the extent to which proximal aortic stiffness increases enhance central arterial forward wave pressures beyond changes in peripheral pressures, is uncertain. We aimed to determine whether increases in proximal aortic stiffness, as indexed by aortic characteristic impedance (Zc) translate into an enhanced central arterial pressure for a given brachial BP.

Design and method:

From central pressure, aortic velocity and outflow tract diameter measurements and echocardiography, we determined Zc and arterial pressure wave morphology in 71 patients with angiographic proven CAD and all other cardiac pathology excluded. We compared central arterial function in these patients with 230 age and sex-matched controls from a community study, and in patients with stroke and CLI (n = 287) diagnosed in a hospital setting.

Results:

Adjusting for confounders, including mean arterial pressure, and aortic root diameter, as compared to controls, both Zc and the pressures generated by the product of peak aortic flow (Q) and Zc (PQxZc) were markedly increased in patients with CAD (p<0.0001) and those with stroke or CLI (p<0.005). Moreover, compared to patients with stroke and CLI, those with CAD also had marked increases in both Zc and PQxZc (p<0.0001). Consequently, with adjustments for the same confounders, pressures generated by forward wave pressures (Pf) were markedly increased in patients with CAD as compared to controls and to patients with alternative arterial diseases (p<0.0001). Importantly, after further adjustments for brachial PP or SBP, the higher Pf values in patients with CAD were retained (p<0.005 to <0.0001). However, with adjustments for brachial SBP and confounders, central aortic PP did not differ between groups.

Conclusions:

Independent of confounders and aortic root diameter, a marked increase in proximal aortic Zc occurs in patients with CAD as compared to both controls and patients with arterial disease in alternative beds. This translates into a greater central arterial pulsatile load determined by forward travelling pressure waves, but not peak central PP than that predicted by brachial BP measurements. These data support a need for intense brachial BP lowering in CAD.
ARTERIAL BAROREFLEX FUNCTION IS IMPAIRED DURING THE RECOVERY FROM ACUTE LUNG INJURY IN A BLEOMYCIN-INDUCED RAT LUNG INJURY MODEL
Authors: Wang Hanjun , Rudebush Tara , Zucker Irving
Published: June 2023

Objective:

Acute lung injury (ALI) and its clinical correlate, the acute respiratory distress syndrome (ARDS), results due, in part, to disruption of the normal capillary endothelial barrier and invokes perturbations of ventilatory control. ALI is associated with autonomic dysfunction and cardiac arrhythmias. In a recent study we suggested that rats were susceptible to cardiac arrhythmia even during the recovery from ALI, in part, due to abnormalities in cardiac sympathetic ganglia. On the other hand, if arterial baroreflex function is altered during the recovery of ALI remains unknown. The primary goal of this study was to examine baroreflex function during the recovery stage from ALI in a bleomycin (Bleo)-induced rat ALI model.

Design and method:

ALI was induced in male SD rats (200-250g) using a single intra-tracheal injection of Bleo (2.5 mg/kg). 4 weeks post Bleo (n = 7) or saline (sham, n = 6), rats were anesthetized with urethane (800 mg/kg ip) and alpha-chloralose (40 mg/kg ip) to measure baroreflex sensitivity. Baroreflex curves were generated by measuring the heart rate (HR) and renal sympathetic nerve activity (RSNA) responses to decreases and increases in mean blood pressure (MAP) by intravenous administration of nitroglycerin (25 μg) followed by phenylephrine (10 μg). Differences between sham and Bleo rats were determined by one-way ANOVA followed by the Tukey post hoc test.

Results:

Compared to sham rats, there was a significant decrease in the RSNA (117.4±11.6 vs. 77.5±8.9 %baseline, P = 0.018) or HR (147.5±9.7 vs. 75.1±11.3 bpm, P<0.001) range in Bleo rats. Minimum RSNA or HR was also decreased in bleo rats compared to sham rats. There was no significant difference in either the slope coefficient or the blood pressure at the midpoint of the range (BP50) between the two groups. There was a significant decrease in peak slope [or maximum gain (Gainmax) in Bleo rats (MAP-RSNA Gainmax: 3.11±0.27 vs. 1.74±0.31, p = 0.017; MAP-HR Gainmax: 3.57±0.31 vs. 1.21±0.14, p<0.001).

Conclusions:

Our data demonstrate impaired baroreflex function during the recovery state from ALI. Autonomic dysfunction may also contribute to increased cardiovascular risk during the recovery stage from ALI.
CLINICAL COURSE OF COVID-19 DEPENDING ON PRESENCE OF HYPERTENSION AND BLOOD PRESSURE CONTROL
Authors: Kuryata Olexandr , Frolova Yevheniia , Stadnyk Olexandr , Semenov Viktor
Published: June 2023

Objective:

Hypertension (HTN) is suggested to be associated with higher susceptibility to SARS-CoV-2 virus as well as with the worse prognosis of COVID-19. The aim of this study is to investigate whether the presence of HTN and blood pressure (BP) control are associated with the severity of COVID-19.

Design and method:

To the study were included 260 patients with confirmed infection with SARS-CoV-2 virus. COVID-19 was confirmed using nasopharyngeal PCR swab. The diagnosis of HTN was confirmed from the medical records of the patient or if the patient had a history of treatment with antihypertensive drugs. The patients were divided into two groups: no HTN (n = 97) and HTN (n = 163).

Results:

The median age of patients with HTN was significantly higher than of patients without HTN (65.0 [57.5;73.0] vs 52.0 [43.0;66.0], p<0.01). The percentage of lung injury was higher in patients without hypertension, as well as the percentage of patients with lung injury above 50% (p = 0.01 and p<0.01). Medians of hemoglobin did not differ significantly between groups, but the percentage of patients with anemia was significantly higher among patients with HTN (p<0.01). Medians of chloride and sodium levels were significantly higher in the patients without HTN (p<0.01). Total cholesterol level was significantly higher in the patients without HTN (p = 0.01).

Conclusions:

In the presented study presence of hypertension was not associated with a more severe course of COVID-19.
ARTERIAL HYPERTENSION AND COVID-19: A RETROSPECTIVE STUDY
Authors: Latsabidze Nino
Published: June 2023

Objective:

The aim of this study was in patients who had COVID-19 to rate the frequency of newly verified or worsened existing hypertension

Design and method:

The retrospective study was done, which lasted from April 2021 to May 2022, 78 patients (29 males, 49 females) who have had COVID-19 were analyzed at the Emergency department in our clinic. In order to be categorized as a COVID patient, a positive PCR test at a single point in time was required. According to the accepted definitions of COVID-19 and its manifestations in respect to time from a positive PCR test, the patients were divided into two groups: acute COVID patients (PCR test positive < 30 days ago) and post-acute COVID patients (PCR test positive > 30 days ago). Patients’ age, history, BMI, laboratory values, and antihypertensive therapy were recorded

Results:

Out of 78 patients studied, 16(12.48 %) had either newly verified (9) or worsened existing (7) arterial hypertension. Among those, the median time from a verified SARS-CoV-2 infection to onset of symptoms was 90 days. Compared to the rest of the study population, patients presenting with arterial hypertension had significantly higher systolic (median 160 vs. 128 mmHg, p = 0.004) and diastolic (median 97 vs 80 mmHg, p = 0.02) blood pressure and were non-significantly younger (median 49 vs 57 years, p = 0.067).

Conclusions:

Arterial hypertension following COVID-19, either newly verified or worsened existing, is a relatively common (12.04% of our patient pool) occurrence and more effort should be directed into evaluating patients’ blood pressure values following COVID-19 in order to make a timely diagnosis and start proper treatment early.
THE IMPACT OF ON-ADMISSION SYSTOLIC BLOOD PRESSURE READING ON THE SEVERITY AND CLINICAL OUTCOME OF HYPERTENSIVE COVID-19 HOSPITALIZED PATIENTS AT JABRA ISOLATION CENTRE/SUDAN: A CROSS-SECTIONAL HOSPITAL-BASED STUDY (2021)
Authors: Beheiry Hind M. , Alhaj Waleed M. , Jaber Mohammed H. , Mohamed Hazim H. , Almahie Mohannad A. , Ahmed Amjad M. , Almadhoun Wadi , Hilali Mahmoud
Published: June 2023

Objective:

Covid-19 is characterized by higher rates of morbidity and mortality; when accompanied with hypertension and diabetes mellitus comorbidities. The incidence of hypertension among patients with Covid-19 ranged from 15%-20% to 30%-35%.

To investigate the effect of on-admission SBP reading on the severity and the clinical outcome of hypertensive hospitalized patients with COVI-19.

Design and method:

A retrospective hospital-based study conducted in 2022 based on 2021 records at Jabra Isolation Centre/Sudan. Using the FMOH triage Protocol Checklist for Acute Respiratory Sickness at health institutions designed on 2020, onset of COVID-19; the severity was measured. The clinical outcome, record-based, was either death, discharged with residual complications or fully recovered.

Results:

317 patients were enrolled; 205 (65%) were males, 135 (42.6%) were hypertensive of which 67 (49.7%) were hypertensive diabetic. The deaths were 183 (57.7%); of which 76 (41.5%) were hypertensive. The mean on-admission SBP of hypertensive was 139 ± 24.4 mmHg; of hypertensive non-diabetic was 91± 8.8mmHg; and of hypertensive diabetic was 139±27 mmHg. Using on-admission SBP: 72 (53.3%) of hypertensive (135) were critical, 47 (34.8%) were severe and 16 (11.9%) were moderate/mild. There was no significant association between age of hypertensive and severity. There was significant association between severity and outcome P (0.047). There was no significant difference between SBP on-admission and categories of severity nor outcome. There was significant difference in death between the age groups of hypertensive Chiq square 0.86; highest with age >60 years.

Conclusions:

The mean on-admission SBP of the hypertensive diabetic was higher than of the hypertensive non-diabetic. There was significant association between the severity and outcome; but no significant difference between SBP on-admission and categories of severity nor outcome. The total deaths were 57.7% of which 41.5% were hypertensive and highest with age >60 years. The on-admission SBP did not have significant difference with the categories of severity nor the clinical outcome.
HYPERTENSION AND RISK FACTOR TO MORTALITY IN CORONAVIRUS DISEASE (COVID-19)
Authors: Oliveira Monica Amorim de , Haddad Andréa , Godomiczer Alessandra , Garcia Thaisa Rodrigues , Sten Camila , Moisés Flavia Pedro , Ferraz Cristiane Comarck , Costa Eduardo
Published: June 2023

Objective:

the aim of this study is to assess whether hypertension was considered a risk factor for mortality in in adult patients with COVID-19 hospitalized for acute respiratory distress syndrome (ARDS).

Design and method:

Retrospective study with analysis of electronic medical records of adult patients admitted for mild and moderate COVID-19 and related acute respiratory distress syndrome in a single quaternary private hospital in Rio de Janeiro, Brazil.

Consecutive patients aged 18 years and older with COVID-19 confirmed by a positive reverse transcription polymerase chain reaction (RT-PCR) testing.

ll data were collected in spreadsheets in Microsoft Excel version 365 (Microsoft Corp., Redmon – WA – USA) and the statistical analysis was performed using SAS Guide 4.3 (SAS Institute Inc., Cary – NV – USA).

Results:

Two hundred and two patients were were consecutively admitted for mild or moderate COVID-19 related ARDS and were included in this study. The mean age of the studied population was 69.1 ± 14.8 years. Of these, 130 patients (64.4%) were male. The mean BMI was 29.9 ± 6 kg/m2.

Hypertension was present in 134 patients, corresponding to 67% of the studied population. 35.8% of patients had diabetes and 10.45% dyslipidemia.

Among hypertensive patients, 58 (74%) died, with a relative risk of 1.45 (CI 0.96-2.2)

Conclusions:

The studies presented systemic arterial hypertension as the most common chronic disease in subjects diagnosed with covid-19. Hypertension is one of the main risk factors for adverse outcomes in subjects with covid-19. The results found in this study suggest that hypertension is associated with an increased risk of developing the severe form of covid-19, and increased mortality. Future studies should include the analysis of individual variables that may influence the outcome of systemic arterial hypertension subjects infected by SARS-CoV-2, such as genetic factors, race/ethnicity, occupation, lifestyle habits, in addition to the evaluation of educational level and diagnosis of the socioeconomic and environmental situation.
SYSTEMATIC LONG COVID SYMPTOMS ASSESSMENT IN HYPERTENSIVE AND NON-HYPERTENSIVE INDIVIDUALS DURING THE 12-MONTHS FOLLOW-UP AFTER HOSPITAL DISCHARGE
Authors: Honchar Oleksii
Published: June 2023

Objective:

To study the impact of hypertension on the dynamics of physical, emotional and cognitive symptoms during the 12-months follow-up after hospitalization for COVID-19.

Design and method:

212 patients hospitalized for COVID-19 (50% hypertensive, 53% female, mean age 53,4±13,6 years) underwent comprehensive questionnaire survey evaluating physical (CAT, CCQ and mMRC dyspnea scales for respiratory and EFTER-COVID for other related symptoms), emotional (HADS) and cognitive well-being (Memory, Thinking and Communication subscale of SBQ-LC questionnaire, MTC-SBQ-LC) that was performed pre-discharge and repeated after 1, 3, and 12 months.

Results:

Despite being older (57,8±11,8 vs 50,7±13,9, p<0,001) and having higher BMI (31,7±5,3 vs 27,4±4,4 kg/m2, p<0,001), hypertensive patrticipants had similar baseline summary scores of symptoms severity but slightly higher mMRC dyspnea score (2,7±1,1 vs 2,3±1,1, p = 0,023), and no significant difference in trends of summary scores have been detected by ANOVA (see graphic abstract). Non-hypertensive subjects had worse baseline limitation of everyday activity, cough and sputum production by respective CAT and CCQ sections that were characterized by better dynamics during follow-up. The residual level of respiratory-related symptoms at 12 months was higher in hypertensive cohort (CAT score 8,1±5,1 vs 5,8±5,0, p = 0,003, CCQ score 7,5±6,1 vs 4,5±5,1, p<0,001, mMRC dyspnea score 1,57±0,63 vs 1,27±0,54, p<0,001), most likely due to more frequent concomitant obesity and diastolic dysfunction.

The most striking data was obtained in the MTC-SBQ-LC: yonger and healthier non-hypertensive participants displayed similar trends of most cognitive symptoms to the hypertensive cohort, but had persistently worse brain fog, difficulties in understanding others’ speech, planning, concentrating, and word-finding, that resulted in significantly higher summary score at 12 months after discharge (1,71±2,36 vs 0,96±1,30, p = 0,010).

No differences were detected in anxiety and depression levels as assessed by HADS.

Conclusions:

Hypertensive patients that had been hospitalized for COVID-19 displayed similar trends of resolving physical, emotional and cognitive symptoms throughout the 12-month follow-up but had higher levels of residual respiratory-related symptoms and dyspnoea compared to the non-hypertensive participants, whereas the latter were characterized by significantly higher level of cognitive dysfunction as assessed by the dedicated SBQ-LC subscale.
SUBCLINICAL TARGET ORGAN DAMAGE IN PATIENTS WITH TYPE 1 DIABETES MELLITUS. A PROSPECTIVE PRELIMINARY STUDY
Authors: Rosin Elena , Franzin Angelica , Burrei Giulia , Sabba’ Giulia Elena , Biasotto Andrea , Morellini Sarah , Giontella Alice , Tagetti Angela , Cattazzo Filippo , Marcon Denise , Piona Claudia , Maffeis Claudio , Bortolotti Stefano , Minuz Pietro , Fava Cristiano
Published: June 2023

Objective:

Early atherosclerosis is the main cause of cardiovascular damage and death in patients with type 1 Diabetes Mellitus (T1DM). Some vascular indexes can help to identify and stratify patients before clinical events. This study aims to evaluate the trend over time of some markers of subclinical vascular damage to identify possible associations with anthropometric parameters, blood pressure (BP) and metabolic variables.

Design and method:

Fifty-six patients with T1DM (mean age: 17.5±2.5 years; mean duration of diabetes: 8.9±4.0 years) were assessed in two occasions (mean follow-up time: 2.7±0.9 years). Peripheral systolic and diastolic BP (pSBP, pDBP), central systolic and diastolic BP (cSBP, cDBP) and Pulse Wave Velocity (PWV) were measured by the SphygmoCorXCEL. Carotid Intima-Media Thickness (cIMT) and the carotid Distensibility Coefficient (cCD) were assessed by ultrasound connected with an image acquisition and analysis system (CardiovascularSuite). Biochemical and anthropometric data were also recorded.

Results:

At follow-up, PWV and BP values increased significantly while cDC further decreased with the 80.4% of patients that presented a pathological cDC (lower than 40x10 -3 KPa or the 5th percentile). BP values at baseline correlated with all vascular indexes at follow-up: in particular, cSBP was associated with cDC (r = -0.46, p< 0.001), cIMT (r = 0.39, p = 0.004) and PWV (r = 0.32, p = 0.01). These associations remained significant even after adjustment for metabolic (including glycated hemoglobin) and anthropometric parameters. Moreover, baseline arterial stiffness significantly correlated with BP values at follow-up: particularly cDC and PWV were associated with cDBP (r = -0.354, p = 0.009 and r = 0.40, p = 0.002; respectively) even after multiple adjustments. Regarding metabolic parameters, non-HDL-to-HDL-cholesterol ratio correlated with both cDC (r = -0.36, p = 0.007) and PWV (r = 0.30, p = 0.03).

Conclusions:

The most important finding of this study is the strict and independent association between BP parameters, especially cSBP at baseline, and indexes of vascular damage at follow-up, even after multiple adjustments. Indeed, cDC at baseline is also associated with increased cDBP at follow-up. Our data support the hypothesis of a vicious cycle between BP and arterial stiffness, which may worsen both parameters over time.
FAR-INFRARED IRRADIATION INHIBITS CELL PROLIFERATION IN BASAL AND PDGF-STIMULATED RAT VASCULAR SMOOTH MUSCLE CELLS THROUGH REGULATION AMPK/MTOR/P70S6K SIGNALING AXIS
Authors: Hwang Yun-Jin , Cho Du-Hyong
Published: June 2023

Objective:

Far-infrared (FIR) rays are invisible electromagnetic radiation with a wavelength of 3-1000 um, which elicits molecular vibrations in water and other organic molecules in cells and tissues, thereby FIR rays may have various biological effects. Aberrant proliferation of vascular smooth muscle cells (VSMCs) is associated with the development of diverse vascular diseases including atherosclerosis. Although FIR irradiation is reported to inhibit cell proliferation in various types of cells, effect of FIR irradiation on VSMC proliferation and the underlying mechanism remain elusive. Here, we investigated the molecular mechanism by which FIR irradiation inhibited VSMC proliferation.

Design and method:

We performed cell proliferation and viability assay, inhibitor studies, transfection of dominant negative (dn)-AMP-activated protein kinase (AMPK) alpha 1 gene, and western blot analyses. We also conducted confocal microscopic image analyses and ex vivo studies using isolated rat aortas.

Results:

FIR irradiation for 30 min decreased VSMC proliferation with no alteration in cell viability, which was accompanied by decreased phosphorylation of mammalian target of rapamycin (mTOR) at Ser2448 (p-mTOR-Ser2448) and p70 S6 kinase (p70S6K) at Thr389 (p-p70S6K-Thr389). Furthermore, FIR irradiation increased phosphorylation of AMP-activated protein kinase (AMPK) at Thr172 (p-AMPK-Thr172). Pre-treatment with compound C, a specific AMPK inhibitor, or ectopic expression of dn-AMPK alpha 1 gene, significantly reversed FIR irradiation-decreased VSMC proliferation, p-mTOR-Ser2448, and p-p70S6K-Thr389. However, hyperthermal stimulus (39 degrees) did not change VSMC proliferation and AMPK/mTOR/p70S6K phosphorylation. Similar to in vitro results, FIR irradiation increased p-AMPK-Thr172, and decreased p-mTOR-Ser2448 and p-p70S6K-Thr389 in isolated rat aortas. Finally, FIR irradiation attenuated platelet-derived growth factor (PDGF)-stimulated VSMC proliferation by increasing p-AMPK-Thr172, and decreasing p-mTOR-Ser2448 and p-p70S6K-Thr389 in PDGF-induced in vitro atherosclerosis model.

Conclusions:

We demonstrate that FIR irradiation decreases VSMC proliferation, at least in part, by regulating AMPK/mTOR/p70S6K signaling axis. These observations suggest that FIR ray therapy can be used to treat arterial narrowing diseases including atherosclerosis and in-stent restenosis.
HYPERTENSION AWARENESS, TREATMENT, AND CONTROL IN AUSTRALIA. A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Wang Xia , Yu Jie , Schutte Alta
Published: June 2023

Objective:

Research from the NCD Risk Factor Collaboration indicated that the hypertension control rates in Australia are lagging behind other high-income countries, and a call to action to improve blood pressure (BP) control has been published. To understand the size of the problem, we will systematically examine contemporary evidence of hypertension awareness, treatment and control rates in Australia.

Design and method:

We performed a systematic literature search of reports of hypertension awareness, treatment and control rates in Australia. We undertook an individual participant data meta-analysis (IPDMA) shared by the NCD Risk Factor Collaboration. Where possible, data were pooled for meta-analysis by random effects meta-analysis.

Results:

In our meta-analysis based on aggregated data from 23 studies, the pooled proportion of hypertension awareness, treatment and control rates in Australia was 61% (95% confidence interval: 47%–74%), 58% (53%-63%), 40% (33%-47%), respectively. The National Health Survey data (n = 61799) shows a higher proportion of hypertension among males than females was observed until the 7th decade of life, and among those with lower socioeconomic status in Australia. The proportion of hypertensive subjects who were on 1, 2, and 3 or more types of antihypertensives was 44.4%(43.5%-45.2%), 18.4% (17.7%-19.0%), 7.7%(7.3%-8.2%), respectively. Our IPDMA was of 12598 (26.3%, n = 57104) hypertensive subjects, among whom 7227 (57.4%) were on antihypertensives and 58.6% had uncontrolled hypertension (SBP equal to or greater than 140 mmHg or DBP equal to or greater than 90 mmHg, n = 4238). The proportion of uncontrolled hypertension was higher among males (62.7%) than females (55.5%, p<0.0001).

Conclusions:

The hypertension burden in Australia is substantial, with a significant proportion of people with high BP who were unaware, untreated and uncontrolled. There is a lack of high-quality studies to identify barriers and enablers for hypertension treatment and control in Australia. These results will be key to informing the actions of the National Hypertension Taskforce that the Federal Minister of Health newly established.
HYPERTENSION SUSCEPTIBILITY IN AFRICAN MIGRANTS: SOLVING THE PUZZLE THROUGH TRANSCONTINENTAL PROSPECTIVE COHORT STUDY DESIGN. THE RODAM-PROS STUDY
Authors: Linden Eva L. van der , Beune Erik , Owusu-Dabo Ellis , Henneman Peter , Born Bert-Jan van den , Agyemang Charles
Published: June 2023

Objective:

Sub-Saharan African (SSA) migrants are disproportionately affected by hypertension, compared to the European-host population. Underlying reasons for the increased hypertension prevalence are still unclear, but suggest that rapid changes in lifestyle and environment after migration, in combination with genetic factors, might be responsible. The aim of the Research on Obesity and Diabetes among African Migrant prospective (RODAM-Pros) cohort study is to identify key changes in environmental exposures and epigenetic modifications driving the high prevalence of hypertension among African migrants.

Design and method:

The multicentre RODAM-Pros study included non-migrant Ghanaians residing in rural and urban Ghana, Ghanaians who migrated and are residing in Amsterdam (the Netherlands), and European-Dutch population who participated in baseline (2011-2015) and follow-up data collection (2019-2021). Data were collected on anthropometrics, blood pressure, biological samples, sociodemographic, health, lifestyle and environmental factors. Moreover, ∼1300 participants were included for DNA methylation analysis (Infinium® 850K DNA Methylation BeadChip) to assess methylation loci associated with incident hypertension in a nested case-control study.

Results:

In the follow-up data collection, 2165 Ghanaian participants (n = 638 from rural Ghana, n = 608 from urban Ghana, and n = 919 Ghanaian migrants in Amsterdam) and 2098 European-Dutch participants were included. The participation rates were 90.8 % in rural Ghana, 95.3% in urban Ghana, 52.7% among Amsterdam-Ghanaian and 67.2% among European-Dutch. Preliminary results show unstandardised prevalence rates of hypertension at follow-up of 43.3% in rural Ghana, 48.7% in urban Ghana, 60.1% in Amsterdam-Ghanaians, and 25.8% in European-Dutch. Unstandardised 5-year hypertension incidence rates were 18.5% in rural Ghana, 17.7% in urban Ghana, 14.1% in Amsterdam-Ghanaians, and 8.5% in European-Dutch.

Conclusions:

The preliminary findings show significant differences in hypertension prevalence and incidence rates among Ghanaians living in Ghana and in Europe. Future analysis are aimed to identify epigenetic and environmental determinants responsible for the increased prevalence of hypertension in SSA migrants. The findings from the RODAM-Pros study will be valuable for designing effective prevention and clinical management strategies to prevent the burden of hypertension and related complications, both in SSA and SSA migrants in Europe.
LINKAGE BETWEEN BLOOD PRESSURE, BODY MASS INDEX AND ANTHROPOMETRIC, METABOLIC, HORMONAL PARAMETERS IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION
Authors: Semianiv Marianna , Sydorchuk Larysa , Biletsky Semen , Petrynych Oksana , Kazantseva Tatyana , Repchuk Yuliya , Semianiv Ihor , Sokolenko Alina , Yarynych Yuliya , Voroniuk Ksenia , Dzhuriak Valentina
Published: June 2023

Objective:

The aim of the study was to evaluate changes in clinical and laboratory parameters and to analyze the linkage between blood pressure (BP), body mass index (BMI) and anthropometric, metabolic, hormonal parameters in patients with essential arterial hypertension (EAH).

Design and method:

100 subjects with EAH and target-organ damaging (2nd stage), moderate, high, very high cardiovascular risk were involved in the case-control study. There were 70.84% females, 29.16% males, the mean age 57.86±7,81 yo. The control group consisted of 60 healthy individuals, that did not differ by sex and age (p>0.05). Pearson's ⇙2-test was used to establish the linkage between the parameters, in the case of categorical variables; ANOVA variance analysis, if one of the variables is categorical and the other is numerical (interval), in the case of abnormal array distribution – non-parametric Kruskal-Wallis's test.

Results:

The development and course of EAH is characterized by clinical, hemodynamic and metabolic disorders that are nonlinearly exacerbated with the severity of hypertension. ANOVA analysis showed that BP is directly related to age (F = 7.46; p<0.001), body weight (F = 4.32; p = 0.048), height (F = 5.60; p = 0.04), waist circumference (F = 7.61; p = 0.043), as well as Waist-Hip Ratio (⇙2 = 6.75; p = 0.004), glucose concentration (⇙2 = 9.41; p = 0.003), vitamin D and parathyroid hormone (PTH) (⇙2 = 6.08; p = 0.043 and ⇙2 = 19.34; p = 0.013), respectively. Body mass index (BMI) is expected to be strongly associated with BP (⇙2 = 40.06; p<0.001), Waist-Hip Ratio (⇙2 = 12.13; p = 0.007), blood glucose and vitamin D (⇙2 = 19.11; p<0.001 and ⇙2 = 16.12; p = 0.001), bordering on heredity for cardiovascular diseases (⇙2 = 7.72; p = 0.052).

Conclusions:

Blood pressure is directly related to age, body weight, height, WC (F = 4.32-7.46; p<0.048-0.001), as well as Waist-Hip Ratio, glucose level, vitamin D and PTH (⇙2 = 6.08-19.34; p = 0.043-0.003). BMI is strongly associated with WC (⇙2 = 40.06; p<0.001), Waist-Hip Ratio (⇙2 = 12.13; p = 0.007), blood glucose and vitamin D concentration (⇙2 = 19.11; p<0.001; ⇙2 = 16.12; p = 0.001).
SPATIAL VARIABILITY IN THE PREVALENCE OF HYPERTENSION: A CANADIAN PERSPECTIVE
Authors: Leroux Denis , Cloutier Lyne
Published: June 2023

Objective:

Despite significant improvements in hypertension treatment, high blood pressure (HBP) still affects 22.6% of Canadians (Hypertension Canada, 2016). However, disparities associated with risk factors like, age, sex, and lifestyle can impact global prevalence in population. It is also a well-known fact that prevalence varies geographically. Thus, spatial location can give us a different perspective of hypertension in population. Reliable information about trends in hypertension rate is needed at regional scale to support the development of health programs. Geographic information systems (GIS) can provide that information by detecting spatial clusters of high or low HTN rate at health regions scale. The objectives of the study were to identify health regions with significantly high or low HTN rate using geostatistics and compare evolution from 2005 to 2019. It also seeks out to identify their populations’ characteristics using statistical analysis. Canadian Community Health Survey (2005, 2015 & 2019) data were used for the analysis.

Design and method:

For the analysis, we used Canadian Community Health Survey from 2005, 2015 and 2019. The 130,000 respondents representing the whole population are located according to health regions and data can be analyzed using a GIS. Using age and gender as subgroups criteria creation, we applied spatial autocorrelation analysis and Getis-Ord hot analysis to identify geographically contiguous health regions with high or low HTN rates. We then extracted the records in CCHS database for all respondents living in these regions for supplemental statistical analysis.

Results:

HTN is still a problem in Canada. This is especially true for people aged 65 and older although 72.9% considered themselves in good health. Increase in HTN rate is spread all over Canada, although some regions showed a rate decrease. Getis-ord analysis located regions with low HTN rates while regions with high rates were also located. Cluster of health regions with high HTN rates shows more diabetes and more obese people even though 38.4% declared being in good health.

Conclusions:

Hypertension is still a major problem in Canada. Age and gender are still significant risk factors. Geographical variations in HTN rate are presents at health regions scale.
RELATION OF METABOLIC PROFILE WITH DIFFERENT TYPES OF CAROTID LESIONS IN HYPERTENSIVE PATIENTS
Authors: Kadanina Kseniia , Bragina Anna , Druzhinina Natalia , Mohammadi Leila , Shakhmagomedov Rustam , Tyulin Maxim , Kartashov Ioann , Podzolkov Valeriy
Published: June 2023

Objective:

The aim of our study was to identify the relations of lipid profile and uric acid (UA) with the types of carotid artery lesions (CL) in hypertensive patients.

Design and method:

67 hypertensive patients (35 men and 32 women) were examined (median age 51[45;55], hypertension duration was 3[2;5]). The subjects underwent duplex scanning of the carotid arteries (Samsung HS50, 2021). Metabolic profile included total cholesterol(TC), low density lipoproteins(LDL), high density lipoproteins(HDL), triglycerides(TG), and uric acid(UA). The results of the study were processed by the program Statistica 10.0.

Results:

All patients were divided into 4 groups according to on the type of CL: group 1 (n = 39) without pathological carotid tortuosity(PCAT) and atherosclerotic plaques(AP); group 2 (n = 11) with PCAT, but without AP; group 3 (n = 11) with AP<70% stenosis and without PCAT, and group 4 (n = 6), with both PCAT and AP<70% stenosis. The groups did not differ significantly in gender and age (p>0.05). Group 1 had TC level of 5.1[4.5;6.4]mmol/L, LDL of 2.3[2.05;2.8]mmol/L, HDL of 1.3[1.06;1.57]mmol/L, TG 1.2[0.7;1.6]mmol/L. The medians of the lipid profile in group 1 were not statistically different from those in group 2: TC - 4.85[4.5;7.69]mmol/l, LDL- 2.34[2.03;5.05]mmol/L, HDL- 1.38[1.3;1.6]mmol/L, TG- 1.1[0.9;1.23], p>0.05. Group 3, when compared with groups 1 and 2, had the highest levels of TC - 6.7[5.87;6.8]mmol/L (p = 0.001), LDL - 2.97[2.9;3.8]mmol/L (p = 0.0005), HDL - 1.5[0.6;1.64]mmol/L (p>0.05), and TG 1.9[1.8;2.35]mmol/L (p = 0.002), but did not significantly differed from those in group 4 (p>0.05), where median of TC was 6.32[6.02;6.7]mmol/L, LDL 3.5[2.89;3.28]mmol/L, HDL 0.69[0.6;1.64]mmol/L, and TG 2.1[2.01;2.85]mmol/L, p<0.05 when compared with groups 1 and 2. Median UA levels in group 1 (254 [212;310]mmol/L) was significantly lower (p = 0.011), when compared with patients in groups 2, 3, and 4 (311[301;395], 302[286;407], and 325[305;346], mmol/L, accordingly). There were correlations between the presence of PCAT+AP and levels of TC (r = 0.37; p<0.05), LDL (r = 0.53; p<0.05), TG (r = 0.47; p<0.05), presence of dyslipidemia (r = 0.44; p<0.05), and UA level (r = 0.4; p<0.05).

Conclusions:

We have demonstrated a relation of metabolic markers (TC, LDL, and UA) not only with atherosclerotic carotid lesion, but also with pathological carotid tortuosity in hypertensive patients.
ASSOCIATION BETWEEN OBESITY STATUS CHANGE AND HYPERTENSION ONSET: A COMMUNITY-BASED LONGITUDINAL COHORT STUDY IN NORTH CHINA
Authors: Zhao Xiaolei , Zhang Xinmin , Cai Qiujing , Wang Chenglong , Zhou Yi , Tian Tao , Zhou Xianliang , Zhang Yuqing , Liu Lisheng , Zhang Weiguo , Hu Aihua
Published: June 2023

Objective:

Our study aimed to investigate the association between obesity status change and hypertension onset based on a longitudinal community-based cohort study in north China.

Design and method:

A total of 2618 individuals free of hypertension at baseline were collected from the longitudinal cohort study from 2011 to 2019. The correlation between the obesity status change and the hypertension onset was analyzed by inter groups differences analysis, an adjusted Cox regression model, and Kaplan-Meier survival analysis. Furthermore, the forest plot was used to visualize the subgroups analysis results including age, gender, and the differences of BMI and blood pressure between the baseline and the follow-up.

Results:

Over nearly 7 years follow-up, a total of 811 (31%) were found to develop future hypertension. The new-onset hypertension was mostly observed in participants who were keeping obese all the time (P for trend < 0.01). In the fully adjusted Cox regression model, keeping obese all the time would result in a 30.10% elevated risk of hypertension. The Kaplan-Meier survival analysis revealed the change in obesity status as an important feature to predict the occurrence of hypertension. What's more, we found the female gender and age over 60 years old were the important risks for people with different degree of BMI to have future hypertension.

Conclusions:

This study suggested maintaining obesity status was significantly associated with the risk of hypertension onset among Chinese adults based on a community-based longitudinal cohort. Even if people delivered weight loss after obesity, their hypertension level could not return to normal in a short time.
RIOCIGUAT-INDUCED DOWNREGULATION OF GENES RESPONSIBLE FOR SODIUM TRANSPORT THROUGH THE ALVEOLAR EPITHELIUM IN THE MONOCROTALINE MODEL OF PULMONARY HYPERTENSION
Authors: Lelková Katarína , Velasova Eva , Kmecova Zuzana , Veteskova Jana , Pivackova Lenka Bies , Doka Gabriel , Babal Pavel , Klimas Jan , Krenek Peter
Published: June 2023

Objective:

Pleural effusions (PLEF) in patients with pulmonary arterial hypertension (PAH) co-diagnosed with isolated right-sided heart failure (RHF) have been reported to be associated with increased mortality. We hypothesized that alterations of transporters responsible for alveolar fluid clearance contributes to fluid accumulation in lungs and secondary formation of PLEF. This was examined in a model of PAH including administration of riociguat (RIO) that as a stimulator of sGC may be responsible for cGMP-dependent inhibition of epithelial sodium channel (ENaC) and might affect alveolar epithelial sodium transport.

Design and method:

Wistar rats were injected with monocrotaline (MCT; 60 mg/kg, s.c.) or vehicle (CON). 2 weeks after MCT administration, RIO treatment (10 mg/kg/d, p.o.) was started (CON+RIO, MCT+RIO). MCT groups were subdivided: MCT4W - sacrificed 4 weeks after MCT application and prematurely terminated MCT (ptMCT) - sacrificed after PAH deterioration. Expressions of ENaC alpha, beta, gama subunits, Na-K-Cl cotransporter (NKCC1), sodium-glucose linked transporter (SGLT1), sodium-coupled neutral amino acid transporters (SNAT2, SNAT5), aquaporin 3 (AQP3) were determined by RT-qPCR in lungs. Lung samples were subjected to histological analysis.

Results:

Increased lung weight was observed in MCT4W (2.331g vs.CON, p<0.05) and ptMCT (2.778g, vs.MCT4W, p<0.05). Similar situation was observed in RIO treated groups, however, more profound compared to MCT4W (ptMCT+RIO = 3.086g, p<0.05). Expression of ENaC, SNAT5 was decreased in ptMCT and ptMCT+RIO. Expression of NKCC1 decreased in ptMCT+RIO (by 30%) and simultaneously expression of SNAT2 in MCT4W+RIO, ptMCT+RIO (by 58%), both p<0.05 vs.CON, without any changes in MCT4W and ptMCT. 15-fold increase in AQP3 expression was observed in ptMCT, ptMCT+RIO (p<0.05 vs.CON). The presence of fluid in alveoli was observed in MCT4W and ptMCT with incidence of PLEF 20% and 30% respectively (ns). Incidence of PLEF in MCT4W+RIO and ptMCT+RIO was 22% and 44% (p<0.05), however, with interstitial swelling present.

Conclusions:

Downregulation of ENaC in MCT-induced PAH may represent a predisposing factor for alveolar fluid clearance impairment contributing to accumulation of fluid in lungs manifested as lung weight increase. Incidence of PLEF is probably related to lung weight increase. Riociguat rather worsened the incidence of PLEF and downregulation of ENaC.
CARDIORENAL DYSFUNCTION IN MICE SUBMITTED TO AORTIC STENOSIS AND TREATED WITH SODIUM OXALATE
Authors: Silva Amanda , Marques Juliana , Nascimento Bruno , Souza Leandro , Silva Maikon , Benetti Acaris , Irigoyen Maria Claudia
Published: June 2023

Objective:

The transverse aortic constriction (TAC) model mimics cardiac hypertrophy (CH) caused by hypertension. The model of kidney injury by consumption of soluble sodium oxalate (SO) in the feed also mimics lesions similar to hypertension. Our objective is to test the hypothesis that mice submitted to TAC and gavage with SO will represent an effective model of cardiorenal dysfunction.

Design and method:

Forty male C57BL mice were randomized into 4 groups: sham-operated animals that received gavage for 15 days with water or sodium oxalate (SO) and animals that received TAC and gavage also for 15 days with water or SO. In the fourth and eighth weeks, an echocardiogram was evaluated. Metabolic cage, direct hemodynamic recording, and histological analysis were performed in the eighth week. Data were analyzed using 1-2 way ANOVA followed by Bonferroni's posthoc, considering significant differences for p<0.05.

Results:

The TAC+SO group showed increased serum urea (SHAM:37.85±3 vs. TAC+SO:49.9±2.6mg/dL, p = 0.02) and, compared to the SHAM+SO group, a decrease in water consumption and water balance. The TAC+SO group had the highest systolic (SHAM:122.4±5.2 vs. TAC+SO:160±5.2mmHg, p<0.01), diastolic (SHAM:78.9±5.4 vs. TAC+SO:105±5mmHg, p<0.01) and mean pressure (SHAM:100.6±5 vs. TAC+SO:132±4.8mmHg, p<0.01) values. Compared to the SHAM+SO and the SHAM, TAC+SO showed increased double product (DP) (SHAM:64.6 ± 4.7 vs. SHAM+SO:62.7±3.3 vs. TAC+SO:96.6±5.2, p<0.01). The TAC group had the highest weight of corrected ventricles (SHAM:6.73 ± 0.1 vs.TAC:10±0.6mg/mm, p<0.01), and the TAC+SO group had the highest pulmonary congestion index. The SHAM+SO group showed increased autonomic modulation and HR variability, while the TAC+SO group showed an important reduction. TAC animals had the highest mean BP variability. The reflex tachycardia of the TAC, SHAM+SO and TAC+SO groups was very reduced, and only the TAC+SO group had a reduction in the alpha index.

Conclusions:

TAC surgery caused CH, reduction in reflex tachycardia, and changes in autonomic modulation. Gavage with SO for 15 days promoted primary renal injury, and separately it was able to increase autonomic modulation. TAC surgery associated with SO gavage caused greater cardiac and renal dysfunction.
THE ASSOCIATION BETWEEN PURINE AND PYRIMIDINE INHIBITORS AND THE RISK OF HYPERTENSION: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Alosaimi Hani , Maffia Pasquale , Padmanabhan Sandosh , Guzik Tomasz
Published: June 2023

Objective:

To compare the effects of various purine and pyrimidine inhibitors in drug format on the risk of hypertension.

Design and method:

Various meta-analyses and systematic reviews of randomised-control trials (RCTs) were identified using a selection of relevant electronic databases, including MEDLINE Ovid, EMBASE Ovid and CENTRAL. These documents were then all assessed to extrapolate current approaches towards analysis of the effects of purine and pyrimidine inhibitors in adult patients with respect to hypertension.

Results:

The search as described yielded data for 27 trials, featuring a total of 8,907 participants, across three relevant medications: Azathioprine, Mycophenolate Mofetil (MMF), and Leflunomide.

Purine and pyrimidine inhibitors were compared to placebos in five studies, which included 1,748 patients, and to other active drugs in 22 studies, which thus included 7,159 patients.

A total of 50 (4.1%) and 16 (3%) events occurred for purine and pyrimidine inhibitors and the placebo groups, respectively. The risk of hypertension was higher among the purine and pyrimidine inhibitor groups than the placebo groups, although the resulting risk ratio was not statistically significant (RR = 1.37, 95% CI 0.78; 2.44, P = 0.28).

A total of 696 and 971 events occurred in purine and pyrimidine inhibitor and the active drug groups, respectively. The risk of hypertension was significantly lower in the purine and pyrimidine inhibitor groups than in those featuring other active drugs (RR = 0.8, 95% CI 0.65; 0.99, P = 0.04), thus favouring the use of purine and pyrimidine inhibitors. Studies by Gheith and Becker contributed to 10.7% and 10.8% of the meta-analysis weight, respectively. Substantial heterogeneity was thus observed between studies (I2 = 77%, P < 0.00001).

Conclusions:

The final outcomes indicated that the initial hypothesis of this meta-analysis, that purine and pyrimidine meta-analysis do not cause any additional risk of hypertension as compared to the placebo group could not be rejected. Additionally, a reduction in levels of risk as compared to other active drugs emerged that may require further analysis.
THE CHANGES OF LIPIDS` METABOLISM IN PATIENTS WITH ARTERIAL HYPERTENSION DEPENDING ON THE VITAMIN D RECEPTOR GENE (VDR, RS2228570) POLYMORPHISM
Authors: Repchuk Yuliia , Sydorchuk Larysa , Biletsky Semen , Petrynych Oksana , Kasantseva Tetiana , Ivashchuk Serge , Semianiv Marianna , Sokolenko Alina , Voroniuk Kseniia , Yarynych Yuliia , Dzhuryak Valentyna
Published: June 2023

Objective:

The aim of the study was to analyze lipids` changes in patients with essential arterial hypertension (EAH) depending on the vitamin D receptor gene (VDR, rs2228570) polymorphism.

Design and method:

The study involved 100 patients suffering from EAH with target-organ damaging, moderate, high, or very high cardiovascular risk. Among them were 79.0% (79) women and 21.0% (21) men, the average age was 59.87±8.02 yo. The control group involved 60 practically healthy persons, matched by age and gender distribution. All enrolled/screened patients signed the Informed Consent to participate in the research. The VDR gene (rs2228570) polymorphism was studied by a real-time polymerase chain reaction (RT-PCR) method. Lipids’ profile in serum was studied by total cholesterol (TC), high- and low-density cholesterol levels(HDL-C, LDL-C), triglycerides (TG) concentration, and atherogenic index (AI).

Results:

The levels of TC and LDL-C in AA-genotype carriers of the control group exceeded those of GG-genotype carriers by 13.85% (PGG = 0.044) and 22.59% (PGG = 0.045), and the content of HDL-C, on the contrary, was lower - by 16 .56% (PGG = 0.048). The analysis of the lipid profile, taking into account the gender distribution, showed a higher concentration of TC, due to LDL-C, in hypertensive women with AA-genotype than in those with the G-allele: according to the TC- by 7.61-14.07% (RAA<0.03), for LDL-C - by 12.78-17.39% (RAA<0.02), respectively. On the other hand, men with EAH carrying the AA-genotype, on the contrary, had lower levels of TC and LDL-C than those with the G-allele: for TC - by 20.24% (PAA = 0.02), for LDL-C - by 30.20% and 24.45% (PAA<0.04), respectively. In practically healthy carriers of the A-allele of the VDR gene (rs2228570), especially the AA-genotype, the concentrations of TC and LDL-C were within the reference values, but exceeded that in GG-genotype carriers: for TC - by 13.85% (PGG = 0.044), LDL-C - by 22.59% (PGG = 0.045), and the content of HDL-C, on the contrary, was lower - by 16.56% (PGG = 0.048).

Conclusions:

Thus, the polymorphic site of the VDR gene (rs2228570) is associated with an increased LDL-C in practically healthy individuals, according to the analysis of variance (ANOVA) (F = 4.61; p = 0.014).