bluuebunny/crossref_metadata_2025 huggingface dataset:
LONG TERM FOLLOW-UP OF ADOLESCENTS WITH WHITE COAT HYPERTENSION
Authors: Obrycki Lukasz , Podymniak-grzeszykowska Malgorzata , Pac Michal , Skoczynski Krzysztof , Koziej Jan , Mitoraj Kacper , Pilip Jakub , Wierzbicka-rucinska Aldona , Swiader-lesniak Anna , Swiderska Marta , Feber Janusz , Litwin Mieczyslaw
Published: May 2024

Objective:

White coat hypertension (WCH) defined as elevated office blood pressure (BP) with normal ambulatory blood pressure monitoring (ABPM) is diagnosed in up to 43% of adolescents referred for hypertension based on office BP. Prospective data on adults show that WCH may be associated with the development of sustained hypertension (SH), hypertension-mediated organ damage (HMOD), and consequently, a higher cardiovascular risk. The aim of our study was to re-evaluate a group of young adults who were diagnosed with WCH in their adolescence.

Design and method:

27 patients diagnosed with WCH at the age of 14.5±2.5 years, with full diagnostic assessment (anthropometry, biochemistry, office BP, ABPM, central systolic blood pressure (cSBP) and augmentation pressure (AugPress), carotid intima media thickness – cIMT, left ventricular mass – LVMi and pulse wave velocity – PWV) were re-evaluated after 8.3±1.2 years.

Results:

At the time of WCH diagnosis, left ventricular hypertrophy (LVH) was diagnosed in 3/27 (11%), increased cIMT in 3/27 (11%), and increased PWV in 19/27 (70%). At the 2nd measurement 8 years after, 20/27 (74%) normalized BP or maintained their WCH status, whereas 7/27 (26%) developed SH. Waist circumference, total and LDL-cholesterol, fasting glycemia, cSBP, PWV, cIMT and LVMI increased in normal BP/WCH and SH subjects, not significantly different between WCH and SH subjects except for LVMI (higher increase in SH). At the 2nd measurement LVH was diagnosed in 3/20 (15%), increased cIMT in 0/20 and increased PWV in 4/20 (20%) WCH patients and in 2/7 (29%), 0/7, and 2/7 (29%) of SH patients, respectively. Despite having lower 24h BP values (p<0.05), patients who normalized BP/maintained WCH had lower LDL cholesterol values at the time of WCH diagnosis (85±27 vs 103±30 mg/dL; p<0.05). LVMi was significantly higher at follow-up in patients who developed SH (p=0.001).

Conclusions:

Children with WCH are at risk of developing SH and HMOD, therefore, this group should be closely monitored. The presence of lipid disorders may be an additional parameter assessing the risk of developing SH in this group.
PREDICTIVE VALUE OF CARDIOMETABOLIC INDEX IN CHINESE ADOLESCENTS AGED 12–18 YEARS OLD FOR METABOLICALLY UNHEALTHY PHENOTYPE IN NORMAL WEIGHT POPULATION
Authors: Ma Xiaoyan , Tan Mei , Liu Jianxi , Tong Lingling , Ding Wenqing
Published: May 2024

Objective:

There are few studies on the predictive value of Cardiometabolic index (CMI) on metabolically unhealthy normal weight (MUNW) phenotype in adolescents. Hence, the aim of this study was to investigate the relationship between CMI and MUNW phenotype in Chinese adolescents and to assess the predictive value of CMI for MUNW phenotype.

Design and method:

Using stratified cluster sampling method, 1009 adolescents (605 males, 60%) aged 12-18 years old in Ningxia were randomly selected from October 2017 to September 2020 for questionnaire survey, physical measurements, body composition measurements and laboratory examinations. The relationship between MUNW phenotype and CMI was analyzed using binary logistic regression, and the predictive ability of relevant indicators for MUNW phenotype was assessed by constructing receiver operating characteristic (ROC) curves.

Results:

There were 913 cases of metabolically healthy weight normal (MHNW) phenotype and 96 cases of metabolically abnormal weight normal (MUNW) phenotype. The CMI level of the MUNW phenotype was higher than that of the MHNW phenotype (P<0.001). After adjusting for confounders such as age and gender, the risk of MUNW in the highest quartile group (Q4) of CMI was 3.37 times (95% CI: 1.66-6.83) higher than that of the lowest quartile group (Q1), and the risk of MUNW was at a gradually increasing (P<0.001). The MUNW risk of CMI in male and female students in Q4 group was 3.18 times (95% CI: 1.11-9.14) and 3.90 times (95% CI: 1.45-10.50) higher than that in Q1 group (all P < 0.05). Compared with BMI, TG/HDL-C, WC and WHtR, CMI was the best predictor of MUNW phenotype in both sexes (boys:AUC=0.686,95%CI:0.581∼0.792; girls: AUC=0.696,95%CI: 0.607∼0.785) (P<0.001).

Conclusions:

CMI is a risk factor for the risk of developing theMUNW phenotype in Chinese adolescents, and CMI has strong predictive efficacy as a valid tool for identifying the MUNW phenotype in a normal weight population.
CYSTATIN C BASED EGFR IS SUPERIOR FOR THE ASSESSMENT OF CARDIOVASCULAR RISK IN PRETERM CHILDREN
Authors: Chainoglou Athanasia , Sarafidis Kosmas , Taparkou Anna , Farmaki Evangelia , Chrysaidoy Katerina , Gidaris Dimos , Kollios Konstantinos , Kotsis Vasilios , Stabouli Stella
Published: May 2024

Objective:

Preterm birth is a risk factor for hypertension (HTN), chronic kidney disease (CKD) and adverse cardiovascular (CV) outcomes. The aims of the study were to evaluate the utility of eGFR based on cystatin C (Cys C) compared to creatinine in regard to associations with office blood pressure (BP) and central systolic BP (cSBP).

Design and method:

This case-control study included 52 children and adolescents born prematurely (ex-preterms) and 26 at full term (controls) matched for age in 2:1 ratio. All participants underwent office BP and cSBP measurement and laboratory evaluation including assessment of CysC values at the same visit.

Results:

Mean age of the population was 10.74±3.55 years. There were no significant differences in BP levels, eGFR(creatinine) and eGFR(CysC) between ex-preterm and control group. CysC levels were similar between the ex-preterm and the control group. CysC significantly correlated with cSBP z score (r=0.32, p=0.02, Spearman test). This association remained significant after adjustment for age, sex and BMI z score in the ex-preterm group (B=1.003, 95%CI 1.001-0.005, p=0.006). 42% (n=22) of the ex-preterm children presented cSBP levels greater than the 95th percentile. eGFR(CysC) presented positive association with office DBP (r=-0.37, p= 0.006, Spearman test) and cSBP z score (r= -0.32, p=0.022, Spearman test) in the ex-preterm group, but not in the control group (Figure). eGFR(creatinine) did not associate with BP parameters. eGFR(creatinine) overestimated eGFR levels in ex-preterm group (mean difference 20.56±22.66, p <0.001). Two (3%) and 17(32.6%) ex preterm children had GFR < 90 ml/min/1.73m2 by creatinine-based eGFR compared by eGFR(CysC).

Conclusions:

eGFR(CysC) presents apositive association with cSBP and thus, may better classify future cardiovascular risk in ex-preterm children. cSBP elevation and its association with CysC maybe a target for future studies to elucidate the role of central hemodynamic alterations in the development of HTN and CV disease in the ex-preterm individuals.
EARLY BLOOD PRESSURE AND MEDICATION CHANGES AFTER DELIVERY IN PATIENTS WITH POSTPARTUM HYPERTENSION
Authors: Jalanthiran Subeedhja , Socrates Thenral , Wenker Céline , Rana Alessandro , Piattini Leana , Strobel Noémie , Schumacher Christina , Vischer Annina , Mayr Michael , Mosimann Beatrice , Lapaire Olav , Burkard Thilo
Published: May 2024

Objective:

Postpartum Hypertension (PPHT) is defined as elevated blood pressure (BP) (systolic >= 140 mmHg, diastolic >= 90 mmHg) after delivery. PPHT is frequent and has various etiologies. In addition, several factors including hemodynamic fluctuations, sodium homeostasis, and stress attribute to dynamic changes in blood pressure. In this analysis, we focused on early BP trends and therapeutic intensity scores (TIS) trajectories during the first three months after delivery.

Design and method:

Starting in June 2020, patients were enrolled in the Basel-PPHT Cohort. Those with chronic hypertension (CH), hypertensive disorders of pregnancy (HDP), and de novo PPHT were eligible. This analysis included all patients with both a mobile App, which leads patients through guideline conform home BP measurements (HBPM), and a 24-hour ambulatory BP measurement 3 months after delivery. Therapy adjustments were done at the discretion of the treating physician via telemedicine consultations based on HBPM. BP and TIS trajectories were evaluated. TIS as quantification of treatment was defined as seen in Figure 1. Normotensive values were defined as systolic/diastolic <135mmHg/<85mmHg (HBPM and mean awake ABPM). BP comparisons between baseline visit (BV) defined as BP at enrollment to first post-baseline visit (FPBV) and landmark visit at 3 months post-delivery (LV).

Results:

41 participants were included in this analysis. The mean (SD) age was 33(±4.9). BV, FPBV, and LV were conducted at a median (IQR)) of 3(3), 18(7), and 112 (28) days after delivery, respectively. Figure 1 shows BP and TIS trajectories. Mean systolic/diastolic BP decreased by 13(0.6)/2(1.7) mmHg between BV and FPBV, p=0.00/p=0.09, without a significant change of TIS. Whereas, changes in BP were not significant between FPBV and LV, but TIS significantly decreased (p<0.00). At LV median awake systolic/diastolic BP was 127(14)/ 82(9) mmHg, with 17% of participants on antihypertensive treatment, compared to 95% at BV.

Conclusions:

This analysis shows a significant decrease in BP during the transition period to ambulatory care. BP medication could be down-titrated in a relevant proportion of patients. These trends indicate the need for close monitoring of these patients in the early postpartum period.
ASSOCIATION BETWEEN THE WEIGHT ADJUSTED WAIST INDEX AND INCIDENT STROKE
Authors: Hu Junli , Cai Xintian , Li Nanfang
Published: May 2024

Objective:

The association between weight-adjusted-waist index (WWI) and stroke is unclear. We aimed to determine the relationship of the WWI and stroke among the elderly patients with hypertension.

Design and method:

The Cox regression model was used to evaluate the relationship between baseline WWI and the risk of new-onset stroke. Restricted cubic splines were performed to explore the shape of the association between baseline WWI and stroke. Besides, we conducted subgroup analyses and interaction tests.

Results:

A total of 4962 hypertensive participants aged more than 60 years without a history of stroke were recruited in our study. During a median follow-up of 3.2 years, 547 incidents of new-onset stroke occurred. After adjusted for covariates, cox regression models showed the positive relationship between the baseline WWI and first stroke event. The hazard ratios (HRs) gradually increases, along with augment in WWI. Compared to the lowest quartile of WWI (Q1), HR and 95% confidence interval (CI) for stroke in the Q4 were 1.87 (1.44, 2.42). In stratified analyses, the association between WWI and the risk of stroke maintained.

Conclusions:

High WWI showed a positive association with new on-set stroke among elderly patients with hypertension. The rising prevalence of WWI may increase the future burden of stroke in elderly hypertensive cases.
ASSOCIATIONS OF THE CARDIOMETABOLIC INDEX WITH THE RISK OF CARDIOVASCULAR DISEASE IN PATIENTS WITH HYPERTENSION AND OBSTRUCTIVE SLEEP APNEA: RESULTS OF A LONGITUDINAL COHORT STUDY
Authors: Cai Xintian , Hu Junli , Li Nanfang
Published: May 2024

Objective:

We aimed to explore the relationship between the cardiometabolic index (CMI) and cardiovascular disease (CVD) and its subtypes (coronary artery disease and stroke) in patients with hypertension and obstructive sleep apnea (OSA).

Design and method:

We conducted a retrospective cohort study enrolling 2067 participants from the Urumqi Research on Sleep Apnea and Hypertension study. The CMI was calculated as triglyceride to high-density lipoprotein cholesterol ratio × waist-to-height ratio. Participants were divided into three groups (T1, T2, and T3) according to the tertile of CMI. The Kaplan-Meier method helped to calculate the cumulative incidence of CVD in different groups. We assessed the association of CMI with the risk of CVD and CVD subtypes by estimating hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models.

Results:

During a median follow-up of 6.83 years (interquartile range: 5.92-8.00 years), 326 incident CVD were identified, including 121 incident stroke and 205 incident coronary heart disease (CHD). Overall, after adjusting for confounding variables, CMI was positively associated with the risk of new-onset CVD (per SD increment, adjusted HR: 1.31; 95% CI: 1.20, 1.43), new-onset CHD (per SD increment, adjusted HR: 1.33; 95% CI: 1.20, 1.48), and new-onset stroke (per SD increment, adjusted HR: 1.27; 95% CI: 1.10, 1.47). Similar results were obtained in various subgroup and sensitivity analyses. Adding CMI to the baseline risk model for CVD improved the C-index (P < 0.001), continuous net reclassification improvement (P < 0.001), and integrated discrimination index (P < 0.001). Similar results were observed for CHD and stroke.

Conclusions:

There was a positive association between CMI levels and the risk of new-onset CVD in patients with hypertension and OSA. This finding suggests that CMI may help identify people at high risk of developing CVD.
KARDIA-3 STUDY DESIGN: ZILEBESIRAN AS ADD-ON THERAPY IN PATIENTS WITH HIGH CARDIOVASCULAR RISK AND HYPERTENSION INADEQUATELY CONTROLLED BY STANDARD OF CARE ANTIHYPERTENSIVES
Authors: Havasi Andrea , Pagidipati Neha , Bakris George , Weber Michael , Bengus Monica , Daga Shruti , Xiang Zhihua , Zee Tiffany , Bhan Ishir , Granger Christopher Bull
Published: May 2024

Objective:

Zilebesiran is an investigational subcutaneous (SC) RNA interference therapeutic that targets synthesis of hepatic angiotensinogen, the most upstream precursor of the renin-angiotensin system. In the phase 2 KARDIA-1 (NCT04936035) study, a single dose of zilebesiran monotherapy significantly reduced 24-hr mean ambulatory and office systolic blood pressure (SBP) from baseline to 3 and 6 months versus placebo in patients with mild to moderate hypertension. KARDIA-3, a phase 2 randomized, double-blind, placebo-controlled study (NCT06272487) will evaluate the efficacy and safety of zilebesiran as add-on therapy in patients with established cardiovascular (CV) disease or at high CV risk, with uncontrolled hypertension despite treatment with at least 2 standard-of-care antihypertensives.

Design and method:

KARDIA-3 will enroll adults with seated automated mean office SBP 140-170 mmHg on stable therapy with 2-4 antihypertensives and prior documented CV history or 10-year atherosclerotic CV disease risk >15% or estimated glomerular filtration rate (eGFR) 30-60 mL/min/1.73m2 at screening in 2 cohorts: Cohort A (∼270 patients, eGFR at least 45 mL/min/1.73m2) and Cohort B (up to 120 patients, eGFR 30 to <45 mL/min/1.73m2). Patients will be randomized 1:1:1 to receive a single SC dose of zilebesiran 300 or 600 mg or placebo in Cohort A, or 1:1:1:1 to receive a single SC dose of zilebesiran 150, 300, or 600 mg or placebo in Cohort B. The primary endpoint is change in mean seated office SBP from baseline to month 3, assessed as the mean difference between each zilebesiran dose and placebo separately for Cohorts A and B. Secondary and exploratory endpoints include other measures of blood pressure response, pharmacodynamics, and safety and tolerability through month 6.

Results:

KARDIA-3 will initiate enrollment in early 2024.

Conclusions:

There remains a substantial unmet need to treat uncontrolled hypertension in patients at high CV risk, including those with advanced chronic kidney disease. This novel phase 2 KARDIA-3 study will evaluate efficacy and safety of zilebesiran in patients with or at high risk for CV disease, building on previous phase 1 and 2 studies of this innovative therapeutic.
BLOOD PRESSURE CONTROL AND CIRCADIAN RHYTHM AMONG PATIENTS WITH PROGRESSIVE GLAUCOMA – PRELIMINARY RESULTS
Authors: Wizner Barbara , Jedrychowska-jamborska Justyna , Sajak-hydzik Katarzyna , Pawlicka Ilona , Grodzicki Tomasz
Published: May 2024

Objective:

Blood pressure (BP) control, postural changes and daily variability in patients with progressive glaucoma.

Design and method:

The study included 55 patients with different duration of open-angle glaucoma who had disease progression during the visit qualifying for this observational study. During two separate visits with 7 to 14 days interval, an ophthalmological and the clinical examination (standardized questionnaire, three BP measurements, orthostatic test, 24hour ABPM) were performed. The criterion for hypertension (HT) control in treated patients aged 80 years and over was office BP <150/90 mmHg. Postural hypotension was defined as a drop in systolic BP (SBP) of at least 20 mmHg and/or a drop in diastolic BP (DBP) of at least 10 mmHg within 1, 3, or 5 minutes after standing. The validated devices were used to obtain BP measurements.

Results:

The mean age of patients was 69 years, most subjects were over 60 years of age; 40% were men, 75% were treated for hypertension (HT).

∗Data from ABPM are currently available for 39 patients.

Patients with glaucoma progression noted in the short course of the disease (<5 years) were more likely to have uncontrolled HT in the office setting; in ABPM also had higher daytime SBP and greater daily SBP variability, although no statistical significance was observed. In turn, the oldest patients with long-term (>10 years) progressive glaucoma had too low nighttime SBP and DBP values.

Conclusions:

Conclusions. The results indicate an unfavorable prognostic impact of insufficient HT control and daily BP variability in people with a few years of glaucoma history. In the oldest patients, too low BP levels throughout the 24-hour period may contribute to its progression. Since most our patients had ABPM performed for the first time, emphasis should be placed on more frequent monitoring of circadian BP profile in glaucoma patients, especially among the oldest.
INFLUENCE OF ARTERIAL HYPERTENSION ON THE OCCURRENCE AND COURSE OF ATRIAL FIBRILLATION IN PATIENTS AFTER CORONAVIRUS DISEASE (COVID-19)
Authors: Stasyshena Oksana , Sychov Oleg , Marchenko Olena , Mikhalieva Tatiana , Torbas Olena , Getman Taisia , Romanova Olena , Sribna Olga
Published: May 2024

Objective:

To determine the influence of arterial hypertension on the occurrence and course of atrial fibrillation (AF) in patients after suffering from the coronavirus disease (COVID-19).

Design and method:

The study included 187 patients aged 62.5±0.9 years (47% men, 53% women). The first three groups formed 116 patients who had AF and underwent COVID-19. The first group (G1) consisted of 36 patients who developed AF for the first time after COVID-19. The second group (G2) was represented by 25 patients in whom the transformation of the paroxysmal form of AF into persistent, or persistent AF into its permanent form occurred. The third group (G3) consisted of 55 patients in whom the form of AF did not change. Two control groups (CG) were also formed: control group 1 (CG1) - 49 patients with AF who did not have a history of COVID-19, and control group 2 (CG2) - 22 patients with extrasystole who experienced COVID-19, but who did not develop AF.

Results:

Arterial hypertension was a common comorbidity in patients with AF who underwent COVID-19. In patients who developed AF after COVID-19 (G1), arterial hypertension occurred 1.4 times more often (83,3% vs 59,1%, p<0.001) than in patients who suffered from COVID-19, but this type of arrhythmia did not develop (comparison CG 2). The presence of hypertension worsened the course of AF in patients who had this arrhythmia before COVID-19. Thus, in patients of G2, in whom AF transformation took place, in comparison with patients in whom the form of AF did not change G3 (88,4% vs 80,0%, p<0,05), hypertension occurred more often.

Conclusions:

Arterial hypertension is one of the most common diseases in patients with atrial fibrillation after the coronavirus infection, which contributed to the emergence of new paroxysms of AF and worsened the course of already existing arrhythmia.
IMPROVED ACCURACY OF LONG COVID-19 PREDICTION IN HOSPITALIZED HYPERTENSIVE PATIENTS COMPARED TO THE GENERAL COHORT
Authors: Honchar Oleksii , Ashcheulova Tetiana
Published: May 2024

Objective:

The accuracy of prediction of Long COVID-19 development is currently suboptimal. Phenotyping a general post-COVID-19 population based on simple clinical and anamnestic criteria may be used to address this problem.

The purpose of this study was to identify the early predictors of Long COVID-19 syndrome at 3 months after discharge in hospitalized patients with a history of hypertension (HT).

Design and method:

221 hospitalized patients with COVID-19 (mean age 53.4+-13.6 years, 53% female, 40% with a history of hypertension) underwent comprehensive transthoracic echocardiography and a 6-minute walk test (6MWT) 1-2 days prior to discharge and after 1 month. A combination of logistic regression analysis and unsupervised machine learning was used to derive predictive models of self-assessed Long COVID-19 at 3 months after discharge (166 patients who have completed all visits comprised the final cohort).

Results:

Self-assessed Long COVID-19 at 3 months was detected in 50 (77%) of hypertensive and 74 (73%) of normotensive participants, p = 0,597. In the general cohort, a modest performance of 83% was observed in the validation subset for the derived pre-discharge predictors-based ML classification model, which only constituted to re-classification of 1/3 of otherwise false-positive cases compared to the assumption of 100% prevalence of Long COVID, with a total net reclassification improvement (NRI) of 8%. Phenotyping the general cohort based on the presence of hypertensive anamnesis significantly improved the predictive accuracy for the HT-positive subgroup: 100% accuracy was observed in the validation subset with an NRI of 23% vs baseline assumption, Chi-square test P < 0,001 vs the general cohort model confusion matrix. The derived models used sex, MRC dyspnea class, Charlson comorbidity index, and either (1) pre-discharge systolic BP and mitral E to left ventricular global longitudinal strain ratio, or (2) peak D-dimer, pre-discharge 6-minute walk distance, and peak capillary oxygen desaturation during the 6MWT.

Conclusions:

History of hypertension can be used as a phenotyping criterion to improve the accuracy of Long COVID-19 prediction among hospitalized patients: the derived ML-based classification models yielded a 100% predictive accuracy in the pre-specified validation subset of hypertensive patients hospitalized for acute COVID-19.
INFLUENCE OF CORONAVIRUS INFECTION ON VASCULAR REMODELING PARAMETERS IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Atoyeva Munisa , Abdullayeva Go’Zal , Yusupova Khafiza , Masharipov Shuhrat , Khamidullayeva Gulnoz
Published: May 2024

Objective:

to evaluate the effect of COVID19 on arterial stiffness parameters and microalbuminuria (MAU) baseline and in dynamics against the background of antihypertensive therapy (AHT) in patients with arterial hypertension (AH).

Design and method:

74 male and female patients with I-III degree of AH (ESH/ESC, 2018) were included in the study. Age was 53.54±1.92, duration of AH was 8.61.2 groups were identified: 1stgroup with AH who had suffered COVID19, no more than a month (N=42) and 2ndgroup with AH not suffered COVID19 (N=32).Vascular stiffness was determined by applanation tonometry using SphygmoCor apparatus (AtCor Medical, Australia); central systolic BP (CSBP), central diastolic BP (CDBP), central pulse pressure (CPP), aortic augmentation (AA), augmentation index (AIx), pulse wave velocity (PWV) were studied. The level of MAU was determined by enzymatic analysis on the biochemical analyser Daytona TM by Rendox (UK), which allows estimating MAU within the range of 30-300 mg/l and higher. The study was conducted before and after 6 months of AHT.p<0.05. The results are presented as μ±SD

Results:

The level ofMAU in 2ndgroup being 25,5±20,3 mg/l, in 1stgroup being 32,8±27,9 mg/l, but the difference was not significant (p>0,05). There was a significant decrease of MAU level in group I of patients: from 32,8±27,9 mg/l to 20,1±19,2,4 mg/l in dynamics (p<0,02). In 1st group, cSBP decreased from 154.86±24.11 to 134.38±13.9 mmHg (p<0.001) and in 2nd from 163.84±19.87 to 139.47±19.41 mmHg (p<0.001); cPP in 1stgroup decreased from 74.79±22.02 to 53.67±13.32 mmHg (p<0.001) and in 2ndgroup- from 78.84±14.48 to 54.71±12.46 mmHg (p<0.001). (p<0.001) and in 2ndgroup from 78.84±14.48 to 54.71±12.46 mmHg (p<0.001); PWV in 1stgroup decreased from 10.6±2.3 to 9.32±2.21 m/s (p<0.05) and in 2nd from 11.21±3.02 to 9.89±2.12 m/s (p<0.001). AA was significantly reduced only in 2nd: 19.24±7.67 mmHg before and 14.31±7.57 mmHg after(p<0.02) compared to 1stgroup: 15.67±6.97 before and 14.5±6.08 mmHg after treatment (p>0.05).

Conclusions:

The analysis of central haemodynamics and arterial stiffness parameters revealed positive dynamics of 6-month AHT in both studied groups of patients with advantage in the 2ndgroup. AA index significantly decreased only in the 2ndgroup. The level of MAU initially exceeded normal values in the 1stgroup
CARDIAC REMODELING IN PATIENTS WITH DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE
Authors: Vasilkova Volha , Mokhort Tatsiana , Borovets Yana
Published: May 2024

Objective:

To study the features of cardiac remodeling in patients with diabetes mellitus (DM) depending on the stage of chronic kidney disease (CKD).

Design and method:

We examined 499 patients with type 1 and type 2 diabetes mellitus older than 25 years. The laboratory examination of the patients included the measurement of serum creatinine, eGFR according to the CKD-EPI equation. An echocardiographic investigation was performed to study structural and geometric heart parameters. Left ventricular hypertrophy (LVH) was diagnosed when the left ventricular myocardial mass index (LVMI) exceeded 115 g/m2 in men and 95 g/m2 in women.

Results:

LVH was detected in 57.7% of patients with DM, while in the comparison group – in 35.4%. The frequency of LVH increased with a decrease in eGFR and was diagnosed in 100% of cases with CKD 5. In patients with DM, the left ventricular concentric remodeling significantly predominated (29.2%). Multiple linear regression analysis demonstrated the influence of age (ß=0.30, p=0.01) and serum creatinine (ß=0.15, p<0.0001) on the LVMI, independent of other factors, which confirms their independent pathogenetic significance.

Conclusions:

Patients with DM and CKD have structural and functional changes in the LV myocardium. Regardless of the nitrogen-excretion function of the kidneys, the predominant pattern of LV remodeling is concentric. The study of the features of structural and functional restructuring of the left heart in patients with diabetes should be taken into account in determining the cardiovascular prognosis.
ASSEMENT OF MYOCARDIAL MICROVASCULAR DYSFUNCTION IN PATIENTS WITH DIABETES MELLITUS: AN ADENOSINE STRESS PERFUSION CARDIAC MAGNETIC RESONANCE STUDY
Authors: Li Xinni , Shen Chenxing , Lu Zhigang , Liu Yuting , Kang Sang , Xiao Huoyuan , Ma Wenkun , Pan Jingwei
Published: May 2024

Objective:

Coronary microvascular dysfunction (CMD) is an independent predictor of cardiovascular events in patients with diabetes, while glucose fluctuations worsen vascular lesions. This study aims to examine myocardial microvascular perfusion in patients with type 2 diabetes mellitus (T2DM) and to determine whether uncontrolled blood glucose levels lead to further deterioration of myocardial microvascular function.

Design and method:

Cardiac magnetic resonance (CMR) examinations were performed on 114 T2DM patients with complaints of atypical chest tightness and 55 matched controls. Obstructive coronary artery disease (CAD) was ruled out in all subjects, who were further divided into four subgroups: Q1 (T2DM-negative [–], glycated hemoglobin A1c [HbA1c] < 5.7%); Q2 (T2DM–, 5.7% <= HbA1c <= 6.4%); Q3 (T2DM-positive [+], HbA1c <7%; and Q4 (T2DM+, HbA1c >= 7%). The correlation between HbA1c levels and myocardial perfusion parameters was also evaluated.

Results:

Compared with controls, the myocardial perfusion reserve index (MPRI) in patients with T2DM was reduced (P < 0.001) due to decreased stress perfusion index (PI) (P < 0.001). MPRI was decreased in patients with uncontrolled T2DM (Q4) than in patients with controlled T2DM (Q3), with borderline significance (P = 0.065). Compared with controls (Q1), stress T1 reactivity (δT1) was significantly reduced in patients with controlled and uncontrolled T2DM (P = 0.004 and < 0.001, respectively), but elevated in patients with prediabetes (Q2) (P = 0.018). Extracellular volume (ECV) was significantly greater in patients with prediabetes and increased gradually in patients with controlled and uncontrolled T2DM compared with controls (P = 0.011, 0.001, and 0.007, respectively). Furthermore, HbA1c was negatively associated with MPRI and stress δT1, but positively correlated with ECV (β = -1.993, P < 0.001; β = 0.127, P < 0.001; and β = -0.180, P < 0.001, respectively).

Conclusions:

MPRI was negatively correlated with HbA1c, and its decrease in patients with T2DM was due to a lower increase in stress PI compared with controls. Stress δT1 decreased in patients with T2DM but increased in patients with prediabetes, indicating damage to microvascular perfusion in the prediabetic stage. Elevated ECV persists throughout diabetes.
MICROVASULAR ALTERATIONS IN PREDIABETES / PRELIMINARY REPORT
Authors: Liskiewicz-jankowska Martyna , Wolf Jacek , Dabrowska Edyta , Hellmann Marcin , Narkiewicz Krzysztof
Published: May 2024

Objective:

Type 2 diabetes (T2DM) through various mechanisms increases CV risk, therefore early diagnosis is pivotal for patients prognosis. Microcirculation function and its’ structural changes may coincide or even precede overt cardiovascular disease in T2DM. Thus, microcirculation assessment holds potential to serve as early diagnostic window and/or basis for precision medicine strategies. Using novel microcirculation assessment techniques, in our study we focused on both structural and functional markers of abnormal microvascular bed performance in patients with glucose metabolism impairment.

Design and method:

Both, patients with (1) established diabetes, (2) prediabetes, and subjects (3) free of carbohydrates metabolism impairment were enrolled (n=180; 40% women). Microvascular phenotyping using RTX1 Adaptive Optics Retinal Camera (vessels remodeling denoted by wall-to-lumen ratio; WLR) and flow-mediated skin fluorescence (FMSF; hypoxia sensitivity; logHS) were performed.

Results:

Mean age of the studied population was 60.7 ±10.8 yo, BMI=29.9±4.8; Comparisons of WLR and logHS are presented in the figure. Patients with prediabetes had similar structural microcirculation phenotype as controls (left panel). However, prediabetic subjects were characterized by functional skin circulation abnormalities comparable to the ones evident in established T2DM (right panel). The observed differences were, however, lessened when age, and BMI status were included in the multivariate analyses.

Conclusions:

In patients with prediabetes, functional microcirculation alterations are present in the absence of structural changes of microvascular bed. The magnitude of these abnormalities are comparable to the ones seen in established diabetes. Our study however suggests that most of the differences in microcirculation misperformance in prediabetes are attributable to advancing age and higher body weight.
THE UTILITY OF BODY INDICES FOR DIABETES PREDICTION IN PATIENTS WITH FASTING HYPERGLYCEMIA: A 10-YEAR FOLLOW-UP STUDY
Authors: Kolesova Ekaterina , Rotar Oxana , Moguchaia Ekaterina , Boiarinova Maria , Erina Anastasia , Tolkunova Kristina , Kibkalo Sofia , Vasilieva Elena , Usoltsev Dmitry , Artomov Nikita , Maslyanskiy Alexey , Konradi Aleksandra
Published: May 2024

Objective:

We aimed to compare the new body indices against traditional body mass index in their ability to predict diabetes development in patients with fasting hyperglycemia.

Design and method:

Baseline examination of population-based cohort was performed 2012-2013 in the framework of epidemiological study ESSE-RF which included questionnaires, anthropometry (weight, height, waist and hip circumference), laboratory tests (fasting glucose, glycated hemoglobin, lipids) and target organ damage assessment. In 2022-2023 patients with fasting hyperglycemia at baseline visit were re-examined to register onset of diabetes mellitus (DM), glucose and glycated hemoglobin levels. Several anthropometric indices were calculated: body mass index (BMI), waist-to-height ratio (WHtR), body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), and lipid accumulation product (LAP).

Results:

In total 72 participants were re-examined - 35 men and 37 women (mean age 43,6 years and 50,5 years, respectively). New onset of DM was confirmed in 15 patients (20,8%), in 6 men and 9 women. According to multiple regression analysis the most significant predictors of DM development were BRI (p=0,04, beta=-2,2) and WHTR (p=0,04, beta=2,94), but not BMI (p=0,42, beta=-0,22), model (R2 = 0.32; p=0,0014). After adjustment for traditional risk factors (sex, triglycerides, age, insulin, high density lipoproteins, waist circumference, glucose), the most significant diabetes predictors were the WHTR (p=0,01, beta=4,23) and VAI indices (p=0,04, beta=0,732), model (R2 = 0.547; p=1x10-4). We used individual body indices as predictors for the DM and estimated the area under the ROC curve (AUC). The AUC ROC for BRI, WHTR, CVAI and ABSI was greater than for traditional BMI, while for VAI and LAP indices performed worse than BMI (Table 1).

Conclusions:

New body composition indices involving advanced mathematical framework and including extended set of parameters - BRI, WHTR, CVAI and ABSI, are more reliable diabetes predictors than BMI in patients with fasting hyperglycemia after 10 years of follow-up.

This work was supported by the Ministry of Science and Higher Education of the Russian Federation

(Agreement # 075-15-2022-301) to A.Konradi.
IMPACT OF DIFFERENT TYPES OF HYPERTENSIVE DISORDERS OF PREGNANCY AND THEIR DURATION ON INCIDENT POST-PARTUM RISK OF DIABETES MELLITUS; RESULTS FROM A FRENCH NATIONWIDE STUDY
Authors: Olié Valerie , Lailler Grégory , Fosse-edorh Sandrine , Lebreton Élodie , Regnauld Nolwenn , Deneux-tharaux Catherine , Tsatsaris Vassilis , Plu-bureau Genevieve , Kretz Sandrine , Blacher Jacques
Published: May 2024

Objective:

The reasons for the association between hypertensive disorders of pregnancy (HDP) and diabetes mellitus (DM) are poorly understood. Several studies have suggested an association between HDP and long-term onset of incident type 2 DM, irrespective of gestational diabetes status during pregnancy. The present study aimed to evaluate the impact of various types of HDP on the risk of incident DM.

Design and method:

We used data from the ongoing French nationwide prospective cohort study CONCEPTION which investigates the impact of HDP on women's health. For the present analysis, we included all primiparous women in CONCEPTION who had no personal history of DM prior to giving birth and who delivered between 2010 and 2018 (n=2,815,057 women). Follow-up spanned from childbirth to 31 December, 2021. HDP and incident DM onset during follow-up were identified using algorithms combining ICD-10 coded diagnoses during hospitalization and/or medication dispensing. We used Cox models

Results:

Pre-eclampsia and GH occurred in 2.6% and 4.6% of the study sample, respectively. During follow-up, 16 670 women had incident DM. The cumulative incidences of DM were 17.5% and 2.1% in women who had pre-eclampsia during pregnancy with and without concomitant gestational diabetes, respectively. The risk of DM was higher after HDP (all types) irrespective of gestational diabetes status during pregnancy. In women without gestational diabetes, compared with those who had no HDP, the risk of incident DM was higher in women who had GH (adjusted hazard ratio, aHR= 1.97 [1.81-2.16]), pre-eclampsia (aHR=2.42 [2.21-2.65]), and preexisting chronic hypertension prior to pregnancy (aHR=3.35 [3.03-3.70]). Early onset and severe pre-eclampsia were associated with a higher risk of DM. Finally, pre-eclampsia duration was significantly and positively associated with a higher risk of DM.

Conclusions:

Women who experienced an HDP had twice the risk of developing DM, even in the absence of gestational diabetes. Taking into account the phenotype and duration of pre-eclampsia could improve HDP risk stratification of pregnant women with a history of these disorders. Early concurrent blood glucose assessment and blood pressure monitoring should be more widely recommended after HDP diagnosis.
EVALUATION AND COMPARISON OF DIAGNOSTIC EFFICACY OF INDICATORS TO SCREENING FOR PRIMARY ALDOSTERONISM BEFORE ENDOCRINE PATHWAY
Authors: Wang Meng -HUI , Luo Qin , Li Nan -FANG
Published: May 2024

Objective:

To evaluate and compare the effectiveness to screen for primary aldosteronism (PA) before the endocrine performing among hypokalemia, the serum sodium to urinary sodium to (serum potassium) to urinary potassium (SUSPPUP) index, combination of urine pH, sex, and serum potassium (PFK score) and PA-nomogram prediction model.2

Design and method:

From January 2010 to January 2014, 937 patients with hypertension were admitted in the People's Hospital of Xinjiang Uygur Autonomous Region. Fasting elbow venous blood was collected on admission day, serum, potassium, sodium and calcium ion levels were determined, calcium and phosphorus products were calculated, plasma sitting aldosterone/renin activity (ARR) were measured, and calculated. 24 h urine was collected and the ion level was measured. The pH value of urine was detected by pH test paper in the morning. Serum potassium (<3.5 mmol/L), SUSPPUP (>5.3/ (mmol/L)), PFK score (>2 points), nomogram prediction model (>21%) as positive screening criteria, ARR (>20ng/dL/ ng/mL/h) as positive endocrine screening index, were respectively used to predict and screen PA. The patients with positive ARR were confirmed PA using saline infusion test. The ROC curve was drawn to evaluate the efficacy of serum potassium, SUSPPUP, PFK score, and PA-nomogram prediction model to screen PA. Kappa test was used to evaluate its consistency with ARR screening results.

Results:

The area under ROC curve of serum potassium <3.5 mmol/L, SUSPPUP >5.3 (mmol/L)-1, PFK score >2 points, nomogram prediction probability>21% to screen PA in patients with hypertensive respectively were 0.61(95%CI:0.56∼0.66, P<0.001), 0.52(0.47∼0.57, P=0.479), 0.57(0.52∼0.62, P=0.005), 0.62(0.57∼0.67, P<0.001), and the sensitivity was 36%, 7%, 24% and 53%, the specificity was 86%, 96%, 90% and 70%, respectively. There was good consistency between nomogram prediction model or PFK score and ARR (Kappa=0.122, P <0.001, Kappa=0.092,P <0.001), and the Kappa value of nomogram prediction model with ARR was higher than the PFK score with ARR (X2=163.577, P < 0.001).

Conclusions:

The nomogram prediction model, which includes gender, serum potassium, calcium-phosphorus product and urine pH value, is more sensitive to screen PA in patients with hypertension, and the nomogram prediction probability>21% is more consistent with ARR.
WHO USES MHEALTH IN HYPERTENSION CARE? - INSIGHTS FROM A QUANTITATIVE SURVEY AMONG HYPERTENSION APP USERS
Authors: Mühlensiepen Felix , Petit Pascal , Vuillerme Nicolas , May Susann , Seifert Frances , Wengemuth Eileen , Johannsen Olen , Middeke Martin , Heinze Martin , Spethman Sebastian , Bruch Dunja
Published: May 2024

Objective:

Digital health technologies, particularly mHealth apps, are proving to be effective tools for both prevention and monitoring of hypertension therapy. The aim of this study is to gain an in-depth understanding of the profiles and adoption patterns of mHealth users in hypertension care.

Design and method:

From January to October 2023, a quantitative, standardized questionnaire-survey was conducted with users of a hypertension-focused mHealth app (Hypertension.App). The data analysis included descriptive statistics as well as Bayesian univariate and multivariate logistic regressions. The study is part of the Innovation Fund Project DiPaH.

Results:

Overall, 255 questionnaires were included in the analysis. The mean age of the app users was 53.6 ± 13.9 years. Most participants were male (54.3%, 139/255), 42.9% (109/255) were female and 0.79% (2/255) non-binary. Most participants had a university degree (44.5%, 113/255) or high school diploma (22%, 56/255). The majority reported that they live in an urban environment (57.8%, 147/255). Overall, 44.5% (113/255) of the participants reported a monthly net income of more than 2500 € per month and 20.1% (51/255) an income between 1500-2500€ per month. The mean eHEALS score (eHealth literacy / 1-40) was 31.0 ± 4.91. Most users received a hypertension diagnosis more than 10 years ago (60.2%, 153/255) or more than 10 years ago.

The most common method of discovering the app was personal searches on the web or app store (44.1%, 112/255). The majority reported using the app at least once a week (80.7%, 205/255), with daily usage reported by 52.4% (133/255). However, the app's integration into formal medical treatment was limited, with only 11.8% (30/255) of participants having their medication adjusted based on app entries.

Conclusions:

The high frequency of app usage suggests that users find it a valuable tool in monitoring their blood pressure. The results indicate that people with a high level of education, high income and in urban regions are more likely to use mHealth in hypertension care. Additionally, the limited integration of the app into medical treatment indicates a gap between personal health monitoring and formal healthcare.
FUTURE BLOOD PRESSURE PREDICTION ARTIFICIAL INTELLIGENCE PROGRAM: THE DR. ANSWER MEDICAL SOFTWARE
Authors: Ahn Joon Ho , Oh Seok , Lee Ki Hong , Kim Ju Han
Published: May 2024

Objective:

Current guidelines recommend home blood pressure (HBP) monitoring in patients diagnosis with hypertension and those with white coat hypertension or masked hypertension. Delicate classification of these patients are important because the intensification of antihypertensive drug therapy for patients with white coat uncontrolled hypertension or white coat hypertension may not be needed because cardiovascular risk seems not to be greater. Therefore, its detection is important to avoid overtreatment. Meanwhile patients with masked hypertension or masked uncontrolled hypertension and uncontrolled hypertension need further intensification of antihypertensive treatment. Dr. Answer project consists of 21 artificial intelligence (AI) medical software that cover eight major diseases including hypertension. The main object of Dr. Answer hypertension project is to predict the patients next visit office BP according to the home BP data and provide effective and precise treatment plan.

Design and method:

2,057 patients and 156,117 pure HBP data were collected in the Dr. Answer hypertension project. Patients were enrolled in 1 tertiary center (Chonnam National University Hospital) and other 21 non-tertiary centers from January 2022 to September 2022. 1,447 patients and 153,712 were excluded due to insufficient HBP data and follow up loss. Finally 610 patients and 2,405 HBP data were evaluated in the AI program model.

Results:

Patients were 66.7 ± 14.4 years and proportion of women was 24.1%. and patients enrolled in tertiary center was 73.4%. Mean HBP 8weeks of systolic blood pressure and 4 weeks of diastolic blood pressure data were evaluated in the AI program model. Recurrent Neural Network, Long Short-term Memory, Attention algorism were selected in AI model program. Mean Absolute Error (MAE) and Root Mean Square Error (RMSE) and Accuracy data were used as the AI model parameter. MAE of systolic BP was 3.96 and MAE of diastolic BP was 2.1. Meanwhile, RMSE of systolic BP was 5.81 and RSME of diastolic BP was 2.88. Accuracy data showed 74.1% and 91.4% respectively.

Conclusions:

Dr. Answer hypertension AI medical software showed promising results for predicting future blood pressure data in hypertension patients. Further advancement in the AI program model would be needed.
CORRELATIONS OF BLOOD PRESSURE AND ANTHROPOMETRIC BIOMARKERS IN THE BRAZILIAN FEMALE AND MALE POPULATION FROM THE FIRST BRAZILIAN REGISTRY OF ARTERIAL HYPERTENSION
Authors: Euzébio Maicon Borges , Vitorino Priscila , Rosa Lorena , Sousa Ana , Inuzuka Sayure , Jardim Paulo , Barroso Weimar
Published: May 2024

Objective:

To correlate blood pressure and anthropometric biomarkers in the Brazilian populations of biological sexes female and male from the First Brazilian Registry of Arterial Hypertension (1RBH), highlighting similarities or divergences in these correlations between these populations.

Design and method:

This is a descriptive multicenter cross-sectional study of 1RBH, with data collection conducted from June 2013 to October 2015. The Shapiro-Wilk test was used to check the distribution of variable data, and a significance level of p <0,05 was adopted. In the correlation analysis, the Spearman test was used if p <0,05 and the Pearson test was used if p >0.05. For the interpretation of correlation indices, the following ranges were considered: 0.00 to 0.19 (very weak correlation), 0.20 to 0.39 (weak correlation), 0.40 to 0.69 (moderate correlation), 0.70 to 0.89 (strong correlation), and 0.90 to 1.00 (very strong correlation). We decided to compare correlation indices >0.70. The anthropometric variables were: age (Age), in years; Body Mass Index (BMI) in Kg/m2; Waist Circumference (WC) in cm. For biomarker variables, we used: Peripheral Systolic Blood Pressure (SBP); Peripheral Diastolic Blood Pressure (DBP); Central Systolic Blood Pressure (cSBP); Central Diastolic Blood Pressure (cDBP).

Results:

Out of a total of 2,643 participants from 45 locations in Brazilian regions, 1,472 (55.7%) were female, and 1,171 (44.3%) were male. The median age of the female population was 62.9 years (54.7-70.3); BMI 28.9 Kg/m2 (25.6-32.6); and WC 97.0 cm (89.0-105.0). The median age of the male population was 61.1 years (53.5-68.1); BMI 28.4 Kg/m2 (25.5-31.5); and WC 100.0 cm (92.8-109.0). In both female and male populations, SBP-cSBP, DBP-cDBP, WC-BMI showed significance with p <0.05 and strong correlations, and Age-PWV showed very strong correlation with statistical significance in both populations.

Conclusions:

Comparing the correlations of blood pressure and anthropometric biomarkers in the hypertensive Brazilian female and male population, we conclude that SBP-cSBP, DBP-cDBP, WC-BMI, and Age-PWV exhibit similar strong and very strong correlations, respectively, with statistical significance in both populations.