bluuebunny/crossref_metadata_2025 huggingface dataset:
FOLINIC ACID OR L-METHYLFOLATE SUPPLEMENTATION FOR THE TREATMENT OF HYPERHOMOCYSTEINEMIA
Authors: Papadakis Ioannis , Papadomanolaki Maria , Vougiouklakis George , Spentzouri Despoina , Mazokopakis Elias
Published: June 2023

Objective:

Hyperhomocysteinemia (HHcy) is recognized as a risk factor for for cardiovascular disease. The aim of this study was to investigate and compare the efficacy of two tHcy-lowering treatments including FNA or L-methylfolate in healthy Greek adults.

Design and method:

Two hundred and seventy two (272) health Greek adults (143 men; mean age±SD: 43.0±15.3 years), with elevated serum tHcy levels (>10 mmol/L) received randomized folinic acid (Group 1) or L-methylfolate (Group 2) orally both with hydroxycobalamine im for three months. Serum folate, Cbl and tHcy levels were determined using immunoassays methods at the beginning and the end of the study period. The MTHFR C677T and A1298C gene polymorphisms were genotyped using polymerase chain reaction and reverse hybridization.

Results:

At the end of the 3-month intervention period the levels of serum folate and Cbl were significantly increased, whereas serum tHcy concentrations were significantly decreased in both groups. The individuals with 677TT genotype had significantly higher reduction of serum tHcy levels than individuals with the 677CC or 677CT genotypes.

Although the individuals of Group 1 had significantly greater increase of their serum folate levels than those of Group 2, the reduction of serum tHcy concentrations between the two groups did not differ significantly. The individuals with 677CT genotype had statistically significant greater reduction of serum tHcy levels when received folinic acid than methylfolate supplementation.

Conclusions:

The tHcy-lowering treatment which included FNA supplementation compared to treatment which included L-methylfolate supplementation caused a greater increase of serum folate levels but no difference in reduction of serum tHcy levels. The reduction of serum tHcy levels was influenced by the existence of MTHFR C677T and not A1298C gene polymorphisms. The individuals with 677CT genotype appear to benefit more by the treatment which included FNA than L-methylfolate supplementation.
POLYVASCULAR ATHEROSCLEROSIS INVOLVEMENT AND CARDIAC REHABILITATION: FUNCTIONAL IMPROVEMENT AND RISK RECLASSIFICATION
Authors: Pezzoli Stefano , Maloberti Alessandro , Ghidini Simone , Colombo Valentina , Daus Francesca , Censi Lorenzo De , Morelli Martina , Alloni Marta , Giannattasio Cristina
Published: June 2023

Objective:

polyvascular atherosclerotic involvement is one of the definitions of extreme CV risk. For this reason, the search for carotid or lower limb asyntomatic atherosclerotic pathology can be useful to guarantee more intensive treatments for these individuals, who have already had a myocardial infarction. To understand how much the polyvascular patients can improve in functional terms after Cardiological Rehabilitation, comparing them with monovasculars. Furthermore, we want to evaluate how many patients are reclassified with an active research of asyntomatic atherosclerotic disease with carotid ultrasound and Ankle Brachial Index (ABI).

Design and method:

The study sample was composed by 87 patients who underwent a cardiological rehabilitation cycle at the Niguarda hospital in Milan from March 2021 to April 2022. Anamnestic, clinical, laboratory and instrumental data were collected. Functional improvement was assessed as the difference in meters walked on the 6-minutes walking test (6MWT) at the beginning (6MWT-1) and at the end of the rehabilitation (6MWT-2). All patients underwent ABI (to evaluate asyntomatic PAD) and carotid ultrasound (to evaluate asyntomatic cerebrovascular disease).

Results:

Pre-riclassification, polyvascolar patients (13) compared to monovascular (74) were older (70 years vs 59 years, p = 0.01), more frequenly males (100% vs 73%, p<0.001), had more previous recurrent myocardial infarctions (46% vs 8%, p = 0.002) and had a worse performance in terms of 6MWT-1 (428m vs 514m, p = 0.002) and 6MWT-2 (517m vs 597m, p = 0.008). However, absolute functional improvement durgin rehabilitation is imilar between the two group (81m vs 82m, p = 0.919). Following reclassification, 7 patients switched from monovascular (87) to polyvascular (20).

Conclusions:

Our data showed that polyvascular patients can improve as much as monovasculars after Cardiological Rehabilitation. Furthermore, following ABI and carotid ultrasound, 8% of patients were reclassified. Polyvascular patients may receive more targeted and intensive therapies if properly diagnosed.
THE PART OF HYPERTENSION IN HEART FAILURE IN NIGERIA
Authors: Dennis Anthony
Published: June 2023

Objective:

The objective of this study was to determine the part of hypertension among the heart failure cause in Nigeria. It was a retrospective study realized to January to December 2020 in Nigeria.

Design and method:

A total of 294 patients with heart failure were selected. Between them 26.5%{78) had hypertension like of heart failure. The sex-ratio was 0.73 and mean,s age of patients was 60.8 + 12.2 years.

Results:

Thirsty three cases of dyspnea (42.3%) and 31 cases (39.7) and respectively of class lll and IV of New York Heart Association were observed. Global heart failure was found in 45 cases (57.7%) and it concern left ventricular only in 33 cases(42.3%). Age = 50 years (74.4%), overweight (60.3%) and alcohol (42.3%) were the most risk factors noted. Clinical evolution was favourable in most cases. Also we noted a death rate of 5.1% and 7.9% and re-hospitalization in the year.

Conclusions:

Education and early management of patients with high blood pressure are necessary to reduce risk of complication.
ASSOCIATIONS OF INTER-ARM BLOOD PRESSURE DIFFERENCE WITH TREATMENT RESPONSE IN NEWLY TREATED HYPERTENSION
Authors: Clark Chris , Jordan Andrew , Anning Christine , Wilkes Lindsay , Ball Claire , Pamphilon Nicola , Bellenger Nicholas , Shore Angela , Sharp Andrew
Published: June 2023

Objective:

Inter-arm differences (IAD) in systolic blood pressure (SBP) predict future cardiovascular mortality and morbidity. IAD varies between measures and gets smaller with repeated measures. The relationship of IAD to response to antihypertensive treatment is unknown. We set out to examine associations of IAD with BP treatment response over 18 weeks in treatment-naïve adults with moderate to severe hypertension.

Design and method:

We previously reported that nurse-led accelerated stepwise management of treatment-naïve grade II/III hypertension is feasible, safe and effective, achieving control of SBP to < 140 mmHg for 76% after 18 weeks. Using this cohort, univariable associations of IAD (mean of 8 simultaneous BP measurements) with vascular and clinical indices, and with BP change on treatment, were examined with mixed-effects linear regression models. Candidate univariable indices (p<0.2) entered multivariable modelling. Regression modelling of change in IAD was undertaken. All analyses adjusted for age, sex and entry SBP.

Results:

For 52 participants (mean age 59; 42% female), mean (standard deviation: SD) entry SBP was 171 (13.9) mmHg falling, after protocol-led treatment intensification, to 131 (10.7) mmHg at 18 weeks; mean systolic IAD was 4.5 (4.2) mmHg at entry and 3.9 (4.3) mmHg at 18 weeks (p = 0.28). In final adjusted models, IAD at entry was associated with handedness, height, body mass index, smoking and absence of pedal pulses. Greater reduction of SBP from entry to 18 weeks was associated with lower entry IAD, greater SD of daytime ambulatory BP, smoking history and handedness. Adjusted change in IAD over 18 weeks was correlated with falls in SBP (Adjusted R2 = 0.56).

Conclusions:

These data associate greater systolic IAD with reduced response to intensive BP lowering, and correlate reduction in IAD with change in BP. Slower BP target achievement can carry prognostic implications, suggesting one possible mechanism whereby IAD might predict future mortality.
ADVERSE CHILDHOOD EXPERIENCES AND RISK OF HYPERTENSION AMONG MIDDLE-AGED AND OLDER ADULTS IN CHINA: A POPULATION-BASED STUDY
Authors: Chen Chao-Lei
Published: June 2023

Objective:

Although the association of ACEs with hypertension has been reported in different contexts, the conclusions remain inconsistent, and few studies have investigated the independent role of threat-related and deprivation-related ACEs on later-life hypertension in the general population. We aimed to examine the association between threat-related and deprivation-related ACEs and incident hypertension and to assess whether demographic characteristics (age, sex) and socioeconomic status (education, occupation, and income) could modify these associations.

Design and method:

This prospective cohort study used data from the baseline survey (year 2011-2012) and follow-up survey (year 2015) of the China Health and Retirement Longitudinal Study (CHARLS). The study population consisted of middle-aged and older adults with complete data on ACEs and two physical assessments and without hypertension at baseline. The associations of 5 threat-related ACEs (ie, physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and 5 deprivation-related ACEs (ie, emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death) with hypertension were evaluated using Cox proportional hazards regression models. The cumulative scores of the 2 ACE dimensions were calculated and grouped into 3 categories as 0, 1, and 2 or more in main analyses.

Results:

Of the 7,912 individuals included, the mean (SD) age was 58.65 (8.65) years and 4018 (50.8%) were men. Compared with no exposures, experience of 2 or more threat-related ACEs was associated with higher risk of hypertension (HR = 1.26 [95% CI, 1.03-1.53)]). In addition, compared with those who experienced no deprivation-related exposures, both experience of 1 and 2 or more deprivation-related exposures were associated with hypertension (HR for 1 exposure: 1.32 [1.09-1.55]; HR for 2 or more exposures: 1.65 [1.15-2.31]). These associations were not significantly modified by demographic and socioeconomic characteristics.

Conclusions:

Both threat-related and deprivation-related ACEs were associated with higher risk of later-life hypertension, independent of demographic and socioeconomic factors. These findings highlight importance of in preventing later-life hypertension among individuals who have experienced ACEs.
ASSOCIATION OF UNILATERAL LOW ANKLE-BRACHIAL INDEX AND BILATERAL LOW ANKLE-BRACHIAL INDEX WITH INCIDENT CARDIOVASCULAR DISEASE AND MORTALITY: THE NORTHERN SHANGHAI STUDY
Authors: Zhao Song , Xu Chong , Xiong Jing , Tang Jiamin , Yu Shikai , Maimaitiaili Rusitanmujiang , Teliewubai Jiadela , Chi Chen , Xu Yawei , Zhang Yi
Published: June 2023

Objective:

Ankle-brachial index (ABI) has been used as a marker for atherosclerosis and a risk factor of cardiovascular disease (CVD). Nevertheless, it is not yet clear whether there is a difference in cardiovascular risk between patients with one leg low ABI (<0.9) (unilateral low ABI) and those with both legs low ABI (bilateral low ABI). Therefore, we investigated the association of target organ damage (TOD) and incident of major cardiovascular events (MACE) in participants with unilateral low ABI and bilateral low ABI.

Design and method:

We enrolled 3168 participants (mean age 71.3 years, 1361 men) from North Shanghai Study (NCT02368938). The participants were divided into 3 groups according to both legs ABI (bilateral low ABI, unilateral low ABI and bilateral normal ABI). TOD, including left ventricular hypertrophy, arterial stiffness, carotid plaque, and renal damage, were measured using standard methods at baseline. MACE was a composite outcome that consisted of nonfatal myocardial infarction, nonfatal stroke and CVD death.

Results:

Compared with bilateral normal ABI, bilateral low ABI had higher risk of all TOD, but unilateral low ABI only had higher risk of carotid plaque and renal damage after adjustment covariates. During a median follow-up of 5.4 years, 199 MACE and 192 all-cause mortality occurred. The multivariable-adjusted risk for MACE in individuals with bilateral low ABI (hazard ratio (HR): 1.86; 95% confidence interval (CI), 1.20-2.88) and individuals with unilateral low ABI (HR: 1.58; 95% CI, 1.04-2.41) were higher than individuals with bilateral normal ABI (referent group). Compared with bilateral normal ABI, both unilateral low ABI (hazard ratio: 1.70; 95% CI, 1.13-2.57) and bilateral low ABI (HR: 2.10; 95% CI, 1.39-3.18) had higher risk of all-cause mortality after adjustment covariates.

Conclusions:

Both unilateral low ABI and bilateral low ABI are associated with increased CVD risk, but bilateral low ABI with a trend towards increasing CVD risk. More attention should be paid to whether a patient has a unilateral or bilateral low ABI for a more accurate CVD risk assessment.
ASSOCIATION OF HANDGRIP STRENGTH WITH CARDIOMETABOLIC MULTIMORBIDITY: FINDINGS FROM FOUR LONGITUDINAL COHORT STUDIES
Authors: Chen Chao-Lei , Nie Zhi-Qiang , Feng Yingqing
Published: June 2023

Objective:

Cardiometabolic multimorbidity is an increasing public health burden and clinical concern. However, predictors for the development of cardiometabolic multimorbidity are poorly understood. We aimed to investigate the association between handgrip strength and the risk of cardiometabolic multimorbidity among adults aged 50 years or above from high-income and low- and middle-income countries.

Design and method:

In this multicohort study, we extracted individual-level data from four longitudinal cohort studies that included nationally representative samples across 20+ countries, including the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). Handgrip strength was measured following a homogeneous procedure, in which the maximum measurements of dominant hand were used and expressed in absolute units (kg) for subsequent analysis. Cardiometabolic multimorbidity was defined as the simultaneous occurrence of two or more of the following conditions: type 2 diabetes, stroke, and heart diseases. Cox proportional hazards models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs).

Results:

We included 50,118 participants recruited between 2011 and 2019 with a median follow-up of 7.6 years. The incident rates of cardiometabolic multimorbidity in participants from HRS, ELSA, SHARE, and CHARLS were 9.1%, 4.0%, 3.1%, and 2.7%, respectively. After adjusting for sociodemographic characteristics, lifestyle factors, and vascular risk factors, the HRs (95% CIs) of per SD increment in handgrip strength for cardiometabolic multimorbidity were 0.80 (0.73-0.87) in HRS, 0.62 (0.55-0.71) in ELSA, 0.69 (0.64-0.75) in SHARE, and 0.85 (0.75-0.96) in CHARLS. Those associations remained statistically significant for separate outcomes including diabetes, heart diseases, and stroke in all four cohorts.

Conclusions:

Higher grip strength was associated with a range of cardiometabolic outcomes as well as cardiometabolic multimorbidity regardless of whether they live in high-income or low- and middle-income countries. Further work on the use of grip strength in risk scores or risk screening is needed to establish its potential clinical utility.
SRT1720 ALLEVIATES ENDOTHELIAL CRIF1 DEFICIENCY-INDUCED CARDIAC FUNCTION
Authors: Piao Shuyu , Kim Seonhee , Vu Gianghuong , Lee Miae , Kim Minsu , Jeon Byeong Hwa , Kim Cuk-Seong
Published: June 2023

Objective:

CR6-interacting factor1 (CRIF1) is a mitochondrial inner membrane and plays an important role in peptide synthesis and oxidative phosphorylation. Cardiomyocyte-specific deletion of CRIF1 led to an exaggerated decline in cardiac function and impaired cardiomyopathy. However, whether endothelial deletion of CRIF1 influences cardiac function has not yet been fully determined.

Design and method:

We developed an endothelial cell-specific CRIF1 deletion mouse and observed cardiac function in vivo.

Results:

Our results showed that endothelial deletion of CRIF1 increased heart-to-body weight ratio, enhanced lethality, and lowered fractional shortening of the left ventricle, which contributed to severe cardiac dysfunction. Furthermore, we observed severe mitochondrial dysfunction, decreased ATP level, inflammation, and enhanced oxidative stress in CRIF1 KO mice heart tissues, along with reduced SIRT1 expression. The SIRT1 activator SRT1720 attenuated cardiac dysfunction by activating endothelial nitric oxide synthase, reducing oxidative stress, inhibiting inflammation, and endothelial junction associated protein Zonula occludens-1 in CRIF1 KO mice.

Conclusions:

Therefore, our results suggest that endothelial mitochondrial OXPHOS dysfunction plays an essential role in maintaining cardiac function, and SIRT1 activator could be a promising therapeutic strategy for endothelial dysfunction-induced cardiac dysfunction.
DO COGNITIVE FUNCTION IN HYPERTENSION WORSE OR BETTER IN WOMEN OR MEN: ARE COMPARISONS REALISTIC?
Authors: Krotova Viktoriia , Hubar Iryna , Khomazyuk Tetyana
Published: June 2023

Objective:

More evidence confirms that cognitive disorders (CD) in hypertension (H) are early signs of cerebral blood flow deregulation and often occur before other target organs are affected. Therefore, assessment and monitoring of cognitive functions in H should be a criterion for the effectiveness of treatment and prognosis of the course of the disease.

Design and method:

The study results are based on the data of a comprehensive examination of 185 working patients with controlled H stage II with SCORE risk of CVD <5 %. According to the neuropsychological testing on MMSE and MoCA scales, 157 people with various severity CD were found. There were 87 (55.4 %) women and 70 (44.6 %) men among them, and the average age was 52.3 (8.2) years; the average duration of H was 10 (8 - 12 years). The comparison and control groups were adequate for the purpose. The standard methods of parametric and non-parametric statistics processed the obtained data.

Results:

Significant differences were noted in the parameters of the daily profile of blood pressure (VAR SBP, VAR DBP), both during day and night, in patients with H and CD of both genders due to ambulatory monitoring of BP. According to the data of the correlation analysis, a significant direct correlation of average strength was established between the day and night variability of SBP and DBP and the development of CD in patients with H, regardless of the gender of the patients: with VAR SBP during the day - r = 0.573, with VAR SBP at night - r = 0.614, with VAR DBP during the day - r = 0.426, with VAR DBP at night - r = 0.453.

Conclusions:

Hypertension is a significant risk factor for the development and progression of CD in both genders. No objective reason to discuss whose gender cognitive functions are worse or better. It is also essential to pay attention to the high autonomic index and variability of blood pressure ambulatory monitored day and night due to the increased risk of development and progression of CD.
FAT-FREE MASS DOMINATES THE RELATIONSHIP BETWEEN BODY COMPOSITION AND SYSTOLIC BLOOD PRESSURE IN CHILDREN AND ADOLESCENTS
Authors: Zhao Song , Yu Shikai , Tang Jiamin , Zhao Yifan , Xu Chong , Li Moran , Xu Yawei , Zhang Yi
Published: June 2023

Objective:

Systolic blood pressure (SBP) significantly associates with body composition. However, which one of the components of body composition is the dominant contributor to SBP in children and adolescents remains unclear. We aimed to determine the dominant contributor to SBP among components of body composition in a large cohort of American children and adolescents derived from the National Health and Nutrition Examination Survey.

Design and method:

13618 children and adolescents (median age 13 years; 6107 girls) with available data on whole-body dual-emission X-ray absorptiometry measurements were included.

Results:

Multiple linear regression showed that SBP significantly associated with fat-free mass in boys (↓ = 0.49, P<0.001) and girls (↓ = 0.47, P<0.001) and with total fat mass only in boys (↓ = 0.12, P<0.001), after adjustment for covariates. When taking fat distribution into consideration, SBP positively associated with trunk fat mass (Boys: ↓ = 0.28, P<0.001; Girls: ↓ = 0.15, P<0.001), but negatively associated with leg fat mass (Boys: ↓ = -0.14, P<0.001; Girls: ↓ = -0.11, P<0.001), in both boys and girls. Dominance analysis showed that fat-free mass was the dominant contributor to SBP (boys: 49%; girls: 55.3%), followed by trunk fat mass (boys: 32.1%; girls: 26.9%); leg fat mass contributed the least to SBP in boys (18.9%) and girls (17.8%).

Conclusions:

Fat-free mass was not only significantly associated with SBP, but also the most dominant contributor to SBP variation in American children and adolescents.
NOCTURNAL BLOOD PRESSURE DIPPING AND PRECLINICAL TARGET ORGAN DAMAGE IN YOUNG INDIVIDUALS
Authors: Theodosiadi Aikaterini , Kollias Anastasios , Ntineri Angeliki , Destounis Antonios , Menti Ariadni , Zeniodi Maria Elena , Stambolliu Emelina , Servos George , Moyssakis Ioannis , Vazeou Andriani , Stergiou George S.
Published: June 2023

Objective:

A blunted nighttime blood pressure (BP) decrease (non-dipping) has been linked to increased cardiovascular risk. Relevant research data in children and adolescents are scarce with most studies conducted in young individuals with medical conditions, e.g., diabetes. This study investigated the relationship of nighttime dipping with indices of preclinical target organ damage (TOD) in young individuals.

Design and method:

Individuals referred for suspected hypertension and healthy volunteers aged 6-25 years were evaluated with 24h ambulatory BP (ABP) monitoring. The nighttime BP dip was quantified as the percentage BP decline as compared to the daytime value. Non-dippers were defined as those with systolic and/or diastolic nighttime dip <10%. TOD was assessed by echocardiographic left ventricular mass index (LVMI) and ultrasonographic determination of intima-media thickness of the common carotid artery (IMT).

Results:

276 individuals were included (13.8±3.8 years, 67% males, 31.2% children, 56.1% adolescents, 12.7% adults, 3.3% healthy volunteers, BMI z-score 1.18±0.96, 37.4% obese, 25.7% with elevated 24h ABP, 27.9% with elevated nighttime BP). LVMI measurements were available in 257 and IMT in 205. The average systolic/diastolic dip was 12.1±4.7/19.6±6.3% and 30.4% of participants were classified as non-dippers. TOD indices were higher in non-dippers than in dippers (LVMI 30.5±8.2 versus 28.4±5.9 g/m2.7; IMT 0.517±0.054 versus 0.500±0.053 mm, p<0.05 for both). In linear regression analysis, non-dipping was independently associated with LVMI (↓ = 2.14, p = 0.01) and IMT (↓ = 0.02, p = 0.02), after adjustment for sex, age, BMI z-score and 24h systolic ABP. However, after adjustment for the nighttime BP levels (instead of 24h ABP) this association lost its statistical significance.

Conclusions:

These data suggest that in young individuals nocturnal non-dipping is associated with TOD, but not after accounting for the nighttime BP levels.
SEX DIFFERENCES IN THE INCIDENCE OF ARTERIAL HYPERTENSION FOLLOWING HEART TRANSPLANTATION
Authors: Vachulova Anna , Regec Dominika , Dankova Marcela , Simovicova Veronika , Luknar Milan , Lesny Peter , Goncalvesova Eva
Published: June 2023

Objective:

Arterial hypertension (AH) is a common complication in heart transplant (HTX) recipients affecting 50-80% of patients (pts). The aim of our study was to evaluate sex differences in the incidence of AH in HTX pts.

Design and method:

We retrospectively analyzed pts who underwent HTX in our center between 01/2010 and 12/2020.

Results:

We enrolled a total of 164 pts with a survival of more than 1 year after HTx. The study group included 126 males, average age of 50,5 ± 10,8 years, and 38 females average age of 46,4 ± 10,2 years. All pts after HTX received standard immunosuppressive treatment according to the protocol of our center, including calcineurin inhibitors. Pre-transplant AH was present in 35% (n = 58 pts). Pre-transplant - AH was more prevalent in males 41% (n = 52 pts) compared to females 16% (n = 6 pts). Prevalence of AH after HTx was 68% (n = 112) pts, more frequent in males 71% (n = 90) vs females 58% (n = 22). The average BP in the medical record 1 year after HTX was 136 ±14/ 84 ± 10 mmHg. All 112 pts with post-transplant AH were treated with AH treatment: 52% (n = 58) were treated with monotherapy, 35% (n = 39) with two-drug combinations, 10% (n = 11) with three-drug combinations, and 3% (n = 4) with four-drug combinations. The most frequently used AH drugs were calcium channel blockers in 54% (n = 60) pts, followed by ACE inhibitors in 46% (n = 52) and beta-blockers in 34% (n = 38). As independent risk factors for developing post-transplant AH in both groups were identified presence pre- transplant AH ( RR 1,5; CI 2,27 – 13,17), hypertriglyceridemia (RR 1,6 ; CI 1,75 – 16,24) and pre-transplant ischemic cardiomyopathy ( RR 1,4 ; CI 1,41 – 7,68).

Conclusions:

AH 1 year after HTx is a common complication. In our group of pts affected 68% of pts. We observed a greater increase in the incidence of post-transplant vs pre-transplant AH in females pts. Patients with pre-transplant AH, elevated triacylglycerides, and ischemic cardiomyopathy, are at high risk to develop post-transplant AH. Therefore they require more consistent follow-up even in the early period after HTX.
PROGRESSION OF HYPERTENSION-MEDIATED ORGAN DAMAGE IN PATIENTS WITH AND WITHOUT NONALCOHOLIC FATTY LIVER DISEASE
Authors: Siafi Eirini , Andrikou Ioannis , Konstantinidis Dimitrios , Kakouri Niki , Tatakis Fotis , Fragoulis Christos , Iliakis Panagiotis , Manta Eleni , Drogkaris Sotirios , Liatakis Ioannis , Sakalidis Athanasios , Filippou Christina , Kouremeti Maria , Zammanis Ioannis , Grigoriou Kalliopi , Tsoumpou Ioanna , Charalampous Georgios , Dimitriadis Kyriakos , Thomopoulos Costas , Tsioufis Konstantinos
Published: June 2023

Objective:

Nonalcoholic fatty liver disease (NAFLD) is the main cause of chronic liver disease and is associated with an increased risk of cardiovascular death. Fatty liver index (FLI) is a validated marker of NAFLD and can be used as a screening measure of hepatic steatosis. The purpose of the study was to compare the progression of hypertension-mediated organ damage (HMOD) in hypertensive patients with and without NAFLD.

Design and method:

Hypertensive patients (n = 60) without a history of cardiovascular disease participated in the study (mean age, 52 years; males, 55%; baseline clinic BP, 145/92 mmHg) and were followed for one year. In the baseline visit, FLI was calculated, and patients were divided into two groups by FLI below 60 or 60 or above (i.e., high-risk of NAFLD). All patients underwent clinic and 24-hour ambulatory BP measurements, echocardiographic examination, nailfold capillaroscopy, pulse wave velocity, and urinary albumin excretion assessment (albumin to creatinine ratio, [ACR]). Left ventricular mass index (LVMI) was also calculated using the Devereux formula.

Results:

In baseline visit, patients with FLI > or = 60 (n = 32) compared to the control group had higher values of ACR (26.5±57mg/g vs. 9.6±6.3 mg/g, p = 0.02) and lower values of capillary densities (75±18cap/mm2 vs. 86±12cap/mm2, p = 0.002), whereas there was no relative difference in PWV and LVMI. At the end of follow-up, patients with FLI > or = 60 had higher values of ACR (12.6±11.9 mg/g vs. 6.8±5.3 mg/g p = 0.025), PWV (9.9±2m/sec vs. 8.8±1.3 m/sec, p = 0.02), LVMI (81.4±13.2 g/m2 vs. 72.5±13.2 g/m2, p = 0.02) but lower number of capillaries (65.1±8.8 cap/mm2 vs. 79.6±7.5 cap/mm2, p<0.001). Linear regression analysis revealed that FLI > or = 60 was an independent determinant of follow-up ACR, PWV, LVMI, and the number of capillaries.

Conclusions:

Increased FLI may adversely modify the progression of HMOD in hypertension.
PREVALENCE, COMORBIDITIES AND CONTROL OF HYPERTENSION IN A WEST AFRICAN PERI-URBAN POPULATION
Authors: Malik Koussoh Simone , Amangoua Annita , Meless David , Ake Michèle , Guinan Jean - Claude , Oga Serges , Adoubi Anicet , Ndindin Claude
Published: June 2023

Objective:

In sub-Saharan Africa, hypertension has become a major public health problem that contributes to the increase in premature deaths in this region. The objective of this survey was to investigate comorbidities and determine the level of hypertension control in hypertensive patients in a West African population

Design and method:

This cross-sectional survey concerned adults aged 18 and over and was conducted in a peri-urban population in West Africa (Côte d’Ivoire). Sociodemographic data (age, sex, marital status, education level, occupation) were collected. A history of diabetes and hypertension was sought. Lifestyle data (tobacco and alcohol consumption) and some cardiovascular risk factors were collected. Blood pressure was measured with an OMRON M6 electronic blood pressure monitor in the sitting position after 5 minutes of rest. Capillary blood glucose was measured with a glucometer in fasting participants. Weight was measured by a scale and catch on the identity document. Hypertension was defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg and/or antihypertensive treatment during

Results:

Three hundred and eighty (380) people were surveyed, 39.8% were men and 60.2% women. The average age was 40.4 ± 13.8 years. The 35-44 age group represented more than a quarter of the population. The mean systolic blood pressure was 128.6 ± 25.3 mmHg. The mean diastolic blood pressure was 80.6 ± 13.7 mmHg. The prevalence of hypertension was 39.2%, more than half of the population were women. Hypertension affected 41.6% of men and 58.4% of women; women were more hypertensive than men (p = 0.03). Among those with known hypertension, 31.6% had controlled blood pressure. The prevalence of diabetes was approximately 10%. Nine percent (9%) of individuals had both hypertension and obesity and less than two percent had the comorbidity hypertension, diabetes, and obesity.

Conclusions:

In this African population, less than half of the hypertensive individuals had their blood pressure controlled. The focus should be on awareness to avoid complications
SERUM N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE LEVEL IS NEGATIVELY ASSOCIATED WITH VASCULAR REACTIVITY INDEX BY DIGITAL THERMAL MONITORING IN PATIENTS WITH HYPERTENSION
Authors: Yang Chiu-Fen , Wang Hui-Sheng , Wang Ji-Hung , Hsu Bang-Gee
Published: June 2023

Objective:

B-type natriuretic peptide (BNP) participates in the coordination of endothelial regeneration/hypertrophy and the accompanying angiogenesis. Endothelial dysfunction is associated with increased mortality in patients on hypertension. The present study aimed to determine the relationship between serum N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) level and endothelial dysfunction in patients with hypertension

Design and method:

The present cross-sectional, single-center study included 90 hypertension patients. An electrochemiluminescence immunoassay was used to measure NT-pro-BNP levels. The endothelial function and vascular reactivity index (VRI) were measured using digital thermal monitoring (DTM) test (VENDYS). In this study, VRI < 1.0 was used as the poor vascular reactivity, 1.0 < VRI < 2.0 was used as the intermediate vascular reactivity, and VRI > 2.0 was used as the good vascular reactivity.

Results:

Eight hypertensive patients (8.9%) were categorized as poor vascular reactivity (VRI < 1.0), 39 hypertensive patients (43.3%) were categorized as intermediate vascular reactivity (1.0 < VRI < 2.0), and 43 hypertensive patients had good vascular reactivity. Older age (p = 0.012) and higher serum NT-pro-BNP level (p < 0.001) was associated with poor vascular reactivity. Advanced age (r = -0.221, p = 0.036) and logarithmically transformed serum level of NT-pro-BNP (log-NT-pro-BNP, r = -0.505, p < 0.001) was negatively associated with VRI values in hypertensive patients. After multivariable forward stepwise linear regression analysis noted that serum log-NT-pro-BNP level (adjusted R2 change = 0.246, p < 0.001) was significantly and independently associated with VRI values in hypertensive patients.

Conclusions:

Serum log-NT-pro-BNP levels were negative associated with VRI and associated with endothelial dysfunction in patients with hypertension.
CARDIOPULMONARY STATUS AND RIGHT VENTRICLE FUNCTIONALITY IN HYPERTENSIVE PATIENTS HOSPITALIZED OR NOT FOR SARS-COV-2 INFECTION
Authors: Kariori Maria , Fragoulis Christos , Chrysochoou Christina , Tsioufis Panagiotis , Grigoriou Kalliopi , Papakonstantinou Panteleimon , Mageiras Nikolaos , Manta Eleni , Nikolopoulou Lefki , Siafi Eirini , Mantzouranis Emmanouil , Tatakis Fotios , Konstantinidis Dimitrios , Thomopoulos Costas , Tsioufis Konstantinos
Published: June 2023

Objective:

There is little data concerning the impact of SARS-Cov-2 infection on the cardiopulmonary status and right ventricle (RV) function of patients with arterial hypertension (HTN). The purpose of our study was to investigate whether hospitalization for COVID19 affects the functional status of hypertensive patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the infection onset.

Design and method:

All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol where all cardiorespiratory parameters were evaluated. Echocardiographic parameters including right ventricle longitudinal strain were analyzed using an offline program. Subjects with history of HTN were divided into two groups according to hospitalization for Covid-19 infection. Group I included 34 subjects who were hospitalized for Sars-Cov-2 infection and Group II included 28 subjects without need for hospitalization.

Results:

Out of total population of 198 patients with COVID19 infection, 62 subjects had a hypertension history (mean age: 61±10 years, 58.1 % males, history of coronary artery disease: 16.1%) and they were evaluated 3 months after the symptoms’ onset. Hospitalized patients were older (63±8 vs. 52±11 years, p<0.001). Analysis of cardiopulmonary test parameters, oxygen consumption (ml/kg/min) both maximum (21±4 vs. 23.5±4, p: 0.01) and during the 1st minute of recovery (15.5±2 vs. 21±25, p: 0.02), VO2_AT (17±4 vs. 27.5±32) and PETCO2 (39±4 vs. 38±19 mmHg, p: 0.03) were impaired comparing to non-hospitalized subjects. Out of echocardiographic parameters, diameter of left atrium (mm), differed significantly between two groups (41±6 vs.38±5 p: 0.02). The absolute mean value of right ventricle strain (RVLS, (%): 13±8 vs. 23±3, p:0.04) was impaired to hospitalized despite a similar left ventricle ejection fraction between two groups. Using linear regression analysis adjusted for age, gender and hospitalization, hospitalization (p: 0.001) proved to be independent predictive factor for RVLS in hypertensive patients.

Conclusions:

To conclude our study highlighted negative impact of hospitalization for Sars-Cov-2 infection in the capacity for exercise and in right ventricle functionality, implying the severity of disease as a negative independent predictive factor in hypertensive patients.
DO RENIN-ANGIOTENSIN SYSTEM INHIBITORS HAVE ANY EFFECT ON THE SEVERITY OF COVID-19 IN HYPERTENSIVE SUBJECTS?
Authors: Nieto Javier , Abellán-Alemán José , Sánchez-Macarro Maravillas , Velasco-Soria Ángeles , Crespo-Sabaris Rafael , García-Romanos Fernando , Fuentes-Jiménez Francisco J. , Iturralde-Iriso Jesús , Valls-Roca Francisco , Díaz-Vera Alcibiades S. , Sobrino-Martínez Javier , Gómez-Marcos Manuel A.
Published: June 2023

Objective:

An increase in angiotensin-converting enzyme (ACE) type 2 levels would stimulate the infection by SARS-Cov-2. On the other hand, the inhibition of the effect of angiotensin II could decrease the inflammatory and oxidative response related to the severity of the disease. Our purpose is to assess the effect of renin-angiotensin inhibitors (RASi) on the severity of COVID-19 in a primary care population of hypertensives.

Design and method:

Multicenter, observational, cross-sectional, retrospective and analytical study. The subjects were enrolled by a random sampling from 10 autonomous regions in Spain, among patients over 18 years-old with treated hypertension and COVID-19 (PCR positive), within the framework of primary health care (119 physicians). Patients were treated 6 months prior data collection (May 2021–February 2022) in the third wave. Multivariate logistic regression analysis adjusted by age, sex, smoking, and obesity was performed to assess the relationship of COVID-19 severity with anti-hypertensive therapy.

Results:

1372 patients were enrolled, mean age 67.1±13.6 years, women 50.8%, smoking 12.5%, obesity 43.9%, diabetes 27.5%, controlled arterial hypertension 55.9% (office BP <140 /90). The severity of COVID-19 was: mild-asymptomatic 971 (70.8%), hospital admission 401 (29.2%), ICU admission 74 (5.4%) and death 48 (Fatality rate, 4%). 64.3% of patients were treated with RASi alone or as add-on therapy during COVID-19. Comparing the progression of COVID-19 between those patients who required hospitalisation versus mild-asymptomatic, we found statistically significant differences (Figure 1): RASi vs Diuretics(D)+Calcium channel blockers(CCB)+RASi (OR = 0.36; 95%CI: 0.22-0.57; p<0.001) and D+RASi vs D (OR = 0.49; 95%CI: 0.28-0.93; p<0.05). RASi alone or in combination vs other anti-hypertensives only showed a non-significant trend for fewer hospitalizations (OR = 0.87; 95%CI: 0.68-1.12; p = 0.274). There were no differences between survivors vs non-survivors treated with RASi: 63.2% vs 58.3% (p = 0.496).

Conclusions:

RASi do not worsen the severity of COVID-19 among hypertensive patients. Regarding its possible protective effect on the progression of the disease, the results are not conclusive, although there could be a trend in this sense, especially when RASi are compared with some antihypertensive combinations.
ROLE OF THE T (-344) C POLYMORPHISM OF ALDOSTERONE SYNTHASE GENE CYP11B2 IN THE DEVELOPMENT OF CARDIORENAL SYNDROME IN PATIENTS WITH DIABETES MELLITUS
Authors: Vasilkova Volha , Savasteeva Irina , Borovets Yana , Mokhort Tatsiana
Published: June 2023

Objective:

To evaluate the role of the T (-344)C polymorphism of CYP11B2 gene in the development of cardiorenal syndrome (CRS) in diabetes mellitus (DM).

Design and method:

We examined 270 patients with type 1 and type 2 diabetes aged over 25 years. Control group included 60 healthy patients the same age. Renal function was assessed based on the levels of serum creatinine, cystatin C, eGFR, which was calculated according to the CKD-EPI formula, and albuminuria, which was assessed as albumin/creatinine ratio. All patients underwent molecular genetic analysis using deoxyribonucleic acid isolated from whole venous blood.

Results:

The frequency of carriage of the TT polymorphism of the CYP11B2 gene was significantly higher (47%) in the group of patients with DM than in the control group (26%). Carriers of the TT genotype had significantly high levels of homocysteine (10.5 [8.3;15.1] μmol/L) and FGF-23 (3.22 [0.77;7.60] pmol/L) as in DM group and in the control group (8.3 [7.54;10.9] μmol/l and 2.4 [2.19;2.6] pmol/l, respectively) than carriers of the CC genotype. The TT genotype was associated with the risk of developing CRS manifestations such as left ventricular hypertrophy (odds ratio (OR) 2.64; 95% CI (0.93–4.19), chronic heart failure (OR 4.26; 95% CI (2.26 - 8.06), subclinical atherosclerosis (OR 4.04; 95% CI (1.89 - 8.58), chronic kidney disease (CKD) (OR 10.77; 95% CI (3.56 - 32.61), and the CT genotype (OR 3.28; 95% CI (1.02 – 10.59) with CKD risk.

Conclusions:

There are pathogenetic association between the renin-angiotensin-aldosterone system, cardiovascular complications and a decrease renal function. Further research is needed for a deep understanding of the complex pathogenetic mechanisms of the development and progression of cardiovascular and renal pathology.
THE PREVALENCE AND INFLUENCE OF DIABETES ON THE COURSE OF PULMONARY TUBERCULOSIS
Authors: Semianiv Ihor , Todoriko Liliia , Semianiv Marianna , Suholitky Yuriy
Published: June 2023

Objective:

Objective of the study is establish prevalence and influence of diabetes on the course of pulmonary tuberculosis.

Design and method:

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

Results:

The retrospective analysis showed that in the patients included in the study, diabetes mellitus was detected in 28 cases (31.2%) simultaneously with the pulmonary tuberculosis; in 60 cases (68.8%) diabetes mellitus developed before tuberculosis and was the background for the manifestation of tuberculosis infection, with the average duration of the disease was 6.4 ± 1.2 years. Most patients had type 2 – 64 diabetes mellitus (72.7%). According to the severity of diabetes, patients were distributed as follows: moderate severity – 48 patients (54.5%), severe – 8 patients (9.1%) mild – 30 (36.4%).

Depending on the form of diabetes compensation, the distribution was the following: compensated – 27 patients (30.7%), subcompensated – 49 patients (55.7%) and decompensated diabetes – 12 patients (13.6%). Most patients had type 2 – 64 diabetes mellitus (72.7%). According to the severity of diabetes, patients were distributed as follows: moderate severity – 48 patients (54.5%), severe – 8 patients (9.1%) mild – 30 (36.4%).

According to the results of a clinical study of blood in both groups to the same extent recorded acceleration of ESR, anemia, leukocytosis, lymphopenia. On admission to the hospital, blood sugar averaged 10.6 ± 1.1 mmol / l in group 1 versus 3.7 ± 0.8 mmol / l. control groups.

Conclusions:

There is a clear tendency to increase the combined pathology and chemoresistance in the structure of the incidence of tuberculosis, the proportion of recurrences of tuberculosis in the presence of diabetes mellitus.
TYPE 2 DIABETES IN YOUNG ADULTS: PREVALENCE AND RISK FACTOR CONTROL IN A TERTIARY DIABETES CENTRE
Authors: Currie Gemma , Saeed Fatima
Published: June 2023

Objective:

The prevalence of type 2 diabetes (T2DM) is increasing in younger adults. Diagnosis at young age translates into increased lifetime complications risk and number of years of life lost. Despite this, clinical guidelines advocate risk-factor management based on 10-year rather than lifetime risk, and there are no specific treatment targets for young adults as this group is under-represented in outcome studies. We reviewed prescribing; risk-factor management; glycaemic control; and follow-up arrangements in people with T2DM aged 18-30 living in North-East Glasgow.

Design and method:

We used the Scottish Care Information – Diabetes Collaboration (Sci-Diabetes) registry to identify all individuals with T2DM aged 18-30 years and collected data from online medical records.

Results:

We identified a cohort of 74 (70% female) individuals. Mean age at diagnosis was 23 years. Social deprivation was high (mean SIMD 1.7). Mean HbA1c was 60.4 (range 32 – 119) mmol/mol with 35 (47%) requiring more than 1 glucose-lowering medication and 7 were (9%) insulin-treated. Mean BMI was 35kg/m2 and 55 (74%) individuals were clinically obese. Dietetic review was documented in 30 (45%), GLP-1 analogues were prescribed to 18 (24%). Blood pressure (mean 125/82; range 100-168/60-101) mmHg was above target in 16 (22%) individuals. Only 8 (10%) and 4 (5%) people were on anti-hypertensive and lipid-lowering drugs respectively. Pregnancy advice had been given in 39 (75%) of female patients. Seventeen (22%) individuals were lost to follow-up.

Conclusions:

Follow-up and risk-factor control are inconsistent in this high-risk group. Service innovation is urgently required to ensure young adults with T2DM are offered appropriate and accessible follow-up in order to minimise cardiovascular risk in later life.
DIABETES IMPAIRS PERIVASCULAR ADIPOSE TISSUE (PVAT)-MEDIATED VASCULAR RESPONSES IN RAT MESENTERIC AND ILIAC ARTERIES
Authors: López Edwyn Omar Cruz , Stolk Daniël G. , Danser A.H. Jan
Published: June 2023

Objective:

To study the role of PVAT in vascular function of blood vessels from hypertensive and diabetic rats.

Design and method:

Mesenteric and iliac artery rings were isolated ± PVAT from Sprague Dawley (SD), and diabetic and non-diabetic TGR (mREN2)27 (REN2) rats. Vascular activity was measured in organ baths by constructing concentration-response curves to endothelin (ET-1) or acetylcholine (ACh). To assess the involvement of NO and endothelium-dependent hyperpolarization (EDH) pathways, ACh effects were studied with the NO synthase inhibitor L-NAME and/or the EDH inhibitors apamine+TRAM-34. ET-1 effects were additionally studied in the presence of the endothelin type A and type B receptor (ETAR, ETBR) blockers BQ123 and BQ788. Constrictor data are expressed as a % of the response to 100 mmol/L K+, and dilator effects as a % of the preconstriction to the thromboxane A2 agonist U46619.

Results:

With PVAT, ET-1 constricted SD and REN2 iliac arteries identically (Emax 126±28 and 119±48, pEC50 7.68±0.29 and 7.59±0.35). BQ788 potentiated constriction, while BQ123 prevented it. Without PVAT, BQ788 had potentiating effect, while BQ123 exerted blockade. Indicating that acute ETBR stimulation results in PVAT-dependent vasodilation. DM reduced the effect of ET-1 in PVAT+ vessels (Emax 78±56, pEC50 6.36±2.59). Yet, PVAT removal restored the ET-1 effect to normal, while BQ788 was still without effect, and BQ123 exerted its usual blockade. This indicates that in DM, PVAT continuously releases relaxant factors that counteract ET-1-mediated effects, even without ETBR stimulation. ACh relaxed PVAT+ SD and REN2 mesenteric arteries identically (Emax 85±15 and 81±16, pEC50 5.70±0.79 and 6.43±0.61), additionally L-NAME blocked was comparable, while EDH blockade had no effect. PVAT removal did not alter ACh responses, and L-NAME and EDH inhibition yielded an identical degree of blockade, with additive effects. This indicates that PVAT counteracts EDH-mediated responses. DM did not alter the response to ACh, but under DM conditions, EDH inhibition yielded blockade in the presence of PVAT, this effect was additive to that of L-NAME. Thus, DM diminishes the anti-EDH effects of PVAT.

Conclusions:

PVAT releases both relaxant and contractile factors that affect vascular reactivity, and DM impairs PVAT function.