bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C20-11: ANTIHYPERTENSIVE TREATMENT IMPROVES LEFT VENTRICULAR DIASTOLIC FUNCTION AND INDICES OF ARTERIAL STIFFNESS IN YOUNGER MEN WITH GRADE 1 HYPERTENSION
Authors: Jedrzejewski Dawid , McFarlane Ewan , Lacy Peter , Williams Bryan
Published: January 2023

Background:

Hypertension is a major risk factor for diastolic dysfunction which, once established, is essentially irreversible. However, it is unclear whether early manifestations of diastolic dysfunction in younger people with mild hypertension can improve with antihypertensive treatment.

Objectives:

Evaluate whether one-year antihypertensive treatment in younger men (age < 55 years) with low-risk (no evidence of hypertension mediated organ damage) grade 1 hypertension improves diastolic function and indices of arterial stiffness.

Methods:

105 treatment-naive men (mean age: 47 ± 6 years) with grade 1 hypertension (confirmed on ABPM) were recruited. Patients were randomised using a PROBE design to one-year antihypertensive treatment (ARB and/or CCB) or no treatment (control). Cardiac function was assessed at baseline and study end via 1.5-Tesla cMRI (MAGNETOM Avanto; Siemens Healthineers AG, Germany) using prospectively gated mid-left-ventricular golden angle tissue phase mapping (primary outcome). Arterial stiffness was measured using CAVI device (VS-1500N; Fukuda Denshi, Japan).

Results:

Diastolic (longitudinal E/A ratio) and systolic (longitudinal S peak velocity) function improved with treatment (n = 38; 0.11 ± 0.24 and 0.38 ± 1.19 cm.s−1, P = 0.01 and 0.05, respectively) but deteriorated in the control group (n = 44; -0.06 ± 0.33 and -0.13 ± 1.12 cm.s−1, P = 0.01 and 0.05, respectively). Improvement in diastolic function was significantly influenced by baseline bodyfat % and BMI (20 ± 8 versus 27 ± 10%, P = 0.04 and 27.8 ± 3.4 versus 31.0 ± 5.3 kg.m−2, P = 0.03, respectively). CAVI pre-ejection period (-9 ± 15 versus 1 ± 13 ms, P = 0.006), pre-ejection-period.ejection-time−1 (-0.03 ± 0.06 versus 0.00 ± 0.05, P = 0.02), upstroke time (-33 ± 50 versus -8 ± 45 ms, P = 0.03), pulse wave velocity (-0.89 ± 0.64 versus -0.02 ± 0.64 m.s−1, P < 0.001), CAVI (-0.40 ± 0.65 versus 0.03 ± 0.62, P = 0.005) and CAVI estimated vascular age (-3 ± 7 versus 1 ± 7 years old, P = 0.02) all improved with TREATMENT (n = 40) versus CONTROL (n = 44).

Conclusions:

Early treatment of Grade 1 hypertension improves left ventricular diastolic function. Treated patients with E/A improvements were leaner, which highlights the importance of a healthy lifestyle. Treatment also improved arterial stiffness, however it is unclear whether those changes were predominantly structural and/or functional. Further work is warranted to establish whether an even earlier intervention is needed to restore diastolic function to the level of normotensive age-matched controls.
PS-C21-10: A LC-MS/MS-EQUIVALENT VALUE OF ALDOSTERONE MEASUREMENT BY A NEW CHEMILUMINESCENT ENZYME IMMUNOASSAY USING A TWO-STEP SANDWICH METHOD
Authors: Ozeki Yoshinori , Miyamoto Shotaro , Yoshida Yuichi , Okamoto Mitsuhiro , Gotoh Koro , Masaki Takayuki , Shibata Hirotaka
Published: January 2023

Primary aldosteronism (PA) is the most frequent cause of secondary hypertension. Patients with PA have an increased risk of cardiovascular events, such as cerebral infarction, myocardial infarction, and chronic kidney disease, compared to those with essential hypertension, and early diagnosis makes PA a treatable disease. In clinical practice, accurate measurement of plasma aldosterone concentration (PAC) is crucial because entire diagnostic tests critically depend on aldosterone concentrations. Recently, we developed a new chemiluminescent enzyme immunoassay (CLEIA) using a two step sandwich method to measure aldosterone concentrations. We measured PAC in blood samples from patients using a radioimmunoassay (RIA) and the CLEIA (with current and newly improved reagents) as well as liquid chromatography tandem mass spectrometry (LC MS/MS). Based on the results of the Passing Bablok regression analysis, the aldosterone levels measured using CLEIA with the new reagents and those measured by LC MS/MS were found to be significantly correlated. However, aldosterone levels were lower with the improved CLEIA method than with RIA and CLEIA using the current reagent. Since April 2021, the plasma aldosterone concentration has been measured by CLEIA in Japan. As a provisional response due to changes of the measurement method, the Japan Endocrine Society Clinical Practice Guideline for the Diagnosis and Management of Primary Aldosteronism 2021 was announced. This time, we will report on the new measuring method.
PS-C23-2: GUT MICROBIOTA AND SUBCLINICAL CORONARY ARTERY CALCIFICATION IN A GENERAL POPULATION OF JAPANESE MEN
Authors: Okami Yukiko , Arima Hisatomi , Kondo Keiko , Hexun Zhang , Yano Yuichiro , Kadota Aya , Torii Sayuki , Hisamatsu Takashi , Fujiyoshi Akira , Kadowaki Sayaka , Watanabe Yoshiyuki , Ando Akira , Nakagawa Yoshihisa , Ueshima Hirotsugu , Miura Katsuyuki
Published: January 2023

Objective:

The gut microbiota of patients with coronary artery disease is being shown to differ from that of healthy individuals. However, it is unclear whether it is altered before the onset of the disease. The aim of this study is to investigate the association between gut microbiota and subclinical coronary artery calcification (CAC) in general Japanese men.

Design and method:

We randomly selected men from the general Japanese population, who underwent computed tomography and gut microbiology tests between 2010 and 2016. Among participants who underwent both tests, excluding those with myocardial infarction history, leaving a sample size of 653 participants in the analysis. DNA was extracted from fecal samples, the bacterial 16S ribosomal RNA gene was amplified using a two-step tail polymerase chain reaction method, and DNA sequencing was performed on a MiSeq System, followed by data analysis using QIIME2 algorithm. Agatston scores > = 100 was defined as the presence of CAC. LEfSe identified different taxa between with and without CAC, and Poisson regression analysis examined them when logarithmic LDA score was > = 3.5 and phylogenetic levels > = 3. Each taxon was ranked in quartiles (Q1–4) and the relative risk (RR) of CAC was calculated. Adjustment factors were age, smoking, drinking, body mass index, use of medication to treat hypertension, dyslipidemia, or diabetes, and history of cardiovascular events. Sensitivity analysis also delimited Agatston scores by 0 or 10.

Results:

Mean age of the participants was 68.3 years, and 215 (32.9%) participants had a CAC score > = 100. Relative abundance of phylum level was 55.1% and 53.2% for Firmicutes, and 32.4% and 34.3% for Bacteroidetes among participants with versus without CAC score > = 100, respectively. Among taxa identified by LEfSe, Poisson regression analysis revealed the genus Bacteroides was inversely associated and genus Ruminococcus was positively associated with CAC after multivariable adjustment (Bacteroides: RR [95%CI] = 0.62 [0.45–0.86] (Q4) vs. ref (Q1)) (Ruminococcus: RR [95%CI] = 1.69 [1.25–2.29] (Q4) vs. ref (Q1)). Sensitivity analysis showed similar results.

Conclusions:

The ratio of Firmicutes to Bacteroidetes was high from the beginning of atherosclerosis. Higher genus Ruminococcus and lower genus Bacteroides were associated with a CAC score > = 100 in general Japanese men.
PS-C23-10: STUDY TO ASSESS THE TYPE OF MEAL SKIPPED AND CHOICE OF FOOD OUTLET (FOOD OUTSIDE HOME) BY COLLEGE GOING GIRLS
Authors: Sahu Poonam
Published: January 2023

Background:

Obesity and hypertension are important public health issues. Most of the population does not consume the recommended daily amount of fruit and vegetables, nuts, and seeds. It has been shown that after the transition from adolescence to young adulthood, when independency increases, young adults are continuously challenged to make unhealthy food choices.

Aim:

To assess the type of meal skipped and choice of food outlet (food outside the home) by college-going girls.

Material & Method:

This study was conducted on 96 college-going girls between the age group of 18–25 years who were selected by a random sampling method. The data was collected with the help of a questionnaire.

Results:

Results showed that 30% of girls skipped their breakfast while 22% skipped their lunch and 26% were not skipping any of their meals. It was found that 43% of the college-going girls chose to eat food in the canteen during the college hours while 41% chose to eat in the cafeteria/ restaurant.

Conclusion:

The skipping of meals and consumption of food in food outlets (food outside the home) seem to contribute to reducing the consumption of nutrient dense food because majority of college canteens have few choices of healthy food options. Hence, this can lead to obesity, and the pathway from obesity to hypertension will most likely become one of the major health issues of twenty-first century.
PS-C26-8: UNIQUE PROPERTIES OF DEPRESSOR, RENAL, AND ALDOSTERONE RESPONSES TO ALISKIREN THERAPY IN HYPERTENSIVE PATIENTS WITH NEPHROPATHY
Authors: Saita Mitsuhiko
Published: January 2023

Objective:

Blood pressure (BP) control using renin-angiotensin system (RAS) inhibitor as a first choice is recommended in hypertension accompanied by chronic kidney disease (CKD), and RAS localized in the kidney is known to exist independent of circulating RAS. Aliskiren, direct renin inhibitor (DRI), is most excellent in kidney tissue migration among RAS inhibitors despite it has been reported to cause aldosterone breakthrough like angiotensin II receptor blocker (ARB) in essential hypertension. Therefore, DRI-induced antihypertensive, renoprotective and aldosterone-suppressing effects were investigated as compared to those of ARB in hypertensive CKD patients.

Design and method:

168 hypertensive patients with CKD (stage G1–4) were employed in this study. Home BP in the morning, estimated glomerular filtration rate (eGFR), urinary protein/creatinine ratio (UPCR), urinary liver-type fatty-acid-binding protein (U-LFABP) as an indicator of tubular dysfunction, plasma and urinary aldosterone concentration (PAC and UAC) were measured before and 0.5 to 5 years after administration of ARB or DRI and assessed retrospectively. Aldosterone breakthrough was defined as any increase in PAC from the baseline level following treatment with a RAS inhibitor.

Results:

In ARB-treated group, BP and UPCR decreased significantly at 6 months, but sufficient declines were not observed 1st year onward. In DRI-treated group, a significant reduction in BP was sustained until 3 years and BP unchanged decreasing tendency even 4 years later, meanwhile UPCR decreased significantly for 2 years and was below the pretreatment value 3 years after. ARB raised BP and UPCR again in patients with CKD G3–4 prior to those with CKD G1–2, however, DRI expressed no difference between stages. Although PAC diminished up to 6 months in ARB group and 1 year in DRI group, it turned up 1 year and 2 years after, respectively. PAC-ascensive rate and maximum elevation in PAC were higher and greater in ARB group than in DRI group (48.7 vs 22.6%, 56.1 vs 29.3pg/ml). All significant differences in rising PAC cases disappeared by 5 years, whereas in non-rising PAC cases, only DRI reduced U-LFABP without deterioration in eGFR and UAC further lowered while PAC was maintained.

Conclusions:

In comparison with ARB, aliskiren prolongs hypotensive and proteinuria-lowering effects with retained eGFR regardless of CKD severity possibly via improvement of tubular disorders and less PAC reascent in hypertensive nephropathy. Aliskiren given to CKD patients might elicit mild and delayed aldosterone breakthrough rather than ARB due to a direct action against aldosterone derived from the kidney.
PS-C26-9: A URINARY PEPTIDOMICS APPROACH FOR EARLY STAGES OF CARDIOVASCULAR DISEASE RISK: THE AFRICAN-PREDICT STUDY
Authors: de Beer Dalene , Mels Catharina MC , Schutte Aletta E , Delles Christian , Samji Sheon M , Mullen William , Mischak Harald , Kruger Ruan
Published: January 2023

Objective:

Cardiovascular disease (CVD) affects individuals across the lifespan with multiple cardiovascular (CV) risk factors increasingly present in young populations. The underlying mechanisms in early cardiovascular disease development are complex and still poorly understood. We therefore employed urinary proteomics as a novel approach to gain better insight into the early CVD-related molecular pathways based on a CVD-risk stratified approach.

Design and Methods:

This study included 964 apparently healthy (no self-reported chronic illnesses and free from clinical symptoms of CVD) black and white men and women (aged 20–30 years old) from the African-PREDICT study. Cardiovascular risk factors used for stratification included obesity, physical inactivity, tobacco use, high alcohol intake, hyperglycemia, dyslipidemia and hypertension. Participants were divided into low (0 risk factors), medium (1–2 risk factors) and high (3 or more risk factors) CV risk groups. We analyzed urinary peptidomics profiles by capillary electrophoresis time-of-flight mass spectrometry.

Results:

Upon adjusting for ethnicity, we identified 293 sequenced urinary peptides that were differentially expressed between the CV risk groups (all q-value smaller or equal to 0.01). These peptides included a lower abundance of collagen type I and a higher abundance of collagen type III derived peptides in the high compared to the low CV risk group. We also found a lower abundance of fibrinogen alpha and alpha antitrypsin 1 and a higher abundance of uromodulin derived peptides in the high compared to the low CV risk group (all q-value smaller or equal to 0.007).

Conclusion:

Our findings point out different abundances in collagen I and III between the high compared to low CV risk group, suggesting potential early alterations in the CV extracellular matrix.
PS-P07-2: KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING TRADITIONAL MEDICINE AMONG PATIENTS WITH HYPERTENSION IN OMAN
Authors: Maskari Ahmed Al , Maamari Qasim Al , Riyami Hassan Al , Nadar Sunil K
Published: January 2023

Background and Aims:

The aim of the study was to assess the knowledge, attitudes and practices with regards to use of traditional medicine(TM) among patients with hypertension in Oman and to assess the characteristics that favor its use

Methods:

This was a cross sectional questionnaire-based study. All Omani nationals above the age of 18, who were diagnosed with hypertension were eligible to be enrolled. The questionnaire consisted of questions regarding the knowledge, attitudes and use of TM practices.

Results:

There were 121 (out of 150) responses to the questionnaire (response rate of 69.3%) of which 104 (mean age 44_11.6 years; 92 or 88.5% male) were complete and used for analysis. Majority of the respondents (90.4%) are aware of the different types of TM. A high percentage (90.4%) feel that it is effective. 74(71.2%) had tried at least one method, though only 29(27.9%) had tried it specifically for hypertension. There was no difference between age, genders, occupation or educational status. between those who had tried or not, though there was a trend towards those who had tried some form of TM to being non significantly older (45.61 + 11.9 years vs 41.4 + 10.2 years, p = 0.09), Cupping (58.6%) and herbal medications (49.1%) were the most common form of TM that was practiced. Backpain (47.4%)and headaches(44.2%) were the main reason for using TM among these patients. For reducing blood pressure, the main forms of TM used were herbal medications(82.8%), branding(78.2%) and cupping (75.9%). Most of the patients (90.4%)felt that these practices were effective. Around half of patients 43(41.3%) said that they had used these practices alongside modern medicine. Only 7.7% said that they had any side effect, and 63(60.6%) said that they would use it again. However, only 18(17.3%) said that they would encourage others to use it. Of those who had not used any TM practice, majority (90%) felt that they did not know enough about it to use it while only 12% said that they did not believe in its efficacy. 90% of them also said that they would like to try it in the future.

Conclusion:

There is widespread use of TM practices among the hypertensive patients in Oman. Better understanding of their benefits will help incorporate them into modern health care services.
PS-P09-1: ASSOCIATIONS OF FATS AND CARBOHYDRATE INTAKE WITH METABOLIC SYNDROME IN CHINESE POPULATION
Authors: Xia Yanjie , Yin Lu , Wang Chuangshi , Li Wei
Published: January 2023

Background:

Low carbohydrate diets, which restrict carbohydrate in favour of increased protein or fat intake, or both, are a popular weight-loss strategy. However, it remains unclear whether a high-carbohydrate is more metabolically harmful or a high-fat or high protein is more metabolically harmful, and the optimal amount of carbohydrates and fat and protein has not been determined. The aim of our study was to examine the role of carbohydrate and fat and protein intake in Metabolic Syndrome (MetS) in a Chinese population.

Methods:

This study is a cross-sectional component of Prospective Urban Rural Epidemiology (PURE)-China study, which recruited over 46,000 participants from 70 rural and 45 urban communities between 2005 and 2009. Dietary intake of 43,494 individuals was recorded using validated food frequency questionnaires. MetS was defined according to The 2016 guidelines for prevention and treatment of dyslipidemia in Chinese adults, as having any 3 of the following 5 criteria: elevated blood pressure (BP) (systolic BP more than 130 mm/Hg or diastolic BP more than 85 mm/Hg or treatment of hypertension); low high-density lipoprotein cholesterol < 1.00 mmol/dl; triglycerides more than 1.7 mmol/dl; increased waist circumference (more than 90 cm in males or more than 85 cm in females); or fasting glucose more than 6.1 mmol/dl or having antidiabetic medication. Multivariate logistic regression model was used to examine the association between snoring habits and MetS. Participants were divided into quintiles of nutrients intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with MetS risk. Odds ratio (OR) is calculated by using multivariable logistic regression.

Results:

Among 43,494 participants, after adjusted for age, sex, smoke and drink status, education, waist-to-hip, physical activity, urban and rural, and energy intake, multiple logistic regression showed that both higher carbohydrate and protein intake was associated with a decreased risk of MetS (highest [quintile 5] vs lowest [quintile 1]) category, OR 0.82 [95% 0.75–0.89], ptrend < 0.001 and 0.75 [95% 0.62–0.91], ptrend < 0.001). Total fat and saturated and unsaturated fats were not significantly associated with risk of MetS.

Conclusion:

High carbohydrate and high protein intake was associated with lower risk of MetS. Total fat and types of fat were not associated with lower MetS. Chinese dietary guidelines should be reconsidered in light of these findings.
PS-P10-4: A NOVEL AND NONINVASIVE RISK ASSESSMENT SCORE AND ITS CHILD-TO-ADULT TRAJECTORIES TO SCREEN SUBCLINICAL RENAL DAMAGE IN MIDDLE AGE
Authors: Chen Chen , Mu Jianjun
Published: January 2023

This study aimed to develop a noninvasive, economical and effective subclinical renal damage (SRD) risk assessment tool to identify the high-risk asymptomatic people from large-scale population and improve current clinical SRD screening strategies. 2303 participants were included from Hanzhong Adolescent Hypertension Cohort, an ongoing prospective study followed for 30 years. Three noninvasive prediction factors (SBP, DBP and BMI) were identified as SRD-associated variables. Based on these three variables., an SRD risk assessment score with excellent classification ability (AUC value of ROC curve: 0.778 for SRD estimation, 0.729 for 4-year SRD risk prediction), calibration (Hosmer-Lemeshow goodness-of-fit test P = 0.62 for SRD estimation, P = 0.34 for 4-year SRD risk prediction) and more potential clinical benefits was developed. In addition, we identified three child-to-adult SRD risk assessment score trajectories: increasing, increasing-stable and stable. Further difference analysis and logistic regression analysis also showed these SRD risk assessment score trajectories were highly associated with the incidence of SRD in middle age. In brief, we developed a novel and noninvasive SRD risk assessment tool with excellent performance to help identify high-risk asymptomatic people from large-scale population and assist in SRD screening.

JOURNAL/jhype/04.03/00004872-202301001-01109/figure1/v/2023-10-24T163949Z/r/image-jpeg
PS-R03-2: UNILATERAL PRIMARY ALDOSTERONISM AND CONTRALATERAL GROWING ADRENAL MASS: GROWING CONCERN FOR PHEOCHROMOCYTOMA
Authors: Miyamoto Shotaro , Yoshida Yuichi , Ozeki Yoshinori , Okamoto Mitsuhiro , Gotoh Koro , Masaki Takayuki , Nishida Haruto , Fujinami Hiroyuki , Shin Toshitaka , Daa Tsutomu , Asayama Yoshiki , Shibata Hirotaka
Published: January 2023

Concomitant unilateral primary aldosteronism (PA) and pheochromocytoma is extremely rare. A 52-year-old previously healthy woman with no family history of endocrine disease was admitted to our hospital with suspected PA based on high blood pressure, spontaneous hypokalemia, and a high aldosterone-to-renin ratio. She had no catecholamine excess symptoms other than hypertension. Abdominal computed tomography (CT) showed a right lipid-rich adrenal mass and a left lipid-poor adrenal mass. PA was diagnosed by the captopril challenge test. The 24-h urinary fractionated metanephrines were slightly elevated. Adrenal vein sampling (AVS) confirmed that the right adrenal gland was responsible for aldosterone hypersecretion. Medical therapy with eplerenone was started because the patient refused surgery. Five years later, she requested surgery for PA. The second AVS confirmed right unilateral hyperaldosteronism, as expected. Repeat abdominal CT showed the enlargement of the left adrenal mass. The 24-h urinary fractionated metanephrines had risen to the diagnostic level. 123I-MIBG scintigraphy showed a marked accumulation in the left adrenal tumor with no metastatic lesion. After preoperative management of alpha-blockade, laparoscopic left partial adrenalectomy was performed. Immunohistochemical examination of the tumor showed chromogranin A positivity leading to the diagnosis of left pheochromocytoma. One year after surgery, blood pressure and serum K levels remain well controlled. No surgical treatment for the right adrenal mass has been performed, and PHEO has not recurred. This case highlights the potential pitfalls in the treatment and diagnosis of unilateral primary aldosteronism with contralateral pheochromocytoma.

In cases of unilateral PA with contralateral lipid-poor adrenal mass, clinicians should rule out if the contralateral adrenal mass is pheochromocytoma to proceed to undergo unilateral adrenalectomy for the treatment of PA.
PS-R03-11: ANTI-NMDA RECEPTOR ENCEPHALITIS: SEIZURES AND PSYCHOSIS: A CASE REPORT ABOUT 18-YEAR OLD ADMITTED AT ARMMC
Authors: Alfonso Ma Cassandra Carranza , Manongas Ken Pham , Tagayuna Criselda Allas
Published: January 2023

Introduction:

Anti-NMDA receptor encephalitis is one of many autoimmune diseases that need further recognization. Its signs and symptoms are indefinite and there is no specific pathognomic sign that can be use to properly diagnosed the disease immediately. Therefore more often these patients are prone to misdiagnosis. Many reports claimed that it is directly associated with ovarian teratomas in women though in some reports it can also be seen in males. This case helps in further recognizing anti-NMDA receptor encephalitis especially in our country where there are only few cases reported.

Case:

The case presented is about an 18-year old female from Mindoro Philippines who was previously well and had sudden changes in behavior with seizures episodes. Patient had consult at their local hospital where she was being treated as a case of viral meningitis but apparently no improvement was noted and subsequently transferred to a tertiary hospital in Metro Manila for further evaluation and management. During her hospital stay at Amang Rodriguez Memorial Medical Center patient presented as seizures with abnormal psychiatric features where she was eventually suspected to have anti-NMDA (anti-N-methyl-D-aspartate) receptor encephalitis but further testing was done initially to rule out other neurologic diseases. Almost all laboratories and radiologic tests turn out to be normal hence a video electroencephalogram (EEG) was requested and result was that the patient is suggestive to have the said disease. Definitive test for anti-NMDA receptor encephalitis was done which turned out positive. The patient was then treated as a case of anti-NMDA receptor encephalitis and manage accordingly. Improvement was noted and the patient was then discharged subsequently.

Conclusion:

There may be increasing cases of anti-NMDA receptor encephalitis worldwide further research must still be done to be able to understand its features diagnose and manage it appropriately. And since it is more common in young adult females anti-NMDA receptor encephalitis must be suspected and be taken into consideration when there is a patient who presented with sudden changes in behavior with psychosis and seizures.
PS-R04-8: DIFFERENTIAL RECOVERY OF IMPAIRED ENDOTHELIAL AND RENAL FUNCTION IN A CASE OF MALIGNANT HYPERTENSION
Authors: Hayashi Shinichiro , Iwashima Yoshio , Ohta Yuko , Kusunoki Hiroshi , Kusano Kengo , Rakugi Hiromi , Morishita Ryuichi , Kawano Yuhei
Published: January 2023

A 37-year-old man with no past history of hypertension presented with no symptoms but with acutely elevated blood pressure (230/140mmHg) and proteinuria (> 300 mg/dL). Fundoscopic appearance represented grade IV hypertensive retinopathy with papilledema, flamed-shaped hemorrhages, exudates and arteriovenous nipping, indicating typical features of the malignant hypertension. The laboratory tests at admission indicated the possible organ damages in kidney and heart (eGFR 21 mL/min/1.73m2, BNP 263pg/mL). The other examinations are normal. After 20 days of treatments with amlodipine, azilsartan and carvedilol, the average of multiple blood pressure measurements and BNP showed almost normal levels (146/87mmHg, BNP < 10pg/mL), although eGFR level was still under 30. In addition, at this time point, flow mediated dilation (FMD), a noninvasive index of vascular endothelial function measured in forearm, showed significant impairment of endothelial function (%FMD 2.6). At 60 days, fundoscopic images represented entire restoration of retinopathy with disappearance of papilledema, hemorrhage and exudates. In contrast, however, both endothelial and renal function were still under normal levels (%FMD 3.2, eGFR 28.2 mL/min/1.73m2). Notably, FMD showed improvement of sustained endothelial dysfunction at day 90 (% FMD 7.5), while a little recovery of renal function was observed at 360 days (eGFR 35.4 mL/min/1.73m2). This case represents the possibility that damaged endothelial and renal function in acute severe hypertension seem to be still reversal with appropriate anti-hypertensive treatment, while differential time-course recovery in each organ might be existed.
PS-R05-6: A CASE OF ACUTE KIDNEY INJURY WITH THROMBOTIC MICROANGIOPATHY CAUSED BY MALIGNANT HYPERTENSION
Authors: Nakagawa Terumasa , Shimasaki Akiko , Miura Rei , Inoue Hideki , Minami Shogo , Ko Takehiro , Izumi Yuichiro , Kuwabara Takashige , Adachi Masataka , Kohda Yukimasa , Mukoyama Masashi
Published: January 2023

A 31-year-old man was transferred to our hospital because of severe hypertension, acute kidney injury (AKI) and thrombotic microangiopathy (TMA). A month earlier, the patient sought medical attention for epigastric pain. Upper gastrointestinal endoscopy revealed hemorrhagic gastric ulcer, and hemostasis was performed. At that time, his was found to have severe high blood pressure (200/140 mmHg), together with low levels of hemoglobin (Hb) (10.5 g/dL) and platelet (Plt) count (107 x 109/L). One week later, gastric ulcer tended to improve, but the blood pressure was still high (192/122 mmHg), along with severe abnormalities in creatinine (Cr) (10.7 mg/dL), Hb (6.6 g/dL) and Plt levels (139 x 109/L). On the following day, the serum Cr level increased to 13.7 mg/dL, while Hb and Plt levels decreased to 6.3 g/dL and 111 x 109/L, respectively. He was referred and admitted to a local affiliated hospital. Because the patient was considered as AKI due to dehydration and anemia, fluid replacement and blood transfusion were performed. However, his renal function was worsened further and pulmonary congestion appeared, which required initiation of hemodialysis therapy. Because low platelet counts, high LDH levels and schistocytes in peripheral blood were observed, he was diagnosed with TMA and transferred to our hospital. Laboratory data on admission revealed as follows: the plasma renin activity (PRA), 7.8 ng/ml/h, plasma aldosterone concentration (PAC), 443 pg/mL, plasma adrenaline, 12 pg/mL, noradrenaline, 172 pg/ml, ACTH, 17.3 pg/mL, cortisol, 6.9 g/dL, and TSH, 1.71 IU/mL. Renal artery stenosis was not observed by renal artery ultrasound. Echocardiography showed hypertrophy of the left ventricle. Funduscopic examination showed retinal hemorrhages. Renal biopsy revealed a large number of collapsed glomeruli, onion skin lesions in the arterioles and interlobular arteries, luminal narrowing due to thrombosis, and fibrin accumulation on the blood vessel walls, which lead to histological diagnosis of malignant nephrosclerosis and TMA. Intensive treatment with a calcium channel blocker, an ACE inhibitor, and other antihypertensive agents resulted in improved hypertension, and normalized platelet count and LDH levels, together with reduced PRA (3.2 ng/ml/h) and PAC (208 pg/mL). However, withdrawal from hemodialysis was not achieved. We consider that in this case TMA was caused by malignant hypertension due to essential hypertension. We conclude that early detection and intervention for hypertension are mandatory to prevent the progression of malignant hypertension and related organ damages.
PS-B10-1: DIFFERENT MECHANISMS OF BLOOD PRESSURE REDUCTION INDUCED BY CHRONIC PERORAL OR INTRACEREBROVENTRICULAR CLONIDINE ADMINISTRATION IN SALT-DEPENDENT OR ANGIOTENSIN II-DEPENDENT HYPERTENSION
Authors: Zicha Josef , Rezacova Lenka , Behuliak Michal , Vaneckova Ivana
Published: January 2023

Objective:

The agonists of alpha2-adrenergic receptors are known to lower blood pressure (BP) through a reduction of brain sympathetic outflow but their chronic antihypertensive effects in rats with low-renin or high-renin forms of experimental hypertension were not studied yet. Moreover, there is no comparison of mechanisms underlying BP reduction elicited by chronic peroral (PO) or intracerebroventricular (ICV) clonidine treatment.

Design and Methods:

Adult male Dahl S rats fed 4% NaCl diet and Ren-2 transgenic rats were treated with clonidine administered either in the drinking fluid (0.5 mg/kg/day PO) or via the infusion into the lateral brain ventricle (0.1 mg/kg/day ICV) for 4 weeks. Basal BP as well as the contributions of renin-angiotensin system or sympathetic nervous system (acute BP responses to intravenous injection of either captopril 10 mg/kg or pentolinium 5 mg/kg) to BP maintenance were determined in conscious cannulated rats at the end of the study.

Results:

Both peroral and intracerebroventricular clonidine treatment lowered BP to the same extent in either rat model. However, in both models chronic clonidine treatment reduced sympathetic BP component only in rats treated intracerebroventricularly but not perorally treated animals. In contrast, peroral clonidine treatment reduced angiotensin-dependent vasoconstriction in Ren- transgenic rats, whereas it lowered residual BP in Dahl rats.

Conclusions:

Our results indicate different mechanisms of antihypertensive action of clonidine depending on the route of its administration - central or systemical
PS-B10-3: POST-STROKE LEARNING IMPAIRMENT IS AUGMENTED IN HYPERTENSIVE MICE
Authors: Zhang David Edward Wong , Drummond Grant Raymond , Sobey Christopher Graeme , Aruguman Thiruma Valavan , Selvaraji Shamelee , De Silva Travice Michael
Published: January 2023

Objective:

Cognitive impairment is disorder that can arise as a result of cardiovascular pathology or cerebrovascular injury. Due to the aging population, the incidence of cognitive impairment is expected to rise. Hypertension is a major risk factor for stroke and cognitive impairment, but it is unclear whether it may affect post-stroke cognitive outcomes. This study aims to assess the effects of hypertension and/or stroke on the brain and its effect on cognitive impairment.

Design and method:

C57BL/6J mice (n = 117) aged 3–5 months received infusion of either saline or angiotensin II (0.7 mg/kg/day for 14d or 0.28 mg/kg/day for 28d). 7 d after minipump implantation mice received either sham or photothrombotic stroke surgery targeting the prefrontal cortex. The Barnes maze was utilised to assess cognitive function. RNA sequencing was used to quantify transcriptomic changes in the brain.

Results:

Angiotensin II increased blood pressure (normotensive: 118 ± 1 mmHg vs. hypertensive: 149 ± 2 mmHg; P < 0.05). In the Barnes maze, hypertensive mice that received stroke surgery had increased latency to enter the escape hole when compared to other groups (day 3 escape latency: hypertensive + stroke = 166.6 ± 6.0 s vs. hypertensive + sham = 122.8 ± 13.8 s vs. normotensive + stroke = 139.9 ± 10.1 s vs. normotensive + sham = 101.9 ± 16.7 s), consistent with a greater learning impairment. Interestingly, we observed 5 incidences of haemorrhage within the HT + stroke group. RNA sequencing revealed > 1500 differentially expressed genes in hypertensive + stroke vs. hypertensive + sham, including genes related to inflammation and synaptic function.

Conclusions:

These findings indicate that the combination of hypertension and stroke resulted in greater learning impairment and brain injury. If transferrable to humans, the present data suggest that therapeutic approaches to effectively treat hypertension are likely to mitigate worsened post-stroke cognitive outcomes.
PS-B10-7: A VASCULAR SMOOTH MUSCLE POTASSIUM CHANNEL DYSFUNCTION UNDERLIES SMALL VESSEL DISEASE OF THE BRAIN IN BOTH HYPERTENSION AND ALZHEIMER'S DISEASE
Authors: Taylor Jade L , Pritchard Harry AT , Walsh Katy R , Danby Thea GE , Hennig Grant , Allan Stuart M , Nelson Mark T , Greenstein Adam S
Published: January 2023

Alzheimer's disease (AD) and hypertension-related vascular dementia share many common clinical and radiological features. Indeed, at post-mortem the majority of patients diagnosed with either disorder show extensive small vessel disease (SVD) of the brain. One phenotypic character of SVD is a reduction in cerebral blood flow (CBF). The large-conductance calcium-activated potassium (BK) channel reduces arterial contractility through hyperpolarisation of the vascular smooth muscle cell membrane. The BK channel is activated via small, localised calcium release events from ryanodine receptors (RyR), known as calcium sparks. We wished to examine whether defects in calcium spark to BK channel coupling contributes to the SVD phenotype in these diseases, which could suggest new avenues for therapy based on improvement of brain vascular health.

Male spontaneously hypertensive (BPH/2) mice and normotensive controls (BPN/3) were used at 8 months of age to study hypertension-induced cSVD. To study AD we used 18–20 month old male APP23 mice that have a 7-fold increased expression of amyloid precursor protein, which results in significant amyloid-beta accumulation as is seen in human AD. During this study we used a range of physiological techniques; mainly pressure myography, patch clamp electrophysiology and high-speed spinning disc confocal microscopy, to investigate in depth, vascular ion channel function within the cerebral microvasculature of these mice.

Pressure-induced constriction from cerebral pial arteries was significantly greater in both the BPH/2 and APP23 animals compared to controls. Pressure myography studies revealed that in both models there was a reduction in BK channel activity. This was confirmed with electrophysiology data that showed a decrease in spontaneous transient outward currents, which represent BK channel openings in response to calcium sparks. In the APP23 model, this reduction in BK channel function was due to a decrease in calcium spark frequency. However in the BPH/2 mice, spark frequency was equal between hypertensive individuals and controls. In this model separation of the BK channel and RyR resulted in BK channel dysfunction.

Overall our data indicates that vascular BK channel dysfunction is a common mechanism underpinning reduced CBF in SVD. Therefore, therapies aimed at improving vascular BK channel function could provide new therapeutic targets for the treatment of both AD and hypertension-induced vascular dementia.
PS-B11-8: ONE NOVEL MIRNA WITH 4 MRNA TARGETS WAS IDENTIFIED IN PERIPHERAL BLOOD MONONUCLEAR CELLS OF HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME
Authors: Berillo Olga , Huo Kugeng , Fraulob-Aquino Julio C , Richer Chantal , Li Na , Briet Marie , Lipman Mark L , Sinnett Daniel , Paradis Pierre , Schiffrin Ernesto L
Published: January 2023

Objective:

Hypertension (HTN), metabolic syndrome (MetS) and chronic kidney disease (CKD) are global health disorders that are epidemiologically associated. The immune system plays a role in hypertension and target organ damage. MicroRNAs are crucial post-transcriptional regulators of immune cell development and function. We hypothesized that microRNAs play a role in activation of immune cells in hypertension with target organ damage in humans.

Design and method:

Normotensive subjects (NTN) and patients with HTN associated or not with at least 2 other features of the MetS or with CKD were studied (n = 15–16). Peripheral blood mononuclear cells (PBMCs) were isolated, RNA extracted, small and total RNA sequencing (RNA-seq) done using Illumina HiSeq-2500 and data analyzed using a systems biology approach. Differentially expressed (DE) microRNAs and mRNAs were identified with fold change (FC) > 2 and > 1.5, respectively, and P < 0.005. The most representative DE miRNA isoforms with RNA-seq count number (CN) > 500, and with predicted targets by TargetScan with CN> 300 were validated by reverse transcription-quantitative PCR (RT-qPCR) in PBMCs.

Results:

RNA-seq identified DE microRNAs and mRNAs in HTN (22 and 19), MetS (57 and 401) and CKD (6 and 26) compared to NTN. Three of 14 selected miRNAs were validated by RT-qPCR. miR-409–5p and miR-411–5p were decreased respectively by 46% (P < 0.05) and 60% (P < 0.001), whereas the novel miR-pl-86 was increased 2-fold (P < 0.05) in MetS vs NTN. RT-qPCR data showed that tubulin alpha 1a (TUBA1A) predicted as mRNA target for miR-409–5p and miR-411–5p was increased 1.9-fold in MetS vs NTN group (P < 0.05). However, there was no correlation between RT-qPCR and RNA-seq data for TUBA1A. RT-qPCR data validated the decrease of 4 predicted miR-pl-86 targets. WD repeat domain 89 (WDR89), Dmx like 1 (DMXL1), zinc finger protein 600 (ZNF600) and NOC3-like DNA replication regulator (NOC3L) were decreased by ≧ 50% in MetS vs NTN (P < 0.05). RT-qPCR data demonstrated a correlation with RNA-seq data for miR-pl-86 (R2 = 0.37, P < 5.5E-07, n = 56), WDR89 (R2 = 0.29, P < 1.4E-05, n = 57), DMXL1 (R2 = 0.33, P < 2.7E-06, n = 57), ZNF600 (R2 = 0.25, P < 7.9E-05, n = 57), and NOC3L (R2 = 0.27, P < 3.5E-05, n = 57).

Conclusion:

This study identified one up-regulated novel microRNA and 4 down-regulated mRNA targets in PBMCs of patients with HTN and MetS. The role of this miRNA and mRNAs in immune cells of HTN patients with MetS needs to be determined.
PS-B11-11: IMPLICATIONS OF OBESITY ON MALE FERTILITY HORMONES
Authors: Amusat Saheed Oladele
Published: January 2023

Background:

The prevalence of obesity is alarming, with prevalence reported from 24 to 36% in developed worlds and a global estimate of adult obesity at over 11%. The relationship between obesity and infertility in men has been emphasized in multiple studies. However, there is a paucity of studies on the disparity between obese and overweight men fertility profiles. Therefore, this study aims to investigate the sex hormones distribution in overweight and obese men.

Method:

A retrospective case-control study on reproductive hormones in obese and overweight participants was conducted on 789 NHANES 2015–2016 survey data. Of the 789 participants, 229 were control, 270 were overweight, and 290 were obese between 18–80 years of age. We compared the mean plasma level of testosterone, estradiol, and Sex Hormone Binding Globulin (SHBG) among the groups using one-way ANOVA and mean differences using Tamhane post hoc tests.

Results:

There was a significant increase in the mean testosterone, and SHBG levels in the control group compared with overweight and obese subjects. However, a significant increase in mean estradiol was observed in the obese compared with overweight and control groups. Interestingly, there was no significant difference in the estradiol level between the control and overweight groups. There was a significant increase in BMI in the obese group compared with overweight, and control groups.

Conclusion:

Obesity has negative feedback effects on testosterone and SHBG production. However, an unknown mechanism contributes to the lower estradiol level in overweight relative to obese men. Therefore, there is a need to research the molecular basis of fertility hormone metabolism in obese and overweight men.
PS-C28-1: EARLY DETECTION OF DEMENTIA AT COMMUNITY PHARMACIES USING SIMPLE TOUCH PANEL SCREENING CHECK
Authors: Kai Mamiko , Tominaga Koji , Morita Kazutoshi , Soda Yoshio , Sejima Ei , Dendo Hitomi , Yamaguchi Ryosuke , Takada Makiko , Akura Hiroshi , Ono Kazuhiko , Hayashi Toshinobu , Iida Hitoshi , Ogomori Koji , Kawasaski Hiroaki , Egawa Takashi
Published: January 2023

Objective:

The purpose of this study was to examine whether a simple touch panel screening check for dementia (TPCD) would be effective for early detection of dementia at community pharmacies.

Design and Methods:

This was a prospective study of adult visitors presenting to a pharmacy adjacent to a university hospital (Project 1) or to a general physician clinic (Project 2). Participants were voluntarily recruited in the pharmacies and were registered after written informed consent. To evaluate the cognitive function of participants, we scored immediate and recent memories of words, time orientation, figure recognition using a Forgetfulness Consultation Program MSP-1100 (Nihon Kohden, Tokyo). When the score was or less than 12 out of 15 points, participants were suspected as having dementia and recommended to visit the psychiatric outpatient clinic of the university hospital (Project 1) or to visit the general physician (Project 2). On the next visit to the pharmacy, the participants were asked whether they had received the consultation of the psychiatric specialists.

Results:

[Project 1] TPCD was conducted on 81 individuals (35 men) from January 2019 to January 2020. One was excluded because of agreement withdrawal and another was excluded because he had already been treated for dementia at another clinic. Of 79 participants, 17 (21.5%, 8 men) were suspected as having dementia and were recommended to visit the psychiatric clinic. Two participant visited psychiatric specialists and were diagnosed as having mild cognitive impairment. Four consulted with their family physicians but have not yet visit the psychiatric clinic. Eleven refused the consultation. [Project 2] Currently, TPCD was conducted on 30 individuals (8 men) and 10 (33.3%, 3 men) were suspected to having dementia from January 2021 to April 2022. The recruitment is now ongoing.

Conclusion:

This preliminary analysis suggests that TPCD in pharmacies may be effective for early detection of dementia. It is necessary to strengthen the pass to support the consultation visit to psychiatric specialists.
PS-C29-7: ASSOCIATION OF SERUM LEPTIN TO ADIPONECTIN RATIO AND CARDIOVASCULAR STRUCTURAL INDICES IN ESSENTIAL HYPERTENSIVE PATIENTS WITHOUT CHRONIC KIDNEY DISEASE
Authors: Ohara Maiko , Koike Tsutomu , Tomoda Fumihiro , Yamazaki Hidenori , Kinugawa Koichiro
Published: January 2023

Objective:

Dysregulated leptin and adiponectin profile is known to be associated with atherosclerotic disease. The evaluation of the leptin to adiponectin (L/A) ratio has been suggested as a powerful useful atherosclerotic index compared with adiponectin and leptin alone in patients with type 2 diabetes and obesity. In this study, we investigated the usefulness of L/A ratio for vascular structural abnormalities in essential hypertensive patients.

Design and method:

In 151 untreated essential hypertensive patients (86 males, average age 56 ± 12 years) without chronic kidney disease (urinary albumin excretion (UAE) less than 300 mg/g of creatinine and estimated glomerular filtration rate 60 mL/min/1.73m2 or more), blood sampling, 24-hour urine collection, and 24-hour blood pressure monitoring were performed. Intima-media thickness of carotid artery (IMT) and minimal forearm vascular resistance (MVR) (wall to lumen ratio in resistance vessel) were also measured by using ultrasonography and strain-gauge plethysmography, respectively.

Results:

L/A ratio was higher in men than in women (1.23 ± 1.56 vs 0.73 ± 0.87, p < 0.05). There was no correlation between L/A ratio and systolic and diastolic blood pressure, and pulse rate. L/A ratio correlated positively with body mass index, triglyceride, hemoglobin A1c, HOMA-R and urinary C-peptide excretion (r = 0.57, 0.20, 0.20, 0.31, 0.27, p < 0.05, respectively) and negatively with HDL-cholesterol (r = -0.24, p < 0.05). In addition, UAE, IMT and MVR were increased accompanying incremental L/A ratio (r = 0.20, 0.17, 0.19, p < 0.05, respectively)In addition, UAE, IMT and MVR were increased accompanying incremental L/A ratio (r = 0.20, 0.17, 0.19, p < 0.05, respectively), whereas these indices did not associated with leptin and adiponectin individually. In multiple regression analysis, L/A ratio was an independent determinant for UAE, IMT and MVR.

Conclusions:

In patients with essential hypertension, L/A ratio was associated with obesity, abnormal glucose and lipid metabolism, increase in microalbuminuria, and arterial and arteriolar sclerosis. L/A ratio was considered as a useful indicator of vascular structural abnormalities in patients with essential hypertension.