bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P116: Differences In Shared Decision Making Among Patients With Hypertension
Authors: Elias Sabrina , Perrin Nancy , Wenzel Jennifer , Slone Sarah , Lewis Krystina B , Turkson-Ocran Ruth-Alma , Ogungbe Oluwabunmi , Commodore-Mensah Yvonne , Himmelfarb Cheryl R
Published: October 2023

Background:
Shared decision-making (SDM) is sanctioned by US legislation and promoted by hypertension guidelines. However, evidence is scarce for ethnically diverse groups. We aimed to examine the relationships between SDM, blood pressure, self-identified race/ethnicity, and baseline characteristics among patients with hypertension.

Methods and results:
Secondary data analysis of a pragmatic clinical trial with individuals with uncontrolled hypertension using linear regression and generalized estimating equations. Participants (n=1426) were predominantly middle-aged (mean 60 years ± 11.6), female (59.4%, 847), non-Latino Black people (59%, 844), and high school graduates or below (65%, 931). SDM was averaged at 7.2 (±2.6) out of 9, SBP at 152.2 (±12.0), and DBP at 85.3 (±12.1) mmHg. We found a greater reduction in SBP over time with higher SDM mean score (B -0.44, p 0.032). Positive association was found between SDM and patient activation (B 0.01, p=0.001), considering taking blood pressure medication as very important (B 0.56, p=0.022), and patients’ self-reported race/ethnicity. Non-Latino Black people had 0.74 points higher mean SDM score (p<0.001) than Non-Latino White people. On the contrary, the association was negative for knowing that high blood pressure is the same as hypertension (B -0.35, p 0.046), and education. Those with more than high school education had lower mean SDM (B -0.44, p 0.045).

Conclusions:
Future research should further explore SDM differences among racial/ethnic groups to better align care with needs of patients with hypertension. Our results offer actionable information to enhance clinical practice and policy development.
Abstract P118: The Promotion Of Cardiac Dysfunction By Resiquimod-accelerated Systemic Lupus
Authors: Hawkins Kennedy P , Colvert Alex , McCrorey Marice , Deleon-Pennell Kristine Y , Cunningham Melissa A , Van Beusecum Justin P
Published: October 2023

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by autoantibody formation and immune complex deposition in target organs. Individuals with SLE are more than twice as likely to experience a cardiovascular event than the rest of the population, contributing to the increased morbidity and mortality of individuals with this disease. While this increased risk of cardiovascular events in lupus is well known, SLE-specific phenotypes and mechanisms remain unknown. Therefore, we hypothesized that inducing the acceleration of SLE would lead to higher incidence of cardiovascular pathology in a lupus-prone murine model. To test this hypothesis, we treated female B6.Nba2 mice aged 10-14 weeks with Resiquimod (R848; 100μg/30μL), a TLR7/8 agonist shown to induce SLE, twice weekly for four weeks. The mice were followed with echocardiography every 4 weeks, up to 16 weeks. By 16 weeks, organs were harvested, weighed, and fixed or frozen for analysis. Echocardiographic imaging found left ventricular wall thickening 4 weeks after the start of R848 treatment. This was followed by a progressive increase in left ventricular internal dimensions, and a simultaneous decrease in ejection fraction (39.95 ± 0.05 vs 57.68 ± 1.12, p=0.0007) over the course of 16 weeks, culminating in significant cardiac dysfunction compared to vehicle controls. Moreover, tissue harvest revealed significant cardiomegaly (p<0.0001), as well as a four-fold increase in spleen weight of R848-treated mice compared to their vehicle treated counterparts. Furthermore, we investigated the mechanosensitive cation channel Piezo1 by protein and gene expression in cardiac tissues, and found that R848 acceleration of SLE significantly increased protein expression in the heart (1.37 ± 0.13 vs 1.00 ± 0.05, p=0.0208). Our data demonstrates that R848-accelerated SLE in female, lupus-prone B6.Nba2 mice does increase the occurrence of cardiac pathology compared to vehicle controls, and revealed potential for a Piezo-1 mechanism for cardiac dysfunction in Systemic Lupus. These findings present potentially new insight into the development of SLE-associated cardiovascular dysfunction.
Abstract P131: Global Burden Of Stroke Attributable To High Systolic Blood Pressure In 38 Oecd Countries: A Systematic Analysis For The Global Burden Of Disease Study 2019
Authors: Amin Vishrant , Lakkimsetti Mohit , Chenna Venkata Sai Harshabhargav , Gangannapalle Mahesh , Patel Charmy , Undaviya Devang , Dhawan Arushi , Gajjar Rohan , DESAI HARDIK D
Published: October 2023

Background:
High blood pressure (HBP) emerges as the primary leading cause of death and disability among all risk factors for stroke in Organization for Economic Cooperation and Development (OECD) countries.

Method:
This study employed the Global Burden of Disease methodology to evaluate mortality, DALY (Disability Adjusted Life Years) and YLD (Years Lived with Disability) associated with stroke attributable to HBP by age group, sex, year across the 38 OECD countries from 1990-2019.

Results:
The annual percentage change (APC) of deaths due to stroke attributable to HBP decreased by 22% (557,114-436,389) between 1990-2019, while DALY decreased by 26% (10,970,202-8,087,473) and YLD increased by 19% (1,451,842- 1,727,949). Among the OECD countries, Turkey exhibited the highest APC in deaths at 113% (11,476- 24,440). The highest APC in deaths was observed in the 95+ age group reaching 170% (13,578- 36,655) between 1990-2019.

Conclusion:
Despite a decreasing burden of stroke due to HBP, OECD countries continue to face significant mortality and DALY rates, necessitating ongoing efforts to reduce the burden.
Abstract P132: Life’S Essential 8 And Racial/ethnic Differences In Cardiometabolic Profile Of Ever Pregnant Adults In The United States: The National Health And Nutrition Examination Survey 2011-2020
Authors: ADELEYE Khadijat , Turkson-Ocran Ruth-Alma , Boakye Ellen , Kwapong Yaa A , Tomiwa Tosin , Ogungbe Oluwabunmi V
Published: October 2023

Background:
Cardiometabolic conditions are the leading cause of maternal mortality in the US. The AHA Life’s Essentials 8TM is an actionable summary measure for improving and maintaining cardiometabolic health.

Objectives:
To examine racial/ethnic differences in cardiometabolic profile using the AHA Life’s Essentials 8TM metric among US ever-pregnant adults.

Method:
We performed a cross-sectional analysis of 2011-2020 National Health and Nutrition Examination Survey (NHANES) data. Using AHA Life’s Essentials 8TM, we examined cardiometabolic risk factors: current smoking, high body mass index (BMI), high cholesterol, high blood pressure, high HbA1C/blood glucose levels, inadequate physical activity, poor diet, and poor sleep. We fitted Poisson regression models adjusting for age, income, insurance, and employment.

Result:
We included a weighted sample of 8,355 ever-pregnant adults (mean age: 51.8± 27.6 years). Compared to White adults, Black adults had a 36% (adjusted PRR:1.36, 95% CI: 1.25-1.48) higher likelihood of high blood pressure (Table). Black, Mexican and Asian adults had 72%, 81% and 57% higher likelihood of high blood glucose, respectively. The likelihood of poor diet was 34% and 41% higher among Black and Mexican adults, and they were 16% and 12% more likely to be overweight/obese, respectively. Mexican and Asian adults were less likely to smoke, and alongside Black adults were less likely to report poor sleep.

Conclusions:
There are racial differences in the cardiometabolic profile of US ever-pregnant adults, which may be driving maternal health disparities. Public health efforts are needed to improve maternal cardiovascular health.
Abstract P134: Does Co-morbid Obesity Change Hospitalization Outcomes In Patients With Hypertensive Crisis?
Authors: Karki Sadichhya , Teaima Taha , Gajjar Rohan , Jamshed Aneeza
Published: October 2023

Introduction:
The prevalence of hypertension and obesity has been soaring, emerging as major global health problems. Similarly, optimal management of hypertension in obese individuals has been a perpetual struggle due to barriers to accurate diagnosis, monitoring, and treatment, primarily due to complex body habitus and intricate underlying pathological facets.

Methods:
The National Inpatient Sample database (NIS) 2020 was employed to identify hospitalizations with Hypertensive crisis which were further dichotomized based on Co-morbid obesity using ICD-10 codes. The primary outcome was inpatient mortality. The secondary outcomes were inpatient complications, mean length of stay (LOS), and mean total hospital charge (THC). Multivariate linear and logistic regression analyses were utilized to adjust for possible confounders.

Results:
There were 132,995 patients with primary diagnosis of hypertensive crisis, of which 31,400 (23.6%) were obese. Analysis showed similar adjusted odds of inpatient mortality (Adjusted Odds Ratio [aOR]: 0.85, [95% CI: 0.43-1.67], p=0.57). Obese patients were more likely to develop acute coronary syndrome (ACS) during hospitalization (2.4% vs 2%, P=0.036), and acute kidney injury (AKI) (27.1% vs 23.7%, p<0.001) than non-obese patients with hypertensive crisis (Figure 1)

Conclusion:
Hospitalizations for hypertensive crisis among obese individuals had similar inpatient mortality compared to those with normal BMI. However, obese patients had higher odds for ACS and AKI. Further clinical studies should be directed toward this patient population to mitigate the associated risk and improve outcomes.
Abstract P142: Association Of COVID-19 With Hypertensive Crises Outcomes
Authors: Seok Minji , Muhyieddeen Amer , Gulati Martha
Published: October 2023

Introduction:
Patients with hypertension who contracted COVID-19 had increased risk of severe disease and hospitalization compared to those without. This analysis aimed to explore the effect of a concurrent COVID-19 diagnosis on patients admitted due to a hypertensive emergency in the first nine months of the pandemic.

Methods:
We examined data from the 2020 National Inpatient Sample to identify patients who were admitted for hypertensive emergency. We used ICD-10 codes to distinguish between those with and without a COVID-19 diagnosis. We employed logistic and linear regression analyses and accounted for potential confounders. We deemed the results as statistically significant when the 2-tailed p-value was <0.05.

Results:
In 2020, there were 1,221,535 hospitalizations for a principal diagnosis of hypertensive emergency with 9590 (0.78%) involving patients with a secondary diagnosis of COVID-19. After accounting for confounding factors, patients admitted for hypertensive emergency with COVID-19 exhibited a higher rate of in-hospital mortality (aOR 3.58, 95% CI 2.94-4.35), vasopressor initiation (aOR 1.88, 95% CI 1.27-2.77), and hemodialysis initiation (aOR 1.87, 95% CI 1.65-2.12) (Figure 1). These patients had longer hospital stays (7.90 days vs. 5.23 days, p<0.001) and incurred higher overall hospital costs ($78,775 vs. $61,331, p<0.001).

Conclusion:
Infection with COVID-19 appeared to play a significant role in patients admitted for hypertensive emergency. As COVID-19 settles into an endemic virus, the question of how its pathophysiology may drive more complicated disease in severely hypertensive patients remains an important point of study.
Abstract P143: Racial Disparities In Acute Renal Failure Incidence Amidst Hypertensive Emergencies
Authors: Seok Minji , Muhyieddeen Amer , Gulati Martha
Published: October 2023

Introduction:
Persons from diverse backgrounds are disproportionately affected by adverse outcomes related to hypertension. We aimed to examine the likelihood of requiring hemodialysis during hospitalization in patients admitted for hypertensive emergency by race.

Methods:
We analyzed the 2020 National Inpatient Sample data to evaluate patients primarily admitted for hypertensive emergencies and acutely required hemodialysis. Patients who were already on hemodialysis were excluded. To assess for correlations, we applied logistic and linear regression analyses, taking into account potential confounders. The threshold for statistical significance was established at a 2-tailed p-value <0.05.

Results:
In 2020, of 1,221,535 hypertensive emergency hospital admissions, 128,095 (10.5%) necessitated hemodialysis due to acute renal failure. After controlling for age, gender, hospital characteristics, insurance status, income, and Elixhauser comorbidities, we found that Black, Hispanic, Asian/Pacific Islander, and Native American patients had higher likelihoods of requiring hemodialysis compared to White patients, with aORs of 1.88 (95% CI 1.79-1.96), 2.96 (95% CI 2.74-3.19), 3.29 (95% CI 2.99-3.62), and 2.57 (95% CI 2.18-3.04) respectively (Figure 1).

Conclusion:
This analysis was unable to account for the degree of hypertension control prior to admission, a significant limitation. Further investigation is needed to discern what factors preceding or during hospital admission increase the risk of acute renal failure, in order to address these observed racial disparities in outcomes for patients with hypertensive emergencies.
Abstract P151: Examining The Inclusion And Analysis Of Race-Sex Groups In Primary Hypertension Studies Conducted In The US: A Comprehensive Review
Authors: Jurado Velez Javier A , Barron Ileana , Kanney Nita , Anderson Nekaylaa , Hidalgo Bertha
Published: October 2023

Background:
Patients from underrepresented backgrounds, including women of color, in the US have a higher prevalence of hypertension and may experience worse outcomes. Although there has been increased awareness regarding the importance of representation in cardiovascular studies, a substantial disparity in study populations persists.

Objective:
This study aimed to assess the inclusion and reporting of race-sex groups in studies conducted in the US between 2012-2022 that focused on primary hypertension as an outcome.

Methods:
We conducted a systematic search using Covidence to extract original peer-reviewed studies from PubMed and Embase. After removing duplicates, two investigators performed a title and abstract review to select studies. The studies that met the criteria underwent full-text screening and were downloaded to a shared spreadsheet. Additionally, studies with analyses by race-sex groups were identified and reviewed for theme extraction.

Results:
Out of 157 studies on hypertension, 20 studies (12.7%) reported results stratified by race-sex. Within these studies, women accounted for an average of 56.5 ± 14.7% of the overall study population, and the primary focus was on the prevalence of hypertension (N=17). However, some reported hypertension control (N=6), treatment (N=5), and trends (N=5). While all these studies included Non-Hispanic (NH) White and NH Black subgroups, only nine (45%) included Hispanic/Latinx, six (30%) included Asian American and Pacific Islander, and none included Native American/American Indian. Among the studies that reported demographic breakdowns (N=14), NH White individuals consisted of more than 50% of the study population in nine studies, whereas NH Black individuals comprised ≥20% of the study population in six studies.

Conclusion:
There is still a lack of studies on primary hypertension in the US that include and analyze - but most importantly - report their results by race-sex groups. Additionally, a significant gap persists in the inclusion of individuals from underrepresented backgrounds, especially Asian American and Pacific Islanders and Native American/American Indians. Future studies could benefit from incorporating race-sex analyses and results to address these disparities.
Abstract P154: Differences In Sleep Duration Between Black Ethnic Subgroups And Non-hispanic White Adults With Hypertension In The 2004 - 2018 National Health Interview Survey
Authors: Turkson-Ocran Ruth-Alma N , Ogungbe Oluwabunmi V , Metlock Faith , Baptiste Diana , Aidoo Emily , Larbi Kwapong Fredrick , Commodore-Mensah Yvonne , Mukamal Ken J , Juraschek Stephen P
Published: October 2023

Background:
Sleep is a naturally occurring period of lower blood pressure (BP), recommended by the AHA as an essential lifestyle feature to prevent cardiovascular disease (CVD). While hypertension (HTN) disproportionately affects Black adults in the United States (US), differences in sleep duration among Black ethnic subgroups including African American, African immigrant, and Afro-Caribbean adults with hypertension are unknown.

Objective:
To examine differences in sleep duration among Black ethnic subgroups and Non-Hispanic (NH) White persons with HTN in the US.

Methods:
Using cross-sectional data from the 2004-2018 National Health Interview Survey, sleep duration was defined by participants’ self-reported average number of hours of sleep per day. Survey-weightedgeneralized linear models were used to examine the differences between sleep duration among the Black ethnic subgroups with hypertension compared to their NH White counterparts.

Results:
Of 120,511 adults (17% Black, 51% female with mean age 57±.08 [SE] years) mean(±SE) sleep duration was 7.2 (0.01) hours. Unadjusted, African immigrants had the shortest mean sleep duration (6.8 hours) compared to NH White persons (7.2 hours). In the fully adjusted model, compared to NH White persons, all adults in the Black Ethnic Subgroups had significantly lower sleep durations compared to White persons, with Afro-Caribbean persons having the lowest sleep duration (
Table
).

Conclusion:
Sleep duration varied across ethnic subgroups of Black adults with self-reported HTN. Whether interventions targeting these differences could improve hypertension control represents an important subject for subsequent research.
Abstract P168: Hypertensive Emergency And Covid-19 Outcomes 2020
Authors: Umrani Rohan , Khalid Yaser S , Dasu Kirti , Dasu Neethi
Published: October 2023

Introduction:
Hypertension affects over a billion people worldwide and contributes to millions of cardiovascular deaths annually. Furthermore, COVID-19 was a global health crisis that led to numerous deaths. Due to a paucity of data, we aimed to study the effect of COVID-19 on patients with hypertensive emergency and to identify positive predictors that led to increased healthcare utilization.

Methods:
A retrospective analysis was completed utilizing the National Inpatient Sample (2020). Patients were identified based on ICD-10 codes corresponding to those with Hypertensive Emergency and COVID-19 vs. patients with only Hypertensive Emergency. Primary outcomes were all-cause mortality, length of stay (LOS) and total hospital charge (TOTHC). Secondary outcomes of race, insurance, and post-procedural complications were analyzed using multivariate analysis.

Results:
1,685,745 patients had COVID-19, of which 284,350 had hypertensive emergency. After propensity score matching, patients with Hypertensive Emergency and COVID-19 had increased mortality (OR 2.21, 95% CI [2.05- 2.40], p=0.00), LOS (+2.38, 95% CI [1.70- 3.05], p=0.00) and TOTHC (+69558.30, 95% CI [$51,437.27- $87,679.34], p=0.00). It was shown that either CVA, ESRD, or AKI increased mortality, TOTHC, and LOS in patients with Hypertensive Emergency and COVID-19.

Conclusion:
In the wake of the COVID-19 pandemic, this study demonstrates the impact of hypertensive emergency as a significant factor increasing mortality, LOS and TOTHC. Moving forward, efforts should be made to improve out of hospital treatment and to reduce the number of admissions for hypertensive emergencies in these conditions.
Abstract P174: Determining The Effect Of Diet And Short-term Voluntary Exercise On Renal Function And RAS mRNA Expression In Male C57Bl/6 Mice: A Pilot Study
Authors: Le Vey Austin , Vail McClain , Nguyen Thuy-Linh , Rodriguez Aaron , Spears Nathaniel , Houghton Jeffrey , Gigliotti Joseph
Published: October 2023

Poor dietary quality and exercise are key risk factors for kidney and cardiovascular diseases. Dietary quality is not considered in most preclinical animal studies and has likely hindered overall progress in biomedical research. We developed a novel diet to model the nutritional inadequacies of Americans and our data suggest poor dietary quality influences kidney function. Therefore, the goal of the current study is to determine how diet and exercise impact kidney and cardiovascular health in mice. Male C57Bl/6 mice were assigned to 1 of 3 diets: chow, synthetic AIN93G, or our novel Americanized diet (AD). Mice were assigned to exercise or control groups, with exercise being free access to an exercise wheel for 16 hours 3 times a week. After 4 weeks, systolic blood pressure (SBP) and renal blood flow (RBF) were quantified in a subset of each group. Renal mRNA expression of RAS genes was determined by RT-PCR in the remaining animals. Data were analyzed using General Linear Model Procedures in SPSS, with significance determined at
P
<0.05 and a tendency indicated at
P
<0.1. Neither diet (
P
=0.6) nor exercise (
P=
0.5) significantly influenced SBP or RBF, however, a significant diet*exercise interaction occurred (
P
=0.03). AIN-fed mice with exercise had a significantly lower (94±8 mmHg, p=0.009) blood pressure as compared to the AIN control group (116±4 mmHg). Similarly, exercise also tended (
P
=0.09) to reduce RBF in mice fed AIN. Exercise, regardless of diet, resulted in a doubling (p=0.03) in renal angiotensinogen expression as compared to control mice. This effect was most apparent in mice fed chow. Diet also mediated the significant effect of exercise on renal
Mme
expression (
P
=0.04), with exercise lowering
Mme
expression in mice fed AIN and AD (50% reduction) and increasing its expression (3-times greater) in mice fed chow. A similar trend was observed with
Agtr1a
(
P
=0.07). Regardless of diet, exercise also tended to upregulate
Ace1
(p=0.054) compared to control mice. Results of this pilot study suggest that diet significantly influences the physiological response to exercise, particularly renal physiology and the control of blood pressure. Additional studies are needed to confirm these preliminary results and identify the molecular mechanisms responsible.
Abstract P180: Hypertension-linked Immune Activation Regulates Osteoclastogenesis
Authors: Hennen Elizabeth M , Chen Wei , De La Visitacion Nestor , Uppuganti Sasidhar , Ao Mingfang , Nyman Jeffry , Harrison David G
Published: October 2023

Osteoporosis is an age-related disease affecting 18% of adults. Hypertension is associated with increased risk for fragility fracture and accelerated bone loss in adults. We hypothesized that experimental hypertension would induce osteoporosis and examined the mechanisms involved. We used two preclinical models in 12-week-old male C57Bl/6J mice: angiotensin (ang) II infusion (490 ng/kg/min) and deoxycorticosterone acetate (DOCA)-salt. After 6 weeks of ang II or 3 weeks of DOCA-salt, the left femur and sixth lumbar vertebral body were studied. Mechanical testing showed that ang II reduced femoral ultimate strength (170.7±4.794 vs 157.3±3.670 MPa, p=0.0325; 154.1±7.403 vs. 119.9±4.375 MPa, p=0.0026) and peak moment (39.09±1.660 vs. 32.77±0.9380 Newton millimeters (Nmm), p=0.0018; 29.15±1.291 vs 19.58±1.308 Nmm, p=0.0004) with cortical and trabecular bone loss compared to controls. μCT showed that hypertension reduced vertebral body bone volume fraction (30.1±1.41 vs 25.1±0.992 %, p=0.0068; 25.9±2.03 vs 18.5±1.29 %, p=0.0119) and trabecular thickness (62±1.6 vs 57±1.4 μm, p=0.0105; 60±2.1 vs 51 ±1.6 μm, p=0.0069). Flow cytometry of bone marrow from ang II-treated mice revealed that CD4+ T cells and γδ T cells produce increased IL-17A which is known to induce osteoclastogenesis. Colony stimulating factor-1 (CSF1) is also known to stimulate osteoclast formation. Using in situ hybridization, we observed increased CSF1 mRNA in endothelial cells (ECs) of transcortical arterioles of hypertensive mice. Subsequent studies of cultured bone marrow derived ECs showed that CSF1 mRNA expression increased with 0% and 10% compared to 5% stretch. 5% stretch treated with endothelial nitric oxide synthase inhibitor, L-NAME, increased expression comparable to 0% and 10%, indicating that nitric oxide inhibits CSF1 production. Thus, T-cell activation and nitric oxide-dependent EC dysfunction in hypertension may skew the bone marrow to favor osteoclastogenesis, leading to bone loss. Understanding this mechanism will elucidate novel pharmacological targets to mitigate hypertension-induced bone loss.
Abstract P186: CCR10 Promotes Blood Pressure Elevations And Renal Damage In A Mouse Model Of Hypertension
Authors: Nguyen Bianca A , Chen Ziche , Fehrenbach Daniel J , Zhong Xue , Xiong Na , Madhur Meena S , Alexander Matthew R
Published: October 2023

Emerging evidence suggests inflammation plays a key role in hypertension and its associatedend-organ damage. Regulatory T cells (Tregs) function primarily by limiting inflammation andare considered protective in the pathogenesis of hypertension. However, Tregs also havetissue-specific functions and have been found to play pathogenic roles in some chronicdiseases by limiting angiogenesis. As such, the role of Tregs and its subsets in chronichypertension remains unclear. Recently, we identified CCR10
+
Tregs as an immune populationselectively decreased in the circulation of hypertensive patients. CCR10 is a chemokinereceptor important for recruitment of immune cells to the skin. Although skin has not been wellstudied in hypertension, prior reports in humans demonstrate that loss of skin microvessels(microvascular rarefaction) occurs as a putative mechanism by which blood pressure (BP) isincreased. Thus, we hypothesized that CCR10
+
Tregs promote hypertension through skininfiltration leading to enhanced microvascular rarefaction. Herein, we demonstrate that,compared to normotensive controls, mice with Angiotensin II (Ang II)-induced hypertension haveincreased abundance of CCR10
+
Tregs in the skin (p=0.0004) with a corresponding decrease incirculation (p=0.003). These mice also displayed increased cutaneous levels of CCL27(p=0.0007), a ligand for CCR10. Among circulating lymphocytes in normotensive mice, wefound that Tregs express the highest frequency of CCR10 (p=0.0007). Importantly, wedemonstrate that CCR10-deficient mice (CCR10
-/-
) are more resistant to Ang II-induced systolicblood pressure elevations (p=0.004) and albuminuria (p=0.01) compared to wild type mice.CCR10
-/-
mice also exhibit higher levels of cutaneous arteriolar density (p=0.02) and VEGFA(p=0.009), consistent with reduced skin microvascular rarefaction. Finally, using PrediXcan, wedemonstrate that higher genetically predicted levels of CCR10 are associated with increasedrisk of hypertension in humans. Taken together, our data suggest that CCR10 promotes Ang II-induced BP elevations and renal damage in mice, at least in part by promoting Treg recruitmentto the skin leading to microvascular rarefaction.
Abstract P189: Hypercontractility Of Pudendal Artery And Corpus Cavernosum Is Associated With LRRC8A-VRAC And Superoxide Anion Production In Diabetic Vasculogenic Erectile Dysfunction
Authors: Vieira dos Santos Cintia , Rodrigues dos Passos Rinaldo , Arishe Olufunke , Choi Hyehun , Wilczynski Stephanie , Lamb Fred S , Webb R Clinton C , Priviero Fernanda
Published: October 2023

Erectile dysfunction (ED) may be an early marker for cardiovascular diseases and it isoften associated with an hypercontractility of the corpus cavernosum (CC) and pudendalartery (PA) in consequence of increased reactive oxygen species (ROS), which favorsthe flaccid state of the penis. Leucine Rich Repeat Containing 8 (LRRC8) VolumeRegulated Anion Channels (VRACs) regulates Nox1 and modulates the extracellularproduction of superoxide anion (O2
•-
). Downregulation of LRRC8 is associated withdecreased production of O2
•-
and we have demonstrated improved relaxation andreduced contraction of the pudendal artery in LRRC8A knockout mice. In this study, wehypothesize that inhibition of Nox or LRRC8A decreases phenylephrine (PE)-inducedcontraction in the CC and PA of diabetic mice. To test this hypothesis, the CC and PA ofdiabetic (dbdb-/-) mice were mounted in myographs, and the contraction elicited by PEwas performed in the presence of apocynin (non-selective NOX inhibitor), GKT137831(NOX1/4 inhibitor) and montelukast (LRRC8A inhibitor). In the PA, the potency of PE wasincreased in diabetic mice, and apocynin (1 mM) restored the contraction of PE to thenormal levels. In the CC, the maximal contraction of PE was increased in diabetic animals,and in the presence of 3 mM of apocynin, the contractile response was markedlydiminished in both control and diabetic mice. The LRRC8A inhibitor, montelukast,significantly reduced PE-induced contraction of the CC reaching maximal contraction of69 + 7% and 65 + 10% in the control and diabetic group, respectively, compared to thecontraction in the absence of the inhibitor. In the presence of the Nox1/Nox4 inhibitor,GKT137831, the contraction elicited by PE was reduced only in the diabetic group (68 +9% of the maximal contraction), whereas in the control group this reduction was notsignificant (82 + 14% of the PE-maximal contraction). In the CC and PA, LRRC8Amodulates the contractile response induced by α-adrenergic stimulation and in diabetes,this may be associated with O2
•-
production, which plays a role in the development of ED.Inhibition of LRRC8A may be a therapeutic target to prevent hypercontractility of arteriesand CC in vasculogenic ED.
Abstract P198: Initial Management Of Hypertensive Disorders In Youth With And Without Chronic Kidney Disease
Authors: Vincent Carol , Campbell Jessica F , Londeree Jackson , Murphy Maggie , Misurac Jason M , Onugha Elizabeth , Riar Sandeep , Sethna Christine , Siddiqui Sahar , Weaver Donald J , Yamaguchi Ikuyo , South Andrew
Published: October 2023

Hypertension (HTN) and target organ injury (TOI) are common in youth with chronic kidney disease (CKD). Understanding current TOI screening and treatment practices in this population will help identify gaps in implementation of HTN management. Our objective was to determine initial management of youth with and without CKD at first visit to a subspecialist for HTN disorder, hypothesizing that youth with CKD are more likely to have anti-hypertensive medication and echocardiogram (ECHO) ordered. Interim cross-sectional analysis of baseline EHR data from youth referred for HTN disorders in the multisite retrospective SUPERHERO Registry. Inclusion criteria were age <19 years and initial subspecialty clinic visit for HTN disorders by ICD-10 codes from 1/1/2015-12/31/2022. Exclusion criteria were kidney failure on dialysis, kidney transplantation, or pregnancy by ICD-10 codes. Our exposure was any-stage CKD by ICD-10 codes. Outcomes were orders placed for anti-hypertensive medication, ECHO, or referral to dietician or weight management clinic. We used unadjusted generalized linear models. Of 11,580 participants, 488 (4%) had a CKD diagnosis (Table). Youth with at least one CKD ICD-10 code were more likely to be prescribed an anti-hypertensive medication (RR 1.76; 95% CL 1.47 to 2.1) and less likely to have an ECHO order (RR 0.52; 95% CL 0.41 to 0.67) or be referred to a dietician (RR 0.51; 95% CL 0.26 to 0.98) or weight management clinic (RR 0.24; 95% CL 0.06 to 0.95). Our findings reflect a need for better implementation of TOI screening for youth with CKD and HTN. Future steps include validation of data and longitudinal data collection on this cohort to follow change in practice.
Abstract P202: Changes In Cerebral Mitochondrial Function In Intrauterine Growth-Restricted Offspring Before The Development Of Hypertension And Cerebrovascular Dysfunction
Authors: Jones Kylie , Smith Jonna , Smith Savanna , Castillo Angie , Cunningham Mark
Published: October 2023

Background:
Preeclampsia (PE), new-onset gestational hypertension (HTN) affects 3-8% of all births in the USA. PE is the leading cause for intrauterine growth restriction (IUGR). IUGR children have increased risks of HTN and cerebrovascular disease (CVD) later in life. Prior studies in our lab show adult male IUGR rat offspring (OS) to develop HTN, CVD, and cerebral mitochondrial dysfunction (mtDys) at 17 weeks while female IUGR OS exhibit CVD. The role of mtDys in HTN is unknown and is the focus of our study. We hypothesize that IUGR OS will have mtDys prior to HTN.

Methods:
Our surgical PE animal model utilized the reduced-uterine-perfusion pressure (RUPP) surgery at GD 14. OS from NP served as controls (CON) while OS from RUPP mothers were IUGR. At 12 weeks, OS BP was measured alongside cerebral mtDys through mitochondrial fusion and fission, electron-transport chain (ETC) proteins, and respiration.

Results:
BP did not change between sexes or among IUGR and CON offspring. Male IUGR OS showed elevated mtRes (State 2: 199 ± 1.08 v. 76 ± 1.13 pmol/mg,
p
< .05; State 3: 555 ± 3.02 v. 245 ± 1.77 pmol/mg,
p
< .05; State 4: 346 ± 1.66 v. 85 ± 1.12 pmol/mg,
p
< .05). Female IUGR and CON OS had no changes in BP or mtRes. Male IUGR OS had increased mito-fusion proteins MFN-1 (176 ± 1.68 v. 100 ± .57 IU/protein/CON %,
p
< .05), MFN-2 (155 ± 1.36 v. 100 ± .74 IU/protein/CON %,
p
< .05) and OPA-1 (166 ± 1.99 v. 100 ± .73 IU/protein/CON %,
p
< .05). DRP-1 had no changes in males; females had no changes in fusion or fission. Male IUGR OS had changes in ETC proteins (CI: 8 ± 9.34 v. 100 ± .82 IU/protein/CON %,
p
< .05; CII: 23 ± .53 v. 100 ± .52 IU/protein/CON %,
p
< .05; CIII: 26 ± .23 v. 100 ± .41 IU/protein/CON %,
p
< .05), as did female IUGR OS (CI: 12 ± .24 v. 100 ± .86 IU/protein/CON %,
p
< .05; CII: 29 ± .39 v. 100 ± .61 IU/protein/CON %,
p
< .05; CIII: 39 ± .56 v. 100 ± .62 IU/protein/CON %,
p
< .05; CIV: 76 ± .74 v. 100 ± .73 IU/protein/CON %,
p
< .05) vs. CON OS.

Summary:
Male IUGR OS have elevated mtRes, changed ETC proteins, and fusion proteins that may lead to mtDys and HTN development. This study is clinically relevant because specific cerebral therapy for mtDys for IUGR OS may prevent HTN and CVD development. Future studies will examine changes in mtDys causing male HTN and protection from HTN in females.
Abstract P205: G Protein-Coupled Estrogen Receptor Stimulation Attenuates Hypertension And Cardiac Dysfunction In The Reduced Uterine Perfusion Pressure Model Of Preeclampsia
Authors: Nogueira de Alencar Allan kardec , Swan Kenneth F , Mahapatra Smruti , Pridjian Gabriella , Lindsey Sarah H , Bayer Carolyn
Published: October 2023

Preeclampsia (PE) is a disorder of pregnancy associated with maternal hypertension and cardiac dysfunction. Women with a history of PE have increased risk of cardiovascular disease and mortality that persist well beyond the post-partum period. Evidence suggests that the new estrogen receptor (GPER) is a beneficial regulator of placental development. Other studies have shown the role of GPER in promoting vasodilation and cardioprotection. However, the cardiovascular effects of GPER in an animal model of PE have not yet been determined. Thus, we hypothesize that the activation of GPER by its selective agonist G-1 is associated with the regulation of hypertension and cardiac dysfunction in rats following placental insufficiency. The reduced uterine perfusion pressure (RUPP) model was used to induce placental insufficiency in the dam by placing silver clips on abdominal aorta and uterine arteries on gestational day (GD) 14 of a 19-day gestation. RUPP rats received G-1 (100 μg/kg/day) or vehicle subcutaneously by osmotic minipump. Echocardiography was performed on GD18 to assess the effectiveness of G-1 on heart function in PE dams. On GD19, rats had carotid catheters placed, and hemodynamic measurements were made. RUPP rats exhibited hypertension and cardiac alterations, including global myocardial motion dyssynchrony, and reduced left ventricular systolic and diastolic function when compared with SHAM animals. G-1 treatment significantly attenuated hypertension and cardiac functional aberrations caused by PE in RUPP rats, a finding that may have important implications for the ongoing clinical evaluations of new drugs for the treatment of PE and its comorbidities.
Abstract P226: Length Of Stay Discrepancies Between Rural And Urban Hospital Settings For Hypertension Admissions
Authors: Allu Sai Vishnu Vardhan , Parikh Harsh , Shrivastava Shitij , Thet Aung , Saad Muhammad
Published: October 2023

Introduction:
Rural populations experience greater barriers to healthcare access compared to urban populations. This can be attributed to fewer public health services, greater uninsured rate, and greater burden of healthcare shortages in urban healthcare settings. Our study aims to quantify the disproportionate allocation in healthcare resources through analysis of Length of Stay (LOS) in-respect to hypertensive urgency and hypertensive urgency.

Methods:
This cross-sectional study reviewed the LOS estimates for patients with ICD-10 diagnoses for Hypertension Emergency or Hypertension Urgency within the state of New York, categorized by the type of community hospital; rural or urban. This study utilizes the 2020 National Inpatient Sample (NIS), specifically for urban and rural hospitals in New York. ICD-10 codes included I16.1 & I16.9 for Hypertensive Emergency and I16.0 for Hypertensive Urgency. Community hospital setting was categorized as either rural or urban based on the overlying zip code of the admitting inpatient hospital.

Results:
LOS was unique to the community setting (p<0.01), but not to hypertensive disease (p=0.11). In summary, the LOS was longer in rural-level inpatient hospital systems when compared to their urban counterparts in both Hypertensive Urgency, 4.4 days vs 3.1 days (p=0.01), and Hypertensive Emergency, 5.5 days vs 3.4 days (p<0.01).

Conclusion:
The LOS of patients admitted for both hypertensive urgency and emergency were significantly higher in rural hospitals. Furthermore, increased disease severity emphasizes the divide in LOS between the community healthcare settings. Redistribution of resources to rural communities can enhance access to preventative healthcare services, specialty healthcare, and potentially decrease overall community disease burden.
Abstract P229: Beyond Cooling Sensation: Topical Penile Administration Of The Trpm8 Agonist Improves Hypertension Associated-erectile Dysfunction
Authors: Araujo Fenix A , Cruz Jesus Rafael , Szasz Theodora , Wenceslau Camilla F , McCarthy Cam , Webb R Clinton C , Flavia Silva Darizy
Published: October 2023

Background and Purpose:
Erectile dysfunction (ED) is an indicator for futurecardiovascular events. The search for new targets is crucial due to the low efficacy ofPDE5 inhibitors in patients with endothelial dysfunction. Menthol, a TRPM8 agonist, iswidely used in preparations to improve sensation during sexual intercourse, although nodata are reported for the improvement of ED. So, we hypothesize that chronic topicalactivation of TRPM8 improves hypertension associated-ED.

Experimental Approach:
Adult (9-12 weeks) male spontaneously hypertensive rats (SHR) and Wistar rats wereused for protein expression analysis and TRPM8 agonist curves in isolated CC. We alsotreated rats topically on the penis for 30 days with carbopol 940 (hydrogel, vehicle) ormenthol (carbopol 940 + menthol 0.1%). After treatment, we measured the mean bloodpressure (MBP), CC and iliac (IL) artery contractility.

Key Results:
Both strains of rathad similar TRPM8 expression in CC by western blotting and immunofluorescence.TRPM8 activation by cooling compounds, icilin (10
-8
–10
-4
M) or menthol (10
-7
–10
-3
M),relaxed CC strips pre-contracted by phenylephrine (PE, 10
-6
or 10
-5
M), but with reducedeffect in SHR. Interestingly, the topical penile treatment with menthol decreased the MBPof the SHR (151.8±6.8 mmHg, n=6) compared to the SHR vehicle group (174.6±2.6mmHg, n=5; p<0.05). In addition, in CC, the concentration-response curves to PE andthromboxane agonists were shifted to the left after menthol treatment. Interestingly, nochange in acetylcholine and sodium nitroprusside (SNP) relaxation were observed aftertopical penile treatment with menthol. The concentration-response curves to PE and SNPwere shifted to the left in IL arterial rings. This suggests topical menthol administrationinduced systemic vascular influence leading to a response like the normotensive Wistar.

Conclusion:
TRPM8 channels are expressed and functional in the CC, with decreasedsensitivity in SHR. Also, our data suggest that topical administration of menthol improvesthe reactivity of vascular tissue, demonstrating the potential of TRPM8 activation fortherapeutic benefits in hypertension associated-ED.
Abstract P230: Central Artery Pulsatile Hemodynamics Are Associated With Cerebral Total, Periventricular, And Deep White Matter Lesions: Role Of Reservoir-excess Pressure Components.
Authors: Armstrong Matthew K , Jain Shivangi , Nuckols Virginia , Gimblet Colin , Dubose Lyndsey E , Voss Michelle W , Pierce Gary L
Published: October 2023

Introduction:
Accumulating evidence suggests that increased central, rather than peripheral, blood pressure (BP) may be a better predictor of cardiovascular risk. The shape of the central BP waveform is determined by ventricular-arterial interactions that can be quantified via novel hemodynamic analyses, from which some parameters have been implicated in the development of cardiac, vascular, and renal dysfunction. Comparatively, the potential effect of central pulsatile hemodynamics on brain structure has been understudied. Thus, we sought to determine the association of novel central hemodynamic parameters with cerebral white matter lesions.

Methods:
Central BP waveforms were measured in 130 healthy adults (age 63±6y; 58% female) via non-invasive carotid tonometry and modeled using reservoir-excess pressure analysis to separate the central BP waveform into a reservoir (Rp
TI
) and excess (Ep
TI
) pressure component. Systolic (Sk) and diastolic (Dk) rate constants were estimated from the rate of increase and decrease of the Rp
TI
component, respectively. Total, periventricular, and deep cerebral white matter lesion volumes (WMLV) were estimated from T2 weighted and FLAIR MRI and adjusted for total intracranial volume.

Results:
Both Sk and Ep
TI
were correlated with total (Sk:
r
= -0.19,
p
= 0.033; Ep
TI
:
r
= 0.21,
p
= 0.016), periventricular (Sk:
r
= -0.18,
p
= 0.037; Ep
TI
:
r
= 0.23,
p
= 0.009), and deep (Sk:
r
= -0.28,
p
= 0.002; Ep
TI
:
r
= 0.20,
p
= 0.027) WMLV. The association of Sk with total (
B
= -0.032; 95% confidence interval [CI] = -0.054, -0.010;
p
= 0.0056), periventricular (
B
= -0.030; 95%CI = -0.051, -0.009;
p
= 0.0063), and deep (
B
= -0.064; 95%CI = -0.101, -0.028;
p
<0.001) WMLV remained significant in multivariable analyses adjusting for age, sex, BMI, peripheral pulse pressure, carotid-femoral pulse wave velocity, heart rate, and non-HDL cholesterol. Additionally, the association between Ep
TI
and deep WMLV persisted in multivariable analysis (
B
= 0.158; 95%CI = 0.045, 0.271;
p
= 0.007).

Conclusion:
Pulsatile components of central artery hemodynamics are associated with cerebral WMLV independent of traditional cardiovascular risk factors. In particular, Sk may represent a novel biomarker of early central BP-related cerebral white matter damage.
Abstract P236: Association Of Vitamin B Deficiency-induced Hyperhomocysteinemia With Subclinical Atherosclerosis In Adolescents: Implications For Early Cardiovascular Disease Detection
Authors: Shirode Parth , Parekh Anjali , Gummalla Vaishnavi , Jaimalani Aniket , Wala Janmay
Published: October 2023

In recent decades, the increased incidence of cardiovascular disease (CVD) mortality among young adults has raised concerns. Although clinical manifestations of CVD typically occur later in life, the underlying pathological processes emerge early on. Numerous studies have demonstrated that elevated homocysteine levels serve as an independent risk factor for endothelial dysfunction and arterial stiffness, which are key contributors to CVD. Notably, vitamin B deficiency, particularly deficiencies in Vitamins B9 and B12, emerges as a significant factor in childhood hyperhomocysteinemia, initiating the development of subclinical atherosclerosis in early life. In this narrative review, we summarize the association between vitamin B deficiency-induced hyperhomocysteinemia and subclinical atherosclerosis in adolescents. We conducted a comprehensive review of relevant literature from prominent bibliographic databases, including PubMed/MEDLINE, PMC Central, Google Scholar, and Cochrane database. Four cross-sectional studies were included and reviewed as part of our analysis. The reviewed studies, focusing on homocysteine levels as an exposure variable and markers of atherosclerosis as outcome measures, demonstrate a strong correlation between homocysteine levels and markers of atherosclerosis, including increased carotid intima-media thickness (CIMT) and endothelial dysfunction. Particularly, adolescents with vitamin B12 deficiency exhibit a significant positive correlation between homocysteine levels and CIMT. These findings underscore the potential of hyperhomocysteinemia as an early marker for detecting subclinical atherosclerosis in adolescents with vitamin B deficiency. Despite limited research in this area, recognizing the importance of early detection and management of subclinical atherosclerosis in adolescents can help mitigate the risk of severe cardiovascular and cerebrovascular events in young adulthood.
Abstract P238: Chemerin Is Resident To Vascular Tunicas And Contributes To Vascular Tone
Authors: Wabel Emma A , Orr Alexis , Flood Emma D , Mullick Adam E , Garver Hannah , Fink Gregory D , Kung Theodore A , Watts Stephanie W
Published: October 2023

The adipokine chemerin has the potential to support blood pressure, evidenced by a fall in mean arterial pressure following knockdown of chemerin protein by whole-body antisense oligonucleotides (ASO) in rat models of normal and elevated blood pressure. While the liver is the greatest contributor of circulating chemerin, liver-specific (GalNAc) ASOs that abolished hepatic-derived chemerin did not change blood pressure in these models. Thus, other sites must produce the chemerin that supports blood pressure. Presently, we hypothesize that the vasculature—the blood vessel and its perivascular adipose tissue (PVAT)—is a source of chemerin that is independent of the liver and supports arterial tone. RNAScope®, Western blot, ASOs, and isometric contractility were used in the Dahl salt sensitive (SS) rat, male and female, on a normal diet. Species-specific ZZ probes detected
Rarres2
mRNA in the smooth muscle, adventitia, and PVAT of the thoracic aorta. Chemerin protein was detected immunohistochemically in the endothelium, smooth muscle cells, adventitia, and PVAT. Chemerin colocalized with the vascular smooth muscle marker a-actin and the adipocyte marker perilipin. Importantly, chemerin protein in the aorta was not reduced when liver-derived chemerin was abolished by a liver-specific ASO against chemerin (thoracic aorta control ASO = 0.62 + 0.03; GalNAc ASO = 0.35 + 0.04; abdominal aorta control ASO = 0.38 ± 0.04, GalNAc ASO = 0.40 ± 0.22). Finally, inhibition of the receptor Chemerin1 by the receptor antagonist CCX832 resulted in aortic vasorelaxation [Media/PVAT + endothelium: -8.8 ± 3.3%; Media/PVAT - endothelium: -14.6 ± 4.2%; Media + endothelium: -1.5 ± 1.3%; and Media - endothelium: -5.1 ± 7.0%, quantified by percentage of initial wakeup to phenylephrine (-152 ± 67 mg of 1660 ± 121 mg; -93 ± 13 mg of 868 ± 171 mg, -20 ± 28 mg of 1906 ± 213 mg; and -59 ± 69 mg of 964 ± 70 mg, respectively)]. These data suggest that vessel-derived chemerin may support vascular tone locally through constitutive activation of Chemerin1 and highlights vascular chemerin as a potential therapeutic target in blood pressure regulation.