bluuebunny/crossref_metadata_2025 huggingface dataset:
PERIDIALYTIC AND INTRADIALYTIC BLOOD PRESSURE MEASUREMENTS ARE NOT VALID ESTIMATES OF 44-HOUR AMBULATORY BLOOD PRESSURE IN PATIENTS WITH INTRADIALYTIC HYPERTENSION
Authors: Theodorakopoulou Marieta , Alexandrou Maria-Eleni , Iatridi Fotini , Karpetas Antonios , Geladari Virginia , Pella Eva , Alexiou Sophia , Ziakka Stavroula , Papagianni Aikaterini , Sarafidis Pantelis
Published: June 2022

Objective:

In contrast to pre- and post-dialysis blood pressure (BP), intradialytic and home BP measurements are accurate metrics of ambulatory BP load in hemodialysis patients. This study assessed the agreement of peridialytic, intradialytic and scheduled interdialytic recordings with 44-h interdialytic BP in a distinct hemodialysis population, patients with intradialytic-hypertension (IDH).

Design and method:

45 patients with IDH (defined as: SBP rise greater than or equal to 10 mmHg from pre- to post-dialysis and post-dialysis SBP greater than or equal to 150 mmHg) with valid 48-h ABPM and 197 without IDH were included in this analysis. With 44-h BP used as reference method, we tested the accuracy of the following BP metrics: Pre- and post-dialysis, intradialytic, intradialytic plus pre/post-dialysis readings and scheduled interdialytic BP (out-of-dialysis day: readings at 8:00 am, 8:00 pm or their average).

Results:

In patients with IDH, peri-dialytic and intradialytic BP metrics showed at best moderate correlations, while averaged-interdialytic-SBP/DBP exhibited strong correlation (r = 0.882/r = 0.855) with 44-h SBP/DBP. Bland-Altman plots showed large between-method difference for peri- and intradialytic BP, but only + 0.7 mmHg between-method difference and good 95% limits-of-agreement for averaged-interdialytic-SBP. The sensitivity/specificity and kappa-statistic for diagnosing 44-h SBP greater than or equal to 130 mmHg were low for pre-dialysis (72.5%/40.0%, kappa-statistic = 0.074) and post-dialysis (90.0%/0.0%, kappa-statistic = -0.110), intradialytic (85.0%/40.0%, kappa-statistic = 0.198) and intradialytic plus pre/post-dialysis SBP (85.0%/20.0%, kappa-statistic = 0.043). Averaged-interdialytic-SBP showed high values of sensitivity/specificity (97.5%/80.0%,) and strong agreement (kappa-statistic = 0.775). In ROC-analyses, the peri- and intradialytic BP metrics showed bad performance with low Area-Under-the-Curve values; scheduled interdialytic SBP/DBP had the largest AUC (0.967/0.951), along with the highest sensitivity(90.0%/88.0%) and specificity(100.0%/90.0%) for detecting elevated 44-h BP.

Conclusions:

In patients with IDH, averaged-scheduled-interdialytic but not pre- and post-dialysis, nor intradialytic BP recordings show reasonable agreement with ambulatory BP. Interdialytic BP recordings only could be used for hypertension diagnosis and management in these subjects.
PULSE PRESSURE AND HEART RATE LEVEL DO NOT INFLUENCE THE ACCURACY OF HEART RATE MEASUREMENT WITH AN OSCILLOMETRIC DEVICE
Authors: Palatini Paolo , Fania Claudio , Saladini Francesca
Published: June 2022

Objective:

Little information is available on the accuracy of oscillometric devices for the measurement of heart rate (HR) and on whether the device performance may depend on the level of pulse pressure or HR. Our aim was to determine whether these variables can influence the accuracy of an oscillometric device for the measurement of HR during rest and exercise.

Design and method:

The Microlife WatchBPO3 was tested in 36 subjects from the general population (mean age, 72.9 years; 18 men). HR was measured at rest and during stress testing on a cycle ergometer in order to increase HR by 15% or more. Pulse detection started during the deflation phase a few pulses before the systolic point and ended a few pulses after the diastolic point. Thus, the number of pulse intervals used to measure HR differed from subject to subject in relation to the level of pulse pressure and HR. The device HR was compared with HR measured by pulse palpation in triplicate by two observers.

Results:

The mean device–observer HR difference was 0.9 ± 2.1 bpm at rest and 0.6 ± 2.6 bpm during exercise (mean ± DS HR increase, 20.3 ± 3.5%). The number of pulse intervals taken into account ranged from 14 to 28 at rest (mean ± DS, 20.4 ± 3.5) and from 16 to 35 during exercise (mean ± DS, 23.0 ± 4.1) and was correlated to pulse pressure and HR (p < 0.0001 for both rest and exercise). A close correlation was found between HR measured by the observers and the device at rest (r = 0.978) and during exercise (r = 0.973). Kappa statistics showed a very good agreement between device and observers both at rest (kappa scores, 0.82–0.88) and during exercise (kappa scores, 0.81 and 0.86 for the two exercise steps). The device-observer HR differences at rest and during exercise were all within 6 bpm and were unrelated to the level of HR (p> = 0.12) and pulse pressure (p> = 0.84).

Conclusions:

The present study shows that the oscillometric device Microlife WatchBP O3 is able to provide reliable HR measurements during rest and mild exercise. The device performance was not influenced by the level of pulse pressure or HR.
COMPARISON OF AMBULATORY AND HOME BLOOD PRESSURE TELEMONITORING WITH PHYSICAL INACTIVITY MONITORING
Authors: Muzik Jan , Peleska Jan , Holubova Anna , Camek Rene , Navratil Vojtech , Fiala Dominik , Doksansky Marek , Hana Karel , Vranka Jakub , Hronova Julie , Chrolenko Anna , Jiravova Maria , Dolezil David , Jizofova Marie
Published: June 2022

Objective:

Combined use of office BP (OBP) and out-of-office BP evaluation (ABPM or HBPM) is recommended according to recent guidelines. Aim of the study was to compare the results of BP measurement (BPM) by these methods while improving reliability of HBPTM by the physical activity monitoring.

Design and method:

BP monitor For a P30Plus was used both for office BP and 3 months home BP telemonitoring (HBPTM) study in triplets on each occasion. Frequency of ABPM (SEIVA TonoTrack) measurement was 15 min during day and 30 min during night. Patients were given preconfigured sets for HBPTM containing For a P30Plus, mobile phone and Xiaomi MiBand 2 smart wristband. 144 treated essential hypertensives aged 24–85 years, 60% males, were referred by their physicians as well controlled. Their therapy was not changed during this study. BP and HR values were accessible to patients and their physicians on a secured server. The demanded 5 minutes of physical inactivity before and during BPM were checked in informed patients by smart wristbands to increase the reliability of HBPTM. Undesired physical activity before and during BP measuring process was shown as the footmark symbol near to BP value in HBPTM logbook. Data were evaluated using a linear mixed model adjusted for gender, age, and BMI.

Results:

There was no significant difference in mean systolic BP (SBP) of both HBPT week cycle (132.6 ± 10.6 vs. 131.3 ± 9.9 mmHg) and daytime ABPM (135.8 ± 11.5 vs. 134.0 ± 10.6 mmHg) during the time period, respectively. Mean SBP of daytime ABPM was significantly higher (p < 0.001) compared to mean SBP of HBPTM both at entry (135.8 ± 11.5 vs. 132.6 ± 10.6 mmHg) and exit (134.0 ± 10.6 vs. 131.3 ± 9.9 mmHg).

Conclusions:

Mean SBP of both HBPTM and daytime ABPM were consistent during the study. Daytime ABPM was consistently significantly higher by approximately 3 mmHg compared to HBPTM with the checked 5 min rest before BPM by smart wristbands. Our results suggest, that both methods are comparable.
DEMOGRAPHIC FACTORS AFFECTING NOCTURNAL BLOOD PRESSURE VARIABILITY IN THE GENERAL POPULATION: RESULTS OF A LARGE DIGITAL STUDY USING AN OPTICAL BLOOD PRESSURE MONITOR
Authors: Perruchoud David , Cortes Meritxell , Sola Josep , Lobo Melvin D. , Wuerzner Gregoire , Fisher Naomi D.L.
Published: June 2022

Objective:

The association between blood pressure variability (BPV) and increased cardiovascular risk is complex, and robust analyses have been limited by methodologic and statistical challenges. Short-term BVP has generally been assessed by ambulatory monitoring, and longer-term by repeated office measures. Recent advancements in optical sensors providing frequent and non-disruptive BP readings around the clock allow first characterization of night-to-night nocturnal BPV in a large population.

Design and method:

We nalysed 210’000 nocturnal systolic and diastolic BP (SBP, DBP) readings from 1’538 adults who wore the CE-marked Aktiia BP monitor for two weeks between April and November 2021 in Europe: mean age 56 ± 11 years, BMI 27 ± 5 Kg/m2, SBP 132 ± 14 mmHg, DBP 82 ± 10 mmHg; 15% females. For each user, we studied the variability of nocturnal BP over two weeks: we first averaged all BP readings from each night (midnight to 6am), and then calculated the standard deviation of the averaged values across nights. We finally adjusted a multivariate logistic regression to identify factors associated with high or low nocturnal BPV (defined as BPV above or below the mean of our population) based on gender, age, body mass index (BMI), and daytime home BP (measured twice by an upper-arm oscillometric cuff on day one of the monitoring period). This analysis was performed for both systolic and diastolic BPV.

Results:

High nocturnal systolic BPV was more likely in males (OR 1.37, CI:1.02–1.83, p = 0.035), and subjects younger than 55 years (OR 1.51, CI:1.23–1.86, p < 0.001). High nocturnal diastolic BPV was more likely in females (OR 1.63, CI:1.23–2.16, p = 0.001), and subjects with a BMI below 30 kg/m2 (OR 1.71, CI:1.32–2.20, p < 0.001). Daytime upper-arm cuff BP (systolic > = 135mmHg or diastolic > = 85mmHg) did not show a statistically significant effect in either of the two models (all p> 0.2).

Conclusions:

This digital investigation showed greater night-to-night variability of nocturnal systolic BP in male and young subjects, and greater variability of nocturnal diastolic BP in females and non-obese subjects. The large-scale deployment of wearable medical devices that continuously record BP enables observations that may help elucidate adverse cardiovascular risk profiles in the general population.
ASSOCIATION OF INTER-ARM SYSTOLIC BLOOD PRESSURE DIFFERENCES WITH ARTERIOSCLEROSIS AND ATHEROSCLEROSIS: A COHORT STUDY OF 117,407 PEOPLE
Authors: Lee Seung-Jae , Kang Jeonggyu , Lee Jong Young , Sung Ki-Chul
Published: June 2022

Objective:

Inter-arm blood pressure differences (IADs) are known to be associated with adverse cardiovascular outcomes. We evaluated the distribution of IADs in a large cohort of apparently healthy people and the association of IADs with brachial-ankle pulse wave velocity (baPWV) and coronary artery calcium (CAC).

Methods: Blood pressure was measured in both arms of 117,407 people who participated in the Kangbuk Samsung Health Study. IAD was defined as the absolute difference in systolic blood pressure in both arms and was confirmed by measuring the baPWV using an automatic oscillometric device. Arterial stiffness was measured by the baPWV, and CAC was assessed using multi-detector computed tomography.

Design and method:

Blood pressure was measured in both arms of 117,407 people who participated in the Kangbuk Samsung Health Study. IAD was defined as the absolute difference in systolic blood pressure in both arms and was confirmed by measuring the baPWV using an automatic oscillometric device. Arterial stiffness was measured by the baPWV, and CAC was assessed using multi-detector computed tomography.

Results:

The mean IAD in the overall subjects was 3.09 ± 2.83 mmHg, 6 mmHg in the 90th percentile, 8 mmHg in the 95th percentile, and 10 mmHg in the 97th percentile. In the multivariable-adjusted analysis of 92,949 subjects excluding those with a history of HTN, DM, and cardiovascular disease (CVD), increasing IAD did not statistically increase the risk of developing a CAC > 0. However, IAD was associated with a baPWV of > 1,400 cm/s (odds ratio [95% confidence interval], 1.23 [1.13–1.35] in the total cohort, 1.19 [1.08–1.31] in males, and 1.39 [1.11–1.73] in females).

Conclusions:

More than 97% of all participants had an IAD of 10 mmHg or less. IAD was significantly associated with arterial stiffness, reflecting arteriosclerosis, but not the presence of CAC, reflecting atherosclerosis. IAD may be a valuable tool for the early detection of asymptomatic, low-risk individuals with subclinical arterial disease.
CYCLOOXYGENASE-2 INHIBITION AS A NEW TOOL TO COMBAT ANGIOGENESIS INHIBITOR-INDUCED HYPERTENSION AND RENAL TOXICITY
Authors: Van Dorst Daan , Colafella Katrina Mirabito , Van Doorn Leni , Van Veghel Richard , Garrelds Ingrid , Mathijssen Ron , Danser Jan , Versmissen Jorie
Published: June 2022

Objective:

Angiogenesis inhibitors are effective anti-cancer agents, but also cause hypertension and renal injury. Earlier, we observed in rats that high-dose aspirin (capable of blocking cyclooxygenase (COX)-1 and -2) prevented these side effects better than low-dose aspirin (blocking COX-1 only). Therefore, we hypothesized that selective COX-2 inhibition would prevent toxicity during angiogenesis inhibition, and that this toxicity involves a reduced ratio of vasodilator/constrictor COX-derived prostanoids, i.e., prostacyclin (PGI2) and thromboxane (TXA2).

Design and method:

Male WKY rats received vehicle, angiogenesis inhibition (sunitinib (SU), 14 mg/kg/day) alone or combined with COX-2 inhibition (celecoxib, 10 mg/kg/day), a PGI2 analogue (iloprost 100 mcg/kg/day), or a dual TXA2 synthase/receptor antagonist (picotamide, 2.5 mg/kg/day) for 8 days (n = 7–8/group). Mean arterial pressure (MAP) was measured via radiotelemetry, vascular function was assessed via wire myography, and biochemical measurements were performed by ELISA.

Results:

SU induced a rapid increase in MAP (16 ± 2 vs. 3 ± 1 mmHg after vehicle on day 6, P < 0.001), which was blunted by celecoxib (10 ± 2 mmHg on day 6, P = 0.06 versus SU), temporarily attenuated by iloprost (on treatment days 1–2) and unaffected by picotamide. Wire myography demonstrated a trend towards increased vasoconstrictor response to endothelin-1 in iliac arteries after SU, which was prevented by celecoxib (P < 0.001). SU increased albuminuria (0.6 ± 0.1 vs. 0.3 ± 0.1 mg/24 h after vehicle; P < 0.001), and this was prevented by celecoxib only (0.4 ± 0.1 mg/24 h, P = 0.01 vs. SU). SU increased the PGI2/TXA2 ratio in both plasma (3.0 ± 1.1 vs. 0.6 ± 0.2 after vehicle, P = 0.02) and urine (23 ± 2.1 vs. 0.9 ± 0.2 after vehicle, P < 0.0001).

Conclusions:

In conclusion, selective COX-2 inhibition combats angiogenesis inhibitor-induced hypertension and renal toxicity. SU paradoxically increases the PGI2/TXA2 ratio, particularly in the kidney. Although this upregulation might initially be protective, it could eventually contribute to renal toxicity, most likely because PGI2 exerts deleterious effects in excessive concentrations. Targeting excessive renal PGI2 production might be another promising strategy to prevent renal toxicity during angiogenesis inhibition.
RHO KINASE BLOCKADE ALLEVIATE BLOOD PRESSURE ELEVATION AND INHIBIT VASCULAR REMODELING IN APATINIB-INDUCED HYPERTENSION TO BE CONFERMED
Authors: Li Caie , Wang Qiongying , Ma Liping , Wang Wenjuan , Yu Jing
Published: June 2022

Objective:

Hypertension is one of the major adverse effects of tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factors. However, the mechanism underlying TKIs-induced hypertension remains unclear. Here, we evaluated BP responses at different doses of apatinib, a TKI used for anti-tumor therapy, in normotensive Wistar–Kyoto rats. Furthermore, we explored the role of the RhoA/Rho kinase (ROCK) emodellin pathway in elevation of blood pressure (BP) induced by apatinib, a selective TKI approved in China for treatment of advanced or metastatic gastric cancer. A non-specific ROCK inhibitor, Y27632, was then combined with apatinib and its efficacy in alleviating apatinib-induced hypertension was evaluated.

Design and method:

Normotensive female Wistar–Kyoto rats were exposed to two different doses of apatinib, or apatinib combined with Y27632, or vehicle for two weeks. BP was monitored by a tail-cuff plethysmography system. The mRNA levels and protein expression in the RhoA/ROCK pathway were determined, and vascular emodelling assessed.

Results:

Administration of either a high or low dose of apatinib was associated with a rapid rise in BP, reaching a plateau after 12 days. Apatinib treatment mediated upregulation of RhoA and ROCK 2 in the mid-aorta, more significant in the high dose group. However, ROCK1 expression showed no statistically significant differences. Furthermore, the mRNA level of GRAF3 decreased dose-dependently. Apatinib administration was also associated with decreased levels of MLCP, and elevated endothelin-1 (ET-1) and collagen 1, which was accompanied with increased mid-aortic media. However, treatment with Y27632 attenuated the above changes.

Conclusions:

Results of the present study indicated that apatinib treatment increased BP and promoted vascular emodelling by activating the RhoA/ROCK emodellin pathway. However, Y27632, a non-specific ROCK inhibitor, reversed apatinib-induced increase in BP and vascular emodelling. Therefore, RhoA/ROCK activation could be the underlying mechanism of apatinib-induced hypertension, while ROCK inhibitors could be potential therapeutic drugs.
HYPERTENSION AND COMORBIDITY AS MACE DEVELOPMENT RISK FACTORS IN THE EAST EUROPEAN REGION
Authors: Surunovich Julia , Podpalov Vladislav
Published: June 2022

Objective:

To identify the impact of Hypertension and comorbidity on the MACE development in the East European Region

Design and method:

In 2007/2008- 2012/2013 5-year prospective analysis was conducted. Evaluating cardiovascular risk factors with standard questionnaires, measurements of blood pressure, electrocardiography, blood chemistry (serum C-reactively protein, uric acid and cholesterol data) were included in the survey. In 5 years we registered new cases of MACE in the Belarusian population.

Results:

70 new cases of MACE were developed in population of 3427 persons during 5-years survey. According to one-variable regression the MACE development was independently associated with the following risk factors adjusted for age and sex: COPD (p < 0.01), HF (p < 0.001), edema (p < 0.01), angina pectoris (p < 0.01), hypertension (p < 0.01), intermittent claudication (p < 0.05), low HDL-C level < 1.08 mmol/l, triglycerides level > 1.87 mmol/l (p < 0.05), myocardial infarction (p < 0.05), low physical activity (p < 0.1), family history of premature cardiovascular disease (p < 0.1). After including these parameters in multifactorial regression analysis and deriving the final model of MACE development (df = 1; x2 Walda = 32.2; p < 0.001) hypertension (p < 0.05), COPD (p < 0,01),HF (p < 0.01), low HDL-C level (<1.08 mmol / l) were significantly associatied with MACE development.

Conclusions:

Hypertension and comorbidity particularly dyslipidemia, COPD, HF are significant risk factors associated with MACE development in The East European Region.
SEVERE HYPERTRIGLYCERIDEMIA, THE REALITY OF A UNIVERSITY HOSPITAL
Authors: Laranjeira Francisco Soares , Raimundo Anabela , Horta Alexandra Bayão
Published: June 2022

Objective:

Severe hypertriglyceridemia (SHTG) is defined as a serum triglyceride (TG) level > 1000 mg/dL. It is a rare condition associated with serious complications, such as acute pancreatitis (AP). A paucity of published data exists evaluating management and outcome in SHTG. So, the best treatment is still a matter of discussion. The aim of this study is to outline the demographics, management and outcome (reoccurrence and mortality) in all patients with SHTG treated at a University hospital.

Design and method:

A retrospective, observational and analytical study was carried out, through the collection of data from the clinical files of patients with SHTG admitted to the Internal and Intensive Medicine Department between 1 January 2009 and 31 December 2020, in a level III hospital. Data were nalysed using the IBM SPSSstatistics program.

Results:

The sample included 17 patients. The most common complication was AP (70.6%), followed by decompensated diabetes mellitus (DM). 84.2% required admission to the Intensive Care Unit (ICU). Concerning the metabolic profile: 94% were overweight; 52.9% had previous dyslipidemia; 47.1% arterial hypertension and 52.9% type 2 DM. Among patients with AP, the most common therapies instituted were insulin (82.4%) and fibrates (76.5%). 58.8% required plasmapheresis, and a single session allowed, on average, a reduction of 56.8% in the value of TGs. The criteria for implementation were mainly clinical and laboratory, including lactic acidosis (58.8%) and renal dysfunction (23.5%). There were no deaths, the readmission rate was 36.3%, all due to AP.

Conclusions:

This study shows the morbidity associated with SHTG, with a high level of admissions to the ICU and performance of plasmapheresis. This allowed a significant reduction in TG values, with the clinical severity being the main criteria for its initiation. In our population, this approach was effective, and should be highlighted, as there are no clear international guidelines on this area. Our data do not allow us to distinguish between patients with familial chylomicronemia syndrome or with multifactorial chylomicronemia. The recent appearance of specific therapy for LPL genetic deficit makes it important, and in the future the genetic study should be considered.
ROLE OF ESTIMATING PULSE WAVE VELOCITY IN COMMUNITY PHARMACIES IN SPAIN COMPARED TO SCORE
Authors: Rodilla Enrique , Adell Manuel , Vicente Baixauli , Otón Bellver , Lidón Castillo , Santiago Centelles , Edelmira Córcoles , Rosario Hernández , Sara Martínez , Zeneida Perseguer , Rosa Prats , Javier Reig , Desiré Ruiz , Fanny Ruiz , Luis Salar , José-Antonio Costa , José Chordá , Ana Gómez , Andrea Mendizábal , Teresa Climent María
Published: June 2022

Objective:

European Guidelines clearly state the need to estimate cardiovascular (CV) risk using tables validated for this purpose. However, they also recommend assessing subclinical organ damage to improve stratification, since target organ lesions, such as arterial stiffness, estimated by brachial oscillometry, have an independent and additional prognostic value. Previous studies have shown that Community Pharmacies are able to correctly measure arterial stiffness.The objective of this study is to assess whether the estimation of arterial stiffness can improve CV risk stratification according to SCORE in Community Pharmacies.

Design and method:

This is an observational prospective epidemiological study in which everyone who enters the participating Community Pharmacies will be offered a voluntary measurement of blood pressure and arterial stiffness to compare the stratification of their CV risk according to SCORE with or without considering pulse wave velocity. The expected duration of the study is 12 months.

Results:

In the first month of recruitment, data from 275 patients (173 women, 102 men) were collected. Five of 39 (12.8%) patients under 40 years of age and 42 of 109 (38.5%) over 65 years of age presented pathological stiffness and could be classified as high risk even though being out of the age-range of SCORE. Of the 133 (48.4%) who were capable of calculating SCORE, the cholesterol value was available only in 69 patients (51.9%). Among them, according to SCORE, 18 patients (26.0%) were at low risk, 50 (72.5%) at moderate risk and only 1 (1.5%) at high risk, while 28 patients (21.1%) presented pathological arterial stiffness.

Conclusions:

Almost half of the people who randomly enter a community pharmacy had ages that make it impossible to calculate the CV risk by SCORE. Among them, arterial damage was detected in a third. Of the other half, one in five presented arterial damage and, therefore, high CV risk, when SCORE only detected it in a single patient. Therefore, estimating arterial stiffness in community pharmacies markedly improves detection of high CV risk compared to SCORE.
CARDIOVASCULAR DISEASE RISK PREDICTION IN EASTERN EUROPE ACCORDING TO 5-YEARS PROSPECTIVE STUDY
Authors: Podpalov Vladislav , Zhurova Olga , Podpalova Olga , Surunovich Juliya
Published: June 2022

Objective:

The aim of the study was to identify the most significant risk factors for cardiovascular diseases in Eastern European.

Design and method:

We conducted 5-years prospective andomised study of 3,500 individuals of the Belarusian population living in a district of Vitebsk in 2007/2008 (coverage of the survey was 97.9%), 2010/2011 (coverage of the survey was 77.8%) and 2012/2013 (coverage of the survey was 84.3%). The survey included standard questionnaires for detection of cardiovascular risk factors, measurements of blood pressure, electrocardiography, blood chemistry (serum CRP, uric acid and cholesterol data). In 5 years we registered new cases of hypertension, myocardial infarction, stroke and death from cardiovascular diseases in the studied population.

Results:

According to multifactorial regression analysis the risk factors for hypertension development included in the final model (df = 10; 2 Walda = 422,98; p < 0,001) were traditional risk factors, such as age (p < 0,001), sex (p < 0,23), high systolic blood pressure (>120 mmHg) (p < 0,001), high body mass index (>25,7 kg/m2) (p < 0,001), alcohol abuse (p < 0,01), heart rate (>70 beats/min) (p < 0,01), hereditary burden of stroke (p < 0,05) and new risk factors - high uric acid level (>338 mol/l) (p < 0,001), and high level of amount of ECG peaks SV1+RV5–V6 (>25 mm) (p < 0,001). The risk factors for the development of new cases of myocardial infarction, stroke and death from cardiovascular diseases included in the final model (df = 1; 2Walda = 32,2; p < 0,001) were age (p < 0,001), sex (p < 0,001), heart failure (p < 0,01), hypertension (p < 0,05), edema (p < 0,05) as well as low HDL (<1,08 mmol/l) (p < 0,01) and comorbidity, especially COPD (p < 0,01). The special role of COPD can be explained by the high prevalence of smoking in the Belarusian population (men - 60.6%, women - 13.8% (p < 0,001)).

Conclusions:

In the Belarusian population as well as traditional risk factors for cardiovascular diseases and cardiovascular death new risk factors, such as high uric acid level, high level of amount of ECG peaks SV1+RV5–V6, low HDL cholesterol and COPD, were established.
IMPACT OF POSTURAL POSITION ON DETERMINATION OF AORTIC STIFFNESS AND CENTRAL BLOOD PRESSURE
Authors: Philibert Emy , Paré Mathilde , Côté Nadège , Fortier Catherine , Duval Karine , Goupil Rémi , Obeid Hasan , Agharazii Mohsen
Published: June 2022

Objective:

Aortic stiffness is associated with increased central pulse pressure and cardiovascular disease and mortality. It is generally performed by determination of carotid-femoral pulse wave velocity (PWV) in a supine position. Two alternative approaches have been developed to estimate aortic stiffness, namely brachial pulse waveform analysis (Mobil-O-Graph) and finger-to-toe PWV by photoplethysmography (pOpmeter). These devices make it possible to assess and estimate aortic stiffness conveniently in different positions. However, it remains unclear if the values obtained are independent of the position at the time of measurement. Therefore, the aim of the present study is to determine the extent of postural changes on pulse wave velocity and central blood pressure estimation using pOpmetre and Mobil-O-Graph devices in a group of healthy controls.

Design and method:

Central blood pressure and PWV were assessed in 20 healthy subjects using both Mobil-O-Graph (PWV-M) and pOpmetre (PWV-pop) in three positions: supine position in bed, supine position in medical sampling chair and a sitting position. Central systolic blood pressure (SBP) was determined by calibration of brachial systolic and diastolic blood pressures (C1 calibration) by both methods (SBP-M and SBP-pop).

Results:

In the supine position in bed, PWV-M and PWV-pop were similar (5.5 ± 1.0 vs 5.4 ± 1.3 m/s, P = NS). In the supine position in a sampling chair, PWV-M decreased slightly (5.3 ± 1.0 m/s, P = 0.04 vs supine in bed), while PWV-pop increased significantly (5.9 ± 1.5 m/s, P = 0.04 vs supine in bed). However, in the sitting position, while PWV-M was not statistically different from the supine position (5.5 ± 1.0 m/s, P = NS), PWV-pop increased very significantly (9.2 ± 1.7 m/s, P < 0.001). Central blood pressure estimation remained similar for SBP-M (110.2 ± 10.3 vs 106.9 ± 10.5 vs 108.8 ± 11.1 mmHg, P = NS) and for SBP-pop (107.7 ± 10.4 vs 110.3 ± 9.6 vs 109.5 ± 9.9 mmHg, P = NS).

Conclusions:

These preliminary results tell us that postural position has little impact on the determination of aortic stiffness by the approach using brachial pulse wave analysis. However, finger-to-toe PWV increases remarkably with changes in position, possibly offering to explore the relationship between hydrostatic pressure and arterial stiffness as a dynamic test.
RISK FACTOR PROFILING OF ACUTE CORONARY SYNDROME IN PREMENOPAUSAL WOMEN PRESENTING AT A TERTIARY CARE HOSPITAL IN URBAN INDIAN SETTING: AN OBSERVATIONAL STUDY
Authors: Mishra Prashant , Karegowda Praveen , Amritkar Vijay
Published: June 2022

Objective:

This study aimed to evaluate cardiovascular risk factors in premenopausal women presenting with acute coronary syndrome (ACS).

Design and method:

Premenopausal women presenting with ACS at the Deenanath Mangeshkar hospital & research center, Pune between January 2012 and June 2019 were enrolled. Data concerning demographics, risk factors and medical history (self-reported) were collected.

Results:

Ninety premenopausal women (mean age: 40.8 ± 5.0 years) were included in the study. The most common presenting symptoms were chest pain (83.3%) and shortness of breath. ACS presentation included ST-elevation myocardial infarction (38.9%), unstable angina (34.4%) and non-ST-elevation myocardial infarction (25.6%). Mild-to-severe left ventricular dysfunction was seen in 52.2% women and triple or double vessel disease in 52.2% women. The most frequent conventional coronary risk factors were diabetes (of total 41%, 48. 6% were poorly controlled) and hypertension (38.9%); lifestyle-related risk factor were low levels of physical activity (51.1%); and obstetric and gynaecological factors were history of at least one miscarriage (26.7%) and hormonal contraceptive use (26.7%). No correlation was found between the risk factors and presentation of ACS or severity of coronary artery disease.

Conclusions:

The high prevalence of conventional risk factors need to be identified and addressed early. Novel gynaecological risk factors are often ignored and need fair attention in routine practice in premenopausal women presenting with ACS. To our knowledge, this is one of the largest data set that determined cardiovascular risk factors in premenopausal women with ACS.
HYPERTENSION IN CAMEROONIAN RURAL AND URBAN PYGMIES AND BANTUS OF THE SOUTHERN REGION
Authors: Hako Yves , Bika Claude , Okala Cecile , Dissongo Jean Ii , M’buyamba Kabangu Jean-René , Degaute Jean Paul , Van De Borne Philippe , Lemogoum Daniel
Published: June 2022

Objective:

To determine the prevalence of hypertension and associated risk factors among rural and urban pygmy and Bantu dwellers of southern Cameroon

Design and method:

In this cross-sectional cluster sampling survey, we examined 100 traditional pygmies (TP) living in equatorial forest in Kavabousse village under hunter-gatherer subsistence mode, 100 traditional Bantus (TB) living in Bidjouka village closed to Kavabousse (rural area); and 100 contemporary pygmies (CP) and 100 contemporary Bantus (CB) both living in the same urban environment in Kribi city. Trained observers recorded in each participant lifestyle and socio-demographic data, and clinical parameters. Brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in triplicate using an automatic sphygmomanometer (Omron 705 CP). Hypertension was defined as SBP/DBP > or = 140/90 mmHg.

Results:

As compared to Bantus, Pygmies were younger (38 ± 16 vs 45 ± 17 years, p = 0.0001), with lower body mass index (22.7 ± 3.3 vs 24.9 ± 4.6, p < 0.0001). Age-adjusted SBP and DBP were lower in Pygmies than in Bantus (p < 0.0001), however within group SBP and DBP were similar among rural and urban individuals. Age-adjusted prevalence of hypertension was lower in pygmies than Bantus globally (7.5% vs 21.5% p = 0.0001), and in rural and urban areas: 4% vs 19% and 11% vs 24 %, respectively, both p < 0.01). In pygmies taken separately, the age-adjusted prevalence of hypertension was lower in TP than in CP (4% vs 11%). In the whole study population, multivariate logistic regression analysis revealed that hypertension was independently associated with urban area (OR = 2.15, 95%CI: 1.14–4.05), Bantu status (OR = 2.17, 95%CI: 1.09–4.34), age >or = 50 years (OR = 2.15, 95%CI: 1.14–4.05), and abdominal obesity (OR = 0.20 95%CI: 0.09–0.46) (all p < 0.05). In pygmies taken separately, multivariate logistic regression analysis shown that age >or = 50 years (OR = 3.83, CI95%: 1.33–11.36) and urban area (OR = 3.33, CI95%: 1.04–11.11) (both p < 0.05) were independent determinants of hypertension.

Conclusions:

This study reveals that hunter-gatherer lifestyle is associated with lower prevalence of hypertension as illustrated in TP. Hypertension is more common in Bantus and CP, and is largely attributable to their westernized lifestyle and the growing urbanization of rural area.
METABOLIC PHENOTYPE OF OBESITY IN YOUNG WOMEN AND THEIR DAILY BLOOD PRESSURE PROFILE
Authors: Evsevyeva Maria , Prokhorenko-Kolomoitseva Irina , Sergeeva Oksana , Gachkova Irina , Penzova Violetta , Ovchinnikova Olga
Published: June 2022

Objective:

The prevalence of overweight (MT) and obesity among women is 59.2%. The expediency of singling out a group of patients with metabolically healthy obesity is being actively discussed.The ratio of obesity variants and hemodynamic status is still poorly studied, including of young women. These data are necessary to optimize the predictive diagnosis of diseases associated with various variants of obesity, and to improve their personalized prevention. to evaluate the effect of metabolic phenotype (MP) of obesity on the indicators of daily monitoring of blood pressure (DMBP).

Design and method:

The study included 100 women aged 18 to 35 years. The MP was determined by different combinations of such indicators as the body mass index (BMI) and the HOMA-Index (HI). In the 1st group, women with a BMI less 25 kg/m2 and HI less 2.52 (control), in the 2nd group with BMI less 25 kg/m2 and HI more 2,52, in the 3rd group BMI more 25 kg/m2 and HI less 2.52, in the 4th group BMI more 25 kg/m2 and HI more 2.52. DMBP indicators were evaluated using the BPLab Vasotens device (N-Novgorod, Russia).

Results:

In women in 4th group, compared with the control during the daytime, SBP increased by 16.8 mm Hg or 14.8% (P = 0.0000), DBP increased by 7.1 mm Hg or 9.4% (P = 0.0000). SBP is enlarged in midnight by 14.3 mmHg or 14.5% (P = 0.0000), DBP - by 5.0 mmHg or 8.0% (P = 0.0044). In women from the 2nd and 3rd groups, these indicators were higher than the control, but these differences were less pronounced.

Conclusions:

In young women, the maximum increase in SBP and DBP per day was detected when excessive BM/obesity was combined with high insulin resistance. Their presence in an isolated form is associated with less pronounced disorders of DMBP. It is useful to take these data into account when creating a system of predictive diagnostics of the consequences of obesity and their individualized prevention by more differentiated formation of cardiovascular risk groups among the discussed contingent, according to the metabolic status.
THE RELATIONSHIP BETWEEN THE MUSCLE MASS INDEX AND THE AGGREGATION OF CARDIOVASCULAR RISK FACTORS IN CHINESE ADOLESCENTS AGED 12–17 YEARS
Authors: Bai Ling , Zhou Jinyu , Tong Lingling , Ding Wenqing
Published: June 2022

Objective:

The relationship between muscle mass and the aggregation of cardiovascular risk factors in adolescents is still controversial, therefore this study aimed to explore the relationship between muscle mass index (MMI) and the aggregation of cardiovascular risk factors (CVRFs) in adolescents.

Design and method:

A total of 1622 adolescents(1000 boys, 61.6%) aged 12–17 years from Ningxia were randomly selected through a stratified cluster sampling. we measured body composition by bioelectric impedance analysis (BIA), and calculated muscle mass index (MMI). The aggregation of cardiovascular risk factors is defined as the number of hypertension, abnormal fasting blood glucose, High total cholesterol (TC), High low-density lipoprotein cholesterol (LDL-C), Low high-density lipoprotein cholesterol (HDL-C), High triglyceride (TG).

Results:

MMI was a risk factor for the aggregation of cardiovascular risk factors (all P values < 0.001). After adjusting for age, gender and BMI, MMI became a protective factor for CVRFs>=1 (OR= 0.74, 95%CI: 0.62–0.89). In total population, the ORs for CVRFs> = 1 were 0.60 (95%CI: 0.46–0.79) in good MMI, 0.56 (95%CI:0.37–0.85) in sufficient MMI compared with insufficient MMI; The ORs for CVRFs> = 2 were 0.54 (95%CI: 0.37–0.79), 0.51 (95%CI: 0.30–0.87) respectively. Similar results were found in boys (all P values < 0.05).

Conclusions:

Muscle mass index as a protective factor for cardiovascular risk factor aggregation in adolescents with the same BMI level. Physical exercise of children and adolescents should be emphasized to maintain the best muscle mass and weight.
THE CARDIOVASCULAR HEALTH STATUS OF CARDIOLOGISTS IN CHINA: THE CHINA CARDIOLOGIST HEART STUDY
Authors: Yu Shikai , Zhang Yi , Peng Wenhui , Zhao Dong , Shi Hong , Zhang Shuning , Huo Yong , Xu Yawei , Ge Junbo
Published: June 2022

Objective:

The morbidity and mortality of cardiovascular disease in China are still increasing. China cardiologists, as the gatekeeper of Chinese cardiovascular health, themselves should be healthy in cardiovasculature firstly, before they can take care of their patients. A national survey eligible to every China cardiologist was conducted to evaluate their health status and boost their perception on their own cardiovascular health.

Design and method:

An online questionnaire based on Wechat, a social application widely used in China, was tried to spread out to every cardiologist practicing in China. The information including age, gender, height, weight, life and work habits, cardiovascular risk factors, and histories of diseases and medication, were filled out by each surveyed cardiologist. Crude prevalences of cardiovascular risk factors, organ damage, and cardiovascular diseases were calculated and compared with data from Chinese general population.

Results:

A total of 17010 cardiologists (mean age 39 ± 9 years; 54.3% males) across China participated the survey between August 2020 and November 2021. Hyperlipidemia was the most common cardiovascular risk factor, followed by hypertension 2126 (12.5%), smoking 1232 (7.2%), overweight 1031 (6.1%), diabetes 404 (2.4%) and obesity 379 (2.2%). Compared with data from Chinese general population, cardiologists in China showed higher rates of awareness, treatment, and control rates of hypertension, diabetes, and hyperlipidemia. Male, versus female, cardiologists showed significantly higher prevalences of hypertension (18.6% vs 5.2%), diabetes (3.4% vs 1.2%), and hyperlipidemia (31.8% vs 18.1%). Intervention, versus non-intervention, cardiologists showed significantly higher prevalences of hypertension (15.6% vs 9.7%) and hyperlipidemia (30.8% vs 21.1%). Carotid plaque (3.5%) and microalbuminuria (1.3%) were the most prevalent subclinical organ damage. There were 539 (3.2%) cardiologists presented with arrhythmia, 378 (2.2%) with OSAS, and 82 (0.5%) with coronary artery disease.

Conclusions:

Compared to general population, China Cardiologists showed lower prevalences of hypertension, diabetes and hyperlipidemia and better management of cardiovascular risk. More attention and efforts are still needed to further improve the cardiovascular health of cardiologists in China, especially for males and intervention cardiologists.
PREVALENCE OF TARGET ORGAN DAMAGE AND CARDIOVASCULAR RISK FACTORS IN PATIENTS OF THE IBERICAN STUDY
Authors: Secin Anny Altagracia Romero , Gamarra Amelia González , Pérez Rafael Manuel Micó , Oria Virginia Lasso , Gil Ines Gil , Jelsbak Cristina Murillo , Royo Josefa Maria Panisello , Gómez González María José , Garcia Antonio Ruiz , Diaz Miguel Angel Prieto
Published: June 2022

Objective:

The general aim of IBERICAN study is to know the prevalence and incidence of cardiovascular risk factors and cardiovascular and renal disease in Spain. The aim of this abstract is to know the prevalence of subclinical target organ damage (TOD) and cardiovascular risk in population of the IBERICAN Study.

Design and method:

The IBERICAN Study is a longitudinal, observational, and multicentric study with subjects between 18 to 85 years of age, recruited in Primary Care (PC) and who will be follow up at least 10 years. The final sample size is estimated in 8,066 patients. We show the baseline characteristics of the patients in the first visit (n = 8,066). To define the TOD, we consider the ESH 2013 Guide criteria: pressure pulse in aged > 60 mmHg, ankle/brachial index < 0.9, microalbuminuria: albumin/creatinine ratio (between 30 - 299 mg/g), glomerular filtration (CDK-EPI < 60 ml/min), left ventricular hypertrophy (electrocardiogram or ECHO).

Results:

2,052 patients presented TOD (25.4%). The most frequent cardiovascular risk in patients with TOD are: hypertension in 73.7% vs 39.1% p< 0.001, dyslipidemia in 65.3% vs 45.1% p < 0.001, obesity in 43% vs 32, 5% p < 0.001, type 2 diabetes mellitus (T2DM) in 35.2% vs 15% p < 0.001, sedentary lifestyle 66.2% vs 27.8% p = 0.2 and smoking in 11.1% vs 19.9% p < 0.001. Of the patients with TOD and hypertension had good control 46.4% vs 66.6% p < 0.001, TOD and T2DM 74.4% vs 66.2% p = 0.8, TOD and dyslipidemia 22.2% vs 30 .2% p < 0.001. 57% (n = 1,170) of the patients with TOD met the criteria for Metabolic Syndrome and 23.3% (n = 477) met premorbid metabolic syndrome.

Conclusions:

All cardiovascular risk factors were more frequent in patients with TOD, except for smoking. The most frequent cardiovascular rissk was hypertension arterial and the worst controlled was dyslipidemia. TOD classifies patients as having high cardiovascular risk, so being able to detect it in patients with one or more cardiovascular risk factor is relevant for the optimal therapeutic approach in primary prevention.
ASSOCIATION BETWEEN ARTERIAL STIFFNESS AND LEFT VENTRICULAR FUNCTION IN HYPERTENSIVE PATIENTS
Authors: Georgieva N. , Kinova E. , Borizanova A. , Shopov L. , Krastev B. , Ilieva R. , Goudev A.
Published: June 2022

Objective:

Increased arterial stiffness is an early predictor of cardiovascular changes. However the association between arterial stiffness with LV myocardial changes is poorly understood

The aim of this study was to examine the relationship between arterial stiffness and LV function in well - controlled hypertensive patients.

Methods: A total 100 consecutive patients with hypertension adapted by age, gender and BMI, were separated in two groups: 27 patients with normal ventriculo - arterial coupling (VAC) and 63 hypertensive patients with disturbed VAC, measured by arterial elastance/ventricular elastance ratio(AE/Ees). All patients underwent standard two - dimentional (2D) echocardiography with Speckle tracking analysis for left ventricle (LV) global longitudinal strain (GLS). End - systolic pressure was determined from the brachial pulse wave. Arterial elastance (AE) and ventricular elastance (Ees) were calculated as and - systolic pressure/stroke volume and end - systolic pressure/end - systolic volume. Parameters for arterial stiffness - 24 - hour central systolic pressure (cSys24 h), central pulse pressure (cPP24 h), augmentation index 24 h (Aix24 h) and 24 - hour pulse wave velocity (PWV24 h) were measured non - invasively with oscillometric method by Mobil-O-graph PWA.

Results:

Statistically significant differences in parameters of vascular stiffness were found in patients with normal AE/Ees ratio in comparison disturbed AE/Ees: cSys24 h (108.76 ± 7.65 vs. 115.12 ± 11.58 mm Hg, p = 0.03), cPP24 h (39.61 ± 12.25 vs. 47.12 ± 11.52 mm Hg, p = 0.03). There is a statistically significant difference in echocardiography parameters between patients with normal VAC in comparison to other group: LV - GLS (-17.98 ± 0.65 vs. -15.9 ± 1.8 %, p = 0.0001), AE (2.09 ± 0.63 vs. 1.75 ± 0.34, p = 0.003), Ees (2.89 ± 0.71vs. 4.29 ± 0.72, p = 0.0001), AE/Ees ratio (0.74 ± 0.27 vs. 0.47 ± 0.46, p = 0.003). There were no statistically significant differences in LV ejection fraction, PWV24 h, Aix24 h and heart rate between two groups. There are moderately positive correlation between cSys24 h and LVMI (r = 0.325, p = 0.001) and negative with AE/Ees (r = -0.326, p = 0.01). cPP24 h correlate positively with AE (r = 0.249, p = 0.015) and negative with E/Em (r = -0.220, p = 0.032).

Conclusion:

Elevated arterial stiffness was intimately determines early LV alterations, before LV dysfunction, becomes clinically evident
CASE REPORT: HELLP-LIKE SYNDROME IN A 19-YEAR-OLD WOMAN WITH NOT WELL - CONTROLLED HYPERTENSION
Authors: Wojciechowska Ewa , Gryglas Piotr
Published: June 2022

Objective:

We report a young woman with malignant hypertension (HTN) and multiorgan damage due to microangiopathy.

Design and method:

A 19-year old woman with previously recognized HTN and family history of HTN developed acute symptoms related to long-standing not well-controlled HTN. The patient presented with high blood pressure (BP), vomiting, epigastric pain, jaundice, impaired consciousness, tonic-clonic seizures, complete left eye blindness and partial right eye blindness. On admission, the patient was conscious but obtunded, with marked cognitive dysfunction, BP 255/143 mm Hg, heart rate 130 bpm, breathing rate 34/min, temperature 36,9C, SpO2 95%. Following admission, a transient loss of consciousness with eyes turning to the left was observed upon sitting up, without any arrhythmia seen in ECG monitoring. Neurological examination was unremarkable. Fundoscopy showed grade IV changes with papilledema, numerous hemorrhages and cotton wool spots.

Results:

Pregnancy test was negative. Laboratory test abnormalities included macrocytic anemia (Hb 10.25 g/dL, Hct 33.6%, MCV 103 fL), elevated leukocyte count (17.1x10 3 /L), low platelet count (69x10 3 /L), elevated serum bilirubin (10.4 mg/dL) and creatinine (4.2 mg/dL), and slightly elevated AspAT and troponin I. Brain CT showed chronic vascular brain damage. BP was gradually normalized using intravenous/oral antihypertensive drugs. Clinical symptoms and laboratory abnormalities resolved, except for left eye blindness and serum creatinine (2.47 mg/dL at discharge). Secondary HTN was excluded. The final diagnosis was malignant HTN, acute hypertensive encephalopathy with seizures, acute liver damage, chronic kidney disease, acute hemolytic anemia due to hypertensive microangiopathy, and permanent left eye blindness. Due to hemolysis and low platelet count, differential diagnosis included hemolytic-uremic syndrome which was excluded. The clinical presentation resembled that of HELLP syndrome in pregnant women with eclampsia, with evidence of target organ damage, low platelet count, liver and kidney dysfunction, and hemolytic jaundice.

Conclusions:

Young patients with essential HTN rarely present with such fulminant malignant HTN manifesting with neurological symptoms, with evidence of multiorgan damage due to microangiopathy. Similarly, microangiopathic hemolytic anemia rarely complicates malignant HTN. Initial clinical presentation was challenging due to neurological symptoms and evidence of multiorgan failure.