bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P342: Acute Nasal Breathing Lowers Blood Pressure And Increases Parasympathetic Contributions To Heart Rate Variability In Young Adults
Authors: Watso Joseph C , Cuba Jens N , Boutwell Savannah L , Moss Justine , Bowerfind Allison K , Fernandez Isabela M , Cassette Jessica M , May Allyson M , Kirk Katherine F
Published: October 2023

Introduction:
Interest is growing in how breathing pace, pattern, and training (e.g., device-assisted or -resisted breathing) affect prognostic cardiovascular variables (e.g., blood pressure (BP)). Nasal breathing increases bronchodilation via airway epithelium nitric oxide production, increases diaphragmatic movement, and reduces accessory inspiratory muscle recruitment. Despite these changes, the effect of nasal compared with oral breathing (i.e., breathing route) on prognostic cardiovascular variables is unclear.

Hypothesis:
We hypothesized that nasal compared with oral breathing would acutely lower BP and improve heart rate variability (HRV) metrics.

Methods:
We tested 20 young healthy adults in this study (13 Female/7 Male; age: 18 [1] years, median [IQR]; body mass index: 23 ± 2 kg•m
-2
, screening systolic / diastolic BP 116 ± 12 / 67 ± 7 mmHg mean ± SD). Participants self-selected their breathing rate during a five-minute ‘run-in’ period. Using a metronome, their breathing rate was fixed during two subsequent (random order) five-minute resting periods with nasal and oral breathing while we measured brachial BP and HRV metrics via ECG. We compared data between conditions using a Wilcoxon signed-rank paired test (data presented as median [IQR]) or using paired, two-tailed t-tests (data presented as mean ± SD). We set the significance to
p
<0.05.

Results:
Nasal breathing lowered mean (nasal: 84 ± 7 vs. oral: 86 ± 5 mmHg,
p
=0.006, Cohen’s
d
=0.70) and diastolic (nasal: 68 [8] vs. oral: 72 [5] mmHg,
p
<0.001, Rank-biserial correlation=0.89), but not systolic (nasal: 116 ± 11 vs. oral: 117 ± 9 mmHg,
p
=0.48, Cohen’s
d
=0.16) BP. Nasal breathing also raised the High-Frequency contribution to HRV (nasal: 59 ± 19 vs. oral: 52 ± 21 %,
p
=0.04, Cohen’s
d
=0.50) and lowered the Low-Frequency to High-Frequency ratio (nasal: 0.9 ± 0.8 vs. oral: 1.2 ± 0.9,
p
=0.04, Cohen’s
d
=0.49), suggesting a greater parasympathetic contribution to HRV. There were no differences between conditions for heart rate (
p=
0.90) or time-domain HRV metrics (
ps
≥0.07; e.g., the standard deviation of NN intervals).

Conclusion:
These data suggest that nasal compared with oral breathing acutely lowers mean and diastolic BP as well as potentially increases parasympathetic contributions to HRV.
Abstract P346: Patient Characteristics Related To Medication Adherence In A Nationwide Pragmatic Trial Comparing Thiazide-type Diuretics
Authors: Hynes Colleen , Hau Cynthia , Woods Patricia , Leatherman Sarah , Glassman Peter , Taylor Addison , Cushman William C , Ishani AREEF
Published: October 2023

Background:
Antihypertensive treatment (AHT) is crucial for preventing major adverse cardiovascular events and other negative health outcomes, but poor adherence remains a challenge. We assessed the associations between patient characteristics and adherence to two thiazide-type diuretics in a large sample of hypertensive patients from the Diuretic Comparison Project (DCP), a nationwide randomized pragmatic trial conducted in the Veterans Affairs Healthcare System.

Methods:
Study data, collected electronically during routine clinical care, were used to determine adherence to chlorthalidone and hydrochlorothiazide. Participants were classified as adherent (70.3%; 9,501 of 13,523) or non-adherent (29.7%; 4,022 of 13,523) based on a medication possession ratio threshold of 80%, irrespective of randomized drug assignment. Logistic regression was used to measure the associations.

Results:
Non-adherent participants were more likely to be older, Black, not married, residing in urban areas, current smokers, and had a higher level of baseline systolic blood pressure (Table 1). History of cardiovascular disease and diabetes were associated with lower adherence. However, participants with higher BMI and those who received more antihypertensive drugs showed better adherence than those with lower levels.

Conclusion:
These findings contribute to the identification of several patient characteristics as predictors of lower medication adherence. DCP’s pragmatic nature allowed for real-world data capture and may be useful to inform clinicians of patient groups who may not adhere to their medication and who might benefit from targeted interventions.
Abstract P352: High Rates Of Hypertension Control Require Mean Systolic Blood Pressure 10 Mm Hg Or More Below Target.
Authors: Egan Brent M , Sutherland Susan E , Martin Ben , Rakotz Michael
Published: October 2023

Background:
Given BP variability, we hypothesized that hypertension (HTN) control rates >80% to <140/90, required by some national recognition programs, occur when mean systolic (S)BP is 10 mmHg or more below target.

Methods:
Two cohort databases were analyzed: (i) SBP Intervention Trial (SPRINT-POP) Year 02 and (ii) American Medical Association’s Measure accurately, Act Rapidly, Partner with patients BP (AMA MAP
TM
BP) quality improvement program. MAP BP included adults with HTN at diverse health systems who had 2+ healthcare visits and received care from clinicians (N=544) with 24+ patients. The main outcome was the relationship of mean SBP to BP control (<140/90) in SPRINT standard (SPRINT-S) and intensive (SPRINT-I) treatment arms and by 5 mmHg increments in mean patient-panel SBP of clinicians in MAP BP.

Results:
In SPRINT-S (n=4,303) and SPRINT-I (n=4,323), mean SBP was 136.7 and 121.7 at the last visit with BP <140/90 in 60.7% and 88.4% of participants, respectively (Figure). In AMA MAP BP (n=168,978), mean SBP at the last visit was 132.1 with BP <140/<90 in 69.8% of patients. For MAP BP clinicians with mean patient-panel SBP 120-<125 (similar to SPRINT-I), 87.6% of patients were controlled to <140/90 (Figure) with control falling to 78.8%, 70.8% and 56.9% with mean clinician SBP 125-<130, 130-<135, 135-<140 (similar to SPRINT-S), respectively. In MAP BP, mean SBP accounted for 80% of variance (R
2
=0.80) in control to <140/90.

Conclusions:
Attaining HTN control rates >80% to <140/90 in a clinical trial and diverse practice settings occurs with group mean SBP <130. The findings are relevant to clinicians, BP targets, and incentives for HTN control.
Abstract P353: Greater Access To Care And Use Of Antihypertensive Medications Explain Lower Blood Pressures And Better Control In Statin-treated Than Statin-eligible Untreated Adults
Authors: Egan Brent M , Li Jiexiang , Sutherland Susan E , Rakotz Michael
Published: October 2023

Background:
Statin-treated adults have much better hypertension (HTN) control than statin-eligible untreated adults, although statins have limited BP effects. This study assessed whether greater access to care and use of BP medications contributed to better HTN control in statin-treated than statin-eligible untreated adults.

Methods:
NHANES 2009-2020 data were analyzed for adults 21-75 years (N=3,814) with HTN (BP 140+/90+ or treated) and control <140/90. The 2013 ACC/AHA Guideline defined statin eligibility and statin-treated adults deemed eligible. Access to care was defined as having healthcare insurance, at least one healthcare visit in the past year, and usual source of care. Descriptive and multivariate methods were used.

Results:
During 2009-2020, 69.7% of adults with HTN were statin eligible with 53.0% of statin-eligible adults on statins. Statin-treated vs. statin-eligible untreated adults had lower SBP (130.3 vs. 138.6 mmHg), greater access to care (93.2% vs. 77.7%), and greater HTN awareness, treatment, and better control (Figure, all p-values <0.01). In multivariable analysis, access to care was associated with HTN control (odds ratio,3.03 [95% confidence interval, 2.29-4.02]) and statin therapy (2.52 [1.69-3.78]). The association between statins and HTN control (1.94 [1.53-2.47]) was insignificant after controlling for antihypertensive therapy (1.29 [0.96-1.73]).

Conclusions:
Better HTN control in statin treated than statin-eligible untreated adults largely reflects greater access to care and use of antihypertensive therapy. Greater access to care in statin-eligible untreated adults may increase both statin therapy and HTN control.
Abstract P356: Hypertension Trends And Disparities Over Twelve Years In A Large Health System: Leveraging The Electronic Health Records
Authors: Lu Yuan , Brush John E , Liu Yuntian , Asher Jordan , Li Shu-Xia , Sawano Mitsuaki , Young Patrick , Schulz Wade , Anderson Mark , Burrows John , Krumholz Harlan M
Published: October 2023

Introduction:
The digital transformation of medical data has provided health systems with an opportunity to utilize electronic health records (EHR) for analyzing hypertension trends and identifying areas for improvement.

Methods:
We conducted a serial cross-sectional analysis of outpatients of the Sentara Healthcare System using EHR data from 2010 to 2021 to gain actionable insights about hypertension trends and disparities. Hypertension was defined as elevated visit blood pressure (BP >= 140/90 mmHg) or use of antihypertensive medications. We compared four different definitions of hypertension and assessed age-adjusted prevalence, BP control rate, and coded diagnosis rate as outcome measures.

Results:
The study included 1,376,325 unique adults. Hypertension prevalence varied by the definition used, ranging from 36.5% to 50.9% in 2010, and steadily increased by approximately 5% over time. BP control rates initially ranged from 61.2% to 71.3% in 2010, stabilized, experienced an increase during 2018-2019, and declined during 2020-2021. The proportion of hypertensive patients with a coded diagnosis ranged from 45.5% to 60.2% in 2010, showing improvement over time. Non-Hispanic Black patients consistently had higher hypertension prevalence, mean age-adjusted BP, and lower BP control rates compared to other racial/ethnic groups.

Conclusions:
Over 12 years, hypertension prevalence increased within the regional health system. Although BP control rates improved, they remained below 73% and revealed significant racial disparities. The assessment of EHR data uncovered important trends and highlighted opportunities for enhancing health system performance.
Abstract P361: Performance Of A Digital, Mobile, On-demand Hypertension Health Worker Training Course In Nigeria
Authors: Odu Joseph , Osi Kufor , Nguyen Leander , Goldstein Allison , Appel Lawrence J , Matsushita Kuni , Ojji Dike , Orji Anthony , Alex-Okoh Morenike , Odoh Deborah , Toma Malau Mangai , Elemuwa Chris , Lamorde Sulaiman , Baraya Hasana , Obagha Chijioke , Moran Andrew E , Agogo Emmanuel , Thomas Marshall
Published: October 2023

Introduction:
Currently only 2.8% of Nigerian adults with HTN have their blood pressure treated and controlled. Training health workers in HTN management is crucial for improving diagnosis and treatment, but in-person training has limitations.

Objectives:
The objective of this study is to evaluate the effectiveness of a self-paced, on-demand digital mobile course for training Nigerian health workers in HTN diagnosis and management.

Materials & Methods:
Twelve HTN training modules based on World Health Organization and Nigerian guidelines were drafted by the investigators. After review by local academic and government partners, Nigerian health workers staffing government-owned primary health care centers piloted the app. Participants were doctors, nurses, and community health workers who completed the course on their own smart phones. Multiple choice questions assessed HTN knowledge before and after the course. Learner feedback was collected in the last module of the course with Likert scale and open response questions.

Results:
Of 748 users who sampled the course, 574 enrolled. Of those enrolled, 431 completed the course (75% completion rate). Among completers, mean pre-test score was 65.4%, which increased to 78.2% post-test (
P
<0.001, paired t test). Health workers not part of existing HTN control programs had lower pre-test scores and greater score gains. Most learners (96.1%) strongly agreed the training was relevant to their work, and almost all (99.8%) agreed that they enjoyed the training.

Conclusions:
This pilot project developed an on-demand mobile digital HTN training course for Nigerian health workers. If deployed by the Nigerian government, the course will provide an easy way for health workers of all cadres (doctors, nurses, and community health workers) to participate in either induction or refresher training in HTN management.
Abstract P363: Design And Implementation Of A Technology-Powered Cross-Sector Collaborative To Improve Hypertension Control
Authors: Shine Kyna , Rivera De Jesus Jesa , Ebitu Aniekan , Sachs Brittany , Feldmeth Gillian , Hebert Lindsay , Ahmadi-Montecalvo Halima
Published: October 2023

Introduction:
The National Hypertension Control initiative (NHCI) aims to improve hypertension control among Black, Hispanic, American Indian/Alaskan Native persons through systematic, culturally sensitive, and evidence-based interventions. To accomplish this aim, the American Heart Association (AHA) partnered with a technology platform (Unite Us) to onboard community health centers (CHCs) and community-based organizations (CBOs) to participate in a national cross-sector network of health and social care providers. This study describes insights from the first year of planning and implementation.

Hypothesis:
CHCs are interested in and willing to use cross-sector collaboration software to address the social needs of patients with hypertension.

Methods:
The collaborative launched in December 2021, and partner outreach and engagement efforts began in June 2022. A five-week cohort-based onboarding process was deployed to prepare interested partners to use the software platform as part of the NHCI.

Results:
Between June 2022 and May 2023, the collaborative contacted 300 organizations. Twenty-three informational sessions were hosted and 21% (n=64) of organizations attended at least 1 session. Sixteen CHCs across 11 states completed the five-week onboarding process and launched use of the platform. With platform access, these CHCs can now refer patients with hypertension to local networks of CBOs (e.g. food support, benefits application assistance, rent assistance).

Conclusions:
Early insights from the outreach and onboarding of a cross-sector collaboration platform suggest that organizations are interested in leveraging technology to support the needs of patients with hypertension. Outcome focused data collection is ongoing and includes understanding platform reach (e.g. # of patients engaged) and referral outcomes (e.g. % resolved). These findings will be shared at the session.
Abstract P364: Qian Yang Yu Yin Granule (QYYYG) Treats Cardiac Hypertrophy In Spontaneously Hypertensive Rats By Improving Mitochondrial Function
Authors: Fang Yuan , Zheng Yawei , Ding Kang , Yang Ke
Published: October 2023

Background:
QYYYG is a Chinese herbal formula. The previous study found that QYYYG can improve subclinical myocardial damage of hypertension. Mitochondrial dysfunction plays a key role in promoting cardiac hypertrophy. The emphasis of this study lies in detecting mitochondrial function and further illuminating the multi-target effect of the QYYYG.

Methods:
Based on transcriptome data, perform bioinformatics analysis. WKY rats as a normal control group, SHR were randomly divided into 3 groups: Model group (SHR), Valsartan group and QYYY group. Intragastric administration, once a day for 8 weeks. The mitochondrial function was detected by mtDNA. The general view and degree of fibrosis were observed by HE and Masson staining. The WGA staining was used to examine the cell size.

Results:
Transcriptome analysis showed that mitochondrial dysfunction was an essential mechanism of hypertensive myocardial remodeling in mice. Compared with the WKY group, SHR group HE and Masson staining showed characteristic pathological lesions including cardiomyocytes becoming thicker and apparent interstitial fibrosis. The QYYY group showed a remarkable improvement in cardiac hypertrophy and degree of fibrosis. The WGA staining was also consistent with HE staining. The QYYY group mtDNA copy number was significantly increased.

Conclusions:
Overall, QYYYG might improve cardiac hypertrophy by rescuing mitochondrial function. The therapeutic effects of QYYYG on cardiac hypertrophy were consistent with those suggested by transcriptome analysis. Transcriptome analysis as those described here may contribute to the holistic understanding and pharmacological evaluation of herbal remedies.
Abstract P367: Evaluation Of Left Ventricular Pulsatile Workload In Heart Failure With Preserved Ejection Fraction Using A Single Pressure Waveform Form Framingham Heart Study
Authors: Niroumandi Soha , Wolfson Aaron , Vaidya Ajay , Pahlevan Niema M
Published: October 2023

Introduction:
The significance of ventricular-arterial coupling (VAC) in understanding the pathophysiology of heart failure (HF) and other cardiovascular diseases is well-established. Recent studies suggest that evaluation of VAC via assessment of left ventricle (LV) pulsatile workload (LVPW) may be useful in diagnosing HF with preserved ejection fraction (HFpEF). In addition, several studies have indicated that abnormal pulsatile hemodynamics is one of the key characteristics of HFpEF. Specifically, a higher pulsatile load is identified as one of the main causes of HFpEF in older women. Assessment of the LVPW requires measurement of both pressure and flow waves. Our aim in this study is to develop a new method for evaluation of LVPW in HFpEF (and HF in general) using only noninvasive carotid pressure waves (without flow or velocity measurement).

Method:
Our method combines intrinsic frequency (IF) of a carotid pressure wave form with machine learning (IF-ML) to develop a hybrid model that approximates LVPW. The model was developed using 80% of Framingham Heart Study (n=6538, 53% female, age range 19-90). The IF-ML model was blindly tested on the remaining 20% of Framingham data. The final model was evaluated among HFpEF patients (n=38) and all HF patients (n=82).

Result:
The Pearson correlation coefficient (R) between single waveform LVPW and measured LVPW was 0.91 and 0.89 among HFpEF and all HF respectively (Fig.1). In blind-tested general population R=0.88.

Conclusion:
Single pressure waveform assessment of LVPW can improve the utility of LV pulsatile hemodynamic assessment in diagnosis and monitoring of HFpEF patients.
Abstract P368: A Case Of Cardiac Arrest In A Healthy 21-year-old Man Due To Ischemic Cardiomyopathy
Authors: Rahman ALI , Alqaisi Sura
Published: October 2023

Background:
Sudden cardiac arrest due to coronary artery disease (CAD) is an important matter of research, particularly among young adults with no overt heart disease. Despite the rare incidence of myocardial infarction (MI) in patients aged < 45 years, it is necessary to identify the etiologies and the angiographic profile of the disease at a young age.

Case report:
A 21-year-old male with no past medical history presented with cardiac arrest. The patient was playing basketball, and he went for a water break. Then, he was found unconscious with no pulse. At the emergency department, the patient was hypoxemic (oxygen saturation: 88% on room air) with T wave inversions on electrocardiogram. Laboratory testing showed elevations of lactate, creatine kinase, creatinine, liver function parameters, lactic acid, and white blood cells. An echocardiogram showed an ejection fraction (EF) of 25% and acute non-ST elevation MI. Coronary angiography revealed a ruptured plaque and total occlusion of the proximal left anterior descending (LAD) coronary artery. The patient was intubated and he underwent a successful percutaneous coronary intervention (PCI) and stenting of the occluded LAD. An Impella blood pump (Impella 3.5) was implanted, which led to an improvement of the EF (42%). On the next day, the Impella device was removed; the patient passed the spontaneous breathing trial and was extubated. Patient started on carvedilol 3.125 mg twice daily, spironolactone 25 mg daily, aspirin, ticagrelor and sacubitril/ valsartan. Follow-up was advised at the outpatient clinic for the possible placement of an automated implantable cardioverter defibrillator.

Conclusion and clinical implications:
Among young patients with MI due to ischemic cardiomyopathy, echocardiogram and coronary angiography are diagnostic, and emergency PCI results in a significant improvement.
Abstract P370: Progranulin Regulates Vascular Function And Blood Pressure Dependent On Ephrin A2 And Sortlin1 Receptors And Nitric Oxide Production.
Authors: Bruder do Nascimento Ariane , Awata Wanessa , Alves Juliano , Singh Shubhnita , Costa Rafael , Bruder Thiago
Published: October 2023

Background:
Progranulin (PGRN) is implicated in scar formation, cell proliferation, and anti-inflammation. Although high level of circulating PGRN was previously reported in hypertension, it is still not clear if PGRN can counteract the increases in blood pressure (BP) via modulating vascular tone. We sought to examine the role of PGRN maintaining the vascular tone and BP.

Methods:
we used male and female global PGRN deficient mice (PGRN-/-) and their counterparts (PGRN+/+) of 10-12-weeks of age to study vascular function and BP by wire myograph and radiotelemetry, respectively.

Results:
We found that two different mouse models of hypertension (angiotensin II or aldosterone treatments), elevated the levels of circulating PGRN. We also found that male and female PGRN-/- mice display elevated mean arterial pressure (MAP) (mmHg: PGRN+/+: 102.3 ± 3.9 vs PGRN-/-: 112.9 ± 3.7*, *P<0.05) followed by vascular hypercontractility to noradrenaline (NA) [Maximal response (% of 60mM of KCl) male PGRN+/+: 121.9 ± 14.1 PGRN-/-: 152.6 ± 18.8*; female PGRN+/+: 102.6 ± 4.1 and PGRN-/- 131.3 ± 11.4*, *P<0.05) in mesenteric arteries (MA), and increased circulating CCL2, IL-13, and interferon-γ. Whereas replacing PGRN with recombinant PGRN (rPGRN, 20ug/day/7-days) restored the MAP and vascular contractility in PGRN-/-. To explore the mechanisms by which PGRN modulates vascular tone, we treated MA from PGRN+/+, 1-hour prior NA curves, with rPGRN (600ng/mL) and found that PGRN attenuates the vascular contractility, such effect was abolished by blocking Ephrin A2 (EphA2) and Sortlin1 (Sort1) receptors or nitric oxide (NO) synthase (NOS). Next, we freshly isolated endothelial cells (EC) from mesentery of male and female PGRN+/+ mice via magnetic CD31+ microbeads to evaluate any sex difference on EphA2 and Sort1 expressions, which revealed that both receptors are equally expressed in EC from both sexes. In isolated mouse mesenteric EC, rPGRN stimulated NO formation and endothelial NOS activation, which were prevented by blocking EphA2 and Sort1.

Conclusion:
PGRN adjusts the vascular tone and BP via modulating NO formation and EphA2 and Sort1 receptors activation. Therefore, PGRN might be elevated in hypertension as a tentative to reduce BP by regulating vascular resistance.
Abstract P373: Nuclear Receptor 4As (NR4A) Expression In Patients With Chronic Kidney Disease
Authors: Gamboa Jorge L , Roshanravan Baback , Begue Gwenaelle , Brown Nancy J , Ikizler Talat A
Published: October 2023

Background:
Nuclear Receptor 4As (NR4A1, NR4A2, and NR4A3) play important metabolic, immune, and cardiovascular functions. These receptors also play a role in mitochondrial function. Patients with chronic kidney disease (CKD) have impaired mitochondrial function and biogenesis. Thus, in this study, we hypothesize that NR4As are downregulated in muscles in patients with CKD.

Methods:
In a cross-sectional study, we performed RNA sequencing in skeletal muscle biopsies from three groups; controls (n=13), patients with CKD 3-5 not yet on hemodialysis (n=13), and patients on maintenance hemodialysis (MHD, n=10). Total RNA was extracted to construct libraries for total RNA sequencing using Illumina NovaSeq 6000 system. Differentially expressed genes were identified with a false discovery rate (FDR) <0.05 and fold change > 2. We focused our analysis on genes involved in mitochondrial biogenesis.

Results:
Groups were matched by gender, body mass index, and history of diabetes and hypertension. There was no difference in markers of mitochondrial biogenesis between controls and patients with CKD 3-5. We only found a significant decrease in NR4A1 and NR4A3 gene expression in patients on MHD (
Figure 1
) compared to control (p=0.006 and p= 0.02; NR4A1 and NR4A3, respectively) and to patients with CKD 3-5 (p=8.85E-05 and p=0.005; NR4A1 and NR4A3, respectively).

Conclusions:
NR4A1 and NR4A3 were downregulated in muscle biopsies from patients on MHD. These findings may explain the reduced mitochondrial content and impaired mitochondrial function in patients with CKD. Further studies should evaluate the benefit of NR4As-targeted therapies to prevent mitochondrial dysfunction in CKD.
Abstract P375: Association Of Blood Pressure Variability With Kidney Function In Living Kidney Donors
Authors: Tantisattamo Ekamol , Rochanaroon Voramol , Noree Wanprapit , Tribuddharat Narisara , Kulthamrongsri Narathorn , Suenghataiphorn Thanathip , Naunsilp Piengpich , Chuenchaem Urairat , Srikulmontri Thitiphan , Puchongmart Chanokporn , Thiravetyan Ben , Vutthikraivit Possawat , Tanariyakul Manasawee , Leesutipornchai Thiratest , Lalitnithi Pakin , Wattanachayakul Phuuwadith
Published: October 2023

Background:
Relationship between BP variability and kidney function in living kidney donors (LKD) is unknown. We aim to examine the association between BP variability and the risk of worsening kidney function post-donation.

Methods:
A cohort study using OPTN/SRTR includes adult LKD undergoing donation between 6/1972 and 9/2022. Average real variability (ARV) defined as an average of absolute difference in consecutive BP at 6, 12 and 24 months post-donation was used for assessing BP variability and categorized into quartiles (Q) for SBP and DBP (AVR-SBP and AVR-DBP). The risks of ≥35% decrease in post-donation eGFR from pre-donation eGFR among the quartiles of AVR-SBP and AVR-DBP were evaluated by Cox regression.

Results:
Of 136,984 LKD, mean±SD age was 42±12 years and 6% were female. Mean pre-donation SBP and DBP were 122±13 and 74±9 mmHg, respectively. Median (IQR) ARV-SBP and ARV-DBP were 7 (3, 12) and 5.5 (2, 9.5), respectively. Median pre-donation eGFR was 98.33 (82.94, 116.66; P
trend
0.110). Median eGFR at 6-, 12-, and 24-months post-donation were 57.58 (48.43, 68.89), 58.93 (49.53, 70.61), and 61.02 (51.34, 72.78) mmHg, respectively. Compared to Q1 of the ARV-SBP, only Q3 and Q4 had a 4-6% higher risk for declined eGFR (HR
Q3
(95%CI) 1.04 (1.00, 1.08) and HR
Q4
1.06 (1.02, 1.11)). After adjusting for age, gender, race/ethnicity, U.S. citizenship status, level of education, history of hypertension, pre-donation BMI, SBP, DBP, creatinine, proteinuria and the interaction term between ARV and age (<65 vs. ≥65), only Q4 remained to have significantly greater risk of the event (HR
Q4
1.09 (1.03, 1.16)) and older LKD ≥65 years old had lower the risk compared to the younger (HR
Q4-Age
0.75 (0.57, 0.98), P
interaction
0.037). For ARV-DBP, Q2 and Q3 had 4-5% higher risk of the event compared to the Q1 (HR
Q
2
1.04 (1.00, 1.08) and HR HR
Q
3
1.05 (1.01, 1.09)) and only Q3 remained significantly having higher the risk after adjusting for confounders (HR
Q
3
1.06 (1.00, 1.13); P
interaction
non-significance).

Conclusions:
ARV-SBP especially in <65 years old and ARV-DBP are associated with a higher risk for a decline in post-donation kidney function. Pathophysiological alteration with hyperfiltration after unilateral nephrectomy may involve BP variability related to kidney function.
Abstract P377: Effect Of Treatment Of Denture Stomatitis On Blood Pressure, C-reactive Protein, Body Mass Index, And Lipid Profile.
Authors: Ribeiro Adriana B , Clemente Lorena M , Ribeiro Aline B , Fortes Caroline V , Fazan Rubens , Salgado Helio C , Silva Cláudia H
Published: October 2023

Background:
The literature shows that partially or entirely edentulous patients can have an increased risk of cardiovascular diseases, particularly hypertension and stroke. However, edentulous patients wearing complete dentures present Denture Stomatitis (DS) very frequently, associated with deleterious cardiovascular effects, mainly arterial hypertension.

Objective:
This study evaluated blood pressure, C-reactive protein (CRP), body mass index (BMI), and lipid profiles of completely edentulous DS-positive patients at baseline, and after 15 and 45 days of treatment.

Methods:
The treatment protocol consists of brushing the palate with a soft brush and water, denture brushing with a denture-specific brush and mild soap, and oral, topical application of nystatin 100,000 IU. The degree of DS was diagnosed by two calibrated and blinded researchers using the modified Newton classification. Three measurements were performed at 5-minute intervals recording the systolic and diastolic blood pressure. The ELISA assessed the CRP (mg/L) of blood samples. The Friedman test and Dunn's post-test evaluated blood pressure (mmHg), BMI (kg/m
2
), and lipid profile (mg/dL) data. ANOVA and Tukey's post-test was applied for CRP using the software SPSS 25.0 (p<0.05).

Results:
Twenty-five participants were included, with a mean age of 68±6.4 years.DS degree decreased over time (p<0.001), significantly decreasing after 15 days and intermediate values after 45 days. Systolic blood pressure showed a trend for reduction at 15 days (147.9±17.3 vs. 141.7±19.0 mmHg; p=0.058) and a significant decrease after 45 days (147.9±17.3 vs. 140.5±14.1 mmHg; p=0.017), while diastolic blood pressure was similar over time (88±13.3, 87±10.5 and 86±9.8 mmHg). The treatment did not significantly affect the CRP (1.3±0.9; 1.3±0.1; 1.1±0.1 mg/L; p=0.824), BMI (30.1±6; 30.3±6; 30.2±6 kg/m
2
; p=0.391), and lipid profile (Total cholesterol: 187.3±39; 185.2±40; 185.3±33 mg/dl; p=0.416, HDL: 48.9±11.5; 49.0±9.8; 47.4±11.0 mg/dL; p=0.217).

Conclusion:
The applied treatment of DS reduced the patients' DS degree and systolic arterial pressure.
Abstract P378: Expression Of Micro-rna 221, 222 And 223 In Individuals Suffering From Ischemic Stroke Due To Hypertensive Emergency
Authors: Vilela-Martin Jose F , Oliveira de Andrade Days , Cosenso-Martin Luciana , Yugar Toledo Juan C
Published: October 2023

Hypertensive crisis can account for damage on target organs characterizing hypertensive emergencies (HE). Ischemic Stroke (IS) is among these injuries. Expression of microRNAs (miRNAs) is considered the possible factors related to HE. This study evaluated the association of expression of miRNAs 221, 222 and 223 in patients suffering ischemic stroke due to HE. Material and Methods

Thirty and four patients with IS due to hypertensive emergency (IS-HE), 33 individuals with IS without HE (IS), 31 controlled hypertensive (CHT) and 33 normotensive (NT) individuals were studied. The expression of miRNAs 221, 222 and 223 was performed by RT-q PCR (real-time quantitative polymerase chain reaction). Results

Systolic and diastolic blood pressure were significantly higher in the IS-HE compared to IS, CHT and NT groups (162/99 mmHg vs 140/87, 128/69 and 129/82 mmHg, respectively; p <0.05). The miRNA-221 expression was higher in the IS-HE group compared to the IS, CHT and NT groups (4.23 vs 2.44, 1.35 and 1.05, respectively; p<0.0001). There was overexpression of miRNA-223 in the IS-HE and IS groups compared to CHT and NT groups (1.56 and 1.73 vs 0.13 and 0.66; p < 0.001). For miRNA-222 there was overexpression in the IS-HE, IS, and NT groups compared to the CHT group (P<0.0001 for all). Conclusions

This study provides evidence of the miRNAs participation in the pathophysiology of ischemic stroke due hypertensive emergency, thus assuring that the increased expression of miR-221 and miR-223 determines a greater chance of the individual presenting IS due HE. The miRNAs 221 and 223 are related to endothelial damage; thus, their overexpression shows the participation of endothelial dysfunction in cases of acute blood pressure elevation.
Abstract P379: Acute Mineralocorticoid Receptor Antagonism Does Not Alter Insulin Sensitivity Or Secretion In Metabolic Syndrome
Authors: Mustapha Taopheeq A , Manning Robert , Luther James M
Published: October 2023

We previously demonstrated that maximal dietary sodium restriction impairs insulin secretion in humans, and that aldosterone impairs insulin secretion
ex vivo
in isolated islets. Aldosterone is inappropriately elevated in obesity and metabolic syndrome, but it is unknown if mineralocorticoid receptor antagonism with eplerenone improves insulin secretion in metabolic syndrome (MS) during moderate sodium restriction.

We hypothesized that eplerenone would improve insulin secretion and insulin sensitivity in participants with the metabolic syndrome. We conducted a randomized, double-blind cross-over study in 16 volunteers with MS and elevated blood pressure in whom we provided either Eplerenone 50 mg or Amlodipine 5 mg and a standardized 50mmol Na/day diet for 7 days. Insulin sensitivity was assessed with hyperinsulinemic clamp and insulin secretion was assessed with hyperglycemic clamp at 5 and 7 days of diet, respectively.

EPL increased plasma aldosterone compared to AML treatment (19.8±9.3 vs 12.2±3.9 ng/dL, in EPL and AML, respectively; mean±SD, for all descriptions;
P
<0.001) but did alter systolic blood pressure (127.5±15.6 vs 124.5±14.5 mmHg;
P
=0.51). EPL did not alter insulin sensitivity assessed by hyperinsulinemic clamp (19.3±7.8 vs 18.7±7.3 μg/kg/min per uU/mL Insulin;
P
=0.82).Fasting glucose (101.8±9.0 vs 100.5±6.8 mg/dL, P=0.76) and insulin (28.1±18.0 vs 23.9±12.7 μU/mL;
P
=0.7) were similar during EPL treatment. EPL did not alter acute glucose-stimulated insulin secretion (68.2±45.5 vs 58.7±43.7 μU/ml;
P
=0.7) or L-arginine stimulated insulin secretion (578±238 vs 579±228 μU/ml;
P
=0.8) assessed by hyperglycemic clamp. Disposition index was similarly unchanged (1.2±0.8 vs 1.1±0.9;
P
=0.8).

We conclude that mineralocorticoid receptor antagonism with eplerenone during 7 days of moderate sodium restriction does not alter insulin sensitivity or insulin secretion in Metabolic Syndrome.
Abstract P387:
FOXO3
Longevity Genotype Mitigates The Risk Of Coronary Heart Disease In Men With Hypertension
Authors: Chen Randi , Donlon Timothy A , Morris Brian J , Masaki Kamal , Nakagawa Kazuma , Allsopp Richard , Willcox Bradley
Published: October 2023

Background:
We have shown that the
FOXO3
longevity genotype moderates the mortality risk in men with hypertension. This study aimed to test whether the
FOXO3
longevity genotype moderates the risk of incident coronary heart disease (CHD) in men with hypertension.

Methods:
The study included 6,312 Japanese American men who were free of CHD at the baseline examination of the Kuakini Honolulu Heart Program (1965-1968, age 53.9±5.4, range 45-68 years), and had been genotyped for the
FOXO3 SNP rs2802292
(
FOXO3-292
). The minor
G
allele, i.e.,
TG
or
GG (TG
/
GG)
genotype is associated with longevity vs. the common
TT
genotype, which is not
.
Hypertension was defined as systolic/diastolic BP ≥ 140/90 mmHg or taking antihypertensive medication. Incident CHD was diagnosed from hospital records and follow up examinations to 12/31/2000 (35 years of follow-up). The date of the first coronary event was defined as onset date of CHD, including myocardial infarction, coronary insufficiency, angina, coronary bypass, coronary angioplasty, silent myocardial ischemia, and CHD death. Cox proportional hazard models were used to assess the association of
FOXO3-292
genotype and hypertension with incident CHD.

Results:
During follow-up, 1,629 men developed incident CHD. The age-adjusted incidence rate of CHD was 8.99, 8.31, and 8.62 per 1,000 person-years (
p
=0.62) for
FOXO3-292
genotypes
TT, TG,
and
GG
, respectively. The Cox model, adjusting for age and CVD risk factors, showed hazard ratio (95%CI) for CHD with
FOXO3-292
genotypes
TG
/
GG
compared to genotype
TT
was 0.91 (0.82-1.00;
p
=0.058). The full Cox model, adjusting for age and CVD risk factors, showed a significant interaction effect of
FOXO3-292
genotypes
TG
/
GG
with hypertension on incident CHD (β= -0.22,
p
=0.03). After stratifying for hypertension,
FOXO3-292
genotypes
TG
/
GG
had no effect on incident CHD in those without hypertension HR=1.01 (0.88-1.17;
p
=0.84) but had a protective effect on incident CHD HR=0.82 (0.74-0.95;
p
= 0.0064) in those with hypertension.

Conclusion:
We found the longevity associated
FOXO3
genotype may not independently affect the risk of CHD in all men but was associated with protection against incident CHD in men with hypertension.
Abstract P396: Blood Pressure Of Individuals With Salt Sensitivity But Not Salt Resistance Is Increased After Acute Na
+
Loading
Authors: Xu Peng , Akhter Mahabuba , Schiermeyer Katie , Gildea John J , Felder Robin , Carey Robert M
Published: October 2023

Kidney function is influenced by salt intake and may adapt rapidly to dietary salt variations by modulating pressure-natriuresis. In particular, salt-sensitive (SS) individuals respond to a high-salt diet with a large rise in blood pressure (BP), indicative of a blunted pressure-natriuresis relationship, while 7-12% of the normotensive population have reduced BP with Na
+
loading, a condition termed inverse salt sensitivity. We compared effects of acute intravenous Na
+
loading on renal function in normotensive salt-resistant (SR) (11) and SS (5) individuals, as described below. After subjects were prepared in metabolic balance at 100 mmol Na
+
/d, they underwent

Phase
I

renal function studies (0700h-1100h);

Phase
II

oral sodium citrate load (1100h) followed by a continuous intravenous infusion of 0.9% saline (1100h-1300h);

Phase III

post-control monitoring period (1300h-1500h). During the entire protocol, BP and heart rate were monitored every 10 min. Blood and urine samples were obtained every hour and analyzed for Na
+
, K
+
, creatinine, osmolality and pH. Renal function tests included GFR, filtered Na
+
load (F
Na
), urinary Na
+
exretion (U
Na
V), fractional Na
+
reabsorption (FR
Na
), and fractional Na
+
excretion (FE
Na
). Mean BP was calculated using 6 measurements/hour. SS systolic (SBP) and diastolic BP (DBP) were significantly higher than in subjects with SR throughout the procedure (at 1100h SS 137±6.3 vs SR 114±2.6 mmHg, p<0.001 two-way ANOVA).
Phase II
changes in BP were calculated by subtracting BP at 1100h; there were no significant changes for SR BP. With Na
+
infusion, SS SBP and DBP increased and remained elevated through the end of the procedure. The increase of SS DBP at 1500h was significantly higher than that of SR (85.8±5.5 vs 65.9±1.6 mmHg, p<0.05 t-test). Both GFR and F
Na
were increased in SR, while there were no changes in SS after Na
+
infusion (GFR SR Y=2.9*X-28.37; SS Y=0.61*X-11.45). FR
Na
was increased in SR, but decreased in SS. The difference between slopes was significant (SS Y=-1.92*X+21.56; SR Y=0.64*X-6.8, P<0.01). After 1 h of Na
+
loading, FE
Na
decreased to 1.3 in SS but increased to 1.6 in SR (P=0.089 t-test). The results indicate that renal function of individuals with SS responds differently to acute intravenous Na
+
loading than those with SR.
Abstract P397: Preservation Of Renal Microvascular Function In Ischemia-reperfusion Induced Kidney Injury In Rats
Authors: Guan Zhengrong , Feng Wenguang , Meera Samia
Published: October 2023

Proper renal blood flow and glomerular filtration rate are critical for maintaining normal kidney function by precisely adjusting preglomerular microvascular resistance. Renal ischemia-reperfusion (IR) insult markedly increased mRNA expression of the inflammatory chemokine (C-C motif) Ligand 2 (CCL2) in rat kidney tissues. We hypothesized that depletion of macrophages prevented IR-induced renal autoregulatory impairment via reduction of CCL2 in preglomerular microvessels (PGMV). IR was induced in male rats by 60-minute bilateral renal artery occlusion followed by reperfusion. Some IR rats were treated with the selective macrophage inhibitor, Liposome-encapsulated clodronate (LC) following reperfusion and repeated 72 hours post-IR. Afferent arteriolar autoregulatory reactivity was assessed using the
in vitro
blood-perfused juxtamedullary nephron preparation in sham, IR, and IR+LC rats on day 7. Afferent arterioles from sham-operated rats exhibited pressure-dependent vasoresponsiveness. The baseline arteriolar diameter averaged 13.4 ± 0.5 μm at renal perfusion pressure (RPP) of 100 mmHg. Diameter increased to 117 ± 4% of baseline at RPP of 65 mmHg and decreased to 69 ± 2% at 170 mmHg, respectively. In contrast, afferent arterioles from IR rats only increased to 104 ± 2% and decreased to 91 ± 5% of baseline at 65 and 170 mmHg, respectively (P < 0.05 vs sham), indicating the impaired autoregulatory capacity in IR rats. LC-treated IR rats, however, markedly improved the pressure-dependent vasoresponsiveness. A decrease in RPP to 65 mmHg resulted in a 124 ± 17% increase in the baseline diameter, whereas increasing RPP to 170 mmHg led to a 74 ± 7% decrease in diameter. Additionally, IR markedly increased CCL2 mRNA expression in isolated PGMV by 10-fold 7 days post-IR. IR also elevated NADPH oxidase subunits (gp91
phox
, P67
phox
, and P47
phox
). Significantly, LC treatment suppressed mRNA expression of CCL2, gp91
phox
, P67
phox
, and P47
phox
in IR-PGMV. In conclusion, depletion of macrophages preserves afferent arteriolar autoregulatory capacity and reduces PGMV CCL2 mRNA expression in IR rats, suggesting a critical role of macrophages in mediating renal microvascular autoregulatory impairment in IR-induced kidney injury via the increase of CCL2 in PGMV.
Abstract P400: Effects Of Time Restricted Feeding On Blood Pressure And Urine Output
Authors: Yunker Lauren E , Williams Adaysha C , Marks Amanda M , Kriegel Alison J
Published: October 2023

Americans consume ~48% more salt than the recommended daily intake, increasing the sodium load placed on the kidneys. Normally, the kidneys excrete this excess sodium, however salt-sensitive (SS) individuals are unable to do so and develop hypertension. Time-restricted feeding (TRF), in which food is consumed in <10 hours, has been shown to improve various cardiometabolic disorders, however there is limited research on its effect in SS hypertension. The goal of this study was to determine if intermittent salt consumption via TRF can improve SS hypertension in the Dahl SS rat model. Male (n=7-9/group) and female (n=4/group) SS rats were randomly divided into the following groups: low salt ad libitum (LS ad lib), low salt TRF (LS TRF), high salt ad libitum (HS ad lib), or high salt TRF (HS TRF) and underwent a two-week protocol. During the first week, all rats had ad libitum access to their respective diet to establish hypertension in the HS groups. During the second week, some animals began TRF, in which food was provided for 8 hours during the active period (2200-0600 hrs), and metabolic phenotypes were assessed in all rats using the Promethion (Sable Systems). Urine was collected for 8-9 hrs after the feeding period. Prior to endpoint, anesthetized blood pressure was measured at the end of the fasting period. We found that the HS TRF group had reduced systolic blood pressure in both males (138.69 ± 4.29 mmHg vs 143.33 ± 7.43 mmHg; mean ± SEM) and females (129.19 ± 6.29 mmHg vs 135.85 ± 10.88 mmHg; mean ± SEM) compared to the HS ad lib group, however this was not significant. Urine excretion was significantly higher in the HS TRF group compared to the HS ad lib group in both males (8.89 ± 1.06 mL vs 4.06 ± 0.42 mL; mean ± SEM; p<0.05) and females (7.5 ± 0.20 mL vs 4.88 ± 0.43 mL; mean ± SEM; p<0.05). Furthermore, while the rats were in the Promethion, there was a higher amount of water loss (VH
2
O; which can include evaporated urine) in the HS TRF group compared to the HS ad lib group during the fasting period in both males (1.52 ± 0.03 g/hr vs 1.40 ± 0.03 g/hr; mean ± SEM; p<0.05) and females (1.18 ± 0.03 g/hr vs 0.96 ± 0.01 g/hr; mean ± SEM; p<0.05). Overall, these results may suggest that TRF produces a diuretic effect in the Dahl SS rat model, however further studies are required to confirm this.
Abstract P404: Statewide Burden Of Ischemic Heart Disease Attributable To High Blood Pressure In United States From 1990-2019: A Benchmarking And Comparative Analysis For The Gbd 2019
Authors: Kyada Sumit , Kamani Yashkumar Girdharlal , Gangannapalle Mahesh , chenna venkata sai harshabhargav , Dhawan Arushi , Gajjar Rohan , AMIN VISHRANT P , Lakkimsetti Mohit , DESAI HARDIK D , PATEL JUHI , Marsool Mohammed Dheyaa Marsool
Published: October 2023

Background:
Ischemic Heart Disease (IHD) is the 1
st
leading cause of death across the United States accounting for 18.9% of all casualties. The burden of IHD due to hypertension (HTN) in the United States is significant and multifaceted.

Method:
Using Global Burden of Disease methodology, deaths and disability adjusted life years (DALY) were assessed by age, sex and year across the US from 1990-2019.

Results:
Total number of deaths due to IHD attributable to HTN decreased from 343,151 in 1990 to 252,093 in 2019, DALYs decreased from 5,877,382 to 4,115,645 from 1990-2019. The age standardized death rate (ASMR) decreased from 102 to 41 per 100,000 person year 1990-2019. The highest annual percentage change (APC) increase in deaths observed in Nevada 88% (1217-2,283) followed by Alaska, Arizona from 1990-2019.

Conclusion:
IHD due to HTN found to be the leading cause of deaths across the US. Despite significant advancements in the management of IHD, the burden of IHD attributable to HTN remains a major health concern across the United States.
Abstract P415: Interleukin-17a And Incident Hypertension In The Reasons For Geographic And Racial Differences In Stroke (REGARDS) Study
Authors: Plante Timothy B , Juraschek Stephen P , Howard George , Howard Virginia J , Tracy Russell , Judd Suzanne E , Kamin Mukaz Debora , Zakai Neil , Long Leann , Cushman Mary
Published: October 2023

Background:
Inflammation is implicated in hypertension’s etiology. IL-17A is a cytokine representing specific immune pathways. Its association with incident hypertension in adults is unknown.

Objective:
Determine risk of incident hypertension among adults by level of IL-17A.

Methods:
In 2003-2007, REGARDS enrolled 30,239 US Black and White adults aged ≥45 years from the 48 contiguous states; a second visit occurred in 2013-16. The Biomarkers as Mediators of Racial Disparities in Risk Factors (BioMedioR) substudy included 4,400 gender-race stratified REGARDS participants who attended both visits. Hypertension was defined with a blood pressure threshold of 140/90 mm Hg or reported use of antihypertensive medications. We excluded those in BioMedioR with prevalent hypertension at baseline. IL-17A was measured from baseline samples with an ELISA. Because of a gender*IL-17A interaction on incident hypertension results were gender-stratified. Modified Poisson regression estimated relative risk (RR) of incident hypertension by IL-17A tertiles in models adjusting for known confounders of the inflammation-hypertension relationship.

Results:
Among the 1,885 participants (mean [SD] age 62 [8] years, 25% Black race, 55% women), incident hypertension occurred in 35% each of men and women. Higher IL-17A was associated with greater hypertension risk in the crude model for women, but not men (Figure). Adjusting for confounders attenuated this association in women.

Conclusions:
Higher IL-17A is associated with greater risk of hypertension in women in crude models only. How IL-17A and other specific inflammatory cytokines interrelate to hypertension’s onset is unclear.