bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C02-9: ASSOCIATIONS OF SHORT-TERM BLOOD PRESSURE VARIABILITY WITH ELECTROCARDIOGRAM PARAMETERS IN OBESITY-RELATED HYPERTENSION
Authors: Luo Xing , Zhang Yu Xiao , Zheng Ting Ting , Luo Di Chao , Tian Gang
Published: January 2023

Background:

Both blood pressure variability (BPV) and mean blood pressure levels can induce target organ damage and affect the prognosis in patients with hypertension. The fluctuation of BPV is more obvious among patients with obesity-related hypertension, yet few researches have shown the correlation between BPV and electrocardiographic parameters.

Objective:

This study aimed to analyze the association of short-term BPV with electrocardiographic parameters, so as to identify the risk of arrhythmia in patients with obesity-related hypertension.

Methods:

All enrolled 330 subjects from the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xi’an Jiaotong University were diagnosed with obesity-related hypertension. The short-term BPV, including standard deviation(SD), coefficient of variation(CoV), and weighted standard deviation(wSD), were analyzed by ambulatory blood pressure monitoring(ABPM). The atrial parameters(PR interval, maximum duration of P wave(Pmax), and P wave dispersion(Pwd)) and ventricular parameters(QT interval, Tpe interval, and Tpe/QT ratio) were measured on standard 12-lead electrocardiogram. Multivariate ordinary and binary logistic regression were conducted to evaluate the independent association between short-term BPV and electrocardiographic parameters. The study also analyzed the association of renin-angiotensin-aldosterone system (RAAS) with short-term BPV in 129 patients with obesity-related hypertension.

Results:

Although short-term BPV of 24 hours showed little association with electrocardiographic parameters, the association of daytime and nighttime BPV with electrocardiographic parameters was remarkably significant. And reverse dippers also showed longer Pmax than nondippers (P = 0.041). In this study, we found that the incidence of prolonged PR interval increased to 6% in patients with obesity-related hypertension, yet the prevalence was only 1% in healthy population younger than 60 years old. And those with a larger SD of nighttime systolic blood pressure had a longer PR interval(P = 0.025). Furthermore, ordinary logistic regression analysis showed that the nighttime CoV of diastolic blood pressure was independently correlated with PR interval. Meanwhile, logistic regression analysis also showed that the nocturnal blood pressure decline rate was independently associated with Tpe/QT ratio. However, the association of RAAS and short-term BPV was not significant.

Conclusions:
PS-C03-1: FULLY REMOTE INITIATION OF HOME BLOOD PRESSURE MONITORING INCLUDING ELECTRONIC TRANSMISSION OF RESULTS
Authors: Michaud Andre , Cloutier Lyne , Vadeboncoeur Alain , Goupil Remi
Published: January 2023

Objective:

The pressure exerted on the health care system from COVID-19 pandemic is unprecedented. Social distancing and self-isolation called for innovative, readily implementable, and effective short-term health solutions. The objective of this study was to assess the feasibility of a remote initiation of home health surveillance, including home blood pressure monitoring (HBPM), carried out by confined hypertensive adults diagnosed with COVID-19.

Design and method:

Individuals included in the study were between 40 and 69 years old with a known diagnosis of hypertension and a recent positive SARS-CoV-2 PCR test. During the initial phone contact and following electronic consent, participants were directed to a secure online platform to obtain all the information needed to participate in the study. Each participant received at home the equipment needed for vital signs assessment, including a LifeSource® UA-651BLE BP monitoring device. The Sphygmo® mobile app was used by the participants for the electronic transmission of results. Participants had to assess their symptoms and completed vital signs including two BP measurements, twice a day, for 14 consecutive days. Electronic and written guidance was also provided to participants on the correct method to perform the various vital signs measurements and data collection.

Results:

A total of 46 participants completed the study. The mean age was 54.1 ± 6.9 years and 54% of participants were men. On average, participants performed 12.3 days of measurements, 4.4 BP measurements per day for an average total of 54 BP measurements, Among the 46 participants, 11(24%) sent an email and two participants (4%) made a phone call for technical assistance.

Conclusions:

In a pandemic context, among hypertensive participants with a positive SARS-CoV-2 PCR test, the completed remote initiation of HBPM with electronic transmission of results is feasible. Moreover, participants were able to perform nearly fourteen days of BP measurements including self-assessment of symptoms, twice a day, and transmit their data using a mobile app and a web-based platform.
PS-C03-4: THE REAL WORLD TRENDS IN BLOOD PRESSURE OF DIALYSIS PATIENTS IN JAPAN USING THE WEB-BASED DATABASE
Authors: Sakuma Hirofumi , Matsuki Motoki , Hasebe Naoyuki , Nakagawa Naoki
Published: January 2023

Objective:

Hypertension is common in dialysis patients, which is frequent as well as poorly controlled. Blood pressure (BP) has a J curve relationship with cardiovascular disease and survival in dialysis patients; however, optimal BP is not well defined. We wanted to learn about the clinical characteristics of Japanese patients undergoing dialysis and the prevalence of cardiovascular death based on systolic blood pressure (SBP) using the Web based Analysis of Dialysis Data Archives (WADDA) system database.

Design and Methods:

We enrolled the patients undergoing dialysis who were recorded pre dialysis SBP from 2012 to 2020 using WADDA system 2.1. According to the Japanese Society of Hypertension guidelines 2019 (JSH 2019), we classified SBP and evaluated their trends over time by gender and age. Moreover, we evaluated the association between SBP and cardiovascular death.

Results:

Using the 2020 database, we looked at 336,759 Japanese patients undergoing dialysis (222,510 men and 114,249 women). The mean age was 69.4 ± 12.5 years, the mean dialysis history was 7.4 ± 7.7 years, and the mean pre dialysis SBP was 152.3 ± 24.7 mmHg. Among these patients, 72% had hypertension, 56.4% had diabetes, 28.9% had ischemic heart disease, and 25.4% had cerebrovascular disease. From 2012 to 2020, there was no change in the percentage of hypertension in each age group. The rate of grade II and III hypertension was predominantly male in the younger population (the twenties to fifties), but it shifted to females in the older population (over sixties). This gender disparity was more pronounced in the grade III hypertension group. Patients with cerebrovascular death had higher rates of hypertension (60.7 percent [gradeI; 26.2%, gradeII; 17.3%, gradeIII; 17.3%]) than those with heart failure death (32.9 percent [gradeI; 18.3%, gradeII; 8.4%, gradeIII; 6.2%]).

Conclusion:

Using the WADDA system, we summarized recent trends in BP of Japanese dialysis patients. We discovered that the rate of hypertension in patients undergoing dialysis has remained high (around 70%) and has not changed over the last decade. Furthermore, we discovered higher rates of hypertension, particularly in younger males, implying that optimal BP management for these populations may reduce cerebrovascular mortality.
PS-C03-12: FINGER-TO-TOE PULSE WAVE VELOCITY IN RESPONSE TO SITTING POSITION
Authors: Philibert Emy , Paré Mathilde , Côté Nadège , Fortier Catherine , Goupil Rémi , Obeid Hasan , Agharazii Mohsen
Published: January 2023

Objective:

Aortic stiffness is a non-traditional risk factor for cardiovascular disease and mortality and is associated with increased central pulse pressure. It is generally measured by carotid-femoral pulse wave velocity (PWV) in a supine position. We hypothesized that, in a sitting position, the additional hydrostatic pressure exerted on the vascular wall could represent a vascular stress test. Two alternative methods can now estimate aortic stiffness and can be used conveniently in different positions: 1) brachial pulse wave analysis approach used by Mobil-O-Graph and 2) transit time approach using finger-to-toe PWV by photoplethysmography with the pOpmetre. The aim of the present study is to determine the impact of postural changes on PWV and central blood pressure estimation using these two distinct methods.

Design and method:

Central blood pressure and PWV were assessed in 20 healthy subjects using Mobil-O-Graph (PWV-M) and pOpmetre (PWV-pop) in three positions: supine in bed, supine in reclining chair and sitting. Central systolic blood pressure (SBP) was determined by calibration of brachial systolic and diastolic blood pressures by both methods (SBP-M and SBP-pop). Generalized estimating equations were used for analysis.

Results:

The PWV-M remained relatively constant and generally independent of the position (5.5 ± 1.0, 5.3 ± 1.0 and 5.5 ± 1.0 m/s). While PWV-M and PWV-pop were similar in the supine position (5.5 ± 1.0 vs 5.4 ± 1.3 m/s, P = NS), PWV-pop increased very significantly to 5.9 ± 1.5 m/s in supine in reclining chair position (P = 0.04), and to 9.2 ± 1.7 m/s in sitting position (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 results suggest that estimated PWV by brachial pulse wave analysis remains robust independent of position. However, the estimated finger-to-toe PWV by pulse transit time increases remarkably with the imposition of hydrostatic pressure on the vascular wall. We conclude that the finger-to-toe PWV may provide the opportunity to evaluated vascular wall property in a dynamic fashion using postural changes as a stress test.
PS-C06-3: QUANTITATIVE CARDIAC AUTONOMIC OUTCOMES OF HYDROTHERAPY DURING CHILDBIRTH
Authors: Ghimouz Rym , Dias Raquel Aparecida , Cardoso Claudia de Faria , Nono Daniel Alessander , Junior Jose Antonio Silva , Acuna Juan , Baltatu Ovidiu Constantin , Campos Luciana Aparecida
Published: January 2023

Objective:

Most hydrotherapy studies during childbirth report findings related to pain using a widespread set of subjective measures. In this study we evaluated warm shower hydrotherapy s effects during childbirth through ECG biomarkers as quantitative cardiac autonomic outcomes.

Design and Methods:

This was a prospective single blind cohort study. The cardiac autonomic function was assessed using heart rate variability (HRV) measures during a deep breathing test using an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. Labor pain and anxiety were assessed using the Visual Analogue Scale for Pain (VASP) and the Beck Anxiety Inventory (BAI), respectively. A total of 105 pregnant women in the first stage of labor who received warm shower hydrotherapy, intravenous analgesia (scopolamine + sodium dipyrone), or spinal anesthetic (bupivacaine + morphine) were enrolled.

Results:

Parasympathetic modulation reflected through RMSSD (root mean square of successive RR interval differences) was significantly reduced by hydrotherapy and intravenous analgesia (before vs. after mean rank diff. 35.73 and 65.93, respectively, p < 0.05). Overall HRV (SDNN, standard deviation of RR intervals) was significantly decreased only by intravenous analgesia (before vs. after mean rank diff. 65.43, p < 0.001). Mean heart rate was significantly increased by intravenous analgesia, while spinal anesthesia reduced it and hydrotherapy did not alter it (before vs. after mean rank diff. -49.35∗, 70.38∗, -24.20NS, respectively, ∗ p < 0.05, NS not significant).

Conclusions:

This study s findings give quantitative support for the use of warm shower hydrotherapy during labor. This study suggests that warm shower therapy may alter the sympathovagal balance, resulting in a shift towards sympathetic predominance as a result of parasympathetic withdrawal, as well as a better anticipation of higher levels of stress during labor. The dependability of hydrotherapy as a nonpharmacological treatment is linked to the completion of more clinical research demonstrating quantitative evidence via outcome biomarkers to support indications pertaining to stress and birth progress.
PS-C08-8: OUTCOMES FROM BLOOD PRESSURE REDUCTION IN PATIENTS WITH DIFFERENT BASELINE CARDIOVASCULAR RISK: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED TRIALS
Authors: Manta Eleni , Thomopoulos Costas , Kariori Maria , Konstantinidis Dimitrios , Siafi Eirini , Polyzos Dimitrios , Tatakis Fotis , Drogkaris Sotirios , Filippou Christina , Dimitriadis Kyriakos , Tsioufis Konstantinos
Published: January 2023

Objective:

Blood pressure (BP) lowering is accompanied by reducing cardiovascular (CV) outcomes and death in hypertensive patients. No data are available for the effect of BP lowering in trials stratified according to baseline CV risk that was assessed according to SCORE-2.

Design and method:

A systematic review was conducted to identify randomized trials in electronic databases (Pubmed and CENTRAL, years: 1966 to 9/2021) for the effect of BP-lowering treatment against placebo or less aggressive BP reduction on 6 fatal or non-fatal CV outcomes and all-cause death. Selected studies reported outcomes in patients without a history of previous CV disease. In each study, we calculated baseline cardiovascular risk using SCORE-2. Risk ratios (RR) were calculated together with their 95% confidence interval (CI) under the random-effects model.

Results:

We included 54 studies (i.e., 12 trials with low-to-moderate CV risk, n = 21,192 patients; 13 trials with high risk, n = 66,886; and 29 trials with very high risk, n = 79,061). For a standard SBP/DBP reduction of 10/5 mmHg, the relative risk of the combined outcome of major CV events (i.e., myocardial infarction, stroke, and heart failure) was decreased by 27% (95% CI, 22–35%) in the category of very high-risk patients, and this reduction was significantly greater (P = 0.02) compared to high-risk trials (0.90 [95% CI, 0.77–1.04]). Moreover, CV death showed a significant reduction in the high-risk group compared to the low-moderate risk group (p = 0.005), as well as in the very high-risk group compared to the low-moderate risk group (p = 0.001). The same pattern was observed for all-cause death in the very high-risk group compared to the high-risk group (p = 0.045).

Conclusions:

The greatest outcome benefit from BP lowering in primary prevention is observed in patients at higher baseline cardiovascular risk as calculated by the SCORE-2.
PS-C08-10: RELATIONSHIP OF PHYSICAL ACTIVITY AND MEDICATION ADHERENCE IN HYPERTENSIVE PATIENTS: BEHAVIORAL CARDIOLOGY UNIT DATA
Authors: Fragoulis Christos , Kontogianni Evangelia , Prentakis Andreas , Polyzos Dimitrios , Kariori Maria , Kalos Theodoros , Mantzouranis Emmanouil , Leontsinis Ioannis , Chrysochoou Christina , Politis Antonios , Tsioufis Konstantinos
Published: January 2023

Objective:

Few studies have examined the relationship between exercise and adherence to antihypertensive medication, examining all possible factors contributing to blood pressure control. The purpose of our study was to access the possible dependence relationship among hypertensive patients visiting the Behavioral Cardiology Unit in a Tertiary Hospital.

Design and method:

The study population consisted of patients reporting to the Behavioral Cardiology Unit in a Tertiary Hospital during a period of 6 months in 2021. In terms of holistic approach, all patients underwent a thorough clinical in-depth interview, using the Morisky Medication Adherence Scale (MMAS8), the Frail Questionnaire Screening Tool (Frailty Score) and the Patient Health Questionnaire-4 (PHQ-4). All patients also provided full history of exercise (at least 150 minutes of physical activity or 75 minutes of intense activity per week), while completing the Duke Activity Status Index (DASI).

Results:

The population consisted of 42 hypertensive patients, 54.8% of them were females, with a mean age of all patients at 55.8 ± 15.2 years. Body Mass Index was averaging at 27.6 kg/m2. Salt consumption above the daily suggested amount (> 5gr/day) was reported by 60% of patients, binge drinking by 43% of them, while 43% had a history of active smoking. High adherence was reported by 17 patients (46%), medium adherence by 14 (37.8%) and low adherence by 6 (16.2%). Results indicate a relationship between exercise and adherence to medication. More specifically, Chi-Square test showed statistical significance between exercise and medium medication adherence in MMAS8 (MMAS8: 6–7, p = 0.033). Moreover, statistical analysis showed significant relationship between exercise, frailty and PHQ-4 score. Particularly, patients with absence of exercise showed higher level of PHQ-4 score (F = 7.07, p = 0.011).

Conclusions:

Our study highlights the possible dependency relationship of exercise and adherence to medication. Results indicate that patients with good adherence to medication have better behavioral activation. There is need for further research in this domain, to confirm the findings.
PS-C08-11: RELATIONSHIP OF AMBULATORY WAKE SYSTOLIC BLOOD PRESSURE AND COGNITIVE FUNCTIONING IN CHILDREN AND ADOLESCENTS: THE SHIP-AHOY STUDY
Authors: Hooper Stephen , Lande Marc , Flynn Joseph , Samuels Joshua , Meyers Kevin , Ferguson Michael , Urbina Elaine
Published: January 2023

Objective:

24-Hour Ambulatory blood pressure monitoring (ABPM) has been shown to be associated with cognitive functioning in both adults and children with hypertension. Few studies have examined this relationship in youth with normal to mildly elevated blood pressure (BP). We aimed to address this gap in the literature by examining the relationship between average wake systolic BP and targeted cognitive abilities in children and adolescents with normal to mildly elevated BP.

Design:

Cross-sectional cohort study across six academic centers in the United States.

Methods:

Participants were part of the SHIP AHOY Project examining target organ damage in children and adolescents with normal to mildly elevated BP. Patients were recruited from pediatric nephrology and/or cardiology clinics and had BP levels > 75th percentile to > 95th percentile). Ascertainment was designed to balance BMI across this BP range by actively recruiting normotensive subjects with obesity. Exclusion criteria included stage 2 hypertension, use of antihypertensive or lipid-lowering medication in the past 6 months, diabetes mellitus (type 1 or 2), kidney disease, or other chronic medical conditions. The primary exposure for this study was average wake Systolic BP. Cognitive variables included the Test of Nonverbal Intelligence, Woodcock-Johnson-V Verbal Attention, and Conners Continuous Performance Test-3 Errors of Omission and Errors of Commission. Preliminary analyses comprised the use of unadjusted linear regressions for the entire sample, with follow-up analyses planned to include key covariates for any significant findings.

Results:

We recruited 397 adolescents, ages 11–19 years (M∼15.5 yrs.), who comprised approximately 60% males and 53% white. About 25% of the participants had caregivers with a high school degree or less. About 40% of the sample had elevated BP (> 90th percentile).

There was a significant relationship between wake average systolic BP and Verbal Attention (p < .009); and wake average systolic BP and Errors of Commission (p < .026). All findings were in the expected direction with higher average wake BP being related to lower performance on the attention-related variables. SBP and Errors of Omission approached significance (p < .07), while Nonverbal IQ was nonsignificant (p < .34).

Conclusions:

Higher average wake BP, even in adolescents with BP below the hypertensive range, is associated with lower performance on tests of attention regulation and response inhibition. These findings suggest that efforts to minimize associated neurocognitive dysfunction in the late adolescence and young adult years should begin before the presence of hypertension.
PS-C10-10: AWARENESS AND RECOMMENDATION OF HOME BLOOD PRESSURE MEASUREMENT AMONG PHYSICIAN IN INDIA - RESULTS FROM ASIA HBPM SURVEY 2020
Authors: Verma Narsingh , Matsushita Noriko , Salman Ebtehal , Tomar Isha , Wander Gurpreet Singh
Published: January 2023

Background:

In Asia Pacific region, 66% of deaths are caused from cardiovascular diseases (CVD) which are attributed to hypertension, and in India alone, ischemic heart disease and stroke are the top causes of death. Awareness of hypertension and blood pressure (BP) control rate are still low in India; therefore, physicians and patients hypertension education are important for increasing awareness and improving hypertension management. Home blood pressure monitoring (HBPM) is recognized as a valuable tool to diagnose and support hypertension treatment including prevention of CVD and target organ damage. We explored the prevailing knowledge and current recommendation of HBPM in daily practice by physicians in India.

Methods:

As part of Asia HBPM Survey-2020, a cross-sectional survey was conducted among health care professionals from India between December 2020 to June 2021. The questionnaire consisted of 37 questions, including sub-questions, related to HBPM awareness and recommendations to patients. All analyses were performed using the proper statistical software and results were presented as descriptive data.

Results:

A total of 832 physicians participated in the survey. Almost 83% were male, whereas age, specialty and workplace were well distributed. Among physicians who recommend HBPM in the morning, more than 60% of respondents are giving instruction to their patients in alignment with local Indian hypertension guidelines regarding the body position and time of rest before measurement. Nevertheless, only 31% of physicians instruct their patients to measure their BP before taking anti-hypertensive drugs, while around 30% of physicians gave no instructions. A noticeable percentage of the physicians gave no instructions related to home BP measurement to their patients. Reference value of hypertension diagnosis amongst the physicians was substantially low based on clinic BP (34%) and home BP (15%).

Among physicians who manage hypertensive patients, nearly 88% recommend HBPM to their patients, however, only 29% of their patients own HBPM device and 35% of the patients measure their own BP at home.

Conclusions:

The survey reveals that awareness of HBPM amongst physicians in India is low and instruction to their patients are either lacking or not well aligned with the local hypertension guidelines which may have led to the low HBPM rate among patients. Considering the challenges and limitations physicians face in daily practice, clear and practical educational material and sessions are needed to improve the understanding of HBPM amongst physicians.
PS-C11-11: DEGREE OF BRACHIAL AND CENTRAL ARTERIAL BLOOD PRESSURE IN HYPERTENSIVE PATIENTS WITH INTER-ARM BLOOD PRESSURE DIFFERENCE(IAD)< 10MMHG VERSUS≧ 10MMHG
Authors: Cheng Wen Li
Published: January 2023

RuFei Liu, WenLi Cheng(Email:chengwenli2000@163.com)

Objective:

IAD ≧ 10mmHg has been proven to be a predictor of cardiovascular morbidity and mortality, especially in people with hypertension. Compared with brachial blood pressure, central blood pressure was more effective in reflecting hemodynamic changes and had a stronger relationship with target organ damage. No study has analyzed the degree of central blood pressure in hypertensive patients with IAD < 10mmHg versus ≧ 10mmHg. The objective of this study was to analyze differences in central and brachial arterial blood pressure and the proportion of brachial systolic blood pressure ≧ 140mmHg or central systolic blood pressure ≧ 130mmHg in hypertensive patients grouped by IAD.

Methods:

The study cohort comprised of 2103 eligible individuals. Their BPs were assessed simultaneously in both arms using an Omron BP-203RPEIII vascular profiler, and the IAD was measured as the absolute difference in these values (absolute value of left minus right). The CBP was noninvasively measured using an Omron HEM-9000AI device. Multivariate regression analysis was used to assess the association between the central SBP (cSBP) and the inter-arm systolic blood pressure difference (IASBPD).

Results:

Applying 130/140 mmHg as cSBP/bSBP thresholds delineated concordant central and brachial normotension (n = 1131;53.8%) and hypertension (n = 702;33.4%) versus isolated brachial hypertension (n = 178;8.5%) and isolated central hypertension (n = 92;4.4%). Women made up close to 70% of the patient with central systolic hypertension but normal bSBP. After adjusting for brachial SBP, brachial DBP, sex, age and BMI, patients with IAD ≧ 10mmHg had a higher risk of cSBP ≧ 130mmHg [OR (95%CI): 1.6 (1.3, 2.1), P < 0.001].

Conclusion:

Hypertensive patients with IAD *&ge* 10mmHg had higher cSBP, cDBP and a higher proportion of central systolic blood pressure.
PS-C12-3: OPEN-ANGLE GLAUCOMATOUS OPTIC DAMAGE IN RELATION TO SYSTEMIC AND OCULAR PERFUSION PRESSURE
Authors: Melgarejo Jesus D , Eijgen Jan Van , Wei Dongmei , Maestre Gladys E , Aswad Lama A Al , Mena Luis J , Vanassche Thomas , Janssens Stefan , Verhamme Peter , Zhang ZhenYu , Keer Karel V , Stalmans Ingeborg
Published: January 2023

Objective:

Glaucoma is the leading cause of irreversible blindness worldwide. One of the pivotal physiopathological mechanisms involved is reduced ocular perfusion pressure (OPP) at the optic nerve head, which depends on the mean arterial pressure (MAP) and intraocular pressure levels. The interplay association of variability and dips in the 24-h MAP with OPP in relation to glaucoma progression remains undocumented. Therefore, we conducted a retrospective longitudinal study to investigate variability and dips in the 24-h MAP and OPP in relation to the progression of open-angle glaucoma damage.

Methods:

A total of 265 patients with normal-tension glaucoma (NTG; n = 155) and primary open-angle glaucoma (POAG; n = 110) followed at the University Hospital Leuven with longitudinal visual field tests (n = 7000 measures, including both eyes) who underwent ambulatory blood pressure monitoring were studied. The main outcome was longitudinal changes in the mean deviation (MD), expressed in decibels (dB), which was retrieved from visual field tests. The intraocular pressure (IOP) was measured with applanation tonometry. MAP variability independent of the mean (VIMmap) was computed and the five lowest dips in MAP readings were further analyzed. OPP was the difference between 2/3 of the 24-h MAP minus 24-h intraocular pressure levels. Statistics methods included mixed models.

Results:

The mean age was 64.0y (53% were women). The IOP during eight years of follow-up was 11.3 mmHg. All IOP measures were higher in POAG than NTG (P < 0.046). POAG patients had lower OPP than NTG (P < 0.045). In adjusted mixed models, higher 24-h VIMmap was associated with longitudinal changes in MD in POAG (-2.07 dB changes, P < 0.001). The longitudinal changes in MD associated with dip measures ranged from -2.84 dB (95% confidence interval [CI], -4.12, -1.57; P < 0.001) to -2.16 dB (95% CI, -3.46,-0.85; P = 0.001) in POAG. Lower 24-h MAP combined with high variability and extreme dips in MAP resulted in worse progression of MD (P = 0.009). Reduced OPP was associated with -2.51 to -2.00 dB changes in the MD (P < 0.001) in POAG. Progression in MD was worse in patients experiencing reduced OPP along with high variability and dips in MAP.

Conclusions:

Progression of open-angle glaucoma damage is associated with high variability and dips in MAP, and reduced OPP. This progression exacerbates if the lower OPP occurs along with extreme dips in the MAP. 24-h ambulatory blood pressure and intraocular pressure should be implemented in the follow-up of glaucoma patients experiencing progression of the disease despite the intraocular pressure remaining normal.
PS-C12-5: MATHEMATICAL COMPARISON OF THE SEQUENTIAL VARIABLE RATIOS AMONG THE BLOOD PRESSURE VARIABILITIES OF AMBULATORY, HOME, AND OFFICE BLOOD PRESSURE MONITORING
Authors: Ohno Yoichi
Published: January 2023

Objective:

The importance of blood pressure variabilities (BPVs) is warranted; however, it seems difficult to discuss some blood pressure variabilities together since the definitions and pathophysiological meanings are different among the various BPVs. The aim of this study is the mathematical comparison of the sequential variable ratios among BPVs.

Design and method:

As previously reported (BMC Inform Decis Mak 2011, Internal Medicine 2016, Clin Exp Hypertens 2019, Ohno et al.), I assumed the systolic blood pressure values of a virtual Japanese male 1000 subjects at 60 to 69 years of age which were normally distributed around the corresponding measurements. From the epidemiological studies, I assumed the mean and the stand deviation (SD) of 24-hour ambulatory (ABP), 14-day home (HBP), and 12-month office blood pressure (OBP) monitoring as 134 ± 18, 134 ± 15, and 144 ± 20. I also assumed the median and 75-percentile BPVs for SD of the ABP, HBP and OBP as 15 and 18, 8 and 10, and 10 and 14. Using the numerical analysis of the sequential autoregressive model, at the 2nd term, BP was randomly changed according to the certain variability ratio (0.04∼0.09) for the sequential BP recordings to satisfy the normal stochastic distribution. At the 3rd term, BP was calculated as the sum of a third of the initial BP and two thirds of the 2nd BP values and so on. Considering the periodicity, the last three terms, BP was calculated as the sum of a third of the initial BP and the two thirds of the previous BP values. Time factors were 10 mmHg lower in the nighttime for ABP, 4 mmHg lower in the evening for HBP and 0.25mmHg lower for 1 temperature rise in Celsius for OBP. I calculated SD of BPV under the condition of several variability ratios for ABP, HBP and OBP.

Results:

The variability ratios were 0.05 and 0.06 for the corresponding median and 75 percentile of ABP, 0.04 and 0.05 for those of HBP, and 0.07 and 0.09 for those of OBP for the epidemiological studies.

Conclusions:

The variability ratios of the sequential BP recordings were 1.75 (0.07/0.04) to 1.8 (0.09/0.05) times greater in OBP than in HBP. Therefore, less than 10 mmHg (144 x 0.07) BPV in the sequential recordings for OBP should not be a cause for concern.
PS-C12-7: THE EFFECT OF RAMADHAN FASTING ON HYPERTENSIVE PATIENTS IN ASIA: A SYSTEMATIC REVIEW
Authors: Adnan Muhammad Luthfi , Pramaningtyas Miranti Dewi
Published: January 2023

Objective:

Hypertension is a major risk factor for cardiovascular disease. Fasting in the month of Ramadan is a form of worship for Muslims, and the largest Muslim population is in Asia. Although the effect of fasting during the month of Ramadan on health has been widely studied, its effect on changes in blood pressure has not been widely studied. This study aims to determine the effect of Ramadan fasting on hypertensive patients in the Asian population.

Design and method:

The study subjects of this systematic review were derived from the original articles by previous systematic reviews (Alinezhad-namaghi and Salehi (2016) Effects of Ramadan Fasting on Blood Pressure in Hypertensive Patients A Systematic Review) which we then adjusted according to our inclusion criteria. Literature searches were conducted with the search engines PubMed, Google Scholar, and other search engines with limited publication between 2012 to 2022. The keywords used were “Ramadan fasting”, “blood pressure”, and “hypertension”. The inclusion criteria used were observational studies, cohort studies, retrospective analysis, or other non interventional studies with full text in English, the study conducted on hypertension patients during Ramadhan fasting, studies conducted in Asian countries, and blood pressure outcomes was reported. The exclusion criteria used were the study not conducted in Asian countries or not mentioned, and the outcome report was not blood pressure change.

Result:

The original systematic review previously found 5 studies. Based on literature search and data extraction based on inclusion criteria, we accumulated a total of 6 studies’ findings. Two studies were conducted on populations in India and Iran and one study in Iraq and Lebanon. A total of 220 subjects included in this study (Table 1). Our findings suggest that Ramadan fasting exerts a blood pressure changing effect despite results of inconsistent significance.

Conclusion:

Ramadan fasting can affect blood pressure change in hypertensive patients in the Asian population. Studies in a wider population are needed to assess the effect of Ramadan fasting on blood pressure in hypertensive patients.
PS-C13-2: UNCOMPLICATED ARTERIAL HYPERTENSION, FROM BLOOD PRESSURE TO A NEW APPROACH BASED ON SUBCLINICAL TARGET ORGANS DAMAGE
Authors: Ouail Djamel Eddine , Tebbani Meriem , Bouali Faycal
Published: January 2023

Introduction:

High blood pressure remains asymptomatic for a long time until complications, which can be fatal from the outset. HTA is considered by the WHO as a silent killer. It's appropriate to directly assess subclinical vascular lesions.

The objective of our work is to classify uncomplicated hypertensive patients according to their target organ damage.

Material and method:

Prospective cohort of hypertensive patients seen in consultation.

Patients benefit from exploration of target organ damage.

Calculation of PP, Serum creatinine and estimation of GFR by MDRD and search for albuminuria.

ECG and Cardiac Doppler ultrasound for LVH.

Echo - Carotid Doppler with measurement of the IMT or the presence of a plaque.

Systolic pressure index (IPS) for AOMI. Fundus examination for hypertensive retinopathy.

We classified patients according to target organ damage into three categories:

TOD 0: no damage.

TOD 1 (beginner): IMT > 0.9 mm, EUA A2. Stage 1 and 2 retinopathy

TOD 2 (advanced): Carotid plaques, LVH, decrease in GFR, EUA A3, PP > 60 mmHg, AOMI and stage 3 hypertensive retinopathy

Results:

300 patients included in our series, 180 women and 120 men, the mean age is 59.75 years ± 10.54 [38, 87 years].

LVH is discovered in 20%, 30% on ECG and echocardiography respectively.

The EIM is pathological in 35% of cases, carotid plaques are present in 40% of cases.

PP is pathological in 34.33% of cases, and AOMI is found in 9% of patients.

Kidney disease is found in 34% of patients.

Retinopathy is found in 28% of cases.

At the end of our assessment, patients are classified according to their target organ damage as follows:

AOC 0: 29% of patients.

AOC 1 (beginner): 11.7%

AOC 2 (advanced): 59.3%

The correlation between AOC groups and cardiovascular risk categories is significant with p = 0.0001

Conclusion:

The approach based on the classification of uncomplicated hypertensive patients according to subclinical target organ damage is a precise, accessible and inexpensive method. It allows an individual assessment of the state of vascular, cardiac and renal remodeling of patients.

By validating this approach, hypertension no longer becomes a silent killer, the detection of the early stages of damage to the AOC 1 target organs, allows the slowing down or even the regression of the lesions. The intervention on the group of AOC 2 allows protection against the feared irreversible complication.
PS-C13-8: IMPACT OF SACUBITRIL/VALSARTAN ON NT-PRO BNP LEVELS IN HYPERTENSIVE PATIENTS
Authors: Imamura Teruhiko , Kinugawa Koichiro
Published: January 2023

Background:

Even a slight increase in plasmasNT-pro BNP levels is associated with an incremental cardiovascular events in a healthy cohort. Sacubitril/valsartan has recently been reimbursed in Japan for hypertension. Its impact on reducing plasma NT-pro BNP levels in hypertensive patients remains unknown.

Methods:

Patients who received 3-month sacubitril/valsartan administration for their hypertension were retrospectively included. Changes in plasma NT-pro BNP levels during 3-month sacubitril/valsartan therapy (on-treatment period) were compared with those during pre-treatment 3-month period (pre-treatment period).

Results:

A total of 33 hypertensive patients (73 [64, 77] years old and systolic blood pressure 138 [134, 149] mmHg on median) were included. During a pre-treatment period, systolic blood pressure tended to decrease (p = 0.091) whereas plasma NT-pro BNP levels remained unchanged (from 204 [132, 412] pg/mL to 207 [107, 386] pg/mL, p = 0.84). During on-treatment period, both systolic pressure and plasma NT-pro BNP levels decreased significantly (p < 0.001 and p = 0.001, respectively, from 207 [107, 386] pg/mL to 119 [64, 355] pg/mL in NT-pro BNP). The amount of changes in plasma NT-pro BNP levels during on-treatment period was significantly higher than those during pre-treatment period (-51 [-158, -17] mmHg versus -12 [-28, 33] mmHg, p = 0.001).

Conclusions:

Plasma NT-pro BNP levels decreased significantly following 3-month sacubitril/valsartan therapy. Its clinical implication requires further long-term studies.
PS-C13-14: ARNI DECREASED NIGHTTIME BLOOD PRESSURE EVALUATED BY WRIST-TYPE NOCTURNAL MONITORING DEVICE IN A PATIENT WITH TREATMENT-RESISTANT HYPERTENSION AFTER RENAL DENERVATION
Authors: Narita Keisuke , Kario Kazuomi
Published: January 2023

Angiotensin receptor-neprilysin inhibitor (ARNI), Sacubitril/Valsartan has been reported to decrease nighttime blood pressure (BP). Moreover, Sacubitril/Valsartan is expected to be useful in treatment resistant hypertension because neprilysin inhibition offers an additional effect to reducing BP levels. In this case report, we observed decreasing nighttime BP by changing from angiotensin-1 receptor blocker (ARB) and hydrochlorothiazide (HCTZ) to Sacubitril/Valsartan in a patient with sustained resistant hypertension despite he had been conducted the procedure of renal denervation. Additionally, we evaluated nighttime BP by newly developed wrist-type nocturnal BP monitoring device, Nightview (Omron HEM9601T, Omron health care, Kyoto, Japan). A 46 year old Asian male, who had underwent renal denervation 8-years ago, suffered for treatment-resistant hypertension despite of administration of multiple antihypertensive medications including combination agent of ARB/HCTZ, Ca-channel antagonist, beta-blocker, alpha-blocker, and mineralocorticoid receptor antagonist. His average of usual daytime (morning and evening) home BP level was 155/85 mmHg. We performed a 7-day consecutive nighttime BP measurement using wrist-type BP monitoring device, which also revealed nocturnal hypertension, 125/65 mmHg. To decrease his daytime or nighttime BP levels, we initiated administration of sacubitril/valsartan 400 mg instead of combination agent of ARB/hydrochlorothiazide (Candesartan 8 mg and Hydrochlorothiazide 6.25 mg). Then, we performed nighttime BP measurements using wrist-type device again, which revealed decreasing nighttime BP to 119/61 mmHg just after initiating Sacubitril/Valsartan instead of combination agent of ARB/HCTZ. His usual daytime home BP also decreased to 140/80 mmHg. Additionally, NT-pro BNP also decreased from 87 to 55 pg/mL. From these observations in this case report, ARNI is expected to improve BP control, especially nighttime BP level, in patients with uncontrolled treatment-resistant hypertension despite multiple drug and denervation therapy. ARNI may be also expected to prevent heart failure in resistant hypertension.
PS-C14-5: ECHOCARDIOGRAPHIC PHENOTYPES OF HYPERTENSIVE IN NORTH CENTRAL NIGERIA
Authors: Shidali Vincent Yaba
Published: January 2023

Objective:

To describe the cardiac morphologic phynotypes in hypertensives as seen on echocardiography .

Design and Methods:

All patients presenting for echocardiography at the echocardiography lab were evaluated and documented alongside there biodata and anthropometry. The study was a cross sectional descriptive study done from 2019 t0 2022. Criteria for inclusion was hypertension and hypertension related cardiac morbidity. Data obtained was analyzed using SPSS version 16. Quantitative variables were presented as mean and standard deviation while qualitative variables were presented as frequencies and percentages. Level of significance p was at 0.05

Results:

Five hundred and eighteen patients were included consisting of 50.6% male and 49.4% female with mean age of 55.08 ± 12.62 years. Majority (54.97%) of patients were between 50 -70 years of age. The mean age and BMI of males and females were significantly different at p values of 0.029 and 0.0001 respectively. Most patients had hypertensive heart disease ((96.0%), preserved EF(80.04%), grade 1 diastolic dysfunction(76.64%) and normal RV systolic function(90.98%). The mean LVEF, LAD, LVID, IVSd and LVPWd for males and females were significantly different at p value of 0.0001. The predominant LV geometry was concentric LV hypertrophy (45.8%) and 14% of patients had a dilated cardiomyopathy.

Conclusions:

Echocardiographic findings in hypertensives showed predominant abnormal morphologies with significant differences between male and females. This calls for management of hypertension beyond the numbers
PS-C14-6: THE USEFULNESS OF C-REACTIVE PROTEIN TO PREDICT IMPROVING LEFT VENTRICULAR FUNCTION AFTER AORTIC VALVE REPLACEMENT IN AORTIC REGURGITATION PATIENTS
Authors: Oike Fumi , Yamamoto Eiichiro , Usuku Hiroki , Egashira Koichi , Sueta Daisuke , Tsujita Kenichi
Published: January 2023

Background:

We aimed to clarify the predictive factors for left ventricular (LV) function after aortic valve replacement (AVR) in patients with aortic regurgitation (AR).

Methods and Results:

Among 555 patients who underwent AVR at our institution from January 2015 to December 2020, we enrolled 44 patients for whom only AVR (or AVR + aortic replacement) was performed. We defined LV dysfunction under any of the following criteria: LV ejection fraction (LVEF) < 50%, LV diastolic dimension> 65 mm, LV systolic dimension (LVDs) > 50 mm, or LVDs/body surface area > 25 mm/m2. Multivariable logistic regression analysis revealed high natural logarithm (ln) C reactive protein (CRP) and low LVEF in the pre AVR period significantly associated with LV dysfunction after AVR (ln CRP: odds ratio [OR] 4.15, 95% confidence interval [CI] 1.44 to 11.98, p < 0.01; LVEF: OR 0.79, 95%CI 0.65 to 0.97, p < 0.05). Receiver operating characteristic analysis revealed an area under curve of CRP and LVEF in the pre AVR period for LV dysfunction after AVR of 0.84 and 0.83, respectively. Upon dividing the patients into four groups according to cutoff values of CRP (0.13 mg/dL) and LVEF (50%) in the pre AVR period, no patients (0/19) had LV dysfunction in the low CRP (< 0.13 mg/dL) and high LVEF ( 50%) group, and all patients (5/5) in the high CRP ( 0.13 mg/dL) and low LVEF (< 50%) group had LV dysfunction after AVR.

Conclusion:

High CRP level was significantly and independently associated with LV dysfunction after AVR. Combination of CRP and LVEF values might be useful for predicting improvement in LV function after AVR.
PS-C15-11: HYPERTENSION AND ITS CORRELATES AMONG SCHOOL ADOLESCENTS IN DELHI
Authors: Grover Shekhar
Published: January 2023

Background:

Hypertension is fast emerging as a major health problem amongst all school adolescents, particularly in urban areas. Regular screening of the students for this is required for preventing the emergence of complications later in life. Therefore the present study was undertaken with the objective to determine the prevalence of hypertension amongst urban school adolescents and its correlation with anthropometric measurements.

Methods:

A cross sectional study was conducted in a school in Central Delhi involving all 315 students of 9th and 11th standard. A proforma was filled by the students and anthropometric measurements along with blood pressure BP measurements were taken for each student. Data were analyzed using Epi info 2005 and SPSS 16.0.

Results:

Out of the total 315 students, 208 or 66% were boys and 107 or 34% were girls and the mean age was 14.31 SD 0.96 years. The overall prevalence of malnutrition was 24% and boys were found to be more obese as compared to girls. There were 5 students 1.6% who were found to have systolic hypertension while 17 or 5.4% were found to have diastolic hypertension while 4.1% n = 13 of the participants were systolic pre hypertensive and 26% n = 82 were in the stage of diastolic pre hypertension. Body mass index and gender were found to be independent predictors of systolic hypertension.

Conclusions:

Prevalence of hypertension and pre hypertension was high amongst the school children. BP check ups for children and adolescents are thus recommended to take remedial action on time
PS-P02-5: ENCOURAGING ONLINE MEDICAL CARE BASED ON ECG MEASUREMENTS FROM WEARABLE DEVICES
Authors: Yoneyama Akio , Takai Koichi , Hammarlund Hampus , Miyake Yoshinori , Nakanishi Takeshi , Sawada Ryousuke , Yatabe Junichi , Taguchi Kenta
Published: January 2023

Background:

Apple Watch can measure electrocardiograms, which can be useful for detecting heart conditions. However, even if atrial fibrillation is detected, few patients will seek out further medical evaluation. In this paper, we evaluated the effectiveness of several methods for motivating users to receive online medical care based on the heart alert detected by Apple Watch.

Method:

In this study, we investigated multiple schemes that guide users to online medical care based on the ECG measurement results.

1) Alert messages from a smartphone application, 2) E-mail notification to multiple presets when heart alerts are detected, and 3) E-mail information provided by experts on heart disease.

In our experiment, we recruited people age 30 and up who regularly use Apple Watch and iPhone, for a total of 489 participants. We asked ECG measurement to be taken several times a day with the Apple Watch for 3 months. We recommended online medical care when a heart alert is detected.

Result:

In this experiment, 20 participants’ atrial fibrillation was detected, and 5 participants took online medical care. Effectiveness of each reminder is explained as follows:

Conclusion:

We evaluated guidance to online medical care using the ECG measurement of Apple Watch. As a result of evaluating the three types of guidance, it was confirmed that the effect of providing information by experts is high.