bluuebunny/crossref_metadata_2025 huggingface dataset:
LONG-TERM TEMPERATURE VARIABILITY AND THE INCIDENCE OF CARDIOVASCULAR DISEASES: A LARGE, REPRESENTATIVE COHORT STUDY IN CHINA
Authors: Kang Yuting , Tang Haosu , Zhang Linfeng , Wang Su , Wang Xin , Chen Zuo , Zheng Congyi , Yang Ying , Wang Zengwu , Huang Gang , Gao Runlin
Published: April 2021

Objective:

In the context of global climate change, far less is known about the impact of long-term temperature variability (TV), especially in developing countries. The current study was aimed to estimate the effect of long-term TV on cardiovascular disease in China.

Design and method:

The current study enrolled 23,721 individuals with mean age of 56.15 years in China from 2012–2016 and followed up during 2017 and 2019. TV was defined as the standard deviation of daily temperatures during survey years. The Cox regression was used to estimate the multivariable-adjusted hazard ratio (HR) between TV and cardiovascular diseases (CVD).

Results:

During the follow-up time, we ascertained 836 cases of incident of CVD. A significant positive trend was observed between CVD risk and increasing levels of TV comparing to the lowest tertile with an HR = 1.343 (95% CI: 1.133–1.591) for the medium tertile and an OR = 1.717(95% CI: 1.347–2.189) for the highest tertile (ptrend < 0.001). The HR per 1°C increase in TV was 1.062 (95% CI:1.014–1.112) for CVD. We also estimated that exposure to high TV would lost 2.11 years disease-free years for population aged 35 to 65 years, and was attributable to 2.93 million CVD cases (or 12.14% cases) in China.

Conclusions:

Long-term TV was associated with higher risk of incident CVD. Our findings will be valuable for future efforts assessing health risks related to the climate change and developing related policies to reduce TV related adverse health effect.
THE PREVALENCE AND RISK FACTORS OF HIGH-ALTITUDE PULMONARY HYPERTENSION AMONG THE HIGHLANDERS IN TIBETAN AREA
Authors: Gou Qiling , Li Xinran , Rong Xi , Zhang Xin , Ye Runyu , Zhang Zhipeng , Hu Xianjin , Chen Xiaoping
Published: April 2021

Objective:

The study aimed to investigate the prevalence and risk factors of high-altitude pulmonary hypertension (HAPH) among the highlanders living at 3500m above sea level in Tibetan area of China.

Design and method:

we conducted a cross-sectional survey on the permanent Tibetans residing at an average altitude of 3500m. Age 18 years and above were selected by stratified cluster random sampling technique and screened for recording questionnaire, anthropometric indices, blood pressure, biochemical factors and echocardiography. HAPH was defined as mean pulmonary artery pressure over30mmHg indicated by echocardiography. Data of 1130 subjects were analyzed who were free of polycythemia and cardiorespiratory diseases to determine the prevalence of HAPH and its predisposing factors.

Results:

The prevalence of HAPH was different in males and females (8.7% vs 4.6%,P = 0.033). Patients with hypertension are more likely to develop HAPH compared with normal blood pressure (9.6% vs 4.4%,P = 0.010). T-test analysis suggested that patients with HAPH had lower pulse oxygen saturation and estimated glomerular filtration rate. In addition, patients with HAPH have more significant metabolic abnormalities (including elevated blood pressure, blood glucose, triglyceride, low density lipoprotein cholesterol, uric acid, waist circumference, hip circumference, BMI. all p value < 0.05), patients with HAPH have mildly increased RV, RA, and diameter of the main pulmonary artery. After stepwise multivariate logistic regression, it was suggested that age, hemoglobin level, and increased TG were independent risk factors for HAPH.

Conclusions:

It can be concluded that HAPH is prevalent in 5.8% of natives of Tibetan area in China. Increasing age, hemoglobin and triglyceride are independent predisposing factors.
ASSOCIATIONS OF PARITY AND AGE AT MENARCHE WITH SILENT CEREBROVASCULAR LESIONS OF BRAIN MAGNETIC RESONANCE IMAGING: THE OHASAMA STUDY
Authors: Nomura Kyoko , Sato Wakana , Satoh Michihro , Hara Azusa , Tsubota-Utsugi Megumi , Kobayashi Yuuki , Murakami Takahisa , Totsune Tomoko , Hirose Takuo , Tatsumi Yukako , Inoue Ryusuke , Asayama Kei , Kikuya Masahiro , Metoki Hirohito , Hozawa Atsushi , Watanabe Hiroyuki , Imai Yutaka , Ohkubo Takayoshi
Published: April 2021

Objective:

Objective: Previous studies suggest that parity and menstrual factors were associated with an increased risk of cerebrocardiovascular diseases. We aimed to investigate if parity and menstrual factors are associated with brain ischemic lesions diagnosed by magnetic resonance imaging (MRI).

Design and method:

Materials and Methods: We identified 511 women aged 60 years or older from the general population of Ohasama, a rural Japanese community, who answered a questionnaire on parity and gravidity and age at menarche and menopause, were free of previous cardiocerebrovascular disease including atrial fibrillation, and underwent MRI. Silent cerebrovascular lesions were diagnosed by MRI and assessed by the presence of either lacunar infarcts or white matter hyperintensity, or both. Logistic regression model was used to investigate an association between any of quartiles of parity, gravidity, and age at menarche and menopause, and silent cerebrovascular lesions with adjustment for possible confounding factors including self-measured blood pressure values at home (home BP).

Results:

Results: Silent cerebrovascular lesion was observed in 269 subjects (53%) including lacunar infarcts (26%) and white matter hyperintensity (49%). Means of home systolic and diastolic BP levels were 128.9 ± 14.8 mmHg and 74.2 ± 8.6mmHg, respectively. Approximately 31% of subjects were under antihypertensive medication and 36 % had hypertension defined by home BP levels greater than or equal to 135/85. Age adjusted odds ratio of the highest quartile of parity (4- vs. 2 as reference) was 1.84 (1.10–3.06) for having silent cerebrovascular lesions and 1.83 (1.11–3.01) for white matter hyperintensity. Adjusting for age (p < 0.001), body mass index (p = 0.005), home systolic BP level (p = 0.039), hypertensive drug use (p = 0.001), impaired glucose tolerance (p = 0.418), hyperlipidemia (p = 0.103), and current smoker (p = 0.938) and drinker (p = 0.716), compared with women who had two children, women who had four or more children were more likely to have an increased risk with silent ischemic lesions (OR 1.88, 95%CI, 1.11–3.20). Similar association was also observed with white matter hyperintensity (OR 1.86, 95%CI, 1.11–3.12).

Conclusions:

Conclusion: Higher parity was associated with silent brain ischemic lesions and white matter hyperintensity diagnosed by MRI, independent of confounding factors including age and home BP levels.
IMPAIRED NO SIGNALLING, ER STRESS AND RHO KINASE MEDIATE PERIPHERAL VASCULAR DYSFUNCTION IN A MODEL OF SMALL VESSEL DISEASE OF THE BRAIN (CADASIL)
Authors: Neves Karla , Morris Hannah , Alves-Lopes Rheure , Montezano Augusto , Touyz Rhian
Published: April 2021

Objective:

CADASIL, a monogenic condition due to Notch3 mutations, is a very aggressive small vessel disease of the brain resulting in premature vascular dementia and stroke. Changes in cerebral vessels include vascular dysfunction and narrowing, and accumulation of granular osmiophilic material (GOM). It is not clear whether small peripheral arteries undergo similar damage. Thus our aim is to assess vascular dysfunction and associated mechanisms in mesenteric resistance arteries from CADASIL mice.

Design and method:

Mesenteric arteries (MA) from male CADASIL-causing Notch3 mutation (TgNotch3R169C) and wildtype (TgNotch3WT) mice (6 months old) were investigated. Blood pressure (BP) was assessed by tail-cuff and vascular function by myography.

Results:

BP and cardiac function were unchanged in CADASIL mice. By electron microscopy GOM deposits were identified in MA from CADASIL mice. Notch3 (WT: 2.0 ± 0.5 vs. 6.0 ± 1.3) and HeyL (WT: 1.1 ± 0.4 vs. 2.9 ± 0.6) mRNA were augmented in CADASIL mice (p < 0.01). CADASIL mice exhibited endothelial (Emax 109.9 ± 7.4 vs. 81.3 ± 5.4) and VSMC-dysfunction (pD2 7.8 ± 0.1 vs 6.8 ± 0.3); effects associated with increased eNOS inhibition (p-Thr495) (1.8-fold increase) and decreased cGMP levels (1.2 ± 0.2 vs 0.59 ± 0.2) (p < 0.05). Contraction to Ang II (Emax 33.7 ± 6.8 vs. 72.8 ± 4.4), phenylephrine (Emax: 70.6 ± 7.2 vs. 92.1 ± 4.2) and U46619 (Emax: 123.4 ± 4.4 vs. 215.1 ± 24.4) (p < 0.05) was increased in CADASIL; effects attenuated by fasudil (Rho-kinase inhibitor) and 4-PBA (ER stress inhibitor) (p < 0.05). MA structure and mechanics from CADASIL mice remain unchanged at this stage. U46619-induced calcium influx was increased in TgNotch3R169C VSMCs (AUC: 1.3-fold increase) as well as SERCA (1.5 ± 0.7 vs. 8.1 ± 1.4) and TRPM2 (0.7 ± 0.3 vs. 4.5 ± 1.6) mRNA levels (p < 0.05). BiP protein expression (ER stress marker) (1.7-fold increase) and gene expression of Rho GEFs (LARG: 1.1 ± 0.1 vs. 2.1 ± 0.3; PDZ: 0.9 ± 0.1 vs. 2.9 ± 0.4) were increased in MA from TgNotch3R169C vs. TgNotch3WT mice (p < 0.05). These effects may be associated with the increase in oxidative stress observed in VSMCs from peripheral arteries and brain vessels from CADASIL patients (p < 0.05).

Conclusions:

Our findings demonstrate that the cerebral vasculopathy associated with Notch3 mutations is also present in peripheral small vessels and identify ER stress and Rho kinase as potential new therapeutic targets in CADASIL, for which there are no disease-specific treatments.
NEUROLOGICAL HYPERTENSIVE EMERGENCIES: CORRELATION OF BLOOD PRESSURE VALUES WITH IN-HOSPITAL MORTALITY AND DISCHARGE DISABILITY
Authors: Giani Valentina , Maloberti Alessandro , Biolcati Marco , Bianchi Sofia , Magni Gloria , Albertini Valentina , Conti Matilde , Curci Camilla , Porta Lorenzo , Rigamonti Annalisa , Trucchi Andrea , Battistini Marta , Bergamaschi Marta , Valobra Tommaso , Capsoni Niccolo , Cassano Giulio , Gheda Silvia , Ceresa Chiara , Agostoni Elio Clemente , Beretta Andrea , Bellone Andrea , Giannattasio Cristina
Published: April 2021

Objective:

Definitive data on acute management of Blood Pressure (BP) in neurological Hypertensive Emergencies (HE) are still lacking. Aim of our study was to evaluate BP values and management as a determinant of in-hospital mortality and early complications in stroke patients.

Design and method:

We collected data of 267 patients, who presented with ischemic stroke and BP > 180/120 mmHg at the Emergency Department of Niguarda Hospital from 2015 to 2017. In-hospital mortality, hospitalization length and discharge disability (evaluated with modified Rankin score – mRs) were considered as outcomes.

Results:

Mean age was 75.7 ± 11.7 years with SBP values of 194.9 ± 14.9 mmHg at admission. 34.8% of the patients received anti-hypertensive treatment with those achieving a higher SBP reduction in comparison with the untreated one (dSBP 37.8 ± 26.8 mmHg vs 30.7 ± 20.8 mmHg p = 0.034). At the multivariate analysis in the overall population, no SBP values are related to all causes in-hospital mortality. Instead, higher admission SBP relates to high discharge disability and hospitalization length. Furthermore, SBP values at admission in Emergency Department appear as disability determinants in patients who did not receive systemic thrombolysis and in patients who did not receive antihypertensive drugs. In these two subgroups, higher SBP values at department entrance determine a higher in-hospital mortality.

Conclusions:

In overall population, no BP values are related to all causes in-hospital mortality while higher admission BP relates to high disability and hospitalization length.
COGNITIVE FUNCTION AND CAROTID STRUCTURE OVER LONG-TERM OBSERVATION IN PATIENTS WITH RESISTANCE HYPERTENSION
Authors: Gulkevych Oksana , Mishchenko Larisa , Matova Olena , Logvinenko Alla , Bezrodnyj Volodymyr , Serbeniuk Kateryna
Published: April 2021

Objective:

to investigate the changes of cognitive function and carotid structure in patients with résistance hypertension (RH) over 24 months observation

Design and method:

In 51 pts with RH (average age 52,3 ± 0,9; 27 males) we measured ultrasonographically diameter (D) of common carotid arteries (CCA), carotid intima-media thickness (IMT) value at the carotid bifurcations and at the level of CCA, blood flow velocities (BFV) of CCA, internal carotid arteries (ICA) and cognitive function by Montreal cognitive assessment (MoCA) test twice: at baseline and after 24 months. Changes in D CCA, IMT and MoCA test were defined as a difference between subject's baseline D CCA, IMT, MoCA test and subsequent measurements obtained 24 months later. All pts received 4 antihypertensive drugs during observation period

Results:

systolic and diastolic blood pressure were significantly decreased at the end of observation period. Carotid diameter and IMT value at the level of CCA were significantly decreased during observation period (DCCA from 8,6 ± 0,03 to 8,3 ± 0,03 mm, p = 0,02, CCA IMT from 1,24 ± 0,02 to 1,11 ± 0,02 mm, p = 0,01). IMT value at carotid bifurcation didn’t change significantly. We observed improvement in cognitive function: MoCA test results at baseline was 22,2 ± 0,5 after 24 months - 24,9 ± 0,5. The end diastolic BFV in CCA, ICA were significantly increased (accordingly: CCA – 0,14 ± 0,03 vs 0,34 ± 0,03m/s, p = 0,001, ICA – 0,23 ± 0,02 vs 0,48 ± 0,03m/s, p = 0,001) and resistance index (RI) of ICA was significantly decreased from 0,65 ± 0,02 to 0,61 ± 0,02. Changes of peak systolic BFV were not significant. Changes of MoCA results were related to IMT value at the level of CCA at baseline and at the end of observation (accordingly: r = -0,81; p < 0,01 and r = -0,79; p < 0,02). The same relations were between MoCA results and IMT value at bifurcation CCA.

Conclusions:

our 24 months study showed the positive dynamics of cognitive function and carotid structure such as decreasing of carotid diameters, intima-media thickness at level CCA and carotid resistance in patients with resistance hypertension who were receiving antihypertensive treatment.
ASSOCIATION OF AMBULATORY BLOOD PRESSURE WITH FRONTAL CORTICAL THICKNESS AND HIPPOCAMPAL VOLUME
Authors: Ha Jeongha , Lee Chan Joo , Kim Woojin , Jang Heeseon , Oh Jaewon , Lee Sang -Hak , Kang Seok -Min , Lee Seung -Koo , Kim Changsoo , Park Sungha , Seo Sangwon
Published: April 2021

Objective:

In the elderly, the effect of blood pressure on brain structure or cognitive function has not been clear. However, there are limitations in that most of studies was done using serial change in clinic blood pressure. We sought to determine the association of the ambulatory blood pressure over time with the brain structural alterations and cognitive function

Design and method:

In this study, we sought to examine the association between blood pressure and brain structure/cognitive function in the elderly over the age of 60 by using the 24-hour ambulatory blood pressure information at 2 different visits (mean time interval is 3.4 years). From October 2018, we included participants performed Korean Mini Mental State Exam; older than 60 years old among the participants in Cardiovascular and Metabolic Disease Etiology Research Center-High Risk Cohort.

Results:

When we divided the 170 participants into two groups according to the control of cumulative average daytime blood pressure, the cortical thickness of frontal lobe was thinner and the average hippocampal volume was smaller in the uncontrolled group (P = 0.002, P = 0.01 respectively). In multivariate linear analysis, the uncontrolled group for cumulative average daytime blood pressure was associated with thinner cortical thickness of frontal lobe and smaller average hippocampal volume (P = 0.007, P = 0.024 respectively). However, the baseline daytime blood pressure had no associations with brain structure or cognitive function.

Conclusions:

Our observations suggest that serial measurements of 24-hour ambulatory blood pressure may be important to assess the cumulative pressure load and the association with structural changes of the brain.
ASSESSMENT OF CAROTID INTRAPLAQUE HEMORRAGE BY PHOTOACUSTICS IMAGING (PAI) IN PATIENTS UNDERGOING TROMBOENDOARTERIECTOMY: FIRST IN-VIVO HUMAN VALIDATION STUDY
Authors: Bruno Rosa Maria , Imaizumi Yuki , Hobeid Hasan , Jaeger Michael , Julia Pierre , Bruneval Patrick , Calvet David , Boutouyrie Pierre
Published: April 2021

Objective:

The aim of the study is the validation of a portable multimodal photoacoustic imaging (PAI) system, for the identification of intraplaque haemorrhage and compare with MRI and histology (gold standard).

Design and method:

25 patients with carotid stenosis>70% and clinical indication to tromboendoarterectomy were recruited. Angio-MRI for intraplaque hemorrhage assessment (Cube sequence) was performed. PAI clips (5 seconds, Frame rate 1000/sec) were acquired. Each clip was scored for the presence of PAI signal by means of an integrated scoring system (semiquantitative, from 0 to 12). Semiquantitative grading scales were used to assess plaque histological features of hemorrage and vulnerability.

Results:

18 patients had no missing MRI, PAI and histology data and were included in this analysis. Mean age was 73 ± 8 years, 60% men, 80% Caucasians, 92% hypertensives, 60% with a previous stroke. Only 3 plaques out of 21 showed no signs of intraplaque hemorrhage, 4 showed small hemorrage, while 14 (67%) showed large hemorrhages. PAI score (best cut-off >4) correctly classified 14 out of 18 patients (Sensitivity 73.3%, specificity 100%, AUC 0.867). MRI performance was substantially similar (Sensitivity 60%, specificity 100%, AUC 0.800, 12 patients correctly classified), with a non-significant difference in AUC compared to PAI (p = 0.420).

Conclusions:

In this first in-vivo human study, PAI is able to identify histological intraplaque hemorrhage with an excellent specificity and acceptable sensitivity, equivalent to MRI. The very high specificity, with a low number of false positives, make PAI a good candidate for evaluation of plaques prior to surgery to i.e. reinforce the decision to perform surgery.
BLOOD PRESSURE IN RELATION TO INTERACTION BETWEEN DIETARY SODIUM INTAKE AND SERUM URIC ACID IN CHILDREN AND ADOLESCENTS WITH PRIMARY HYPERTENSION
Authors: Zhang Wei , Wang Dian , Xu Jian-Zhong , Li Yan , Wang Ji-Guang
Published: April 2021

Objective:

We investigated ambulatory blood pressure in relation to interaction between dietary sodium intake and serum uric acid in children and adolescents with primary hypertension.

Design and method:

The study subjects were in the age range from 10 to 24 years, admitted in Ruijin Hospital because of hypertension. Ambulatory blood pressure monitoring was performed during hospitalization using SpaceLabs 90217 monitors. We collected 24-hour urine for measurements of sodium excretion. We measured serum uric acid concentration with a blood chemistry autoanalyzer, and defined hyperuricemia as a serum uric acid concentration of at least 5.5 mg/dl. Our analysis was restricted to those with primary hypertension (n = 580).

Results:

The prevalence of hyperuricemia was 48.7%, being higher in male (n = 252) than female (n = 31, 54.9% vs 25.4%) and in untreated (n = 84) than treated patients (n = 199, 56.4% vs 46.1%). Ambulatory blood pressure did not differ across the quartile distributions of urinary sodium excretion (P > = 0.05), but was significantly (P <  = 0.04) higher in patients with hyperuricemia than those without for all components, except 24-hour and daytime systolic blood pressure (P > = 0.15). In multivariable regression analysis adjusted for age, sex, body mass index, current smoking and alcohol intake, there was a significant (P < = 0.03) interaction between urinary sodium excretion and serum uric acid in relation to 24-hour systolic and diastolic blood pressure. Indeed, in the presence of hyperuricemia, 24-hour systolic/diastolic blood pressure was 2.2/1.1 mm Hg higher with 100 mmol increase in urinary sodium excretion.

Conclusions:

Dietary sodium intake interacts with serum uric acid to be associated with ambulatory blood pressure.
URINE METABOLITES OF CORTISOL CORRELATES WITH AMBULATORY BLOOD PRESSURE VALUES IN OBESE CHILDREN
Authors: Tagetti Angela , Danese Elisa , Pucci Mairi , Minuz Pietro , Antoniazzi Franco , Maffeis Claudio , Fava Cristiano
Published: April 2021

Objective:

Obesity is considered a pseudo-Cushing state and often elevated levels of cortisol and its metabolites can be found; however, the relationship between cortisol metabolites and blood pressure (BP) in obese children is understudied. 11b-hydroxysteroid dehydrogenase type 2 (11b-HSD-2) catalyses the reversible conversion of physiological glucocorticoids (tetrahydrocortisol, THF and allo-tetrahydrocortisol, allo-THF) to inactive products (tetrahydrocortisone, THE). An increase in the THFs/THE ratio reflects 11b-HSD-2 impairment and has been associated with BP elevation. Ambulatory blood pressure monitoring (ABPM) provides an accurate measurement of BP during 24 hours. We aimed to investigate the relationship between BP measured by ABPM, urinary cortisol and its metabolites, in a sample of obese children.

Design and method:

50 obese children aged between 8 and 17 years (mean age 11.5 ± 3.3 years, 66% males), were included in the present study. Children underwent ABPM. Cortisol, sodium, THF, allo-THF and THE were measured on urinary 24-hour collection. Cortisol urinary metabolites were quantified by liquid chromatography tandem mass spectrometry (Nexera Shimadzu, 4500 MD Sciex).

Results:

The THF + alloTHF/THE ratio negatively correlates with 24-hours urinary sodium excretion (p = -0.346; r = 0.015) and to SBP and DBP load (% of measure of PAS > 130mmHg or % of PAD > 80mmHg) (respectively r = 0.283 p = 0.047 and r = 0,284; p = 0.046). No correlation between THFs/THE ratio and daytime or nighttime SPB or DBP were found. The sum of urinary cortisol and its metabolites, a gross index of relative excess of cortisol, is directly correlated with SBP load (r = 0.355; p = 0.029).

Conclusions:

In our sample of obese children, both the impaired activity of the 11b-HSD-2 and the amount of cortisol and its metabolites excreted by urine are associated with an excessive 24-h BP load. Reduced urinary sodium excretion mediated by increasing of THF/THE ratio could be involved.
THE OPTIMAL NIGHTTIME HOME BLOOD PRESSURE MONITORING SCHEDULE IN CHILDREN AND ADOLESCENTS: ASSOCIATION WITH AMBULATORY BLOOD PRESSURE AND PRECLINICAL ORGAN DAMAGE
Authors: Kollias Anastasios , Stambolliu Emelina , Bountzona Ioanna , Servos George , Vazeou Andriani , Stergiou George S.
Published: April 2021

Objective:

To evaluate the optimal schedule of nighttime blood pressure (BP) assessed by home monitoring (HBP) in children and adolescents in terms of agreement with nighttime ambulatory (ABP) and association with preclinical target-organ damage.

Design and method:

Apparently healthy children and adolescents (age 6–18 yeas) referred for elevated BP were subjected to (i) 24 h ABP monitoring (Microlife WatchBP O3), (ii) HBP monitoring during daytime (7 days, duplicate morning and evening measurements) and nighttime (3 nights, 3 hourly readings/night; Microlife WatchBP Home-N), (iii) carotid intima-media thickness (cIMT) measurement, (iv) carotid-femoral pulse wave velocity (PWV; Complior device; duplicate measurements), and (v) echocardiographic left ventricular mass index (LVMI).

Results:

49 children and adolescents were analysed (mean age 13.4 ± 2.7 years, 25 males, BMI 24.3 ± 4.9 kg/m2, 14 with 24 h ABP > 95th percentile).). There was no difference in nighttime HBP between the 3 nights (1st 109.7 ± 10.9/60.8 ± 7.3 mmHg, systolic/diastolic; 2nd 109.1 ± 11.7/59.7 ± 8.6; 3rd 109.1 ± 11.5/60.4 ± 8.4, p = NS). By averaging an increasing number of nighttime systolic HBP readings, there was a consistent trend towards stronger association of nighttime HBP with nighttime ABP (correlation coefficients r increased from 0.65 to 0.81), and with target-organ damage (for LVMI r increased from 0.21 to 0.30; cIMT from 0.38 to 0.57; PWV from 0.60 to 0.69). No further improvement in the associations was observed by averaging more than 4 nighttime HBP readings.

Conclusions:

In line with findings in adults, in children and adolescents 2-night HBP schedule (6 readings) appears to be the minimum requirement for a reliable assessment of nighttime HBP, which gives reasonable association with ABP and preclinical organ damage.
NOCTURNAL HOME VERSUS AMBULATORY BLOOD PRESSURE MONITORING IN CHILDREN AND ADOLESCENTS: FEASIBILITY AND PATIENTS PREFERENCE
Authors: Bountzona Ioanna , Stambolliu Emelina , Kollias Anastasios , Ntineri Angeliki , Servos George , Vazeou Andriani , Stergiou George
Published: April 2021

Objective:

To evaluate the feasibility of nighttime blood pressure (BP) assessed by home (HBP) monitoring in children and adolescents and compare with ambulatory (ABP) monitoring.

Design and method:

Apparently healthy children and adolescents (age 6–18 yeas) referred for elevated BP were subjected to (i) 24 h ABP monitoring (Microlife WatchBP O3), (ii) HBP monitoring during daytime (7 days, duplicate morning and evening measurements) and nighttime (3 nights, 3 hourly readings/night; Microlife WatchBP Home-N). Participants filled a questionnaire (Likert-type scale questions) evaluating the acceptance and compliance, stress, inconvenience, sleep disturbance, ease, feasibility, and preference regarding nighttime ABP and HBP monitoring. Score for each question ranged from 0 to 4 (4 indicating highest disturbance/difficulty).

Results:

84 subjects were analyzed (mean age 13.3 ± 2.8, BMI 25.2 ± 4.9 kg/m2, 49 males, 15 with 24 h ABP >  = 95th percentile). Nighttime HBP monitoring was feasible in all subjects (average number of monitoring nights 2.9 ± 0.4 [range 1–3] and nighttime HBP readings 7.9 ± 1.6 [range 2–9]). Participants reported a worse score regarding stress and inconvenience with nighttime ABP than HBP (1.2 ± 0.8 vs. 0.9 ± 0.7 respectively, p < 0.01), despite similar sleep disturbance (1.7 ± 1.4 vs. 1.6 ± 1.3, p = NS). 12% reported severe sleep disturbance with nighttime ABP and 8% with nighttime HBP. Worse ease and feasibility score was reported for nighttime ABP than HBP (1.3 ± 1.1 vs. 0.9 ± 1.0, p = 0.02). Optimal compliance with doctor's instructions was reported by 67% for nighttime HBP vs. 68% for ABP (p = NS). 74% reported that they prefer nighttime HBP versus ABP for their next assessment.

Conclusions:

These results indicate that in children and adolescents nocturnal HBP monitoring is feasible and tends to be superior to nocturnal ABP in terms of overall acceptance and preference.
COMMON HEART RHYTHMS AMONG SCHOOL CHILDREN IN ENUGU, SOUTH EAST NIGERIA
Authors: Okorie Pamela , Isiguzo Godsent , Anyaehie Bond
Published: April 2021

Objective:

The aim is to study the different heart rhythms among school children in Enugu Nigeria

Design and method:

This is a descriptive cross-sectional study of 341 apparently healthy children aged 6–12 years with no previous history of fits, fainting spells, dizziness and related illness. It involved interviewer-administered questionnaires, physical examination and ECG using a 12-lead ECG machine. All collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Values of p < 0.05 at 95% confidence interval were taken as significant.

Results:

None of the children had structural evidence of heart disease, and throughout the duration of the study, no abnormal events occurred. The prevalence of normal sinus rhythm was 79.1%, abnormal rhythm was seen in 20.9%. During the study, the following were recorded, premature complexes consist 8.44%; atrial tachycardia 5.64%; first degree atrioventricular block, 5.63%); bradycardia (2.82%) and incomplete right bundle block 2.82%.

Conclusions:

This study shows that abnormal rhythms are present amongst apparently healthy school children, and these could be missed without cardiovascular screening. With reported cases of sudden death during sports in children and young adults, it is important to encourage routine screening to aid early detection and prevention.
PREVALENCE OF HYPERTENSION IN ADOLESCENTS: DIFFERENCES BETWEEN 2016 ESH AND 2017 AAP GUIDELINES
Authors: Mule’ Giuseppe , Sorce Alessandra , Tranchida Valeria , Peritore Luigi , Cottone Santina
Published: April 2021

Objective:

The objective was to assess the differences about the prevalence of high blood pressure values in adolescents by applying the 2016 ESH and the 2017 AAP hypertension guidelines and analyze the relationship of pressure increases with lifestyles and potentially risky behaviors, which in Italy are little investigated.

Design and method:

Blood pressure levels of 1301 students aged between 13 and 20 were recorded. Two questionnaires were administered, one related to anamnestic data and anthropometric parameters and a second one, combined with the measurement of blood pressure, investigated the prevalence of hypertension and its relationship with lifestyle. Three blood pressure and heart rate measurements were taken and the average of these measurements was calculated. For the diagnosis of increased blood pressure both ESH and AAP criteria were considered. For the definition of the height centiles as well as for the BMI, reference was made to the tables produced by WHO 2007.

Results:

The main result concern the greater prevalence of high blood pressure values by applying new AAP criteria (14,8%)than ESH guidelines (7,5%).

In our study we found significant correlation of systolic values and anthropometrics variables: weight (r = 0,342) height (r = 0,321) and BMI (r = 0,318) in the entire population.

The condition of overweight in hypertensive subjects in comparison to normotensive was evident, while the prevalence of obesity despite being tendentially greater in hypertensives was not significantly higher. Higher SBP (systolic blood pressure) and DBP (diastolic blood pressure) values are associated with a higher mean heart rate (88 ± 18 bpm). No significant correlations was found with smoking, height and sex.

Conclusions:

At the best of our knowledge, this study is the first in our country, which investigates the prevalence of hypertension in adolescents, after the publication of 2017 AAP guidelines. Results shows how hypertension is not a rare phenomenon in this age group and confirm that it deserves more attention and following studies.
PREMATURE AND FAVORABLE VASCULAR AGING IN YOUNG PEOPLE TAKING INTO ACCOUNT BLOOD PRESSURE
Authors: Evsevyeva Maria , Rostovtseva Maria , Fursova Elena , Rusidi Anjelika , Shtsetinin Evgenij
Published: April 2021

Objective:

Features of vascular aging in young people have been studied very poorly to date. Meanwhile, increased vascular stiffness is regarded by experts as a realized risk factor. Purpose was to assess the representation of different variants of elastic vascular potential in young people depending on the level of blood pressure and taking into account sex.

Design and method:

243 freshmen students including 81 boys and 162 girls were examined on the basis of the Health Center of StSMU within the framework of the National Preventive Project University is Territory of Health. All the examined patients were divided into quartile groups according to such an indicator of vascular stiffness as cardiovascular vascular index or CAVI, which was determined using the diagnostic complex VaSera-1500, Fucuda Denshia, Japan. According to some experts, the fourth quartile of this distribution corresponds to early vascular aging or EVA syndrome. The first quartile corresponds to favorable vascular aging. Then the representation of carriers of prehypertension (PH) and arterial hypertension (AH) in each of the four quartile groups was analyzed. The same analysis was carried out among carriers of normotension and hypotension. Data processing was carried out using the software package Statistica 10.0, StatSoft Inc, USA.

Results:

The representation of both boys and girls with normal and reduced blood pressure is slightly higher in the first quartile CAVI-group. The representation of young men with increased blood pressure is also somewhat greater in the first quartile CAVI-group. The bulk of girls with high blood pressure is represented in the first and second quartile CAVI-groups.

Conclusions:

Among freshmen with different levels of blood pressure there are carriers of different variants of elastic vascular potential. At the same time, regardless of the BP level, carriers of favorable vascular aging dominate among young people. Cases of premature vascular aging also occur among individuals with any level of blood pressure. This suggests the need for an optimized approach to the formation of youth groups of cardiovascular risk, taking into account not only traditional risk factors such as hypertension, but also the characteristics of vascular elastic status.
OBESITY, HYPERTRIGLYCERIDAEMIA AND ENDOTHELIAL DYSFUNCTION ARE RISK FACTORS OF HYPERTENSION IN SOUTH AFRICAN ADOLESCENTS
Authors: Engwa Godwill , Letswalo Prescilla , Nkeh-Chungag Benedicta
Published: April 2021

Objective:

Obesity, dyslipidaemia, endothelial dysfunction and chronic low-grade inflammation are suggested to be risk factors of hypertension in adolescents. Though reports suggest relationship between hypertension and endothelial dysfunction, the exact role of the former in hypertension has not been clarified. Thus, this study assessed the relationship between hypertension, metabolic syndrome and vascular function in South African adolescents.

Design and method:

Two hundred and thirty four adolescents (234) aged 13–16 years were recruited from schools around Mthatha, an under-privileged area of South Africa. Measures of obesity, lipid profile as well as endothelial function indices (PWV, nitric oxide (NO) and asymmetric dimethyl arginine (ADMA)) were determined and assessed for association with blood pressure parameters.

Results:

More than one third of adolescents, both males and females, were pre-hypertensive or hypertensive (39%) and obese (32%). Almost half of all adolescents were identified as being at risk of hypertension, either through obesity or hypertriglyceridemia as these measures were significantly higher (p less than 0.05) in pre-hypertensive/hypertensive (pre-HT/HT) subjects compared to normotensive subjects. More so, pre-HT/HT was associated with measures of obesity. Endothelial dysfunction may have influenced pre-HT/HT and vice versa as PWV greater than 50 percentile was associated with SBP while ADMA was associated with DBP. On the other hand, pre-HT/HT was associated with NO. PWV and ADMA both showed and independent relationship with hypertension.

Conclusions:

This finding suggests that obesity, hypertriglyceridemia and endothelial dysfunction are risk factors of hypertension in Adolescents living in Mthatha. Hence the need for lifestyle changes to prevent development of cardiovascular diseases later on in life.
CONCENTRATION OF ACTIVE RENIN IN CHILDREN WITH PRIMARY HYPERTENSION
Authors: Skrzypczyk Piotr , Pers Anna , Nowak Magdalena , Wronska Malgorzata , Szyszka Michal , Stelmaszczyk-Emmel Anna , Panczyk-Tomaszewska Malgorzata
Published: April 2021

Objective:

Renin-angiotensin-aldosetone system (RAAS) is a key player in regulation of blood pressure, vascular resistance, and fluid and electrolyte balance. Thus, activation of RAAS is considered as one of potential steps in development of primary hypertension (PH). Literature data suggest that active renin (AR) concentration is a precise marker of RAAS activation. The objective of the study was to assess the AR concentration in children with primary hypertension.

Design and method:

In this single-center cross-sectional study we evaluated AR [pg/mL], BMI Z-score, peripheral and central pressure, blood pressure in ABPM, biochemical parameters, ultrasonographic kidney image and arterial damage (cIMT, AIx75HR, PWV, elasticity of common carotid artery by E-tracking) in 98 children with PH (14.83 ± 2.92 years) and 45 healthy children.

Results:

Children with PH compared to healthy children had significantly higher: AR concentration (median: 34.3 [IQR:24.38–64.94] vs. 24.94 [IQR:16.81–34.32] [pg/ml], p < 0.001), BMI Z-score, peripheral and central blood pressure, blood pressure in ABPM, also cIMT, PWV, and uric acid and triglycerides concentrations. In the whole group of 143 children AR correlated significantly (p < 0.05) with office systolic (r = 0.24) and diastolic (r = 0.22) blood pressure, neutrophil count (r = 0.17), total (r = 0.20) and HDL (r = 0.20) cholesterol, heart rate (r = 0.17) and systolic pressure load in ABPM (r = 0.19); in 98 children with PH AR correlated also with number of hypotensive drugs (r = 0.42) and right and left kidney length (r = -0.23; r = -0.25); in 51 children with newly diagnosed PH also with ABPM MAP 24 h Z-score (r = 0.35) and central mean pressure (r = 0.41). In children with newly diagnosed PH AR in patients with isolated systolic hypertension was significantly lower compared to patients with systolic and diastolic hypertension (26.16 [IQR: 18.60–34.16] vs. 37.79 [IQR:27.03–49.58], p = 0.014) and did not differ from AR in healthy children.

Conclusions:

In this single-center cross-sectional study we evaluated AR [pg/mL], BMI Z-score, peripheral and central pressure, blood pressure in ABPM, biochemical parameters, ultrasonographic kidney image and arterial damage (cIMT, AIx75HR, PWV, elasticity of common carotid artery by E-tracking) in 98 children with PH (14.83 ± 2.92 years) and 45 healthy children.
RESISTANT ARTERIAL HYPERTENSION AND ARTERIAL STIFFNESS IN HYPERTENSIVE RENAL TRANSPLANTATION RECIPIENTS SUFFERING FROM PERIODONTITIS
Authors: Oreskovic Josip , Kovacevic Katja , Vuckovic Marijana , Raos Hrvoje , Roguljic Marija , Gelemanovic Andrea , Radic Josipa
Published: April 2021

Objective:

Previous studies showed a positive correlation between periodontitis, a chronic inflammation of gingival tissue, and arterial hypertension (AH), which is one of the main risk factors for cardiovascular diseases. The aim of this study was to evaluate the prevalence of resistant AH (RAH) and difference in parameters of arterial stiffness, blood pressure and body composition among hypertensive RTCs with periodontitis with special focus on RAH.

Design and method:

A comprehensive medical and periodontal examination was performed and for each RTR data was collected on various biochemistry and anthropometry.

To measure arterial pressure (both peripheral and central, systolic and diastolic) and parameters of arterial stiffness (pulse wave velocity (PWV) and augmentation Index (AIx)) Agedio B900 device was used. Tanita MC780 Multi Frequency segmental body composition analyser was used to measure content of body fat, muscle mass and visceral fat each study subject. Oral periodontal status included full mouth plaque score (FMPS), full mouth bleeding score (FMBS), periodontal probing depth (PPD) and clinical attachment loss (CAL), all measured at six sites of each tooth.

Results:

Out of 55 RTRs suffering from periodontitis, 45 (82%) had AH, out of which 31 (69%) had resistant AH (RAH). Those RTRs with periodontitis and RAH have statistically higher value of glucose (P = 0.007), PWV (P = 0.008) and AIx (P = 0.050). Two groups of patients did not show any statistically significant difference in other measured parameters (e.g. body composition and blood pressure parameters, etc.).

Conclusions:

Our study showed high incidence of RAH among hypertensive RTRs suffering from periodontitis. Also those patients with RAH had higher arterial stiffness. Results are suggesting that this patient population is especially vulnerable, which could lead to increased morbidity and mortality. Further studies are required to infer causality between periodontitis and AH.
ANALYSIS OF THE RELATIONSHIP OF COMORBID PATHOLOGY AND CORONARY DISEASES IN ACUTE MYOCARDIAL INFARCTION
Authors: Oralbekova Zhanar , Berkinbaev Salim , Junusbekova Gulnara , Tundybaeva Meiramgul , Utebaliyeva Dariya , Mamedguliyeva Zhannat , Leonovich Tatyana , Kabdulkaeva Aliya , Abenova Aliya , Kodasbaev Almat , Iskakova Gaukhar
Published: April 2021

Objective:

To identify the relationship of comorbid pathology and the degree of coronary lesion.

Design and method:

A retrospective analysis of cases of acute myocardial infarction (AMI) was carried out in 4 cardiology departments of the “City Cardiology Center” in Almaty (CCC) this year.

Results:

During the study period, 148 patients with AMI were treated, mainly men — 59.4% (88), the average age of the patients was 61.3 ± 7.8 years (p -0.0001), with the following average level of LDL-4.013 - mol / l and a preserved ejection fraction - average 52.375%. The most common comorbid pathologies were hypertension in 83.7% (124), diabetes mellitus (DM) 25% (37), chronic kidney disease (CKD) 25.6% (38), and cardiac arrhythmias (LDCs) 8.7% (13), COPD in 2.7% (4), and 38.9% (59) other diseases (gastrointestinal tract, thyroid gland, anemia, etc.). It was determined that according to the Charlson comorbidity index, these were mainly in 51.3% (76) cases - more than 8 points, which correspond to a very high risk of an unfavorable prognosis, in the remaining 26.3% (39) and 21.6% (32) cases high and moderate risk, respectively. It was revealed that only 4 patients had no comorbid pathology, while they were younger than 45 years old, had these risk factors: burdened heredity, smoking and dyslipidemia. 18.2% (4) cases had 1–2 concomitant pathology 37.1% (55), a combination of 3–4 comorbid pathologies was detected in 45.9% (68), 5 and more met 14.3% (21 cases).

By the results of coronarography, the most common multivascular lesion of the coronary vessels - 62.1% (92), single-vascular lesion - 27.7% (41), stem lesion - 10.2% (15). According to the linear regression analysis, a reliable relationship between the presence of a combined pathology of more than two nosological forms and a multivascular lesion of the coronary bed, especially the combination of AH + DM, AH + SD_KHB, was revealed (p < 0.05).

Conclusions:

The most common nosological forms of comorbid pathology were determined, the relationship between combined pathology and multivascular coronary lesion in patients with AMI in the conditions of the cardiological department of the CCC was revealed.
FUSTER-BEWAT SCORE VERSUS IDEAL CARDIOVASCULAR HEALTH SCORE TO PREDICT LEFT VENTRICULAR HYPERTROPHY: DATA FROM CHINA PEACE MILLIONS PERSONS PROJECT
Authors: Liu Lin , Huang Yuqing , Huang Jiayi , Chen Chaolei , Yu Yuling , Shen Geng , Feng Yingqing
Published: April 2021

Objective:

The Fuster-BEWAT Score (FBS) has been recently developed for use in lifestyle-based cardiovascular disease prevention, presenting similar accuracy in predicting subclinical atherosclerosis with ideal cardiovascular health score (ICHS), but it is unclear whether these scores exhibit comparable predictive values for detection of left ventricular hypertrophy (LVH). We evaluated the effectiveness of ICHS and FBS in assessing the presence of LVH among Chinese population.

Design and method:

A total of 3,521 participants aged 35 to 75 years with echocardiography screening in Guangdong were enrolled in the China PEACE (Patient centered Evaluative Assessment of Cardiac Events) Millions Persons Project. Subjects were grouped into three categories according to the number of favorable ICHS or FBS: ideal, intermediate, and poor. Left ventricular mass index (LVMI) was assessed by left ventricular mass divided by body surface area. LVH was defined as LVMI > = 115 g/m2 in male and LVMI > = 95 g/m2 in female.

Results:

In this study, poor ICHS accounts for 14.3% of all participants, intermediate ICHS 78.2%, and ideal ICHS 7.6%; poor FBS accounts for 4.4% of all participants, intermediate FBS 65.4%, and ideal FBS 30.2%. With poor ICHS as references, those with intermediate and ideal ICHS showed substantially lower adjusted odds of having LVH (odds ratio (OR) [95% confidence interval (CI)]: 0.643 [0.417, 0.991] and 0.346 [0.219, 0.547], respectively, with a p-value for trend < 0.001). Compared with participants with poor FBS, intermediate and ideal FBS were negatively associated with the likelihood of LVH (OR [95%CI]: 0.638 [0.512, 0.796] and 0.316 [0.211, 0.473], respectively, with a p-value for trend < 0.001). The Receiver Operating Characteristic Curve (ROC) indicated identical discriminating accuracy of ICHS (Area Under Curve (AUC): 0.696) and FBS (AUC: 0.702) with DeLong's test p-value 0.172 in identifying LVH.

Conclusions:

Both ICHS and FBS predict the presence and extent of subclinical atherosclerosis with similar accuracy, highlighting the value of the FBS as a simpler and more affordable score for evaluating the risk of LVH.
EFFECTS OF URIC ACID LOWERING THERAPY IN PATIENTS WITH PRIMARY HYPERTENSION
Authors: Gruszka Krystian , Rajzer Marek , Drozdz Tomasz , Czarnecka Danuta
Published: April 2021

Objective:

The aim of the study was to determine the effects of asymptomatic hyperuricemia (HU) treatment on selected Hypertension Mediated Organ Damage (HMOD) in patients with essential hypertension (EH).

Design and method:

We included 51 patients with stage 1–2 EH with newly diagnosed asymptomatic HU, on optimal, stable antihypertensive therapy, without coronary heart disease, symptomatic heart or renal failure.

Participants were randomly divided into two sub-groups: G1 (N = 27) and G2 (N = 24). Patients in both groups received the same dietary advice. In G1 we additionally started uric acid (UA) lowering therapy with allopurinol 100–300 mg/day. We measured blood pressure (BP) using office and 24-hour ambulatory blood pressure monitoring (ABMP), carotid-femoral pulse wave velocity (PWV), carotid artery intima-media thickness (IMT), performed echocardiography and blood tests including UA and NT-proBNP. All tests were repeated after 6 months.

Results:

UA lowering therapy in G1 was associated with a significant reduction in serum UA concentration (456 (414–488) vs. 310 (281–379) mmol/l, p < 0.001), while dietary advice alone (G2) did not cause significant reduction in serum UA concentration (406 (338–447) vs. 370 (345–401) mmol/l, p = 0.75). In G1 after 6 months of follow-up we observed significant reduction in left atrium volume (75 (58–97) vs. 72 (58–92) ml, p = 0.04), IMT thickness (0.81 (0.72–0.93) vs. 0.76 (0.72–0.89) mm, p = 0.03) and systolic office BP (141 (128–150) vs. 130 (123–136) mmHg, p = 0.03). UA lowering therapy after 6 months follow up did not affect 24-hour systolic BP (115 (105–125) vs. 112 (107–130) mmHg, p = 0.41), 24-hour diastolic BP (69 (63–76) vs. 70 (66–73) mmHg, p = 0.73), PWV (7.8 (6.9–8.7) vs. 7.7 (6.9–8.7) m/s, p = 0.45) and NT-proBNP levels (93 (51–227) vs. 114 (35–230) ng/l, p = 0.81).

In addition, allopurinol therapy at a higher dose than 00/day was associated with improved left ventricle global longitudinal strain (GLS): (-18.4 (-18.1;-21) vs. -18.9 (-18.4;-21.5) %, p = 0.02).

In G2 there were no significant differences in the tested parameters after 6 months.

Conclusions:

Our results may support the thesis that treatment of asymptomatic HU may lead to the reduction of some HMOD parameters (in particular left atrial enlargement and IMT thickness) and improve left ventricle GLS.