bluuebunny/crossref_metadata_2025 huggingface dataset:
P112 SUPPRESSION OF PROTEIN KINASE RNA-LIKE ENDOPLASMIC RETICULUM KINASE BY PROBIOTICS CIRCUMVENTS CARDIOVASCULAR RISK PROFILE IN EXPERIMENTALLY-INDUCED PCOS MODEL
Authors: Areloegbe Stephanie Esosa Joy , Olaniyi Kehinde
Published: September 2024

Background and Objective:

The global cause of death attributable to cardiovascular diseases (CVD). including in women of reproductive age is alarming. Individuals with PCOS usually present CVD as a long-term life-threatening effect of PCOS. Protein kinase RNA-like endoplasmic reticulum kinase (PERK) has been implicated in cardiomyopathy. However, its role in PCOS-induced CVD risk has not been established. Studies have shown that probiotics improves metabolic-related disorders. The present study was designed to investigate the role of PERK in CVD risk associated with PCOS in experimental rat model, and the therapeutic benefits of probiotics.

Methods:

Eight-week-old female Wistar rats were assigned into four groups (n=6). Polycystic ovarian syndrome was induced by uninterrupted administration of letrozole (1 mg/kg) for 21 days, thereafter, probiotics (2 x 107 CFU) was administered for 6 weeks. Gene expression, biochemical parameters and histological evaluations were performed with Western blot, ELISA, and H&E staining techniques

Results:

The present findings revealed that animals with PCOS were characterized with phenotypic features such as hyperandrogenemia and multiple cysts in the ovaries. In addition, PCOS rats manifested insulin resistance and increase in glucose regulatory protein (GRP78), together with increased levels of circulating corticosterone, cardiac triglyceride, inflammatory mediators (NF- kappaB/TNF-alpha), TGF-beta1, Caspase-6, and HDAC2, while a decrease in HIF-1alpha and NrF2 was observed when compared with control animals. These were accompanied by elevated expression of PERK. However, treatment with probiotics reversed these systemic, endocrine, metabolic and cardiac anomalies.

Conclusion:

The present study suggests that probiotics attenuates CVD risk profile in experimental PCOS rat model by suppression of PERK/HDAC2-dependent pathway.
P118 EFFECT OF A FIXED COMBINATION THERAPY WITH PERINDOPRIL/AMLODIPINE AND ROSUVASTATIN TO PATIENTS WITH HIGH AND VERY HIGH RISK HYPERTENSION AND DYSLIPEDEMIA
Authors: Fayzullayeva Shakhlo Sodiqjon Qizi , Xamidullaeva Gulnoza Abdusattarovna , Abdullaeva Guzal Djaloliddinovna
Published: September 2024

Purpose:

Assess achievement target level blood pressure, LDL cholesterol, non-HDL cholesterol, Triglyceride, patients with high, very high risk AH during 6-month therapy with fixed combination perindopril/amlodipine addition rosuvastatin.

Material, methods:

Study included 43 patients hypertension I-II degrees (ESC/ESH, 2018), All patients assessed for cardiovascular risk using the SCORE2scale, high risk identified n=34 (80%) patients, very high n=9 (20%) patients. Average age patients 58.23±9.82 years, the average duration hypertension 13.07±8.53 years. SBP 159.46±10.52 mmHg, DBP 91.69±8.60 mmHg. All patients underwent: determination level blood lipids, glucose, ALT, AST, CPK, creatinine, uric acid in the blood and microalbuminuria. All patients with AHT and hypolipidemic purposes prescribed fixed combination drug perindopril/amlodipine and rosuvastatin. Drug dose titrated every 2 weeks until target values of BP and LDL cholesterol (<100-70 mg/dl), non-HDL cholesterol (<100-85 mg/dl), TG (<150 mg/dl) achieved. Average drug doses were perindopril at dose 4 to 8 mg/day, amlodipine dose 5 to 10 mg/day, initial dose orosuvastatin10 mg/day. All types analysis, p values <0.05 were considered statistically significant (Wilcoxontest).

Results:

In general, 6-month combination therapy with perindopril/amlodipine, rosuvastatin showed high lipotensive effectiveness. There was significant decrease in scores SCORE2scale, LDL cholesterol, non-HDL cholesterol, TG, SBP, DBP, blood pressure. The degree of scores SCORE2scale: initially 20.92±8.05 dynamics 14.92±9.66 points (p<0.001); LDL cholesterol 146.53±35.90,dynamics 114.86±36.43 mg/dl (p<0.003); Non-HDL cholesterol 185.61±35.90 mg/dl, dynamics 143.25±37.01 mg/dl (p<0.079); TG 181.23±108.47 dynamics 143.90±64.47 mg/dl (p<0.006); SBP 159.84±9 mmHg, dynamics 131.65±5.93 mmHg (p<0.000); DBP 91.69±8.60 mmHg, dynamics 82.55±4.17 mmHg(p<0.000); BPmean 115.48±7.22 mmHg, dynamics 99.96±3.75 mmHg. (p<0.000). In addition SBP decreased by -16.86±4.70%, DBP by -8.16±6.99%. The target level LDL cholesterol reached by39% patients, non-HDL cholesterol by 18%, Triglycerides by 55%, the target level SBP reached 88%, DBP 81% patients, SBP and DBP simultaneously 81% patients.

Conclusion:

Analysis effectiveness of combination therapy with drug perindopril/amlodipine, rosuvastatin showed significant decrease in level of indicators SCORE2 scores, LDL cholesterol, non-HDL cholesterol, TG, SBP, DBP, blood pressure. In patients with high, very high risk hypertension.
P119 COMPARISON BETWEEN MACRONUTRIENT DISTRIBUTION AND ANTHROPOMETRIC MEASURES IN POSTMENOPAUSAL WOMEN WITH AND WITHOUT HYPERTENSION
Authors: Ávila Mariana Ouriques , Dalmazo Aline , Santetti Daniele , Irigoyen Maria Cláudia , Fetter Claudia
Published: September 2024

Introduction:

The hormonal changes of menopause have a deleterious effect on metabolism and on blood pressure regulation, since 50% of women have metabolic syndrome. At this stage, there is an increased risk for some chronic non-communicable diseases, especially hypertension. Anthropometric data are established indicators for the risk of heart disease and, associated with the food consumption of post-menopausal women and hypertension, represent a gap to be elucidated.

Objective:

To compare the relationships between anthropometric measures and macronutrient distribution in the diet of postmenopausal women with and without hypertension.

Methods:

The study recruited 45 women between 45 and 65 years old, with and without hypertension and a minimum of one year of amenorrhea. Participants answered a food recall and had their weight, height, waist circumference, abdomen and hips collected. Distribution of macronutrients in the diet, waist/hip ratio and waist/height were calculated. Data by T-test considering significant differences between groups for p <0.05.

Results:

There was a statistical difference between normotensive and hypertensive women for BMI (24.87±4.05 kg/m2 vs. 32.03±4.20 kg/m2; p<0.001) Waist Circumference (80.91±9.96 cm vs. 102.08±9.27 cm, p<0.001); Hips circumference (101.43±8.15 cm vs. 111.23±8.93 cm; p<0.001); Waist-to-height ratio (0.43±0.06 cm vs. 0.64±0.06 cm, p<0.001); and Waist-to-hips ratio (0.79±0.05 cm vs. 0.91±0.04 cm, p<0.001) In food consumption, there was an important disparity in intake of carbohydrates (172.66±88.67 g vs. 250.32 ± 92.95 g, p=0.007) and lipids (55.69±26.23 g vs. 82.07±51.12 g, p=0.037) with no difference in protein consumption (62.80±23.32 g vs. 77.60±39.67 g, p=0.139).

Conclusion:

The study suggests that there are significant differences in anthropometric and food consumption variables among the participants, which may, therefore, be related to the development of hypertension.
P121 ROLE OF AMBULATORY BLOOD PRESSURE MONITORING (ABPM) IN THE EVALUATION OF PATIENTS WITH SUSPECTED SLEEP APNEA
Authors: Geliz-vilaro Carlos , Valle Carlos Campos-Del , Mercado-Marchena Riguey , Hernandez-Nieto Bryan , Barrios-Agamez Wilfrido , Quintero-Baiz Adalberto , Urina-Triana Miguel
Published: September 2024

Background and Objective:

Obstructive sleep apnea (OSA) often coexists with hypertension. Ambulatory blood pressure monitoring (ABPM) is essential for detecting significant blood pressure fluctuations, especially during nighttime. This study seeks to assess the role of ABPM in identifying OSA.

Methods:

We analyzed a database of patients with suspected OSA using the STOP-BANG questionnaire at a cardiology center from July 2020 to April 2024. Anthropometric characteristics, blood pressure behavior through ABPM, and sleep patterns via polysomnography were evaluated. The influence of risk predictors on OSA development was assessed using multinomial logistic regression.

Results:

The study included 38 men (50.6%) and 37 women (49.3%); 48 hypertensive patients (64%) and 27 without hypertension (27%). The average STOP-BANG score was 3.8. Of these, 92% had some degree of OSA. The mean age was 60±13.2 years. Neck circumference (NC) and total apnea-hypopnea index were 37.5 cm and 19.7 events/hour, respectively, with a predominance of REM OSA. Only NC and nocturnal diastolic pressure were significant variables. For the development of moderate OSA, NC showed significant relative risk ratios (RRR) (p=0.045). Severe OSA development was influenced by mean nocturnal diastolic blood pressure (MNDAP) and NC, with significant RRRs (p=0.007 and p=0.041, respectively). This means that for each mmHg increase in nocturnal diastolic pressure, the risk of severe OSA increases by 1.3 times compared to healthy patients, predominantly during REM sleep. Conversely, increased daytime diastolic pressure decreases this risk by 25%.

Conclusions:

An increase in mean nocturnal diastolic pressure measured by ABPM is a significant predictor of severe OSA development. This underscores ABPM's importance in evaluating patients with suspected OSA. While the STOP-BANG questionnaire is useful for initial OSA suspicion, it has limitations in identifying the most severe cases, necessitating tools like ABPM for more accurate assessment. The use of ABPM improves accuracy in detecting severe OSA and enhances understanding of hypertension phenotypes’ pathophysiology.

Table 1. Obstructive Sleep Apnea (OSA) Severity Classification and Its Correlation with Mean Nocturnal Diastolic Blood Pressure (MNDAP), Mean Daytime Diastolic Blood Pressure (MDDAP), and Neck Circumference (NC)
P125 WORKING LONG HOURS DURING MIDLIFE IS LATER ASSOCIATED WITH INCREASED ARTERIAL STIFFNESS
Authors: Milot Alain , Sisti Carolina Braga , Gilbert-Ouimet Mahée , Lavigne-Robichaud Mathilde , Brisson Chantal , Trudel Xavier
Published: September 2024

Background and Objectives:

Arterial stiffness is an asymptomatic cardiovascular disease (CVD) risk marker, resulting from reduced ability of large proximal arteries to dilate and retract. Arterial stiffness is associated with increased CVD, independently of blood pressure (BP). Evidence suggest that tackling modifiable risk factors may alter the pathogenic process leading to CVD, by reducing arterial stiffness progression. Long working hours is a frequent and modifiable risk factor from the work environment, shown to increase the risk of CVD. There is sparse evidence about the effect of long working hours on arterial stiffness. No previous study have used carotid-femoral pulse wave velocity (PWV), recognized as the reference assessment method. This study aims to examine whether long working hours, repeatedly assessed at midlife, is associated with increased arterial stiffness at older age in a 24-year prospective study of white-collar workers in Quebec City, Canada.

Methods:

This study relied on a prospective cohort, initiated in 1991-1993 (T1) with two follow-ups after 8 years (T2, 1999-2000) and 24 years (T3, 2015-2018). Participants (N=1,629) were randomly selected for arterial stiffness measurement at T3 using carotid-femoral pulse wave velocity (PWV). Long working hours (>40 h/week) were assessed at baseline (T1) and at the first follow-up (T2). Mean differences in PWV were estimated using generalized linear models, accounting for sociodemographic factors, lifestyle-related risk factors, clinical factors and psychosocial stressors at work.

Results:

Among participants who remained actively employed over the study period, baseline (+0.54 m/s, 95% CI: 0.05 – 1.02) and repeated (+1.54 m/s, 95% CI: 0.83 – 2.26) exposures to long working hours were associated with increased arterial stiffness. No association was observed among participants who retired between follow-ups.

Conclusions:

Working long hours during midlife is associated with increased arterial stiffness, among aging workers. Workplace preventive strategies reducing long working hours may be effective to mitigate long-term arterial stiffening.
P126 LONG WORKING HOURS ARE ASSOCIATED WITH INCREASED BLOOD PRESSURE VARIABILITY
Authors: Sylvain-Morneau Marc-Antoine , Lavigne-Robichaud Mathilde , Trudel Xavier , Milot Alain
Published: September 2024

Background and Objectives:

Elevated blood pressure variability (BPV) is associated with an increased risk of cardiovascular morbidity and mortality, independently of blood pressure values. Long working hours increase the risk of hypertension and cardiovascular diseases. The present study aims to determine whether long working hours have a detrimental effect on BPV.

Methods:

The present study relied on a prospective cohort of 3 639 white-collar workers in Quebec City evaluated at three visits: at recruitment, 3 years, and 5 years. At each visit, participants wore an ambulatory blood pressure monitor during working hours and answered a questionnaire. Work hours per week were divided into the following categories: 21 to 34 hours, 35 to 40 hours (reference group), and 41 hours or more. Working hours BPV was calculated using average real variability.

Results:

A total of 7 056 observations (n = 4 234 in women and n = 2 822 in men) were available. Systolic and diastolic BPV were higher in participants working long hours (41 hours and more per week) than in participants working 35 to 40 hours per week. These associations were robust to adjustment for socio-demographics, lifestyle-related and clinical risk factors as well as psychosocial stressors at work (psychological demand – job control and reward).

Conclusions:

Participants exposed to long working hours showed higher BPV than non-exposed participants. Intervention aiming at reducing long working hours should be considered for the primordial prevention of hypertension and cardiovascular diseases.

Average real variability of systolic and diastolic blood pressure during working hours according to hours worked per week
P133 ALTERED P-WAVE DISPERSION IN NEWLY DIAGNOSED YOUNG HYPERTENSIVES
Authors: Rufino Nuñez Harline Raquel , Carmona Puerta Raimundo , Lorenzo Martinez Elizabeth , Gonzalez Katia Hurtado , Batista Yajaira A. Flete , Sanchez Marielys Del Carmen Martinez , Calderon Jose Bernardo Gomez , Batista Joel Peñaló
Published: September 2024

Background and objective:

P wave dispersion (Pd) is a useful electrocardiographic marker for predicting the onset of atrial fibrillation. It has been little studied in recent hypertension. The aim was to determine the behavior of maximum P wave duration (Pmax) and Pd in young hypertensive patients with recent onset and its relationship with other variables.

Methods:

A cross-sectional, prospective, comparative study was performed in 60 young men (30 hypertensive and 30 non-hypertensive). P wave measurements were obtained with 12-lead electrocardiogram. Statistical analysis included applications of simple linear correlation, sample means were compared by Student's t-test.

Results:

There were no significant differences in the baseline characteristics of both groups. Pmax (78.67 ± 5.71 ms) and Pd (42.33 ± 6.26ms) were found to be significantly prolonged (p<0.001) in the hypertensive group compared to normotensive subjects (Pmax 61.00 ± 7.69 ms; Pd 25.00 ± 8.61 ms). Pd correlated significantly (r = 0.716; p<0.001) with systolic and diastolic blood pressure (r = 0.696; p<0.001).

Conclusions:

Pmax and Pd are found to be increased in young patients with recent-onset hypertension, and these values increase in direct proportion to blood pressure figures.
P134 CHARACTERIZATION OF RISK FACTORS IN RELATION TO THE INCREASE IN CARDIOVASCULAR RISK
Authors: Moya Luis , Escobar Hugo , Santoyo Gutierrez Ana Maria , Cely Leidy Bolena , Perez Maria Valentina Martinez , Lopez Claudia Milena Alvarez , Lombo Ricardo , Castro Mauricio , Chamie Katya , Saenz Ludy , Jimenez Oscar
Published: September 2024

Objective:

Identify risk factors and their relationship with 10-year cardiovascular risk evaluated using the modified Framingham scale, in order to promote education and healthy lifestyle habits, generating an impact on the incidence of this disease.

Methods:

A descriptive study was carried out to characterize risk factors related to a high cardiovascular risk at 10 years, based on a cross-sectional study consisting of information collection with modified Framingham surveys, for risk assessment at 10 years.

Results:

A total of 3,025 people were surveyed, where the following factors were associated with a high cardiovascular risk: diabetes with 221 people and 6.7% at high risk, obesity with 242 people with 11.2% at high risk, alcohol consumption with 938 people with 15.3% high risk and smoking with 333 people with a high risk of 5.8%.

Conclusions:

Cardiovascular diseases are the most common non-communicable diseases with considerable morbidity and mortality worldwide, especially in low- and middle-income countries. As a fundamental part of the study, the importance of risk factors and their relationship with high cardiovascular risk in a capital city of Colombia is considered, within these diabetes, obesity, alcohol consumption and tobacco consumption, the alcohol consumption as the risk factor with the biggest impact linked to high cardiovascular risk with 15.3%. On the other hand, a negative impact is evident in the relationship between obesity associated with high cardiovascular risk with 11.2% of the total the obese population, the results of this study demonstrate the association with high cardiovascular risk, revealing alcohol consumption and obesity and how it is related to the increase in cardiovascular risk according to the Framingham scale, revealing the importance of education as a fundamental pillar for the prevention of risk and development of the disease, generating new educational campaigns and studies about the relationship of the factors and their modification with healthy lifestyle habits
P135 FITNESS INFLUENCES THE RELATIONSHIP BETWEEN EXERCISE BLOOD PRESSURE AND LEFT VENTRICULAR STRUCTURE: EVIDENCE FROM THE EXERCISE STRESS TEST COLLABORATION (EXERTION) STUDY
Authors: Silva Ruiz Catalina , Sharman James E. , Otahal Petr , Staton Tony , Wahi Sudhir , Hare James L. , Selvanayagam Joseph , Venn Alison , Marwick Thomas H. , Schultz Martin
Published: September 2024

Background.

A hypertensive response to exercise is associated with left ventricular (LV) remodelling, a principal sign of hypertensive heart disease. Fitness may modify this relationship, making clinical interpretation of peak exercise systolic blood pressure (SBP) challenging. This study examines the influence of fitness on the relationship between peak exercise SBP and LV structure.

Methods.

Cardiovascular structure and function (LV mass index (LVMI), LV relative wall thickness (RWT), cardiac output (CO) and total peripheral resistance (TPR)) were assessed at rest by echocardiography on 4,309 individuals (aged 58.6±12.7 years,52.0% male). SBP was measured at peak treadmill exercise, and fitness (exercise duration (minutes)) was grouped into thirds. Multiple regression analysis was conducted with fitness as an interaction term with peak exercise SBP, adjusted for age, sex, pre-exercise SBP, and cardiovascular disease (CVD) history.

Results.

Peak exercise SBP was similar across low (180±26.5mmHg), moderate (181±26.3mmHg) and high (182±24.5mmHg) fitness groups. Fitness modified the relationship between exercise SBP and LVMI; each 5mmHg increase in exercise SBP was associated with LVMI in moderate [0.27(0.10–0.43) and high [0.25(0.06–0.43)] fitness groups, which was not observed among those with low fitness [-0.05(-0.22–0.12)]. RWT increased with higher peak exercise SBP at all fitness levels (all p<0.001), with higher values among those with low fitness. Prevalence of LV concentric remodelling was highest in those with low fitness (29.9%) and lowest in those with high fitness (10.8%). A lower CO and higher TPR were observed in the low fitness group (7.5±2.5L/min and 14.3±5.1mmHg min/L) compared to those with high fitness (10.9±3.1L/min and 9.2±2.09mmHg min/L). Conclusion. Whilst a small effect, fitness modified the peak exercise SBP-LV structure relationship, such that for similar peak exercise SBP, those with low fitness exhibit a more adverse LV remodelling, with lower CO and higher TPR, compared to those with higher fitness. Considering fitness when interpreting SBP and cardiac imaging results from exercise stress testing may be relevant in identifying CVD risk and optimal patient management.
P144 PHENOTYPIC CHARACTERISATION OF HEART FAILURE WITH PRESERVED EJECTION FRACTION ACCORDING TO BODY MASS INDEX: SUBANALYSIS OF THE ARGENTINE ARFEY-PRESER REGISTRY
Authors: Renna Nicolás Federico , Coronel María Lorena , Echazarreta Diego , Moris Maria Cecilia , Ceballos A , Cursack Guillermo , Colque Roberto , Brocal L , Poy Carlos , Perna Eduardo
Published: September 2024

Background:

Nutritional status, characterised by body mass index (BMI), may influence therapeutic decisions in heart failure with preserved ejection fraction (HFpEF). The objectives of this study were to identify clinical and echocardiographic characteristics associated with nutritional status and to analyse therapeutic strategies in HFpEF patients in Argentina.

Materials and Methods:

This prospective, multicentre observational registry enrolled outpatients or those discharged from hospitals, with prior informed consent. The study spanned from December 2022 to February 2024. Inclusion criteria were: 1) presence of current signs and symptoms, LVEF ≥50%, 2) structural heart disease with LVH, LAE, or average E/e’ ≥15 on Doppler, 3) elevated natriuretic peptides: sinus rhythm: NTproBNP >125 pg/ml or BNP >35 pg/ml; Atrial fibrillation/flutter: NTproBNP >375 pg/ml or BNP >105 pg/ml; and 5) commitment to 6-month and 1-year follow-ups. Exclusion criteria comprised: 1) acute coronary syndrome, 2) coronary artery bypass grafting, or valve replacement within the preceding 3 months, 3) confirmed infiltrative or hypertrophic cardiomyopathy, severe valvular disease, 4) severe illness with <1-year prognosis, and chronic renal failure on permanent dialysis.

Results:

A total of 449 patients were enrolled, with 440 having available BMI data for this analysis. Patient enrolment was consistent across centres and nationwide. BMI analysis revealed 0.7% undernutrition, 16.6% normal weight, 32% overweight, and 50.7% obesity. In Figure1 showed the analysis of clinical, laboratory, echocardiographic, and HF severity variables according to BMI. Significant differences were found in treatment, with lower use of RAS inhibitors and beta-blockers in non-normal weight patients compared to those with overweight and obesity.

Conclusions:

For a similar HFpEF severity profile, the phenotype according to BMI suggests different clinical characteristics. Underweight/normal weight patients were older, with more LAE and pulmonary hypertension, and fewer risk factors. Obesity was present in half of the cases, characterised by younger patients with a high burden of cardiovascular risk factors. This impacts the use of certain heart failure medications.
P152 PHYSICIANS’ KNOWLEDGE OF HYPERTENSION CLINICAL PRACTICE GUIDELINE AND ITS CORRELATION WITH ADHERENCE
Authors: Cruz Cuevas José D. , Villar Juan Carlos , Moreno Angélica M.
Published: September 2024

Background:

Hypertension remains the main cardiovascular risk factor. Despite the availability of high-quality clinical practice guidelines (CPG), their implementation is suboptimal pending on several factors, including clinicians’ knowledge of the guideline. The purpose of this study is to report clinicians’ knowledge the Colombian hypertension CPG, their adherence to it and the correlation between them.

Methods:

We performed a cross-sectional study with clinicians from 5 health-care institutions in Bogotá, Colombia, who voluntarily accepted to participate. A panel of experts selected seven recommendations from the Colombian hypertension CPG and designed a 17-item questionnaire to evaluate knowledge of the CPG. We consulted electronic health-records of a consecutive sample of 20 patients with hypertension treated by the clinicians to evaluate adherence (percentage of applicable recommendations that were fulfilled) and the questionnaire was sent via email to evaluate CPG knowledge (percentage of correct answers). Pearson correlation coefficient was calculated for clinicians’ knowledge and adherence.

Results:

From 266 physicians screened, 239 agreed to participate, 68 reported treating patients with hypertension and 38 answered the questionnaire (52% male, mean age and clinical experience 35.1 and 9.8 years, respectively). The mean score of CPG knowledge was 57.9% (95%CI 56.3-59.4%) and it did not differ according to clinicians’ sex or experience. Of the 38 physicians, 27 had available records of patients with hypertension. There was no difference in the mean knowledge score of clinicians who had eligible patients and those who did not (p=0.55). The mean adherence to the recommendations of clinicians who had eligible records (n=37) was 25.81% (IC95% 20.3-31.2%). This was similar for physicians who did and did not answer the knowledge questionnaire. A moderate positive correlation was shown between knowledge and adherence to recommendations (r 0.55, 95%CI 0.19-0.76, p=0.003) (Figure 1.)

Conclusions

Clinicians’ knowledge of CPG was moderate but adherence to recommendations was poor. While adherence could be partially explained by clinicians’ knowledge of CPG, correlation was at best moderate and other factors must be considered.
P160 MODELLING CARDIOVASCULAR TOXICITY IN CELLULO ASSOCIATED WITH ANTITUMORALS
Authors: Sánchez-pérez Isabel , Herrero Jorge Melones , Villacampa Alicia , Figueiras T Sofia , Calés Carmela , Sanchez Ferrer Carlos F. , Quiroga Adoración Gómez , Peiro Concha
Published: September 2024

Background and Objective:

Gastrointestinal cancer (GIC) stands as a leading cause of cancer-related mortality worldwide. Currently combination chemotherapy, particularly metal-based drugs, often induces side effects, limiting their clinical efficacy. Cardiotoxicity, a common complication associated with various therapeutic agents, manifests through vascular endothelial dysfunction, a hallmark of ischemic coronary disease.

Our aim is to design novel metal-based drugs with enhanced efficacy, specificity, and mitigated off-target cytotoxicity. We identified the isomers trans and cis-[PtI2(isopropylamine)2] (I5 and I6, respectively), as promising candidates against GIC, both in vitro and in vivo 1. RNA seq was performed in 6 different GIC cells. The Gene Set Enrichment Analysis (GSEA) revealed a significant enrichment of inflammation-related genes and downregulation of angiogenesis-associated pathways in treated cells.

Our objective now is to develop preclinical studies of the cardiovascular toxicity of I5 and I6.

Methods:

Cardiovascular effects of these drugs were studies using a in cellulo model system (AC16, HUVEC cell lines). Biological and biochemistry approaches and techniques were used to assess senescence, mitochondrial respiration, viability by MTS and wound healing assays.

Results:

Our findings indicate that both I5 and I6 decrease cellular viability, induce senescence (as evidenced by β-galactosidase activity), and generate reactive oxygen species compared to commonly used cisplatin. Additionally, I5 impact oxidative phosphorylation (OXPHOS) and glycolysis metabolism. Furthermore, a wound healing assay suggests that the migration of cells is modulated in response to treatment with these compounds.

Conclusions:

Accurate preclinical assessment of the effects of novel drugs on the vascular endothelium is imperative to address treatment-induced endothelial dysfunction before envisioning clinical trials. Understanding the impact of anti-cancer agents on the vascular endothelium will not only inform therapeutic strategies to prevent or reverse treatment-induced cardiotoxicity but may also serve as a vital tool for predicting, monitoring, and preventing adverse cardiovascular outcomes in patients undergoing cancer treatment.

1 Commun Biol 7, 353, doi:10.1038/s42003-024-06052-5 (2024).
P168 CHARACTERIZATION OF THE HEMODYNAMIC PATTERN OF CONTROLLED HYPERTENSIVE PATIENTS
Authors: Bang Joon Ho , Obregon Sebastian , Koretzky Martin , Dileva Ana , Fischerson Gabriela , Botto Fernando , Kotliar Carol
Published: September 2024

Background:

Hemodynamic alterations have been described in hypertensive disease. However, we still do not know if the identification of an altered hemodynamic pattern in patients with controlled hypertension could predict cardiovascular risk or evolution of hypertension.

Objective:

to identify the hemodynamic pattern of hypertensive patients with BP values in goals.

Methods:

Controlled hypertensive subjects were recruited (n = 107) and included a control group of normotensive subjects (n: 35.9). A non-invasive hemodynamic study (Z Logic, lying down / standing) was performed, and the cardiac index (CI) and vascular resistance index (VRI) data were recorded for the determination of the hemodynamic pattern. Hypodynamic pattern was considered: CI <2.5 L / min / m2 and VRI> 2500 dynas.seg.cm-5.m2; Hyperdynamic pattern IC> 4,4 L / min / m2 and VRI <2500 dynas.seg.cm-5.m2

Results:

The SBP / DBP of the HTA group was 133.09 +/- 6.01 / 82.4 +/-7.2 mm Hg; and of the NT group was SBP/ DBP 123.6 +/- 9.7 / 75.5 +/- 8.9. The CI and VRI of the HTA group obtained was 2.81 l / m2 / min and 2842.31 dynas that, without corresponding to a hypodynamic pattern, showed a predominance of the VRI increase. In the control group of NT subjects, the values were 3.23 and 2289.23, respectively, corresponding to a normal pattern. The values obtained were different between both groups (p <.05).

Conclusions:

Controlled hypertensive patients with hypertension goals have a hemodynamics pattern with an increase in the VRI different from that of normotensive subjects. These results coincide with those reported by Ferrario and col. The relevance of the imbalance found could only be analyzed in the context of long-term follow-up to identify whether it is a predictor of CV events and / or complications.
P169 VEGF INHIBITION-INDUCED PARP OVERACTIVATION LEADS TO ENDOTHELIAL DYSFUNCTION AND INFLAMMATION: ROLE OF SIRTUIN 1 SIGNALLING
Authors: Neves Karla , Alves-Lopes Rheure , Montezano Augusto , Touyz Rhian
Published: September 2024

Hypertension is a common unwanted effect of VEGF inhibitors (VEGFi), which are used as anti-angiogenic drugs in cancer treatment. Clinical observations indicate that the magnitude of blood pressure elevation is lower in patients with cancer who are treated with combination VEGFi and olaparib (poly-ADP ribose polymerase[PARP] inhibitor[PARPi]), versus monotherapy. However, putative vascular mechanisms are still unknown. PARP plays a major role in the activation of TRPM2, a redox-sensitive Ca2+ channel associated with hypertension-induced vascular dysfunction, and sirtuin deacetylases activity, especially sirtuin 1 (SIRT1), which is involved in vascular homeostasis/diseases. Here we sought to determine whether VEGFi-induce oxidative stress and PARP activation lead to vascular dysfunction through disruption of SIRT1 signalling. Human aortic endothelial cells (HAEC) and mouse mesenteric arteries were studied. Cells were exposed to axitinib (VEGFi;1 μM) alone or in combination with olaparib (PARPi;1 μM) in the presence or absence of a SIRT1 activator (SRT1720;2 μM). Axitinib increased PARP activity in a ROS-dependent manner (au:[Veh] 0.31 vs. [Axi] 0.55; [Tiron+Axi] 0.38] whereas SIRT1 activity was reduced by VEGF inhibition (33760 vs. 23367), which was prevented by olaparib. Expression of acetyl-p53 (au: 0.17 vs. 0.35) was increased. SIRT1 activation decreased levels of MCP-1 and IL-6 and reduced mRNA expression of VCAM-1 and ICAM-1 in HAEC exposed to axitinib, which was accompanied by a reduction in monocyte adhesion to HAEC, as observed for olaparib. U46619- and ET-1-induced vasoconstriction were increased by axitinib (U4:101.2[Ct] vs. 141.4[Axi]-ET-1:122.6[Ct] vs. 152.5[Axi]), an effect not observed with axitinib plus olaparib. Pre-incubation with SRT1720 exacerbated the anti-contractile effects of olaparib. Axitinib impaired ACh-induced vasodilation (%70.5 vs. 34.8), which was blocked by olaparib and SRT1720. Phosphorylation of eNOS (Thr495) was increased in HAEC (au: 0.18 vs. 0.37) and restored by SRT1720. In conclusion, our findings show that VEGFi-induced PARP overactivation leads to endothelial dysfunction and inflammatory responses via disruption of SIRT1 signalling. We define a putative vasoprotective effect of olaparib that may ameliorate vascular injury induced by VEGFi during cancer treatment.
P174 MAGNESIUM IMPROVES METABOLIC PROFILE AND HYPERTENSION
Authors: Kisters Klaus , Kisters Sophia , Hausberg Martin
Published: September 2024

Background and Objective:

Magnesium is an essential electrolyte involved in about 600 enzymatic reactions and metabolic processes. Recent data show that nutritive magnesium supplementation decreases interleukin-6 levels and metabolic parameters.

Patients and Methods:

We conducted a prospective double-blinded, prospective study on magnesium and interleukin-6 and blood pressure values in 27 patients with a metabolic syndrome as compared to 27 controls (all patients beyond 60 years with normal renal function). Patients were supplemented with 400 mg magnesium daily. Measurements of parameters were performed before and after 6 and 12 weeks of treatment.

Results:

In the magnesium-treated group, interleukin-6 values decreased significantly from 4.94+/-3.30 to 4.53+/-6.89 after 6 weeks to 3.01+/-1.32pg/mL after 12 weeks (mean+/-SD, p < 0.01). In the control group, interleukin-6 was 3.73+/-4.36 before the start of supplementation, 4.87+/-4.35 after 6 weeks, and 4.41+/- 3,15 pg/mL after 12 weeks (n.s.). In the magnesium-treated group, there was also a significant decrease in both systolic and diastolic blood pressure after 12 weeks (systolic: 134.6+/-6.8 to 126.3+/-5.6 mmHG; diastolic: 84.1+/-3.9 to 79.4+/-1.6 mmHg)(mean+/-SD, p< 0.01).

HbA1c and lipd profile increased in patients slightly not reaching significane. Vitamin D status also improved significantly in patients after 12 weeks (p< 0.05).

For statistics Mann-Whitney U test was used.

Conclusions:

In patients wit metabolic syndrome, magnesium supplementation significantly decreased interleukin-6 and both systolic and diastolic blood pressure values, vitamin D significantly increased. Metabolic parameters improved. The anti-inflammatory effects of magnesium as well as anti-arteriosclerotic effects are of benefit for patients with a metabolic syndrome at a high risk for cardiovascular diseases and mortality.
P191 CO-EXISTING HYPERTENSION: AN INDEPENDENT RISK FACTOR FOR DIABETIC RETINOPATHY IN TYPE-2 DIABETES
Authors: Bukht Mohammad Sadaat , Ahmed Kazi Rumana
Published: September 2024

Background and Objectives:

Hypertension has plausible reason to be show the interaction due to its independent effect on retina. Epidemiological studies also provide clue that for hypertension as a possible effect modifier in the risk development of retinopathy in diabetic patients. It is worth exploring whether subgroup in diabetic population with Hypertension have different risk potential of developing retinopathy. The present study aimed to assess the association of hypertension as a risk factor for diabetic retinopathy (DR) in type 2 diabetes mellitus.

Methods:

A total of 977 type-2 diabetic patients recruited retrospectively in 2008 from Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM) based on hospital records for determining the incidence of diabetic retinopathy (DR), who were naı̈ve type-2 diabetes during 1993. At the end of 15 year follow-up 495 patients were diagnosed as DR by retinal colour photography. Data on diabetes and lipid profile with serum creatinine, blood pressure and biophysical measures were obtained at baseline, 5, 10 and 15 years follow-up. Binary logistic regression model was used to assess the associations of co-existing hypertension with retinopathy risk adjusting for clinical, biochemical and anthropometric variables.

Results:

In all three follow-up points, including at baseline, mean systolic and diastolic blood pressure were found to significantly higher among patients who developed DR (P<.001). Binary logistic regression model confirmed coexisting hypertension (OR 3.2; 95% CI 2.2 -4.7) as a significant risk factor of DR adjusting for possible confounders; serum creatinine (OR 21.9; 95% CI 14.0 -35.4) and glycemic control status (OR 17.2; 95% CI 9.4 -31.4). Interaction between hypertension, glycemic control and raised serum creatinine did not appear to be statistically significant (P>0.05).

Conclusions:

Co-existing hypertension is a significant risk factor of DR irrespective of nephropathy or glycolic control status among Type 2 diabetes mellitus.
P193 BLOOD PRESSURE CHANGES IN THE IMMEDIATE POST OPERATIVE PERIOD OF LIVE-RELATED KIDNEY DONORS IN AN INDIAN COHORT: SHOULD WE BE LOOKING MORE?
Authors: Chavan Abhijit , Singh Narinder Pal , Dighe Tushar , Sajgure Atul , Yadav Prabhakar , Bale Charan , Wakhare Pavan , shinde Nilesh , kulkarni Akshay
Published: September 2024

Background & Objective:

Kidney donation is associated with physiological changes (hyperfiltration, changes in renin-angiotensin-aldosterone system & vascular tone) and its effects can be more pronounced in the elderly. The immediate reduction in GFR after nephrectomy can pose a risk for development or worsening of hypertension. There is a paucity of data determining the impact of reduced GFR on BP in post-operative period. Our study aims to analyze the hemodynamics in the post-operative period after nephrectomy.

Methods

This was a prospective observational study of 30 donors who underwent live-related Donor Nephrectomy. Parameters like demography, pre- and post-nephrectomy BP (reading taken daily for every 3 hours till post-operative day (POD) 4 using BPL oscillometric device) were studied. Continuous variables were were expressed as mean & standard deviation. The Student's paired t-test was used for comparison using SPSS Windows software.

Results

The age of donors ranged from 23-73 years. Mean SBP/DBP was 112.69 ± 5.44/76.77 ± 3.78 mmHg in donors <50 years, while in donors aged >50 years the mean SBP/DBP was 126.6 ± 7.9/81.7 ± 3.82 mmHg. Post-donation in donors aged <50 years (17 donors), mean S.B.P/DBP on POD 1 was 108.38 ± 4.77/76.20 mmHg followed by 108.92 ± 4.24/76.84,110.12 ± 5.42, 114 ± 4.8/78.88 ± 2.66 on POD-2, 3 & 4 respectively. After Nephrectomy in donors aged more than 50 years(13 donors), mean SBP/DBP on POD 1 was 124.38 ± 4.56/78.20 mmHg followed by 126.40 ± 4.54/79.88,127.72 ± 6.22, 130.22 ± 3.8/84.58 ± 4.24 on POD-2, 3 & 4 respectively. The BP on POD-4 was significantly higher in donors with age more than 50 years than donors with age less than 50 years (p<0.05).

Conclusion:

After nephrectomy, blood pressure changes in the immediate post-operative period in the elderly need to be monitored closely. Frequent BP monitoring after nephrectomy should be implemented to determine risk of HTN in kidney donors.
P203 IMPACT OF IMPLEMENTING A COMMUNITY CARE STRATEGY TO REDUCE THE RISK OF CARDIOVASCULAR DISEASE IN SANTANDER, COLOMBIA: PRELIMINARY RESULTS OF THE RE-HOPE STUDY
Authors: Giraldo-Castrillon Yessica , Hernandez-Quiñones Daniela , Sanchez-Martinez Yuri , Martinez-Bello Daniel , Otero-Wandurraga Johanna , Castañeda-Hernandez Alvaro , Lopez-Lopez Jose P. , Jaramillo Patricio López
Published: September 2024

Background:

Hypertension is the main risk factor of cardiovascular disease (CVD), affecting 1.28 billion adults and resulting in 1.16 million deaths. In Colombia, hypertension affected 7.8 million adults in 2019. Different sociocultural and health system-related barriers may interfere with hypertension management. Our aim was to determine the preliminary impact of this community-based strategy on the changes in hypertension control in Colombia.

Methods

The Re-Hope study is a community-based strategy to reduce CVD risk in 13 municipalities of Santander, Colombia. Nursing assistants referred patients to the cardiovascular risk program (CVRP), facilitated medical appointments, and provided health counseling. A longitudinal analysis was conducted on data from the first three follow-up visits. Included were adults >18 years with hypertension not enrolled in the CVRP. Standardized questionnaires gathered sociodemographic, medication, and lifestyle data. Anthropometric and blood pressure measurements were taken. Hypertension was defined as systolic BP >140 mmHg, diastolic BP >90 mmHg, self-reported hypertension, or antihypertensive medication use. Pharmacological adherence was assessed with the Morisky 4-item scale. Tobacco and alcohol use were categorized as never or current consumers. Blood pressure changes were evaluated with a paired t-test, and categorical variable changes with McNemar and Stuart-Maxwell tests. Analysis was done using Stata software.

Results

A total of 2,585 participants were included. The mean age was 65.1 years (SD 11.9) and 64.3% were women. After 6 months of follow-up, the mean systolic and diastolic blood pressure reduced 17.03 mmHg (SD 17.95) and 7.04 mmHg (SD 11.22), respectively. Hypertension control increased on 11.7%. Antihypertensive combination therapy increased by 4.4% for dual therapy and 4.6% for triple therapy. The low pharmacological adherence was reduced by 3.35%.

Conclusions

The implementation of a community-based care strategy in Santander at the first three visits achieved a relevant reduction of hypertension values and greater use of combined antihypertensive therapy. Continuation of the study is required to identify the total results.
P214 PREDICTION OF AMBULATORY BRACHIAL CUFF-BASED OSCILLOMETRIC PULSE WAVE VELOCITY USING A NOVEL METHOD FOR ESTIMATING TOTAL ARTERIAL COMPLIANCE
Authors: Gallo-villegas Jaime , Álvarez-Montoya Diego , Aristizábal-Ocampo Dagnovar
Published: September 2024

Background and Objective:

Total arterial compliance (Ct) serves as a critical determinant of arterial hemodynamics, providing insights into the mechanical and structural characteristics of large arteries and influencing ventricular-arterial coupling. To estimate Ct, we developed a method utilizing data from 24-hour ambulatory blood pressure monitoring (24-h ABPM) recordings. Our objective is to evaluate the reliability of Ct in estimating oscillometric pulse wave velocity (oPWV), with the potential to eliminate the requirement for additional oPWV measurements.

Methods:

A cross-sectional study was conducted, involving 162 patients who underwent 24-h ABPM, resulting in a total of 8,113 blood pressure (BP) recordings. oPWV was measured during 24-h ABPM using a Custo Screen 310 device (Custo, Ottobrunn, Germany), which has been validated. Ct was estimated employing a two-element Windkessel model based on mean systolic pressure. The formula utilized for Ct estimation was Ct/BSA= (38/PPth)×(4/5)×(Td/T)-(3/7), where BSA denotes body surface area, Td represents diastolic time, T signifies the cardiac period, and PPth denotes theoretical pulse pressure. A linear regression model (LRM) was developed to estimate oPWV from Ct.

Results:

Among the participants, 55.1% were men, with an average age of 55.7±16.2 years and a body mass index of 27.4±3.7 kg/m2. The analyzed records revealed an average systolic blood pressure of 125.6±18.7 mmHg, diastolic blood pressure of 79.5±12.2 mmHg, heart rate of 71.0±12.2 beats per minute, Ct of 0.9±0.3 mL/mmHg, and oPWV of 7.2±1.8 m/s. The best predictive model (R2=0.42; r=0.65) for oPWV was based on the ratio of systolic time (Ts) to Ct as follows: oPWV=3.3 × 6.0 ×[Ts/(Ct/BSA)]. Indexed Ct demonstrated an inverse relationship with oPWV (Figure). Residuals analysis confirmed compliance with assumptions.

Conclusions:

The Ts/Ct ratio inversely predicts oPWV, indicating an inverse relationship between Ct and oPWV in this population. These findings suggest that estimated Ct has the potential to replace oPWV in clinical practice for cardiovascular risk stratification.
Radiographic Accuracy of Identifying Anterolateral Tibial Plafond Involvement in Pronation Abduction Ankle Fractures
Authors: Robles Abrianna S. , Rockov Zachary A. , Gross Melissa M. , Ewing Brett A. , Lieder Charles M. , Weatherford Brian M. , Levack Ashley E. , Garlich John M. , Haller Justin M. , Earhart Jeffrey S. , Marecek Geoffrey S.
Published: September 2024

OBJECTIVES:

To evaluate the incidence of anterolateral tibial plafond involvement in pronation-abduction (PAB) ankle fractures and analyze the accuracy of radiographs in detecting anterolateral tibial plafond involvement, impaction, and predicting the need for direct visualization and an articular reduction.

METHODS:

Design:

A multi-institutional retrospective chart review.

Setting:

Five Level 1 trauma centers in the United States.

Patient Selection Criteria:

Adult patients with PAB ankle fractures (OTA/AO 44B2.3, 44C2.2, 44C2.3) from 2020 to 2022 were reviewed by 7 fellowship-trained orthopaedic trauma surgeons. They were queried about the presence of anterolateral tibial plafond involvement and impaction, and whether they would need direct visualization and an articular reduction using both radiographs and CT.

Outcome Measurements and Comparisons:

The presence of anterolateral tibial plafond impaction was tabulated separately using radiographs and CT scans. The accuracy of radiographs and changes in surgical plan after CT review were calculated using CT as the gold standard.

RESULTS:

Sixty-one fractures in 61 patients were evaluated using CT and/or plain radiographs. Using plain radiographs, anterolateral tibial plafond involvement and impaction were identified in 61% and 36% of cases, respectively. In the 38 fractures with both plain radiographs and CT scans, anterolateral tibial plafond involvement was identified in 66% of radiographs and 74% of CT scans (P = 0.4). Plafond impaction was identified in 42% of plain radiographs and 37% of CT scans (P = 0.62). There was no difference in the rate of involvement between radiographs and CT scan. The diagnosis of anterolateral tibial plafond impaction using plain radiographs was correct in 74% of fractures when compared with using CT imaging, resulting in a sensitivity of 71%, a specificity of 75%, a positive predictive value (PPV) of 62%, and a negative predictive value (NPV) of 82%. Plain radiographs correctly predicted the need for direct visualization and an articular reduction in 74% of cases and had a PPV of 59% and an NPV of 86%.

CONCLUSIONS:

Anterolateral tibial plafond involvement and impaction were present on CT in 74% and 37% of pronation-abduction (PAB) ankle fractures, respectively. Plain radiographs had higher NPV for identifying impaction and the need for articular reduction than they did sensitivity, specificity, or PPV. CT is an important tool for preoperative planning that should be considered when planning for operative fixation of PAB ankle fractures.

Level of Evidence:

Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.