bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSOCIATION OF PLASMA METANEPHRINES LEVELS WITH CARDIOMETABOLIC RISK IN ESSENTIAL HYPERTENSIVE INDIVIDUALS
Authors: Concistrè Antonio , Petramala Luigi , Schifano Arianna , Servello Adriana , Circosta Francesco , Cavallaro Giuseppe , Letizia Claudio
Published: June 2023

Objective:

The aim of the study was to evaluate a possible relationship between plasma metanephrine concentrations and some surrogate parameters of cardio-metabolic damage such as carotid intima media thickness (IMT), cardiac left ventricular mass (LVM) and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH).

Design and method:

From January 2021 to September 2022, we consecutively enrolled 719 essential hypertensive patients (367 men and 352 women, mean age 52.2 ± 15 years) without cardiovascular complications, distinguishing patients in quartiles according to plasma metanephrine concentration (PMC).

Results:

compared with the first quartile, the highest PMC quartile was associated with the highest levels of of 24-h μalbuminuria (20.1 ± 8.9 mg/24 h and 11.4 ± 6.2 mg/24 h, p = 0.04), serum creatinine (0.96 ± 0.2 mg/dl vs 0.90 ± 0.22 mg/dl; p = 0.002), plasma calcium (9.5 ± 0.4 mg/dl vs 9.38 ± 0.4 mg/dl; p = 0.004) and a lower prevalence of metabolic syndrome (18% vs 32%; p = 0.001). More male hypertensives belonged to the fourth quartile than to the first quartile (64% vs 43%, p<0.001). Moreover, we found that the fourth PMC quartile was associated with higher values of 24h-ABPM diastolic blood pressure (78.8 ± 9.0 mmHg vs 76.3 ± 9.1 mmHg; p = 0.007), higher values of left ventricular myocardial mass indexed for body surface area (LVMi) (89.0 ± 27.0 g/m2 vs 81.8 ± 21.9 g/m2; p = 0.01) and left ventricular hypertrophy (LVH) (18% vs 11%, p = 0.031) prevalence than the first PMC quartile. PMC was also found to be an independent predictor of the presence of LVH and μalbuminuria.

Conclusions:

Our results revealed that higher PMC values are strongly associated with increased LVMi and μalbuminuria that, together with elevated blood pressure values, are strictly correlated with higher risk of atherosclerosis and cardiovascular complications.
ASSESSMENT OF ENDOTHELIAL FUNCTION BY FLOW-MEDIATED DILATION IN WELL-CONTROLLED PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Anyfanti Panagiota , Nikolaidou Barbara , Triantafyllou Areti , Gavriilaki Eleni , Angeloudi Elena , Malliora Anastasia , Dimitroulas Theodoros , Doumas Michalis , Gkaliagkousi Eugenia
Published: June 2023

Objective:

Endothelial dysfunction is considered as the primary pathophysiological process towards the development of cardiovascular disease (CVD). Patients with rheumatoid arthritis (RA) are at increased CVD risk attributed to the synergistic effect of chronic inflammation and traditional cardiovascular risk factors. However, it is uncertain whether endothelial function in RA is impaired even in the absence of cardiovascular comorbidities and pronounced inflammatory load.

Design and method:

Patients with RA who presented low levels of systemic inflammation and were free from cardiovascular comorbidities including hypertension, diabetes mellitus and established CVD, were studied. Non-RA individuals matched for age, sex and office systolic/diastolic blood pressure comprised the control group. Endothelial function was evaluated with the gold-standard flow-mediated dilation (FMD) in the brachial artery (Aloka ProSound A7 Ultrasound System).

Results:

A total of 22 female individuals were included in the study, of whom 10 were RA patients aged 57±13 years and 12 healthy volunteers aged 56±9 years. All patients with RA were at remission or low disease activity. Traditional CVD risk factors (age, systolic and diastolic blood pressure, smoking, body mass index and lipids) did not significantly differ between RA patients and controls. By contrast, significantly lower FMD values were observed in the RA group compared to controls [6.4 (5.0) vs 11.8 (5.2) %, p = 0.003]. The association between RA and FMD levels remained significant even after adjustment for age and systolic blood pressure (beta = 0.562, p = 0.009).

Conclusions:

Endothelial dysfunction is present in RA, even in a population characterized by the absence of hypertension and cardiovascular comorbidities and with relatively low systemic inflammatory burden. Further studies are warranted to verify the findings of this pilot study and delineate the role of endothelial dysfunction as a potential prognostic marker or therapeutic target.
HYPERTENSION SCREENING CAMPAIGN: THE STRENGTH OF A CITY NETWORK INVOLVING THE HOSPITAL AT MAY MEASUREMENT MONTH 2022
Authors: Lopez-Sublet Marilucy , Marck Marck Bouaziz , Soare Cynthia , Leprieur Benedicte Giroux , Bamiere Clement , Hilal Yassine , Lesage Sarah , Thomas Christian , Sariya Rashida , Nguyen Rosaline , Dhote Robin , Moysan Mathilde
Published: June 2023

Objective:

The World Hypertension League (WHL) created the World Hypertension Day on May 17. This day gave way to the campaign called MMM (May Measurement Month), which each year raises awareness against hypertension. The objective of this study is to disseminate the data obtained from a sample of adults screened in Bobigny, France.

Design and method:

Following the MMM protocol adapted in France by the French Society of Hypertension (SFHTA), numerous volunteers from the network of territorial professional health communities (CPST) (physicians, nurses, pharmacists, dieticians, psychologists, social workers, and patients’ association) and in association with the hospital, carried out a screening campaign in a prefab adapted for this action. In addition and organized upstream, the CPTS and the city of Bobigny were able to offer self-measurement devices.

Results:

The general anonymous data of this population of 270 subjects (including 146 F) are summarized in the table. All participants reported having had at least one BP measurement within the last year. Of the 58% of participants reported as hypertensive, 37.3% were unaware of their antihypertensive treatment. CVD history was: diabetes (n = 101), myocardial infarction and hypertension pregnancy disorders (n = 25 each one), and stroke (n = 13).

Conclusions:

The organization of an MMM-type screening campaign by a CPTS and under the aegis of a ‘neighborhood”-attending attending physician seems to promote the participation of a population. A wide dissemination of information prior to such a campaign by a city-hospital network must be encouraged, as well as succeeding in obtaining the participation of health professionals.
REFLECTION MAGNITUDE AND ITS ASSOCIATION WITH INCIDENT HYPERTENSION AND BLOOD PRESSURE CHANGES IN A MULTI-ETHNIC COHORT: THE HELIUS STUDY
Authors: Bouwmeester Thomas , Ton Dennis , Collard Didier , Vriend Esther , Westerhof Berend , Galenkamp Henrike , Born Bert-Jan van den
Published: June 2023

Objective:

A higher reflection magnitude (RM), defined as the ratio of the backward and forward moving pressure wave, is associated with hypertension and incident heart failure. Whether RM is predictive of future hypertension and blood pressure (BP) increase is unknown. We assessed the association between RM, incident hypertension and BP increase over time.

Design and method:

Data of the Healthy Life in an Urban Setting study was analysed focusing on the six major ethnic groups living in Amsterdam, The Netherlands, aged between 18 and 70 years. Central arterial blood pressure was reconstructed from non-invasive continuous finger BP measurements. RM was calculated through wave separation analysis. Logistic regression models were created to investigate the association between RM and incident hypertension in the normotensive individuals. Linear regression was used to investigate the association between RM and changes in BP, which was corrected for the use of antihypertensive medication. All models were corrected for age, sex, ethnicity and baseline BP. The association between RM and delta SBP was additionally corrected for BMI.

Results:

A total of 5,779 participants were included for analysis, median age was 48 years (IQR 37-55), 54.6% were female and 67% were normotensive at baseline. In normotensive participants aged < 50 years at baseline, a 10% increase in RM resulted in an increased odds ratio (OR) of 1.37 (95% CI 1.09 – 1.72 for developing incident hypertension, which attenuated to 1.12 (95% CI 0.88 – 1.42) following adjustment for baseline SBP. Additionally, in individuals below 50 years an increase in RM of 10% was associated with a 1.77 mmHg (95% CI 1.00 – 2.53) increase in SBP (figure 1). No significant association between delta SBP and RM was found in the participants aged 50 or older.

Conclusions:

In a multi-ethnic cohort, RM is positively associated with the development of hypertension in individuals aged < 50 years. However, additional correction for baseline SBP attenuated this association. In addition, RM is predictive of SBP increase, with significant interaction for ethnicity.
ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA SYMPTOMS AND INCIDENCE OF DE NOVO HYPERTENSION IN A LARGE FRENCH POPULATION-BASED EPIDEMIOLOGICAL COHORT
Authors: Vidal-Petiot Emmanuelle , Balagny Pauline , Kab Sofiane , Frija-Masson Justine , Steg Philippe -Gabrie , Goldberg Marcel , Zins Marie , D’Ortho Marie-Pia , Wiernick Emmanuel
Published: June 2023

Objective:

There is a strong association between Obstructive Sleep Apnea (OSA) and hypertension but the effects of OSA symptoms on the risk of incident hypertension in previously normotensive individuals are not well documented.

The aim of this prospective cohort study was to examine whether OSA symptoms (snoring and sleepiness) are associated with the incidence of hypertension independently of confounding factors including body mass index.

Design and method:

Data from the French population-based CONSTANCES cohort were analyzed. Participants, aged 18 to 69 years, were included between 2012 and 2016, and screened for OSA in 2017 using the Berlin Questionnaire. Snoring and sleepiness were assessed from the questionnaire, and considered as severe when they were declared to occur at least three times a week. Individuals who had a history of treated OSA, cardiovascular diseases or hypertension (defined either by blood pressure of 140/90 mmHg or more at the inclusion visit, or by self-reported hypertension or antihypertensive drugs delivering until 2017) were excluded from these analyses. We used Cox models, adjusted for age, gender, smoking, alcohol consumption, physical activity, education level, household income and body mass index, to compute hazards ratios (HR) of incident treated hypertension (defined by antihypertensive drugs delivering through linkage to the National Health Data System (SNDS)) until December 2020.

Results:

Among 36,798 normotensive subjects, the prevalence of high risk of OSA according to Berlin questionnaire was 7.6% and the incidence of treated hypertension was 4.2%. Risk of de novo treated hypertension increased significantly in participants who declared symptoms of severe snoring (adjusted HR [95% CI] = 1.17 [1.04-1.31]), severe sleepiness after sleep (adjusted HR [95% CI] = 1.18 [1.03-1.36]) and severe sleepiness during waking time (adjusted HR [95% CI] = 1.40 [1.23-1.64]), and increased with the weekly frequency of these symptoms with a dose-dependent relationship (p for trend <0.005).

Conclusions:

Self-declared snoring and sleepiness are associated with an increased risk of developing de novo hypertension. Our results suggest that primary care patients should be routinely screened for these symptoms, not only to identify possible OSA, but also to encourage preventive measures and regular blood pressure monitoring.
THE INHIBITORY EFFECTS OF VALPROIC ACID ON RHOA-MEDIATED VASCULAR SMOOTH MUSCLE CELL CONTRACTION
Authors: Hwang Yun-Jin , Cho Du-Hyong
Published: June 2023

Objective:

Valproic acid (VPA) has been used to treat epilepsy and bipolar disorder. Dysfunction of vascular smooth muscle cells (VSMCs) is well-established to contribute to the pathogenesis of various vascular diseases. Growing evidence indicates that increased VSMC contractility plays a primary role in the development of pathological artery spasms. Nevertheless, effect of VPA on VSMC contractility, and its mechanism of action remain unknown. Here, we investigated the mechanism by which VPA inhibits VSMC contractility and vessel contraction in rat VSMCs and endothelium-deprived aortas.

Design and method:

We performed quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR), RhoA activity assay, transfection of constitutively active (CA)-RhoA gene, and western blot analyses. We also conducted ex vivo studies using isolated rat aortas.

Results:

VPA inhibited phenylephrine (PE)-induced phosphorylation of myosin light chain (MLC) at Ser19 (p-MLC-Ser19) in VSMCs. VPA did not alter expressions of MLC kinase and Rho-associated kinase 1, the upstream kinases responsible for MLC phosphorylation. In addition, VPA did not affect phosphorylation of myosin phosphatase target subunit 1, a regulatory subunit of myosin phosphatase. VPA decreased RhoA mRNA expression and its protein levels in a time- and dose-dependent manner, and as expected, VPA decreased amount of active GTP-bound RhoA in a dose-dependent manner. Ectopic expression of CA-RhoA gene significantly reversed VPA-inhibited p-MLC-Ser19 and p-CPI-17-Thr38. Finally, VPA significantly attenuated PE-induced vessel contraction in endothelium-deprived rat aortas, and similar to the in vitro results, VPA decreased RhoA expression and levels of p-MLC-Ser19 and p-CPI-17-Thr38 in rat aortas.

Conclusions:

We demonstrate that VPA mitigates PE-induced VSMC contractility and vessel contraction by decreasing expressions of RhoA and p-MLC-Ser19 in rat VSMCs and aortas. These results suggest that VPA may be useful in the treatment of vasospastic diseases including coronary artery vasospasm and post-subarachnoid hemorrhage cerebral vasospasm.
CHLOROGENIC ACID CAN INHIBIT CATECHOLAMINE SECRETION FROM THE ADRENAL MEDULLA
Authors: Lim Dong Yoon , Koh Young Youp
Published: June 2023

Objective:

Chlorogenic acid (CGA) is one of the most available phenolic acid compounds in foods, such as coffee and tea, which is known to be the most effective agent in lowering blood pressure and helpful in treating hypertension-related disorders. Thus the present study was aimed to determine the characteristics of CGA on secretion of catecholamines (CA) in the perfused model of the rat adrenal medulla, and also to validify its mechanism of action.

Design and method:

he adrenal gland was isolated and perfused with Krebs-bicarbonate. CA was measured directly by using the fluorospectrophotometer.

Results:

CGA, administered into an adrenal vein for 90 min, reduced ACh -induced CA secretion in a dose- and time-dependent manner. CGA also time-dependently depressed the CA secretion induced by McN-A-343, DMPP, and angiotensin II . CGA itself failed to influence spontaneous CA secretion. Also, During the perfusion of CGA for 90 min, the CA secretory responses induced by high K+, veratridine, cyclopiazonic acid, Bay-K-8644 were suppressed. However, in the simultaneous presence of CGA and L-NAME, the CA secretory responses induced by ACh, Ang II, Bay-K-8644 and veratridine was restored nearly to the control level compared to those of the inhibitory effects of CGA-treatment alone. Virtually, the adrenal NO release was significantly enhanced by CGA-treatment. Also, in the coexistence of CGA and olmesartan, ACh-induced CA secretion was markedly reduced compared to that of olmesartan-treatment alone.

Conclusions:

Taken together, we present the first evidence that CGA suppresses the CA secretion induced by activation of cholinoceptors as well as AT1-receptors. This CGA-induced inhibitory effect seems to be exerted by reducing both the influx of Na+ and Ca2+ through their ionic channels into adrenomedullary chromaffin cells as well as by suppressing the Ca2+ release from the cytoplasmic calcium store, through the elevated NO release by the activation of NO synthase, which is associated to the blockade of neuronal cholinonoceptors and AT1-receptors. Based on these results, the ingestion of CGA may be helpful to alleviate or prevent the cardiovascular diseases, via reduction of adrenal CA secretion and consequent decreased CA level in circulation.
THE ASSOCIATION BETWEEN INTERLEUKIN-1 BETA INHIBITORS AND HYPERTENSION RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Alosaimi Hani , Maffia Pasquale , Padmanabhan Sandosh , Guzik Tomasz
Published: June 2023

Objective:

To compare the effects of various interleukin-1 beta inhibiting drugs on the risk of hypertension in users.

Design and method:

Various meta-analyses and systematic reviews of randomised-control trials (RCTs) were identified using relevant electronic databases, including MEDLINE Ovid, EMBASE Ovid, and CENTRAL. These were then examined to assess current approaches towards analysis of the effects of interleukin-1 beta inhibitors in adult patients in terms of hypertension.

Results:

A total of 3,522 patients were enrolled in the qualitative and quantitative studies synthesised for the final review.

Seven studies included in the meta-analysis compared anti-IL1B to a placebo, with a total of 2,506 and 1,016 patients included in the anti-IL 1B and the placebo arms, respectively, with event rates of 1.1% and 1.8%. The risk of hypertension was thus not significantly different between groups (RR = 0.82, 95% 0.45; 1.5, P = 0.52) and no heterogeneity was observed between studies (I2 = 0%, P = 0.92). The effect size was not statistically significant in any of the included studies. The Howard study contributed to one-third of the meta-analysis weight, while those by Ridher and Choudhury contributed 21.5% and 18.6%, respectively.

Conclusions:

The final results of this meta-analysis based on the hypothesis that interleukin-1 beta inhibitors, namely Canakinumab and Anakinra, do not cause any changes in levels of blood pressure and thus pose no additional risk associated with the hypertension demonstrated that while some previous studies indicated a non-statistically significant increase in risk with Canakinumab, re-investigation is required to fully understand the occurrence of hypertension during the use of inhibitors of interleukin-1 beta at standard doses.
THE ASSOCIATION BETWEEN COLCHICINE AND HYPERTENSION RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Alosaimi Hani , Maffia Pasquale , Padmanabhan Sandosh , Guzik Tomasz
Published: June 2023

Objective:

To assess the effects of colchicine as a treatment option for gut and other autoimmune diseases with respect to the risk of hypertension, as compared to both placebos and active comparators.

Design and method:

Various relevant meta-analyses and systematic reviews of randomised-control trials (RCTs) were identified using relevant electronic databases such as MEDLINE Ovid, EMBASE Ovid, and CENTRAL to assess current approaches towards the analysis of the effects of colchicine in adult patients with respect to hypertension risk.

Results:

Just four trials were identified, including 899 patients across the qualitative and quantitative studies synthesised for this final review.

Two of these compared colchicine to a placebo and three compared it to other active drugs. The risk of hypertension was not found to be significantly different between colchicine and the placebo (RR = 0.50, 95% CI 0.10; 2.38, P = 0.38), and no heterogeneity was observed between studies (I2 = 0%, P = 0.96). When colchicine was compared to other active drugs, no statistically significant difference was observed in the risk of hypertension (RR = 0.44, 95% CI 0.09; 2.11, P = 0.31). Low heterogeneity was also observed between studies (I2 = 35%, P = 0.21). Only three events occurred in patients who received Colchicine (1.7%), as compared to the 25 events observed in patients who received other active drugs (5.5%), suggesting a lower risk of hypertension in cases applying colchicine

Conclusions:

The final results of this meta-analysis based on the hypothesis that colchicine does not cause any changes in blood pressure, thus presenting no additional risk of hypertension, was when not rejected, based on comparisons to both the placebo and other active drug groups.
ENDOTHELIAL NITRIC OXIDE SYNTHASE (NOS3) AND GUANINE NUCLEOTIDE-BINDING PROTEIN (GNB3) GENES’ POLYMORPHISMS PORTEND OBESITY IN HYPERTENSIVE PATIENTS: THE GENDER ASPECT
Authors: Sydorchuk Andrii , Voroniuk Ksenia , Sydorchuk Larysa , Repchuk Yulia , Sydorchuk Ruslan , Iftoda. Oksana
Published: June 2023

Objective:

Obesity is a major risk factor of essential arterial hypertension (EAH) because of neuro-hormonal, sympathoadrenal and renin-angiotensin-aldosterone system activation, as well as endothelial dysfunction and systemic low grade inflammation. However, genetic mechanisms of obesity development in EAH patients remained unclear. Therefore, we studied the guanine nucleotide-binding protein-↓3 (GNB3, rs5443) and endothelial nitric oxide synthase (NOS3, rs2070744) genes’ polymorphisms as possible genetic harbingers of obesity in EAH patients particularly focusing on gender.

Design and method:

One-hundred EAH patients with hypertensive-mediated organ damage (moderate-very high cardiovascular risks, aged 45-65 years) and 48 practically healthy (control) participated in the cohort case-control study. Obesity was determined by body mass index (BMI) >30 kg/m2. GNB3 (rs5443) and NOS3 (rs2070744) genotyping performed by TaqMan probes (CFX96 Real-Time PCR).

Results:

The NOS3 gene mutation in the homozygous state occurs in 16.67% of EAH patients and for the GNB3 gene in 8.33% of cases, which does not differ from the control group. The relative frequency of obese prevailed among EAH patients with the mutated C-allele carriers of the NOS3 gene by 31.94% (⇙2 = 13.58; p<0.001) and T-allele of the GNB3 gene (30.56%) in the absence of such among healthy control. The risk of obesity increases in EAH patients in C-allele carriers of the NOS3 gene almost 6 times [OR 95%CI:2.11-14.82; p<0.001] and in T-allele patients of the GNB3 gene – more than 10 times [OR 95%CI:2.25-45.44; p<0.001], 1.3 times more often in women than men (p<0,05), regardless the genes’ allelic state. The TT-genotype of the NOS3 gene and the CC-genotype of the GNB3 gene play a protective role against obesity.

Conclusions:

The C-allele of the NOS3 gene (rs2070744) and the T-allele of the GNB3 gene (rs5443) increase the obesity risk in hypertensive patients 6-10 fold (p<0.001) as well, 1.3 times more often in women, than men.
URINARY PROTEOMIC SIGNATURE OF THE RETINAL MICROVASCULATURE
Authors: Hu Angie , Wei Dongmei , Melgarejo Jesus , Latosinska Agnieszka , Vanassche Thomas , Mischak Harald , Verhamme Peter , Zhang Zhen-Yu
Published: June 2023

Objective:

The retinal vasculature provides a window into the body's microcirculation. Variations in retinal vessel diameters have been associated with adverse cardiovascular outcomes, such as stroke and coronary heart disease. As the pathogenesis of retinal microvascular diameter changes remain poorly understood, this study aimed to provide novel insights by characterizing the urinary proteomic signature of the retinal microvasculature.

Design and method:

The central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arteriole-to venule-ratio (AVR) were measured from digitized retinal photographs of 562 randomly recruited Flemish participants (mean age, 48.9 years; 50.9% women). The urinary proteome was analyzed using capillary electrophoresis coupled with mass spectrometry. Multivariable linear regression analysis identified significant urinary peptides with adjustment for age, sex, body mass index, smoking, hypertension, plasma glucose, total and HDL cholesterol, eGFR, and history of cardiovascular disease. Reactome pathway enrichment analysis was performed to interpret the proteomic signature.

Results:

Table 1 shows participant characteristics. Of the 359 peptides analyzed, 19 were significantly associated with CRAE after adjusting for potential confounders and multiple testing (Table 2). In the proteomic profile, 14 peptides (74%) were fragments of collagen I, III, and XI proteins, while the remaining peptides were fragments of the fibrinogen alpha chain (11%), xylosyltransferase 1 (5%), S100 calcium-binding protein A9 (5%), and hemoglobin subunit alpha (5%) proteins. Pathway analysis showed that these proteins were predominantly involved in endothelial cell proliferation and migration, collagen formation and degradation, and cell-extracellular matrix interactions (Figure 1). No peptides were significantly associated with CRVE and AVR following adjustment.

Conclusions:

This study revealed a novel urinary proteomic signature as a potential biomarker of retinal arteriolar narrowing. The signature suggests fibrosis and neovascularization may be involved in retinal microvascular diameter changes. Further investigation may help elucidate the pathophysiologic mechanisms underlying the relationship between microvascular and macrovascular disease.
STUDY OF THE CONTRIBUTION OF GENES NERVOUS SYSTEM RELATED TO HEART FAILURE
Authors: Santos Mafalda , Matias Ana , Aguira Laura , Mascarenhas Mário Rui , Barbosa Mário , Falcão Luiz Menezes , Bicho Manuel , Inácio Ângela
Published: June 2023

Objective:

Heart Failure (HF) is a complex syndrome that can be amplified by pathology associated with the nervous system.

This study aims to investigate the contribution of genetic polymorphisms of Brain Derived Neurotrophic Factor (BDNF, rs6265), Neurotrophic Receptor Tyrosine Kinase 2 (NTRK2, rs2289656) and Neural Growth Factor (NGF, rs6330) genes in the development of HF.

Design and method:

A case-control study was conducted with a population of 261 individuals, of which 131 had HF (66 women and 65 men) with a median age of 77 years (Min = 31 years and Max = 96 years) and a BMI median of 25,00 Kg/m2 (Min = 17,80 Kg/m2 and Max = 47,30 Kg/m2), and 130 controls (113 women and 17 men) with a median of age 60,50 years (Min = 44 years and Max = 84 years) and a median BMI of 29,09 Kg/m2 (Min = 14,19 Kg/m2 and Max = 47,30 Kg/m2). Analyses of the 3 polymorphisms were performed using the Genotyping Endpoint PCR technique. Statistical analysis was performed using IBM software® SPSS® Statistics 28.0, with a statistical significance level set at p < 0,05.

Results:

For the rs2289656 polymorphism of the NTRK2 gene, the GG genotype was found to be a risk factor for HF [OR (CI, 95%) = 3.029 (1.053 – 8.718); p = 0.040]. The association between the presence of the A allele of the NTRK2 gene and HF [OR (CI, 95%) = 0.330 (0.115 – 0.950); p = 0.040] was also verified, with this allele constituting a protection factor. Regarding BDNF and NGF gene polymorphisms, no statistically significant differences were found. These results were adjusted for age, BMI and gender.

Conclusions:

These results show an association between the NTRK2 gene and HF, suggesting that this gene variation may enhance the development of HF. The identification of genetic polymorphisms that may somehow influence the development and severity of HF may allow its faster diagnosis and the application of methodologies for disease prevention. Moreover, our results will contribute to define a genomic profile associated with the role of the nervous system in HF.
BLOOD PRESSURE LOWERING TREATMENT AND BASELINE CARDIOVASCULAR RISK IN PRIMARY PREVENTION: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED TRIALS
Authors: Manta Eleni , Thomopoulos Costas , Konstantinidis Dimitrios , Drogkaris Sotirios , Polyzos Dimitrios , Tatakis Fotis , Tsioufis Konstantinos
Published: June 2023

Objective:

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

Design and method:

A systematic review was conducted to identify randomized trials in electronic databases (Pubmed and CENTRAL, years: 1966 to 11/2022) for the effect of BP-lowering treatment against placebo, no treatment or less intense BP reduction on fatal or non-fatal CV outcomes. Selected studies reported outcomes in patients without a history of previous CV disease. In each study, we calculated baseline cardiovascular risk using SCORE-2. Risk ratios (RR) were calculated together with their 95% confidence interval (CI) under the random-effects model.

Results:

We studied 12 trials with low-to-moderate CV risk, n = 21,192 patients; 13 trials with high risk, n = 66,886; and 29 trials with very high risk, n = 79,061. For a standard SBP/DBP reduction of 10/5 mmHg, the relative risk of the combined outcome of major CV events (i.e., myocardial infarction, stroke, and heart failure) was decreased by 27% (95% CI, 22-35%) in the category of very high-risk patients, and by 10% in the category of high-risk patients (p value for interaction = 0.020). Also, the relative risk reduction of the combined outcome was progressively greater the higher the baseline CV risk (p trend = 0.006). The risk reduction of CV death showed a significant trend from lower to higher baseline CV risk (p trend = 0.036). CV death showed a significant reduction in the high-risk group compared to the low-moderate risk group (p = 0.005), and in the very high-risk group compared to the low-moderate risk group (p = 0.001).

Conclusions:

The greatest outcome benefit from BP lowering treatment in primary is observed in patients at higher baseline cardiovascular risk, as calculated by the SCORE-2.
DIFFERENCIAL HEMODYNAMIC CHARACTERISTICS OF TRUE SYSTOLIC HYPERTENSION AND SPURIUS HYPERTENSION IN THE YOUTH
Authors: Sanchez Ramiro Ariel , Ramirez Agustin Jose
Published: June 2023

Objective:

In adolescents, isolated systolic hypertension (ISHT) could be associated with normal central blood pressure (cBP). This is called spurious hypertension (Sp-HT), typically occurs more in young males, and does not lead to organ damage compared to true ISHT (t-ISHT.

Recently, the possibility to measure non-invasively cBP seems to be a tool able to discriminate Sp-HT from t-ISHT.

Design and method:

To evaluate in ISHT youths the ability of cBP to discriminate both diagnosis, t-ISHT and Sp-HT and to analyze hemodynamic and arterial stiffness parameters in both group of patients (n = 58)

Methods:

From 75 young subjects, no receiving antihypertensive drugs, 58 (25±4 years, 32 male) of them were identified having ISHT by 24hs ABPM. Afterwards, cBP was evaluated through a validated Mobil-O-Graph device. vs intraarterial cBP measurements, performed by our group. By this way, 28 of them were considered having t-ISHT and the 30 remaining having Sp-HT.

In all of them, left ventricular mass index (LVMI, Echocardiography), Cardiac Index (CI), Pulse Wave Velocity (PWV) and microalbuminuria (mAlb) were recorded.

Results:

As Shown in Table 1, in t-ISHT, cBP, Heart Rate (HR), mAlb and CI were higher, compared to subjects with Sp-HT. The remaining parameters evaluated failed to show any statistical difference.

Conclusions:

In this cohort of youths, cBP was able to discriminate ISHT from Sp-HT. In addition, t-HT youths showed a hyperkinetic cardiac behavior (high Heart Rate and CI) and early target organ damage (increased LVMI and mAlb), thus suggesting and increased cardiovascular risk in these t-HT patients.
POTENTIAL CONTRIBUTION OF HOME BLOOD PRESSURE TELEMONITORING (HBPTM), WITH CONCURRENT MEASUREMENT OF PHYSICAL ACTIVITY, TO AID THE CONTROL OF BOTH HYPERTENSION AND HEART FAILURE
Authors: Peleska Jan , Muzik Jan , Holubova Anna , Camek Rene , Navratil Vojtech , Fiala Dominik , Doksansky Marek , Hana Karel , Vranka Jakub , Dolezil David , Jozifova Marie , Reissigova Jindra
Published: June 2023

Objective:

Despite the comparability of HBPM and ABPM in majority of cases (ESH 2021), physicians do not trust their patients to measure their BP correctly. Our study has also showed a small consistent significant difference between week mean systolic BP in HBPTM and daytime ABPM (ca 3 mmHg), and no difference between HBPTM and ABPM/24h (Athens 2022). The aim of this presentation is to show the advantages of HBPTM for practice.

Design and method:

BP monitor Fora P30Plus (triplets of BP measurements in morning and evening) and mobile phone for data transfer are used. The required 5 minutes of physical inactivity before BPM and daytime physical activity are checked in by Xiaomi MiBand 2 smart wristbands. BP and HR values are accessible to patients and their physicians on a secure server.

Results:

Diani telemedicine system enables recording of all BPM with the marked insufficient rest before BPM, a calculation of week total, morning and evening mean BP with export of logbook in pdf, a day profile with BPM each hour to detect hypotension and daytime physical activity. It is easy to browse through week cycles of HBMTM, to record patient troubles and therapy changes (also by the patient). The system reports extreme BP and HR values (suitable for medication titration in heart failure) and occurrence of arrhythmia by e-mail to both physician and patient. It reports voice evaluation of actual BPM to the patient and gives him a signal to start a new BPM in case of insufficient rest before BPM.

Conclusions:

HBPTM in connection with a smart wristband improves the reliability of HBPM. The system reports extreme BP and HR values by e-mail and voice evaluation of actual BPM to the patient. HBPTM is suitable for long-term BP follow-up and is technically sound. It has a potential for control of both BP and rehabilitation in heart failure. Questions around regulations and financing remain to be resolved.
COMPARISON STUDY FOR 24H AMBULATORY BLOOD PRESSURE MEASUREMENT (ABPM) WITH BIOBEAT PATCH ABPM® CUFFLESS WEARABLE DEVICE IN SUBJECTS WITH DIFFERENT BODY MASS INDEX
Authors: Pecchioli Valerio , Lomartire Nazzareno , Valente Lucia , Pecchioli Lorenzo , Germanò Giuseppe I.
Published: June 2023

Objective:

ABPM blood pressure measurement is a widely used method for the diagnosis and management of hypertension. In the era of digital medicine, the creation of some photoplethysmographic wearable sensors can allow to overcome the technical difficulties and procedural complexity that limit the use of ABPM-cuff systems. The purpose of the study is to validate whether the ABPM Biobeat cuffless patch improves the management of hypertensive patients and also to evaluate the degree of satisfaction through the measurement of the Customer Satisfaction Score (CSAT) both in patients and healthcare personnel.

Design and method:

We enrolled 30 patients, divided into two groups. For both groups, BP was monitored for 24 hours with traditional and wireless wearable systems and satisfaction questionnaires were administered.

Subsequently, subgroups of analyzes will be extrapolated by isolating the obese group: patients who used the larger cuff with arm diameter 42 cm, compared to those of normal weight.

will also be addressed to operators questioned on the applicability of calibrated versus non-calibrated and self-wearable devices by the patient independently compared to those who necessarily have to go to the clinic.

The clinical data and the variables measured in the study groups were compared using the Bland Altman plot to indicate the level of agreement between the different measurement methods and between observers measuring the same phenomenon.

At the end of the procedure we administered a customer satisfaction questionnaire for users and operators.

Results:

the data analysis highlighted an adequacy of the wearable patch for the number of valid measurements performed in 24 hours.

There was improved accuracy of the wearable system in detecting values exceeding 130 mmHg for SBP and 89 mmHg for PAD.

The satisfaction regarding the wearability of the BioBeat Patch ABPM system was also significant.

Conclusions:

The extremely encouraging results obtained with this preliminary pilot study allow us to continue enrolling other subjects in order to have a significant sample size.
COULD THE CAROTID BODY REDUCTION BE RELATED TO RESISTANT AND UNCONTROLLED HYPERTENSION?
Authors: Silva Lamoel Mohandas Cruz da , Morais Camilla Giovanna Vieira de , Albuquerque Juliana Lara Santos de , Morales Kevin Rafael de Paula , Rochitte Carlos Eduardo , Lacchini Silvia
Published: June 2023

Objective:

Considering that the carotid bodies act on autonomic regulation and their impact on blood pressure control still needs to be better clarified, the objective of the study was to characterize the carotid body of patients with controlled and uncontrolled hypertension through a retrospective study of angiotomography.

Design and method:

For this, CT angiograms of hypertensive patients treated and evaluated at Heart Institute (USP, São Paulo, Brazil) were studied. The evaluated patients were separated into three groups: controlled hypertensive (C-Hyp, receiving up to 2 categories of antihypertensive drugs), resistant hypertensive (receiving 3 or more categories of antihypertensive drugs), with controlled blood pressure (CR-Hyp) and uncontrolled (UnCR -Hyp). CT angiography (Aquilion ONE/PRISM – Canon) of patients undergoing evaluation of cervical arteries with iodinated contrast were evaluated. The reconstructions of the arteries used slices of 0.5mm thickness, with orthogonal measurements of the carotid body to assess the diameters and bilateral carotid bifurcations.

Results:

The morphology of the common, internal and external carotid arteries was very similar between groups. The mean age of the assessed groups was not significantly different (C-Hyp: 59±14; CR-Hyp: 66±8; UnCR-Hyp: 52±13 years). In the C-Hyp group (n = 29), 24% had uncontrolled blood pressure, perhaps associated with the treatment adjustment process. When assessing the presence of atherosclerotic lesions, the C-Hyp and CR-Hyp groups showed a higher proportion (34% and 40%, respectively), when compared to uncontrolled resistant hypertensive patients (8.3%); however, this lower precentage must be due to the duration of treatment and the control of comorbidities that these patients must undergo. On the other hand, the UnCR-Hyp group showed a reduction in the axial and sagittal measures of the carotid body (1.9±0.3 and 2.8±0.7mm, respectively, -14% and -12%).

Conclusions:

This reduction observed in the carotid body may be related to a loss of microvascularization (making it difficult to measure on tomography) and interfering with blood pressure control in the UnCR-Hyp group. Further studies, including more patients and normotensive individuals, will be important to define which pattern of changes in the carotid body may be related to the loss of response to antihypertensive treatment.
GALECTIN-3 AS A BIOMARKER OF CARDIOVASCULAR FIBROSIS IN RHEUMATOID ARTHRITIS PATIENTS WITH SUPPRESSED INFLAMMATION
Authors: Anyfanti Panagiota , Dimitriadou Antonia , Gavriilaki Eleni , Triantafyllou Areti , Nikolaidou Barbara , Angeloudi Elena , Koravou Evdoxia Evaggeli , Dimitroulas Theodoros , Gkaliagkousi Eugenia
Published: June 2023

Objective:

Galectin-3 has emerged as a biomarker of cardiovascular fibrosis in high cardiovascular risk individuals. Increased levels of galectin-3 have been previously reported in patients with immune-mediated inflammatory diseases. Nevertheless, it has not been elucidated whether this finding is secondary to the presence of cardiovascular comorbidities and/or the pronounced inflammatory burden of the populations most commonly included in relevant studies. We investigated whether patients with rheumatoid arthritis (RA), a disease characterized by excess cardiovascular risk, present increased levels of galectin-3 even in the absence of cardiovascular comorbidities and pronounced inflammatory load.

Design and method:

We recruited patients with RA who presented low levels of systemic inflammation and were free from cardiovascular comorbidities including hypertension, diabetes mellitus and established CVD, and non-RA individuals matched for age, sex and office systolic/diastolic blood pressure. Galectin-3 and high-sensitivity C-reactive protein (hsCRP) were measured with enzyme-linked immunosorbent assay using commercially available kits. Carotid-femoral pulse wave velocity (PWV) was estimated with applanation tonometry (SphygmoCor AtCor Medical, Sidney, Australia).

Results:

In a total of 48 individuals (mean age 53.4±8.6 years, 83.3% females), hsCRP did not significantly differ between RA patients (n = 24) and controls (n = 24) [2.0 (5.6) vs 1.7 (2.4) μg/ml), p = 0.718]. By contrast, significantly increased levels of galectin-3 were observed in the RA group compared to controls [6.9 (6.7) vs 4.6 (4.7)] ng/dl, p = 0.015]. Galectin-3 was associated with PWV (r = 0.390, p = 0.009), but this association was rendered non-significant after adjustment for age and sex.

Conclusions:

Patients with RA present increased levels of galectin-3. These findings were observed even in a meticulously selected population such as ours, characterized by suppressed inflammation and the absence of hypertension and cardiovascular comorbidities. Further studies are warranted to investigate the potential role of galectin-3 as a potential prognostic marker or therapeutic target in patients with immune-mediated inflammatory diseases.
BLOOD PRESSURE REDUCTION AFTER RENAL DENERVATION IN PATIENTS WITH OR WITHOUT CHRONIC KIDNEY DISEASE: THE ERLANGER EXPERIENCE
Authors: Günes-Altan Merve , Schmid Axel , Ott Christian , Bosch Agnes , Schiffer Mario , Uder Michael , Schmieder Roland , Kannenkeril Dennis
Published: June 2023

Objective:

Renal denervation (RDN) has emerged as an adjacent option for the treatment of hypertension. This analysis of the ERLANGER registry aimed of comparing the blood pressure (BP) lowering effects and safety of RDN in patients with and without CKD.

Design and method:

Radiofrequency, ultrasound or alcohol-infusion device based RDN was performed in 47 patients with and 127 without CKD. Office and 24-h ambulatory BP were measured at baseline, after 6 and 12 months. We splitted the study cohort based on the median systolic 24h ABP reduction after 6 months into responders and non-responders and compared baseline characteristics between these groups. CKD was defined by clinical diagnosis, estimated glomerular filtration rate (eGFR: 15-59 ml/min/1.73m2) or A2 albuminuria (> = 30 mg/g creatinine ).

Results:

174 patients with a mean age of 59.0±10 were followed up for at least 12 months. At baseline mean eGFR was 55.8±21 ml/min/1.73m2 in patients with CKD and 87.3±13 ml/min/1.73m2 in patients without CKD according to the CKD-EPI formula. There was no significant eGFR decline in either of the groups during follow up. Office and 24-h systolic and diastolic BP were significantly reduced from baseline in patients with or without CKD at all time points after RDN (all p<0.01). There was no significant difference in the reduction of 24h, day- and nighttime ABP between the 2 groups at any time point (see table below). In addition to 24h baseline systolic ABP we identified several predictors (all p < 0.05): patients with a high baseline office heart rate (HR), without T2D, without diuretic medication and current smokers were more likely to be responders. With exception of rare local adverse events (e.g. haematoma at the puncture site), we had no safety signals, especially in our patients with CKD.

Conclusions:

According to our single center experience, we observed a similar reduction in 24-h, day and nighttime ambulatory BP as well as in office BP in patients with and without CKD at any time point up to 12 months. We conclude that RDN is an effective and safe treatment option for patients with arterial hypertension and CKD.
IMPACT OF RENAL DENERVATION TREATMENT ON LEFT VENTRICLE REMODELING IN RESISTANT HYPERTENSIVE PATIENTS: THREE YEARS FOLLOW-UP
Authors: Moiseeva Anna , Caraus Alexandru , Cociu Maria , Ciobanu Nicolae , Abras Marcel , Surev Artiom
Published: June 2023

Objective:

Evaluation of effects of RDN on left ventricle remodeling in patients with resistant hypertension and heart failure with preserved ejection fraction.

Design and method:

The study enrolled 125 hypertensive patients, who after 3-week of standardized treatment with Losartan, Amlodipine and Indapamide and confirmation of their drug resistance, were randomly assigned into three groups depending on medication supplemented to previously administered: group I - selective I1-imidazoline agonist Moxonidine, group II - cardioselective beta-blocker Bisoprolol and group III - renal denervation. All patients underwent a transthoracic echocardiogram at baseline, one, two and three years follow-up. Renal denervation was performed in the main renal arteries and their branches.

Results:

Transthoracic echocardiography at baseline revealed LV hypertrophy in all patients. The majority of patients in all three research groups had concentric hypertrophy (52% versus 60% and 56% in group I, II and III, respectively), the normal pattern not being recorded in any group.

An authentic reduction in LV mass index was noted from 1-year follow-up in all three observational groups, the progressive reduction being maintained until the end of the study, the group of patients undergoing renal denervation manifested a net superior effect to both pharmacological groups. So, at 3-years follow-up LV mass index was 128,57±4,91 g/m2 in Moxonidine group versus 126,0±5,34 g/m2 in Bisoprolol group and 94,44±3,90 g/m2 in RDN group, p < 0.001.

Analyzing the impact of various therapeutic regimes on the geometric pattern of the LV, we can note the fact that both treatment schemes with SNS blockers and RDN favored LV reverse remodeling, its normal pattern being regained by 5 (10%) patients from group I and 7 (28%) patients from group III. This time as well RDN demonstrated absolute superiority over both pharmacological treatment regimens (Figure 1).

Conclusions:

The obtained data confirm the benefit of RDN treatment on the reverse remodeling of the LV by significantly reduction in LV mass index and inducing the recovery of its normal physiological pattern in practically a third of treated patients at 3 years post-procedurally.
THE PREVALENCE OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Duysewnbaeva Aziza , Srojidinova Nigora , Saidakbarova Feruza
Published: June 2023

Objective:

To study the prevalence of chronic kidney disease (CKD) markers in patients with arterial hypertension(AH).

Design and method:

Retrospective analysis of 188 case histories of patients with AH of 1-3 degrees (ESC/ESH, 2018) who received inpatient treatment was carried out. 109 women and 79 men were studied. Mean age 62.8 ± 10.2 years. CKD stages were established according the modern KDIGO 2013 classification.

Results:

Among the examined patients there were 18% patients with CKD 1(n = 34); 56.3% patients with CKD 2 (n = 106); 17.5% patients with CKD 3A(n = 33); 5.3% patients with CKD 3B (n = 10); 2.6% patients with CKD 4 (n = 5) (p<0.00001). It should be noted that patients with stage 4 CKD were significantly older (55±8 vs 62±9 vs 68±8 vs 69±9 vs 74±16; p = 0.00001). According to the level of SBP, DBP, heart rate, the patients did not differ significantly. SBP (p = 0.26). DBP (p = 0.25). Patients with stage 4 CKD had severe abdominal obesity. WC: 102.4 ± 10 vs 104.7 ± 13.6 vs 103.2 ± 10.7 vs 101.5 ± 12.4 vs 110 ± 27.3 (p = 0.68). Mean creatinine in the groups was 70.6 ± 14.7 vs 85.2 ± 14.4 vs 102.3 ± 14.6 vs 121.6 ± 25.3 vs 209.6 ± 45.5 (p<0.00001) . Mean eGFR 98.2 ± 7.3 vs 72.9 ± 7.4 vs 53.7 ± 4.2 vs 37.5 ± 4.1 vs 22.6 ± 3.8 p (p<0.00001). The analysis showed that as the stage of CKD increases, the level of microalbuminuria increases. Thus, MAU indicators were 31.05 ± 25.5 vs 41.6 ± 50.2 vs 38.6 ± 46 vs 96.6 ± 144.7 vs 308.8 ± 147.5 (p<0.00001). It should be noted, that the high stages of CKD are characterized by significantly more pronounced asymptomatic hyperuremia. At the same time, the level of uric acid in group I was 5.4 ± 1.4 vs 6.5 ± 4.7 vs 6.5 ± 1.7 vs 7.5 ± 1.7 vs 7.8 ± 1.01 (p <0.00001).

Conclusions:

Among patients with hypertension, the prevalence of CKD is significantly high (82%), which additionally increases the cardiovascular risk of this category of patients.