bluuebunny/crossref_metadata_2025 huggingface dataset:
CARDIAC AUTONOMIC NEUROPATHY RISK ESTIMATED BY SUDOMOTOR FUNCTION IN YOUNG ADULTS WITH INTELLECTUAL DISABILITY
Authors: Zwack Clara , Mcdonald Rachael , Eikelis Nina , Lambert Gavin , Lambert Elisabeth
Published: April 2021

Objective:

Young adults with Intellectual Disability (ID) are at higher risk of premature death, and present with increased prevalence of cardiovascular disease (CVD) than the general population. Cardiac autonomic neuropathy (CAN) is often associated with CVD risk factors including diabetes mellitus, metabolic syndrome and hypertension. Hence, it may be a predictor for cardiovascular morbidity and mortality. Screening for CAN risk through assessment of sudomotor function has been introduced as a method for early detection of autonomic dysfunction.

Design and method:

Adults with ID aged 18–45 years (n = 31) were compared to the general population (GP) (n = 29). Seated blood pressure, arterial stiffness (Pulse Wave Velocity [m/s] measured with Sphygmacor) and sudomotor function (measured with SUDOSCAN) were assessed.

Results:

Hand and feet electrical skin conductance (ESC) were lower in adults with ID ([Feet] ID = 72.8 microsiemens, GP = 80.4 microsiemens; p = 0.021 [Hands] ID = 65.6 microsiemens, GP = 76.8 microsiemens; p = 0.013) indicating elevated risk for CAN in the ID cohort. ESC in the ID population did not correlate with arterial stiffness, blood pressure nor body mass index (BMI), with both groups showing similar mean systolic blood pressures (ID = 127mmHg, GP = 122mmHg; p = 0.10) and PWV (ID = 8.0m/s, GP = 7.8m/s; p = 0.81), despite elevated BMI in the ID cohort (ID = 31.4 kg/m2, GP = 25.9 kg/m2; p = 0.002). However, ESC was related to Hb1Ac concentration, which was elevated in those with ID (ID = 34.4mmol/mol, GP = 29.7mmol/mol; p = 0.002).

Conclusions:

Our data indicates that sudomotor dysfunction is present in adults with ID and this was associated with impaired glucose metabolism. This suggest that CAN may play a role in the early development of CVD in young adults with ID. Given the increasing urgency to provide young individuals living with ID with the means to improve their health and wellbeing, screening for CAN could prove a useful tool in early detection of CVD risk, before the development of other typical risk factors including arterial stiffness and hypertension.
VASCULAR PROFILE IN PATIENTS WHO UNDERWENT CORONARY ANGIOGRAPHY WITH AND WITHOUT HYPERTENSION
Authors: Posadzy-Malaczynska Anna , Woznicka-Leskiewicz Lucyna
Published: April 2021

Objective:

Assessment of vascular profile in women and men with and without hypertension who didn‘t have coronary artery stenosis in the angiography.

Design and method:

We divided 100 patients in two groups: HT+ patients with arterial hypertension (25 women and 25 men); and HT- patients without arterial hypertension (25 women and 25 men). All patients underwent coronary angiography because of angina. The average age of them [yrs]: 56 and 53 (∗p < 0,05). Ankle-brachial index (ABI), pulse wave velocity (PWV) and carotid intima-media thickness (IMT), BMI, uric acid were evaluated.

Statistical calculations were performed in the StatSoft Statistica 10. For comparison of variables with a normal distribution and equal variances we used the t-test for unrelated samples.

Results:

We revealed following results in both groups: HT+ and HT- respectively [∗for p < = 0,05; ∗∗for p < 0,001; NS- negligible statistically].

In hypertensive group women were characterized by lower uric acid level, IMT and PWV than men.

In normotensive group women were characterized by lower uric acid level than men

Conclusions:

1. There was no difference in: ABI, PWV and IMT between the sexes in normotensive patients who underwent coronary angiography.

2. Women without stenosis in coronary angiography with and without hypertension were characterised by better metabolic profile than men.

3. Hypertensive women without stenosis in coronary angiography were characterized by minor vascular damages assessed by IMT and PWV than hypertensive men.
PROGNOSTIC SIGNIFICANS OF EARLIER HYPERTENSION, NORMAL AND HIGH ADMISSION SYSTOLIC BLOOD PRESSURE OF PATIENTS WITH MYOCARDIAL INFARCTION WITH AND WITHOUT ST ELEVATION
Authors: Vulin Aleksandra , Todic Vanja Drljevic , Stefanovic Maja , Popov Tanja , Poljak Jelena Pavic , Ljubotina Andrea , Popov Iva , Petrovic Milovan
Published: April 2021

Objective:

To study the effects of earlier hypertension and admission blood pressure on left ventricular ejection fraction (LVEF) and mortality in patients with acute myocardial infarction.

Design and method:

Retrospective study on 11346 consecutive patients (aged 67,28 + /-11,92years, 7421 (65,4%) male) admitted with ST-elevation myocardial infarction (STEMI) (8268 (72,9%)) and non-ST elevation myocardial infarction (NSTEMI) and normal and high normal (90–139mmHg) or high (> = 140mmHg) systolic blood pressure (SBP) in our tertiary center from january 2013. to october 2019. Intrahospital left ventricular ejection fraction (LVEF) and mortality were recorded.

Results:

NSTEMI patient compared with STEMI were older (69,68 + /- 11,34 vs. 66,38 + /-12,01; p < 0,001), more frequently had earlier hypertension (2119 (68,8%) vs 5015 (60,7%); p < 0,001), diabetes (843 (27.4%) vs. 1620 (19.6%); p < 0.001), dyslipidemia (909 (29,5,8%) vs 1727 (20,9%); p < 0,001), had higher SBP (140.82 + /-26.03 vs. 139.13 + /-24.23mmHg; p = 0,001), higher proportion of admission hypertensive patients (1665 (54.09%) vs. 3411 (46.48%); p < 0.001), higher LVEF (48.32 + /-11.30% vs. 47.31 + /-9.32%; p < 0.001), and mortality (318 (10.33%) vs. 621 (7.51%) p < 0.001), without diastolic BP difference (82.35 + /-14.02 vs. 82.80 + /-14.14 mmHg; p = 0.131). Only NSTEMI patients with earlier hypertension had higher LVEF (48.61 + /- 9.89% vs. 47.66 + /- 10,81%; p = 0.036) compared with patients without. All hypertensive patients on admission had higher LVEF (NSTEMI 49.05% vs 47.44% and STEMI 48.49% vs 46.30%; p < 0.001), regardless od tipe of MI. NSTEMI patients, compared with STEMI, had higher LVEF, regardless of admission SBP. Only in NSTEMI patients mortality was higher in patients without earlier hypertension (12.2% vs. 9.49%; p = 0.022). Patients with STEMI and normal admission SBP had higher mortality compared with admission hypertensive patient (416 (10,6%) vs. 166 (4,9%); p < 0,001), and even higher if they had prior hypertension. The same was registered in NSTEMI patients with normal SBP (201 (14,2%) vs. 117 (7,0%); p < 0,001), but mortality was even higher without prior hypertension.

Conclusions:

Patient with NSTEMI more frequently had earlier hypertension, and admission hypertension. NSTEMI patients with normal admission SBP had lower LVEF, only in patients with prior hypertension, and higher mortality particularly in patients without prior hypertension. In STEMI patients mortality was higher in admission normotensive patients, particularly if thay had prior hypertension.
THE EFFECT OF 7-DAY HIGH-SALT DIET ON SERUM ANTIOXIDANT ENZYMES PROTEIN CONCENTRATIONS: DOES ANTIOXIDANT VITAMINS SUPPLEMENTATION MATTER?
Authors: Baric Lidija , Drenjancevic Ines , Matic Anita , Susnjara Petar , Stupin Marko , Kolobaric Nikolina , Kolar Luka , Mihaljevic Zrinka , Stupin Ana
Published: April 2021

Objective:

It is well documented that high salt (HS) diet causes increased oxidative stress. Present study aimed to test the effect of 7-day HS diet on serum protein concentrations of Cu/Zn superoxide dismutase (Cu/Zn SOD), glutathione peroxidase 1 (GPx1) and catalase, and to examine whether the oral supplementation of non-specific ROS scavengers (vitamin C and vitamin E) during 7-day HS loading will change serum protein concentrations of these antioxidant enzymes in otherwise healthy normotensive individuals.

Design and method:

40 young healthy individuals (20 men and 20 women, age ranged 18–24) were assigned to a 7-day low-salt diet (<3.5 g salt/day) followed by a 7-day HS diet (∼14 g salt/day) without (HS group) or with the daily supplementation of vitamins C (1000 mg) and E (800 IU) (HS + C + E group). Blood pressure (BP) and heart rate (HR) were measured at each study visit. Serum protein concentrations of Cu/Zn SOD, GPx1 and catalase were measured by commercially available ELISA kits before and after diet protocols.

Results:

BP and HR were not significantly different in both, HS and HS + C + E groups compared to LS diet. Changes in calculated daily salt intake from 24 h sodium excretion confirmed that participants conformed to the diet protocols. Serum protein concentration of Cu/Zn SOD and GPx1 were not significantly changed following both HS or HS + C + E diet compared to measurement following LS diet. 7-day HS diet significantly decreased serum catalase concentration in HS group compared to LS diet (catalase pg/ml LS 347 ± 495 vs. HS 261 ± 462, P < 0.05), while catalase concentration was similar after LS and following 7 days of HS + C + E diet (catalase pg/ml LS 249 ± 375 vs. HS + C + E 186 ± 349, P > 0.05).

Conclusions:

The results of this study suggest that disturbing the activity of antioxidative defense itself (decreased serum catalase concentration) could potentially contribute to the altered oxidative status in healthy individuals on a HS diet, which could be prevented by intake of antioxidant vitamins C and E during HS diet.
THE ASSOCIATION OF 25-HYDROXYVITAMIN D, PARATHORMONE, IONIZED CALCIUM AND THE RISK OF ESSENTIAL HYPERTENSION
Authors: Semianiv Marianna , Sydorchuk Larysa , Biletsky Semen , Petrynych Oksana , Repchuk Yuliia , Semianiv Igor , Kazantseva Tetiana , Sokolenko Alina , Voroniuk Ksenia
Published: April 2021

Objective:

The aim of the research was to establish the association of 25-hydroxyvitamin D (25 (OH)D), parathormone, ionized calcium and essential hypertension.

Design and method:

The study involved 48 healthy individuals in the control group and 72 patients with EH in the main group. The mean age in the healthy group was 43 ± 7.7 years, in the group of patients it was 58 ± 7.2 years. In terms of gender distribution, there were 30 females and 18 males in the control group, 51 and 21 ones in the main group, respectively.

Results:

The results of the analysis showed that the average level of PTH in the main group was significantly higher, compared to the control group, specifically 60.8 pg/mL versus 54.8 pg/mL (p < 0.05). However, the mean of the parameter did not go beyond the reference values in both groups. The study of 25 (OH)D levels in the sample examined showed a statistically significantly lower level of it in the group of patients with EH, that was 21.3 ng/ml, compared to the group of healthy individuals, which was 24.4 ng/ml (p < 0.05). The data obtained point to the vitamin D deficiency in patients in the main group.

Reduction of ionized calcium (below the lower quartile of normal) increases the risk of essential hypertension in 1,12 times [OR = 1,12; 95%CI:0,54–2,32; p > 0,05]. With the growth of content PTH risk of EH in the population was significantly lower [OR = 0,48; 95%CI:0,21–0,97, X2 = 3,31; p = 0,049]. Reduction of 25 (OH)D concentration (below the lower quartile of normal) increases the risk of hypertension in the examine by almost 3 times [OR = 2.83; 95%CI:1.07–8.59, X2 = 3.84; p = 0.049].

Conclusions:

The reduction of 25-hydroxyvitamin D concentration increases the risk of essential hypertension in the population by almost 3 times, the increase in parathormone content played a protective role in the examined, the decrease of the ionized calcium content had no effect on the risk of EH in the population.
ASSOCIATION OF PARITY AND GRAVIDITY WITH CAROTID INTIMA-MEDIA THICKNESS: THE OHASAMA STUDY
Authors: Sato Wakana , Nomura Kyoko , Hara Azusa , Satoh Michihiro , Tsubota-Utsugi Megumi , Inoue Ryusuke , Asayama Kei , Kikuya Masahiro , Metoki Hirohito , Kobayashi Yuuki , Tatsumi Yukako , Hirose Takuo , Murakami Takahisa , Hozawa Atsushi , Watanabe Hiroyuki , Imai Yutaka , Ohkubo Takayoshi
Published: April 2021

Objective:

We aimed to investigate if any of parity, gravidity and menstrual factors are associated with carotid atherosclerosis diagnosed by ultrasound imaging.

Design and method:

We identified 543 women aged 60 years or older from the general population of Ohasama, a rural Japanese community, who answered a questionnaire on parity and gravidity and age at menarche, were free of previous cardiocerebrovascular disease. The carotid atherosclerosis was assessed based on the presence of focal carotid plaque and mean common carotid intima-media thickness (IMT) by using ultrasound imaging. Information on possible confounding factors including self-measured blood pressure at home (home BP) was simultaneously obtained.

Results:

Plaque lesion was observed in 138 (25%) and the median of IMT was 0.68 mm with interquartile range of 0.63–0.75. Means of home systolic and diastolic BP levels were 129.5 ± 14.2 mmHg and 74.0 ± 8.4 mmHg, respectively. Multivariate logistic regression models showed that compared with women who had two children, women who had three children (OR 1.82, 95%CI, 1.12–2.96) and women who had four or more children (OR 2.60, 95%CI, 1.47–4.58) were more likely to have an increased risk with the presence of focal carotid plaque adjusting for age (p < 0.001), body mass index (p = 0.012), hypertensive drug use (p = 0.319), home systolic BP levels (p = 0.364), impaired glucose tolerance (p = 0.230) and hyperlipidemia (p = 0.808), and current smoker (p = 0.955) and drinker (p = 0.294). Adjusting for these covariates, the highest quartile of gravidity (4- vs. 2) was associated with an increased risk of the plaques lesion (OR 2.03; 95%CI: 1.14–3.62) and youngest age quartile of age at menarche (13- y/o vs. 14 years) was associated with a decreased risk of the presence of plaque (OR, 0.51, 95%CI: 0.28–0.92). Multivariate general linear regression model showed that the wall thickness of carotid artery appeared slightly thicker among women who had highest parity quartile (b = 0.036, p = 0.009) adjusting for same covariates. The wall thickness of carotid artery was not associated with both gravidity (p = 0.089) and age at menarche (p = 0.113).

Conclusions:

Higher parity and gravidity, and younger age at menarche were associated with carotid atherosclerosis, independent of major confounding factors including age and home BP levels.
THE ROLE OF GENES COMBINATION IN ESSENTIAL ARTERIAL HYPERTENSION
Authors: Repchuk Yuliia , Sydorchuk Larisa , Biletsky Semen , Petrynych Oksana , Semianiv Marianna , Kasantseva Tetiana , Sokolenko Alina , Voroniuk Kseniia
Published: April 2021

Objective:

The aim of the study was to analyze the association of AGT (T704C) and VDR (1056T/C) genes polymorphisms combination with essential hypertension (EH).

Design and method:

The study involved 100 patients suffering from PAH with target-organ damaging, moderate, high or very high cardiovascular risk. Among them there were 79.0% (79) women and 21.0% (21) men, average age 59.87 ± 8.02 yo. The control group involved 30 practically healthy persons, matched by age (43.36 ± 7.1 y) and gender (62.5% women, 37.5% men). All enrolled / screened patients signed the Informed Consent to participate in the research. The genes polymorphism AGT (704 T > C) and VDR (1056T/C) was studied with PCR based method.

Results:

The genotypes distribution of the AGT (704T > C) and VDR (1056T/C) genes genotypes in patients vs control group did not differ reliably and was as follows: for AGT gene TT-, TC- and CC –genotypes - 13.89% vs 16.67%, 59.72% vs 54.17% and CC-genotype - 26.39% vs 29.17%; for VDR gene AA-, AG-, GG-genotypes – 23.0% vs 30.0%, 50.0% vs 46.67%, 27.0% vs 23.33% (p > 0.05) accordingly. Distribution of polymorphic variants of both genes corresponded to the Hardy-Weinberg Equilibrium (p > 0.05). The distribution of mutant genotypes combinations of both genes in study and control groups was as follows: TC + AG - 31.94% vs 29.17% (p > 0.05), TC + GG – 16.67% vs 8.33% (p > 0.05), TT + AG – 8.33% vs 4.17% (p > 0.05), TT + GG – 4.17% vs 8.33% (p > 0.05). The polymorphic variant combinations of both genes don’t influence the risk of EH in observed population. However, in AA-genotypes carrier of VDR gene hypertensive women increased a risk of EH almost 3 times [OR = 3.08; 95% CI: 1.02–10.25; p = 0.047].

Conclusions:

Thus, the mutant genotypes combinations of AGT (T704C) and VDR (1056T/C) genes don’t influence the risk of EH in population. However, AA-genotype of VDR gene in hypertensive women elevated risk of EH 3 times.
PLASMA XANTHINE OXIDASE ACTIVITY IS ASSOCIATED WITH LOW ESTIMATED GLOMERULAR FILTRATION RATE IN NEWLY DIAGNOSED HYPERTENSIVES
Authors: Olatunji Victoria , Arinde Olufemi , Olaoye Morolake , Olarinoye John , Olatunji Lawrence
Published: April 2021

Objective:

Elevated circulating uric acid level has emerged as an independent predictor of adverse outcomes in hypertension. Increased reactive oxygen species that could be caused by increased activity of xanthine oxidase (XO) during the production of uric acid has been attributed to hypertension. However, the predictive value of XO on impaired glomerular filtration rate in hypertension is unknown. The present study aims at evaluating the correlations between plasma uric acid concentration and XO activity, and estimated glomerular filtration rate (eGFR) in newly diagnosed non-diabetic hypertensive subjects.

Design and method:

Cross-sectional analyses were performed in treatment-naïve hypertensives with blood pressure equals to or more than 140/90 mmHg (n = 46) and normotensive with blood pressure equals to or less than 120/80 mmHg (n = 17), who were without history of diabetes mellitus, hyperlipidemia, smoking, thyroid disease and insulin or steroid use. Both groups were matched for age, sex and BMI. Using the modification of diet in renal disease equation, individuals with < median value of 91 ml/min/1.73 m2 were considered to have impaired eGFR.

Results:

Our results showed that hypertensives had higher uric acid level than the normotensives. Activity of XO was comparable in both the hypertensives and normotensives. Interestingly, hypertensives or normotensives with impaired eGFR had higher (p < 0.0001) XO activity than those with normal eGFR. Using multivariate regression analysis, results showed that XO activity (beta = 0.277; p < 0.0001) was an independent determinant of impaired eGFR in hypertensives only. The receiver operating characteristic curve analysis also showed that plasma XO activity (0.699) was a better predictor of impaired eGFR in hypertensives than plasma uric acid.

Conclusions:

These results demonstrate that plasma XO activity is significantly associated with low eGFR in hypertensives, independently of plasma uric acid level. The findings could imply that elevated plasma activity of XO may be a stronger risk factor that would promote the development of hypertension-related renal dysfunction.
ECONOMIC BURDEN OF CARDIOVASCULAR DISEASES ASSOCIATED WITH TOBACCO USE IN THE RUSSIAN FEDERATION IN 2016
Authors: Mukaneeva Dinara , Kontsevaya Anna , Myrzamatova Azalia , Khudyakov Mikhail
Published: April 2021

Objective:

To estimate the economic burden of cardiovascular diseases (CVD) associated with tobacco use in the Russian Federation (RF) in 2016, including the direct costs and the economic losses caused by reduced productivity.

Design and method:

The prevalence of tobacco use in the Russian population was determined in a ESSE-RF epidemiological study - 23.6%. The relative risks (RRs) of morbidity and mortality from CVD associated with tobacco use were identified through meta-analyzes and large studies. Based on the data on the prevalence of tobacco use in the Russian population and relative risks (RRs), the population attributable fractions (PAFs) was calculated for CVD. Associations were presented as RRs and PAFs with 95% CIs.

PAF (%) = (P_exp (RR-1))/([P_exp (RR-1)] + 1),

where:

P_exp - the proportion of individuals in a population who are exposed to tobacco;

RR - the relative risk of a specific outcome for a given exposure to a risk factor;

To assess the economic burden, the proportion of the analyzed risk factor in the morbidity and mortality from CVD was determined, and then the proportion in the economic burden of the CVD. Then we estimated attributable costs by multiplying PAFs outcomes with estimated 2016 annual direct health care and indirect costs for CVD. We used data from the Federal State Statistics Service, parameters of Annual Forms of Federal Statistical Monitoring, the results of Program of state guarantees for free medical care and the corresponding diagnosis-related groups for 2016. The calculations were performed in Microsoft Excel 10.0. (Microsoft, USA).

Results:

The calculated PAFs, associated with tobacco use, for CVD mortality and morbidity was 13% and 9%, respectively. Economic burden of CVD associated with tobacco use in 2016 in the RF reached 335 billion rubles (4.7 billion €). The losses in the economy due to premature mortality (313.8 billion rubles) prevail in the structure of the main burden. Estimated direct costs were responsible up to 21 billion rubles.

Conclusions:

The significant economic burden associated with cardiovascular diseases provides an economic rationale for action to reduce the prevalence of lifestyle-related risk factors.
A HYPERTENSIVE RESPONSE TO EXERCISE IS ASSOCIATED WITH AN ALTERATED CARDIOVASCULAR RISK PROFILE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Moore Myles , Climie Rachel , Otahal Petr , Sharman James , Schultz Martin
Published: April 2021

Objective:

A hypertensive response to exercise (HRE) is a risk factor for cardiovascular disease and reveals high blood pressure (BP) not detected at rest. Alterations to markers of cardiovascular risk may underlie associations between HRE and high BP, although this has not been systematically elucidated. This study aimed to assess relationships between HRE and cardiovascular risk markers via systematic review and meta-analysis of published literature.

Design and method:

Three online databases were searched from inception to July 2019 for studies reporting associations between exercise BP and cardiovascular risk markers (including lipid, metabolic, inflammatory and vascular stiffness markers). Pooled mean differences (random effects) were calculated for each cardiovascular risk marker between individuals with and without HRE. Univariable meta-regressions were performed to assess differences in pooled mean differences by resting hypertension and health status, intensity at the time BP was measured and exercise modality.

Results:

Overall, 37 studies with 37,878 participants (aged 50 ± 3years; 79% male) were included. On average, individuals with HRE had elevated total cholesterol (26 studies, pooled mean difference 0.13 ± 0.08mmol/L, p < 0.001), low-density lipoprotein cholesterol (17 studies, 0.12 ± 0.03mmol/L, p < 0.001), triglycerides (22 studies, 0.24 ± 0.04mmol/L, p < 0.001), glucose (21 studies, 0.15 ± 0.05mmol/L, p = 0.002), white blood cell count (4 studies, 0.49 ± 0.16x109 cells, p = 0.003), and aortic pulse wave velocity (3 studies, 0.8 ± 0.35m/s, p = 0.02), compared to those without HRE. Participants with HRE also had decreased high-density lipoprotein cholesterol (20 studies, -0.03 ± 0.01mmol/L, p = 0.003) and impaired flow-mediated dilation (2 studies, -4.13 ± 1.02%, p < 0.0001) compared to those without HRE. All pooled mean differences between HRE and no HRE were similar irrespective of resting hypertension and health status, exercise intensity and modality, except low-density lipoprotein cholesterol which had a greater mean difference during treadmill testing compared to cycling (p = 0.036), and aortic pulse wave velocity, which had a smaller mean difference in athletes compared to general populations (p = 0.018).

Conclusions:

HRE is associated with alterations in cardiovascular risk markers including increased lipid, metabolic, inflammatory and vascular stiffness and function markers. Associations varied with health status and test modality, but were consistent irrespective of resting hypertension status and exercise intensity. Results further highlight the advanced cardiovascular risk associated with HRE.
ARTERIAL HYPERTENSION MANAGEMENT TRENDS IN PAKISTAN; CROSS-SECTIONAL OBSERVATIONAL STUDY OF A SAMPLE OF PAKISTANI DOCTORS
Authors: Mohydin Bilal , Siddique Saulat , Mumtaz Khadija
Published: April 2021

Objective:

To look at the practice trends regarding Hypertension in Pakistani doctors and to find out the weak links in our diagnosis, management, care and followup.

Design and method:

Study Setting:

The study was conducted on 600 doctors practicing in different cities of Pakistan. These doctors came from all professional spheres, Fresh Graduates, Post graduate trainee, Consultants (of all ranks) and Family Physicians etc.

Study Design:

Observational cross-sectional.

Study Population and Sampling Technique:

We used cluster random sampling method to collect data.

Results:

Only 146 (24.3%) were following the guidelines while 235 (39.2%) were measuring it too early or 148 (24.6%) were measuring too late. Seventy one (11.8%) of the surveyed individual did not respond to this question.

According to latest guidelines, - A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, that facilitates achieving a desirable weight is recommended for adults with elevated BP or hypertension. Sodium reduction is recommended for adults with elevated BP or hypertension. Only 3.7% doctors talked about DASH diet in survey questionnaire, and not all the doctors are advising salt reduction to hypertensive patients comprising only 70.2%.

Only 2.5% doctors are advising to increase water intake and even alarming is that advising smoking cessation to hypertensive patients is talked about by only 4.3% of doctors.

Desired BP control is a difficult task even in developed countries. In Pakistan less than 3 % have adequate control Table 3 shows the responses to our inquiry - Grade each of the following separately which is in your opinion the most likely cause of inadequate BP control; from 1–5 (1 being somewhat common cause, and 5 being leas t common cause). The response shows the wide range of issues that we have regarding controlling the blood pressure.

Conclusions:

Issues in our society are multi-factorial. Need to emphasize to the physicians the importance of Continuance Medical Education and improving your practice skills. Also need to reach out to patients by all current mediums so they may be able to better understand the risks a person is under when he/she develop hypertension.
ASSOCIATIONS BETWEEN SMOKING HABITS AND MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS WHO UNDERWENT CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY
Authors: Miura Shin-Ichiro , Higashi Sara , Yano Masaya , Tashiro Kohei , Idemoto Yoshiaki , Suematsu Yasunori , Shiga Yuhei
Published: April 2021

Objective:

We analyzed that smoking could induce major adverse cardiovascular events (MACE) and the progression of coronary atherosclerosis as assessed by coronary computed tomography angiography (CCTA) as screening for coronary artery disease (CAD).

Design and method:

We enrolled 443 patients who had all underwent CCTA and either were clinically suspected of having CAD or had at least one cardiovascular risk factor. We divided the patients into smoking (past and current smoker) and non-smoking groups or males and females, and evaluated the presence of CAD and MACE (cardiovascular death, ischemic stroke, acute myocardial infarction and coronary revascularization) with a follow-up of up to 5 years.

Results:

%CAD in the smoking group was significantly higher than that in the non-smoking group. %MACE in males and smokers were significantly higher than those in females and non-smokers, respectively. Kaplan-Meier curves showed that smokers and females tended to show greater freedom from MACE than non-smokers and males, respectively (log-rank test p = 0.057 and p = 0.073, respectively). More interestingly, Kaplan-Meier curves also showed that non-smokers in females significantly greater freedom from MACE than smokers in females (p = 0.007), whereas there was no significant difference in freedom from MACE between non-smokers and smokers in males (p = 0.984). Although there were no significant predictors of MACE in all patients according to a multiple logistic regression analysis, smoking was useful for predicting MACE in females, but not males.

Conclusions:

Smoking was significantly associated with MACE in females, but not males, who underwent CCTA as screening for CAD. Various conventional risk factors may be associated with MACE in males.
MICE EXPOSED TO EARLY LIFE STRESS SHOW SEX-SPECIFIC EFFECT OF WATOKINES ON ENDOTHELIAL FUNCTION
Authors: Loria Analia
Published: April 2021

Objective:

The aim of this study was to determine the effects of Maternal Separation and Early Weaning (MSEW), a mouse model of early life stress, on leptin production from different fat depots and the capacity of fat conditioned media to modulate the endothelial function of aortic ring in a sex-specific manner.

Design and method:

At weaning, control and MSEW mice were fed a high fat (HF, 16-weeks, 60% Kcal from fat). In one subset of mice, white adipose tissue (WAT) was collagenase-digested and preadipocytes counted by flow cytometry. In another subset of mice, ∼50 mg of freshly-isolated WAT was incubated in DMEM + 2% fatty acid free BSA (1 hour, 37°C) to measure leptin levels.

Further, acetylcholine-induced relaxation in aortic rings from healthy mice (16-week-old fed a regular chow) was assessed to test how different fat depots media explants can modulate the endothelial function independently of the effects of MSEW on the vascular wall.

Results:

MSEW females showed a 20% increase in preadipocyte number in visceral-WAT vs. control (p < 0.05). Fat-derived leptin secretion was similar between control and MSEW mice fed a low fat diet. However, HF increased leptin secretion in subcutaneous-WAT from male MSEW mice and visceral-WAT from female MSEW mice (p < 0.05). Similarly, HF increased leptin mRNA in subcutaneous-WAT from male MSEW mice and visceral-WAT from female MSEW mice (p < 0.05).

Baseline vascular relaxation (48 ± 3 % relaxation at 5.5 x10–5mmol/L) was similarly impaired when aortic rings were incubated with perivascular adipose tissue (PVAT) media explants from female MSEW and control mice (25 ± 4 and 32 ± 2 % relaxation, respectively). However, rings incubated with visceral-WAT from female MSEW mice showed greater impairment of the vascular relaxation compared to controls (15 ± 3 and 29 ± 2 % relaxation, respectively, p < 0.05). Male MSEW mice also displayed endothelial dysfunction in isolated rings; however, PVAT and visceral-VAT media explant induced a protective effect on endothelial function.

Conclusions:

Taken together this data indicates that there is a sex and depot-specific release of WATokines that could be an important factor modulating the vascular function in mice exposed to early life stress.
CARDIOVASCULAR RISK FACTORS, LIFESTYLE AND SOCIAL DETERMINANTS IN A CROSS-SECTIONAL POPULATION STUDY- LAPARC STUDY
Authors: Leiria Vinicius , Muxfeldt Elizabeth Silaid , Pecly Inah Maria Drummond , Botelho Bruna Gopp , Barbalho Daniella Gomes , Mourão Maria Antonia Oakim
Published: April 2021

Objective:

To evaluate the relationship between the main CV risk factors and socioeconomic indicators in a population of adults registered in a Family Health Care (FHC) unit in the center of Rio de Janeiro.

Design and method:

Cross-sectional population study that included adults aged between 20 and 50 years living in the area covered by the FHC in Rio de Janeiro. Demographic data (gender and age), socioeconomic data (education level, profession, employment), CV risk factors (smoking, sedentary lifestyle, obesity, hypertension, diabetes, dyslipidemia) were recorded. The metabolic profile is evaluated through laboratory tests. Those who studied up to high school were considered poorly educated.

Results:

604 individuals were enrolled [39% male, mean age: 38.8 ± 8,9 years] The median of schooling was 12 years. 288 individuals had high schooling, 44.5% were male. A total of 130 individuals did not study or work. Women with low education had a higher risk of smoking, obesity and hypertension with no difference regarding labor or study activities. Otherwise, men with low education had higher risk of sedentary lifestyle and hypertension. Among men, not working or studying increased the risk of smoking and hypertension.

Conclusions:

We found an inverse association between socioeconomic conditions and the prevalence of CV risk factors. Women are more affected by low schooling, while men are more affected by their working occupation. The study suggests that socioeconomic factors influence the CV risk, affecting men and women differently, pointing to the need for public policies to reverse this situation.
IS BARIATRIC SURGERY A TREATMENT FOR HYPERTENSION AND FOR THE OTHER COMPONENTS OF THE METABOLIC SYNDROME?
Authors: Lechea Elena , Popescu Mihaela , Ploesteanu Rodica , Dimulescu Doina , Catalin Copaescu
Published: April 2021

Objective:

Our objective is to determine the impact of weight loss obtained by bariatric surgery on the components of the metabolic syndrome such as visceral obesity, atherogenic dyslipidemia, glycemic disorders and hypertension secondary.

Design and method:

This is a retrospective pilot study including 59 patients subjected to bariatric surgery (gastric sleeve laparoscopy) during 2016 at Ponderas Academic Hospital Bucharest, Romania. We have reviewed the hospital database for blood tests, diabetes, cardiologic and surgery consultations before surgery and at 12 months follow up. We tracked the evolution of the following parameters: body mass index, waist circumference, weight, blood sugar, triglycerides, high density cholesterol, low density cholesterol, glycated hemoglobin, liver enzymes, the presence or absence of hypertension, dyslipidemia and diabetes and the necessary for antihypertensive, lipid lowering and antidiabetic treatment. 51 of the patients (86%) were hypertensive, 48 of them had chronic antihypertensive oral treatment and 3 of them were equilibrated by low salt diet.

Results:

The need for antihypertensive treatment was reduced by 60%, only 19 out of 48 patients still had chronic blood pressure lowering treatment at 12 moths follow up. Patients still on treatment had lower doses or fewer classes of the initial drugs. BMI decreased by 38%; waist was reduced by 31%, weight declined by 41%; blood sugar was lowered by 16%, triglycerides decreased by 37%; high density cholesterol increased by 18%, low density cholesterol decreased by 9%. In diabetic patients glycated hemoglobin decreased by 28% and the necessity for antidiabetic medical treatment dropped by 69%. The decline was statistically significant for al variables (P < 0.001) except for low density cholesterol. Blood sugar values registered a more accelerated decrease in the first 6 months.

Conclusions:

Weight loss obtained by bariatric surgery in this study, improves metabolic syndrome in all of its components. The lower decrease in LDL Cholesterol in our study can be partly explained by the borderline values at the baseline. Longer retrospective analyses and prospective studies, expanding the number of patients are necessary and in progress, in order to determine the recurrence or new onset of hypertension.
THE EFFECT OF PILATES METHOD OF AUTONOMIC MODULATION IN OLDER WOMEN
Authors: Alves Tatiana Pereira , De Oliv Patrick Rodrigues Correia , Costa Ana Carolina , Belarmino Giliane , Lima Cintia Taniguti , Rodrigues Gabriel Dias , Waitzberg Dan Linetzky , Soares Pedro Paulo Da Silva , Busse Alexandre Leopold , Irigoyen Maria Claudia , Filho Wilson Jacob , Lacchini Silvia
Published: April 2021

Objective:

To verify the effects of the Pilates compared to Resistance method on autonomic modulation of heart rate of older women.

Design and method:

Twenty-four older women (60 to 80 y.o.) submitted to resistance training, W (RT, n = 12) or Pilates (PT, n = 12) for 12 weeks, twice a week, one hour per session. Physical evaluation was performed at the beginning (week 0, RT0 and PM0) and the end of training protocols (week 12, RT12 and PM12), to analyse body composition (bioimpedance, X-ray emission densitometry), and unipodal balance, hand grip strength, functional mobility (Timed Up and Go test–TUGT). Pulse pressure was obtained by using Finometer, and spectral analysis was performed by using Heartscoope Software to obtain normalized high frequency component (RRHFn), normalized low frequency component (RRLFn), LF/HF ratio, baroreflex sensitivity (BRS), harte rate (HR), diastolic blood pressure mean (DAP), and systolic blood pressure mean (SAP). Statistical analysis was performed by two-way ANOVA.

Results:

observed an improve of unipodal balance in both groups (RT1 = 12,9 ± 8 s vs. RT12 = 24,8 ± 8,4 s and PT1 = 8,6 ± 2,5 s vs. PT12 = 22 ± 9,23 s). Pilates was able to improve TUGT (PT1 = 5,5 ± 1.6 s vs. PT12 = 2,9 ± 0,5 s). No chances in body composition and hand grip strength were observed. Bood pressure evaluation showed no changes in RT (DAP 84.05 ± 10 and SAP: 135 ± 18mmHg) and PT (DAP 73.6 ± 8 and SAP: 135 ± 14mmHg); HR (RT: 62.7 ± 6 and PT: 60.1 ± 3 bpm) and BRS were also unchanged after training. Spectral analysis shows a decrease, but non significant, in RT of RRLFn (-14,6%) and RR LF/HF (-27,3%). Interstingly, RRHFn increased significantly (+27,3%). On the other hands, PT presented a significant decrease of RRLFn (-36,2%), RR LF/HF (-55,6%) and an increase of RRHFn (+33,9%).

Conclusions:

Both exercise protocols were effective to improve physical capacity, but Pilates method was also efficient to improve TUGT. Both methods were able to increase HF (parasimpathetic modulation). However, Pilates was also efficient to reduce LF, indicating a reduction of sympathetic modulation, combined to the increase of parasympathetic activity on the heart. The improve of autonomic modulation indicate a better efficiency to reduce cardiovascular risk.
RESPONSIBILITY AS ONE OF STRESS PARAMETERS AT WORK PLACE IN OPEN URBAN POPULATION: GENDER ASPECT
Authors: Akimov Aleksander , Kayumova Marina , Gafarov Valery , Kuznetsov Vadim
Published: April 2021

Objective:

To study responsibility, as one of the stress parameters in workplace, in males and females of open urban population from a gender perspective.

Design and method:

The study was conducted as a part of cardiological screening in open workable population of both sexes aged 25–64 years in Tyumen. A representative sample was formed from voting lists of 2,000 citizens of one of the administrative districts of Tyumen, 250 people in each of eight groups defined by sex and age (25–34, 35–44, 45–54, 55–64). Response to cardiac screening was 77.7%. To analyze stress at work, questionnaire WHO MONICA-psychosocial “Knowledge and attitude to your health” was applied. In this study, questions regarding workplace responsibility were used to determine stress in the workplace.

Results:

Statistically significant differences in answers to a question “Has your responsibility at work changed in the past 12 months?” were registered at young age in favor of women (25–34 years: 37.5–54.9%; 35–44: 39.5–53.1% in males and females, respectively, p < 0.01). Over the past 12 months, work responsibility was rated as “insignificant” by 7.9% of males and 3.4% of females in open population, p < 0.001. Similar trends in males and females in relation to this category of answers were detected in age groups of 25–34 (5.7–0.8%, p < 0.05) and 55–64 (18.7–3.7%, p < 0.001). Self-assessment of work responsibility as “high” over the past 12 months was significantly more often detected among females compared to males in general population (53.6–45.2%, p < 0.001) and in elder age group 55–64 (52.8–32.7%, p < 0.001).

Conclusions:

In open urban population, according to the model of Tyumen city, the highest self-assessment of responsibility in workplace was registered in females, mainly in elder group, and increased work responsibility as in elder age group 55–64 so as predominantly in females younger than 45 years. Thus, generating informational and educational technologies for heart diseases prevention in adult population of the city, top-priority orientation is to be focused on needs of “social risk” groups in population, exactly in young workable females.
THE MEASUREMENT OF MALONDIALDEHYDE LEVEL IN HEART TISSUE OF HYPERLIPIDEMIC RATS AFTER INTERVENTION OF COMBINATION OF JICAMA (PACHYRHIZUS EROSUS) CONCENTRATE AND KEFIR MILK AS A SYN
Authors: Khotijah Alfreda Amelia , Prabowo Rafik , Pramaningtyas Miranti Dewi
Published: April 2021

Objective:

This research aims to know the effect of synbiotic drink from jicama concentrate and kefir milk on malondialdehyde (MDA) level in heart tissue of hyperlipidemic rats.

Design and method:

Twenty five rats divided into 5 groups such as negative control (K-), positive control (K+), and intervention groups (P1, P2, and P3). All animal model was acclimatized for seven days. Group of K+, P1, P2, and P3 were given quail egg yolks 5 ml/200 grBW/day for 4 weeks to make the hyperlipidemic model. For next 4 weeks, the intervention groups (P1, P2, and P3) were given a different formulations synbiotic drink with 5 ml/ 200 grBW/day. There are three formulations of synbiotic drink, P1: 85% Kefir Milk (KM), 15% Jicama Concentrate (JC), P2: 75% (KM), 25% (JC), P3: 65% (KM), 35% (JC). In the end of experiment, the animal model was terminated to get the heart organs. The heart organs were saved in a cup which have filled with alcohol and began to measure MDA level in heart tissue. All data were statistically analyzed with One-Way Annova. Values were considered significant at p < 0,05.

Results:

Based on data, all of the data were expressed as mean ± SD. The mean of MDA level (nmol/gr) in negative control group (K-) was 1.50 ± 0.08 and positive control group (K+) was 10.70 ± 0.14. The groups of intervention were 6.60 ± 0.09 (P1), 4.56 ± 0.11 (P2), and 3.02 ± 0.13 (P3). The result showed there was significant differences between all groups (p < 0,001).

Conclusions:

Synbiotic drink from jicama concentrate and kefir milk significantly to improve MDA level in heart tissue of hyperlipidemic rats and can be considered for adjuvant therapy to decrease the risk of hypertension.
ARTERIAL STIFFNESS IN HYPERTENSIVE CRISIS DEPENDING ON PATIENT DIPPING PROFILE
Authors: Jug Juraj , Bencic Martina Lovric , Prkacin Ingrid
Published: April 2021

Objective:

Arterial stiffness and its value, approximated from pulse wave velocity, correlate with cardiovascular risk. Therapeutic restoration of normal physiologic blood pressure reduction by 10–20% during night-time sleep is the most significant independent predictor of decreased cardiovascular risk. The aim of this study was to present the difference in pulse wave velocity value between gender and their dipping profile.

Design and method:

We divided 205 patients (54% female) in four groups by their dipping profile and gender. Additionally, because pulse wave velocity depends on age, we created five main age groups (<50, 51–60, 61–70, 71–80 and over 80 years). We checked their dipping profile with 24-hour ambulatory blood pressure monitoring. Pulse wave velocity was checked by Agedio oscillometer. Also, serum creatinine and glomerular filtration rate was calculated by CKD-EPI formula in all patients.

Results:

An average glomerular filtrate rate in dipper patients was significantly higher than non-dippers (81.32 vs 72.82 ml/min/1.73m2; p < 0.05). The number of non-dippers was higher than dippers (103 vs. 39 patients, p < 0.01). Women were significantly older than men (69.02 vs. 62.01 years, p < 0.01). Comparing pulse wave velocity by age groups and dipping profile in men the results were: 1 – 8.20 vs 8.31m/s; 2 – 8.78 vs. 9.30m/s; 3 – 10.01m/s vs. 10.35m/s, p = NS; 4 – 11.70 vs. 13.27m/s, p < 0.01. In women we found statistically higher values of pulse wave velocity compared to men of the same age groups (11.71 vs. 10.44m/s, p < 0.05). By age groups and their dipping profile the results were: 1 – 9.01 vs. 9.04m/s; 2 – 9.66 vs 9.97m/s, p = NS; 3 – 10.35 vs. 11.34m/s, p < 0.05; 4 – 11.85 vs. 12.91m/s, p < 0.01).

Conclusions:

Non-dipping profile could be a potential risk factor for hypertensive crisis development. Pulse wave velocity values increased more rapidly in non-dippers compared to dippers and turned out to be higher in women compared to men of the same age. Treating and discovering non-dipper patients could decrease the level of the cardiovascular risk and potentially prevent the incidence of the hypertensive crisis events. Kidney function restoration also showed its importance in cardiovascular prevention.
CHRONIC KIDNEY DISEASE AND SURVIVAL AFTER FIRST ISCHEMIC STROKE. CROATIAN COHORT OF THE ESH STROKE SURVEY
Authors: Jelakovic Ana , Malojcic Branko , Stevanovic Ranko , Kos Jelena , Premuzic Vedran , Dika Zivka , Vrkic Tajana Zeljkovic , Karanovic Sandra , Wohlfahrt Peter , Krajcoviechova Alena , Cifkova Renata , Jelakovic Bojan
Published: April 2021

Objective:

Aim of this study was to analyze the association of chronic kidney disease (CKD) with survival of patients after first ischemic stroke in the Croatian cohort of the ESH Stroke Survey.

Design and method:

Consecutive sample of 292 patients (171 m, average age 64 y) who were admitted to UHC Zagreb and diagnosed with ischemic stroke between 2011- 2014 were included in this analyses. Patients were followed-up for 2350 days. Mortality data were obtained from Croatian National Public Health archive. CKD was defined as eGFR < 60 ml/min/1,73m2 (CKD-Epi).

Results:

Previously we reported that hypertension, smoking, diabetes, dyslipidemia and atrial fibrillation were diagnosed in 75%, 27.3%, 24.5%, 17.4%, and 11.7% of patients, respectively. CKD was diagnosed in 51.7%. CKD stages 1, 2, 3a, 3b, 4, 5 were confrimed in 6.8%, 41%, 31.8%, 14.7%, 3.4% and 1.7% of patients, respectively. During the follow-up period 91 patients (31.1%) died from stroke, CV diseases, cancer and other causes (60.4%, 9.8%, 14.2% and 15.3%, respectively). We also reported that stroke deaths and CV composite deaths were more frequently present in CKD than in non-CKD patients p < 0.001). Here we are reporting that patients with CKD (both gender) lived significantly shorter than non-CKD patients (2290 days vs. 2546 days, p < 0.001). Even patients in CKD stages 3a/3b survived significantly shorter than patients in CKD stages 1 and 2.

Conclusions:

High prevalence of CKD was observed in our cohort of patients who survived first ischemic stroke. We confirmed previous results that CKD is significantly associated with survival after stroke and found that even CKD stage 3a is associated with shorter survival than non-CKD patients indicating that CKD should be considered as an independent prognostic factor in patients with ischemic stroke.