bluuebunny/crossref_metadata_2025 huggingface dataset:
SECOND DERIVATIVE OF THE FINGER PHOTOPLETHYSMOGRAPHY PREDICTS THE RISK OF FUTURE DEVELOPMENT OF HYPERTENSION IN MIDDLE-AGED MALE POPULATION
Authors: Otsuka Toshiaki , Kodani Eitaro , Kato Katsuhito , Jinnouchi Hiroshige , Kawada Tomoyuki
Published: May 2024

Objective:

Increase in arterial stiffness deteriorates blood pressure (BP) control. Therefore, increased arterial stiffness is thought to be a risk factor for incident hypertension. We reported that indices of arterial stiffness obtained from second derivative of the finger photoplethysmography (SDPTG) is cross-sectionally associated with several cardiovascular risk factors including BP and future cardiovascular risk. The aim of the present study is to test whether indices obtained from SDPTG predict future development of hypertension in middle-aged male population.

Design and method:

SDPTG was measured in 902 non-hypertensive men (mean age 44±6 years) at an annual medical checkup in a Japanese company. The development of hypertension was followed for a maximum of 4 years. Two indices of arterial stiffness (b/a, an index of large arterial stiffness; d/a, an index of structural and functional properties of the systemic arterial tree including the peripheral circulation) were calculated from the SDPTG waveforms. A Cox proportional hazards model was used to examine whether b/a and d/a were independent predictors of future development of hypertension.

Results:

During a follow up period, 124 subjects developed hypertension, defined as systolic/diastolic BP >=140/90 mmHg or use of antihypertensive medications. The hazard ratio for future development of hypertension was significantly increased in the lowest quartile of d/a compared with the highest quartile (2.86, 95%CI 1.59–5.15, p=0.001) after adjusting for multiple potential confounders. However, b/a did not show significant hazard ratios for future development of hypertension.

Conclusions:

The d/a, but not b/a, could predict the risk of future development of hypertension in this study population. The measurement of d/a may be useful for identify high-risk subjects for future development of hypertension.
ASSESSMENT OF THE NORRISK 2 AND THE SCORE2-DIABETES RISK ALGORITHMS IN PATIENTS WITH HYPERTENSION – ROOM FOR IMPROVEMENTS
Authors: Olsen Eirik , Halvorsen Lene , Brobak Karl Marius , Aune Arleen , Rognstad Stine , Bergland Ola , Solbu Marit , Gerdts Eva , H⊘ieggen Aud , Kjeldsen Sverre E , Rostrup Morten , Larstorp Anne Cecilie K , Mo Rune , S⊘raas Camilla L
Published: May 2024

Objective:

NORRISK 2 is a Nordic risk assessment tool used for 10-year prediction of cardiovascular disease (CVD) or death. It is based on a 10-year follow up of a large population-based cohort and is widely used in clinical practice. The SCORE2-Diabetes algorithm was recently developed by the European Society of Cardiology, and also predicts 10-year risk of CVD or death, specific for patients with diabetes. We aimed to investigate how the NORRISK 2 and SCORE2-Diabetes risk scores differed in hypertensive patients with type 2 diabetes mellitus (T2DM).

Design and method:

We included patients with T2DM (n=239) from a national cross-sectional study of 1156 patients treated with >= 2 antihypertensive agents. Due to the set restrictions in NORRISK 2 and SCORE2-Diabetes, patients aged 45-69 years with systolic blood pressure >=120 mmHg and <=160 mmHg, total cholesterol 4-8 mmol/l, HDL-cholesterol <=4 mmol/l, and without target organ damage (urinary albumin/creatinine-ratio >300mg/mmol, estimated glomerulus filtration rate <45ml/min/1.73m2) or previous CVD were eligible for risk assessment. Forty-seven patients fulfilled these criteria and had both SCORE2-Diabetes and NORRISK 2 risk scores calculated. Patients were stratified into three age groups according to NORRISK 2, which recommends antihypertensive drug treatment if 10-year risk for CVD is >5% at age 45-54 years, >10% at age 55-64 and >15% at age >=65 years.

Results:

SCORE2-Diabetes calculated 59% higher risk for 10-year CVD than the NORRISK 2 in the youngest patients aged 45-54 years (Table 1). In patients aged 55-64 years SCORE2-Diabetes estimated 22% higher risk than the NORRISK 2, and among patients >=65 years SCORE-2 Diabetes estimated 6% higher risk than NORRISK 2.

Conclusions:

Our data suggest that NORRISK 2 estimates a lower 10-year risk for cardiovascular disease than the SCORE2-Diabetes risk assessment tool in patients with hypertension and type-2 diabetes mellitus, especially in patients <65 years. Furthermore, our data indicate that only a low proportion of hypertensive patients with diabetes are eligible for assessment with the current risk algorithms and that the Nordic and European diabetes risk algorithms are insufficiently coordinated for patients in hypertension.
STUDY OF THE RELATIONSHIP BETWEEN SERUM VITAMIN D LEVELS, URICEMIA AND CARDIOVASCULAR RISK OF NON- STUDY OF THE RELATIONSHIP BETWEEN SERUM VITAMIN D LEVELS, URICEMIA AND CARDIOVASC
Authors: Liliane Kuate Mfeukeu , Rene Nkeck Jan , Claudine Yondo Ndedi , Doris Essama , Madeleine Ngandeu , Vicky Ama Moor
Published: May 2024

Objective:

To study the relationship between serum vitamin D levels, uricemia, and cardiovascular risk (CVR) in non-diabetic hypertensive patients in Yaoundé (Cameroon).

Design and method:

We carried out a cross-sectional study from January to August 2022 among non-diabetic hypertensive patients followed in Yaoundé. We measured serum 25 (OH) vitamin D, uricemia, and estimated CVR using the WHO Africa, SCORE 2003, Framingham 2008, ASCVD 2013, and Reynolds scores. Association between variables were sought by linear regression and calculation of odds ratio (OR) with its 95% confidence interval (95% CI). Linear regression results are presented with the regression coefficient (B)and its 95% CI.

Results:

Among the 155 participants (63.9% women, mean 57.3 ±10 years), hyperuricemia and vitamin D deficit concerned 25.2 and 68.4%, respectively. Vitamin D deficit was associated with duration of hypertension of less than 9 years (OR=2.5 [1.29; 5.19]) and hypocalcemia (OR=2.93 [1.39; 6.15]). No linear regression model was predictive of vitamin D concentrations from uricemia. In linear regression, vitamin D did shown an association with CVR scores; whereas, uricemia independently predicted WHO (B=0.18 [0.002; 0.137]) and Framingham (p=0.04 [0.007; 0.180]) scores

Conclusions:

This study did not reveal an association between vitamin D and serum uric acid concentrations in the population studied. In contrast to vitamin D, there is a clear relevance of serum uric acid in the prediction of their CVR
INFLUENCE OF METABOLIC SYNDROME AND ITS COMPONENTS ON TELOMERE LENGTH
Authors: Lezhenikova Alyona , Bragina Anna , Druzhinina Nataliya , Vasileva Lubov , Shikhmagomedov Rustam , Mohammadi Leila , Novikov Kirill , Podzolkov Valeriy
Published: May 2024

Objective:

to assess the influence of different metabolic markers, metabolic syndrome (MS) and its components on telomere length

Design and method:

we examined 45 patients (44.4% men) age median was 26[21;39] years. All patients underwent waist circumference (WC), hip circumference (HC), neck circumference (NC) measurement, LAP (Lipid Accumulation Product), VAI (Visceral Adiposity Index), BFP (Body Fat Percentage), BAI (Body Adiposity Index) indices evaluation, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TC), blood glucose testing. Telomere length was assessed by PCR and fluorimetry. Statistical processing of the data was done with

STATISTICA 10 software.

Results:

the patients were divided into two groups: with MS (n=10; 22.2%) and without MS (n=35; 77.8%). Groups had no difference by gender, age and smoking status (p>0.05). MS group had elevated levels of BMI, WC, HC, NC and percentage of obesity in comparison with non-MS group (p<0.05). Patients with MS more frequently suffered from hypertension (50%), dyslipidemia (90%), hyperglycemia (20%) and had higher systolic blood pressure (SBP), diastolic blood pressure (DBP) than non-MS group (p<0.05). In MS group LAP (138.7[90.6;156]), BFP (33.3[28.7;43.9]) and BAI (33.6[29.7;38.5]) indices were significantly higher than in control group (LAP (16.17[9.7;38.2]), BFP (25.8[17.6;29.2]) and BAI (24.8[21.5;27.4])) (p<0.001). We revealed correlation relationships of telomere length with WC (r=-0.3; p<0.05), HC (r=-0.35; p<0.05), NC (r=-0.53; p<0.05); TC (r=-0.64; p<0.05), LDL (r=-0.52; p<0.05), HDL (r=0.59; p<0.05), TG (r=-0.46; p<0.05), blood glucose (r=-0.33; p<0.05), integral metabolic indices: LAP(r=-0.4; p<0.05), BAI(r=-0.32; p<0.05) and presence of MS (r=-0.36; p<0.05), dyslipidemia (r=-0.76; p<0.05) and DBP level (r=-0.31; p<0.05). We performed multivariate linear regression analysis to assess influence of different MS components that demonstrated correlation with telomere length: TC (b = -0.4, Std. Err of b = -0.1, p= 0.003), blood glucose (b = -0.26, Std. Err of b = 0.12, p= 0.004) and HDL (b = 0.69, Std. Err of b = 0.26, p= 0.001).

Conclusions:

telomere length is significantly shorter in patients with MS than in patients of comparable age without MS. Decrease in HDL and increase in TC and blood glucose significantly influences on telomere length.
REMNANT CHOLESTEROL TRAJECTORY AND INCIDENT ISCHEMIC STROKE IN THE GENERAL POPULATION: A PROSPECTIVE COHORT STUDY
Authors: Chen Chaolei , Huang Yuqing , Wu Shouling , Feng Yingqing
Published: May 2024

Objective:

Studies have demonstrated that single measure of remnant cholesterol (RC) is correlated with the risk of ischemic stroke. However, it is unknown whether long-term patterns such as RC trajectory affects the risk of ischemic stroke. We sought to examine the role of RC trajectory in the subsequent development of ischemic stroke in the general population.

Design and method:

We performed analysis using data of eligible participants from the Kailuan Study cohort who underwent 3 health examinations and were free of atrial fibrillation, myocardial infarction, stroke, cancer, or known lipid-medication use from 2006 to 2010. Distinct RC trajectories were fitted using group-based trajectory modeling. Participants were followed up for stroke events until 31 December 2021. Multivariate analysis was performed using Cox proportional hazards regression models to estimate hazard ratio (HR) with 95% CI.

Results:

The final study cohort comprised 42 979 participants (mean [SD] age, 49.3 [11.8] years, and 76.6% of them were men). After a median follow-up of 11.0 years, 2277 individuals were newly diagnosed with ischemic stroke. We identified three RC trajectories, which included the low-decreasing group (n=38 413, 89.4%), the moderate-increasing group (n=1282, 3%), and the high-decreasing group (n=3284, 7.6%). Compared with the low-decreasing trajectory group, both individuals in the moderate-increasing group (HR, 1.26; 95% CI, 1.01 to 1.56) and high-decreasing group (HR, 1.24; 95% CI, 1.07 to 1.43) had higher risk of ischemic stroke after adjusting for age, sex, education, income, marriage, smoking, drinking, physical activity, family history of cardiovascular disease, estimated glomerular filtration rate, C-reactive protein, heart rate, body mass index, fasting blood glucose, antidiabetic drugs, systolic blood pressure, diastolic blood pressure, antihypertensive drugs, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Results remained robust after additionally adjusting for baseline RC or cumulative RC exposure during 2006-2010, excluding events within the first year of follow-up, or considering death as competing risk.

Conclusions:

Both moderate and high RC trajectories were associated with a higher risk of ischemic stroke in the general population.
ASSOCIATION OF BLOOD PRESSURE TRAJECTORIES SINCE YOUNG ADULTHOOD WITH CARDIOVASCULAR DISEASES IN LATER LIFE
Authors: Chen Chaolei , Huang Yuqing , Wu Shouling , Feng Yingqing
Published: May 2024

Objective:

To identify blood pressure (BP) trajectories since young adulthood and to determine their association with risk of cardiovascular diseases (CVD) in later life.

Design and method:

This cohort study used data of young adults aged 18 to 39 years from the Kailuan Cohort, a prospective longitudinal study of Chinese men and women. Using group-based trajectory modeling, distinct BP trajectories from 2006 to 2010 were identified for 5 BP traits (mid-BP, SBP, DBP, MAP, and PP). Main outcomes were incident CVD (coronary revascularization, myocardial infarction, heart failure, or stroke), which were collected until 31 December 2020. Cox proportional hazards regression models were used to estimate the associations between BP trajectories and the risk of incident CVD.

Results:

Of the 11 535 adults included in the study (mean [SD] age, 32.6 [5.1] years), 8708 (75.5%) were men. We identified 3 trajectories for all BP traits (except for PP, which was 2). Among them, the mid-BP trajectory distribution was 4566 individuals (39.6%) with low-increasing, 5996 (52.0%) with moderate-increasing, and 973 (8.4%) with high-stable. Compared with the mid-BP low-increasing trajectory group, individuals in the moderate-increasing and high-stable groups had higher risk of CVD (moderate: HR, 2.44; 95% CI, 1.47 to 4.06; high: HR, 3.82; 95% CI, 1.98 to 7.39) after adjusting for socio-demographics and cardiovascular risk factors, as well as the baseline mid-BP level. Results were consistent after additionally adjusting for cumulative mid-BP exposure during 2006 to 2010 (moderate: HR, 2.31; 95% CI, 1.41 to 3.79; high: HR, 3.18; 95% CI, 1.72 to 5.90). Besides, the increased CVD risk associated with higher trajectories were also significant for SBP, DBP, MAP, and PP, and remained robust through several sensitivity analyses, which included excluding those who ever used antihypertensive drugs during 2006 to 2010, excluding events within the first year of follow-up, and considering death as competing risk.

Conclusions:

Higher BP trajectories since early adulthood were associated with an increased risk of CVD in later life. Early detection of BP trajectories may assist in more accurate identification of individuals with high risk of future CVD.
ASSOCIATION BETWEEN THE GERIATRIC NUTRITIONAL RISK INDEX AND THE RISK OF STROKE IN ELDERLY PATIENTS WITH HYPERTENSION: A LONGITUDINAL AND COHORT STUDY
Authors: Cai Xintian , Hu Junli , Li Nanfang
Published: May 2024

Objective:

We aimed to investigate the association between the GNRI and the risk of stroke in elderly patients with hypertension.

Design and method:

A total of 5312 elderly hypertensive patients free of history of stroke were included. Multivariate Cox models were used to calculate hazard ratios (HRs) and their 95% confidence intervals (CIs) for stroke and its subtypes.

Results:

The average time of follow-up was 3.8 years, and the median time was 3.2 years. We identified 640 individuals with stroke, of whom 526 had an ischemic stroke (IS) and 114 had a hemorrhagic stroke (HS). After adjusting for confounding variables, compared with participants in the lowest quartile of the GNRI, those in the third and fourth quartiles were associated with a decreased risk of stroke (adjusted HR 0.72, 95% CI 0.58-0.90, and adjusted HR 0.58, 95% CI 0.46-0.74, respectively, P for trend < 0.001). Similar results were found for IS and HS. Moreover, there were L-shaped associations of GNRI with new-onset HS (P for non-linearity = 0.034). Multiple sensitivity analyses and stratified analyses did not materially change the results.

Conclusions:

In summary, we found that a lower GNRI was associated with a higher risk of incident stroke in elderly hypertensive patients. Additional prospective data collection is required to confirm our findings.
THE ASSOCIATION OF SERUM URIC ACID LEVELS WITH CARDIOVASCULAR MORBIDITY AND MORTALITY
Authors: Boyarinova Maria , Rotar Oxana , Moguchaia Ekaterina , Kolesova Ekaterina , Erina Anastasia , Tolkunova Kristina , Vasilieva Elena , Usoltsev Dmitry , Artomov Mykyta , Konradi Alexandra
Published: May 2024

Objective:

A number of epidemiological studies have demonstrated the association of hyperuricemia with cardiovascular morbidity and mortality. There are also data showing that hypouricemia can lead to endothelial dysfunction and oxidative stress, therefore, increasing the risk of hypertension, diabetes mellitus and kidney disease. The purpose was to evaluate the relationship between serum uric acid levels and fatal/non-fatal cardiovascular diseases in the Russian population-based sample during 8 years of follow-up

Design and method:

As a part of all-Russian epidemiology survey ESSE-RF a random sample of 4800 subjects was enrolled into the study. All subjects signed informed consent and underwent a questionnaire, anthropometry, blood pressure measurement, laboratory examination (biochemical blood tests, including uric acid). The observation period was 8 years with registration of cardiovascular end points: fatal and non-fatal myocardial infarction, stroke, transient ischemic attack. All patients were divided into 8 groups according to the reference level of serum uric acid based on South Korean population-based study categorization (Cho SK et al., 2018).

Results:

Data from 4168 subjects were collected. We demonstrated association between serum uric acid level and risk of CVD events, where age-adjusted hazard ratio (HR) for cardiovascular morbidity and mortality was significant only for the highest group of uric acid (Table 1). When the model was adjusted for body mass index (BMI), hypertension, glomerular filtration rate (GFR) and diabetes mellitus (DM), for DM only significant association remained (HR 4,6 (95% CI 1,91-11,0), p<0,001).

Conclusions:

In the Russian cohort only the highest uric acid level was predictive for increased cardiovascular morbidity and mortality. In the Russian population, the association between uric acid and cardiovascular events is explained primarily by the presence of diabetes.

Agreement No 075-15-2022-301.
CAN ANTHROPOMETRIC INDICES PREDICT THE CHANCE OF HYPERTENSION? A MULTICENTRE CROSS-SECTIONAL STUDY IN IRAN
Authors: Bazrafshan Mehdi , Drissi Hamed Bazrafshan , Akbari-khezrabadi Ali , Zibaeenezhad Mohammad Javad , Shojaeefard Ehsan , Naseri Arzhang , Mousavi Shahrokh , Sarejloo Shirin , Karimi Mohammadreza , Parsa Nader , Sayadi Mehrab , Razeghian-jahromi Iman , Zibaeenejad Fatemeh , Mohammadi Seyyed Saeed
Published: May 2024

Objective:

This study aims to assess the prevalence of hypertension (HTN) and determine the relationship between HTN and anthropometric indices including fat distribution, body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in Shiraz Heart Study.

Design and method:

Setting: In this cross-sectional study, subjects were enrolled in 25 clinics in Shiraz. I.R. Iran between 2019 and 2021.

Participants: A total number of 7225 individuals were selected, aged between 40 and 70 years of whom 52.3% were female. Among the people living in Shiraz, individuals living far from clinics, cases of mental or physical disabilitiy and documented cardiovascular diseases were excluded.

Primary and secondary outcome measures:

Primary outcome: The association of body composition, WHR, WHtR and BMI with HTN.

Secondary outcome: The sensitivity and specificity of the WHtR for the prediction of HTN.

Results:

A total number of 7225 adults were enrolled. HTN prevalence was 19.3%. Obesity prevalence was estimated to be 28.5%. WHR and lean body mass showed a significant association with HTN (p<0.05). Receiver operating characteristic for WHtR yielded an area under the curve of 0.62 (95% CI 0.61 to 0.64) and 0.63 (95% CI 0.62 to 0.65) for males and females, respectively. The optimal threshold value yielded 0.54 in men and 0.61 in women. The sensitivity was 72.3% and 73.9% in women and men, with specificity of 48.4% and 44.3%, respectively.

Conclusions:

HTN had a meaningful association with all the noted anthropometric indices. WHtR performed well as a predictor of HTN.
PRECLINICAL VASCULAR ORGAN DAMAGE AND VASCULAR AGEING ASSESMENT IN NON-ALCOHOLIC FATTY LIVER DISEASE AND METABOLIC ASSOCIATED FATTY LIVER DISEASE PATIENTS
Authors: Barbato Vincenzo , Grillo Andrea , Rosson Marco , Pierro Giuliano Di , Zorat Francesca , Comar Consuelo , Fabris Bruno , Bernardi Stella , Puato Massimo
Published: May 2024

Objective:

Non-alcoholic fatty liver disease (NAFLD) and metabolic associated fatty liver disease (MAFLD) are a growing health problem, with a growing prevalence due to its association with metabolic syndrome and diabetes. It is known to be a risk factor for the development of cirrhosis and hepatocarcinoma, but it is also known to be an important cardiovascular risk factor. The aim of this study is to assess the burden of preclinical vascular organ damage.

Design and method:

The study enrolled 80 consecutive patients (mean age 63.3±15.0) who underwent hepatological evaluation in our department, with evaluation of liver fibrosis score (APRI score, FIB-4) and liver stiffness, and quantification of cardiovascular risk according to Guidelines (2021 ESC Guidelines on cardiovascular disease prevention in clinical practice). Carotid atherosclerotic burden was evaluated by B-mode ultrasound in each segment (common, bulb, internal), bilaterally, and expressed as mean of maximum IMT (M-MAX), right common carotid artery distensibility and stiffness (CardioVascular Suite 4, Quipu, Italy). Aortic stiffness was evaluated as carotid-femoral pulse wave velocity (PWV), measured by applanation tonometry (PulsePen DiaTecne, Italy), with calculation of vascular ageing.

Results:

We found no significant correlation between ultrasound or tonometry parameters and liver stiffness and fibrosis scores. VPWV was significantly above upper limit of normal of 10 m/s (11.6±6.0 m/s, p=0.02), and the percentiles for age were significantly higher than 50th (61.7±25.1, p<0.001), with 52,5% of patients showing increased PWV. Similarly, M-MAX was higher than the upper normality level of 0.9 mm (1.09±0.30 mm, p<0.001). 70% of patients had an increased M-MAX. Vascular age based on arterial stiffness resulted significantly higher than biological age (mean difference 4.6 years, p<0.001). 76.2% (71/80) of the overall cohort and 45,2% (14/31) of patients classified as low risk showed at least one type of vascular organ damage.

Conclusions:

Patients with NAFLD or MAFLD showed a large prevalence of arterial stiffening and increased IMT and an enhanced vascular ageing, even among those classified at low cardiovascular risk according to Guidelines. Vascular organ damage evaluation could be useful to identify preclinical organ damage in these patients
ASSESSMENT OF CARDIOVASCULAR RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS ACCORDING TO CURRENT HYPERTENSION GUIDELINES
Authors: Anyfanti Panagiota , Xanthopoulou Maria , Nousiou Christina , Angeloudi Elena , Lazaridis Antonios , Michaillou Olga , Dimitroulas Theodoros , Kotsis Vasileios , Gkaliagkousi Eugenia
Published: May 2024

Objective:

Patients with rheumatoid arthritis (RA) are at increased risk of cardiovascular disease (CVD) by as much as 50% compared to the general population. Considering that disease-specific calculators have failed to provide more accurate CVD risk stratification in RA, CVD risk calculation in RA patients is challenging, especially for those who are not by definition at high risk based on concomitant established CVD or its equivalents. The presence of an immune-mediated inflammatory disease (e.g., RA) has been considered as a CVD risk modifier by the previous 2018 European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines. Nevertheless, current 2023 ESH/ESC guidelines recommend assessment in RA using general CVD risk calculators.

Design and method:

We aimed to calculate CVD risk in RA patients using the most frequently applied CVD risk calculators in the general population. We only stratified patients free from established CVD (heart disease, stroke) or its equivalents (diabetes mellitus, chronic kidney disease) aged 40-74 years. The following algorithms were applied: (i) SCORE2 (Systemic Coronary Risk Estimation-2), (ii) Framingham Risk Score-Adult Treatment Panel (FRS-ATP) CVD risk calculator, and (iii) the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Equation. We further correlated the estimated CVD risk by each algorithm with surrogate CVD markers, i.e. arterial stiffness and carotid atherosclerosis. For this purpose, carotid-femoral pulse wave velocity (cfPWV) was measured using applanation tonometry (Sphygmocor ®), and carotid intima-media thickness (cIMT) was estimated using carotid ultrasound.

Results:

A total of 91 patients aged 60.3±8.1 years were included (78% females). Using the FRS-ATP algorithm, more patients were classified as high risk and fewer as low risk compared to the other calculators (Table 1). Moreover, CVD risk calculated with FRS-ATP correlated stronger with both cfPWV and cIMT, compared to CVD risk calculated with the other algorithms (Table 2).

Conclusions:

In RA patients without established CVD, diabetes, or chronic kidney disease, the FRS-ATP algorithm may be applied as a useful tool for CVD risk stratification. Prospective, large-scale studies are warranted to determine the most reliable CVD risk prediction model for patients with RA.
FEATURES OF LIPID METABOLISM DISORDERS IN INDIVIDUALS WITH GENETIC PREDISPOSITION TO ARTERIAL HYPERTENSION AND PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION
Authors: Kuzminova Nataliia , Ivankova Anastasiia , Stanislavchuk Mykola , Romanova Valentyna , Shapoval Iryna , Kulchytska Olena , Bilovol Oleksandr , Kniazkova Iryna
Published: May 2024

Objective:

To determine the peculiarities of lipid metabolism indicators’ changes in healthy individuals with a genetic predisposition to arterial hypertension (AH) and patients with essential arterial hypertension (EAH).

Design and method:

231 patients with second stage of EAH (105 men and 126 women; average age was 52.3±1.2 years) were examined. The duration of EAH was 9.7±0.45 years. 121 of them had a concomitant stable coronary artery disease (CAD). The control group included 30 healthy people of similar age and gender. A comparison group consisted of 23 healthy individuals with a AH family history. Additionally to lipid spectrum, levels of lipoprotein (a) (Lp(a)), apolipoprotein B100 (apoB100) and apolipoprotein A-1 (apoA-1) were determined. Statistical calculations were performed using Statistica for Windows 10.0.

Results:

Patients with genetic predisposition to AH had similar to indicators in patients with II EAH stage proatherogenic changes in lipid fractions. Their Lp(a) levels increased to 29.9 (24.5; 32.1) mg/dl, which is 67.0% higher than the levels in the control group (p=0.0005). Levels of apolipoproteins (apoB100 and apoA1) in the serum of healthy persons with AH predisposition did not differ from the control group. Patients with stage II EAH showed an increase in proatherogenic fractions of lipoproteins, apoB100, Lp(a), and a decrease in high-density lipoprotein cholesterol (HDL-C) and apoA-1 compared to control (p<0.0001). Analysis of lipid indicators in patients with concomitant CAD compared to patients without CAD revealed no significant differences between these two groups, except of increasing in the Lp(a) level by 24.4% (p<0.05). A significant positive correlations were found between the Lp(a) level with both the sum of scores on the SCORE scale and the CAD presence (r=0.25 and r=0.35, p=0.002), respectively.

Conclusions:

The lipid metabolism disorders in people with determinism for AH begin even before an increase in blood pressure and are genetically determined. The addition of hypertension contributes to the further progression of lipid metabolism disorders. The obtained data indicate the high prognostic significance of Lp(a) in patients with EAH in the development and establishment of both hypertension itself and CAD and increasing of patients’ cardiovascular risk.
COMPARISON OF SALINE INFUSION TEST AND CAPTOPRIL CHALLENGE TEST IN THE DIAGNOSIS OF PRIMARY ALDOSTERONISM IN DIFFERENT AGE GROUPS
Authors: Sun Kaiwen , Gong Minghui , Yu Yang , Yang Minghui , Zhang Ying , Jiang Yinong , Song Wei
Published: May 2024

Objective:

To explore the diagnostic accuracy and the optimal cut-off value between the saline infusion test (SIT) and captopril challenge test (CCT) (including the value and suppression of plasma aldosterone concentration (PAC)) for PA diagnosing.

Design and method:

A total of 318 patients with hypertension were consecutive enrolled including 126 patients with PA and 192 patients with essential hypertension (EH). The characteristics of patients and laboratory examinations were collected and compared. The comparison between SIT and CCT was carried by drawing receiver operator characteristic curve (ROC) and calculating area under the curve (AUC) to explore the diagnostic accuracy and the optimal cut-off value.

Results:

The average age was 51.59±10.43 in PA group and 45.72±12.44 in EA group (P<0.05). The optimal cut-off value was 10.7 ng/dl for post-CCT PAC, 6.8 ng/dl for post-SIT PAC and 26.9% for suppression of post-CCT PAC. The diagnostic value of post-CCT PAC was the highest with 0.831 for the AUC and 0.552 for the Youden index. The optimal cut-off value for patients who were less than 50 years old was 11.5 ng/dl for post-CCT PAC and 8.4 ng/dl for post-SIT PAC. The suppression of post-CCT PAC turned to 18.2% for those of 50 years old or more than 50 years old.

Conclusions:

Compared with SIT, CCT presented a higher diagnostic value when post-CCT PAC was used as the diagnostic criteria among Chinese people, while the selection of diagnostic thresholds depended on patients at different age stages.
IMPACT OF ACCESSORY RENAL ARTERIES ON HYPERTENSION IN YOUNG PATIENTS
Authors: Rushid Mesut , Kisheva Antonia , Yotov Yoto , Galabov Tsanko
Published: May 2024

Objective:

To determine whether there is a correlation between hypertension, accessory renal arteries, and levels of renin and aldosterone.

Design and method:

From March 2023 to December 2023, 11 young patients (9 males and 2 females) between 22-41 years were hospitalized with suspected secondary arterial hypertension (AH). Prior to hospitalization, all underwent standard pre-analytical medication preparation with cessation of hormone affecting medications and transferred to alternative treatment. For all patients, a computer tomography was conducted following a renal angiography protocol for the presence of adrenal glands formations and the presence of accessory renal arteries. In parallel with the imaging study, laboratory analyses for renin/aldosterone, metanephrine, and normetanephrine were done. ECG, echocardiography and 24-hour monitoring of arterial blood pressure were performed.

Results:

In 10 (91%) of the examined patients, accessory renal arteries were identified - 2 (20%) on the right with two accessory renal arteries; 4 (40%) on the left, and the remaining 4 (40%) had bilateral accessory renal arteries. One patient exhibited an accessory artery in conjunction with Nutcracker Syndrome, and another patient with a combination of a hormonally inactive adenoma of the right adrenal gland. The average blood pressure during 24-hour monitoring was 165/96±12/8 mmHg. Echocardiography revealed initial left ventricular hypertrophy in 50% of the examined patients, with a trend towards reduced relaxation.

Overall, 8 patients had abnormal renin/aldosterone abnormalities - 7 (64%) in the group with accessory renal arteries (ARA), and 1 (9%) in the group without ARA where primary hyperaldosteronism was diagnosed. In the ARA, 6 had elevated levels of both renin and aldosterone. In 1 case in ARA group, only renin was elevated. Metanephrine and normetanephrine levels were within normal limits in all cases.

Conclusions:

We find relatively high rate of the presence of ARA, which may be regarded as an etiological entity. Elevated levels of renin and aldosterone were detected in a significant subset of the patients. Hypertensive patients with ARA may develop early severe damage of target organs.
COMPARATIVE CHARACTERIZATION OF PLASMATIC FATTY ACIDS PROFILES IN PATIENTS WITH PRIMARY ALDOSTERONISM AND ESSENTIAL HYPERTENSION
Authors: Mango Gabriele , Castagna Annalisa , Pattini Patrizia , Spizzo Marianna , Martinelli Nicola , Begali Francesca , Spillere Carlotta , Olivieri Oliviero , Friso Simonetta , Pizzolo Francesca
Published: May 2024

Objective:

Fatty acids (FAs) represent a wide class of lipids performing a variety of functions in living organisms.

FA plasma concentration is greatly related to dietary intake. FA levels have been proven to be useful biomarkers for the prediction of cardiovascular disease (CVD) development and progression, due to their capability to mediate endothelial disfunction. As one of the major CVD risk factors, hypertension can also be affected by FA concentration. In particular, hypertensive patients with primary aldosteronism (PA) are characterized by a higher incidence of cardiovascular complications and endothelial dysfunction than patients with essential hypertension (EH). Aims of the study were: 1) analyze FA plasma levels in hypertensive subjects, focusing on the comparison between patients affected by PA and EH; 2) evaluate possible correlations between FA and other biochemical parameter in order to better characterize the pathophysiological mechanisms involved in the disease.

Design and method:

PA and EH patients were enrolled, and biochemical parameters were collected. Plasma FAs were extracted through a direct transesterification reaction and separated using gas chromatography. Peak identification and quantification were performed with commercially available reference FAs, using heptadecanoic acid (17:0) as the internal standard. FA levels were presented as percentages of total FAs.

Results:

Significant differences in the FA plasma levels were detected between PA patients and EH patients, for palmitoleic acid (POA) and for non-esterified fatty acids (NEFAs). Lower POA and higher NEFAs percentage were found in APA (n=22) compared to EH subjects (n=101) (POA 1.67 [95%CI, 1.37, 2.49] vs 2.62 [95%CI, 1.88, 3.11] respectively, P<0.01, and NEFAs 92.89 ± 1.65 vs 91.77 ± 1.44 respectively, P<0.01).

Conclusions:

This study provides insights into the possible role of fatty acids in the physiopathology of primary aldosteronism. Hypertensive patients with APA compared to EH were characterized by higher concentrations of NEFAs (a category of fatty acids previously associated with a detrimental effect by promoting endothelial dysfunction, oxidative stress, and vascular cell growth) and lower POA.

Further analyses are required to better characterize the precise cellular mechanisms in which these fatty acids are involved.
BIBLIOMETRIC ANALYSIS OF VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTOR TYROSINE KINASE INHIBITORS ASSOCIATED WITH HYPERTENSION, 2013 - 2023
Authors: Li Jiaxin , Ma Jie , Su Quanbin , Shi Futian , Yu Jing
Published: May 2024

Objective:

To conduct a bibliometric and visualization analysis of the literature on the association of VEGFR-TKIs with hypertension, to provide a reference for clinical identification of current research hotspots and for conducting relevant studies in the future.

Design and method:

In this bibliometric study, we used Excel, VOSviewer and Citespace software to describe the literature on VEGFR-TKIs and hypertension with more than 60 citations from 2013 to 2023, then visualized and analyzed the countries, authors, journals and keywords involved in the literature.

Results:

A total of 132 highly cited publications were retrieved, and the types of VEGFR-TKIs involved more frequently included lenvatinib (23, 15.4%), sorafenib (22, 14.8%), and axitinib (15,10.1%), and a comparison of the prevalence of hypertension in each study revealed that the probability of hypertension was higher for lenvatinib (21%-73%), followed by axitinib (17%-49%), and sorafenib (5%-34%); the United States dominated the field during the study period, France and China were also important contributors to this category; Professors Masatoshi Kudo, Toni K. Choueiri, Brian Rini, Robert J. Motzer, and Shukui Qin were the the most productive researchers; among the journals, and  are journals dedicated to oncology, which published more relevant articles; keyword analysis showed that hypertension appeared earlier as a keyword in the last decade, survival analysis and combination of drugs appeared later as keywords, where the analysis of outbreak words showed that the year of survival outbreak was in 2016-2017, indicating that there were more survival analysis studies in this field in these two years.

Conclusions:

VEGFR-TKIs and hypertension related topics have formed several more stable author collaboration groups, combination medication is a hotspot of VEGFR-TKIs treatment research, and the related studies have also gradually increased in recent years, which may guide the future direction of research, and will also help clinics to better understand VEGFR-TKIs and hypertension.
ASSOCIATION OF ARTERIAL STIFFNESS WITH CARDIORENAL INJURY IN CHINESE PATIENTS WITH NEWLY-CONFIRMED PRIMARY ALDOSTERONISM: A CROSS-SECTION STUDY
Authors: Zenglei Zhang
Published: May 2024

Objective:

Although the significant associations between arterial stiffness and target organ damage (TOD) have been established in essential hypertension, the evidence on the relationship in newly diagnosed primary aldosteronism (PA) are still limited. The present study aimed to investigate the association of arterial stiffness and TOD in Chinese newly confirmed PA patients.

Design and method:

Included were 823 newly diagnosed PA patients receiving the extremity blood pressure monitoring from January 2016 to December 2021 at the Fuwai Hospital. Spearman correlation analysis was performed to assess the correlation of vascular stiffing parameters with left ventricular mass index (LVMI), estimated glomerular filtration rate (eGFR) and 24 h urinary albumin to creatinine ratio (UACR). The least absolute shrinkage and selection operator (LASSO) regression model were conducted to select the potential influencing factors, and the univariate and multivariate logistic analysis were used to identify the potential risk factors.

Results:

The mean age of included patients (female 43.4%) was 51.24 years, and the proportion of TOD was 78.13% (643/823). Compared with PA patients without TOD, those with TOD were older in age, had higher systolic blood pressure, diastolic blood pressure, brachial-ankle pulse wave velocity (BaPWV), UACR and LVMI, and lower eGFR. BaPWV was positively correlated with LVMI (r=0.20, P<0.001) and UACR (r=0.27, P<0.001) but inversely correlated with eGFR (r=0.29,P<0.001). Multivariate adjusted logistic analysis suggested that BaPWV was markedly associated with TOD (odds ratio [OR] =1.134; 95% confidence interval [CI]: 1.055-1.220; P=0.001), left ventricular hypertrophy (LVH) (OR=1.069, 95%CI: 1.011-1.131; P=0.019) and renal injury (OR=1.100, 95%CI: 1.039-1.165; P=0.001).

Conclusions:

BaPWV was significantly associated with TOD, LVH and renal injury in Chinese newly confirmed PA patients. The present study emphasized the important role of BaPWV in early recognition of TOD in newly confirmed PA patients, which may improve the clinical outcomes via early intervention.
EXPLORATION OF SCREENING FOR PRIMARY ALDOSTERONISM BY IMMUNOHISTOCHEMISTRY IN PATIENTS WITH ADRENAL SURGERY IN CHINESE
Authors: Yu Yang , Gong Minghui , Zhang Ying , Jiang Yinong , Gao Xue , Yang Deyong , Song Wei
Published: May 2024

Objective:

Primary aldosteronism (PA) is common secondary hypertension, however, the screening rate for PA is not entirely satisfactory. This study aimed to use immunohistochemical staining for retrospective analysis of screening for PA in patients with adrenal surgery in Chinese to improve the screening rate of PA.

Design and method:

A total of 101 patients who were diagnosed with adrenal tumors and treated with adrenalectomy were collected. Immunohistochemical staining for anti-CYP11B1 and anti-CYP11B2 monoclonal antibodies was performed on postoperative specimens. Analysis of staining results according to the expert consensus on the histopathology of PA.

Results:

Of the 101 patients included, 25 (24.75%) patients had completed secondary hypertension screening before surgery. Of the remaining 76 (75.25%) patients, immunohistochemical staining was identified in 13 patients (12.87%) with PA and 4 patients (3.96%) with autonomous secretion of cortisol. Only APM or MAPM was seen in 42 patients (41.58%). APM and MAPM were used as a potential diagnostic basis leading to PA, and functional lesions were observed in postoperative pathology in 83.17% of patients. Still, 16.83% of patients did not show clear functional histopathology on pathological staining. The overall incidence of APM and MAPM was 64.36%. Increased prevalence of APM and MAPM in patients older than or equal to 50 years old compared to patients younger than 50 years old (67.14% versus. 58.06%) and in female patients compared to males (77.78% versus. 42.11%). There without a significant difference between different ages (χ2 = 0.772, P = 0.380) but there was a significant difference between genders (χ2 = 13.149, P < 0.001).

Conclusions:

The screening rate of PA before adrenalectomy was less than 1/4. More than 40% of patients had pathologically confirmed APM or MAPM without systematic PA screening. Meanwhile, 16.83% of patients undergoing adrenal surgery had no clear functional histopathological manifestations. The problem of inadequate screening for PA still exists. Immunohistochemistry by anti-CYP11B1 and anti-CYP11B2 monoclonal antibodies is an important tool in the pathological diagnosis of PA and will help identify potential autonomous secretion of aldosterone and guide improved screening for PA.
CLINICAL CHARACTERISTICS OF PATIENTS WITH FIBROMUSCULAR DYSPLASIA WITH AND WITHOUT ANEURYSMS IN THE ARCADIA-POL STUDY
Authors: Talarowska Paulina , Kolodziejczyk-kruk Sylwia , Szwench-pietrasz Elzbieta , Florczak Elzbieta , Kadziela Jacek , Michalowska Ilona , Michalowska Anna , Sterlinski Ignacy , Januszewicz Andrzej , Persu Alexandre , Januszewicz Magdalena
Published: May 2024

Objective:

Fibromuscular dysplasia (FMD) is idiopathic, segmental, non-inflammatory, non- atherosclerotic disease affecting small and medium-sized arteries. FMD causes artery stenosis, although it may also lead to aneurysm, dissection or arterial tortuosity. The aim of the study was to evaluate prevalence and clinical characteristics of patients with FMD and aneurysms.

Design and method:

The ARCADIA-Pol is an ongoing study, initiated in 2015 at the Department of Hypertension, National Institute of Cardiology in Warsaw, Poland. Patients enrolled in the study met the inclusion criteria: presence or suspicion of FMD and/or radiologically documented episode of spontaneous dissection of any artery. Each patient underwent: clinical and 24h ambulatory blood pressure monitoring, biochemical tests, echocardiography, US Doppler of renal and carotid arteries and whole body angio-CT. We present data of 435 currently enrolled patients.

Results:

Among 435 patients enrolled to the analysis FMD was confirmed in 281 patients. Out of 281 FMD patients, aneurysms were found in 32.7% subjects, most often in renal (14.6%), intracranial (11.7%) and splenic (10.7%) arteries. In every fourth patient with FMD the presence of aneurysm was detected during evaluation in the study. Most important 72.9% patients with newly diagnosed aneurysm were qualified to interventional treatment. In FMD patients with aneurysm mean age was 52.3±12.0 years, most patients were women (91.3%). In this group prevalence of HT was 85.9%, hyperlipidemia 47.8%, history of smoking 26.1% and history of contraceptive pills use among women 20.7%. Patients with FMD and aneurysm were significantly older as compared to groups of patients without aneurysms and included a significantly higher percentage of female as compared to other groups of patients. Women with FMD and aneurysm had more often history of contraceptive pills use than women without FMD.

Conclusions:

Aneurysms are relatively often found among patients with FMD (32.7%), most often in renal, cerebrovascular and splenic arteries. Radiological screening performed in ARCADIA-Pol study enabled to detect aneurysms in each fourth patient with FMD enrolled to the program, of which 72.9% were qualified to interventional treatment of aneurysm.
CENTRAL BLOOD PRESSURE AND VASCULAR RESPONSES TO DIFFERENT PHYSICAL EXERCISE INTENSITIES IN NORMAL AND HIGH-NORMAL BLOOD PRESSURE AS A TOOL TO IDENTIFY EARLY VASCULAR DAMAGE
Authors: Rodrigues Sara , Verardino Renata , Costa Marcel , Bortolotto Luiz
Published: May 2024

Objective:

To evaluate acute changes in arterial distensibility and central pressure by high-intensity interval physical exercise (HIIPE) compared to moderate intensity continuous physical exercise (MICPE) sessions in subjects with normal and high-normal blood pressure (BP).

Design and method:

A randomized two-period crossover trial with 29 subjects (48±7years, 76%female, BMI=28.3±4.3kg/m2) divided into two groups according to Normal BP (120-129 and/or 80-84 mmHg) or HighNormal BP (130-139 and 85-89 mmHg) levels. They underwent either MICPE-HIIPE or HIIPE-MICPE sequences. Exercise intensity was defined according to the cardiopulmonary exercise test. The measures included aortic pulse wave velocity (PWV) and applanation tonometry (Sphygmocor®) changes at baseline, immediately, and 24 hours after each physical exercise session.

Results:

In HighNormal BP group, PWV was significantly lower 24h after MICPE compared to baseline (7.49 ±0.95 vs 8.20± 0.64 m/s; p=0.022). Aortic SBP was significantly lower immediately after HIIPE than baseline and 24h after MICPE (113 ± 8; 124±9 and 121±9; p < 0.05). Comparison between groups, aortic SBP was higher in HighNormal BP at baseline and immediately after MICPE compared to Normal BP (124 ±9 and 122 ±17 vs 114± 9 and 110 ±8; respectively p=0.012).

Conclusions:

In subjects with normal and high-normal BP, vascular distensibility response to exercise is more dependent on basal levels of stiffness and more sensitive to the stimulus of MICPE; however, changes in aortic BP are more dependent on basal BP levels and more sensitive to high-intensity stimuli.
CENTRAL AORTIC PRESSURE (CAP) MEASURED IN THE OFFICE WITH SPHYGMOCOR AND DURING 24 HOURS (MOBIL-O-GRAPH AND ARTERIOGRAPH) AND HYPERTENSION MEDIATED ORGAN DAMAGE (HMOD) IN YOUNG PAT
Authors: Prelevic Vladimir , Jelakovic Ana , Gasparovic Kristina , Bazadona Danira , Radunovic Danilo , Josipovic Josipa , Jelakovic Bojan
Published: May 2024

Objective:

Central aortic pressure (CAP) is a parameter of central hemodynamics. It can be measured in the office with SphygmoCor, and during 24-hours with Mobil-O-Graph and Arteriograph. Debate is going on whether CAP is more associated with HMOD than brachial blood pressure. The aim of our study is to analyse assocation of office CAP and 24-hour CAP with HMOD in patients with stage 1 hypertension.

Design and method:

This study included 154 patients with the primary hypertension (69.5% women, mean age 38.5). In all of them we collected various clincial data and antroplogical paramaters. CAP was measured in the office (SphygmoCor) and during regular working days (24h ABPM systems: Mobil-o-Graph and Arteriograph).

Results:

The increased office CAP was associated with five indicators of HMOD: decrease in eGFR, increase in 24 hours albuminuria, thickness of the intima and carotid media (cIMT), NT pro-BNP, left ventricular hypertrophy- ECG Cornell criteria (LVH). Elevated 24-hour (Mobi-O-Graph) systolic CAP was associated with increased cITM and decreased EF. Higher values of diastolic CAP (Mobi-O-Graph) were accompanied by a greater possibility of LVH. An increase in 24 hours systolic CAP (Arteriograph) was followed with an increase in the cITM. An increase in 24 hours diastolic CAP(Arteriograph) was followed with a decrease in eGFR.

Conclusions:

CAP could be considered as a indicator of HMOD and total cardiovascular risk especially in young patients, but large longitudinal studies are need in order to confirm this.

CAP measured with SphymoCor can be considered a better predictor of HMOD compared to CAP measured over 24 hours. Further investigation is needed to determine clinical value of both office and 24 hours CAP.