bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P017: Association Of Secondhand Smoke Exposure With Hypertension Among Non-smoking Stroke-free Africans
Authors: Okekunle Akinkunmi , Asowata Osahon , Akpa Onoja , Fakunle Adekunle , SARFO FRED S , Akpalu Albert , Obiako Reginald , Wahab Kolawole , Osaigbovo Godwin , Owolabi Lukman , Komolafe Morenikeji , Akinyemi Rufus O , Ovbiagele Bruce , Owolabi Mayowa
Published: September 2022

Background:
Secondhand smoking (SHS) is the exposure to smoke arising from a burning cigarette or exhaled by a smoker. It is a significant public health problem worldwide and whether it is associated with hypertension, particularly among Africans, is yet to be clearly understood. This study evaluated the relationship between SHS and hypertension among stroke-free adults who are non-smokers in the Stroke Investigation Research and Educational Network (SIREN) study.

Methods:
We identified 3905 adults (≥18years who had never smoked) in the SIREN study conducted in Ghana and Nigeria. Participants reported a history of SHS exposure in an indoor environment. Hypertension was defined as one of the following conditions; mean SBP≥140mmHg, DBP≥90mmHg or use of antihypertensive medications. Logistic regression was used to estimate the multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) for hypertension by SHS exposure at a two-sided
P
<0.05.

Results:
Overall, mean age was 55.8±14.9years, 18.2% (712 of 3905) had SHS exposure, with a higher proportion among males 20.0% (360 of 1803) than females 16.7% (352 of 2102). SHS was associated with higher odds of having hypertension in the overall population; OR: 1.2 (95%CI: 1.0, 1.5) among females; OR: 1.6 (95%CI: 1.2, 2.1), but not among males; OR: 0.9 (95%CI: 0.7, 1.2).

Conclusion:
SHS was associated with higher odds of hypertension, particularly among females in this sample. The viability of public interventions in mitigating the potential effect of SHS cannot be underestimated in managing the hypertension burden among Africans, pending longitudinal studies to establish causal associations between SHS and hypertension.
Abstract P019: Clinical Impact Of A 3 Versus 5-minute Delay On Automated Office Blood Pressure Measurement
Authors: Lynn-Green Erika , Ishak Anthony , Cluett Jennifer , Turkson-Ocran Ruth-Alma N , Anderson Timothy , Mukamal Ken J , Cohen Marc L , Li Jonathan , Juraschek Stephen P
Published: September 2022

Background:
Recent studies suggest that a reduced delay during automated office blood pressure (AOBP) measurement may be as accurate as a 5-minute delay. The clinical impact of this change compared to gold-standard assessments (i.e. 24-hour ambulatory BP monitoring, ABPM) has not been reported.

Objective:
To compare the impact of a 3- vs 5-minute delay on AOBP and its relation with average awake-time ABPM.

Methods:
Patients referred to a single hypertension (HTN) center had BP measurements with ABPM and one of two non-randomized, unattended AOBP protocols. Half of patients underwent AOBP with a 5-minute delay; the other half underwent AOBP with a 3-minute delay. All measurements were compared to the average awake-time ABPM. HTN was defined as SBP≥140 or DBP≥90 mmHg. We used linear regression adjusted for age, sex, and race to assess whether the 3-minute protocol was associated with a difference between mean AOBP and average awake-time ABPM.

Results:
Among 100 participants (mean age 59.7±15.5 years, 58% women, 26% Black), the average awake-time BP was 132.6±14.8/77.4±11 for the 5-minute protocol and 134.4±17/78.2±11 for the 3-minute protocol. HTN misclassification between groups based on awake-ABPM was similar (14% for 5- versus 12% for 3-minute delay, p=0.51). Compared to 5-minute delay, 3-minute delay was not associated with a significant difference between mean AOBP and mean awake-time ABPM for SBP (2.3 mm Hg; 95% CI: -3.7, 8.2) or DBP (1.2 mm Hg; 95% CI: -2.5, 4.8).

Conclusion:
Measuring AOBP with a 3-minute delay did not result in statistically different accuracy compared with average awake-time ABPM. However, this finding should be confirmed in a larger, clinic-based sample.
Abstract P021: Degree Of Risk Factor Control And Incident Cardiovascular Diseases In Patients With Hypertension
Authors: Kou Minghao , Wang Xuan , Ma Hao , Li Xiang , Heianza Yoriko , Qi Lu
Published: September 2022

Introduction:
Hypertensive patients have a higher risk of cardiovascular complications than non-hypertensive individuals.

Hypothesis:
We assessed the hypothesis that the joint risk factor control could attenuate hypertension-related excess risk of cardiovascular diseases (CVD) in hypertensive patients.

Methods:
We included 100368 participants with diagnosed hypertension from the UK Biobank, and matched them with 256875 controls, from 2006 to 2021. Hypertensive patients were categorized by the number of risk factors that met the recommended guideline: smoking, blood pressure, albuminuria, and low-density lipoprotein cholesterol. The Cox proportional hazards models were used to estimate associations between the degree of risk factor control and the risk of CVD.

Results:
Among hypertensive patients, each additional risk factor control was related to 14 to 21% lower risks of CVD events; and the group with optimal risk factor control was associated with the lowest risk (HR [95%CI], 0.59 [0.55-0.63] for CVD, 0.63 [0.58-0.69] for coronary heart disease, 0.43 [0.36-0.50] for stroke, and 0.53 [0.46-0.60] for heart failure). The hypertension-related excess risks of stroke and heart failure in those with optimal risk factor control were diminished to be not different from non-hypertensive controls. The protective associations of joint risk factor control and risks of CVD events were stronger among men than women (p for interaction < 0.001).

Conclusions:
Among hypertensive patients, the degree of risk factor control is inversely associated with risks of CVD events and optimal risk factor control may considerably attenuate or eliminate the hypertension-related excess risk.
Abstract P034: Increased Toll-Like Receptor 4 In Perirenal Adipose Tissue Is Associated With Elevated Systolic Blood Pressure In Obese Mice
Authors: Pita Marichelle Renee , Maddie Nicole , Carrillo-Sepulveda Maria Alicia
Published: September 2022

Obesity is a major risk factor for the development of vascular dysfunction and hypertension. According to the Framingham Heart Study, obesity accounts for 70% of cases of primary hypertension. Emerging evidence suggests that perirenal adipose tissue (PRAT) is linked to cardiovascular complications in obesity. Whether PRAT is linked with blood pressure regulation in obesity remains unknown. We hypothesize that, in obesity, PRAT expands and activates local Toll-like receptor 4 (TLR4), a key factor of the immune system, in association with increased systolic blood pressure (SBP). Eight-week-old male and female C57BL6 mice were randomized into two experimental groups. The control group (n=10) received a standard chow diet (5% fat, 48.7% carbohydrates [3.2% sucrose]) and the obese group (n=10) received a Western Diet (WD) (40% fat, 43% carbohydrates [34% sucrose]) for 38 weeks. Central obesity was confirmed by increased body weight (Females: 34.88 ± 2.71 g vs. 22.86 ± 0.68 g controls, p<0.001; Males: 45.39 ± 1.98 g vs. 29.21 ± 0.79 g controls, p<0.0001), BMI (Females: 0.37 ± 0.01 kg/m2 vs. 0.27 ± 0.01 kg/m2 controls, p<0.0001; Males: 0.45 ± 0.02 kg/m2 vs. 0.32 ± 0.01 kg/m2 controls, p<0.001), and waist circumference (Females: 8.95 ± 0.44 cm vs. 7.65 ± 0.17 cm controls, p<0.05; Males: 10.79 ± 0.25 cm vs. 8.70 ± 0.16 cm controls, p<0.0001). Significant increase in PRAT weight was detected in the WD groups (Females: 11.78 ± 1.79 mg/g vs. 3.19 ± 0.31 mg/g controls, p<0.05; Males: 17.42 ± 2.34 mg/g vs. 2.92 ± 0.43 mg/g controls, p<0.001). By using radiotelemetry system, we found that SBP was significantly increased in the WD male group in the light cycle (125.12 ± 2.11 mmHg vs. 115.19 ± 2.19 mmHg controls, p<0.05) and dark cycle (132.42 ± 1.72 mmHg vs. 123.13 ± 1.67 mmHg controls, p<0.05). Strikingly, TLR4 expression in PRAT from male obese mice was significantly increased (2.1 fold of increase, p<0.05). In conclusion, our results show that obese male mice exhibit expanded PRAT with increased TLR4 expression in association with elevated SBP, suggesting a local inflammation in PRAT potentially contributing to disturbance of renal mechanisms of blood pressure regulation.
Abstract P036: The Association Of CD4:CD8 Ratio With Cardiometabolic Risk Factors In People With HIV
Authors: Inestroza Karla L , Hurtado Vanessa , Larson Michaela , Severdija Ryan , Satish Sanjana , Ebner Bertrand , Vincent Louis , Grant Jelani , Powell Alexis , Hurwitz Barry E , Boulanger Catherine , Jayaweera Dushyantha , Martinez Claudia
Published: September 2022

Background:
In People with HIV (PWH) with virologic suppression, the CD4:CD8 ratio inversely correlates with immune senescence response. The association between CD4:CD8 ratio and cardiovascular (CV) risk in PWH remains unclear.

Methods:
A retrospective chart review was performed of patients who received HIV care at the University of Miami/Jackson Memorial Hospital between 2017-2019 with available CD4: CD8 ratio (n=1,137). We stratified patients according to the CD4:CD8 ratio ≥1 or <1, and compared available data.

Results:
The prevalence of CD4:CD8 ratio <1 was 69.5%. A ratio <1 was associated with male gender (57.1% vs 45.8%, p<0.001), lower body mass index (28.29 vs 29.80 kg/m2, p=0.001), lower HDL cholesterol (Chol) (47.57 vs. 53.25 mg/dL, p<0.001), higher total Chol/HDL (4.22 vs. 3.8, p=0.001), higher CRP levels (4.94 vs. 2.61 mg/L, and less statin use (25% vs 35.3%, p<0.001), p=0.02) compared to those with a ratio ≥1. Those with a CD4:CD8 ratio <1 were more likely to have a detectable viral load (35.9% vs. 14.6%. p<0.001), have been on antiretroviral therapy for <6 months (4% vs 1.5%, p=0.27), to be current smokers (27.6% vs. 16.5%, p<0.001), current drug users (9.7% vs 5.5%, p=0.025), and had higher rates of atrial fibrillation/flutter (1.9% vs 0%, p=0.008) than those with a ratio ≥1.

Conclusion:
Patients with an inverted CD4:CD8 ratio had higher total Chol/HDL levels, which has been associated with a higher risk of CV disease. Statin use in this high-risk population was lower despite having more CV risk factors and atrial fibrillation/flutter. Further studies are needed to determine the usefulness of the CD4:CD8 ratio as a marker of immune activation and predictor of CV risk in PWH.
Abstract P038: Tissue-specific Regulation Of Ceramide
De Novo
Biosynthesis In Type 1 Diabetes. Role Of Metformin
Authors: Manzo Onorina L , Sasset Linda , Rubinelli Luisa , Vellecco Valentina , Bucci Mariarosaria , Di Lorenzo Annarita
Published: September 2022

Endothelial cell (EC) dysfunction precedes the onset of cardiovascular diseases (CVD), main complications of diabetes. Sphingolipids (SL) are essential components of cell membranes and bioactive lipids regulating different cellular functions in health and diseases. Dysregulation of SL, such as ceramides (Cer) accrual, has been implicated in diabetes and CVD, although specific mechanisms remain poorly understood. Whereas Cer accrual impairs endothelial nitric oxide synthase (eNOS) activity, low ceramides disrupt endothelial signal transduction and vascular tone regulation. To date, how Cer changes in diabetic EC
in vivo
is unknown. Metformin (Met), first-line therapy for diabetes, was shown to lower Cer in liver and muscle in mice. This study investigates the role of sphingolipid metabolism in diabetes and whether Met directly regulates this pathway.We discovered that Met can directly downregulate serine palmitoyltransferase activity, catalyzing the first step of the
de novo
biosynthesis of SL, thus refraining Cer from accrual. To assess this effect
in vivo
, we used non-obese diabetic mice, a model of type 1 diabetes, and nondiabetic mice as control. Diabetic mice were treated with Met (300mg/Kg/d) or vehicle for 5 weeks. Diabetic mesenteric arteries showed an impaired vasodilation to acetylcholine and exaggerated response to vasoconstrictors. Met treatment significantly improved endothelial function, by restoring acetylcholine-vasodilation and increasing phosphorylation of vasodilator stimulated phosphoprotein, index of eNOS-cGMP signaling. Interestingly, whereas Cer and sphingomyelins (SM) increased in the heart and liver, they were significantly decreased in myocardial EC, suggesting that in diabetes SL are differentially regulated. Met refrained Cer/SM from accrual in the heart and liver, while further decreased Cer/SM in EC. In conclusions, Met prevents Cer accrual in the heart and liver, thus limiting its deleterious effects. Contrary to the current believe, Cer are suppressed in diabetic EC
in vivo
, and might contribute to the progression of dysfunction. Most likely, Met downregulation of sphingolipid
de novo
biosynthesis, already suppressed in diabetic EC, does not underlie beneficial effects of Met on the endothelium.
Abstract P041: Spontaneous Coronary Artery Dissection In A Patient With Polycystic Ovary Syndrome
Authors: Nway Nway , Arora Amita , Tun Myo Myint , Mainali Arjun , Aryal Binit , KC Nabin , Chen Victor , Dufresne Alix
Published: September 2022

Introduction:
Women with Polycystic Ovary Syndrome (PCOS) have classic risk factors for cardiovascular disease such as obesity, hypertension, hypercholesterolemia, insulin resistance, and metabolic syndrome. Studies have demonstrated that they have increased markers of cardiovascular disease, including endothelial dysfunction, coronary artery calcification, and increased arterial stiffness leading to myocardial infarction, angina, stroke, and rarely coronary artery dissection. We present a case of a young female with PCOS without any other major classic cardiovascular risk factors except hypertension who presented with chest pain, later found to have myocardial infarction due to dissection of the right coronary artery.

Case:
A 33year old female presented with lightheadedness and intermittent dull mid-sternal chest pain. It became progressively worse in 5-6 hours. Past medical history was relevant for hypertension, insulin resistance, PCOS, and overweight. She was noncompliant with her medications. Family history was significant for hypertension, diabetes, coronary artery disease, and negative for any connective tissue disorders. Electrocardiogram showed ST-T elevation in leads II, III, and aVF and depression in leads I and aVL. Troponin level was significantly high at 0.378 ng/ml. Dual antiplatelet therapy was initiated. The patient underwent an emergency cardiac catheterization that revealed focal 85% flow limiting dissection in the proximal right coronary artery with a long 35% lesion in the mid right coronary artery and 40% focal lesion in the right posterior descending artery. Percutaneous intervention with a drug-eluting stent was placed successfully. She was discharged later with dual antiplatelet therapy, beta-blocker, angiotensin receptor blocker, and statin.

Conclusion:
Spontaneous coronary artery dissection in young females is usually associated with hormonal therapy or in the postpartum state. However, our case report highlights that physicians should have a high index of suspicion for spontaneous coronary artery dissection in a young female with PCOS.
Abstract P043: Preeclampsia Superimposed On Chronic Hypertension: Evidence For A Hormone-mediated, Lasting Effect On Antihypertensive Needs
Authors: Hesson Ashley , Plazyo Olesya , Gudjonsson Johann , Langen Elizabeth , Ganesh Santhi
Published: September 2022

Objective:
To characterize clinical and molecular differences between chronic hypertension (HTN), preeclampsia superimposed on chronic hypertension (SI), and isolated pregnancy induced hypertension (PIH).

Methods:
Individuals with HTN, SI, or PIH who had a livebirth between 2017 and 2020 were identified in an obstetric biorepository. Medical histories were reviewed. Paraffin-embedded placental samples (N=36; N
HTN
=13, N
SI
=7, N
PIH
=16) were submitted for bulk RNA sequencing along with matched non-hypertensive controls (N=12). Differential gene expression was assessed for the HTN, SI, and PIH samples relative to the controls; transcripts with significant differences (P
adj
<0.05) underwent Gene Ontology analysis.

Results:
Chronic hypertension was present in 28.6% (N=40/140) of the sample; 37.5% (N=15/40) developed SI. Those with SI were more likely to require additional peripartum antihypertensive therapy than with those with PIH (P<0.01). They also had lower rates of antihypertensive down-titration or discontinuation at 6 weeks postpartum (P=0.01). Placental samples demonstrated a hormone-mediated mechanism for these differences with gonadotropin secretion and regulation differences in the transcriptomic signature of SI. Growth factors and mediators of placental development were differentially expressed in HTN and PIH (Figure 1).

Conclusion:
SI has longer-lasting effects on hypertension trajectory than PIH. Placentally mediated differences in sex hormone dysregulation may underlie clinical differences in antihypertensive needs.

Figure 1
Gene ontology results with Bonferroni-corrected significance threshold.
Abstract P047: The Protective Effect Of The D2R Against Inflammation Is Dependent On Sex And The Presence Of Hormones In Human Renal Proximal Tubule Cells.
Authors: Moore Shaun , Alves Soares Vaz de Castro Pedro , Polzin Jacob , Jose Pedro A , Armando Ines
Published: September 2022

The renal inflammatory response is regulated by the dopamine receptor D2 (D2R) and its function is impaired in the presence of
DRD2
gene variants rs6276/rs6277 (SNPs). Recent reports suggest that sex plays a role in the inflammatory response. We hypothesized that sex and sex hormones affect the D2R-mediated renal inflammatory response. We studied human renal proximal tubule cells (hRPTCs) genotyped for the presence or absence of SNPs. Four cell lines were studied: 2 from female (F) or male (M) subjects not bearing SNPs (wild type [WT]) and 2 from female or male subjects bearing SNPs. We measured mRNA and protein expression of D2R, markers of inflammation (TNF-α, TGF- β1), markers of fibrosis (FN1), injury (Kim-1), and cell proliferation (Ki-67). D2R expression was highest in FWT than in FSNPs, MWT or MSNPs (P<0.02; n=3/group). By contrast TNF-α, TGF- β1, FN1, Kim-1, and Ki-67 expressions were highest in MSNPs than in any of the other group (P<0.05). To assess the effect of the presence of hormones in fetal bovine serum (FBS), we cultured the cell lines in media containing charcoal stripped FBS for 24 h. In the absence of hormones, D2R expression was even higher in FWT (P<0.05), indicating that hormones inhibit the expression of the receptor; there were no significant differences in the other groups, suggesting that the decreased D2R expression due to the presence of SNPs is not hormone-related. The expressions of TNF-α, TGF- β1, and Kim-1 were higher (P<0.05) in MSNPS than in the other groups indicating that either the decreased D2R expression or the presence of hormones per se inhibits the expression of these factors. The expression of Ki-67, however, was decreased in all groups in the absence of hormones (P<0.05), indicating that hormones are necessary for cell proliferation. These results show not only that even in
in vitro
experiments cells derived from males have a greater response of proinflammatory factors than cells derived from females but also that in hRPTCs the presence of the D2R SNPs imparts an inflammatory phenotype, and that this impairment is dependent on sex and presence of hormones.
Abstract P048: Western Diet Consumption Exacerbates Hypertension In Hyperandrogenemic Female Rat, A Model Of Polycystic Ovary Syndrome.
Authors: Quin Ruth M , Davenport Kacey , Shawky Noha M
Published: September 2022

Background:
Polycystic ovary syndrome (
PCOS
) is the most common endocrinopathy affecting women of reproductive age. It is characterized by hyperandrogenemia, increased blood pressure (
BP
) and metabolic dysfunction. Consumption of western diet (
WD
) aggravates the reproductive and metabolic phenotypes of PCOS. Yet, the effect of WD consumption on BP in PCOS women is not clear. Therefore, this study was undertaken to test the hypothesis that WD consumption in hyperandrogenemic female (
HAF
) rats (a model that mimics most of PCOS symptoms) increases BP along with increasing renal expression of the vasoconstrictor (
VC
) components of the renin-angiotensin system (
RAS
).

Methods:
At 4 wks of age, female Sprague Dawley rats were implanted (s.c.) with either 5α-dihydrotestosterone pellets (7.5 mg/90 d; HAF rats) or placebo pellets (controls;
CON)
, that were replaced throughout life. At 4 wks of age, HAF and CON rats were also started on WD (high fat and high sucrose content) or control diet (
CD
), thus forming 4 groups; CON-CD, CON-WD, HAF-CD and HAF-WD. At 20 wks of age, rats were implanted with radiotelemetry transmitters in the abdominal aorta to measure mean arterial pressure (
MAP
) [n=4-5/group]. Another set of rats (n=3-6/group) were euthanized and kidneys collected for measurement of components of the RAS by western blot.

Results:
are shown in
Table 1
.

Conclusion:
WD consumption in HAF results in further increases in BP, despite upregulation of components of the intrarenal vasodilator RAS (ACE2 and AT2R), which is likely a protective mechanism. Future studies will determine the role(s) of other major VC pathways (e.g. endothelin system) in hypertension in WD-fed HAFs.
Abstract P058: Endothelial Dysfunction And Increased Contractility In Resistance Arteries Occurs Prior To Onset Of Hypertension In Schlager (BPH/2J) Mice
Authors: Pernomian Laena , Waigi Emily , McCarthy Cam , Wenceslau Camilla F
Published: September 2022

Genetically hypertensive mice (BPH/2J) were developed by Gunther Schlager more than 45 years ago, and these mice have neurogenic hypertension. Seven-weeks-old male BPH/2J mice present elevations in systolic blood pressure (SBP), and its highest value is observed in 20-weeks-old mice. Several studies have showed vascular dysfunction in these mice, but no one has demonstrated whether resistance artery dysfunction is present prior to the elevation in SBP. We hypothesized that hypercontractility and endothelial dysfunction is associated with the cause of hypertension in BPH/2J mice. We evaluated mesenteric resistance arteries (MRA) function from 5-weeks-old male BPH/2J and 9-weeks-old normotensive mice (BPN/3J), prior to the elevation of SBP. Intact-endothelium MRA were mounted in wire myographs. KCl-induced contraction (120 mM), or phenylephrine (PE) and acetylcholine (ACh) cummulative concentration curves were performed. Non-linear curve regressions were performed and maximum response (Rmax) was analyzed by Student
t
test (
p
<0.05). BPH/2J mice presented increased KCl contraction (BPH/2J: 6.47±0.51 vs. BPN/3J: 2.95±0.13 mN/mm, n=4,
p
<0.05) and PE-induced contraction (Rmax: BPH/2J: 6.25±0.54 vs. BPN/3J: 4.23±0.28 mN/mm, n=4,
p
<0.05). ACh-dependent relaxation was decreased in BPH/2J (Rmax: BPH/2J: 76±5, n=4 vs. BPN/3J: 93±2%, n=3,
p
<0.05). ACh promoted contraction at high concentrations (>0.3 μM) in BPH/2J mice but not BPN/3J mice (Fig.1), suggesting increased cyclooxygenase-induced inflammation. These data reveal that vascular dysfunction contributes to the cause of hypertension in Schlager mice.
Abstract P060: Chronic Gout And Hypertension: A Nationwide Analysis Of Patient Demographics
Authors: Amoateng Richard , Ahmed Ibrahim , Gadani Mrudula
Published: September 2022

Introduction:
Hypertension (HTN) contributes significantly to cardiovascular disease (CVD) and chronic gout (CG) is associated with HTN. Our aim is to characterize patient demographics of patients with HTN and CG.

Methods:
This was a retrospective cohort study using the National Inpatient Sample, Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality to identify admissions in adults with principal and secondary diagnoses of HTN and CG in 2019. Multivariate linear and logistic regression models were adjusted for age, gender, race, household income, insurance status, Elixhauser comorbidity score, hospital location, and bed size. Primary outcome was all-cause mortality, and secondary outcomes were length of stay (LOS) and total charge in USD.

Results:
Out of 9,582,450 hospital admissions with HTN, 17,710 had a diagnosis of CG. Mean age of 67.5 ± 0.23 years in the CG-HTN group compared to 65.74 ± 0.06 years (p<0.001). Compared to the non-CG-HTN group, there were more males in the CG-HTN group (75% vs 48%, p<0.001). CG-HTN was more common in Asian and Pacific Islanders. Alcohol abuse, arthropathies, leukemia, dementia, peripheral vascular disease, obesity, and complicated diabetes was associated with the CG-HTN group. Compared to non-CG-HTN, CG-HTN cohort had lower all-cause mortality rate (1.13% vs 1.69%, p<0.05), mean LOS of 4.85 vs 4.65 days (0.10 days OR, 95%CI -0.07-0.27, p=0.255), and lower total hospitalization charge -$6,424.47 (95% CI -$9,230.47- -$3,618.47, p<0.001).

Conclusion:
Chronic gout in the presence of hypertensive disease was associated lower all-cause mortality and hospitalization cost.
Abstract P065: Standing Echocardiogram For Orthostatic Hypotension: A Feasibility Study
Authors: Castilla-Ojo Noelle , Wood Julia , Turkson-Ocran Ruth-Alma N , Mukamal Ken J , Matos Jason D , Manning Warren J , Strom Jordan B , Baptista Carla , Kolaci Gabrielle , Picanzo Araina , Juraschek Stephen P
Published: September 2022

Background:
Orthostatic hypotension (OH) is associated with cardiovascular disease, particularly in older adults. While standing transthoracic echocardiography (TTE) could identify changes in cardiac output to diagnose OH, no established protocols exist, and its feasibility is unknown.

Objective:
Determine the feasibility of standing TTE on adults in the outpatient setting.

Methods:
We recruited 72 adults scheduled for elective TTE. Consenting participants underwent recumbent TTE, followed by a focused standing TTE within 1-2 minutes of standing. The focused standing TTE used apical windows to measure left ventricular outflow tract velocity time integral, subsequently used to determine stroke volume and cardiac output. Standing blood pressure and heart rate were taken concurrently, and patients were monitored for symptoms.

Results:
Of the 72 enrolled participants, 60 (over 80%) completed the standing TTE. Mean age was 63 years (49% were ≥70 years), 49% were women, 42% had a BMI ≥30 kg/m
2
, and 18% had OH. The average duration of the study in the standing position was 127 seconds. Doppler quality was good-to-excellent in 87% of all our completing participants, 54% in those ≥70 years, and 86% in those with obesity. Only 5% of the participants experienced discomfort, and 9% experienced dizziness. There was no significant association between standing blood pressure and standing cardiac output.

Conclusions:
Standing focused TTE is safe, well-tolerated, and feasible in the ambulatory setting. While this clinical assessment is promising for identifying cardiogenic OH, further work is needed in larger at-risk cohorts to determine its clinical utility.
Abstract P066: Short-term Outcomes Of Hypertensive Crises In Patients With Orthostatic Hypotension.
Authors: Elzanaty Ahmed M , Royfman Rachel , Maraey Ahmed , Saeyeldin Ayman , Meenakshisundaram CHANDRAMOHAN , Khalil Mahmoud , Aboulnour Hassan , Grubb Blair P
Published: September 2022

Introduction:
Current recommendations in management of supine hypertension-orthostatic hypotension disease (SH-OH) are mainly derived from outpatient studies with the aim of controlling SH while minimizing OH symptoms rather than targeting a specific standing blood pressure value. Data on short term outcomes of patients with OH who are hospitalized with hypertensive (HTN) crises is lacking.

Methods:
The Nationwide Readmission Database 2016-2019 was queried for all hospitalizations of HTN crises. Hospitalizations were stratified according to whether OH was present or not. We employed propensity score to match hospitalizations for patients with OH to those without, at 1:1 ratio. Outcomes evaluated were 30-days readmission with HTN crises or falls, as well as hospital outcomes of in-hospital mortality, acute kidney injury (AKI), acute congestive heart failure (CHF), acute coronary syndrome (ACS), type 2 myocardial infarction (T2MI), aortic dissection, stroke, length of stay (LOS), discharge to nursing home and hospitalization costs.

Results:
We included a total of 9,451 hospitalization (4,735 in the OH group vs 4,716 in the control group). OH group was more likely to be readmitted with falls (Odds ratio [OR]:3.27, p<0.01) but not with HTN crises(p=0.05). Both groups had similar likelihood of developing AKI (p=0.08), stroke/TIA (p=p=0.52), and aortic dissection(p=0.66). Alternatively, OH group were less likely to develop acute CHF (OR:0.54, p<0.01) or ACS (OR:0.39,p<0.01) in the setting of HTN crises than non-OH group. OH group were more likely to have longer LOS and have higher hospitalization costs.

Conclusion:
Patients with OH who are admitted with HTN crises tend to have similar or lower HTN-related complications to non-OH group while having higher likelihood of readmission with falls, LOS and hospitalization costs. Further randomized studies are needed to confirm such findings
Abstract P069: Vegetable Consumption And Hypertension Among 16,445 Africans
Authors: Okekunle Akinkunmi , Akpa Onoja , Asowata Osahon , Chikowore Tinashe , Mohamed Shukri , SARFO FRED S , Akinyemi Rufus O , Akpalu Albert , Wahab Kolawole , Obiako Reginald , Komolafe Morenikeji , Owolabi Lukman , Osaigbovo Godwin , Ogbole Godwin , Tiwari Hemant K , Akinyemi Joshua , Fakunle Adekunle , Uvere Ezinne , Adeoye Abiodun , Lackland Daniel T , Arnett Donna K , Ovbiagele Bruce , Ramsay Michèle , Owolabi Mayowa
Published: September 2022

Background:
The association of vegetable consumption with hypertension remains poorly described in sub-Saharan Africa. This study assessed the relationship between vegetable consumption and hypertension among indigenous Africans.

Methods:
We harmonized data on the frequency of vegetable consumption (servings/week) and hypertension (defined as systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90mmHg or previous diagnosis or use of antihypertensive medications) from 16,445 participants across five African countries (Ghana, Burkina Faso, Kenya, Nigeria and South Africa) from the SIREN and AWI-Gen studies. Using the recommendation of at least five servings/day (35 servings/week) adapted from the World Health Organization recommendations, and vegetable consumption was classified as 'inadequate' (<35 servings/week) or 'adequate' (≥35 servings/week). The odds ratio (OR) and 95% confidence interval (CI) for hypertension risk was estimated for adequate vegetable consumption using multivariable-adjusted logistic regressions at a two-sided
P
<0.05.

Results:
The mean age of participants was 53.0±10.7years, 45.9% (7,552 of 16,445) were males, and 42.9% (7,070 of 16,445) were hypertensives. Adequate vegetable consumption was associated with lower odds of hypertension; OR: 0.86 (95%CI: 0.76, 0.97). The sex-stratified odds was; OR: 0.87 (95%CI: 0.73, 1.02) for females and 0.84 (95%CI: 0.71, 1.00) for males.

Conclusion:
These findings provide new evidence for promoting regular vegetable consumption in the guidelines for the primary prevention of hypertension among Africans.
Abstract P072: Prostaglandin I
2
(PGI
2
) Signaling Attenuates Hypertension And Associated Vascular Inflammation
Authors: Norlander Allison E , Zhang Jian , Abney Masako , Peebles Stokes
Published: September 2022

In recent years, inflammation was determined to play a causal role in hypertension. Interestingly, evidence suggests that long-lasting use of cyclooxygenase inhibitors, which prevent metabolism of arachidonic acid (AA) to prostaglandins and thromboxane, increases blood pressure. Prostaglandin I
2
(PGI
2
) is an AA metabolite that has immunomodulatory effects. Our group has demonstrated that PGI
2
acts to directly inhibit the functionality of pro-inflammatory DCs and CD4+ Th1 and Th2 cells, while promoting the function of tolerogenic DCs and T regulatory cells (Treg). Further, mice deficient in the receptor for PGI
2
, IP, develop elevated blood pressure in response to high salt diet, suggesting that PGI
2
signaling is important for controlling blood pressure elevation in response to stimuli. These studies led us to hypothesize that PGI
2
signaling attenuates hypertension and associated vascular inflammation. We found that infusion of the PGI
2
analog, treprostinil (TPL), into mice resulted in blunted blood pressure following 4 weeks of angiotensin II (Ang II) infusion (490ng/kg/min) compared to mice that received Ang II and TPL vehicle (42.8 mmHg reduction, p<0.05). Concomitantly, TPL prevented Ang II-induced vascular infiltration of CD3+ T cells (0.98 x10
3
compared to 2.04x10
3
cells/aorta, p<0.05) and CD11c+MHCII+ cells (0.59 x10
3
compared to 1.95x10
3
cells/aorta, p<0.0001). Further, IP deficient mice (IP KO) had elevated blood pressure compared to wild-type (WT) mice in response to low dose Ang II (150ng/kg/mg) (19.9 mmHg elevation, p<0.05). IP KO mice also had increased infiltration of vascular CD3+ T cells (2.42x10
3
compared to 1.36x10
3
cells/aorta p<0.05) and a trend toward increased CD11c+MHCII+ cells compared to WT mice. These studies demonstrate that understanding the mechanisms through which PGI
2
augments the immune response associated with hypertension may shed new insight into potential therapeutics.
Abstract P073: Long-term Augmentation Of Acetylcholine Bioavailability Halts The Progression Of Lupus Hypertension
Authors: Gusson Shimoura Caroline , Young-Stubbs Cassandra M , Chaudhari Sarika , Dinh Viet Q , Mathis Keisa W
Published: September 2022

Renal inflammation promotes hypertension in systemic lupus erythematosus (SLE). Our recent studies suggest that renal inflammation is regulated by the vagally-mediated cholinergic anti-inflammatory pathway, and that vagal tone is reduced in SLE mice. We found that augmenting central bioavailability of acetylcholine via the acetylcholinesterase inhibitor, galantamine, increases vagal tone and reduces renal inflammation and mean arterial pressure (MAP) in SLE mice after two weeks. However, the long-term efficacy and therapeutic potential of galantamine are unknown. Thus, we hypothesized that chronic galantamine administration would effectively halt the progression of SLE hypertension and renal injury. Starting at 20 weeks of age, female SLE (
NZBWF1
) and control (
NZW
) mice received galantamine hydrobromide (3 mg/kg/day, SQ) or vehicle continuously for 16 weeks via osmotic minipump. At 35 weeks, mice were placed in metabolic cages for urine collection, carotid catheters were implanted to assess MAP in conscious mice, and tissues were harvested. MAP (mmHg, n=4-6) was higher in SLE mice than controls (161.9±9.9 vs. 128.3±0.9, p=0.001) and long-term galantamine treatment prevented further increases in MAP in SLE mice (161.9±9.9 vs. 138.3±4.9, p= 0.01). Survival rate was lower in SLE mice compared to controls (50% vs. 100%) and galantamine improved survival to 70% in SLE mice. Eighty percent (4 of 5) of SLE mice had urinary albumin over 300 mg/dL and chronic galantamine lowered the prevalence to 57% (4 of 7); no controls had albuminuria. There was no difference in CD3+CD4+ T cells amongst groups, but the percentage of renal CD3+CD8+ T cells was increased in SLE mice compared to controls (29.7±2.2 vs. 12.8±0.79, p<0.0001, n=4-7) and galantamine reduced this percentage in SLE mice (29.7±2.2 vs. 22.9±1.2, p=0.0261). Taken together, our data indicate chronic augmentation of central acetylcholine bioavailability is protective against SLE hypertension since it improves survival rate, decreases renal injury and alters cytotoxic renal immune cell populations. These data further support acetylcholinesterase inhibition as a novel therapeutic option for hypertension associated with autoimmunity.
Abstract P076: Obesity Is Associated With Increased F2-isoprostanes And Il-6 In Black Women.
Authors: Saleem Mohammad , Mehr Pouya E , Milne Ginger , Kastner Paul D , Shibao Cyndya A , Kirabo Annet
Published: September 2022

Obesity affects over 40% of the adult population and is a major risk factor for morbidity and mortality due to cardiovascular disease. Black women have one of the highest prevalence of obesity in the United States and approximately 80% are overweight or obese with increased insulin resistance, hypertension, and cardiovascular events. We previously found that isolevuglandins formed in the F2-isoprostane pathway of free radical–mediated lipid peroxidation contributes to IL-6 production in dendritic cells leading to inflammation and hypertension. Thus, we hypothesized that F2-isoprostanes contribute to increased inflammation and IL-6 production among obese Black women. We recruited 88 Black women of age 42.0±9.8 years, weight 102±16 kg, body mass index (BMI) 37.68±5.08, systolic blood pressure 124±14 mmHg, diastolic blood pressure 76.2±9.9 mmHg, and insulin 15.0±8.7 uU/ml. We measured plasma F2-isoprostane levels using gas chromatography/negative ion chemical ionization mass spectrometry (GC/NICI-MS) at the Eicosanoid Core at Vanderbilt University Medical Center. We also measured plasma cytokines including TNF-α 68±174, IL-1β 135±372, IL-6 1615±2769, IL-8 3536±1901, and IL-10 324±633 pg/mL. Using Pearson’s correlation analysis, we found that increased BMI correlated with increased plasma F2-isoprostane levels (Fig. 1A, R=0.23, p=0.037). Interestingly among all the inflammatory cytokines, elevated IL-6 correlated with increased F2-isoprostanes (Fig. 1B, R= 0.44, p=.0025). These results suggest that F2-isoprostanes may contribute to the obesity-induced cardiovascular risk in Black women by increasing production of inflammatory cytokine IL-6.
Abstract P077: Targeting Neutrophilia Is A Therapeutic Strategy To Regulate Blood Pressure
Authors: Saha Piu , Mell Blair , Mei Xue , Golonka Rachel , Chakraborty Saroj , Yeoh Beng San , Joe Bina , Vijay-Kumar Matam
Published: September 2022

Neutrophils are important innate immune cells that are relatively understudied for their contributions to blood pressure (BP) regulation. As neutrophilia is a clinical marker for various pathologies, we hypothesized that neutrophilia is also a feature of hypertension and curtailing neutrophilia is beneficial for lowering BP. Peripheral neutrophil levels were quantitated in Dahl salt-sensitive (S) and Dahl salt-resistant (R) rats consuming either a low salt (0.3% NaCl) or high salt (2% NaCl) diet. Compared to R rats, S rats on a low-salt diet already exhibited neutrophilia (% neutrophils, 33.51±1.6 vs. 39.74±1.2, p<0.05). Introducing a high salt diet further potentiated the neutrophilia in S rats prone to salt-induced hypertension (% neutrophils, 48.21±0.6, p<0.05). These data suggest that neutrophilia is pro-hypertensive. To determine the possible mechanism for the pro-hypertensive effects of neutrophils, we investigated two major functions of neutrophils
i.e.,
generation of reactive oxygen species (ROS) and neutrophil extracellular traps (NETs, web-like structures of expelled neutrophil DNA). Peripheral neutrophils stimulated with either PMA or LPS showed a ~ 3-fold induction of ROS and NETs, respectively, in S rats compared to R rats on a low-salt diet. Introducing a high-salt diet increased ROS and NETs (~2-fold), the extent of elevation being higher in S rats. Impressively, treatment of S rats on a high-salt diet with 1,3-butandiol [(β
-
hydroxybutyrate (βOHB, a ketone body) precursor] in the drinking water (20% v/v, 4 weeks) significantly lowered neutrophilia (vehicle: 1.74±0.5 vs βOHB: 0.73±0.3 x 10
9
cells/l, p<0.05) in tandem with their decreased BP (vehicle: 161.2±9.3 vs βOHB: 138.3±4.5 mmHg systolic BP, p<0.05). Interestingly, βOHB intervention also reduced neutrophil levels in R rats (vehicle: 1.15±0.5 vs βOHB: 0.95±0.5 x 10
9
cells/l),
albeit
to a lesser degree than S rats. Importantly, βOHB administration to S and R rats also reduced NETs and ROS (~2-fold), predominantly in S rats. Collectively, our data are the first to demonstrate that an exaggerated innate immune response via neutrophilia is pathological in hypertension, whereby curbing the neutrophilic response (
e.g.,
βOHB) could present therapeutic potential in lowering BP.
Abstract P078: Excess Risk Of Hypertension Among Black Adults And The Mediating Effects Of Leptin: The Reasons For Geographic And Racial Differences In Stroke (REGARDS) Cohort Study
Authors: Sherman Sarah E , Stoutenburg Eric , Long Leann , Juraschek Stephen P , Cushman Mary , Howard Virginia J , Tracy Russell P , Judd Suzanne E , Kamin Mukaz Debora , Zakai Neil , Plante Tim B
Published: September 2022

Background:
Leptin is a hypertension-related adipokine. We previously found leptin to associate with greater risk of incident hypertension in non-obese adults. Relative to White adults, Black adults have higher circulating leptin concentration. As such, leptin may be a mediator of the excess burden of incident hypertension among Black adults.

Methods:
REGARDS recruited 30,239 Black or White adults aged ≥45 years from 48 US states. Leptin was measured from baseline samples among 4,400 participants who attended 2 visits 9 years apart. Modified Poisson regression estimated the relative risk (RR) of incident hypertension (≥140/90 mmHg or use of antihypertensives) of Black relative to White adults, adjusting for risk factors. Inverse odds ratio weighting estimated the % mediation by leptin of the excess hypertension RR among Black relative to White participants in 1,000 bootstrapped samples.

Results:
In 1,834 participants without prevalent hypertension (mean age 62, 56% women, 25% Black adults), incident hypertension developed in 47% of Black & 32% of White participants. The
Table
presents the RR for incident hypertension among Black relative to White adults. In the crude model, Black adults had a 52% greater risk of incident hypertension and leptin mediated 20% of this disparity. Similar associations were seen when adjusting for demographics, behaviors, and diseases. After adjusting for measures of adiposity, leptin no longer mediated the disparity.

Conclusions:
Leptin mediated approximately 20% of the Black-White disparity in hypertension incidence in crude and some adjusted models. These data support that this mediation acts through adiposity.
Abstract P080: Il-18 Potentiates Contractile Responses To Phenylephrine And Inhibits Relaxation Responses To Acetylcholine In Resistance Arteries From Wistar Rats
Authors: Arishe Olufunke O , Wilczynski Stephanie , Priviero Fernanda , Webb R Clinton
Published: September 2022

Background:
The etiology of essential hypertension remains unclear, and its mechanisms are complex. Indeed, low-grade inflammation and activation of the immune system have been implicated in hypertension. Clinical and population studies have consistently found increased circulating levels of interleukin 18 (IL-18) in patients with hypertension.

Hypothesis:
This study tests the hypothesis that IL-18 will enhance contractile responses to phenylephrine and impair relaxation responses to acetylcholine in isolated arterial rings from rats.

Methods:
Vascular function was performed on isolated pudendal arteries from male Wistar rats using wire myographs, kept in Krebs solution at 37°C, constantly aerated with 95%O
2
/5%CO
2
. Concentration-response curves to phenylephrine (PE; 10
-9
-3x10
-5
M), and acetylcholine (ACh; 10
-9
- 3x10
-5
M) were performed in the absence or in the presence of IL-18 (20ng/ml) for 1 hour and 6 hours respectively. Ten minutes prior to the incubation with IL-18, some arterial rings were incubated separately with the mitogen-activated protein kinase (MKK / MEK) inhibitor, PD98059 (10
-5
M). Concentration-response curves were analyzed using non-linear regression analysis. Data are presented as mean ± S.E.M. Statistical significance set at p<0.05. Data analyzed with GraphPad Prism 9.2.0.

Results:
In the pudendal arterial rings, the potency of PE was increased in the presence of IL-18 (pEC
50
6.510 ± 0.3987 vs 6.022 ± 0.2738 for control; p = 0.0268), Incubation with IL-18 plus PD98059 restored the contraction to PE to control levels. (pEC
50
6.105 ± 0.4007 vs 6.170 ± 0.2847 for control; p = 0.7120). Relaxation responses to Ach were impaired by incubation with IL-18 for 6 hours (pEC
50
5.942 ± 0.1575 vs 7.341 ± 0.1796 for control; p=0.0042)

Conclusion:
Our results show that IL-18 enhances the contractile responses to PE in pudendal arteries from Wistar rats by activation of the mitogen-activated protein kinase/extracellular signal-regulated kinase pathway. Thus, IL-18 may contribute to the increased vascular resistance characteristic of hypertension.
Abstract P085: Sex Differences In Cardiovascular Measurements And Inflammatory Markers At Peak Influenza Infection In Mice
Authors: Martin Brigitte E , Taylor Erin , Attipoe Esinam , Showmaker Kurt C , Garrett Michael R
Published: September 2022

For better infectious disease surveillance, there is a growing interest in the detection of subtle changes in cardiovascular physiology in response to viral infection. This is not only important for earlier diagnosis and better prognosis of symptomatic carriers, but also useful to diagnose asymptomatic carriers of the virus. Previous studies and literature provide strong evidence of an association between inflammatory biomarker levels and changes in both blood pressure (BP) and heart rate (HR). Thus, the identification of novel biomarkers during an inflammatory event could significantly improve predictions for cardiovascular events. We saw changes in cardiovascular physiology can be induced and detected in A/Puerto Rico/8/34 (PR8) influenza infections in female and male C57B6/j mice. Using PA-C10 implanted radio telemeter devices, we were able to track changes in BP, heart rate HR, and activity. Infected females showed reduction in normal physiology for approximately 10 days during infection including loss of diurnal rhythm and reduced activity starting at about 3 dpi for HR and 4 dpi for activity and BP; this continued until about 13 dpi. Males on the other hand had less reduction in physiological measurements for a shorter period compared to females with a reduction starting at 5 dpi for activity, 6 dpi for BP, and 7 dpi for HR until about 12 dpi, 10 dpi, and 9 dpi, respectively. Lastly, we found females and males had different patterns of inflammatory maker expression in lungs at peak infection by analyzing bulk RNA sequencing (RNA-seq) data for lungs and Bio-plex cytokine assay for blood collected from influenza infected (n=6) and naïve (n=6) C57B6/j female and male mice at 7 dpi.