bluuebunny/crossref_metadata_2025 huggingface dataset:
P072 VALIDATION OF A NOVEL METHOD FOR NONINVASIVE ESTIMATION OF CARDIAC OUTPUT USING BRACHIAL OSCILLOMETRIC BLOOD PRESSURE MEASUREMENTS IN PATIENTS WITH VARIOUS CLINICAL CONDITIONS
Authors: Madrid-Muñoz Camilo , Álvarez-Montoya Diego , Fernández-Ruíz Ricardo , Gallo-Villegas Jaime , Aristizábal-Ocampo Dagnovar
Published: September 2024

Background and Objective:

Estimating cardiac output (CO) and other hemodynamic parameters from blood pressure (BP) measurements could aid in selecting appropriate antihypertensive treatments in clinical settings. Our research group has developed a non-invasive method to estimate CO based on total arterial compliance (Ct). However, its validity in populations with various cardio-metabolic chronic diseases remains uncertain. The objective of this study is to assess the validity of our CO estimation method across different patient with varied clinical conditions.

Methods:

A cross-sectional study was conducted involving 217 adult patients who underwent ambulatory transthoracic Doppler echocardiograms, irrespective of valvular or cardiac pathology, or medication use, provided they had normal aortic valvular anatomy. Stroke volume was calculated as the product of the cross-sectional area of the aortic annulus and the average velocity of the left ventricular outflow tract. Simultaneously, oscillometric BP measurements were obtained. Subsequently, the CO values obtained via Doppler echocardiography and those estimated based on Ct were compared to determine validity. Ct was estimated as: Ct/BSA= 38/PPth + 4/5 × Td/T - 3/7, where BSA denotes body surface area, Td signifies diastolic time, T represents the cardiac period, and PPth refers to the theoretical pulse pressure.

Results:

Of the participants, 49.7% were men, with an average age of 54.0±14.0 years. Among them, three had a history of acute myocardial infarction, one had a pacemaker, nineteen were diabetic, and one hundred thirty-six were hypertensive. CO by echocardiography averaged 4.9±1.0 L/min, ranging from 2.0 to 8.5 L/min. The agreement of CO between the new method and Doppler echocardiography was good. Bland-Altman plots showed that the differences between the methods were randomly distributed along the mean difference line (Figure).

Conclusions:

The novel method for noninvasive estimation of CO based on Ct with brachial oscillometric BP measurements in patients with various clinical conditions is deemed valid. Its implementation in clinical practice has the potential to transform patient assessment.
P073 KNOWLEDGE OF HYPERTENSION AND HOME BLOOD PRESSURE MONITORING AMONG HYPERTENSIVE PATIENTS IN INDIA: RESULTS FROM THE GRAND STUDY
Authors: Maheshwari Anuj , Verma Narsingh
Published: September 2024

Background and Objective:

Hypertension remains a significant risk factor for cardiovascular diseases in India, contributing substantially to cardiovascular mortality. Despite the rising prevalence of hypertension, blood pressure control among hypertensive patients remains low, emphasizing the need for improved hypertension management and treatment. Home blood pressure monitoring (HBPM) serves as a vital tool in hypertension management, yet its recognition and utilization in developing countries like India remain limited. This study aimed to assess the knowledge of hypertension and HBPM among hypertensive patients across 18 medical centers in 12 States in India.

Methods:

A survey was conducted among 1,920 hypertensive patients, analyzing the patients’ background, the reasons for home blood pressure (HBP) measurement and non-HBP measurement, and associated factors to knowledge levels of hypertension and HBPM.

Results:

Findings revealed that 47.5% were measuring HBP, with reasons mainly attributed to physicians’ recommendations, while cost and lack of physician guidance were common reasons for non-HBP measurement. High knowledge levels of hypertension and HBPM significantly associated with measuring HBP (OR 16.23; 11.28-23.35, P-value <0.001), however, a significant gap existed in adherence to the optimal guidelines-based procedures of HBPM with only 40.7% following any 2 out of 8 steps to measure HBP.

Conclusions:

These results highlight the necessity for increased physicians’ recommendations of HBP measurement and providing clear instructions for measuring HBP aligned with guideline-based procedures.
P075 IS OFFICE BLOOD PRESSURE MEASUREMENT SUFFICIENT FOR DIAGNOSING HYPERTENSION IN PRIMARY HEALTH CARE?
Authors: Muxeldt Elizabeth , Vasconcellos Clara , Guimarães Luana , Leite Thiago , Westgarth Harrison , Vianna Gabriel , Rezende Pedro Paulo , Neno João , Monteiro Maria Eduarda , Duarte João Felipe , De Souza Thomás , Pecly Inah , Fernandes Ana Cristina
Published: September 2024

Background and Objective:

Recent guidelines have recommended out-of-office blood pressure (BP) measurement to improve the accuracy of the diagnosis of hypertension (HTN) but there are few studies evaluating its use in the scope of primary care. Our objective is to assess the degree of agreement between office BP and HBPM, evaluating their use in a young population assisted in primary care.

Methods:

This is a cross-sectional population study with adults between 20-50 years old registered in the Family Health Strategy. Sociodemographic, anthropometric data and CV risk factors were recorded. Office BP was the mean of 2 measurements and HBPM followed the 7-day protocol. HBPM < 135 x 85 mmHg and office BP < 140 x 90 mmHg were considered normal, identifying the 4 phenotypes: Normotension (controlled office BP and HBPM); white-coat HTN (uncontrolled office BP and controlled HBPM); masked HTN (controlled office BP and uncontrolled HBPM) and sustained HTN (uncontrolled office BP and HBPM).

Results:

475 individuals were included (male sex: 38%; mean age: 37.6 years ± 8.8 years, of which 93 (20%) had their diagnosis modified after HBPM (43 with white-coat and 47 with masked HTN). In multiple logistics regression, male gender (OR 3.87: 95%CI 1.70-8.82) was independently correlated with white-coat HTN, while obesity and prehypertension increased the risk of masked HTN by 2 and 5.5 times, respectively. Uncontrolled office BP has high specificity (89%) and low sensitivity (49%) for detecting sustained HTN, with a low concordance in the diagnosis of HTN (kappa=0.388) Among men with uncontrolled office BP, 55.6% had a diagnosis of white-coat HTN and among women, 37.1%.

Conclusion:

Office BP was not a sufficient measurement to diagnose hypertension. HBPM was a useful procedure in this young and apparently healthy population in primary care, especially in those with uncontrolled office BP to identify white-coat HTN and in those with high normal office BP, especially if they are male or obese for early diagnosis of masked HTN.
P077 IS THERE A DIFFERENCE IN THE ACCURACY OF AUTOMATED BLOOD PRESSURE DEVICES DESIGNED FOR HOME OR IN-CLINIC USE? A SYSTEMATIC REVIEW AND META-ANALYSIS OF VALIDATION STUDIES
Authors: Bothe Tomas , Bui Tan , Bao Yueyang , Chapman Niamh , Sharman James , Picone Dean
Published: September 2024

Background and Objective:

Advances in technology mean that accurate BP measurements can be automatically performed, allowing widescale use of BP measurement at home. Despite these advances, some health professionals and patients question the accuracy of devices that are designated for use at home compared to in-clinic BP devices.

This study sought to determine if there were differences in the accuracy of home BP devices compared with in-clinic BP devices.

Methods:

A systematic review of BP measurement validation studies of automated, upper-arm devices in adults published between 1987-2023. Intended primary use of each device was extracted from the published validation study. A random effects meta-analysis was performed to estimate pooled mean BP differences across validation studies for home BP and in-clinic BP devices, compared to manual BP.

Results:

There were 210 home device, and 77 in-clinic device validation studies that met inclusion criteria. In comparison to manual systolic BP, the mean difference for home device systolic BP was 0.11 mmHg (95% CI: 0.09, 0.13), and the mean difference for in-clinic device systolic BP was 0.18 mmHg (95% CI: 0.16, 0.21). There was no significant difference in the accuracy of home vs. in-clinic systolic BP (p=0.88).

In comparison to manual diastolic BP, the mean difference for home device diastolic BP was 0.15 mmHg (95% CI: 0.13, 0.17), and the mean difference for in-clinic device diastolic BP was -0.93 mmHg (95% CI: -0.96, -0.90). There was a small difference in the accuracy of home vs. in-clinic device diastolic BP (1.08 mmHg, 95%CI: 0.44, 1.72; p<0.01).

Conclusion:

There were no meaningful differences in accuracy between home BP devices and in-clinic BP devices, showing that any validated device will yield accurate BP results if used according to standardized measurement principles.
P078 EVALUATION OF THE FREQUENCY AND GEOGRAPHICAL DISTRIBUTION OF THE USE OF AMBULATORY BLOOD PRESSURE MONITORING IN COLOMBIA
Authors: Herrera Leaño Nancy Muriel , Calvo Betancourt Lauren Sofia , Beltrán España Jesús Andres , Porras Bueno Cristian Orlando , Camargo Abello Andrés Felipe , León Sanabria Nicolas , García Peña Ángel Alberto
Published: September 2024

Background and Objectives:

Hypertension is the main modifiable cardiovascular risk factor. However, 46% of adults with hypertension are unaware of their diagnosis. Ambulatory blood pressure monitoring (ABPM) can be very helpful in the identification of white coat and masked hypertension, offering advantages when compared to in-office measurement. Unfortunately, this method is not available at all levels of care. Particularly in Colombia, there is no information regarding the frequency of use or geographic distribution; however, it's inferred that it's more available in the most developed regions. Therefore, the purpose of this study is to evaluate the frequency of use, geographic distribution, and demographic characteristics of patients who underwent ABPM in Colombia.

Methods:

Cross sectional study, carried out through the review of the SISPRO records of Colombians aged 18 years or older, with indication of performing ABPM between 2019 and 2023.

Results:

405,396 individuals in Colombia underwent ABPM (7.7 ABPMs per 1000 inhabitants per year). 63.1% were females. The departments with the highest number of ABPM studies were Bogotá (71,709 ABPMs – 9.9 ABPMs per 1000 inhabitants per year), followed by Antioquia (45,097 ABPMs - 7.5 ABPMs per 1000 inhabitants per year) (Figure 1). Concerning age groups, the highest number of ABPM requests was between 70 and 74 years (50,103 patients), followed by the 55-59 years group (46,944 patients). 72.25% of the requests were for patients older than 50 years.

Conclusions:

Although Colombia has improved in the implementation and use of ABPM at the national level, its use predominates in women, patients aged between 70 and 74 years, and at the level of the 2 largest cities in the country. Collective efforts are required at national level to improve the implementation and registration of the ABPM.
P080 THE IMPORTANCE OF ADEQUATE BLOOD PRESSURE MEASUREMENT: ERROR IN APPROXIMATION OF THE TREND TO 120/80 MMHG
Authors: Quintero-Baiz Adalberto , Cáceres-Maldonado Sergio , Hernández-Nieto Bryan , Soler-Vanoy Luis , Mercado-Marchena Riguey , Urina-Triana Miguel
Published: September 2024

Background and Objective:

In clinical practice, errors in blood pressure (BP) measurement are all too common carrying significant implications. Accurate BP measurement is vital, yet inaccuracies in recording can skew clinical decisions. This study investigates the widespread practice of documenting BP as 120/80 mmHg, aiming to gauge its prevalence and repercussions within a comprehensive dataset from Colombia.

Methods:

A cross-sectional analysis was conducted using data from Colombia's “High-Cost Account” in the period from 2014 to 2018 on 18,481,259 BP measurements from 4,576,091 patients, the study performed a descriptive examination, centering on the most frequently reported (medians) systolic blood pressure (SBP) and diastolic blood pressure (DBP).

Results:

The findings revealed 120 mmHg (IQR 120-130) as the median SBP and 80 mmHg (IQR 80-70) as the median DBP over the five years. This behavior was maintained consistently in the 5 regions of Colombia, except the systolic median in the Eastern Region.

Conclusions:

The tendency to approach 120/80 mmHg in BP in primary care centers in Colombia suggests a potential for underestimation or overestimation of hypertension control. This highlights the need to enhance BP measurement accuracy for effective hypertension management. Reviewing the correct methodology and using validated electronic devices is crucial to mitigate diagnostic and therapeutic errors, ensuring precise management of this prevalent condition.
P089 RELATION BETWEEN ISOMETRIC STRESS-INDUCED PRESSURE RESPONSE AND P-WAVE OF THE ELECTROCARDIOGRAM
Authors: Rufino Nuñez Harline Raquel , Carmona Puerta Raimundo , Lorenzo Martinez Elizabeth , Gonzalez Katia Hurtado , Batista Yajaira A. Flete , Sanchez Marielys Del Carmen Martinez , Gomez Calderon Jose Bernardo , Peñaló Batista Joel
Published: September 2024

Background and objectives:

The effects of isometric stress-induced vascular hyperreactivity on P wave duration have scarcely been studied. We set out to determine the relationship between isometric stress reactivity and the P wave in young hypertensives.

Materials:

A cross-sectional, prospective study was carried out on the relationship between the duration of the maximum P wave corrected for heart rate (Pmaxc) and the degree of blood pressure reactivity in two groups of 30 young men, who were divided into normotensive and hypertensive patients. The hypertensive patients were of recent clinical diagnosis. Vascular reactivity was measured by the sustained weight test (PPS).

Results:

Diastolic blood pressure variation (ΔPAD) was greater in hypertensives than in normotensives (15.83 mmHg ± 7.321 vs. 10.17 mmHg ± 5.331, p<0.01) after application of the PPS. The ΔPAD correlated positively with Pmaxc in both groups studied, but was only significant in the hypertensive group (r=0.433; p<0.05).

Conclusions:

Increasing levels of isometric stress induced by PPS correlate positively and significantly with Pmaxc.

Figure 1: Correlation between diastolic blood pressure reactivity (ΔPAD) and heart rate correction for peak P wave (Pmaxc) in hypertensives and normotensives
P093 PLASMA PROTEINS PROFILE AND THERAPEUTIC RESPONSIVENESS IN PATIENTS WITH PREECLAMPSIA
Authors: Pinto-Souza Caroline Cristina , Saito Kaihara Julyane Natisumi , Cavecci-Mendonça Bruna , Mastella Moises Henrique , Rossini Bruno César , Cavalli Ricardo Carvalho , Dos Santos Lucilene Delazari , Sandrim Valéria Cristina
Published: September 2024

Preeclampsia (PE) is a hypertensive syndrome of pregnancy, characterized by target organ damage, related to a high incidence of cardiovascular sequelae. PE requires antihypertensive drug therapy, however, about 40% of patients do not respond to this treatment, leading to worse clinical outcomes. Through the proteomic strategy, we 1) compared the profile of circulating proteins expressed in 10 responsive (R-PE) and 10 non-responsive to antihypertensive therapy (NR-PE), besides 10 healthy pregnant (HP); 2) investigated which proteins are differentially expressed between the groups and 3) found out which signaling pathways are altered between them. The study followed the Declaration of Helsinki and was approved by the Research Ethics Committee of the Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP, protocol code CAAE-37738620.0.0000.5440). We performed plasma protein quantification using mass spectrometry, the obtained data underwent bioinformatics analyses based on Uniprot, PatternLab for Proteomics, String and MetaboAnalyst softwares. Considering a fold change of 1.5, three proteins showed as significantly differentially expressed between HP and R-PE, one downregulated (transtyretin) and two upregulated (apolipoprotein C1 and hemoglobin subunit beta). Between HP and NR-PE, there were six, two downregulated (clusterin and plasmin heavy chain A) and four upregulated (apolipoprotein A-IV; heparin cofactor II; complement C4B and haptoglobin related protein). Between R-PE and NR-PE there were four, one downregulated (fibronectin) and three upregulated (pregnancy-specific beta-1-glycoprotein 1 (PSG1); complement C4B (C4B) and complement C4A (C4A). Regarding PE, C4A and C4B intensity peaks were correlated with blood pressure and creatinine levels. Both, together with PSG1, showed significant correlations with the newborn's weight and gestational week (all p< 0.05). These findings help to understand the pathophysiological mechanisms between the two subgroups of the disease, since the under regulated circulating proteins act in the blood pressure modulation and the upregulated may occur as compensatory mechanisms due to an inflammatory scenario. These data give insights to explain the complexity and clinical consequences of this disorder.
P095 LEFT VENTRICULAR DIASTOLIC FUNCTION IN HYPERTENSIVE PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Zhemanyuk Svitlana , Syvolap Vitaliy
Published: September 2024

The aim of this work was to study the prevalence of the left ventricular diastolic dysfunction and indeterminate diastolic function in sinus hypertension individuals with left ventricular hypertrophy and preserved ejection fraction, and its associated factors.

Methods.

We enrolled 56 patients (aged 62, 95% confidence intervals (CI) 58–65 years, 53.6% men) with uncontrolled in-treated arterial hypertension who underwent transthoracic echocardiography (TTE, Esaote, MyLabEight). Cardiac diastolic dysfunction was defined when more than half of the TTE criteria was met according to the existing algorithm (average E/e‘, septal / lateral e‘, tricuspid regurgitation velocity, left atrium volume) and indeterminate one, when half of the criteria was encountered.

A binary logistic regression analysis (Stata 15, USA) was performed to evaluate parameters for indeterminate diastolic function state.

Results.

TTE detected the left ventricular diastolic dysfunction only in 5.4%, however, 80.0% subjects had indeterminate diastolic function. Associated with the indeterminate diastolic function pattern factors were age and mitral regurgitation (odds ratios (OR) 8.0, 95% CI 2.19-29.25, p=0.002 and OR 1.06, 95% CI 1.01-1.12, p=0.014, respectively), however, not sex, height, weight, body mass index, diabetes, overweight/obese, and E/e‘. After adjustment for age, sex (female vs male) mitral regurgitation was occurred significantly more often in patients with indeterminate diastolic function in multivariate logistic regression model (OR 5.97, 95% CI1.47-24.35, p=0.013).

Conclusions.

Prevalence of the left ventricular diastolic dysfunction pattern is low (5.4%) and the indeterminate diastolic function is considerable (80.0%) in cohort of hypertensions with preserved ejection fraction with sinus rhythm. Mitral regurgitation identifies as a factor that associated with the indeterminate diastolic function patterns in hypertension patients.
P096 LEFT VENTRICULAR HYPERTROPHY PATTERNS IN HYPERTENSIVE SUBJECTS WITH CHRONIC KIDNEY DISEASE
Authors: Zhemanyuk Svitlana , Syvolap Vitaliy , Lukashenko Lanna
Published: September 2024

Background and Objective.

A left ventricular (LV) geometric pattern classification based on its concentrically and dilatation has been recommended for clinical practice use. However, there is no clear data demonstrating whether such categorization could improve the diagnostic strategy of adult hypertensives with chronic kidney disease (CKD).

The aim of the study was to analyze LV hypertensive patterns in adult individuals with arterial hypertension and CKD.

Methods.

We studied 56 hypertension in-treated individuals with sinus rhythm (mean age, 62 [95% CI, 58–65] years, 46.4% women) using transthoracic echocardiogram (Esaote, MyLabEight). There were no pregnant women and objects engaged in professional sport. LV geometric patterns classified according to LV mass, volume, and relative wall thickness were analyzed. Moreover, CKD stages were studied with glomerular filtration rate calculation (the CKD-EPI creatinine equation).

Results.

Concentric hypertrophy (24/56) for 1-4 CKD stages, mixed hypertrophy (1/56) for the 4th CKD stage, dilated hypertrophy (12/56) for 2-3 CKD stages, normal/physiological hypertrophy (14/56) for 1-3 CKD stages, and the eccentric hypertrophy (4/56) for 1-3 CKD stages were detected. Objects with the stage 1 CKD had mainly normal/physiological hypertrophy (44.4%), with stages 2 and 3 CKD had concentric hypertrophy (43% and 48%, respectively), and with the 4 CKD had the same rate of concentric and mixed hypertrophy (50%).

Conclusions.

It was found different LV hypertensive geometric patterns among hypertensive individuals with CKD. Unexpectedly, there was a large amount of the normal/physiological hypertrophy pattern in arterial hypertension individuals with CKD, mainly with the stage 3.
P100 ALPHA KETOGLUTARATE RECEPTOR 1 REGULATES THE EXPRESSION OF THE (PRO)RENIN RECEPTOR IN MEDULLARY RENAL TISSUES, MODULATES SODIUM EXCRETION AND ATTENUATES TWO-KIDNEY, ONE-CLIP GOLDBLATT HYPERTENSION IN MICE
Authors: Gonzalez Alexis A. , Nuñez-Allimant Camila , Silva Katherin , Prieto Minolfa C. , Vallotton Ms. Zoe , Lorca Ramón A. , Casarini Dulce E. , Cespedes Carlos , Cardenas Ms. Pilar
Published: September 2024

Background:

The two-kidney, one-clip (2K1C) Goldblatt model elicits a reduction of renal blood flow (RBF) in the clipped kidney (CK). The reduced RBF and oxygen bio ability causes the accumulation of the intermediary of the tricarboxylic cycle, α-ketoglutarate, which activates the oxoglutarate receptor-1 (OXGR1). In the kidney, the OXGR1 is abundantly expressed in intercalated cells (IC) of the collecting duct (CD), which may contribute to Na+ transport and electrolyte balance. The (pro)renin receptor (PRR), a member of the renin-angiotensin-aldosterone system is a key regulator of Na+ reabsorption, and blood pressure (BP) and is also expressed in IC. PRR is upregulated in 2K1C. Here, we tested the hypothesis that reduction of RBF in the CK leads to OXGR1-dependent PRR upregulation in the CD and alterations of Na+ balance and BP in 2K1C mice.

Methods:

To determine the role of OXGR1 in regulating PRR in the CDs during renovascular hypertension, we used 2K1C Goldblatt surgery (clip= 0.13 mm internal gap) in two groups of male mice: 1) Oxgr1-/- knockout (n=6) mice; and 2) mice treated with Montelukast (OXGR1 antagonist; 5 mg/Kg/day, n=6). WT and sham-operated mice were used as controls.

Results:

2K1C mice showed increased systolic BP (SBP) (108 ± 11 vs. control 82 ± 5 mmHg, p<0.01) and a lower natriuretic response after the saline challenge test. The CK showed augmented levels of α-ketoglutarate, erythropoietin mRNA levels, PRR (mRNA and protein abundances) in the renal medulla. Non-CK showed PRR upregulation in the CDs. However, the CK of Oxgr1-/- knockout mice, and from those subjected to OXGR1 antagonism, elicited impaired PRR upregulation, attenuated SBP (Oxgr1-/- 2K1C: 90 ± 8 mmHg, p=non-significant vs. control; Montelukast 2K1C: 95 ± 3 mmHg, p<0.05 vs. control) and better natriuretic responses.

Conclusion:

In 2K1C mice, the effect of reduced RBF on the OXGR1-dependent PRR upregulation in the CK may contribute to the anti-natriuretic and increased SBP responses.
P110 INITIAL TREATMENT WITH A SINGLE CAPSULE CONTAINING HALF-DOSE QUADRUPLE THERAPY VS STANDARD-DOSE DUAL THERAPY IN HYPERTENSIVE PATIENTS (QUADUAL): A RANDOMIZED, BLINDED, CROSSOVER TRIAL
Authors: Zhao Xiexiong , Liu Tao , Yang Qiong , Yang Guoping , Li Xingli , Tang Xiaohong , Li Lingle , Liang Zhongshu , Li Anying , Zeng Lixiong , Wen Juan , Peng Liping , Cai Jingjing , Li Xiaogang , Jiang Weihong
Published: September 2024

Background and Objective:

Guidelines recognized the dual combination in initial antihypertensive therapy. Studies demonstrated low-dose quadruple combination antihypertensive was superior to monotherapy. However, whether low-dose quadruple therapy is better than dual combination is unknown.

Methods:

A randomized blinded crossover trial was conducted to compare the efficacy and safety of low-dose quadruple antihypertensives (irbesartan 75 mg + metoprolol 23·75 mg + amlodipine 2·5 mg + indapamide 1·25 mg) with standard-dose dual antihypertensives (irbesartan 150 mg + amlodipine 5 mg) in the initial treatment of patients with mild to moderate hypertension. Patients were randomly assigned in a 1:1 ratio to two crossover sequences. Each sequence received four-weeks of either half-dose quadruple antihypertensives or standard-dose dual antihypertensives, followed by a two-week washout and crossover for four-weeks. Participants and researchers were blinded, except for randomization and drug coding. The primary outcome was the reduction of mean 24-hour systolic blood pressure in ambulatory blood pressure monitoring. Safety outcomes were adverse events and changes in biochemistry after treatment. Analyses were per intention to treat. This trial was prospectively registered on www.clinicaltrials.gov (NCT05377203), and is now complete.

Results:

A total of 90 eligible participants were randomized between July 13, 2022, and April 20, 2023. The mean age of the population was 43.88 years, and 25.6% were women. The mean baseline 24-h blood pressure was 145.59/93.84 mm Hg. Half-dose quadruple treatment compared with standard-dose dual treatment further reduced mean 24-hour blood pressure by 4.72/4.17 mm Hg (P < 0.001 for both systolic and diastolic blood pressure). Except for fasting blood glucose (P = 0.029) and blood uric acid increased significantly (P < 0.001) in half-dose quadruple group, other adverse events and changes in laboratory values between the two treatments were not statistical different.

Conclusions:

Initiating treatment with half-dose quadruple combination therapy was more effective in lowering blood pressure than standard-dose dual therapy. The safety of half-dose quadruple therapy was comparable.
P115 CLINICAL PROFILE AND PREVALENCE OF OBSTRUCTIVE SLEEP APNEA IN A POPULATION OF YOUNG ADULTS REGISTERED IN A PRIMARY CARE UNIT IN RIO DE JANEIRO
Authors: Light Maria Beatriz , Guizzo Maria Eduarda Bazzanelli , Magalhães Victoria Enne , Lima Sara dos Santos , Neno João Oliveira Góes , Silva Camila Moura , da Silveira João Pedro Soares , Vargas Isabella Lima , Bassani Patrícia Barros , Ramirez Breno Garcia , Castellões Pedro Paulo , Westgarth Harrison James , Reiniack Suelen , Muxfeldt Elizabeth Silaid , Fernandes Ana Cristina Tenório
Published: September 2024

Background:

Obstructive Sleep Apnea (OSA) is strongly associated with high blood pressure (BP) and cardiovascular risk (CVR). There is a lack of studies and specific screening for younger populations, which could allow for early intervention and potentially reduce CVR.

Objective:

Analyze the prevalence and clinical profile of OSA, identifying the best screening method in a young population attended by a Family Health Strategy Unit in Rio de Janeiro.

Methods:

Cross-sectional population study of adults between 20 and 65 years old. Sociodemographic characteristics, anthropometric measures and CVR were obtained. Office BP was calculated using two measurements. The risk of OSA was assessed using STOP-BANG (SB) and Epworth Sleepiness Scale (ESS) questionnaires. All underwent home polysomnography.

Result:

67 individuals included [38.9% men; average age of 38.9 ± 8 years]: 35 without OSA, 20 with mild OSA, 9 with moderate OSA and 3 with severe OSA. The prevalence of moderate/severe OSA was 18%. Individuals with moderate/severe OSA were older, more obese, had higher prevalence of increased neck circumference, dyslipidemia and heart rate. High risk for OSA in screening by SB, ESS and both questionnaires was respectively 55.2%, 44.8% and 19.4%. SB confirmed moderate/severe OSA in 30% in high-risk individuals, and excluded in 97% of low risk, with 60% accuracy. The sensitivity, specificity, PPV and NPV of SB to identify moderate/severe OSA were respectively 92%, 53%, 36% and 97%. In those with high risk according to the ESS, moderate/severe OSA was confirmed in 13%, while in those with low risk it was excluded in 78%. The accuracy of the ESS was 49%. The sensitivity, specificity, PPV and NPV of the ESS to identify moderate/severe OSA were respectively 33%, 53%, 13% and 78%.

Conclusion:

Moderate/severe OSA was more associated with an adverse metabolic profile than with high BP. The best screening questionnaire for this population is the STOP-BANG.
P117 PREVALENCE OF UNDIAGNOSED HYPERTENSION AND RELATED RISK FACTORS IN WAD-MEDANI ALKOBRA LOCALITY IN GEZIRA STATE, SUDAN, 2022
Authors: Elameen Sawsan , Elmubarak Mohab , Elmubarak Mohannad , Ahmed Farah , Alhamid Mustafa , Elamin Abubakr , Ibrahim Raghda , Abukoe Mawada
Published: September 2024

Background:

Hypertension is defined as blood pressure ≥140/90 mm Hg. It is emerging as one of the major healthcare challenges in low- and middle-income countries. Hypertension is considered a silent killer and is the leading risk factor for cardiovascular mortality and accounts for a large proportion of premature deaths in developing countries. Most people with hypertension are asymptomatic and have been undiagnosed for years.

Objectives:

This study aimed to find out the prevalence of undiagnosed hypertension and related risk factors among adults in Wad Medani Alkobra locality in Gezira State, Sudan.

Methods:

A community-based cross-sectional study involving 464 adults in different locations in Wad-Medani Alkobra locality, from June 2022 to August 2022 was performed in collaboration with the Sudanese Society of Hypertension. WHO Stepwise Approach to Surveillance (STEPS) questionnaire was used to collect data, and was analyzed by SPSS version 20. Demographics, blood pressure, pulse, and socioeconomic status were measured. Diagnosis of hypertension was defined based on systolic and diastolic blood pressure of ≥140 mmHg and ≥90 mmHg, respectively, and three readings were obtained. Blood pressure was measured in all women and men aged 15 years and above.

Results:

The total number of study population was 464, males were 239, females were 225. The mean age was 45 years. 68 were known hypertensive. Of those who were hypertensive, 27 had high blood pressure. Undiagnosed hypertension in the study population was found to be 10% which equals 59.1% of the total number of the populations who had HTN. The prevalence of HTN in this study group was 25%. There was a positive relation between high blood pressure and old age, diabetes mellitus increased body weight, and sex (more common in males).

Conclusion:

The prevalence of hypertension was high and associated with some modifiable risk factors which should be addressed. Frequent screening and proper treatment are required to prevent complications of this epidemic.
P120 FRUITS AND VEGETABLES CONSUMPTION, PHYSICAL ACTIVITY AND ADHERENCE TO RISK FACTORS MODIFICATION AMONG ACADEMIC STAFF OF A STATE PEDAGOGICAL UNIVERSITY
Authors: Gasımov Zaur , Dadashova Gulnaz , Javadova Tarana , Abdullayeva Shahzoda , Allazova Shafa , Jafarov Rasim , Behbudova Jamila , Əliyeva Ilaha
Published: September 2024

Objective:

The aim of our study was to examine level of management of the risk factors of cardiovascular diseaseas well as physical activity level in an academic staff of a State Pedagogical University. Hypertension, awareness, control of disease and obesity(overweight) rate, as well as other risk factors were in the focus of this study.

Design and method:

107(16,5%)subjects,80(74,8%) female,27(25,2%)male, age 24-81, represented sample of 648 subjects of the academic staff of Azerbaijan State Pedagogical University. Intended to participate subjects (consent forms were signed) were interviewed by assessment of modified STEPS questionnaire (WHO). Participants were underwent physical examination: measurement of weight and height, waist circumference, waist-to-hip ratio; calculation of mean of 3 sitting BP measurements(automatic BP measurement device A&D UA 888(Japan).Fasting blood glucose (glucometers Optium Xceed Abbot and FIA Biomed Salut) and total cholesterol in capillary blood (device 3 in1 Slovenia) were measured.

Results:

40(39%) out of 103 were obese, 41(40%) were overweight and only 22(21%) had normal body mass index. Majority of participants reported low consumption of fruit and vegetables, high consumption of salt, and salty beverages, low physical activity.

All of 80 women reported no smoking until the time of the interview. Few of them reported second smoking. 8 men reported smoking and 6 –no smoking, from those 4 men give up to smoke more than 5 years before the time of interview. Cholesterol and glucose level and smoking status were available in 55 out of 107 participants .44 (80.%) had a raised total cholesterol level (≥ 5 mmol/L or taking medication for hypercholesterolemia).12(11%) out of 107 had T2D, from those, possibly, 2 subjects had new onset. Impaired fasting glucose had 15, normal range of fasting glucose had 22participants.7 out of 55 had 3 risk factors,10 out of 55 had 2 risk factors

Conclusion:

Strategy to improve dietary status, adherence to low salt usage, hypertension awareness, treatment and control, measures to increase adherence to lifestyle modification must be a public health priority.
P123 ASSOCIATION OF VERY SHORT INTERNVAL HEART RATE MEAN ABSOLUTE DEVIATION WITH HYPERTENSION: FROM NHANES 2017- 2020
Authors: Kulthamrongsri Narathorn , Nuchpramool P , Kookanok C , Kanthajan T , Prasitsumrit V , Sripusanapan A , Wareesawetsuwan N , Sodsri T , Suriyathumrongkul N , Yinadsawaphan T , Wattanachayakul P , Thiravetyan B , Suenghataiporn T , Srikulmontri T , Tantisattamo E
Published: September 2024

Background:

Heart Rate Variability (HRV) has recently gained popularity as an indicator of cardiovascular health. However, the association between the Mean Absolute Deviation of Heart Rate (HR-AMD), one of the HRV parameters, and Hypertension (HT), especially in very short intervals, in a nationally representative population, remains unknown. This study aims to investigate the relationship between HR-AMD and HT in the general population.

Methods:

A cross-sectional analysis of data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) was conducted to explore the association. Participants had their heart rate measured three consecutive times, 60 seconds apart, using a digital device. HR-AMD was calculated and categorized into quartiles. HT data were collected through self-reporting. Logistic regression models, comparing participants with HR-MAD in Q1 to those in higher quartiles and adjusting for demographics and comorbidities, were analyzed.

Results:

The study included 9,204 adult participants with a mean HR-AMD of 0.02 beats per minute. Among them, 3,554(38.61%) experienced HT.

In the general population, hypertension is lower in Q2-Q4, with statistically significant differences noted in Q2 with Odd ratio (OR) 0.80.

After stratification by race and diabetic status (DM), there was a non-statistically significant negative association of 0.90 times with HT in Q2 of HR-AMD among White participants, while among Black participants, the OR were statistically significantly lower at 0.70 times.

There also was a non-statistically significant negative association of 0.91 times with HT in Q2 of HR-AMD among DM individuals, while among non-DM individuals, the OR were statistically significantly lower at 0.78 times.

Conclusions:

A very short interval HR-AMD shows a negative association with HT in the general population, especially statistically significant in Q2. The greater negative associations only in black and non DM populations suggest that DM status and race may act as effect modifiers in the Q2 of HR-AMD. Further studies are required for a deeper understanding of this relationship.
P128 ESTABLISHING A RELATIONSHIP BETWEEN BLOOD PRESSURE AND HANDGRIP STRENGTH AMONG OBESE PATIENTS
Authors: Patil Mansi , Patil Vishal
Published: September 2024

Background:

While grip strength is known to correlate with cardiovascular health, its relationship with blood pressure (BP) remains unclear, especially when considering adiposity.

Methods:

We investigated the grip strength-BP association in 12,000 individuals aged 18–65 years, stratifying by body mass index (BMI) and Dietary diversity (DDS). Grip strength, BP, and Body-fat(BF%) were measured using hand dynamometry, digital blood pressure instrument, and dual-energy x-ray absorptiometry. DDS was measured using the FAO validated DDS tool.

Results:

Overall, elevated BP was associated with greater grip strength (37.1 kg vs 36.5 kg, p < 0.001), particularly in overweight or obese individuals (42.0 kg vs 40.2 kg, p = 0.003 and 41.7 kg vs 40.0 kg, p = 0.03), and those in the highest DDS (12 Vs 9, p < 0.01). Higher grip strength increased the odds of elevated BP (OR = 1.014, p = 0.004), particularly in overweight or obese individuals (OR = 1.025, p < 0.001) and those with the highest DDS (OR = 1.036, p < 0.001). However, individuals with low grip strength and high DDS had lower odds of elevated BP (OR = 0.514, p = 0.002), while those with low grip strength and low DDS had higher odds (OR = 2.162, p = 0.043).

Conclusion:

Our study reveals that increased grip strength is linked to higher blood pressure in overweight or obese individuals or those with a high dietary diversity score (DDS). However, individuals with a BMI < 25 kg/m2 or lower DDS may experience a reduced association between grip strength and blood pressure. These findings underscore the importance of considering both body mass index and dietary diversity in assessing cardiovascular health. We suggest integrating dietary analysis and handgrip evaluation in hypertension screening. Intervention trials combining dietary modifications with strength training are vital. Further research is warranted to explore the underlying mechanisms and potential interventions targeting grip strength, adiposity, and dietary factors to mitigate the risk of hypertension.
P129 ASSESS THE ACCURACY OF FOUR RISK ASSESSMENT MODELS (RISKFRS, RISKWHO, RISKACC/AHA, AND RISKJBS) IN PREDICTING 10-YEAR CARDIOVASCULAR EVENT RISK IN INDIAN ACUTE MYOCARDIAL INFARCTION PATIENTS
Authors: Patil Vishal , Patil Mansi
Published: September 2024

Background:

Despite numerous risk assessment models available for estimating the 10-year risk of cardiovascular (CV) events in individuals requiring primary prevention of CV disease, their applicability and accuracy in the Indian population remain inadequately studied. Objective of the study is to Assess and compare the predictive accuracy of four cardiovascular risk assessment models—RiskFRS, RiskWHO, RiskACC/AHA, and RiskJBS—in determining the 10-year cardiovascular event risk among Indian acute MI patients.

Methods:

In this study, 250 participants (mean age 59.4 ± 10.6 years; 205 males) without prior cardiovascular disease who experienced acute myocardial infarction (MI) were assessed using four established risk assessment models: Framingham Risk Score (RiskFRS), World Health Organization risk prediction charts (RiskWHO), American College of Cardiology/American Heart Association pooled cohort equations (RiskACC/AHA), and the 3rd Joint British Societies’ risk calculator (RiskJBS). These models estimated the participants’ predicted 10-year risk of cardiovascular events if assessed before the acute MI.

Results:

RiskWHO provided the lowest risk estimates, with 86.6% of patients estimated to have less than 20% 10-year risk. Conversely, RiskFRS and RiskACC/AHA yielded higher risk estimates (61.7% and 69.8% with less than 20% risk, respectively; p values <0.001 compared to RiskWHO). However, RiskJBS identified the highest proportion of patients as high-risk (only 44.1% at less than 20% risk, p values < 0.01 compared to all other three risk scores).

Conclusions:

In Indian patients experiencing acute MI, RiskJBS identifies a larger proportion of patients as ’high-risk’ compared to RiskWHO, RiskFRS, and RiskACC/AHA. However, further validation through large-scale prospective studies is necessary. These findings underscore the importance of tailoring risk assessment models to the unique characteristics of the Indian population and highlight the need for additional research to optimize cardiovascular risk prediction and management strategies in this demographic.
P136 EMOTIONAL DISORDERS AND CARDIOVASCULAR RISK PROFILE IN YOUNG ADULTS IN PRIMARY HEALTH CARE – MULTICENTRIC LAPARC STUDY
Authors: de Araujo Sousa Randerson José , Bernardes Gabriel Parente , e Silva Clara Serique Massaranduba , Silva Bruno Antônio Gomes , da Cruz Emilly Pinheiro , da Silva Victor Fernando Xavier Laurindo , Lima Luiz Emanuel Batista , Guizzo Maria Eduarda Bazzanelli , Fernandes Ana Cristina Tenório , Filgueiras Ligia Amaral , Muxfeldt Elizabeth Silaid
Published: September 2024

Introduction:

Several factors are associated with the diseases genesis that affect heart and blood vessels, and emotional disorders, such as depression and anxiety, are progressively related to an increase in cardiovascular risk.

Objective:

to evaluate the cardiovascular risk profile and the prevalence of anxiety and depression in young adults receiving primary care in the Brazilian Unified Health System.

Methods:

This is a multicenter cross-sectional population study (arm of the LapARC study–Rio de Janeiro) developed in a center in Santarém, Pará, located in the Brazilian Amazon. Young adults (20 to 50 years old) were evaluated in relation to their cardiovascular risk profile, sociodemographic characteristics, anthropometry, electrical bioimpedance and laboratory tests. Blood pressure (BP) was measured in the office and Home Blood Pressure Monitoring (HBPM) was performed with a 7-day protocol. In screening for depression and anxiety, the PHQ-9 and GAD-7 questionnaires were applied, respectively.

Results:

161 individuals were included (81.4% female; mean age 39.6 ± 7.9 years). More than half of the population has 3 or more risk factors (55.9%), with dyslipidemia being the most prevalent (60.2%), followed by hypertension (55.9%) and obesity (41.0%). Women had significantly more abdominal obesity (67.2% vs 30.0%, p<0.001), with a higher percentage of body fat (42.2 ± 7.5 vs 28.7 ± 7.8%, p<0.001). Men have a higher prevalence of dyslipidemia (80.0% vs 55.7%, p<0.05). Regarding emotional disorders, we observed high prevalence in the moderate/severe category of depression (51.6%) and anxiety (57.8%), both conditions being significantly higher among women (55.7% vs 33.3%, p<0.05|63.4% vs 33.3%, p<0.05), respectively.

Conclusion:

the population, although apparently young and healthy, presented moderate and high risk, which associated with the high prevalence of symptoms of depression and anxiety, can increase the risk for the emergence of cardiovascular diseases, which supports the importance of continuing the study, in order to understand the behavior of these variables in this age group and draw attention to psychological screening and monitoring in primary health care.
P139 THE GUT MICROBIOME AS A PREDICTOR OF INCIDENT HYPERTENSION: DATA FROM A POPULATION SAMPLE OF 3055 INDIVIDUALS WITH A FOLLOW-UP OF 20 YEARS
Authors: Niiranen Teemu , Palmu Joonatan , Havulinna Aki , Jousilahti Pekka , Knight Rob , Salomaa Veikko
Published: September 2024

Background and Objective:

Our goal was to examine the previously unknown long-term association between gut microbiome composition and incident hypertension in a representative population cohort.

Methods:

We collected fecal samples from a population sample of 3,055 non-hypertensive Finns (mean age 43.1 years; 60.8% women) in 2002. These individuals were followed up for incident hypertension until 31 December 2021 using nationwide register data. The samples were sequenced using shotgun metagenomics. We examined associations between gut microbiome composition and incident hypertension using Cox regression (alpha diversity and microbial taxa), permutational multivariate ANOVA (beta diversity) and Analysis of Compositions of Microbiomes with Bias Correction (ANCOM-BC; microbial taxa) models adjusted for conventional hypertension risk factors.

Results:

Altogether, 587 cases of incident diabetes occurred over the median follow-up of 19.8 years. Gut microbiome alpha diversity (Shannon index; p=0.98) and beta diversity (R2=0.49%; p=0.99) were not associated with incident hypertension. Furthermore, the associations between microbial taxa and incident hypertension were non-significant. In Cox regression models (Figure), two species reached an FDR-corrected P-value <0.1: Eubacterium G Ventriosum (hazard ratio per 1-SD increase 0.89; 95% CI 0.83-0.96; P=0.07) and Hespellia Stercorisuis (hazard ratio 1.16; 95% CI 1.05-1.27; P=0.098). In ANCOM-BC models, three species reached an FDR corrected P-value of <0.1: Merdousia sp000438015 (log2 fold change 0.32±0.09; P=0.06), Mitsuokella multacida (log2 fold change -0.32±0.09; P=0.06), and Scybalousia sp900543675 (log2 fold change -0.28±0.09; P=0.07).

Conclusions:

In this first-ever analysis on the association between the gut microbiome and long-term hypertension incidence, we observed that the associations between overall gut taxonomic composition and incident hypertension are weak. In addition, only a few microbial taxa reached a borderline level of significance with inconsistent results between two statistical methods. These findings suggest that the gut microbiome is not a strong predictor of future hypertension.
P140 PREVALENCE OF HYPERTENSION IN A RURAL COMMUNITY IN THE FEDERAL CAPITAL TERRITORY ABUJA (GBESSA) NORTH CENTRAL NIGERIA
Authors: Musango Dennis Anthony , Olufue Gerry
Published: September 2024

Background:

High Blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan Africa. This has been attributed to acculturation of the populace who are rapidly adopting modern lifestyle changes.

Aim

This study aimed to describe the prevalence and identify risk factors for hypertension in rural community in the Federal capital territory in Nigeria.

Methods

A cross sectional survey of 491 households with 1,739 adults aged 18 years and above was carried out. Information about health and lifestyle was obtained from structured questionnaire interviews, followed by assessment of blood pressure (BP) and anthropometry.

Results:

There were 18.1% (95% confidence interval (CI), 16.0-20.6% participants with hypertension (defined as a systolic BP-140, diastolic BP-90mmHg or on antihypertensives medication). This prevalence of Hypertension was found to rise with age. Between the sexes males recorded a higher prevalence of 19.6% compared to 17.4%: females but this was not statistically ×2 P-value =0.34. Single and widowed subjects recorded high prevalence of 32.2% and 30.0% of Hypertension while students had low rate of 5.6%. The prevalence of Hypertension was 20.5% among farmers.Whereas, obesity (measured by WHR), alcohol intake, cigarette smoking, and family history of hypertension had no valid statistical evidence, chewing tobacco/ snuff, previously diagnosed diabetes mellitus or family history of diabetes showed statistically significant differences.

Conclusion:

This findings underscore the need for public health campaign at community levels to prevent increasing blood pressure and it's sequelae. This will involve campaigns to maintain the age- long tradition of exercise, avoidance of smoking, alcohol and weight maintenance.