bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C13-1: PREVALENCE AND ASSOCIATED FACTORS OF LEFT VENTRICULAR HYPERTROPHY IN ASYMPTOMATIC HYPERTENSIVE PATIENTS
Authors: Ouail Djamel eddine , Bouali Faycal , Tebbani Meriem , Ahmed Djamila Si
Published: January 2023

Introduction:

Left ventricular hypertrophy (LVH) is a major target organ impairment in hypertensive patients, LVH is an independent cardiovascular risk factor.

The objective of our work is to detect and analyze the factors associated with electrical left ventricular hypertrophy in asymptomatic hypertensive patients.

Method:

Prospective study of a cohort of asymptomatic hypertensive patients, aged over 35, seen in consultation.

All patients had undergone a 12 lead ECG examination looking for left ventricular hypertrophy defined by Sokolow Lyon index > 3.5 mV and/or RaVL> 1.1 mV and/or Cornell voltage duration product > 244 mV ms

Results:

263 patients evaluated during the study period, 151 women or 57% and 112 men or 43%, the average age of the population is 59.78 years ± 10.67 [36 to 87 years].

Left ventricular hypertrophy is observed in 52 patients, i.e. 19.7% of asymptomatic hypertensives. These are 31 women (20.3% of women) and 21 men (18.75% of men).

The analysis of the subgroups finds a high prevalence of electrical LVH between 45 and 55 years and between 55 and 65 years with ORs at 7.80 [0.97, 62.37] p = 0.0528 and at 7.76 [0.99, 60.82] p = 0.0511.

Regarding the blood pressure profile, LVH is strongly associated with systolic blood pressure levels. The analysis of the subgroups of the seniority of hypertension finds an increase in the OR to 2.95 in the group of 1 to 5 years of seniority with significant p at 0.02.

After the multivariate analysis, the two independent risk factors associated with the development of electrical left ventricular hypertrophy are: Systolic Blood Pressure level between 140 and 179 mmHg and Total Cholesterol level greater than 2 g/l. The p is very significant (0.016 and 0.025 respectively)

Conclusion:

LVH is common in our series, it affects 19.7% of our asymptomatic hypertensive patients. The most affected age group is from 45 to 65 years old whose seniority from the time of diagnosis is less than 5 years.

The two factors associated with LVH are systolic blood pressure and total cholesterol level.

In the light of these results, the prevention of LVH must associate; Early screening by ECG at the time of diagnosis and during the first 5 years, management of hypertension with a target SBP of less than 140 and a cholesterol level of less than 2 g/l
PS-C13-12: NOVEL HEMODYNAMIC INDEX OF ABPM-OBTAINED PULSE WAVEFORM; EVALUATION OF CHANGES IN CARDIAC FUNCTION BEFORE AND AFTER TREATMENT OF HEART FAILURE
Authors: Narita Keisuke , Yuan Zihan , Yasui Nobuhiko , Hoshide Satoshi , Kario Kazuomi
Published: January 2023

Introduction:

In this pilot study, we developed the novel hemodynamic index from pulse waveform for estimation of cardiac function. We obtained volumetric pulse waveform from diastolic phase of each BP measurement by our recently developed device, a Multisensor-ambulatory BP monitoring (ABPM) device (TM-2441, A&D Co., Tokyo). This pulse waveform is divided into ejection and reflex wave. The area of ejection wave is square forward pulse wave (Sf), which is related with cardiac ejection volume. Second, amplitude measured pulse wave (Am) of the pulse waveform is a parameter defined by central and peripheral artery compliance and cuff compliance (Figure). We then calculated that Sf was divided by Am, Sf/Am, to eliminate the effect of arterial and cuff compliance from the area of ejection wave, which would indicate cardiac ejective function.

Methods:

We prospectively assessed the changes in Sf/Am and echocardiographic left ventricular ejection fraction (LVEF) between patients with and without improved cardiac function during treatment of heart failure (HF). We conducted twice measurements of Multisensor-ABPM in 20 patients with HF (mean ± SD age, 63.3 ± 14.1 years; male, 65%; ischemic heart disease, 15%; atrial fibrillation, 25%) at baseline (just after initial or adjusted treatments) and at follow-up (6–12 months after tailored treatment). Second, we divided these patients into an improved (n = 11 patients) and a not-improved (n = 9) cardiac function group; an increase in LVEF of ≧ 10%. We then compared the changes of Sf/Am between the two groups.

Results:

Improvement of Sf/Am was shown in the improved group using paired t-test (Sf/Am before, 21.4 ± 4.5; after, 25.6 ± 3.7, p = 0.004), but there was no difference in the not-improved group (Sf/Am before, 26.8 ± 3.0; after, 27.7 ± 4.0, p = 0.293). Moreover, Sf/Am was associated with LVEF in overall measurements (N = 40) (r = 0.490, p = 0.004) (Figure). The change of Sf/Am from baseline to follow-up tended to be related to the changes of LVEF (r = 0.391, p = 0.080) (Figure).

Conclusion:

Although the present study was conducted in a small sample, this is the first study to prospectively observe the changes in pulse waveform before and after HF treatment using new ABPM device in ambulatory setting. Our study findings might show the possibility of a new hemodynamic assessment by ABPM.
PS-C14-10: THE INFLUENCE OF ARTERIAL HYPERTENSION ON THE PROGRESSION OF OBSTRUCTION IN HYPERTROPHIC CARDIOMYOPATHY
Authors: Nurbay Zhanar , Tuleutayev Rustem , Zhakaev Maksat , Konisbekova Akzhan , Daniyarova Laura , Bagramov Akan , Ibragimov Timur , Kunapianov Daniyar , Abzaliev Kuat , Ishakbaeva Guzel , Sultanov Galymzhan , Nagimatullaeva Aigerim , Muzaev Vladimir
Published: January 2023

The nature of hypertrophic cardiomyopathy remains unexplored to date, but there is a very reasonable opinion about the genetic transmission of the disease. Given the presence of arterial hypertension in 88% of patients with hypertrophic cardiomyopathy, the issue remains relevant. To date, there is no clear understanding of hypertrophy in hypertrophic cardiomyopathy and hypertensive heart.

Objective:

To evaluate the effect of arterial hypertension on obstruction in hypertrophic cardiomyopathy.

Material and Methods:

From 2017 to 2022, 70 patients diagnosed with hypertrophic cardiomyopathy were under observation. Given the obstructive form of hypertrophic cardiomyopathy, 40 patients were operated on, Morrow operation, 30 patients diagnosed with hypertrophic cardiomyopathy without obstructive lesions are under observation, this group will take part in the study. All patients underwent genetic testing. The age of the patients ranged from 18.3 to 80.4 years, the median was 57.3 years; in most cases, pathology occurs in females, 67%, while in men it is 2 times less, 33%. Exclusion criteria for patients with aortic stenosis and “athletic” heart. Complaints were shortness of breath, headaches, dizziness, syncope.

Results as a result of studies in 56% of patients test for genetic mutations is positive. Arterial hypertension was detected in 88% of patients. The duration of the disease in patients varied significantly from 1 to 35 years, the interquartile range was from 5.3 to 15.1 years, the median was 10 years. Systolic blood pressure in patients ranged from 92 to 260 mm Hg, the median was 180.5 mm Hg. Diastolic blood pressure in patients ranged from 61 to 130 mm Hg, the median was 90 mm Hg. In patients with a negative genetic analysis, 44%, a long history of arterial hypertension was revealed. Most of the patients were not adherent to therapy, despite the 3rd degree of arterial hypertension, only 13% were constantly taking antihypertensive drugs. Considering these data, we identified relevant data on echocardiography. In patients with a long history of hypertension, an increase in the left atrium, a concentric variant of hypertrophy, can be noted. There is thickening of both the aorta and the aortic valve cusps.

Conclusions:

The mechanism of development of hypertrophic cardiomyopathy is not completely clear; therefore, the genetic diagnosis of this disease is an integral part. Timely identified and initiated treatment of hypertension can prevent the risks of developing hypertrophy in the future.
PS-C14-12: RIGHT VENTRICLE SYSTOLIC FUNCTION IN HYPERTENSIVE NEPHROPATHY PATIENTS
Authors: Bezrodnyi Volodymyr Borysovych , Bezrodnyi Andrii Borysovych
Published: January 2023

Objective:

To investigate right ventricular systolic function in chronic kidney disease (CKD) patients.

Design and method:

We examined 15 essential hypertensive subjects and 34 untreated non-diabetic essential hypertensive patients with II and III stage of hypertensive CKD. Echocardiography and ambulatory blood pressure (BP) monitoring was performed for all patients. Glomerular filtration rate (GFR) assessment was based on CKD-EPI formula. Patients underwent a two-dimensional Doppler-coupled echocardiography with determination of right ventricular (RV) systolic function with conventional echocardiographic methods: RV fractional area change, Tricuspid Annular Plane of Systolic Excursion (TAPSE), Tricuspid annular S’ velocity of the lateral tricuspid annulus, RV Tei index. Right ventricle free wall longitudinal strain (RVFWLS) obtained by speckle-tracking.

Results:

CKD patients and essential hypertensive subjects had no significant difference between RV systolic function values evaluated with RV fractional area change and RV Tei index. At the same time we observed significantly lower values of TAPSE and Tricuspid annular S’ velocity of the lateral tricuspid annulus (p < 0.05 in both cases) in CKD patients. Highly significant RVFWLS decline was observed in CKD patients comparing to essential hypertensive subjects (p < 0.01).

In univariate correlation analysis GFR was more closely related to RVFWLS (r = 0,523, p < 0.01) comparing to Tricuspid annular S’ velocity of the lateral tricuspid annulus and TAPSE (r = 0,371, p < 0.05 and r = 0,293, p < 0.05 respectively).

Conclusion:

Hypertensive nephropathy patients have early impairment of RV systolic function detected by significantly lower Tricuspid annular S’ velocity as well as TAPSE and highly significant RVFWLS decline comparing to essential hypertensive subjects. There was more significant relationship between GFR and RVFWLS rather than Tricuspid annular S’ velocity of the lateral tricuspid annulus and TAPSE.
PS-C15-3: CORRELATIONS BETWEEN CORONARY ARTERY DISEASE, CORONARY ARTERY CALCIUM SCORE, AND LIPOPROTEIN(A) LEVEL IN KOREA
Authors: Kim Weon , Rhew Jaeyoung
Published: January 2023

Background:

Lipoprotein(a) levels are associated with coronary artery disease (CAD) and aortic valve calcification. This study aimed to determine the correlation between Lp(a) levels and coronary artery calcium (CAC) scores in patients who underwent coronary computed tomography angiography (CCTA).

Methods:

This was a single-center observational study. The patients had not been previously diagnosed with CAD and underwent CCTA and Lp(a) measurement within a three-month interval. Coronary angiography and further management were performed according to the physicians decision. Among 252 patients, 81 and 171 patients underwent coronary revascularization and received medical treatment, respectively. To examine the relationship between Lp(a) and CAC score and between Lp(a) and CAD, we divided the patients by Lp(a) level (50 mg/dL) and CAC score (400).

Results:

No relationship was observed between Lp(a) and CAD and other risk factors for that. There were no differences in the ratio of patients who underwent coronary revascularization and the CAC score according to an Lp(a) level of 50 ml/dL. There was no difference in Lp(a) level at a CAC level of 400. The proportion of patients who underwent coronary intervention was high in the high CAC score group (50.6% vs. 23.7%, p = 0.000). No association was observed between Lp(a) and CAC in the Pearson correlation (0.000, p < 0.998).

Conclusion:

Correlations between Lp(a) and CAC and between Lp(a) and CAD were not observed in Korean patients. However, a high CAC score was correlated with coronary revascularization.
PS-C15-4: CARDIOVASCULAR COMPLICATIONS IN RESISTANT HYPERTENSIVE PATIENTS
Authors: Matova Olena , Mishchenko Larysa
Published: January 2023

Objective:

To evaluate the incidence of cardiovascular (CV) complications and its predictors in treated resistant hypertensive (RH) patients.

Design and Methods:

We studied 117 RH patients and 114 controlled hypertensive (CH) patients on a triple fixed-dose combination of a blocker of the renin-angiotensin system / calcium channel blocker / thiazide or thiazide-like diuretic. Patients with RH treated with the same type of triple fixed-dose combination in maximally tolerated doses plus the individually defined most effective fourth-line agent (spironolactone/eplerenone 56.1%, torasemide 26.8 %, nebivolol 14.6 %, moxonidine 2.5 %); the fifth class of antihypertensive drug was added for 35.2 % of patients. A cardiovascular complications (CV death, myocardial infarction and/or revascularization, stroke, atrial fibrillation, peripheral arterial disease, kidney outcome (dialysis or GFR decline by 40 % or greater) were estimated after five years (5.1 ± 0.1).

Results:

The goal office and 24-h blood pressure (BP) were achieved at 49.6 and 34.2 % RH patients at the end of follow-up. The incidence of CV outcomes were in 4.4 times higher at RH patients compared to CH patients (composite CV events (30.8 vs 7.0 %, P = 0.001).

According to univariate logistic regression analysis CV complications were associated with baseline TNF-a (β = 0.78; OR = 2.18; 95% CI: 1.15 - 4.13), cystatin C (β= 0.56; OR = 1.81; 95% CI: 1.22 - 2.68), citrulline plasma levels (β= 0.07; OR = 1.07; 95% CI: 1.03 - 1.10); 24-h albuminuria (β= 0.006; OR = 1.01; 95% CI: 1.0 - 1.01), CysC GFR (β= -0.44; OR = 0.96; 95% CI: 0.93 - 0.99), body mass index (β = 0.15; OR = 1.17; 95% CI: 1.03 - 1.32) and low initial adherence to treatment (β= 0.97; OR = 2.63; 95% CI: 1.11 - 6.21).

Conclusions:

A median follow-up time of 5 years, RH was associated with increased risk for incidence of CV outcomes. The markers of low-grade systemic inflammation, kidney function, body mass index, and initial adherence to treatment were associated with the composite CV endpoint.
PS-C15-5: HYPERTENSION AND HYPERLIPIDEMIA CO-MORBIDITIES AMONG THE NEPALESE TYPE II DIABETES MELLITUS PATIENTS
Authors: Subedi Sandhya , Hawlader Mohammad Delwer Hossain , Hossain Ahmed , Alam Mohammad Morshad , Zaman Sanjana
Published: January 2023

Type II Diabetes Mellitus is a global pandemic disease, and its prevalence is more rapidly increasing in low- and middle-income countries (LMICs), including Nepal. Hypertension and Hyperlipidemia are two common comorbidity of T2DM is likely to be exacerbated the development of cardiovascular diseases. This study was aimed to determine the proportion and associated factors of hypertension and hyperlipidemia co-morbidities among T2DM adult patients of Nepal. Our research was designed as an analytical cross-sectional study among type II diabetes mellitus patients attended Rapti Zonal Hospital between May to November 2017 using purposive sampling technique and validated semi-structured pretested questionnaires. Study found, out of 141 respondents, 38.29% had co-existence of hypertension and hyperlipidemia, 34% and 7% had only hypertension and hyperlipidemia respectively, and 21% had none of them. Our multivariate logistic model indicated an age of 60 and above (OR = 9.00, 95% CI = 1.88–55.49), living in the urban area (OR = 4.32, 95% CI = 1.15–19.55), Overweight or Obesity (OR = 6.12, 95%CI = 1.65–28.32) were significant predictors of co-morbidities. The significant predictors might have an enhanced interactive influence on the prevalence of Type 2 diabetes mellitus co-morbidities. Results from this study will help clinicians to treat type II diabetes mellitus patients along with their co-morbid conditions. So that, many complications can be prevented.
PS-C16-1: COURSE OF ACS IN PATIENTS CO-INFECTED WITH COVID-19
Authors: Fozilov Khurshid , Atamuratov Bakhtiyor , Yuldashov Bakhtiyor , Butaev Sherzod , Yuldashov Alisher
Published: January 2023

Aim:

To study and compare the features of the course of ACS in patients who underwent COVID19 infection.

Material and Methods:

The study included ACS patients with ST segment elevation admitted from January 2021 to February 2022. Patients were compared with a group of patients who did not suffer from COVID 19 infection and were hospitalized for ACS in a similar period of time. The study included 114 patients. In all patients, the presence of IgG antibodies to the agent of the coronavirus infection COVID-19 was determined, which indicates that the person has already had a coronavirus infection or not. Patients were divided into 2 groups: 1 - patients who had COVID19 infection; 2 - not recovered from coronavirus infection. All patients were assessed the following indicators: the presence of coronary artery disease before hospitalization, the incidence of cardiogenic shock, the presence of STEMI, as well as the number of deaths during hospitalization.

Results:

In the first group, only 39.5% (45) of patients were examined, of which men - 80.0% (36). Prior to hospitalization, coronary artery disease was present in 64.4% (29) of patients. STEMI was present in 75.5% (34) of patients. The incidence of cardiogenic shock in 4.4% (2) of patients. The number of deaths during hospitalization is 4.4% (2). In the second group, only 60.5% (69) of patients were examined, of which 78.3% (54) were men. Prior to hospitalization, CAD was present in 55.07% (38) of patients. STEMI was recorded in 59.4% (41) of patients. The incidence of cardiogenic shock is 1.45% of patients. The number of deaths during hospitalization was 1.45%.

Conclusion:

Before hospitalization, CAD was present in the majority of patients 39.5% (45) who had COVID 19, who did not have COVID19 patients 60.5% (69). STEMI was present in 75.5% (34) of patients who had COVID19 and 59.4% (41) of those who did not have COVID 19 infection (p < 0.05). During the pandemic, there is a high incidence of cardiogenic shock in 4.4% (2) of patients who have had COVID19 and 1.45% (1) of those who have not been ill. The percentage of deaths during hospitalization in COVID19 survivors is higher compared to 4.4% with 1.45% who did not recover.
PS-C16-2: ASSESS THE TREATMENT ADHERENCE OF ANTIHYPERTENSIVE MEDICATIONS DURING COVID-19, A MULTICENTER CENTER STUDY OF PAKISTAN
Authors: Arain Mudassar Iqbal , Fricovsky Eduardo , Shahnaz Saira , Anwar Ramesha
Published: January 2023

Objective:

Important challenging factor for health care professionals is to ensure the treatment adherence of hypertension during COVID-19. To prevent the cardiovascular problems, adherence is one of essential parameter among the patients. The current study was designed to assess the treatment adherence of antihypertensive medications during COVID-19.

Methodology:

The descriptive, cross-sectional and multi-center study was conducted in 4 different clinical settings of two major cities of Sindh, Pakistan. The sampling method was systemic and patients were enrolled in the study from June to December 2021. Only those patients were selected who had confirmed diagnosis for hypertension and taken atleast one antihypertensive medications. A total of 1428 hypertensive patients were taken part in the study. Using self-administered adherence scale i.e. SDAS-14, the data were analyzed accordingly.

Results:

According to SDAS-14, the patients were categorized on score of adherence scale i.e. more than 10 means good adherence, 5–9 were medium adherent and less than 5 no or less adherent. Out of total 1428 patients, the average age was 58 years + 9 years. Majority were of male gender. Based on BP measurements and a series of questions were asked that showed low level of adherence were found during COVID-19. High educational level (OR 2.64, 95% CI 1.46–3.36) and ARBs treatment (OR 0.76, 95% CI 0.61–0.91) were independent predictors of good adherence.

Conclusion:

The study reflects that during COVID-19 the level of adherence was low due to unavailability of medications and access to the health care professionals. More over the values of blood pressure was also not under control due to no exercise. The education is directly professional to the high level of adherence.
PS-C16-4: COMPARATIVE EFFICACY OF VARIOUS ANTICOAGULANTS IN COVID-19 INDIAN SUBJECTS: AN OBSERVATIONAL STUDY
Authors: Munganda Hariharan Ranga Satya , Amle Dnyanesh , Ponnaganti Satyanarayana Chowdary , Tirumalsetty Gopalakrishna Murthy , Vvl Aparna Devi
Published: January 2023

Background:

To assess the efficacy of various anticoagulants being prescribed in the COVID 19 induced hypercoagulability, so as to know optimally effective anticoagulant.

Methods:

This was a Indian observational study conducted in our covid centre at vijayawada,Andhra Pradesh between june 2020 to January 2021 .

Results:

A total of 100 COVID 19 subjects were included. The patients were found to be matched with respect to age, gender, diet and past history of various illnesses. Gender wise more males (60 patients)are affected when compared to females(40 patients). Age group more affected are less than or equal to 50yrs . Comorbidites like Diabetes(67patients),cardiac problems(62patients), dyslipidemia(62patients) were seen. Risk factors like smoking(52patients), alcoholism(50patients) noticed. Almost all subjects are RTPCR positive. IL-6,CRP,LDH high in most subjects. Ferritin and PT/INR are normal in more subjects. Out of 100 patients oxygen is required in 48 subjects and BIPAP/CPAP required in 26 subjects. Death occurred in 24 patients (2 with CVA,22 with myocardial infraction). Mortality rate is more in vegetarians. More patients in our study belongs to CORADS score 4 and 5. D-dimer are increased in 67subjects. IL-6 are increased in 68patients .

Frequency of subjects with raised D-dimer (p = 0.049) and CRP (p = 0.002) levels were found to be benefitted on receiving nattokinase. However, no other parameters such as IL-6 (p = 0.068) ferritin (p = 0.396), ESR (p = 0.278), PT/INR (p = 0.47) LDH (p = 0.34) or CORADS staging achieved such significant association. Also need of interventions such as Oxygen (p = 0.001), BIPAP/CPAP (p < 0.0001) were low in patients on nattokinase. No significant difference was noted in follow up investigations such as PT/INR (p = 0.31) and other markers (D-dimer, IL-6, LDH, CRP) (p = 0.55). No bleeding episodes were reported in subjects on nattokinase. Significant low rate of death was found in subjects who received nattokinase (p < 0.0001) and rivaroxaban (p < 0.0001). Also, significantly higher mortality rate was observed in subjects who required to be put on oxygen (p < 0.0001) as well as BIPAP/CPAP (p < 0.0001).

Conclusions:

Nattokinase simultaneously effects several key favourable benefits for thrombosis, hypertension, atherosclerosis, hyperlipidaemia, platelet aggregation, and neuroprotection in patients with COVID 19 infection.
PS-C16-11: PREVALENCE AND HOSPITAL OUTCOME OF BACTERIAL CO-INFECTION IN RESPIRATORY TRACT SPECIMEN AMONG COVID 19 PATIENTS WITH SARS-COV-2 PNEUMONIA
Authors: Soliman Dianne Joy Capuz
Published: January 2023

Introduction:

COVID-19, a zoonotic disease caused by the novel coronavirus SARS-CoV-2, is a highly transmittable pathogenic viral infection, infecting millions of people globally. Guidelines recommendthe use of empiric antimicrobials based on clinical judgment, patient host factors and local epidemiology in patients suspected or confirmed severe COVID-19. However, current evidence does not support a high rate of bacterial respiratory co-infections in patients with SARS-COV-2 infection. At present, there is no known study regarding the prevalence of bacterial co-infection in COVID-19 patients in the Philippines

Methods:

This research is a cross-sectional hospital-based study that utilized hospital electronic and printed medical records, chest radiograph and microbiologic results. All respiratory specimen bacteriologic results for the year 2020 and 2021 were collected from the hospital laboratory unit followed by review of the hospital electronic records, printed medical records and chest radiograph results. Data were analyzed using Two-tailed Z-test for significance test for proportions and Chi-square test.

Results:

Among 100 subjects, only 22% (n = 22) of the subjects were found to have bacterial isolates. the only demographic that is dependent with presence of bacterial infection is gender. The three most common bacterial isolate among COVID confirmed patients are Klebsiella pneumoniae (n = 9), Pseudomonas aeruginosa (n = 5), and Acinetobacter baumannii (n = 3). Although the most common bacterial isolate is Klebsiella pneumoniae, the most common bacterial co-infection in patients who died are Acinetobacter baumannii (n = 2, 29%)and Pseudomonas aeruginosa (n = 2, 29%).

Conclusion:

The prevalence of bacterial co-infection among COVID confirmed patients is relatively low, hence appropriate guidelines regarding antibiotic use should be formed taking into consideration local data on antimicrobial resistance.
PS-C16-12: IS ARTERIAL HYPERTENSION A MODIFIER OF CARDIOPULMONARY EXERCISE TEST AND ECHOCARDIOGAPHIC FINDINGS AFTER HOSPITALIZATION FOR SARS-COV-2?
Authors: Kariori Maria , Fragkoulis Christos , Chrysochoou Christina , Konstantinidis Dimitrios , Leontsinis Ioannis , Andrikou Ioannis , Iliakis Panagiotis , Mantzouranis Emmanouil , Konstantinou Konstantinos , Kalos Theodoros , Grigoriou Kalliopi , Thomopoulos Costas , Tsioufis Costas
Published: January 2023

Objective:

There is little data concerning the impact of arterial hypertension (HTN) on the cardiopulmonary status and right ventricle (RV) function of patients with SARS-Cov-2 infection. The purpose of our study was to investigate whether HTN affects the functional status of hospitalized for SARS-Cov-2 patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the first day of infection.

Design and Method:

Subjects who were hospitalized and survived Covid-19 infection were divided into two groups according to history of HTN. All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol evaluating all parameters. Echocardiographic findings including right ventricle strain were analyzed using an offline program.

Results and Conclusion:

A total population of 52 hospitalized Sars-Cov-2 patients with a mean age of 57 ± 11.5 years were evaluated 3 months after the symptoms onset. Males amounted to 51.9 %. History of coronary artery disease was recorded in 15.4% of them. In hypertensive subjects, age (63 ± 8 vs. 52 ± 11 years, p < 0.001), BMI (29.9 ± 4.6 vs. 27.1 ± 5.8 kg/m2, p:0.03) and BSA (2.1 ± 0.25 vs. 2 ± 0.9 m2, p:0.04) were significantly higher. When analyzing cardiopulmonary test parameters, only maximum systolic blood pressure ((SBP, mmHg), 190 ± 21 vs.171 ± 26, p: 0.02) at peak and during the 1st minute of recovery (180 ± 23 vs. 157 ± 27 mmHg, p: 0.005) were higher comparing to normotensive subjects. Furthermore, diameter of left atrium ((LA, mm), 42 ± 6 vs.38 ± 6 p: 0.009), left ventricle ejection fraction ((LVEF,%), 48 ± 11 vs. 57 ± 6, p:0.004) and the absolute mean value of right ventricle strain ((RVLS, %), 9.1 ± 4 vs. 12.7 ± 5.4, p:0.04) differed significantly between two groups. Using linear regression analysis adjusted for age, gender, HTN, coronary heart disease and LVEF, HTN (p: 0.01) proved to be independent predictive factor for RVLS in hospitalized patients. To conclude our study highlighted negative impact of HTN both in right and left ventricle functionality, implying HTN as a negative independent predictive factor for right ventricle strain in patients hospitalized for SARS-Cov-2.
PS-P01-5: ASSOCIATION BETWEEN BLOOD PRESSURE RELATED INDICATORS AND PHYSICAL FRAILTY AMONG THE JAPANESE COMMUNITY-DWELLING OLDER ADULTS: THE NOSE STUDY
Authors: Godai Kayo , Kubo Mio , Kabayama Mai , Wada Arisa , Kido Michiko , Hashimoto Sumiyo , Higashi Makiko , Hatanaka Hiromi , Kikuchi Takeshi , Dodo Takayuki , Tabara Yasuharu , Asayama Kei , Ohkubo Takayoshi , Rakugi Hiromi , Kamide Kei
Published: January 2023

Objective:

The purpose of this study was to assess the association between blood pressure (BP) related indicators and physical frailty among the Japanese community-dwelling elderly.

Design and method:

The present cross-sectional analysis was based on an ongoing community-based intervention study in Nose, Osaka, which was designed to assess the effect of home BP measurement on prolonging healthy life expectancy. A total of 1153 participants, 420 were aged 63–91 and measured their home BP. Among them, 273 participants were currently available for analysis. Physical frailty was defined as a case either the weak grip strength defined as < 28 kg for males and < 18 kg for females or the slow gait speed defined as < 1 m/s. Participants measured their home BP and pulse rate (PR) with an oscillometric device (HEM-7281; Omron Healthcare CO., Ltd) and wrote the value on the recording book. The value of and variability in home BP and PR were calculated as the average and coefficient of variation (CV) of the measurements, respectively. Office BP was measured at the survey venue using same device, HEM-7281. The associations of BP related indicators with physical frailty were examined using multiple logistic regression models by age group: 63–74, and ≧ 75 years.

Results:

Overall, 195 participants were aged 63–74 years and 78 were aged ≧ 75 years. The percentage of physical frailty in each age group was 10.3% and 30.8%, respectively. Among participants aged 63–74 years, office systolic BP (odds ratio [OR] 0.964, 95% confidence interval [CI] 0.932–0.998) and female (OR 5.943, 95% CI 1.524–23.185) were associated with physical frailty. Among participants aged ≧ 75 years, CV of morning PR (OR 1.320, 95% CI 1.003–1.739) and age (OR 1.313, 95% CI 1.085–1.588), but not the BP level, were associated with physical frailty.

Conclusions:

The indicators associated to physical frailty differed depending on the age group. Among the relatively young old group, physical frailty was few with increasing office systolic BP. Among the older group aged ≧ 75 years, variability of PR was associated with physical frailty. There may be the influence of declined autonomic nervous function by aging or reduced muscle mass.
PS-P01-9: RELATIONSHIP BETWEEN BLOOD PRESSURE AND FRAILTY IN ELDERLY PATIENTS WITH ANY CARDIOMETABOLIC RISK FACTORS
Authors: Ishikawa Joji , Toba Ayumi , Tamura Yoshiaki , Araki Atsushi , Harada Kazumasa
Published: January 2023

Background:

High blood pressure in mid-life was associated with frailty in elderly patients; however, frail patients have reduced quality of life (QOL) causing blood pressure decline. We thought to evaluated relationship between the blood pressure and frailty.

Methods:

We registered 691 elderly patients who had any cardiometabolic risk factors (hypertension, diabetes, dyslipidemia, atrial fibrillation, and heart failure) between Sep. 2015 and April 2022, and follow up for 1 year (N = 363). Clinic blood pressure (CBP) was taken twice in a seated position, using semi-automatic upper arm device, without doctors or nurses present. Frailty was evaluated using modified Japanese Cardiovascular Health Study score (J-CHS) that included appendicular skeletal muscle index, hand grip strength, and walk speed, and Kihon check list (KCL) that included QOL associated with frailty.

Results:

Mean age was 79.2 ± 6.3 years (male 35.6%). There were 30.4 % of patients with frailty by J-CHS criteria and 38.0 % by KCL criteria. In the multivariate-adjusted logistic regression analysis, frailty by J-CHS criteria was significantly associated with lower clinic DBP (OR = 0.901 per 5 mmHg increase, 95%CI, 0.829–0.978, P = 0.013); frailty by KCL criteria was with lower clinic SBP (OR = 0.843 per 10 mmHg increase, 95%CI 0.761–0.933, P = 0.001). In patients with antihypertensive medication, frailty with KCL was associated with clinic SBP (OR = 0.815 per 10 mmHg increase, 95%CI 0.703–0.944, P = 0.006). In frail patients by J-CHS criteria at baseline, low clinic DBP at baseline (OR = 0.937 per 1 mmHg increase, 95%CI 0.883–0.994, P = 0.031) and change in clinic DBP (OR = 0.921 per 1 mmHg change, 95%CI 0.861–0.986, P = 0.018) were associated with sustained frailty at 1 year later. In patients with preserved walk speed (> 1.0m/sec) at baseline, change in clinic DBP was associated with development of reduced walk speed (< 1.0m/s) at 1 year later (OR = 0.945, 95%CI 0.893–0.999, P = 0.046).

Conclusion:

Frailty was associated with lower clinic systolic or diastolic blood pressure, and change in clinic DBP in elderly patients with cardiometabolic risk factors.
PS-P02-2: EFFECT OF A STRUCTURED TRAINING PROGRAM ON KNOWLEDGE AND PRACTICE OF LIFESTYLE MODIFICATION AMONG HEALTHCARE PROFESSIONALS
Authors: Patil Mansi , Patil Vishal
Published: January 2023

Objective:

Hypertension awareness among healthcare professionals (HCPs) regarding lifestyle modification is still low. According to research, the best method to solve this problem is to sensitize and train HCPs regarding the different modalities of lifestyle management. This study aims to see how a structured training program aimed at HCPs is effective in improving knowledge of hypertension in the advice of lifestyle changes to their patients.

Design and Methods:

The sample size (n = 30) HCPs was determined using a quasi-experimental method. The Hypertension Knowledge-Level Scale (HK-LS), a modified structured questionnaire from the World Health Organization (WHO), was used to assess understanding of hypertension, knowledge of lifestyle modification, and practice. A 7-module, 12-week online course was delivered to the HCPs and a pre-test and post-test was administered to assess the change in knowledge regarding the awareness of lifestyle modifications.

Results:

The result showed that the t-test of the pre-knowledge about hypertension among HCPs differed significantly from post-knowledge after intervention (t = 4.90, p = 0.001). In addition, there is a significantly different between the pre and post-knowledge levels about lifestyle modification after intervention (t = 3.62, p = 0.001). A significant difference was also observed between the pre and post their advice of lifestyle modification to their patient after intervention (t = 3.56, p = 0.001).

Conclusions:

The health care providers, especially the allied healthcare professionals must be trained in a structured way to improve their knowledge of lifestyle modification specifically in hypertension as part of the primary prevention of hypertension.
PS-P03-1: THE EFFECTIVENESS OF SHORT EDUCATIONAL VIDEOS ON PROPER HOME BLOOD PRESSURE MONITORING KNOWLEDGE AMONG MEDICAL STUDENTS: A PILOT STUDY
Authors: Rashid Aneesa Abdul , Thew Hui Zhu , Zakaria Zulaikha , Faizal Muhammad Shafirul Daniel Mohd , Choo Zhi Cheng
Published: January 2023

Objective:

Hypertension is a major global public health problem. It is often poorly controlled leading to many health complications. The use of home blood pressure monitoring (HBPM) is an effective tool for assisting clinicians in diagnosing and managing patients with hypertension. HBPM has been proven to improve BP levels for at least twelve months when used in conjunction with co-inventions such as educational interventions or support from health care. Around 15% of those with hypertension are young adults; aged between 18–39 years. Developing hypertension at a young age puts this group at risk of earlier onset cardiovascular events. Challenges in treating hypertension in young adults include the perception that it is a disorder for older people; lack of health education; shortage of suitable educational materials; and limited health resources. Short videos are one of the ways to address this problem. Hence, this study aimed to determine the effectiveness of short videos on knowledge of HBPM among medical students.

Design and method:

This is a pre-post interventional pilot study. It was done among 13 first year medical students in the Universiti Putra Malaysia from January to April 2022. The students were given a two-part online questionnaire on HBPM pre and immediately post intervention. The questionnaire was adapted from the Malaysian clinical practice guidelines on the management of hypertension and content validation was done by a panel of experts. It consisted of 20 questions, with one point for each correct answer. A higher score indicates better knowledge. The intervention consists of three short 1 minute videos on (1) things to avoid before taking blood pressure, (2) how to take proper HBPM and (3) how to take proper BP.

Results:

Thirteen students took part in the study. Most of the respondents were female n = 10, 76.9% and Malay ethnicity n = 12, 92.%, and mostly family income of <RM2000 (approximately USD 460); n = 6,46.2%. There were 30.8% that practised monitoring their own BP and 69.2% assist family members in monitoring their BP. There was a significant increase in the mean knowledge score pre-test, and post-test which was 10.85 (+3.63), and 16.15 (±2.27) respectively (p < 0.001).

Conclusions:

We found our short educational videos were effective in increasing knowledge of HBPM among first year medical students. This has great potential as an intervention for not only health sciences students but those with a different educational background, and later on to the public.
PS-P03-2: RACIAL AND ETHNIC DISPARITIES IN HYPERTENSION CONTROL IN AN INTEGRATED HEALTHCARE SYSTEM IN THE UNITED STATES, 2008–2019
Authors: Reynolds Kristi , Harrison Teresa N , Zhou Hui , Wei Rong , Brettler Jeffrey , Su Angeline L Ong , An Jaejin , Sanders Mark , Muntner Paul
Published: January 2023

Objective:

To determine whether racial/ethnic disparities in control of hypertension changed from 2008 through 2019 within a large and diverse integrated healthcare system that implemented a series of health care delivery changes in 2011 to address disparities in hypertension control.

Design and method:

We evaluated hypertension control, defined as systolic BP < 140 mmHg and diastolic BP < 90 mmHg, among adults age 18 years and older with diagnosed hypertension identified from a clinical hypertension registry, stratified by race/ethnicity (self-reported as non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic, or Asian or Pacific Islander (API)) from 2008–2019.

Results:

Between 2008 and 2019, the population with hypertension increased from 624,094 to 855,257. Mean age was 61.8 years in 2008 and increased to 64.5 years in 2019; ∼52% of the population in each year was female. The proportion of NHW and NHB adults decreased during this period from 45.4% to 38.8% and 14.3% to 12.5%, respectively, while the proportion of API and Hispanic adults increased from 9.8% to 12.6% and 25.2% to 33.0%, respectively. The overall age-adjusted estimated proportion with controlled hypertension increased from 2008 to 2013 from 74.3% (95% CI, 74.1%-74.6%) to 83.0% (95% CI, 82.8%-83.2%) and then decreased from 2014 to 2019 from 81.1% (95% CI, 80.9%-81.3%) to 79.3% (95% CI, 79.1%-79.4%). This trend was present in men and women across all races/ethnicities (Figure). In each year, API adults had the highest and NHB adults had the lowest age-adjusted estimated proportion with controlled hypertension. The disparity in controlled hypertension between NHW and NHB women was 5.7% (p < .001) in 2008 and decreased to 1.6% (p < .001) in 2015 and increased to 2.7% (p < .001) by 2019. In 2008, the disparity in controlled hypertension between NHW and NHB men was 7.1% (p < .001) and decreased to 2.8% (p < .001) in 2016 and increased to 3.7% (p < .001) by 2019. In 2019, NHB adults were more likely to have uncontrolled hypertension compared with NHW adults (multivariable-adjusted prevalence ratio, 1.13 [95% CI, 1.12–1.14]).

Conclusions:

While disparities in hypertension control have narrowed between NHB and NHW adults in this integrated healthcare system, differences persist. Understanding these differences can help identify continued unmet needs and guide more equitable health care to reduce the burden of hypertension-related cardiovascular disease.
PS-P04-1: RISK FACTOR PROFILE AND LACK OF TREATMENT INTENSIFICATION AS A MAIN FACTOR OF INCREASED STROKE MORTALITY IN BULGARIA
Authors: Postadzhiyan Arman , Yotov Yoto , Tisheva Snezana , Nikolov Fedya , Ramshev Konstantin , Grouev Ivan
Published: January 2023

Objective:

Bulgaria is one of the leading countries in terms of premature mortality due to stroke with 6406,4 years of life lost per 100000 (95% CI 5211,7 to 7763,4) according to the data from Global Burden of Disease for 2019. In the same year The May Measurement Month (MMM) initiative was implemented in the country aiming to raise hypertension awareness and control. The aim of the study was to identify whether national-level MMM hypertension parameters are associated with national stroke mortality statistics.

Design and method:

Three BP readings and self-reported demographic, lifestyle and cardiovascular risk factors were collected from 3678 participants during MMM2019 campaign. National stroke mortality statistics and Socio-Demographic Index (SDI) were extracted from the Global Burden of Disease (GBD) study 2019. Hypertension was defined as a raised BP (systolic BP > 140 mmHg or diastolic BP > 90 mmHg based on the mean of the second and third readings), or on antihypertensive medication. Logistic and linear regression were applied, respectively, to the association between hypertension and stroke and between national-level GBD stroke mortality with MMM proportions with raised, treated and uncontrolled BP.

Results:

Overall we notice a relatively high proportion of participants with a previous stroke 237 (6.4%). Stroke survivors were older (69 vs 58,1, p < 0.001), with higher levels of systolic BP (139,4 vs 134,9 mmHg), but lower diastolic BP (80,2 vs 82,5 mmHg) and significantly more frequent concomitant coronary and peripheral arterial diseases, diabetes or heart failure (p < 0.001 for all). The proportion with previous atrial fibrillation was also higher among previous stroke patients 13,9 vs 5,6%. Stroke mortality increased, on average, by 680 per 100,000 per 1% increase in the proportion of individuals with raised BP (p = 0.006) and by 909 per 100,000 per 1% increase in proportion with treated but uncontrolled BP (p = 0.012). The corresponding years of life lost due to ischemic stroke were 736 (p = 0.015) and 172 per 100000 (p = 0.0005) due to hemorrhagic stroke per 1% increase in proportion with suboptimally treated BP.

Conclusions:

There was a significant association between national stroke mortality from GBD and the proportions of participants with raised BP and of hypertensives treated but uncontrolled in MMM. This suggests that despite lacking a population-based design, estimates from MMM broadly reflect rates of downstream mortality and that opportunistic screening can be an effective means not only of screening for hypertension, but of improving control of the patients already treated. The data presented gives rational for using estimates to inform policy and to start national campaign in order to change the existing tendencies.
PS-P04-5: A COMPARISON OF PREVALENCE OF HYPERTENSION AND BLOOD PRESSURE MEASUREMENTS BETWEEN SHORT-STATURE AND TALLER IN HEAVIER ADULTS OF BANGLADESH
Authors: Abrar Ahmad Khairul , Afroza Ummay , Choudhury Sohel Reza
Published: January 2023

Objective:

To compare the odds of hypertension and means of Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), and Pulse Pressure (PP) in different quartiles of stature among the heavier adults of Bangladesh with a priory hypothesis- the overnutrition in adulthood with poor nutrition in early life is associated with a higher risk of hypertension.

Design and method:

To attain the objectives, we analyzed the Non-communicable Disease Risk Factor Survey 2018 data. This population-based national cross-sectional study was conducted in equally distributed 496 urban and rural PSUs in all divisions of Bangladesh. Total 8185 adults (18–69 years) completed STEP-1 and STEP-2 of the survey. After exclusion of the extreme values participants who had complete information on height, weight, and blood pressure measurements (n = 7969), were included in the analysis. Short-stature and heavier adults were defined as participants belonging to the sex-specific first quartile of height and fourth quartile of weight, respectively. Hypertension was defined as an SBP ≧ 140 mmHg or/and a DBP ≧ 90 mmHg, or current use of antihypertensive medication. MAP and PP were calculated with standard formulae. Differences between means were compared by ANOVA. Multivariate logistic regression model was used.

Result:

Prevalence of hypertension was higher in the short-stature heavier adults (men 41.7%, women 49.0%) than the taller and heavier adults (men 35.1%, women 37.6%). Odds of hypertension in short-stature women were 59% higher compared to taller (OR:1.59, 95% CI:1.02–2.49, p < 0.05).

Among heavier adults, mean of the blood pressure measurements founded to be lower in the taller participants compared with short stature. In short-stature men (n = 72) mean SBP (129.24 mmHg), DBP (85.21 mmHg), and MAP (99.89 mmHg) were higher than mean SBP (127.69 mmHg), DBP (82.91 mmHg), and MAP (97.83 mmHg) of the taller men (n = 441). In short-stature women (n = 96) mean SBP (129.09 mmHg), DBP (86.52 mmHg), MAP (100.71 mmHg), and PP (42.58 mmHg) were more than mean SBP (124.22 mmHg), DBP (84.69 mmHg), MAP (97.87 mmHg), and PP (39.53 mmHg) of the taller women (n = 407). Differences in the means were not statistically significant.

Conclusion:

Stature is an indicator of poor nutrition in early life in countries prevailing undernutrition. The association found from this nationally representative data supports the theory of a critical ontogenetic dependence of adult blood pressure, especially in women.