bluuebunny/crossref_metadata_2025 huggingface dataset:
P081 ASSOCIATION BETWEEN 24-HOUR BLOOD PRESSURE VARIABILITY AND FALLS
Authors: Reynolds Kristi , Wei R , Bowling C.B. , Cannavale K , Harrison TN , Qian L , Muntner P , Schwartz JE , Sim JJ , Shimbo D
Published: September 2024

Background and Objective:

Clinicians may worry that fluctuations in blood pressure (BP) put older adults at risk for falling. While many adults taking antihypertensive medication have high BP variability (BPV), associations between higher BPV and risk of falls among older adults taking antihypertensive medication are unknown.

Methods:

We conducted a prospective cohort study of adults ≥65 years old taking antihypertensive medication recruited from a US integrated healthcare system. Information on demographics, clinical characteristics, geriatric assessments, mean clinic BP, and 24-hour ambulatory BP monitoring was collected at a baseline visit. Participants recorded falls over one year using monthly falls calendars. BPV was assessed as 24-hour standard deviation (SD) weighted for day-night BP. Participants were grouped into quartiles of 24-hour SD of systolic BP (SBP) and diastolic BP (DBP), respectively. We used multivariable Cox proportional hazards models to examine the association between BPV and time to first fall comparing the highest quartile to the three lower quartiles of these BPV measures.

Results:

We analyzed 608 participants [mean age 74.6 years, 14% Asian/Pacific Islander, 22% Black, 18% Hispanic, 45% White, and 57% female]. During follow-up, 238 participants (39%) experienced at least one fall. The incidence rate per 100 person-years of falls was 52.2 (95% CI, 44.9-60.6) in the lower quartiles of SBP variability and 65.0 (51.1-82.7) in the highest quartile. Higher 24-hour BPV was not associated with a higher risk of falls in the overall population (adjusted HR 1.17, 95% CI 0.86-1.58 for SBP and 1.09, 95% CI 0.81-1.48 for DBP). The results did not differ across subgroups defined by age, sex, race and ethnicity, and history of falls. However, higher BPV among individuals with clinic SBP ≥140 mmHg at baseline was associated with an increased risk of falls (Table).

Conclusions:

In this study of older adults with treated hypertension, higher BPV was associated with a two-fold increased risk of falls only among adults with clinic SBP ≥140 mmHg at baseline.
P090 VASCULAR GROWTH FACTORS AND ARTERIAL STIFFENING IN YOUNG PEOPLE FROM THE 1986 JAMAICA BIRTH COHORT
Authors: Bennett Nadia , Ferguson Trevor , Younger-Coleman Novie , Tulloch-Reid Marshall , Wilks Rainford , Cruickshank J Kennedy
Published: September 2024

Background and Objective:

Vascular growth factors (GFs), as endothelial (VEGF), epidermal (EGF), and angiopoietin 1 (Angp1) and 2 (Angp2) promote blood vessel growth in early and later life. Increased arterial stiffness as aortic pulse wave velocity (PWV) is a powerful indicator of prognosis, independent of blood pressure (BP). Few studies have examined impacts of GFs epidemiologically although VEGF inhibitors eg; for macular degeneration, can cause steep BP rises. We tested the hypothesis that these factors measured aged 18-20y in a Caribbean cohort would be related to arterial function as PWV in the same people 10 years later.

Methods:

Participants were restricted to a cohort subset born in Jamaica September-October 1986 with PWV at 28-30y. Socio-demography and anthropometry were recorded at 18-20 and 28-30yo visits, with serum stored at -70o from 18-20y with GFs measured by Elisa assays. Analyses were mainly by linear regression, as separate then if significant, combined models. Other included risk factors (RFs) were age, sex, smoking education, BMI, mean BP and their change over follow-up.

Results:

In 387 participants (47% male) at 28-30y, median serum GF concentrations ranged from VEGF 103.7 pg/ml to EGF 949.6 pg/ml with Angp1 70.8pg/ml Angp2 907.8 pg/ml with male:female differences in BMI (26.3:28.5 kg/m2), smokers (29.7:2.4%) tertiary education (22: 38%), SBP (114:108mmHg), MAP (85.5:85.5mmHg) and PWV (6.4:6.8 m/s).

In the final multivariable model, VEGF (Beta, 95% CI) 0.13, 0.05-0.22; p=0.003, with gender, BMI, MAP and their changes over 10y were all independently and positively related to PWV (all p<0.001). EGF's marginal inverse relationship was not significant and Angp1 or Angp2 were unrelated alone, or jointly in the same model.

Conclusion:

At 18-20y, VEGF concentrations were positively and independently related to aortic PWV indicating arterial stiffening at 28-30y, as were other standard risk factors. These data suggest that VEGF may in part drive such stiffening/ remodeling over time, aggravated by other standard RFs.
P094 HYPERTENSION AT ADMISSION AFFECTS THE RESULTS OF CARDIAC SCINTIGRAPHY IN THE ELDER PATIENTS WITH ISCHEMIC HEART DISEASE
Authors: Sakida Miho , Hirai Takumi , Miyahara Yuiko , Kubo Kazuhiko
Published: September 2024

Background and Objective:

The heart disease is the second most common cause of death after cancer in Japan. Since a myocardial ischemia leads directly to life prognosis, the evaluation of severity of myocardial ischemia is very important to reduce mortality in the patients with ischemic heart disease. The cardiac scintigraphy is less-invasive method to check it than cardiac catheter while results of cardiac scintigraphy are affected by aging and hypertension. The aim of this study is to evaluate the effect of both aging and hypertension at admission on the results of cardiac scintigraphy in the patients with ischemic heart disease.

Methods:

We recruited 102 patients with ischemic heart disease who were admitted to Chidoribashi General Hospital and underwent cardiac scintigraphy from April 2021 to March 2023. The various parameters such as patient's profile and results of cardiac scintigraphy were collected from electric medical records retrospectively. The comparison was statistically tested using JMP Pro 17. This study was approved by our ethical committee.

Results:

Thirty-one patients were under 70 years old and seventy-one patients were 70 years old or more. In elder patients, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and the difference of LVEDV from LVESV at rest were more in the patients with hypertension at admission than in the patients without that. In contrast, no difference existed in younger patients.

Conclusions:

These results suggest that aging may change the ischemic status affected by hypertension.
P102 PH-SENSOR GPR68 PLAYS A ROLE IN THE CARDIOPROTECTIVE EFFECTS OF A HIGH FIBRE DIET
Authors: Dinakis Evany , Xu Chudan , Jama Hamdi , Muralitharan Rikeish , Xie Liang , Mackay Charles , O’Donnell Joanne , Marques Francine
Published: September 2024

Background/Objective:

Dietary fibre lowers blood pressure (BP) via short-chain fatty acids, acidic metabolites released from fibre fermentation by the bacteria in the large intestine. This acidic microenvironment may activate pH-sensing receptor GPR68, expressed primarily on immune cells, which play a crucial role in BP regulation. Here, we aimed to investigate whether GPR68 confers the cardioprotective effects of a high-fibre diet in hypertension by regulating inflammatory responses.

Methods:

6–8-week-old male wildtype (WT) and GPR68-deficient (Gpr68-/-) fed a control or high-fibre diet underwent subcutaneous implantation of minipumps containing Angiotensin II (0.75 mg/kg body weight/day, 4 weeks, n=8/group). BP was measured weekly by tail-cuff. Morphometric, histological, and flow cytometric analyses were performed following the 4-week protocol.

Results:

High-fibre-fed WT mice exhibited blunted elevations in systolic BP (week 4; p=0.0508) and lower cardiac interstitial collagen deposition (p=0.0495) compared to WT mice fed a control diet. However, high fibre did not lower BP (week 4; control vs high-fibre, p=0.689) or cardiac collagen deposition (p=0.842) in Gpr68-/- mice. High-fibre-fed WT mice exhibited improved aortic elastin content compared to control-fed WT mice (p=0.0503), whereas this remained negligible in Gpr68-/- mice (p=0.885). Flow cytometric analysis revealed that high fibre decreased aortic macrophage (p=0.0072) and neutrophil cell counts (p=0.0273) in mice, irrespective of genotype. High fibre also decreased overall renal immune cell counts (p=0.0213) and dendritic cells (p=0.0488) in mice, irrespective of genotype. Finally, high fibre-fed mice had overall decreased circulating immune cell counts (p=0.0264), specifically CD8+ T cells (p=0.0235), and γδ T cells (p=0.0264).

Conclusions:

High fibre intervention on Angiotensin II-treated GPR68-deficient mice did not lower their BP or cardiac fibrosis. All angiotensin II-treated mice fed a high-fibre diet exhibited prominent changes in various immune cell populations, irrespective of genotype. Nonetheless, this study provides novel insight that GPR68 is involved in the cardioprotective effects of a high-fibre diet. This is most likely via in an immune-independent manner, warranting further investigations into its underlying mechanisms of action.
P105 RENAL DENERVATION WITH SPYRAL SIMPLICITY SYSTEM: A SINGLE CENTER EXPERIENCE IN COLOMBIA
Authors: Sanchez Velásquez Alejandro , Jagua Ana María García , Dukón María del Pilar González
Published: September 2024

Background and Objectives:

Hypertension is the leading cause of death with 10,4 million deaths and 218 disability adjusted life years (DALYs) worldwide in 2017. Despite GDMT, about 10 to 20% of hypertensive subjects will be poorly controlled, meeting the definition for difficult to treat (DTTH) and refractory hypertension (RH). Renal denervation (RDN) with Spyral

Simplicity SystemTM has become a promising nonpharmacological treatment for DTTH and RH, and it has shown to be an effective and safe procedure for RH patients in randomized clinical trials with up to 12 months follow-up.

Methods:

This is a single-center registry including 6 adults with DTTH and RH confirmed by ABPM and without secondary hypertension, underwent RDN in a tertiary hospital in

Bucaramanga, Colombia. A 6-months follow-up was performed, recording clinical data (symptoms, NYHA functional class, number and type of antihypertensive medications, heart rate and ER visits) and paraclinical tests (ABPM, eGFR and echocardiogram).

Results:

Mean age was 73 ± 4,64 years-old with 50% females. Main comorbidities were dyslipidemia (100%), cardiovascular disease (100%), and type 2 diabetes (83,3%). Pre-procedural medication average was 5. All patients were in NYHA II, with preserved left ventricular EF and mild to moderate diastolic disfunction. At 6 months of follow-up, there was a mean reduction in systolic blood pressure (SBP) of 10 mmHg (145 to 135 mmHg) in ABPM and 26 mmHg (169 to 143 mmHg) in office. There were not significant changes between pre- and post-procedural mean HR (68 vs. 61 bpm), neither short- or long-term complications associated with the procedure. In average, one drug withdrawal was observed. All the subjects improved their NYHA functional class. There were no ER visits in the 6-month follow-up.

Conclusions:

RDN is effective and safe for patients with DTTH and RH, achieving significant reduction in ABPM and office SBP, reducing medication number, improving NYHA functional class and avoiding visits to ER in the mid-term follow-up.
P114 SHORT-TERM EFFECTS OF BLOOD PRESSURE LOWERING DRUGS ON CARDIOVASCULAR EVENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED, PLACEBO-CONTROLLED, DOUBLED-BLIND TRIALS
Authors: Gnanenthiran Sonali , Kaistha Prachi , Pant Rashmi , Dhurjati Rupasvi , Kumar Amit , Haghdoost Faraidoon , Kota Vidyasagar , Wang Nelson , Rodgers Anthony , Salam Abdul
Published: September 2024

Background and Objective:

There remains uncertainty about the short-term effects of blood pressure (BP) lowering drugs on cardiovascular events. This meta-analysis of double-blind, short-term randomised trials, evaluated the effect of BP-lowering drugs on cardiovascular events compared to placebo.

Methods:

A systematic search was performed in the following databases: MEDLINE, Cochrane Central Register of Controlled Trials, and Epistemonikos. Trials satisfying the following criteria were included: (i) randomized, double-blind placebo-controlled trials of 2-26 weeks published in English language; (ii) adults (age ≥18 years) with hypertension (BP ≥140/90 mmHg) or taking BP-lowering drugs; (iii) intervention: oral fixed dose of BP-lowering drug(s) as either monotherapy or combination therapy from five major classes (angiotensin converting enzyme, angiotensin-II receptor blockers, calcium channel blockers, beta-blockers, and diuretics); (iv) placebo comparator; (v) reported data on cardiovascular events; (vi). The primary outcome was major adverse cardiovascular events (MACE), defined as stroke, transient ischaemic attack (TIA), myocardial infarction, heart failure, angina or coronary revascularisation.

Results:

451 trials (93121 participants [mean age 54yrs, 56% males, mean follow-up 8 weeks] were included. There was no effect of the intervention compared to placebo on MACE (0.19% versus 0.43%; relative risk [RR] 0.89, 95% CI 0.69-1.14, p=0.35). There was a significant reduction in stroke (0.01% versus 0.05%; RR 0.37 [0.19-0.72]; p<0.001) and TIA (0.001% versus 0.01%; RR 0.26 [0.08-0.82]; p=0.02). Subgroup analysis suggested combination therapy provided the most benefit in stroke reduction (RR 0.21 [0.04-1.01], p=0.05), but benefits were observed across all anti-hypertensive groups for TIA outcomes. There were no between group differences in all-cause or cardiovascular mortality, myocardial infarction, heart failure hospitalization, angina or coronary secularization.

Conclusions:

This meta-analysis of placebo-controlled RCTs demonstrated reduced stroke and TIA events with BP-lowering drugs even at short-term follow up. These findings suggest BP lowering treatment should be initiated as soon as possible in at risk individuals because even 8 weeks of treatment can significantly reduce the risk of stroke/TIA.
P127 TO INVESTIGATE THE ASSOCIATION BETWEEN BODY MASS INDEX(BMI) AND NECK CIRCUMFERENCE FOR ASSESSING THE RISK OF DEVELOPING HYPERTENSION
Authors: Patil Mansi , Patil Vishal
Published: September 2024

Background:

This study investigates the association between body mass index (BMI) in combination with neck circumference and the risk of developing hypertension.

Methods:

Participants (35,000) were selected from the 2021 May Measurement Month participants, comprising normotensive individuals. We categorized participants into four groups based on BMI and neck circumference. Neck circumference was then analyzed for its association with BMI in both females and males. Receiver operating characteristic (ROC) analysis was conducted to determine the best cut-off values for predicting central obesity, and the area under the curve (AUC) was compared between neck circumference and BMI.

Results:

Following a median observation period of 2.1years, hypertension was diagnosed in 22,400 (64%) participants. Groups 2, 3, and 4 displayed notably elevated hypertension risks compared to Group 1, exhibiting hazard ratios (HRs) of 1.066 (95% CI: 1.025, 1.110), 1.322 (95% CI: 1.235, 1.415), and 1.422 (95% CI: 1.337, 1.512), respectively. Moreover, integrating BMI into a conventional model yielded a more substantial enhancement in hypertension prediction than neck circumference alone. Concurrently assessing BMI and neck circumference further improved hypertension risk estimation accuracy.

Neck circumference demonstrated significant correlations with waist circumference in both females and males, with respective b-coefficients of 1.03 (95% CI: 0.85, 1.21) and 0.74 (95% CI: 0.54, 0.70). Receiver operating characteristic (ROC) analysis identified neck circumferences ≥36 cm in females and ≥40 cm in males as optimal thresholds for predicting central obesity. Additionally, the area under the curve (AUC) for neck circumference (0.71; 95% CI: 0.72–0.77) in predicting central obesity surpassed that of BMI (0.77; 95% CI: 0.78–0.82).

Conclusion:

Individuals with elevated BMI and neck circumference face an increased risk of developing hypertension. While BMI proves to be a predictor of hypertension risk, neck circumference is a superior predictor. Utilizing both measures together enhances hypertension risk prediction accuracy. This underscores the importance of considering both BMI and neck circumference in assessing hypertension risk among individuals.
P151 RECOMMENDATIONS FOR HOME BLOOD PRESSURE MEASUREMENT ARE INCONSISTENT BETWEEN INTERNATIONAL GUIDELINES
Authors: Clapham Eleanor , Slater Kaylee , Picone Dean , Chapman Niamh
Published: September 2024

Background and objective.

Recommendations made across blood pressure (BP) guidelines should use consistent messaging to inform patient education for home BP measurement. It is not known if recommendations for home BP measurement are consistent across BP guidelines, which was the aim of this study.

Methods.

Recommendations for home BP measurement were extracted verbatim from six BP guidelines and expert consensus statements (Australian, United States, Canadian, European, International and Japanese). Consistency between BP guidelines was assessed by head-to-head comparison of recommendations and classified as inconsistent if the recommendation was not differed from one or more other recommendation. Analysis was conducted independently by two investigators (EC, KS) and conflicts adjudicated by two other investigators (NC, DP).

Results.

In total, 101 recommendations for home BP measurement were identified, and each guideline contained a median of 33 recommendations. Forty-four recommendations (44%) were present in two or more of the six guidelines. The only recommendation made by all six guidelines was to measure BP in a seated position. Forty-nine recommendations (49%) were inconsistent with at least one other recommendation. Twenty-nine of these recommendations (59%) contained a time parameter such as how many days to measure BP at home and how long to abstain from caffeine or tobacco usage prior to measurement. All recommendations on choosing and fitting a BP cuff were inconsistent, except the recommendations to fit the cuff to a bare arm and choose an appropriately sized cuff.

Conclusion.

There is a lack of consistency in the recommendations made for home BP measurement by international guidelines. Harmonisation across BP guidelines is needed to create clear, unambiguous messaging in guideline recommendations to support implementation of evidence-based care for home BP measurement and management.
P154 GETTING OPTIMAL AND TARGET BLOOD PRESSURE IS MORE CHALLENGING FOR HYPERTENSIVE PATIENTS WITH ANOTHER CARDIOVASCULAR DISEASE
Authors: Vachulova Anna , Simkova Adriana , Sidlo Rastislav
Published: September 2024

Home blood pressure monitoring (HBPM) compared with office-based monitoring could be better at predicting cardiovascular morbidity and mortality.

Patients and Methods:

This project aimed to evaluate HBPM in adult pts with AH. It was conducted from April to June 2022 at 178 general physicians practices in Slovakia.

Results:

4375 pts with AH were enrolled (2089 women, 51,8%), mean age 61,1 ± 19,1 years. BP values at HBPM decreased over the period of seven days by -2.2/-1.4 mm Hg (p < 0.01). The first treatment goal, office BP ≤ 140/90 mm Hg, was achieved by 67% of patients. The second treatment goal, based on patients’ age was achieved by 35% of patients. The number of patients with CV comorbidities surpassed 48.8%. They were significantly older 67,3± 15,2 years vs 57,1 ± 12,6 years (p<0,01), with a higher BMI of 30,1± 5,2 kg/m2vs 28,7 ± 3,8 kg/m2 (p<0,01) in comparison with patients without CV comorbidities. In HBPM patients with CV comorbidities have higher both systolic BP (SBP) and diastolic BP (DBP) 134,8 ± 11,2/80,3± 7,6 mmHg vs 131,9±8,2/80,4 ±6,4 mmHg (p<0,01). To compare with office blood pressure measurements: higher SBP was in patients with CV comorbidities 137,1 ±18,1 mmHg vs 135,2 ±16,3 mmHg (p 0,516), higher DBP was in patients without CV comorbidities 81,5 ±6,4 mmHg vs 80,3 ± 5,1 mmHg (p<0,01). Dyslipidemia was present in 67% of patients. Women were more likely to have dyslipidemia and hypertension 68,8% vs 65,5% (p=0.03) in men.

Conclusions:

The results of office and home BPM 2022 demonstrated active involvement of patients in the management of AH can have a significant impact. We need to be more consistent in treating AH, according to 2023 ESH guidelines, mainly in patients with cardiovascular comorbidities. By achieving a 67% success rate in control of AH patients, The Charter 70/2023 is imminent.
P156 HYPERTENSIVES USERS OF A HEALTH WEB PORTAL
Authors: Bédard, J. Rousseau , Cloutier Lyne , Michaud A.
Published: September 2024

Background and objective:

In Canada, approximately 1 in 4 adults live with high blood pressure. These people, concerned about their health, often turn to health information Web portals. To meet this need for information, Quebec Society of Vascular Sciences (QSVS) du Québec has created a web portal (www.yourvascularhealth.ca). However, limited data is available to describe the characteristics and motivations of hypertensive users of these websites.

Method

In this multicenter study, participants had to be ≥18 years old, hypertensive and able to use digital tools. They were approached by collaborating physicians (n=30) during routine consultations. An anonymous, validated electronic questionnaire assessed socio-demographic variables, digital competence, and motivations for using a health website. Adapted Technology Acceptance Model III was used as a framework.

Results:

Forty-three participants were recruited mean age of 70.3 ± 10.5 years, 67% male, 33% had achieved a university level of education. For health behaviors, less than 30% attained the 150 weekly minutes of exercise promoted in Canada while a less than half (44%) say that they eat according to DASH guidelines. The vast majority don’t smoke (67%) and drink less than once a month (86%). Preliminary analysis show that most participants (84%) use search engine. When questioned (on a Likert scale 1 to 7) about the portal, they perceived it was useful (6.0 ± 1.1), easy to use (5.4 ± 1.2) and expressed the intention of using the portal again (5.7 ± 1.5). When motivation was assessed; autonomous motivation was highest (5.83 ± 0.99) followed by amotivation (3.83 ± 1.35) and controlled motivation (3.13 ± 1.39).

Conclusion:

Patients with hypertension are consulting websites to obtain more information and this even later in life. It is our responsibility to provide websites that are designed for this population and scientifically based. This study will contribute to a better characterization of health website users and may guide the development and dissemination of health websites.
P164 SOLUBLE GUANYLATE CYCLASE STIMULATORS: AN EMERGING OPTION IN THE TREATMENT OF PRESSURE AND VOLUME OVERLOAD INDUCED CHRONIC HEART FAILURE
Authors: Bačová Barbara Szeiffová , Sýkora Matúš , Martišková Adriana , Gawrys Olga , Tribulová Narcisa , Červenka Luděk
Published: September 2024

Pressure and volume overload-induced chronic heart failure (HF) is associated with characteristic cardiac remodeling and ventricular myocardial proteomic alterations, that can lead to the formation of a substrate for arrhythmias. Antiarrhythmic drug therapy is still suboptimal and current therapies are not efficacious enough. The purpose of the current study was therefore to examine the efficiency of nitric oxide (NO)/soluble guanylyl cyclase (sGC)/cyclic guanosine monophosphate (cGMP) stimulator.

We used as an experimental model male hypertensive Ren-2 transgenic rats (TGR) (n = 16), normotensive Hannover Sprague–Dawley rats (HSD, n = 17), and a volume-overload HF rat model induced by creating the aortocaval fistula (ACF) in rats of both strains (n = 27). Rats were after the induction of ACF treated by sGC stimulator BAY41-8543 (3 mg/kg/day for 30 weeks) alone or combined with angiotensin-converting enzyme inhibitor (ACEi) Trandolapril (0.25 mg/kg/day for 30 weeks). The age of the animals at the end of the experiment was 40 weeks. Left ventricle tissue and plasma samples were used for further analyses. Blood pressure (BP) was measured by telemetry.

Combined treatment with sGC stimulator and ACEi was the most potent in lowering BP. Moreover, supplementation by sGC stimulator alone significantly decreased mortality and increased levels of the antioxidant enzyme superoxide dismutase 1, matrix metalloproteinase 2, total and phosphorylated connexin 43 as well as protein kinase C epsilon, implicated in remodeling of extracellular matrix and intercellular communication, in the left ventricle of TGR rats. Application of the sGC stimulator also slightly normalized elevated collagen deposition and hydroxyproline content in the left ventricular tissue of TGR rats. Unfortunately, we did not observe any effect of the sGC stimulator in the TGR ACF group.

These results support the hypothesis that sGC stimulators might represent a class of drugs suitable for the prevention and treatment of related disorders in HF.

This work was supported by APVV-21-0410, VEGA 2/0006/23, and EXCELES LX22NPO5104. Supported by APVV-21-0410, VEGA 2/0006/23, and EXCELES LX22NPO5104.
P172 WHAT ARE CONSUMERS’ KNOWLEDGE, ATTITUDES, AND BEHAVIORS RELATED TO REDUCED-SODIUM SALT? A SYSTEMATIC REVIEW
Authors: Ghammachi Nadine , Kissock Katrina , Hoek Annet , Bullen James , Webster Jacqui , Neal Bruce , Trieu Kathy
Published: September 2024

Background and objective:

Despite compelling evidence of the efficacy of reduced-sodium salt in lowering blood pressure and cardiovascular disease risk, it is currently an underutilized intervention. To inform the approaches needed to scale-up use of reduced-sodium salt, it is important to understand how it is perceived by consumers. This study systematically assessed consumers’ knowledge, attitudes, and behaviors relating to reduced-sodium salt.

Methods:

PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) plus, Cochrane Central Register for Controlled Trials (CENTRAL) and Google Scholar (all years to 8 February 2024) were systematically searched to identify studies reporting quantitative or qualitative outcome measures of knowledge, attitudes, or behaviors related to reduced-sodium salt. Reduced-sodium salt was salt where all or a proportion of sodium chloride is replaced with a non-sodium component. The population of interest included consumers, healthcare professionals and chefs.

Results:

Twenty-eight studies from 11 countries were included. 17 were evaluations following a reduced-sodium salt intervention and 11 were descriptive studies of knowledge, attitudes, and behaviors in the general population. Intervention studies in China identified high overall acceptability, with medium-to-long-term continued use, ranging from 65 to 83% of participants despite about half reporting adverse taste differences. Rates of reduced-sodium salt use were lower among the general population groups studied (ranging from 10-16%) where interventions such as education and cost subsidization were not used. Descriptive studies without a reduced-sodium salt intervention found lower knowledge and awareness among consumers compared to healthcare professionals.

Conclusions:

Differences in taste were detectable by many but did not appear to affect overall acceptability of reduced-sodium salts. Increased awareness and knowledge about reduced-sodium salt, particularly among the general population, will be key to scaling the use of reduced-sodium salts.
P188 HYPERTENSION IN COVID-19 VACCINATED POPULATION: SUDAN MMM 2022
Authors: Ahmed Amjad M. , Beheiry Hind , Ahmed Omer
Published: September 2024

Introduction:

Little is available in the literature about high blood pressure readings after COVID-19 vaccination. Although all launched vaccines used different mechanisms of action other than the primary disease, hypertension development after receiving COVID-19 vaccination is still questionable. In this study, we will assess the predictability of utilizing the COVID-19 vaccine in the development of hypertension.

Methods:

Utilizing Sudan MMM 2022 data, participants’ BP was measured. Hypertension is defined as blood pressure ≥140/90 mmHg. Continuous data was presented in mean and standard deviation, and categorical data was presented in frequencies and percentages. Logistic regression models (unadjusted and adjusted) were used to predict high blood pressure readings.

Result: A total of 13,938 (42.6% were male, and the mean age was 34.9±14.6 years) patients were included in the study. The prevalence of associated medical conditions, diabetes, heart attack, heart failure, arrhythmia, and stroke were 6.2%, 1.2%, 1.5%, 0.8%, 5.0%, and 1.1%, respectively. The mean SBP was 117.8±17.3, and the mean DBP was 78.1±11.0. Of the population, 4,314 (31.0%) patients have received COVID-19 vaccination. The vaccinated patients were older (37.4±14.6 vs. 33.8±14.5, p<0.001), more frequently males (48.8% vs. 39.9%, p <0.001), and diabetic (8.3% vs. 5.3%, p<0.001). The incidence of SBP≥140 mmHg, DBP≥90 mmHg, and BP≥140/90 was 9.76%, 12.66%, and 5.73% respectively. The mean SBP is higher within vaccinated patients (119.1±17.3 vs. 117.2±17.3 p<0.001) as well as mean DBP (78.9±11.0 vs. 77.7±11.3 p<0.001). Using unadjusted logistic regression, vaccination use significantly predicted both SBP≥140 (OR 1.24, 95%CI 1.11-1.39, p<0.001) and DBP≥90 (OR 1.12, 95%CI 1.01-1.25, p=0.032). However, this significant finding didn’t hold after adjustment for known confounders.

Conclusion:

The COVID-19 vaccine reduced the mortality rate significantly. Although mean SBP and DBP were high within the vaccinated group, receiving the vaccine failed to predict the SBP≥140 and DBP≥90 in the adjusted model.
P192 PREVALENCE OF HYPERTENSION AND ITS ASSOCIATED FACTORS AMONG PUBLIC VEHICLE DRIVERS IN POKHARA, NEPAL
Authors: Chapagain Nawaraj , Gahatraj Nand Ram , Neupane Dinesh
Published: September 2024

Introduction:

Hypertension, defined as >=140/90 mm Hg or currently taking antihypertensive medicine, is a major public health concern globally, affecting individuals of all ages, backgrounds, and lifestyles. Occupational risk factors associated with hypertension are poorly studied in the context of Nepal, drivers could be at a higher risk of hypertension because of multiple shift work, stress, inactivity, and poor diet.

Methodology

This cross-sectional study recruited 358 public vehicle drivers from Pokhara Metropolitan City of Nepal. The WHO STEPS questionnaire was used to assess the prevalence of hypertension. Data were entered into REDCap software and analyzed by using SPSS. The chi-square test and binary logistic regression were applied to identify hypertension-related factors.

Results:

The mean age of the participants was 37.3 ±8.5 years, and all of them were male. The prevalence of hypertension was found to be 41.9%. Using the chi-square test, hypertension was found to be associated with age, lower education, being married, tobacco consumption, age of smoking initiation, alcohol consumption, binge alcohol intake, lower physical activity, obesity, duration of driving, and service. However, when using binary logistic regression, the association was found only with age (OR=0.353; 95% CI: 0.183 to 0.680) and obesity (OR=0.429; 95% CI: 0.234 to 0.783).

Conclusion:

This study concludes that nearly two-fifths of drivers had hypertension, which is higher than the prevalence in the general population. The research highlights the need to focus on risk factors associated with hypertension among public vehicle drivers in Pokhara, Nepal.
P197 PULSE WAVE ANALYSIS IN POST COVID PATIENTS WITH AND WITHOUT DE NOVO ARTERIAL HYPERTENSION. HOSPITAL UNIVERSITARIO DE LOS ANDES (HULA) VENEZUELA. 2021-2023
Authors: Medina Cabrita Jose Daniel , Aranguren Vielma Vanessa Coromoto , Serrano Marco Aurelio , Rivera Jesus Lopez , Quiñonez Magaly , Zambrano Carlos
Published: September 2024

Background and Objective:

COVID 19 infection is characterized by an acute respiratory process that can range from mild to severe and has been related to short- and long-term complications. Post COVID 19 syndrome has been described among these long-term complications, where alterations in pulse wave velocity define vascular alteration, increasing risk of systemic arterial hypertension. The objective is analyze pulse wave velocity and arterial stiffness in post-COVID 19 patients with and without de novo arterial hypertension at the HULA, Venezuela between 2021-2023.

Methods:

Observational case-control study on pulse wave velocity in post-COVID-19 patients with and without de novo arterial hypertension in the HULA post-COVID-19 consultation, 2021-2023.

Results:

The sample consisted of 90 patients: 30 cases and 60 controls, there was no statistically significant difference in variables such as sex, body mass index (BMI) and abdominal circumference between both cohorts, with a predominance of the age group between 35 to 49 years with 33.3%, and less frequency at the extremes of life, where the group of 18-34 years and over 65 corresponded to 20%, there was a statistically significant association between syndrome post COVID 19 and arterial stiffness, the risk of de novo arterial hypertension was found to be 4.9 times and 7.9 times higher in the small and large vessel arterial stiffness group compared to the group without arterial stiffness, respectively.

Conclusions:

It is impressive that the age group between 35 and 49 years has a higher risk of developing arterial hypertension associated with COVID 19, the alteration of pulse wave analysis in the patients in the consultation post COVID 19 was associated with a higher risk of developing de novo arterial hypertension compared to those who did not present alterations.
P200 INCIDENCE OF LENVATINIB INDUCED ARTERIAL HYPERTENSION IN THYROID CARCINOMA: A RETROSPECTIVE ANALYSIS OF A SERIES OF CASES
Authors: Rivera Martínez Wilfredo Antonio , Castaño María Johana Ramírez , Salazar Solarte Aura María , Oliveros Pierce Sebastián , Echeverri Rendón Ángela Patricia , Villegas Jaime Gallo , Ocampo Dagnóvar Aristizábal , Restrepo Johnayro Gutiérrez , González Alejandro Román
Published: September 2024

Background and Objective:

Advanced thyroid cancer leads to worse overall survival and a higher risk of locoregional recurrence. Tyrosine kinase inhibitors have emerged as a management alternative in these conditions. However, serious adverse effects such as high blood pressure are common in clinical trials and real-life studies. The objective of this study was to evaluate the incidence of arterial hypertension in patients undergoing treatment for advanced thyroid cancer with the tyrosine kinase inhibitors lenvatinib

Methods

This is a retrospective cohort study of patients with advanced thyroid cancer being managed with Lenvatinib, a tyrosine kinase inhibitor. The incidence of arterial hypertension after the start of treatment was evaluated.

Results

Among the subjects included in the study (n=26), the mean age was 64.6 ±11.8; 57.7% were women and hypertension occurred in 88.5% (23/26), being CTCAE grade ≥ 3 in 43.5% (10/23). In 12 of 23 it occurred due to exacerbation of pre-existing hypertension and in 10 of 23 it corresponded to de novo hypertension induced by the drug. A patient presented grade 4 hypertension due to posterior reversible encephalopathy syndrome. 6 patients died during follow-up, all developed hypertension during treatment with Lenvatinib.

Conclusions:

High blood pressure is a common and early adverse effect in the management of advanced thyroid cancer with Lenvatinib. Management strategies to improve drug tolerability may improve disease outcomes, treatment adherence and patient-related outcomes.
P202 KNOW YOUR NUMBERS AND GET THEM RIGHT: HOW MANY AND WHAT KIND OF PATIENTS KNOW THEIR BP TARGETS AND LEVELS IN BOGOTÁ?
Authors: Cruz Cuevas José D. , Villar Juan Carlos , Moreno Angélica M.
Published: September 2024

Background and objective:

Patient's knowledge of their disease and goals is a key component for achieving blood pressure (BP) control in patients with hypertension. Several guidelines and public health campaigns promote patient self-monitoring of BP levels and knowing their goals. The aim of this study was to estimate the proportion of patients meeting both knowledge of their BP targets and able to report their BP levels, as well as exploring their characteristics compared with unaware patients.

Methods

we performed a cross-sectional study with adults previously diagnosed hypertension from 6 out-patient clinics from different institutions in Bogotá, Colombia. Consenting participants answered a phone call survey regarding their disease, follow-up, treatment and knowledge. Participants were classified in three groups: those knowing both BP targets (systolic <140mmHg and diastolic <80mmHg) and their BP levels, those knowing either one of them, or those not knowing neither. We report sociodemographic and clinical characteristics using descriptive statistics and tested hypothesis of inter-group difference with Chi-square or ANOVA as appropriate.

Results

From 5051 patients invited, 1675 answered the survey (mean age of 66.3, 74% female, and mean time after diagnosis 11.3 years). From this population, 24% (95%CI 21.9-26.1%) knew both BP targets and their own levels while 38.5% (95%CI 36.1-40.8%) knew neither. Patients who knew BP levels and target were younger, more frequently male, resided in a higher socioeconomical area, had a higher educational level, and used more antihypertensive medications (table 1). Among 707 patients who reported the BP levels, awareness of target and levels did not translate into differences in systolic or diastolic pressure.

Conclusions

most patients with hypertension are unaware of BP targets or know their BP levels. Those knowing BP targets and levels were in better sociodemographic conditions than those who did not. However, being aware does not necessarily implies lower BP levels. Awareness campaigns in the future should prioritize patients with more social disadvantages.
P215 EFFECT OF OXYGEN LOADING MODEL ON RETINOPATHY OF PREMATURITY IN INTRAUTERINE GROWTH RETARDED MICE
Authors: Mogi Masaki , Watanabe Ryusuke , Liu Shuang , Eguchi Mariko
Published: September 2024

Background and Objective:

Fetal growth retardation (IUGR) not only induces various complications in newborns, but is also known to be associated with the future development of lifestyle-related diseases and conditions. Therefore, the neonatal treatment often struggles between life-sustaining and oxygen administration. We have previously reported that IUGR mice born from mothers raised on a low-protein diet show enhanced vascular remodeling. The mechanism is influenced by an increased inflammatory response associated with a decreased angiogenic response due to hypoxic loading in a femoral artery cuff implantation model. Based on this, we hypothesized that in IUGR mice, the reduced angiogenic response in retinopathy of prematurity may work to suppress the onset of the disease. To test this hypothesis, we examined the effects of oxygen loading on the retinal neovasculature using the mouse oxygen-induced retinopathy of prematurity (OIR) model.

Methods

The OIR model was created in newborns born from mothers raised on a normal protein diet (20%) and in IUGR newborns born from mothers raised on a low protein diet (8%). Specifically, the newborns were exposed to 75% hyperoxia for 5 days starting at 7 days of age, and retinal neovascularization was histologically evaluated 5 days later at 17 days of age for comprehensive transcriptome analysis.

Results:

Compared to normal birth weight OIR mice, retinal neovascularization was significantly suppressed in OIR mice with FGR. Retinal RNA sequencing revealed decreased expression of angiogenic factors that trigger pathological retinal neovascularization, such as the mitogen-activated protein kinase pathway (MAPK) pathway and corresponding upstream signaling pathways.

Conclusions

Our findings suggest that IUGR neonates have a weaker response to retinal oxygen stress and consequently are likely to have reduced retinopathy of prematurity. These results indicate that the risk of developing retinopathy of prematurity is attenuated in IUGR neonates compared to mature neonates with normal birth weight.
P220 APOL 1 RISK GENOTYPE IS ASSOCIATED WITH ALBUMINURIA IN SUB-SAHARAN AFRICAN WITHOUT HYPERTENSION: A CASE STUDY OF TRYPANOSOMA BRUCEI GAMBIENSE ENDEMIC AREA
Authors: Mupepe Dominique , Bayauli Pascal , Buila Nathan , Situakibanza Hippolyte , Ekulu Pépé , Wameso Marie-Noelle , Van Den Heuvel Lambertus P. , Levtchenko Elena , Mumba Dieudonné , M’buyamba-Kabangu Jean René
Published: September 2024

Background and Objective.

An association between APOL1 risk genotypes and hypertension has been reported in African Americans with chronic kidney diseases (CKD). However, such data from African populations living in a Human African Trypanosomiasis (HAT) area remain limited. This study assessed the association between APOL1 high-risk genotypes (HRG) and hypertension among sub-Saharan African in T.b. gambiense endemic area.

Methods.

This cross-sectional study enrolled 94 HAT-infected and 144 non–infected participants in Masimanimba, the Democratic Republic of the Congo, from April 2019 to April 2021. APOL1 HRG was defined as the presence of two risk variants (G1/G1, G2/G2, or G1/G2), and a low-risk genotype (LRG) with the presence of 0 or 1 single variant. The elevated albuminuria was defined as urinary albumin/creatinine ratio ≥ 30 mg/g. Student's and Pearson's Chi2 tests or Fisher's exact test were used to compare means and proportions. Statistical significance was set at p < 0.05, based on 2-tailed test.

Results.

APOL1 sequence analysis revealed that 3 of 21 (14.3%) hypertensive participants carried HRG (G1G1) and 7 of 103 (6.8%) non-hypertensive carried HRG (G1G1, G2G2, and G1G2) (p=0.371). Ten of 21 (47.6%) hypertensive individuals with elevated albuminuria had a higher incidence of CKD (100% vs. 0%; p < 0.001) and HRG (30% vs. 0%; p = 0.09) than 11 (52.3%) without albuminuria who carried LRG. Of 103 non-hypertensive subjects, 43 (41.7%) with elevated albuminuria had a higher frequency of HRG (16.3% vs. 0%; p = 0.002) and CKD (100% vs. 1.7%; p<0.001) compared with 60 of 103 (58.3%) without albuminuria who carried LRG.

Conclusion.

APOL1 HRG was associated with albuminuria and CKD, regardless of the hypertension status in T.b. gambiense HAT endemic area.
P222 PREDICTOR FACTORS OF UNCONTROLLED MASKED HYPERTENSION IN PATIENTS WITH HYPERTENSION WITH CHRONIC KIDNEY DISEASE
Authors: Santos Roberto , Silva Gabriel Fernandes , Drager Luciano F. , Pio-Abreu Andrea
Published: September 2024

Background and Objective:

Masked uncontrolled hypertension (MUCH) is commonly observed in patients with hypertension who are normotensive in the clinic. MUCH is associated with increased risk for target- organ damage and adverse cardiovascular and renal outcomes in high-risk patients, such as those with chronic kidney disease (CKD). The objective of this study was to evaluate predictors of MUCH in patients with hypertension and CKD.

Methods:

This was cross-sectional study that performed 24-hour ambulatory blood pressure (BP) monitoring (ABPM) in 220 patients with hypertension and CKD (glomerular filtration rate <60 mL/min/1.73 m2) and controlled BP in the office (<140/90 mmHg). We categorized participants into two groups: 1) controlled BP group (24-hour ABPM <130/80 mmHg), and 2) MUCH group (24-hour ABPM ≥130/80 mmHg). Epidemiological, clinical, anthropometric variables and laboratory data were collected and compared between the two groups. We used logistic-regression models to identify the predictors of MUCH.

Results:

Approximately half of patients (n=109, 49.6%) had MUCH. Higher office BP values were observed in patients classified as controlled BP, both systolic (127 vs 125 mmHg, p=0.06) and diastolic BP (75 vs 72 mmHg, p=0.01). When analyzing anthropometric variables, a higher body mass index (BMI) was noted in the controlled BP group (26 vs 28 kg/m2, p<0.01). Regarding laboratory data, higher levels of urine albumin-creatinine ratio (uACR) were observed in the MUCH group (275 vs 69 mg/g, p<0.01). In a logistic regression model, were significant: diastolic BP in the office between 75 and 89 mmHg (OR: 1.93, 95%CI 1.03-3.64; p=0.04), BMI <25Kg/m2 (OR: 2.21, 95%CI 1.08-4.52; p=0.03) and uACR greater than 300 mg/g (OR: 3.26, 95%CI 1, 71-6.19; p<0.01).

Conclusion:

In patients with CKD and BP controlled at the office, diastolic BP in the office between 75 and 89 mmHg, BMI <25 kg/m2 and uACR >300 mg/g were predictive factors for MUCH.
Analysis of the Pathogen Distribution and Antimicrobial Resistance after Plastic Surgery of the Urogenital System
Authors: Jiang Fengli , Chen Qi , Wu Yuanyuan , Lin Jinhao , Su Xueshang , Zhuang Jun , Zhan Sien
Published: September 2024

Background:

We aimed to summarize the distribution of pathogenic bacteria for postoperative infection of different genitourinary plastic surgery and the antimicrobial resistance of the major pathogens.

Methods:

Between January 2011 and December 2021, following plastic surgery of the urogenital system, microbial strains from infected patients were collected, identified, and counted. The antibiotic sensitivity and distribution characteristics of common pathogens in relation with the surgical procedures were studied by WHONET 5.6, along with the main bacteria accounting for early infection.

Results:

A total of 76 cases were included in the study. Among these, 53 Gram-negative bacteria were detected, with Escherichia coli (18 of 53) and Pseudomonas aeruginosa (nine of 53) accounting for the majority. There were also 23 Gram-positive bacteria, among which Staphylococcus aureus (six of 23) and Coagulase-negative Staphylococcus (five of 23) were the most common. In terms of antimicrobial resistance, E. coli was highly sensitive to amikacin, piperacillin/tazobactam, cefoxitin, and imipenem, whereas P. aeruginosa was highly sensitive to gentamicin, amikacin, cefepime, piperacillin/tazobactam, imipenem, ceftazidime, and ciprofloxacin. Procedures for urethral repair, urethral reconstruction, and lump resection were most commonly associated with infection. Among these, urethral repair was responsible for the majority of infections. The pathogenic bacteria involved in postoperative infections varied overall, but the most prevalent was E. coli.

Conclusions:

Gram-negative bacteria are the major cause of infection following genitourinary plastic surgery. The specific bacterial strains, degrees of antimicrobial resistance, and length of infection varied among the various procedures. The results of this study may provide references for clinical medication and the prevention and control of such infections.