bluuebunny/crossref_metadata_2025 huggingface dataset:
HUMAN STOOL METABOLOMES DIFFER UPON 24-HOUR BLOOD PRESSURE LEVELS AND THE NON-DIPPING BLOOD PRESSURE PROFILE
Authors: Huart Justine , Cirillo Arianna , Taminiau Bernard , Julie Descy , Annie Saint -Remy , Georges Daube , Jean-Marie Krzesinski , Pierrette Melin , Pascal De Tullio , Francois Jouret
Published: April 2021

Objective:

Dysbiosis of gut microbiota (GM) has been implicated in the pathophysiology of arterial hypertension (HT), via a putative role of food-derived short chain fatty acids (SCFAs) and other metabolites. Among the clinical manifestations of HT, the absence of a significant drop in blood pressure (BP) overnight (i.e. the non-dipping BP profile) has been associated with poor cardiovascular outcomes. The link between GM and the non-dipping BP profile is unknown.

Design and method:

After informed consent, 16 male patients (mean age = 52.3 ± 12.4 years; 1 patient under beta blocker) and their female partners (n = 10; mean age = 46.5 ± 13.2 years; 1 patient under thiazide diuretic and angiotensin-converting-enzyme inhibitor) were subjected to 24-hour ambulatory BP monitoring and categorized in 2 groups: HT (n = 6 men and 1 woman) and normotension (n = 19). According to the conventional night/day BP ratio >0.9, 15 individuals (n = 8 men and 7 women) were categorized as non-dippers. Metabolomics using Nuclear Magnetic Resonance was performed on stool samples, including the quantification of the 3 main SCFAs (i.e. acetate, propionate and butyrate).

Results:

Principal component analyses (PCA) discriminated HT versus normotensive individuals on the basis of the stool metabolomes of the entire cohort (Q2 = 0.10). PCA also discriminated dippers versus non-dippers upon the stool metabolomes of the male and female cohorts (Q2 = 0.76 and 0.98, respectively) or the entire cohort (Q2 = 0.27). Significant correlations between stool metabolomes and the mean 24-hour BP levels were highlighted in male and female cohorts (R2 = 0.63 and 0.79, respectively), as well as in the entire cohort (R2 = 0.54). Interestingly enough, a higher variation between stool metabolomes (represented by the measure of inertia) was found in couples with a different BP status (51.4% of inertia) compared to the couples in whom both individuals presented with the same BP status (37.5% of inertia). The propionate/butyrate ratio was higher in the stools of male HT patients versus male normotensive patients (p = 0.03), but no difference was observed in the female cohort or in the entire cohort.

Conclusions:

In conclusion, this 26-patient cohort highlights significant correlations between the stool metabolome and (i) BP levels and (ii) the non-dipping BP profile in both genders.
DECREASED BLOOD PRESSURE AND INCREASED HEART RATE IN WOMEN WITH BREAST CANCER AFTER COMBINED CHEMOTHERAPY LEADS TO PSEUDO-POSITIVE CHANGES IN ARTERIAL STIFFNESS AND PULSE WAVE
Authors: Zairova Alsu , Rogoza Anatoly , Avaljan Ani , Oshchepkova Elena , Zheleznova E
Published: April 2021

Objective:

The aim of the study was to study the effect of combined chemotherapy in women with breast cancer (BC) on arterial stiffness and pulse wave by ultrasound examination of the common carotid artery (CCA) using echo tracking technology

Design and method:

40 women with triple negative breast cancer aged 27 to 75 years (47.5 ± 12.0) were examined initially and after chemotherapy with the inclusion of anthracyclines (doxorubicin),taxanes (paclitaxel) and platinum derivatives (cisplatin). Arterial stiffness parametres (beta-stiffness index, Ep-elastic modulus, AC-arterial compliance, PWV-pulse wave velocity) and AI – augmentation index were studied in the distal CCA at a distance of 2 cm from bifurcation on an Aloka ProSound alrha7 ultrasound machine using echo tracking technology.

Results:

After combined chemotherapy the parameters beta-index, Ep, PWV not significantly changed (9,3 ± 4,3 vs 8,9 ± 4,5, p = 0,63;128,73 ± 65,9 vs 119,0 ± 69,5 kPa, p = 0,29; 6,7 ± 1,5 vs 6,3 ± 1,5 m/s, p = 0,24 respectively).

Statistically significant decrease in AI from 14, 5 ± 11,3 to 11,1 ± 10,6% (p = 0,009) and an increase in AC from 0,72 ± 0,25 to 0,87 ± 0.3 mm2 /kPa (p = 0,004) were demonstrated as well as decrease in systolic blood pressure (SBP) from 129,5 ± 14,0 to 118,5 ± 14,5 mm Hg (p = 0,0001) and an increase in heart rate from 67,9 ± 10,7 to 76,6 ± 12,1 bpm (p = 0,0004),lower the level of hemoglobin from 129,6 ± 20,4 to 102,2 ± 16,3 g/ l (p = 0,00001) and red blood cells from 4,7 ± 0,4 to 3,3 ± 0,6 1012 / l(p = 0,00001). SBP levels decreased both in women with AH (n = 12) who received anti-hypertensive therapy – from 146,5 ± 9,9 to 130,0 ± 14,6 mm Hg (p < 0,01), and in eutonic women (n = 28) who received no antihypertensive treatment – from 122,2 ± 7,6 to 115,4 ± 8.3 mm Hg (p = 0,002).

Conclusions:

In women with breast cancer in the early period after combined chemotherapy with the inclusion of anthracyclines (doxorubicin),taxanes (paclitaxel) and platinum derivatives (cisplatin), there were no increased stiffness of the common carotid artery. Pseudo-positive changes in the form of an increase in the extensibility of the vascular wall and a decrease in the augmentation index are explained by general hemodynamic changes in the form of a decrease in the SBP, an increase in heart rate, as well as anemia during chemotherapy.
CARDIOVASCULAR STATUS REFERENCE VALUES OF RECENTLY DIAGNOSED AND NAÏVE TO TREATMENT HUMAN IMMUNODEFICIENCY VIRUS (HIV) PATIENTS. A PILOT STUDY
Authors: Triantafyllidi Helen , Fragkou Paraskevi , Mpirmpa Dionyssia , Benas Dimitrios , Thymis Ioannis , Kostelli Gavriella , Schoinas Antonios , Protopapas Konstantinos , Kavvatha Dimitra , Antoniadou Anastasia , Papadopoulos Antonios , Ikonomidis Ignatios , Iliodromitis Eystathios
Published: April 2021

Objective:

HIV infection is a well recognized risk factor for cardiovascular (CV) disease. Virus induced chronic inflammation plays a key role in the development of early CV disease. The aim of this study is to explore the baseline CV status of recently diagnosed and naïve to treatment HIV patients regarding arterial blood pressure parameters, target organ damage indices as well as aerobic capacity (AC).

Design and method:

Forty two (42) recently diagnosed and naïve HIV patients were evaluated regarding office and central blood pressure (SBP/DBP), carotid-femoral aortic stiffness estimated by PWV and endothelial function measured by endothelial glycocalyx integrity. Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (ranged from 5–9 micrometers) Using Sideview Darkfield imaging (Microscan, Glycocheck) was measured as a non-invasive accurate index of reduced EG thickness. Finally AC status was evaluated after a maximal cardiopulmonary exercise test (CPET). No one patient had ever received any treatment for HIV or any cardiovascular disease.

Results:

HIV patients were mostly males (38 men, 90%), young (mean age = 37 + 10 years), smokers (21, 42%) and normotensives (office SBP/DBP = 124 + 13/76 + 10 mmHg and central SBP/DBP = 116 + 12/77 + 10 mmHg). PWV was estimated as 9.2 + 1.7 m/sec. Endothelial glycocalyx intergrity was measured as PBR5–9 = 1.2 + 0.2 micrometers. During maximum aerobic CPET, HIV patients achieved 8 + 2 METS and 28 + 6 ml/kg/min peak VO2 which corresponds to 80 + 14% of peak VO2 predicted. Their SBP was measured as 112 + 10 mmHg at exercise initiation and 169 + 22 mmHg at peak exercise. Two male patients (5%) had a hypertensive response during CPET defined as SBP > 210 mmHg.

Conclusions:

It seems that recently diagnosed naïve HIV patients have a CV status similar to which corresponds to their age. We are going to re-evaluate those patients, one and three years after HIV treatment initiation, in order to explore any early differences regarding their CV status.
CARDIOVASCULAR RISK PROFILE IN YOUNG PATIENTS WITH EPILEPSY
Authors: Szczurkowska Patrycja , Wolf Jacek , Polonis Katarzyna , Becari Christiane , Pilarska Ewa , Hoffmann Michal , Chrostowska Marzena , Mazurkiewicz-Beldzinska Maria , Narkiewicz Krzysztof
Published: April 2021

Objective:

The risk of premature deaths in patients with epilepsy (approx. 50 mln. patients worldwide) is about 2–3 times higher as compared to general population. This phenomenon is mainly explained by cardiovascular causes as well as sudden unexpected deaths in epilepsy (SUDEP). Epilepsy is associated with sympathetic overdrive and renin-angiotensin-system abnormalities all of which may be implicated in organ damage (both directly and indirectly via high blood pressure; BP). In our study, we aimed at the evaluation of several cardiovascular risk factors and organ damage in patients with epilepsy; its’ relation to disease control and comorbid hypertension.

Design and method:

A total of 48 patients and matched controls were included in the study. Anthropometry, biochemical assessment, office and ambulatory blood pressure, structural and/ or functional vascular changes were recorded. One-way ANOVA and ANCOVA were employed (mean ± SE).

Results:

Patients were comparable in terms of age and BMI. Hypertensives were aware of high BP in 50% of cases. Study subgroups were comparable in terms of heart rate, serum uric acid, triglicerides, HDL, glucose, serum creatinine and eGFR, serum potassium (P = NS for all comparisons). Total cholesterol was the lowest in well-controlled epileptic patients which was followed by refractory disease and epilepsy with comorbid hypertension (167.6 ± 6.7 vs. 196.9 ± 7.4 vs. 223.5 ± 8.9; respectively). Patients with refractory epilepsy had comparable serum LDL and PWV to hypertensive well-controlled epileptics; both contrasted with values recorded in patients with well-controlled epilepsy who were free of hypertension (LDL: 121.7 ± 6.8 vs. 140.9 ± 8.2 vs. 99.2 ± 6.1; respectively, and PWV: 6.4 ± 0.24 vs. 6.8 ± 0.30 vs. 5.5 ± 0.22; respectively). Reported differences were valid after adjustment for age and BMI.

Conclusions:

Except for BP values, patients with refractory epilepsy who are free of hypertension have similar CV risk profile to patients with high BP. These findings along with underdiagnosed hypertension may explain higher CV mortality and morbidity documented in epilepsy.
“CHRYSIN” AMELIORATES CARDIAC HYPERTROPHY IN RATS
Authors: Sahu Anil Kumar , Meshram Sonali , Arya D.S.
Published: April 2021

Objective:

Cardiac hypertrophy: thickening of cardiac muscle which causes decreased pumping ability of heart, results in cardiac dysfunction. Chrysin, is a naturally occurring flavone, found in bee propolis and honey and possesses anti-oxidant, anti-inflammatory, anti-diabetic, anti-estrogenic, anti-tumour and anti-apoptotic properties. Present study investigates the effect of Chrysin on isoproterenol induced cardiac hypertrophy in male albino wistar rats.

Design and method:

Male wistar albino rats were divided into eight groups: Group 1 (Control); Group 2 (Isoprotorenol); Group 3; 4; 5 and 6 (Chrysin 15, 30, and 60 mg/kg and 60 mg/kg per se p.o. respectively), Group 7 (Losartan 10 mg/kg; p.o.) and Group 8 (Losartan 10 mg/kg; p.o. + Chrysin 60 mg/kg; p.o.) in which respective compound was given accordingly. ISO (3 mg/ kg; s.c.) was administered daily for 28 days to all groups except normal and per se to induce Cardiac Hypertrophy. On day 29, animals were anesthetized, blood was taken from heart and serum was separated for estimation of cardiac injury parameters and inflammatory cytokines level. Thereafter, rats were sacrificed and heart was isolated and preserved for biochemical, histopathological, ultra-structural, immuno-histochemical and western blot analysis.

Results:

Chrysin with Losartan treatment of 28 days significantly attenuated cardiac hypertrophy via. decreased cardiac injury markers, inflammatory cytokine, oxidative stress and apoptosis. The combination of Chrysin and Losartan exhibited significant effect to that of Chrysin or Losartan separately. The histopathological, Immunhistochemical and immunoblot analysis showed that the chrysin attenuates cardiac hypertrophy via modulation in MAPK pathways and showing anti-apoptotic effect. The combination of Chrysin and Losartan showed beneficial effect among all groups.

Conclusions:

Chrysin and Losartan reduce Isoprotorenol- induced cardiac hypertrophy by mitigating oxidative stress, inflammation and apoptosis resulting in improvement of cardiac function, structural changes and antioxidants levels. Chrysin and Losartan in combination attenuated DNA damage or apoptosis and showed best cardio-protection against Cardiac hypertrophy.
PERIODONTITIS IS PREVALENT IN HYPERTENSIVE RENAL TRANSPLANT RECIPIENTS AND IS CORRELATED WITH OXIDATIVE STRESS AND ARTERIAL STIFFNES
Authors: Kovacevic Katja , Oreskovic Josip , Vuckovic Marijana , Raos Hrvoje , Roguljic Marija , Gelemanovic Andrea , Radic Josipa
Published: April 2021

Objective:

The balance between oxidative stress (OS) and antioxidants is speculated to be associated with occurrence, severity, and progression of periodontal disease. Previous studies suggested that OS regulates the relationship between periodontitis and endothelial dysfunction. The increased arterial stiffness is a major pathophysiological player involved in the adverse cardiovascular profile of renal transplant recipients (RTRs) and graft survival due to the occurrence of cardiovascular disease. The aim of this study was to evaluate the incidence and severity of periodontitis among RTRs suffering from arterial hypertension (AH) and to investigate possible correlation with OS arterial stiffness and blood pressure parameters regards severity of periodontitis.

Design and method:

A comprehensive medical and periodontal examination was performed and for each RTR and data were collected. To measure arterial pressure (both peripheral and central, systolic and diastolic) and parameters of arterial stiffness (pulse wave velocity (PWV) and augmentation Index (AIx)) Agedio B900 device was used. Oral periodontal status included full mouth plaque score (FMPS), full mouth bleeding score (FMBS), periodontal probing depth (PPD) and clinical attachment loss (CAL), all measured at six sites of each tooth. Also, to measure Advanced Glycation End products (AGE) proteins in tissue the AGE Reader was used.

Results:

Out of 55 RTRs suffering from periodontitis, 45 (82%) had AH, out of which 9 (20%) were classified as periodontitis stage I (mild), 14 (31%) as stage II (moderate) and 22 (49%) as stage III and IV (severe). With the severity of periodontitis increasing, statistically significant increase was observed in parameters CAL and AGE (P < 0.001 and P = 0.045, respectively). In addition, CAL showed positive correlation with AGE and PWV (P < 0.001 and P = 0.002, respectively). Three groups of patients did not show any statistically significant difference in arterial blood pressure (both peripheral and central, systolic and diastolic).

Conclusions:

The results showed that incidence of periodontitis is high and that almost half of RTRs with AH had severe stage of periodontitis. Also, severity of periodontitis is correlated with markers of OS and arterial stiffens. Despite the small sample size, we showed that as periodontitis severity is increasing arterial stiffness is higher.
ASSESSMENT OF 10 YEARs CARDIOVASCULAR RISK IN RURAL AREA OF SRI LANKA: A COMMUNITY BASED STUDY
Authors: Gamage Nadun Danushka Pitiduwa , Kumarage Shirmila , Samarasekara Tharanga , Koottage Menaka , Nilupuli Emashi
Published: April 2021

Objective:

Prevalence of non communicable diseases (NCDs) are rising rapidly around the globe. It is also getting more and more prevalent in the rural areas as well. However rural areas of Sri Lanka still does not have enough evidence of cardiovascular risk status.

The objective is to screen for NCDs and stratify risk of the 10 cardiovascular disease among the community based patient sample.

Design and method:

Non interventional descriptive cross sectional study was carried out in a rural area of Sri Lanka. All the patients were measured for body mass index (BMI), blood pressure (BP), fasting blood sugar (FBS) values and lipid profile values as well. The Framingham score was used to calcuate the 10% CVD risk.

The data was analiyzed using SPSS (Statistical Package of Social Sciences). Ethical clearance was obtained before the commencement study.

Results:

Total of 255 (number of males 54 and female 201) participants with the age range of 21 -86, mean (SD) 56.2 (13.1) were selected for the study. The prevalence of major CVD risk factors was: hypertension 27.1%, diabetes 26.7%, elevated total cholesterol 11.8 %, obesity 29.8% and current smoking 9.1%.

Utilizing the Framingham 10-year Risk Estimation 61.57% of the study population were identified to be under lower risk level (<10%) category while 23.53% were represented intermediate risk level (10–20%) and 14.90% noted with high risk level.

Accessing the difference between gender and the 10 - year CVD risk, from the male population 50% of majority were noted with high risk level and 29.63%, 20.37% respectively for intermediate and low risk level. Similarly for the female population, 5.47% was presented with high risk level while 21.89% for intermediate and 72.64% with low risk level.

Conclusions:

NCD prevalences are higher in the rural areas at present. 10 year CVD risk is comparatively higher among the males rather than females. Gender specific interventions should be implemented to reduce the risk among males.
PORTUGUESE RESISTANT HYPERTENSION POPULATION: IS IT POSSIBLE A RISK SCORE?
Authors: Pereira Flávio , Lopes Susana , Briosa Ana , Cavadas Susana , Mesquita José
Published: April 2021

Objective:

Introduction: Resistant hypertension isn’t well studied with Ambulatory blood pressure monitoring (ABPM).

Study in a RH population obtained in hypertension department to characterize it and identify cardiovascular (CV) outcome predictors.

Design and method:

ABPM - collected 1999–2018. Identified RH patients according to the ESC Guidelines 2018. Sample was characterized and analysed for predictors of CV events (CVe). CVe were ischaemic (IS), haemorrhagic stroke (HS), transient ischaemic attack (if hospitalized - TIA), acute coronary syndrome (ACS), acute heart failure (if hospitalized - AHF), peripheral arterial disease (PAD). Follow-up finished with event, the last evaluation of the patient or death. Statistical significance was assumed if p < 0.05.

Results:

Sample - 268 patients (161 males and 107 females) with RH. Age - 60.4 + /- 11.3 years (mean + /- SD). Follow-up - 5.5 + /- 4.9 years. Diabetes Mellitus (DM) - 44.4%, dyslipidaemia -75.4%, obesity - 45.1%, Chronic Kidney Disease (CKD) - 32.1%, history of previous CVe - 34.7% (PCVe). CVe observed - 55 (18 IS, 3 HS, 1 TIA, 16 ACS, 11 AHF, 6 PAD). 12 death from non-CVe. When the sample was analysed events vs no-event, those who with event, were older, had higher glycaemia, more prevalence of DM, history of PCVe and CKD.

In Univariate Cox analysis for the prognosis of future CVe, it was significant: gender, DM, PCVe, age, glycaemia (Table 1). In a multivariate Cox Analysis with all these variables in the same sample, those who stood significant: glycaemia, age, gender, PCVe (Table 1). Even when these variables were adjusted to 24 h systolic blood pressure (24SBP) and night-time blood pressure (NSBP), they remained significant, but the 24SBP and NSBP didn’t (Table 1).

In Kaplan-Meier survival curve free of events, being male, history of PCVe revealed worst survival prognosis (respectively log rank 5.74, p < 0.05; 18.50, p = 0.000).

Conclusions:

In our population of RH, age, glycaemia, male, DM and history of PCVe are associated with markers of worst prognosis independent of blood pressure values. Perhaps in the future in larger samples, these variables can be taken in account for a risk score.
ASSESSING THE SENSITIVITY OF NECK CIRCUMFERENCE AS A PREDICTOR OF CENTRAL OBESITY IN ADULT HYPERTENSIVE PATIENTS
Authors: Patil Mansi , Patil Vishal , Schlaich Markus , Lambert Gavin
Published: April 2021

Objective:

Waist circumference has been used till now for determining central obesity which is found to be considerably variable over a short period of time. Neck circumference on the other hand is reliable and does not show short term variability. The objective of the study was to determine the cut-off values of neck circumference as a predictor of central obesity in adult hypertensive patients.

Design and method:

A cross-sectional study was carried out on 500hypertensive patients under treatment to assess the correlation of neck circumference and waist circumference by applying the pairwise correlation coefficient. Height, weight and waist circumference were measured using the NHANES standard procedures. BMI was calculated from the data. ROC curve analysis was performed and Youden index was calculated. Neck circumference yielding the maximum Youden Index was considered as the cut-off for central obesity.

Results:

Neck circumference was found to be significantly associated with waist circumference in both females and males with b-coefficients of 1.06 (95% CI: 0.87, 1.17) and 0.71 (95% CI:0.51, 0.79), respectively.

After applying ROC analysis, neck circumferences more than equal to 34 cms in females and more than equal to 38 cms in males was determined as the best cut-off to predict central obesity. When compared with BMI, AUC of NC (0.75; 95% CI: 0.73–0.78) for predicting central obesity was higher than AUC of BMI (0.74; 95% CI: 0.72–0.77).

Conclusions:

Neck circumference could be considered as an alternative for screening for central obesity in hypertensive patients.

Neck circumference can be used as a screening tool for pregnant women or for patients suffering from ascites and does not require removal of clothing.

The procedure for measurement of neck circumference requires minimal training with lesser scope of error in measurement.

Position of measurement (supine/prone/standing), meal consumption or respiration does not hamper the measurement and can be measured in bed-ridden patients also.
ASSOCIATION OF SOLUBLE DIPEPTIDYL PEPTIDASE-4 AND PLATELET-LYMPHOCYTE RATIO WITH PULSE PRESSURE IN TREATMENT-NAIVE HYPERTENSIVES
Authors: Olatunji Victoria , Olaoye Morolake , Arinde Olufemi , Olarinoye John , Bolarinwa Oladimeji , Olatunji Lawrence
Published: April 2021

Objective:

Hypertension is a major risk factor for cardiovascular diseases (CVD) and the burden is increasing globally especially in Africans. This is as a result of increasing adult population, rapid urbanization and uptake of western lifestyles. Hypertensive patients with elevated pulse pressure (PP) have increased risk of cardiovascular morbidity and mortality. Soluble dipeptidyl peptidase-4 (sDPP-4) and platelet-lymphocyte ratio (PLR) have been linked to the development and progression of CVD. We hypothesized that sDPP-4 and PLR would be correlated with PP in hypertensive Nigerians.

Design and method:

A cross-sectional study comparing the anthropometrical, hematological, inflammatory and cardiometabolic disorder markers between normotensives (blood pressure less than or equal to 120/80 mmHg; n = 19) and treatment-naïve hypertensive adults (sustained blood pressure equals to or greater than 140/90 mmHg; n = 48).

Results:

Our results showed that hypertensive group had significantly higher body weight, neck circumference, hip circumference, mid-arm circumference, LDL-cholesterol, PP, systolic and diastolic blood pressure than the normotensive group. Using multivariate linear regression analysis, results indicated that PP (R2 = 0.22) was correlated with sDPP-4 (Beta = 0.41, p = 0.004) and PLR Beta = 0.31, p = 0.025) in the hypertensive group. A receiver operating characteristic curve analysis also revealed that area under curve (AUC) for sDPP-4 was 0.65 (p = 0.04) and AUC for PLR was 0.74 (p = 0.001) and are efficient predictors of PP in hypertensives.

Conclusions:

Findings from the present study reveal that circulating sDPP-4 and PLR are strongly correlated with PP in treatment-naive hypertensive individuals.
CORRELATION BETWEEN SUBJECTIVE ASSESSMENT OF STRESS LEVEL AND BLOOD PRESSURE OR OTHER CARDIOVASCULAR RISK FACTORS AMONG STUDENTS OF WROCLAW UNIVERSITIES
Authors: Niewiadomska Joanna , Wolinska Anna , Ziemer Marta , Zuromski Adrian , Zawadzki Jacek , Gac Pawel , Poreba Malgorzata
Published: April 2021

Objective:

Hypertension is a global public health problem and one of the crucial risk factors for cardiovascular disorders. There are many agents that can influence blood pressure such as smoking, physical activity, obesity, diet, alcohol consumption, stress. Stress plays a major role in various pathophysiological processes associated with the circulatory system. The aim of the study was to examine whether subjective assessment of stress level is correlated with blood pressure or other cardiovascular risk factors among the students of Wroclaw Universities.

Design and method:

The study group consists of 122 students (61 females and 61 males) with average age 21,60 ± 2,15 years. The stress level was evaluated using authorial questionnaire for assessment of cardiovascular risk factors prevalence among students. The questionnaire comprised the assessment of health status based on the medical history, eating habits, physical activity, family history and intake of drugs. Anthropometric measurements and calculations included body weight, body height, BMI (Body Mass Index) and WHR (Waist Hip Ratio). The systolic and the diastolic blood pressure (SBP and DBP) were measured by the traditional sphygmomanometer with participant in a sitting position. The U Manna Whitney or ANOVA Kruskal-Wallis test were used to analyze the data. P value was set at value < 0.05.

Results:

Only 9,8% (n = 12) of students declared their lifestyle as not stressful. Other interviewees established their exposure to stress as: daily- 27,0% (n = 33), at least several times weekly- 36,1% (n = 44), periodically- 27,0% (n = 33). No assosiation were found for level of stress and other cardiovascular risk factors. The study group characterized high prevalence of drug intake: smoking declared 11,5% (n = 14) of students, strong alcohol consumption 46,7% (n = 57), weak alcohol 77,9% (n = 95) consumption, hard drugs intake 1,6% (n = 2) and soft drugs intake (especially cannabis products [hash and marijuana]) 13,9% (n = 17). Differences in strong alcohol consumption were significantly higher among the group of male students (p < 0,05).

Conclusions:

According the study there was no statistically significant correlation between the value of stress level declared by student and blood pressure or other cardiovascular risk factors. We observed high percentage of miscellaneous drug intake among the study group.
CARDIOVASCULAR RISK PROFILE OF A YOUNG ADULT POPULATION WITH HIGH RISK FOR OBSTRUCTIVE SLEEP APNEA SCREENED BY STOP-BANG AND EPWORTH SLEEPINESS SCALE IN A PRIMARY HEALTH CARE UNIT
Authors: Barbalho Daniella Gomes , De Souza Mello Tomas , Zink Luciana Oliveira , Louzada Vinicius Leiria Teixeira , Borges Rodrigo Eugênio Vinuto , Ribeiro Sávio Ferreira , De Hollanda João Victor Gonçalves , Botelho Bruna Gopp , Da Silva Amanda Oliveira , Silva Rodrigo , Ushijima Natalia Rossilho Moyses , Kendler Daniel Barreto , Fernandes Ana Cristina Tenório Da C. , Muxfeldt Elizabeth Silaid
Published: April 2021

Objective:

To establish the relationship between cardiovascular (CV) risk profile and detected risk of Obstructive Sleep Apnea (OSA) in two questionnaires - STOP-BANG (SB) and Epworth Sleepiness Scale (ESS), in a young population of adults registered in a Primary Health Care unit in Rio de Janeiro, Brazil.

Design and method:

This cross-sectional population study enrolled adults between 20–50 years old, registered in a primary healthcare unit in Rio de Janeiro. A database is being developed including sociodemographic and anthropometric data, and CV risk factors. Office blood pressure (BP) and Home Blood Pressure Monitoring (HBPM) (7-day protocol) (Omron-705CP). Moreover, OSA was investigated by SB and ESS. Patients with a high risk for OSA in either of these two questionnaires were subsequently assigned for polysomnography (PSG).

Results:

A total of 562 subjects were evaluated [40% males, 38.9 ± 8.8 years], where 151 (26.9%) were identified as high risk for OSA by the SB questionnaire and 210 (37.4%) by ESS. The most common CV risk factor was physical inactivity (43%), followed by dyslipidemia (38%) and obesity (28%). By OBP, the prevalence of hypertension was 13.4% while by HBPM was 18.6%, with a low concordance between them (kappa = 0.472). Subjects with a high risk at SB are older, with a higher prevalence of obesity, hypertension and higher office BP and HBPM. On the other hand, individuals with high-risk by ESS were more obese, with increased waist circumference, higher prevalence of dyslipidemia and metabolic syndrome. Nevertheless, there was no difference in BP levels. Among the subjects submitted to PSG, 46% had a diagnosis of OSA (AHI higher 5/hour) and 23% of moderate/severe OSA (AHI higher 15/hour). The best predictor of AOS was SB, positive in 100% of subjects with moderate/severe OSA, while ESS was positive in only 20% of them.

Conclusions:

This young and apparently healthy population presented a high prevalence and risk for OSA. The SB had a higher association with higher BP levels, while ESE was associated with a worse metabolic profile. SB questionnaire seems to be the best predictor for moderate/severe OSA in this young adult population.
SERUM PROTEOME AND HIGH WATTAGE E-CIGARETTE VAPING: A RANDOMIZED CROSSOVER STUDY
Authors: Chaumont Martin , Communi David , Tagliatti Vanessa , Colet Jean -Marie , Van de Borne Philippe
Published: April 2021

Objective:

Electronic cigarettes (e-cigarettes) are battery-powered devices that aerosolize a liquid (i.e. “e-liquid”) composed of propylene glycol (PG) and/or glycerol (GLY), flavorings and most commonly, nicotine. Suspension of fine particles in a gas forms the aerosol, that is inhaled (i.e. “vaped”). As these small hydrophilic molecules have a short serum/urine half-live, we hypothesized that short-term cessation of vaping in regular users would change serum proteomic signatures.

Design and method:

Thirty regular e-cigarette users were enrolled in this randomized, investigator-blinded, three-period crossover-study. The periods consisted of nicotine-vaping (nicotine-session), nicotine-free vaping (nicotine-free-session), and complete cessation of vaping (stop-session), all maintained for five days before the session began. Multiparametric metabolomic analyses on urine and serum were used to verify subjects’ protocol compliance, which was 95%. Serum proteomic analysis was performed with Sequential Windowed Acquisition of All theoretical Fragment Ion Mass Spectra (SWATH-MS)

Results:

Complete cessation of vaping allowed to identify 13 proteins in the serum, which were differentially modulated among sessions. The following proteins of coagulation cascade: anti thrombin III, heparin cofactor II and alpha-2-antiplasmin were higher in the stop-session compared to nicotine- and nicotine-free session. Compared to stop-session, two proteins of complement cascade were lower in the stop-session compared to the nicotine-session.

Finally; lower levels of apolipoprotein E were also found in the stop-session compared to the nicotine-free session. (Table 1)

Conclusions:

In conclusion, our study reveals that short-term e-cigarette cessation in regular users modified several proteins involved in the coagulation pathways, complement cascade and lipid transport. E-cigarette cessation could have a beneficial effect on the cardiovascular health by decreasing the level of proteins involved in the pathogenesis of atherosclerosis, irrespective of the presence of nicotine. This will need further researches in order to confirm our findings in cellular and animal models and to find potential biomarkers of vaping toxicity.
EXCESSIVE SALT INTAKE: PREVALENCE AND ECONOMIC BURDEN IN THE RUSSIAN FEDERATION
Authors: Balanova Yulia , Shalnova S , Imaeva A , Kontsevaya A , Myrzamatova A , Mukaneeva D , Khudyakov M
Published: April 2021

Objective:

WHO recommended average salt intake is 5 g/day. However, in the Russian market basket (the minimum food consumption norms approved by the government) include the salt norm is 10.1 g / day for the working population.

Aim. To assess the prevalence of excess salt intake (ESI) and the economic burden (EB) of ESI in the Russian Federation (RF) in 2016: direct costs of the health care system and indirect economic losses due to morbidity and mortality from chronic non-communicable diseases (CNCD) associated with ESI.

Design and method:

A cross-sectional study Epidemiology of cardiovascular diseases in the RF (ESSE) was carried out in 14 Russian regions (2012–13). Randomly selected aged 25–64 years males (N = 8304), females (N = 13464) were included (response rate>80%). Standard epidemiology methods and criteria were used. The prevalence of ESI was determined using questionnaire. Data sources included federal statistics, regulatory documents. Based on prevalence ESI in the RF and relative risks (RR) derived from meta-analyzes, population attributable risk (PAR) for cardiovascular diseases (CVD), stroke, type 2 diabetes (T2D), stomach cancer (SC) was calculated. Indirect costs (IC) associated with ESI included costs of premature death and disability. The calculations were performed in Microsoft Excel 10.0.

Results:

The prevalence of ESI was 49.9%, higher among males (54.2% vs 47.1%, p < 0,001). PAR of ESI was 5% for CVD mortality, 6% for CVD morbidity; stroke: 17%&10% accordingly, 18% for DM2 morbidity, and 7% for SC morbidity. The highest contribution of the ESI to the EB is associated with CVD (122.8 billion rubles), where half(68,1 billion rubles) is attributable to the EB associated with stroke. In the structure of the EB of each analyzed CNCD, ESI cause from 4.5% (CVD) to 16,1% (stroke) and 17% (for T2D) of the entire burden. The economic burden to CNCD associated with ESI in the RF in 2016 reached 160.9 billion rubles.

Conclusions:

ESI was found in half of Russian population aged 25–64. In the burden structure the direct costs were only12%, the economics losses were 88%. Total economic impact due to ESI in the RF was 0.19% of the gross domestic product(2016).
BIRTH WEIGHT AND RISK FACTORS FOR ATHEROSCLEROSIS -RETROSPECTIVE COHORT STUDY IN JAPANESE WORKERS
Authors: Azegami Tatsuhiko , Takeda Ayano , Yokoyama Hirokazu , Wainai Yumiko , Hirose Hiroshi , Makino Shinji , Nishimura Tomoyasu , Goto Nobuko , Itoh Hiroshi , Mori Masaaki
Published: April 2021

Objective:

Low birth weight is associated with chronic health conditions later in life. B-type natriuretic peptide (BNP) is recently recognized as one of prognostic factors for cardiovascular events in general population. However, the association between the birth weight and BNP remains unclear. We aimed to examine the relation of birth weight with atherosclerotic risk factors including BNP among Japanese workers.

Design and method:

This study included 517 male and 592 female Japanese workers aged 40–70 years who attended an annual health checkup in 2018. The participants were divided into three groups according to their birth weight and evaluated the association between birth weight and risk factors for atherosclerosis including BNP, body mass index, blood pressure, creatinine, uric acid, triglyceride, HDL-cholesterol, LDL-cholesterol, glucose and HbA1c.

Results:

Trend test according to birth weight category showed that birth weight was inversely associated with HbA1c in men and with diastolic blood pressure in women, whereas it was not related with BNP levels in both men and women. Correlation coefficient test for birth weight data also revealed the correlation of birth weight with HbA1c in men (Pearson correlation coefficient -0.217, 95% CI [-0.350, -0.084]) and with diastolic blood pressure in women (-0.091, [-0.195, 0.000]), but not with log-transformed BNP level (-0.006, [-0.130, 0.142] for men, and -0.047 [-0.152, 0.057] for women). Multiple linear regression analysis indicated that birth weight was one of explanatory factors for HbA1c and regression model including birth weight, body mass index, ALT, creatine, hemoglobin, WBC, and platelet predicted HbA1c levels in men (R2 = 0.278).

Conclusions:

The present study showed no significant association between birth weight and BNP, whereas inverse associations of birth weight with HbA1c in men and with diastolic blood pressure in women were found. These data suggest that the birth weight may partially predict the future risk factors for atherosclerosis.
SIX-YEAR SURVIVAL RATE OF PATIENTS WITH ARTERIAL HYPERTENSION AND WITHOUT CONCOMITANT CARDIOVASCULAR DISEASES
Authors: Pereverzeva Kristina , Yakushin Sergey
Published: April 2021

Objective:

To evaluate survival rate and determine factors, affecting risk of death for patients with arterial hypertension (AH) and without concomitant cardiovascular diseases (CVD) for 6 years of observation according to the register.

Design and method:

716 patients with AH and without another CVD took part in this research in 2012-2013.The median age is 56.7 [49.0; 63.8] years, 29.1% of them are men. Diabetes mellitus and impaired fasting glycaemia were registered in 11.3% and 1.3% of cases, dyslipidemia – in 2.9%, obesity – in 12.7%, anemia – in 8.5% and hemorrhage – in 1.5%, diseases of the respiratory organs – in 17.6%, diseases of the gastrointestinal tract – in 44.6%, kidney diseases – in 30.4%. The frequency of prescription of beta-adrenergic blocker was 32.0%, angiotensin-converting enzyme/sartans – 76.7%, calcium channel blockers – 15.2%, diuretics – 39,4%, antagonists of mineralocorticoid receptors – 1.3%, central acting drugs – 2.4%, statins – 6.0%, aspirin – 23.0%.

Results:

The median of time from the moment of inclusion to the date of last contact was 6.1 [5.8; 6.7] years. Information about 95.7% of patients was received.The survival rate was 87.3%. Among the patients with know causes of death (n = 66) in 40.9% of cases CVD was the cause of death, the oncological disease – in 39.4%. Diseases of the respiratory organs were registered more frequently among deceased patients in 25.3% and 16.5% consequently (p = 0.04), but this factor did not have a statistically significant effect on the prognosis. Independent risks of death factors among patients with AH and without another CVD were age and gender: the risk of death for patients over the age of 60 was 6% higher, at the age of 70 years was 12% higher, at the age of 80 years was 21% higher compared with patients younger than 60 years (p < 0.05), the relative risk of death of male patients compared with female patients was 2.4 (1.6–3.4) times higher (p < 0.05).

Conclusions:

Six-year survival rate of patients with arterial hypertension and without concomitant cardiovascular diseases is 87.3%. Risk of death factors are age and male gender in this group of patients.
ANALYSIS OF HEART RATE AND OXYGEN SATURATION USING PULSE OXIMETER BETWEEN MALE AND FEMALE AT HYDERABAD PAKISTAN
Authors: Ali Muhammad
Published: April 2021

Objective:

By knowing heart rate, the condition of the heart can better judge. Tachycardia and Bradycardia are one of the factors that may leads to various moralities of the heart. Oxygen saturation may also relate with the heart and electrolyte balance system. The current study was conducted to analyze the heart rate and oxygen saturation in blood by using pulse oximeter.

Design and method:

The descriptive, observational study was conducted among 400 individuals from various places of Hyderabad, Pakistan. The age range of enrolled individuals are from 20 to 40 years of age including male and female. The duration of study was of six months from July to December 2019. The sampling technique was random. The place of study was from Hyderabad, Pakistan

Results:

Out of total 400 Individuals, 200 each male and female respectively were enrolled to get the equal response. The pulse oximeter showed the average heart rate was 87 + 15 and saturated oxygen was 99 + 2. While in female individuals, the average heart rate was 110 + 21 and saturated oxygen was 98 + 2. The maximum age was from 20 to 25 years of age in which maximum disturbance of heart rate was noted.

Conclusions:

The study concluded that the heart rate was more in female particularly girls as compared to boys. Further analysis will be required to sort out the reason.
RISK OF CARDIOVASCULAR DISEASES IN PEOPLE WITH TYPE 1 DIABETES MELLITUS
Authors: Chalakova Tatyana , Yotov Yoto , Tsochev Kaloyan , Bocheva Yana , Iotova Violeta , Usheva Natalya , Galcheva Sonya , Valchev Georgi
Published: April 2021

Objective:

People with diabetes mellitus (DM) are at several times higher risk for cardiovascular diseases (CVD).

The o objective is to assess the CVD risk in patients with long-lasting Type 1 DM (T1DM) and to compare several risk tools performance.

Design and method:

A total of T1DM 95 persons, 50 (52.6%) men, at an average age of 41.34 ± 10.3 years were studied. The average duration of T1DM was 25.22 ± 8.7 years, and the median HbA1c 8.15%. All participants completed a demographic questionnaire. Basic anthropometric and hemodynamic parameters were measured applying standard methods. Venous blood was drawn after 12 hours fast. The global CVD risk was assessed by two methods: Steno-2 formula and the recent recommendations of the European Society of Cardiology (ESC). The coronary calcium score (CACS) was evaluated on computer tomography.a

Results:

Steno-2 method showed gender CVD risk difference - 69.4% of the men were at moderate or high risk while 57.8% of the women were at low risk (p = 0.029). ESC guidelines found that all patients are either at high, 39% and 31% for men and women or at very high risk - 61% and 69% resp. (p = 0.5). The two methods for risk characterization do not correlate well - 44% of people with T1DM who have high and very high risk (ESC) are at low risk according to Steno-2, Cohen's kappa for agreement of the two methods is 0.016, p = 0.78. When CACS is added, a large proportion of patients who are at moderate or high risk by Steno-2 method (20 and 21.3% in total) had CACS-0. Conversely, 10 (10.6%) of all T1DM participants had low Steno-2 risk and CACS > 0, Kendall's tau coefficient b = 0.4, p < 0.0001. The agreement between Steno-2 and CACS is mild (Cronbach's a = 0.501; Intraclass Correlation Coefficient, ICC = 0.44; p = 0.003). The addition of CACS to the clinical risk assessment model improves the diagnostic accuracy, with area under the curve (AUC) 0.72, 95% CI 0.61–0.84, p = 0.001.

Conclusions:

The T1DM CVD risk assessment methods do not agree well. The addition of CAC score further reclassifies the patients which is important for the timely CVD prevention.
WHICH AMBULATORY BLOOD PRESSURE PARAMETERS ARE RELATED TO COGNITIVE IMPAIRMENT AND DEMENTIA IN HYPERTENSIVE PATIENTS?
Authors: Germán-Salló Márta , Pál Tünde , Szentendrey Dalma Bálint , Tatar Cristina Maria , Sallay Márta , Nyulas Kinga , Preg Zoltán
Published: April 2021

Objective:

Ambulatory blood pressure monitoring (ABPM) parameters are more accurately linked to target organ damage than office or home blood pressure values. Few studies focus on the relationship between ABPM parameters and cognitive aging. We aimed to investigate the relationship between ABPM parameters and prevalence of cognitive impairment and dementia among hypertensive patients.

Design and method:

In the present paper, we included 294 consecutive hypertensive patients admitted to a Cardiovascular Rehabilitation Clinic aged between 50–91years (mean age: 68.6 ± 8.8 years; 50.3% female; 49.7% male). After routine clinical assessment all participants had an ABPM recording (on antihypertensive medical treatment), completed the Montreal Cognitive Assessment (MoCA) test used for the detection of cognitive impairment, and the Mini Mental State Examination (MMSE) test for detection of dementia. We divided patients in two groups acording to cognitive status based on these cutoff values: 26 points for MOCA score, respectively 24 points for MMSE score – and compared ABPM parameters of the two groups. Statistical analysis was performed with the IBM SPSS v.20 program.

Results:

In patients with cognitive impairment (MOCA <26) we found significantly lower mean diastolic (69.9 vs. 72.4 mmHg, p = 0.023), daytime diastolic (72.0 vs. 75.1 mmHg, p = 0.012), nighttime diastolic (64.5 vs. 66.9 mmHg, p = 0.039), and higher pulse pressure values (average pulse pressure 61.5 vs. 55.5 mmHg, p = 0.002, daytime pulse pressure 61.7 vs. 56.6 mmHg, p = 0.003, nighttime pulse pressure (59.8 vs. 55.1 mmHg, p = 0.004). In patients with dementia (MMSE<24) we found significant differences between nighttime systolic values (129.7 vs. 124.5 mmHg, p = 0.04), average pulse pressure (63.5 vs. 58.9 mmHg, p = 0.038), and nighttime pulse pressure (63.5 vs. 57.4 mmHg, p = 0.003), values compared to patients with normal cognitive function.

Conclusions:

The presence of cognitive impairment was related to lower diastolic values, and higher pulse pressure values, while dementia was associated with higher nighttime systolic values in the studied patient population. Lowering too much diastolic blood pressure leading to higher pulse pressure and insufficient control of systolic blood pressure over night could have deleterious effect on neurocognitive abilities of treated hypertensive patients.
MORTALITY RATE OF PATIENTS WITH ARTERIAL HYPERTENSION AND MILD COGNITIVE IMPAIRMENT
Authors: Yaneva-Sirakova Teodora , Dimov Anastas , Vassilev Dobrin , Traykov Latchezar
Published: April 2021

Objective:

People with mild cognitive impairment (MCI) are with elevated risk of death. On the other hand, patients with cardiovascular risk factors are at a higher risk of death in comparison with the general population. Thus, the combination of mild cognitive impairment and hypertension/high cardio-vascular risk, may lead to even higher mortality rate than expected. However, this has not been proven. The question is important in the light of effective early screening and prophylaxis, because the real patients in our everyday practice are not with a single isolated disease or risk factor.

Design and method:

This is a retrospective analysis. We compared the general death rate of hypertensive high-cardio-vascular-risk patients with and without MCI. Two hundred-forty-nine patients underwent neuropsychological screening twice at least 6 months apart with MMSE and MoCA, Geriatric Depression scale and 4-point version of the scale for evaluating the performance in instrumental activities of daily living (4-IADL). The patients also had laboratory testing, ambulatory blood pressure monitoring, ECG echocardiography. Their death rate was examined 8 to 10 years afterwards.

Results:

The patients with arterial hypertension and clinically diagnosed mild cognitive impairment (MoCA and MMSE) had significantly higher general death rate compared to those without MCI. Logistic regression analysis showed that about 14.6% of the mortality rate in this high-risk group could be attributed to MCI. The home blood pressure values were not in the target range for 63.85% at the initial neuropsychological test and for 56.43% on the reevaluation 8–10 years ago, despite the multi-drug antihypertensive regimen. The yearly all-cause mortality rate for the recent years for Bulgaria was about 14.1–15.4/1000. The relative all-cause mortality rate of this studied population was about 25.7/1000 patient on yearly basis – 1.67 times higher.

Conclusions:

It is known that MCI is correlated with cardiovascular risk factors and mainly - arterial hypertension. We found that the combination of MCI and arterial hypertension may lead to high mortality rate. This has important clinical implications. We will study further this issue to define in detail the factors responsible for the higher death rate in this group.