bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPREHENSIVE BIOMARKER PROFILING OF HYPERTENSION IN 36,985 FINNISH INDIVIDUALS
Authors: Palmu Joonatan , Tikkanen Emmi , Havulinna Aki S. , Vartiainen Erkki , Lundqvist Annamari , Ruuskanen Matti O. , Perola Markus , Ala-Korpela Mika , Jousilahti Pekka , Würtz Peter , Salomaa Veikko , Lahti Leo , Niiranen Teemu
Published: June 2022

Objective:

Previous studies on the association between metabolic biomarkers and hypertension have been limited by small sample sizes, low number of studied biomarkers, and cross-sectional study design. In the largest study to date, we assess the cross-sectional and longitudinal associations between high-abundance serum biomarkers and blood pressure (BP).

Design and method:

We studied cross-sectional (N = 36,985; age 50.5 ± 14.2; 53.1% women) and longitudinal (N = 4,197; age 49.4 ± 11.8, 55.3% women) population samples of Finnish individuals. We included 53 serum biomarkers and other detailed lipoprotein subclass measures in our analyses. We studied the associations between serum biomarkers and BP using both conventional statistical methods and a machine learning algorithm (gradient boosting) while adjusting for clinical risk factors.

Results:

Fifty-one of 53 serum biomarkers were cross- sectionally related to BP (adjusted P < 0.05 for all). Conventional linear regression modeling demonstrated that LDL cholesterol, remnant cholesterol, apolipoprotein B, and acetate were positively, and HDL particle size was negatively, associated with SBP change over time (adjusted P < 0.05 for all). Adding serum biomarkers (cross-sectional root-mean-square error: 16.27 mmHg; longitudinal: 17.61 mmHg) in the model with clinical measures (cross- sectional: 16.70 mmHg; longitudinal 18.52 mmHg) improved the machine learning model fit. Glucose, albumin, triglycerides in LDL, glycerol, VLDL particle size, and acetoacetate had the highest importance scores in models related to current or future BP (Figure).

Conclusions:

Our results suggest that serum lipids, and particularly LDL-derived and VLDL-derived cholesterol measures, and glucose metabolism abnormalities are associated with hypertension onset. Use of serum metabolite determination could improve identification of individuals at high risk of developing hypertension.
ASSOCIATION BETWEEN PSYCHOLOGICAL DISTRESS AND LATER REPORTS OF HYPERTENSION AMONG ADULTS IN EAST ZIMBABWE
Authors: Shamsuddin Shehla , Davis Katherine , Moorhouse Louisa , Mandizvidza Phyllis , Dadirai Tawanda , Nyamukapa Constance , Gregson Simon , Chigogora Sungano
Published: June 2022

Objective:

Little is known about the temporal relationship between psychological distress (PD) and hypertension, especially in low-income countries. We assessed the association between PD and later development of hypertension among Zimbabwean adults, and the role of smoking, alcohol consumption and recreational drug use in this relationship.

Design and method:

Data were taken from the Manicaland Study, an open cohort study in east Zimbabwe. Participants aged 15–54 were surveyed in 2012/2013 and followed-up in 2018/19. At baseline, PD was assessed using the Shona Symptom Questionnaire, a screening tool developed and validated in Shona-speaking countries. Participants self-reported whether they were currently: smokers; took drugs for pleasure; or regularly visited bars and/or consumed over three alcoholic drinks per sitting. At baseline and follow-up, participants reported whether they had ever been diagnosed with hypertension by a doctor/nurse. We selected individuals who did not report hypertension at baseline and used logistic regression to examine associations between baseline PD and hypertension at follow-up, controlling for sociodemographic and economic confounders. We also explored the effect of including binary variables capturing smoking status, drug use and alcohol consumption in the model.

Results:

742 participants who completed baseline and follow-up surveys, were not hypertensive at baseline, and had full covariate data, were included. At baseline, 10.4% of these had PD, and at follow-up 17.5% (overall) had developed hypertension. The odds of developing hypertension were 2.01 (95% Confidence Interval = 1.14–3.54) times higher among those with PD at baseline, after adjustment for sociodemographic and economic confounders (Table 1). Introducing smoking status, drug use and alcohol consumption into the model had little effect on our findings (adjusted Odds Ratio, aOR:2.04, 1.16–3.59) and we had little evidence that these behaviours were independently associated with hypertension (aORs:smoking:1.41, 0.40–4.98; alcohol consumption:1.49, 0.61–3.66; drug use:0.49, 0.14–1.75).

Conclusions:

PD was associated with increased odds of developing hypertension in Manicaland. However, we did not find strong evidence that smoking status, drug use and alcohol consumption contributed to this relationship, which may reflect the low prevalence of these behaviours in our study. The results suggest mental health interventions may be beneficial for reducing hypertension in Zimbabwe.
A COMBINATION OF HYPERTENSION AND A HIGH ATHEROGENIC INDEX OF PLASMA AS AN INDICATOR OF A CORONARY HEART DISEASE RISK
Authors: Ruf Ruslan , Grinshtein Yuri , Shabalin Vladimir
Published: June 2022

Objective:

Our study demonstrated the changes in the prevalence of coronary heart disease (CHD) depending on hypertension and atherogenic index of plasma

Design and method:

The atherogenic index of plasma (AIP) is a common logarithm of a ratio of triglycerides and HDL-cholesterol molar concentrations. According to M. Dobiasova (2006), at AIP < 0.10, cardiovascular risk is low; at the range of 0.10 to 0.24, the risk is medium, and if AIP is higher than 0.24, the risk is high.

For the randomized sample of the ESSE-RF study, which included 1603 Krasnoyarsk Krai inhabitants, we used a standard questionnaire, anthropometry, office blood pressure measurement, and biochemical blood analyses to find a prevalence of known cardiovascular diseases and their risk factors. We registered hypertension if a person took antihypertensive medications or their measured blood pressure was at 140/90 mm Hg or higher.

Coronary heart disease was diagnosed with a Rose angina questionnaire and 12-lead rest ECG encoded by the Minnesota system (the authors wish to thank the National Medical Research Center for Therapy and Preventive Medicine for assistance in laboratory tests and ECG encoding).

Results:

In 14.7% (95% CI = 13.8%-15.6%) of the study participants, we found CHD. Along with it, 73.5% of people had a low risk by AIP; in 10.4%, AIP indicated a medium risk, and 16.1% of the study participants had a high risk.

People with normal blood pressure had no significant interrelation between the prevalence of CHD and AIP level (p = 0.669). Contrary, hypertensives with low risk by AIP had 23.2% (95% CI = 19.5%-27.0%) cases of CHD; at the medium risk, the prevalence of CHD was at 31.5% (95% CI = 21.8%-41.1%), and in the group of high risk, there were 17.5% (95% CI = 11.9%-23.1%) people with CHD. Chi-square was for trend at p = 0.036.

Conclusions:

The atherogenic index of plasma and coronary heart disease had no interrelation in normal blood pressure. In hypertension, however, the atherogenic index of plasma at a medium level may indicate a higher probability of coronary heart disease.
A NOVEL VASOACTIVE PENTAPEPTIDE “PG1’’ FROM BUFFALO ICE-CREAM PROTECTS FROM ANGIOTENSIN-EVOKED HIGH BLOOD PRESSURE
Authors: Carrizzo Albino , Pietro Paola Di , Basilicata Manuela , Pepe Giacomo , Damato Antonio , Campiglia Pietro , Vecchione Carmine
Published: June 2022

Objective:

Arterial hypertension is the most important risk factor for cardiovascular diseases, myocardial infarction, heart failure, renal failure and peripheral vascular disease. In the last decade, milk-derived bioactive peptides have attracted attention for their beneficial cardiovascular properties. Identify new vasoactive natural peptides able to fight arterial hypertension that can be used as a preventive strategy.

Design and method:

Here we combined in-vitro chemical assay such as LC-MS / MS analysis of buffalo ice cream, ex-vivo vascular studies evaluating endothelial and smooth muscle responses using pressure myograph, and translational assay testing in-vivo the vascular actions of PG1 administration in murine models.

Results:

We demonstrate that a novel buffalo ice-cream-derived pentapeptide “QKEPM’’, namely PG1, is a stable peptide that can be obtained at higher concentration after gastro-intestinal digestions (GID) of buffalo ice-cream (BIC). It owns potent vascular effect in counteract the effects of angiotensin II-evoked vasoconstriction and high blood pressure levels. Its effects are mediated by the inhibitory effect on AT1 receptor leading to a downregulation of p-ERK½ / Rac1-GTP and consequent reduction of oxidative stress.

Conclusions:

These results strongly candidate PG1, as a novel bioactive peptide for the prevention and management of hypertension, thus expanding the armamentarium of preventive strategies aimed at reducing the incidence and progression of hypertension and its related cardiovascular complicications.
COHORT STUDY IN PATIENTS WITH HYPERTENSIVE CRISIS: CHARACTERISTICS AND FOLLOW-UP AFTER 30 DAYS
Authors: Flórido Carime Farah , Pierin Angela Maria Geraldo
Published: June 2022

Objective:

Characterize patients with hypertensive crisis and evaluate occurrences 30 days after the hypertensive event.

Design and method:

Cohort study was performed with 583 patients treated between August 2020 and July 2021, from an Emergency Unit in a Hospital specializes in cardiology in São Paulo, Brazil. Inclusion criteria: 18 years old, systolic pressure > 180 mmHg and/or diastolic pressure > 120 mmHg, have telephone contact. A consulting on the electronic medical record was made to identify the elegible patients, whom after were included on the REDCap platform, and 30 days of the hypertensive event, an interview by telephone was made to investigate cardiovascular events.

Results:

The sample characteristics were: women (53%), 66.24(13.89) years, white ethnicity (78.7%), married (50.5%), high school (27.9%), retired people (77.5%), average [(mean(SD)] monthly income R$2384.6 (R$3438). The mean(SD) systolic/diastolic blood pressure, respectively, in emergency department was 189.74(17.46)/99.28(19.89) mmHg. Hypertensive emergencies were 63.8%, urgencies 27.4% and 8.7% were not possible to classify. The prevalent symptoms in the emergency department were: chest pain (41.2%), dyspnea (34.3%), nausea (11.7%), dizziness (10,4%), radiating pain (10.1%). The most used treatments were: anticoagulant (35.1%), diuretic (28.1%), analgesic (25.3%), ACE inhibitor (23.8.7%). Regarding the performance of tests: 85.6% underwent laboratory tests, 71% electrocardiogram, 36.3% echocardiogram and 30.5% computed tomography. After being treated at the emergency department, 60.1% of patients were discharged, 35.8% hospitalized, 3.8% transferred to other hospitals and 0,3% died. Regarding comorbidities, 97.7% had hypertension, 68.7% high cholesterol, 48.4% diabetes, 34.1% acute myocardial infarction, 25.1% heart failure, 19.6% kidney disease and 12% stroke. Regarding outcomes 30 days after the hypertensive event, 1.4% had some type of stroke, being 85.7% ischemic and 14.3% hemorrhagic, 2.3% had acute infarction of the myocardium, and 2% cardiorespiratory arrest. Also, 14.5% returned to a health service for high blood pressure, and 23.1% for others reasons like angina, bradycardia, aortic aneurysm, covid-19, acute pulmonary edema, epigastric pain, dyspnea. Besides we identify that 4.7% died within 30 days.

Conclusions:

The findings indicate the need for tertiary systematization, through outpatient follow-up programs for people with hypertensive crisis in emergencies units.
VASCULAR OR CARDIAC? DIFFERENT TARGET ORGAN DAMAGE IN HYPERTENSIVE PATIENTS WITH OR WITHOUT CHRONIC KIDNEY DISEASE
Authors: Meazza Roberto , Rossi Marilisa , Guareschi Alessandro , Iaci Gioella , Soraruff Nora , Villarini Anna , Carugo Stefano
Published: June 2022

Objective:

The aim of our study was to evaluate different types of target organ damage (TOD) in hypertensive patients, with or without chronic kidney disease (CKD).

Design and method:

90 hypertensive patients were enrolled from our Hypertension Center: 48 with normal renal function and 42 with CKD. We performed a complete echocardiographic study in all subjects in order to evaluate cardiac damage; non-mydriatic digital fundus oculi examination and carotid-femoral PWV to assess, respectively, small vessels and large arteries alterations.

We considered Left Ventricular Mass index (LVMi) and h/r index to determine Left Ventricular Hypertrophy (LVH) or remodeling, Arteriolar-Venular Ratio (AVR) to evaluate retinal vessels and carotid-femoral PWV as a measure of arterial stiffness.

Results:

Both groups showed abnormal values of PWV, but significantly higher in CKD group (13.72 ± 1.3 vs 9.78 ± 0.491, p = 0.0166). Mean AVR values were abnormal only in CKD hypertensive, with a significant difference compared to simply hypertensive patients (0.75 ± 0.006 vs 0.84 ± 0.020, p = 0.0001). In the echocardiographic examination, no statistically significant alterations were found between the two groups (LVMi 118.04 ± 4.870 vs 113.42 ± 3.440, p = 0.123; h/r 0.42 ± 0.119 vs 0.44 ± 0.010, p = 0.454).

Conclusions:

Our results confirm that TOD is different in hypertensive patients with CKD. In these patients the target is essentially vascular, affecting either big and small vessels. Hypertensive patients without CKD showed a more typical cardiac TOD with an increase of left ventricular remodeling and hypertrophy.

The assessment of vascular damage pays an essential role in TOD detection, so the use of PWV and the evaluation of retinal vessels should be always performed.
EFFECTS OF CAFFEINE ON BLOOD PRESSURE AND HEART RATE VARIABILITY AT REST AND DURING COLD PRESSOR TEST
Authors: Ketelhut Sascha , Gassner Carole , Nigg Claudio
Published: June 2022

Objective:

Caffeine is the most widely consumed pharmacologically active substance in the world and is found in a variety of foods, and beverages. Even though the acute and long-term effects on the cardiovascular system are widely studied, the accumulated effects of caffeine and physiological stress are not clear. This study aimed to characterize the acute effects of caffeine on blood pressure (BP), heart rate (HR), and heart rate variability (HRV) at rest and during a cold pressor test (CPT) in healthy individuals.

Design and method:

Nineteen normotensive male participants (25 ± 2 years, BMI 24 ± 3) were enrolled in this double-blinded, placebo-controlled trial. Participants randomly received both a placebo (PL) and a caffeinated (3 mg/kg) drink (CAF) on two separate days. Before and following a 45-minute wash-in period BP, HR, and HRV were measured at supine rest and during a CPT. During the CPT, participants immersed their right hand into cold water (5C) for two minutes.

Results:

There were no significant differences in resting systolic (130 ± 13 mmHg vs. 125 ± 12 mmHg, p = .187), and diastolic (76 ± 7 mmHg vs. 73 ± 8 mmHg, p = .236) BP, as well as in HR (61 ± 10 bpm vs. 60 ± 8 bpm, p = .531), RMSSD (74 ± 36 ms vs. 83 ± 40 ms, p = .217), and Mean RR (1014 ± 155 ms vs. 1034 ± 140 ms, p = .570) between CAF and PL. The same was true for systolic (152 ± 14 mmHg vs. 151 ± 14 mmHg, p = .785) and diastolic (95 ± 11 mmHg vs. 96 ± 13 mmHg, p = .236) BP during CPT. However, CAF supplementation resulted in a significantly lower HR (62 ± 8 bpm vs. 73 ± 18 bpm, p = .013), and a significantly higher RMSSD (83 ± 51 ms vs. 55 ± 28 ms, p = .004), and Mean RR (1005 ± 158 ms vs. 867 ± 152 ms, p < .001) during CPT compared to PL.

Conclusions:

The often reported acute increase in BP after caffeine supplementation could not be confirmed in this cohort of normotensive young adults. Caffeine supplementation neither increased nor blunted BP response during the CPT. However, HR was significantly lower, and parasympathetic HRV indices were significantly higher during the CPT after consuming CAF. Thus, caffeine seems to attenuate stress response with a shift in sympathovagal control toward enhanced parasympathetic activity.
NEPHROPROTECTIVE EFFECT OF RD ACCORDING TO 5-YEAR FOLLOW-UP
Authors: Ryumshina Nadezhda , Zyubanova Irina , Baev Andrew , Mochula Olga , Manukyan Musheg , Suhareva Anna , Tsoy Ekaterina , Shelkovnikova Tatyana , Gusakova Anna , Maksimova Aleksandra , Falkovskaya Alla , Ussov Wladimir , Pekarskiy Stanislav
Published: June 2022

Objective:

To evaluate the nephroprotective effect of renal denervation (RD) in the form of anatomical and functional preservation of the kidneys in patients with resistant hypertension (RHT) over 5 years of follow-up.

Design and method:

The data of 23 patients with RHT (average age 57.6 ± 8.3 years) were analyzed. Initially and 6, 12, 24, 36 and 60 months after RD of observation, all patients were measured office and average 24-hour blood pressure (BP) monitoring, kidney function was assessed by serum creatinine and cystatin C levels and the calculation of glomerular filtration rate (eGFR). Non-contrast MRI of the kidneys (magnetic field strength 1.5 T) was performed at all observation points. RD was performed using a renal ablation electrode Symplicity Flex and an automated RF voltage generator Symplicity G2.

Results:

The average values of creatinine level corresponded to 80.2 ± 14.8 mmol/L, cystatin C – 684.8 ± 86.2 mg/l. According to MRI data, the volume of the right/left kidneys was 174 ± 41.6/ 194.9 ± 52.7 cm3, the cortical layer of the right/left kidneys was 62.7 ± 19.2/67.8 ± 26.1 cm3, respectively. 5 years after RD, there was a pronounced and significant decrease in the daily systolic BP/diastolic BP by -12.7/ -10.4 mmHg, respectively (p = 0.007), which confirms the effectiveness of RD. There was a statistically significant decrease in the volume of the cortex (right/left -24 cm3/21 cm3, p < 0.001), which was accompanied by a significant increase in creatinine ( 7 mmol/L, p = 0.0003) and cystatin C ( -298 mg/L, p = 0.0003), as well as a decrease in eGFR ( -14 ml/min/1.73 m2, p = 0.0005). Nevertheless, the average rate of decrease in eGFR was -2.8 ml/min/1.73 m2/year, which turned out to be significantly lower than those for the specified cohort according to literature sources (-6 ml/min/1.73 m2/year). In the dynamics of observation, eGFR was directly correlated with the volumes of the renal medulla (r = 0.78, p = ,005). Cystatin C correlated with the volume of the renal parenchyma (r = -0.88, p = ,000).

Conclusions:

RD is a successful way to reduce blood pressure in patients with RHT, allowing to slow down the rate of reduction in the amount of renal parenchyma and the progression of renal dysfunction during 5 years of follow-up.
THE IMPACT AND INTERACTION OF METABOLIC ELEMENTS ON LEFT ATRIAL STIFFNESS IN HYPERTENSION
Authors: Liu Yan , Sun Qiaobing , Fu Tingting , Pan Yu , Sun Yancui , Jiang Yinong
Published: June 2022

Objective:

To evaluate left atrial (LA) stiffness using two-dimensional speckle-tracking echocardiography (2DSTE) and investigate the impact and interaction of metabolic elements on LA stiffness index (LASI).

Design and method:

340 subjects were enrolled and divided into three groups: Group I (n = 38), healthy controls; Group II (n = 138), hypertension without metabolic syndrome (MS); Group III (n = 164), hypertension with MS. All subjects were performed LA phasic strains using 2DSTE, and the following parameters were measured: LA reservoir strain and strain rate (LAS-S, LASR-S), LA conduit strain and strain rate (LAS-E and LASR-E), LA booster strain and strain rate (LAS-A and LASR-A). The LASI was defined as the ratio of early diastolic transmitral flow velocity/lateral mitral annulus myocardial velocity (E/e’) to LAS-S. Binary logistic regression models were performed, and the odds ratios (OR) at 95% confidence interval (CIs) were used to approximate the associated risk of the elements of MS (obesity, diabetes and dyslipidaemia) for LA stiffness, with the lowest binary serving as the reference category.

Results:

LASI was significantly higher in Group II (0.34 ± 0.21) than Group I (0.19 ± 0.04) (p < 0.001), and further increased in Group III (0.39 ± 0.22) (p < 0.001). LA reservoir and conduit functions gradually and significantly decreased from Group I to Group III (p < 0.001). However, there were no significant differences in LA booster pump function among three groups (p> 0.05). Regarding the elements of MS, body mass index (BMI), hemoglobin A1c (HbA1c) and triglyceride (TG) were positively associated with LASI. Furthermore, we performed the interaction analyses between two of the three elements of MS (BMI, HbA1c and TG). We simultaneously stratified both elements into equal-sized binaries of their individual distribution and then showed that compared with the lowest risk reference group, risk for LA stiffness significantly increased in other groups (Figure).

Conclusions:

LA phasic function was impaired and LA stiffness was increased in hypertensive patients with MS. Elements of MS (BMI, HbA1c and TG levels) had independent and interaction effect on LA stiffness in hypertension.
DIFFERENCES IN BOLD MRI SIGNAL INTENSITY BETWEEN HYPERTENSIVE PATIENTS AND HEALTHY VOLUNTEERS
Authors: Hendriks-Balk Mariëlle , Da Costa Sandra , Polychronopoulou Erietta , Damianaki Katerina , Theiler Kenji , Van De Ville Dimitri , Wuerzner Gregoire
Published: June 2022

Objective:

An increased sympathetic tone is associated with the initiation and maintenance of most forms of arterial hypertension. Background activity of a core network of neurons in the brain and brainstem is supposed to be important for long-term blood pressure control. Imaging techniques such as blood oxygen level dependant magnetic resonance imaging (BOLD MRI) are now capable of detecting changes in oxygenation within the brain using blood oxygen levels. So far, the BOLD fMRI signal intensity changes provoked by a cold pressor test (CPT) have not been compared between hypertensive patients (HT) and normotensive subjects (NT). The primary objective was to compare the signal intensity changes in HT and NT participants.

Design and method:

This was a prospective case-controlled study. A 7 tesla MRI was used for fMRI acquisition. BOLD MRI signal intensity changes during a cold pressure test and during rest were analyzed using statistical parametric mapping (SPM) for whole brain analysis. The connectivity CONN toolbox was used to analyze functional networks.

Results:

30 NT subjects (age 34 ± 10 (mean ± SD), BMI 23 ± 2 kg/m2, systolic blood pressure (SBP) 117 ± 10 mm Hg and diastolic blood pressure (DBP) 71 ± 9 mm Hg) and 16 HT patients (age 46.5 ± 13, BMI 27 ± 3 kg/m2, SBP 148 ± 11 mm Hg and DBP 92 ± 6 mm Hg) were enrolled. The CPT increased the SBP by 21 ± 20 (median ± SD) and 25 ± 24 mm Hg in NT and HT, respectively, and the DBP by 20 ± 19 (NT) and 19 ± 17 (HT) mm Hg. BOLD fMRI signal intensity increased significantly in NT but not in HT. The pattern of resting state connectivity was different between NT and HT, with a decreased global connectivity in HT.

Conclusions:

BOLD fMRI signal intensity responses to CPT test were less pronounced in HTA patients compared to NT. The different response to stress may be secondary to different neuronal activity pattern during the resting state between the two groups as suggested by connectivity analysis.
THE EFFECT OF RENAL DENERVATION ON CEREBRAL BLOOD FLOW IN DIABETIC PATIENTS WITH RESISTANT HYPERTENSION
Authors: Falkovskaya Alla , Mordovin V. , Pekarskiy S. , Manukyan M. , Zyubanova I. , Lichikaki V. , Tsoy E. , Vtorushina A. , Khunkhinova S. , Guliaeva E.
Published: June 2022

Objective:

Long-term and persistent increase in blood pressure (BP) leads to vascular remodeling, which deteriorates cerebral blood flow. The combination of hypertension (HTN) with diabetes mellitus (DM) accelerates the vascular damage and impairs the cerebral blood flow autoregulation, which may be accompanied by an uncompensated decrease in cerebral perfusion in response to a decrease in BP. Renal denervation (RDN) leads to a rapid and sustained decrease in BP, therefore the aim of this study was to assess of changes in cerebral blood flow in patients with resistant HTN (RHTN) and type 2 DM at 6 month after the intervention.

Design and method:

Evaluation of cerebral blood flow was performed in 21 patients with RHTN and type 2 DM, who were included in single-arm prospective interventional studies (protocol numbers NCT01499810 and NCT02667912 on ClinicalTrials.gov) (mean age 61.4 ± 7.6 years, mean office (systolic/diastolic) BP (SBP/DBP) 167.1 ± 19.4/85.6 ± 15.9 mmHg, HbA1c 7.1 ± 1.3%, 8 men (32%), 19 pts (91%) had atherosclerosis of internal carotid arteries (ICA) with mean values of stenosis 22.2 ± 9.7%). All patients were undergone to ambulatory 24-hour BP, Doppler high-resolution ultrasound of ICA and middle cerebral arteries (MCA) at baseline and 6 month follow-up. The patients were instructed not to change their medication regimen during the study.

Results:

There was a significant decrease in mean 24-hour BP (systolic/diastolic) (-12.6/-7.3 mmHg, p < 0.05). At the same time, there was no deterioration in blood flow of ICA and MCA at 6 months after RDN.

Conclusions:

Our data indicate that the significant decrease in BP after RDN does not lead to deterioration of cerebral blood flow and therefore indicates the safety of this procedure for the brain in patients with RHTN with type 2 DM.
SHORT TERM EVALUATION OF LEFT VENTRICULAR FUNCTION FOLLOWING DUAL CHAMBER PACEMAKER A SPECKLE TRACKING STUDY
Authors: Abdulrahman Fahad
Published: June 2022

Objective:

Background:In 2012 the consensus issued by both the American College of Cardiology & Foundation Heart Rhythm

Society Recommend the use of Dual Chamber Pace maker instead of Single chamber pace maker for patients with

Sinus Node dysfunction. Restoration of atrioventricular synchrony in patient with sinus node dysfunction or

Atrioventricular block representing a new era in electrical therapy. the focus on normal physiology led to the nearly universal application of dual-chamber pacing to restore atrioventricular (AV) synchrony in patients with sinus rhythm.

Design and method:

Speckle tracking was used to evaluate the percent of ventricular deformation before and 3months follow upafter dual chamber implantation, this study included 28 patients with Sinus node dysfunction or Heart Failure-LBBB. This prospective observational study was carried out on patients of medical city, Baghdad Teaching Hospital, cardiology & Echocardiography Higher Education (Diploma) center from November 2016 to July 2017.

Results:

No statistical difference was noted between both gender groups in regard to main risk factors.Four methods were used to evaluate ventricular function synchrony (Ejection Fraction %, Global longitudinal stain, intraventricular synchrony using septal to posterior wall motion delay, interventricular Mechanical delay by Pulse wave), Global EF evaluated by Simpson biplane method remained the same in all patients after 3-month follow-up

(P = NS). Global longitudinal strain (GLS) significantly decreased in all patients. Inter-ventricular dyssynchrony evaluation revealed no significant change after 3 months.

Conclusions:

Global longitudinal strain and Left Ventricular dessynchrony assessment enables us to detect early signs of LV dysfunction in Subjects with dual chamber pacemaker.
IMPACT OF AQUAPORIN-3, AQUAPORIN-7 AND HEPARANASE GENETIC POLYMORPHISMS ON AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE PROGRESSION
Authors: Santos Ana Carolina , Rechitean Andreea , Silva Inês Vieira Da , Matos Andreia , Ferreira Joana , Soveral Graça , Bicho Manuel , Almeida Edgar
Published: June 2022

Objective:

Autosomal Dominant Polycystic Kidney Disease(ADPKD) is a monogenic disease characterized by the growth of cysts in the kidneys, which can progress to end-stage renal disease(ESRD). However, this progression is heterogeneous.

Aquaporin-3(AQP3) and Aquaporin-7(AQP7) are water channels involved in the inflammatory response and proliferation, expressed in the kidney and may have a role in cyst epithelial proliferation. Heparanase(HPSE) is an enzyme that cleaves heparan sulfate side chains of proteoglycans and has an increased expression in the glomerulus in diseases associated with proteinuria.

This study aims to evaluate the impact of AQP3, AQP7 and HPSE genetic polymorphisms and some biomarkers related to cardiovascular risk in ESRD progression in patients with ADPKD.

Design and method:

95 ADPKD(52.6% females), mean age 44.78 ± 14.34 years were diagnosed and had follow-up> 60 months. Variation values of serum creatinine(SCr) were used to stratify patients into fast progressors(FP) and slow progressors. Biochemical parameters and genetic polymorphisms were determined by standardized methods and endpoint analysis, respectively. Statistical analysis was performed using SPSS software considering p-value < 0.05.

Results:

For HPSE, genotype AA was associated with increased risk for FP in CKD(p = 0.027), while allele G was associated with high values of SCr(p = 0.010). A trend was observed in genotype CC of AQP7 with higher SCr(p = 0.066). No associations were found between AQP3 polymorphism and progression in ADPKD.

The increased levels of: creatinine(SCr), albumin creatinine ratio(Alb/Cr), microalbumin(mAlb) and parathyroid hormone(PTH) were associated with the FP and stage 4 and 5 of chronic kidney disease(CKD). The opposite occurred in hemoglobin(Hb) levels and the product of calcium and phosphorus. No associations were found between AQP3 polymorphism and progression in ADPKD.

Higher values of SCr were found in genotype CC of AQP3(p = 0.016) and a trend in allele T of AQP7(p = 0.070) and genotype AA of HPSE(p = 0.056). PTH was higher in genotype CC of AQP3(p = 0.047).

AQP7 polymorphism was associated with elevated values of:Alb/Scr(p = 0.021) in allele T, calcium(p = 0.003) in genotype TT and Hb(p = 0.012) in allele C.

Conclusions:

The studied polymorphisms seem to directly impact and/or modulate levels of some biomarkers associated with progression and stage of CKD in ADPKD patients.
DECREASED URINARY LEVELS OF SIRT1 AS NON-INVASIVE BIOMARKER OF EARLY RENAL DAMAGE IN HYPERTENSION
Authors: Martinez-Arroyo Olga , Ortega Ana , Solaz Elena , Martinez Fernando , Martinez-Hervas Sergio , Redon Josep , Cortes Raquel
Published: June 2022

Objective:

Hypertension and diabetes mellitus (DM) produce renal injury. Sirtuins have become important players in renal damage, but their value as biomarkers is poorly assessed. The aims of the study were to evaluate the sirtuin1 levels (SIRT1), and miRNAs miR-34a and miR-200, that regulate SIRT1 expression in urinary cell pellet from hypertensive patients with incipient renal damage with and without diabetes. In addition, to mimic disease conditions and deepen into the implications of SIRT1 in podocyte injury, employed cultured podocytes subjected to high glucose (HG) and angiotensin II (Ang II) concentrations.

Design and method:

We quantified urinary SIRT1 and claudin 1 (CLDN1) mRNA and miR-34a and miR-200a levels by quantitative real-time polymerase chain reaction (RT-qPCR) from urinary cell free pellet from patients and in cultured human immortalized podocytes treated with HG and ANG II. Protein levels and subcellular localization were analyzed by Western blot and fluorescence analyses by confocal microscopy.

Results:

We found decreased SIRT1 levels in patients with increased urinary albumin excretion (UAE), the lowest with diabetes presence, and a strong association with UAE, discriminating incipient renal damage. In vitro experiments also showed SIRT1 overall decreases in podocyte cultures under treatment conditions. In urine samples, miR-34a was reduced and miR-200a increased, both related to UAE levels. However, both miRNAs were generally increased in podocyte cultures under high glucose and angiotensin-II treatment.

Conclusions:

Results evidenced reduction of urinary SIRT1 from hypertensives with or without DM. The decrease of SIRT1 and increase of CLDN1 in patients and podocytes subjected to stress support the implication of both in renal injury and evidence a reflection in urinary levels. The alterations found in miR-34a and miR-200a both in patients’ urine and podocyte cultures reveal novel points to further address their implication in renal injury through SIRT1 regulation. Interestingly, SIRT1 mRNA levels and miR-200a are related to increases in UAE and discriminate the presence of UAE in patients. In summary, SIRT1 mRNA measurements is an easily accessible and non-invasive method to early characterize renal damage in patients.
ACUTE RENAL FAILURE PROGRESSING TO ESRD IN A PATIENT WITH UNTREATED HIGH GRADE HYPERTENSION – THE MALIGNANT NATURE OF “BENIGN’’ NEPHROSCLEROSIS
Authors: Leiba Adi , Rappoport Vladi , Hausmann Michael
Published: June 2022

Objective:

A 43 year old male with history of hypertension, non-adherence to medications, heavy smoking (since age 8) and alcohol abuse was admitted with epigastric pain, heartburn and upper GI bleeding (hematochezia) for which he had been recently taking PPI. On arrival his BP was 182/100 mmHg, HR-89, decreased breath sounds + wheezes.

Design and method:

Hemoglobin was 7.4 mg/dL, Creatinine 11.2 mg/dl (recent baseline 1.1 mg/dl) Urea- 200 mg/dl.

He soon after needed HD which he continues a thrice weekly basis.

Four months prior to this admission he was hospitalized with hemoptysis, BP up to 261/136mmHg, proteinuria (1.5 gram/gram) and microhematuria, mild creatinine elevation to 1.3 mg/dL and hypokalemia of 2.6 mg/dL. Fundus examination revealed high grade retinopathy with cotton wool spots and flame hemorrhages but no papilledema. Supine Renin was 41.37microunits/ml, aldosterone was 30ng/dl.

Results:

Since his renal function has not improved, and in parallel with HD treatments he undergone a kidney biopsy which revealed advanced benign nephrosclerosis (figure 1) with some FSGS, a single crescent and marked interstitial inflammation with eosinophils (figure 2)

Conclusions:

Untreated high-grade hypertension and severe “benign’’ nephrosclerosis represent a microvascular ischemic nephropathy (similar to critical bilateral RAS) in which a relatively minor insult can deteriorate the patient into ESRD.

While being non-adherent to different anti hypertensive medications, patient did take omeprazole which triggered acute interstitial nephritis on the background of advanced ischemic nephropathy, leading to permanent loss of renal function.
DINAMICS OF ARTERIAL STIFFNESS USING CAVI INDEX DEPENDS ON ADDED STATIN TO FIXED COMBINATION ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Rekovets Oksana , Sirenko Yuriy , Torbas Olena , Kushnir Svitlana , Botsyuk Yuriy , Primak Galina
Published: June 2022

Objective:

Aim of this study was to evaluate dynamics of arterial stiffness using cardio-vascular index (CAVI), of the fixed triple combination of valsartan / amlodipine / hydrochlorothiazide and a double fixed combination of valsartan / amlodipine in the treatment of patients with arterial hypertension II-III degree depends on added statin therapy.

Design and method:

The study included patients with moderate and severe arterial hypertension without diabetes. Patients were divided into 2 groups. The first group (n = 59) was assigned a fixed combination of Val/Amlo/HCT of Val/Amlo plus statins. Patients in the second group (n = 40) received fixed combination Val/Amlo/HCT or Val/Amlo without statins. After 6 months of treatment there was control of therapy.

Results:

The study included 99 patients with moderate and severe hypertension. The average age of patients 1-st group - 58.05 ± 1.28 (37–75) years, 2-d group – 50,05 ± 2.30 (24–76) years. Office SBP/DBP at the beginning 1-st group - 162.25 ± 1.53/97.36 ± 1.20 mm Hg and 160.85 ± 2.18/100.30 ± 1.64 mm Hg in 2-nd group. The office heart rate was 70.07 ± 1.14 bpm and 71.90 ± 1.71 bpm respectively. At baseline, 24-h ambulatory SBP/DBP baseline in 1-st group was – 141,21 ± 1.10 /85,63 ± 1.11 mm Hg and - 141,80 ± 1.32 /86,65 ± 1.33 mm Hg in 2-nd group. Decrease office blood pressure (SBP/DBP) in 1-st group was 35,69/16,52 mm Hg (p < 0,05) and in 2-nd group – 35,32/21,77 mm Hg (p < 0,05). There was increase the stiffness of the arterial wall in terms of cardio-vascular index CAVI in 2-d group without added statin. CAVI on the right/left site changed from 7.73 ± 0.26/7.62 ± 0.29 units to 8.63 ± 0.32/8.62 ± 0.32 units after treatment (p < 0,05). Cardio-vascular index (CAVI) in 1-st group with added statin was not changed. CAVI on the right/left site changed from 8.32 ± 0.16/8.33 ± 0.19 units to 8.44 ± 0.16/8.24 ± 0.15 units after treatment (p > 0,05).

Conclusions:

The added of statin to fixed combination antihypertensive therapy prevented the progression of arterial stiffness in patients with arterial hypertension.
ORAL ADMINISTRATION OF METHYLGLYOXAL ELEVATES BLOOD PRESSURE, BUT NOT ARTERIAL STIFFNESS, IN MICE
Authors: Bruggen Myrthe van der , Giudici Alessandro , Pencheva Margarita , Vangrieken Philippe , Parikh Shaiv , Bitsch Nicole , Leenders Peter , Berends Eline , Foulquier Sébastien , Delhaas Tammo , Reesink Koen , Spronck Bart , Schalkwijk Casper
Published: June 2022

Objective:

Methylglyoxal (MGO), a highly reactive dicarbonyl compound, is associated with diabetes and other age-related diseases such as hypertension. In these diseases, MGO may accelerate arterial stiffening. In the present study, we investigated the effect of elevated plasma MGO concentrations on arterial stiffness measured in- and ex vivo.

Design and method:

Eight-week-old male C57BL/6 mice were randomly allocated to control (n = 22) and treatment (n = 22) groups. Treatment started at age 10 weeks and consisted of 50 mM MGO in the drinking water for 13 weeks. Blood pressure (tail-cuff) and tonometric carotid-to-femoral pulse wave velocity (PWV) were recorded after 0, 5, and 11 weeks. After 15 weeks, mice were euthanised and their left common carotid arteries (CCAs) harvested for ex vivo bi-axial biomechanical testing. First, CCAs were stretched to in vivo length and exposed to quasi-static pressure inflation from 0–200 mmHg. Second, a 5 Hz pulsatile pressure of 120/80 mmHg was applied, to enable calculation of single-point PWV (Bramwell-Hill). Third, a structural axial stiffness coefficient was determined by performing quasi-static axial stretch sweeps at constant pressures of 60/100/140/200 mmHg. Finally, a four-fibre family strain energy function was fitted to the dataset to allow for calculation of material stiffness variables.

Results:

Plasma MGO levels at 15 weeks in the treatment group were 2.2-fold higher than the control group (879 ± 274 nM vs. 399 ± 45 nM, mean ± standard deviation, p < 0.001). After 11 weeks, systolic and diastolic blood pressures were elevated in the treatment group (systolic 110 ± 3 vs 105 ± 7 mmHg, p = 0.015, diastolic 85 ± 3 vs 80 ± 7 mmHg, p = 0.019). No differences in carotid-to-femoral PWV were observed at any time point (Figure). Ex vivo PWVs were not significantly different; neither were the axial stiffness coefficients. CCAs from treated mice showed a non-significant smaller inner radius and thickness than controls. Material stiffness, as assessed by constitutive modelling at a reference pressure of 100 mmHg, did not show any difference between groups.

Conclusions:

Higher plasma MGO levels are associated with an increase in blood pressure, but not an increase in arterial stiffness.
ESTIMATION OF MEAN SALT INTAKE IN LITHUANIA BY 24-HOUR URINARY SODIUM EXCRETION
Authors: Zakauskiene Urte , Macioniene Ernesta , Sukackiene Diana , Bratcikoviene Nomeda , Banys Valdas , Zabuliene Lina , Miglinas Marius
Published: June 2022

Objective:

High salt intake is associated with increased arterial blood pressure, high risk of other preventable cardiovascular diseases, reduced life expectancy and higher mortality. WHO strongly recommends to take less than 5 g of salt per day.

The aim of this study was to evaluate mean salt intake by 24-hour urinary sodium excretion and correlations with arterial blood pressure in Lithuanian population.

Design and method:

1034 participants of age 18–69 years were invited to participate in the study and collect 24-hour urine using random sample design. Their blood pressure (BP) was measured 3 times. Arterial hypertension was defined as systolic or diastolic BP > 140/90 mmHg. 146 participants were excluded due to incomplete or inaccurate urine collection and 24 h urinary creatinine excretion outside 2 standard deviations of the sex-specific distribution.

Results:

888 participants were included in a final analysis. An average age of participants was 47,4 years and 52,48% were women. Mean calculated salt intake in Lithuania was 10 ± 5,3 g/d. Only 12,5% of subjects consumed WHO recommended salt amount. Results varied between groups: mean salt consumption in males was 11,7 ± 5,8 g/d vs. in females 8,4 ± 4,1 g/d (p < 0,001). 35,1% of participants has hypertension. Female participants had lower mean BP (systolic 119,1 mmHg vs. 129,7 mmHg, diastolic 75,7 mmHg vs. 80,4 mmHg). Sodium excretion and male sex had significant impact on systolic blood pressure in the multiple linear regression model.

Conclusions:

Salt consumption in Lithuania extremely exceeds recommended amount. Females use less salt and have lower blood pressure.
POSTEXERCISE HYPOTENSION IN AFRICAN AND ASIAN POPULATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Bersaoui Marina , Bisai Ashwin , Toelsie Jerry , Goessler Karla , Baldew Se-Sergio , Cornelissen Veronique
Published: June 2022

Objective:

Hypertension is the global leading risk factor for the development of cardiovascular diseases, with the highest prevalence in Asian and African populations. Post-exercise hypotension (PEH) defined as a sustained reduction in blood pressure (BP) after a single bout of exercise is an important physiological phenomenon in BP management. However, little is known about PEH in non-Caucasian populations.

Therefore, we aim to systematically summarize the effects of a single bout of aerobic exercise on BP in non-Caucasian populations.

Design and method:

We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations published in a peer reviewed journal up to August 2021. A meta-analysis was performed to estimate random effect sizes within 95% of confidence intervals.

Results:

We identified 10 aerobic exercise trials in individuals of Asian origin (n = 156; mean age: 27.05 years: 72% male) and 11 aerobic exercise trials involving individuals of African origin (n = 112; mean age: 41.37 years; 62% male). Non-significant reductions in office BP at 30 minutes (-1.18 [-9.98, 7.62]/-1.29 [-7.32, 4.74] mmHg) and 60 minutes postexercise (-1.80 [-9.98, 7.62]/ -1.28 [-6.03, 3.46] mmHg) were observed in the African group. Similar to the African group, non-significant reductions in office BP at 30 minutes (-2.17 [-6.78, 2.43] / -0.82 [-2.41, 0.77] mmHg) postexercise were observed in the Asian group. No effect was found on 24h-systolic BP postexercise, but 24h-diastolic BP reduced significantly (-1.89 [-3.47, -0.31] mmHg) in the African group.

Conclusions:

Except for a small, though statistically significant effect on 24h-DBP in the African group, a single bout of aerobic exercise does not seem to cause clinically relevant PEH in the African and Asian populations. It should be acknowledged that the available studies on PEH applying aerobic exercise are limited and there is a lack of data on PEH following isometric and resistance exercise in these populations. This systematic review and meta-analysis is a call for more research on exercise therapy in non-Caucasians.
NEURODEGENERATION, MICROVASCULAR DYSFUNCTION AND THEIR INTERACTION: ASSOCIATIONS WITH COGNITIVE PERFORMANCE – THE MAASTRICHT STUDY
Authors: Heide Frank van der , Henry Ronald , Houben Alfons , Kroon Abraham , Kallen Carla van der , Dagnelie Pieter , Schram Miranda , Eussen Simone , Berendschot Tos , Schouten Jan , Webers Carroll , Greevenbroek Marleen Van , Wesselius Anke , Koster Annemarie , Savelberg Hans , Schaper Nicolaas , Schalkwijk Casper , Boxtel Martin van , Kohler Seb , Stehouwer Coen
Published: June 2022

Objective:

The main objective was to investigate whether there was an interaction between retinal nerve fibre layer (RNFL) thickness, an index of neurodegeneration, and retinal venular diameter, an index of microvascular dysfunction, in the associations of RNFL thickness and retinal venular diameter with global cognitive performance, an index of cognitive function.

Design and method:

We used cross-sectional data from The Maastricht Study (n = 1,785 participants, 47.8% men, mean age 59 years, and 24.5% with type 2 diabetes [oversampled by design]) and tested for an interaction between RNFL thickness and retinal venular diameter in the non-linear associations of RNFL thickness and retinal venular diameter with global cognitive performance. RNFL thickness was defined as low (lowest quartile) and high (highest three quartiles combined). Retinal venular diameter was defined as wide (highest quartile) and narrow (lowest three quartiles combined). All associations were adjusted for potential confounders (demographic variables and cardiovascular risk factors). In addition, we tested for interaction by hypertension.

Results:

The association of RNFL thickness with global cognitive performance was modified by retinal venular diameter (Pinteraction = 0.02) and the association of retinal venular diameter with global cognitive performance was modified by RNFL thickness (Pinteraction = 0.02). After full adjustment, low versus high RNFL thickness was associated with lower global cognitive performance in individuals with, but not in individuals without, a wide retinal venular diameter (beta, [95% confidence interval] low versus high RNFL thickness, -0.26 [-0.43; -0.08] versus -0.03 [-0.14; 0.08], respectively); and wide versus narrow retinal venular diameter was associated with lower global cognitive performance in individuals with, but not in individuals without, a low RNFL thickness (-0.27 [-0.47; -0.06] versus 0.01 [-0.11; 0.12], respectively). Hypertension modified the above associations. In stratified analyses, the above associations were stronger in individuals with, versus without, hypertension.

Conclusions:

In summary, the present population-based study found an interaction between neurodegeneration, estimated from RNFL thickness, and microvascular dysfunction, estimated from retinal venular diameter, in the associations of RNFL thickness and retinal venular diameter with global cognitive performance. Hence, the interaction between neurodegeneration and microvascular dysfunction may contribute to the pathobiology of cognitive dysfunction.