bluuebunny/crossref_metadata_2025 huggingface dataset:
COMBINING NATURAL LANGUAGE PROCESSING METHOD AND MENDELIAN RANDOMIZATION TO ESTABLISH CAUSAL EFFECT OF BLOOD PRESSURE ON OUTCOMES
Authors: Le Nhu Ngoc , Tran Quoc Bao Tran , Bhaskar Ravi , Du Toit Clea , Padmanabhan Sandosh
Published: June 2022

Objective:

Mendelian rioritisedn (MR) uses genetic variants as instruments to estimate a causal effect of an exposure on an outcome. Specific conditions need to be satisfied to ensure the validity of the genetic variant as an instrumental variable (IV). Pleiotropy is one of the reasons for invalid IV and erroneous causal estimation. We applied natural language processing (NLP) on multidimensional GWAS datasets enriched with gene-expression information to select appropriate IVs for MR analysis. The selected set of IVs was then used in MR analysis to investigate the causal effect of blood pressure (BP) on cardiovascular outcomes (ischaemic stroke, atrial fibrillation (AF), coronary artery disease (CAD), and chronic kidney disease (CKD)).

Design and method:

We curated corpus of data by integrating GWAS results, gene expression, single nucleotide polymorphism (SNP) proxies and proximate genes on 2955 phenotypes. We used chromosome cytobands to partition the genome into documents, in which SNPs, genes, tissues and phenotype domains are treated as the terms. We subsequently calculated term frequency – inverse document frequency (TF-IDF) for all the terms in the corpus and identified the cytobands with the highest TF-IDF for BP. Independent non-pleiotropic SNPs associated with BP in the rioritised cytogenetic bands were selected as IVs for two-sample MR analysis. We performed inverse-variance weighted (IVW) MR and MR Egger analysis using GWAS meta-analysis systolic BP (SBP) estimates and the following outcomes: ischaemic stroke (N = 440328), AF (N = 1030836), CAD (N = 547261), CKD (N = 117165). Analyses were performed on the MR-Base platform.

Results:

We identified 10 non-pleiotropic, BP-associated SNPs from the top 10 cytobands with the highest TF-IDF scores for BP over the whole genome. Two-sample MR analyses showed a significant causal relationship between genetically determined greater SBP and higher risk of ischemic stroke, AF but not for CAD and CKD (ischemic stroke: IVW = 0.03 ± 0.01, P = 0.006; MR-Egger = 0.05 ± 0.02, P = 0.09; AF: IVW = 0.03 ± 0.006, P = 9.017E-07; MR-Egger = 0.04 ± 0.01, P = 0.01) (Figure).

Conclusions:

Our joint NLP and MR analyses allowed selection of a parsimonious set of instrumental variable SNPs for MR analyses and may be an option for high-throughput analyses across multiple traits.
THE ROLE OF BIOCHEMICAL BIOMARKERS FOR NEURONAL ACTIVITY AND CLINICAL NEUROPSYCHOLOGICAL TESTS IN PATIENTS WITH CAROTID STENTING
Authors: Yaneva-Sirakova Teodora , Vassilev Dobrin , Karamfiloff Kiril , Hristova Julieta , Shumkova Monika , Dimov Anastas , Traykov Latchezar
Published: June 2022

Objective:

The application of carotid stenting is rising. We need biomarkers, which would guide us and help in the assessment of its effectiveness regarding brain blood flow and cognition. Potential candidate biomarkers are the markers for neuronal activity Brain Derived Neurotrophic Factor (BDNF) and Neural Growth Factor (NGF). Their serum concentration is correlated with brain hemodynamics and function.

Design and method:

We included 78 patients: 39 with hemodynamically significant carotid stenoses and 39 controls - without. All underwent ultrasound diagnostics and ELISA test of BDNF and NGF serum concentrations. The biomarkers for neural activity in patients with significant carotid stenoses, were tested at 3 phases: before (n34), 24 h. post (n22) and at least 1 month after stenting (n18). Cognitive functions were assessed with MMSE and MoCA. On their basis the patients were classified as having or not potential mild cognitive impairment (MCI) Statistical analysis was done with SPSS 19(IBM), p < 0.05, CI 95%.

Results:

There was a significant difference in the BDNF concentration before and after carotid stenting (p < 0.0001); in BDNF [p = 0.001, CI (-5.11- -1.44)] and NGF [p = 0.049, CI (0.64–347.75)] between patients with significant stenoses/stenting and controls. Periprocedural hypotension, stroke history and MCI did not influence biomarkers concentrations. Correlation analysis showed intermediate positive correlation between systolic, diastolic, pulse pressure and biomarkers at a certain time of sampling. This association was proven for the systolic blood pressure by the regression analysis too. The mean values of BDNF after stenting raised and for NGF lowered after carotid stenting.

Conclusions:

A larger sample is needed to prove further our results, namely: 1. Arterial blood pressure is an important factor for BDNF and NGF concentrations; 2. The correlation between these markers and interventional treatment may be not linear; 3. There are significant differences in the serum concentrations of biomarkers for neural activity between patients with and without significant carotid stenoses.

Research Grant 2020 from Medical University Sofia, Bulgaria, contract 133/24.06.2020
CORRELATION OF CAROTID INTIMA-MEDIA THICKNESS AND PULSE WAVE VELOCITY WITH HEMATOCRIT, PLATELET COUNT AND FIBRINOGEN LEVELS IN DIPPER AND NON-DIPPER HYPERTENSIVE PATIENTS
Authors: Vazquez-Agra Néstor , Marques-Afonso Ana T. , Fernandez-Castro Ivan , Lopez-Paz Jose E. , Hermida-Ameijeiras Alvaro , Pose-Reino Antonio
Published: June 2022

Objective:

Carotid intima-media thickness (IMT) and pulse wave velocity (PWV) are the two most widely recognized methods for the assessment of arterial stiffness. The aim of this study was to verify whether there is a correlation between them and some blood parameters in dipper and non-dipper hypertensive patients.

Design and method:

This was a cross-sectional study that included patients with arterial hypertension (AHT) who were greater than 18 years old. Demographic and epidemiological variables were collected. Blood pressure (BP) parameters were assessed by office BP measurements and 24-hour ambulatory BP monitoring (24 h ABPM). We collected blood samples for biochemistry, blood count and coagulation variables. Individuals were divided into two groups: dipper and non-dipper patients. Quantitative normally distributed variables were nalysed using the Student’s t-test while non-normally distributed variables were nalysed using the Mann–Whitney U-test. A Chi-square test was used for categorical variables to test differences between groups. This study was approved by the center Ethics Committee of Clinical Research, and it adhered to the ethical standards that were outlined in the Declaration of Helsinki. All subjects provided informed consent.

Results:

There were 563 patients (47% women) with a mean age of 54 years who were included in this study.

One third of patients suffered from diabetes and two out of three had plasma lipid abnormalities. There were differences in age, frequency of diabetes, dyslipidemia and antihypertensive therapy between dipper and non-dipper patients. After an adjustment for those variables, we observed a relevant correlation of PTC (Pearson correlation coefficient [r] -0.215, P = 0.002) and hematocrit (r 0.215 P = 0.002) with IMT in patients with a dipper profile while individuals with a non-dipper BP pattern showed a correlation of PWV with PTC (r -0.149, P = 0.031) and fibrinogen levels (r 0.238, P = 0.031). Uric acid levels were correlated with IMT in both groups of patients.

Conclusions:

It seems that some blood parameters could be linked to the development of arterial stiffness in both dipper and non-dipper patients. This was a preliminary retrospective, single-center study that could open the door to the investigation of new analytical indices in arterial stiffness.
IMPACT OF POLYCYSTIC OVARIAN SYNDROME (PCOS) ASSOCIATED WITH HYPERTENSION ON SOME METABOLIC MARKERS
Authors: Bendiab Nabila Taleb , Bouanane Samira , Ahmed Fatema Zohra Baba
Published: June 2022

Objective:

Polycystic ovary syndrome (PCOS) is a multifactorial syndrome, including the hyper androgenism, ovulatory disorders with a polycystic appearance of the ovaries. PCOS is a disorder metabolic associated with an increased risk of insulin resistance, hyper insulinemia, central obesity, high blood pressure, type 2 diabetes, dyslipidemia and cardiovascular disease. Variability of sound expression and the difficulty of defining it with precision hamper the visibility of this affection, both in the population general than in a number of clinical situations. Several studies have highlighted an HTA in obese patients with PCOS.

The objective of our work consists in studying the impact of the HTA and PCOS association on the disturbances of the metabolism (hepatic, lipid and renal).

Design and method:

For this study, 26 hypertensive patients with this syndrome were selected, recruited from level of the Tlemcen teaching hospital, and 30 healthy women witnesses. After their consent, patients benefited a specific biochemical assessment of liver function (TGO transaminases, TGP), renal function (acid uric, creatinine, urea), and the lipid profile (total cholesterol, LDL, triglycerides).

Results:

A comparison of the results obtained in hypertensive and normotensive PCOS patients shown that there is a disturbance in hepatic metabolism, expressed by high levels of transaminases (TGO, TGP), kidney damage, due to increased creatinine and urea, with lipidogram disturbance in hypertensive women with PCOS compared to women witnesses.

Conclusions:

In conclusion, PCOS associated with hypertension is the source of many dysfunctions metabolic (dyslipidemia, kidney and liver damage). For this, the dietary management and drug treatment of this syndrome is a strategy to reduce complications associated metabolic.
INCREASED PULSE WAVE VELOCITY AND ASSOCIATED FACTORS IN BRAZILIAN HYPERTENSIVE PATIENTS
Authors: Cruz Giannandréa D. , Oliveira Kallita Brito , Barroso Weimar K. Sebba , Batista Sandro Rodrigues , Vitorino Priscila V.O.
Published: June 2022

Objective:

The increase in pulse wave velocity (PWV) reflects arterial stiffness and indicates an increased risk of cardiovascular disease (CVD). Several factors have been associated with increased PWV in different populations and some of them are poorly studied or have controversial results. The objective of this study was to identify the sociodemographic, laboratory and blood pressure factors associated with the increase in PWV in participants of the I Brazilian Registry of Hypertension (I RBH).

Design and method:

Cross-sectional, multicenter and national study with data taken from the baseline of the I RBH. Participants with central blood pressure measured were nalyses. A questionnaire was applied with demographic data, personal medical history, lifestyle and biochemical tests. The PWV value considered as changed was > or = 10 m/s. Statistical nalyses were performed using Stata 15, comparisons established with chi-square and correlations with Spearman or Pearson tests, p < 0.05 adopted.

Results:

44 participants were evaluated: 62.5% women, 63.8 ± 14.4 years, PWV 9.5 ± 2.2 m/s and 40.7% had PWV > or = 10 m/s. Higher frequency of altered PWV was presented in those aged > or = 60 years (62.8%) and with > or = three cardiovascular risk facts (p < 0.001). Age (r = 0.907), central systolic blood pressure (SBP) (r = 0.223), peripheral SBP (r = 0.237) and HDL (r = 0.240) were correlated with PWV.

Conclusions:

We identified a higher frequency of PWV > or = 10m/s in patients with 60 years or more, patients with three or more risk factors and a positive correlation of age, PASc, PASp and HDL with PWV in hypertensive patients of the I RBH.
DIABETIC STATUS AND NIGHT-TIME SYSTOLIC BLOOD PRESSURE PREDICT EARLY MYOCARDIAL DAMAGE IN NEWLY DIAGNOSED DIABETES MELLITUS TYPE 2 PATIENTS AS THIS IS DEPICTED BY GALECTIN-3 LEVELS
Authors: Nikolaidou Barbara , Anyfanti Panagiota , Gavriilaki Eleni , Dolgyras Panagiotis , Koravou Evaggelia , Lazaridis Antonios , Vakalopoulos Nikolaos , Malliora Anastasia , Triantafyllou Areti , Douma Stella , Gkaliagkousi Eugenia
Published: June 2022

Objective:

Long standing Diabetes Mellitus Type 2 (T2DM) shows a high frequency of cardiovascular events. However, it is not known if newly diagnosed patients with T2DM present early signs of cardiovascular dysfunction. On the other hand, galectin has been introduced as a novel biomarker of myocardial fibrosis. The aim of the study was to evaluate levels of galectin-3 in patients with a very recent diagnosis of T2DM without established cardiovascular disease. In addition, hemodynamic parameters as well as their possible correlation with galactin-3 levels were studied.

Design and method:

Patients with a recent diagnosis of T2DM (<6 months) and non-T2DM volunteers were studied. A thorough medical history with emphasis on hypertension and relevant comorbidities, somatometric measurements and blood tests was obtained from all participants. Serum levels of galectin-3 were determined by ELISA. Myocardial function and hemodynamic profile were noninvasively assessed with impedance cardiography. Furthermore, Atherosclerotic Cardiovascular Disease Risk (ASCVD) was calculated.

Results:

We studied 135 subjects, 79 T2DM patients with a median disease duration of 1 month (IR: 5) and 56 controls matched by age, sex and hypertension. T2DM patients had significantly higher values of galectin-3 (90 ± 88ng/dl vs 32.92 ± 6.32ng/dl, p < 0.001), Cardiac Output (CO), ASCVD Risk compared to controls. Galectin-3 was associated with T2DM (p < 0.001), fasting glucose (p < 0.001), glycosylated hemoglobin (p < 0.001). Furthermore, galectin-3 was associated with CO (p = 0.023), nighttime systolic blood pressure (SBP) (p = 0.03) and ASCVD Risk (p = 0.001). In multiple linear regression analysis, T2DM (Beta: 0.406, p < 0.001) and nighttime SBP (Beta: 0.196, p = 0.028), were identified as independent predictors of galectin-3, after adjustment for age, sex, Body Mass Index and CO.

Conclusions:

Galectin-3 is elevated in patients with early stage T2DM even in the absence of established cardiovascular disease, and is independently correlated with T2DM and nighttime SBP. In this group of patients galectin may be used as a biomarker of early myocardial damage. Nighttime SBP emerge as an important mediator in early target organ damage in cardiovascular diseases.
SERUM HEPATOCYTE GROWTH FACTOR CONCENTRATION IS ASSOCIATED WITH BLOOD PRESSURE IN SUBJECTS WITH PREHYPERTENSION
Authors: Prlic Margareta Fistrek , Kos Jelena , Fucek Mirjana , Knezevic Tamara , Ivkovic Vanja , Jelakovic Ana , Josipovic Josipa , Simicevic Livija , Jelakovic Bojan
Published: June 2022

Objective:

Hepatocyte growth factor (HGF) is a pleiotropic factor that regulates cellular processes such as cell survival, proliferation, migration, and differentiation. Serum HGF concentration is associated with systolic blood pressure (BP) and is higher in hypertensive than in normotensive individuals, especially if complications of arterial hypertension are developed. Our aim was to determine the association of serum HGF concentration in subjects with prehypertension.

Design and method:

Data from 612 subjects (57,8% women, average age 41 years) was nalysed. After clinical examination, fasting blood and urine samples were drawn. HGF was measured using a commercial test. BP was measured according to the ESC/ESH guidelines. Based on BP values, subjects were divided into two groups: OBP - subjects with optimal blood pressure (BP < 120/80 mmHg, N = 295), and PHT (subjects with BP 120/80–140/90 mmHg N = 317).

Results:

Subjects with PHT were significantly older and had higher values of body mass index, waist circumference, serum total cholesterol levels, triglyceride levels, and fasting glucose levels (all p < 0.001). The prevalence of metabolic syndrome was significantly higher in PHT group (4.3% vs. 30.4%, p < 0,001). Serum HGF concentrations were higher in PHT subjects, but the difference was not significant (270.8 vs. 277.9 pg/ml, p = 0.651). Serum HGF concentration showed a significant positive correlation to systolic and diastolic BP in PHT (r = 0,226, p < 0,05 and r = 0,232, p < 0,01, respectively), but not in OBP group (p > 0.05).

Conclusions:

Serum HGF is associated with BP in prehypertensive subjects, but not in subjects with optimal BP. In our cohort, the correlation is more pronounced for diastolic blood pressure.
UTILITY OF IRISIN AND APELIN IN PREDICTION OF HEART FAILURE PHENOTYPES IN TYPE 2 DIABETES MELLITUS PATIENTS
Authors: Berezin Alexander , Fushtey Ivan , Berezin Alexander
Published: June 2022

Objective:

The aim of the study was to investigate whether serum levels of both irisin and apelin predict HF with preserved ejection fraction (HFpEF) in patients with type 2 diabetes mellitus (T2DM).

Design and method:

One hundred and eight HF patients with T2DM having HFpEF (n = 58), HF with mildly reduced ejection fraction (HFmrEF, n = 22), HF with reduced ejection fraction (HFrEF, n = 28) aged from 41 to 62 years and 20 non-HF patients with T2DM. Healthy control group was consisted of 25 individuals matched with age and sex. All patients gave voluntary written informed consent to participate in the study. We polled at baseline demographic and anthropometric information, data for hemodynamic performances by B-mode echocardiography, Doppler and TDI, and the levels of biomarkers including irisin, apelin, N-terminal pro-brain natriuretic peptide (NT-proBNP) by ELISA.

Results:

Using ROC curve we revealed that cut-off points for irisin and apelin that distinguished HFpEF from HFrEF/HFmrEF were (6.50 ng/mL; AUC = 0.78; 95% confidence interval [CI] = 6.85 - 10.66 ng/mL and 4.12 ng/mL, AUC = 0.72; 95% CI = 3.90–5.75 ng/mL, respectively). Then we divided all patients with HF having elevation of NT-proBNP > 750 pmol/mL into three subgroups depending on the biomarkers’ levels. Patients from subgroup A had both irisin and apelin levels higher cut-off points, individuals from group B had higher concentration of one of two biomarkers, and patients from subgroup C demonstrated levels of both peptides lower cut-off points. Multivariate logistic regression analysis revealed that discriminative value of irisin and apelin to predict HFpEF in subgroup B (Odds Ratio [OR] = 2.18; 95% CI = 1.26–3.14; P = 0.001) were substantially higher compared with subgroups A and C (OR = 1.03; 95% CI = 1.00–1.05; P = 0.64 and OR = 0.92; 95% CI = 0.89–1.01; P = 0.62, respectively). Adding irisin and apelin to NT-proBNP as independent variables to the predictive model sufficiently improved discriminative ability of whole model for HFpEF.

Conclusions:

Multidirectional changes in the levels of irisin and apelin in T2DM patients had better predictive value for HFpEF that simultaneous increase and decrease in the circulating levels of these peptides.
BLOOD PRESSURE MEASUREMENT IN PUBLIC SPACES (KIOSK): SYSTEMATIC REVIEW OF SOLUTIONS AND APPLICATION
Authors: Menti Ariadni , Kyriakoulis Konstantinos , Ntineri Angeliki , Kollias Anastasios , Stergiou George S.
Published: June 2022

Objective:

Kiosk-type blood pressure (BP) measuring devices developed for public spaces are available in several countries and might be useful in improving hypertension awareness and management. A systematic review of the evidence on their implementation, accuracy, and usefulness was performed.

Design and method:

A systematic search of PubMed studies involving kiosk BP measurements until Sep. 2021 was performed.

Results:

Of 271 articles initially identified, 42 were selected and analysed. Kiosks are automated BP devices equipped with a single solid wide-range upper-arm cuff, mostly portable (~90%) and few station-type. Kiosk BP devices are used in healthcare settings (doctors’ office or waiting room, hospital, pharmacy) and in non-healthcare settings (shopping centre/market, department store, community centre, grocery store, church, workplace, senior centre), offering unsupervised self-BP measurement. Kiosk BP measurement is well-accepted by users and healthcare professionals (10 studies) and is useful for hypertension screening (10 studies, 7 uncontrolled) and long-term monitoring of treated hypertensives, and may reduce doctors’ visit time. Limitations include patients’ doubts on their accuracy, lack of awareness about the method, and user preference for other BP measurement methods. Fifteen studies compared kiosk versus office or out-of-office BP measurements, but had several methodological issues including lack of standard protocol, small sample size, and variable and thus questionable results. Among 72 kiosk BP devices available on the market, only 10 (13.9%) by 4 manufacturers have a published successful validation study using an established protocol (A&D, Japan; InBody, S Korea; Omron, Japan; Pharma-Smart, USA).

Conclusions:

The published evidence on kiosk BP measurement is promising but limited. Further research is needed to investigate the potential of the method in hypertension screening and management and its optimal implementation in clinical practice.
MASKED ARTERIAL HYPERTENSION IN MIDDLE-AGE PATIENTS AND THE ELDERLY. PREVALENCE, CARDIOVASCULAR RISK FACTORS AND SOME LONG-TERM RISK TRENDS
Authors: Snincak Marian , Pella Jozef , Hrabcakova Petra , Kolesar Kamil
Published: June 2022

Objective:

To assess frequency of masked hypertension (MAH) in middle-aged patients and in the elderly, the prevalence of cardiovascular risk factors (CV RF) with special aspects to pts with type 2 diabetes mellitus (T2D) and long-term prognosis trends of subjects with MAH.

Design and method:

A screening study that included 314 consecutive patients aged 35–74 years with normal in-office blood pressure (BP) in hypertension centre. Participants were performed to identify cardiovascular risk factors, underwent following 24-hours blood pressure monitoring to verify the MAH diagnosis, too. Patients with confirmed MAH were periodically clinically monitored for an average of 5.5 years (3.5–7 yrs).

Results:

MAH was detected in the age category of 45–54 years, in 24.2 % and 9.9 % women, 55–64 years, in 19.4% men and 8.1 % women. Middle-aged and elderly men with MAH frequently identified CV RF compared to evenly aged women - family history of CV diseases, higher rate of smoking and dyslipidemia, lower physical activity prevailed. From a patients with the diagnosis of T2D, a total 44.3% presented normal in-office BP and the pts with the diagnosed MAH were older (63.9 vs. 54.7 years; p < 0.001), also with earlier diagnosis of T2D, higher rate of smokers (26.4 % vs. 1.9%; p = 0.002), and higher levels of HbA1c (10.7 % vs. 9.9%; p = 0.006), creatinine (0.73 vs. 0.65 mg/dl; p = 0.040), and microalbuminuria (139.4 vs. 27.4 mcg/mg; p < 0.001). Patients with MAH at the beginning of the study had long-term risk of progression to sustained office hypertension in 37.9 %, increased frequency of developing T2D 9.3 % and in the two oldest cohorts we observed a trend for a lower cognitive score on the MMSE.

Conclusions:

MAH is common finding in patients especially in the age category of 45–54 and 55–64 years, in males, smokers ith unfavourable risk profile, and it is also common in diabetics. MAH is associated with progression to sustained office hypertension, increased frequency of developing T2D and in the oldest cohort, patients may show decreased cognitive function compared to patients with normotension.
USE OF ANTHROPOMETRIC INDICES TO IDENTIFY APPROPRIATE CUFF SHAPES FOR BLOOD PRESSURE MEASUREMENT: NORMATIVE DATA FOR ADULTS
Authors: Palatini Paolo , Fania Claudio , Ermolao Andrea , Battista Francesca , Saladini Francesca
Published: June 2022

Objective:

Published evidence has shown that tronco-conical cuffs improve BP measurement accuracy in obese subjects. However, the exact shape of these cuffs according to arm size has not been established. The aim of the present study was to investigate the anthropometric characteristics of the upper arm in a large population in order to identify the appropriate shape of the cuff according to arm size.

Design and method:

Anthropometric characteristics were assessed in 729 adults with middle arm circumference ranging from 16 to 55 cm. Upper arm length and proximal, middle, and distal circumferences were measured to calculate the slant angle of the upper-arm truncated cone. Subjects were divided into 6 classes of upper arm middle circumference, and the upper arm slant angle was calculated within each class.

Results:

In all subjects the upper arm showed a tronco-conical shape with a slant angle ranging from 80.4 to 89.2. The conical shape of the arm progressively increased with increasing arm circumference (r = 0.61,p < 0.0001). Independent predictors of the conical shape were arm circumference (p < 0.0001) and length (negative relationship, p < 0.0001). Women had a slightly more pronounced conical shape of the arm than men. In a two-way ANOVA, a significant effect of both arm size (p < 0.001) and sex (p = 0.001) was found on the conical shape of the arm. However, the decrease in the slant angle across the arm size classes showed a similar trend in men and women, and in the two-way ANOVA there was no interactive effect between arm size and gender (p = 0.11). On the basis of the slant angle calculated in each arm-size class, we identified appropriate dimensions for bladders that would fit the arm within a given circumference range. The upper arm slant angle and the proximal-distal circumference difference for the 4 cuff sizes (small adult, adult, large adult, and extra-large adult) recommended by the American Heart Association were also provided.

Conclusions:

To properly fit the upper arm, cuffs should have a tronco-conical shape especially in obese individuals. This study provides reference data for appropriate proximal and distal circumferences of bladders according to arm size.
PLEASE TRY THIS AT HOME: STANDARDIZED BLOOD PRESSURE SELF-MEASUREMENT - WILLINGNESS TO PARTICIPATE AND FEASIBILITY STUDY
Authors: Neuhauser Hannelore , Weihrauch Tim , Lemcke Johannes , Julia Büschges , Kirstaedter Margitta , Kintscher Ulrich , Allen Jennifer , Schmich Patrick , Maier Birga
Published: June 2022

Objective:

Clinical and epidemiological research needs standardized resting blood pressure (BP) measurements, as even small mean differences of a few mmHg between treatment groups or populations have prognostic or public health relevance. Standardization of sitting and arm position, cuff choice and resting time are usually ensured by trained study staff. The MeinBlutdruck study investigates willingness to participate and feasibility of standardized blood pressure self-measurements at home.

Design and method:

1) Willingness to self-measure BP with mailed devices: interview of 6,469 adults embedded in a nationwide telephone interview survey, on their willingness to measure their blood pressure on three days in the morning and in the evening with mailed devices and video and written instructions. 2) Barriers to participation: qualitative interviews (n = 20). 3) Explanatory video 4) Feasibility: self-measurements with mailed devices (n = 200) with accompanying online-interviews.

Results:

Willingness to participate was affirmed by 38% of 6,469 respondents and, after adjustment for sociodemographic, health and ehavioural aspects, was associated with higher educational attainment (highest to lowest educational attainment (OR:2.06 [95% CI:1.60–2.66] and absence of chronic disease (OR:0.58 [95% CI:0.47- 0.73]), but not with self-reported hypertension (OR = 0.83 [95% CI:0.66- 1.06]). The qualitative interviews showed that the time for standardized measurements due to resting time and multiple measurements was considered long. The focus of the video was on the motivation to participate and on conveying a standardized calm measurement situation. First results of the feasibility study (n = 96) were: 14% of the devices were not returned 4 weeks after sending (n = 13), 4% were damaged and data was lost (n = 4), and 20% of the collected blood pressure measurement data did not correspond to the standardization specifications with 2 measurements in the morning and 2 in the evening on 3 days (n = 19). Standardized blood pressure measurement data could be collected from 62% of those willing to participate.

Conclusions:

The first preliminary results suggest that a standardized blood pressure self-measurement under home conditions is possible, however, response and adherence to the measurement protocol are much lower compared to blood pressure measurement in a study center.
DIFFERENCES OF BLOOD PRESSURE MEASURED AT CLINIC VERSUS AT HOME IN THE MORNING AND IN THE EVENING IN EUROPE AND ASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Miao Huanhuan , Yang Shijie , Zhang Yuqing
Published: June 2022

Objective:

Although the comparison of clinic blood pressure (BP) and home BP has been investigated, the differences between clinic BP and home morning/evening BP were poorly explored. Thus, we perform the systematic review to determine the quantitative differences of BP measured at clinic versus at home in the morning and in the evening in Europe and Asia.

Design and method:

PubMed, Embase and Scopus databases were searched up to October 2021. Studies that compared clinic BP with home morning and (or) home evening BP with detailed BP values in European and Asian populations were included. Random effect model was applied to pool the differences between clinic BP and home morning/evening BP.

Results:

Thirty-five studies, for a total of 49432 patients, were included in the meta-analysis. Mean clinic systolic BP (SBP) values were significantly higher than home morning SBP values by 3.79 mmHg (95% CI, 2.77–4.80). The differences were much larger in Europe [(6.53 mmHg (95% CI, 4.10–8.97)] than in Asia [(2.70 mmHg (95% CI, 1.74–3.66)], and region was a significant predictor for the differences. Mean clinic SBP values were also significantly higher than home evening SBP values by 6.59 mmHg (95% CI, 4.98–8.21). The differences were much smaller in Europe [5.85 mmHg (95% CI, 3.24–8.45)] than in Asia [7.13 mmHg (95% CI, 4.92–9.35)], while age and clinic SBP might contribute to it.

Conclusions:

The difference between clinic and home morning SBP was much larger in European than Asian populations, whereas the difference between clinic and home evening SBP was the opposite. The differing characteristics of region, ethnic, age and clinic BP might explain the diversities.
EFFECTS OF TRANSCUTANEOUS PERIPHERAL NERVE ELECTROSTIMULATION DEVICE FOR BLOOD PRESSURE CORRECTION
Authors: Mamontov Oleg , Kozlenok Andrey , Brodsakaya Inna S. , Malakhov Konstantin , Shlyakhto Eugene
Published: June 2022

Objective:

Currently the therapy of arterial hypertension (AH) is mainly based on antihypertensive medicines. The medical transcutaneous peripheral nerve electrostimulator “ABP-051’’ (“Shvabe’’& “INFERUM’’, Russia) allows to influence the level of blood pressure (BP) in a non-drug way, but its effectiveness was tested only by comparing discrete blood pressure measurements.

The aim of the study was to evaluate the effect of the course use of the stimulator “ABP-051’’ on the circadian blood pressure profile (CBPP), reconstructed according to three-day BP-monitoring in patients with hypertension.

Design and method:

Patients: the study included 62 patients with hypertension: AH patients with regular antihypertensive therapy, who were andomised into 2 groups: the main group of 52 patients who were treated by the “ABP-051’’ and 10 patients in control group with sham stimulation.

Methods: all patients underwent a study of the dynamics of the level and profile of blood pressure by means assessment of CBPP (the method of non-sinusoidal variability) based on the reconstruction of three-day BP monitoring.

Results:

It was found that stimulation therapy is not accompanied by side effects and does not lead to significant fluctuations in blood pressure after a single procedure. During the course of therapy, a significant decrease in blood pressure and circadian profile indicators was observed in 66% of patients (fig.1). The average decrease in systolic blood pressure is -8.3 ± 7.7 mm Hg, diastolic blood pressure is 5.8 ± 3.8 mm Hg. The effect of the course treatment was observed by the end of the 2-week stimulation cycle and in most patients persisted for 2 weeks after its completion. In general, positive effects on the blood pressure profile were observed in 90% of patients, whereas there were no changes in the control group.

Conclusions:

The course use of “ABP-051’’ is safe and in 90% of patients with hypertension contributes to decrease of BP and/or the improvement of the circadian blood pressure profile.
BASELINE CHARACTERISTICS, ANTIHYPERTENSIVE EFFECTIVENESS, AND TREATMENT ADHERENCE IN HYPERTENSIVE PATIENTS DEPENDING ON AGE: POST-HOC ANALYSIS OF THE TRICOLOR STUDY
Authors: Logunova Natalia , Karpov Yuri , Khomitskaya Yunona , Kvasnikov Boris
Published: June 2022

Objective:

To describe baseline (BL) characteristics, changes in systolic (SBP) and diastolic blood pressure (DBP) and in adherence to treatment in patients from TRICOLOR study stratified by age (under 65 years (< 65 y.o.) and 65 years old and older (>= 65 y.o.).

Design and method:

TRICOLOR (NCT03722524) was a multicenter, 3-month, open-label, uncontrolled observational study that included 1 247 uncontrolled hypertensive (HTN) patients in outpatient settings in Russia, in whom perindopril/indapamide/amlodipine single-pill combination (SPC) was initiated in accordance with the Russian label. Treatment adherence was assessed at the final visit (V4) using Girerd’s adherence questionnaire. This post-hoc-analysis is focused on antihypertensive effectiveness, and treatment adherence in HTN patients depending on age.

Results:

Of 1 116 patients included in the analysis, 66.9% (n = 747) were under 65 y.o. and 33.1% (n = 369) were > = 65 y.o. At BL, a higher grade of HTN was observed more often in patients > = 65 y.o. (96.9% vs 88.9%; p < 0.001), they had longer HTN duration (15.11 ± 7,82 vs 8.07 ± 5.31 years; p < 0.001) and more often had HTN-associated comorbidities such as dyslipidemia (73.4% vs 58.5%; p < 0.001), history of coronary artery disease (40.4% vs 17.0%; p < 0.001), prior myocardial infarction or stroke (18.7% vs 8.3%; p < 0.001) comparing to those < 65 y.o.

At V4, in patients treated with the SPC, SBP significantly decreased by 33.5 (95%CI 34.3, 32.7) and 33.2 mmHg (95%CI 34.4, 31.9), DBP by 14.6 (95%CI 15.1, 13.9) and 13.9 mmHg (95%CI 14.8, 12.9), in patients < 65 y.o and > = 65 y.o. respectively, with no significant between group difference. More patients < 65 y.o. achieved target SBP level < 140/90 mmHg at V4 compared to those > = 65 y.o. (96.7% vs 93.6%, respectively; p = 0.027). Proportion of patients adherent to the treatment increased from 54.8% to 95.5% and from 51.2% to.94.0% in both groups, while only 4.6% and 6.0% of patients in these groups remained non-adherent to the treatment.

Conclusions:

Treatment with perindopril/indapamide/amlodipine SPC showed high antihypertensive effectiveness and significantly increased adherence in both age-stratified groups of patients, despite more severe and comorbid conditions observed in patients > = 65 y.o. comparing to those under 65 y.o.
UNATTENDED AUTOMATED OFFICE BLOOD PRESSURE MEASUREMENT VERSUS CLASSIC OFFICE AUTOMATED BLOOD PRESSURE MEASUREMENT IN A HYPERTENSION OUTPATIENT CLINIC
Authors: Légrády Péter , Fejes Imola , Czombos András , Ábrahám György
Published: June 2022

Objective:

Accurate measurement of blood pressure is a fundamental pre-requisite requirement for an appropriate management of arterial hypertension. In order to eliminate the well-known limitations of classic office blood pressure measurements, the so-called unattended automatic office blood pressure measurement method can be a solution.

Design and method:

In 52 patients arriving for regular follow-up into one of the Hypertension Outpatinet Clinic of the Nephrology-Hypertension Center of the University of Szeged 3–3 blood pressure measurements were made at 1–1 minute intervals first by a doctor with an MIT5 automatic device and then in a separate room unattended, starting alone by the patient with a Hem-907 device. We also included the patients’ home blood pressure in the comparison, which was recorded on the basis of the home diaries they kept.

Results:

Based on our results, the MIT5 device had the highest blood pressure values of the three modalities, both in terms of systolic and diastolic values. The mean systolic blood pressure values measured with MIT5 device were signifincantly higher but not with Hem-907 device compared to home blood pressure values (p = 0.004). Diastolic values measured with MIT5 were significantly higher compared to Hem-907 (p < 0.001) and compared to home measurements (p = 0.001). Forty-nine percent of the patients had blood pressure in the goal range both with MIT5 and Hem-907 device, and 29% with both methods above the goal range. If only one measurement had been taken in each patient during the study, a much higher rate of hypertension would be included in the data.

Conclusions:

Our results support the use of unattended automated office blood pressure measurements in the everyday practice. Whether Hem-907 or other devices should be used is another matter.
ACCURACY AND FEASIBILITY OF SMARTWATCH-BASED CUFFLESS BLOOD PRESSURE MEASUREMENT: A REAL-WORLD PROSPECTIVE OBSERVATIONAL STUDY
Authors: Lee Hae-Young , Han Minju , Lee Young-Ro , Park Taeyoung , Ihm Sang-Hyun , Pyun Wook Bum , Suh Jong-Mo
Published: June 2022

Objective:

Smartwatch-based blood pressure (BP) measurement will continue to grow in the near future. Recently, BP measurement using a photoplethysmography-based smartphone algorithm paired with a smartwatch is approved as a medical device. We aimed to evaluate the feasibility and measurement stability of the smartphone-based BP measurement.

Design and method:

The Korean Society of Hypertension (KSH) hosted a one-month campaign entitled Daily BP measurement with your Galaxy Watch, and collected the real-world data of smartwatch-based BP measurement. We evaluated the clinical characteristics and blood pressure variability according to measurement timing. Furthermore, we investigated the measurement stability following calibration process.

Results:

We collected 35,646 BP measurement data from 767 participants. Mean age of the participants were 43.72 ± 11.89 years and 80.26% were men. Each participant had an average of 1.50 ± 1.31 BP measurements per day, and 19.74% of the participants measured their BP every day. BP values showed large variability, higher on Monday than those on other days in a week and the lowest from midnight to 4 a.m. highest from noon to 4 p.m., and decreased toward midnight during a day. The degree of measurement error by calibration defined as a BP difference between the measurement values seven days before and after calibration was 6.78 ± 5.58 mmHg. Higher mean BP is the single significant determining factors among age, sex, BP or heart rate in calibration error of the preceding week. The BP values became deviated small but significantly after 17 days of the calibration, with the change was on average 0.02 mmHg/daily.

Conclusions:

Smartwatch-based BP measurement is feasible for BP measurement every day. BP values showed large variability mostly according to measurement hours, then measurement days. The error during the calibration process showed substantial BP fluctuation, warranting meticulous calibration assisted by medical personnel.
OFFICE BLOOD PRESSURE MEASUREMENTS IN HUNGARY: 3 YEAR RESULTS OF AN OPEN LABEL, PROSPECTIVE, OBSERVATIONAL STUDY
Authors: Járai Zoltán , Nemcsik János , Páll Dénes
Published: June 2022

Objective:

Office blood pressure measurements are used to check the control of blood pressure in treated hypertensive patients. The Hungarian Hypertension Registry which is a noninterventional project of the Hungarian Society of Hypertension, was started in 2018 and will end in 2023.

Our objective was to assess the control rate of hypertension in Hungary and to prove that the increase in the number if routine blood pressure measurement is associated with the higher number of controlled hypertensive subjects.

Design and method:

This is a multicenter, open-label, observational non-interventional study (anonymous data collection), that is performed in GPs’ practices and in outpatient clinics of cardiology and internal medicine. OMRON Medistanceâ service and validated automatic upper arm cuff BP monitors (M3 IT) are used. Data collection are performed directly from the arms of the patients (through Medistanceâ HUB 150 Mobil data procession). All anonymous blood pressure data are directly transferred to the central database.

Results:

3 132 360 blood pressure (BP) measurements were done so far. Before Covid pandemic the average number of daily measurements was 5/day/office, during Covid pandemic this number decreased to 3/day/office. 14.1% of the measurements were in optimal BP range, 14.3 % in normal BP range, 16.0% in elevated-normal range, 31.5% in grade I. hypertension range, 16.8% in grade II. hypertension range and 7.3% in grade III. hypertension range. We observed a substantial seasonal variability in the average BP values: 144.1 mmHg versus 135.7 mmHg and 86.6 versus 82.4 mmHg during wintertime and summertime according to systolic and diastolic blood pressure, respectively.

Conclusions:

The average number of BP measurements in the GPs’ office is low, and during the pandemic it further decreased. The measured BP results indicate, that the majority of the patients are not well-controlled. There is a substantial variability in average BP values between seasons, that has to be accounted during patients’ follow-up.
BLOOD PRESSURE MONITORING IN HEMODIALYSIS PATIENTS: ARE IMPRECISE THE MEASURING PRE- AND POSTDIALYSIS OR INTERDIALYTIC AMBULATORY BP?
Authors: Kasabji Jorge Estifan , Montero Sylvia Sanchez , Rosero Caterin Martinez , Guerrero Xhamy Martelli , Zaldumbide Erica Romero , Alvarez Cristina Lucas , Lopez Arancha Sastre , Giux Elena Monfa , De Leon Gomez Benjamin , Velasco Mario Prieto
Published: June 2022

Objective:

The optimal Blood Pressure in Hemodialysis are still unclear as to their value or measurement time and better hypotensive treatment.

Some authors recommend BP < 140/90 mmHg and < 130/80 mmHg before and after HD respectively.

There are an associations between predialysis systolic, diastolic and pulse pressure with all-cause mortality.

Our objective is to assess the percentage of hypertensive patients in our hemodialysis unit after adjusting their dry weight and there is a difference between the pre and postdialysis blood pressure measurement.

Design and method:

We included 66 patients(N 66) hemodialysis unit, we have performed standardized BP measurements among hemodialysis patients, predialysis SBP/DBP, postdialysis SBP/DBP, pulse pressure and interdialytic BP assessed by ambulatory.

Patients characteristics: (male [n 36] 54,5%), median age 68 yrs (R 29–90y), DM 25 patients (37,8%),nontraumatic amputation 10 patients (15%).

Results:

Predialysis SBP/DBP values >140/90 mmHg was 50% (33 patients), 51,5% female.

Predialysis Pulse pressure 82 mmHg

Postdialysis SBP/DBP values > 140/90 mmHg was 59% (39 patients), 54% female.

Postdialysis Pulse pressure 83 mmHg

Interdialytic BP value > 140/90 mmHg was 50% (30 patients) and Pulse pressure 78 mmHg

Group HT:DM 17 patients(52%) nontraumatic amputation 8 patients(24%)

Group NO HT:DM 8 patients(24%) nontraumatic amputation 2 patients(6%)

(TABLE 1)

Conclusions:

Until the actuality there is no optimal criteria of BP in hemodialysis patients, or when it should be measured pre or postdialysis.

In our study, we do not see a difference between BP Predialysis, Postdialysis or Interdialytic BP.

Also we see in group HT, there are more diabetics and more nontrauamtic amputation but there is no significant difference between both groups, possibly for being a small sample
REPRODUCIBILITY OF MASKED HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Antza Christina , Farmakis Ioannis , Doundoulakis Ioannis , Akrivos Evangelos , Stalikas Nikolaos , Zafeiropoulos Stefanos , Kostopoulos Georgios , Stabouli Stella , Giannakoulas George , Kotsis Vasilios
Published: June 2022

Objective:

The aim of this study was to investigate the reproducibility of masked hypertension (MH) either with ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM).

Design and method:

PubMed, Cochrane Library and Web of Science were searched to identify studies with paired baseline office BP and ABPM or HBPM measurements at two timepoints. The outcome of the analysis was the individual phenotype reproducibility between the baseline and follow-up timepoints. The used effect measure was Cohen’s kappa coefficient.

Results:

We found 15 studies eligible for the meta-analysis (5729 patients). The reproducibility of MH was better with ABPM, kappa reliability test: 0.41 (95%CI: 0.32 – 0.49), than with HBPM, kappa reliability test: 0.26 (95%CI: 0.10 – 0.40).

Conclusions:

This systematic review and meta-analysis show a slight to fair reproducibility of MH assessed through HBPM, but better when assessed with ABPM. Considering that poor reproducibility may be a result of office BP measurements, an ABPM/HBPM based strategy should be established for the evaluation and treatment of patients with MH.
THE PERSONAL TRAIT CORRELATED WITH THE NIGHT BLOOD PRESSURE LEVEL IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Andreeva Galiya , Gorbunov Vladimir , Lyusin Dmitriy
Published: June 2022

Objective:

The aim of our study was to determine associations between the personal trait of patients and the night blood pressure (BP) level in untreated arterial hypertension (AH) patients.

Design and method:

We nalysed database of several studies (200 AH patients without serious concomitant diseases). Ambulatory blood pressure monitoring (ABPM) (Spacelabs 90207) was performed after the washout period (3–7 days). After ABPM each patient completed the Russian version of the psychological questionnaire Minnesota Multiphasis Personality Inventory (MMPI) and the emotional intelligence questionnaire (EmIn, by Lyusin D.) (only 90 patients). We nalysed the following MMPI scales: L – lie scale, F – aggravation scale, K – correction scale, 1 (Hs) – hypochondria, 2 (D) – depression, 3 (Hy) – hysteria, 4 (Pd) – psychopathy, 6 (Pa) – rigidity of affect, 7 (Pt) – psychasthenia, 8 (Sc) – schrizothemia, 9 (Ma) – hypomania. We assessed the following EmIn scale scores: I - emotion self-awareness; II - management of one’s own emotions; III - control of emotional expression; IV - understanding others’ emotions; V- management of others’ emotions. We used Pearson correlation coefficient ®.

Results:

The initial mean ambulatory daytime systolic BP (SBP) was 142.1 ± 14.2, diastolic (DBP) - 89.5 ± 10.1 mm Hg), age - 52,7 ± 12.2 years.(M ± SD). We found the following significant correlations: 1) 9 scale scores of MMPI (optimism, good mood, cheerfulness level) had negative relationships with the night DBP (r = -0,17, p < 0,05) and night SBP (r = -0,16, p < 0,05) levels; 2) IV scale scores of EmIn (understanding others’ emotions) had relations with the night DBP (r = -0,28, p < 0,05) and night SBP (r = -0,30, p < 0,05) levels; 3) V scale scores of EmIn (management of others’ emotions) had correlations with the night DBP (r = -0,26, p < 0,05) and night SBP (r = -0,26, p < 0,05) parameters.

Optimism, cheerfulness, good mood (9 scale scores of MMPI) was associated with the night BP decrease, but intensification of the interpersonal emotional interactions (IV, V scale - management or understanding others’ emotions) can lead to the night BP increase.

Conclusions:

Optimism, cheerfulness, good mood was related with the night BP decrease. But intensification of the interpersonal emotional interactions can lead to the night BP increase.