bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C30-2: SHORT STATURE IS ASSOCIATED WITH HIGHER PULSE WAVE VELOCITY IN SUBJECTS WITHOUT OVERT CARDIOVASCULAR DISEASE
Authors: Moon Jeonggeun , Kang Woong Chol
Published: January 2023

Objective:

Short stature is reportedly associated with cardiovascular disease (CVD). However, the mechanism underlying this intriguing epidemiological finding is unclear. Pulse wave velocity (PWV), a marker of vascular stiffness, is a predictor of future CVD. Therefore, PWV may be affected by height even before overt CVD occurs. Here, we investigated the association between adult height and PWV in subjects without overt CVD.

Design and method:

A total of 1019 subjects (48 ± 12 years old; 509 men, 21 with diabetes mellitus, 209 with hypertension) without overt CVD were enrolled, all of whom underwent brachial-ankle PWV (baPWV) measurements. The subjects were divided into 3 groups by height. A multiple regression model was used to estimate baPWV values among heights after the adjustment for confounders.

Results:

Mean baPWV value was highest in the group with the shortest height for both sexes (both P < .001). Bivariate correlation analysis between height and baPWV showed significant correlations in men (r = -0.131, P = .003) and women (r = -0.180, P < .001). In the multiple regression analysis with adjustment for identified confounders, group height was a predictor of baPWV (P for trend = .003) in younger men (< 50 years old) but not in older men, while group height was correlated with baPWV in older women (50 years old or more, P for trend = .014) but not in younger women.

Conclusions:

Height is inversely correlated with baPWV in subjects without overt CVD, especially in younger men and older women. This may explain the historical epidemiological observation of an inverse relationship between height and CVD.
PS-C30-5: COMPARISON OF INTRAVENOUS LABETALOL WITH ORAL NIFEDIPINE FOR CONTROL OF BLOOD PRESSURE IN SEVERE PREECLAMPSIA
Authors: Thakur Achala , Vashisht Raabiya , Agrawal Ajay
Published: January 2023

Objective:

The objective was to compare the effect of intravenous labetalol and oral nifedipine in severe preeclampsia in terms of time interval and the dose required to achieve the targeted blood pressure of 150/100 mm Hg.

Design and method:

Pregnant women at or beyond 28 weeks POG with live fetus and severe preeclampsia with blood pressure 160/110mmHg or more were enrolled and randomized into two groups. Women in group A received injection labetalol 20 mg and group B received 10 mg oral nifedipine. Blood pressure was monitored at an interval of 20 minutes. Intravenous labetalol for group A participants was repeated at 20 minutes interval in escalating doses of 40,80,80 and 80 upto maximum of 5 doses adding upto 300 mg until the target blood pressure was reached. In group B participants received oral nifedipine 10 mg orally at 20 minutes interval upto maximum of 5 doses adding upto 50 mg. If blood pressure was still not controlled then crossover of treatment was planned in the same manner after 2 hours of starting initial treatment such that participants receiving group A drug would receive group B and vice versa.

Results:

Total of 104 participants with 52 in each group were enrolled. The mean age of the participants was 24.01 ± 0.7 years. Primigravida were 82(78.8%) and 22(21.2%) were multigravida. The mean POG at enrollment was 36 to 37 weeks in both the groups (p = 0.9). The mean systolic blood pressure was 175.28 mmHg in the labetalol group and 175.23 in the nifedipine group (p = 0.7). The mean diastolic blood pressure was 119.57mmHg in labetalol group and 117.40 in the nifedipine group (p value = 0.8). Among labetalol group, maximum 76.9% participants achieved target blood pressure in 20 minutes after the first dose whereas 36.5% participants took 60 minutes with three doses to achieve target blood pressure in nifedipine group which was statistically significant (p = 0.00). Forty two (80.7%) had vaginal delivery and 10 (19.2%) participants had cesarean section in labetalol group. In nifedipine group 40(76.9%) participants had vaginal delivery and 12(23.1%) had cesarean section (p = 0.8). In both the groups Apgar score of newborn was normal for 82.7% of participants.

Conclusion:

Intravenous labetalol is more efficacious than oral nifedipine in terms of less time and low dose required to control blood pressure in severe preeclampsia.
PS-C31-2: PRELIMINARY STUDY OF ANTIHYPERTENSIVE TREATMENT EFFECT ON EARLY EVENING ELEVATED BLOOD PRESSURE
Authors: MA Zhiyi , Zhang Yuqing , Chen Yingjun , Xu Yang , Wang Tianhao
Published: January 2023

Objective:

The aim of this study is to retrospectively analyze the intervention effect of routine antihypertensive treatment on early evening elevated blood pressure (EEE) under community health service.

Design and method:

The ambulatory blood pressure monitoring (ABMP) data of hypertension patients was collected from YJY digital intelligence chronic disease monitoring and management platform from Jan 2019 to Nov 2021. The hypertension patients were from seven community health service stations and divided into treated group and untreated group according to their self-report. The age of each patient should be not less than 18 years old. The percentage of successful measurements for ABPM should not be lower than 70%. Only the first ABPM of one patient during this period was included. The EEE was defined as high average blood pressure from 6pm to 10pm (detailed definition and classification seen in Table).

Results:

1. There were 171 pateints in treated group and 251 patients in untreated group. 2. According to EEE definition A, there are 120 EEE patients in treated group and 206 EEE patients in untreated group (X2 = 8.19059, P = 0.00421). 3. According to EEE definition B, there are 87 EEE patients in treated group and 125 EEE patients in untreated group (X2 = 0.04714, P = 0.82812). 4. According to EEE definition C, there are 101 EEE patients in treated group and 141 EEE patients in untreated group (X2 = 0.34705, P = 0.55579). 5. According to EEE definition X, there are 147 EEE patients in treated group and 224 EEE patients in untreated group (X2 = 1.0287, P = 0.21047).

Conclusions:

According to EEE definition A which indicated the absolute value increase of blood pressure, the detection rate of EEE was significantly lower in treated group than in untreated group. However, based on definition B and definition C, which compared EEE with morning blood pressure and afternoon blood pressure respectively, routine antihypertensive treatment provided by community health service didn’t obtain the significant reduction of EEE detection rate. This phenomenon that a considerable proportion of early evening blood pressure under antihypertension treatment was still higher than morning blood pressure or afternoon blood pressure might result in low compliance of hypertension management, dosage increase of antihypertension medication or multiple administration daily.
PS-C31-5: COMPARISON OF THE BLOOD PRESSURE MANAGEMENT BETWEEN SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS AND GLUCAGON-LIKE PEPTIDE 1 RECEPTOR AGONISTS
Authors: Kobayashi Kazuo , Tamura Kouichi , Hatori Nobuo , Toyoda Masao , Kanamori Akira
Published: January 2023

Background:

Several large clinical studies using not only sodium-glucose co-transporter 2 inhibitors (SGLT-2is) but also glucagon-like peptide 1 receptor agonists (GLP-1Ras) showed the superiority on the renal outcome on patients with type 2 diabetes (T2DM). There is no direct comparison of renoprotective effects between these two drugs, further, the mechanism for the renoprotective effects is not fully understood. Our previous survey revealed the superiority of SGLT2i treatment for the renoprotective effects compared to GLP1Ra. We also reported the importance of the reduction of BP during treatment, however, there is no direct comparison between their BP lowering efficacies.

Aim:

This study aimed to compare the rates of achieving a target BP and the renal effects, with SGLT-2i and GLP-1Ra treatments, administered in Japanese patients with T2DM and poorly controlled BP.

Methods:

Kanagawa Physicians Association separately carried out retrospective surveys that included patients with T2DM receiving therapy with SGLT-2i or GLP-1Ra for more than one year. After excluding the patients who used both SGLT2i and GLP1Ra, 384 SGLT-2i- and 160 GLP-1Ra-treated patients, with a BP more than 130/80 mmHg, before treatment were included in this study. Propensity score (PS) for the SGLT2i treatment were calculated using logistic regression and the inverse probability weighting method with average effect for treatment (ATE) weight and the trimming of patients with 0.05 ≦ PS≦ 0.95. The BP control rates were compared using a generalized linear model.

Results:

In this study, the rage of the standardized difference between two treatments was form 0.02 to0.20. SGLT-2i treatment resulted in significantly higher BP control rates than GLP1Ra treatment (odds ratio [95%confidence interval] = 2.09 [1.08, 4.03], p = 0.03). Compared with GLP-1Ra-treated patients, SGLT-2i-treated patients had significantly larger decreases in diastolic BP, mean arterial pressure, and body weight (-3.8[-6.6, -1.1] mmHg, P = 0.006; -4.1[-7.2, -1.0] mmHg, P = 0.01; and -1.5 [-2.7, -0.4], P = 0.008, respectively) and increased annual estimated glomerular filtration rate (eGFR; 1.5 [0.05, 2.9] mL/min/1.73 m2/year, P = 0.04).

Conclusion:

In T2DM patients with poorly controlled BP, compared with GLP-1Ra, SGLT-2i treatment significantly improved BP management and increased eGFR. When the renoprotective effect is expected in the clinical practice, it is necessary to consider the degree of contribution to the achievement of BP control in addition to the characteristics of the drugs.
PS-C31-11: THE RELATION BETWEEN ANTIHYPERTENSIVE DRUGS AND DIURETICS AND ADVERSE DRUG REACTIONS IN THE OLDER INPATIENTS
Authors: Hamaie Chie , Takeya Yasushi , Nakajima Tsuneo , Nozato Yoichi , Yokoyama Serina , Takahashi Toshimasa , Hongyo Kazuhiro , Nakagami Futoshi , Akasaka Hiroshi , Takami Youichi , Yamamoto Kouichi , Rakugi Hiromi
Published: January 2023

Aim:

We investigated whether antihypertensive drugs and diuretics were associated with adverse drug reactions in the older inpatients.

Methods:

We retrospectively investigated factors related to adverse drug reactions(ADRs) in inpatients aged 65 and over in the geriatrics and hypertension ward of Osaka University Hospital in Japan. We identified drug information and ADRs from the medical records of 1031 inpatients during the 7 years from September 2014 to August 2021.

Results:

There were 94 ADRs in 81 patients(7.9%) of the total of 1031 patients (female 54.0%, mean age 78.1 ± 6.7 years), there happened the most in 24 cases is with antihypertensive drugs, and the second most in 15 casess is with diuretics. Of the 24 cases of ADRs thought to be caused by antihypertensive drugs, 20 cases of ADR occurred with antihypertensive drugs taken before admission. The details of ADRs by antihypertensive drugs were hypotention / orthostatic hypotension in 16 cases, bradycardia in 7 cases, and edema in 1 case. Of the 15 cases of ADRs thought to be caused by diuretics, 10 cases of ADRs occurred with diuretics that had been taken before admission. The details of ADRs by diuretics were electrolyte abnormalities in 8 cases, hypotension / orthostatic hypotension in 6 cases, and renal dysfunction in 1 case. Of the 24 cases in which antihypertensive drugs were suspected to be ADRs, the most common disease were heart failure in 7 cases, followed by hypertension in 4 cases. Of the 15 cases in which diuretics were suspected to be ADRs, the most common diseases were heart failure (3 cases) and diabetes (3 cases). However, the results of multivariate analysis showed no significant association between the disease that triggered admission and the occurrence of ADRs.

Conclusions:

The subjects of this study included many patients with hypertension and heart failure, and since they used many antihypertensive drugs and diuretics, there were many ADRs caused by them. The same situation seems to be naturally accepted in medical care for the older people. It is important to be aware that antihypertensive drugs and diuretics, being the most common in medical care for the older people, may cause ADRs.
PS-C34-2: CORRELATION BETWEEN SERUM URIC ACID AND RENIN - ANGIOTENSIN - ALDOSTERONE SYSTEM IN COLLEGE STUDENTS
Authors: Ji Xiaoyi , Zhao Haiying , Li Yaru , Wang Xinyu , Wang Menglin , Wang Hao , Jiang Ling
Published: January 2023

Objective:

To study the correlation between serum uric acid (SUA) and renin-angiotensin-aldosterone(RAAS) in college students.

Design and method:

A total of 228 college students (age 20.44 ± 2.09 years, male 108 cases) without cardiovascular complications and any treatment were enrolled by random sampling method. The whole study population was divided into three groups according to the SUA level(umol/L) from low to high: Q1 (139∼325), Q2(326∼396), Q3 (398∼670). The participants were divided into SUA-tertiles according to sex-specific cut-off values of SUA: q1 (males 240∼370, females 139∼279), q2 (males 375∼458, females 280∼343), q3 (males 461∼670, females 345∼641). We investigated the relationship among SUA, plasma renin concentration(PRC) and plasma aldosterone concentration(PAC).

Results:

In this study, the numbers of SUA tertile groups were 8 (10.5%), 40 (52.6%) and 60 (78.9%) in males. Compared with females, men have higher SUA [410.5 (358.5–487.0) VS 315 (265.0–367.5), P < 0.001] and lower PAC[29.95 (19.03–53.33) VS 46.80 (26.93–82.48), P < 0.001], PRC [23.06(16.93–30.22) VS 22.92 (17.56–29.70) pg/ml, P = 0.941] was not significantly different. PAC in Q1 and Q3 was different (P = 0.001). PRC in male group q1 and q3 was different (P = 0.017). There was no statistical difference in RAAS among the three groups in female population.

There was a negative correlation between SUA and PAC in the general population (P < 0.05), and a negative correlation between SUA and PRC and PAC in males (P < 0.05). After adjusting confounding factors, there was still a negative correlation between SUA and PRC in males (R = -0.209, P = 0.041). The model was constructed with uric acid triquartile as dependent variable, including gender, SBP, DBP, BMI, BaPWV, fasting blood glucose, blood lipids (triglyceride, HDL-C, LDL-C, except total cholesterol due to collinearity), eGFR, PRC, Ang2, PAC and other independent variables. Multivariate Logistic regression analysis showed that with the first quartile of uric acid as the control group, there were significant differences in renin concentration in causing different quartile uric acid levels. For every 1pg/ml increase of renin concentration in males, the possibility of developing high-quartile uric acid was 0.931 times higher than that of low-quartile uric acid.

Conclusions:

SUA was negatively correlated with PRC in college students, but not with PAC.
PS-C34-9: ASSESSMENT OF BLOOD PRESSURE IN TOBACCO CONSUMERS: A PILOT STUDY
Authors: Singh Anjali , Verma Narsingh
Published: January 2023

Background:

Tobacco and hypertension are respectively the first and second leading cause of preventable mortality worldwide. The effect of tobacco on blood pressure is complex with evidence that tobacco increase blood pressure acutely and increase the risk of developing hypertension.

Objective:

The objective of this study was to examine the impact of tobacco use on blood pressure among tobacco users.

Methodology:

In this study we recruited total 101 tobacco using subjects and measured their systolic and diastolic blood pressure in the outpatient department (OPD) of KGMU.

Results:

The effects of tobacco use on the risk of development of hypertension were assessed from a lifelong perspective. Study participants aged between 49 ± 13. Use of tobacco was positively associated with the risk of hypertension. Systolic BP of these tobacco using subjects was 131.86 ± 21.11 mmHg and the diastolic BP of was 84.32 ± 10.95 mmHg.

Conclusion:

Study concluded that use of tobacco is a risk factor for hypertension and it has association to cardiovascular and cerebrovascular complications. However, both use of tobacco and smoking increase the risk of development of hypertension as well as atherosclerosis. Tobacco causes an acute increase in blood pressure.
PS-C35-1: SPOT URINE SODIUM: CREATININE RATIO: A SIMPLE METHOD TO ESTIMATE SODIUM INTAKE
Authors: Kunanon Sirisawat , Mukdaloy Yatip , Srithongkul Thatsaphan
Published: January 2023

Objective:

High sodium intake is a worldwide problem and contributes to high blood pressure and target organ damage. Measurement of 24-hour urine sodium excretion is gold standard for sodium intake evaluation but it is difficult to practice. In this study, the correlation between spot urine sodium: creatinine ratio from second void (AM), before dinner (PM), before bedtime (HS) and 24-hr samples with 24-hour urine sodium were evaluated.

Methods:

The participants were recruited from single hospital. Participants with age > 20 years, eGFR > 60 ml/min/1.73 m2 and no history of diuretics use were included. Urine sodium, urine creatinine and urine volume of each sample were measured. Urine sodium (mmol/L): urine creatinine (mg/dL) ratio of AM, PM, HS and 24-hour samples were calculated. Correlations of each ratio with 24 hour urine sodium (mmol/day) were studied by Pearson correlation coefficients.

Results:

43 participants were included in this study. Mean age was 46.9 ± 13.6 years. Hypertension was diagnosed in 31 participants (72%). Mean blood pressure was 134 ± 15/81 ± 9 mmHg. Estimated eGFR was 100 ± 16 ml/min/1.73 m2. Mean 24 hour urine sodium was 178 + 92 mmol/day (equivalent to sodium intake 4,094 + 2,116 mg/day). Urine sodium: creatinine ratio of AM, PM, HS and 24-hr samples (correlation coefficient, r, with 24-hour urine sodium excretion) were 1.6 ± 0.8 (r = 0.11, P = 0.49), 1.9 ± 1.1 (r = 0.71, P < 0.001), 1.7 ± 1.1 (r = 0.59, P < 0.001) and 1.8 ± 0.7 (r = 0.77, < 0.001) respectively. Spot urine sodium: creatinine ratio from PM sample cut-off point of 1.2 had sensitivity of 81% and specificity of 73% to determine 24-hr urine sodium of 100 mmol/day.

Conclusions:

Spot urine sodium: creatinine ratio from PM sample correlates well with 24-hr urine sodium (r = 0.62) and ratio of 1.2 is equivalent to 24-hr urine sodium of 100 mmol/day. Sodium intake of study participants was 178 mmol/day which higher than recommended level.
PS-C35-2: BASELINE KNOWLEDGE AND SOCIODEMOGRAPHIC FACTORS RELATED TO SALT-INTAKE BEHAVIOR AMONG HYPERTENSIVE INDIVIDUALS IN BANGLADESH: SUB-STUDY OF A RANDOMIZED CONTROLLED TRIAL
Authors: Jahan Most Yasmin , Rahman Md Moshiur , Rahman SM Atiqur , Moriyama Michiko
Published: January 2023

Excess salt consumption increases blood pressure which is a leading risk for developing cardiovascular diseases. Therefore, this sub-study was designed among the rural hypertensive individuals to assess the baseline knowledge about hypertension, dietary salt intake behavior and identify the potential predictors for urinary salt excretion in Bangladesh. A total of 420 participants were enrolled after meeting the eligibility criteria during the 12 months of the study period. The participants received behavior changes related to short message services (SMS) and face-to-face education from community health workers. Our study results found that most of the participants (80%) had positive knowledge of HTN. This study showed that the mean value of overnight urinary sodium excretion was 10.65 ± 3.00 at 1st-month follow-up and 10.24 ± 3.03 at the endline. We found mid-upper arm circumference (MUAC) systolic blood pressure (SBP), and diastolic blood pressure (DBP) were significantly related to higher salt-intake (p = 0.009, p = 0.011 and p = 0.005 respectively). However, participants had improved their MUAC, SBP, and DBP status than their 1st follow-up period, but still, significant associations were observed between them (p = 0.033, p = 0.011, and p = 0.002 respectively). In conclusion, most of our study participants had satisfactory knowledge related to HTN and salt intake. Besides, our study results found that sodium excretion among hypertensive participants was higher, and higher urinary sodium excretion was associated with overweight and BP in adults. Nonetheless, the real salt intake practice among the Bangladeshi population is still unknown which demands further research.
PS-C35-4: ASSOCIATION OF SODIUM INTAKE WITH ADVERSE LEFT ATRIAL FUNCTION AND LEFT ATRIOVENTRICULAR COUPLING
Authors: Yin Lili , Mei Jiajie , Jiang Yinong , Dong Jianli
Published: January 2023

Objective:

In this study, we investigated the relationship between 24-hour urinary sodium (a surrogate for estimating dietary sodium intake), ambulatory blood pressure parameters, cardiac MRI-assessed left atrial function and left atrioventricular coupling, as well as the influence of nighttime blood pressure and body mass index(BMI) on 24-hour urinary sodium and subclinical cardiac function.

Design and method:

Participants in our study included 398 individuals, all of whom were subjected to 24-hour urine collection, 24-hour ambulatory blood pressure measurement, and cardiac magnetic resonance imaging to determine left atrial function (myocardial strain) as well as left atrioventricular coupling index. LACI is defined as the ratio of left atrial end-diastolic volume divided by left ventricular end-diastolic volume. Our study evaluated the relationship between 24-hour urinary sodium and ambulatory blood pressure parameters, left atrial function, and left atrioventricular coupling index, and used mediation analysis to explain the indirect effects of nighttime blood pressure and BMI between 24-hour urinary sodium and left atrial function and left atrioventricular coupling index.

Results:

It was found that the average age of the participants was 55.70 ± 11.30 years old, with 58% of the participants being male and 47.5% experiencing hypertension. The mean urinary sodium value was 172.01 ± 80.24mmol/24 hours, and the average body mass index was 25.46 ± 3.78 kg/m2. After adjusting for age, gender, history of diabetes, smoking status, alcohol consumption, and use of diuretics, 24-hour urinary sodium was correlated with multiple ambulatory blood pressure parameters, especially with nighttime diastolic blood pressure. Left atrial structure and function (left atrial reservoir function and left atrial conduit function) and left atrioventricular coupling index were correlated (P < 0.05). Mediation analysis showed that BMI explained 16% of the indirect effect of 24-hour urinary sodium and left atrial function (left atrial reservoir function and left atrial conduit function), and 30% of the indirect effect of LACI. Independent of the mediator, 24-hour urinary sodium had a significant direct effect on left atrial reservoir function, left atrial conduit function, and left atrioventricular coupling.

Conclusions:

Higher 24-hour urinary sodium was associated with a greater BMI as well as poor left atrial function and left atrioventricular coupling, and the BMI mediated the relationship between 24-hour urinary sodium and subclinical left cardiac function, and, more importantly, 24-hour urinary sodium may directly affect the left atrial function and left atrioventricular coupling independent of intermediary factors.
PS-C36-2: COMPARATIVE STUDIES OF DRUG-DRUG INTERACTIONS AMONG HYPERTENSIVE PATIENTS AT DIFFERENT PRIVATE CLINICAL SETUPS OF HYDERABAD, PAKISTAN
Authors: Arain Mudassar Iqbal , Fricovsky Eduardo
Published: January 2023

Objective:

To Evaluate the degree of drug-drug interactions and their comparison among known hypertensive patients in government hospital and charitable hospital.

Methodology:

This study involved the assessment of 1500 patients prescription selected by random sampling technique from the OPDs of 02 different private clinical setups of Hyderabad, Sindh, Pakistan. Patients prescription was evaluated for drug-drug interactions using drug interaction software, Lexi-comp Lexi-Interact, Drug Information website, Hansten and Horn drug interactions: Analysis and Management.

Results:

Randomly collected samples have been arranged according to their flow in private clinical setups i.e 663 and 837 were collected from government and charitable setups respectively. While on gender wise 62% were male and 38% of female in charitable, 59% and 41% were of male and female respectively in government setup. Out of 1500 Prescriptions, 645 (43%) prescriptions having different degree of interactions. Furthermore, 44% of total interactions were found in government setup that was more than charitable setup i.e 42%. Out of 44%, 61% of interactions were belong to moderate type of interactions, which is less as compared to charitable setup i.e 64%. Mostly 37 cases b/w Diuretics with Laxatives, Antidiabetic, NSAIDS and Antihistamines in government setups in a total of moderate interactions, while 55 cases of interaction b/w ACEIs with NSAIDS, Antihistamines, Antidiabetic and vasodilators in a total of moderate interactions in charitable setups.

Conclusion:

It was clearly stated that drug-drug interactions may leads to morbidities and treatment failures that may leads to unnecessary economic burden on the patients. A proper vigilance system should be established in clinical setups of government and charitable hospitals to sort out the problem. A series of training session will be started to cope up the situation.
PS-C36-7: FACTORS ASSOCIATED WITH NONACHIEVEMENT OF TARGET BLOOD PRESSURE IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON ANTITHROMBOTIC THERAPY
Authors: Odaguchi Naoyuki , Sakima Atsushi , Shimoji Yoko , Sunakawa Haruna , Yonamine Reina , Yamada Iori , Uezato Madoka , Uehara Masaki , Kinjo Kazushi
Published: January 2023

Background:

Patients with chronic kidney disease (CKD) can become at risk for thromboembolism and bleeding such as hemorrhagic stroke. The Japanese Society of Hypertension Guidelines for the Management of Hypertension 2019 (JSH2019) recommend that blood pressure (BP) should be cautiously controlled in patients on antithrombotic therapy, with a target value of < 130/80 mmHg to prevent hemorrhagic complications during antithrombotic therapy.

Objective:

The current study aimed to investigate the achievement rate of target BP, and factors associated with nonachievement of target BP in patients with CKD on antithrombotic therapy.

Methods:

This cross-sectional study was conducted at an outpatient clinic in 2018. Of 2,427 outpatients who received antithrombotic therapy, patients without CKD, those with CKD stage 5 or on hemodialysis, and those with missing data on body mass index, urinalysis results, and estimated glomerular filtration rate were excluded from the study. Finally, 786 outpatients met the inclusion criteria. Clinical parameters were obtained from the center's electronic database. The office BP value was classified according to the JSH2019 guidelines. The target office BP was set at < 130/80 mmHg in patients with CKD on antithrombotic therapy. The odds ratio (OR) for nonachievement of target BP was calculated via multivariable logistic regression analyses.

Results:

The majority of patients were on antihypertensive therapy. Calcium channel blockers were the most frequently prescribed drugs, followed by angiotensin II receptor blockers and then diuretics. Acetylsalicylic acid was the most commonly prescribed antithrombotic agent, followed by P2Y12 receptor inhibitors and warfarin. The distribution of BP in this population is 16.2%, 14.1%, 29.1%, 29.5%, 10.1%, and 1.0% had normal BP, high-normal BP, elevated BP, grade I hypertension, grade II hypertension, and grade III hypertension, respectively. Approximately 30% achieved the target BP of < 130/80 mmHg. Multivariable logistic regression analyses indicated that obesity (OR = 1.849, P < 0.001) and proteinuria (OR = 1.846, P < 0.001) were significantly correlated with nonachievement of target BP. Moreover, heart failure and cerebrovascular disease were negatively associated with the nonachievement of target BP.

Conclusions:

Only a small proportion of patients with CKD on antithrombotic therapy achieved the target BP. Obesity and proteinuria were associated with nonachievement of the target BP in patients with CKD on antithrombotic therapy.
PS-C36-10: HYPERTENSION KNOWLEDGE AND MAGNITUDE OF NON-ADHERENCE TO ANTIHYPERTENSIVE TREATMENT IN YOUNG ADULTS AGED 18–39 YEARS IN GABORONE, BOTSWANA
Authors: Maoto Jakoba Jacob , Mbenge Chidzani , Dipebe Tears , Lehelepa Meshack , Mhlanga Niketiwe , Zongwa Tefo , Masupe Tiny
Published: January 2023

Objective:

We sought to determine hypertension knowledge and magnitude of non-adherence to treatment among hypertension patients aged 18–39 years attending selected clinics in Gaborone, Botswana.

Design and Methods:

This was a cross sectional survey across five high volume primary care clinics among young adults conducted between March and April 2021. Stratified sampling was used to estimate sample size per clinic followed by systematic random sampling to select participants and an adapted questionnaire plus Morisky 8-Item Medication Adherence checklist were used to measure non-adherence.

Results:

135 participants enrolled in the study with mean and median ages of 27, majority 90 (66.7%) being female. 15 (11.1%) were smokers while 57 (42.2%) consumed alcohol. Most common comorbidities were asthma 14(10.4%) and HIV/AIDS 9(6.7%).

100% participants had been told they have hypertension. 68 (50.4%) correctly stated that hypertension means increased blood pressure, 73 (54.0%) thought hypertension is curable and 8 (5.93%) thought there is no danger in not taking antihypertensives.

69/135 (51.2%) were on antihypertensives with almost half, 49.3%, of those being on treatment for more than 12 months. Only 43/69 (62.3%) knew their medication by name. Main reasons of not being on medication was: 22/66 (33.3%) did not want lifelong medication and 12/66 (18.2%) feared of side effects.

Pre- treatment adherence counselling was received by 78 (58%) while post-treatment counselling was received twice or more by 59 (43.7%). 35 (25.9%) missed some clinical appointments - reasons being feeling better 18 (31.6%), followed by depression/lack of interest 14 (24.6%). Very few, 11 (19.3%) forgot appointments. Majority of total participants, 75 (81.5%), experienced some side effects after medication mainly nausea 44 (58.7%), headaches 43 (55.1%), dizziness 24 (30.8%) and depression 16(20.5%).

On the Morisky questionnaire for those currently on antihypertensives: 27/69 (39.1%) admitted to sometimes forgetting to take medication. 49/69 (71.0%) sometimes stopped medication without doctor's consultation as they felt worse. A similar number, 68.1%, sometimes stopped medication when feeling better and 28/69 (40.5%) reported that it was a hassle to take medication. A few 5/69 (7.7%) forgot to take medication the day before the consultation.

Conclusion:

Most participants had limited knowledge of hypertension and were not adherent to medication. Reasons for non-adherence were predominantly related to side effects and feeling better. A significant proportion stopped medications without consultation with a healthcare worker. These results highlight the need to enhance hypertension awareness and continuous adherence counselling in young people to curb hypertension related complications.
PS-P11-8: GESTATIONAL DIABETES MELLITUS AS A PREDICTOR OF TYPE 2 DIABETES MELLITUS: CARDIOVASCULAR RISK FACTORS AND BIOLOGICAL MARKERS IN KAZAKH WOMEN
Authors: Danyarova Laura , Kuanyshbekova Roza , Svyatova Gulnara , Berezina Galina , Sultanova Balnur
Published: January 2023

Aim:

To study the prevalence of gestational diabetes mellitus in the regions of the Republic of Kazakhstan, cardiovascular risk factors and biological markers in women of the Kazakh population

Design and method:

Analysis of the prevalence of gestational diabetes mellitus was carried out according to the data of the medical information systems “Diabetes mellitus” and “Register of pregnant women and women of childbearing age”.

Results:

Analysis of the primary incidence of DM2 among adults, within 5 years there has been a steady increase, while women with type 2 diabetes are much more - 65.5%. The increase in cases of type 2 diabetes was 140 thousand cases (46%), and among women over this period - 85 thousand cases (41%). At the same time, an analysis of the prevalence of type 1 diabetes indicates that there is no gender difference in this type of diabetes mellitus, the number of women left 47.3%. The increase since 2016 was 34.2%, among women 29.5%.

The increase DM2 among women of childbearing age is 58.3%, which is significantly higher than in women of all age groups (41%). DM1 increase was 37.4%.

Analysis of the prevalence of GDM according to the statistical data of the “Register of pregnant women and women of childbearing age” showed differences in frequency across the regions of Kazakhstan (from 4.0% to 11.0%). At the same time, in 2021 alone, the growth in GDM amounted to about 50% compared to 2020.

Abdominal obesity was found in more than 50% of patients with GDM (the highest rate in the Almaty region, the lowest in Aktobe). The prevalence of hypertension among women with GDM is also lower in Aktobe region. An analysis of the prevalence of behavioral risk factors for CVD showed that the largest number of smokers was in Almaty and Almaty region.

To study gene polymorphism, GWAS-associated SNPs polymorphisms with the development of GDM were selected: genes for impaired insulin synthesis and those associated with insulin signal transmission; genes for impaired insulin secretion; genes that regulate carbohydrate and lipid metabolism.

Conclusion:

The results of the analysis demonstrate high prevalence rates of GDM and DM 2. among women in the studied regions, including women of childbearing age, and high variability between regions.

There is a need to standardize approaches to screening for GDM. Abdominal obesity and hypertension are the leading risk factors for the development of GDM.
PS-P12-12: ASSOCIATION OF PSYCHOLOGICAL STRESS WITH FEMALE HYPERTENSION: EVIDENCE FROM OVER 10 MILLION CHINESE MARRIED FEMALE POPULATION
Authors: Lyu Xinyi , Zhao Zhenyan , Jia Jiajing , Yang Ying , Zhang Lihua , Wang Yuanyuan , He Yuan , Peng Zuoqi , Zhang Ya , Zhang Hongguang , Wang Qiaomei , Shen Haiping , Zhang Yiping , Yan Donghai , Ma Xu
Published: January 2023

Objective:

Psychological stress was a potential risk factor for hypertension, but the association between specific chronic stressors and female hypertension remains unclear. We examined the potential associations between the psychological stress within the family and female hypertension.

Design and method:

Reproductive-aged females along with their husbands from the National Free Pre-pregnancy Checkup Projects in 2016 and 2017 were recruited. The stress of wives and husbands was collected by a 5-point Likert-type scale, assessed by two domains: work/life-related stress and economic-related stress. Overall stress was defined as the higher stress level of work/life stress and economic stress. To include categories in the analysis with sufficient numbers of persons, this variable was recoded into four categories as follows: 1 = not stressed at all, 2 = slightly stressed, 3 = moderately stressed and 4 = a lot or extremely stressed. Hypertension was defined as systolic BP/diastolic BP > = 140/90 mm Hg or self-reported history of hypertension. Age-adjusted and multiple-covariates-adjusted logistic regression models were used to assess the associations between multiple types of stress statuses and hypertension.

Results:

Of 10 027 644 couples, 261 098 (2.60%) females were hypertension. The median age of wives was 27 (24–32) years and husbands 29 (26–34) years.1 574 191 (15.7%) wives feel stressed and 1 807 480(18.0%) husbands feel stressed. The stressor of 734 095 (7.32%) wives and 878 887 (8.76%) husbands was work/life, and 1 400 973 (14.0%) wives and 1722 007(17.2%) husbands economic. The results showed that the higher stress level wives or husbands had, the higher prevalence of female hypertension was found (Pfor trend < 0.001). Compared with the unstressed participants, wives or husbands with the highest stress level had the highest risk of female hypertension, with adjusted ORs of 1.28(95%CI:1.23 to 1.34) and 1.23(95%CI:1.18 to 1.27), respectively. After further adjustment for female stress, slightly stressed husbands decreased the risk of female hypertension [OR:0.96(95%CI: 0.94 to 0.97)]. Consistent trends were also observed in economic-stressed groups and life/work-stressed groups.

Conclusions:

Not only stress of wives but also moderate or severe stress of husbands within the family indicates a higher risk of female hypertension. A family-based stress-relieving program may help improve hypertension control in females.
PS-P13-1: DIFFERENTIAL MANAGEMENT OF HYPERTENSION AND DYSLIPIDAEMIA IN URBAN SOUTH AFRICANS BY GLYCAEMIC STATUS
Authors: Peer Nasheeta , Horstmann Liske Kotze , Hill Jillian , Kengne Andre Pascal
Published: January 2023

Objective:

Considering the sub-optimal care of hypertension and other cardiovascular disease risk factors (CVDRF), this study aimed to describe the management and associations of hypertension and dyslipidaemia in adults with known diabetes (KD), newly diagnosed diabetes (NDD) and normoglycaemia.

Design and Method:

In this population-based cross-sectional study, participants with KD, and those identified as high-risk for diabetes who subsequently underwent oral glucose tolerance tests, and were classified as NDD or normoglycaemia, were included. Data collection comprised administered interviews, clinical measurements, and biochemical analyses. Multiple logistic regressions determined the associations of sociodemographic and CVDRF with hypertension and dyslipidaemia detection, treatment and control in separate models.

Results:

Among 618 participants (82% women), aged 49–63 years, there were 339 participants with KD, 70 with NDD and 212 with normoglycaemia. KD participants were older, but had lower rates of obesity, smoking and alcohol use than their counterparts. Prevalence of hypertension (BP > 140/90mmHg or on treatment) and dyslipidaemia (raised low-density lipoprotein cholesterol > 3mmol/l or on treatment) was highest in known diabetes (89% and 83%) compared with NDD (64% and 74%) and normoglycaemia (66% for both) (p < 0.001). Hypertension detection, treatment and control among participants with hypertension (n = 485) was higher in KD (97%, 88%, 74%) compared with NDD (89%, 69%, 44%) and normoglycaemia (80%, 60%, 46%) (all p < 0.005). Dyslipidaemia detection, treatment and control among participants with dyslipidaemia (n = 471) was higher in KD (85%, 73%, 49%) compared with NDD (37%, 23%, 10%) and normoglycaemia (36%, 22%, 14%) (all p < 0.001). Diabetes control was poor; only 20% of KD had HbA1c < 7%. In the regression models, KD compared with normoglycaemia was associated with hypertension detection (OR:6.91, 95%CI:2.25–21.22) and control (OR:2.05, 95%CI:1.04–4.02,). KD compared with normoglycaemia was associated with dyslipidaemia detection (OR:10.29, 95%CI:5.21–20.32) and treatment (OR:3.94, 95%CI:1.68–9.27). Sociodemographic (age, gender, education, income, employment) and CVDRF (smoking, alcohol use, physical inactivity, obesity) were generally not associated with hypertension or dyslipidaemia management.

Conclusions:

Albeit that diabetes control was poor and requires better management, hypertension and dyslipidaemia prevalence were higher and better managed in KD than their counterparts, likely because of their regular contact with healthcare services for their diabetes management. Improved screening and management of cardiometabolic diseases are required for individuals at high-risk for diabetes, who may not be in regular contact with healthcare services.
PS-P14-8: BRINGING SALT REDUCTION TO THE ACTIVITIES OF COMMUNITY SERVICE ORGANIZATION KURE ROTARY CLUBS. SMALL EFFORTS TO REDUCE SALT
Authors: Kusaka Miho
Published: January 2023

I am just a practicing physician. Although I cannot move society or influence medical policies, I have nevertheless been steadily building up small salt reduction activities with people in the community since 2008.

Since there is a limit to individual efforts to reduce salt, the ultimate goal is to make society as a whole a low-salt society where people can automatically reduce salt in their normal lives. To achieve this, it is important to work to deepen understanding not only among medical professionals, but also across the board, including companies, government, mass media, and education.

This time I introduce a community service organization (Kure Rotary Club) that I am a member of, which has started a salt reduction activity that takes advantage of the characteristics of the organization.

This organization is composed of managers and executives from many professions in the community, and the members have a great deal of influence, so we thought it would be effective in spreading the word about salt reduction. We have weekly meetings over lunch and learn about community service and other topics. The first thing we did at this meeting was to have a low-sodium and potassium-enriched lunch once a month for all 70 members, with the standard for one serving being less than 2.5 g of salt and more than 1,000 mg of potassium. The day is named “Natokari Lunch Day” and is well known.

In addition, to encourage citizens to reduce salt intake, a video supporting salt reduction has been created and distributed on YouTube. Many members, including a director of a major local hospital, a nutritionist, a researcher, a financier, a shipping businessman, a restaurant owner, a miso manufacturer, a Shinto priest, a lawyer and others appear in the videos and relay short speeches of one minute or less about how they are reducing salt and their recommendations for salt reduction. I believe that many doctors in the world are members of Rotary clubs. I hope this will inspire your activities.

We have been conducting a series of small activities. For example, we held the “Low-Sodium Summit in Kure 2012,” which led to the start of low-sodium school lunches at elementary schools in Kure City. We have also had many restaurants serve low-sodium dishes, bakeries make low-sodium bread, and we have produced a book of low-sodium recipes. These are just a few examples of activities that medical practitioners can do
PS-P14-10: CHALLENGES TO HYPERTENSION AND DIABETES DETECTION AND MANAGEMENT IN URBAN AREA OF DUBREKA, GUINEA
Authors: Bah Fatoumata , Balde Alpha Oumar , Traore Mohamed Sahar , Dioubate Djessona , Keita Tenin Oulen , Sylla Ibrahima Kalil , Diane Sere , Barry Rayhanatou , Balde Elhadj Saidou , Balde Aliou Mamadou
Published: January 2023

Background:

Hypertension (HTN) and Diabetes mellitus (DT2) are frequently underdiagnosed in Africa. The present study was carried out to assess the situation in the urban commune of Dubreka.

Methods:

Prospective and transversal, the study was focused on 287 participants (174 females; 113 males). HTN and DT2 were defined according to the blood pressure standards of at least 140/90 mm Hg and glycemia at least 1.26 g /l, respectively [1,2].

Results:

Overall rate was 74% (211/287) for HTN and 37% (105/287) for DT2. Both sex were concerned: 75% HTN and 36% DT2 in females vs 71% HTN and 38% DT2 in males. Salty diet and sedentary lifestyle were common. In females, 39% were overweight and 34% were obese. The association HTN and DT2 have been noted in 46% (96/211) among the hypertensive and 91% (96/105) among the diabetics. Of the 96 diabetic hypertensives, 45% were overweight (43/96), and 27% (26/96) were obese. In hypertensive, 85% (179/211) were aware of their status and 7% (13/179) were undergoing treatment without any control. In diabetics, 22% (23/105) were aware of their diagnosis with 30% (7/23) on treatment without any control. Conventional treatment of the few patients has generally focused on generic metformin and glibenclamide for diabetes and nifedipine for hypertension which in health centers cost from 15,000 GNF to 25,000 GNF (3,45$ to 5,75$). Such financial inaccessibility to conventional medicine partly justifies the frequent use of medicinal plants either alone or in association with conventional medicines.

Conclusion:

Hypertension and diabetes remain a concern in Dubréka where low rates of awareness, treatment and control were noticed.

REFERENCES

1. 2018 ESC/ESH Guidelines for the management of arterial hypertension: J Hypertens. 2018 Oct;36(10):1953–2041.

2. [2019] ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. European Heart Journal (2020) 41, 255–323.
PS-R06-4: POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME TRIGGERED BY FLUID RETENTION AND HYPERTENSION AFTER STEROID INITIATION IN PATIENTS WITH ANCA-ASSOCIATED VASCULITIS
Authors: Mimura Ayumi , Fujii Kentaro , Sugi Wataru , Kato Ai , Yoshifuji Ayumi , Komatsu Motoaki , Ryuzaki Munekazu
Published: January 2023

Objectives:

Central nervous system (CNS) involvement in antineutrophil cytoplasmic antibody (ANCA) -associated vasculitis is common, with hypertrophic pachymeninges, cerebrovascular events, hypophysitis, or posterior reversible encephalopathy syndrome (PRES) being the most common CNS presentations.

Design and Methods:

Case report.

Results:

A 73-year-old Japanese woman presented with a fever and cough. The patient had no relevant medical history. Her c-reactive protein (CRP) level increased to 22.38 mg/dl, and meropenem was initiated; however, her fever and CRP levels did not improve. Furthermore, creatinine level increased from 0.83 to 3.44 mg/dl during hospitalization. She was transferred to our hospital for evaluation of renal function deterioration. Her consciousness level was alert, and her blood pressure was 140/80 mm Hg. A renal biopsy was performed, and histological examination of the kidneys revealed diffuse pauci-immune necrotizing and crescentic glomerulonephritis. Myeloperoxidase (MPO) -ANCA was 2.9 IU/mL and proteinase 3 (PR3) -ANCA was negative. On the basis of these findings, the patient was diagnosed with ANCA-associated vasculitis. On the fourth hospital day, she was treated with 500 mg intravenous methylprednisolone, once daily, for 3 days, followed by oral prednisolone (40 mg; 0.8 mg/kg). Although her fever and CRP levels improved after the initiation of immunosuppressive therapy, she required renal replacement therapy on the eighth hospital day. Rituximab (500 mg) was administered on the ninth hospital day. Her blood pressure subsequently increased, with the systolic blood pressure being 190 mmHg, and consciousness suddenly deteriorated on the 11th hospital day. Head fluid-attenuated inversion-recovery (FLAIR) MRI showed multiple lesions with high signal intensity, and she was diagnosed with PRES. After intravenous administration of nicardipine and fluid removal by hemodialysis, her blood pressure decreased and her consciousness dramatically improved.

Conclusion:

In addition to the vascular endothelial damage associated with vasculitis itself, steroid therapy, renal failure, elevated blood pressure, and administration of rituximab are related to an increased susceptibility of PRES. In particular, steroid administration increases blood pressure due to fluid retention and can be a risk factor for the development of PRES, suggesting the need for adequate fluid management during steroid administration.