bluuebunny/crossref_metadata_2025 huggingface dataset:
ERECTILE DYSFUNCTION IN HYPERTENSIVE PATIENTS: SCREENING AND MANAGEMENT BY GENERAL PRACTITIONERS IN FRANCE
Authors: Victor Latapie , Benedicte Giroux Leprieur , Cynthia Soare , Sabine Mercier , Rosaline Nguyen , Rashida Sariya , Robin Dhote , Marilucy Lopez-Sublet
Published: June 2023

Objective:

Non-compliance remains one of the main factors of poor blood pressure control in France and worldwide. Erectile dysfunction (ED), a cardiovascular risk factor (CVRF), is common in hypertensive patients. The general practitioner (GP) is in the front line in the management of hypertension and is often the first point of contact in the event of ED.

To review the knowledge and practices of a sample of French GPs to promote the French Society of Hypertension (SFHTA) expert consensus on ED in hypertensive patients.

Design and method:

Descriptive observational study, carried out in a declarative mode via a Google Forms questionnaire distributed to 102 GPs practicing in Seine-St-Denis.

Results:

GPs (94,1 %) didn’t know the French Expert Consensus of the SFHTA, regardless their age or their mode of exercise. Only 10% of the GPs talked about ED with their patient regularly, whereas 68.6% of them declared to be comfortable discussing sexuality. GPs recognized ED as CVRF marker and were aware of possible side effects of the antihypertensive treatment on sexual function of their patient. However, the GPs were divided on the fact of warning the patients of the possible side effect of the treatments.

Conclusions:

Beyond the fact that the French Expert Consensus of the SFHTA concerning ED in hypertensive patients (2018) is not known in GPs, this work also highlights the difficulty of addressing the subject in consultation. Not prescribing beta-blockers in hypertensive patients (without any other indication) and identifying hypertensive patients with CVRF a fortiori with several drug classes are key elements for the best management of ED and combat non-compliance in hypertension.
INCREASED SERUM SCLEROSTIN LEVEL IS A RISK FACTOR FOR PERIPHERAL ARTERY OCCLUSIVE DISEASE IN PATIENTS WITH HYPERTENSION
Authors: Wang Hui-Sheng , Hsiao Chien-Hao , Wang Ji-Hung , Hsu Bang-Gee
Published: June 2023

Objective:

Sclerostin is associated with endothelial inflammation and vascular calcification and therefore contributes to atherosclerosis disease. Hypertension is one of risk factors of peripheral arterial occlusive disease (PAOD), is associated with increased mortality in patients with hypertension. The aim of this study was to determine the relationship between serum sclerostin level and PAOD in patients with hypertension.

Design and method:

Fasting blood samples and baseline characteristics were obtained from 92 hypertensive patients. ABI values were measured using an automated oscillometric device. Patients with ABIs of <0.9 were categorized into the low ABI group. The serum sclerostin and dickkopf-1 (DKK1) concentrations were determined using commercially available enzyme-linked immunosorbent assays.

Results:

In total, 14 patients with hypertension (15.2%) were in the low ABI group. When compared to those in the normal ABI group, the low ABI group had high rates of diabetes mellitus (P = 0.044) as well as the high serum C-reactive protein levels (P = 0.001) and sclerostin levels (P < 0.001), but the serum DKK1 level did not find this association (P = 0.639). The multivariable logistic regression analysis revealed that serum levels of sclerostin (odds ratio [OR]: 1.052, 95% confidence interval [CI]: 1.018–1.088, P = 0.002) was independently associated with PAD in patients with hypertension.

Conclusions:

Serum levels of sclerostin, but not DKK1, were associated with PAOD in patients with hypertension.
MANAGING ANXIETY AND STRESS IN HYPERTENSION: DEVELOPMENT OF HEART RATE VARIABILITY BIOFEEDBACK WITH PSYCHOLOGICAL SUPPORT
Authors: Cross Ainslea
Published: June 2023

Objective:

How can digital wearable Heart Rate Variability (HRV) biofeedback and psychological support be used to improve the management of anxiety and stress in hypertension?

Design and method:

A mixed methods study was used to develop and evaluate initial outcomes from a HRV biofeedback intervention for the management of anxiety and stress in hypertension.

We used systematic review evidence to guide a series of patient and stakeholder consultations to co-design a HRV biofeedback intervention to assess and treat anxiety and cardiovascular stress reactivity in a hypertension specialist outpatient's service. We evaluated initial outcomes from case studies of 15 patients who attended 2-5 x 1 hour face to face sessions with a Health Psychologist. Sessions involved: 1) assessment of anxiety and stress responses; 2) resonance frequency breathing training with HRV biofeedback with a respiration rate (between 6.5 and 4.5 breaths/minute) to produce optimal baroreflex stimulation and blood pressure regulation; 3) psychological skills development for dealing with anxiety and stress.

Results:

At 8 weeks follow up, 45% patients reported a 5-10 mmHg systolic reduction in blood pressure and 55% reported a reduction of 10-20 mmHg. 85% of patients reported increased morning HRV readiness scores and improvements in patient reported psychological outcomes (e.g. improvements in BP, anxiety reduction and increase in valued activities). 11 patients reported improved health behaviour change (increased physical activity, improved diet, reduction in alcohol intake). Whitecoat hypertension was improved in 70% of patients.

Conclusions:

Biofeedback with psychological support can help improve anxiety and stress symptoms, as well as improvements in systolic blood pressure within an integrated specialist hypertension team.
FEATURES OF COMORBIDITY IN COMBATANTS WITH ARTERIAL HYPERTENSION
Authors: Seliuk Olha , Voronko Andrii , Seliuk Mariana , Kozachok Mykola
Published: June 2023

Objective:

Comprehensive assessment of comorbidity in patients with arterial hypertension of participants in modern armed conflicts in order to implement timely preventive measures with the aim of prolonging their health status for military service.

Design and method:

By design, the research was a passive retrospective one-time (cross-sectional) type. The medical charts of inpatient patients of 213 male combatants, aged 27-59 years, average age 45.0 ± 6.8 years, who underwent treatment during 2018-2021, were analyzed by the method of random sampling. The examined were stratified according to the stage of hypertension: 126 patients with stage I hypertension and 87 patients with stage II hypertension.

Results:

The value of the indicator of the complex assessment of comorbidity depending on the stage of hypertension (the overall assessment of comorbidity according to the CIRS cumulative scale of diseases was 7.1 ± 2.1 and 8.8 ± 2.9 points in patients with hypertension of the I and II stages, respectively, p < 0.05 .

The value of the indicators of the comprehensive assessment of comorbidity (the overall assessment of comorbidity according to the CIRS cumulative disease scale) in stage II hypertension is due to an increase in the number of causal diseases, which were 3.1 ± 0.8 in stage II hypertension and 2.2 ± 0.9 in stage I hypertension, p < 0.05.

No statistically significant differences were found in the number of diagnoses of competitive diseases: 4.1 ± 2.1 in stage II hypertension and 3.7 ± 1.7 in stage I hypertension, p > 0.05.

Conclusions:

With the progression of high blood pressure in military personnel who are participants in modern armed conflicts, suffering from high blood pressure, the number of concomitant diseases and the indicator of the comprehensive assessment of comorbidity (the overall assessment of comorbidity according to the CIRS cumulative disease scale) increase, which are caused by an increase in the number of causal diseases.

In order to extend the state of health for military personnel, patients with hypertension, participants of modern armed conflicts, measures for the secondary prevention of causal diseases are appropriate.
EPIDEMIOLOGICAL FEATURES OF COMORBID PATHOLOGY IN COMBATANTS WITH ARTERIAL HYPERTENSION
Authors: Seliuk Olha , Voronko Andrii , Seliuk Mariana , Kozachok Mykola
Published: June 2023

Objective:

Determination of the prevalence of comorbid pathology in patients with arterial hypertension (AH) participants in modern armed conflicts in order to implement timely preventive measures in order to prolong their health for military service.

Design and method:

By design, the research was a passive retrospective one-time (cross-sectional) study. The medical charts of inpatient patients of 213 male combatants, aged 27-59 years, average age 45.0 ± 6.8 years, who underwent treatment during 2018-2021, were analyzed by the method of random sampling. The examined patients were stratified according to the stage of hypertension: 126 patients with hypertension stage I and 87 patients with hypertension stage II.

Results:

The most common comorbid diseases with hypertension in combatants were diseases of the circulatory system (DCS, 60%), diseases of the endocrine system, nutritional disorders and metabolic disorders (DES, 82%), diseases of the nervous system (DNS, 65%), musculoskeletal diseases ulcer system and connective tissue (59%), diseases of digestive organs (52%), anxiety and depressive disorders (85% and 97% of patients, respectively).

The association of an increase in the frequency of various concomitant diseases with the second stage of hypertension was determined - in stage II hypertension, compared with stage I hypertension, DCS was diagnosed more often (98% and 33%, respectively, p < 0.05), DEC (86% and 78%, respectively, p < 0.05), DNS (respectively 77% and 56%, p < 0.05). And diseases of the genitourinary system were more often diagnosed with stage I hypertension (43% and 22%, respectively, p < 0.05).

The higher frequency of diagnosis of DCS in stage II hypertension is caused by coronary heart disease (97% and 25%, respectively, p < 0.05).

Conclusions:

The most common comorbid diseases in military personnel with hypertension who are participants in modern armed conflicts are DCS, DES, DNS, diseases of the musculoskeletal system and connective tissue, diseases of the digestive organs, anxiety and depressive disorders.

In order to prolong the health for military personnel with hypertension and participants in modern armed conflicts, measures for the secondary prevention of DCS (primarily coronary heart disease), DES, DNS, anxiety and depressive disorders are expedient.
QUALITY OF TREATMENT OF ARTERIAL HYPERTENSION IN COMBATANTS TAKING INTO ACCOUNT THE PRESENT COMORBID PATHOLOGY
Authors: Seliuk Olha , Voronko Andrii , Buzhenko Alla , Seliuk Mariana , Kozachok Mykola , Dmytruk Liliia , Buzhenko Ivan , Havretskyi Anatolii , Voronko Oleksii , Buzhenko Zhanna
Published: June 2023

Objective:

Assessment of compliance of treatment of arterial hypertension (AH) in participants of modern armed conflicts with the requirements of evidence-based medicine, taking into account their comorbid pathology.

Design and method:

The design of the study was passive retrospective one-time (cross-sectional). The medical charts of inpatient patients of 213 male combatants, aged 27-59 years, average age 45.0 ± 6.8 years, who underwent treatment during 2018-2021, were analyzed by the method of random sampling.

Results:

It was established that all combatants with hypertension were prescribed antihypertensive drugs: angiotensin-converting enzyme inhibitors (54% of patients), calcium channel blockers (26%), angiotensin receptor blockers (25%) (that is, not all patients used angiotensin-converting enzyme inhibitors or angiotensin receptor blockers), beta blockers (24%) and diuretics (16%). In combatants suffering from hypertension with comorbid coronary heart disease (CHD), beta blockers were prescribed in 26%, calcium channel blockers in 28%, statins in only 45% of patients, without monitoring the achievement of target levels of low-density lipoprotein cholesterol density; antiplatelet therapy was prescribed for 70% of patients, which does not meet the requirements of modern medical and technological documents and needs correction. An insufficient prescription of antihypertensive drugs from the groups of beta blockers (26% of patients) and calcium channel blockers (28%) was established in military personnel with hypertension - participants in modern armed conflicts with comorbid coronary artery disease. Inadequate prescribing of statins (only in 45% of patients) and antiplatelet therapy (70%) to patients with hypertension with comorbid coronary heart disease and lack of strict control of low-density lipoprotein cholesterol levels were revealed.

Conclusions:

It is necessary to increase the awareness of military doctors about the need for cardiovascular risk stratification in all patients with hypertension and patients with hypertension with comorbid coronary heart disease of combatants, regarding modern requirements for the treatment of patients with hypertension with concomitant pathology, on issues of safety and feasibility of prescribing statins and antiplatelet therapy to combatants with hypertension and concomitant coronary heart disease to reduce the risk of developing cardiovascular complications and improve the prognosis with this comorbidity.
ASSOCIATION BETWEEN BRACHIAL-ANKLE PULSE WAVE VELOCITY AND LONG-TERM OUTCOMES FOLLOWING PERCUTANEOUS CORONARY INTERVENTION
Authors: Shin Jeong-Hun , Kim Byung Sik , Hwang Jin-Yong , Jeong Young-Hoon
Published: June 2023

Objective:

The aim of this study was to determine the associations between brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, and risk of long-term clinical outcomes in patients who underwent percutaneous coronary intervention (PCI).

Design and method:

A prospective single-center registry was used to identify 3930 patients with baseline baPWV measurements who underwent PCI between 2014 and 2018. Major adverse cardiac and cerebrovascular event (MACCE, a composite of all-cause death, spontaneous myocardial infarction, and non-fatal stroke) and net adverse clinical event (NACE, a composite of MACCE components and major bleeding) were evaluated up to 4 years.

Results:

From the registry, 980 (24.9%) patients had high baPWV (>1850 cm/s) and 2,950 (75.1%) patients had low baPWV (< = 1850 cm/s). During follow-up period of up to 4 years, MACCE occurred in 266 (6.8%) patients (112 (11.4%) in high baPWV and 154 (5.2%) in low baPWV) and NACE occurred in 309 (7.9%) patients (131(13.4%) in high baPWV and 178 (6.0%) in low baPWV). In multivariable analysis, patients with high baPWV showed a higher risk of occurring MACCE (adjusted hazard ratio [HR] 1.441; 95% confidence interval [CI], 1.101–1.886) and NACE (adjusted HR 1.505; 95% CI, 1.174–1.929) than those with low baPWV. In addition, predictive performance was significantly increased when PWV was incorporated into the Cox regression models for MACCE (net reclassification improvement [NRI] 0.154, p = 0.040; integrated discrimination improvement [IDI] 0.003, p = 0.013) and NACE (NRI 0.144, p = 0.027; IDI 0.003, p = 0.027).

Conclusions:

Elevated baPWV in patients who underwent PCI, is significantly associated with the long-term clinical outcomes and may be valuable for the initial assessment to identify high-risk patients following PCI.
POTENTIAL FUNCTIONAL ASSOCIATION OF MIR-21 AND MIR-133B WITH ATHEROSCLEROTIC CORONARY ARTERY DISEASE THROUGH MODULATING THEIR NOVEL TARGET GENES SGPP1, ATG5, AND LRP6
Authors: Kumar Dinesh , Narang Rajiv , Saluja Daman , Srivastava Kamna
Published: June 2023

Objective:

Atherosclerosis, a progressive manifestation of coronary artery disease (CAD), is an inflammatory disorder characterised by the accumulation of atherosclerotic plaque. MicroRNAs regulate several pathophysiological events of atherosclerosis. In our previous study, miR-133b and miR-21 were reported to be differentially expressed in CAD patients as compared to controls, suggesting their possible implications in the pathophysiology of CAD. To better understand their functional role we sought to predict their target genes through bioinformatic tools and validate them while assessing their expression at the protein level in CAD subjects as well as in THP1 macrophages treated with respective miRNA inhibitors.

Design and method:

Upon bioinformatics approach, three predicted target genes, SGPP1, ATG5 and LRP6, were chosen from 22 predicted target genes of candidate miRNAs, which have not been explored so far for their association with the respective miRNAs in CAD or related pathologies. Validation of the expressions was performed through western blot analysis.

Results:

Following the prediction of target genes and validation through immunoblotting, SGPP1 was observed to be a potential target gene of miR-133b, ATG5 of miR-21 and LRP6 of both miR-133b and miR-21. SGPP1 was identified to be upregulated in CAD patients whereas ATG5 and LRP6 were both observed to be downregulated in CAD patients as compared to controls. Moreover, the protein expression pattern of all the target genes was observed to be modulated, when cells were treated with respective miRNAs inhibitors.

Conclusions:

The results from the present study suggest that SGPP1, ATG5 and LRP6 are potential target genes that may serve as possible therapeutic targets in the management of CAD which undoubtedly merit further experimental confirmation.
IMPACT OF CARDIOVASCULAR RISK AND HYPERTENSION ON SUBCLINICAL CORONARY ATHEROSCLEROSIS IN ASYMPTOMATIC DIABETIC INDIVIDUALS
Authors: Jeon Young Hun , Park Gyung-Min
Published: June 2023

Objective:

This study sought to evaluate the effect of 10-year ASCVD (Atherosclerotic Cardiovascular Disease) risk and blood pressure (BP) on subclinical coronary atherosclerosis in asymptomatic diabetic individuals.

Design and method:

We analyzed 739 asymptomatic diabetic individuals (mean age 55.5 ± 7.3 years; 541 [73.2%] men) with no prior history of coronary artery disease who voluntarily underwent coronary computed tomography angiography (CCTA) as part of a general health examination. The classification of BP was adapted from the American College of Cardiology/American Heart Association 2017 guideline. Study participants were categorized as low (<15%) and high ASCVD risk (> = 15%) groups, respectively. Subclinical coronary atherosclerosis was defined as the presence of any coronary plaque by CCTA.

Results:

In subjects with low ASCVD risk (n = 498), after adjustment for cardiovascular risk factors, subclinical coronary atherosclerosis was not associated with elevated BP, stage 1, and stage 2 hypertension groups compared with normal BP group (P for all > 0.05). On the other hand, in subjects with high ASCVD risk (n = 241), there was no statistically difference in the adjusted odds ratios of both elevated BP (adjusted odds ratio [aOR] 2.068; 95% confidence interval [CI], 0.703–6.080; P = 0.187) and stage 1 hypertension groups (aOR, 1.533; 95% CI, 0.679–3.459; P = 0.304) for the presence of any coronary plaque. However, the stage 2 hypertension group had a significant association with subclinical coronary atherosclerosis (aOR, 4.127; 95% CI, 1.592–10.696; P = 0.004).

Conclusions:

In asymptomatic diabetic individuals with low ASCVD risk, BP levels were not associated with an increased risk of subclinical coronary atherosclerosis. However, in those with high ASCVD risk, stage 2 hypertension was only associated with an increased risk of subclinical coronary atherosclerosis. These results suggest that hypertension management may be different in diabetic individuals according to the their ASCVD risk.
WHEN PERCUTANEOUS CORONARY INTERVENTION (PCI) IS NOT AN OPTION - CONSERVATIVE TREATMENT OF STEMI DUE TO THE CONTRAINDICATIONS AND SEVERE COVID-19 INFECTION
Authors: Zbroch Edyta , Adasko Grzegorz , Cabaj Marta , Barano Magdalena , Zbroch Aleksandra , Wawiernia Julia , Zalewska Aleksandra , Zapora-Kurel Agnieszka
Published: June 2023

Objective:

The case report presents patient with the history of ST-segment elevation myocardial infarction (STEMI) and COVID-19 infection. STEMI is one of the acute coronary syndromes, defined as sudden ischaemia of the heart muscle. The most common cause of STEMI is the abrupt cessation in coronary artery blood flow based on pre-existing atherosclerosis. Percutaneous coronary intervention (PCI) remains the gold standard for patients with STEMI. In some cases, due to contraindications, only conservative treatment is possible.

Design and method:

Case report presentation of the patient admitted to the hospital due to the shortness of breath, cough and chest pain as well as analysis of symptoms, additional tests, diagnosis and treatment options.

Results:

A 78-year-old woman with the history of heart failure, type 2 diabetes mellitus, obesity, hypertension, chronic kidney disease, several myocardial infarctions, anaemia and thrombocytopenia in the course of myelodysplastic syndrome was admitted to Department of Internal Medicine and Hypertension because of compressive chest pain, deteriorating shortness of breath and cough. In the Emergency Unit COVID-19 infection was confirmed, as well as STEMI was diagnosed. An invasive cardiologist, due to severe thrombocytopenia, qualified the patient for conservative treatment, including fondaparinux, statin, nitroglycerin infusion and beta blocker. Due to the severe course of COVID-19 infection oxygen therapy and pharmacotherapy were implemented. During hospitalization, an attack of atrial fibrillation occurred. Considering the risk of haemorrhage an apixaban was recommended, without antiplatelet agent. The patient was discharged home in general good condition.

Conclusions:

Reperfusion treatment involves PCI, which should be performed within 120 minutes from the diagnosis of STEMI. Other methods include coronary artery bypass grafting and fibrinolytic treatment. Due to the increased risk of complications, particularly the high bleeding risk, conservative treatment was applied, resulting in a significant improvement of the patient's condition, despite unexpected new incidents.
HEART FAILURE PATIENT AND MEDICAL WORKERS, INTERACTION POST DISCHARGE: SINGLE CENTER STUDY
Authors: Gasimov Zaur , Dadashova Gulnaz , Javadova Tarana , Aliyeva Sevinj
Published: June 2023

Objective:

It is well known that the period after discharge from the hospital is very important for a patient with heart failure. For to achieve the desired result, improve the quality of life, reduce the number of repeated hospitalizations, increase life expectancy, it is necessary to coordinate all parts of the healthcare system.

The purpose of the study: to find out the level of involvement of medical workers of various parts of the health care system in the treatment of patients with heart failure.

Design and method:

91 patient, 61male, 30 women,mean age 59, years, 31-84, mean hospitalization rate mean 4 times, 1-10+, represented, 33,7%, sample of 271 patients with heart failure hospitalized at Research Institute of Cardiology, Baku, Azerbaijan in 11 june-18 august 2022 represented study population. Patient-hospital-ambulatory interaction related questionnaire,15questions, table 1, and Voils patient adherence to medications questionnaire, 3main+18 detailed question, were used.

Results:

74,7% noticed that after discharge they being in touch with hospital cardiologist,73,4% being in touch no later than 1 time in a 3 month,mainly once a month, 54% of patients recognized hospital cardiologist as –my doctor,44% offered to the hospital cardiologist during post-discharge period this percentage increase to 52%patients when their condition worsens. Only 23% of patients offered to polyclinic in the period after discharge, drive by patients with heart failure and Type 2 Diabetes. 12% of patients noticed that they offer to the hospital cardiologist and polyclinic doctor.73% noticed that have no contacts with polyclinic medical workers, neither cardiologist or general practice. 79% of patients noticed high adherence to medication. Cardiologists weak adherence related to the list and dosages of medications recommended in modern guidelines has been observed. table 2.

Conclusions:

It is necessary to organize optimal medical care for the heart failure patients and to work measures for effective interaction of all chains of medical system.
COVID-19 INFECTION IN PATIENTS WITH PROVEN HEART DISEASE
Authors: Ouankou Christian Ngongang , Njonnou Sylvain Raoul Simeni , Kuate Liliane Mfeukeu , Ndedi Claudine Jessica Yondo , Chemgne Marie Ida , Lekpa Fernando Kemta , Ouankou Merimee , Choukem Simeon Pierre
Published: June 2023

Objective:

The COVID-19 pandemic remains a hot topic whose results are highly uncertain. This acute respiratory infection is mainly transmitted through respiratory droplets and contact routes. Frail patients such as those with severe heart disease are at higher risk of contracting moderate to severe forms of COVID-19 pneumonia. our goal was to determine the prevalence of COVID-19 in patients with proven heart failure and to give the result of this disease.

Design and method:

We collected data from the medical records of heart failure patients followed at the Medical and Cardiology Center over the past two years and looked for the onset of COVID-19 disease, risk factors for poor outcomes as well as the final outcome of the disease.

Results:

Out of 130 medical records, we recorded a total of 66 cases. The mean age of patients was 61.4 ± 17.8 years. The sex ratio was 0.81. LV systolic function was preserved in 47.7% of cases. COVID-19-related pneumonia was detected in 14.9% of cases; The clinical presentation was dominated by respiratory distress associated with moderate oxygen desaturation and fever. Forty-six patients (70.7%) were on renin-angiotensin-aldosterone inhibitors. Poor outcome factors were: BT systolic dysfunction (52.3%), atrial fibrillation (31.3%), pulmonary arterial hypertension (16.4%), impaired renal function (41.8%), impaired liver function (59.7%), and at least 10-fold increase in NT-Pro-BNP values (55.2%). In addition, LVH was observed in 32.8% of cases, complete LBBB in 13.4% of cases, and significant LV dilation in 55.2% of cases. There have been 8 deaths, including 5 related to COVID-19-related pneumonia. Survivors received long-term chest physiotherapy in addition to treatment for heart failure.

Conclusions:

Acute pneumonia due to COVID-19 can have a negative impact on the prognosis of heart disease. Thus, the factors of poor performance should encourage the isolation and/or treatment of these at-risk populations.
WHAT HAPPENED IN THE CARDIOLOGICAL OUTPATIENT PRACTICE AFTER THE COVID-19 PANDEMIA?
Authors: Gruev Ivan , Tsanova Veska
Published: June 2023

Objective:

The COVID 19 pandemia has passed its peak, but the consequences are still present and unclear. COVID 19 infection is a respiratory, but also a vascular disease and future will show the real impact on the cardiovascular health.

Design and method:

We studied the medical records of the patients in one outpatient cardiological practice in Sofia, Bulgaria.

We found out that the patients had returned to the clinical visits in the practice. They did not postpone their appointments anymore.

During last year, 712 clinical examinations were performed in this particular practice. 70 % of the patients had passed through COVID 19 infection once or twice and 75 % of the patients over 65 years of age were vaccinated.

Results:

What were the main clinical findings:

Conclusions:

COVID 19 as a vascular disease and the post- COVID syndrome created a big challenge for the outpatient cardiological practice. The real consequences of this infection are not clear and will be assessed in the future. All the patients who had recovered from COVID 19 have to be followed up at least once in the first year after the infection.
HYPERTENSIVE EMERGENCIES AND BLOOD PRESSURE CONTROL DURING THE COVID-19 PANDEMIC
Authors: Solé Ricardo Cabrera , Turpin Caridad , Luepke Erik , Aguilera Manuel
Published: June 2023

Objective:

To assess the quality of adequate control of hypertension, during the pandemic and in the year after it in 100 previously treated patients as well as the percentage of hypertensive emergencies (HE).

Design and method:

From July 2020 to July 2021, we studied 100 patients with hypertension, 60 women and 40 men with an age of 72±8 years, who have previously been diagnosed and treated for hypertension. In the first consultation after the pandemic and at 6 months, they underwent an AMPA and a study with home control to all of them. Subsequently, they were asked at 12 months to perform a new home control. The following parameters were measured: systolic and diastolic blood pressure (TAS, TAD), treatment completion (Ctto), control by family doctor (Cmap), the number of times they have gone to the emergency room for uncontrolled tension. Results between the first measurement and 6 months later were compared.

Results:

The BP per home control at baseline was 148±6/98±4 compared at 6 months was 135±2/84±3 (p<0.05). The baseline ABPM: 152±4/89±3 and at 6 months were 135±2/79±3 (p<0.05). The completion was assessed using the Morisky-Green method and basally we found that 45% of patients were compliant, while, at one year it was 100% (at 6 months of the study 68%). Regarding the number of patients who were controlled by their MAP in these first months was only 5% while at the end of the study they were 55% (80% telephone). Of these P, 18 have gone to the emergency room for an HE (18%).

Conclusions:
IMPACT OF THE COVID-19 PANDEMIC ON THE TREATMENT AND ADHERENCE OF HYPERTENSIVE PATIENTS: CHALLENGES AND OUTCOMES
Authors: Pleava Roxana , Vinkele Ilze , Mosteoru Svetlana , Gaita Laura
Published: June 2023

Objective:

The COVID19 pandemic has seen an important decrease in outpatient clinic visits across all medical specialties as well as a raise in emergency presentations often more severe than previously. Although Sweden has not undergone a strict lockdown, patients’ behaviour was similar to the rest of the European countries. The aim of our study was to evaluate the impact of the pandemic on hypertensive patients follow-up and adherence to medical treatment at a Primary Health Care Center (PHCC) in Sweden.

Design and method:

We conducted a prospective, single centre study which included patients diagnosed with arterial hypertension undergoing regular follow-ups at the PHCC. Inclusion criteria were no record of blood pressure (BP) measurement within the last two years from start date (March 2022) and ongoing prescribed medication from the PHCC. A letter with recommendation to book a follow-up was sent to all the patients who met the inclusion criteria. We analysed patient characteristics, laboratory and prescribed medication at baseline (visit 1) and 6 months after the letters were sent (visit 2).

Results:

213 patients were initially evaluated and 102 patients (aged 64.58 ± 9.45; 61 males, 59.8%) diagnosed with hypertension were included in the study. Out of these 73 patients (71.56%) booked a follow-up visit with 26 patients (35.61%) receiving changes in their medication. The mean BMI between visit 1 and 2 was 30.19 kg/m2 vs. 29.72 kg/m2, p = 0.578. Also there were no significant differences regarding systolic (139.04 ± 13.87 vs. 141.92 ± 14.55, p = 0.103) and diastolic (83.18 ± 9.19 vs. 84.61 ± 8.07, p = 0.176) BP. Most patients were treated with a calcium channel blocker (58 pat, 56.7%) followed by an angiotensin receptor blocker (38 pat, 37.3%). No significant differences were found for the lipidic profile between visits with only 30 patients (29.41%) being on statin at visit 1 compared to 36 patients (35.3%) at visit 2.

Conclusions:

Although patient follow-up was affected by the Covid-19 pandemic, we did not find statistically significant changes in their BP, lipidic profile or weight.
CLINICAL CONSEQUENCES IN POST COVID-19 HYPERTENSIVE PATIENTS
Authors: Matova Olena , Mishchenko Larysa , Talaeva Tatyana , Bezrodnyj Volodymyr , Bozhenko Galina
Published: June 2023

Objective:

to evaluate the clinical consequences in hypertensive patients after 1.2 ± 0.3 years after COVID-19 recovery.

Design and method:

We studied 51 treated hypertensive patients, which were divided into 2 groups: 26 patients recovered from mild to moderate COVID-19 in 2020-2021 years (1st group) and 25 patients were not ill COVID-19 (2nd group). The clinical characteristics, laboratory finding, echocardiographic measurement and clinical outcomes were analyzed.

Results:

There were no significant differences in sex, age, duration of hypertension, frequency of family history of premature CVD and presence of concomitant obesity, DM, CAD, stroke/TIA, atrial fibrillation, heart failure, CKD, PAD and average number of antihypertensive drugs, office systolic BP between the 2 groups. Levels of office diastolic BP by 10 % (P = 0.001) and heart rate by 13 % (P = 0.01) were higher in post COVID-19 group. Low adherence was present at 81.8 % patients 1st group compared with 45 % of 2nd patients group (P = 0.03). Cognitive impairment by the MMSE scale was detected in 68.2 % of COVID-19 recovered patients and 25 % of 2nd patients group (P = 0.03). Fasting glucose by 7.5 % (P = 0.046), 24-h albuminuria in 1.8 times (P = 0.049), level of CRP by 38.5 % (P = 0.04) were higher and blood concentration of endothelial progenitor cells (CD133+CD31+CD45-/+) by 14, 9 % (P = 0.04), left ventricular ejection fraction by 10 % (P = 0.03) were lower in post COVID-19 patients than in patients of 2nd group.

Conclusions:

The study indicate that the changes were found in the hypertensive patients after 1.2 ± 0.3 years of recovery from COVID-19. In the future these may signal an increased risk for incidence of CV outcomes. Cognitive dysfunction and possibly as a consequence poor adherence to antihypertensive treatment contribute to negative outcomes.
ELECTROLYTE IMBALANCES IN THE CONTEXT OF SARS-COV-2 INFECTION IN HYPERTENSIVE PATIENTS
Authors: Grigore Cristiana , Balaceanu Beatrice , Gurau Cristian Dorin , Giuglea Carmen , Dina Ion , Balaceanu Alice
Published: June 2023

Objective:

The purpose of this study is to compare the clinical features and laboratory examinations in hypertensive patients diagnosed with Sars Cov 2 infection and electrolyte imbalance detected during hospitalization.

Design and method:

We conducted a retrospective study on 43 patients diagnosed with Sars Cov 2 infection admitted to an Internal Medicine department of an Emergency Hospital between January 2022 and October 2022.

43 patients diagnosed with Sars Cov 2 infection by RT-PCR test were admitted to the internal medicine department, most of them with a severe form of the disease (24 patients, 55%), of which only 8 patients (18.6%) were vaccinated anti Sars Cov 2. The average age of the patients was 78.7 years, with a minimum age of 62 years old and a maximum of 98 years old. The sex ration shows: females 26 patients (60.4%) and 17 men (39.6%).

Patient comorbidities: 5 patients (11.62%) had neoplasms before hospitalization and 2 patients (4.65%) were diagnosed during hospitalization. Cognitive dysfunctions and dementia are found in 18 patients (41.86%) and all patients had a history of hypertension at admission. Heart failure in different stages is found in 15 patients (34.88%). 41.86% (18) of the patients had type 2 diabetes upon admission and 3 patients (6.97%) were diagnosed during hospitalization through specific tests. Atrial fibrillation is in a small percentage (31.23%-13 patients) and the frequently followed treatments are beta blockers (53.48%-23 patients) and thiazide and loop diuretics (17 patients-39.53%). 44.18% of patients died during hospitalization.

Results:

During the hospitalization, the patients presented various electrolytes disorders. An approximately equal number of patients, 22 and 23 respectively, had normal serum levels of sodium and potassium. Mild electrolytie disorders were prevalent: mild hyponatremia (7 pac, 16.27%) and hypokalemia followed the rule (20.93% - 9 patients).

Conclusions:

The electrolytic disorders occurring in the case of patients with multiple cardiovascular comorbidities and diagnosed with Sars Cov 2 infection can worsen their prognosis, ranging from psychiatric effects to death.
PROGNOSTIC ROLE OF INTERLEUKIN-10 AND GLYCOSYLATED HEMOGLOBIN IN THE DEVELOPMENT OF CARBOHYDRATE DISORDERS IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Zhuravlyova Larysa , Kulikova Maryna
Published: June 2023

Objective:

Arterial hypertension (AH) is one of the most pressing problems in medicine due to its prevalence and central role in the development of vascular accidents. Among the causes that increase the risk of developing the disease and its complications, consider hyperglycemia, insulin resistance, hyperinsulinemia. The aim of our study is to develop a diagnostic algorithm for predicting type 2 diabetes mellitus (T2DM) based on a comprehensive study of carbohydrate metabolism and serum interleukin-10 (IL-10) activity in patients with AH.

Design and method:

The study involved 54 patients with AH. The levels of glucose, insulin, HbA1c were determined by biochemical method, HOMA index was calculated. In order to determine the level of anti-inflammatory IL -10 was used ELISA method. A discriminant analysis was used to identify the dependencies that explain the mechanisms of T2DM development in patients with AH.

Results:

As the result of evaluation of carbohydrate metabolism, 24 patients were diagnosed with type 2 DM (fasting glucose> 7.0 mmol / L; 2-hour oral glucose tolerance test (OGGT) >11.1 mmol / L, HbA1c >6.5%)), 30 - prediabetes (fasting glucose from 5.6 to 6.9 mmol / L or 2-hour OGGT - from 7.8 to 11.0 mmol / L, HbA1c from 5.7 to 6.4%). The level of IL-10 was increased in patients with AH and prediabetes (90.8 (90.6-91.1) pg / ml, p <0.05). At the same time, patients with AH combined with T2DM were characterized by the decrease of IL-10 level (77.4 (75.5-79.3) pg / ml, p <0.05). According to the results of discriminant analysis, directed to search of signs that allow to differentiate prediabetes and T2DM, it was found that IL-10 and HbA1c are exactly the required signs:

Type 2 DM = 5,216xIL-10 + 2,643xHbA1c-211,174;

Prediabetes = 6,114xIL-10 + 3,059xHbA1c-290,53.

Conclusions:

These studies demonstrate that an increase in the level of anti-inflammatory IL-10 in patients with AH and prediabetes can serve as a protective reaction and an early marker of carbohydrate metabolism disorders. Changes in the levels of IL-10 and HbA1c are the most important prognostic factors that affect the development of carbohydrate metabolism disorders in hypertensive patients.
THE EFFICACY OF COMBITATION OF EMPAGLIFLOZIN AND METFORMIN IN PATIENTS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS
Authors: Zhuravlyova Larysa , Filonenko Maryna , Rogachova Tetyana , Sokolnikova Nelly
Published: June 2023

Objective:

To determine the efficacy of combination of empagliflozin and metformin in patients with arterial hypertension (AH) and type 2 diabetes mellitus (T2DM).

Design and method:

A total of 52 patients with AH, stage II; obesity, stage I and concomitant T2DM were examined (28 women and 24 men, mean age 58.4 ± 2.9, fasting plasma glucose < 9 mmol/L, glycosylated hemoglobin (HbA1c) - 7.54 ± 1.2%, mean blood pressure (BP) 167/104 ± 15.5/3.6 mm Hg, BMI 32.2 ± 2.1 kg/m2, disease duration 5.4 ± 1.6 years,). Two groups of patients were formed: the comparison group included 25 patients who received metformin 1000 mg 2/day, amlodipine 10 mg 1/day and lisinopril 10 mg 1/day. Patients of the main group (n = 27) received empagliflozin 10 mg in addition to standard therapy. The follow-up period lasted 6 months.

Results:

The following results were obtained by the end of the study period: HbA1C in the main group was 6.23±0.7%, while in the comparison group – 6.58±0.5% (p < 0.05). 46.6% of patients in the main group had achieved the target HgA1c<7.0% compared to 24.5% in the control group (p<0.01). There was no significant increase in the frequency and severity of hypoglycemic episodes. The patients of the main group were characterized by greater weight loss (3.4±0.4 kg) than those of comparison group (0.9±0.3 kg), p<0.01. The mean systolic BP in the main group was 133 ± 6.12 mm Hg., while in the comparison group - 147.2 ± 8.13 mm Hg., p < 0.05. The diastolic blood pressure (DBP) was 84.6 ± 3.7 mm Hg and 89,8 ± 5.1 mm Hg, respectively.

Conclusions:

The obtained data suggest that inclusion of empagliflozin into a standard therapy of hypertension and type 2 diabetes provides multiple benefits, namely: improves glycemic control, ensures better regulation of blood pressure and promotes weight loss.
ROSUVASTATINE TREAMENT IN A BIG UKRAINIAN COHORT OF PATIENTS WITH TYPE 2 DIABETES
Authors: Torbas Olena , Kushnir Svitlana , Sirenko Yuriy
Published: June 2023

Objective:

Diabetes mellitus (DM) remains one of the most important cardiovascular risk factors significantly worsening the prognosis in patients with hypertension and dyslipidemia. The leading role among drugs for the treatment of such patients is played by statins with their powerful influence on the development and progression of atherosclerosis and its complications. We used the OZIRKA study database and performed additional subanalysis to study the effects of rosuvastatin in patients with diabetes and dyslipidemia. To study the effect of Ozalex (rosuvastatin) on lipid and cholesterol levels in patients with lipid metabolism disorders and hypercholesterolemia and DM.

Design and method:

A prospective open population study on a primary care level. Recruitment of patients was conducted from March to December 2019. The analysis of the study data was conducted from June to November 2020. All patients attended in total 3 visits.

Results:

A total of 20,000 patients from all over Ukraine were included in the study. The full follow-up period was completed by 18,100 patients, of whom 17,530 had all the necessary data, and they were included in the final analysis. The mean follow-up period was 2.2 months. Approximately 13% of patients included in the study had DM type 2. We observed a significant reduction in total cholesterol, LDL and triglyceride levels in patients with diabetes. In addition, there was a tendency to increase the level of HDL in this group of patients. In general, it can be noted that there was a significant improvement in lipid profile in patients with diabetes - the level of total cholesterol decreased by 28%, LDL cholesterol by 34%, and triglycerides by 24%. Administration of rosuvastatin did not impair glucose control in any way in the group of patients with DM, moreover, even in the group of people without DM there was no negative effect of rosuvastatin on fasting glucose level.

Conclusions:

In general, we can recommend rosuvastatin in a dose of 10 to 20 mg as an optimal start of statin therapy at the stage of primary care for patients with DM.
TOTAL CARDIOVASCULAR RISK ASSESSMENT AND CAROTID DAMAGE IN HYPERTENSIVE INDIVIDUALS WITH TYPE-2 DIABETES/PRE-DIABETES: A PILOT STUDY
Authors: Menti Ariadni , Kollias Anastasios , Kyriakoulis Konstantinos , Ntousopoulos Vasileios , Stathopoulou Panagiota , Theodosiadi Aikaterini , Ntineri Angeliki , Bountzona Ioanna , Asimakopoulou Athina , Stergiou George S.
Published: June 2023

Objective:

This study compared the performance of cardiovascular disease (CVD) risk prediction scores in terms of their association with preclinical carotid damage in patients with type-2 diabetes/pre-diabetes and hypertension without established CVD.

Design and method:

Adults (> = 18 years) with type-2 diabetes/pre-diabetes and hypertension, without pre-existing CVD were assessed through anthropometric parameters and blood tests. Preclinical carotid damage was assessed by echocardiographic estimation of Carotid Plaque Score (CPS). Carotid damage was defined as CPS higher than the value of the 75th percentile and/or carotid stenosis >50%. Five CVD risk scores were considered (SCORE2/OP2; FRAMINGHAM; UKPDS STR; UKPDS CHD; ASCVD).

Results:

Fifty-one individuals with complete data on age, sex, smoking, lipid profile and HbA1c were analyzed [mean age (years) 63.7±8.0 (SD), 63% males, body mass index (BMI) (kg/m2) 31.4±5.0 (SD), 44 diabetes, LDL-cholesterol 99.3±32.1 mg/dl, HbA1c 6.4±0.8%]. The C-statistic (ROC curve) in identifying patients with carotid damage was 0.642 [95% CI 0.487, 0.797] for SCORE2/OP2, 0.576 [95% CI 0.408, 0.745] for FRAMINGHAM, 0.696 [95% CI 0.553, 0.839] for UKPDS STR, 0.644 [95% CI 0.491, 0.796] for UKPDS CHD and 0.563 [95% CI 0.396, 0.730] for ASCVD. The UKPDS STR had a significant higher C-statistic value compared to ASCVD (p<0.05), whereas no other score discriminated better than the others in identifying individuals with preclinical carotid damage (p = NS).

Conclusions:

This pilot analysis suggests that the available CVD risk prediction scores show moderate ability in identifying which patients with type-2 diabetes/pre-diabetes and hypertension have preclinical carotid damage. Although there seems to be no superiority of any of them, the UKPDS STR performed somewhat better.
ASSOCIATION OF SERUM VITAMIN E WITH DIABETES IN THE US NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES) 2001-2006
Authors: Liang Xiaopeng , Chou Oscar Hou In , Cheung Bernard Man Yung
Published: June 2023

Objective:

Although there has long been interested in how vitamin E affects human health, the effect of vitamin E on diabetes is controversial. This study aimed to investigate the relationship between serum alpha-tocopherol (the main form of vitamin E) and diabetes.

Design and method:

The National Health and Nutrition Examination Survey (NHANES) 2001-2006 included 8240 non-pregnant adults aged over 20 in this cross-sectional study. Participants with invalid data on fasting glucose or glycated haemoglobin, serum vitamin E and covariates, including demographics, socioeconomic status, smoking, alcohol, medical history, and vitamin E supplements, were excluded. Restricted cubic spline and logistic regression were used to examine the association between serum vitamin E with diabetes.

Results:

7.3% (95% CI, 6.6-8.0) of participants had diabetes. The mean (± standard error) serum vitamin E was (28.62 ± 0.34) μmol/L. Serum vitamin E greater than 45.8 μmol/L was highly associated with diabetes [OR = 1.56, 95% CI (1.24-1.80), P < 0.01]. Stratified by gender, the cut-off serum vitamin E concentration with an odds ratio less than 1.0 was 41.6 μmol/L for men and 48.5μmol/L for women. The odds ratio for high serum vitamin E (> 41.6μmol/L for men or > 48.5μmol/L for women) associated with diabetes was 1.77 [95% CI (1.35-2.13)] in men and 1.49, [95% CI (1.30-1.72)] in women.

Conclusions:

High serum vitamin E is associated with diabetes; this association is stronger among men. Prospective research is needed to investigate whether there is a causal relationship.