bluuebunny/crossref_metadata_2025 huggingface dataset:
STRESS AT WORK ENHANCES RISK OF ARTERIAL HYPERTENSION IN GENERAL POPULATION. WHO MONICA-PSYCHOSOCIAL PROGRAM
Authors: Gafarov Valery , Gromova Elena , Panov Dmitriy , Gagulin Igor , Gafarova Almira , Krymov Eldar
Published: April 2021

Objective:

To determine the effects of stress at work on the risk of arterial hypertension (AH) in population of 25–64 years in Russia/Siberia

Design and method:

Under the III screening of the WHO MONICA-psychosocial program, a random representative sample of a population of both sexes aged of 25–64 years in Novosibirsk was examined in 1994 (n = 1346, 48.8% males; mean age 44.9 ± 0.4 years, response rate - 77.3%). The screening program performed in frame budgetary issue # AAAA-A17-117112850280-2. It's included: registration of socio-demographic data, determination of stress at work. The duration of follow-up was 16 years.

Results:

A high level of stress at work was in 29.5% of men and 31.6% of women (p > 0.05). An increase in the level of high stress at the workplace was found for men - workers engaged in moderate physical labor (34.7%) compared with women (17.7%) in this group (p < 0.05). The risk of AH over a 16-year period in those who experiencing stress at work was 1.4-fold higher in men and 1.27-fold higher in women. An increase in the risk of hypertension was observed in widowed men HR = 2.5. Risk of AH gradually increased in women depending on age group: 35–44 years – HR = 1.699; 45–54 years – HR = 2.472 and 55–64 years – HR = 2.694 (p for all < 0.05).

Conclusions:

High levels of stress at work increased the risk of hypertension both in men and women.
CORONARY PLAQUE INSTABILITY SYNCHRONIZES WITH INFLAMMATORY ACTIVITY OF MULTIPLE ORGANS INCLUDING CAROTID PLAQUES AND VISCERAL ADIPOSE TISSUE
Authors: Pahk Kisoo , Kwon Hyun Woo , Eo Jae Seon , Seo Hong Seog , Kim Sungeun
Published: April 2021

Objective:

Positron emission tomography (PET) is very useful to determine inflammatory activity in the body including arterial plaque. Although many studies suggested that local and systemic inflammation could affect the arterial plaque instability, there were no direct evidences showing the inflammatory activity of other organs in acute myocardial infarction (AMI) patients.

Design and method:

Whole body combined fluorodeoxyglucose PET/computed tomography was performed in 32 patients with AMI (57 ± 12 years) within a week of disease onset, 33 patients with stable coronary artery disease (CAD) (61 ± 12 years), and 25 control subjects (57 ± 8 years). Maximal standard uptake value (SUV) of the highest regions of interest was calculated in the right carotid artery, bone marrow, liver, visceral (VAT) and subcutaneous adipose tissue (SAT).

Results:

The SUVs of AMI patients in the carotid artery and other organs except SAT were significantly higher than those of CAD patients or control group with and without adjustment for other covariates, whereas SAT SUVs were not significantly different among three groups. Furthermore, the SUVs of CAD patients in bone marrow, liver, and VAT were also higher than those of control group. In the overall population, hsCRP and the SUVs of all measured organs except SAT were significantly correlated to each other.

Conclusions:

These findings suggest that coronary plaque instability accompanying other vascular inflammation synchronizes with and might be attributed to increased innate immune surveillance by macrophage resident in different tissues such as VAT and reticuloendothelial system including bone marrow and liver.
THE ECONOMIC BURDEN OF CARDIOVASCULAR DISEASES ASSOCIATED WITH UNHEALTHY DIET IN THE RUSSIAN FEDERATION IN 2016
Authors: Mukaneeva Dinara , Kontsevaya Anna , Myrzamatova Azaliia , Balanova Yulia , Khudyakov Mikhail , Drapkina Oxana
Published: April 2021

Objective:

To estimate the economic burden of cardiovascular diseases (CVD) attributable to unhealthy diet in the Russian Federation (RF) in 2016.

Design and method:

According to the ESSE-RF epidemiological study, the prevalence of excess consumption of salt, processed red meat and sugar-sweetened beverages (SSB) in the Russian population was recorded in 49.9%, 22.5 %, 8.6% surveyed, respectively. We first obtained CVD risk estimates for intakes of harmful foods (salt, processed red meat, SSB). The relative risks (RRs) of morbidity and mortality from CVD associated with unhealthy diet were identified through a literature search. Based on the data on the prevalence of excess salt intake, processed red meat and SSB consumption in the Russian population and RRs, the population attributable fractions (PAFs) was calculated for CVD. Associations were presented as RRs and PAFs with 95% CIs. To assess the economic burden, the proportion of the analyzed risk factors in the morbidity and mortality from CVD was determined, and then the proportion in the economic burden of the CVD. The direct costs of the health care system and losses in the economy due to morbidity and mortality from CVD associated with unhealthy diet were determined. The calculations were performed in Microsoft Excel 10.0. (Microsoft, USA).

Results:

The calculated PAR, associated with excess salt intake, for CVD mortality and morbidity was 5% and 7% respectively; for stroke: in mortality — 17%, in morbidity — 10%. The daily of processed red meat consumption determine 8.6% contribution to the morbidity of coronary heart disease. PAR of SSB consumption for CVD mortality and morbidity – 2%. The economic burden of CVD associated with an unhealthy diet in the Russian Federation in 2016 amounted to 204.2 billion rubles (2.9 billion €). Excessive salt intake makes the largest contribution to this burden. The losses in the economy due to premature mortality (177.2 billion rubles) prevail in the structure of the main burden. Direct medical expenses amounted to 26.9 billion rubles.

Conclusions:

The significant economic burden associated with preventable disease provides an economic rationale for action to reduce the prevalence of lifestyle-related risk factors.
ASSOCIATIONS BETWEEN PREVALENCE OF ARTERIAL HYPERTENSION AND HIGH LEVELS OF HOSTILITY IN MALES OF OPEN URBAN POPULATION
Authors: Kayumova Marina , Gafarov Valery , Kuznetsov Vadim
Published: April 2021

Objective:

To establish associations of arterial hypertension (AH) prevalence and hostility (H) levels in open urban population in males aged 25–64 years.

Design and method:

A cross-sectional epidemiology study was conducted on representative sample, formed randomly from voting lists of males aged 25–64 years from one of Tyumen administrative districts in the amount of 1,000 people, including 250 individuals in each of four decades of life. The response was 85.0%. The study analysis included AH prevalence according to unified assessment criteria and the prevalence of low, medium and high levels of H according to the WHO MONICA-Psychosocial questionnaire. Statistical processing of study data was carried out using IBM SPSS Statistics 21.0. software applications for medical information. Pearson chi-square test was used in assessing statistical significance of differences between groups.

Results:

In open urban male population aged 25–64 years, age-standardized indicator of H level was 70.0%, with predominance of high H level (average H level - 23.7%, high H level - 46.6%). In younger age groups, statistically insignificant tendency to increase average and high levels of H regarding to general population indicators and indicators of elder age groups was revealed. AH prevalence was 48.7% in males aged 25–64. With the age increase, AH prevalence rose significantly escalating during transition from the third to the fourth and the fourth to the fifth decades of life (20.3–55.3%, p < 0.001; 55.3–68.8%, p < 0.01; respectively, in 25–34, 35–44 and 45–54 age groups). Statistically significant differences of AH prevalence with general population indicator were found in age groups of 25–34, 45–54 and 55–64 years. Statistically significant patterns regarding H levels and their associations with AH were established in open urban population. In groups with presence of AH, high level of H was significantly oftener, and its average level was significantly rarer.

Conclusions:

Thus, epidemiological criteria of psychosocial risk factors, including H, identified using standardized questionnaire methods, should be used during routine preventive examinations of male population and selection of workable people with cardiovascular diseases, who need in-depth and preventive medical examination.
INTERPRETING AND EXPANDING ON THE OBSERVED CORRELATION BETWEEN THE AMBULATORY ARTERIAL STIFFNESS INDEX AND THE LOWER LIMIT OF CEREBRAL AUTOREGULATION DURING CARDIAC SURGERY
Authors: Gavish Benjamin , Gottschalk Allan , Hogue Charles W. , Steppan Jochen
Published: April 2021

Objective:

The lower limit of cerebral autoregulation (LLA) refers to the mean arterial pressure below which cerebral blood flow becomes pressure dependent, resulting increased stroke risk. Thus, markers correlated with the LLA are highly desired. The LLA measured during cardiac surgery, correlates with the Ambulatory Arterial Stiffness Index (AASI) determined from intraoperative continuous radial blood pressure (BP) before cardiopulmonary bypass (‘baseline’). Using these data the present study investigated factors underlying this association and its potential refinement.

Design and method:

The study population included 181 patients undergoing cardiac surgery (age 71 ± 8 years, 68% males). Given the linear relationship between systolic BP (SBP) and diastolic BP (DBP), the AASI is defined as 1 minus the DBP-on-SBP regression slope. The analytic expression of AASI is 1-Rsd/K, where Rsd is the SBP-DBP correlation coefficient, and K = SD (SBP)/SD (DBP), where SD = standard deviation. K measures the relative increase in arterial stiffness during systole (‘stiffening’). Factors affecting the LLA were investigated using multilinear regression models with backward-stepwise procedure. Each model included age, sex, diabetes mellitus, heart rate, and one BP factor (average SBP, DBP, and pulse pressure) during baseline, called ‘group1’, and one or more of the factors including body mass index (BMI), Rsd, 1/K, AASI (equivalent to Rsd/K), and BMI∗Rsd/K (equals BMI∗(1-AASI), called ‘group2’.

Results:

BMI, Rsd and 1/K, alone or taken together, adjusted to group 1 factors, were found to be the only significant explanatory predictors. Results were insensitive to the BP factor used. These three predictors were either weakly- or not-correlated with one another. The table below shows the correlation coefficient r of a single predictor from group2 with the LLA and its P-value, and the P value adjusted for group1 predictors.

Conclusions:

Results explain the likelihood of an elevated LLA by a single- or combined predictors associated with the known effects on cerebral vasculature of obesity (lower BMI); elevated arterial stiffening (greater K) and reduced beat-by-beat BP control (lower Rsd). Thus, combining these predictors may be useful markers for cerebral autoregulation.
MILD CORTISOL HYPERPRODUCTION IS ASSOCIATED WITH IMPAIRED GLUCOSE HOMEOSTASIS AND INSULIN-RESISTANCE IN NON-DIABETIC ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Bulfone Luca , Catena Cristiana , Da Porto Andrea , Novello Marileda , Abrusci Rosangela , Colussi Gianluca , Presello Agnese , Frangipane Alessandro , Sechi Leonardo
Published: April 2021

Objective:

Patients with Cushing syndrome (CS) and subclinical Cushing syndrome (SCS) have higher risk of cardiovascular events than the general population. Excess cortisol secretion might reduce insulin secretion, insulin sensitivity, glucose uptake, and increase gluconeogenesis. Data on cortisol secretion in patients with essential hypertension and on its relationships with glucose homeostasis are scanty. The aim of the study was to evaluate cortisol secretion and its relationship with glucose homeostasis and insulin-sensitivity in essential hypertensive (EH) patients.

Design and method:

In 155 EH patients (age 43 ± 13 years, 81 men) we measured fasting glucose and insulin, HOMA index, plasma cortisol levels at 8 AM, 5 PM and 11 PM, and after an overnight suppression test (DST) with 1 mg of dexamethasone, 24-h free urinary cortisol, and ACTH, and performed a standard oral glucose tolerance test (OGTT), calculating the area under the curve for glucose (G-AUC) and insulin (I-AUC).

Results:

Fasting glucose was positively related to 11 PM cortisol level (r = 0.221, P = 0.019) and post-DST cortisol levels (r = 0.244, P = 0.002). Post-DST cortisol level was positively related with fasting insulin (r = 0.264, P = 0.001), HOMA (r = 0.273, P = 0.001) and I-AUC (r = 0.185, P = 0.023). G-AUC was positively related to 11 PM cortisol (r = 0.246, P = 0.008) and post-DST cortisol levels (r = 0.216, P = 0.007). These associations were independent of age, body mass index, alcohol intake, physical activity, plasma potassium and ACTH levels.

Conclusions:

In non-diabetic patients with EH, relative cortisol hypersecretion is independently associated with impaired glucose homeostasis and insulin resistance.
LONGITUDINAL ASSOCIATION BETWEEN DEPRESSION AND INCIDENT HYPERTENSION-AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Alnakhli/Anwar Anwar , Bazuhair Mohammed , Padmanabhan Sandosh , Smith Daniel
Published: April 2021

Objective:

Background: The association between depression and cardiovascular disease (CVD) is well documented. However, depression has also been proposed to be involved in the pathological pathways linking the main risk factors of CVDs. Several studies including one meta-analysis have suggested that depression may be an independent risk factor for hypertension. Objective:To evaluate the relationship between depression and incident hypertension

Design and method:

Bibliographic databases Medline, EMBASE, Web of Science and PsycINFO without language restrictions were searched from 2005 up to 2019. We included prospective cohort studies, involving normotensive subjects at baseline with diagnosis of depression measured using clinical evaluation or a standardised psychometric tool and recorded as a dichotomous variable. Outcome was new-onset hypertension. We excluded studies that enrolled participants with a history of antihypertensive medication at the time of study initiation. Methodological quality was assessed using the Newcastle-Ottawa Scale. Pooled hazard ratios (HR) were calculated using inverse variance method in random effects models.

Results:

We identified five studies with a total of 201,886 participants and an average follow-up of 7.52 years. Out of the five studies, only two reported a positive association between depression and incident hypertension. The pooled effect of three studies included in the meta-analysis showed that depression was associated with 20% increased risk of hypertension (HR = 1.20, 95%CI 1.01–1.43) but with a substantial heterogeneity (I2 = 70%). One study reported a null result for a dose-response relationship between depressive symptoms and incident hypertension. Quality analysis showed increased risk of bias notably in the ascertainment of the outcome as most studies relied on self-report and/or prescription of antihypertensive medication as a proxy for hypertension.

Conclusions:

Our findings indicate a possible increased risk of hypertension with depressive symptoms, but this result is limited by heterogeneity and ascertainment bias in the studies included.
THE IMPACT OF POLLUTION ON HYPERTENSION AND ECONOMY
Authors: De Rosa Maria Leonarda , De Vita Alessio , Piccolo Andrea , Ruggiero Federico , Ferrara Nicola
Published: April 2021

Objective:

We investigated whether traffic-related air pollution and noise are associated with incident hypertension in Naples, Italy, our city. Given the pervasive nature and significant health effects of environmental noise pollution, the corresponding economic impacts may be substantial. Design and method We included 102 study our ambulatory patients for air pollution effects. The economic assessment developed a new approach to estimate the impact of environmental noise on the prevalence and cost of key components of hypertension. Noise data our exposure estimates were derived from are >30 years old. We modelled concentrations of particulate matter with aerodynamic diameter < = 2,5ƒÊm, PM2.5,< = 10ƒÊm, PM10, > 2,5,and < = 10ƒÊm, PM coarse, soot,PM2.5 absorbance, and nitrogen oxides at the addresses of participants with land use regression. Residential exposure to traffic noise was modelled in according to the EU Directive 2002 /49 / EC.We assessed hypertension as self-reported and measured (systolic BP = >140 mmHg or diastolic BP = >90 mmHg or intake of antihypertensive drugs We used Poisson regression to analyze associations of traffic-related exposures with incidence of hypertension, controlling for relevant confounders.

Results:

Among 102 participants free of self-reported hypertension at baseline, 11 incident cases occurred within 1.3 years of follow-up. Incidence of self-reported hypertension was positively associated with PM2.5 relative risk 1.22[95%-confidence interval:1.08; 1.37] per 5 ƒÊg/m3) and PM2.5 absorbance (relative risk 1.13[95%CI:1.02; 1.24] per10 P 5 m P 1. These estimates decreased slightly upon adjustment for road traffic noise. Road traffic noise was weakly positively associated with the incidence of self-reported hypertension. Among 102 participants at risk, 34 new cases of measured hypertension occurred. We found no clear associations with measured hypertension. The analyses suggested that a 5-dB noise reduction scenario would reduce the Hypertension prevalence by 1.4%

Conclusions:

Long-term residential exposures to air pollution and noise are associated with increased incidence of self-reported hypertension. These findings suggest significant economic impacts from environmental noise-related cardiovascular disease. Given these initial findings, noise may deserve increased priority and research as an environmental health hazard.
RELATIONSHIP OF P WAVE DISPERSION AND LEFT VENTRICULAR HYPERTROPHY AMONG HYPERTENSIVES
Authors: Inofomoh Francisca , Familoni Oluranti , Amadi Casmir , Kushimo Oyewole
Published: April 2021

Objective:

Cardiovascular diseases constitute a global problem. Hypertension is the single most important cardiovascular risk factor for coronary heart disease, congestive heart failure and stroke.

Late detection, poor risk stratification and suboptimal management leads to increased mortality.

Electrocardiography (ECG) is cheap, easily accessible and useful tool to identify early markers of arrhythmias such as P wave dispersion (PWD) and hypertensive target organ damage like LVH.

This study aimed to assess the relationship of PWD and LVH among hypertensive subjects, comparing with normotensive controls and to analyse whether PWD correlates with other cardiovascular risk factors.

Design and method:

150 hypertensives; 25–75 years from cardiology outpatient clinic enrolled with 150 age and sex matched controls. Informed consent taken,clinical history, anthropometric measurements, standard 12 lead ECG and echocardiography were done for all 300 participants following standard operating procedures.

P-wave duration assessed using digital measurements of all leads; PWD calculated as difference between maximum and minimum P wave durations, LVH was determined using the sokolow-lyon criteria on ECG and Left Ventricular Mass Indexed to height2.7 on echocardiography. Left ventricular systolic and diastolic functions were assessed.

Results:

Of 300 participants; 49.3% were males. Mean age of total population was 42.26 ± 11.55 years. Mean Body Mass Index of subjects (26.84 ± 3.64 kg/m2) significantly higher than controls (25.32 ± 3.22)P = <0.001. Likewise the mean waist circumference of the subjects (95.74 ± 11.08 cm) vs. (92.24 ± 9.62 cm), p = 0.004.

Mean P wave dispersion among subjects was 38.29 ± 8.02ms compared to controls; 32.11 ± 4.72ms, P < 0.001. Mean Left Ventricular Mass Index(LVMI)to height was also significantly higher among subjects compared to control; 42.04 ± 15.55 g/ht2.7 vs. 34.24 ± 10.01 g/ht2.7, P < 0.001.

In this study, prevalence of prolonged P wave dispersion among subjects(105)70.0% was significantly higher than(49) 32.6% in the controls, P < 0.001. The correlation of P wave dispersion and left ventricular systolic function (EF) showed inverse relationship r = -0.17 and P = 0.03. A linear positive relations was observed between P wave dispersion and waist circumference r = 0.23, P = 0.004.

Conclusions:

PWD & LVMI are increased in hypertensives; prolonged P wave dispersion is an indicator of presence of other cardiovascular risk factors.
REDUCING SALT ADDED TO CEREAL-BASED FOODS - A POSSIBLE CONTEXT SPECIFIC STRATEGY FOR ACHIEVING SALT REDUCTION IN INDIA
Authors: Shivashankar Roopa , Garg Vandana , Santos Joseph Alvin , Johnson Claire , Rogers Kris , Raj Thout Sudhir , Gupta Priti , Amarchand Ritivk , Krishnan Anand , Prabhakaran Dorairaj , Mohan Sailesh
Published: April 2021

Objective:

Reducing dietary salt consumption is one of the World Health Organization's best buys. In India, about 80% of dietary salt comes from added salt during cooking at home or at table. In this study, we assessed whether or not adding salt to cereal-based foods such as roti or rice, which comprise the main staple food, is associated with higher salt intake in India.

Design and method:

We used population-based representative data from India collected during 2013-14. We estimated daily salt intake among 651 North and 540 South Indian adult participants who provided complete 24-hour urine samples. Participants were asked how many days a week salt was added to dough or rice cooked at home. We stratified the responses ‘0 days’ as ‘NO added salt’ and the responses ‘1–7’ as ‘added salt’. We did linear regression of sodium intake and added salt to dough and rice after adjusting for age, gender, and residence.

Results:

Salt was added to dough and rice at least once a week in 67% and 62% of North India and 62% and 12% in South India, respectively. Salt intake was significantly higher among participants who added salt to the dough (8.09 vs. 7.03 gm compared those who did not) in North India. No association was found with added salt to rice in North India and to dough or rice in South India and urinary sodium excretion. (Table 1)

Conclusions:

Roti and cooked rice are the most frequently consumed staple cereal-based foods in North and South India, respectively. Tailored public health messages on not adding salt to staple cereal-based foods, particularly to rotis in North India may contribute to salt reduction in India.
CARDIOVASCULAR OUTCOMES WITH SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITORS IN ASIANS: AN UPDATED META-ANALYSIS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Imprialos Konstantinos , Stavropoulos Konstantinos , Toumpourleka Maria , Koutsampasopoulos Konstantinos , Mavridou Maria , Siskos Fotios , Papadopoulos Christodoulos , Doumas Michael
Published: April 2021

Objective:

Asians represent an emerging and growing population worldwide, facing the hazardous epidemic of cardiovascular disease (CVD) during the last decades. They experience increased prevalence rates of type 2 diabetes mellitus (T2DM), a co-morbidity that inevitably augments CVD incidence and mortality, and all-cause mortality. Therefore, appropriate treatment strategy is required.

Design and method:

We searched PubMed from its inception to 28 September 2020. We sought to determine the effect of SGLT-2 inhibitors on cardiovascular outcomes of interest in Asians utilizing data from the “hallmark” cardiovascular outcome trials, extracting data concerning Asian patients, as reported across the selected studies. We set as primary efficacy outcome the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke, as defined across all the selected cardiovascular outcome trials, and as secondary efficacy outcome the composite of hospitalization for heart failure (HF) worsening and cardiovascular death.

Results:

SGLT-2 inhibitor treatment resulted in a non-significant decrease in the odds for the primary composite efficacy outcome (OR = 0.90, 95% CI; 0.70 to 1.16, I2 = 35%). Regarding the secondary efficacy outcome, it was shown that SGLT-2 inhibitor treatment led to a significant decrease equal to 27% (OR = 0.73, 95% CI; 0.54 to 0.97, I2 = 58%), which was primarily driven by the results observed in the dedicated HF with reduced ejection fraction (HFrEF) trials. More specifically, we demonstrated that SGLT-2 inhibitor treatment did not induce a significant decrease in the odds for HF hospitalization or CV death across the cardiovascular outcome trials (OR = 0.86, 95% CI; 0.56 to 1.33, I2 = 59%), while it produced a significant result when we pooled the data from the DAPA-HF and the EMPEROR-Reduced trials (OR = 0.58, 95% CI; 0.46 to 0.74, I2 = 0%).

Conclusions:

SGLT-2 inhibitors can confer to cardiovascular risk reduction in Asians, especially those suffering from concomitant HFrEF.
RELATION BETWEEN NOISE ANNOYANCE, STRESS HORMONES AND THE RENAL HEMODYNAMIC
Authors: Bosch Agnes , Kannenkeril Dennis , Rauh Manfred , Ott Christian , Striepe Kristina , Jung Susanne , Kolwelter Julie , Schmieder Roland E.
Published: April 2021

Objective:

Our previous studies showed that healthy men subjectively annoyed by every day noise showed lower renal plasma flow and higher renal vascular resistance compared to not annoyed men. We now further explored the pathophysiological mechanisms of this finding by analysing relations between noise annoyance and chronic stress hormones in healthy men.

Design and method:

We analysed the renal hemodynamic in 80 healthy men using steady state input clearance with infusion of paraaminohippuric acid and inulin, respectively. Intraglomerular pressure and resistances of the afferent (RA) and efferent (RE) arterioles were calculated according to the Gomez equation. Fasting morning cortisol and dehydroepiandrosterone sultate (DHEA-S) were also measured. All study participants ranked subjective annoyance due to noise in everyday life on a 7 grade likert scale. The median of all rankings was used as cut off point to divide the group into annoyed and non-annoyed subjects.

Results:

Even though annoyed subjects (n = 32) showed lower renal plasma flow (635 ± 96 vs 685 ± 116 ml/min, p = 0.039) and higher renal vascular resistance (77.4 ± 15 vs 70.0 ± 14 (mmHg/(ml/min)), p = 0.033) compared to not-annoyed subjects (n = 46) there was no difference in serum cortisol and DHEA-S between the groups (table 1). However, there was a correlation between serum cortisol and glomerular filtration rate (r = 0.345, p = 0.002) as well as renal plasma flow (r = 0.408, p < 0.001), and an inverse correlation between serum cortisol and renal vascular resistance (r = -0.420, p < 0.001), resistance of the vas afferens (r = -0.376, p = 0.001) and resistance of the vas efferens (r = -0.441, p < 0.001) in the total healthy study population. There was also an inverse correlation between DHEA-S and resistance of the vas efferens (r = -0.409, p < 0.001) in the total healthy study population.

Conclusions:

Annoyance due to noise in everyday life was not associated with an increased level of chronic stress hormones. However, our data suggests a relation between chronic stress hormones and impaired renal function. Chronic stress may trigger early renal vascular changes potentially leading to hypertension.
TREATMENT WITH BETA-BLOCKERS IS ASSOCIAT TREATMENT WITH BETA-BLOCKERS IS ASSOCIATED WITH AN INCREASED RISK FOR DEPRESSION AND ASTHENIA IN PATIENTS PRESENTING WITH COGNITIVE DISORDERS
Authors: Riemer Thomas , Herzer Laura , Mailahn Jakob , Lohse Andrea , Fuentes Linda Elizabeth Villagomez , Bermpohl Felix , Kreutz Reinhold
Published: April 2021

Objective:

Beta-blockers (BB) are among the most frequently prescribed medications worldwide. In the past, their potential to induce depression has been discussed controversially, and heterogeneous results have been published. We hypothesized that possible reasons for this heterogeneity may be differences in (1) the classification of patient-reported symptoms as “depression”, (2) the ability to pass the blood-brain-barrier for different BB, and (3) cerebral vulnerability of the exposed patients. In our study, we investigate the influence of BB use on two different cardinal symptoms of depression, depressive mood and asthenia. Furthermore, we examine whether the magnitude of these symptoms is moderated by the lipophilia of the BB and by the presence of dementia in Alzheimer's disease (DAT) as an indicator of cerebral damage. Design and Method: In this retrospective monocentric study we evaluated 196 patients aged 55 to 89 years who were admitted in our outpatient clinic for cognitive disorders. The sample included 98 users of BB, of whom 60 were diagnosed with DAT and 38 had subjective cognitive impairment (SCI) but inconspicuous results in neuropsychological testing and cerebral imaging. Furthermore, 13 patients had comorbid depression. A set of 98 non-users of BB was randomly matched to the BB users based on demographic parameters (gender, age, educational level) and psychiatric diagnoses. Depressive mood and asthenia were measured using subscores of the Geriatric Depression Scale (GDS).

Design and method:

We found a significant association between BB use and the GDS subscores for both asthenia and depressive mood, with higher values in BB users than in non-users (2.83 vs. 1.96; p < 0.01 and 2.39 vs. 1.62; p < 0.05). The risk was not affected by lipophilia status of BB (high vs. moderate) or cognitive diagnosis (DAT vs. SCI). Conclusion: The magnitude of both asthenia and depressive mood was distinctly higher in users of BB. Neither lipophilia of BB nor presence of DAT substantially influenced symptoms. In patients presenting with cognitive disorders on a BB medication, BB should be critically evaluated as possible etiology of asthenia and depressive mood.
ACETATE AMELIORATES GLUCOSE DYSREGULATION AND NEUROBEHAVIOURAL DEFICIT IN DEXAMETHASONE PLUS SCOPOLAMINE-TREATED MICE: GUT-HEART-BRAIN CROSSTALK
Authors: Michael Olugbenga , Adedayo Lawrence , Bamidele Olubayode , Morakinyo Amos , Awobajo Funmileyi
Published: April 2021

Objective:

Cardiometabolic disorders have been shown to be associated with the etiology of neurodegenerative diseases but the mechanisms are elusive. There is increasing evidence that the gut microbiota-derived short-chain fatty acids (SCFAs) plays key role in mediating the beneficial effects of the gut microbiome in maintenance of host health. This study was designed to investigate whether SCFA, acetate, would mitigate dexamethasone plus scopolamine-induced dysmetabolism and cognitive decline.

Design and method:

Male mice (n = 6/group) received (p.o.) vehicle, dexamethasone with scopolamine (DEX; 0.2 mg/kg + SC; 3.0 mg/kg), DEX+SC with sodium acetate (ACE; 200 mg/kg) and DEX+SC with donepezil hydrochloride (DP; 1.0 mg/kg) for 7 days. Morris water maze was used to examine spatial learning and memory while Y-maze was used to determine working and cognitive memory respectively. Oral glucose tolerance test was carried.

Results:

Degenerative changes such as weight loss, reduced exploratory/working memory, frontal-dependent motor deficits, cognitive decline, memory dysfunction and anxiety during behavioural assessments were noticed in DEX+SC-treated mice compared to control. Furthermore, DEX+SC treatment led to impaired glucose tolerance, elevated 1-hour postload glucose response and increased triglyceride-glucose index. Likewise oxidative impairment was indicated by depleted plasma, cardiac and brain glutathione reductase, nitric oxide and elevated lipid peroxidation (malondialdehyde). Cholinergic deficits characterized by increased neural acetylcholinestrase (AChE) expression and elevated uric acid, lactate dehydrogenase, lactate the plasma, cardiac and neural tissues of the DEX+SC-treated mice further implied cardiac dysfunction alongside the degenerative changes. Consequently, proteolysis was evident by observed diminshed Nissl profiles in axons and dendrites of neurons which correspond to apoptotic changes observed in H&E staining of prefrontal cortex and hippocampal sections.

Conclusions:

Interestingly, ACE treatment ameliorated the DEX+SC-induced behavioural deficits and cardiometabolic dysfunctions in mice. The effects of ACE treatment were comparable to the DP in DEX+SC-treated rats. Hence, ACE prevents neural and cardiac oxidative damage, behavioural deficits and glucose deregulation. Furthermore, ACE could be a potential AChE inhibitor. These findings suggest that the gut microbiota-derived SCFA, acetate, would be a cost effective therapeutic target for inhibition of neuro-cardiac degenerative processes and behavioural deficits through the gut-heart-brain crosstalk
SHORT-TERM BLOOD PRESSURE VARIABILITY WAS ASSOCIATED WITH COGNITIVE IMPAIRMENT IN HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Komori Takahiro , Hoshide Satoshi , Kario Kazuomi
Published: April 2021

Objective:

We previously reported that abnormal circadian blood pressure (BP) rhythm, a riser BP rhythm in which nocturnal BP exceeds awake BP was associated with cognitive impairment (CI) in heart failure (HF) patients. However, it is not clear that the short-term BP variability (BPV) was associated with cognitive impairment (CI) in HF patients.

Design and method:

We enrolled 416 hospitalized HF patients and performed ambulatory BP measurement (ABPM) and mini-mental state examination (MMSE). Cognitive impairment (CI) was defined as MMSE score <26.

Results:

HF with CI was significantly older, higher frequency of female, lower BMI, higer prevalence of HFpEF, higher LVM index than HF without CI. With regard to BP parameters, HF with CI was significantly higher BP variability than HF without CI. In multivariable logistic regression analysis to investigate the association between CI and BP variability, riser BP pattern and SD of sleep DBP (per 5mmHg) were significantly associated with CI (Odds ratio 2.58, 95%CI 1.51–4.43, p < 0.01, Odds ratio 1.45, 95%CI 1.12–1.87, p < 0.01, respectively).

Conclusions:

Nocturnal short-term BPV and riser BP pattern were associated with CI in HF patients. Hemodynamic abnormality during night should be paid attention not to impaired cognitive function in HF.
THE ASSOCIATION OF BLOOD PRESSURE VARIABILITY WITH DEMENTIA AND COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: De Heus Rianne , Tully Phillip , Consortium Na Variable Brain
Published: April 2021

Objective:

A body of empirical work demonstrates that high within-individual blood pressure variability (BPV) holds prognostic value to predict stroke and transient ischemic attack. The magnitude of association between BPV and other neurological outcomes remains less clear. We aimed to summarise the current evidence on whether BPV is associated to dementia and cognitive impairment in healthy older adults.

Design and method:

Electronic databases were searched for full text articles and conference abstracts in English. Prospective and cross-sectional cohort studies or clinical trials in adults without cognitive impairment at baseline were eligible. Measures of BPV included any metric over any duration (i.e. visit-to-visit BPV, day-to-day BPV, 24-hour BPV), but not day-night patterns. Outcomes included: 1. incident dementia, 2. cognitive impairment (change in cognition over time), 3. the combined endpoint of dementia and cognitive impairment, and 4. cognitive function (cross-sectional studies). If the association of mean BP with the study outcome was reported, this was extracted as well, to compare to prognostic ability of BPV with mean BP.

Results:

After screening of the initial search of 2214 references, 40 papers were included. Seven studies assessed incident dementia, 12 assessed cognitive impairment and 23 assessed cognitive function. The majority of studies assessed visit-to-visit BPV (n = 23), followed by 24-hour BPV (n = 14) and day-to-day BPV (n = 3). Increased systolic BPV was associated with the combined endpoint of dementia and cognitive impairment (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.14–1.35), however mean systolic BP was not (OR = 1.13, 95% CI 0.87 to 1.45). There was no evidence of heterogeneity between BPV and mean systolic BP effect sizes (p = 0.47 for comparison, I2 = 0%). Results for diastolic BP(V) were similar. Meta-analysis for all outcomes will be available in May 2020 at the conference.

Conclusions:

On the basis of the available studies, high fluctuations in systolic BP were associated with cognitive impairment. However, there was large methodological and statistical heterogeneity among studies. To clarify whether BPV is an independent risk factor for dementia and cognitive impairment, future work should involve an individual participant data meta-analysis to overcome heterogeneity in analytical approaches.
ASSOCIATION BETWEEN HYPERTENSION AND CHILD BURNS
Authors: Zahidi Hatim Amine , Anass Maaroufi , Mehdi Aqli , Hajar Bendahou , Imad Nouamou , Salim Arous , Ghali Bennouna , Drighil Abdenacer , Leila Azzouzi , Habbal Rachida
Published: April 2021

Objective:

Although systemic arterial hypertension has been recognized as a common complication of thermal injury. In children, its pathophysiological characteristics have not been defined. The aim of this study was to assess the incidence of hypertension in such patients and identify the risk factors for its development and its influence on the clinical outcome.

Design and method:

We conducted a retrospective study in the national burn center of the Hospital University IBN ROCHD of Casablanca between September 2019 and January 2020 including 120 childs suffering from different types of burns.

Results:

24 patients developed hypertension (20%) wich occurred most frequently in boys and in the age group of 7 to 12 years. The incidence increases with the severity of the burn up to a total surface area of 40%. Four of the 30 patients developed hypertensive encephalopathy and epileptic seizures.

We didn’t found any correlation between hypertension and mortality in our study. And according to our results hypertension could not be related to the location of the burn, drug treatment or differences in transfusions.

Conclusions:

Monitoring daily blood pressure showed that hypertension is limited to the phase treatment of burns and blood pressure levels normalized after complete autologous transplantation. Encephalopathy and seizure problems seek the need for careful monitoring of blood pressure and effective antihypertensive therapy in children with burns.
ARTERIAL STIFFNESS AND LOW-GRADE INFLAMMATION IN CHILDREN WITH PRIMARY HYPERTENSION
Authors: Skrzypczyk Piotr , Ofiara Anna , Zacharzewska Anna , Szyszka Michal , Panczyk-Tomaszewska Malgorzata
Published: April 2021

Objective:

In last years, numerous associations between immune system and pathogenesis of primary hypertension (PH) have been revealed. Also, experimental and adult data suggest that inflammation plays a major role in arteries stiffening. The aim of the study was to assess relation between low-grade inflammation and arterial damage in children with PH.

Design and method:

In the group of 119 pediatric patients with PH (14.94 ± 2.76 years, 86 boys, 33 girls) and 45 healthy children (14.91 ± 2.69 years, 27 boys, 18 d girls) we analyzed parameters of low-grade inflammation: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV), peripheral office blood pressure, ABPM, central blood pressure, parameters of arterial damage: aortic pulse wave velocity (aPWV) [m/s], [Z-score], augmentation index (AIx75HR [%]), common carotid artery intima media thickness (cIMT) [mm], [Z-score], carotid artery stiffness (E-tracking), and clinical and biochemical parameters.

Results:

Children with PH had higher NLR (1.93 ± 1.52 vs. 1.32 ± 0.44, p = 0.010), PLR (131.39 ± 41.87 vs. 114.68 ± 37.60, p = 0.020), MAP 24 h Z-score in ABPM (1.34 ± 1.38 vs. 0.43 ± 0.49, p = 0.002), aortic systolic blood pressure (AoSBP) (110.44 ± 9.95 vs. 101.50 ± 8.99 [mm Hg], p < 0.001), aPWV (5.36 ± 0.88 vs. 4.88 ± 0.92 [m/s], p = 0.004) and cIMT (0.46 ± 0.07 vs. 0.43 ± 0.07 [mm], p = 0.002) compared to healthy children. In children with PH NLR correlated (p < 0.05) positively with systolic, diastolic, and mean blood pressure in ABPM (r = 0,24, r = 0,22, r = 0,25), with aPWV [m/s], [Z-score] (r = 0,24, r = 0,20) and pulse wave velocity in carotid artery (PWVbeta) [m/s] (r = 0.20); no such correlations were found in healthy children. NLR, PLR, and MPV did not correlate with cIMT, age, and sex in either of the groups.

Conclusions:

In pediatric patients with primary hypertension arterial stiffness is related to degree of low-grade
OBESITY AMONG TEENAGERS AND IT'S RELATION WITH HYPERTENSION IN BAHRAIN
Authors: Alsaid Jafar , Nawaz Nada , Alsharif Fadia
Published: April 2021

Objective:

To determine the prevalence of overweight and obesity among teenagers in Bahrain as part of raising awareness on this matter. The correlation with gender, age, waist and Hypertension was tested. Central obesity as compared to BMI estimation was assessed and their prevalence within both genders were evaluated.

Design and method:

This is a cross sectional, prospective study to screen for obesity prevalence among teenagers in Bahrain. Students attending middle and high schools where the target sample.

A specific date was scheduled for each school. A group of physicians and nurses measured and registered the height, weight, waist circumference and blood pressure for all the students between 6th till the 12th grades. The study was started in May 2015 and these data are inclusive until Dec. 2018.

Independent factors correlated with high BMI were assessed in univariate as well as multivariate correlations. Difference between central obesity and BMI was analyzed as well as different prevalence among genders.

Results:

The total number of the students included were 2742 from 14 schools.

After testing the correlation of the independent variables with BMI, we found that gender, waist circumference, Systolic pressure, Diastolic pressure, Pulse pressure, mean arterial pressure and Pulse rate were significantly correlated with BMI.

Calculating a multivariate linear regression equation, including the significant independent variables, mentioned above, in relation to BMI revealed that gender, waist and pulse rate were the only significant variables. However, systolic, diastolic, pulse pressure, and MAP were not significantly correlated. The coefficient of determination, R square, was 0.26 for this model.

Conclusions:

A significant difference was noticed between genders in relation to central obesity, which was more prevalent among females, while a BMI classified obesity were more common among males. Gender, waist and pulse rate were significantly related to BMI. The BP was not related to BMI.
INCREASED PREVALENCE AND HIGHER 1-YEAR MORTALITY OF PATIENT HOSPITALIZED FOR AORTIC STENOSIS WITH COMORBID CHRONIC KIDNEY DISEASE IN THE PROVINCE OF QUEBEC, CANADA
Authors: Khelifi Nada , Hamel Denis , Jean Sonia , Blais Claudia , Mac-Way Fabrice
Published: April 2021

Objective:

Development of aortic stenosis is associated with valvular calcifications which are highly prevalent in chronic kidney disease (CKD). The objective of this study was to evaluate the temporal trends in the prevalence and 1-year mortality of patients hospitalized for aortic stenosis according to comorbid CKD status in the province of Quebec, between 2000–2017.

Design and method:

Using the Quebec Integrated Chronic Disease Surveillance System, we identified patients aged 20 years and older with incident aortic stenosis using International Classification of Diseases diagnostic codes versions 9 and 10, in the hospital discharge database. We subsequently combined hospital discharges and physician billing claims databases to identify patients with comorbid CKD in the two years prior to aortic stenosis’ diagnosis. Three subgroups of CKD were considered: 1) non-CKD, 2) pre-dialysis and 3) dialysis. The distribution of the 2016–2017 aortic stenosis population was used for age-standardization of prevalence, 1-year all-cause and cardiovascular mortality.

Results:

We included 108 780 patients with incident aortic stenosis (females: 51.8%; mean age (±SD): 76.4 ± 11.7; comorbid CKD status: 80 768 non-CKD; 26 809 pre-dialysis; 1 203 dialysis). During the study period, the age-standardized prevalence of non-CKD patients decreased by 14% (80.72% [95% CI 77.56–83.99] to 69.56% [95% CI 67.23–71.94]; Figure 1). Inversely, the age-standardized prevalence of pre-dialysis and dialysis patients increased by 58% (18.52% [95% CI 16.93–20.21] to 29.33% [95% CI 27.82–30.91]) and 46% (0.76% [95% CI 0.51–1.11] to 1.11% [95% CI 0.84–1.44]), respectively. Age-standardized 1-year all-cause and cardiovascular mortality decreased over time but remained higher in patients with comorbid CKD. In 2015–2016, age-standardized relative risk of 1-year all-cause mortality was significantly higher in pre-dialysis (RR = 1.56 [95% CI 1.44, 1.69]) and dialysis (RR = 2.04 [95% CI 1.62–2.61]) than in non-CKD patients. Age-standardized relative risk of 1-year cardiovascular mortality was also significantly higher in pre-dialysis (RR = 1.83 [95% CI 1.66–2.03]) and dialysis (RR = 2.28 [95% CI 1.68–3.09]) than in non-CKD patients.

Conclusions:

Prevalence of patients with incident aortic stenosis and comorbid CKD increased between 2000–2017. 1-year all-cause and cardiovascular mortality improved over time but remain higher in aortic stenosis patients with comorbid CKD.
CAN HYPERTENSION EXPLAIN THE DIFFERENT SEASONAL EVOLUTION OF STEMI PATIENTS?
Authors: Vintila Vlad Damian , Stuparu Cosmin , Bratu Vladimir , Andreescu Adriana , Mitrut Radu , Cotoban Alexandru George , Vintila Ana -Maria , Vinereanu Dragos
Published: April 2021

Objective:

To determine the impact of hypertension on evolution of a STEMI population studied during winter and summer months.

Design and method:

We reviewed the local STEMI registry data. Data were recorded from the in-hospital medical charts and from a phone follow-up with patients/family. Hospitalization inform consent stipulates the possibility of follow-up for research purposes.

Results:

We reviewed the 2018 data from a local STEMI registry We analyzed 470 patients admitted with STEMI in a primary PCI hospital from a temperate region.

We reviewed 247 (52.6%) patients admitted during 3 winter months and 223 (47.4%) during 3 summer months and we interviewed 32.6% (153) patients for follow-up.

In-hospital death-rate was 7.9% (37 patients), with death-rate at follow-up to 13.2% (62 patients). A higher in-hospital mortality was noted for winter (10,5% vs. 4,9%, X2 = 5,05, p = 0,025), while at follow-up a similar evolution was noted (16,7% vs. 9.5%, x2 = 5,35, p = 0,021).

A higher median blood pressure was recorded for the alive STEMI patients at discharge (132,09 ± 23,64 mmHg vs. 107,15 ± 38,84 mmHg; t (463) = 5,524; p = 0,000) and at follow-up (131,94 ± 23,56 mmHg vs. 118,60 ± 36,3 mmHg; t (460) = 3,73; p = 0,000).

During wintertime, the maximum in-hospital Killip class was higher (x2 = 9,28, p = 0,026); Killip class was higher in dead persons, initialy and after discharge.

At follow-up, patients were asked to self-report their exercise capacity. A lower BP level was noted for higher exercise tolerance - NYHA I, 140,92 ± 20,66 mmHg, p = 0.04), NYHA II (141,25 ± 17,24 mmHg, p = 0.06), both compared with lower exercise tolerance - NYHA III-IV (162.33 ± 29,45 mmHg, p = 0.04); differences were significant (ANOVA test (F (3) = 4.53, P = 0.005).

Limitations. The phone interview was performed at different time interval after discharge, 17,11 ± 5,48 months for winter group, and 16,23 ± 0.89 months for summer (T (468) = 2,37, p = 0.018) with a low rate of answers. Evaluation of larger cohorts is needed for further validation of the results.

Conclusions:

The course of a STEMI patient is critical. It's valuable to predict evolution upon the level of cardiovascular risk factors. A good high blood pressure control migth further improve outcome.