bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C30-11: EFFECTS OF SGLT-2 INHIBITORS ON 24 H AMBP IN PATIENTS WITH TYPE 2 DIABETIC AND HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Wang Qiongying , Tian Li , Yu Jing , Bai Feng
Published: January 2023

Objective:

To analyze the effects of different types of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on 24-hour ambulatory blood pressure in patients with type 2 diabetes mellitus and hypertension.

Method:

In the meta-analysis, The PubMed, Web of science, and Cochrane Library were searched for relevant literature, and the references obtained from these sources were retrieved from inception till December 2020, Using sodium-glucose cotransporter 2 inhibito, hypertension and randomized controlled trial as keywords. The inclusion and exclusion criteria were formulated in accordance with the requirements of Cochrane systematic review. A total of 1354 articles were retrieved, 592 duplicate articles were excluded, 372 articles were excluded after reading the title and abstract, 87 articles were excluded from non-randomized control and irrelevant outcome indicators, and 7 studies with 2343 patients were finally included. Use RevMan5.3 software to compare the changes in 24-hour ambulatory blood pressure, day and night blood pressure of patients with type 2 diabetes and hypertension before and after treatment with different types and doses of SGLT2i.

Results:

A total of four types of SGLT-2i (Empagliflozin, Canagliflozin, Dapagliflozin, Ertugliflozin) were evaluated in the application of patients with type 2 diabetes and hypertension. The result showed that compared with placebo, SGLT2i could reduce the 24-hour systolic blood pressure of patients with type 2 diabetes and hypertension by 4.36mmHg, among which the antihypertensive effects of empagliflozin, canagliflozin, dapagliflozin and ertugliflozin were -4.59mmHg, -3.74mmHg, -5.06mmHg, -3.64mmHg, respectively; similarly, the 24-hour dynamic diastolic blood pressure decreased by 2.20mmHg, among which the antihypertensive effects of empagliflozin, canagliflozin, dapagliflozin and ertugliflozin were -2.38mmHg, -1.22mmHg, -2.00mmHg,- 2.69mmHg, respectively. At the same time, the systolic and diastolic blood pressure during the day and night decreased significantly.

Conclusions:

This meta-analysis shows that SGLT2i can have beneficial effects on the cardiovascular system by reducing 24-hour ambulatory blood pressure in patients with type 2 diabetes and hypertension, other than reducing blood sugar. Therefore, for patients with type 2 diabetes and hypertension, SGLT2i may be the best hypoglycemic choice.
PS-C31-3: PREVALENCE OF A FALL OR RISE IN BLOOD PRESSURE FROM A SITTING TO A STANDING POSITION IN TREATED HYPERTENSIVE PATIENTS
Authors: Cheng Maong Hui , Chia Yook Chin
Published: January 2023

Objective:

It is known that blood pressure (BP) fluctuates with positioning of an individual. Usually BP falls when changing from lying to standing position which can cause orthostatic/postural hypotension.

However, studies have also shown that BP rises in certain individuals from lying to standing position.

Studies have also shown that rises are associated with increasing age, obesity and presence of diabetes.

While the prevalence of orthostatic/postural hypotension is known, prevalence of rise in BP upon standing is not well documented.

It is important to identify falls or rise in BP upon standing as orthostatic/postural hypotension is associated with increased risk of falls while a rise in BP is associated with increased risk of cardiovascular events (CV).

The aim of our study is to examine the proportion of patients whose BP rises or falls upon standing amongst hypertensive patients. We also examined the association of age, diabetic status, obesity and CV with rises of BP upon standing.

Materials and Methods:

This is a cross sectional study of hypertensive patients in a primary care clinic. Demographic data was collected with weight and height measured. Sitting BP was taken twice after 5 minutes rest, standing BP was taken after 5 minutes of standing. Any fall or rise in BP from sitting to standing was categorized as fallers and risers respectively.

Results:

1736 patients were recruited into this study,734 were invited to have their standing BP done. Mean age was 66.0 ± 9.9years, mean sitting systolic blood pressure (SBP) was 144.4 ± 19.1mmHg, mean sitting diastolic blood pressure (DBP) was 82.4 ± 10.9mmHg, mean sitting heart rate (HR) was 71.4 ± 12.6 min−1. Mean standing SBP was 146.0 ± 19.7mmHg, mean standing HR was 74.1 ± 13.3mins−1.

Mean BMI was 27.1 ± 5.5 kg/m2, of which 69.5% (n = 437) were female, 51.6% (n = 379) were diabetic, and 25.3% (n = 378) were obese. Percentage of patients 65 years and older was 58.5% (n = 428). 22.5% (n = 164) of the patients also had prior CV events.

The proportion of risers and fallers upon standing was 44.5% and 52.8% respectively.

There was no significant difference between the proportion of risers and fallers with increasing age(p = 0.312) or diabetic status (p = 0.406).

However, it was statistically significant associated with obesity (BMI of 30 kg/m2 or more)(p = 0.038).

Conclusion:

Although BP usually drops upon standing, our study showed more than half of treated hypertensives had a rise in their standing BP. There was association of risers/fallers with obesity but not with age or diabetes.
PS-C32-2: PRECAPILLARY PULMONARY HYPERTENSION IN ENUGU, NIGERIA AETIOLOGY, CLINICAL FEATURES AND RISK FACTORS
Authors: Ejim Emmanuel Chukwudi , Oguanobi Nelson Ifeanyi , Iloanusi Nneka Ifeyinwa , Udora Nneka Clara , Nwigwe Scholastica Ijeoma , Obiefuna Adaobi Genevive , Agu Ifeanyi Chukwudi , Onwubere Basden Jones
Published: January 2023

Objective:

Pulmonary hypertension is characterized by a progressive and sustained increase in pulmonary vascular resistance which eventually may lead to right heart failure. Echocardiography can be used to diagnose pulmonary hypertension, and CT pulmonary angiography can be used to confirm the cause in most patients. Precapillary pulmonary hypertension includes WHO Clinical Groups 1, 3, 4 and 5. Data on the causes of pulmonary hypertension are lacking in our environment, and we set out to identify the common causes, clinical features and the risk factors.

Design and Method:

Consecutive patients who had moderate to severe pulmonary hypertension on transthoracic echocardiography in the absence of left heart disease were recruited for the study from July 2015 to April 2022. All the patients were expected to do CT pulmonary angiography to determine the cause of the pulmonary hypertension. The case notes of patients who had done CT pulmonary angiography were retrieved and retrospectively reviewed, and demographic data, presenting complaints, physical signs, and associated clinical conditions extracted.

Results:

A total of 82 patients met the inclusion criteria, but only 46 did CT pulmonary angiography. The age range of the latter group was from 24 to 80 years with a mean age of 50.35 ± 12.43 years. Chronic thromboembolic pulmonary hypertension (CTEPH) was noted in 30 patients (65%), out of which 24 (80%) are females. Idiopathic cases and VSD Eisenmenger were the next common causes. Breathlessness on exertion, cough and syncopal attacks were the commonest presenting features. The presence of uterine fibroids was a frequent association with CTEPH.

Conclusion:

Chronic thromboembolic pulmonary hypertension is the commonest cause of pre capillary pulmonary hypertension, and is basically a disease of middle aged women in Nigeria. Breathlessness on exertion and syncopal attacks are common symptoms, and the presence of uterine fibroids is strongly associated with its presence.
PS-C33-8: INFLAMMATORY MARKERS AND REFRACTORY HYPERTENSION
Authors: Muxfeldt Elizabeth Silaid , Chedier Bernardo , Cortez Arthur Fernandes , Margallo Victor , Santos Taissa Lorena Dos
Published: January 2023

Introduction:

Refractory hypertension (RfHT) is defined as an uncontrolled blood pressure (BP) despite the use of 5 or more antihypertensives, including spironolactone and it is considered an extreme phenotype of resistant hypertension (RHT). High BP levels lead to RAAS stimulation, sympathetic hyperactivity and endothelial dysfunction with consequent production of pro-inflammatory cytokines.

Objective:

To evaluate the relationship between inflammatory markers and refractory hypertension in a large cohort of patients with RHT.

Methods:

A cross-sectional study that evaluated 423 resistant hypertensives (30.5% male, mean age 63.9 + 10.8 years), of which 62 (14.6%) diagnosed as RfHT. All of them were submitted to the dosage of inflammatory markers: TNF-alpha, MCP-1, E-selectin and PAI-1. Socio-demographic and anthropometric characteristics and cardiovascular risk factors (CV) were recorded. Variance analysis compared serum levels of the 4 inflammatory markers and bivariate analysis compared patients with RHT versus RfHT.

Results:

Patients with RfHT are younger, with higher prevalence of smoking, higher levels of albuminuria and higher prevalence of chronic cerebrovascular and renal disease stages 4 and 5. PAI-1 values (126 [108–162] vs 118 [94–153] were higher in those with RfHT, although they did not reach statistical significance. The other biomarkers evaluated showed no association with the diagnosis of RfHT.

Conclusion:

Among inflammatory markers, PAI-1 was the one that correlated most strongly with refractory hypertension. Our study is the first one to demonstrate PAI-1 association with treatment refractoriness
PS-C34-12: MAJOR CLINICAL CHARACTERISTICS OF RENAL ARTERY FIBROMUSCULAR DYSPLASIA IN CHINESE HYPERTENSIVE PATIENTS
Authors: Kang Yuanyuan , Chen Yang , Wu Qihong , Dong Hui , Zou Yubao , Gao Pinjin , Xu Jianzhong , Jiang Xiongjing , Wang Jiguang
Published: January 2023

Background:

Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease that most commonly affects renal arteries. There is growing awareness of this disease entity. However, most of the previous studies have been from US or European populations.

Methods:

Consecutive hypertensive patients with renal artery stenosis caused by FMD underwent catheter-based angiography, followed at two Chinese referral centers in China between January 2000 and December 2021.

Results:

Of 245 study participants, with a mean diagnosed age of 26.9 ± 9.9 years, 137 (55.9%) were female, 38 (15.5%) were children. All patients had diagnosed hypertension at a mean age of 23.4 ± 8.4 years. 73.5% were focal and 15.2% were multivessel. Aneurysms, arterial dissections, and total occlusions were found in 21.6%, 4.1% and 12.2% of patients, respectively. Patients with multifocal FMD, compared to those with focal FMD, were older (26.0 vs.23.7 years, P = 0.021) and more often female (70.8% vs. 50.6%, P = 0.004), had a higher proportion of renal artery dissection (9.2% vs. 2.2%, P = 0.014), lower proportion of kidney atrophy (18.5% vs.31.1%, P = 0.013), and had fewer antihypertensive drugs (1.7 vs. 2.1, P = 0.002). After a median of 6.9 years follow-up, multifocal FMD had a higher cure rate of hypertension than focal FMD after revascularization (71.2% vs.55.2%, P = 0.033).

Conclusions:

Chinese patients with renal artery FMD had different characteristics from Caucasians, especially in adults. In Chinese, renal artery FMD occurred primarily in the young hypertensive patients with little sex predilection, and was frequently focal, which showed a worse blood pressure outcome than multifocal.
PS-C35-6: NATIONWIDE TREND ANALYSIS OF ADDING SALT TO MEALS IN JAPAN: COOKPAD DATA, 2010–2014
Authors: Suzuki Takahiro , Mizuno Atsushi
Published: January 2023

Objective:

Numerous studies have revealed that dietary salt intake is associated with blood pressure and mortality. Adding salt to food as a seasoning is deeply rooted in Japanese culture, which results in that the amount of salt in the diet in Japan remains high. Cookpad is one of the popular cooking-recipe sharing websites globally, where the amount of seasonings can be quantitatively extracted. This epidemiological study aimed to investigate a nationwide trend of adding salt to meals using real-world data in Japan.

Design and method:

This is a large-scale retrospective study using Cookpad data from January 2010 to December 2014, provided by Informatics Research Data Repository, National Institute of Informatics. The amount of salt added as the seasoning was calculated in each recipe. The “Salt Seasoning Rate” was defined as the percentage of recipes that contained salt as an ingredient out of all recipes. We also expressed the “Low-sodium Ingredient Rate” as the percentage of all recipes that contains low sodium food or ingredient. Additionally, the salt added per person per meal was used as “Salt Seasoning Amount” to quantify the amount of salt added as a seasoning. Year-to-year differences in salt seasoning rate and the amount of salt seasoning per person per meal from 2010 to 2014 were analyzed using the Cochrane-Armitage test for percentage trends and the Jonckheere-Terpstra trend test for salt amount.

Results:

Overall, 1,119,555 recipes were identified from January 2010 to December 2014 and stratified by the year of publication. A total of 494,216 recipes (44.1%) containing salt as an ingredient were extracted. The Salt Seasoning Rate trended upward from 85,466/219,549 (38.9%) in 2010 to 74,950/212,162 (35.3%) in 2014 (p-trend < .001). The Low-sodium Seasoning Rate showed a statistically higher trend from 0.07% (144/219,549) in 2010 to 0.18% (375/212,162) in 2014 (p-trend < .001). Furthermore, the Salt Seasoning Amount showed a gradual downward trend, from 0.86 g in 2010 to 0.81 g in 2014 (p-trend < .01).

Conclusions:

This study showed that the frequency and amount of adding salt to meals as seasonings had decreased gradually, and that of using low sodium ingredients has increased, which could reflect the increasing trend of a low-sodium diet and low-sodium food taking behavior.
PS-C35-8: ESTIMATING A MODEL FOR 24-HOUR URINARY SODIUM EXCRETION FROM SPOT URINE SODIUM AND CREATININE OF BANGLADESHI POPULATION
Authors: Sayem Md Noor Nabi , Akhtar Jubaida , Mamun Mohammad Abdullah Al , Choudhury Sohel Reza
Published: January 2023

Background:

The best estimate of population distribution and the average level of dietary salt intake is provided by measuring 24hour urinary sodium (Na) excretion in a representative sample. Collection of 24hour urine is difficult for community living people, and therefore, use of the spot urine Na concentration for estimation of daily salt intake was proposed as an alternative to 24hour urine collection.

Purpose:

To develop and validate equations to estimate the population mean levels of 24hour urinary Na excretion from spot urine Na for a Bangladeshi population.

Methods:

We utilized a dataset in which estimates of urinary Na levels were available from urine samples from 24hour urine collection and from spot urine of 217 participants, aged 40 to 59 years. We developed formulas to estimate 24hour urinary Na (24HUNa) by using 24hour urinary Creatinine (24HUCr), spot urine Na (SUNa), and spot urine creatinine (SUCr). For the reliability and validity tests of developed formulas, we use another dataset of 517 participants, aged 30 to 59 years, that also contains Na levels from urine samples from 24hour urine collection and from spot urine collection.

Results:

The obtained formulas were as follows: (i) PRCr (mg/day) =  − 6.68 × age (year) + 14.68 × weight (kg) + 23.89 × height (cm) − 3198.18; (ii) estimated 24HUNa (mmol/day) = 42.40 × XNa0.270; where PRCr = predicted value of 24HUCr, XNa = SUNa (mmol/L)/SUCr (mg/L) × PRCr (mg/day). The correlation coefficients of Na (mmol/day) between estimated and measured from 24hour urine sample were 0.477, which was statistically highly significant (p < 0.001). The mean difference (bias) between estimated and measured Na (mmol/day) was 2.9, which was not statistically significant (p > 0.05). Intraclass correlation coefficient (ICC) between estimated and measured 24HUNa was 0.502.

Conclusions:

These formulas are useful for estimating population mean levels of 24hour urinary Na excretion, though this method is not suitable for estimating individual Na excretion.
PS-C35-9: THE EFFECT OF CEREAL MEAL (FRUGURAÂ) ON BLOOD PRESSURE
Authors: Matsushita Satoshi , Mitsui Kumi , Shoji Yayoi , Matsushita Yasushi , Matsushita Masakazu , Ueda Seiji , Kasai Takatoshi , Dohi Tomotaka , Fukao Kosuke , Fukushima Yasufumi , Amano Atsushi
Published: January 2023

Background:

Although Japanese guideline recommends to reduce salt intake to less than 6 g per day for patients with hypertension, dietary salt intake is still high, being around 10–11 g. Cereal food contains much less salt compared to a Japanese breakfast (4–5 g of salt in general), predicting the effect to reduce the blood pressure.

Patients and Methods:

Patients who have a risk for atherosclerotic disease w eligible for enrollment in this study. The participants took a 50 g package of Frugura∨ (cereal meal, contains 0.2 g of salt) with milk or yogurt as a breakfast at least 4 days per week. Blood pressure (BP), body composition data, estimate dietary salt intake, and serum blood data were compared between before and 4 weeks after taking the meal.

Result:

Sixteen patients (9 male and 7 female) were enrolled in this study. The mean age was 68.2 years-old. BP in the morning was reduced from 128.7 to 127.8 [mmHg] (p = 0.635) in systolic, and from 79.8 to 77.3 [mmHg] (p = 0.124) in diastolic. Furthermore, BP in the night was reduced from 123.5 to 122.6 [mmHg] (p = 0.606) in systolic, and from 75.1 to 71.8 [mmHg] (p < 0.05) in diastolic. The estimate dietary salt intake was reduced from 9.3 g to 8.6 g, although there was no significant difference (p = 0.370). There was also no significant difference in body weight (62.0 vs 62.0, p = 0.914 [kg]) and body fat ratio (30.2 vs 31.5, p = 0.330 [%]). Serum interleukin-6 significantly decreased after 4 weeks (2.1 vs 1.5, p < 0.05 [pg/dL]). In note, there was no significant difference in liver, kidney, and diabetes marker (HbA1c) between groups. Moreover, 13 patients out of 16 claimed improvement of bowel movement.

Conclusion:

There could be a potential in Frugura∨ reducing blood pressure via low salt contents.
PS-C36-8: BLOOD PRESSURE REDUCTION AFTER RENAL DENERVATION IN PATIENTS WITH OR WITHOUT CHRONIC KIDNEY DISEASE: THE ERLANGER EXPERIENCE
Authors: Guenesaltan Dennis Or Merve Kannenkeril Or , Schmid Axel , Ott Christian , Bosch Agnes , Schiffer Mario , Uder Michael , Schmieder Roland E , Kannenkeril Dennis
Published: January 2023

Background:

Hypertension is associated with major cardiovascular and renal adverse events and the 24h-ambulatory blood pressure (BP) is superior than the office BP in predicting these complications. Overactivitiy of the sympathetic nervous system is linked with elevation of systemic BP and is also present in patients with chronic kidney disease (CKD). The aim of this study was to compare the BP lowering effects of renal denervation (RDN) in patients with and without CKD.

Methods:

Radiofrequency or ultrasound device based renal denervation was performed in 47 patients with and 127 without CKD in our center. Office and 24h-ambulatory BP were assessed after 3, 6 and 12 months by validated devices. CKD was defined by clinical diagnosis or according to the estimated glomerular filtration rate (eGFR: 15–60 ml/min/1.73m2; CKD-EPI formula).

Results:

Until today, 174 patients with a mean age of 59.0 ± 10 were followed up for at least 12 months. At baseline mean eGFR was 55.8 ± 21 ml/min/1.73m2 in patients with CKD and 87.3 ± 13 ml/min/1.73m2 in patients without CKD. There was no significant eGFR decline in either of the groups during follow up. In patients with CKD eGFR was after 12 months 54.4 ± 23 ml/min/1.73m2 (p = 0.699 vs baseline). Office and 24h-systolic and -diastolic BP were significantly reduced from baseline in patients with or without CKD at all time points after RDN (all p < 0.01). There was no significant difference in the reduction of 24 h, day- and nighttime ambulatory BP between the 2 groups at any time point (see table below). With exception of rare local adverse events (e.g. haematoma at the puncture site), we had no safety signals, especially in our patients with CKD, e.g. there was no dissection, embolism or periprocedural cardiovascular complications.

Conclusion:

In our single center registry, we observed a similar BP reduction in 24 h, day- and nighttime ambulatory BP as well as in office BP in patients with and without CKD at any time point up to 12 months. There was no safety signal related to RDN. In particular, we did not observe a significant eGFR decline in both CKD positive or negative patients. We conclude that RDN is an effective and safe treatment option for patients with hypertension and chronic kidney disease.
PS-C37-5: NEW THERAPEUTIC PERSPECTIVES FOR BLOOD PRESSURE CONTROL: DEXFADROSTAT PHOSPHATE, A NOVEL ALDOSTERONE SYNTHASE INHIBITOR, IN PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Mulatero Paolo , Wurzner Gregoire , Groessl Michael , Vogt Bruno , Brunner Hans
Published: January 2023

Objective:

Aldosterone, the primary mineralocorticoid produced by the adrenal gland, regulates fluid homeostasis by stimulating sodium reabsorption in exchange for potassium in the distal tubules and collecting duct of the kidney. Aldosterone synthase (CYP11B2) is the rate-limiting enzyme for aldosterone biosynthesis. Patients with primary aldosteronism (PA) are characterized by an uncontrolled, excess production of aldosterone and are at higher risk of stroke, atrial fibrillation, and heart failure compared to patients with essential hypertension. Furthermore, PA increases the risk of death even after initiation of medical treatment to control blood pressure. Therefore, PA is the compelling indication to demonstrate the value for an aldosterone synthase inhibitor (ASI) as targeted treatment. Previous attempts to eliminate the excessive spontaneous aldosterone synthesis defining PA have been unsuccessful, particularly due to the unintended inhibition of other steroid hormones. Dexfadrostat phosphate is a novel ASI that acts directly on CYP11B2, targeting the root cause of primary aldosteronism.

Design and method:

Dexfadrostat phosphate was first investigated in patients with PA diagnosed within 1 year of study entry according to medical guidelines including a suppression test to demonstrate autonomous aldosterone production. Eligibility was verified and approved by a Central Review panel. Following a 2-week placebo-controlled run-in period, enrolled patients were randomized to one of three doses of dexfadrostat taken orally, once daily. After 8 weeks of treatment, patients were switched to placebo and followed for an additional 2 weeks. Blood samples were taken at 2-week intervals and evaluated in a central laboratory for steroid and peptide hormone as well as electrolyte levels. Blood pressure was measured in the office during each clinic visit. Ambulatory systolic blood pressure (aSBP) was monitored over 24-hours at baseline and after 8 weeks of dexfadrostat treatment.

Results:

All endpoints of the study were met with high significance. Dexfadrostat phosphate treatment was safe and well tolerated. We present the effects on the aldosterone-to-renin ratio (ARR) and subsequent blood pressure reduction, the correction of hypokalemia, and the persistence and reversal of therapeutic effects upon drug withdrawal.

Conclusions:

The phase 2 study in patients evaluated the ability of dexfadrostat phosphate to deliver both biochemical (ARR, potassium) and subsequent clinical (aSBP) correction of the consequences of uncontrolled aldosterone production. By demonstrating its clinical utility in a rarely diagnosed indication of extreme aldosterone dysregulation, the potential of dexfadrostat phosphate may well expand to address essential hypertension, chronic kidney disease, hypokalemia, volume expansion and organ remodeling.
PS-P11-3: OBESITY, HYPERTENSION, DIABETES MELLITUS, AND HYPERCHOLESTEROLEMIA OF KOREAN ADULTS
Authors: Lee Ga Bin , Kim Yoonjung , Park Suyeon , Kim Hyeon Chang , Oh Kyungwon
Published: January 2023

Objectives:

We investigated the trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the COVID-19 outbreak in the Korean adult population.

Methods:

Data from 60,098 individuals of the Korean National Health and Nutritional examination Survey between 2011 and 2020 aged> = 19 were used. The age-standardized prevalence and annual percent changes (APC) were calculated for obesity (body mass index> = 25 kg/m 2), hypertension (systolic/diastolic blood pressure> = 140/90mmHg or under treatment), diabetes (hemoglobin A1c> = 6.5%, fasting glucose> = 126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol> = 240 mg/dL or under treatment).

Results:

Over the past decade of 2011–2020, age-standardized APCs (95% confidence interval)during 2011–2020 for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8%), 0.1% (-1.3 to 1.5%), 1.5% (-1.0 to 4.0%) and 8.0% (5.7 to 10.3%), respectively in men; and -0.2% (-1.5 to 1.2%), -0.5% (-1.9 to 0.9%), -0.1% (-2.3 to 2.2%) and 5.9% (3.9 to 8.0%), respectively in women. In 2020 compared to the previous three years (2017–2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (+6.0, + 1.8, + 1.9 and + 2.8 percentage points, respectively), but the increase was not apparent in women (+2.5, -1.1, + 0.8 and + 0.7 percentage points, respectively).

Conclusion:

An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 epidemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.
PS-P11-5: BIOSOCIAL CORRELATES OF HYPERTENSION IN NORTHEAST INDIA INDIGENOUS POPULATION
Authors: Lalnuneng Abigail
Published: January 2023

India is home to about 700 Indigenous and Tribal People with a population of 104.3 million. Over the years, displacement and rapid acculturation of the Tribal Peoples in India has led to dramatic changes in their social, cultural, economic and value systems. The rapid demographic, epidemiologic, nutrition and health transitions accompanied by economic development, stresses of urbanization and westernization of lifestyle predisposes the tribal population to overweight/obesity and hypertension.

A cross-sectional sample of 615 Hmar adults (18–70 years) from five rural villages of the Churachandpur sub-division and 592 urban adults were collected from Imphal East and Imphal West, Manipur. Data on socio-economic, demographic, behavioural parameters, blood pressure, height, weight, sitting height, mid-upper arm, waist and hip circumferences; and three skinfold thickness, namely, biceps, triceps and subscapular were taken from each participant.

JOURNAL/jhype/04.03/00004872-202301001-01269/figure1/v/2023-10-24T163949Z/r/image-jpeg

The results from the present study can be presented into two broad categories:

1. Intra-variation in hypertension by independent variables within each setting.

The findings of this study strengthen the case that for men, increasing age, overweight and/or obese, alcohol consumption, and household income significantly increase the odds of developing hypertension.

2. Inter-variation in terms of rural-urban differences in hypertension for each categorical independent variable

The prevalence of hypertension was significantly higher in urban than in rural areas. The urban Hmars likely have a higher level of bio-behavioural and psychological stress as compared to their rural counterparts. The rural and urban differences in the risk of developing hypertension are largely due to the differences in BMI and household income. These results should, however, be interpreted with caution. Firstly, while BMI may be a contributing factor to hypertension, the relationship between socioeconomic status and hypertension is highly inconsistent. Secondly, urbanization and economic development may be associated with hypertension, but they should not be considered the causal factors of hypertension.

The overall prevalence of hypertension in the present study is about 21%. Urban areas (25%) show higher risk of developing hypertension compared with their rural counterparts (17%). Obesity is the strongest predictor of hypertension in both the rural and urban Hmar adults which might require hypertension intervention at a lower BMI. The bio-behavioural and socio-economic factors taken in the present study are unevenly distributed across rural and urban settings presenting a formidable challenge to institute public health intervention strategies specific to rural and urban areas. Early diagnosis, increasing awareness and enhancing the frequency of screenings for hypertension are suggested.
PS-P11-7: DIABETES AND HYPERTENSION SELF-MANAGEMENT: CHALLENGES AND SOLUTIONS FROM SOUTH AFRICAN PATIENTS AND HEALTH CARE PROVIDERS: A QUALITATIVE STUDY
Authors: Masupe Tiny , Onagbiye Sunday , Puoane Thandi , Absetz Pilvikki , Alvesson Helle Molsted , Delobelle Peter
Published: January 2023

Objective:

This study aimed to unravel experiences, identify barriers to self management of diabetes and hypertension and solicit solutions for enhancing chronic disease self management from patients and their healthcare providers.

Design and Methods:

This was a qualitative study which collected data from eight in-depth interviews conducted with healthcare providers and four focus group discussions among patients with type 2 diabetes and hypertension receiving chronic disease care from two health facilities in a large peri-urban Township in Cape Town, South Africa. The Self Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data

Results:

Patients experienced challenges across all three self management tasks of behavioural or medical management, role management and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients lived experiences and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management including dedicated multidisciplinary chronic disease management services, counselling services, strengthened family support, patient buddy system, patient-led community projects and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations.

Conclusions:

Patients experienced several barriers to self-management of their chronic disease. Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects towards healthy lifestyle and diet, and advocacy are needed to improve patient self-management. This will contribute towards SDG 3
PS-P12-1: SELF-CARE MANAGEMENT FOR HYPERTENSION IN SOUTHEAST ASIA: A SCOPING REVIEW
Authors: Irwan Andi Masyitha , Potempa Kathleen , Abikusno Nugroho
Published: January 2023

Objective:

This scoping review aims to explore the current state of self-care management practices used by hypertension populations based on evidence from the existing scientific literature for SEA.

Self-care practices such as lifestyle modifications in diet, exercise, and stress management, are effective in reducing the incidence of and enhancing better management of hypertension. However, little is known about the self-care management practices of people with hypertension in Southeast Asia (SEA) countries where the prevalence of hypertension is sharply increasing.

Design and method:

A scoping review of research and grey literature (2006–2021) was performed using Scoping Review Frameworks by Arkey and O Malley. For the research literature, ten databases were searched followed by a manual search of the reference lists of relevant topical papers.

Results:

Results indicate that bodyweight management, physical exercise, dietary intake, and medication adherence were largely poorly practiced by hypertensive people. Stress-relieving methods such as sleep, rest, and spiritual fulfilment was described as alternative self-care management methods. Anecdotal evidence of factors that facilitated or inhibited the implementation of self-care practices were described.

Conclusion:

While the overall evidence review suggests that hypertensive people in SEA do not adequately implement self-care to better manage hypertension, the anecdotal information provided by several reports indicate that there is individual variation in the facilitators and barriers to implementing self-care practices. The facilitators and barriers are relevant to personal choice [internal factors] or to the environment or context [external factors]. Enhancing self-care management of hypertension in SEA may require a multi-focused approach including targeting personal choice as well as external factors such as cultural relevance, environment and resources.

Health workers working in the community in SEA countries should consider a multi-focused approach and cultural aspect in helping hypertensive patients to manage their self-care.
PS-P12-2: NEEDS ASSESSMENT OF LEADERSHIP AND GOVERNANCE IN CARDIOVASCULAR HEALTH IN NEPAL
Authors: Pradhan Pranil Man Singh , Bhatt Rajendra Dev , Pandit Rajan , Shrestha Archana , Maharjan Rashmi , Jha Niharika , Bajracharya Swornim , Shrestha Soniya , Karmacharya Biraj Man , Koju Rajendra
Published: January 2023

Objective:

Good governance and leadership to address non-communicable diseases and minimization of their risk factors is crucial to improve healthy life expectancy particularly in low- and middle-income countries. The objective of this study was to understand and document cardiovascular disease (CVD) programs and policy formulation process and epitomize the challenges and opportunities for leadership and good governance for the health system to address non-communicable diseases particularly cardiovascular diseases in Nepal.

Design and method:

A national level task force was formed to coordinate and steer the overall needs assessment process. A qualitative study design was adopted using The Health System Assessment Approach Manual. Eighteen indicators under six topical areas of leadership and governance in cardiovascular health were assessed. Health laws, policies, regulatory standards, planning and strategy documents and reports on civil society engagement were reviewed. Seven key stakeholders from ministry, professional councils and non-governmental organizations working on CVD were identified and in depth interviews were conducted. Field notes and tape records of interview were compiled and transcribed. Strength, weakness, opportunities and threats in each topical area of leadership and governance were analyzed.

Results:

Voice and accountability exist in planning for health from the local level. The government has shown strong willingness and has a strategy to work together with the private and non-government sectors in health however, the coordination with non-state actors during policy formulation has not been effective. There are strong rules in place for regulatory quality, control of corruption and maintaining financial transparency. The government frequently relies on evidence generated from large-scale surveys for health policy formulation and planning but research in cardiovascular health has been below par. There is a scarcity of CVD-specific treatment protocols at all levels of government coupled with weak reporting from the private sector. Expensive health care with ineffective cost control over drugs and services, medical malpractice with commission system and lack of interest among donors to invest in CVD were important challenges for strong leadership and governance.

Conclusions:

Despite plenty of opportunities, much homework is needed to improve leadership and governance in cardiovascular health in Nepal. The government needs to designate a workforce for specific programs to help monitor the enforcement of health sector regulations, allocate enough funding to encourage CVD research and work towards developing CVD-specific guidelines, protocols, and capacity building. The government needs to leverage the opportunities associated with the current decentralized health system.
PS-P12-5: CHALLENGES FOR REGISTERED PATIENTS RECEIVING HYPERTENSION CARE FROM PRIMARY HEALTH CENTERS IN BANGLADESH
Authors: Jubayer Shamim , Luna Mahfuja , Islam Shahinul , Bhuiyan Mahfuzur Rahman , Choudhury Sohel Reza
Published: January 2023

Introduction:

One in every five adults in Bangladesh suffers from Hypertension. There is a high prevalence of undetected hypertensive patients. Among the detected cases, the control rate of hypertension is poor. Since 2018, the National Heart Foundation of Bangladesh has undertaken an intensive hypertension control program along with the Non-Communicable Disease Control (NCDC) program, the Government of Bangladesh at primary health care settings. This control program implements a number of proven strategies which are a standard simplified treatment protocol, community-based care and task sharing, regular supply of medication, and patient-centered care. Irregular follow up visit and non-adherent to medication fail to control hypertension and increase premature death among patients.

Objectives:

To identify the challenges and barriers to the adherence of antihypertensive medication.

Design and method:

A cross sectional study where total number of 6498 registered hypertensive patients of four Upazila Health Complexes (UHC)s in Sylhet district, northeast part of Bangladesh is selected from April 2019 to August 2020 for this study purpose. These patients are identified since they missed all of their three consecutive monthly follow-up visits at their respective UHCs.. A digital android based application is used as the monitoring tool in the program through which patients are identified as overdue. Data were collected by a questionnaire through an interview over telephone.

Result:

Among 6498 registered hypertensive patients, 3548 patients were contacted. Among those 47% mentioned the distance to the UHCs and long waiting time as challenging factors for receiving antihypertensive medications monthly from their assigned facilities. Due to poor treatment compliance, a number of patients (2.9%) did not return. Moreover, 3.3% of the respondents switched to private practitioners and 0.2% moved to the secondary or tertiary hospital. 0.6% of the respondents could not receive the antihypertensive medication from UHC due to their physical illness and 0.3% migrated to another location. The interviewer found 0.4% overdue patients dead. 12.9% did not receive the call and 8.6% did not mention any reason. 23.5% of the overdue patients gave wrong phone number during their registration.

Conclusion:

This study revealed a number of challenges mentioned by the respondents receiving hypertension care from primary health centers. Addressing these challenges might be effective to improve the hypertension care. Hypertension treatment at community level from the nearest health facility should be included to overcome the barriers.
PS-P13-2: ASSOCIATION BETWEEN TRIGLYCERIDE-GLUCOSE INDEX AND TARGET ORGAN DAMAGES IN HYPERTENSIVE PATIENTS
Authors: Liu Changyuan , Zheng Shuping , Chen Xin
Published: January 2023

Objective:

To investigate the association between triglyceride-glucose index (TyG index) and albuminuria and left ventricular hypertrophy (LVH) in adults with hypertension.

Methods:

The study participants were recruited from a residential area in the suburb of Putuo district in Shanghai. We administered a standard questionnaire for basic information and history of diseases. Clinic blood pressure was measured by an experienced physician with the Omron HEM-7124 monitor (Omron HealthCare, Kyoto, Japan). Venous blood samples were drawn after overnight fasting for biochemical measurements, electrocardiogram (ECG)- left ventricular hypertrophy (LVH) was defined according to the Cornell product index and urinary routine test was performed on fresh urine samples.

Results:

The 5 190 subjects had a mean age of (66.41 ± 7.77) years, and included 2 423 (46.7%) men. Compared with women, men has a little lower TyG index (8.64 ± 0.58 vs 8.69 ± 0.55, P = 0.001). when divided the patients into three groups according to the tertile of TyG index (TyG index less than 8.39, 8.39 - TyG - 8.85, TyG index greater or equal to 8.85), the prevalence of LVH were 4.0%, 3.7% and 6.0%, P for trend = 0.004, and the prevalence of albuminuria were 1.9%, 2.0% and 3.0%, P for trend = 0.03, respectively. After adjustment for related risk factors, the risk for LVH elevated 64% with one unite increase of TyG index, the odds ratio (OR) and 95% confidence interval (CI) was 1.64 (1.31–2.04, P = 0.001). However, there was no significant association between the prevalence of albuminuria and TyG index (OR 0.92, 95% CI 0.56–1.50, P = 0.73).

Conclusions:

TyG index was associated with LVH and albuminuria, and was an independent risk factor for LVH in hypertension.
PS-P14-1: EFFECT OF MONOSODIUM GLUTAMATE ON DIETARY SALT REDUCTION IN FEMALE STUDENTS FROM EAST AND SOUTHEAST ASIA: AN INTERNATIONAL COMPARISON
Authors: Morita Rieko , Ohta Masanori , Hayabuchi Hitomi
Published: January 2023

Objective:

High sodium intake is a leading dietary risk factor for mortality, especially in China, Japan, and Thailand. Salt reduction is imperative in East and Southeast Asia. The use of umami (glutamate) can effectively decrease salt intake while maintaining food palatability. However, it is unclear whether different eating habits and lifestyles among various nationalities influence the effect of glutamate. This study compared the effects of monosodium glutamate (MSG) on the saltiness and palatability of low-salt solutions among students from East and Southeast Asia.

Design and method:

A total of 77 female students, stratified into four groups by nationality (from Japan [N = 28], China [N = 17], South Korea [N = 15], and Southeast Asia [Vietnam, Malaysia, and Thailand, N = 17]), tasted 0.3, 0.6, and 0.9% NaCl solutions with or without 0.3% MSG to evaluate saltiness and palatability. Saltiness and palatability were assessed using a visual analog scale. Then, the participants were asked for their height (cm), weight (kg), length of stay in Japan (for international students only), and degree of sodium intake. We analyzed the within-group and intergroup differences in ratings of saltiness and palatability.

Results:

Among the 77 participants (mean age of 21.6 years), only the 0.3% NaCl solution with MSG showed significantly higher saltiness and palatability ratings than those without MSG. The 0.6%, and 0.9% NaCl solutions with MSG showed significantly higher palatability ratings than solutions without MSG. The 0.6% NaCl solution with MSG had the highest palatability rating of the six solutions. The saltiness ratings for each NaCl solution with or without MSG differed significantly by their nationality (p < 0.05), except for the 0.9% NaCl solution without MSG. The saltiness rating was lowest in the Southeast Asian group. Participants in the Japan, China, and Southeast Asia groups rated the palatability of 0.3% NaCl solution as significantly higher with MSG than without MSG (all p < 0.05). In this regard, a higher but non-significant trend was noted in the South Korean group (p = 0.074). There was no intergroup difference in palatability in the six solutions (p > 0.05).

Conclusions:

Adding an appropriate amount of umami ingredients improved the palatability of low-salt solutions, regardless of the difference in salty taste rating by their nationality. It was clarified that the utilization of umami is effective for salt reduction in East and Southeast Asia, where excessive salt intake is a major issue.
PS-P14-4: ACTIVITIES TO PROMOTE “ADEQUATE SALT INTAKE” IN AMAGASAKI CITY
Authors: Katsuya Tomohiro
Published: January 2023

To promote the prevention and treatment of hypertension, it is essential to educate the public. Since 2015, the city of Amagasaki, where I practice, has been conducting activities to promote health through multidisciplinary cooperation. First of all, volunteers from the Amagasaki City Medical Association gathered to form the “Amagasaki Adequate Salt Intake Promotion Committee”. Next, in a tie-up with Amagasaki City's Health Up Amagasaki Strategic Project, which has been focusing on measures against metabolic syndrome, the committee has reserved a hotel for a day to hold a hands-on forum where citizens can participate in not only lectures on health and medicine, but also a movie screening and low-sodium cooking experiences. The event has been held in a hands-on manner. In addition, active interventions have been made for a wide range of age groups, such as active intervention for particularly high-risk subjects in health checkups, health checkups by placing health checkup vehicles in convenience store parking lots for younger generations who are less likely to receive checkups, and 2.2 g salt equivalent school lunches. In particular, forums for citizens, dentists, pharmacists, nurses, dietitians, the Chamber of Commerce and Industry, universities, the Japanese Association of Hypertension, and Amagasaki City Administration have worked together to devise new approaches every year for four years, which have resulted in the participation of a large number of citizens. The key point is that we aimed to create a social environment in which salt reduction can be implemented as a matter of course in society, rather than relying solely on the efforts of individuals. Another feature of the event was that it was not targeted only at the elderly, who are highly interested in health, but was also designed to be an interactive event that young people can participate in with their children. In the future, we plan to continue our efforts with our colleagues to build a future in which “Adequate Salt Intake” is a part of daily life, while involving more industries.