bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSOCIATION BETWEEN NON-DIPPER OR NIGHT-TIME BLOOD PRESSURE PATTERN AND ALCOHOL DRINKING OR QUALITY OF SLEEP IN KOREAN REGISTRY OF AMBULATORY BLOOD PRESSURE MONITORING STUDY
Authors: Shin Jinho , Kim Ju-Han , Kim Woo-Shik , Lee Sang-Jae , Kim Jang-Young , Park Sungha , Lee Eun-Mi , Ihm Sang-Hyun , Pyun Wook Bum
Published: June 2022

Objective:

Non-dipper or reverse dipper is known to be associated with adverse cardiovascular prognosis in general population and clinical cohort. There are few large sized to explore the factor related to non-dipper or nighttime blood pressure pattern in terms of sleep quality and lifestyle factors.

Design and method:

With the database of Korean multicenter nationwide prospective Registry of Ambulatory Blood Pressure monitoring (KORABP) study, 3745 patients referred for blood pressure evaluation was nalysed for clinical profiles including current smoking and alcohol drinking habits, sleep quality in 4 Likert scale as hardly sleep, poor sleep, not so bad, and very good with 1 to 4 points, and medical history.

Results:

Age was 55.5+/-14.3 years and female was 45%. BMI was 24.7+/-3.4 kg/m2. 33.6% of the study population. Smoking and drinking habits 14.6% and 37.2%, respectively. Prevalence of diabetes mellitus, hypercholesterolemia, and cardiovascular diseases were 19.0%, 27.9% and 22.1%, respectively. Normotensive, untreated hypertension, and treated hypertension were 29.1%, 37.2% and 33.6%, respectively. Sleep qualities in hardly sleep, poor sleep, not so bad, and very good were 14.7%, 32.6%, 32.1% and 20.6%, respectively. In multivariable regression analyses for non-dipper or reverse dipper, age > 56 years, cardiovascular disease history, hypertension by ABPM, and poor sleep are positively associated factors whereas drinking and hypertension by clinic BP were negatively associated factors. Antihypertensive medication has no association. Sleep quality was negatively and positively associated with extreme dipper and reverse dipper, respectively.

Conclusions:

Age, cardiovascular diseases, and hypertension by ABPM were associated with non-dipper. Drinking was associated with dipper. Good and poor sleep qualities were significant factors for extreme dipper and reverse dipper or non-dipper, respectively.
EFFECT OF DIFFERENT TREATMENT OF HYPERTENSIVE PATIENTS WITH OBSTRUCTIVE SLEEP APNEA ON BLOOD PRESSURE: A NETWORK META-ANALYSIS
Authors: Kou Chengkun , Zhao Xu , Fan Xin , Wang Qiongying , Yu Jing
Published: June 2022

Objective:

OSA is one of the common causes of secondary hypertension. The antihypertensive treatment include pharmacotherapy and non-pharmacotherapy. However, the effect of different treatment on blood pressure is still unclear. Theaim of this study was to compare the effect of pharmacotherapy and non-pharmacotherapy for obstructive sleep apnea on blood pressure.

Design and method:

We searched PubMed, EMBASE, Web of Science, Cochrane Library database, China Biology Medicine disc (up to June 1, 2021) to identify the studies that met the inclusion criteria. Two reviewers independently screened literature, extracted data, and assessed the risk of bias. R software was used to perform the meta-analysis.

Results:

A total of 30 clinical trials involving 3483 patients were included. Angiotensin-Converting Enzyme Inhibitors(ACEI) /Angiotensin receptor blockers(ARB) showed the most significant antihypertensive effects on office systolic blood pressure as compared with placebo (MD = -4.56, 95%CI: -27.53~-1.69). Mineralocorticoid receptor antagonist (MRA) showed the most significant antihypertensive effects on office diastolic blood pressure as compared with placebo (MD = -15.02, 95%CI: -24.35~-5.72). Rankogram also shows the ACEI/ ARB is the best treatment on office systolic blood pressure and MRA is the best treatment on office diastolic blood pressure.

Conclusions:

For hypertensive patients with obstructive sleep apnea, Renin-angiotensin-aldosterone System inhibitor (RAS-I) may be the optimal antihypertensive treatment.
AMBULATORY BLOOD PRESSURE MONITORING IN HUNGARY: THE FIRST CROSS-SECTIONAL RESULTS OF AN OPEN LABEL, PROSPECTIVE, OBSERVATIONAL STUDY
Authors: Járai Zoltán , Nemcsik János , Páll Dénes
Published: June 2022

Objective:

Background: Ambulatory blood pressure monitoring (ABPM) is gold standard method in the diagnosis and follow-up of hypertensive patients. There is no systematic assessment on the daily practice of the utilization of ABPM in Hungary.

Aim: The goal of the project is to assess the indication and the number of monitoring, and to analyze the blood pressure results.

Design and method:

This is a multicenter, open-label, observational non-interventional study. Data collection is performed in GPs’ practices and in outpatient clinics of cardiology and internal medicine. Meditech ABPM-06 monitors are used for ABPM measurements. Basic patients’ data are documented in an eCRF and all ABPM data are transferred through a closed online surface into the database for further analysis.

Results:

7498 ABPM were performed between 21st of February and 21st of December, 2021. The monitoring was performed mainly by GPs (62%). The average age of the patients was 54.4 years (12–96 years). More than half of the patients (54%) were female. The indication of ABPM was elevated blood pressure (BP) at home (59.7%), labile BP (41.5%), therapy control (17.0%), suspicion of white coat hypertension (13.5%), suspicion of masked hypertension (2.5%), suspicion of nocturnal hypertension (3.2%) and suspicion of secondary hypertension (1.3%). The average duration of hypertension among hypertensive patients was 9.8 years (1–73 years). 32.6% of the patients were newly diagnosed as hypertensive. The average 24-hour systolic blood pressure was 133.9 mmHg, the average diastolic blood pressure was 79.3 mmHg, while the average pulse rate was 73.2 beats/min. The 24-hour average percent time elevation of systolic and diastolic blood pressure was 53.0% and 38.8%, respectively. The average systolic diurnal index was 9.6%, the average diastolic diurnal index was 13.3%.

Conclusions:

The two most frequent indication for ABPM in the routine practice are elevated home BP and labile BP values. One third of the patients was newly diagnosed as hypertensive subject. ABPM was performed mainly in patients with uncontrolled hypertension. The routine use of ABPM may increase the awareness of hypertension.
IMPACT OF ARTERIAL SITE AND PULSE WAVE ANALYSIS METHOD ON ARTERIAL FORM FACTOR AND MEAN ARTERIAL PRESSURE ESTIMATION
Authors: Izzo Joseph , Mukhopadhyay Debduti , Nagpal Sagar , Osmond Peter
Published: June 2022

Objective:

Mean arterial pressure (MAP) is often estimated from systolic (S) and diastolic (D) blood pressure (BP) using a constant “form factor’’ (FF), usually MAP = DBP + 0.33*pulse pressure (PP), yet accurate measurement requires pulse wave analysis (PWA) and waveform integration. MAP is constant across all conduit arteries but PP increases distally [peripheral (p)PP > central ©PP]. Thus, cFF should be higher than pFF; results should also be similar between PWA methods.

Design and method:

We tested these principles in 2 cohorts using 2 transfer function-dependent PWA devices: SphygmoCor (SPG, radial tonometric PWA with integrated MAP) and Mobil-O-Graph (MOB, 24-hour ambulatory brachial oscillometric PWA with proprietary MAP). SPG data (signal-average of 10 PWA) were obtained after 5–10 minutes of rest and MOB values at 20-minute intervals. For direct MAP comparisons, 101 pairs from the SPG and MOB cohorts were matched precisely for pSBP and pDBP (130.9/78.7 mmHg for each, p>.999).

Results:

For SPG, n = 376, [mean(SD)]: pBP 140(28)/80(15) and cBP 126(28)/81(15) mmHg, age 48(20) yr, BMI 28(6.6), 54% men, 20% black. SPG-cFF was higher than SPG-pFF [0.44(.049) vs 0.34(.056), p < 0.000] and cFF and pFF were correlated (r2 = 0.23, p < 0.000). On stepwise multiple regression, SPG-pFF was related to MAP > gender > age (multiple-r2 = 0.37, p < 0.000; BMI and race were excluded). For MOB: n = 157, pBP 135(18)/81(12) and cBP 123(16)/83(12) mmHg, age 59(16) yr, BMI 30(6), 52% men, 24% black. MOB-pFF was almost invariate, lower than MOB-cFF [0.46(0.00098) vs 0.57(0.048), p < 0.000], and not correlated with MOB-cFF or any other characteristic. MOB-cFF was higher than SPG-cFF (p < 0.000) with similar variability. In the paired cohorts, mean FF’s were similar to the full cohorts but SPG-MAP was much lower than MOB-MAP [96.3 vs 102.6 mmHg (p < 0.000)].

Conclusions:

1) FF varies within-subjects by arterial location, with cFF > pFF; 2) SPG-pFF varies between-subjects and is affected by MAP, gender, and age; 3) proprietary MOB-pFF is invariate and higher than integrated SPG-pFF; and 4) MOB-MAP is 6% higher than SPG-MAP. These findings may impact studies requiring FF or MAP estimates, especially from proprietary oscillometric devices.
HOW MANY DAYS TO CONFIRM HYPERTENSION USING HOME BOOD PRESSURE MONITORING
Authors: Girerd Xavier , De Buyer Paul , Boualit Robert , Hanon Olivier , Pathak Atul , Asmar Roland
Published: June 2022

Objective:

To confirm the diagnosis of hypertension with a probability of 99% according to the blood pressure obtained by Home Blood Pressure Monitoring (HBPM) at home after one or two days.

Design and method:

In 3910 subjects followed in a specialist hospital department, 72% of whom were treated with at least one antihypertensive drug, HBPM was performed with 18 measurements over 3 days (3 measurements in the morning and evening). The mean of the 18 measurements was used as the reference value to define ‘hypertension’ status with the thresholds SBP> = 135 or DBP > = 85. Univariate statistical analysis determined the mean SBP/DBP value obtained after day 1 and day 2 to affirm or deny the diagnosis of hypertension at the 99% threshold

Results:

The population, aged 60 ± 13 years, had a mean SBP/DBP of 134 ± 14/81 ± 10 mmHg. With the average of the 3 days of self-measurement to define blood pressure status, the diagnosis of hypertension or normotension was obtained for 44% of the population after the first day and for 73% after the second day.

The values of mean SBP and/or DBP that allowed the diagnosis to be confirmed after 1 or 2 days of self-measurement with the probability of 99% are given in the table:

Conclusions:

It is possible to shorten the HBPM protocol to 1 day in 42% of patients followed for hypertension while maintaining a very high probability of diagnosis of blood pressure status. To allow patients to follow a HBPM protocol adapted to their blood pressure level Applications dedicated to self-measurement should use these results.
IMPROVED OFFICE BLOOD PRESSURE CONTROL BY AUTOMATIC DELAYED-READING OSCILLOMETRIC DEVICE
Authors: Fernandez-Llama Patricia , Coll-Brito Veronica , Calero Francesca , Arias Piedad , Ayasreh Nadia , Ochoa Jackson , Ramos Alejandra , Guirado Luis
Published: June 2022

Objective:

Office blood pressure measurement is a recommended procedure by clinical guidelines. We designed the study to know the degree of blood pressure control by clinical measurement using an automatic delayed-reading oscillometric device.

Design and method:

During one month we collect demographic and clinical data, office attended systolic blood pressure and diastolic blood pressure measured with an automatic device with a delayed start of the measurement and, if performed, data from ambulatory blood pressure monitoring.

Results:

We included 102 patients (67 men), with a mean age of 64.9 years, 30% diabetic and 34% with cardiovascular complications. 70% had a controlled hypertesion (<140/90 mmHg) by office blood pressure, the mean systolic blood pressure was 131 ± 16.5 mmHg and the diastolic blood pressure was 73 ± 9.5 mmHg which is a high percentage compared with other studies. Old age and diabetes were associated with uncontrolled hypertension. Thirty three patients had ambulatory blood pressure monitoring data, which allowed them to be classified according to the 24-hour blood pressure into: 30% true normotension, 9% white-coat hypertension, 15% sustained hypertension, and 45% masked hypertension. Therefore, ambulatory measurements did not confirm the good blood pressure control.

Conclusions:

The use of automatic delayed-reading device reduces the white-coat phenomenon, improving the percentage of patients with office blood pressure controlled. However, this control is not confirmed outside the clinic, showing the importance of ambulatory blood pressure monitoring in the global evaluation of hypertension control. Aspects such as the presence or not of an observer, the number of blood pressure readings and the use of validated automatic devices with or without delayed start of the measurement should be the subject of clinical studies to determine the optimal technique for measuring office blood pressure.
BLOOD PRESSURE MEASUREMENT AMONG PATIENTS WITH PERIPARTUM CARDIOMYOPATHY; CONTROL AND BARRIERS DURING FOLLOW UP
Authors: Farhan Hasan Ali , Yaseen Israa Fadhil
Published: June 2022

Objective:

To identify the frequency of blood pressure (BP) control among patients with peripartum cardiomyopathy (PPCM), barriers for follow up, and causes for elevation of BP.

Design and method:

Data about BP values, control, follow up, and treatment were prospectively documented for patients with PPCM who were presented to the cardio-maternal unit between 2015 - 2020. Baseline BP values were compared with the second readings between six months to one year postpartum. Adherence to medication and identifying the causes of elevated BP were reported.

Results:

Among 64 patients with PPCM presented to the unit, loss of follow up reported in 59.4% of patients; 60.5% for unknown cause, 21.1% due to COVID-19 pandemic, and 18.4 due to death. For 26 (40.6%) patients who adhered to follow up, the mean age was (32.5 ± 7), 61.5% patients had normal BP at baseline and during follow up, while 38.5% of them had elevated BP at baseline or during follow up (cutoff 140/90); 30% showed reduced BP to normal values comparing to their baseline measurements, and 70% developed increased in BP values during follow up (Table 1). All patients with increased BP measurements during follow up had hypertension associated with pregnancy, however, only 28.6% of them had known history of hypertension before pregnancy. Most common anti-hypertensive drug used post delivery was angiotensin-converting enzyme inhibitors 77%. Causes for increased BP measurements during follow up were obesity 57.1%, stress 28.6%, and use of oral contraceptive pills 14.3%.

Conclusions:

Among patients with PPCM with elevated BP at baseline, control of BP was reported in less than one-third of the patients. However, data for more than half of the patients was missing due to loss of follow up which is related to COVID-19 pandemic or mortality, but for the majority of patients the cause was unknown. Factors associated with elevated BP were obesity, stress, and use of oral contraceptive pills. Therefore, future enhancement in patient education regarding the importance of follow up and life style modifications is essential for better BP control among patients with PPCM.
NOCTURNAL BLOOD PRESSURE, NOCTURNAL DIPPING, AND MORTALITY
Authors: de La Sierra Alejandro , Williams Bryan , Gorostidi Manuel , Vinyoles Ernest , Segura Julian , Ruilope Luis
Published: June 2022

Objective:

A blunted nocturnal BP decline is associated with an increased cardiovascular risk. Nevertheless, patients with a reduced BP dip usually have higher levels of nighttime BP, being both parameters clearly related. The aim of the study was to assess the prognostic value of nocturnal BP decline, independently of the presence or not of nocturnal BP elevation.

Design and method:

Vital status and death due to cardiovascular causes were obtained from death certificates in 59110 adults, mostly hypertensives, enrolled in the Spanish ABPM Registry between 2004 and 2014, and having a valid 24-h ABPM at entry. On the basis of BP data, patients were classified in 4 groups: Normal (<120 mmHg) night systolic BP (SBP) and normal (<0.9) systolic night-to-day ratio (NDR). Normal night SBP with elevated (> = 0.9) NDR. Elevated (> = 120 mmHg) SBP with normal NDR and both elevated SBP and NDR. Association between NDR, dipping status and groups combining night SBP and NDR with total and cardiovascular mortality were assessed by Cox models, adjusted for clinical confounders.

Results:

The total number of deaths were 2866 (978 of cardiovascular causes) during a median follow-up of 5 years. NDR predicted total mortality (HR for 1 SD change: 1.19; 95%CI: 1.15–1.23). Both patients with reduced dipping (HR: 1.28; 1.17–1.41) and risers (HR: 1.59; 1.42–1.77) had increased risk of total mortality, whereas extreme dippers (NDR < 0.8) did not. With respect to patients with both normal night SBP and NDR, those with elevated NDR in the absence of elevated night SBP had increased risk of death (HR: 1.36; 1.19–1.55), as well as those with elevated night SBP and normal NDR (HR; 1.40; 1.21–1.62). Those combining both abnormalities had the highest risk (HR: 1.78; 1.60–1.98). Similar results were obtained for cardiovascular mortality.

Conclusions:

Abnormalities in the circadian dipping pattern are responsible for an increased risk of mortality, both total and cardiovascular. Increased mortality rates are observed in patients with a reduced nocturnal dip and, even more intensively, in those with a riser pattern. This abnormal dipping increases the risk of mortality even in the absence of BP elevation.
ARE COMMERCIAL CUFFLESS BLOOD PRESSURE DEVICES BEING VALIDATED?
Authors: Cox James , Louka Kyrollos , Avolio Alberto P. , Tan Isabella , Butlin Mark
Published: June 2022

Objective:

Hypertension is an increasingly prevalent global disease with an overwhelming burden on society and the healthcare system. Undiagnosed hypertension and poor adherence to monitoring have been highlighted in the literature to be a key factor in addressing this issue. Wearable devices are a potential solution to this problem through offering continuous and convenient blood pressure (BP) measurements, unlike current cuff-based approaches. However, the validity of such novel devices is a limiting factor to their integration as a medical tool. This literature review aims to highlight the lack of validity of current commercial cuffless BP devices and the resulting impact on BP measurement and monitoring.

Design and method:

Investigators generated a list of commercial cuffless BP devices and search terms based on a preliminary search performed in Google and literature databases. Google Scholar, PubMed and Scopus were then systematically searched. Articles were included following a criterion on the basis that they must mention a cuffless BP device and have performed a comparison of measurements with a reference device, either cuff-based or invasive. Statistical analyses were then undertaken.

Results:

Two hundred and five search terms were generated. Following the systematic search there were 932 articles captured. After the inclusion and exclusion criteria was applied more than 90% of papers were excluded on the basis that they did not perform a validation, were in another language and/or were not relevant to blood pressure measurement. Of the 205 commercial devices initially searched only 11 of these had performed some sort of validity test. None of the devices had undertaken a validity test in accordance with the 2014 IEEE Standard for Wearable, Cuffless BP Measuring Devices or the 2019 amendment.

Conclusions:

Current cuffless BP devices lack published validity and as a result clinical utility. Performing stringent testing on the accuracy and reliability of devices will result in the progression and acceptance of such devices with the capacity to revolutionise BP measurement and therefore hypertension.
CORRELATION OF BLOOD PRESSURE CHANGES WITH THE FUNCTIONAL CAPACITY IN HEART FAILURE PATIENTS WITH PRESERVED AND MID-RANGE EJECTION FRACTION
Authors: Algamal Abdulsalam , Osman Adel , Elhusseiny Shady , Elshal Abdallah , Salem Mahmoud
Published: June 2022

Objective:

6-minute walk test (6-MWT) reflects the daily activity of heart failure (HF) patients who develop progressive limitation of functional capacity (FC). Our aim was to assess different blood pressure (BP) parameters and their changes after 6-MWT in patients with HF with mid-range ejection fraction (EF) (HFmEF) and HF with preserved EF (HFpEF) and correlate them with the FC assessed by 6-minute walk distance (6-MWD).

Design and method:

Patients presented with clinical manifestations of HF were admitted to Cardiology Department and medically stabilized. 40 HFmEF patients and 50 HFpEF patients underwent 6-MWT according to the American Thoracic Society guidelines 2002. Different BP parameters before and after 6-MWT were recorded including systolic blood pressure, diastolic blood pressure (DBP), mean BP, pulse pressure (PP), and proportionate pulse pressure (PPP) defined as the ratio of PP and SBP. Limited FC was defined as 6-MWD < 300 M. Abnormal BP response to exercise (ABPRE) was defined as a decrease, no increase or an increase of the SBP after exercise by < 20 MMHG.

Results:

The mean 6-MWD was 325.3 ± 56.84 meters (M), 316.1 ± 61.33 M, 332.66 ± 52.44 M in all patients, HFmEF patients, and HFpEF patients respectively. 6-MWD and limited FC showed no significant difference between the 2 groups. Limited FC affected 42.5 % and 33 % of HFmEF and HFpEF patients respectively. ABPRE affected 28 (31.1 %) of patients and was significantly higher in HFmEF than HFpEF patients. Independent predictors of limited FC were lower EF, PP and PPP and higher DBP in HFmEF patients and lower EF in HFpEF patients. Cut-off points for prediction of limited included PP < 32.5 MMHG and PPP < 30.22 % in HFmEF patients, PP < 37.5 MMHG and PPP < 32.67 % in HFpEF patients, and EF < 42.5 % in all patients (figure 1).

Conclusions:

The 6-MWT is well tolerated by HF patients and easy to perform in clinical practice. Simple bed-side measurement of BP parameters correlated with the FC and predicted limited FC in HFmEF and HFpEF patients.
BLOOD PRESSURE ADAPTATIONS AND ARTERIAL STIFFNESS IN THE GENERAL POPULATION
Authors: Johansson Madeleine , Fedorowski Artur , Engström Gunnar , Nilsson Peter M. , Hamrefors Viktor
Published: June 2022

Objective:

Arterial stiffness is independently associated with orthostatic hypotension (OH) in older individuals. The relationship between orthostatic blood pressure (BP) and arterial stiffness has not been thoroughly examined in the younger population. To investigate the relationship between orthostatic BP adaptations, central aortic hemodynamics, and arterial stiffness in the general population of young and mid-aged adults.

Design and method:

A cross-sectional, observational, population-based study of 4223 individuals. We assessed arterial stiffness and central hemodynamics by carotid-femoral pulse wave velocity (c-f PWV) and pulse wave analysis (PWA) at the arteria radialis in relation to an orthostatic BP adaptation after 3 min standing.

Results:

The mean age of the population was 41.9 ± 14.5 years and 52.1% were women. We found that higher standing BP was associated with lower arterial stiffness after full adjustment in both men (unstandardized beta coefficient () -0.09, p = 0.02) and women (-0.08, p = 0.03). An increased diastolic BP on standing was inversely correlated with PWV and central aortic hemodynamics in both younger (PWV -0.01, p = 0.02) and older individuals (-0.02, p = 0.001). The lowest arterial stiffness was observed in the lowest and highest quartiles of standing systolic BP differences (p < 0.001), while a gradual reduction in arterial stiffness was observed across increasing quartiles of standing diastolic BP difference for both PWV and measurements of central aortic hemodynamics (p < 0.001).

Conclusions:

The co-existence of orthostatic hypotension, increased blood pressure variability, and vascular stiffness represents a hemodynamic ageing syndrome with important prognostic implications for public health. Our findings demonstrate that impaired hemodynamic response to orthostatic challenges, traditionally observed in older individuals, are independently and inversely associated with markers of arterial stiffness (vascular ageing) and hemodynamic changes also in a younger population. Further studies are required to assess the relationship between impaired blood pressure adaptations on standing in younger subjects and risk of future incident cardiovascular events.
THE ROLE OF MILD SEDATION AND/OR ANALGESIA IN THE NURSING CARE OF PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION. EMPHASIS ON BLOOD PRESSURE AND PATIENTS’ PERCEPTIONS OF RESILIENCE AND SELF-COMPASSION
Authors: Sarrou Maria , Skoularigkis Ioannis , Stougiannos Pavlos , Trikas Athanasios
Published: June 2022

Objective:

Percutaneous coronary interventions create stress and anxiety in patients, which usually affect blood pressure. Safe sedation is considered cornerstone therapy as relieves stress and pain. In chronic heart diseases the patient tries to negotiate the challenges of his illness which often aggravate his anxiety. The patient experiences the inability to manage and respond to others and/or his expectations, and as a result he “hurts” himself mentally. Self-compassion and self-esteem contribute to resilience. Resilience is a protective psychological factor in heart diseases.

Purpose: The purpose of the research is the nursing monitoring and recording of the effects of the administered mild sedatives or analgesia during a percutaneous coronary intervention and the patients’ perception of the care provided.

Materials & Method: Questionnaires were used, answered by cardiac patients undergoing percutaneous coronary interventions (coronary angiography and angioplasty). The sample of participants is 100 people, where the 50 received midazolam (Dormixal) and fentanyl (Fentanyl) (group 1) five minutes before the examination and the remaining 50 did not (group 2). Blood pressure was measured and recorded before the start of the procedure, during, and at the end of it, in both groups to investigate a possible effect of the treatment.

Design and method:

During those three periods, there was a significant change in blood pressure (decrease) after the procedure in group 1 (120.76. 10.75 versus 129.86 ± 22.26 in group 2, p = 0.007). In group 1 the self-compassion scale was significantly and negatively correlated with the STAI scale and positively with the Connor scale. Those with a moderate financial level were less resilient while those with a high financial level showed less stress.

Results:

The majority of studies use these medications based on the adoption of the line “zero pain tolerance” in order to reduce or eliminate it. This difference is indicative of a possible effect of the treatment on the change (reduction) of blood pressure. In addition, it turns out that the higher the self-compassion, the greater the resilience and lower the stress
BLOOD PRESSURE VARIABILITY AND MIND COGNITION IMPAIRMENT: A SYSTEMIC REVIEW AND META-ANALYSIS
Authors: Zhao Xu , Lin Xin , Kou Chenkun , Wang Qiongying , Yu Jing
Published: June 2022

Objective:

Blood pressure variability is hypothesized to play important role in development of cognition impairment. We aimed to explore the relationship of blood pressure variability and cognition impairment.

Design and method:

We searched the following databases, EMBASE, Cochrane Library, Web of Science, up to October 2021 using blood pressure variability, cognition impairment, cognition dysfunction. Randomized double blind and observational trials were included. Dementia and Alzheimer’s disease cases were excluded. Two reviewers confirmed the inclusion of studies and extracted the data independently. STATA V.15.1 was used to synthesize data.

Results:

We included 23 studies and enrolled 42964 hypertensive patients. All studies assessed cognition function using Mini-Mental State Examination (MMSE) or other cognition function test. Ambulatory blood pressure variability, visit-to-visit blood pressure variability, measure to measure blood pressure variability, day-to-day blood pressure variability and beat-to-beat systolic blood pressure variability were applied in included trials. The variability of systolic blood pressure has significant relationship with cognition impairment (OR,1.747[1.25,2.44], P < 0.01), however, the variability of diastolic blood pressure did not show relationship with decreasing cognition function scale(OR,0.912[0.81,1.03], P> 0.05) by nalysing data which trial used MMSE scale. Results showed higher systolic blood pressure variability had negative relationship with attention (OR,1.63, [1.28,1.98], P < 0.01). In the aspect of memory and language function, blood pressure variability did not show a significant relationship. Higher blood pressure variability in both systolic and diastolic was associated with lower hippocampal volume and cortical infarcts.

Conclusions:

The variability of systolic blood pressure is dependently risk factor for cognition impairment in older adults with hypertension. For unsuccessfully treated hypertensive individuals (with blood pressured more than 140/90 mmHg),higher variability in both systolic and diastolic blood pressure was associated with cognitive damage, but these associations were not found in those controlled hypertension older adults.
RELATIONSHIP OF 24-HOUR AMBULATORY BLOOD PRESSURE VARIABILITY WITH MICRO- AND MACROVASCULAR PARAMETERS AND HYPERTENSION STATUS
Authors: Papadopoulou Stella-Lida , Gkaliagkousi Eugenia , Dipla Konstantina , Koletsos Nikolaos , Zafeiridis Andreas , Karamaounas Polykarpos , Stergiou George S. , Douma Stella , Triantafyllou Areti
Published: June 2022

Objective:

Existing evidence shows that increased values of blood pressure variability (BPV) are associated with a higher risk of subclinical organ damage and cardiovascular events, independently of elevated average BP values. We sought to investigate the relation of novel BPV indices with micro- and macrovascular parameters that have not all been previously studied and to identify differences according to hypertension status.

Design and method:

We evaluated the relationship between BPV indices and micro- and macrovascular parameters in a selected population of 344 individuals (233 never-treated, newly diagnosed hypertensive and 111 normotensive individuals).Using data from 24-h ambulatory blood pressure monitoring device, BPV was assessed by average real variability (ARV) during 24-hours, daytime and nighttime and as systolic weighted standard deviation (wSD). Nonmydriatic retinal photography was used to assess retinal microvascular diameters. Arterial stiffness was evaluated by measurement of pulse wave velocity(PWV) and aortic augmentation index (AIx). Myocardial perfusion was evaluated using subendocardial variability ratio (SEVR).The carotid intima-media thickness (cIMT) was measured by ultrasound. We performed a multiple regression analysis for all the parameters which were statistically significant in the univariate analyses.

Results:

After adjusting for potential confounders, all vascular parameters [venular retinal diameter (p = 0.036), PWV (p < 0.007), cIMT (p < 0.06)], except for SEVR were independently associated with ARV components in the total population. Further analysis based on hypertension status showed that in hypertensives only macrocirculation indices such as PWV and cIMT were independently associated with ARV (for PWV: 24-h systolic, p = 0.025, nighttime systolic, p = 0.001 and nighttime diastolic, p = 0.012 respectively; and for cIMT, p = 0.001 for both 24-h and daytime systolic). In normotensive individuals, venular diameter was associated with 24-h systolic and diastolic and daytime systolic and diastolic ARV (p = 0.004, p = 0.002, p = 0.001 and p = 0.049 respectively). The arteriovenous ratio was associated with daytime systolic ARV (p = 0.022), and AIx was associated with daytime diastolic ARV (p = 0.022). None of the univariate correlations between vascular parameters and wSD remained significant after adjustment for potential confounders.

Conclusions:

We concluded that short-term BPV represented by ARV is independently associated with macrovascular parameters in untreated hypertensive patients and microvascular parameters in normotensives.
ASSOCIATION OF SHORT-TERM BLOOD PRESSURE VARIABILITY WITH DIABETES IN HYPERTENSIVE INDIVIDUALS
Authors: Sousa Andréa Cristina , Magalhães Fabrício Galdino , Silva Suelen Benta , Simeoni Adélia Rocha , Inuzuka Sayuri , Batista Sandro Rogério , Vale Raquel Mendonça , De Souza Weimar Kunz Barroso , Sousa Ana Luiza Lima
Published: June 2022

Objective:

Evaluation of short-term blood pressure (BP) variability and its associations with blood pressure measurements, in the different periods nalysed by Ambulatory Blood Pressure Monitoring (ABPM), in hypertensive patients with or without diabetes.

Design and method:

Analytical cross-sectional study, developed with a database containing 25-year historical series (1993 - 2018) of ABPM exams; diabetes is considered as comorbidity for hypertension. Variables nalysed: Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) of 24 h, daytime and nighttime; Standard deviation; coefficient of variation SBP and DBP, nocturnal drop, age and body mass index. Accomplished logistic regression analysis, Confidence Interval of 95% and 5% of significance level.

Results:

Analyzed 1591 exams, identified 281 (17.7%) as diabetic hypertensives. Diabetics were older, (63.0; ± 10.9) than non-diabetics 57.7 (±13.9) and also had higher body mass index (28.9; ± 5.0 - 26.7; ± 4.4); with similar gender distribution. A higher proportion of uncontrolled nocturnal BP was identified among diabetics with 77.5% and 68.1% among non-diabetics. In the multivariate logistic regression analysis, considering in the model the presence or absence of DM as the dependent variable, the associated predictor variables were age (OR 1.04; 95% CI 1.01 - 1.08); media DBP in wakefulness (OR 1.34; IC95% 1.04 - 1.85), IMC (obese/non obese) (OR 2.35; 95%CI 1.18 - 4.66). The Coefficients of variation of blood pressure, systolic or diastolic, showed no significant association with the presence of DM morbidity along with HA. Analysis of the medium Coefficient of Variation of Systolic Blood Pressure showed decreasing measures in 24 hours, daytime, nighttime, similarly between diabetics and non-diabetics. A total of 229 (83.3%) no dipper diabetics and 973 (74.5%) of non-diabetics were identified. (p = 0,002). Diabetics had significantly lower control rate than non-diabetics in the 24-hour period and during nigttime.

Conclusions:

It was identified that diabetic hypertensives were older, had lower blood pressure control during the nighttime period, with a lower proportion of non-dippers and were more obese. The pressure variation coefficients showed the same pattern between diabetics and non-diabetics.
CORRELATION BETWEEN BP VARIABILITY, INSULIN RESISTANCE AND MICROALBUMINURIA
Authors: Sapojnic Nadejda , Bitca Angela , Caraush Alexandru , Durnea Aliona , Moscal Vitalie
Published: June 2022

Objective:

Fueled by a global pandemic of cardiovascular diseases, hypertension (HT) remains the leading cause of early mortality in the world. Blood pressure variability (BPV) is considered to be in relation to a worse prognosis. Disrupted blood pressure variability (BPV) and insulin resistance (IR) often coexist as” satellite conditions”. This association potentiate the target organ damages (TOD). Microalbuminuria (MA) is an important biomarker of extra-cardiac damage, and subsequently, hypertension and/or carbohydrate metabolism’s alteration can lead to abnormalities in urinary albumin excretion. Each of these conditions can increase adverse hazards per se or via promoting hypertension or extracardiac injuries.

Aim: To determine the correlation between disrupted BPV, level of carbohydrate metabolism’s alteration and microalbuminuria.

Design and method:

101 patients with essential hypertension (49,5% men; mean age 50,11 ± 0,79 years, mean BMI 24.4 ± 0.5 kg/m2; eGRF > 60 ml/min/1.73m2) with excessive BPV (systolic BP> 15 mmHg; diastolic BP > 14 mmHg), IR and microalbuminuria. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE), HOMA-IR and Ma were performed. The BPV was referred to the software analysis of ABPM data. To define IR was used The Homeostasis Model Assessment of insulin resistance (HOMAIR) levels; threshold values was considered > 2. MA was appreciated according to the current guidelines (30–300 mg/24 h). Correlation analysis was performed using Pearson’s test. The correlation coefficient was considered weak at < 0.3, medium-0.3–0.7 and strong> 0.7–1.0. Statistical significance was appreciated at a P-value < 0.05 and highly significant at a P-value < 0.001.

Results:

Excessive BPV, HOMA-IR and MA indices demonstrate a statistically significant correlation (p < 0.001). Systolic BPV demonstrated a particularly strong relationship with higher HOMA-IR levels and MA (p < 0.05) (Table 1).

Conclusions:

In hypertensive patients, disrupted BP variability strongly correlates with microalbuminuria and carbohydrate metabolism abnormality. This association appears to have a particularly strong relationship with systolic BPV and correlates with higher HOMA-IR levels.
ISCHEMIC REPERFUSION INJURY IN HYPERTENSIVE RAT HEART
Authors: Lin Zhijun , Zhang Yin Hua
Published: June 2022

Objective:

In patients with cardiovascular disease, myocardial ischaemia reperfusion damage is the leading cause of death. Sustained myocardial ischaemia–reperfusion causes cardiomyocyte death and coronary microvascular injury in different ways. Patients with hypertension who undergo cardiac ischemia-reperfusion have more severe clinical outcomes.

Design and method:

The mechanism, on the other hand, is missing. We use an angiotensin II successfully produced hypertension rat model to investigate the effect of hypertension on cardiac ischemia-reperfusion injury. We successfully established in vitro myocardial ischemia-reperfusion in normal and hypertensive rat hearts using the Langendorff perfusion system.

Results:

Our results reveal that after 30 minutes of ischemia and an hour of reperfusion, the beating pattern of the hypertensive heart was poorer than that of the sham heart.

We also used a Transmission Electron Microscope to examine the morphology of myocardial cells and mitochondria, and discovered that the mitondria structure was dramatically destroyed in the hypertension model compared to the sham model, and that some myocytes in the hypertension model have abnormal morphology after 30 minutes of ischemia and an hour of reperfusion.

To assess mitochondrial function, mitochondria were extracted from an ischemia-reperfused heart and Mitochondrial Function Indexes were calculated. When oligomycin was used to block ATP synthase, the formation of reactive oxygen species (ROS) and mitochondrial membrane potential MMP increased considerably in the hypertension group. Furthermore, when FCCP was utilized as a proton collapser and antimycin A was used to block mitochondrial complex III, the generation of reactive oxygen species (ROS) mitochondrial membrane potential MMP in the hypertension group rose significantly at add additional oil substrate. When the hypertension group is given the substrate succinate or oligomycin to block ATP synthase, oxygen consumption increases significantly.

Conclusions:

Taken together, our research reveals that hypertension can significantly increase the damage caused by myocardial ischemia reperfusion. As a result, hypertension during myocardial ischemia should be given special attention.
EFFECT OF CHOLECALCIFEROL ON RATE OF MORNING BLOOD PRESSURE RISE IN WOMEN WITH ARTERIAL HYPERTENSION IN PREMENOPAUSAL AND EARLY POSTMENOPAUSAL PERIODS
Authors: Kezhun Liudmila
Published: June 2022

Objective:

To assess effect of cholecalciferol on rate of morning blood pressure (BP) rise in women with arterial hypertension (AH) in premenopausal and early postmenopausal periods.

Design and method:

We investigated 102 women with AH stage II risk 3 aged 50 (48; 53) years: 50 females in premenopausal period – group I and 52 females in early postmenopausal period – group II. Serum level of 25(OH)D was determined by the immunoenzymatic assay. In groups I and II we identified subgroups with the level of 25(OH)D< 30ng/ml: subgroup IB (n = 25) and subgroup IIB (n = 21) respectively, in which antihypertensive therapy was supplemented with cholecalciferol 2,000 IU/day for 3 months. In subgroups IA (n = 25) and IIA (n = 31) cholecalciferol was not administered. The rate of morning BP rise was calculated by the ratio of the BP rise value to its time using daily monitoring of BP.

Results:

At baseline the level of 25(OH)D was lower (p < 0,05) in subgroups IB (19,3 ± 8,5ng/ml) and IIB (18,2 ± 9,5ng/ml) than in the comparable subgroups IA (26,7 ± 11,5ng/ml) and IIA (27,4 ± 10,5ng/ml). After supplementation the level of 25(OH)D increased (p < 0,001) in subgroup IB (37,28 ± 11,97ng/ml) and in subgroup IIB (36,4 ± 10,0ng/ml), and became higher (p < 0,001) than in the comparable subgroups I and IIA. At baseline, subgroups IA and IB did not differ (p > 0,05) by rate of morning SBP/DBP rise. In subgroup IIB rate of morning DBP rise was higher (p = 0,04) than in subgroup IIA. After therapy in subgroup IB there was a decrease rate of morning SBP/DBP rise (p < 0,05); in subgroup IA, rate of morning SBP/DBP rise did not change (p > 0,05). In subgroup IIA, there was no decrease (p = 0.62) rate of morning DBP rise, while in subgroup IIB, rate of morning DBP rise in the decreased (p < 0,05) compared to the baseline and in comparison with rate of morning DBP rise in subgroup IIA after therapy (p = 0,04). The contribution of cholecalciferol to the dynamics of rate of morning DBP rise was established: F = 4,33, p = 0,04.

Conclusions:

Correction of 25(OH)D level by intake of cholecalciferol 2000 IU/day for 3 months leads to reduction of rate of morning BP rise in women with AH.
EFFECT OF NIFEDIPINE GITS OR RAMIPRIL ON BLOOD PRESSURE VARIABILITY IN PREVIOUSLY UNTREATED HYPERTENSIVE PATIENTS: RESULTS OF REVERENT RANDOMIZED TRIAL
Authors: Bilo Grzegorz , Kyriakoulis Konsrtantinos , Liu Chang-Yuan , Soranna Davide , Ceravolo Isabella , Cassago Silvia , Zhang Wei , Kollias Anastasios , Pengo Martino F. , Zambon Antonella , Wang Jiguang , Stergiou George S. , Parati Gianfranco
Published: June 2022

Objective:

Blood pressure (BP) variability (BPV) independently predicts adverse outcomes, making it a potential target for treatment. Preliminary data indicate that dihydropyridine calcium channel blockers (CCB) may reduce BPV more than other antihypertensives but data from ad hoc andomised trials are missing. Aim of REVERENT (Reducing blood pressure Variability in Essential hypertension with Ramipril andom Nifedipine GITS) Trial was to compare changes in short-, mid- and long-term BPV in patients treated with a CCB (nifedipine GITS) or an ACE inhibitor (ramipril).

Design and method:

Untreated (treatment-naïve or after treatment washout) patients with mild to moderate essential hypertension and elevated basal BPV (SD of home SBP> 7 mmHg and/or SD of daytime ambulatory SBP> 12 mmHg), were andomised to open label treatment with nifedipine GITS 30 mg or ramipril 10 mg once daily. BPV after 10 weeks and 12 months of treatment was assessed based on home (primary endpoint; validated A&D UA-651BLE monitor), 24-hour ambulatory (A&D TM 2430) and office (A&D UA-651BLE) measurements and expressed as standard deviation (SD) of obtained readings.

Results:

156 patients were included in the intention-to-treat analysis of the main study (10 weeks, primary analysis) and 138 of the extension study (12 months, exploratory analysis). No significant differences were observed between groups at baseline. Patient characteristics, BP and BPV values after 10 weeks of treatment are reported in the table (Table). No significant differences between groups were observed in home and office BPV at the end of main study, also after adjusting for mean BP reduction. 24-hour weighted SD of systolic BP after 10 weeks of treatment was lower in the nifedipine GITS group (p = 0.032) (Table). Exploratory analysis also revealed lower office systolic BPV after 12 months of treatment in nifedipine GITS group (7.2 ± 3.8 vs 9.0 ± 5.3 mmHg, p = 0.026).

Conclusions:

The study did not identify differences between nifedipine GITS and ramipril in their effect on home BPV, while significant differences in favour of nifedipine GITS were observed in 24-hour and office systolic BPV after 12 months. Clinical impact of these findings remains to be evaluated in outcome studies.
RHOA/ROCK PATHWAY PARTICIPATES IN THE STUDY OF RELATED MECHANISMS OF APATINIB IN THE TREATMENT OF BREAST CANCER-INDUCED HYPERTENSION
Authors: Wang Wenjuan , Zhan Haodong , Wang Qiongying , Zhuang Chenchen , Li Caie , Fan Xin , Qi Miaomiao , Sun Runmin
Published: June 2022

Objective:

To explore activation of the RhoA/ROCK pathway whether involved in the mechanism of apatinib in the treatment of breast cancer-induced hypertension and whether ROCK pathway inhibitors can prevent and reverse the increase in blood pressure and target organ damage caused by apatinib in the treatment of breast cancer, thus confirming its therapeutic effect on this type of hypertension.

Design and method:

Thirty female Balb/c nude mice aged 4–6 weeks and the human breast cancer cell MDA-MB-231 were used for breast cancer tumorigenesis. Mice were randomly divided into 5 groups, each with 6 mice; 1): no tumor model, 2): just tumor model; 3): high-salt diet (giving customized 8% high-salt feed); 4) apatinib 50 mg/kg.d; 5): apatinib 50 mg/kg. d + Y27632 10 mg/kg. d. After the tumor grew to the target volume of 100–150mm3, intervention was performed for 3 weeks, blood pressure was measured weekly, and body weight was measured every day.

Results:

1. The blood pressure of the fourth group was higher than other groups. 2. The ventricular thickness of the mice in the third and fourth groups was thicker than the first and second groups, and the fifth group was less than the fourth group. 3. Masson staining of mice aorta from strong to weak is: the fourth group, the third group, the fifth group, the second group, the first group. 4. The results of mice aortic mRNA and Western Blot showed that RhOA and ROCK1 in the third, fourth, and fifth groups were higher than those in the first and second groups, and the fifth group was lower than the fourth group. 5.The mice aortic immunohistochemistry show that the third and fourth groups of COLI and COLIII are higher than the first and the second group, the fifth group has a lower than the fourth group.

Conclusions:

The RhoA/ROCK pathway is involved in the apatinib-induced hypertension. After applying apatinib to breast cancer, the blood pressure, the vascular stiffness, the Endothelin-1, RhoA/ROCK pathway protein and mRNA are increased, the endothelial function decreased, and RhoA/ROCK pathway inhibitors can prevent and reverse the changes by apatinib.