bluuebunny/crossref_metadata_2025 huggingface dataset:
METABOLIC SPECIFICITIES AND CARDIOVASCULAR MORBIDITY AND MORTALITY BETWEEN BLACK AND WHITE HYPERTENSIVE POPULATIONS OF SOUTHERN ALGERIA
Authors: Cherif Abdelghani Bachir , Bennouar Salam , Temmar Mohamed
Published: May 2024

Objective:

The objectives of the study are to analyze the long-term fate of the black hypertensive subjects in Algerian oases in southern Algeria, in terms of morbidity and mortality, comparing the morphometric profile, metabolic and cardiovascular complications with the white population of the same oases.

Design and method:

One thousand two hundred and twenty-nine subjects of both sexes were included (618 blacks and 611 white subjects), aged 40 and older, living in the Algerian Sahara and were reviewed after six years of decline. The control consisted of filling a questionnaire oriented on civil status, metabolic balance, target organ damage, the number of hospitalizations and mortality. All calculations and statistical analyzes are processed by the SPSS 25.0 software.

Results:

The mean age for the black population and the white population was 60.3 ± 11.1 and 58.6 ± 10.6 years, respectively. The metabolic syndrome (MS) frequency is 20.8%, more frequent among women than among men, with a significant difference (28.4% versus 15.1%, P < 0.001). We found out a difference between black and white populations in terms of obesity (37.6% versus 31.1%), hypertension (60.6% versus 55.0%), diabetes (25.2% versus 19.2%) or other MS criteria. The most frequent complications according to decreasing frequency are: hospitalization for cardiovascular diseases 8.9%, stroke 6.3%, heart failure 5.8%, myocardial infarction 3.6%. The mortality rate is 5.7% among the blacks and 4.3% among the whites with difference. The survival rate of the population is influenced by the MS and by a non-checked blood pressure by an antihypertensive treatment.

Conclusions:

These data on hypertension black subjects emphasize the importance of a policy of adequate local health issues raised, both in terms of the management of hypertension, as in investment in local medical research. It is necessary to elaborate an adequate strategy to prevent such cardiovascular morbidity and mortality.
EVALUATION OF PROGNOSTIC BIOLOGICAL MARKERS ON PATIENTS WITH HEART FAILURE
Authors: Ouankou Christian Ngongang
Published: May 2024

Objective:

This study aims to determine the clinical and biological risk factors and the prognostic biological markers of heart failure at the cardiology service of the Yaoundé University Hospital Center and at the Yaoundé Medical Cardiology Center.

Design and method:

This was a descriptive cross-sectional study that targeted patients who came for consultation at the cardiology department of the Yaoundé University Hospital over the period from March to May 2021. The data was collected using a semi-structured questionnaire administered in face-to-face after obtaining informed consent from the participants. Subsequently, a blood sample was taken and the serum was analyzed by spectrophotometry. Several functions have been explored by measuring different biological markers. Data were stored in Ms-Excel software and statistical analyzes were performed using SPSS and EpiInfo 7.2.2.16 software.

Results:

A total of 51 patients agreed to participate in our study, of which 54.9% (28/51) were women with a sex ratio of 1.22 in favor of women. The age ranged from 17 to 94 years with an average of 64 ± 15 years. In total 68.62% (35/51) of the patients were hypertensive, 35.29% (18/51) had stage 4 dyspnea with or without orthopnea and 88.24% (45/51) had an NT- high pro-BNP. The association between biological markers and prognostic factors showed that GFR and a high INR value were respectively associated with the presence of atrial fibrillation and high PAPS. Our study recorded 11.76% (6/51) of deaths and all of its patients had at least two abnormal prognostic markers, both biological and non-biological. The most frequent etiological factor was arterial hypertension and hyperuricaemia. Other markers, such as the elevation of NT-Pro-BNP, impaired renal and hepatic functions, hyponatremia were related to echocardiographic and electrocardiographic prognostic parameters and could be used as alternative solutions in our context.

Conclusions:

The elevation of NT-Pro-BNP, impaired renal and hepatic functions, hyponatremia were related to echocardiographic and electrocardiographic prognostic parameters and could be used as alternative solutions in our context.
GENDER DIFFERENCES IN CARDIAC ORGAN DAMAGE IN ARTERIAL HYPERTENSION: ASSESSING THE ROLE OF DRUG NONADHERENCE
Authors: Aune Arleen , Ohldieck Annbel , Halvorsen Lene V. , Brobak Karl Marius , Olsen Eirik , Rognstad Stine , Larstorp Anne Cecilie K. , Søraas Camilla L. , Rossebø Anne B. , Rossner Assami , Grytaas Marianne Aa. , Gerdts Eva
Published: May 2024

Objective:

Cardiac organ damage is more prevalent in women than men with hypertension, however, the mechanisms underlying this gender difference remain unclear. A possible role of gender differences in drug adherence has recently been suggested.

Design and method:

We assessed left ventricular (LV) hypertrophy and left atrial (LA) enlargement by echocardiography in 186 women and 337 men with uncontrolled hypertension defined as daytime systolic blood pressure (BP) </= 135mmHg despite the use of at least two antihypertensive drugs. Drug adherence was assessed by measurements of serum drug concentrations interpreted by an experienced pharmacologist. Aldosterone-renin-ratio (ARR) was measured on actual medication.

Results:

Women had a higher prevalence of LV hypertrophy (46% vs. 33%) and LA enlargement (79% vs 65%, both p<0.05) than men. Women were older, and had lower serum renin concentration and higher ARR, whereas the prevalence of obesity (43% vs. 50%), 24-h systolic BP (141±9 mmHg vs. 142±9 mmHg), and drug nonadherence (8% vs. 9%, all p>0.10) were comparable between genders. After adjusting for these potential confounders, female gender was independently associated with a two-fold increased risk of LV hypertrophy (OR 2.01[95% CI 1.30-3.10], p=0.002) and LA enlargement (OR 1.90 [95% CI 1.17-3.10], p=0.010), while no association with drug adherence was found. Higher ARR was independently associated with LV hypertrophy in men only (OR 2.12 [95% CI 1.12-4.00] p=0.02).

Conclusions:

Among patients with uncontrolled hypertension, the higher prevalence of LV hypertrophy and LA enlargement in women compared to men was not associated with drug nonadherence.
ASSOCIATION OF THE METABOLIC SCORE FOR INSULIN RESISTANCE WITH INCIDENT HEART FAILURE IN PATIENTS WITH HYPERTENSION
Authors: SHEN DI , Cai Xintian , Li Nanfang
Published: May 2024

Objective:

The association of the metabolic score for insulin resistance (METS-IR) with heart failure (HF) risk in hypertensive patients remains uncertain. This study aimed to examine the relationship of the METS-IR with incident HF in hypertensive patients.

Design and method:

A total of 12,066 patients, free of prior HF, were enrolled. Using multivariable Cox regression models, hazard ratios (HRs) and 95% confidence intervals (CIs) for HF were calculated.

Results:

464 incident HF events were identified over a median follow-up of 5.00 years. Increases in METS-IR per SD were linked to a higher risk of HF (adjusted HR: 1.17; 95% CI: 1.07, 1.28). When METS-IR was evaluated as quartiles, compared with those in the first quartile, the adjusted HRs (95% CI) of incident HF in participants in the second, third, and fourth quartiles were 1.02 (0.77, 1.35), 1.26 (0.97, 1.64), and 1.43 (1.10, 1.85), respectively. Each 1 SD increase in METS-IR was significantly associated with a 17% increase in HF incidence after multivariate adjustment using Model 3. However, restricted cubic spline analysis showed no dose-response connection between METS-IR and HF risk (P for non-linearity = 0.113).

Conclusions:

In summary, the current investigation has discovered that elevated METS-IR is associated with an increased risk of HF in hypertensive patients. If more research supports our findings, METS-IR might be a helpful and practical indicator for the early identification of hypertensive patients at high risk of HF.
EFFECTS OF PROTEINURIA ON MUSCLE OXYGENATION AND MICROVASCULAR REACTIVITY IN PATIENTS WITH PRE-DIALYSIS CKD: A POST-HOC ANALYSIS
Authors: Theodorakopoulou Marieta , Zafeiridis Andreas , Dipla Konstantina , Faitatzidou Danai , Koutlas Aggelos , Iatridi Fotini , Karagiannidis Artemios , Stamatiou Anastasia , Doumas Michael , Papagiannid Aikaterini , Sarafidis Pantelis
Published: May 2024

Objective:

Vascular dysfunction is a hallmark of CKD. Previous studies showed an impaired microvascular reactivity in the skeletal muscles, which deteriorates in advanced CKD stages. This analysis aims to examine the impact of proteinuria on skeletal muscle oxygenation and microvascular reactivity at rest, during an occlusion-reperfusion maneuver, and during exercise in patients with pre-dialysis CKD.

Design and method:

66 patients with CKD stage 2-4 were included in this post-hoc analysis; 24-h urine samples were used for evaluation of proteinuria. Continuous measurement of muscle oxygenation [tissue saturation index (TSI%)] via near-infrared-spectroscopy at rest, during occlusion-reperfusion and during a 3-min handgrip exercise (at 35% of maximal-voluntary-contraction).

Results:

The study groups were similar in terms of age (proteinuric vs nonproteinuric: 68.4±10.6 vs 67.2±10.8; p=0.676), eGFR (41.3±18.9 vs 46.3±14.8; p=0.248) and BMI (28.4±4.9 vs 28.1±4.8; p=0.803). Resting muscle oxygenation did not differ between study groups (proteinuric vs nonproteinuric: 63,35±4,09 vs 62,34±3,21; p=0.280). During occlusion, proteinuric CKD patients had marginally lower TSI occlusion magnitude (25,77±7,87 vs 29,95±10,34; p=0.074) but no difference in occlusion slope (-0,09±.,03 vs -,10±.,04; p=0.134). During reperfusion, the TSI reperfusion slopes were significantly lower in proteinuric CKD (slope to max 1,03±.,45 vs 1,39±.0,69; p=0.035 and 10-sec slope: 1,34±.,63 vs 1,92±.,75; p=0.002); hyperemic response was numerically lower in proteinuric CKD (7,13±.4,27 vs 8,89±.4,68; p=0.131). Finally, during exercise no differences were detected in the average muscle oxygenation between-group (10,76±6,05 vs 10,65±5,39; p=0.943).

Conclusions:

Although no differences in resting muscle oxygenation were detected, CKD patients with proteinuria showed more impaired skeletal muscle oxidative capacity (as suggested by lower TSI magnidute during occlusion), and miscrovascular reactivity during reperfusion.
ARE THERE ANY ASSOCIATION BETWEEN DIASTOLIC AREA INDEX MEASURED BY ARTERIOGRAPH, RENAL FUNCTION AND N-TERMINAL PROHORMONE OF BRAIN NATRIURETIC PEPTIDE IN CHRONIC KIDNEY DISEASE?
Authors: Sági Balázs , Vas Tibor , Csepregi Rita Klaudia , Horváth-szalai Zoltán , Csiky Botond , Nagy Judit , Kovács Tibor József
Published: May 2024

Objective:

IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide. Arterial stiffness may predict cardiovascular (CV) mortality and morbidity in chronic kidney disease (CKD). Diastolic area index (DAI) shows the diastolic cycle interval and may deduce to the coronary perfusion. There is limited data in the literature about the association between the DAI, the renal function and N-terminal prohormone of brain natriuretic peptide (NT-proBNP).

Design and method:

In our cross-sectional study, we examined 89 patients who cared for IgAN in our clinic. Arterial stiffness was determined by measuring pulse wave velocity of the aorta (PWVao) and aortic systolic pressure (SBPao) and DAI was calculated using the Arteriograph. NT-proBNP was measured using ELISA kits. Renal function was detected by the estimated glomerular filtration rate (eGFR-CKD-EPI). Furthermore, a routine echocardiography examination was performed.

Results:

Of the 89 patients included in the study, 50 were male, with a mean age of 54.9 ± 14.4 years. Patients were divided into five groups based on eGFR (CKD 1,2,3,4 and 5). There were significantly higher NT-proBNP (p=0.022, p=0.001) and lower DAI (p=0.007 and p=0.003) in CKD 4 and 5 compared to CKD 1 group. The PWV (p <0.001, p=0.022), and central aortic systolic pressure (p = 0.043, p=0.085), showed significant elevation with the worsening renal function. DAI showed a negative correlation with NT-proBNP (corr. coeff:-0,282, p=0.012), and a postivie correlation with eGFR (corr. coeff.: 0.331, p=0.003). SBPao and PWVao showed negative correlations with DAI (corr. coeff:-0,307, p=0.029 and -0,366, p=0.001) by Spearman's correlation. Only eGFR was an independent predictor of DAI and NT-proBNP by linear regression analysis.

Conclusions:

Decreasing DAI could be a possible mechanism for the development of abnormal myocardial remodelling in CKD patients, in which may help the elevation of the central aortic systolic pressure causing increased PWV and more CV complications in CKD.
ASSOCIATION BETWEEN LOW LEVEL BLOOD LEAD EXPOSURE AND MORTALITY IN US ADULTS WITH CHRONIC KIDNEY DISEASE
Authors: Wang Tianbo , Huang Gang , Xu Junbo , Wu Jin , Liu Xiaohan , Zhang Zhen
Published: May 2024

Objective:

This study aimed to explore the association between blood lead and both chronic kidney disease (CKD) and cardiovascular and all-cause mortality among participants with or without CKD in the US adults.

Design and method:

Date from the National Health and Nutrition Examination Survey (2007-20018) was used and all participants were followed up regularly until December 31, 2019. CKD was defined as an eGFR <60 ml/min/1.73 m2 and/or a urine albumin and creatinine ratio >= 30 mg/g. Logistic regression models were constructed to explore the associations between blood lead and CKD. The Kaplan–Meier analysis with a log-rank test was performed to estimate the cumulative incidence of mortality between groups. Cox proportional-hazards models were used to explore the associations between blood lead and cardiovascular and all-cause mortality.

Results:

Totally, this study enrolled 22,951 participants, including 4,078 CKD participants. Multivariable logistic regression analysis showed that higher level of blood lead (>=1.82 vs. <0.73) was associated with the increased risk of CKD (OR:1.35, 95% CI: 1.13–1.62, p=0.001). During a mean follow-up duration of 85.21±43.58 months, a total of 2,139 all-cause mortality and 525 cardiovascular mortality were recorded. In multivariable Cox model, compared with the lowest quartiles, highest blood lead level (>=1.82 vs. < 0.73) was associated with a higher risk of cardiovascular mortality (HR:3.36, 95% CI: 1.32–8.53) and all-cause mortality (HR:1.85, 95% CI: 1.18–2.90) in participants with CKD.

Conclusions:

In conclusion, in this US cohort, low level blood lead exposure may also be a predictive factor for CKD, and increasing blood lead concentrations significantly contributed to enhanced risk of cardiovascular and all-cause mortality in CKD patients. Hence, the reduce of blood lead exposure may reduce risk of mortality in high-risk individuals with CKD.
THE COHORT STUDY OF ADIPOCYTES’ SECRETORY ACTIVITY, VITAMIN D, PARATHYROID HORMONE, LEPTIN RESISTANCE AND OBESITY IN HYPERTENSIVE PATIENTS
Authors: Sydorchuk Andrii , Tymkul Diana , Sydorchuk Larysa , Voronyuk Ksenia , Sokolenko Alina , Yarynych Yulia , Semianiv Marianna , Repchuk Yulia , Kazantseva Tania , Petrynych Oksana , Ivaschuk Serhii , Sydorchuk Ruslan
Published: May 2024

Objective:

Obesity is a major risk factor of essential arterial hypertension (EAH). Therefore, we studied the dependence of 25-OH vitamin D (VitD), parathyroid hormone (PTH), Adiponectine, Leptin and ionized calcium blood values on Obesity degrees in EAH patients.

Design and method:

Study involves 100 EAH patients with hypertensive-mediated organ damage (moderate-very-high cardiovascular risks, aged 45-65). Obesity was determined by body mass index (BMI) >30 kg/m2: 1st obesity degree – 30-34.9 kg/m2, 2nd – 35-39.9 kg/m2, 3rd – >40 kg/m2. Serum levels of VitD and PTH studied by immunochemiluminescent method, Ca2+– by potentiometric method, Adiponectine and Leptin blood values – by ELISA. Leptin resistance (LR) index calculated by Leptin to Triglycerides Ratio (LTR). Adipocytes Secretory Activity (ASA) calculated by Leptin to BMI Ratio.

Results:

Adiponectin in EAH with obesity was lower, and leptin, on the contrary, was higher than in EAH without obesity – by 7.54-12.81% (p<0.001) and 1.75-2.63 times (p<0.001) respectively. LR and ASA indexes increased in presence of obesity 1.5-2.2 times (p<0.001) and 1.47-1.85 times (p<0.001), respectively. Adipocytokines concentration depended on the obesity: in 2nd and 3rd degrees EAH patients lower by 5.98% (p<0.001), and leptin, on the contrary, was higher by 50.18% (p<0.001), than in the case of 1st degree obesity, leading to LR and adipocytes’ secretory activity growth by 46.88% (p=0.018) and 26% (p=0.004). In EAH patients with 2nd and 3rd obesity degrees, concentration of 25(OH)VitD was lower by 18.48% (p=0.012), and PTH, was higher by 31.62% (p=0.017), than in obesity-free. Ionized calcium level did not depend on the obesity. Obesity risk in EAH elevated with blood adiponectin decrease (<75ng/ml) by 77 times [OR: 16.25-364.8; p<0.001], leptin augmentation (in women >21 ng/ml, in men >14 ng/ml) – 31 times [OR: 3.93-245.48; p<0.001], LR index increase (>15.0 U) – 5.27 times [OR: 2.04-13.60; p<0.001] and adipocytes’ secretory activity (>0.70 U) – 34.1 times [OR: 4.32-268.7; p<0.001].

Conclusions:

Low Adiponectine, Leptin elevation, LR and ASA augmentation increase the obesity risk in EAH 5-77 times (p<0.001). The 2nd and 3rd obesity degrees associate with lower 25(OH)VitD, higher PTH (p<0.05), independetly on ionized calcium.
CORRELATION OF BODY MASS INDEX (BMI) WITH SYSTOLIC AND DIASTOLIC BLOOD PRESSURE IN RURAL INDIAN PATIENTS
Authors: Inamdar Aniket
Published: May 2024

Objective:

Body mass index (BMI) is positively and independently associated with morbidity and mortality from hypertension, cardiovascular disease, type II diabetes mellitus, and other chronic diseases. In Caucasian and Asian populations, a strong association has been depicted between BMI and mortality. Overweight and obesity increase the risks of high BP, coronary heart disease, ischemic stroke, type II diabetes mellitus, and certain cancers. Worldwide, about 58% of diabetes mellitus and 21% of ischemic heart disease are attributable to BMI above 21 kg/m2. The combination of blood pressure and Body Mass Index (BMI) contribute more than 60% cases of cardiovascular disease. The main objective was to determine the correlation between BMI and blood pressure of rural Indian patients.

Design and method:

This cross sectional study used 310 patients who visited our hospital in rural India from January 15,2021 to February 15,2021. Data were collected directly by measuring the blood pressure, weight and height to determine BMI. BMI was derived from booking weight (kilograms) and height (meters). Using this, the patients were categorized as underweight (<18.5 kg/m2), normal or lean BMI (18.5–22.9 kg/m2), overweight (23.0 –24.9 kg/m2) and obese (> 25 kg/m2) based on the revised consensus guidelines for India. Descriptive analysis and Spearman correlation test were used to analyze the data.

Results:

The results of the bivariate analysis using Spearman correlation test showed that there was significant relationship between BMI and systolic blood pressure (p < 0.001, r = 0.375) or diastolic blood pressure (p <0.001, r = 0.432). This study shows that higher BMI was associated with increase in systolic as well as diastolic blood pressure.

Conclusions:

This study shows statistically significant relationship between Body Mass Index (BMI) and systolic and diastolic blood pressure in rural Indian patients. Weight gain seems to be an important risk factor for development of hypertension. Weight loss has been recommended for obese hypertensive patients and has been shown to be most effective non pharmacological treatment approach. Physical activity and caloric restriction should be promoted to control the obesity epidemic which will significantly reduce global cardiovascular disease burden.
EFFECT OF GLP-1 RECEPTOR AGONISTS ON OFFICE BLOOD PRESSURE LEVELS AMONG OVERWEIGHT OR OBESE SUBJECTS TREATED WITH ANTIPSYCHOTIC DRUGS: A META-ANALYSIS
Authors: Patoulias Dimitrios , Imprialos Konstantinos , Stavropoulos Konstantinos , Koufakis Theocharis , Karakasis Paschalis , Varouktsi Anna , Zografou Ioanna , Katsimardou Alexandra , Petidis Konstantinos , Doumas Michael
Published: May 2024

Objective:

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) constitute a drug class primarily developed for the treatment of subjects with type 2 diabetes. Subjects suffering from psychotic disorders and receiving antipsychotic drug treatment are prone to developing obesity, which is a major contributing factor to elevated blood pressure (BP) levels. Herein we sought to determine whether treatment with GLP-1RAs among overweight/obese subjects treated with antipsychotic drugs has any beneficial impact on BP levels.

Design and method:

We searched PubMed and the Cochrane Library from inception to 1 December 2022, for randomized controlled trials (RCTs) enrolling obese or overweight adult subjects with an underlying psychotic disorder treated with antipsychotic drugs, randomized either to GLP-1RAs or control. Effect of GLP-1RA treatment on office systolic and diastolic BP (SBP and DBP, respectively) levels was assessed.

Results:

We pooled data from 4 RCTs (2 utilizing liraglutide and 2 utilizing exenatide) in a total of 199 enrolled subjects. GLP-1RA treatment compared to control resulted in a non-significant effect on office SBP (p = 0.47). Similarly, GLP-1RA treatment compared to control failed to produce a significant decrease in office DBP (p = 0.53).

Conclusions:

Despite their significant weight loss properties in overweight or obese subjects, preliminary evidence suggests that GLP-1RAs do not confer a significant effect on BP levels among overweight/obese subjects treated with antipsychotic drug classes. Further, large-scale trials are required to clarify this interesting clinical aspect.
LEVELS OF MICRO RNA-21-3R IN THE BLOOD OF HYPERTENSIVE PATIENTS WITH NORMAL BODY WEIGHT AND WITH ABDOMINAL OBESITY
Authors: Koval Sergiy , Mysnychenko Olga , Penkova Marina , Lytvynov Vadim , Lytvynova Olga
Published: May 2024

Objective:

The combination of arterial hypertension (AH) with abdominal obesity (AO) significantly increases the severity of hypertension and accelerates the development of hypertension-mediated organ damage, in particular, left ventricular hypertrophy (LVH). MicroRNAs are small non-coding RNA molecules that are involved in the regulation of post-transcriptional gene expression. A number of experimental studies have revealed the antihypertensive, antihypertrophic and antifibrosing properties of microRNA-21-3p. The goal is to study the plasma levels of microRNA-21-3p in hypertensive patients with normal body weight (NBW) and with abdominal obesity (AO).

Design and method:

27 patients (16 men) with stage 2-3 hypertension (13 with NBW and 14 with stage II AO) aged from 42 to 60 years were examined. The control group consisted of 12 practically healthy individuals. All patients underwent general clinical laboratory and instrumental examination. Circulating plasma microRNA-133a levels were obtained by polymerase chain reaction using the CFX96 Touch System, “TaqMan microRNA Assay” and “TaqMan® Universal PCR Master Mix” reagent kits.

Results:

A significant decrease in the levels of micoRNA-21-3p in the blood plasma was established in the whole group of patients with hypertension (with NBW and with AO) (1.43±0.08), p<0.05) in comparison with practically healthy individuals (3.24 ±0.07). At the same time, the levels of this miRNA in the blood plasma of patients with hypertension and AO (1.13±0.06) were significantly lower (p<0.05) than in patients with hypertension and NBW (1.67±0.07). A correlation analysis revealed negative correlations between the levels of micoRNA-21-3p in the blood plasma and the levels of “office” systolic blood pressure (R=-0.44; p=0.04), as well as the left ventricular myocardial mass index (LVMMI) (R= -0.38; p=0.03) in the whole group of patients with AH (with NBW and AO).

Conclusions:

The results of this study may indicate the presence of a significant deficiency in the production of mircRNA-21-3p in patients with hypertension, especially when it is combined with AO, as well as the involvement of this miRNA in the mechanisms of progression of hypertension and the development of LVH.
THE IMPACT OF TRANSCATHETER AORTIC VALVE REPLACEMENT ON THE DYNAMICS OF ARTERIAL HYPERTENSION IN THE ELDERLY
Authors: Moroz Simina Mariana , Nisulescu Daniel -Dumitru , Baba Mirela , Mozos Ioana , Feier Horea , Lighezan Daniel Florin , Paduraru Denisa Andreea
Published: May 2024

Objective:

Aortic stenosis is a common heart condition characterized by the narrowing of the aortic valve, which obstructs blood flow from the heart to the rest of the body. Aortic stenosis patients undergo surgical aortic valve replacement, however, for patients at high surgical risk, transcatheter aortic valve replacement (TAVR), a minimally invasive procedure, has become an option. The present study aims to investigate the blood pressure (BP) response following transcatheter aortic valve replacement.

Design and method:

A retrospective analysis was conducted on a cohort of 90 patients (44 men and 46 women), who underwent TAVR between 2020-2023 in our Institute of Cardiovascular diseases. Statistical analysis was performed using MedCalc Statistical Software version 20.015 (MedCalc Software Ltd, Ostend. Belgium). BP was monitored in patients who underwent TAVR before the intervention and on the day of discharge. Clinical parameters and medical treatment were recorded during hospitalization. Patients were stratified according to their gender and post-procedural systolic and diastolic BP.

Results:

Mean systolic BP at admission in men was 130.56mmHg (95% C.I:125.0693 to 136.0671), versus post-procedural mean systolic BP of 124.00 mmHg (95% C.I: 118.6611 to 129.3389), p=0.0423; mean diastolic BP at admission in men was 75.29 mmHg (95% C.I: 71.5554 to 79.0355) versus post procedural mean diastolic BP of 70.34 mmHg (95% C.I: 66.8553 to 73.8265), p=0.0343. In female participants, mean systolic BP at admission was 135.19 mmHg (C.I: 127.9948 to 142.3965) and post-procedural mean systolic BP dropped to 126.34 mmHg (95% C.I: 121.4238 to 131.2719), p= 0.0094; mean diastolic BP at admission was 73.11 mmHg (95% C.I: 69.2552 to 77.0057), post-procedural mean diastolic BP was 67.73 mmHg (95% C.I: 64.1660 to 71.3123), p=0.0034. There were no statistically significant differences in the adjustment of the post-interventional medication, p=0.1823.

Conclusions:

TAVR is a revolutionary treatment for aortic stenosis demonstrating potential benefits in reducing blood pressure. By eliminating the obstruction caused by aortic stenosis, TAVR improves blood flow, enabling a potential decrease in blood pressure levels, regardless of gender.
CARDIOVASCULAR DISEASES AND CHRONIC PAIN SYNDROM CONCOMITANT IN OLDER PATIENTS: DO THEY PAY ATENTION TO SAFETY OR PRICE OF NSAIDS?
Authors: Mohammadi Reihaneh , Mohammadi Fatemmeh
Published: May 2024

Objective:

cardiovascular diseases(CVD) such as hypertension or heart failure is a common condition in older patients which need chronic medical and non-medical treatment, lifestyle changes, and specific avoidance. older patients are suffering from different chronic diseases as osteoarthritis. NSAIDs usage have proved complications in CVD, while is a common choice for pain management in chronic pain syndrome. In this study we aimed to evaluate the prevalence of Non-steroidal anti-inflammatory drugs (NSAIDs) usage and their complications in older patients with CVD and osteoarthritis.

Design and method:

this was a cross-sectional study in older> 65 years old CVD patients in Kolur, Khalkhal, Iran. we selected CVD patients, their demographic data as age, literacy, and income from electronic health data services and made phone calls to seek about their NSAIDs or other analgesic drugs usage, other comorbidities as chronic pain syndromes, and effectiveness of drugs in pain reduction. There was a pre-designed checklist which used during phone call by a medical doctor. Also the price and insurance coverage of drugs were extracted.

Results:

the results showed 56% population or older patients with a rural lifestyle, 55% of them are hypertensive or having other CVD. 43.5% of them are using NSAIDs to relieve pain, chronically or intermittent. the most common NSAID is Diclofnac with 78.9% which is not recommended in congestive heart disease. it is a low price drug and could be sell without medical prescription in pharmacies.

Conclusions:

Diclofenac is a common NSAID used among CVD patients due to its low price than safer drugs as Naproxen. Having a happy and healthy life during older age with all these comorbidities needs education and policy adjustment. thus, patients training on over the counter drugs is important as always, specially in lower income people who will chose the most available option.
HYPERTENSION IN CARDIO-ONCOLOGY: SURVEY AMONG CARDIOLOGY FELLOWS IN TRAINING
Authors: Farhan Hasan Ali , Yaseen Israa Fadhil
Published: May 2024

Objective:

To evaluate cardio-oncology knowledge among cardiology fellows in training (FIT).

Design and method:

A survey-based multiple choice questions study was conducted among cardiology FIT in June 2022 at a cardiology training center. The survey included five questions about management of cardiovascular diseases in patients with cancer. The questions and the correct answers are shown in Table 1. Google form was used for the survey and the link of the survey was shared with the cardiology FIT in a closed group on WhatsApp.

Results:

Total number of responses was 20, including 12 (60%) third year, 3 (15%) second year, and 5 (25%) first year cardiology FIT. The least correct answer was for question 4 which was about the cutoff value of blood pressure to re-initiate tyrosine kinase inhibitors (TKI) for patients with cancer who developed high blood pressure (>180/110 mmHg) related to TKI and for whom TKI was withheld. Most of the cardiology FIT (85%) chose the option (blood pressure <140/90 mmHg) and only (5%) chose the correct answer which is (<160/100 mmHg).

Conclusions:

Cardiology FIT need training and education in the field of cardio-oncology particularly for the management of hypertension related to cancer therapy. Identifying the cutoff value of blood pressure to re-initiate cancer therapy is one of the very important points as the delay in re-initiate cancer therapy can lead to metastasis of cancer.
SUBCLINICAL HYPERTENSION-MEDIATED ORGAN DAMAGE AND PROGNOSIS IN PATIENTS WITH HYPERTENSIVE EMERGENCIES AND URGENCIES: REPORT FROM THE ONGOING MULTICENTER ERIDANO STUDY
Authors: Cesareo Marco , Vallelonga Fabrizio , Sanapo Martina , Leone Dario , Lupia Enrico , Morello Fulvio , Totaro Silvia , Aggiusti Carlo , Salvetti Massimo , Ioverno Antonella , Maloberti Alessandro , Fucile Ilaria , Cipollini Franco , Nesti Nicola , Mancusi Costantino , Pende Aldo , Giannattasio Cristina , Muiesan Maria Lorenza , Milan Alberto
Published: May 2024

Objective:

Acute hypertensive disorders (namely hypertensive urgencies [HU] and hypertensive emergencies [HE]) are challenges for the Emergency Department (ED) and hypertension experts. The ongoing prospective multicenter study Eridano aims to characterize patients with HE and HU, prevalence of subclinical hypertension-mediated organ damage (HMOD), and short- and long-term prognosis.

Design and method:

Patients admitted to the ED with symptomatic blood pressure (BP) > or = 180/110 mmHg were enrolled. They were managed by ED personnel according to their clinical presentations. They subsequently underwent clinical evaluation and subclinical HMOD assessment at a Hypertension Center within 72h from enrolment, and then clinical follow-up at 3 and 12 months. The endpoints considered were new HU and HE, acute coronary syndrome (ACS), acute aortic syndrome (AAS), stroke, and heart failure hospitalization.

Results:

258 patients were enrolled until October 2023. Mean age was 60±15 years, 130 (50%) were females. 28 (11%) and 230 (89%) patients were diagnosed with HE and HU, respectively. Mean systolic and diastolic BP at ED admission were 189±24 and 105±18 mmHg, respectively. BP values <180/110 mmHg were achieved in 57% and 91% of HE and HU patients, respectively. Mean systolic and diastolic BP at 72h visit were 148±22 and 87±15 mmHg, respectively, and 35% of patients were normotensive. The overall prevalence of subclinical HMOD in at least one site was 74%. The most frequent was cardiac HMOD (41%), followed by vascular (36%), cerebral (25%), and renal (13%) ones. HE patients had higher prevalence of cardiac, cerebral, and renal HMOD than HU patients (p<0.01 for all), while vascular HMOD was similar. 194 patients underwent 3 months follow-up and 113 patients completed 12 months follow-up. A total of 30 events occurred (12%), namely 21 HU, 4 ACS, 2 stroke, 1 HE, and 2 deaths. Five HE patients (18%) and 25 HU patients (11%) experienced at least one events.

Conclusions:

Subclinical hypertension-mediated organ damage is highly prevalent in patients with acute blood pressure disorders. The heart is the most frequent location involved in subclinical HMOD. Hypertensive emergencies and urgencies carry high risk of recurrent BP disorder and cardiovascular complications.
ARTERIAL HYPERTENSION IN PATIENTS LONG TERM AFTER LIVER TRANSPLANTATION
Authors: Adamczak Marcin , Romanowska Barbara , Sarna Dominika , Gojowy Damian , Karkoszka Henryk , Musialik Joanna , Wiecek Andrzej
Published: May 2024

Objective:

Cardiovascular diseases are one of the most frequent causes of death of patients after liver transplantation (LTx). The aim of this retrospective clinical study was to estimate the prevalence of arterial hypertension among patients after successful LTx.

Design and method:

Two hundred forty three patients, aged 49.5±11.7 years (91 women, 152 men) after successful LTx who completed 24 months follow-up were studied. Diagnosis of hypertension was based on the following criteria: office blood pressure equal or higher thab 140/90 mmHg during two separate visit or use of antihypertensive pharmacotherapy. Results are presented as means with standard deviation.

Results:

The prevalence of hypertension in patients before LTx was 28.8%. Twenty four months after LTx the prevalence of hypertension increased significantly to 67.5% (p<0.001, Q Cochrane test). Therefore, annual incidence for arterial hypertension during 24 months after LTx was 18.5%. Systolic and diastolic blood pressure 24 months after LTx were 135.3 ± 18.1, and 86.4 ± 10.7 mmHg, respectively. Number of patients treated with immunosuppressive regimen based on tacrolimus or cyclosporine A or everolimus were 204 (84%), 22 (9%) and 17 (7%), respectively. Prevalence of arterial hypertension in patients treated with immunosuppressive regimen based on tacrolimus, cyclosporine A or everolimus was 63.7%, 86.4% and 88.2% respectively (p=0.01; tacrolimus vs cyclosporine p=0.03; tacrolimus vs everolimus p=0.04). Patients with arterial hypertension were treated with 1.7 ± 1.2 antihypertensive drugs. Beta-adrenergic antagonists were used by 52.2%, calcium channel antagonists by 40.9%, diuretics by 32.1%, angiotensin converting enzyme inhibitors by 28.3%, angiotensin 2 receptor antagonists 8.2% and alfa-adrenergic antagonists by 6.3% patients with arterial hypertension.

Conclusions:

1. Arterial hypertension occurs in nearly 70% of patients long term after LTx. 2. Immunosuppressive regimen might influence the prevalence of arterial hypertension in liver transplant recipients. 3. High prevalence of arterial hypertension in patients after LTx needs special attention and specific treatment in order to reduce increased cardiovascular morbidity and mortality observed in these patients.
A NOVEL METHOD FOR THE ANALYSIS OF RENAL SYMPATHETIC NERVE ACTIVITY FROM MULTI-FIBER NERVE RECORDINGS
Authors: Rodionova Kristina , Ditting Tilmann , Cordasic Nada , Hilgers Karl -Friedrich , Schiffer Mario , Amann Kerstin , Ditting Tilmann
Published: May 2024

Objective:

Measurement of renal sympathetic nerve activity (RSNA) via bipolar electrodes from multi-fiber preparations in various species has been used for decades in the context of autonomic regulation research. Traditionally, raw neurograms are usually integrated over short time intervals and this approach works perfectly for the analysis of dynamic RSNA changes due to acute intervention. However, comparability of baseline activities between groups is limited. We present a novel analysis method, based on the raw neurogram sampled at rate of 25 kHz.

Design and method:

For RSNA-burst analysis a software based programmable algorithm was used. Continuous activities longer than three single spikes (i.e., >8ms) were defined as bursts, followed by silent periods with some single spikes. Approximately 10.000 bursts/rat were analyzed and burst amplitude, burst duration, burst area (i.e., duration integral), as well as the burst frequencies were analyzed.

Results:

In rats with myocardial infarction (n=11) we found no difference in integrated baseline RSNA as compared to controls ((n=10). However, the new method revealed higher higher burst rate per cardiac cycle [CC] (2.65 ± 0.39 vs. 1.61 ± 0.38 bursts/CC; P<0.001) and burst frequency (15.09 ± 2.42 vs. 8.52 ±1.54 Hz; P<0.001) compared to healthy controls, indicating increased RSNA.

Conclusions:

Our new method of RSNA baseline analysis was able to detect subtle differences between groups of animals that could not be detected by the traditional method of integrated RSNA analysis. Furthermore, this method has the potential to give further insights into RNSA patterns and synchronization to afferent regulatory input form the kidney itself or other organs.
HYPERTENSION EXAGGERATES LEFT VENTRICULAR HYPERTROPHY IN FABRY PATIENTS
Authors: Gambardella Jessica , Spinelli Letizia , Fiordelisi Antonella , Aria Massimo , Cerasuolo Federica Andrea , Avvisato Roberta , Buonaiuto Antonietta , Borghi Claudio , Graziani Francesca , Muiesan Maria Lorenza , Biagini Elena , Pieroni Maurizio , Riccio Eleonora , Pisani Antonio , Virdis Agostino , Sorriento Daniela , Iaccarino Guido
Published: May 2024

Objective:

Left ventricular hypertrophy (LVH) and dysfunction are the main causes of death in patients with Fabry Disease (FD). Identification of clinical predictors of FD evolution is crucially important for the correct timing of therapeutic intervention. On this ground, we aim to evaluate the impact of hypertension (H) as a predictor of (LVH) progression in FD.

Design and method:

We compared the FD database (319 patients) with patients from the URRAH study [>15000 patients] for H, indexed ventricular mass (LVMi) and calculated the odds ratio (OR) for LVH development. In a murine model of FD (tg-R301Q/KO mice) we chronically infused phenylephrine (PE,100 mg/Kg, 14-Days) by subcutaneous implantation of miniosmotic pump to increase blood pressure.

Results:

H in FD compared to URRAH exploded the LVH-OR by 6.3 times. In H patients, LVMi is significantly higher in FD than URRAH patients (FD, no H:98.8±47; FD, H:148.8±67.5 g/m2 p<0.01; URRAH, no H:103.6±29.6; U, H:112.4±31.3 g/m2, p<0.01). The multivariate analysis for sex and age indicated that FD and hypertension interact as independent risk factors for LVH. PE-exposure induced a comparable increase in systolic and diastolic blood pressure in FD and control mice. However, in FD mice PE induced a larger increase of LVMi, alongside with higher Heart-body weight ratio, and higher ANP and MEF2 cardiac levels. In FD heart, PE caused energetic stress signaling activation suggesting the potential involvement of AMPK-FOX03-axis in the hypertrophic response of FD-heart under hemodynamic stress.

Conclusions:

Our data suggest that H is associated with a higher risk of LVH, representing a clinical predictor of a worsened evolution of FD cardiac phenotype. Data from the murine model confirm the exaggerated hypertrophic response to H of FD heart, probably due to energetic stress induced by the increased cardiac workload.
FEATURES OF ANTIHYPERTENSIVE THERAPY IN YOUNG KAZAKH PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Mukhtarkhanova Dilayra , Junusbekova Gulnara , Tundybayeva Meiramgul , Baglanova Lyazat , Samitova Sabina , Chingis Medet , Torzhan Ulbolsyn
Published: May 2024

Objective:

Hypertension is the one of the most common diseases and one of the most prevalent causes of mortality and disability. Due to higher cardiovascular risk in patients with hypertension they need to achieve control BP to prevent cardiovascular events: myocardial infarction, stroke, heart failure. The main aim of the study is to assess the features of antihypertensive therapy and achievement of control of blood pressure in young non-organized population of Republic of Kazakhstan.

Design and method:

Prospective cross-sectional studies were conducted in 2021 in Kazakhstan, included 1110 young adults of both sexes (670 women (60%) and 440 men (40%)) of mean age - 31±8 years (95% CI 31-32). Special survey, including cardiovascular risk factors assessment, blood pressure and heart rate measurement were performed. The features of therapy were assessed: proportion of those on therapy, proportion of those adherent to therapy and proportion of those with controlled blood pressure. Statistical test was performed by the StatTech, Russia.

Results:

Percentage of those on antihypertensive medications – 20% of all hypertensive participants (50% of those who know about their high blood pressure). 45% of those on therapy are adherent to antihypertensive medications. Percentage of those proportion who take medications only when necessary – 25%. 14% of participants forget to take medication. In 49% of cases (of those on antihypertensive therapy) blood pressure levels were controlled.

Conclusions:

Only 50% participants of those who knows about their increased blood pressure take antihypertensive medications. Quarter of them take medications only by necessity. According to our data only half of participants on antihypertensive therapy have controlled arterial hypertension. It is important that young patients require more careful management.
HYPERTENSION TREATMENT IN LOW-INCOME COUNTRIES BY POSTTRANSLATIONAL MODIFICATION OF ANGIOTENSIN II
Authors: Lellig Michaela , Muñoz-castañeda Juan , Hermann Juliane , Noels Heidi , Rodríguez Mariano , Tepel Martin , Jankowski Joachim , Jankowski Vera
Published: May 2024

Objective:

Although hypertension is a worldwide health problem, treatment options in low-income countries are still limited, resulting in high mortality. Therefore, the availability of drugs that are affordable and accessible to patients in low-income countries is still an urgent need. Since angiotensin II is one of the essential vasoconstrictive peptides in the human organism, we analyzed the impact of its posttranslational modification to pyruvamide-Ang II by pyridoxal-5’-phosphate on blood pressure. Pyridoxal-5’-phosphate is a less expensive vitamin B6 derivative and therefore could be a novel, cost-effective drug for the treatment of hypertension.

Design and method:

The post-translational modification of angiotensin II to pyruvamide-angiotensin II by pyridoxal-5’-phosphate was investigated in vitro by mass spectrometry. Calcium ion influx into vascular smooth muscle cells treated with angiotensin II or pyruvamide-angiotensin II, respectively, was also investigated in vitro. In ex vivo experiments, the vasoconstrictive effect of angiotensin II and pyruvamide-angiotensin II, respectively, was analyzed by using the bioassay of the isolated perfused rat kidneys. Furthermore, angiotensin II and pyruvamide-angiotensin II were investigated in in vivo experiments. Both Wistar Kyoto rats and spontaneously hypertensive rats were treated with pyridoxal-5’-phosphate by using mini-osmotic pumps and the blood pressure was measured time-dependently.

Results:

Calcium ion influx in vascular smooth muscle cells after stimulation with pyruvamide-angiotensin II was significantly decreased compared to angiotensin II. Perfusion pressure of isolated perfused rat kidney increased less by pyruvamide-angiotensin II than by angiotensin II. The systolic and diastolic blood pressure of spontaneously hypertensive rats treated with pyridoxal-5’-phosphate decreased from 171/139 ± 5 mmHg to 129/98 ± 2 mmHg after three days. The blood pressure of Wistar Kyoto rats treated with angiotensin II increased to 167/133 ± 3 mmHg, while the blood pressure of Wistar Kyoto rats treated with angiotensin II and pyridoxal-5’-phosphate decreased to 129/99 ± 2 mmHg.

Conclusions:

Pyridoxal-5’-phosphate significantly decreased rat blood pressure and might be a cost-effective drug for hypertension treatment. Respectively, an increased pyridoxal-5’-phosphate intake recommendation in the form of vitamin B6 intake might have a decreasing effect on blood pressure in the hypertensive population.
ANTIHYPERTENSIVE DRUGS IN CHRONIC HEART FAILURE IN THE CZECH REPUBLIC, FOCUSING ON BETA-BLOCKERS
Authors: Labr Karel , Spinar Jindrich , Parenica Jiri , Spinarova Lenka , Malek Filip , Spinarova Monika , Krejci Jan , Jarkovsky Jiri , Benesova Klara , Labrova Ruzena , Ludka Ondrej
Published: May 2024

Objective:

Hypertension is a very common comorbidity in patients with heart failure. Beta-blockers (BB) are the first choice drug together with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) in patients with heart failure with reduced left ventricular ejection fraction (HFrEF), reducing morbidity and mortality.

Design and method:

Data were collected in the FARmacology and NeuroHumoral Activation Registry (FAR NHL). Patients with chronic heart failure with left ventricular ejection fraction (LVEF) < 50% for at least one month were included.

Results:

1,100 patients with a mean age of 65 years, 80.8% male, were included. The mean systolic blood pressure was 128.0 mm Hg, mean diastolic blood pressure was 80.0 mm Hg. Of all patients, 20% received low dose of beta-blocker (LD), 57% medium dose (MD) and 17% high dose (HD), 6.2% did not receive BB. The higher the blood pressure (LD 124/ 77; MD 129/ 80; HD 132/ 82 mm Hg; p < 0.001), LV EF (LD 29.5; MD 30.5; HD 32.0%; p = 0.003), creatinine clearance (LD 78.7; MD 87.8; HD 91.1 ml/min; p = 0.001) or weight of the patients, the higher the BB dose they received (LD 83.2; MD 88.7; HD 93.5 kg; p < 0.001). The lower the NT-proBNP, the higher the BB dose patients received (LD 767; MD 456; HD 314 pg/ml; p < 0.001). The presence of atrial fibrillation (AF) did not affect the BB dose. Patients with AF were more likely to be treated with digoxin or a combination of digoxin and BB than patients without AF (p < 0.001).

Conclusions:

According to FAR NHL registry, almost 94% of patients with HFrEF receive BB. A total of 17% of patients take the target dose of BB. If a patient has BB, he/she is treated with the recommended preparation in more than 99% of cases. The more severe the disease, as reflected by lower BP, creatinine clearance, LV EF, weight or higher NT-proBNP, the lower the dose of beta-blockers the patient receives and tolerates.