bluuebunny/crossref_metadata_2025 huggingface dataset:
INSULIN RESISTANCE, CAROTID INTIMA-MEDIA THICKNESS, BODY MASS INDEX IN PATIENTS WITH CORONARY ARTERY DISEASE COMBINED WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE
Authors: Grechanyk Mariya , Kuryata Olexander
Published: May 2024

Objective:

To compare the relationship systolic and diastolic blood pressure (BP) with insulin resistance (IR), carotid intima-media thickness and body mass index (BMI) in patients with coronary artery disease (CHD) combined with metabolic dysfunction-associated steatotic liver disease (MASLD).

Design and method:

We studied 78 patients with CHD in combination with MASLD mean age 58,8±2,14 (group A) and 20 patients with CHD without MASLD mean age 56,6±4,6 (group B). Patients with diabetes were excluded. The study group was divided into 3 subgroups according to BMI (subgroup 1 (36%) - patients who are overweight, 2 (39%) - obesity grade 1, 3 (25%) - obesity grade 2. Studied IR, carotid intima-media thickness depending on BMI.

Results:

In group A the mean level systolic BP and diastolic BP was higher than in group B (140 [130,0; 160,0], 132,5 [120,0; 150,0], p =0,02 and 90 [85,0; 100,0], 80,0 [75,0; 90,0], p=0,001) 82% of patients with CAD and MASLD had insulin resistance (IR). HOMA1-IR index in patients with 2 class obesity was 3.4 compared to the group of patients with 1 class obesity – 2.35 and overweight patients – 2.26, respectively (p<0.05). Carotid wall thickness was lower in a group A (0,14±0,02 cm) than in a group B (0,16±0,01 cm, p =0,01). Frequency of exposure of atherosclerotic carotid plaques in a group A – 82%, was higher than in a group B – 64% (p <0,05). In group A unstable plaques found significantly more often (31%, p = 0,01), than in the control group B (8%).

Conclusions:

There was an association between the BMI and level of glucose (r=0,59, p<0,05) in patients with CHD in combination with MASLD. According to HOMA1-IR index IR was detected in 7% of the overweight patients, in 22% patients with 1 class obesity and in 62% with 2 class; and 86%, 72% and 84% according to the HOMA2-IR index, respectively (p<0.05). According to the frequency of unstable carotid plaques, no statistically significant differences were found between groups depending on BMI.
COMPARISON OF LEFT VENTRICULAR VOLUMES AND EJECTION FRACTION VALUES BETWEEN ECHOCARDIOGRAPHY AND CARDIAC MAGNETIC RESONANCE: A PILOT STUDY
Authors: Zydzik Lukasz , Dadanski Emil , Tyjas Kinga , Wojciechowska Wiktoria , Chyrchel Bernadeta , Popiela Tadeusz , Rajzer Marek
Published: May 2024

Objective:

Although transthoracic echocardiography (TTE) is the most commonly used technique to evaluate left ventricular (LV) parameters, cardiac magnetic resonance (CMR) is considered to provide more accurate measurements. The aim of this study was to compare LV end-diastolic volume (LVEDV), end-systolic volume (LVESV) and ejection fraction (LVEF) assessed by TTE with those parameters obtained by CMR.

Design and method:

The study included 100 patients who underwent both TTE and CMR between 2021 and 2023. Echocardiographic images were analysed retrospectively by three independent investigators (R1, R2, R3). The following parameters were obtained using Simpson's biplane method: LVEDV, LVESV and LVEF. The echocardiographic values assessed by each investigator were then compared with reference values obtained by CMR. Statistical analyses were performed using repeated measures ANOVA with post hoc pairwise t-tests with Bonferroni correction.

Results:

The mean age of the study population was 47±18 years, 64% were male, and the median time between TTE and CMR was 27 days. The most common indication for CMR was evaluation of suspected cardiomyopathy (42%), followed by suspected acute myocarditis (16%). The repeated measures ANOVA test showed that there was a significant difference between measurements (R1/R2/R3/CMR) of LVEDV (R1=132.47 ml, R2=132.38 ml, R3=122.69 ml, CMR=183.72 ml, p=0.002) and LVESV (R1=59.27 ml, R2=65.7 ml, R3=60.97 ml, CMR=80.23 ml, p=0.002). Post hoc analysis showed that the differences were only due to the discrepancy between each echocardiographer and magnetic resonance imaging. There was no significant difference in LVEF between measurements (R1=44.44%, R2=47.56%, R3=46.96%, CMR=48.5%, p=0.243).

Conclusions:

Our study shows that echocardiographic values of LV volumes and EF have low interobserver variability. TTE tends to underestimate LV volumes compared to CMR, but LVEF is similar with both techniques.
SIMPLIFID LUNG ULTRASOUND IN DIAGNOSIS OF HEART FAILURE WITH PRESERVED EJECTION FRACTION IN ARTERIAL HYPERTENSION
Authors: Tsverava Mikheil , Tsverava Dimitri
Published: May 2024

Objective:

About 30% of patients with heart failure (HF) have normal Ejection Fraction (HFpEF). Pulmonary congestion is useful marker of HFpEF. The aim of this study was to determine the efficacy of ultrasound in patients with DHF.

Design and method:

We studied 250 patients with Arterial Hypertension and III-IV NYHA class HF from which 70 patients had HFpEF (group 1) and 100 patients Left Ventricular Diastolic Dysfunction but without signs of HF (control, group 2). All participants undergone standard Echo Cardiography. Sonographic evaluation of a lung was done in horizontal or vertical positions of patient, from 10 points of thoracic wall (5 points from each side), which corresponded to the projection of lower, middle and upper lobes of a right lung and upper and lower lobes of left lung.

Results:

In patients with HFpEF we significantly often found multiple (3 or more) B-lines or Comet tail Phenomenon (CTPh), which was registered in 91.1%. In 40.0% of control group patients, we also registered B-lines, but the count of them was less than 3 lines per each registration point (the difference between control an HF groups was significant). The count of points from where the CTPh was registered was 6.8 in HFpEF gr. and 0.7 in control.

The B-lines were registered from 3 or more points of thoracic wall in 82.86% of patients of I gr and only 5% in II gr participants. In HF groups CTPh was prominent and multiple while in the control group it was single and short lasting, like lightening. There was good correlation between the count of B-line registration points from the thoracic wall and the heart failure NYHA class (r=0.56), left ventricular systolic (r=0.40) and diastolic (r=0.32) diameters and negative MAPS and TAPS (r=-0.42 and 0.41 respectively).

Conclusions:

Thoracic US is a sensitive and accurate method for evaluation pulmonary congestion in patients with AH and HFpEF. The US sign of pulmonary congestion in HF are B-lines or Comet tail phenomenon, which is protracted, prominent, multiple and registered from larger area of thoracic wall (3 points or more).
TREADMILL EXERCISE TEST AND DEVELOPMENT OF HYPERTENSION
Authors: Kalos Theodoros , Dimitriadis Kyriakos , Manta Eleni , Leontsinis Ioannis , Drogkaris Sotirios , Tatakis Fotios , Konstantinidis Dimitrios , Christos Fragkoulis , Liatakis Ioannis , Matzouranis Emmanouil , Sakalidis Athanasios , Andrikou Ioannis , Kakouri Androniki , Kouremeti Maria , Tsioufis Konstantinos
Published: May 2024

Objective:

Guidelines promote screening people with high normal BP for the presence of end-organ damage because their presence is associated with a 2- to 3-fold increase in the risk of CVD.

Design and method:

100 consecutive subjects with high normal BP [systolic BP=130-139mmHg and/or diastolic BP=85-89mmHg] were examined for early signs of hypertension-mediated organ damage (HMOD). They underwent an echocardiographic study, a negative for ischemia treadmill exercise test (Bruce protocol) where the index SBP/MET-slope [(peakSBP—restingSBP)/(peakMET-1)] was used. Arterial stiffness was evaluated based on carotid-femoral pulse wave velocity (PWV). The sympathetic drive was assessed by MSNA. Follow-up was scheduled every 6 months for 3 consecutive years, where BP measurements were assessed in the office and with ambulatory BP monitoring (ABPM). All participants offered lifestyle advice to lower their BP. The endpoint was the development of HTN either with Office BP or ABPM.

Results:

Of 100 subjects (54±8 years, 42 males, baseline office BP: 132/82 mmHg, 24-hour BP: 122/76 mmHg) 40 developed HTN in 3 years. 34 subjects developed Hypertensive Response to Exercise (HRE) (BP >210mmHg in men and >190mmHg in women) and all of them developed HTN. The SBP/MET-slope in Group I was increased in all stages till peak exercise independently of sex type (stage1: 6.7vs4.9 p=0.049, stage2: 8.4vs4.8 p=0.001, peak: 6.7vs4.9, p=0.001). Their exercise capacity was reduced (10vs11.3METs, p=0.002) as well as their maximum exercise heart rate (156vs164, p=<0.0001). Those with HRE had higher 24hSBP (124vs121mmHg, p=0.009), Night SBP (117vs111mmHg, p<0.001), Day SBP (127vs124mmHg, p=0.012) Office PP (51vs47mmHg, p=0.01), while did not differ regarding their metabolic profile at the follow-up. Additionally, they had increased PWV (8.3vs7.5m/sec, p=<0.0001), MSNA levels (36vs28 bursts, p=<0.0001), LVMI(38vs34 gr/m2, p=0.02), deteriorated 2021 CKD-EPI eGFR (90 vs 97 mL/min/1.73 m2, p=0.02).

Conclusions:

Detecting exaggerated blood pressure response is associated with increased systemic vascular resistance and early subclinical HMOD which may upgrade an individual's cardiovascular disease (CVD) risk as they progress to HTN indicating a need for instituting a BP-lowering strategy.
POSSIBILITIES OF THE METHOD OF VOLUMETRIC COMPRESSIVE OSCILLOMETRY FOR THE ASSESSMENT OF BLOOD PRESSURE AND ARTERIAL STIFFNESS IN PATIENTS WITH DECOMPENSATED HEART FAILURE
Authors: Chudarova Irina , Troitskaya Elena , Kozlova Anna , Andreeva Ekaterina , Galochkin Svyatoslav , Tereshchenko Ekaterina , Kobalava Zhanna
Published: May 2024

Objective:

Volumetric compressive oscillometry (VCO) is a technique for non-invasive simultaneous assessment of >20 hemodynamic parameters, including arterial stiffness (AS) by pulse wave velocity (PWV). The possibilities of the method in heart failure (HF) had never been studied previously. The aim of the study was to evaluate the concordance of the results of BP and AS measurement by VCO in patients admitted with decompensated HF by comparing them to standard BP measurement and applanation tonometry (AT).

Design and method:

In patients admitted to the HF center with decompensated HF apart from routine tests, we assessed PWV (carotid-femoral (cf), carotid-radial (cr)) with AT (SphygmoCor) and performed VCO (APKO-8-RIZ-M) (BPvco, PP vco and PWVvco were evaluated). The concordance of the results was assessed by Bland-Altman method. p<0,05 was considered statistically significant.

Results:

We included 54 patients (61% males, 69.6±10 years, median (med) BMI 28.8 (IQR 25;38.9) kg/m2, 38.9% smokers, HTN in all, DM 37%, CAD 51.9%, med EF 51% (38;55%), med NTproBNP 623 (500;1842) pg/ml; HFrEF 37%, HFmrEF 13%, HFpEF 50%). Median BP was 117(106;130)/70 (68;80) mmHg, pulse pressure (PP) 47 (37;56) mmHg, central BP 109.5 (96;120.5)/71.5 (68;80) mmHg, med cfPWV 8 (6.4;10) m/s, crPWV 9.5 (6.9;12.4) m/s. Median BP by VCO 110 (101;118.5)/56 (47;65) mmHg, PP by VCO was 52.7 (46.3;60) mmHg, median PWV was 6.2 (5.5;7.1). There were no significant differences across EF phenotypes. Bland-Altman method showed no concordance between office brachial BP and BPvco (mean difference 9.3 (95%CI 4.8;13.8) mmHg for SBP and 16.8 (95%CI 13.8;19.8) mmHg for DBP, p<0.001 for trend), brachial PP and PPvco (mean difference -6.5 (95%CI -10.2;-2.9) mmHg, p=0.001) and cfPWV or crPWV by AT and PWV by VCO (mean difference 4.2 (95%CI 2.9;5.5) m/s and 2.7 (95%CI 1.4;4.1) m/s, respectively, p<0.001 for trend).

Conclusions:

In patients with decompensated HF VCO can‘t be used as an alternative standard BP measurement and assessment of arterial stiffness by applanation tonometry.
CARDIAC OUTPUT ESTIMATION: PULSE WAVE ANALYSIS (ANTARES) HIGHLY CORRELATES TO ECHOCARDIOGRAPHY ASSESSMENT
Authors: Baulmann Johannes , Hoppe Matthias Wilhelm , Lapp Harald , Richter Stefan , Ohlow Marc -Alexander , Dörr Marcus , Pieper Cornelia , Köster Marco , Eckert Siegfried , Barroso Michael Thomas Coll , Abanador-kamper Nadine , Stäuber Alexander
Published: May 2024

Objective:

Evaluation of cardiac output (CO) is crucial for understanding cardiac function and diagnosis of heart failure. While invasive thermodilution procedures serve as the gold standard for CO assessment, routine clinical practice has widely adopted transthoracic Doppler echocardiography (TTE) as the established non-invasive method. Nevertheless, there is a persistent demand for alternative non-invasive approaches, aiming to improve the efficiency of CO estimation, mitigate complications associated with invasive methods, and extend its application to non-intensive care settings, all of which potentially can be offered by oscillometric pulse wave analysis (PWA). This study aims to compare the non-invasive estimation of CO using TTE and the oscillometric PWA algorithm Antares.

Design and method:

We compared non-invasive cardiac output data obtained through two-dimensional transthoracic echocardiography with data obtained from an oscillometric blood pressure device (custo med GmbH, Ottobrunn, Germany) utilizing the integrated Antares algorithm (Redwave Medical GmbH, Jena, Germany). A total of 59 patients, undergoing elective cardiac catheterization for clinical reasons, were included in the study (mean age 71±10 years, 24% females), but only echocardiography-data with CO were used for analysis. Agreement between the two CO measurement methods (TTE versus Antares) was evaluated through Bland-Altman analysis, Student's t-test, and Pearson correlations.

Results:

The mean difference in CO was 0.04 ± 1.03 l/min. No statistically significant difference in means was observed between the two CO measurement methods. Significant correlations between transthoracic echocardiography (TTE) and Antares CO were evident in the overall population (r=0.71), as well as in both, female (r=0.80) and male patients (r=0.67; all p<0.001).

Conclusions:

The oscillometric PWA algorithm Antares and the established TTE exhibit strong correlations for non-invasive CO estimation in both male and female patients, with no statistically significant differences between the two approaches. This study opens the door to a valid and simple detection of heart failure that is seamlessly integrated into a quick and easy-to-perform upper arm blood pressure measurement.
NEW HOME BLOOD PRESSURE TELEMONITORING SYSTEM IN AN AGED COMMUNITY: PROTOCOL OF THE DIGITAL CARDIOVASCULAR PREVENTION FEASIBILITY STUDY
Authors: Nishizawa Masafumi , Hoshide Satoshi , Kario Kazuomi
Published: May 2024

Objective:

We sought to (i) determine the precise feasibility of a new telemonitoring-based healthcare system in a community of aged individuals and (ii) clarify the clinical implications of blood pressure variabilities in a time series until the end of life for the management of hypertension in elderly patients.

Design and method:

We have devised a simple, easy-to-use blood-pressure monitoring system and automated telemonitoring system, i.e., the DICAP (DIgital Cardiovascular Prevention) system, that obtains all of the different blood pressure values measured in a time series in different settings in community-dwelling elderly individuals in their homes and other facilities.

Results:

The feasibility of the DICAP system was confirmed by the successful serial transmission of the home blood pressure data of the community-dwelling hypertensive patients including those who were not familiar with digital technology and those who resided at different community locations. Among the first-recruited 221 subjects, 92.3% have been monitoring their blood pressure with the DICAP >12 times/week.

Conclusions:

The newly developed DICAP system using a cellular blood-pressure monitoring device suggests the possibility of being feasible and acceptable for the management of hypertension among elderly community-living individuals.
WEBSITES IN VASCULAR HEALTH: A TOOL FOR WHOM? USER CHARACTERISTICS AND MOTIVATIONS
Authors: Michaud André , Blanchette Virginie , Boudreau François , Lafontaine Sarah , Lemelin Martine , Leroux Denis , Miquelon Paule , Rousseau-bédard Joany , Roussin André , Vallée Michel , Cloutier Lyne
Published: May 2024

Objective:

Limited data is available to describe the characteristics and motivations of users of health websites. Self-determination theory (Deci & Ryan, 2000) proposed three categories of motivation: 1) autonomous motivation: engaging in a behavior because it is perceived to be consistent with intrinsic and meaningful goals, 2) controlled motivation: engaging in a behavior for reward, or trying to avoid feelings of guilt, and 3) amotivation: lack of autonomous and controlled motivation. The aim of this study is to profile users and described the motivations behind using a health website.

Design and method:

In this multicenter study, participants had to be 18 years and older, concerned by a vascular health condition, and skilled to use digital tools. They were approached by collaborating physicians (n=30) during routine consultations or through social networks. An anonymous, validated electronic questionnaire assessed socio-demographic variables, digital competence, and motivations for using a health website.

Results:

137 participants, mean age of 65.25 (± 11.78 years, 52.5% female) were recruited. The most prevalent diagnoses among participants were hypertension (48.70%) and diabetes (31.40%). The group aged 64 and below self-evaluated with better digital competence (8.97 ± 2.76) compared to the 65-74 age group (7.5 ± 2.70) and the 75 years and older group (6.41 ± 3.25) (p < 0.01). The difference between the women's and men's group did not reach statistical significance. Regarding motivation to consult a health website, the group aged 64 and below shows higher autonomous motivation (5.53± 0.16) than the 65-74 age group (5.33 ± 0.11) and the 75 years and older group (5.40 ± 0.38) (p < 0.01). Autonomous motivation was higher in the women's group (5.48 ± 0.13) than in the men's group (5.39 ± 0.32) (p < 0.05). Inversely, controlled motivation (2.94 ± 0.58) and amotivation (3.61 ± 0.33), was higher in men's group than in women's group (2.54 ± 0.55 and 3.30 ± 0.40) (p < 0.001).

Conclusions:

Motivations to use a health website vary according to gender and age. This study may contribute to a more tailored to users and guide the development and dissemination of health websites.
SCREENING FOR KIDNEY DISEASE IN HIGH-RISK POPULATION OF DALMATIA - DIFFERENCES REGARDING THE PRESENCE OF ARTERIAL HYPERTENSION
Authors: Vuckovic Marijana , Dogas Hana , Radic Mislav , Kolak Ela , Nenadic Dora Bucan , Topic Ante , Tandara Leida , Sarolic Antonela , Radic Josipa
Published: May 2024

Objective:

Chronic kidney disease is an emerging health burden which often goes unrecognized. Therefore, screening for kidney disease in high-risk hypertensive, obese or diabetic patients was made in University Hospital Split, Croatia. The aim of this study was to assess differences in measured parameters in this high-risk population regarding the presence of arterial hypertension (AH).

Design and method:

Total of 165 participants (33% male) aged 64 (IQR 55-72) years diagnosed with arterial hypertension, diabetes or obesity were screened in March 2023 in Split, Croatia. 57 (34.5%) participants were diagnosed with arterial hypertension. Data about medical history, physical activity and anthropometric and laboratory (serum creatinine, eGFR and albumin creatinine data) were collected. Central and peripheral blood pressure was measured using the Agedio B900 device.

Results:

We found no statistically significant difference in parameters of age, waist circumference, hip circumference and body mass index. Regarding comorbidities, hyperlipidemia was more prevalent in participants with AH (11% vs. 28%, p=0.02). Statistically significant higher values of eGFR were found in participants without AH than in participants with AH (85.5 ml/min/1.73 m2 vs. 76.6 ml/min/1.73 m2, p= 0.01). We found no difference between the levels of albumin to creatinine ratio and albuminuria between the groups.

Conclusions:

Both hypertensive and non-hypertensive participants showed rather high rates of eGFR. Although having lower levels of eGFR and higher prevalence of hyperlipidemia than non-hypertensive high risk population Dalmatian hypertensives did not differ in albuminuria and albumin to creatinine ratio.
CARDIOVASCULAR IMPACT OF DISCONTINUATION OF RENIN-ANGIOTENSIN SYSTEM INHIBITORS IN ADVANCED CHRONIC KIDNEY DISEASE
Authors: Valentin Maisons , Margaux Costes -ALBRESPI , Sophie Liabeuf , Solene Laville M. , Ziad Massy , Benedicte Sautenet , De Pinho Natalia Alencar
Published: May 2024

Objective:

Hypertension is a major problem in chronic kidney disease (CKD) with a prevalence approaching 100%, contributing to the risk of CKD progression, cardiovascular events and all-cause mortality. Renin-angiotensin system inhibitors (RASi) are the first-line therapy for antihypertensive treatment in patients with CKD, due to its protective effects. However, it is common practice stopping RASi in advanced CKD to attempt to delay kidney replacement therapy (KRT) initiation and/or to prevent drug-related acute kidney injury.

Design and method:

From the CKD-Rein prospective cohort, which included 3033 outpatients from nephrology clinics in France, we selected participants with an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73m2 and who were treated with RASi for at least 3 months. We used the G-formula to deal with time-fixed (age, sex, diabetes, heart failure, lung diseases) and time-varying confounding (eGFR, systolic blood pressure, serum sodium and potassium, diuretic prescription) to compare two treatment strategies: to discontinue or to continue RASi. The outcome, MACE, was the composite of cardiovascular death, myocardial infarction, stroke or hospitalization for heart failure. Competing risks were initiation of KRT and non-cardiovascular death.

Results:

From the 1,472 patients included (median age 69 years, median eGFR 25mL/min/1.73m2, 34% women), 27% discontinued RASi over a median follow-up of 35 [17-51] months. The crude rate of RASi discontinuation was higher in the presence of cardiovascular comorbidities and more severe CKD. The number of reported serious adverse reactions over the follow-up (such as acute kidney injury or hyperkalemia) was low, but higher in the discontinuation than in the continuation group (47 versus 23 per 1,000 person-years). After taking the afore-mentioned potential confounders into account, the 36-month risk of MACE was twice as high in the discontinuation group as that in the continuation group (RR 2.13, 95%CI 1.60-2.85).

Conclusions:

RASi discontinuation was significantly associated with MACE risk, the leading cause of morbidity and mortality in advanced CKD. Our results, along with other published data, suggest that the risk-benefit balance favors continued use of RASi in this population.
RACIAL DISPARITY IN DEVELOPING HYPERTENSION
Authors: Tantisattamo Ekamol , Phoonakh Thutpharritchn , Sinkajarern Varissara , Kookanok Chutawat , Rodsom Kamonluk , Noree Wanprapit , Chuenchaem Urairat , Wanichwecharungruang Nisha , Naunsilp Piengpitch , Vutthikraivit Possawat , Thiravetyan Ben , Kulthamrongsri Narathorn , Srikulmontri Thitiphan , Rochanaroon Voramol , Puchongmart Chanokporn , Tribuddharat Narisara , Suenghataiphorn Thanathip , Jariyayothin Irin , Wattanachayaku Phuuwadith
Published: May 2024

Objective:

The magnitude of the association of race with the onset of hypertension (HTN) in nationally representative populations in the United States is unclear. We aim to examine the association between race and risk for HTN.

Design and method:

A retrospective cohort study using the 2017-2020 NHANES included self-reported diagnoses for HTN. The association between race and age of HTN diagnosis was examined by multiple Cox regression.

Results:

Of 9,693 participants >/=18 years old, mean±SD age was 50±19 years and 51% were female. The majority was non-Hispanic White (NHW; 35%) followed by non-Hispanic Black (NHB; 26%), non-Hispanic Asian (NHA; 12%), Mexican American (MA; 12%), Hispanic (10%), and multi-racial (5%). The incidence rate of HTN was 0.013 person-years with a median age of HTN diagnosis of 49 years old (IQR 37, 58). NHB had the youngest age of diagnosis of HTN (median (IQR) 45 (35, 55)) followed by MA (50 (38, 58)), NHW (50 (38, 61)), NHA (50 (40, 59)), Hispanic 49 (40, 58), and multi-racial 42 (30, 52). Compared to the NHW, all other races had a significantly greater risk of developing HTN with the highest and lowest risk in multi-racial and Hispanic groups, respectively (HRMulti-racial 1.47, 95%CI 1.25, 1.73 and HRHispanic 1.13, 95%CI 1.00, 1.28). After adjusting for age, gender, and the interaction term between race and gender, MA and Hispanics became lower risk for developing HTN compared to NHW, while other races had no significant difference (HRMA 0.63, 95%CI 0.52, 0.75 and HRHispanic 0.79, 95%CI 0.66, 0.95). In addition, gender was identified as an effect modifier with an increased risk of developing HTN observed in MA, Hispanic, and NHB females (Pinteraction <0.001, 0.033, and <0.011, respectively).

Conclusions:

While accounting as minority groups, MA and Hispanic populations have a lower risk of developing HTN compared to NHW except for female MA and female Hispanics having a greater risk. Female NHB have a higher risk for HTN compared to NHW. Further studies that assess risk factors for HTN related to race by mixed method may explore mechanisms of racial disparity in developing HTN.
IMPACT OF COVID-19 ON THE PREVALENCE, AWARENESS AND CONTROL OF HYPERTENSION IN GREECE: MAY MEASUREMENT MONTH SURVEY 2019 VS 2022
Authors: Menti Ariadni , Kollias Anastasios , Gkaliagkousi Eugenia , Goumenos Dimitrios , Grassos Charalampos , Kalaitzidis Rigas G. , Kallistratos Manolis , Katsi Vasiliki , Konstantinidis Dimitrios , Kotsis Vasileios , Krokidis Xenophon , Kyriakoulis Konstantinos , Lanaras Leonidas , Makaris Emmanouil , Makris Thomas , Manios Efstathios , Maragkoudakis Spyridon , Manolis Athanasios , Marketou Maria , Milionis Charalampos , Nikitas George , Papachristou Evangelos , Papadakis John , Papadopoulos Dimitrios , Protogerou Athanasios , Pikilidou Maria , Sarafidis Pantelis , Saraki Vasilios , Tsoufis Konstantinos , Zebekakis Pantelis , Doumas Michael , Stergiou George
Published: May 2024

Objective:

The COVID-19 pandemic appeared to have an adverse impact on the management of cardiovascular risk factors. This study investigated the prevalence, awareness, treatment, and control of hypertension in the adult population in Greece before and after the COVID-19 pandemic (2019 and 2022) in the context of the May Measurement Month (MMM) global survey initiated by the International Society of Hypertension (ISH).

Design and method:

Adult volunteers were recruited through opportunistic screening in public areas in several cities of Greece in 2019 and 2022. Information on medical history and triplicate sitting blood pressure (BP) measurements were obtained using validated automated upper-arm cuff devices with appropriate cuff size. Data were uploaded to an international online platform. Hypertension was defined as systolic BP >=140 mmHg and/or diastolic >=90 mmHg, and/or self-reported use of drugs for hypertension. The same threshold was used for the definition of uncontrolled hypertension in treated individuals.

Results:

The MMM survey collected data from 5,727 adults in 2019 and 6,353 in 2022. The characteristics of the participants in 2019/2022 were: men 46/49%, p<0.01; mean age 52.7±16.6/54.8±16.2, p<0.001; smokers, 24.7/30.5, p<0.001; diabetic 12/11.5%, p=NS; history of cardiovascular disease 5/5.8%, p=NS). The prevalence of hypertension was 41.6/42.6% (2019/2022, p=NS). Among patients with hypertension, 21.3/27.5% (2019/2022, p<0.001) were unaware of their condition, 5.6/2.4% were aware but untreated (p<0.001), 24.8/22.1% were treated but uncontrolled (p<0.05), and 48.3/47.8% were treated controlled (p=NS).

Conclusions:

The COVID-19 pandemic did not significantly affect the prevalence and the control of hypertension in the general population in Greece. However, the rate of undiagnosed hypertension was increased after the pandemic.
ASSOCIATION BETWEEN ESTIMATED PULSE WAVE VELOCITY AND INCIDENT NONALCOHOLIC FATTY LIVER DISEASE IN KOREAN ADULTS
Authors: Shin Jeong -HUN , Kim Byung Sik , Kim Hyun -Jin , Lim Young -Hyo
Published: May 2024

Objective:

Nonalcoholic fatty liver disease (NAFLD) is associated with vascular dysfunction, one of the signs of which is arterial stiffness. Carotid–femoral pulse wave velocity (PWV), which is considered the gold standard measure of arterial stiffness, can be estimated using two commonly assessed clinical variables: age and blood pressure. This study aimed to evaluate the association between estimated PWV (ePWV) and the prevalence and incidence of NAFLD among Korean adults.

Design and method:

This study used data from the Ansan–Ansung Cohort Study, a subset of the Korean Genome and Epidemiology Study, and included 8,336 adult participants with and without NAFLD at baseline. The participants were subdivided into three tertile groups according to ePWV.

Results:

At baseline, the prevalence of NAFLD was 10.5, 27.5, and 35.0% in the first (lowest), second, and third (highest) tertiles of ePWV, respectively. During the 18-year follow-up period, 2,467 (42.9%) incident cases of NAFLD were identified among 5,755 participants who did not have NAFLD at baseline. After adjustment for clinically relevant variables, participants in the second (adjusted hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.12–1.40) and third (adjusted HR, 1.42; 95% CI, 1.24–1.64) tertiles of ePWV had a significantly higher risk of incident NAFLD than those in the first tertile.

Conclusions:

Higher ePWV independently associated with an elevated risk of NAFLD in the general population.
INCIDENCE AND MORTALITY RISK OF AKD AND AKI IN THE PRIMARY CARE
Authors: Redon Josep , Lidon Laura , Diaz Javier , Martinez Fernando , Sauri Inma , Fernandez Antonio , Grau Maria , Forner Maria J , Redon Josep
Published: May 2024

Objective:

Objective: The aim of the present study was to assess the impact of hypertension in the incidence of Acute Kidney Damage and Acute Kidney Injury episodes in the community, defined by changes in serum creatinine and temporal window.

Design and method:

The study analyzed the EHR of a community of 1,863,731 adult subjects >23 years of age with serum creatinine before, during and after the AKD episode for a variable period of time. eGFR was calculated using the CKD-EPI formula. AKD and AKI were defined according to the harmonized KDIGO criteria (Lameire 2021). The acute event was defined as having occurred when the blood creatinine was at least 150% of the mean of the previous creatinine measurement. AKD is considered to have ended when the creatinine falls to at least the threshold created by the pre-event mean plus half the increment produced during the episode within three months. AKI was defined as a sudden drop in creatinine within seven days. The RIFLE scale was used to classify episodes. HTN was considered when it was recorded in the EHR (CIE9 and 10).

Results:

During a mean follow-up of 4.8 years, 56,850 episodes of AKD were identified in 47,670 patients. The incidence was 4.49 and 19.0/1000 patients/year in non-CKD and CKD subjects, respectively. Overall, HTN was present in 62.8% of patients, 49,9% among those without CKD before the event and in 92.6% in CKD patients. In patients without CKD, HTN increases the risk of more severe RIFLE class of AKD (Risk 47.4%, Injury 64.1% and Failure 66.0%). The prevalence of HTN in patients with AKI was 76.6% without differences in the RIFLE class (Risk 76.3%, Injury 77.2% and Failure 76.9%). A higher mortality was recorded among the AKI patients.

Conclusions:

The data from this study reinforce the concept that acute elevations in serum creatinine occurring and managed in the community may pose a health risk and HTN is an important risk factor. Future work should consider how best eAlerts can be utilized, targeted and implemented.
BLOOD PRESSURE AND CHOLESTEROL CONTROL IN HYPERTENSIVE PATIENTS WITH DYSLIPIDEMIA: A CROSS-SECTIONAL EPIDEMIOLOGICAL STUDY IN SERBIA (SNAPSHOT STUDY)
Authors: Ivanovic Branislava , Bayle Sabine
Published: May 2024

Objective:

This study aimed to assess the control rates of blood pressure (BP) and low-density lipoprotein-cholesterol (LDL-C), along with the associated cardiovascular (CV) risk, in hypertensive patients with dyslipidemia in Serbia, based on both recommendations from 2021 European Society of Cardiology CV disease prevention guidelines (SCORE2-OP), and physicians’ assessment.

Design and method:

SNAPSHOT, a cross-sectional observational multicenter epidemiological study, involved 97 investigators (56.7%, 19.6%, 21.6% and 2.1% were general practitioners, internist, cardiologists, and endocrinologists, respectively) in Serbia and included 1187 hypertensive patients with dyslipidemia.

Results:

The analysis set included 1168 patients, with a mean (standard deviation [SD]) age of 61.9 (11.3) years. Most patients were female (59.4%), overweight or obese (73.9%), and non-smokers (58.7%). Most (85.5%) patients had at least one additional risk factor and 33.9% had at least one additional CV comorbidity, mainly angina (13.4%), peripheral arterial disease (9.3%), and myocardial infarction (8.0%). Mean (SD) systolic and diastolic BP were 134.4 (15.3) and 82.3 (9.5) mmHg, respectively. Mean (SD) total cholesterol, high density lipoprotein-cholesterol, LDL-C, and triglycerides were 229.1 (49.8), 54.3 (18.4), 137.7 (44.5), and 176.4 (90.5) mg/dl, respectively.

Hypertension was treated in 98.7% of patients. BP was considered controlled according to investigators in 74.8% of patients, and to guidelines in 20.9% of patients. Dyslipidemia was treated in 93.2% of patients. LDL-C was considered controlled according to investigators in 48.2% and to guidelines in 2.9% of patients. 0.70% of patients were controlled on both BP and LDL-C according to guidelines. Single-pill combination was used to treat hypertension, dyslipidemia, and both conditions in respectively 58.8%, 9.2%, and 11.9% of patients.

CV risk was estimated by investigators as moderate (41.9%), high (37.9%), or very high (11.0%) for most patients. However, calculated CV risk according to guidelines was either high or very high for all patients (12.3% and 87.7%, respectively). The investigator underestimated the CV risk in 84.9% of patients.

Conclusions:

This study showed low control rates for BP and LDL-C. CV risk was frequently overestimated by physicians. Enhancing physician education on guideline recommendations and treatment intensification could improve risk factor control.
PREVALENCE OF HIGH BLOOD PRESSURE IN YOUNG PEOPLE: SURVEY IN ALGERIA
Authors: Gacemi Sofiane , Bounab Lyamine , Farid Haddoum , Mourad Chemli , Redouane Bouzid
Published: May 2024

Objective:

Cardiovascular disease is one of the leading causes of death in the world. Hypertension accounts for (13%) of overall mortality. Since it is not accompanied by any signs, arterial hypertension is often unrecognized in young people and its incidence in the age group under 30 years is increasing. Globally, the prevalence of hypertension is estimated to be 13% in males and 7% in females, aged 20 to 29 years. In Algeria, the prevalence among young people aged 18 to 29 is 8.5%.

The objectives of our study were the screening of high blood pressure in healthy young people under 30 years old, using ambulatory blood pressure monitoring.

Design and method:

This is a multicentric cross-sectional analytical study involving 500 individuals, started in April 2018 until May 2021, in western Algeria. Screening for this pathology is based on ambulatory blood pressure monitoring. Statistical analysis was performed by Epi Info software version 7.2.6.

Results:

Over the entire sample, we identified 9% (n: 45) hypertensive, including 2.5% nocturnal hypertension and 2% masked hypertension, the prevalence of white coat hypertension was 4.8%. Systolic blood pressure 2.2%, diastolic 2.2% and systolic-diastolic 1%. Mean SBP was 116.34 mmHg Mean DBP was 66.86 mmHg.

Conclusions:

We were able to develop an epidemiological database that can be the starting point for multicenter studies to estimate the prevalence of hypertension in young adults at the national level. the establishment of an Algerian electronic platform for ABPM under the aegis of learned societies to better assess this pathology as well as its consequences.
PREVALENCE, AWARENESS AND THERAPEUTIC CONTROL OF HYPERTENSION IN BELGIUM: AN OPPORTUNISTIC SCREENING OF NEARLY 6,000 PARTICIPANTS DURING THE MAY MEASUREMENT MONTH CAMPAIGNS 2017-23
Authors: De Backer Tine , Brouwers Sofie , Delmotte Philippe , Falque Bertrand , Heuten Hilde , Krzesinski Jeanmarie , Saint-rémy Annie , Persu Alexandre , Robberechts Tom , Vanassche Thomas , Van De Borne Philippe , Van Parys Joris , Van Der Niepen Patricia , Desloovere Jana , Van Nieuwenhuyse Bregt , De Bacquer Dirk
Published: May 2024

Objective:

The May Measurement Month (MMM) initiative is an annual global screening and awareness campaign started in 2017 by the International Society of Hypertension highlighting the importance of regular measurements of blood pressure (BP), the most important modifiable risk factor contributing to cardiovascular and all-cause mortality worldwide. Here we report on the results of the MMM campaign done in Belgium during the month of May in 2017, 2018, 2019, 2022 and 2023.

Design and method:

Participants 18 years or older were recruited through opportunistic sampling in 12 sites (mostly hospital entrances) across Belgium. Apart from standardized BP recordings (OMRON automated devices) by trained staff, data were collected on demographics, lifestyle factors and comorbidities. Hypertension was defined as raised blood pressure (systolic BP =>140 mmHg and/or diastolic BP => 90 mmHg) and/or taking antihypertensive medication. Age-standardized prevalence rates were calculated using the overall Belgian population (1st Jan 2023) as reference.

Results:

Data were collected from 5,926 participants aged 51.5 years on average. Mean (SD) systolic and diastolic blood pressures were 125.9 (17.6) mmHg and 79.4 (10.9) mmHg with 26.7% exceeding the 140/90 mmHg threshold. Age-standardized prevalences (95% CI) of hypertension were 45.4% (42.6%-48.1%) in men and 36.9% (34.8%-39.0%) in women. Among the 2,468 individuals with hypertension, 1,938 (78.5%) had been previously diagnosed and 1,578 (81.4%) of those with known hypertension, received antihypertensive treatment. Only about half of those being treated (56.3%) did achieve the target of systolic/diastolic BP <140/90 mmHg. Inadequate therapeutic control was independently associated with increasing age and higher body mass index. Untreated hypertension was significantly associated with male sex, age, body mass index and alcohol use.

Conclusions:

Despite the potential limited representativeness of the sample, these data suggest that the ‘rule of halves’ for hypertension does not longer hold in Belgium and that therapeutic control of hypertension is still suboptimal.
SEX DIFFERENCES IN SOCIOECONOMIC FACTORS AND LIFESTYLE HABITS IN HYPERTENSIVE AND NORMOTENSIVE SUBJECTS
Authors: Andelic Ana Marija , Abramovic Inga , Alagic Marieta , Horvat Petra , Ivankovic Iva , Zdilar Ana Marija , Domislovic Marija , Glavic Mihaela Marinovic , Jelakovic Bojan
Published: May 2024

Objective:

Given the alarming prevalence of hypertension, this study aims to explore differences in socioeconomic factors or lifestyle habits between men and women in relation to blood pressure (BP) categories.

Design and method:

This study involved 864 participants (random sample of general adult population in Croatia included in the ’Epidemiology of Hypertension in Croatia -2’ project). Participants, categorized by BP and antihypertensive medication use, were further divided by gender into controlled hypertensive (BP<140/90 mmHg; 94 men and 181 women), uncontrolled hypertensive (101 men and 133 women), and normotensive (115 men and 240 women) groups. Socioeconomic factors and lifestyle habits were assessed through a provided questionnaire.

Results:

The sex difference in average personal monthly income showed statistical significance in all categories of BP. Less than 467€ monthly was earned by 39.4% of men and 71.3% of women among controlled hypertensives (p<0.001), 51.5% of men and 72.2% of women among uncontrolled hypertensives (p<0.001), and 28.7% and 46.3% of women among normotensives (p=0.004). Significant sex differences in level of education were found in both hypertensive groups, but not in normotensives (p=0.250). Education of more than 8 years was observed in 80.9% of men and 58.6% of women in controlled (p=0.006) and 78.2% of men and 56.4% of women in the uncontrolled (p=0.005) group. There is a significant difference in pack years between men and women. The mean amount in controlled hypertensives is 24.0 in men and 20.0 in women (p=0.024); in uncontrolled hypertensives 20.0 in men and 11.0 in women (p=0.029); in normotensives 16.0 in men and 10.0 in women (p=0.004). Difference of hard alcohol consumption between men and women was significant. In controlled hypertensives 17.0% of men and 1.7% of women drink once a week or more (p<0.001); in uncontrolled hypertensives 16.8% of men and 2.3% of women (p=0.001); in normotensives 9.6% of men and 4.2% of women (p=0.048).

Conclusions:

Men with hypertension exhibited a less healthy lifestyle, marked by increased alcohol consumption and smoking, while women with hypertension appear to be affected more by their socioeconomic status, particularly by lower monthly income in comparison with men.
EPIGENESIS OF 11BETA-HYDROXYSTEROID DEHYDROGENASE IN SALT-SENSITIVE HYPERTENSIVE RATS
Authors: Takeda Yoshiyu , Takeda Yoshiichi , Kometani Mitsuhiro , Karashima Shigehiro , Konishi Seigo , Aono Daisuke , Horike Shinichi , Yoneda Takashi
Published: May 2024

Objective:

11Beta-hydroxysteroid dehydrogenase type1 (11beta-HSD1) is the modulator of glucocorticoid hormone and type2 (11beta-HSD2) is the modulator of mineralocorticoid hormone. Both enzymes are related to hypertension. We investigated the effect of high salt diet on the methylation of both enzyme gene in salt-sensitive hypertensive (SSH) rats.

Design and method:

SSH rats were fed a high (7% NaCl) or normal (0.45%) salt chow for 4 weeks. WKY rats were used as controls. Body weight, blood pressure, plasma and urinary aldosterone concentration and PRA were measured. DNA was extracted from both kidneys and visceral fats. Bisulfite sequencing and Pyrosequencing were done for the analysis of methylation status of 11beta-HSD1 and 2 gene.

Results:

High salt diet significantly increased blood pressure in SSH rats compared with control rats (p<0.01). High salt diet significantly decreased methylation ratio of 11beta-HSD1 gene in the visceral fats of SSH rats compared with controls (p<0.05). The methylation ratio of 11beta-HSD2 gene in the kidney of SSH rats was not influenced by high salt diet.

Conclusions:

11Beta-HSD1 overexpression in visceral fats in mice was reported to show SSH. We reported decreased 11beta-HSD2 activity in the artery in SSH rats. In this study high salt diet affected methylation status of 11beta-HSD1 in the adipose tissue but not 11beta-HSD2 gene in the kidney in SSH. Food intake such as salt may influence the epigenesis of 11beta-HSD and induce hypertension.
GENETIC FACTORS CONTRIBUTING TO THE PATHOGENESIS OF ESSENTIAL HYPERTENSION IN TWO AFRICAN POPULATIONS
Authors: Rayner Brian Lindsay , Kalideen Kusha , Ramesar Raj
Published: May 2024

Objective:

This study aimed to assess the association of genetic variants, including RAAS variants, and essential hypertension in a cohort of African patients.

Design and method:

Two hundred and seventy-seven hypertensive patients and one hundred and seventy-six normotensive individuals were genotyped for 79 variants. The cohort could be further stratified on the basis of ethnicity, namely the Mixed Ancestry and the Xhosa-speaking populations. Genotyping was performed using the medium-throughput Illumina Golden Gate Bead Express assay and allele-specific polymerase chain reaction.

Results:

The association of variants with essential hypertension was assessed using the Fisher Exact test, while multivariate logistic regression was used to predict the development of hypertension. Five variants in RAAS genes (CYP11B2 rs179998, AGT rs5051 and rs699, AGTR1 rs5186 and ACE rs4646994) were significantly associated with essential hypertension in the cohort under study. After multinomial logistic regression, rs5186 and rs699 were identified as risk factors for the development of hypertension.

Conclusions:

In the Mixed Ancestry and Xhosa populations of South Africa, an association was observed between RAAS-related genes and the development of hypertension.
MICRORNAS AS BIOMARKERS IN THE DIFFERENTIATION OF HYPERTENSION CAUSED BY TAKAYASU ARTERITIS FROM ESSENTIAL HYPERTENSION
Authors: Ma Huimin , Zhang Delian
Published: May 2024

Objective:

We detected the expression of 10 pre-selected miRNAs in the plasma of patients Takayasu's arteritis(TA) and Essential Hypertension (EH) and explored whether miRNAs expression levels can be used as biomarkers to distinguish between TA and EH in the differential diagnosis.

Design and method:

The study included 20 TA patients and 20 EH patients. The plasma concentrations of miR-125a-5p, miR-126-3p, miR-146a-5p, miR-150-5p, miR-155-5p, miR-181a-5p, miR-203a-3p, miR-223-3p, miR-326 and miR-346 were measured by quantitative polymerase chain reaction. Role of plasma miRNAs concentration in the differential diagnosis of TA and EH was evaluated by the area under the receiver operating characteristic curve (ROC).

Results:

Compared with EH patients, the expression levels of miR-125a-5p, miR-155-5p, miR-181a-5p, miR-203a-3p, miR-326, and miR-346 in TA patients were lower (P < 0.05). After adjusting for potential confounding variables, including age, gender, systolic blood pressure, erythrocyte sedimentation rate, and renin, the differential expression of miR-155-5p, miR-181a-5p, and miR-203a-3p in TA and EH was still statistically significant (P < 0.05). ROC curve analysis showed that when the three microRNAs were combined, the sensitivity increased to 0.95, the specificity was 0.80, the area under the curve (AUC) was 0.805, and the 95% confidence interval (CI) [0.634 0.977].

Conclusions:

The expression levels of miR-155-5p, miR-181a-5p and miR-203a-3p in TA patients were lower than those in EH patients. The combined diagnosis of the three microRNAs may be beneficial to the differentiation of hypertension caused by TA from EH.