bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF HYPOKALEMIA ON LEFT VENTRICULAR STRUCTURE AND FUNCTION IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Wang Qiongying , Zhang Haodong , Wang Wenjuan , Fan Xin , Yu Jing
Published: June 2022

Objective:

Analyzing the changes of left ventricular structure and function in essential hypertension patients with hypokalemia, we want to provide an evidence for clinical diagnosis and treatment of early heart damage caused by hypertension and hypokalemia.

Design and method:

413 patients with hypertension were selected, including 270 cases of essential hypertension and 143 cases of essential hypertension with hypokalemia.Collect patient general information, biochemistry, urine routine, office blood pressure, 24 h ambulatory blood pressure, left atrial diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter, ventricular septal thickness, left ventricular posterior wall thickness and other indicators.After propensity score matching, 108 cases in the essential hypertension group and the essential hypertension with hypokalemia group were each, and statistical analysis was performed.

Results:

Albumin, and urea-creatinine ratio levels of the essential hypertension with hypokalemia group were significantly reduced, and the ratios of sodium ions and sodium potassium were lower than those of the primary hypertension group. Correlation analysis shows that the left ventricular mass index was positively correlated with and the course of hypertension, systolic blood pressure, diastolic blood pressure, mean arterial pressure, creatinine, sodium-to-potassium ratio, mean systolic blood pressure during the day, mean diastolic blood pressure during the day, mean systolic blood pressure at night, mean night diastolic blood pressure. Multiple linear regression analysis showed that the left ventricular mass index was independently positively correlated with systolic blood pressure, hypertension course, creatinine, sodium-to-potassium ratio, night systolic blood pressure, 24 h average systolic blood pressure, and 24 h systolic blood pressure load rate; potassium ion, low density Lipoprotein, angiotensin II and left ventricular mass index are independently and negatively correlated.

Conclusions:

There are more obvious ventricular structural changes in essential hypertension patients with hypokalemia; serum potassium ion concentration and sodium-to-potassium ratio are independent risk factors for left ventricular mass index in essential hypertension patients with hypokalemia.
CORRELATION BETWEEN ESTIMATED PULSE WAVE VELOCITY FROM DERIVATED FROM REFERENCE OR HEALTHY POPULATION EQUATION AMONG INDIVIDUALS COM CARDIOVASCULAR RISK FACTORS
Authors: da Silva Marco Antonio Vieira , Dias Valdo Jose , de Resende Luiz Antonio Pertili R. , Vieira Livia Marchiori , Mesquita Mariana Dornfeld Soffiatti , Martins Maria Julia Sousa , Segawa Maria Eduarda Fernandes , Ferreira Pedro Paulo Soares , Nogueira Marianna de Freitas Rocha , dos Santos Flávia Hermano Rodrigues , dos Santos Giovanna C. Ferreira , Oliveira Guilherme Rodrigues , de Oliveira Rodovalho Euler , Filho André Breda Bauab , Pasquar Danilo R. Goulart
Published: June 2022

Objective:

To evaluate the correlation between estimated pulse wave velocity (ePWV) from two different equations in individuals with cardiovascular (CV) risk factors.

Design and method:

It selected five hundred sixty-five patients who presented at least one cardiovascular risk factor among treated hypertension, an elevated BP (cut off 140–90 mmHg), diabetes, dyslipidemia, smoking, body, and abdominal obesity. Using an automatic device, a non-physician trained observer performed three sequential BP measurements. The ePWV was calculated from age and mean blood pressure (MBP). Two equations derived from reference population (equation 1) and healthy population (equation 2) estimated ePWV (Greeve et al.).

Eq. (1) = 9.58748315543126–0.402467539733184*age+4.56020798207263*10–3*age2–2.6207705511664*10-5*age*MBP+3.1762450559276*10-3*age*MBP-1.83215068503821*10-2MBP.

Eq. (2) = 4.62–0.13*age+0.0018*age2+0.0006*age*MBP+0.0284*MBP.

MBP was calculated as diastolic BP + 0.4 (ystolic BP - diastolic BP). We calculated the mean ePWV with both equations, performed a t-test to compare the means. The concordance correlation coefficient Pc evaluated the precision and accuracy between the measurements. We used the Bland Altman plot to assess an agreement between two ePWV better.

Results:

The Clinical characteristics of the sample: mean age 48.9 ± 13.9 years, 282 (49.9%) women, 219 (38.8%) treated hypertensives, 161 (28.5%) non treated hypertensives, 94 normotensives (16.6%), 38 (6.7%) masked hypertensives, 53 (9.4%) white coat hypertensives, 187 (33.1%) with dyslipidemia, 69 (12.2%) diabetics, 243 (43.1%) obese, 335 (60.3%) with waist circumference at risk, 47 smokers (8.3%). Figure 1 shows the Scatter diagram of correlation between epWV Eq. (1) and Eq. (2). The concordance correlation coefficient was 0.996 (95%CI: 0.995 – 0.997); Pearson coefficient p (precision) = 0.996; bias correction factor Cb (accuracy) = 0.999. On Figure 2 the Bland Altman plot considering the Eq. (1) as a gold standard demonstrates the agreement between two measurements.

The mean difference was 0.03 ((95%CI: -0.28 – 0.33). There was no difference in ePWV with Eq. (1) - 9.17 ± 1.80 m/s and utilizing Eq. (2) - 9.14 ± 1.77 m/s (p = 0.77).

Conclusions:

Our data indicated an almost perfect correlation and values equivalency between ePWV from Eqs. (1) and 2. Therefore both equations could be utilized in individuals with cardiovascular risk factors to estimate PWV.
REDUCED ENDOTHELIAL GLYCOCALYX IS ASSOCIATED WITH HYPERTENSION BURDEN ONLY IN MALE SMOKERS WITH FIRST DIAGNOSED AND NEVER TREATED STAGE I AND II ESSENTIAL HYPERTENSION
Authors: Triantafyllidi Helen , Fabri Anastasia , Benas Dimitris , Birmpa Dionyssia , Schoinas Antonios , Thymis Ioannis , Kostell Gavriela , Ikonomidis Ignatios
Published: June 2022

Objective:

Endothelial dysfunction may be estimated by reduced endothelial glycocalyx (EG). However, the role of EG as a hypertension mediated organ damage (HMOD) still remains controversial. Cigarette smoking represents a significant CV risk factor. Aim of this study is the investigation of the EG’s role in first diagnosed and never treated patients with stage I and II essential hypertension regarding smoking habit.

Design and method:

We studied 194 non-diabetic, first diagnosed and never-treated hypertensive patients (mean age=49 + 10 years, 60% males, 35% smokers). Ambulatory blood pressure monitoring (24 h ABPM) and endothelial dysfunction (PBR5–25) were estimated in each patient before treatment initiation.

Results:

We found that mean 24 h systolic and diastolic ABPM levels were 140 + 8 mmHg and 87 + 9 mmHg, respectively. Regarding EG, mean values of PBR5–25, PBR5-9, PBR10-19 and PBR20-25 were 2.08 + 0.3 m, 1.16 + 0.2 m, 2.22 + 0.34 m and 2.65 + 0.8 m, respectively. No correlations were found between PBR levels and 24 h ABPM regarding the whole population. However, when we performed multiple regression analysis in a subgroup of male smoker hypertensives (n = 46, mean age=47 + 11 years), a significant association (Beta = 0.29, p = 0.05) was revealed between PBR20-25 and 24 h systolic ABPM.

Conclusions:

In first diagnosed and never treated arterial hypertension, endothelial dysfunction, represented by reduced EG, is independently related to systolic BP burden only in male smokers. Probably EG might play a significant role regarding CV risk estimation in specific groups of hypertensive patients.
SMOKING HABIT IS NOT RELATED WITH HYPERTENSION MEDIATED ORGAN DAMAGE IN YOUNG PATIENTS WITH FIRST DIAGNOSED AND NEVER TREATED ESSENTIAL HYPERTENSION
Authors: Triantafyllidi Helen , Benas Dimitris , Fabri Anastasia , Birmpa Dionyssia , Schoinas Antonios , Thymis Ioannis , Kostelli Gavriela , Ikonomidis Ignatios
Published: June 2022

Objective:

Early onset arterial hypertension (AH) is associated with a considerably increased risk for cardiovascular (CV) disease. Cigarette smoking represents a significant CV risk factor. Aim of this study is the investigation of any differences between smokers and non smokers first diagnosed and never treated young patients with essential hypertension regarding the burden of blood pressure and the presence of hypertension-mediated organ damage (HMOD).

Design and method:

We studied 272 non-diabetic, first diagnosed and never-treated young hypertensive patients, [median age=43(39-48), 68% males]. Ambulatory blood pressure monitoring (24 h ABPM), CV risk factors [smoking, obesity (BMI), hyperlipidemia and HMOD [aortic stiffness (PWV), left ventricular diastolic dysfunction (EEa), cardiac hypertrophy (LVMI), coronary arteries microcirculation (CFR), carotid intima-media thickness (cIMT) and endothelial dysfunction (PBR5-25)] were estimated in each young patient before treatment initiation.

Results:

Young patients’ population was divided regarding smoking habit in smokers group [n = 105, age = 43(38–47), 75 males)] and non-smokers [n = 167, age = 43 (39–48), 119 males]. LDL-C levels, triglycerides, 24 h and daytime systolic ABPM, systolic and diastolic BP variability (BPV) and systolic BP load (BPL) during daytime were increased in smokers compared to non-smokers. No significant differences between smokers and non-smokers regarding age, BMI, E/Ea, LVMI, PWV, MAU, CFR, cIMT and PBR5–25 were found. However, the incidence of LVH (13% vs. 6%, p = 0.04) and impaired CFR (p = 0.05) was increased in smokers compared to non-smokers. In multiple regression analysis, we noted that 24 h systolic ABPM was independently associated with PWV (beta = 0.31, p < 0.001), LVMI (beta = 0.32, p < 0.001) and CFR (beta = -0.18, p = 0.01) regardless of smoking habit.

Conclusions:

In young people with first diagnosed arterial hypertension, HMOD is independently related to BP burden, irrespective of smoking habit. As HMOD may regress with successful antihypertensive treatment, there is still time for those young patients to treat hypertension disease and hyperlipidemia and quit smoking, in order to reduce future CV risk.
CONTINUOUS EXPOSURE OF THE HYPERTENSIVE RATS TO LIGHT INCREASES THE RISK OF MALIGNANT CARDIAC ARRHYTHMIAS - OMACOR CARDIOPROTECTION
Authors: Bacova Barbara Szeiffova , Benova Tamara Egan , Sykora Matus , Zurmanova Jitka , Knezl Vladimir , Andelova Katarina , Tribulova Narcis
Published: June 2022

Objective:

Light pollution disturbs circadian rhythm, and this can also be deleterious to the heart by increased susceptibility to arrhythmias. Herein, we investigated if rats exposed to continuous light had altered myocardial gene transcripts and/or protein expression which affects arrhythmogenesis. We then assessed if Omacorâ supplementation benefitted affected rats.

Design and method:

Male and female spontaneously hypertensive (SHR) and normotensive Wistar rats (WR) were housed under standard 12 h/12 h light/dark cycles or exposed to 6-weeks continuous 300 lux light for 24 h. Half the rats were then treated with 200 mg/100 g b.w. Omacorâ.

Results:

Continuous light resulted in higher male rat vulnerability to malignant ventricular fibrillation (VF). This was linked with myocardial connexin-43 (Cx43) down-regulation and deteriorated intercellular electrical coupling, due in part to increased pro-inflammatory NF-kB and iNOS transcripts and decreased sarcoplasmic reticulum Ca2+ATPase transcripts. Omacorâ treatment increased the electrical threshold to induce the VF linked with amelioration of myocardial Cx43 mRNA and Cx43 protein levels and the suppression of NF-kB and iNOS. This indicates that rat exposure to continuous light results in deleterious cardiac alterations jeopardizing intercellular Cx43 channel-mediated electrical communication, thereby increasing the risk of malignant arrhythmias.

Conclusions:

The adverse effects were attenuated by treatment with Omacorâ, thus supporting its potential benefit and the relevance of monitoring omega-3 index in human populations at risk. This research was supported by Slovak VEGA 2/0002/20, 2/0158/19, APVV 18-0548, 19-0317 and EU ITMS 26230120009.
ACHIEVING THERAPEUTIC GOAL ON LDL IN HIGH AND VERY HIGH RISK PATIENTS IN A DEDICATED OUTPATIENT CLINIC
Authors: Trenta Eva Azzurra Li , Napolitano Brunella , Maretta Alessia , Balsano Mario , Spagnuolo Vitaliano
Published: June 2022

Objective:

High LDL cholesterol levels represent an important risk factor for development of cardiovascular disease. The reduction of LDL reduces cardiovascular risk. Current guidelines (ESC 2019) recommend ambitious LDL levels for high and very high risk patients. But, in clinical practice, just a part of these patients achieve the ESC 2019 goals (DA VINCI Study).

Design and method:

We evaluated, in the first 152 patients, at high and very high cardiovascular risk, consecutively afferent to our dedicated clinic for hyperlipidaemia (Lipid Center CS), the achievement of the therapeutic goal of LDL according to ESC 2019 guidelines. All patients were on lipid-lowering drug treatment from at least twelve months and the last blood tests were no less recent than three months.

Results:

Of all patients, 82 were female. The mean age was 65.24 ± 10.33 years. Thirty patients were in secondary prevention. Of all patients, 70% reached the therapeutic goal (77% with very high risk and 68% with high risk). Fifty nine% were taking high-intensity lipid-lowering therapy. Seventy one% were taking combination therapy. Thirty four% were treated with PCSK9 inhibitors.

Conclusions:

Taking note of the limited number of the sample, our therapeutic achieved results are higher than that got in the DA VINCI study in which only 60% of patients, from west Europe, reached the therapeutic goal. A dedicated clinic for hyerlipidaemia and the high use of combination therapy with intensive drugs and extensive use of PCSK9 inhibitors may justify the results of our study. Our center did not participated in the DA VINCI study.
LIPID DISORDERS AND ESSENTIAL ARTERIAL HYPERTENSION RISK DEPENDING ON AGTR1 (RS5186) AND VDR (RS2228570) GENES POLYMORPHISM
Authors: Semianiv Marianna , Sydorchuk Larysa , Biletsky Semen , Petrynych Oksana , Kazantseva Tetyana , Repchuk Yuliya , Semianiv Ihor , Sokolenko Alina , Yarynych Yuliya , Voroniuk Ksenia
Published: June 2022

Objective:

Hypertension and dyslipidemia represent two of the most relevant modifiable cardiovascular risk factors and they often coexist. The aim of the research was to study lipid disorders and essential arterial hypertension (EAH) risk depending on AGTR1 (rs5186) and VDR (rs2228570) genes polymorphism.

Design and method:

100 subjects with EAH and target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were involved in the case-control study. Among them, 70,83% females and 29,17% males, mean age 57,86 ± 7,81y.o. Control group consisted of 60 practically healthy individuals of relevant age. The lipid panel parameters, such as: TC (Total cholesterol), TG (Triglycerides), LDL-C (Low-density lipoprotein cholesterol), HDL-C (High-density lipoprotein cholesterol) were investigated in blood plasma, using diagnostic kits “Accent 200” (Poland). The atherogenic index (IA) was calculated by the formula: (TC – HDL-C)/ HDL-C. Gene polymorphism of AGTR1 (rs5186) and VDR (rs2228570), was detected by polymerase chain reaction (PCR).

Results:

Decreased HDL-C is associated with 2nd and 3d degrees of EAH (p = 0,048). The risk of EAH increases in C-allele carriers of AGTR1 (rs5186) gene with hypercholesterolemia (TC> 5,0mmol/l) 1,5 times (OR–2,50;p = 0,048), with an increase in LDL-C and IA – 1,58 and 2,12 times (OR–10,80;p = 0,019), respectively. Homozygous carriers of the minor A-allele had extremely higher concentrations of TC, atherogenic LDL-C and IA, than GG-carriers – by 9,29%, 11,11% and 12,80% (pAA<0,05), respectively. Risk of EAH increases with hypertriglycerolemia 1,89 times (OR–2,93;p = 0,03) and with the increase in LDL-C – 1,26 times (OR–3,60;p = 0,038) in AA-genotype carriers of VDR (rs2228570) gene. Risk of EAH synergistically escalates almost twice in A-allele carriers of VDR (rs2228570) gene with a decrease of HDL-C (OR–2,88;p = 0,046) and the increase of IA (OR–2,70;p = 0,039), significantly only in AG-carriers though. ANOVA analysis confirmed the association of VDR (rs2228570) gene with the increase in IA (F = 3,80;p = 0,05).

Conclusions:

The EAH risk escalates with hypercholesterolemia, elevated both LDL-C and IA in C-allele carriers of AGTR1 (rs5186) gene, as well as with decreased HDL-C and increased IA in A-allele carriers VDR (rs2228570) in the observed.
ENDOGENOUS SEX HORMONES LEVELS ARE ASSOCIATED WITH THE REVISED FRAMINGHAM STROKE RISK PROFILE IN POSTMENOPAUSAL WOMEN – A CROSS-SECTIONAL STUDY IN A SWEDISH COHORT
Authors: Ottarsdottir Kristin , Tivesten Åsa , Li Ying , Lindblad Ulf , Hellgren Margareta , Ohlsson Claes , Daka Bledar
Published: June 2022

Objective:

Levels of endogenous sex hormones in postmenopausal women have been associated with the risk of cardiovascular diseases. The aim of this study was to investigate the association between eight different endogenous sex hormones and the revised Framingham stroke risk profile (rFSRP) in Swedish postmenopausal women.

Design and method:

This is an observational cross-sectional study within the Vara Skövde cohort, a Swedish population-based study with the main focus on detecting hypertension and diabetes at an early stage. The participants in the present study were physically examined in 2002–2004, and endogenous sex hormones (-17-hydroxy progesterone, estrone, dihydrotestosterone (DHT), estradiol, dehydroepiandrosterone (DHEA), androstenedione, testosterone, and progesterone) were analyzed with a validated liquid chromatography-tandem mass spectrometry assay. Women 55 years old or older, with estradiol levels lower than 20 pg/mL, and non-users of hormonal therapy were included in the study (N = 146). Outcome variable was rFSRP, which estimates the individual´s 10-year risk of stroke based on blood pressure, smoking, atrial fibrillation, age, previous cardiovascular disease and diabetes status. Regression analyses of log-transformed rFSRP were fitted against sex hormones, adjusting for body mass index (BMI) or waist-to-hip ratio (WHR) (depending on which variable was more associated with hormone levels), C-reactive protein (CRP) and total cholesterol level.

Results:

Progesterone levels showed a positive association with rFSRP when adjusting for BMI. (18% increase in rFSRP per SD increase in progesterone, p = 0.020). Estrone was positively associated with rFSRP in the model adjusting for BMI (17 % increase in rFSRP per SD increase in estrone level, p = 0.020). Testosterone showed a positive association in the model adjusting for WHR (13 % increase in rFSRP per SD increase in testosterone, p = 0.019). Additional adjustments for CRP and cholesterol did not change the results for any of the hormones. No significant associations between other hormones and rFSRP were observed in this study.

Conclusions:

Increase in levels of estrone, testosterone and progesterone in postmenopausal women was associated with increase of rFSRP. Prospective studies are warranted for a better understanding of the importance of sex hormone levels for cardiovascular health in postmenopausal women.
PREVALENCE AND RISK FACTORS OF POSTURAL HYPOTENSION AMONG HYPERTENSIVE PATIENTS IN A PRIMARY CARE SETTING
Authors: Ooi Inn Jia , Chia Yook Chin
Published: June 2022

Objective:

The aim of this study was to examine the prevalence of postural hypotension and the risk factors among hypertensive patients in a primary care setting.

Design and method:

This is a cross-sectional questionnaire study carried out at the University Malaya of Medical Centre Primary Care Clinic from July 2017 to July 2019. Patients aged = /> 18 years with hypertension were consecutively recruited. Hypertension was defined as systolic blood pressure (BP) = /> 140mmHg or diastolic BP = /> 90mmHg or taking antihypertensive medication. Postural hypotension in this study was defined as a fall in systolic BP (SBP) of = /> 20mmHg or diastolic BP (DBP) of = /> 10mmHg when getting up from sitting to standing position. Associations between the risk factors/ determinants (sociodemographic & medical comorbidities) with postural hypotension were assessed using Chi-Square test and odds ratio. Confounders were assessed using bivariate logistic regression.

Results:

682 hypertensive patients were included in this study: Mean age 66.1 +/- 9.9 years, 56.9% female, mean BMI 27.06 +/- 5.14 kg/m2. Mean SBP was 144.5 +/- 19.1 mmHg and DBP was 82.5 +/- 10.8 mmHg, and mean heart rate was 71 +/- 12 beat/min.

Prevalence of postural hypotension was 3.5% (n = 24), 1.5% had a decrease of = /> 20mmHg in SBP and 2.1% had a decrease of = /> 10 mmHg in DBP.

Table 1 shows the determinants of postural hypotension among the respondents. Hypertensive patients with heart failure had a significantly higher prevalence of postural hypotension (18.2%) than those without heart failure (3.3%) (X(1) = 7.080, p = 0.008).

Table 2 shows the odds ratio between determinant and postural hypotension among the respondents. The odds of having postural hypotension was higher in hypertensive patients with heart failure (OR: 6.556, 95% CI: 1.337 – 32.147, p = 0.02). Bivariate logistic regression did not attenuate this finding. For other variables studied, there was no statistically significant association with postural hypotension.

Conclusions:

The prevalence of postural hypotension was low at 3.5% among hypertensive patients. Hypertensive patients with comorbid heart failure were 6.6 times more likely to have postural hypotension.
CARDIOVASCULAR RISK AND SUBCLINICAL TARGET ORGAN DAMAGE IN A YOUNG ADULT POPULATION PROVIDED BY A PRIMARY HEALTHCARE UNIT
Authors: Muxfeldt Elizabeth , Fernandes Ana Cristina Tenório C. , Bica Rafael Barbosa S. , Moura Carlos Augusto Parente M. , Ushijima Nathalia Rossilho , Vasconcellos Clara Avelar M. , dos Santos Ferreira Deisianny , Garcia Juliana Camara , dos S. Lemos Pedro Henrique , Calvão Diego Alves , Catharina Luiza Brandão , Pecly Inah Maria Drummond
Published: June 2022

Objective:

To evaluate cardiovascular (CV) risk factors and subclinical target organ damage in a young and apparently healthy population assisted in a Primary Healthcare unit

Design and method:

A cross-sectional population study for CV risk assessment in adults aged 20–50 years old provided by a Primary Healthcare Unit. A total of 632 individuals were evaluated (40% male; mean age 36 ± 9 years). Sociodemographic, anthropometric data, and traditional CV risk factors were recorded. All underwent office Blood Pressure (BP) and pulse pressure (PP) (systolic BP minus diastolic BP) was calculated. Ankle-brachial index (ABI) was also calculated after BP measurements in the 4 limbs. The median of the ABI was 1.14 [1.08–1.22], which is the cutoff point used to define early changes. All participants were submitted to ECG to calculate Sokolow-Lyon Index (SLI) and Cornell Voltage Index (CVI) for left ventricular hypertrophy diagnosis. We considered the median of the SLI (20 mm) and the CVI (11 mm) as the cutoff point for early alterations.

Results:

The prevalence of hypertension was 16%. The median [IQR] office PP was 46 [39–52] mmHg. Elevated Office PP (> 60 mmHg) were identified in 64 participants. High office PP was more frequent in men, obese, with increased neck circumference and lower ABI (1.07 vs 1.16, p < 0.001). It was also associated with higher voltage index: SLI 21.9 vs 19.8, p = 0.04 and CVI 13.4 vs 7.1, p = 0.03. Individuals with decreased ABI are more obese with smaller neck circumference (10 vs 5%, p = 0.03). They also had higher systolic BP (125 vs 119 mmHg, p < 0.001) and PP (49 vs 43 mmHg, p < 0.001). A total of 362 ECGs were performed. Increased SLI was more frequent in men, younger and overweight, in addition to a higher prevalence of hypertension and higher PP. Those with increased CVI are more often male, obese with higher BP levels.

Conclusions:

In this young population, early changes in subclinical target organ damage already identify a higher CV risk profile, indicating the importance of implementing primary prevention measures to reduce this risk.
VASCULAR RISK FACTORS IMPACT IN CAROTID INTIMA-MEDIA INDEX: PATIENTS OVER 65 YEARS
Authors: Mateus Sónia , Mateus Sónia , Mateus Sónia , Pós-De-Mina Vanda , Coelho Patricia , Coelho Patricia , Mendes Irene
Published: June 2022

Objective:

Analyze the carotid intima-media index in individuals over 65 years and verify its correlation with modifiable and non-modifiable vascular risk factors.

Design and method:

A cross-sectional observational study was conducted with a sample of 5885 patients over 65 years who underwent cervical Doppler echo-examination, between January 2012 and December 2021, with measurement of the intima-media index and recording of vascular risk factors.

Results:

The sample consisted of 5885 individuals, 41.8% female and 58.2% male. The mean age was 76.59, aged between 65 and 98 years (+/- 6.69). Hypertensive individuals are 81.3% of the sample. There is a significant relationship between the intima-media index, age and personal history of cardio and cerebrovascular diseases (p = 0.001). Other risk factors such as male sex, hypertension, dyslipidemia, smoking and personal history of cardio and cerebrovascular diseases have a positive correlation with the presence of atheroma plaques.

Conclusions:

In this sample of individuals over 65 years, non-modifiable risk factors are important in increasing the intima-media index and modifiable risk factors for atherosclerotic disease in more advanced stages.
RESTING HEART RATE AND ARTERIAL STIFFNESS: A LONGITUDINAL PROSPECTIVE STUDY IN A POPULATION OF HYPERTENSIVE PATIENTS
Authors: Maloberti Alessandro , Fumagalli Stefano , Garofani Ilaria , Ghidini Simone , Ruzzenenti Giacomo , Bombelli Michele , Fabbri Saverio , Giannattasio Cristina
Published: June 2022

Objective:

The role of resting Heart Rate on the progression of arterial stiffness has not yet been extensively evaluated. The aim of this study is to investigate the relationship between resting HR and baseline arterial stiffness (evaluated by cfPWV) as well as its progression in a population of hypertensive patients over a 3.7 years follow-up period.

Design and method:

We enrolled 572 hypertensive outpatients 18–80 aged, followed by the Hypertension Unit of St. Gerardo Hospital (Monza, Italy). Anamnestic, clinical and laboratory data, BP and cfPWV (complior) were assessed at baseline and after a median follow-up time of 3.7 ± 0.5 years

Results:

At baseline the mean age was 53.9 ± 12.7 years, SBP and DBP were 141.2 ± 17.8 and 86.5 ± 10.5 mmHg, HR was 65.6 ± 10.9 bpm and PWV was 8.6 ± 2.0 m/s. Despite an improvement in BP values (from 141.2/86.5 to 132.6/79.2 mmHg, p < 0.001), during follow-up, PWV increased (PWV 0.5 ± 2.2 m/s). In patients with a HR above as compared to those under the median value (9 bpm), PWV was significantly higher (0.82 ± 2.22 vs. 0.27 ± 2.25 m/s, p = 0.003). At multivariate analysis, HR was among the significant determinants of both baseline PWV and its progression ( = 0.031, p < 0.001). Furthermore, HR was a significant determinant of deltaPWV ( = 0.019; p = 0.017).

Conclusions:

In hypertensive patients there is a significant relationship between basal resting HR and basal PWV as well as between the increase of HR and the increase of PWV during the follow-up period. Beyond age and BP, resting HR must be considered as an independent determinant of arterial stiffness. This represents a possible mechanism through which HR contributes to the increase in CV risk.
COMPARISON OF HYPERTENSION PREVALENCE AND ASSOCIATED RISK FACTORS IN MONKS AND COMMON RESIDENTS FROM ZHEJIANG PROVINCE, SOUTHEAST CHINA
Authors: Li Yang , Xinhua Tang , Xiaoling Xu , Guoxiong Chen , Wei Yu , Jing Yan
Published: June 2022

Objective:

The prevalence of hypertension changes with the level of progress of the economy, society, and civilization. There is a lack of relevant studies on monks populations. This study investigated and compared the prevalence and influencing factors of hypertension among monks and common residents in Zhejiang province.

Design and method:

A cross-sectional survey was conducted by using a stratified multistage random sampling method. Using the probability proportional to size method, 12 districts were selected. A given number of participants from each of the 14 gender/age strata (male/female and aged 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75) were chosen also using the SRS method according to the national demographic composition, from communities or villages using the lists compiled from the local government registers of households (Figure 1). Recruitment included a total of 19254 participants aged 15 or older in 12 districts in Zhejiang province. Socio-demographic profiles, examinations were administrated on each subject. Multilevel logistic regression models were used to identify the risk factors of hypertension.

Results:

The prevalence of hypertension among monks in Zhoushan was relatively lower than that among common residents of Zhejiang province (11.2% VS. 22.5%). Men (vs. women), 40–79 / 50–59 / 60 years and above (vs. 15–39 years), less than middle school (vs. college or higher), large abdominal waist circumference (vs. normal), family history of hypertension (vs. none), salt use 5 gram or above (ref: < 5 gram), large visceral adipose index (VAI) (vs. normal), large body fat percentage (BFP) (vs. normal) and overweight/obesity (vs. normal weight) were the main risk factors for hypertension development among common residents. Men (vs. women), 60 years and above (vs. 15–39 years), obesity (vs. normal weight), large abdominal waist circumference (vs. normal), large VAI (vs. normal) were the main risk factors for hypertension development among monks.

Conclusions:

Zhoushan monks had lower hypertension prevalence, that maybe because they had more healthy lifestyles including of no tobacco and alcohol consumption, more vegetables intake, less anxiety and stress.
PREDICTORS OF THE MAJOR CARDIOVASCULAR EVENTS IN THE EARLY AND MIDDLE-LONG TERM AFTER PERCUTANEOUS CORONARY INTERVENTION
Authors: Kirtbaia Lana , Bockeria Leo , Tetvadze Inga , Tatyana Nikitina , Aleksei Kupryashov , Karen Petrosyan , Anton Skopin , Sevinj Mamedova
Published: June 2022

Objective:

To estimate predictors for major adverse cardiovascular events (MACE) in the early and middle-late periods after percutaneous coronary interventions (PCI).

Design and method:

The study included 116 patients (85% men and 15% women) with coronary artery disease (CAD) after PCI. In the early and middle-long-term periods MACE was developed in 24% of patients. The analysis of MACE predictors included wide range of clinical,angiographic,instrumental parameters,factors associated with the functions of the endovascular procedure,genetic testing.

Results:

There was not found predictive value of known risk factors, such as the presence of diabetes mellitus (DM) type II (OR = 1.75; 95% CI:0.54–4.62), smoking (OR = 1.51; 95% CI:0.64–3.56), hypertension (OR = 1.48; 95% CI:0.56–3.86), obesity (OR = 2.37; 95% CI:0.98–5.71), burdened heredity for CAD (OR = 2.16; 95% CI:0.85–5.48), a combination of several risk factors (DM+smoking) (OR = 2.17; 95% CI:0.65–7.28),DM+AH+obesity (OR = 2.97; 95% CI:0.83–10.61), chronic heart failure (OR = 1.7; 95% CI:0,53–5.46) on the risk of developing of MACE after PCI. It was found that significant MACE predictors in the early term period after PCI were: increased platelet reactivity in the presence of dual antiplatelet therapy (OR = 11.0; 95% CI:1.09–110.5) and carriage of polymorphic alleles of the fibrinogen-beta gene: alleles T (rs1800787) (OR = 4.7; 95% CI:1.07–20.2), alleles A (rs2227401) (OR = 4.9; 95% CI:1.12–21.1), alleles C (rs20426442) (OR = 4.9; 95% CI:1.12–21.1), in the middle-long term period: increased residual platelet reactivity despite of DAPT (OR = 11.67; 95% CI:4.29–31.71), decreased Antithrombin-III activity before and/or after PCI (OR = 5,5; 95% CI:1.4–21.68), SYNTAX Score > 22 (OR-4.53; 95% CI:1.26–16.23), non-drug-eluting stent implantation (OR = 3,24; 95% CI:1.12–9.41), DAPT score > 2 (OR = 3.15; 95% CI:1.3–7.64), the presence of multifocal atherosclerosis (OR = 2.91; 95% CI:1.15–7.39), LVEF < 35% (OR = 2.52; 95% CI:1.05–6.03).

Conclusions:

Predictors of MACE in the early term after PCI were:increased residual platelet and the presence of genetic fibrinogen abnormalities, after middle-long term-increased residual platelet, failure to achieve the target lipid profile, decreased activity Antithrombin-III before and/or after PCI, SYNTAX Score > 22, implantation of non-drug-eluting stents, DAPT score > 2, presence of multifocal atherosclerosis, LVEF < 35%. The frequency of known clinical risk factors, such as smoking, hypertension, DM, physical inactivity, obesity, burdened heredity for CAD, in the group of MACE patients was slightly higher, but did not reach statistical significance.
EFFICACY OF BLOOD PRESSURE MANAGEMENT ACCORDING TO GENDER
Authors: Kim Minsik , Kim Jihee
Published: June 2022

Objective:

High blood pressure (BP) are major causes of cardiovascular(CV) disease

However, there was limited evidence on whether the efficacy of BP management may differ in male and female, whether the risk of high BP may differ depending on gender, or whether menopause changes in female’s risk of CV disease.

We evaluated the risk of CV disease in male and female of central blood pressure(CBP), brachial BP and pulse pressure (PP)

Design and method:

Patients were enrolled from June 2011 to December 2015, and were followed up through December 2019. The primary endpoints were composite outcome of CV disease, HF, and hypertension-induced complications such as left ventricular hypertrophy, retinopathy, and proteinuria

Results:

During an average follow-up period of 6.5 years, a total of 2,112 participants were enrolled, 1,065 were male and 1,047 were female. Of these, 109 events occurred for women and 157 events occurred for men. As a result, when analyzing CBP and systolic BP(SBP) as cox regression model, it was confirmed that the risk increased by 10% to 11% in female(Hazard ratio(HR) according to CBP 10 mmHg increase 1.10, 95% confidence interval; CI 1.01–1.20, p-value 0.021), (HR, SBP 10 mmHg, 1.11, 95% CI 1.01–1.22, p-value 0.029).

However, there were no significant results in the male group(HR, CBP 10 mmHg, 1.04;,95% CI 0.96–1.12, p-value 0.339), (HR, SBP 10 mmHg, 1.08, 95% CI 0.99–1.18, p-value 0.076).

Meanwhile, in female, PP increased the risk by 18% with an increase of 10 mmHg, and these values were confirmed to be strong significant(HR, PP 10 mmHg, 1.18, 95% CI 1.04–1.33, p-value 0.009). This has also been confirmed in men(HR, PP 10 mmHg, 1.14; 95% CI 1.01–1.28, p-value 0.033).

And although not included in this abstract, it was confirmed that the risk of HBP in postmenopaussl female compared to premenopausal female.

Conclusions:

In this study, we confirmed that blood pressure control works more critically in women, and that we should not overlook the fact that pulse pressure was actually acting as a hidden determinant of disease progression, although we have so far set target BP and treated to achieve it.
CARDIOVASCULAR RISK RECLASSIFICATION BY PULSE WAVE VELOCITY IN BRAZILIAN HYPERTENSIVE PATIENTS
Authors: Inuzuka Sayuri , Filho Gilberto Guimaraes , Vitorino Priscila , Barroso Adriana , Filho Robson Alves , Melo Victoria , Urzeda Luiz , Valle Deborah , Silva Eduarda , Mesquita Gustavo , Sousa Ana , Coca Antonio , Jardim Paulo , Sebba-Barroso Weimar
Published: June 2022

Objective:

Objetive: The number of asymptomatic hypertensive patients who already have subclinical injuries in the early stages of hypertensive disease is high and, generally, they are not identified by the traditional evaluation model. The use of Pulse Wave Velocity (PWV) in addition to traditional cardiovascular risk factors can improve risk stratification. The present study intends to perform the reclassification of cardiovascular risk according to the median Pulse Wave Velocity (PWV) and correlate PWV with the intima-media thickness, with the left ventricular (LV) mass indexed and with microalbuminuria.

Design and method:

Design and method:

Multicenter analytical cross-sectional study of patients undergoing measurement of central and peripheral blood pressure parameters between October/2018 and March/2019. Intima-media thickness (IMT) and presence of carotid plaque, left ventricular mass indexed and microalbuminuria were also evaluated. Fisher’s test was applied to verify the association of cardiovascular risk reclassification by median PWV. Spearman’s correlation was used to correlate PWV with intima-media thickness, presence or absence of carotid plaque, microalbuminuria and indexed left ventricular mass. A significance level of 5% was adopted.

Results:

Results:

126 patients were evaluated, with a mean age of 60.58 ± 10.51 years and 87 (69.95%) are women. When reclassified, there was an increase in the frequency of patients who moved from medium to high risk (p<0.001). A weak and positive correlation was identified between PWV and LV mass indexed (r = 0.304, p < 0.001) and with IMT (r = 0.30, p < 0.001).

Conclusions:

Conclusions:

The application of median PWV values is a simple and effective tool to reclassify intermediate-risk individuals to high-risk.
THE RELATIONSHIP BETWEEN BIRTH WEIGHT AND THE LEVEL OF VASCULAR STIFFNESS IN HELTHY YANG PEOPLE
Authors: Druzhinina Valery Natalya Podzolkov , Bragina Anna , Druzhinina Natalya , Milen Khalenyan , Anastasia Balutskaya , Vera Ananeva , Nadezhda Litvinenko , Selen Dishkaya
Published: June 2022

Objective:

To study the effect of birth weight (BW) on ankle-brachial index (ABI) and augmentation index (AIp) levels in healthy young people.

Design and method:

We examined 298 young volunteers without significant clinical cardiovascular diseases (112 men and 186 women), mean age: 21,19 ± 2,24 years. The AIp was determined by photoplethysmography (AngioScan Professional-01, 2015, RF), ABI was determined using the MESI ABPI MD apparatus (2019, Slovenia). Statistical analysis was done using the Statistica 10.0 software.

Results:

All subjects were divided into 3 groups: group 1 (N = 30) persons with BW< 2500 g., group 2 (N = 236) - with a BW of 2550 to 5000 g., and group 3 (N = 32) with a BW > 5050 g., comparable in gender, age and smoking prevalence. ABI in group 1 (0.83 ± 0.06) and in group 3 (0.9 ± 0.07) was lower than in group 2 (1.08 ± 0.12, p < 0.05). A significantly higher AIp was revealed in group 1 (-12.1 ± 14.8%) and in group 3 (-13.7 ± 11.8%) when compared with group 2 (-19.14 ± 12.2%), p < 0.05. There were no differences between ABI and AIp levels in groups 1 and 3. Correlations were found between ABI and weight (R = -0.24, p > 0.05), the level of systolic blood pressure (R = -0.23, p > 0.05), AIp (R = -0.41, p > 0.05) and BW (R = 0.21, p > 0.05). In group 1 (R = 0.48, p > 0.05) and group 2 (R = 0.32, p > 0.05) correlations were found between ABI and BW, and therefore multivariate regression analysis of the influence of weight, smoking, BW, blood pressure on the ABI. Significant effects on ABI were provided by smoking (B = -0.21, Std.Err. of B = 0.02, p = 0.00001) and BW (B = 0.01, Std.Err. of B = 0.0001, p = 0.00000).

Conclusions:

BW is associated with the development of increased vascular stiffness at a young age. Not only with low BW (less than 2500 g), but also increased (more than 5050 g), statistically significantly lower ABI levels are determined.
THE IMPACT OF POLLUTION ON HYPERTENSION AND ECONOMY
Authors: De Rosa Maria Leonarda , Zuccarino Marta , Di Sarro Elena , Iovino Miriam Dafne , Spoleto Mariorosario , Ferrara Nicola
Published: June 2022

Objective:

We investigated whether traffic-related air pollution and noise are associated with incident hypertension in Naples, Italy, our city. Given the pervasive nature and significant health effects of environmental noise pollution, the corresponding economic impacts may be substantial.

Design and method:

We included 102 study our ambulatory patients for air pollution effects. The economic assessment developed a new approach to estimate the impact of environmental noise on the prevalence and cost of key components of hypertension. Noise data our exposure estimates were derived from are > 30 years old.

We modelled concentrations of particulate matter with aerodynamic diameter < = 2,5 microm, PM2.5,< = 10microm, PM 10, > 2,5,and < = 10microm, PM coarse, soot,PM2.5 absorbance, and nitrogen oxides at the addresses of participants with land use regression. Residential exposure to traffic noise was modelled in according to the EU Directive 2002 /49 / EC.We assessed hypertension as self-reported and measured (systolic blood pressure = > 140 mmHg or diastolic BP = > 90 mmHg or intake of antihypertensive drugs We used Poisson regression to analyze associations of traffic-related exposures with incidence of hypertension, controlling for relevant confounders.

Results:

Among 102 participants free of self-reported hypertension at baseline, 11 incident cases occurred within 1–3 years of follow-up. Incidence of self-reported hypertension was positively associated with PM2.5 relative risk 1.22[95%-confidence interval:1.08; 1.37] per 5 microg/m³) and PM2.5 absorbance (relative risk 1.13[95%CI:1.02; 1.24]. These estimates decreased slightly upon adjustment for road traffic noise. Road traffic noise was weakly positively associated with the incidence of self-reported hypertension. Among 102 participants at risk, 34 new cases of measured hypertension occurred. We found no clear associations with measured hypertension. The analyses suggested that a 5-dB noise reduction scenario would reduce the Hypertension prevalence by 1.4%

Conclusions:

Long-term residential exposures to air pollution and noise are associated with increased incidence of self-reported hypertension. These findings suggest significant economic impacts from environmental noise-related cardiovascular disease. Given these initial findings, noise may deserve increased priority and research as an environmental health hazard.
RISK OF CARDIOVASCULAR EVENTS IN TUNISIAN POLYCYSTIC OVARY SYNDROME PATIENTS
Authors: Chaabouni Khansa , Mezghani Chema , Smaoui Fatma , Khanfir Fatma , Frikha Madiha , Chaabene Kais , Elleuch Aida , Ayadi Fatma
Published: June 2022

Objective:

Polycystic ovary syndrome (PCOS) causes many problems ranging from reproductive to cardiovascular pathology. High sensitive C-reactive protein (CRP-hs) has been proved to be one of the strongest predictors of cardiovascular risk events.

Objective:

to assess cardiovascular risk (CVR) in women with PCOS based on CRP-hs values.

Design and method:

women diagnosed with PCOS and age-matched controls were recruited in one year period. PCOS was diagnosed according to the Rotterdam 2003 criteria. Hormonal assessment was performed by electrochemiluminescence and CRP-hs by turbidimetry on cobas-Roche.

CVR was defined as “low” when CRP-hs <1 mg/L, “intermediate” when CRPhs 1–3 mg/L, “high” when CRPhs 3–8.5 mg/L, and “unspecific elevation” CRP-hs > 8.5 mg/L.

Results:

A total of 96 PCOS patients and 108 controls were enrolled. The mean age of patients was 25.67 ± 5.12 years and 28.89 ± 6.57 years for controls. CRP-hs was higher in PCOS compared with controls. In PCOS, 44% were at a low CVR, 31% at an intermediate CVR, and 25% at a high CVR. However, in controls, 58% of had low CVR, 26% intermediate CVR, and 16% high CVR.

Conclusions:

Cardiovascular risk seems to be higher in PCOS patients compared to controls. We suggest an early detection based on CRP-hs levels. Specific guidelines would be established for management of CVR in this young population.
RELATIONSHIPS BETWEEN NAFLD BIOCHEMICAL SCORES AND LEFT VENTRICULAR GEOMETRIC PATTERN IN NAÏVE ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Vacca Antonio , Catena Cristiana , Soardo Giorgio , Spagnol Francesca , Bulfone Luca , Candusso Giulia , Baiano Valeria , Scandolin Laura , Brosolo Gabriele , Da Porto Andrea , Donnini Debora , Colussi Gianluca , Cavarape Alessandro , Bertin Nicole , Vivarelli Cinzia , Sechi Leonardo
Published: June 2022

Objective:

The not alcoholic fatty liver disease (NAFLD) is associated with an increased cardiovascular mortality and morbidity. An hypothesis for this association could be the left ventricular (LV) geometric alteration sometime found in hypertension that is a known prognostic factor for cardiovascular events in hypertension. We searched for a relationship between biochemical scores of NAFLD and left ventricular (LV) hypertrophy (LVH) or LV geometric patterns changes in a large group of never treated essential hypertensive (EH) patients.

Design and method:

In 434 naïve (49 ± 14 years, 234 males) we evaluated BMI, waist circumference, liver steatosis at abdominal echography, the biochemical scores of liver steatosis: Liver Fat Score (LFS), Fatty Liver Index (FLI), Hepatic Steatosis Index (NAÏVE), and the fibrosis scores: NAFLD Fibrosis Score (NFS), APRI, FIB-4, parameters of glucose and insulin homeostasis, liver blood tests, lipids, platelets count, glomerular filtration rate (GFR), reactive C protein. LV mass and relative wall thickness was calculated with echocardiography. Patients were classified in 4 groups of LV geometry: 1 = LV normal geometry, 2 = LV concentric remodeling, 3 = concentric LVH, 4 = eccentric LVH.

Results:

A LVH was present in 17.3% of patients, and these patients had higher LFS (P < 0.001), FLI (P = 0.008), NAÏVE (P = 0.004) and NFS (P = 0.011) scores than patients without LVH. LVH was independently associated with the FLI score but not with fibrosis scores. The steatosis scores (LFS, NAÏVE, FLI) linearly increased across the four LV geometric patterns (P = 0.007, P = 0.001, P = 0.003, respectively). The fibrosis score NFS was significantly higher in subjects with concentric LVH (P = 0.041). The LFS was independently associated with BMI, GAUC, G120, and triglycerides levels. The NFS was independently associated with waist circumference, GFR and weakly with fasting glucose level. Ultrasound steatosis was not different among the four LV geometric patterns.

Conclusions:

In naïve EH patients the biochemical steatosis scores show a relationship with LVH and LV geometric changes, while fibrosis is associated with concentric LVH. An accurate investigation to reveal a NAFLD should be done in EH patients with altered LV geometry and to better understanding of mechanisms linking the two conditions.