bluuebunny/crossref_metadata_2025 huggingface dataset:
P009 CORRELATION BETWEEN PLASMA ALDOSTERONE CONCENTRATION AND BONE MINERAL DENSITY IN HYPERTENSIVE PATIENTS: POTENTIAL IMPACT ON OSTEOPOROSIS AND FUTURE FRACTURE RISK
Authors: Li Nanfang
Published: September 2024

Background:

Previous studies have suggested that aldosterone may play a major role in calcium-phosphorus homeostasis and bone metabolism. However, the relationship between plasma aldosterone concentrations (PAC) and bone mineral density (BMD) in hypertensive patients remains unclear. Therefore, this study sought to investigate the relationship between PAC levels and BMD and explore PAC's potential impact on osteoporosis and future fracture risk in hypertensive patients.

Methods:

Our study included a total of 1430 participants. Associations are tested using multiple linear and logistic regression models. Nonlinearity was investigated using the restricted cubic spline (RCS). We also performed mediating analyses to assess mediating factors mediating the relationship between PAC and osteoporosis.

Results:

The multiple linear regression showed a negative correlation between PAC and BMD and was generally positively associated with FRAX scores. Meanwhile, logistic regression analyses indicated that osteoporosis was highly correlated with PAC levels. In addition, a clear non-linear dose-response relationship was also shown in the constructed RCS model. Finally, mediation analyses showed that serum potassium played an important role in the development of osteoporosis.

Conclusion:

This study demonstrates that elevated PAC levels are strongly associated with decreased BMD, increased prevalence of osteoporosis, and the risk of future fractures in hypertensive patients. Further studies are needed to confirm this relationship and reveal its underlying mechanisms.
P011 PREVALENCE OF HYPERTENSION AND ASSOCIATION WITH RED MEAT AND VEGETABLE CONSUMPTION IN A MEGACITY IN NIGERIA: A POPULATION-BASED SURVEY
Authors: Ogunremi Olufemi , Olanrewaju Timothy Olusegun , Adewumi Enoch Babatunde , Dada Samuel Ayokunle , Idris Olajide , Okeanyaego Ifeyinwa Courtney , Ndukwe Maryanne , Dada Adedamola A. , Oyedepo Dapo S. , Adekoya Adebowale , Adesola Sunday O. , Ige Elisha , Awobusuyi Olugbenga
Published: September 2024

Background and Objectives:

Hypertension is a growing burden worldwide, but the impact is worse in developing countries especially in cities, due to epidemiologic transition, rapid urbanization and socioeconomic dynamics. We determine the current prevalence of hypertension, and association with red meat and vegetable consumption in Lagos, a megacity in Nigeria.

Methods:

This was a population-based opportunistic cross-sectional survey of 2244 voluntary adults ≥ 18years residents of Lagos megacity in Nigeria. Socio-demographic and clinical characteristics were obtained. We measured blood pressure by Omron M3 automatic upper arm monitor after ≥5 min of rest. We defined hypertension as systolic blood pressure of ≥140 mmHg and/or diastolic blood pressure of ≥90 mmHg or use of antihypertensive drugs. Qualitative information on meat and vegetable consumption was documented. Chi squared and multiple logistic regression methods were used to determine association and predictor of hypertension respectively, and odds ratio with confidence interval as the measure of effect size. P value of < 0.05 was taken as statistical significance.

Results:

2244 participants were analyzed, with mean age of 46±14 years, and 75% were women. More than 26% were overweight or obese, 43.2% drinks alcoholic beverages, and 30.3% men and 3.5% women smoked cigarettes. The overall prevalence of hypertension was similar in males (38.1%) and females (37.4%), and it increases with age, reaching 46.7% in ≥ 60years. Daily consumption of meat (38.6% versus 28%(rarely), p =0.03), and infrequent consumption of vegetables (47.7%% versus 19.2%9 (daily intake), p = 0.006) were associated with higher prevalence of hypertension. Older age (OR, 2.133(CI, 1.61 – 2.83)), and family history of hypertension (OR, 1.51(CI, 1.20 – 1.92)) were the predictors of hypertension.

Conclusions:

The prevalence of hypertension is high among middle age urban dwellers in Lagos, Nigeria. Avoidance of red meat, and increased consumption of vegetables, may reduce the burden of hypertension in the population.
P014 APPLICATION OF AI IN HYPERTENSION MANAGEMENT: A REVIEW
Authors: Damodaran Pavithran
Published: September 2024

Background and Objective:

The integration of artificial intelligence (AI) in healthcare has revolutionized the management of various diseases, including hypertension. This review explores the potential of AI applications in improving hypertension diagnosis, treatment, and patient outcomes.

Methods: A comprehensive literature review was conducted using databases such as PubMed, Scopus, and IEEE Xplore. Studies published between 2010 and 2023 were included, focusing on AI models used for hypertension management, such as machine learning algorithms and predictive analytics.

Results:

AI has demonstrated significant accuracy in predicting hypertension risk factors, optimizing treatment plans, and monitoring patient adherence. Machine learning models, such as neural networks and decision trees, have shown up to 95% accuracy in early hypertension detection. Furthermore, AI-driven personalized treatment plans have resulted in improved patient outcomes and reduced healthcare costs.

Conclusions:

AI holds tremendous potential in transforming hypertension management by enhancing diagnostic precision and personalizing treatment strategies. Future research should focus on integrating AI with electronic health records and developing real-time monitoring systems to further improve patient care.
P016 METAPROTEOMICS ANALYSIS IN HEALTHY INDIVIDUALS REVEALS A HIGH CARDIOVASCULAR RISK PROFILE ACROSS BLOOD PRESSURE, DIET, HUMAN AND MICROBIAL PROTEINS
Authors: Yang Chaoran , Tavares Leticia Camargo , Lee Han-Chung , Steele Joel , Ribeiro Rosilene , Yiallourou Stephanie , Carrington Melinda , Kaye David , Head Geoffrey , Schittenhelm Ralf , Marques Francine
Published: September 2024

Background/Objective:

The gut microbiota is a crucial link between diet and cardiovascular health by producing beneficial metabolites, such as short-chain fatty acids (SCFAs), through fibre fermentation. However, most studies have focused on microbial DNA to infer microbiota function. Here, we employed metaproteomics, a novel method to capture gut human and microbiota protein expression profiles concurrently. We aimed to investigate the crosstalk between gut microbiota, diet, host gut health, and blood pressure (BP).

Methods:

Mass spectrometry-based metaproteomic analysis was performed on 61 faecal samples with paired ambulatory BP monitoring, food intake (food frequency questionnaire), and demographic data.

Results:

We identified 21,594 microbial and 1,072 human proteins. Traditional risk factors (age, BMI, sex, BP) explained only ∼10% of the proteome variance. However, unsupervised clustering analysis of both human and microbial proteome revealed two distinct clusters (low-risk and high-risk) with significantly different 24-hour systolic BP (mean±SD, low-risk 116±13mmHg vs high-risk: 126±15mmHg, P=0.016), women prevalence (72.4% vs 40.6%, P=0.025), and diet quality (assessed as Athlete Diet Index, 61.6±6.7 vs 57.8±7.6, P=0.044). In the human proteome, the low-risk group had lower expression of the VEGFA-VEGFR2 signalling pathway and tight junction proteins and higher SCFA production (particularly propionate), suggesting an anti-inflammatory gut environment. In the microbial proteome, the low-risk group had higher activity of inorganic ion transport and metabolism-related proteins, with increased expression of acetate kinase that produces both the SCFAs acetate and propionate, particularly in primary fibre-fermenting bacteria, including Phocaeicola dorei and Blautia wexlerae. Finally, via co-expression networks, we identified profilin-1 (PFN1), which contributes to hypertension and atherosclerosis, as a crucial human protein associated with several bacteria present in the high-risk group.

Conclusions:

Employing an unsupervised clustering based on human and microbial proteomics, we identified two groups of participants with varying traditional and emerging cardiovascular risk factors. This was explained by complex interactions among diet, gut microbiota, and BP. This underscores the need for sophisticated models to understand multifactorial risk factors for cardiovascular disease.
P022 A FEASIBILITY STUDY OF COMMUNITY SUPPORT GROUPS FOR NON-COMMUNICABLE DISEASE SELF-MANAGEMENT IN KATHMANDU DISTRICT OF NEPAL
Authors: Dhakal Rabina , Thapa Barsha , Rai Devika , Bhandari Buna , Manandhar Dibya Laxmi , Sapkota Sujata
Published: September 2024

Background:

Non-communicable diseases (NCDs) are the primary contributors to mortality and, therefore, considered a major public health problem. Community support group (CSG) interventions are advocated as cost-effective strategies for managing NCDs like diabetes and hypertension. While these interventions are globally popular in fostering self-help and motivation for adopting healthy practices, their effectiveness and feasibility in Nepal are poorly assessed. This study aimed to explore the feasibility of creating community support groups to manage NCDs, particularly diabetes and hypertension; conducting regular meetings; and understanding the preliminary impact of CSG meetings on NCD self-management behaviors.

Methods: A pre-post interventional study was conducted in Kathmandu district, Nepal, using a mixed-method approach. CSGs were formed for individuals aged 40 and above, diagnosed with hypertension and/or diabetes. Each of these groups convened twice monthly over three months, focusing on self-management practices related to diet, physical activity, medication adherence, self-monitoring, and foot care. Baseline and end-line surveys measured the initial impact, while qualitative data from meeting discussions and in-depth interviews captured patient perspectives and meeting acceptability. Quantitative analysis involved descriptive statistics, chi-square, and t-tests, while thematic analysis was applied to qualitative data.

Results:

Of the total 41 participants in the study, 80% (mean age: 60.1 years) were female. The attendance in the group meetings ranged from 70% to 90%. Post-intervention, significant improvements were noted in blood pressure and weight. Qualitative findings revealed strong acceptance of CSG meetings, fostering information exchange and shared learning that could motivate self-management behavior changes. While participants acknowledged potential challenges in regular meeting attendance, such as finding common interests for collaborative activities, most found facilitator-led sessions interesting and promising. Homogenous groups, due to shared demands, are more inclined to engage in collaborative activities.

Conclusion:

This study suggests the potential effectiveness of support group activities for self-managing NCDs in Nepal. Large scale randomized controlled trial are recommended to assess the long-term effectiveness and sustainability of this approach.
P035 SOCIAL DETERMINANTS OF HEALTH AND CONTROL OF HYPERTENSION
Authors: Logan Alexander , Lokteva Inna , Zhang Yuhua , Liu ZhihuiAmy
Published: September 2024

Background and Objectives:

Recent national blood pressure (BP) survey data of adults in Canada and United States show a troubling decline in the control of hypertension, particularly in women, the elderly and those with low income, less education and under-using health services. Social determinants of health (SDH) can be important barriers to controlling hypertension. Studies assessing associations of BP control and SDH have focused on one or a few domains. Objectives of this study are to screen treated hypertensive patients for a wide range of SDH, test for correlations and assess the effects of high-quality treatment on SDH and BP control relationship.

Method:

We created and applied a screening tool to gather personal information on 14 SDH from consecutive consenting eligible patients attending a complex hypertension care clinic. Logistic regression was used to assess association of each SDH domain with BP control.

Results:

Of 90 patients enrolled, 88 completed the 6-month study. At baseline, mean age (standard deviation) was 64 (14) years, 64% male, 69% white, 25% experiencing financial hardship, mean BMI 30.4 kg/m2 (5.9), mean automated office BP 138/78 (23/14), mean number of co-morbid conditions 4.2 (2.0) and 55% had treatment-resistant hypertension. From baseline to exit, BP fell to 127/73 (17/12), p<0.001, mean number of antihypertensive drug classes increased from 3.06 (1.43) to 3.23 (1.30), p=0.049 but BMI remained unchanged. There were no associations between uncontrolled hypertension and any of the 14 SDOH domains at baseline. However, at exit financial status was associated with uncontrolled hypertension on univariate analysis (p=0.022) and on multivariate analysis. Stress (p=0.063) and optimism status (p=0.085] showed a similar trend. These analyzes indicated better BP control among those with poorer financial status, higher stress levels or more pessimistic outlook.

Conclusion:

None of the SDOH were associated with uncontrolled hypertension at baseline. However good medical care and follow-up appeared to have improved BP control, noticeably in those experiencing financial hardship. Explanation of findings requires further study.
P040 STRENGTHENING PRIMARY HEALTH SYSTEMS FOR HYPERTENSION: THE CASE OF HEARTS IMPLEMENTATION IN GUATEMALA
Authors: Ayala Luis , Wellmann Alicia , Rodriguez Jose , Ramirez Manuel , Flood David
Published: September 2024

Hypertension is considered the leading cause of death and disability worldwide due to the multiple complications it entails. Hypertension contributes to 40% of the total cardiovascular diseases worldwide. In Guatemala, the burden of hypertension is increasing, with a prevalence of 32.2%. Hypertension alone is responsible for 12% of deaths in the country.

The World Health Organization's (WHO) HEARTS is global to local initiative that consists in a technical package represents a public health approach to hypertension control, with a strong foundation in the effective and sustainable delivery of care for chronic diseases in primary care centers and their communities.

Since 2017, Resolve to Save Lives, WHO, and other partners have supported the implementation of the HEARTS hypertension control program in public health care centers in LMICs (Low- and Middle-Income Countries). The goal was to establish a model for hypertension control suitable for broader expansion. By December 2022, 12.2 million hypertensive patients had been treated in the program across 33 participating LMICs.

A pilot study integrating the diabetes module (HEARTS-D) into the implementation of the hypertension care model has been conducted in two health areas (Sololá and Chiquimula) since 2023. Starting in 2024, the execution of a project funded by the World Diabetes Foundation (WDF) will be carried out to expand these strategies by implementing a national comprehensive care model for diabetes and hypertension in the country.

In 2021, a pilot study focused on the implementation of the model was conducted, resulting in a fourfold increase in the treatment rate of patients and a 14% increase in the proportion achieving blood pressure control. These results support the feasibility of implementing the HEARTS model for blood pressure control in the healthcare system of LMICs.

The integration of the model in Guatemala since November 2022 enhances previous efforts and solidifies the country's commitment to integrating timely responses in the management of these conditions and the implementation of standardized treatment.
P048 CARDIOBREATH APPLICATION: SLOW BREATH TO DECREASE BLOOD PRESSURE AND IMPROVE AUTONOMIC MODULATION
Authors: Fetter Claudia , de Souza Liliane Appratto , Marques Juliana Romeu , Ávila Mariana Ouriques , Niec Jéssica , de Moraes Rodrigo Diogo , Dipp Thiago , Eibel Bruna , Irigoyen Maria Cláudia
Published: September 2024

CardioBreath is an application of slow deep breath for increasing cardiovascular performance in health and sports. Biological signals like spontaneous respiratory rate (SRR) are employed to prescribe slow respiratory exercises. Heart rate (HR) collected by the app is employed to track results. It aims to increase vagal modulation and decrease arterial pressure. The aim of this study is to verify the accuracy of CardioBreath data collection of SRR and HR. Following this, the evaluation of the cardiac vagal modulation evoked by the audiovisual lessons of slow breath of CardioBreath. Methods: Coherence of biological signals: Healthy individuals have been assessed using CardioBreath data collection of HR to compare their values simultanealy with those from Polar V 800, (ten sets each participant. SRR was collected by CardioBreath compared to visual counting (five sets). Pair wise t-test comparisons were performed in order to detect diferences between evaluations. Cardiac vagal modulation has been collected by Finometer and analyzed by Cardioseries, before (baseline evaluation) and after randomized audiovisual lessons of the CardioBreath App. These data will be analyzed by GEE (generalized estimation equation). All data are demonstrated as Mean (M) ± Standard deviation (SD) (p< 0,05) Partial Results: 50 healthy individuals participated of the first phase of the research, aged from 21 to 57 years old generating 460 analyzed pairs: HRApp 71.66 ± 11.68 bpm versus HRPolar 72.02 ± 13.24 bpm (p = 0.66). A total of 225 pairs have been analyzed for SRR: SRRApp 13.88 ± 4.63 cpm versus SRRvisual 13.82 ± 4.48 com (p = 0.44). Conclusions: The comparison of biological signals of CardioBreath App demonstrate that either HR and SRR are in coherence with data obtained by the Polar V 800 (HR) and visual method (SRR). New data of the autonomic responses of lessons of the CardioBreath App will be available in September. More on CardioBreath App at www.cardiobreath.com (only in Portuguese)
P054 REDUCTION OF BLOOD PRESSURE AND CARDIOVASCULAR RISK WITH IMPROVEMENT OF GLUCOSE AND LIPID METABOLISM BY A NUTRACEUTICAL BASED IN MULBERRY LEAF AND FENUGREEK IN SUBJECTS WITH PREDIABETES
Authors: de Leon-Durango RJ , Hernandez-Lazaro A , Rios-Gomez C , Santana-Ojeda B , Molinero-Marcos I , Arnas-Leon C , Hernandez-Hernandez I , Kuzior A , Acosta-Calero C , Perez-Rivero JM , Perez-Garcia MP , Perdomo-Herrera E , Tocino-Hernandez AL , Andrada-Diaz Sara , Martinez-Martin FJ
Published: September 2024

Background and Objective:

In Spain there are >5000000 prediabetic subjects, of which >500000 develop type 2 diabetes annually. Alpha-glucosidase inhibitors such as acarbose have been shown to prevent type 2 diabetes and reduce blood pressure, development of hypertension and cardiovascular risk. White mulberry (Morus alba) leaves contain 1-deoxynojirimycin, a powerful competitive alpha-glucosidase inhibitor. A nutraceutical containing Reducose (standardized white mulberry leaf extract), fenugreek (Trigonella foenum-graecum, an AMP-kinase activator), inuline (soluble fiber), Lactiplantibacillus plantarum (probiotic), niacin (vitamin B3), chromium and zinc (oligoelements) has been developed for use in patients with prediabetes. We endeavored to study its tolerability and efficacy on the metabolic profile, blood pressure and cardiovascular risk of the patients, with the change in the HOMA2-IR index of insulin resistance (as a proxy for the risk of developing type 2 diabetes) as the main outcome.

Methods:

In this ongoing open study, adult patients with prediabetes have been recruited to receive the mentioned nutraceutical daily for 6 months with an intermediate visit after 3 months. BMI, blood pressure, fasting glucose, insulin, lipid profile and HOMA2-IR were determined at each visit.

Results:

Of 94 recruited patients, 37 have completed the second visit. The HOMA-2 IR dropped by 21.5% (p=0.0016), the cardiovascular risk estimated by SCORE2 by 14.6% (p=0.0009), fasting glycemia by 7.6 mg/dL (p=0.0005), HbA1c by 0.22% (p<0.0001), non-HDL cholesterol by 12.4 mg/dL (p=0.0037), systolic blood pressure by 6.3 mmHg (p=0.0001), diastolic blood pressure by 5.2 mmHg (p=0.0236); the body weight and BMI did not change significantly, and there were no withdrawals due to adverse effects or serious tolerance issues.

Conclusions:

This nutraceutical was well tolerated and improved the metabolic (both glycemic and lipidic) profile, the blood pressure and the cardiovascular risk of patients with prediabetes. At present there are no licensed drugs for prediabetes in Spain, but this nutraceutical may be an option for these patients in combination with lifestyle changes.
P057 SOCIODEMOGRAPHIC, ANTHROPOMETRIC, PHYSIOLOGICAL, AND ELECTROCARDIOGRAPHIC FACTORS ASSOCIATED WITH OVERWEIGHT AND OBESITY IN THE YOUNG POPULATION
Authors: Navarro Villa Andrea , Garzón Álvarez Santiago , Suárez Brochero Óscar Felipe , Toquica Alex Rivera , Nieto García Carlos Eduardo
Published: September 2024

Background:

excess weight is increasingly prevalent in young people, raising their cardiovascular and metabolic risk from an early age; therefore, factors associated with the development of overweight and obesity in this population should be identified.

Objectives:

identify associated factors with a body mass index ≥ 25 (BMI≥25) in medical students, Pereira-2022.

Methodology:

A cross-sectional study was conducted on medical students at a public university in Pereira, in which sociodemographic, anthropometric, physiological, and electrocardiographic variables were collected. A bivariate analysis was made comparing individuals with BMI≥25 to those below. A multivariate analysis was performed using logistic regression.

Results:

201 medical students were interviewed (mean age=21.4 years), 56.7% women. There were 48 (23.88%) participants with overweight, 8 (3.9%) with obesity class I, 1 (0.5%) with obesity class II, and 2 (1%) with obesity class III; The factors significantly related to having a BMI ≥25 were the feeling of guilt after drinking alcohol (OR=3.95 95% CI=1.49-10.43), family history of deceased by hypertension (OR=2.27 95% CI=1.08-4.78), a grandparent with obesity (OR=2.53 95% IC=1.20-5.31) and impaired repolarization of the inferior myocardium (OR=5.12 95% CI=1.46-17.95). Otherwise, systolic blood pressure >130mmHg had a marginally significant association (OR=2.38 95% CI=0.91 - 6.18).

Conclusions:

More than a third part of the participants presented a BMI≥25. For overweight and obesity, there must be considered family and behavioral factors, such as feeling guilt after drinking alcohol, a history of a relative deceased by hypertension, and a grandparent with obesity. Additionally, systolic blood pressure >130mmHg and impaired repolarization of the inferior myocardium must be taken into consideration.
P058 ADIPOSE-OVARIAN CROSSTALK IN PCOS-INDUCED CARDIOMETABOLIC SYNDROME: THE ROLE OF HISTONE DEACETYLASE-2
Authors: Olaniyi Kehinde Samuel , Areloegbe Stephanie
Published: September 2024

Background and objective:

In addition to ovarian dysfunction and infertility, individuals with polycystic ovarian syndrome (PCOS) present a number of systemic disturbances including functional derangements in the adipose tissue which possibly aggravates the endocrinometabolic abnormality and subsequent cardiometabolic morbidities in PCOS. Epigenetic changes have been implicated in metabolic-related disorders including PCOS. However, its pathogenic involvement in adipose-ovarian dysfunction and consequent cardiac events is under elucidation. Therefore, the present research was designed to investigate the role of epigenetic regulator, particularly histone deacetylase-2 on adipose-ovarian dysfunction and its attendant cardiometabolic syndrome in PCOS rat model.

Methods:

Eight-weeks-old nulliparous Wistar rats were allotted into four groups of n=5, namely control, acetate (SACT), letrozole (LETZ), and LETZ +SACT. Polycystic ovarian syndrome was induced with 1 mg/kg (p.o.) of LETZ for 21 days. Thereafter, the animals were treated with SACT (200 mg/kg; p.o.) for 6 weeks. Biochemical, histological and immunohistochemical evaluations were performed with appropriate methods.

Results:

Letrozole-induced PCOS rats were presented with androgen excess, insulin resistance/hyperinsulinemia, ovarian cystic follicles, increased levels of anti-Mullerian hormone, leptin, with a corresponding decrease in 17-Beta estradiol, and adiponectin. In addition, the LETZ group also showed dyslipidemia, decreased levels of adipose/ovarian sirtuin-1, adipose triglyceride, increased lipase activity as well as ovarian triglyceride, with corresponding increase in adipose/ovarian lipid peroxidation, caspase-6, TGF-Beta1, inflammatory response (TNF-alpha, NF-kappaB and MIF) and decreased GSH. Adipose/ovarian mitochondrial dysfunction with evidence of decreased MATPS/Mfn2 were observed in LETZ group. The cardiac tissue of PCOS animals also revealed inflammasome and oxidative stress and altogether were accompanied by elevated expression of HDAC2. Nevertheless, administration of acetate reversed these perturbations.

Conclusion:

Overall, the present results suggest that acetate ameliorates adipose-ovarian dysfunction and cardiometabolic pathology that accompany PCOS by suppression of HDAC2. The present data possibly provides a clinical relevance for the management of cardiometabolic syndrome in PCOS individuals.
P063 DIFFERENCES IN CARDIOVASCULAR RISK IN THE GENERAL POPULATION OF LOW AND HIGH-ALTITUDE RESIDENTS IN PERU. HIGH ALTITUDE CARDIOVASCULAR RESEARCH – LATIN AMERICA POPULATION STUDY
Authors: Bilo Grzegorz , Villafuerte Francisco C. , Zanotti Lucia , Soranna Davide , Nava Sara , Rusconi Valentina , Pengo Martino F. , Croce Alessandro , Lombardi Carolina , Macarlupu Jose Luis , Bermudez Daniela , Sosa José Manuel , Carcamo Cesar P. , Zambon Antonella , Parati Gianfranco
Published: September 2024

Background and Objective.

Previous data in a convenience sample of highlanders showed an elevated prevalence of masked hypertension. However, comparative studies describing the prevalence of blood pressure (BP) phenotypes in the general population atof different altitudes are lacking. Our aim was to compare the prevalence of BP phenotypes defined by office BP measurement and ambulatory BP monitoring (ABPM) in a population-based sample of Peruvian lowlanders and highlanders.

Methods.

Sex- and age-stratified random general adult population sample was recruited in urban areas at low (Lima, <500m) and high altitude (Huancayo 3287m, Juliaca 3824m, Cerro de Pasco 4330m). Questionnaires, anthropometric data, conventional BP (3 seated measurements with a validated oscillometric device), 24-hour ambulatory BP (A&D TM2430, Japan), and blood analyses were obtained. BP was defined as elevated if either systolic or diastolic BP was: 1) office (OBP) ≥140/90; 2) 24-hour ≥130/80; 3) Daytime ≥135/85; 4) Night-time ≥120/70 (all in mmHg). BP phenotypes were defined as: normotension (NT) – no BP values elevated; white coat hypertension (WCH) – only OBP elevated; masked hypertension (MH) – any ambulatory BP elevated, normal OBP; sustained hypertension (SH) – OBP and any ambulatory BP elevated

Results.

The analysis included 181 lowlanders and 553 highlanders. Highlanders had slightly lower age (45 vs. 47 years, p=0.005), BMI (26.7 vs. 28.6 kg/m2, p<0.001), and oxygen saturation (88.9 vs. 97.8%, p<0.001) but higher haemoglobin (17.5 vs. 14.4 g/l, p<0.001) than lowlanders. Prevalence of elevated OBP was low at high altitude. Elevated ambulatory BP was much more frequent at both altitudes. Consequently there was a high prevalence of masked hypertension, which was a dominating high BP phenotype among highlanders. Main results are reported in the Table. The altitude of residence remained independently associated with elevated 24-hour BP (p<0.001) in a multiple logistic regression model including age, sex and BMI as covariates.

Conclusions.

Many individuals in Peru, especially highlanders, are exposed to BP-related risk, which cannot be captured by office measurements alone.
P065 NOCUTRNAL BLOOD PRESSURE AND ITS CLINICAL CLASSIFICATION ARE GREATLY AFFECTED BY HYDROSTATIC PRESSURE AND POSTURAL CHANGES BETWEEN MEASUREMENTS
Authors: Bothe Tomas Lucca , Heinz Viktor , Opatz Oliver S. , Visser Tinta , Patzak Andreas , Pilz Niklas
Published: September 2024

Background and Objective:

The assessment of nocturnal blood pressure (BP) is central in evaluating and monitoring cardiovascular health. However, the determination of dipping patterns has shown poor reproducibility. This is possibly caused by influences such as changes in body position during sleep and the resulting variations in hydrostatic pressure. This study aims to investigate the impact of hydrostatic pressure on nocturnal BP and to assess its clinical relevance.

Methods:

26 subjects aged 18 to 30 years, as well as 25 participants aged 50 years and older underwent nocturnal oscillometric BP measurements with concomitant assessment of the hydrostatic pressure difference between the cuff and heart level.

Results:

We observed that the cuff was frequently above the heart level while asleep, leading to negative pressure differences between the cuff and the heart level. With a mean of -9.61 mmHg, the right-sided posture revealed the largest hydrostatic pressure difference during sleep. Correcting for hydrostatic pressure led to reclassification of nocturnal hypertension in 14 subjects (27.5%). Dipping patterns changed in 19 participants (37.3%). In total, 25 subjects (49.0%) changed either their nocturnal hypertension and/or their dipping classification.

Conclusion:

Our findings underscore the importance of accounting for hydrostatic pressure in ambulatory BP monitoring. Hydrostatic pressure differences provide a plausible reason for the variability seen in nocturnal dipping patterns. Further research should focus on incorporating hydrostatic pressure compensation mechanisms in 24-hour BP measurement. Limiting the noticeable effect of hydrostatic pressure differences could greatly improve hypertension diagnosis, classification, and treatment monitoring.
P085 BLOOD PRESSURE AND THE CARDIOMETABOLIC PROFILE IN YOUNG ADULTS ASSISTED IN PRIMARY HEALTH CARE – LapARC MULTICENTRIC STUDY
Authors: de Araujo Sousa Randerson José , Parente Bernardes Gabriel , Massaranduba Silva Clara Serique , Naim Rayan Moura Patrik , Gomes Silva Bruno Antônio , da Silva Oliveira Clara Sofia , Carvalho Veiga Danna , Guizzo Maria Eduarda Bazzanelli , Fernandes Ana Cristina Tenório , Filgueiras Ligia Amaral , Muxfeldt Elizabeth Silaid
Published: September 2024

Introduction:

Hypertension, diabetes mellitus, dyslipidemia, obesity and smoking are risk factors that impact the emergence of subclinical lesions and contribute to increased cardiovascular (CV) morbidity and mortality.

Objective:

to evaluate the cardiometabolic profile and blood pressure levels in young adults treated in primary care in the Brazilian Unified Health System.

Methods:

Multicenter cross-sectional population study (arm of the LapARC study – Rio de Janeiro) approved by the Ethics Committee under registration: 5,046,133. Our center is located in the municipality of Santarém, Pará, Brazilian Amazon. Young adults (20 to 50 years old) were evaluated in relation to their cardiovascular risk profile, sociodemographic, anthropometry and laboratory tests. Office blood pressure (BP) was measured and patients underwent Home Blood Pressure Monitoring (HBPM), with a seven-day protocol.

Results:

161 individuals were included (81.4% female; mean age 39.6 ± 7.9 years), 90% declared themselves black and mixed race and 27.3% had low education. More than half of the population has 3 or more CV risk factors (55.9%), with dyslipidemia being the most prevalent (60.2%), followed by hypertension (55.9%) and women with significantly more abdominal obesity (67.2% vs 30.0%, p<0.001). Among hypertensives, 84.4% knew the diagnosis, of which 71 were treated, with only 31.1% reaching blood pressure control. The most frequently mentioned antihypertensives were renin-angiotensin-aldosterone system inhibitors (36.6%) and diuretics (18.6%). Men had higher office and home systolic BP levels than women (136 ± 22 vs 128 ± 23 and 127 ± 21 vs 116 ± 15, p<0.05), respectively. Furthermore, the mean ankle-brachial index was 1.12 [1.07-1.20]. After HBPM, 20.9% of individuals were identified with masked hypertension, only 1.2% with white coat hypertension and 26.7% with sustained hypertension.

Conclusion:

although apparently healthy, this population have an adverse cardiometabolic profile, marked by low blood pressure control and the prevalence of masked hypertension, which justifies the continuation of the study.
P086 MAY MEASURE MONTH 2023: AN ANALYSIS OF BLOOD PRESSURE SCREENING RESULTS FROM NEPAL
Authors: Yao Zhengbang , Inagaki Y , Koirala S , McLachlan CS , Devkota S , Adhikari TB , Khanal P , Neupane D
Published: September 2024

Background and Objective:

May Measure Month (MMM) is a global annual blood pressure (BP) screening campaign raising awareness about prevention and control of hypertension. Nepal has been participating in this campaign since 2017. We present the results of MMM2023 in Nepal.

Methods:

Opportunistic BP screening was conducted among adults aged ≥ 18 years from May-August 2023 in Nepal. Participants, selected with convenient sampling, were administered a questionnaire developed by the May Measure Month. Three BP measurements were taken by trained volunteers using digital or manual BP devices. Hypertension is defined using both definitions: 1) BP ≥140/90 mm Hg or currently under antihypertensive medication 2) ≥130/80 mm Hg or currently under antihypertensive medication. Multivariate logistic regression analysis was used to identify factors associated with hypertension.

Results:

A total of 7,573 adults participated. The mean (SD) systolic BP (SBP) and diastolic BP (DBP) were 119.0 (15.9) and 79.8 (10.6) mm Hg, respectively. 22.3% and 50.1% participants were hypertensive using thresholds of 140/90 mmHg and 130/80 mmHg, respectively. Proportion of hypertension, overweight (BMI≥ 25 kg/m2), tobacco use, e-cigarette use, alcohol use, diabetes, and mean SBP/DBP were statistically significantly higher among males than females. Among hypertensive individuals, 48.9% were aware of their condition, and 42.1% were receiving pharmacological treatment. Among those under treatment, 60.1% had BP under control (<140/90 mm Hg). Factors associated with hypertension were age ≥40 years (OR 4.91, [95%CI 4.28-5.64]), history of cardiovascular diseases (2.15 [1.30-3.56]), diabetes (1.83 [1.52-2.21]), male sex (1.61 [41.41-1.84]), and overweight (1.60 [1.42-1.80].

Conclusions:

The MMM 2023 underscored the ongoing challenge of hypertension management in Nepal, reaffirming the strong association of hypertension with risk factors including age, male sex, history of CVDs, diabetes, and overweight. Despite higher proportion of hypertension among males, their awareness, treatment, and control levels were significantly lower than in females. This study highlights the need to strengthen community-based programs to enhance the continuum of hypertension management.
P087 ASSOCIATION OF INTRACRANIAL ARTERIAL STENOSIS WITH LEVEL AND VARIABILITY OF THE HOME BLOOD PRESSURE
Authors: Zhang Dong-Yan , An Dewei , Chen Hui , Xu Jie , Wang Ying , Cheng Yibang , Guo Qianhui , Huang Qifang , Huang Jianfeng , Sheng Changsheng , Wang Jiguang , Staessen Jan A , Li Yan
Published: September 2024

Background and Objective:

Given the close relation between intracranial arterial stenosis (ICAS) and systolic blood pressure (SBP), this study assessed whether blood pressure variability (BPV) refines risk stratification for ICAS over and beyond SBP using various BPV indexes derived from home blood pressure (BP) monitoring.

Methods:

In consecutively referred outpatients, all untreated for hypertension, ICAS was assessed by transcranial Doppler ultrasonography. SBP and BPV were determined from 7-day home BP recordings with triplicate readings in the morning and evening. BPV indexes included the standard deviation (SD), the coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV). ICAS probability was assessed with multivariable logistic models and model performance from the area under the curve (AUC).

Results:

Based on all home readings in 1510 patients, SBP, SD, CV, VIM, and ARV averaged 130.1 mm Hg, 8.36 mm Hg, 6.42%, 8.36, and 6.41 mm Hg. ICAS compared to non-ICAS patients had a similar CV and VIM (P≥0.09), but higher (P≤0.007) SBP, SD, and ARV by 3.9 mmHg, 0.66 mmHg, and 0.54 mmHg, respectively. ICAS was associated with SBP (P<0.001) irrespective of the time of day and with the BPV indexes independent of SBP in all morning readings (P≤0.050), but not in evening readings (P≥0.16). However, the AUC increment only reached significance for ARV in all readings and for CV, VIM, and ARV in morning readings.

Conclusions:

BPV derived from all-day and morning home BP readings was associated with ICAS independent of SBP but does not substantially refine ICAS risk assessment.
P098 CARDIAC REMODELING IN MICE TREATED WITH SODIUM OXALATE AND AORTIC STENOSIS
Authors: De Almeida Silva Amanda , Marques Juliana Romeu , Nascimento-Carvalho Bruno , de Souza Leandro Eziquiel , da Silva Maikon Barbosa , Juocys Dias Moreira Nathalia , Veras Mariana Matera , Waked Dunia , Caldini Elia Garcia , Irigoyen Maria Cláudia
Published: September 2024

Background:

Cardiovascular Diseases are one of the main global public health problems, with increasing mortality due to population aging and Hypertension (HTN). HTN is a risk factor for other diseases, such as aortic stenosis, renal dysfunction, and cardiac hypertrophy (CH). The hemodynamic overload caused by HTN affects the heart and kidneys, but the exact mechanisms of these alterations are not fully understood. Experimental models help study these mechanisms; however, a well-established model of CH with cardiorenal dysfunction does not yet exist.

Objective:

to evaluate whether the combination of cardiac hypertrophy, induced by transverse aortic constriction (TAC), and renal injury, induced by soluble sodium oxalate (OXA), can be a new model of CH with cardiorenal dysfunction.

Methods:

Male C57BL mice were randomized as follows: SHAM, receiving saline or OXA solution, and TAC, receiving saline or OXA solution. Echocardiography, direct blood pressure (BP) recording, metabolic cage, histology were performed to evaluate cardiac and renal function, hemodynamics, autonomic modulation, and baroreflex.

Results:

The TAC+OXA group showed the highest systolic BP(SBP) (SBP: SHAM: 122±5.24 vs. TAC+OXA: 160±5.24 mmHg, p<0.01), increased double product (DP) (DP: SHAM: 64.65±4.76 mmHg/bpm vs. TAC: 89.53±5.85 mmHg/bpm, p=0.02), significant reduction in autonomic modulation (RMSSD: OXA: 12.5±1.8 vs. TAC+OXA: 2.8±0.2 ms, p<0.01) and reflex tachycardia, eccentric hypertrophy, and worse renal function. The TAC group showed eccentric hypertrophy, increased BP variability (SD-SBP: SHAM: 2.97±0.07 mmHg vs. TAC: 5.63±0.57 mmHg, p≤0.01), diastolic dysfunction, and dilated left ventricle in diastole. The OXA group showed increased autonomic modulation and heart rate variability, renal damage characterized by inflammation, proximal tubule damage, and interstitial fibrosis when associated with TAC. All treated groups showed a significant reduction in reflex tachycardia.

Conclusion:

Transverse aortic constriction combined with OXA gavage is a model of CH with renal dysfunction, as the combination caused more significant renal damage, systemic hypertension, decreased autonomic modulation and baroreflex sensitivity, and eccentric hypertrophy with subsequent LV diastolic dysfunction.
P103 EFFICACY AND SAFETY OF TRIPLE VERSUS DUAL COMBINATIONS OF ANTIHYPERTENSIVE DRUGS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF DOUBLE-BLIND RANDOMIZED CLINICAL TRIALS
Authors: Dhurjati Rupasvi , Satheesh Gautam , Pant Rashmi , Rodgers Anthony , Haghdoost Faraidoon , Salam Abdul
Published: September 2024

Background:

Some patients taking two blood pressure (BP) lowering drugs do not achieve and maintain BP <140/90mmHg on two drugs and substantially more do not reach <130/80 mmHg targets that are increasingly recommended by guidelines.

Objective:

To evaluate, among adults with hypertension, triple combination of antihypertensive drugs (AHTDs) compared to dual combinations of AHTDs for BP-lowering efficacy and safety.

Methods:

We searched multiple databases and the USFDA website until December 2023 for randomized, double-blind trials involving adults with hypertension, that compared triple versus dual combinations of AHTDs from five major classes (angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, calcium channel blockers, beta-blockers, and diuretics) over a minimum of 4 weeks. Drugs and doses were categorized by standard daily doses based on WHO daily defined dose. Primary outcomes were reduction in BP and treatment withdrawals due to adverse events (WDAE). Meta-analyses were conducted using random-effects model.

Results:

Twenty-four trials (15,533 participants) were included. Overall, triple compared with dual combination reduced BP by 5.1/3.7 mmHg (95% CI 4.3-5.9/3.0-4.4, p<0.001 for both), improved BP control by 69% versus 54% (relative risk [RR] 1.35 [95% CI: 1.25%-1.45%], p=<0.001). Incidence of WDAE was 4.2% versus 2.9% (RR 1.9 [95% CI: 1.3-2.4], P=0.004). Addition of a third drug to dual combinations at 0.5, 1, 1.5 and 2 standard doses resulted in additional SBP reduction of 3.4 (95% CI: 2.2-4.6), 6.1 (95% CI: 4.8-7.0), 4.5 (95% CI: 1.7-7.6) and 7.5 (95% CI: 6.2-8.8) mmHg, respectively with no significant difference in incidence of WDAEs [RR 1.63 (95% CI: 0.84-3.18) vs 1.58 (95% CI: 1.14-2.19) vs 0.94 (95% CI: 0.44-1.98)].

Conclusion:

Triple combinations of AHTDs reduce BP significantly, compared to dual combinations. Adding a third AHTD to dual combination, at 0.5 or 1 standard dose appear to produce most BP reduction and can avoid dose-related adverse effects.
P104 MEDICAL TREATMENT IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION HOSPITALIZED AT RESEARCH INSTITUTE OF CARDIOLOGY DURING 1 YEAR (FROM SEPTEMBER 2022 TO SEPTEMBER 2023)
Authors: Gasımov Zaur , Rahmanov Zahir , Dadashova Gulnaz , Javadova Tarana , Hajiyev Azad
Published: September 2024

Objective:

Patients with heart failure remain most challenging group of patients with cardiovascular diseases. Hospital period of these patients is important period of their life. Therefore evaluation of the level of in- hospital care and treatment options represents valuable information.

Design and method: 477 patients (pts), 13% female,87% male with HFrEF hospitalized at Research Institute of Cardiology during 1 year (September 2022 – September 2023) represented study population. Consecutive patients’ data was extracted from the archive of Institute and evaluated.

Results:

Majority of pts had NYHA III-IV and mean ejection fraction (EF) of 35% (26-43%).Atrial fibrillation (AF) observed in 17,8% out of 477 pts. Myocardial infarction (MI) in anamnesis was in 82%. Systolic Blood Pressure (SBP) – mean 137 mm.Hg(min 80-max 240),Diastolic Blood Pressure(DBP) – mean 84 mm.Hg(min 50 – max 140).Arterial Hypertension(AH) had 61,4%. Type 2 Diabetes (T2D) – 51%.Chronic Kidney Disease had 22,9%.Pulmonary artery hypertension – 33%.Hb<12 g/l had 22,4%.ACE inhibitors or ARB mainly in form of fix combination with thiazide diuretics received 34% out of 477pts. ARNI were used in 27,7% of pts.B-blockers-55%. MRA – 89%. SGLT2 inh – 17,4%.Loop diuretics-86,2%.Digoxin-28,8%.Amiodarone – 22,9%.Ivabradine – 6%. Lab, tests: К+ mean 4,4 (2,9-6,2). Na+, mean 140,4 (133- 155). NT-proBNP, mean 2246.39 pg/ml (10.0-30000.0).

Conclusion:

In significant number of patients with HFrEF hospitalized to Research Institute of Cardiology during the period from September 2022- September 2023 medical therapy was almost adequately adherent to modern international guidelines on management of heart failure. In some cases’ limitations for indication because of low blood pressure, low eGFR and high serum kalium level took place.
P108 DIFFERENCES IN BLOOD PRESSURE CONTROL BASED ON HYPERTENSION SUBTYPE IN PATIENTS WITH A DE NOVO DIAGNOSIS: A RETROSPECTIVE COHORT STUDY
Authors: Rivera-Martínez Wilfredo Antonio , Casanova-Valderrama María Eugenia , Figueroa-Torregroza Lunévar , Ocampo-Chaparro José Mauricio , Salazar-Solarte Aura María , Zambrano Jose Leonel , Gallo-Villegas Jaime , Aristizábal-Ocampo Dagnóvar
Published: September 2024

Background and Objective:

Currently, the selection of antihypertensive pharmacological treatment is carried out without considering whether only systolic or diastolic hypertension is present or both pressures are elevated. It is unknown whether the selection of individualized pharmacological treatment according to arterial hypertension (AH) subtype leads to greater blood pressure (BP) control. Therefore, this study aims to evaluate the association between the selection of pharmacological treatment based on AH subtype and BP control.

Methods:

This was a real-world cohort study that included 1,397 Latin American subjects with a de novo diagnosis of AH who received antihypertensive pharmacological treatment following current guidelines. Retrospectively, patients were classified by AH subtype according to the pattern of systolic or diastolic predominance of AH. Also, appropriateness of the pharmacological treatment was assessed based on AH subtype and the underlying hemodynamics of each subtype. BP control at the follow-up, within the first 12 weeks after diagnosis, was defined as <140/90 mmHg.

Results:

Among the subjects included in the study (n=1,397), the mean age was 52.4±13.2, and body mass index 28.8±4.9 kg/m2; 56.7% were women and 50.6% achieved BP control. The median time to the follow-up after diagnosis was 55 days (IQR 32-89 days). Regarding hemodynamic variables, the mean heart rate was 76.1±7.4 beats per minute, systolic blood pressure 147±13.9 mmHg, diastolic blood pressure 86.4±11.2, mean arterial pressure 108.0±9.5 mmHg, and pulse pressure 61.1±16.1 mmHg. The most frequent AH subtype was isolated systolic hypertension (47.3%). Initiation of appropriate antihypertensive pharmacological treatment was associated with greater BP control (OR 2.17; 95% CI 1.49 to 3.15; P value <0.001) (Figure). The patients who did not reach BP control presented a higher frequency of divergent systolic-diastolic hypertension subtype, and greater hemodynamic alterations.

Conclusions:

Appropriate selection of pharmacological treatment based on AH subtype is associated with better BP control in patients with newly diagnosed AH.