bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECTS OF CHRONIC CANNABIDIOL DOSING ON BRAIN BLOOD FLOW: INSIGHTS FROM THE HYPER-H21-4 TRIAL
Authors: Kumric Marko , Supe-domic Daniela , Vrdoljak Josip , Dujic Goran , Urlic Hrvoje , Dujic Zeljko , Bozic Josko
Published: May 2024

Objective:

HYPER-H21-4 was a randomized, triple-blind, crossover study that demonstrated that 5 week cannabidiol (CBD) supplementation reduces average 24h blood pressure (BP) in patients with arterial hypertension. The aim of this sub-study was to establish whether CBD elicits significant effect on the brain blood flow and memory in these patients.

Design and method:

The trial was designed as a triple-blind randomized crossover trial. For this prespecified sub-analysis, we included 15 hypertensive patients. Patients were randomized to receive either oral CBD or placebo for the period of 5 weeks. After a 2-week washout, patients were crossed over to alternate therapy (CBD/placebo) (Figure 1). Patients visited the lab at the start and at the end of each dosing period (four times in total). Magnetic resonance imaging (MRI), with specific focus on measurement of the blood flow through internal carotid artery using 4D flow technique. Variables of interest were mean flow (mL/min) and Pulsatility Index (AU). In addition, at each visit, venous blood samples were obtained. Finally, patients fulfilled a Memory Complaint Questionnaire (MAC-Q) at the start at the end of the study (after 12 weeks).

Results:

After 5 weeks of CBD supplementation, no significant changes in mean flow (time: P = 0.461, group: P = 0.657, interaction: P = 0.285) or Pulsatility Index (time: P = 0.573, group: P = 0.640, interaction: P = 0.970) in internal carotid artery in comparison to 5 weeks of placebo. In addition, significant reduction after in MAC-Q score was observed (25.8 ± 2.4 vs. 22.6 ± 3.8, P = 0.036), indicating reduced complaint on memory loss.

Conclusions:

The results of the HYPER-H21-4 trial indicate that chronic CBD supplementation leads to BP reduction. However, despite the fact that CBD supplementation improved self-reported memory abilities, no differences in comparison to placebo were noted in terms of blood flow through internal carotid artery, indicating lack of CBD-mediated effect.
ASSOCIATION OF SOCIEOCONOMIC FACTORS, LIFE STYLE WITH CHOLESTEROL IN GENERAL ADULT POPULATION
Authors: Bilobrk Matea , Bilajac Lovorka , Glavic Mihaela Marinovic , Jelakovic Ana , Fucek Mirjana , Pecin Ivan , Jelakovic Bojan
Published: May 2024

Objective:

The relationship between socioeconomic factors, behavior and LDL cholesterol values is a complex process that includes various aspects of an individual's life and environment. The aim of the work is to determine the association of socioeconomic factors and health behavior with LDL cholesterol values.

Design and method:

Through cross-sectional research, we analyzed 1,800 subjects from the general adult population of Croatia (random sample of general adult population in Croatia included in the Epidemiology of Hypertension in Croatia -2 project). For the purposes of the research, a structured questionnaire was used, which consists of data on socioeconomic status and lifestyle. Cholesterol and LDL values were determined from fasting blood samples.

Results:

In the whole group 58.2% of respondents had increased total cholesterol values. However, only 24.96% declare that they had dyslipidemia, which indicates a low awareness of the existence of risks. Total cholesterol values were positively correlated with personal monthly income (r=0,41 p=0.041), professional education (p=0.021), type of work (p=0.011) and are also associated with an unhealthy lifestyle. We found a negative correlation with physical activity (r=-0,10 p<,05). Elevated LDL cholesterol showed association with socioeconomic factors such as personal monthly income, professional education, but there was no significant correlation with drinking black coffee, alcohol consumption, or physical activity. The consumption of fruits and vegetables was related to the occurrence of dyslipidemia and the correlation was statistically significant (r=-0,10, p <0.05).

Conclusions:

Poor awareness for hypercholesterolemia was observed in our general population. Socioeconomic factors and health behavior are interrelated in influencing total and LDL cholesterol levels. General population should be more educated to increase awareness about this important cardiovascular risk factor.
POOR LIFE STYLE IS ASSOCIATED WITH SOCIOECONOMIC STRATA - TARGETED PUBLIC HEALTH INTERVENTIONS ARE NEEDED
Authors: Bilobrk Matea , Bilajac Lovorka , Glavic Mihaela Marinovic , Jelakovic Ana , Fucek Mirjana , Jelakovic Bojan
Published: May 2024

Objective:

The socioeconomic distribution of modifiable risk factors for cardiovascular disease (CVD) is an important aspect of public health research. Understanding how these risk factors vary between different socioeconomic strata is crucial for the development of targeted interventions and policies to reduce the burden of CVD. The aim of the study is to determine the relationship between socioeconomic factors and variable factors for CVD.

Design and method:

The cross-sectional survey included 1,800 participants (random sample of general adult population in Croatia included in the Epidemiology of Hypertension in Croatia -2 project). Socioeconomic status and lifestyle data (physical activity, smoking, alcohol, black coffee) were collected using a structured questionnaire. Blood pressure was measured using an oscilometric device and the data collected was analysed using appropriate statistical methods.

Results:

In the whole group there were 25% smokers and 25% ex-smokers. Only 34.5% reported that they practice physical activity at least twice a week with a very low (51.7%) or moderate intensity (48.3%). A correlation was found between alcohol consumption and average monthly personal income (r=0.24, p<0.05), educational level (r=0.18, p<0.05), and type of work (r=-0.10 p<0.05). Black coffee consumption is complex and depends on individual preferences, cultural practices and other factors not necessarily related to socioeconomic status, but a relationship was found between black coffee consumption and income (p<0.05). and marital status (r=-0.20 p<0.05). The results show that the type of work has a significant influence on the amount and type of physical activity (p<0.05.).

Conclusions:

Understanding links between socioeconomic status and modifiable lifestyle risk factors is crucial for the development of targeted public health interventions. Eliminating inequalities in access to resources and opportunities can contribute to more equitable cardiovascular health outcomes between different socioeconomic groups.
DISPARATE IMPACT OF PRIMARY HYPERTENSION ON RIGHT VERSUS LEFT HEART VENTRICLES OF MALES AND FEMALES WILD TYPE AND HAIRLESS STRAIN OF SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Andelová Katarína , Sykora Matus , Bacova Barbara Szeiffova , Farkasova Veronika , Stankovicova Tatiana , Knezl Vladimir , Pravenec Michal , Tribulova Narcisa
Published: May 2024

Objective:

Poor adherence to lifestyle changes and antihypertensive drugs contributes to increase a risk for malignant cardiac arrhythmias. Hypertension contributes to myocardial structural remodeling, abnormalities in connexin43 (Cx43) which promote electrical instability and mechanical dysfunction. However, it is not known whether changes are confined solely to left heart ventricle (LV) or there is response of right heart ventricle (RV). SHR mimic human primary hypertension and hairless SHR is model of temperature acclimation characterized by increase thermogenesis. Aim of the study was to explore key factors involved in development of malignant arrhythmias and progression to heart failure, in left and right heart ventricles, of males and females wild type (WT) and hairless SHR.

Design and method:

6-month-old males and females WT and hairless SHR and normotensive WKY strain of rats were housed at standard 22°C. Biometric parameters, including electro- and echo-cardiographic were registered. LV and RV tissue was used for immuno-labelling of Cx43 to detect its topology and western blotting for determination protein levels of Cx43, PKA, PKC∊, PKCδ and markers of extracellular matrix (ECM) remodelling: TGFβ, SMAD2/3, MMP-2 and collagen-1. Susceptibility of the heart to electrically-inducible VF was tested using isolated perfused heart technique.

Results:

Comparing to WKY, QT and QRS intervals were prolonged in WT SHR with normalisation in hairless SHR. Hypertension resulted in decrease in Cx43 with its abnormal topology in LV of males and less in hairless SHR but not in females. Cx43 levels and its topology were preserved in RV regardless rat strain and sex. There were no differences in protein levels of ECM-markers when comparing LV and RV in all strains. PKC∊ and PKCδ were increased in RV versus LV in both SHR strains. Hairless SHR males and females were less prone to inducible VF compared to WT SHR.

Conclusions:

Findings point out that hypertension-induced pro-arrhythmic disorders of Cx43 are related to the left while not to right heart ventricle in both hypertensive strains. There is a benefit of cold acclimation in hypertension that may contribute, to the protection from malignant cardiac arrhythmias and mechanical dysfunction. Supported by Vega2/0002/20,2/0006/23 and APVV21-0410.
OBESITY PARADOX, WEIGHT-FREE ANTHROPOMETRIC MEASURES, AND MAJOR ADVERSE CARDIOVASCULAR EVENTS IN THE ELDERLY: INSIGHT FROM THE NORTHERN SHANGHAI STUDY
Authors: Xu Chong , Zhao Song , Tang Jiamin , Xiong Jing , Yu Shikai , Zhang Han , Xu Yawei , Zhang Yi
Published: May 2024

Objective:

Many studies have investigated the obesity paradox in the elderly. However, besides body mass index (BMI), many other anthropometric measures, such as the waist-to-hip ratio (WHR), provide a better indication of body fat distribution and may be more useful in a geriatric population.

Design and method:

3285 participants aged over 65 years old from the Northern Shanghai Study were included in this analysis. Eight anthropometric measures, including weight-related measures (BMI, weight-adjusted-waist index, body shape index and body surface area) and weight-free measures (WHR, waist-to-height ratio, body roundness index, relative fat mass) were measured and calculated with standard methods. Major adverse cardiovascular events (MACEs) included the non-fatal myocardial infarction, non-fatal stroke or cardiovascular death.

Results:

Participants had an average age of 71.4 years and 1428 (43.47%) were men. The median follow-up was 5.4 years (IQR, 4.4-7.3 years) and 218 events occurred. Participants with obesity were associated with a higher risk of MACEs compared with the normal (adjusted Hazard ratio = 1.54, 95% confidence interval (CI): 1.07-2.22, P=0.020). Restricted cubic splines also highlighted the robust correlation between high BMI and high MACEs risk (Pfor overall=0.025, Pfor nonlinear=0.339). Similarly, the aHR for the incidence of MACEs in WHR quartile 4 versus quartile 1 was 1.96 (95% CI: 1.26-3.05, P=0.003). When WHR was examined as a continuous variable, the result remained unaltered (Pfor overall=0.020, Pfor nonlinear=0.353). In adjusted model, all four weight-free measures were significantly associated with increased risk of MACEs (all P<0.05), while only two weight-related measures were related to the risk of MACEs.

Conclusions:

In the elderly, BMI and alternative anthropometric measures showed no evidence of an obesity paradox. Weight-free measures were more relevant to a risk of MACEs.
ECTOPIC ADIPOSE TISSUE: INCIDENCE OF PERICARDIAL AND PERIVASCULAR OBESITY AND RELATIONSHIP WITH METABOLIC AND ANTHROPOMETRIC OBESITY INDICES
Authors: Vasilchenko Maria , Bragina Anna , Rodionova Yulia , Osadchiy Konstantin , Avanesyan Milena , Fomin Alexander , Smagulova Aliya , Podzolkov Valery
Published: May 2024

Objective:

To study the incidence of pericardial and perivascular obesity and their relationship with metabolic and anthropometric indices of obesity.

Design and method:

The study included 100 patients (49 men, 51 women, mean age 58,5±12 years). Anthropometric data (Body Mass Index (BMI), Waist Circumference (WC)), degree and type of obesity, lipid profile and blood glucose were evaluated, and anthropometric (Body Adiposity Index (BAI)) and metabolic indices (Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), Triglyceride-Glucose Index (TyG)) were calculated in all patients. All patients underwent chest computed tomography with the calculation of perivascular adipose tissue (PVAT) and pericardial adipose tissue (PAT) volumes using Tissue Composition Module QCTPro (Mindways Software, USA) after tomograph calibration using a special phantom. Statistical processing was performed using IBM SPSS Statistics 27.

Results:

Obesity of different degrees was detected in 43 (43%) patients, all of them had abdominal type of obesity (AO). High prevalence of hypertension (HTN) was revealed in the study group – 69%. PAT volume greater than or equal to 3,2cm3 and PVAT volume greater than or equal to 0,4cm3 was considered as diagnostic criteria for pericardial and perivascular obesity, respectively. Isolated pericardial obesity (iPCO) was detected in 13(13%) patients, isolated perivascular obesity (iPVO) in 17(17%) patients, mixed ectopic obesity (iPCO + iPVO) in 33(33%) patients, and 25(25%) patients had isolated AO. While analyzing the distribution of ectopic obesity (EO) phenotypes according to BMI, it was found that mixed EO was significantly more common in obese individuals (51,2%) compared to (19,2%) normal weight (p=0.017) and (19,4%) overweight (p=0.016) patients. Patients with HTN were significantly more likely to have iPCO (p=0.005) and mixed EO (p=0.004) compared to patients without HTN. Patients with iAO had significantly higher anthropometric parameters: WC, SAD, BAI compared to those with ectopic obesity (p<0.005). At the same time, no significant differences between metabolic parameters (VAI, LAP, TyG) were found in these groups.

Conclusions:

The results suggest a higher prevalence of mixed EO among patients with obesity and HTN, and the metabolic significance of EO along with AO.
ABDOMINAL OBESITY IS ASSOCIATED WITH DIASTOLIC DYSFUNCTION IN YOUNG PRE- AND HYPERTENSIVE SUBJECTS INDEPENDENTLY OF BLOOD PRESSURE LEVELS AND INSULIN RESISTANCE
Authors: Hawpage Manuli , Ezhova Nadezhda , Shavarova Elena , Kazakova Olga , Bagmanova Nazilya , Shavarov Andrey , Shkolnikova Ekaterina , Kobalava Zhanna
Published: May 2024

Objective:

Metabolic syndrome is one of the most important conditions affecting diastolic function. We aimed to investigate early associations of abdominal obesity and lipid and carbohydrates metabolism with preclinical decline of diastolic function in treatment-naive young patients with hypertension. The aim of our study was to investigate the association of abdominal obesity and insulin resistance with diastolic function in young patients with first time diagnosed hypertension.

Design and method:

We evaluated anthropometric and metabolic characteristics, clinical blood pressure (BP) and 24-hours ambulatory blood pressure monitoring and performed echocardiography in 106 young (18-45 years old) never treated hypertensives (age 22 [21; 25] years, 85% males, body mass index (BMI) 25,8±4,9 kg/m2) free of diabetes mellitus. We divided all patients into subgroups according to median e’ and E/e’. Then we compared main clinical variables including obesity characteristics, common markers of lipid and carbohydrates metabolism and blood pressure levels in derived subgroups. We used Student's t-test and Mann-Whitney U-test to compare variables with normal and non-normal distribution, respectively.

Results:

There was no difference in age, lipids, HbA1c, HOMA-IR, clinical and ambulatory BP levels between subgroups divided according to median e’ and E/e’. We observed significant differences in body mass index, waist circumference and waist-to-height ratio. Then we compared main variables of diastolic function in patients with or without abdominal obesity (AO). Patients with AO had lower e’ and higher E/e’ than patients without AO: 10,5 vs 12,0 (<0,0001) and 7,7 vs 6,5 (<0,0001), respectively. There was no difference in tricuspid regurgitation velocity and left atrial volume index as in BP levels. We performed multiple regression analysis with e’ as dependent variable and age, sex, low density lipoproteins, glucose, HOMA-IR, office systolic and diastolic blood pressure and AO as independent variables. AO along with age remained independently associated with e’ (β= -1,716, p = 0,002 and β= -0,173, p < 0,001, respectively).

Conclusions:

In young hypertensive treatment-naive patients myocardial relaxation and left ventricular filling pressure estimated with e’ and E/e’ significantly differ between patients with or without AO irrespective of the presence of arterial hypertension and insulin resistance.
HYPERTENSION WITH HEALTHY OBESITY IS FAVORABLE IN CIRCADIAN RHYTHM OF BLOOD PRESSURE AND HEART RATE COMPARED WITH PATHOLOGIC OBESITY: KOREAN REGISTRY OF TARGET ORGAN DAMAGES IN HYPERTENSION (KORHR)
Authors: Cho Eun Joo , Yoo Byung Su , Shin Mi Seung , Sung Ki Chul , Kim Eung Ju , Han Seong Woo , Ryu Kyu Hyun
Published: May 2024

Objective:

Metabolically healthy obesity is more advantageous in cardiovascular outcomes than pathologic obesity. This study was to evaluate blood pressure (BP) and heart rate (HR) using 24-hour ambulatory BP monitoring and to compare various types of obesity and non-obesity hypertensives.

Design and method:

The Korean Registry of Target Organ Damages in Hypertension (KorHR), established in March 2013 was a nationwide prospective observation study including 16 tertiary care hospitals. A total of 1654 hypertensive subjects aged more than 30 years old without a history of obvious cardiovascular disease were divided into 4 groups according to body mass index (BMI) and waist circumference (WC). (table) Office BP and 24-hour ambulatory BP with HR were measured with other laboratory data.

Results:

A total of 1096 subjects [mean age = 51.4±11.9 years, including 699 (63.8%) male and 524 (47.8%) naïve hypertensives] BMI and WC data were available. There were no significant differences in lipid profile, hs-CRP, and HbA1C levels among various obesity groups (group 1, 2, and 3). However, the 24-hour mean SBP was significantly lower in group 3 compared with other groups. (138.7±15.0 vs. 137.8±12.7 vs. 133.1±17.6∗ vs. 136.5±14.0, ∗p=0.016 vs. other groups) Early morning HR was significantly lower in group 3 (71.1±11.4 vs. 66.2±12.2∗ vs. 66.2±11.8∗ vs. 69.6±11.9 bpm, ∗p=0.026 vs. group 1) and dipper pattern showed a strong tendency of more prevalent in group 3 and 4 with intermediate significance. The results were consistent in both naïve population and patients with anti-hypertensive medications.

Conclusions:

Healthy obesity hypertensives showed more favorable circadian rhythm in BP and HR than pathologic obesity regardless of metabolic profiles and history of anti-hypertensive medication. This would be a mechanism of advantageous cardiovascular outcomes in healthy obesity hypertensives.
INCREASED IN VIVO INTERSTITIAL HYDROXYL RADICAL GENERATION IN A HIGH-FAT DIET RAT MODEL OF OBESITY: A MICRODIALYSIS STUDY IN SUBCUTANEOUS WHITE ADIPOSE TISSUE
Authors: Graiani Gallia , Bongrani Alice , Verzicco Ignazio , Calvi Anna , Tedeschi Stefano , Cavazzini Stefania , Cacciola Giovanna , Coghi Pietro , Binno Simone , Vicini Vanni , Regolisti Giuseppe , Montanari Alberto , Cabassi Aderville
Published: May 2024

Objective:

Obesity development associates with oxidative stress imbalance. We monitored in a model of obese rat (high fat fed Sprague Dawley rats) the in vivo interstitial hydroxyl radical (an oxidative stress parameter) measured through microdialysis procedure and trapping techniques in subcutaneous white adipose tissue. Hydroxyl radical generation mainly relates to Haber-Weiss-Fenton chemistry that involves iron oxidation. We also monitored plasma and tissue (through a small adipose tissue biopsy) Ceruloplasmin (CP), an alpha2-glycoprotein that owns antioxidant and ferroxidase properties oxidizing ferrous to ferric iron and preventing hydroxyl generation.

Design and method:

At 10 weeks of age, two batches for a total of 54 male Sprague Dawley rats started a high fat diet (D12451; Research Diets, New Brunswick, NJ, USA) for 24 weeks. A control group (n=23) was maintained for the same period on standard diet. The high fat diet contained 24 g % fat (45% of total calories), 24 g% protein, (20%); 41 g% carbohydrate (35%). Control diet fat content was 4.25 g%. At the end of the diet period, body weight increase in high fat diet group was in average 14.7% as compared to controls (mean 515 g vs 449 g). Rats underwent a microdialysis procedure of subcutaneous white adipose tissue at the basal time, after 3, 12 and 24 weeks, to evaluate hydroxyl radical generation by trapping this radical through analysis of 2,3-and 2,5-dihydroxybenzoic or 2-hydroxylterephthalic acid.

Results:

High fat fed rats had a stable rise of hydroxyl radical generated in adipose tissue as compared to control diet rats as well as a higher tissue expression of CP, presumably acting as antioxidant adipokine. CP circulating levels were also elevated.

Conclusions:

High fat fed rats show an increased in vivo free radical generation in subcutaneous adipose tissue that associates with a presumably compensatory increase in Cp in an attempt to buffer the local excess generation of hydroxyl radical. Even if the observed increase in local and systemic Cp could represent the counter response to the activated inflammatory-oxidative pathway in these high fat diet-treated rats its effectiveness seems quite limited.
EFFECT OF TIRZEPATIDE ON OFFICE BLOOD PRESSURE LEVELS IN OVERWEIGHT OR OBESE INDIVIDUALS WITHOUT TYPE 2 DIABETES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Patoulias Dimitrios , Koufakis Theocharis , Stavropoulos Konstantinos , Karakasis Paschalis , Imprialos Konstantinos , Katsimardou Alexandra , Varouktsi Anna , Zografou Ioanna , Petidis Konstantinos , Doumas Michael
Published: May 2024

Objective:

Tirzepatide is a novel, dual, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, recently approved for the treatment of obesity, regardless of concomitant type 2 diabetes (T2D). The aim of the present meta-analysis was to assess the effect of tirzepatide on blood pressure (BP) levels in overweight/obese individuals without baseline T2D.

Design and method:

We searched PubMed and Cochrane Library databases, along with grey literature sources, from inception to December 2023, in order to retrieve randomized controlled trials (RCTs) assessing the effect of tirzepatide versus control on office systolic and diastolic BP (SBP and DBP, respectively) levels in patients with overweight/obesity without T2D at baseline.

Results:

We finally pooled data from 3 placebo controlled RCTs in a total of 3,788 randomized overweight/obese participants. Approximately one-third of enrolled participants had baseline hypertension. Baseline SBP and DBP levels across all eligible RCTs were within normal range. Subjects treated with tirzepatide (all doses) versus placebo experienced a significant reduction in both SBP by 7.3 mm Hg (p < 0.001) and DBP by 4.35 mm Hg (p < 0.001). Overall risk of bias was low for all eligible RCTs included in this analysis.

Conclusions:

In conclusion, preliminary evidence suggests that tirzepatide might produce a significant, beneficial effect on BP levels in overweight/obese subjects without T2D at baseline.
SILENT ATRIAL FIBRILLATION CORRELATES WITH COGNITIVE PERFORMANCE IN OLDER PERSONS
Authors: Rewiuk Krzysztof , Piotrowicz Karolina , Gasowski Jerzy , Sredniawa Beata , Kalarus Zbigniew , Kazmierczak Jaroslaw , Opolski Grzegorz , Zdrojewski Tomasz , Grodzicki Tomasz
Published: May 2024

Objective:

Atrial fibrillation (AF) coexists with dementia in older population. AF often remains undiagnosed due to the occurrence in an asymptomatic form - silent AF (SAF). The aim of the study is to evaluate the relationships between cognitive performance and AF both symptomatic and silent in a representative Polish older population.

Design and method:

The study was conducted as a sub-analysis of the NOMED-AF, a cross-sectional observational study aiming to evaluate the epidemiology of AF in a representative, community-dwelling Polish sample of adults aged 65 years or more. Mini-Mental State Examination (MMSE) was used to assess cognitive disorders. Each study participant, regardless of AF history, was equipped with a continuous electrocardiogram wearable recording system and encouraged to wear it for up to 30 days.

Results:

A sample of 2203 participants from the NOMED-AF study was enrolled in the analyses (mean age 77.1 years, 48.4% female); 491 (22.3%) were diagnosed with AF (41.3% of them with SAF). The mean number of points obtained by the respondents in the MMSE was 25.8±0.1 and was significantly lower in patients with AF (25.2±0.22 vs 26±0.11) This difference between patients with arrhythmia and those without AF was present in the subgroup of subjects aged 65-79 years (26.8±0.21 vs 27.4±0.08) and absent in the older subgroup (23.6±0.36 vs 23.3±0.24) (Fig. 1a). There was a significant difference in the number of points obtained between patients with the symptomatic and silent forms of arrhythmia, with a lower score obtained in the latter group (25.8±0.26 vs 24.3±0.38), which was consistent in both age subgroups (Fig. 1b). Finally, in the multivariate logistic regression model, the impact of SAF (but not overall AF) on MMSE scores has been demonstrated.

Conclusions:

In the older population the presence of AF is associated with a lower MMSE score. As for the silent form of arrhythmia, this relationship is deeper and independent of other risk factors, what suggests the need for a particularly thorough assessment of cognitive disorders in patients with AF and, on the other hand, active search for asymptomatic AF in the group of patients with dementia.
TRENDS IN THE PREVALENCE OF POSSIBLE SARCOPENIA IN PEOPLE AGED 45 YEARS AND OLDER IN CHINA FROM 2011 TO 2015-BASED ON DATA FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
Authors: Ma Weiping , Zhu Huarui , Zhang Ling
Published: May 2024

Objective:

To compare the prevalence of possible sarcopenia in people aged 45 years old and above in China from 2011 to 2015, to increase the epidemiological evidence of possible sarcopenia for early detection and targeted intervention of sarcopenia, and to provide a partial reference basis for the prevention and treatment of sarcopenia in China in the future.

Design and method:

Based on CHARLS data for 2011,2013 and 2015, we analyzed the possible prevalence of sarcopenia in our 45-year-old middle-aged and elderly population using the diagnostic criteria of AWGS 2019.

Results:

The overall prevalence of possible sarcopenia in China was 16.6%,16.6%, and 20.3% in 2011,2013, and 2015, respectively, and was higher in 2015 than in 2011 and 2013 (P<0.05). The prevalence increased with age, and was significantly higher in the elderly population aged 60 years and older than in the middle-aged population aged 45 to 59 years (P< 0.05). The comparison of prevalence between different regions was west > central > east > northeast in both 2011 and 2015, with prevalence decreasing and then increasing in central and west from 2011 to 2015, and the opposite in east and northeast (all P<0.05).

Conclusions:

The detection rate of possible sarcopenia in elderly patients in China was high from 2011 to 2015, and the prevalence varied among different age groups and regions. Awareness of possible sarcopenia should be improved, and timely intervention, early screening, and targeted preventive measures should be provided for specific groups.
THE BENEFICIAL EFFECT OF CARDIORESPIRATORY FITNESS ON THE RISK OF ATRIAL FIBRILLATION IN HYPERTENSIVES OLDER THAN 75 YEARS
Authors: Pittaras Andreas , Kokkinos Peter , Faselis Charles , Grassos Charalampos , Doumas Michael , Maria Papavasileiou , Kyfnidis Konstantinos , Kallistratos Emmanouil , Kapsokoli Chrysoula , Manolis Athanasios , Kypreos Kyriakos , Patrikios Ioannis
Published: May 2024

Objective:

The risk of atrial fibrillation (AF) is strongly associated with age, increasing the risk of both cardiovascular events and mortality. Evidence suggests an inverse, independent and graded association between cardiorespiratory fitness (CRF) and AF incidence in younger individuals. However, information on the association between CRF and AF incidence on hypertensive individuals >75 years of age is limited.

Design and method:

We identified of 57,137 hypertensive individuals ages >75.0 years (mean age 79.4±4.0), with no diagnosis of AF or ischemic cardiac disease prior to or upon completion of a standardized exercise treadmill test (ETT) as a part of clinical evaluation. We established four fitness categories based on age-stratified quartiles of peak METs achieved: Least-fit (3.7±0.8 METs; n=14,518); Low-Fit (5.9±0.9 METs; n=14,518); Moderately-Fit (7.0±0.72 METs; n=11,390); and Highly-Fit (9.8±1.4 METs; n=11,463). Multivariable Cox proportional hazard models were applied after adjusting for age, resting blood pressure, smoking, race, sleep apnea, chronic kidney disease, dyslipidemia, and medications. P-values <0.05 using two sided tests were considered statistically significant.

Results:

During 482,967.0 person-years of follow-up (median 7.8 years), there were 6,645 new AF cases occurred (11.6%) or 13.8 events per 1000 person-years of follow-up. In multivariable-adjusted analyses, CRF was inversely with the risk of developing AF, independent of all traditional comorbidities. For every 1-MET increase in exercise capacity the AF-risk was 9% lower (HR=0.91; CI: 0.90-0.93; p<0.001). The association across CRF categories was graded. Compared to the Least-Fit category (referent), the risk was 22% lower (HR=0.78; CI: 0.74-0.83; p<0.001) for the Low-Fit; 32% lower (HR=0.68; CI: 0.63-0.73; p<0.001) for the Moderately-Fit, and 40% lower (HR=0.60; CI: 0.56-0.65; p<0.001) for Highly-Fit individuals.

Conclusions:

Increased CRF reduces the risk of AF in individuals ages >75 years. The association is inverse, independent, and graded. For every 1-MET increase in exercise capacity the AF-risk was 9% lower.
ARTERIAL HYPERTENSION IN ONCOLOGY
Authors: Bendiab Nabila Tale B , Khedim Nesrine
Published: May 2024

Objective:

Cancer is a public health problem (20 million new cases in 2025 and 9 million deaths. There is a significant toxicity, including cardiac involvement, frequent and sometimes serious. High blood pressure is the most common co-morbidity in cancer patients. It is a possible complication of chemotherapy, especially targeted therapies. It is part of the definition of cardiotoxicity according to the ESC 2016.

Design and method:

An epidemiological, prospective descriptive study over a period of 18 months from June 2018 to December 2019 for 197 cancer patients, received at the cardiology department of the Tlemcen teaching hospital for a pre-therapeutic assessment; oriented: from the hematology department and from the oncolgy department.

Results:

The mean age of population was 49 years, 29.3% of our patients have known hypertension. 64.5% of our patients had malignant hemopathy and 35.5% had solid tumors 92% received poly chemotherapy.

Cyclophosphamide is prescribed in 81%, cisplatin in 12%, targeted therapy in 66%. Before chemotherapy, there was 18.5% systolic hypertension and 10.4% diastolic hypertension with a total of 23.6% hypertension., During chemotherapy, there was 10.3% hypertension systolic and 13.8% diastolic hypertension in total 19% of new hypertension cases according to the ESC 2017, The increase in BP during Chemotherapy was significant; speciallly in elderly women. An alkylating agent such as cyclophosphamide or platinum salt is included in the protocol for new hypertensives. Corticosteroids are present in 46.8%%, and targeted therapy in 3.2%.

Conclusions:

In oncology, high blood pressure is the most common comorbidity. It is a risk factor for certain cancers including kidney, brain. It predisposes to LV dysfunction under anti mitotics.and represents a possible complication of chemotherapy, and in particular targeted therapies. Regular monitoring of BP and the search for proteinuria are essential. The introduction of antihypertensive therapy allows in most cases the continuation of oncological treatment.19% of our population have developed hypertension with chemotherapy. It predominates in women, the elderly and in the group of alkylating agents.
APATINIB MESYLATE CAN PROMOTE THE ACTIVATION OF NOX4/DRP1/NLRP3 IN AORTIC TISSUES OF NUDE MICE WITH GASTRIC CANCER
Authors: Si Fei , Ma Xin , Yu Jing
Published: May 2024

Objective:

Apatinib is a VEGFR-TKI for the treatment of gastric cancer. The aim of this study is to investigate whether apatinib can increase the expression of NOX4/Drp1/NLRP3 pathway in the aorta of mice with gastric cancer.

Design and method:

Six 5-week-old SPF male nude mice were randomly divided into tumor group (T, n=3) and tumor + apatinib treatment group (T+A, n=3). Human gastric cancer cells (MKN45) were inoculated into the armpit of mice. The T group was given normal saline 0.2 ml per day by gavage, and the T + A group was given apatinib 100mg/kg by gavage for one month. The aortic tissues of all nude mice were collected to extract protein. The protein expression levels of NOX4, Drp1, NLRP3, Caspase-1, GSDMD, IL-18, and GAPDH in aortic tissues were detected by Western blot. ImageJ was used to measure the gray value, and the gray value of the target protein /GAPDH gray value was considered as the relative expression of the target protein. Independent sample T-test was used to compare the statistical differences between the two groups using GraphPad 8.0.2. Results were expressed as mean ± standard deviation, and P < 0.05 was considered statistically significant.

Results:

The results showed that compared with the tumor group, The expression of NOX4 in T+A group was increased (2.320±0.2365 VS 1.718±0.1635, P = 0.0223). The expression of Drp1 in T+A group was increased (1.317±0.2160 VS 0.8216±0.2178, P= 0.0489), and the expression of NLRP3 was increased in T+A group (1.634±0.1271 VS 0.7997±0.1848, P=0.0030). The expression of Caspase-1 was increased in T+A group (1.075±0.1088 VS 0.5912±0.05073, P=0.0022). The expression of GSDMD was also increased in T+A group (0.7845±0.01213 VS 0.3443 ±0.07458, P=0.0144). Compared with the tumor group, the expression of IL-18 in the aorta of the T+A group was not significantly different (1.266±0.1236 VS 1.198 ±0.1821, P=0.6170).

Conclusions:

The conclusions show that Apatinib can activate the expression of NOX4/Drp1/NLRP3 pathway in the aorta of mice with gastric cancer, which may cause vascular damage by affecting oxidative stress, mitochondrial dysfunction, and inflammatory response in the aorta. Further in-depth research is needed.
FEMALE GENDER: AN INDEPENDENT PREDICTOR OF HIGH NORMAL BLOOD PRESSURE IN LONG -TERM ADULT SURVIVORS OF CHILDHOOD, ADOLESCENT AND YOUNG ADULT CANCER
Authors: Ouabdesselam Souhila , Benkhedda Salim
Published: May 2024

Objective:

Determine the blood pressure profile in longterm adult survivors of childhood, adolescent and young adult cancer.

Determine predictive factors for abnormal blood pressure figures in these patients.

Design and method:

104 patients aged over 18, who had received chemotherapy with or without mediastinal radiotherapy for the treatment of neoplasia diagnosed and treated before the age of 21. High blood pressure was defined by a SBP > = 140 mmHg and/or DBP > = 90 mmHg or by the use of antihypertensive drugs. High normal blood pressure corresponded to a SBP between 130 mmHg and 139 mmHg and/or a DBP between 85 and 89 mmHg.

Results:

Male predominance (56.7%) with a sex ratio of 1.3. Mean current age 25.12 +/-5.40 years, age at diagnosis 13.4 ±5.13 years, duration since end of treatment of cancer 10.67 +/-5.80 years, BMI 22.77 ±4.66 kg/m2, male waist circumference (WC) 82.7 ±12.6 cm, female (WC) 78.6 ± 10.4 cm, SBP 114.5 ±11.7 mmHg, DBP 74.2 ±7.4 mmHg. Chemotherapy alone 80.8%, chemotherapy + mediastinal radiotherapy 19.2%, anthracyclines 100%, platinum salts 32%, corticoids 9%. Low HDL-cholesterol 44.7%, high normal blood pressure 24.3%, abdominal obesity 15.8%, hypertriglyceridemia 9.7%, obesity 8.7%, prediabetes 6.9%, fasting plasma glucose > = 110 mg/dl 6.9%, metabolic syndrome (MS) 3.8%. Multivariate study: Gender (OR = 3.32 95% CI 1.11 - 9.92 p=0.03) - MS (OR = 0.07 95% CI 0.06 - 0.81 p=0.03).

Conclusions:

Nearly a quarter of the patients in our study (24%) had a high normal blood pressure, which was associated with female gender and the presence of metabolic syndrome. These results confirm the need for early screening of cardiovascular risk factors, particularly hypertension, in long-term adult survivors of childhood, adolescent and young adult cancer.
PRACTICAL IMPLEMENTATION OF THE 2018 ESH/ESC RECOMMENDATION TOWARDS SINGLE PILL COMBINATIONS FOR THE MANAGEMENT OF ARTERIAL HYPERTENSION: A RETROSPECTIVE SINGLE-CENTER ANALYSIS
Authors: Vischer Annina , Nafaa Fiona , Schaffhauser David , Socrates Thenral , Mayr Michael , Breidthardt Tobias , Burkard Thilo
Published: May 2024

Objective:

The 2018 guidelines for the management of arterial hypertension by the European Societies of Hypertension and Cardiology recommend prescription of two or more antihypertensive drugs in a single pill combination (SPC). The aim of this analysis was to assess implementation of this recommendation and compare prescriptions of SPCs in 2019 and 2021.

Design and method:

We performed a retrospective, exploratory analysis from a hospital database that included patients hospitalized in internal medicine wards at a tertiary hospital during two time periods (01.10.-30.11.2019/01.06.-31.07.2021). Exclusion criteria were acute cardiovascular hospitalisation, symptomatic elevated blood pressure (BP) values and an age <18 years. We collected baseline characteristics, BP readings and compared antihypertensive medication at baseline and at discharge. Adverse events (AE), consisting of myocardial infarction, acute kidney injury, intracerebral bleeding, ischemic stroke/TIA, fall/syncope and death, were assessed during hospitalisation and within 30 days of discharge. 30-day hospital readmissions were evaluated using electronic health records.

Results:

The results are shown in the figure below. The prevalence of participants on antihypertensive therapy at baseline was 57.9% (216/373) (Figure). A SPC dual therapy at baseline was used in 10/13 (76.9%) patients in 2019 and in 19/23 (82.6%) in 2021, p-value 0.684. A SPC triple therapy was used in 3/13 (23.1%) patients in 2019 and in 4/23 (17.4%) in 2021, p-value 1.000. In 2019, 50/85 (58.8%) patients had a daily number of antihypertensive pills >1, in 2021, 90/131 (68.7%), p-value 0.147. Median maximum systolic BP (with SPC) was 165 mmHg versus 162 mmHg (without SPC), p-value 0.539. Median maximum diastolic BP was 93 mmHg (with SPC) versus 92 mmHg (without SPC), p-value 0.638.

Conclusions:

Overall, our results showed no significant increase of patients treated with SPC at baseline and of the daily number of antihypertensive pills >1 in 2021. A significantly higher rate of treatment modification was found in patients who already had a SPC in their initial treatment. There was no statistically significant difference in the occurrence of AE during and after hospitalisation between patients with or without SPCs, though numerically, there were less AE after discharge in patients with SPCs.
HYPERTENSION GAMING: A NEW DIVULGATION METHOD FOR GUIDELINES
Authors: Borrell Joan Torras , Camps Mencia Benítez , Nadal Oriol Rebagliato , Salgueiro Maria Cecilia , Artero Melania Priego , Nicolau Marta Vanrell , Vila Laura Camps , Eustaquio Marta Tafalla , Todó Montse Iracheta , Costa Mar Serrat , Ugena Josep Agudo , De Tuero Gabriel Coll , Coll Maria Antònia Vila , Vilaubi Josep Maria Pepió , Bargalló Ernest Vinyoles
Published: May 2024

Objective:

The usual techniques for disseminating knowledge are very often unpractical, useful for those doing the dissemination but sometimes little remembered by those attending.

Our goal is to present three adaptations of different game formats for the dissemination of the approach to hypertension (HT) with the knowledge of new guidelines.

Design and method:

We developed three board games for teams in a participative workshop format: the Hypertension Goose game (similar to the snakes and ladders’ game), a question and answers’ game on different topics adapted to the phases of HTA approach, and a strategy card game about the goal being to achieve the control objectives before the other groups as they solve the game scenarios. The maximum recommended number of players/students is 30.

Results:

The acceptance of the 3 modalities in the 9 editions carried out has been good with high satisfaction of the attendees.

Conclusions:

Group and dynamic board games, adapted to HTA teaching, are valued positively by students. We are currently working on a new line of research to measure not only satisfaction, but specifically the improvement in pre- and post-knowledge in each of the games and in the future we look forward to being able to compare these results with other more classic activities in the future that divulge the same contents.
UNCONTROLLED HYPERTENSION AND HYPERTENSIVE URGENCY – ONE YEAR SINGLE CENTER EMERGENCY DEPARTMENT EXPERIENCE
Authors: Nowicki Jakub , Silka Wojciech , Zalustowicz Aleksandra , Rajzer Marek , Olszanecka Agnieszka
Published: May 2024

Objective:

Background: Elevated blood pressure (BP) is a frequent cause of admittance to the Emergency Department (ED). Since this group of patients is characterized by great heterogeneity, considerable efforts were put to stratify them according to medical state severity and corresponding prognosis. Little is known about this cohort of patients, which in light of their substantial volume burden pose a significant challenge for physicians at the EDs

Aim: To characterize patients admitted to an ED for elevated BP and to evaluate factors associated with hospitalization.

Design and method:

Methods: This retrospective analysis comprised all patients (N=578) admitted to an ED of the university hospital in 2022 due to acute BP rise with an exclusion of hypertensive emergencies.

Results:

The studied group constituted 1.5% of all ED visits in 2022. The median age was 67 years; 69% were females. Headache, and vertigo (36.3%), chest pain (26.8%) as well as shortness of breath (11.4%), and neurological deficits (10.9%) were the most common complaints, however every fifth patient was asymptomatic (22.8%). Median SBP (200 mmHg, n=346) and diastolic BPs (DBP) (105 mmHg, n=316) measured at home were significantly higher than median SBP (173 mmHg n=578) and DBP (95 mmHg, n=578) during triage (p<0.0001). BP-lowering agents prior to admission to ED was taken by 38.6% of patients. In vast majority of patient captopril was used as prehospital BP lowering agent (91%). In the ED nitrendipine was administrated 53.5% of admitted patients, captopril was being administered often (37.5%), whereas furosemide (16.1%), urapidil (9.9%), and nitroglycerine (1.9%) were used less likely. Eventually, a median SBP/DBP of 140/82 mmHg was reached in the median of 289 minutes spent at the ED, i.e. approximately 5 hours. Hospitalization was necessary in 5.4% of patients, whereas 40% of them underwent antihypertensive treatment adjustment. Multivariable regression revealed that median arterial pressure (MAP) was not associated with hospitalization, however, furosemide (odds ratio (OR), 2.2, p<0.01) or urapidil administration (OR, 1.999, p<0.01) increased such risk.

Conclusions:

Improvements in pre-ED management and long-term hypertension treatment may reduce patients seeking ED for elevated BP without end-organ damage.
BLOOD PRESSURE VARIABILITY AND VENTRICULO-ARTERIAL COUPLING
Authors: Dumitrescu Silviu Ionel , Hantulie Ileana , Popescu Raluca , Boingiu Rares , Gherasim Corina , Cecoltan Serghei , Buican Luiza , Ionescu Ruxandra , Stanciu Silviu , Gurzun Magdalena , Munteanu Alice
Published: May 2024

Objective:

To investigate the influence of blood pressure variability on the parameters of arterial load and ventriculo-arterial coupling in apparently healthy individuals.

Design and method:

We screened 193 persons in a primary prevention program recording risk factors, blood pressure and ultrasound data: LV systolic/diastolic dimensions and volumes, septal/posterior wall thickness (SWT/PWT), left ventricle mass (LVM), ejection fraction, Doppler parameters, brachial artery Flow Mediated Dilatation (FMD), carotid artery Intima-Media Thickness (IMT). We calculated: systemic arterial compliance (C=stroke volume/pulse pressure), vascular resistance/cardiac circle length ratio (R/T where R=mean blood pressure/(stroke volume x heart rate)), effective arterial elastance (Ea=0.9 x systolic BP/stroke volume), as an index of artery load. The modified single-beat method was used to estimate left ventricular end-systolic elastance (Ees(sb)) and the ratio of Ea/Ees(sb) was computed as an index of ventriculo-arterial coupling. All subjects underwent a 24-hour Ambulatory Blood Pressure Monitoring (ABPM) on a working day, performing usual daily activities and avoiding heavy physical exercise. Blood pressure and heart rate readings were obtained every 15 minutes during daytime and every 30 minutes during nighttime. We calculated BP variability (BPV) as the Standard Deviation (SD) of mean blood pressure.

Results:

After data collection, we investigated the correlations (Pearson's r) between systolic BPV values and the parameters of arterial load and ventriculo-arterial coupling. We found a weak correlation between BPV and Ea/Ees(sb) ratio (r = 0,257,p < 0,001). We did not find any significant correlations between BPV values and arterial compliance, vascular resistance, effective arterial elastance and left ventricular end-systolic elastance. When we examined the correlations between systolic BPV values and the other markers of subclinical cardiovascular disease we found a moderate correlation with brachial artery FMD (r = -0,399,p < 0,001) and with carotid artery IMT(r = 0,314, p < 0,001) and a weak correlation with LV mass index (r = 0,170, p = 0,019).

Conclusions:

Our study indicates that blood pressure variability differences measured in apparently healthy individuals generate an adaptation of the ventriculo-arterial coupling parameters and correlate with markers of cardiac and vascular remodeling.
THE ASSOCIATION OF 24-HOUR URINARY SODIUM EXCRETION WITH INFLAMMATORY CYTOKINES
Authors: Wistrand Henrik , Kaartinen Niina , Jousilahti Pekka , Niiranen Teemu , Langén Ville
Published: May 2024

Objective:

The complex pathogenesis of hypertension, potentially involving inflammatory pathways, remains elusive. This study aimed to evaluate the relationship between 24-hour urinary sodium excretion and multiple inflammatory cytokines alongside C-reactive protein in a nationwide Finnish sample.

Design and method:

265 participants drawn from the general population who participated in the FINRISK 2002 study were included in the analyses. We examined the multivariable-adjusted associations of 24-hour urinary sodium excretion with levels of circulating C-reactive protein and 26 cytokines in a cross-sectional setting.

Results:

We observed that 24-hour urinary sodium level was not significantly associated with any of the cytokines or C-reactive protein (p >= 0.02 for all). Adjustments for age, sex, serum creatinine concentration, and alcohol intake did not materially alter these results.

Conclusions:

This cross-sectional study revealed no significant associations between 24-hour urinary sodium excretion and cytokine or C-reactive protein levels. These findings do not imply that reducing salt intake would be unbeneficial in hypertension. Instead, they underscore the epidemiological challenges in establishing a direct link in population studies between sodium intake and potential mediators of sustained hypertension. Additional research is required to clarify the mechanisms through which salt may induce hypertension.