bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C07-8: CENTRAL BLOOD PRESSURE ESTIMATION USING THE RADIAL ARTERIAL PRESSURE WAVEFORM IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS
Authors: Murakami Tomoaki , Shiraishi Masahiro , Takeda Atsuhito
Published: January 2023

Objective:

Evaluation of central blood pressure is useful in prevention and treatment of cardiovascular diseases. In this study, we examined the accuracy of non-invasively measured central blood pressure in children, adolescents, and young adults.

Design and Method:

This study enrolled 23 patients who had undergone a cardiac catheterization below 30 years old (10.4 ± 7.2 years, 16 males and 7 females). Ascending aortic blood pressure waveforms were invasively recorded using a pressure sensor-mounted catheter (model SPC-454D, Millar Instrument, Inc., Houston, Texas). Simultaneously, radial artery pulse waveforms were non-invasively recorded by tonometry (HEM-9000AI, Omron Healthcare Co., Ltd., Kyoto, Japan). The measurements were performed before and after angiogram (injection of contrast media) except for one case. We analyzed the degree of coincidence between ascending aortic systolic blood pressure (aSBP) and estimated central systolic blood pressure calculated by the instrument (estCBP) in 45 simultaneous recording of aSBP and estCBP. The HEM-9000AI calculates estCBP using rSBP2, which indicates reflected pressure on radial artery.

Results:

The aSBP was 96.2 ± 13.4 mmHg and estCBP was 92.9 ± 14.7mmHg. There was no significant correlation between the aSBPs before and after angiogram in the same case. There was a significant relationship between aSBP and estCBP (r = 0.83, p < 0.0001). The mean difference of the estSBP minus aSBP was -3.3 ± 8.3 mmHg by Bland-Altman analysis. The relationship between aSBP and rSBP1, which indicates forward pressure on radial artery, was stronger than the relationship between aSBP and rSBP2 (r = 0.88, p < 0.0001 vs. r = 0.83, p < 0.0001). The relationship between aSBP and the average of rSBP1 and rSBP2 (r = 0.90, p < 0.0001) was stronger than the relationship between aSBP and estCBP.

Conclusions:

The estSBP calculated using rSBP2 method by HEM 9000AI was significantly correlated to aSBP in children, adolescents, and young adults. However, the correlation coefficient between aSBP and rSBP2 was smaller than that between aSBP and rSBP1. The estCBP calculated by rSBP1 and rSBP2 was strongly correlated to aSBP rather than estCBP by rSBP2 alone.
PS-C07-11: COMPARISON BETWEEN CUFF-BASED AND INVASIVE SYSTOLIC BLOOD PRESSURE AMPLIFICATION
Authors: Bui Tan , Picone Dean , Schultz Martin , Armstrong Matthew , Peng Xiaoqing , Black Andrew , Dwyer Nathan , Thomson Philip Roberts , Adams Heath , Hughes Alun , Sharman James
Published: January 2023

Objective:

Accurate measurement of central blood pressure (BP) using upper arm cuff-based methods is associated with several factors, including determining the level of systolic BP (SBP) amplification. This study aimed to determine the agreement between cuff-based and invasively measured SBP amplification.

Methods:

Patients undergoing coronary angiography had invasive SBP amplification (brachial SBP minus central SBP) measured simultaneously with cuff-based SBP amplification using a commercially available central BP device (device 1: Sphygmocor Xcel; n = 171, 70% men, 60 ± 10 years) and a now superseded model of a central BP device (device 2: Uscom BP+; n = 52, 83% men, 62 ± 10 years).

Results:

Mean difference (±2SD, limits of agreement) between cuff-based and invasive SBP amplification was 4 mmHg (−12, + 20 mmHg, p < 0.001) for device 1 and -2 mmHg (−14, + 10 mmHg, p = 0.10) for device 2. Both devices systematically overestimated SBP amplification at lower levels and underestimated at higher levels of invasive SBP amplification, but with stronger bias for device 1 (r = −0.68 vs. r = −0.52; Z = 2.72; p = 0.008). Concordance of cuff-based and invasive SBP amplification across quartiles of invasive SBP amplification was low, particularly in the lowest and highest quartiles. The root mean square errors from regression between cuff-based central SBP and brachial SBP were significantly lower (indicating less variability) than from invasive regression models (p < 0.001).

Conclusions:

Irrespective of the difference from invasive measurements, cuff-based estimates of SBP amplification showed evidence of proportional systematic bias and had less individual variability. These observations could provide insights on how to improve the performance of cuff-based central BP.
PS-C08-1: ACCURACY OF CUFF BLOOD PRESSURE AND SYSTOLIC BLOOD PRESSURE AMPLIFICATION
Authors: Bui Tan , Picone Dean , Schultz Martin , Peng Xiaoqing , Black Andrew , Dwyer Nathan , Thomson Philip Roberts , Adams Heath , Chen Chen Huan , Cheng Hao Min , Pucci Giacomo , Wang Jiguang , Goupil Remi , Sharman James
Published: January 2023

Objective:

Automated cuff measured blood pressure (BP) is the global standard used for diagnosing hypertension, but there are concerns regarding the accuracy of the method. Individual variability in systolic BP (SBP) amplification from central (aorta) to peripheral (brachial) arteries could be related to the accuracy of cuff BP, but this has never been determined and was the aim of this study.

Methods:

Cuff BP and invasive brachial BP were recorded in 755 participants (73% male, aged 64 ± 11 years) receiving coronary angiography at six independent research sites (using seven different automated cuff BP devices). SBP amplification was recorded invasively by catheter and defined as brachial SBP minus aortic SBP.

Results:

Compared with invasive brachial SBP, cuff SBP was significantly underestimated (130 ± 18 mmHg vs. 138 ± 22 mmHg, p < 0.001). The level of SBP amplification varied significantly among individuals (mean ± SD, 7.3 ± 9.1 mmHg; interquartile range, -2.4 to 12.3 mmHg) and was similar to level of difference between cuff and invasive brachial SBP (mean difference -7.6 ± 11.9 mmHg). SBP amplification explained most of the variance in accuracy of cuff SBP (R2 = 19%). The accuracy of cuff SBP was greatest among those participants in the lowest SBP amplification quintiles (ptrend< 0.001). After cuff BP values were corrected for SBP amplification, there was a significant improvement in the mean difference from the intra-arterial standard (p < 0.0001) and in the accuracy of hypertension classification according to 2017 ACC/AHA guideline thresholds (p = 0.005).

Conclusions:

The accuracy of automated cuff BP is markedly influenced by individual variability in SBP amplification. This knowledge can help improve the accuracy of cuff BP.
PS-C08-12: SHORT-TERM BLOOD PRESSURE VARIABILITY AND TARGET-ORGAN EFFECTS IN YOUTH: THE SHIP-AHOY STUDY
Authors: Flynn Joseph , Ferguson Michael , Lande Marc , Meyers Kevin , Samuels Joshua , Urbina Elaine
Published: January 2023

Background:

Increased blood pressure variability (BPV) has been associated with development of hypertensive target organ damage in adults, including left ventricular (LV) hypertrophy and increased vascular stiffness. Whether similar relationships can be seen in youth is unknown.

Methods:

We assessed short-term BPV and its relation to LV mass and carotid-femoral pulse wave velocity (cfPWV) in 374 participants (mean age 15.5 years, 60% male) in the SHIP-AHOY cohort. Short-term BPV was assessed by examining the differences in systolic and diastolic blood pressure (S/DBP) between 2 SHIP-AHOY study visits. Average time between visits was 25 days. BP was measured by auscultation; 4 BP measurements were conducted at each visit and averaged. BPV was calculated as the difference between the mean BP measurements at the 2 visits. LV mass was measured by m-mode echocardiography and cfPWV was assessed using plethysmography.

Results:

Mean SBP was 123.1 ± 13.0 mmHg on day 1, and 122.3 ± 12.8 mmHg on day 2, with a mean difference of 0.9 ± 7.5 mmHg between the visits. Mean DBP was 71.6 ± 11.6 mmHg on day 1, and 72.0 ± 11.7 mmHg on day 2, with a mean difference of 0.5 ± 10.4 mmHg between the visits. Participants were then divided into 2 groups according to whether their BPV was above (n = 198) or below (n = 176) the median BPV of the entire cohort. LV mass was similar between the groups: 32.7 ± 7.3 gram/ht^2.7 for those above the median vs. 32.8 ± 6.7 for those below the median (P = NS), but cfPWF was significantly higher in those with BPV above the median: 5.2 ± 0.9 meters/second vs. 5.0 ± 0.8 m/s for those below the median, P = 0.03.

Conclusions:

These data suggest that increased short-term BPV may be associated with the development of increased vascular stiffness in youth.
PS-C09-7: PREVALENCE OF CHRONIC KIDNEY DISEASE IN ARTERIAL HYPERTENSION
Authors: Duysenbaeva Aziza Ikhtiyarovna , Mirakbarova Kamola Abdusattarova , Srojidiniva Nigora Zaynutdinovna
Published: January 2023

Purpose:

To study the prevalence of chronic kidney disease (CKD) markers in patients with arterial hypertension (AH).

Materials and Methods:

A retrospective analysis of 188 case histories of patients with AH of 1–3 degrees (ESC/ESH, 2018) who received inpatient treatmentwas carried out. Mean age 62.8 ± 10.2 years. All patients underwent determination of creatinine, GFR by EPI, uric acid, blood lipids. CKD stages were established according to the modern KDIGO 2013 classification.

Results:

Among the examined patients there were 18% patients with CKDC1, GFR> 90 (n = 34); 56.3% patients with CKDC2, GFR 60–89 (n = 106); 17.5% patients with CKDC3A, GFR 45–59 (n = 33); 5.3% patients with CKDC3B, GFR 30–44 (n = 10); 2.6% patients with CKDC4, GFR 15–29 (n = 5) (p < 0.00001). 98.4% of the examined patients suffered from coronary artery disease; 46.1% had diabetes mellitus. It should be noted that patients with stage 4 CKD were significantly older (55 ± 8 vs 62 ± 9 vs 68 ± 8 vs 69 ± 9 vs 74 ± 16; p < 0.00001). According to the level of SBP, DBP, heart rate, the patients did not differ significantly. SBP was: 134.5 ± 29.3 vs 134.1 ± 31.5 vs 132.5 ± 20.8 vs 138.2 ± 19.4 vs 156 ± 39.1 (p < 0.26). DBP was 87 ± 11.5 vs 84.3 ± 10 vs 82 ± 10 vs 86.3 ± 9.2 vs 90 ± 17.39 (p < 0.25). Patients with stage 4 CKD had severe abdominal obesity. WC: 102.4 ± 10 vs 104.7 ± 13.6 vs 103.2 ± 10.7 vs 101.5 ± 12.4 vs 110 ± 27.3 (p < 0.68). Mean creatinine in the groups was 70.6 ± 14.7 vs 85.2 ± 14.4 vs 102.3 ± 14.6 vs 121.6 ± 25.3 vs 209.6 ± 45.5 (p < 0.00001). Mean eGFR 98.2 ± 7.3 vs 72.9 ± 7.4 vs 53.7 ± 4.2 vs 37.5 ± 4.1 vs 22.6 ± 3.8 p (p < 0.00001). The analysis showed that as the stage of CKD increases, the level of microalbuminuria increases. Thus, MAU indicators were 31.05 ± 25.5 vs 41.6 ± 50.2 vs 38.6 ± 46 vs 96.6 ± 144.7 vs 308.8 ± 147.5 (p < 0.00001). It should be noted, that the high stages of CKD are characterized by significantly more pronounced asymptomatic hyperuremia. At the same time, the level of uric acid in group I was 5.4 ± 1.4 vs 6.5 ± 4.7 vs 6.5 ± 1.7 vs 7.5 ± 1.7 vs 7.8 ± 1.01 (p < 0.00001).

Conclusion:

Among patients with hypertension, the prevalence of CKD is significantly high (82%), which additionally increases the cardiovascular risk of this category of patients.
PS-C09-10: ARTERIAL HYPERTENSION IN RURAL AND NON-RURAL POPULATIONS OF NORTHERN ARGENTINA
Authors: Romano Jose Rene
Published: January 2023

The prevalence of AHT (arterial hypertension) in patients in this population is not known due to the difficult access of health personnel, and the accessibility and cultural characteristics of these patients.

Some characteristics of these populations, blood pressure and differences with patients in cities, were evaluated. The objective of this study is to evaluate what modifications can be made to improve the health of these hypertensive patients.

The study was carried out in 4 towns in the province of Formosa that are 512, 354, 162 and 103 km away from the capital city. It was carried out in all cases in public institutions and the patients used as controls were patients not referred from rural areas. During the year 2020. A survey and pressure measurement were carried out with validated sphygmomanometers and under the recommended conditions. The data was analyzed by the STatistix program.

Of 1034 patients attended, a random sample of 20% of said population was taken and a similar sample in the city, it was observed in the rural sample average age of 48 years, 52% of male sex, the BP (blood pressure) S (systolic)1/2 145 and diastolic D 83, and with AHT 51.1% S and 39.3% D. 24% of the patients attended consulted for AHT, they presented AHT 180/110: 10% were referred 3% of the patients for presenting signs of target organ damage. Those from the city: age ½ 39 years old, consulted due to hypertension 42%, mean BP S 141 D 85, the percentage of hypertensive patients in the consultation was 43% S and 35% D. They were treated in rural areas 8, 75% of native aboriginal race that was increasing over time with the number of attentions (1 pte to 5 to 6 ptes).

It was demonstrated in these populations, the differences with patients who consult in the city of age to which they consult, the degree of control of hypertensive patients and the number of patients known to be hypertensive and consult a control for it, it was possible to serve populations special, in this case aboriginal and measure variables in them. It is hoped in the future to evaluate the usefulness at the population level of these services.
PS-C10-1: BLOOD PRESSURE PROFILE AND CARDIO-VASCULAR FEATURES OF WOMEN WITH A PAST HISTORY OF PREECLAMPSIA
Authors: Christian Ngongang Ouankou , Garba Hawa Koubouratou Oumy Aboubakar , Annick Metogo Ntsama Junie , Loic Mekem Tatsipie , Liliane Mfeukeu Kuate , Raoul Simeni Njonnou Sylvain , Marie Tebeu Pierre , Pierre Choukem Simeon
Published: January 2023

Introduction:

Preeclampsia increases the longterm risk of cardiovascular disease. Some of the women affected by this condition remain hypertensive after delivery. Hypertensive phenotypes such as masked hypertension, sustained hypertension, white coat hypertension and an adverse systolic night-today blood pressure (BP) ratio are often unnoticed and can only be detected with ambulatory BP monitoring (ABPM). This study aimed to determine the prevalence of hypertension using ABPM and office measurements.

Methods:

We conducted a cross- sectional study which included women who delivered between January 2015 and June 2021 and were diagnosed and followed up for preeclampsia in three major obstetrical and gynaecologic units in Yaounde. We excluded from the study all women who had a history of chronic hypertension or a known Cardiopathy. Sociodemographic data and past history were recorded, a physical exam,ecg, an ultrasound and ABPM was performed to all participants.

Results:

101 participants were included. The mean age was 30.56 years. 40.6% of women had hypertension (sustained hypertension, with sometime masked hypertension) with ABPM. Sustained hypertension was most common (26.7%), followed by masked hypertension (11.9%) and white-coat hypertension (2%). With office BP measurement, only 28.7% of women would have been diagnosed hypertensive. 29.8% of women had a disadvantageous dipping pattern. Among those that develop chronic hypertension, 18.8% had LVH at electrocardiography, 7.9% had both LVH and an abnormal left ventricular geometry on ultrasound while in normotensive women 1.9% had LVH at Ecg with 1% having both LVH and abnormal geometry at ultrasound. 20.8% of these women were obese during the follow up compared to 11.9% in the normotensive group. We had 26 patients (25,74%) with severe office hypertension and 32,3% were obeses. The fundus was normal in the majority of cases and we had no signs of neurological deficits or impaired cognition. Renal function was always normal or subnormal. Finally, we had two cases of heart failure.

Conclusion:

Many women affected by preeclampsia remain hypertensive after delivery. Masked hypertension and white-coat hypertension are risk factors for future cardiovascular disease and can only be diagnosed with ABPM. It is important to provide adequate follow-up for these women in order to intervene on the factors leading to this outcome.
PS-C10-3: THE EFFECT OF E HEALTH ESH APPLICATION ON BP MANAGEMENT PRELIMINARY RESULTS
Authors: Siafi Eirini , Konstantinidis Dimitrios , Andrikou Ioannis , Tatakis Fotis , Zamanis Ioannis , Leontinis Ioannis , Drogkaris Sotirios , Polyzos Dimitrios , Manta Eleni , Grigoriou Kalliopi , Dimitriadis Kyriakos , Tsioufis Konstantinos
Published: January 2023

Objective:

Main issues in the treatment of hypertension are the low level of blood pressure (BP) control and the economic burden for health care systems. Mobile application with telemonitoring of BP could contribute to better control and lower costs by reducing office visits. This could be useful nowadays with difficult access to health system due to covid-19. The purpose of this study was to investigate if an innovative management strategy of hypertension, such as the use of ESH care application for smartphones combined with a dedicated platform, could improve hypertension control and replace frequent office visits.

Design and method:

30 uncontrolled hypertensive patients, treated or untreated [mean age 53 ± 9 years, mean office BP (OBP) 146.3 ± 6.2 / 92.5 ± 9 mmHg, 53% men, 33% smokers, 23% with hypercholesterolemia] were randomized to the application assisted strategy (AAS) (17 patients), where a mobile phone application was offered to communicate home BP measurements (HBPm), or to regular office visits (13 patients). Patients BP measurements (HBPm for AAS and OBP for standard care group) were evaluated in 1 and 3 months with treatment titration if uncontrolled. In all patients OBP and ambulatory BP measurement (ABPM) were evaluated in 6 months.

Results:

In both groups the reduction in OBP and ABPM was significant in 6 months. In the AAS group the reduction in systolic/diastolic OBP and 24 h systolic/diastolic BP in 6 months was -26.5 ± 5.6 / -19.4 ± 8.2 mmHg (p < 0,001) and -19.6 ± 7.7 / -13.8 ± 4.8 mmHg (p < 0.001), respectively. In the standard care group, the reduction in systolic/diastolic OBP and 24 h systolic/diastolic BP in 6 months was -22.6 ± 9.7 / -9.6 ± 11 mmHg (p < 0.005) and -18.4 ± 6.0 / - 8.8 ± 4.4 mmHg (p < 0.001). In AAS group compared to standard care group there was a greater reduction in 24 h diastolic BP (-13.8 ± 4.8 mmHg vs -8.8 ± 4.4 mmHg, p = 0.016) and in diastolic OBP (-19.4 ± 8.2 mmHg vs -9.6 ± 11.0 mmHg, p = 0.04).

Conclusions:

The present results indicate that the monitoring of patients through a mobile health tool could be useful in hypertension management as it is correlated with better BP control compared to office visits. The trial is still enrolling patients.
PS-C10-6: ASSOCIATION BETWEEN ANKLE BRACHIAL INDEX AND SEVERITY OF CORONARY ARTERY DISEASE
Authors: Tandon Akanksha , Verma Narsingh
Published: January 2023

Objective:

To investigate ABI as a surrogate marker and predictor for severity of CAD To determine the relation between ankle brachial index and angiographic findings along with major cardiovascular risk factors in patients with suspected or at risk for coronary artery disease

Design and Method:

This hospital based observational study recruited subjects from Department of cardiology, OPD and IPD, KGMU, Lucknow who were planned for or subjected to coronary angiography or CT coronary Angio during October 2019 to September 2020. Relationship between ABI and angiographic findings was evaluated so as to include this as a screening tool in all suspected cardiovascular disease subjects having no past history of PAD and to predict the severity of CAD in future.

Results:

Among the population studied 49 subjects were ABI Positive and 161 were ABI Negative. 49 (23.33‰) subjects had ABI< 0.9 and 20(9.5‰) had ABI > 0.9 < 1.2 i.e. at intermediate risk. Out of the 49 patients 95.68‰ were males and 4.32‰ were females who were found to have low ABI i.e. less than 0.9 showing higher prevalence of low ABI in males. On applying regression analysis in which ABI was the dependent variable and vessel disease (SVD),DVD,TVD)was the independent variable it is evident that more the vessels are involved more is the severity of CAD as the coefficient value increases i.e. SVD(0.84),DVD(0.8492) and TVD(0.86) with significant p < 0.05 whereas in cases of ABI> 0.9 < 1.2 we found that the coefficient value of 0.22 for DVD patients was statistically not significant but patients with TVD having coefficient value of 0.758 is significant at p < 0.05. To analyse the atherosclerotic risk factors like diabetes, hypertension, positive family history of CAD among group 1(ABI Positive)and group 2 (ABI Negative with INTERMEDIATE RISK) showed significant association which was statistically significant with p < 0.05.

Conclusion:

Severity of CAD is associated with vessel involvement which causes derangement of ABI values. Larger randomised study groups are needed to establish the exact relationship between the various CAD risk factors and Ankle Brachial Index.
PS-C10-7: A NOVEL PROFESSIONAL AUTOMATED AUSCULTATORY BLOOD PRESSURE MONITOR FOR OFFICE USE WITH VISUAL DISPLAY OF KOROTKOFF SOUNDS: INBODY BPBIO480KV VALIDATION
Authors: Kyriakoulis Konstantinos G , Ntineri Angeliki , Theodosiadi Aikaterini , Menti Ariadni , Ntousopoulos Vasileios , Kollias Anastasios , Stergiou George S
Published: January 2023

Objective:

A novel professional automated auscultatory upper arm-cuff blood pressure (BP) monitor (InBody BPBIO480KV) for use in the office or clinic by healthcare professionals was developed. The device records the Korotkoff sounds using an electronic stethoscope embedded to the cuff, which are reproduced and graphically displayed on the device screen during cuff deflation, and automatically interpreted to report systolic and diastolic BP values. This validation study assessed the accuracy of the device in general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018) and the ISO Amendment 1.2020-01.

Design and Method:

Subjects were recruited to fulfil the age, gender, BP, arm size and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in general population using the same arm sequential BP measurement method. Three cuffs of the test device were used for arm circumference 23–28, 28–35 and 33–42 cm.

Results:

A total of 108 subjects were recruited and 85 were analyzed (mean age 57.3 ± 15.0 [SD] years, 53 men, arm circumference 32.1 ± 5.1 cm, range 23–42 cm). For validation Criterion 1, the mean ± SD of the differences between the test device and reference BP readings (N = 255) was 0.3 ± 5.5/0.6 ± 4.7 mmHg (systolic/diastolic; pass threshold < = 5 ± 8 mmHg). For Criterion 2, the SD of the averaged BP differences between the test device and reference BP per individual (N = 85) was 3.76/3.61 mmHg (systolic/diastolic; pass threshold < = 6.95/6.91 mmHg).

Conclusions:

The InBody BPBIO480KV professional automated auscultatory BP device for office use comfortably fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060–2:2018) in general population and can be recommended for clinical use in adults.
PS-C10-12: HOW IS THE ESTIMATED GLOMERULAR FILTRATION RATE DISTRIBUTED BY ASSOCIATION OF THE MOST COMMON CARDIOVASCULAR RISK FACTORS IN DIABETIC PATIENTS?
Authors: Félix Rita , Machado Cátia , Glória Joana , Miguéis Inês , Damião Pedro
Published: January 2023

Objective:

This study aims to characterize the distribution of estimated glomerular filtration rate (eGFR) in diabetic patients by association of common cardiovascular risk factors (CVRF) known as alcohol abuse (P15), tobacco abuse (P17), dyslipidemia (T93) and LDL cholesterol value, body mass index (BMI) and systolic blood pressure (sBP).

Design/method:

Cross-sectional, descriptive and analytical study. Anonymized data were obtained from users of 20 medical files who had at least one medical appointment, with at least one record of sBP, LDL, BMI and creatinine in the last 3 years until the 31st December 2021. The studied variables were sex, age, weight, BMI, creatinine, eGFR(CKD-EPI formula), target organ damage (TOD) identified by the existence of the following ICPC-2 coding: K74, K75, K76, K87 or K89, K90, K91 or K92; hypertension (K86 or K87), diabetes (T89 or T90), P15, P17, T93, at the date of the last record under study. For data collection, it was used MIM@UF®; program and the statistical analysis was performed using the R®3.6.3 program.

Cardinality diagrams were created to show the association of CVRF and eGFR, CVRF and sBP, TOD type and sBP. A prediction model for the event of eGFR< 60 mL/min/1.73m2 was also created through a logistic regression model that links the occurrence of chronic kidney disease (CKD) with the predictors HTA, Diabetes, TOD, P15, P17 and T93.

Results:

The convenience sample consisted of 2396 diabetics, of which 1214 were male, and whose mean age was 70 years (IQR = 17 years). It was found that 70% have coded T93, 79% have hipertension, 38% are obese and 19% have TOD. The most frequent association of CVRF is HTA and T93 with 961 diabetics, followed by HTA with 373 diabetics.

The logistic regression model shows that CVRF in diabetic patients in association with CKD, there are two variables that have statistical significance (age and hypertension). So, a constant 1 year increment in age increases the chance of finding a patient with CKD by 10% and the chance of a diabetic patient having CKD while being hypertensive is 2.59 times higher than a normotensive diabetic patient.

Conclusions:

The presence of several CVRF is frequent in the population that was studied, and the identification and understanding of their distribution is essential for an adequate management of diabetes. CKD is a frequent complication in these patients, and regular evaluation of eGFR and the other CVRF is essential for proper therapeutic management.
PS-C11-8: RELATIONS BETWEEN WHITE COAT EFFECT OF BLOOD PRESSURE AND ARTERIAL STIFFNESS
Authors: Cao Rong , Sun Gang , Yang Min Xiao
Published: January 2023

The aim of this study was to analyze the relationship between brachial-ankle pulse wave velocity (b-a PWV) and white coat effect (WCE), that is the difference between the elevated office blood pressure (BP) and the lower mean daytime pressure of ambulatory BP. A total of 444 patients with WCE for systolic BP (54.1% female, age 61.86 ± 13.3 years) were enrolled in the study. Patients were separated into low white coat effect (< 9.5mmHg) and high white coat effect (> = 9.5mmHg) according to the median of WCE. The subjects with a high WCE showed a greater degree of arterial stiffness than those with a low WCE for systolic BP values (P < 0.05). The b-a PWV were 17.2 ± 3.3m/s and 18.4 ± 3.4 m/s in low WCE and high WCE, respectively. The b-a PWV increased with the increase of WCE, showing a positive correlation between them (P < 0.05 for non-linearity). The significant association between the high WCE (β = 87.95, 95% Cl 35.97–139.93, P = . 001) and the b-a PWV was confirmed by the results of multiple regression analysis after adjusting for confounding factors. Similar results were observed in subgroups. In conclusion, WCE is significantly associated with arterial stiffness. More research is needed to determine the WCE and target organ damage.
PS-C12-8: BLOOD PRESSURE VARIABILITY IN PREVIOUSLY UNTREATED HYPERTENSIVE PATIENTS RANDOMIZED TO NIFEDIPINE GITS OR RAMIPRIL. REVERENT STUDY
Authors: Bilo Grzegorz , Kyriakoulis Konstantinos , Liu Chang Yuan , Soranna Davide , Ceravolo Isabella , Cassago Silvia , Zhang Wei , Kollias Anastasios , Pengo Martino F , Zambon Antonella , Wang Jiguang , Stergiou George S , Parati Gianfranco
Published: January 2023

Blood pressure (BP) variability (BPV) independently predicts adverse outcomes, making it a potential target for treatment. Preliminary data indicate that dihydropyridine calcium channel blockers (CCB) may reduce BPV more than other antihypertensives.

Aim of Reverent:

(Reducing blood pressure Variability in Essential hypertension with Ramipril vErsus Nifedipine GITS) Trial was to compare changes in either short-, mid- and long-term BPV in patients treated with a CCB (nifedipine GITS) or an ACE inhibitor (ramipril) in a randomised fashion.

Methods:

Untreated (treatment-naïve or after treatment washout) patients with mild to moderate essential hypertension and elevated basal BPV, were randomized to open label treatment with nifedipine GITS 30 mg or ramipril 10 mg once daily. BPV after 10 weeks and 12 months of treatment was assessed based on home (primary endpoint; validated AND UA-651BLE monitor), 24-hour ambulatory (A&D TM 2430) and office (AND UA-651BLE) measurements and expressed as standard deviation [SD] of obtained readings.

Results:

156 patients were included in the intention-to-treat analysis of the main study (10 weeks, primary analysis) and 138 of the extension study (12 months, exploratory analysis). No significant differences were observed between groups at baseline. Patient characteristics, BP and BPV values after 10 weeks of treatment are reported in the table. No significant differences between groups were observed in home and office BPV at the end of main study, also after adjusting for mean BP reduction. 24-hour weighted SD of systolic BP after 10 weeks of treatment was lower in the nifedipine GITS group (p = 0.032). Exploratory analysis also revealed lower office BPV after 12 months of treatment in nifedipine GITS group (7.15 ± 3.79 vs 9.00 ± 5.28 mmHg, p = 0.026).

Conclusions:

The study did not identify differences between nifedipine GITS and ramipril in reducing home BPV, while significant differences in favour of nifedipine GITS were observed in 24-hour BPV and in office BPV after 12 months. Clinical impact of these findings remains to be evaluated in outcome studies.
PS-C14-7: THE PART OF HYPERTENSION IN HEART FAILURE IN NIGERIA
Authors: Musango Dennis Anthony , Onyeagala Augustine Anayo
Published: January 2023

Objective:

The objective of this study was to determine the part of Hypertension among the heart failure causes in Nigeria.

Methods:

A total of 294 Patients with heart failure were selected. Between them 26 pacent (78) had Hypertension like origin of heart failure. The sex ratio was 0.73 and mean's age of Patients was 60years.

Results:

Thirty three cases of dyspnea and 31 cases respectively of class 3 and 4 New York Heart Association were observed. Global heart failure was found 45 cases and it concern left ventricular only 33 cases. Age 50 years, overweight and alcohol were most at risk factor noted. Clinical evaluation was favourable in the most of case. Also, we noted a death rate 5 percent and 7 percent re hospitalized in the year
PS-C15-10: ASSOCIATION OF BODY MASS INDEX, WAIST-TO-HEIGHT RATIO AND DURATION OF TYPE 2 DIABETES MELLITUS WITH DIABETIC RETINOPATHY IN WOMEN
Authors: Olatunji Victoria Ayodeji , Olarinoye John Kola , Arinde Olufemi William , Olatunji Lawrence Aderemi , Olorundare Olufunke Esan
Published: January 2023

Objective:

Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM). It is a leading cause of visual impairment and blindness worldwide, reducing the quality of life of patients. Clear evidence of association between anthropometric measurements and DR risk is lacking in Nigerian females with type 2 DM (T2DM).

Design and Methods:

A cross-sectional study of 57 female participants with physician-diagnosed T2DM with or without systemic hypertension. Anthropometric measurements were taken. Fasting blood samples were drawn for laboratory analysis. All patients underwent dilated fundoscopy by a single Ophthalmologist and diabetic retinopathy was graded based on the worse eye.

Results:

The mean age of the participants was 60.8 ± 11.0 years with no significant age difference between the DR and Non-DR groups. Of the 57 participants, 36 had varying degrees of DR while 21 had no features of DR. Among the patients with DR, 26 were hypertensive diabetic while 10 were only diabetic. The hypertensive diabetic were older than the diabetic. The mean weight and body mass index (BMI) were higher in the non-DR group compared to the DR group. The DR group had significantly longer disease duration for both diabetes and hypertension. The hypertensive diabetic had significantly higher systolic blood pressure (SBP), pulse pressure (PP), total cholesterol-high density lipid ratio (TC:HDL) and serum triglyceride (TG) than the diabetic. BMI was negatively correlated with presence of DR, while weight, TyG-BMI, weight-height ratio (WHt), hip circumference (HC) and DM duration were positively correlated. BMI, WHt and TyG-BMI were negatively correlated with severity of DR while DM duration showed positive correlation.

Linear regression showed that the independent determinant of the presence of DR in hypertensive diabetic were WHt and DM duration, while for severity of DR, DM duration, neutrophil-lymphocyte ratio (NLR) and HbA1c status were predictors. When adjusted for DM duration, presence of DR was predicted by WHt while severity was predicted by BMI.

The curve of the receiver operating characteristic was also plotted to establish the relevance of each of the factors predicting DR and their area under the curve (AUC) was compared. The results showed that DM duration, HbA1c status, NLR, HTN duration, BMI, WHt were predictors.

Conclusions:

BMI, waist-to-height ratio and DM duration and neutrophil-to-lymphocyte ratio are associated with the occurrence and severity of DR in female hypertensive diabetic.
PS-C16-5: RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS AND CLINICAL OUTCOMES IN COVID-19 PATIENTS WITH HYPERTENSION:A REPORT OF THREE PEAK WAVE PERIODS IN SEMARANG, INDONESIA
Authors: Karunawan Niyata Hananta , Jusuf Iin Irnawati , Tonang Alvin , Nugroho Prihatin Iman
Published: January 2023

Objective:

We aimed to assess the association between RAAS inhibitors (ACEi or ARB) and the clinical outcomes of COVID-19 patients with hypertension in the First Wave, Second Wave and Third Wave at Secondary Referral Hospital, Indonesia

Methods:

This cross sectional study was based on an electronic medical record in the Dr Adhyatma MPH Tugurejo General Hospital, Semarang, Indonesia. All patients more than 18 years old who confirmed COVID-19 case in the first wave (November 2020 to January 2021), second wave (May 2021 to July 2021) and third wave (January 2022 to February 2022) were included in this study. Data about demographic, comorbidities, features of antihypertensive drugs and clinical outcomes were collected. The clinical outcomes included mortality and prolonged hospitalization (length of stay (LOS) > 10 days). The statistical measures calculated were Chi square test and Fischer's exact test.

Results:

From three periods of peak wave, data from 1560 COVID-19 patients was collected in the first wave (304;19.5%), the second wave (1038;66.5%), and the third wave (218;14.0%). Subjects were dominated by males (50.4%) and a median of age 50 (19 -91) years old. The common comorbidities in studies were diabetes mellitus with 318 (20.4%) and hypertension with 254 (16.3%). In the main analysis, 99 (39%) patients with hypertension receiving RAAS inhibitors were compared with 155 (61%) patients receiving other antihypertensive drugs. Our results showed that RAAS inhibitors was not associated with a higher risk of COVID-19 mortality (RR:1.01; 95% CI: 0.61–1.67; p:0.969) or prolonged LOS (RR:0.86; 95%CI: 0.60–1.26; p:0.408).

Conclusions:

In COVID-19 patients with hypertension, the use of RAAS inhibitors showed no increased mortality or prolonged LOS compared to patients without RAAS inhibitors. COVID-19 patients and patients exposed to the COVID-19 pandemic should not discontinue ACEi or ARBs.
PS-C16-14: EFFECT OF THE COVID-19 PANDEMIC ON AMBULATORY BLOOD PRESSURE MEASUREMENT
Authors: Nzokou Daryl Tcheutchoua , Chaumont Martin , Van de Borne Philippe
Published: January 2023

Introduction:

The world is currently facing the fourth wave of the COVID-19 pandemic. The aim of this study is to assess the effect of this pandemic on ambulatory blood pressure measurements (ABPM) and to investigate the effect of SARS-CoV2 infection on blood pressure (BP).

Methods:

We conducted a uni-centric retrospective study on the ERASME hospital ABPM register, from 2010 to 2021. The nycthemeral blood pressure (BP) profile of the pandemic period (January 2020 to October 2021) was compared with that of the previous 5 control periods from January 2010 to October 2019. We also determined the diurnal, nocturnal and 24-hour high blood pressure frequencies for each period. Furthermore, for the COVID-19 period, the BP profiles of COVID-19 positive and negative patients were compared. Finally, in COVID-19 positive patients, we compared ABPMs performed before COVID-19 infection with those performed post-infection.

Results:

After excluding incomplete and poor-quality ABPM, 16,977 ABPMs were selected. The COVID-19 period accounted for 10.58% of ABPMs compared with 15–20% for pré-COVID periods. We observed that diurnal (83.20 vs 81.20; p < 0.001), nocturnal (73.02 vs 71.09; p < 0.001) and 24-hour (79.51 vs 77.50; p < 0.001) diastolic BPs were higher in the COVID-19 period. In contrast, diurnal (131.64 vs 133.18; p < 0.001), nocturnal (121.07 vs 121.93; p = 0.034) and 24-hour (127.82 vs 128.97; p < 0.001) systolic BPs were lower during the pandemic. In logistic regression, diastolic diurnal (OR:1.58 [1.33–1.89]; p < 0.001), nocturnal (OR:1.18 [1.02 - 1.36]; p = 0.026) and 24-hour (OR:1.22 [1.01 - 1.49]; p = 0.044) hypertension were associated with the COVID-19 period, when adjusted for age, gender or history of hypertension. Also, diurnal (OR:0.63 [0.55–0.71]; p < 0.001) and nocturnal (OR:0.82 [0.72–0.93]; p = 0.002) systolic hypertension were less frequent in the COVID-19 period. When comparing BPs between COVID-19 positive and negative patients, there was no significant difference. When ABPMs were compared before and after infection in COVID-19 positive patients, diastolic diurnal (88.41 vs. 78.88; p = 0.001), nocturnal (77.91 vs. 70.55; p = 0.027) and 24-hour (84.57 vs. 75.99; p = 0.002) BPs were higher after COVID-19 infection.

Conclusion:

Our study shows that during the COVID-19 pandemic, diastolic BP was higher and systolic BP was lower compared to the pre-COVID-19 period. We also observed an increase in diastolic BP after COVID-19 infection.
PS-P01-1: EFFECT OF FOOT MASSAGE ON DECREASING BLOOD PRESSURE AND ANXIETY IN OLDER PEOPLE WITH HYPERTENSION IN INDONESIA
Authors: Anwar Nursanti , Irwan Andi Masyitha , Saleh Ariyanti , Usman Suharno
Published: January 2023

Background:

Globally, the prevalence of hypertension in the world is quite high, especially in older people, which continues to increase every year. In addition to increasing blood pressure, many of the older people also experience anxiety. Intervention is needed to reduce blood pressure and overcome anxiety, and one of which is by giving foot massage interventions.

Objective:

To determine the effect of foot massage on reducing blood pressure and anxiety in older people with hypertension

Method:

This study was a quasi-experimental study with time-series design for measuring blood pressure and assessing the degree of anxiety after repeated foot massage interventions for 12 sessions.

Results:

A significant decrease in anxiety was observed after six days and 12 days of foot massage intervention (p < 0.05). A significant decrease was also observed in systolic blood pressure after the 12thintervention compared to baseline and 8th intervention (p < 0.05).

Conclusion:

Foot massage intervention is effective in reducing blood pressure and anxiety in older people with hypertension
PS-P01-6: IMPLEMENTATION OF A BLOOD PRESSURE ACTION SHEET IN A RURAL COMMUNITY SETTING IN INDONESIA
Authors: Rahmawati Riana , Fauziyati Ana , Sholawati Aliza Ayu Puspita
Published: January 2023

Objective:

The Blood Pressure Action Sheet (BPAS) was developed as a written material that provides information about hypertension, records blood pressure monitoring, and facilitates communication among patients, community health workers, and healthcare professionals. The purpose of this study was to evaluate whether the BPAS would help to improve patient adherence to antihypertension medication. Adherence to medication is important in blood pressure control, which helps to reduce the risk of morbidity and mortality. Nonadherence to antihypertensive medications is a serious problem in both developed and developing countries. In this study, the perspectives of community health workers of the implementation of BPAS were also explored.

Design and method:

This was a community based study in Yogyakarta province, Indonesia. Members of the Integrated Health Service Post for the Elderly who were 45 years or older and had stage 2 hypertension were included in the study. This was a mixed methods study that included a pre post interventional study to assess whether medication adherence improved followed by a qualitative study to explore community health workers perspectives of the implementation of BPAS. Adherence to medication was assessed using the Indonesian version of the Medication Adherence Rating Scale (MARS) questionnaire. Adherence was compared from before to 3 months after the intervention. An in depth interview was conducted among community health workers.

Results:

One hundred eight patients fulfilled the inclusion criteria. Most were female (87%) and had a low education level. The average age was 67.2 ± 9.2 years. The MARS score was significantly higher after than before the intervention (20.5 ± 3.4 vs (18.7 ± 4.5, respectively; p < 0.05). The percentages of patients categorized as completely adherent (score 24 or 25) were 11.9% before and 19.6% after the intervention. The percentages of nonadherent patients (MARS score < 20) decreased from 46.2% before to 21.6% at 3 months after the intervention. Community health workers perceived the BPAS as user friendly and useful, and that it had potential for implementation in the Integrated Health Service Post for the Elderly. The challenges for implementation relate to its use for illiterate patients.

Conclusion:

The 3 month implementation of the BPAS improved patients adherence to antihypertension medication. Despite the positive findings, the adherence after the intervention was still not optimal. Further studies are needed to evaluate the effects of administering of the BPAS in different settings.
PS-P02-8: HOST GENOMIC INFLUENCE ON THE GUT MICROBIAL METABOLITE-BLOOD PRESSURE RELATIONSHIP
Authors: Posma Joram M , Perez Isabel Garcia , Karaman Ibrahim , Gao He , Chan Queenie , Daviglus Martha , Horn Linda Van , Holmes Elaine , Nicholson Jeremy K , Elliott Paul
Published: January 2023

Objective:

The human metabolic profile is affected by host genetic, microbiome, environmental/lifestyle, and dietary factors which may all influence human raised blood pressure (BP). We aim to delineate metabolite-BP relationships by evaluating the effect of single-nucleotide polymorphisms (SNPs) mapped to enzyme-coding genes involved in metabolic pathways on this association. We specifically focus on human commensal urinary gut microbial co-metabolites.

Design and Method:

Two cross-sectional datasets of over 4,000 individuals in total were used in a two-stage design. The first cohort uses two timed 24-hr urine samples for the discovery and replication of urinary metabolites associated with BP. The second cohort uses spot urine samples to validate the associations and subsequently investigates the influence of BP and other metabolic syndrome-related SNPs on these associations. Urine samples from both cohorts were measured with 600 MHz 1H Nuclear Magnetic Resonance spectroscopy. The SNPs were mapped to metabolites using a bioinformatic approach, which also incorporates the microbiome in establishing the metabolic distance between SNPs and metabolites through biochemical reactions and pathways.

Results:

11 urinary metabolites, replicated within the first cohort and validated in the second cohort (adjusted P-values 1.68 × 10–15 to 1.08 × 10–4) were associated with systolic BP (SBP); 9 of these were also associated with diastolic BP (DBP) in both cohorts as well as 2 further metabolites with DBP only (adjusted P-values 9.18 × 10–13 to 1.23 × 10–4). The analysis of the host-genomic (SNPs linked to GLYAT, KYAT3 and SULT13A genes) effect on gut microbial co-metabolites phenylacetylglutamine, hippurate and 4-cresylsulfate and their association with BP revealed a significant contribution of SNPs on the metabolite-BP association (P-values 1.08 × 10–133 to 2.87 × 10–29). Other metabolite-BP associations, such as for amino acids tyrosine, glycine, lysine, and leucine, also demonstrated a significant effect of individual SNPs (P-values 1.54 × 10–303 to 2.04 × 10–8) on the relationship. These associations were validated with null models of random SNPs with the same minor allele frequency also mapping to enzyme-coding genes, as well as a null model demonstrating that these metabolites have more SNPs linked to them than other metabolites with similar network topologies in other metabolic pathways.

Conclusions:

We have shown that human commensal urinary gut microbial co-metabolites are reliably associated with BP differences in two cohorts, and we demonstrated a significant host-genetic component that contributes to these associations. These relationships indicate potential complex mechanisms involving host genetics, the gut microbiome, and metabolic changes associated with BP that may lead to new ways to prevent high BP.
PS-P03-7: 24 HR-AMBULATORY BLOOD PRESSURE PROFILE AND CLINICAL FEATURES OF HYPERTENSIVE AND PREHYPERTENSIVE HEALTH CARE WORKERS IN A PHILIPPINE TERTIARY CENTER
Authors: Abarquez Anna Francesca S , Llanes Elmer Jasper B , Santos Lourdes Ella G , Bongcawil Roxanne C , Cruz Angelica C Dela
Published: January 2023

Background:

Hypertension is a leading cause of cardiovascular morbidity, and its prevalence is increasing most rapidly in developing countries like the Philippines, where there is poor hypertension treatment and control ABPM is an important diagnostic tool among patients because it identifies hypertension phenotypes and circadian blood pressure profile that are known to be predictors for target organ damage and increased incidence of future cardiovascular event.

Objectives:

To determine the blood pressure profile and phenotypes of hypertensive and pre-hypertensive health care workers and its association to BP control and dipping status.

Design and Methods:

This is a cross-sectional study of hypertensive employees who underwent 24 hr ambulatory blood pressure monitoring (ABPM).

Results:

181 patients were included with majority from 50–59 years old age group (33.3%), female (70.17%), non-shift workers (61.88%) with the most common comorbidity of obesity (60.22%) and suspected obstructive sleep apnea (60.22%). All the known hypertensives (100%) had uncontrolled blood pressure despite being on antihypertensive medication. The following hypertension phenotypes were identified: Sustained hypertension (64.7%), masked hypertension (13.26%), white coat hypertension (7.18%), and non-dippers (66%).

Conclusion:

There was high prevalence of sustained hypertension among healthcare workers included in this study. All those known hypertensives tested had uncontrolled blood pressure despite being on one or more antihypertensive therapy, while there were also newly diagnosed with masked hypertension.

The overall prevalence of non-dippers and those with elevated mean 24- hour blood pressure levels was high, and there is significant association of working longer hours and nocturnal dipping pattern. However, there was no significant difference on nocturnal dipping status and blood pressure elevation among those with those with shift work, compared to usual office work hours. This study is one of the few local data on 24hr ambulatory blood pressure measurement of Filipino hypertensive and prehypertensive patients and is one of few data on use of ambulatory blood pressure monitoring among Asians. This also highlights the importance of 24-hour ABPM to identify ABPM parameters at high risk for cardiovascular outcomes and finally determine blood pressure control among known hypertensive patients according to the locally available maintenance medications.