bluuebunny/crossref_metadata_2025 huggingface dataset:
NIGHTTIME BLOOD PRESSURE ASSESSED USING A HOME MONITOR IN ADOLESCENTS AND YOUNG ADULTS WITH TYPE 1 DIABETES: CORRELATION AND AGREEMENT WITH AMBULATORY BLOOD PRESSURE MONITORING
Authors: Theodosiadi Aikaterini , Kollias Anastasios , Vakali Elena , Destounis Antonios , Tsiroukidou Kyriaki , Karypidou Erieta , Menti Ariadni , Vazeou Andriani , Zografou Ioanna , Doumas Michael , Stergiou George
Published: May 2024

Objective:

To investigate the association of nighttime blood pressure (BP) evaluated using home (HBPM) versus ambulatory monitoring (ABPM) in adolescents and young adults with type 1 diabetes (T1D).

Design and method:

Individuals aged 12-30 years with T1D underwent 24-hour ABPM (20 min intervals, Microlife WatchBP O3) and HBPM (daytime: duplicate morning and evening measurements; 7 days; night-time: 3 measurements per night for 3 nights; Microlife WatchBP Home-N). Non-dippers were defined as individuals with nighttime systolic and/or diastolic BP fall <10% compared to daytime BP.

Results:

Data from 91 individuals were analyzed (58% males, mean age 21±5.5 years, body mass index 24±4 kg/m2, HbA1c 7.3±1.0%, T1D duration 11.2±6.5 years, 24h systolic/diastolic ambulatory BP 112±9.4/67±5.7 mmHg, 24h ambulatory hypertension 3.2%). The number of valid measurements (day/night) in ABPM was 45.6±6.5/23.5±6 and in HBPM 23.5±4/8±1.4, respectively (p<0.001/<0.001). Daytime HBPM was slightly lower than ABPM by 1.4±5.6/0.6±4.9 mmHg (systolic/diastolic, p<0.05/NS), but nighttime HBPM was higher by 3.7±6.9/2±5.9 mmHg (p<0.01/<0.01). Strong association was observed between ABPM and HBPM (daytime r=0.84/0.72, nighttime r=0.71/0.52, systolic/diastolic, p<0.001). Good agreement (86%/85%; kappa=0.63/0.59, systolic/diastolic) was found between ABPM and HBPM in diagnosing individuals with elevated nighttime BP (upper quartile of distribution; >109/112 mmHg for systolic and >61/64 mmHg for diastolic BP in ABPM/HBPM respectively). Based on ABPM, 22 participants (25.3%) were classified as non-dippers versus 48 (60.4%) on HBPM (56% agreement; kappa=0.2, p=0.01).

Conclusions:

In young individuals with T1D, nocturnal HBPM is feasible and strongly correlates with nighttime ABPM. The two methods indicate good agreement in identifying individuals with increased nighttime BP and fair agreement in detecting non-dippers.
LONG-TERM EFFECTS OF BLOOD PRESSURE 130-139/80-89 MMHG ON ALL-CAUSE AND CARDIOVASCULAR MORTALITY AMONG CHINESE ADULTS WITH DIFFERENT GLUCOSE METABOLISM
Authors: Sheng Chang -SHENG , Tian Jingyan
Published: May 2024

Objective:

This study aimed to investigate the risks of all-cause and cardiovascular mortality associated with blood pressure (BP) levels of 130–139/80–89 mmHg in Chinese adults with different glucose metabolism, during a long-term follow-up of over 20 years.

Design and method:

A prospective population-based cohort of 2,132 adults in Shanghai was established in 2002 and followed for 21 years. The association between BP categories and mortality was assessed, and the risk was further analyzed using multiple Cox regression analysis by combining BP and blood glucose categories.

Results:

The final analysis included 2,004 participants, with 397 all-cause and 166 cardiovascular mortality. The incidence of all-cause and cardiovascular mortality per 1,000 person-years for different BP categories were as follows: BP <130/80 mmHg (4.5 and 1.3), 130-139/80-89 mmHg (7.7 and 2.9), and >=140/90 mmHg or treated groups (19.9 and 8.7), respectively. After adjusting for age, sex, and other factors, BP >=140/90 mmHg was significantly associated with a higher risk of mortality across different blood glucose categories. However, using BP<130/80 mmHg and normoglycemia as the reference, a BP of 130–139/80–89 mmHg was significantly associated with higher risks of all-cause (hazard ratio 3.26 [95% confidence interval 1.46-7.29], P<0.01) and cardiovascular mortality (9.53 [1.92-4.74], P<0.01) in diabetes, but not in those with normoglycemia or prediabetes.

Conclusions:

BP of 130–139/80–89 mmHg may lead to a significantly higher risk of all-cause and cardiovascular mortality in Chinese adults with diabetes, but not in those with normoglycemia or prediabetes. This suggests that the targeted BP for people with diabetes should be <130–139/80–89 mmHg.
EFFECT OF DAPAGLIFLOZIN IN CARDIO AND RENAL PROTECTION IN DIABETIC PATIENTS
Authors: Nelaj Ergita , Feracaku Julinda , Xhixhabesi Kei , Kecaj Irida , Tase Mihal
Published: May 2024

Objective:

Type 2 Diabetes Mellitus (T2DM) is among the major risk factors for both cardiovascular (CVDs) and renal diseases. The management of both cardiovascular risk and progression of kidney disease thus seem crucial in the treatment of the diabetic patient. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been associated with a remarkable reduction of cardiovascular and renal mortality, lower hospitalization rates for heart failure and lower progression of renal damage and albuminuria. The aim of our study was to assess SGLT2i effects on both cardio- and renal protection in diabetic patients.

Design and method:

Our study including elderly patients (>65 years) with T2DM, divided in two groups, one group treated with iSGLT2, and the other without. Data were collected at the beginning of treatment, 3, 6, 9 and 12 months after. HbA1C, BMI, GFR and renal parameters, uric acid, NTproBNP, echocardiography, PAS and PAD values, were evaluated in every meetings, in both groups.

Results:

A total of 298 elderly diabetic patients were included, at 198 of them dapagliflozin 10 mg, was initiated. At 12 months, HbA1c, weight, systolic blood pressure, NTproBNP, uric acid, albuminuria, were lower in group with dapagliflozin versus the other group without it, and estimated glomerular filtration rate was higher (75.3 – 87.19mL/min/1.73m2; p<0.005). Follow up in patients with SGLT2i showed a significant decrease in left ventricular end-diastolic dimension (LV-EDD) (62.86 mm to 54.85 mm; P< 0.001) and improvement in LV-EF. The SGLT2i-induced improvements in cardiac function were more prominent in HF patients than those without HF.

Conclusions:

The use of Dapagliflozin showed metabolic benefits in patients with T2D with clinically significant reductions in HbA1c, blood pressure, weight, uric acid, and NTproBNP. Cardiovascular and renal benefits were shown, also. So, SGLT2i has a significant effect in both, cardio- and renal protection in diabetic patients.
ASSOCIATION BETWEEN CARDIAC ARRHYTHMIA BEFORE PREGNANCY AND GESTATIONAL DIABETES: A NATIONWIDE POPULATION-BASED STUDY IN KOREA
Authors: Choi You -Jung , Wi Won Young , Cho Geum Joon , Na Jin Oh
Published: May 2024

Objective:

We aimed to investigate the relationship between cardiac arrhythmias and the incidence of gestational diabetes (GDM).

Design and method:

This retrospective cohort study utilized data from the Korean Health Insurance Service database, encompassing 1,113,729 women who gave birth between January 2007 and December 2015. We excluded subjects who had not undergone the national health screening test within 1 year before pregnancy (n=723,575), those with multifetal pregnancies (n=17,683), and individuals diagnosed with diabetes (ICD-10 codes E08, E09, E10, E11, and E13) and/or those with a fasting blood glucose level of 126 mg/dL or higher at the health screening test conducted within 1 year before pregnancy (n=6,591). Arrhythmias were classified into 5 categories: lethal arrhythmias, premature beats, paroxysmal tachycardia, atrial flutter/fibrillation, and atrioventricular block. The primary outcome was incident GDM, which was defined as having at least 1 claim with ICD-10 codes of O244 or O249 and the use of insulin during pregnancy, or having at least 3 claims with ICD-10 codes of O244 or O294.

Results:

We analyzed 365,880 singleton pregnancies without a history of diabetes. Of these, 3,253 (0.9%) had cardiac arrhythmias, including premature extra beats, supraventricular tachyarrhythmias, and/or atrial flutter/fibrillation. GDM occurred in 31,938 (8.7%) subjects during pregnancy and was more prevalent in women with cardiac arrhythmia than in those without (14.9 vs. 8.7%, p<0.001). In the multivariate analysis, the association between cardiac arrhythmia and GDM remained statistically significant (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). Subgroup analysis revealed that the risk of GDM was consistently statistically significant in subjects with cardiac arrhythmia, regardless of age, body mass index, and the presence or absence of chronic hypertension.

Conclusions:

Cardiac arrhythmias before and during pregnancy appear to be associated with an increased risk of developing GDM.
RELATIONSHIP BETWEEN INTEGRAL MARKERS OF METABOLIC STATUS AND VASCULAR STIFFNESS IN PATIENTS WITHOUT CARDIOVASCULAR DISEASE
Authors: Novikov Kirill , Bragina Anna , Druzhinina Natalia , Rodionova Yulia , Shikhmagomedov Rustam , Mohammadi Leila , Podzolkov Valeriy
Published: May 2024

Objective:

To evaluate correlation of vascular stiffness (VS) marker – cardio-ankle vascular index (CAVI) with anthropometric, laboratory and integral metabolic markers in patients without cardiovascular diseases (CVD).

Design and method:

160 patients (56 men and 104 women) were examined, age median was 39.0 [22.0;57.0] years. All participants underwent anthropometric measurement (waist circumference (WC), hip circumference (HC), neck circumference (NC)), lipid profile (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG)) and blood glucose testing by CardioChek PA. Integral indices LAP (Lipid Accumulation Product), VAI (Visceral Adiposity Index), BFP (Body Fat Percentage), BAI (Body Adiposity Index) were measured. CAVI (VS indicator) was measured by sphygmomanometry on VaSera scanner. Statistical processing of the data was done with STATISTICA 12.

Results:

Patients were divided into two groups according to the CAVI: normal VS (NVS) and high VS (HVS). In the NVS group age median (30.0 [21.0;53.5]) was lower than in the HVS group (55.0 [48.0;63.0]) (p>0.05). The groups had no statistically significant difference by gender, body mass index, WC, HC, NC, presence of metabolic syndrome (MS), blood pressure, smoking status (p>0.05), TG (p=0.331), HDL (p=0.101). In the HVS group patients with hypertension (p<0.001) and dyslipidemia (p=0.019) were more frequent and blood glucose (p=0.002), TC (p=0.020), LDL (p=0.047) were higher compared to the NVS group.

In the HVS group, levels of LAP (55.9 [39.8;105]), VAI (1.20 [0.928;1.33]), BFP (32.7 [27.1;37.9]), were significantly higher than in the NVS group: LAP (22.1 [10.5;39.0]), VAI (1.03 [0.664;1.37]), BFP (25.6 [19.2;28.5]) (p<0.05). The groups had no statistical difference by BAI index (p>0.05).

CAVI correlation with TC (r=0.267, p<0.05), LDL (r=0.401, p<0.05), LAP (r=0.469, p<0.05), VAI (r=0.420, p<0.05) and BFP (r=0.501, p<0.05) were obtained. According to multivariate linear regression analysis results independent predictors of elevated VS (high CAVI) were identified: age (B=0.065, st.er=0.006, p<0.001), blood glucose (b=0.339, st.er=0.114, p=0.004), LAP (B=0.024, st.er=0,006, p<0.001), VAI (B=0.673, st.er=0.214, p=0.004).

Conclusions:

In addition to traditional risk factors definition of integral markers of metabolic status is significant when measuring vascular stiffness in patients at moderate or high CVD risk. CAVI independently correlates with LAP and VAI indices.
CENTRAL SYSTOLIC BLOOD PRESSURE AND ARTERIAL STIFFNESS IN PATIENTS WITH HEART FAILURE WITH DIFFERENT EJECTION FRACTION PHENOTYPES
Authors: Khutsishvili Nutsiko , Kozlova Anna , Andreeva Ekaterina , Troitskaya Elena , Galochkin Svyatoslav , Tereshchenko Ekaterina , Kobalava Zhanna
Published: May 2024

Objective:

The aim of this study was to assess changes of central BP (cSBP,cDBP) and parameters of AS in HF with different ejection fraction (EF) phenotypes.

Design and method:

In 54 patients (61% males, 69.6±10 years, HTN 100%, median (med) EF 51% (IQR 38;55%), NTproBNP 623 (500; 1842) pg/ml; HFrEF 37%, HFmrEF 13%, HFpEF 50%), apart from routine tests, we assessed CBP and AS with applanation tonometry (SphygmoCor). cSBP above individual reference values [Herbert A,2014], central pulse pressure (cPP)>/=50 mmHg, carotid-femoral pulse wave velocity (cfPWV)>10 m/s, cfPWV above individual reference values [Eur Heart J,2010], and AS gradient (cfPWV/crPWV)>/=1 were considered abnormal. The statistical analysis was performed in the groups with EF >/=and<50%. p<0.05 was considered significant.

Results:

Median office BP was 117(106;130)/70 (68;80) mmHg, bPP 47 (37;56) mmHg; cBP 109.5(96;120.5)/71.5 (68;80) mmHg, cPP 35 (25;43) (p<0.05 compared to brachial measurements). Uncontrolled BP was observed in 26%, hypotension – in 3%. There were no differences in median BP and AS parameters across EF phenotypes. Elevated cSBP was observed in 33% (28.5% in EF >/=50%,38.4% in <50% (p >0.05)): 27.7% with office normotension, in 5.6% with office hypotension and in 66.7% with office HTN. cfPWV>10 ms was observed in 48.1%, cfPWV>individual reference values – in 33.3%, cPP >/=50 mmHg – in 18.5%, AS gradient>/=1–in 70.3% (in 48.1% of patients with normal cfPWV). Elevation of any AS parameter was present in 77.8%: 1–in 20.4%, 2–in 44.4%, 3–in 9.3%. Patients with cSBP elevation had higher uric acid (469.4±104.8vs367.1±126.5 μmol/l, Spearmen correlation coefficient r=0.34,p=0.04) (whole group); more often had CKD (50vs12.5%) (EF<50%); longer duration of HF (med 4.5 vs 1 year), higher BMI (med 39.4 vs 29.4 kg/m2) (EF>/=50%). Patients with cfPWV>10 m/s had higher total cholesterol (med 4.6vs3.7 mmol/l (whole group) and 4.5vs3.6 mmol/l (EF>/=50%)), patients with AS gradient>/=1 had higher triglycerides (1.3.vs0.8 mmol/l) (EF<50%),p<0.05 for trend.

Conclusions:

Patients with HF had high frequency of cSBP and AS elevation regardless of EF and BP control. The most common marker of AS increase was abnormal AS gradient. Elevation of cSBP may be associated with hyperuricemia.
BENEFITS, CHALLENGES, AND INFORMATION NEEDS IN HYPERTENSION APPS – FIRST RESULTS OF A QUANTITATIVE SURVEY AMONG CARDIOLOGISTS IN GERMANY
Authors: Seifert Frances , May Susann , Mühlensiepen Felix , Wengemuth Eileen , Heinze Martin , Spethmann Sebastian , Bruch Dunja
Published: May 2024

Objective:

In Germany, approximately 30 million people suffer from hypertension. Digital applications, such as apps, can assist individuals with hypertension in monitoring their blood pressure at home or in adhering to therapy and medication. However, healthcare professionals, such as doctors, only sporadically provide recommendations for hypertension apps. A qualitative survey has already identified the advantages, challenges, and information needs of cardiologists, which are now intended to be validated through the data from a quantitative cross-sectional study.

Design and method:

From October 2023 to January 2024, a quantitative, standardized questionnaire survey was conducted with cardiologists. Access to cardiologists was facilitated through the Bundesverband Niedergelassener Kardiologen (BNK - Federal Association of Outpatient Cardiologists). Participating physicians received compensation amounting to €75. The survey was conducted online using the Unipark software. Cardiologists were able to assess the advantages, disadvantages, and information needs of hypertension apps using 5-point Likert scales and free-text responses. The study is part of the innovation fund project DiPaH and has been approved by the Ethics Committee of the Brandenburg Medical School (E-02-20220620).

Results:

The questionnaire survey is currently ongoing. The target is to include 200 cardiologists. Descriptive analysis will be conducted in January 2024. The first presentation of quantitative results will take place at the 33rd European Meeting on Hypertension and Cardiovascular Protection.

Conclusions:

Cardiologists could only participate online, potentially leading to a positive bias in the data towards digitally savvy physicians who may have taken part in the online survey. Nevertheless, these are the first and most comprehensive results regarding the attitudes of cardiologists towards apps in hypertension care, providing practical implications for a successful implementation of apps in hypertension management.
IMPACT OF REMOTE MONITORING ON PATIENTS’ QUALITY OF LIFE. A SINGLE CENTRE STUDY
Authors: Marozzi Marialuisa Sveva , Corvasce Francesco , Falcone Giuseppe , Desantis Vanessa , Solimando Antonio Giovanni , Ria Roberto , Vacca Angelo , Cicco Sebastiano
Published: May 2024

Objective:

PROSIT (Patient Reported Outcomes and Smart Imaging in Telecardiology) is an innovative research initiative designed to explore the efficacy of remote patient monitoring in cardiovascular care. This project leverages wearable technology and patient-reported data to enhance the management of cardiac conditions, aiming to improve both patient outcomes and quality of life.

Design and method:

We evaluated 100 Caucasian patients, affected by hypertension, who access to Unit of Internal Medicine “G. Baccelli” and Unit of Hypertension “A.M. Pirrelli” from April to October 2023. Patients were divided in three groups: group A, with a wearable device (Hi) for continuous monitoring and an app with manual vital signs reporting, group B with only manual vital signs reporting through app on personal devices, and group C as the control group. The app for A and B group was able to suggest patient-physician interaction evaluating data inputted. All patients were assigned in different groups with a randomized approach based on factors such as age, gender, ejection fraction, presence of atrial fibrillation, and pulmonary embolism.

Results:

Telemonitoring usage has led patients to experience safe feelingsin their daily lives. In fact, patients in group B (app only) and A (app and Hi device) presented an improvement, notably significant for those in group A (p<0,05), compared to group C. In contrast, group C did not change their responses after one month of follow-up. Despite encountering minor issues during the trial, all enrolled patients believe that the telemonitoring program and telemedicine visits are commendable. Although the patients themselves have pointed out areas for improvement in the software, this does not diminish the substantial foundation that this technology signifies. No change was found in treatment adherence or blood pressure control.

Conclusions:

This study leads up to a future where digital support to medical practice will play a crucial role in accessing patient care and therapies, both for patients and clinicians alike. Patients are ready to embrace a new method for accessing care and being monitored by clinicians, one that integrates the old and the new, keeping pace with the times.
SIGNIFICANT IMPROVEMENT IN THE TREATMENT OF HYPERTENSION IN THE ELDERLY AND THE OLDEST-OLD DURING THE LAST DECADE IN POLAND - RESULTS OF THE POLSENIOR SURVEYS
Authors: Zdrojewski Tomasz , Wierucki Lukasz , Wiecek Andrzej , Jagiello Kacper , Wizner Barbara , Mossakowska Malgorzata , Chudek Jerzy , Bandosz Piotr , Grodzicki Tomasz
Published: May 2024

Objective:

The purpose of this study was to assess changes in the prevalence, detection and effectiveness of treatment of arterial hypertension (AH) over the past decade in people 65+ years of age in Poland.

Design and method:

The results from two national cross-sectional surveys that examined representative samples of Poland's elderly individuals were compared: PolSenior performed in 2008-2009 (n=4950, age range 65-104) and PolSenior2 in 2018-2019 (n=5057, age range 65-106). Blood pressure (BP) was measured by nurses during two separate visits at the subjects’ homes. During each visit, BP was measured three times using one of three cuffs depending on arm circumference to analysis average of the first and second measurements was used. AH was diagnosed when at each of the two visits the mean systolic blood pressure (SBP) was >=140mmHg and/or the mean diastolic blood pressure (DBP) was >=90mmHg or if the subject was taking antihypertensive medication for previously diagnosed AH.

Results:

In the last decade there was a significant reduction in SBP of 7.4mmHg in women [from 146.5mmHg (95%CI 144.6-148.5) to 139.1mmHg (95%CI 137.9-140.3)] and 6.9mmHg in men [from 146. 9mmHg (95%CI 145.5-148.3) to 140.0mmHg (95%CI 138.7-141.3)], and a DBP of 7.7mmHg in women [from 85.7mmHg (95%CI 84.8-86.6) to 78.0mmHg (95%CI 77.3-78.6)] and 4.0mmHg in men [from 83.2mmHg (95%CI 82.5-83.9) to 79.2 mmHg (95%CI 78.7-79.7)]. The prevalence of AH in people aged 65 and older remained unchanged over the analysed time period (78%). The percentage of those aware of AH has increased in the last decade in women from 79.6% to 84.6%, and in men from 70.2% to 78.1%. Among all AH patients, the percentage of those with good BP control (<140/90mmHg) increased in women from 25.1% to 35.3% and in men from 19.9% to 32.2%.

Conclusions:

In the last decade, significant improvement was achieved in the control of AH in seniors in Poland. The percentage of patients with well-controlled AH increased by almost 40% over the decade. The significant reduction in BP in the entire 65+ population and such a large increase in effectively treated hypertensives represent very positive changes.
TRANSGENERATIONAL EFFECTS OF FAMINE IN DIFFERENT PERIODS OF EARLY DEVELOPMENT
Authors: Tolkunova Kristina , Usoltsev Dmitrii , Moguchaia Ekaterina , Boiarinova Maria , Kolesova Ekaterina , Erina Anastasia , Vasilyeva Elena , Artomov Mykyta , Konradi Aleksandra , Shlyakhto Evgeny , Rotar Oxana
Published: May 2024

Objective:

The impact of famine during early stages of development can be transmitted across generations and change susceptibility of chronic cardiometabolic diseases. The study aims to assess possible association of famine during early stages of ancestors’ lives with remote cardiometabolic and behavioral patterns across generations of their descendants.

Design and method:

The besieged Leningrad residents at different ages were exposed to famine during prolonged period of time (8 September 1941–27 January 1944) during World War II. 309 Leningrad survivors were examined in 2007-2008 and divided into three groups depending on the period of exposure to famine: the children group – participants born before 01.01.1941, the infant group – respondents born between 01.01.1941 and 31.10.1941, and the intrauterine group – those born between 01.11.1941 and 27.01.1943. In 2020-2021 87 descendants of Leningrad Siege survivors aged 18 to 63 years without cardiovascular complications were examined. Examination included questionnaires, anthropometry, blood pressure measurement and biochemical blood tests. Mathematical and statistical data analysis was implemented using the R-4.0 programming language. ANOVA test was used to analyze differences between groups.

Results:

The descendants of Leningrad Siege survivors who experienced famine during intrauterine development demonstrated significantly lower triglyceride levels and prevalence of abdominal obesity, hypertension, in comparison to respondents whose ancestors experienced famine in childhood. Descendants of Leningrad Siege survivors, whose ancestors faced famine during the intrauterine period, were more likely to be non-smokers compared to other participants (Table 1).

Table 1. Cardiometabolic and behavioral risk factors in descendants of Leningrad Siege survivors according to the period of ancestral famine exposure.

Conclusions:

The impact of famine during the intrauterine period may exacerbate selection bias resulting in higher survival rate for individuals with favorable risk factor profiles, including non-smoking attitude (Agreement No. 075-15-2022-301).
BLOOD PRESSURE AND 24-HOUR URINARY SODIUM EXCRETION IN ADULT POPULATION OF SLOVENIA
Authors: Sinigoj Petra , Jese Nina Bozic , Kabaklic Amela , Kugler Sasa , Blaznik Urska , Rehberger Marusa , Korosec Ales , Zaletel Metka , Hitij Jana Brguljan
Published: May 2024

Objective:

The aim of our cross-sectional study on a nationally representative sample of adult population was to assess 24-hour urinary sodium excretion, estimate the average salt intake and investigate its association with blood pressure.

Design and method:

A stratified two-staged sample was selected from adult, non-institutionalized inhabitants of Slovenia, aged 25–64 years, by the Statistical Office of Slovenia, using sampling from the Central Population Register. 2000 people were invited to participate in the study; the response rate was 30.4%. The study included survey questionnaire, physical measurements, 24-hour urine collection and laboratory analysis. Each participant's blood pressure was measured conventionally with a validated device (Omron M7 Intelli IT; OMRON Healthcare Co., Kyoto, Japan) by trained personnel, three measurements were performed with 1-minute breaks in between and the average of the last two was used for the final analysis. Data presented are weighted by gender, age group, education, and cohesion region.

Results:

518 participants were included in the final analysis. Men had significantly higher average systolic (130 vs. 117 mmHg) and diastolic blood pressure (83 vs. 79 mmHg) in comparison to women (both p<0.001). 35.2% of participants had blood pressure <120/80 mmHg (19.4% of men vs. 52.4% of women) and 25.7% had blood pressure >140/90 mmHg (32.1% of men vs. 18.8% of women). The mean 24-hour urinary sodium excretion was 168 mmol/day (95% CI 156–180), which corresponds to a mean estimated intake of 10.3 g salt/day (95% CI 9.6–11.1). Only 11.5% of participants had salt intakes <5.0 g salt/day, with statistically significant differences between genders (7.8% of men and 15.5% of women; p<0.001). Mean estimated salt intake among participants with blood pressure in the range of 140–159/90–99 stage was 11.9 g/day, which was significantly higher compared to participants with blood pressure <120/80 mmHg and 120–129/80–84 mmHg (8.9 g/day and 9.8 g/day, respectively).

Conclusions:

The salt intake in adult population of Slovenia remains much higher than recommended. Higher estimated salt intake was associated with higher blood pressure. Statistically significant differences between genders were noted, with higher salt intake and blood pressure among men.
HYPERTENSION MANAGEMENT IN GEORGIA: BRIDGING GAPS IN CARDIOVASCULAR RISK ASSESSMENT AND BLOOD PRESSURE CONTROL (SNAPSHOT STUDY)
Authors: Shaburishvili Tamaz , Bayle Sabine
Published: May 2024

Objective:

To assess management of hypertensive patients in Georgia, including cardiovascular (CV) risk and blood pressure (BP) control.

Design and method:

SNAPSHOT is a cross-sectional observational multicenter epidemiological study that included 607 hypertensive patients in Georgia. The assessment of CV risk and BP control performed by investigators was compared to evaluations based on recommendations from European guidelines (SCORE 2&OP).

Results:

Patients were recruited by 31 investigators, of which 74.2% were cardiologists, 12.9% endocrinologists, 9.7% neurologists, and 3.2% general practitioners.

The analysis included 606 patients with a mean (standard deviation [SD]) age of 63.0 (11.6). Half patients were female (51.7%). Most patients were overweight or obese (81.8%) and non-smokers (68.8%). They had no (11.5%), one (36.6%), 2 (37.5%), 3 (14.2%), or 4 (0.2%) risk factors for hypertension. Most patients (68.4%) had additional comorbidities, mainly dyslipidemia (46.6%), coronary artery disease (35.0%) and diabetes mellitus (24.3%). Hypertension was treated in 93.9% of patients, with the most common treatments consisting of angiotensin-converting enzyme inhibitors (63.0%), diuretics (59.0%), and/or beta blockers (55.5%). The co-administration of these treatments, along with other BP-lowering medications, occurred in 37.3% (combination of 2) and 36.8% (combination of 3) of patients. Moreover, 63.9% of patients used a single-pill combination. Mean (SD) systolic and diastolic BP were 141.2 (20.8) mmHg and 84.7 (11.6) mmHg, respectively. BP was considered controlled according to the investigator in 72.0% of patients, while it was actually controlled according to guidelines in 19.1% of patients.

CV risk was assessed by the investigator as low, moderate, high, or very high in respectively 21.0%, 30.9%, 27.1%, and 21.0% of patients. According to guidelines, CV risk was mainly categorized as high (15.2%) or very high (84.6%). Therefore, there was an agreement between the 2 risk assessments in only 33.3% of cases, while the investigators underestimated the risk for 64.6% of patients.

Conclusions:

This study brought attention to significant disparities in hypertension and CV risk assessment compared to guideline recommendations. This emphasized the importance of adhering to established guidelines for medical assessments to enhance the effectiveness of hypertension management in Georgia.
THE ROLE OF TYG INDEX AS PREDICTOR OF CARDIOVASCULAR EVENTS AMONG YOUNG TO-MIDDLE-AGE STAGE I HYPERTENSIVES
Authors: Saladini Francesca , Mos Lucio , Vriz Olga , Rattazzi Marcello , Mazzer Andrea , Cozzio Susanna , Palatini Paolo
Published: May 2024

Objective:

The triglyceride-glucose index (TYG), a surrogate marker of insulin resistance, was shown to be associated with an increased risk of cardiovascular events among people with diabetes or the metabolic syndrome, while its prognostic capacity among young hypertensives is less explored. The aim of the present study was to investigate the role of TYG as predictor of cardiovascular outcomes among young stage I hypertensives, untreated at baseline.

Design and method:

We investigated 1210 subjects from the HARVEST study, mean age 33.1±8.5 years, 72.8% males. TYG was calculated according to the usual formula. BP was measured with 24-hour ambulatory monitoring. For the analyses, patients were divided into TYG quartiles: 7.008-8.061, 8.063-8.423, 8.424-8.690, 8.691-10.678, respectively. The risk of major adverse cardiovascular events (MACE) was explored by means of survival Cox analyses adjusting for several confounders and risk factors, including lifestyle factors, 24-hour BP and cholesterol.

Results:

TYG was correlated with BMI (r=0.348, p<0.001), age (0.237, p<0.001), serum uric acid (r=0.349, p<0.001), total cholesterol (r=0.422, p<0.001) and HDL-cholesterol (-0.393, p<0.001), and diastolic BP (0.132, p<0.001). Subjects in the top TYG quartile had the highest percentage of smokers (p<0.001), coffee users (p=0.038) and alcohol drinkers (p=0.010). TYG was significantly correlated with left ventricle mass index (r=0.08, p=0.021), left ventricular septum thickness (r=0.15, p<0.001), and posterior wall thickness (r=0.17, p<0.001). During 17.4 years of follow-up, 108 MACE were accrued. In multivariate Cox analysis the risk of MACE was higher in the two highest TYG quartiles than in the bottom quartile. For the top quartile the hazard ratio was 2.46 (95%CI, 1.17-5.20, p=0.018). The association remained significant also when the lifestyle factors were included in the regression with a hazard ratio of 2.43 (95%CI, 1.14-5.17, p=0.022). This was driven mainly by the strong association found in men with a hazard ratio of 4.84 (95%CI, 1.63-14.39, p=0.004).

Conclusions:

TYG index is a surrogate marker of insulin resistance, easy to calculate, which significantly correlates with several other metabolic parameters and with left ventricular wall thickness and mass. It is a predictor of adverse cardiovascular outcomes especially in male individuals.
PREVALENCE AND ASSOCIATIONS OF HYPERTENSION DETECTION, TREATMENT AND CONTROL IN SOUTH AFRICA
Authors: Peer Nasheeta , Levitt Naomi , George Jaya , Lombard Carl , Kengne Andre -Pascal
Published: May 2024

Objective:

Hypertension prevalence is high and rising in South Africa; however, hypertension care remains sub-optimal. The aim was to determine, among participants with hypertension, the prevalence and associations of hypertension care (detection, treatment and control) in Cape Town.

Design and method:

This randomly selected community-based cross-sectional study was conducted across five townships in Cape Town using a 3-stage cluster sampling procedure. Cardiovascular disease risk factors were determined by administered questionnaires, clinical measurements and fasting biochemical analyses, including oral glucose tolerance tests. Hypertension was defined as blood pressure >=140/90 mmHg or known hypertension on treatment. The Chronic kidney disease (CKD) Epidemiology Collaboration equation was used to define CKD as glomerular filtration rate <60 mL/min/1.73m2. Separate logistic regression models evaluated the associations with hypertension detection, treatment and control. Each model comprised sociodemographic characteristics, family history of hypertension, obesity (body mass index >=30 kg/m2), problem drinking, daily tobacco smoking and comorbidities of diabetes, high low-density lipoprotein cholesterol and CKD.

Results:

Among 460 participants with hypertension, 50.7 (SD±12.1) years, hypertension detection (62.4%), treatment (47.2%) and control (27%) were sub-optimal, and rates were better in women (73.6%, 58.9%, 34.8%, respectively) compared with men (41.6%, 25.5%, 12.4%) (p<0.001 for all). Hypertension detection among participants with hypertension was associated with increasing age (OR: 1.07, 95%CI: 1.04-1.09), female gender (OR: 3.20, 95%CI:1.75-5.84), urbanisation (OR:1.01), family history of hypertension (OR: 1.77, 95%CI:1.06-2.94), and co-morbidities of diabetes (OR: 3.30, 95%CI: 1.70-6.42) and CKD (OR: 5.04, 95%CI: 1.07-23.64). Participants in the lowest wealth tertile were less likely to have their hypertension detected (OR: 0.56, 95%CI: 0.29-0.95). Hypertension treatment was associated with increasing age, female gender, low education, family history of hypertension, diabetes and CKD. Hypertension control was associated with increasing age, female gender and comorbid diabetes.

Conclusions:

Participants who were older, female, and with co-morbidities were more likely to have better hypertension care overall, while the poorest participants were less likely to have their hypertension detected. Strategies are required to ensure equitable distribution of hypertension care and target individuals less likely to use healthcare services. In-depth research is required to understand the contributors to suboptimal hypertension care.
PREVALENCE OF CARDIOVASCULAR DISEASES IN KAZAKHSTAN FOR 2013-2020
Authors: Markabayeva Akbayan , Kerimkulova Aiman , Nurpeissova Riza , Ospanova Ainur , Zekenova Yerkezhan
Published: May 2024

Objective:

The purpose of this study was to study the incidence and mortality of diseases of the circulatory system for 2013-2020 in the Republic of Kazakhstan.

Design and method:

A statistical analysis of morbidity and mortality rates was carried out based on the statistical collections of the Ministry of Health of the Republic of Kazakhstan -Health of the population of the Republic of Kazakhstan and the activities of healthcare organizations, the Committee on Statistics of the Ministry of National Economy of the Republic of Kazakhstan for 2013 - 2020.

Results:

In Kazakhstan, according to the official data of the Ministry of Health, the overall incidence rate of diseases of the circulatory system (CSD) increased from 18683.6 cases per 100 thousand of the population in 2013 to 26306.2 cases in 2020, and the primary incidence - from 3315, 7 cases (of which: coronary heart disease - 500.6; acute myocardial infarction - 57.5; cerebrovascular disease - 208.1; arterial hypertension - 1665.9) to 4378.6 (of which: coronary heart disease - 604, 2; acute myocardial infarction - 127.6; cerebrovascular diseases - 433.7; arterial hypertension - 2138.9) cases, respectively.

The mortality rate from CSD decreased from 207.4 cases (of which coronary heart disease - 70.75 and stroke 71.90 cases) per 100 thousand population in 2013 to 193.79 (of which coronary heart disease - 67, 57 and stroke 66.57) cases in 2020.

Conclusions:

In Kazakhstan in 2013-2020, there has been an increase in the overall incidence of diseases of the circulatory system by 40%, and the primary incidence of diseases of the circulatory system by 32%. However, the mortality rate from diseases of the circulatory system over the years has decreased to 37.4%.
HYPERTENSION AND DIABETES DUAL SCREENING ACTION BY A TERRITORIAL PROFESSIONAL HEALTHCARE COMMUNITY (CPTS) USING MAY MEASUREMENT MONTH (MMM) 2023 PROTOCOL: THE FUTURE?
Authors: Lopez-sublet Marilucy , Brieux Cecile , Bouziz Mark , Stanic Silvi , Thomas Christian , Bozec Agnes Le , Leprieur Benedicte Giroux , Nguyen Rosaline , Sariya Rashida , Soare Synthia , Kabla Marina , Dhote Robin , Hilal Yassine , Moysan Mathilde
Published: May 2024

Objective:

In France, there are 17 million hypertensive (25.5% of the population) and 3.6 million diabetics (5.4% of the population). This prevalence is higher in precarious populations such as those in Seine-Saint-Denis. In response to these findings, the Bobigny-Bondy CPTS, in collaboration with our ESH center, has set up a 7-stage screening program (one of which incorporates MMM protocol adapted in French by the French Society of Hypertension (SFHTA)) for these two chronic diseases.

The aim of our study is to disseminate data obtained from a sample of adults in Seine-Saint-Denis during joint ’Hypertension and diabetes’ screening actions in 2023.

Design and method:

Seven stages of action with our population were carried out (reception, biometry, nurse interview, dietetic interview, associative interview, medical interview) (1. Diagram). The MMM protocol, adapted in French by the SFHTA, was also proposed to each participant.

Results:

General anonymous data for this population of 469 subjects (including 275 F) are summarize in Table (2). In this population, 38.6% declared hypertension. Of the non-hypertensive sample (n=279), 24.4% of participants presented with averages above 140/90 mmHg and 10.4% with grade 2 hypertension. As for diabetes, 18.8% of the sample claimed to be diabetic, and 8.3% of fasting participants presented with blood glucose levels suggestive of diabetes.

This joint city/hospital screening program, initiated by a CPTS, confirms the high prevalence of these pathologies in our population, with more than half the participants screened concerned with hypertension and more than a quarter concerned with diabetes.

Conclusions:

Developing prevention and screening actions according to the needs of a population is a priority mission for CPTSs. In the case of hypertension, the MMM kit proposed by the SFHTA has helped to establish part of the framework for action. Ministerial health authorities will need to provide more resources to encourage screening not only for diabetes, but also for frequent cardiovascular diseases such as hypertension, since their association can be ’explosive’, as in the case of COVID.
HYPERTENSION SCREENING FROM A COMMUNITY-BASED CARE PROGRAM TO REDUCE CARDIOVASCULAR RISK IN COLOMBIA: RE-HOPE, A CROSS-SECTIONAL STUDY
Authors: Uribe Maria Gabriela Ruiz , Montoya Isabela Gomez , Quiñones Daniela Hernandez , Bello Daniel Martinez , Wandurraga Johanna Otero , Hernandez Alvaro Castañeda , Lopez-lopez Jose Patricio , Lopez-jaramillo Patricio
Published: May 2024

Objective:

This study aimed to assess the prevalence of hypertension and undiagnosed hypertension and its associated risk factors in people aged 18 to 75 years in the department of Santander, Colombia.

Design and method:

A community-based program was designed, and the first phase was carried from May to November 2023. Data was collected using a structured questionnaire. The questionnaire comprised demographic and socio-economic variables, behavioral measurements, history of raised blood pressure, co-morbidities, and physical measurements. Hypertension screening was performed by averaging three values obtained by an automated electronic monitor in three observations. Collected data were analyzed using JASP 0.17.2.1, and descriptive statistics like frequency, percentages, central tendency (mean) measures, and standard deviations were performed to describe study participants.

Results:

A total of 6305 adults were screened with a mean age of 57.3 years (SD 17.9), 64.25% were women. 3130 (54.3%) individuals were identified as hypertensive, of whom 76% reported a previous diagnosis, 89.5% were on pharmacological treatment, and 38.4% had blood pressure in the control range. Ninety-three percent of those with hypertension were part of the subsidized health system. Of the hypertensive participants, 44.5% were overweight or obese and 24.6% reported doing at least 150 minutes of physical activity per week. When asked about tobacco use, 17% of the hypertensive patients had history of smoking and 4.7% were active smokers. 101 subjects reported having had an acute myocardial infarction, 25 had a cerebrovascular event, 80 had heart failure, and 451 had been diagnosed with diabetes mellitus.

Conclusions:

Half of the Colombian adult population studied suffers from hypertension. A high percentage is on pharmacological treatment, but control rates are low. This highlights the importance of new strategies to identify and improve the factors that influence the adequate control of hypertension.
HIGH PREVALENCE OF ASYMPTOMATIC HYPERURICEMIA IN RURAL POPULATION IS ASSOCIATED WITH HYPERTENSIVE STATUS
Authors: Josipovic Josipa , Abramovic Mirta , Matijevic Vesna , Fucek Mirjana , Domislovic Marija , Kos Jelena , Vrkic Tajana Zeljkovic , Jelakovic Ana , Pecin Ivan , Jelakovic Bojan
Published: May 2024

Objective:

The serum uric acid (SUA) has an important role in the pathogenesis of hypertension, and it is associated with risk for cardiovascular (CV) morbidity and mortality. There is no consensus for treatment of asymptomatic SUA. The aim of our study was to investigate prevalence and predictors for asymptomatic hyperuricemia in general rural adult population (ENAH rural study).

Design and method:

In this cross-sectional survey we included 773 from the original ENAH cohort (men 34.8%, average age 59 ys) who completed structured questionnaire, were clinically examined, fasting blood was drawn and urine samples were collected. Blood pressure (BP) was measurement according to the ESH guidelines. Subjects were divided into 4 groups: treated controlled hypertensives (TCHT 25.4%), treated uncontrolled hypertensives (TUHT 24.9%), untreated hypertensives (UTHT 14.2%) and untreated normotensives (UTNT 35.3%). Thresholds values for hyperuricemia were defined as >333 umol/L for men and >300 umol/L for women.

Results:

The prevalence of hyperuricemia was 45.5%. It was more common in men, subjects with eGFR CKD EPI < 60 ml/min/1.73 m2, TCHT/TUHT, those with uricostatics, and diuretic therapy (52%, p<0.001; 18%, p<0.001; 68%, p<0.001; 11%, p=0.01; 6%, p=0.002, respectively). Subjects with hyperuricemia were older, had higher values of BP and lower eGFR CKD Epi (p<0.001 for all). In bivariate logistic regression, age, male gender, SBP/DBP, hypertensive status (TUHT>TCHT>UNHT), and diuretic therapy increase, while antihypertensive therapy and eGFR CKD Epi >60 ml/min/1.73 m2 decrease the risk for hyperuricemia. With the progression of CKD, risk for hyperuricemia increases, starting from CKD G2 (p<0.001). In multivariate logistic regression, only male gender, and hypertensive status (TCHT >TUHT> UNHT) increase the odds for hyperuricemia, TCHT {OR 4.69, 95% CI (2.98 – 7.40), p<0.001} and TUHT {OR 4.37, 95%CI (2.7-6.82), p<0.001} being the most predictive.

Conclusions:

The prevalence of asymptomatic hyperuricemia in rural population is very high. Male gender and hypertensive status independently increase the risk for hyperuricemia in Croatian rural population.
HYPERTENSION, ETHNIC ORIGIN, IMMIGRATION AND ACCULTURATION
Authors: Goldbourt Uri , Grossman Ehud
Published: May 2024

Objective:

To evaluate the association between ethnic origin, immigration and acculturation and the rate of hypertension.

Design and method:

We assessed the rate of hypertension in male workers who immigrated to Israel before 1963 and followed them through 1996 in Israel. Age at entry was 40 to 70 years.

10, 059 male municipal workers and civil servants in Israel, underwent extensive assessment in 1963, 1965 and 1968. 86% had migrated from 4 continents to the area subsequently included in Israel according to the UN decision. We evaluated the rate of hypertension as was defined by the WHO at that time (SBP>=160 or DBP>=95). We followed these individuals during their stay in Israel and evaluated the rate of hypertension during the follow-up.

Results:

Logistic regression yielded estimated odds ratios (ORs) of hypertension, adjusted for age and body mass index (BMI) of 1.18 (CI 95%, 1.02-1.37) and 1.37 (CI 1.17-1.61) and 1.30 (CI 1.12-1.51) among men who had migrated from Eastern Europe, Central Europe and Balkan states, respectively, compared to the non-migrants, i.e. study participants born in in 1923 or earlier at the eventual 1948 territory of Israel.

Upon further adjustment for length of stay in the country since immigration, the above estimates were altered significantly. Adjusted hypertension rates for the European born men closely resembled those of the Israeli born. Conversely, the above adjustment yielded ORs of 0.87 (CI 95%, 0.76-0.99) and 0.79 (CI 0.68-0.93) for hypertension in migrants from the Mideast Asian countries and North African ones, respectively, adjusted for age and BMI and number of years in the country.

Conclusions:

Changes in living conditions; striving to accommodate altered targets in a multi-language society, where achievement of senior administrative and academic position may depend on acculturation; exposure to altered systems of education for the younger generation and its effects on the parents; even certain changes in dietary habits, might all play a role on health parameters, including blood pressure.