bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk prediction for subclinical carotid atherosclerosis in rotational shift workers in the arctic
Authors: Shurkevich N , Vetoshkin A , Gapon L , Simonyan A , Kuznetsov V 
Published: November 2020

Abstract

Introduction
High prevalence of cardiovascular events at northern latitudes determines the necessity of studying mechanisms of formation and early diagnosis of atherosclerotic process.

Purpose
To determine the most unfavorable prognostic factors that provide the percentage of correct prediction and high accuracy in detection of atherosclerotic plaque (ASP) in common carotid arteries (CCA) in rotational shift workers in the Arctic.

Methods
Within 2010–2012 a study of 424 males aged 30–59 years at the medical unit “Gazprom dobycha Yamburg” (Yamburg settlement, 68°N) was performed. Patients were randomized into 2 groups according to blood pressure (BP). Gr.I included 294 people with BP more than 140/90 mmHg, arterial hypertension (AH) of 1,2 stage and Gr.II included 130 people with BP less than 140/90 mmHg.
Groups did not differ in age (46.9±5.8 years, p=0.435); total work experience in the Arctic: 16.5±6.8 years (p=0.512) and rotational shiftwork duration: 12.5±4.6 years (p=0.597). Office BP was 149.4±13.3/97.1±7.3 mmHg in Gr.I and 123.4±7.5/80.5±5.5 mmHg in Gr.II.
Ultrasound examination of carotid arteries with determination of presence or absence of ASP in CCA and estimation of stenosis using NASCET method were performed; ambulatory blood pressure monitoring was conducted; blood glucose levels, total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol were determined. Statistical analysis was carried out using R (v. 3.6.1) programming language for statistical data processing of R Studio application package (v. 1.2.1335).

Results
Signs of CCA atherosclerosis were revealed in 56% of patients with AH and in 25% of those without AH. According to multivariate analysis, three variables with the most significant set of predictors, associated with ASP in CCA with the percentage of correct prediction of 75.9% were selected by step-by-step method: diastolic BP24 (&lt;0.0001), glucose (0.0167) and cholesterol (0.0439). Based on the obtained model, it was concluded that 1 mmHg increase in diastolic BP24 increases the risk for developing ASP by 5.9%, Exp. (Beta) = 1.059, 1 mmol/l increase in glucose and cholesterol escalates the risk by 44.1% and 25.2%, respectively: Exp. (Beta) = 1.441 and Exp. (Beta) = 1.252.

Conclusion
The data obtained will improve accuracy for the early diagnosis of subclinical atherosclerosis of CCA, allow to prescribe lipid-lowering therapy timely and reduce the risk of adverse cardiovascular events in rotational shift workers in the Arctic.

Funding Acknowledgement
Type of funding source: None
The associations of circulating microRNA-133a with parameters of hypertension heart disease in patients with arterial hypertension and obesity
Authors: Yushko K , Koval S , Snihurska I , Mysnychenko O 
Published: November 2020

Abstract

Introduction
Blood pressure (BP) elevation leads to chronical increasing left ventricular (LV) overload, LV hypertrophy (LVH), impaired LV relaxation, development of LV diastolic dysfunction (DD), left atrial (LA) enlargement, which result in development of hypertension heart disease (HDD), increased risk of atrial fibrillation and heart failure. MicroRNA-133a is one the epigenetics factor, which has cardioprotective properties, but its role in the development of HHD in hypertension patients with obesity is not well understood.

Purpose
The aim of the study was to investigate the circulating microRNA-133a levels in patients with hypertension and obesity and to define its associations with components of HHD.

Methods
The study involved 82 patients with arterial hypertension grades 2–3 and obesity (44 men and 38 women) aged 43 to 70. All patients were separate in two groups: 45 patients with HHD (main group) and 37 patients without HHD (comparison group). The control group consisted of 21 practically healthy individuals of comparable gender and age. The HHD was defined as LVH in hypertension patients with/without LV DD. The LVH was determined according to the 2018 ESC/ESH guidelines. The LV DD was determined according to the 2016 ASE/EACVI recommendations. Obesity was diagnosed at body mass index ≥30 kg/m2. Circulating plasma microRNA-133a levels were obtained by polymerase chain reaction using the CFX96 Touch System, “TaqMan microRNA Assay” and “TaqMan® Universal PCR Master Mix” reagent kits.

Results
The levels of microRNA-133a in main group were significantly lower than in comparison group and control group (0.133 [0.099; 0.184] vs 0.238 [0.155; 0.410], p&lt;0.05 and 0.382 [0.198; 0.474]), p&lt;0.05). In the main group 23 patients had LV DD and 25 patients had normal LV diastolic function. In patients with LV DD the levels of circulating plasma microRNA-133a were significantly lower than in patients with normal LV diastolic function (0.094 [0.067; 0.147] vs 0.152 [0.092; 0.189]), p&lt;0.05). In the main group there was a statistically significant negative correlation between microRNA-133a levels and LV mass index (R=−0.37, p&lt;0.01) and no significant correlation with ejection fraction, LA size or E/e' (averaged) ratio (p&gt;0.05). In patients of the comparison group there were not significant associations of microRNA-133a levels with LV parameters (p&gt;0.05).

Conclusion
The results of the study indicate a significant role of decreased circulating plasma microRNA-133a levels in patients with arterial hypertension and obesity in the pathogenesis and development of HHD and such its components as LVH and LV DD.

Funding Acknowledgement
Type of funding source: None
Pulse wave velocity and blood pressure in athletes performing endurance and intense resistance training
Authors: Said Ouamer D , Guerchani Mohamed Karim M.K , Djermane D , Benkhedda S 
Published: November 2020

Abstract

Background
There have been contradictory reports regarding the impact of intense resistance exercise on arterial stiffness. We examined the effects of long-term endurance training and intense resistance training on central hemodynamic in athletes compared with healthy sedentary controls.

Purpose
We hypothesized that young adults participating in endurance sports would have decreased arterial stiffness, whereas those participating in intense resistance sports would have increased arterial stiffness.

Methods
One hundred thirty participants (20–30 years) including 46 intense resistance trained athletes (IRTA) (weight-lifters), 42 endurance trained athletes (ETA) (long and mid-long distance runners) and 42 sedentary individuals (SED) were investigated by aplanation tonometry and pulse wave analysis; aortic pulse wave velocity (PWV) was measured. Differences were tested by analysis of variance, covariance and multiple linear regressions after adjustment for confounders. The t-test and chi-square test were used to compare the different parameters studied between men and women. The difference between the types of sport in the female subgroup was tested by the Kruskall Wallis test. Quantitative data were expressed as means ±standard deviation or median

Results
There were no differences among all 3 groups regarding age, height, glucose, cholesterol and triglyceride levels. Anthropometrics were higher in IRTA compared to ETA. Heart rates at rest and augmentation index were lower in trained participants than in sedentary individuals. Brachial and aortic blood pressures were lower in ETA compared to IRTA. Aortic PWV was significantly lower (p&lt;0.05) in ETA (mean ±SD: 5.58±1.00 m/s) compared to IRTA (7.06±0.87 m/s) and SED (7.18±1.06 m/s). The results of the statistical analysis in female subjects in the different groups were comparable to those found in men. A subgroup analysis comparing women and men found comparable results for PWV, but women had higher HR at rest and lower brachial and central blood pressures compared to men. After multiple regression analysis, diastolic blood pressure (DBP) remained the only hemodynamic parameter correlated to PWV, whatever the group.

Conclusion
Aortic stiffness is influenced by exercise modalities since ETA had better PWV than IRTA in both sexes. DBP is an important determinant and potential mediator of arterial stiffening in young adults.

Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): No funding sources
Novel index of arterial reflected waves, Arterial Velocity pulse Index, relates to muscle sympathetic nerve activity independent of Arterial Pressure volume Index in patients with hypertension
Authors: Sugimoto H , Murai H , Hamaoka T , Mukai Y , Inoue O , Okabe Y , Tokuhisa H , Takashima S , Kato T , Usui S , Sakata K , Talamura M 
Published: November 2020

Abstract

Background
Arterial reflected wave is determined by not only atherosclerosis but also sympathetic nerve activity. Recently, Arterial Velocity pulse Index (AVI), which is an index of arterial reflected waves, and Arterial Pressure volume Index (API), which is an index of volume of a conductive blood vessel, have been proposed as new index of arterial stiffness. However, it is unclear whether API and AVI would be associated with muscle sympathetic nerve activity (MSNA) in hypertensive subjects.

Purpose
The purpose of this study was to evaluate the correlation between AVI, API and MSNA in hypertensive subjects.

Method
41 hypertensive patients and 40 non-hypertensive subjects were included in this study. We performed a cross-sectional, observational study. Hypertension (HT) was defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg or medical treatment for HT. AVI and API was measured by NAS-1000 (Nihon Koden, Japan). MSNA, central sympathetic outflow to peripheral muscle, was recorded directly from peroneal nerve. MSNA was expressed by burst frequency (bursts/minute) and burst incidence (bursts/100heartbeats). Blood pressure, heart rate and MSNA were recorded simultaneously.

Results
Age, systolic and diastolic pressure were significantly higher in hypertensive patients compared to control (40±15 vs 61±13 years, p&lt;0.001; 142±16 vs 113±9 mmHg, p&lt;0.001; 81±14 vs 67±9 mmHg, p&lt;0.001). MSNA and AVI were significantly augmented in hypertensive patients compared to control (34±11 vs. 23±6 bursts/min, p&lt;0.05; 26±7 vs. 16±4, p&lt;0.05). AVI was correlated with MSNA in each group (hypertension: r=0.59, P&lt;0.001, non-hypertension: r=0.51, p&lt;0.001). However, no correlation was shown between API and MSNA in each group (hypertension: r=0.22, p=0.15, non-hypertension: r=0.07, p=0.63). Multiple regression analysis also showed MSNA was significantly related with AVI but was not with API.

Conclusion
Our finding showed that AVI relates to MSNA independent of API in patients with hypertension. It suggested that Novel index of arterial reflected waves, AVI, is helpful to estimate augmented SNA in hypertensive subjects regardless of volume of a conductive blood vessel.

Funding Acknowledgement
Type of funding source: None
The lower the better? Optimal achieved blood pressure for patients with coronary artery disease undergoing percutaneous coronary interventions and kidney failure
Authors: Yang Y , Leu H.B 
Published: November 2020

Abstract

Background
This study investigates the ideal achieved blood pressure (BP) in ethnic Chinese patients with coronary disease (CAD) and kidney failure (eGFR&lt;15 ml/min/1.73m2).

Methods
A total of 575 kidney failure patients who had undergone percutaneous coronary interventions (PCI) were enrolled and divided into 6 to 4 groups according to blood pressure range were analyzed. The clinic outcomes included major cardiovascular events (MACE) and MACE plus hospitalization for congestive heart failure (Total CV event).

Results
The mean systolic BP was 135.02±24.73 mmHg and diastolic BP was 70.74±13.05 mmHg. Systolic BP 140–149mmHg and diastolic BP 80–89mmHg had lowest MACE/CV event incidence rate (11%/23%; 13.2%/21.1%) compare to other groups. Patients with systolic BP&lt;120mmHg had a higher risk MACE (HR: 2.014; 95% CI: 1.172–3.462, p=0.008) when compared to those with systolic BP 140–149 mmHg. Patients with systolic BP≥160mmHg (HR: 1.838; 95% CI, 3.266–1.035, p=0.038). And diastolic blood BP ≥90mmHg (HR: 2.191; 95% CI: 1.147–4.188, p=0.018) had a higher risk of total cardiovascular events when compared to those with systolic BP 140–149 mmHg and diastolic BP 80–89 mmHg.

Conclusions
A J-shaped BP association of systolic (140–149 mmHg) and diastolic (80–89 mmHg) was found with decreased cardiovascular events for coronary artery disease with kidney failure after undergoing PCI in non-western population.

Funding Acknowledgement
Type of funding source: None
Increased carotid cross-sectional area is a marker of organ damage in young hypertensive patients
Authors: De Marco M , Mancusi C , Canciello G , Losi M.G , Trimarco B , De Luca N , De Simone G , Izzo R 
Published: November 2020

Abstract

Background
Common Carotid artery (CA) cross sectional area (CCSA) is strictly related to vessel remodelling stimulated by mechanical stress due to arterial hypertension. Accordingly, increased CCSA might represent an early marker of vascular target organ damage independently of presence of atherosclerotic plaque.

Purpose
To assess early correlates and prognostic impact of CCSA in a large population of young treated HTN patients.

Methods
We selected 970 hypertensive patients, 18 to 40 years old (mean age 34±5 yrs; 30% women) of the Campania Salute Network registry with available CA ultrasound and follow-up data, free of overt cardiovascular (CV) disease. CCSA was computed as:
CCSA = π [(CAd/2 + IMT)2 – (CAd/2)2]
where CAd = CA diameter and IMT = mean intima media thickness. Participants were compared by CCSA tertiles.

Results
Compared to the lowest and intermediate tertiles, patients in the highest tertile were more often male, smokers, older, and had higher body mass index (BMI), diastolic blood pressure (BP), higher fasting glucose, triglycerides, LDL cholesterol and uric acid, with lower level of HDL cholesterol. They also exhibited higher left ventricular mass index and IMT and had more often carotid atherosclerotic plaque (all p&lt;0.05). During a median follow-up of 45 months, 22 incident composite CV events occurred. In Cox-Regression analyses, adjusting for the above covariates, presence of carotid plaque and classes of antihypertensive medications, increased CCSA was significantly associated with increased CV risk (HR 1.08/mm2; 95% CI 1.02–1.13; p&lt;0.01).

Conclusions
In a population of young hypertensive patients, increased CCSA is related to metabolic and atherosclerotic disease and is associated with increased CV risk, also independently of overt carotid plaque.

Funding Acknowledgement
Type of funding source: None
Correlations of attended and unattended blood pressure with sympathetic nervous system activity in essential hypertension
Authors: Manta E , Kouremeti M , Kakouri N , Kasiakogias A , Konstantinidis D , Papakonstantinou P , Kalos T , Liatakis I , Tousoulis D , Tsioufis C 
Published: November 2020

Abstract

Background/Introduction
Measurement of unattended blood pressure (BP) may provide additional information over conventionally attended BP. Moreover, hypertension is related to sympathetic drive while there are scarce data on the diverse links of attended and unattended BP with muscle sympathetic nerve activity (MSNA) in hypertensive patients.

Purpose
The aim of this study was to appraise the relation of BP levels in the attended and unattended setting with MSNA in patients with essential hypertension.

Methods
We studied 117 patients with essential hypertension (age: 58±11 years, 60 males, office BP: 142/85±17/10 mmHg, 24-hour BP: 133/80±11/9 mmHg). In all participants sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography). Both unattended BP (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, at 1-minute intervals, after 5 minutes) and attended BP were measured with the same device, on the same day of MSNA recording, in random order. Patients were divided into the combined attended and unattended hypertensive group when BP≥140/90 mmHg in both attended and unattended BP estimations and to the attended hypertensive group when only attended BP≥140/90 mmHg.

Results
Patients with combined attended and unattended hypertension (n=70) compared to those with attended hypertension (n=47) did not differ regarding 24-h ambulatory BP levels, glucose levels, renal function and left ventricular mass index (p=NS for all). Moreover, patients with combined attended and unattended hypertension compared to those with attended hypertension were characterized by greater levels of MSNA (43.7±9.9 vs 37.7±9.7 bursts per minute, p=0.032). In all participants, sympathetic nerve traffic as assessed by resting MSNA was related to attended systolic BP (r=0.270, p=0.003), attended diastolic BP (r=0.344, p=0.001), unattended systolic BP (r=0.263, p=0.004) and unattended diastolic BP (r=0.274, p=0.003).

Conclusions
The phenotype of combined attended and unattended hypertension compared to attended hypertension is accompanied by higher sympathetic nervous system activation. Moreover, the close association of MSNA with attended and unattended BP levels in essential hypertension, further supports the key role of sympathetic drive in modulating BP.

Funding Acknowledgement
Type of funding source: None
Comparison of medication adherence between fixed-dose combination of angiotensin receptor blockers and statin and free-combination therapy
Authors: Choi J.H , Choi J.M , Jang Y.J , Kang M , Lee S.H 
Published: November 2020

Abstract

Background
Non-adherence to angiotensin receptor blockers (ARB) or statin is one of major reasons of insufficient treatment for patients with hyperlipidemia and hypertension. We investigated whether fixed-dose combination (FDC) of ARB and statin improved adherence compared to traditional free combination (FC).

Methods
In this retrospective nationwide cohort study, adherence of 128,369 patients who started ARB and stain including atorvastatin or rosuvastatin between July 2014 and June 2015 was investigated. Primary endpoint was proportion of days covered (PDC) per 180 days up to day 540. Good compliance defined by PDC≥80% and persistency rate defined by patients remaining on medication were also investigated.

Results
Patients were 62.9 years of mean age with 48.2% female gender. Compared to FC (N=90,759, 70.7%), FDC (N=37,610, 29.3%) showed higher PDC at day 180 (86% vs 70%), 360 (77% vs 62%), and 540 (74% vs 55%, p&lt;0.001, all). Frequency of patients with PDC≥80% was also higher in FDC compared to FC at day 180 (80.1% vs 51.8%), 360 (71.7% vs 54.2%), and 540 (69.2% vs 49.3%, p&lt;0.001, all). Persistency rate at day 540 was higher in FDC compared to FC (50.4% vs 27.3%, p&lt;0.001). The mean decline in PDC per 180 days were significantly lower in FDC compared to FC per 180 days (6.0% vs. 7.5%, p&lt;0.001).

Conclusions
In this real-world data analysis, FDC resulted in higher medication adherence and persistence compared to FC among patients who started both ARB and atorvastatin or rosuvastatin.
Persistence rate btw FDC and FC

Funding Acknowledgement
Type of funding source: None
Projecting the long-term benefits of single pill combination therapy for patients with hypertension in five countries
Authors: Borghi C , Wang J.G , Rodionov A.V , Rosas M , Sohn I.S , Alcocer L , Valentine W , Deroche-Chibedi D , Granados D , Croce D 
Published: November 2020

Abstract

Background
It is well established that single pill combination (SPC) therapies have the potential to improve patient adherence versus multi-pill regimens, thereby improving blood pressure control and clinical outcomes in populations with hypertension.

Purpose
To develop a microsimulation model, capturing different treatment pathways, to project the impact on clinical outcomes of using single pill combination therapies for the management of hypertension in five countries (Italy, Russia, China, South Korea and Mexico).

Methods
The model was designed to project health outcomes between 2020 and 2030 for populations with hypertension managed according to four different treatment pathways: current treatment practices [CTP], single drug with dosage titration first then sequential addition of other agents [start low and go slow, SLGS], free choice combination with multiple pills [FCC] and combination therapy in the form of a single pill [SPC]. Model inputs were derived from Global Burden of Disease 2017 dataset, including demographics, health status/risk factors, transition probabilities and treatment attributes/healthcare utilization, and the model incorporated real-world challenges to healthcare delivery such as access to care, SBP measurement error, adherence and therapeutic inertia. Simulated outcomes of mortality, incidence of chronic kidney disease (CKD), stroke and ischemic heart disease (IHD), and disability-adjusted life years (DALYs) due to these conditions were estimated for population of 1,000,000 simulated patients for each treatment pathway and country.

Results
SPC therapy was projected to improve health outcomes over SLGS, FCC and CTP over 10 years in all five countries. SPC was forecast to reduce mortality by 5.4% (Italy), 4.9% (Russia), 4.5% (China), 2.3% (South Korea) and 3.6% (Mexico) versus CTP and showed greater projected reductions in mortality than SLGS and FCC. DALYs were projected to be reduced with SPC therapy by between 5.7% (Italy) and 2.2% (South Korea) compared with CTP and reductions in the incidence of clinical events were also projected with SPC therapy, with decreases in the range of 11.5% (Italy) to 4.9% (South Korea) versus CTP.

Conclusions
Ten-year projections of clinical outcomes associated with different anti-hypertensive treatment pathways in five countries indicated that both combination therapies (FCC and SPC) are likely to reduce the disease burden of hypertension compared with conventional management approaches, with SPC showing the greatest overall benefits due to improved adherence.

Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Sanofi, Gentilly, France