bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSESSMENT OF THE REPRODUCIBILITY OF SEMI-AUTOMATED FLOW MEDIATED DILATION MEASUREMENTS PERFORMED ON SEPARATE DAYS
Authors: Dobbie Laurence , Mackin Sharon , Hogarth Katrina , Lonergan Frances , Brooksbank Katriona , Delles Christian 
Published: April 2021

Abstract

Objective:
Assessment of endothelial function has the potential to diagnose cardiovascular disease earlier than traditional methods. The gold standard non-invasive measure of endothelial function is brachial artery flow-mediated dilatation (FMD). However, this technique is limited by significant measurement variability and requiring extensive operator training. Semi-autonomous FMD has the potential to overcome these problems. This study assessed the reproducibility of separate-day semi-autonomous FMD measurements by investigators who received basic training on the correct use of the device.

Design and method:
Forty three healthy participants were recruited for serial FMD readings using the UNEX EF 38G device. The cohort was largely Caucasian and composed of younger normotensive adults. Two readings were taken 20 minutes apart with a further reading taken on a separate day. The device produced automatic FMD outputs which were manually analysed using edge-detection software. The reproducibility of FMD measurements performed on separate days was compared for automated and manual readings.

Results:
25% of scans were not diagnostic (final sample size = 32). Automated results correlated poorly (r = 0.106) whereas manual results demonstrated good correlation (r = 0.622). Poor reproducibility and high measurement variance were shown for automated analyses (intraclass correlation coefficient (ICCC) = 0.103, coefficient of variation (CV) = 45.71%). In contrast, manually analysed scans demonstrated good reproducibility and low measurement variance (ICCC = 0.679, CV = 12.43%). Same day measurements had improved reproducibility for both automatic (ICCC = 0.334) and manual (ICCC = 0.815) results when compared to separate day readings.

Conclusions:
Manually analysed FMD scans had good reproducibility, indicating that semi-autonomous FMD requires manual analysis before independent automatic interrogation. The lower reproducibility of separate-day measurements is most probably due to the inherent biological variability of endothelial function. The high non-diagnostic scan rate most likely reflects the investigator's basic and limited training. Thus, we strongly advocate for more extensive training before performing assessments in a research context.
EFFECTS OF 3 MONTH COMBINED THERAPY WITH PERINDOPRIL AND INDAPAMIDE ON ENDOTHELIAL FUNCTION AND ARTERIAL STIFNESS IN OBESE HYPERTENSIVE WOMEN IN PERIMENOPAUSE
Authors: Danilogorskaya Yulia , Zheleznykh Elena , Privalova Ekaterina , Belenkov Yuriy , Kozhevnikova Maria , Shchendrygina Anastasia , Shakaryants Gayane , Zektser Vita 
Published: April 2021

Abstract

Objective:
To evaluate effects of 3-month combined therapy with Perindopril 10 mg and Indapamide 2.5 mg on endothelial function and arterial stiffness in obese hypertensive women in perimenopause.

Design and method:
Fifty perimenopause women with EAH and Obesity were enrolled in the study (average age 48,5 (40,75;48,00) years old; average body mass index 31,6 (31,2; 32,7) kg/sqm), SBP 139,0 (137,8;146,3) mm Hg., DBP 84 (78,8;89,0) mm Hg.
Investigation of endothelial function and arterial stiffness based on the pulse wave contour analysis and reactive hyperemia test (“Angioscan-01” device used) was conducted before and after 3 month treatment with 10 mg/day perindopril A and 2,5 mg/day indapamide.
The following parameters were evaluated: SI (stifness index), PS (phase shift) which caraterise structural and functional changes in large arteries and RI (resistance index), IO (occlusion index) which caracterise structural and functional changes in arteriols.

Results:
After 3-month combined treatment with 10 mg/day perindopril A and 2.5 mg/day indapamide significant decrease of SBP and DBP were observed: SBP from 139,0 (137,8;146,3) mm Hg. to 123.0 (120,75;128,75), DBP from 84 (78,8;89,0) mm Hg. to 75,5 (70;81,5) mm Hg (p < 0.05); while SI significantly decrease from 9,4 (8,58;11,33) m/s to 8,4 (8,0;9,23) m/s (p < 0.05); as well as RI from 35,0 (31,0;48,5) to 30 (26,75; 34,25)% (p < 0.05); SF significantly increased up to 8,90 (7,4;10,02)ms from 7,45 (6,55;9,15)ms (p < 0.05), as well as IO up to 1,85 (1,7;2,1) from 1,6 (1,3;1,9)

Conclusions:
3-month therapy with perindopril A 10 mg/day and 2,5 mg/day indapamide was associated with not only significat decrease of SBP and DBP but significant improving of endothelial function and structural parameters in large muscular arteries (increase of phase shift between channels, decrease of stiffness of large arteries) as well as in arteriols (decrease of RI and increase of IO).
BODY MASS INDEX TRAJECTORIES IN EARLY LIFE IS PREDICTIVE OF CARDIOMETABOLIC RISK
Authors: Yuan Yue , Mu Jian-Jun , Chu Chao , Zheng Wen-Ling , Ma Qiong , Hu Jia-Wen , Wang Yang , Yan Yu , Liao Yue-Yuan , Chen Chen 
Published: April 2021

Abstract

Objective:
Few studies have clarified the association between body mass index (BMI) and cardiovascular disease (CVD), and in China, the predictive values of BMI trajectory in early life for the cardiometabolic risks remains unclear. This study aimed at exploring the effects of BMI trajectories on the adult CVD outcomes using a dataset with 30 years of follow-up.

Design and method:
A total of 2839 participants aged 6–18 years whose BMIs were measured 3–6 times during the Hanzhong Adolescent Hypertension Study were included in our analysis. Latent Mixture Modeling was used to clarify distinct BMI trajectories in longitudinal analyses.

Results:
Three groups with distinct trajectories in BMI were identified by the latent mixed models: a normal group (n = 1324, 36.64%), a moderate-increasing group (n = 1178, 16.89%) and a high-increasing group (n = 337, 39.46%). Compared with the participants in the normal group, the RRs of hypertension, Type 2 diabetes mellitus, high-risk triglycerides and high-risk high-density lipoprotein (HDL) cholesterol were more than 3.0 in the high-increasing group (all P < 0.001) after being fully adjusted. Increased risks existed in high brachial-ankle pulse wave velocity (baPWV) for the high-increasing group compared with the normal group (RR = 2.75, 95% CI: 1.94–3.91, P < 0.001). Additionally, participants in the moderate-increasing group had a 2.31-fold increased risks of left ventricular hypertrophy (LVH) (95% CI: 1.25–4.30, P = 0.008).

Conclusions:
Our study indicates that BMI trajectories from childhood to adulthood vary and that elevated BMI trajectory in early life is predictive of an increased the risk of developing CVD risks.
DIFFERENT APPROACH FOR Management OF HYPERTENSION EMERGENCY AND URGENCY AMONG EMERGENCY PHYSICIANS AND OTHER SPECIALISTS IN THE ITALIAN REAL WORLD
Authors: Saladini Francesca , Mancusi Costantino , Maloberti Alessandro , Giavarini Alessandra , Bertacchini Fabio , Spannella Francesco , Rosticci Martina , Bruno Rosa Maria , Pucci Giacomo , Pengo Martino , Grassi Davide , Muiesan Maria Lorenza 
Published: April 2021

Abstract

Objective:
To investigate differences for management and treatment of hypertension emergency (HE) (HU) and urgency among emergency physician and doctors working in other departments.

Design and method:
The young investigator research group of the Italian Society of Hypertension developed a 23-item questionnaire spread by E-mail invitation to the members of Italian Scientific societies in the field of Emergency Medicine and Hypertension.

Results:
665 questionnaires were collected: 59.7% from emergency departments (EDs), 22% from Emergency and Urgency Medicine wards, 8.7% from Cardiology Units, 5.7% from Internal Medicines and 3.9% from Intensive care or Stroke units. Emergency physicians more frequently defined chest pain as possible presentation of HE than other physicians (91.2 % vs 85.8% p < 0.05), while tinnitus and conjunctival hemorrhages were less frequently considered as possible presenting symptoms (35% vs 42.9%, p < 0.05 for tinnitus; 38.5% vs 45.9% p = 0.05 for conjunctival hemorrhages). We did not observe any significant differences in most of laboratory and instrumental examinations, except for lung ultrasound that was most frequently performed by emergency physicians compared the other specialists (43.8% vs 32.1% p < 0.005). They also investigated cocaine or amphetamine abuse more frequently than the others (98.5% vs 95.9% p < 0.05). The therapeutic approach for blood pressure (BP) reduction showed some differences: a larger use of urapidil (67.8% vs 54.9% p = 0.003) and captopril (59.6% vs 39.2 % p = 0.002) and lower of furosemide (54.4% vs 66.8% p < 0.05) was reported by ED physicians compared to other groups. Hospitalization was more frequently required in the presence of acute organ damage (45.3% vs 30% p < 0.05) by emergency physicians than other specialists, on the opposite side they suggested less frequently hypertension specialist evaluation (63% vs 74% hypertension specialist advice in more than 50% of cases, p < 0.05) and ambulatory BP monitoring (65% vs 79% p = 0.001) or home self BP monitoring (39.4% vs 56.1% in at least the 75% of cases, p = 0.003) than the other specialists.

Conclusions:
Management and treatment of HE and HU may be different according to doctor's specialty. Educational initiatives, should be done to standardized treatment protocols and to improve medical knowledge about this largely prevalent problem.
BP VALUES AND CONTROL RATES IN A GENERAL POPULATION: IMPACT OF THE ESC-ESH AND ACC-AHA GUIDELINES
Authors: Ruiz Adrian , Fernandez Antonio , Holgado Jose Luis , Lopez Cristina , Sauri Inmaculada , Uso Ruth , Trillo Jose Luis , Vela Sara , Bea Carlos , Martinez Fernando , Redon Josep 
Published: April 2021

Abstract

Objective:
The recent guidelines on the hypertension (HTN) management, ESC-ESH and ACC-AHA, establish different recommendations for BP goals. The impact in the rates of BP control differs among the countries based on the prevalence of HTN. The objective was to assess the rates of BP control in a Mediterranean population.

Design and method:
The sample was recruited from beneficiaries of the Valencian Health Agency's health care system, with a population of 3799884 people older than 25 years in 2012. The observational study was undertaken as part of routine clinical practice in data from the last 6 months of 2016. Hypertension was defined by a recorded physician diagnosis, or antihypertensive medication use.

Results:
Among the total population, 2552417 normotensives and 1247467 hypertensives were included. Among normotensives 123332 (4.8%) were diabetics and 45142 (1.7%) CKD. Among HTN, 387590 (31%) were diabetics and 272800 (21.8%) CKD. BP values was recorded in 46% of subject no diagnosed of HTN and 80% of HTN. According the ESH-ESC (<140/90 mmHg) and the ACC-AHA (<130/80 mmHg) criteria, distribution of subjects with BP higher that the recommended among the non-diagnosed of HTN (left figure) and the rate of control by the in the HTN (right figure), by decades of age and sex are below.

Conclusions:
Control rates of hypertension among subjects diagnosed varies across age and sex. Furthermore, large per cent of subjects with BP recorded were not diagnosed of hypertension neither are receiving antihypertensive treatment. The magnitude of this “diagnosed inertia” is clearly magnified, around twice, if the ACC criteria for diagnosis and goals are adopted.
ASSOCIATION OF THYROXINE WITH INSULIN RESISTANCE IN NEWLY DIAGNOSED HYPERTENSIVES WITH OR WITHOUT DIABETES MELLITUS
Authors: Olatunji Victoria , Olaoye Morolake , Arinde Olufemi , Olarinoye John , Olatunji Lawrence 
Published: April 2021

Abstract

Objective:
Altered thyroid function is associated with insulin resistance (IR). There are divergent reports regarding association of thyroid function with IR in hypertension and type 2 diabetes mellitus (T2DM). The present study aimed at determining the association between thyroxine (T4), thyronine (T3) or T3/T4 ratio and IR in hypertensives with or without T2DM.

Design and method:
Cross-sectional study involving newly diagnosed hypertensives with (n = 39) or without T2DM (n = 35) and healthy controls (n = 19). The groups were matched for age, sex and BMI. Fasting blood glucose, glycated hemoglobin, T3, T4, and lipid profile were determined. Homeostatic model assessment of IR (HOMA-IR) was used to determine the level of IR. T3/T4 ratio was estimated and anthropometric variables were recorded.

Results:
Plasma T3, T4 and T3/T4 ratios were comparable among the groups, however, using multiple regression (stepwise) analysis, there was a strong relationship between T4 but not T3 and IR in hypertensive with (Beta = 0.456, p < 0.001, R2 = 0.208) and without T2DM (Beta = 0.781, p < 0.0001, R2 = 0.610). On the other hand, there was no relationship between T4 and IR in the control group.

Conclusions:
The findings in the present study indicate that IR could be predicted by T4 but not T3 or T3/T4 ratio in treatment-naïve hypertensives with or without T2DM.
MEAN ANNUAL TEMPERATURE IN VARIOUS REGION IS ASSOCIATED WITH THE PREVALENCE OF MASKED MORNING HYPERTENSION: THE J-HOP STUDY
Authors: Narita Keisuke , Hoshide Satoshi , Kario Kazuomi 
Published: April 2021

Abstract

Objective:
Although previous studies have been reported home BP (HBP) is higher in cold region than that in warm region, regional variation in prevalence of masked hypertension remains unclear. We hypothesized that the prevalence of masked hypertension would be higher in cold region than that in warm region. Thus, we assessed the regional variation in the prevalence of masked hypertension using the dataset of the Japan Morning Home-Surge BP (J-HOP) study.

Design and method:
This is a cross-sectional, post-hoc analysis using the dataset of the J-HOP study, which recruited patients with a history of or risk factors of cardiovascular disease. Participants underwent consecutive 14-day HBP measurements (morning and evening). We divided participants into three regions, which were divided by mean annual temperature (< 13 degree [Celsius], 13–15 degree, 15 degree < ) in each participated facility. Masked morning or evening hypertension was defined as controlled office BP (systolic BP [SBP] < 140 mmHg and diastolic BP [DBP] < 90 mmHg) and uncontrolled morning or evening HBP (SBP >  = 135 or DBP > = 85 mmHg). These criteria of BP levels were based on the Japanese guidelin on the management hypertension 2014 (JSH2014).

Results:
In the present study, 4268 participants (mean age, 64.9 ± 10.9 years; 46.9% male; 91.4% hypertensives) were divided 453, 1955, and 1860 partcipants into cold, moderate, and warm region, respectively. Office SBP was higher in cold region than others and morning home SBP was also higher in cold region than others. Whereas, evening home SBP had no significant differences between three regions. Moreover, in participants with normal (well-controlled) office BP, the prevalence of masked morning hypertension was higher in cold and moderate region than in warm region. However, the prevalence of masked evening hypertension had no significant differences between three regions. These relationships were also demonstrated after adjusted for traditional host factors in multivariate logistic regression analysis (All results are shown in Table).

Conclusions:
The present study demonstrated that the prevalence of masked morning hypertension was higher in colder regions than in warmer regions.
CLINICAL OUTCOMES AND PATIENT CHARACTERISTICS ACCORDING TO THE COMBINATION OF TEN-YEAR RISK OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE AND SYSTOLIC BLOOD PRESSURE
Authors: Harris Katie , Jun Min , Oshima Megumi , Woodward Mark , Menard Joel , Chalmers John 
Published: April 2021

Abstract

Objective:
Improving the efficiency of hypertension management has driven treatment indications to be based on cardiovascular disease risk calculations instead of blood pressure or cholesterol management.
The aim of this study was to explore the relationship between ten-year risk of atherosclerotic cardiovascular disease (ASCVD) and systolic blood pressure (SBP) in individuals with type 2 diabetes and describe the characteristics of individuals according to their ASCVD risk and SBP cross-classification. The secondary aim was to model the association of ASCVD risk and SBP at study baseline with clinical outcomes (major macrovascular, major microvascular and death).

Design and method:
This current study used 7,426 individuals from the Action in Diabetes and Vascular Disease: PreterAx and DiamicroN Modified-Release Controlled Evaluation (ADVANCE) randomised clinical trial, that were free from macrovascular disease at baseline.
ASCVD risk and SBP were categorised into approximate thirds, reflecting clinically meaningful cut points, defined as intermediate risk: ASCVD < 20 or SBP < 130, high risk: ASCVD 20 -34 or SBP 130–149, and very high risk: ASCVD > = 35 or SBP > = 150. Individuals were cross-classified according to their ASCVD and SBP categories.
Characteristics of individuals among the categories were summarised using descriptive statistics. Cox proportional hazards models were fitted to model the association of ASCVD and SBP cross-classification with clinical outcomes.

Results:
There was a high proportion of women for ASCVD < 20 across the three sequential SBP categories (67.3%, 80.3% and 87.6%). Mean age increased through increasing ASCVD risk categories, in all risk categories the mean age was highest for SBP < 130 and lowest for SBP > = 150.
The risk of death increased as ASCVD increased; though there was no significant association of SBP within the ASCVD categories. The risk of major macrovascular events increased sequentially through the combined effect of ASCVD and SBP (see figure). The highest risk of major microvascular events was for SBP > = 150 across all ASCVD categories.

Conclusions:
The cross-classification of ASCVD and SBP yielded varying associations with death, major macrovascular and major microvascular events, thus indicating that using ASCVD and /or SBP as predictors produces a non-uniform pattern for adverse clinical outcomes.
EVALUATION OF THE CONCOMITANT PRESENCE OF HYPERTENSION AND OSTEOPOROSIS AND THE IMPORTANCE OF SCREENING IN LEBANON: A PILOT STUDY
Authors: El-Bikai Rana , Eid Kevin , Sader Georgio , Al-Masry Zeina , Skaf Rana , Abbass Nivine 
Published: April 2021

Abstract

Objective:
Hypertension and osteoporosis are two age-related diseases whose interlinkage are under investigated. In Lebanon, given the high morbidity and mortality rates due to cardiovascular diseases, and the low national health priority given to osteoporosis, we conducted a pilot study to investigate the relationship between the two diseases and the need to screen for them.

Design and method:
In the summer of 2019, Lebanon participated for a second year in the May Measurement Month. As part of this campaign, a cross-sectional pilot study was launched based on a convenient sampling. It included 730 participants of both genders, aged 18 and above; consent was obtained from all participants. Participants answered a questionnaire about blood pressure and bone health, and were screened for hypertension, following which lifestyle tips were distributed.

Results:
Our data showed a hypertension prevalence of 41%. When asked about the last time they checked their blood pressure, participants’ response was: 11.4% never, 19.8% more than a year ago, and 68.8% within the last 12 months. 45% of hypertensive participants were not aware of their hypertensive status. Concerning osteoporosis, 8.3% of participants claimed they had it, while 24.8% did not know whether they had it or not. Furthermore, 80.5% mentioned never screening for bone thinning in their lifetime (with 35.6% of them being 43 years and above). A significant association was observed between hypertension and osteoporosis (P = 0.0424). Osteoporosis was a significant risk factor for fractures (P = 0.0068), with an OR of 2.2 CI (1.23–3.99). Height was significantly associated with blood pressure (P < 0.0001), with a higher correlation among participants less than 43 years of age (P < 0.0001). Hypertensive status was significantly associated with bone fractures (P = 0.011).

Conclusions:
An association exists between hypertension, osteoporosis and bone fractures. This makes screening for both diseases important, given that hypertension is the leading risk factor for cardiovascular death in Lebanon and that the country lacks national comprehensive data about incidence and prevalence of hypertension and osteoporosis. This pilot study can serve as a foundation for an upcoming nationwide screening campaign, and an evidence base for future preventative measures.
FACTORS ASSOCIATED WITH ANTIHYPERTENSIVE MONOTHERAPY AMONG US ADULTS WITH TREATED AND UNCONTROLLED BLOOD PRESSURE, NHANES 2005-2016
Authors: Derington Catherine , King Jordan , Herrick Jennifer , Dixon Dave , Cohen Jordana , Shimbo Daichi , Kronish Ian , Saseen Joseph , Muntner Paul , Moran Andrew , Bress Adam 
Published: April 2021

Abstract

Objective:
Combining antihypertensive medication classes more efficaciously lowers blood pressure (BP) than monotherapy. We sought to determine factors associated with antihypertensive monotherapy in US adults with uncontrolled BP.

Design and method:
This serial, cross-sectional study analyzed pooled data from the 2005–2008, 2009–2012, and 2013–2016 US National Health and Nutrition Examination Survey (NHANES) cycles. We included NHANES participants age 20 years or older with hypertension taking antihypertensive medication and with uncontrolled BP, defined as systolic BP of 140 mm Hg or greater or diastolic BP of 90 mm Hg or greater (N = 2,699). Antihypertensive medication use was obtained from a medication inventory of participants’ pill bottles. We calculated prevalence ratios (PRs) and 95% confidence intervals (CIs) for antihypertensive monotherapy versus taking more than one antihypertensive medication associated with each characteristic using multivariable adjusted Poisson regression models with robust standard errors.

Results:
The proportion of US adults with hypertension and uncontrolled BP taking monotherapy was 35.7%, 36.3%, and 37.9% in 2005–2008, 2009–2012, and 2013–2016, respectively. After multivariable-adjustment, monotherapy was more common among current smokers (PR 1.26, 95%CI 1.06–1.50) compared to never/former smokers. Monotherapy was less common among participants 75 years or older (PR 0.71, 95%CI 0.53–0.95) compared to participants younger than 40 years, females (PR 0.81, 95%CI 0.71–0.92) compared to males, non-Hispanic black adults (PR 0.76, 95%CI 0.65–0.89) compared to non-Hispanic white adults, and obese (PR 0.73, 95%CI 0.63–0.86) compared to normal/underweight participants. Monotherapy was also less common among participants with versus without diabetes (PR 0.80 95%CI 0.67–0.94), coronary heart disease (PR 0.73, 95%CI 0.54–0.98), chronic kidney disease (PR 0.80, 95%CI 0.68–0.94), and heart failure (PR 0.46, 95%CI 0.29–0.73).

Conclusions:
Among US adults with hypertension and uncontrolled BP, smoking was positively associated with monotherapy use while older age, female sex, and comorbidities of diabetes, coronary heart disease, chronic kidney disease, and heart failure were associated with a lower prevalence of monotherapy use. The extent to which other factors such as clinician or patient preferences, adverse medication effects, or therapeutic inertia influence monotherapy among those with uncontrolled BP need to be investigated.