bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF SERUM UROMODULIN AND GENETIC VARIANTS WITH BLOOD PRESSURE CHANGES, AND HYPERTENSION IN CHINESE ADULTS: RESULTS FROM TWO PROSPECTIVE COHORTS
Authors: Du Mingfei , Wang Yang , Gao Wei-Hua , Sun Yue , Zhang Xiao -Yu , Zou Ting , Yao Shi , Chu Chao , Chen Chen , Wang Dan , Liao Yue-Yuan , Ma Qiong , Yuan Yue , Wang Ke-Ke , Niu Ze-Jiaxin , Yan Yu , Zhou Hao-Wei , Jia Hao , Li Hao , Li Chun-Hua , Chen Fang-Yao , Gao Ke , Li Min , Li Hui-Xian , Lu Wan-Hong , Chang John , Safirstei Robert , Yang Tie-Lin , Mu Jian-Jun 
Published: April 2021

Objective:
Uromodulin is a novel tissue-specific biomarker for kidney function. We sought to examine the associations of serum uromodulin and genetic variants with salt sensitive and longitudinal blood pressure (BP) changes, or hypertension in humans.

Design and method:
Subjects (n = 514) from the Baoji Salt-Sensitive Study cohort recruited in 2004 were on the chronic salt intake intervention. We evaluated them for the development of hypertension in 2009 and 2012. In addition, a total of 2210 participants from the Hanzhong Adolescent Hypertension Study cohort were used to examine the relationships between serum uromodulin and the risk of hypertension.

Results:
We found that SNPs rs12708631 and rs1291770 in the uromodulin gene were significantly associated with longitudinal changes in BPs. SNP rs7198000 was significantly associated with incident hypertension over an 8-year follow-up. Several SNPs was significantly associated with diastolic BP, mean arterial pressure and pulse pressure responses to both low-salt and high-salt diets. Gene-based analyses also supported the overall association of uromodulin gene with longitudinal BP changes and hypertension incidence. In addition, hypertensive subjects have lower levels of serum uromodulin than normotensive subjects. Serum uromodulin showed a linear association with increased BP (34.6, 33.2, 27.8, 27.1 and 26.1 ng/mL for subjects with normotension, high-normal, grade 1, grade 2 and grade 3 hypertension, respectively). Serum uromodulin was significantly associated with the lower risk of hypertension in 2210 Chinese subjects.

Conclusions:
This study shows that uromodulin gene is associated with salt sensitive and longitudinal BP changes, or hypertension incidence, and serum uromodulin may serve as a biomarker marker for hypertension.
BLOOD PRESSURE TRAJECTORIES IN EARLY LIFE ARE ASSOCIATED WITH TARGET ORGAN DAMAGE IN MIDDLE AGE
Authors: Zheng Wenling , Mu Jianjun , Yuan Yue 
Published: April 2021

Objective:
Hypertension is a pivotal factor in target organ damage (TOD). However, the association of longitudinal BP trajectories in the early life course and adult risk for TOD is poorly reported.

Design and method:
In a prospective cohort, we identified BP trajectories from early childhood to middle age using group-based trajectory models among 2430 individuals in the Hanzhong Adolescent Hypertension Study (HAHS) and examined the relationship between BP trajectories and TOD risk in later life.

Results:
Four discrete long-term SBP, DBP and MAP trajectories were identified, namely, low stable, moderate stable, high stable (low increasing), and moderate increasing groups, based on the BP levels at baseline and in the 30-year follow-up. The brachial-ankle pulse wave velocity (baPWV), carotid intima–media thickness (cIMT), urinary albumin-to-creatinine ratio (uACR) were higher in persistently high or increasing trajectories in comparison to the low stable group. Individuals with deteriorative trajectories during early life were at an increased risk of suffering from a single or combined TOD in middle age (36–49 years old).

Conclusions:
Higher longitudinal SBP, DBP and MAP trajectories early in life were associated with increased TOD risk in midlife. Identifying BP trajectories in early life can help screen individuals with a single or multiple TODs later.
PROPOSAL OF A UNIVERSAL OFFICE BLOOD PRESSURE MEASUREMENT PROCEDURE FOR CLINICAL AND SCIENTIFIC USE
Authors: Vischer Annina , Socrates Thenral , Winterhalder Clemens , Eckstein Jens , Mayr Michael , Burkard Thilo 
Published: April 2021

Objective:
Office blood pressure measurement (OBPM) procedures recommended in guidelines and applied in studies vary highly. The current European Societies of Cardiology/Hypertension (ESC/ESH) guidelines for OBPM are impractical to use in clinical settings and trials and lack scientific evidence. Our aim was to explore the meaning of the fourth BP measurement as recommended by ESC/ESH and to study whether a simplified OBPM procedure is feasible without loss of quality.

Design and method:
Four sequentially taken blood pressure measurements (BPMs) were used to calculate blood pressure (BP) as a mean of the second/third systolic/diastolic BPM (S2S3/D2D3), or as a mean of the third/fourth BPM (S3S4/D3D4). Patients were stratified according to the absolute difference between the first/second BPM (S1S2/D1D2) into >10 mmHg and < =10 mmHg. A linear model was used to predict S3S4/D3D4 from S2S3/D2D3.

Results:
Complete measurements were available in 802 patients. 206 patients (25.7%) had an absolute S1S2 difference >10 mmHg, 60 patients (7.5%) for D1D2. Correlation tests showed a median decrease from S2S3 to S3S4 of 0.5 mmHg and 0.5 mmHg for D2D3 to D3D4 (p < 0.0005 for both). For patients with S1S2 >10 mmHg the median decrease was 0.0 mmHg (p = 0.174), with S1S2 <  = 10 mmHg 0.5 mmHg (p < 0.0005), with D1D2 >10 mmHg 1.0 mmHg (p = 0.269), with D1D2 <=10 mmHg 0.5 mmHg (p < 0.0005). There was a linear relationship between S2S3/S3S4 (R2 = 0.944, p < 0.0005, Figure(A); for patients with S1S2 >10 mmHg R2 = 0.958, p < 0.0005, Figure(B), with < =10 mmHg R2 = 0.953, p < 0.0005, Figure(C)) and D2D3/D3D4 (R2 = 0.911, p < 0.0005, Figure(D); for patients with D1D2 >10 mmHg R2 = 0.694, p < 0.0005, Figure(E), with < = 10 mmHg R2 = 0.968, p < 0.0005, Figure(F)). S3S4 and D3D4 could be predicted with an accuracy of 0.967/0.960 from S2S3 and D2D3.

Conclusions:
A fourth BPM does not provide any significant benefit in the context of a standardized OBPM procedure. Therefore, we propose a simplified procedure based on the mean of the second/third standardized OBPM measurement and refrain from a fourth measurement in both clinical practice and study protocols.
RELATION OF SYMPATHETIC NERVOUS SYSTEM ACTIVITY WITH ATTENDED AND UNATTENDED BLOOD PRESSURE LEVELS IN ESSENTIAL HYPERTENSION
Authors: Manta E. , Tsioufis K. , Leontsinis I. , Konstantinidis. D. , Kouremeti M. , Iliakis P. , Papakonstantinou P. , Tatakis F. , Anastasiou A. , Dimitriadi M. , Andrikou I. , Tousoulis D. 
Published: April 2021

Objective:
Measurement of unattended blood pressure (BP) may have a key role in the assessment of hypertensive patients. Moreover, hypertension is related to sympathetic drive, while there are scarce data on the diverse links of attended and unattended blood pressure with muscle sympathetic nerve activity (MSNA). The aim of this study was to evaluate the association of BP levels in the attended and unattended setting with MSNA in patients with essential hypertension.

Design and method:
We enrolled 38 patients with essential hypertension (age: 59 ± 11 years, 20 males, office BP: 142/86 ± 19/11 mmHg, 24-hour BP: 137/80 ± 14/12 mmHg), in whom sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography). Both types of BP measurement, attended and unattended (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, 1 minute apart, after 5 minutes), were conducted 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 > or = 140/90 mmHg in both attended and unattended BP estimations and to the attended hypertensive group when only attended BP > or = 140/90 mmHg.

Results:
Patients with combined attended and unattended hypertension (n = 18) compared to those with attended only hypertension (n = 20) were older (61 ± 11 vs 57 ± 11 years, p = 0.03), with no differences regarding metabolic profile, renal function, 24-h ambulatory BP levelsand left ventricular mass index (p = NS for all). In addition, the group of combined hypertension was characterized by greater levels of MSNA, compared to the attended only hypertension group (41.2 ± 11.6 vs 32.2 ± 10.1 bursts per minute, p = 0.031). In all participants, sympathetic nerve traffic as assessed by resting MSNA was related to attended systolic BP (r = 0.459, p = 0.004), attended diastolic BP (r = 0.503, p = 0.001), unattended systolic BP (r = 0.433, p = 0.007) and unattended diastolic BP (r = 0.423, p = 0.008).

Conclusions:
The phenotype of combined attended and unattended hypertension compared to attended hypertension is accompanied by higher sympathetic nervous system activation. This close association of MSNA with attended and unattended BP levels in essential hypertension further supports the key role of sympathetic drive in modulating BP.
“WATCH OUT FOR YOUR BLOOD PRESSURE!” CAMPAIGN IS A REMINDER FOR CRITICAL ROLE OF PUBLIC INFORMING CAMPAIGNS IN HYPERTENSION AWARENESS
Authors: Tavassoli Elham , Zolfaghari Mahsa 
Published: April 2021

Objective:
Our Campaign held in Tehran, Iran dedicated to raising awareness on hypertension through emphasizing the importance of blood pressure measurement. 1 month long campaign – starting on 17th April and ending on 17th May 2018 – comprised of three phases.

Design and method:
For the first phase which went on for 7 days (coincide with national health week in Iran) we turned to the social media as a powerful asset for bringing attention to hypertension. On each day we covered a separate topic on blood pressure, which are respectively about: Universal health coverage and hypertension, What is hypertension and what are its signs and symptoms, Hypertension and diet (with a especial focus on salt intake), Obesity and high blood pressure, high blood pressure and physical activity, Smoking and high blood pressure, and finally Monitoring and treatment in hypertension. Our second phase is a 14 day journey (marking the 14th anniversary of WHD) where, on each day we would present them with a new fact about high blood pressure. Moving on to the third phase of the campaign which included our 5 day physical presence, our teams dressed in uniforms were stationed at 5 of the most busiest locations around Tehran. We dedicated the last day of our campaign to screening blood pressures at the food court the blood pressure of 45 people along with their details (including age, gender, history of cigarette, height, weight, etc.) were collected with each person receiving a campaign pack.

Results:
In cases of high or near high blood pressure our experts would intervene with giving advice on what cautionary measures they should take and how they should proceed about their blood pressure from there.

Conclusions:
We hope through our campaign we have been able to contribute to raising awareness on hypertension and its global health impact.
CUFFLESS BLOOD PRESSURE DEVICES AND INCONSISTENT TRACKING OF BLOOD PRESSURE CHANGES
Authors: Tan Isabella , Barin Edward , Gueguen Cindy , Head Geoff , Avolio Alberto , Butlin Mark 
Published: April 2021

Objective:
Single point calibration is common in cuffless blood pressure (BP) measurement devices. Consequently, they may be apt at re-assessing BP at that same calibration BP but have potential for increased error as BP changes from that calibration point. This study investigates one pulse waveform-based (BPro, HealthStats) and one pulse arrival time-based (Maisense Freescanâ) cuffless device in their tracking of BP changes as compared to that of conventional cuff-based oscillometric devices.

Design and method:
14 participants had 24-hour assessment of BP using BPro and a validated cuff-based oscillometric device (BPLab, Petr Telegin). Nocturnal BP dipping as measured by both devices was compared. In a separate study, six participants had BP measured with a validated cuff-based oscillometric device (OMRONâ HEM-7121) and either the BPro (n = 3) or Freescanâ device (n = 3) before and during a 2-minute cold-pressor challenge. BP change from baseline as reported by the devices were compared.

Results:
Average nocturnal fall in BP (mean ± SD) as reported by the cuff-based device and BPro were -15 ± 8% and -10 ± 6% (p = 0.061), respectively, for systolic BP; -19 ± 8% and -10 ± 7% (p = 0.008), respectively, for diastolic BP. Nocturnal dipping (defined as nocturnal fall > 10% in either systolic or diastolic BP) was detected in 6 participants with the BPro device as opposed to 14 as detected with the cuff-based device. During cold-pressor challenge, Freescanâ reported a systolic BP change of -4 ± 8 mmHg compared to the cuff measured change of 12 ± 8 mmHg (p = 0.017). BPro followed a similar trend to the Freescanâ device and reported a systolic BP change of -2 ± 2 mmHg compared to the cuff measured change of 14 ± 4 mmHg (p = 0.002).

Conclusions:
The BPro device was able to track nocturnal dipping in some but not all participants, with significant underestimation of nocturnal dipping in diastolic BP. Cold-pressor challenge induced BP changes that were unable to be detected by the cuffless devices. Whilst single point calibration may permit a cuffless device to assess when BP returns to that calibration point, tracking of BP changes appears to be inconsistent. Further investigation is required to understand the underlying factors that contribute to this inconsistency.
EFFECTS OF PHOTOPERIODISM ON DAILY RHYTHMS OF BLOOD PRESSURE AND HEART RATE IN DIFFERENT SEASONS OF THE YEAR IN THE ARCTIC
Authors: Vetoshkin Aleksandr , Shurkevich Nina , Gapon Lyudmila , Simonyan Ani 
Published: April 2021

Objective:
To study the effect of the rhythm of natural light on circadian rhythms of blood pressure (BP) and heart rate (HR) in the Arctic.

Design and method:
Analysis of 24-hour BP monitoring was performed in 373 male patients with arterial hypertension (AH) stage II engaged in rotational shiftwork in the Arctic compared with the group of the same type of 144 patients living in moderate climate (Tyumen, 57 N) 93 randomly selected patients of the Northern group and 64 patients of the Tyumen group. Based on 24-hour ambulatory blood pressure monitoring chronobiological and standard parameters, daily BP profile, circadian BP and HR indices, percentage contribution value (PC), amplitude of a rhythm (RA), acrophase and BP MESOR in different seasons were analyzed.

Results:
In the conditions of Arctic shift work circadian BP and HR rhythms in patients with AH differed significantly compared with Tyumen patients regardless of season and were characterized by the absence of seasonality signs of BP and HR rhythms and the presence of inside desynchronosis of rhythms. Lack of natural light during the polar day and polar night leads to flattened HR and circadian BP in patients with AH in the Far North. The major differences were the loss of 24-hour period components and low-amplitude spectrum profile. Seasonal changes in the HR parameters were not significant in the comparison group versus northern group with a clear flattening of HR in the polar day period. In the main group of patients the worst condition for 24-hour BP profile was winter period (polar night) characterized by the peak flattening of circadian rhythms and the prevalence of high-frequency oscillations in the spectrum.

Conclusions:
In patients with AH in the conditions of Arctic shift work, formation of daily rhythm and absence of seasonality signs of HR and BP is associated with nature of work and climate factors, including natural light rhythm in the northern latitude.
THE IMPACT OF BLOOD PRESSURE MANAGEMENT IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A MULTICENTER PROSPECTIVE COHORT STUDY IN JAPAN
Authors: Nishiwaki Mariko , Uchida Haruhito A , Otaka Nozomu , Hada Yoshiko , Onishi Yasuhiro , Uchiyama Natsumi , Okamoto Shugo , Takemoto Rika , Kitagawa Masashi , Sugiyama Hitoshi , Saito Chie , Yamagata Kunihiro , Wada Jun 
Published: April 2021

Objective:
The effect of intensive blood pressure (BP) lowering on kidney and cardiovascular outcomes among the patients with chronic kidney disease (CKD) remains unclear. We aimed to examine a preferable BP level to manage the patients with CKD.

Design and method:
We recruited patients with CKD under consultation with general physicians (GPs), a total of 489 GPs in 49 local medical associations. The outcomes were the renal and cardiovascular events. The renal event was defined as a doubling of the serum creatinine level, a 50 % reduction in estimated GFR or a diagnosis of end stage renal disease. We classified patients into 6 groups according to the systolic BP (SBP) level at the registration (<120, 120–129, 130–139, 140–149, 150–159, > = 160). The relationship between SBP and renal and cardiovascular events were statistically analyzed.

Results:
A total of 2033 patients aged 40 to 74 were participated with written informed consent. A strong correlation between SBP and the renal event was identified after adjustments for confounders. The 120–129 group had the lowest renal events, as well as <120 group (reference 120–129; <120: hazard ratio (HR) 1.30 (95% confidence interval 0.80–2.11); 130–139: HR 1.49 (1.03–2.17); 140–149; HR 1.61 (1.33–2.85); 159–160: HR 2.50 (1.68–3.78); > = 160: HR 2.17 (1.42–3.33)). Unexpectedly, regarding cardiovascular events, the 130–139 and 140–149 groups had no significant difference compared with 120–129 group, however, 150–159 and > = 160 groups had significantly large number of events (reference 120–129; <120: HR 1.29 (0.67–2.42); 130–139: HR 0.82 (0.47–1.45); 140–149: HR 1.46 (0.86–2.53); 159–160: HR 2.08 (1.20–3.66); > = 160: HR 2.80 (1.20–8.15)). Interestingly, the patients who achieved SBP levels <130 mmHg after one-year had significantly lower renal events compared with those did not (HR 0.62, (0.46–0.84)), among the patients with SBP levels > = 130 mmHg at registration.

Conclusions:
The SBP level <130 mmHg was associated with the lowest renal events in the patients with CKD. Furthermore, this study indicated that the patient with SBP levels > = 130 mmHg should be reduced SBP to less than 130 mmHg within a year.
THE VALUE OF EMERGENCY DEPARTMENT BLOOD PRESSURE MEASUREMENT FOR THE SCREENING OF HYPERTENSION. PAIN IS A SIGNIFICANT FACTOR? SEEMS NOT
Authors: Michaud André , Vadeboncoeur Alain , Lamarre-Cliche Maxime , Cloutier Lyne 
Published: April 2021

Objective:
The value of emergency department (ED) blood pressure measurement for the screening of hypertension remains unclear. A systematic review was conducted to assess the performance of a screening strategy in adults using blood pressure (BP) measurement at the time of an ED consultation. The link between pain and high blood pressure is also described.

Design and method:
A systematic literature search on Embase, CINHAL and Medline was carried out. This systematic review was conducted in accordance with the PRISMA-Diagnostic Test Accuracy. Intervention studies with adults including at least one BP measurement for all participants were included. A repeat blood pressure assessment had to have been carried out to assess the validity of the elevated BP value within the next few days after the ED initial visit.

Results:
After review of 1,030 articles published between 1985 and 2018, 10 articles met the inclusion criteria. Mean age of participants was 51.6 years. A single study reports that BP screening was measured according to all the recommendations within the HTN guidelines referred to in the study. Half of the patients (50.2%) with elevated BP during the ED visit had BP corresponding to uncontrolled elevated blood pressure at follow-up measurement. Data about pain and blood pressure is reported in six of the included studies. None of these found a significant relationship between the concomitant presence of pain and an elevated BP measurement, and the fact of having an elevated or normal BP in a subsequent measurement without the presence of pain.

Conclusions:
The value of the blood pressure measurement in the ED is far from useless because it allows recognizing a true hypertension in one in two adults presenting with elevated BP. Moreover, it would be a mistake to attribute to pain alone the fact of presenting with an elevated OBPM in ED. Such patients could just as well be hypertensive when an ambulatory measurement is performed later without the presence of pain.
MAY MEASUREMENT MONTH 2018: AN ANALYSIS OF BLOOD PRESSURE SCREENING RESULTS FROM BOTSWANA
Authors: Masupe Tiny , Tlhakanelo John Thato , Tiro Mary Banyana , Motlhatlhedi Keneilwe , Mamela Abraham , Makwati Obuile , Kololo Masego , Phuswane Orapeleng , Lesetedi Onalethata , Motlhagodi Amogelang , Beaney Thomas , Ster Ancha Chis , Poulter Neil R , Xia Xin , Mosepele Mosepele 
Published: April 2021

Objective:
During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure across different communities in Botswana.

Design and method:
Study sites were four large villages and Gaborone (capital city). Screening sites included shopping malls, train stations, churches and workplaces. Individuals aged over 18 years were recruited through fliers, word of mouth and volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three blood pressure (BP) readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: SBP above 140 mmHg or DBP above 90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used, and was estimated using multiple imputation where missing. Ethical clearance was obtained from the Ministry of Health and University of Botswana.

Results:
Amongst 4,599 participants whose BPs were measured, 54.5% were female, mean age was 35.9 years. A total of 1,510 (32.8%) participants were hypertensive with 712 (47.1%) aware of the hypertension. In participants not taking antihypertensive medication, the association between age and sex with SBP showed a linear increase, with the mean BP in males prominently higher than the mean BP in females across ages below 85–90 years, where they became equal. The DBP association showed an inverted U curve, with the mean DBP in males exceeding the mean DBP in females at age of 25 years, and the peak on the male curve at ages 45–50 years, while in females it was at ages 50–55 years. Only 35.2% of hypertensives were on anti-hypertensive treatment with 54.4% having controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Factors associated with higher BP included obesity, more than 1unit of alcohol/week and BP measured on Sunday.

Conclusions:
Less than half (52.9%) of those identified to have hypertension during MMM18 campaign were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like the MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.