bluuebunny/crossref_metadata_2025_split huggingface dataset:
DOES OFFICE BLOOD PRESSURE STILL RELIABLE IN TYPE 2 DIABETES MELLITUS TO ASSESS BLOOD PRESSURE CONTROL?
Authors: Allouche Emna , Ahmed Habib Ben , Abid Omar , Boudiche Faten , Beji Mohamed , Ouechtati Wejdene , Bezdah Leila 
Published: April 2021

Objective:
Ambulatory blood pressure (ABP) monitoring in type 2 diabetes (T2DM) is not yet routine in clinical practice.
We aimed to quantify abnormal ABP patterns and their associations with diabetic complications and to assess the reliability of office blood pressure (OBP) for assessing BP control in T2DM.

Design and method:
In a cross-sectional study, eligible patients with T2DM underwent OBP and 24- hour ABP measurements under standardized conditions and screening for diabetic complications.

Results:
Eighty patients (mean age 58 + 10 years, males 30%) completed assessment. All patients had a known history of hypertension. Non-dipping and nocturnal systolic hypertension (SHT) were prevalent in 54 (67,5%) and 30(37,5%) patients, respectively. Non-dipping had a significant association with microvascular complications (p = 0,001). There was no association between other abnormal ABP patterns and diabetic complications. The sensitivity and specificity of OBP for assessing BP control were 52% and 63% respectively. The positive and negative predictive values were 31% and 81% respectively.

Conclusions:
Non-dipping, reverse dipping and nocturnal SHT are highly prevalent in patients with T2DM with a known history of hypertension. Compared with nocturnal SHT, non-dipping may be a stronger predictor of end-organ damage. The reliability of OBP for assessing BP in T2DM is only modest. Patients with T2DM are likely to benefit from routine ABP monitoring.
CORONARY ARTERY CALCIUM SCORE AND HOME BLOOD PRESSURE VARIABILITY IN A MIDDLE-AGED SAMPLE OF THE SWEDISH POPULATION
Authors: Wijkman Magnus , Engvall Jan , Östgren Carl Johan , Nystrom Fredrik H. 
Published: April 2021

Objective:
The aim of this study was to explore associations between coronary artery calcium (CAC) score and home blood pressure variability (HBPV) in a Swedish population sample.

Design and method:
In this cross-sectional study, we analysed data from a Swedish population-based cohort (n = 5057). We included all participants (n = 4262) who as part of the baseline examination had undergone a CAC scoring, and who also during a seven-day period had performed systolic home blood pressure measurements thirteen times (each in triplicate). Mean home systolic blood pressure (HSBP) was calculated, and its standard deviation (SD) and coefficient of variation (CV = 100 X SD / HSBP) were used as measures of HBPV. Participants were divided in four groups: group 1 had CAC score zero (n = 2578), group 2 had CAC score 1–99 (n = 1180), group 3 had CAC score 100–399 (n = 352) and group 4 had CAC score > = 400 (n = 152). One-way analysis of variance was used to test for statistically significant between-group differences. Post-hoc pairwise comparisons were adjusted for multiple comparisons as described by Bonferroni.

Results:
Overall, there were significant associations between CAC score groups and SD, CV and HSBP, (P < 0.001 for all comparisons). Average SD in group 1 (7.0 ± 2.4 mmHg) was significantly lower than in group 2 (7.3 ± 2.6 mmHg), group 3 (8.1 ± 3.0 mmHg) and group 4 (8.4 ± 3.3 mmHg), P for pairwise comparisons: 0.006, <0.001 and <0.001, respectively. Average CV in group 1 (5.9 ± 1.9) was not significantly different from group 2 (6.0 ± 2.0, P = 1.00) but was significantly lower than in group 3 (6.3 ± 2.1, P = 0.005) and group 4 (6.5 ± 2.4, P = 0.003). Average HSBP in group 1 (117.9 ± 13.6 mmHg) was significantly lower than in group 2 (122.6 ± 13.0 mmHg), group 3 (127.3 ± 12.5) and group 4 (129.1 ± 12.2 mmHg), P for all pairwise comparisons <0.001.

Conclusions:
In this middle-aged sample of the Swedish population, CAC score was modestly but significantly associated with HBPV. The prognostic performance of HBPV remains to be determined in this cohort.
VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY IS ASSOCIATED WITH RISK OF HOSPITALIZATION IN A COMMUNITY ELDERLY COHORT OF 1095 PARTICIPANTS IN HONG KONG
Authors: Yiu Karen , Tsoi Kelvin , Yu Ruby , Woo Jean , Lee Eric , Wong Samuel 
Published: April 2021

Objective:
Hospitalization rate is significantly higher among the elderly compared to those aged below 65. This study aimed to identify the risk factors to predict the hospitalization based on the visit-to-visit BPV.

Design and method:
e-Health project is an ongoing multi-centered programme targets to monitor BP in the elderly community by using cloud system for real-time analysis. Participants had regular BP measurement weekly and those with at least 30 BP records in the first year of follow-up were included in this analysis. Visit-to-visit BPV is defined by the mean absolute residuals of individual linear regression trend of BP readings. Machine learning approach has been used to stratify the levels of BPV for K-means clustering algorithm on both systolic and diastolic BP. All subjects were classified into low, medium and high levels of BPV groups. The hospitalization was used as the study outcome. Age, gender, mean BP, BPV, number of medications used, frailty, sarcopenia, and memory function were considered to investigate the associations. Multivariate logistic regression was used to measure the odds ratio (OR) with 95% confidence interval (CI).

Results:
A total of 1,095 subjects were follow-up for 1 year with average of 163 BP readings per each participant (SD = 74). Age, BPV, use of medications, frailty, sarcopenia, and memory function were shown to be associated with the risk of hospitalization (Table 1). In the multivariate analyses, there were significantly increased risk of hospitalization in the medium and high BPV groups (OR = 1.67; 95% CI = 1.23–2.28 and OR = 2.07; 95% CI = 1.36–3.13, respectively), in patients prescribed 1–4 medications and 5 or above medications (OR = 2.39; 95% CI = 1.29–4.86 and OR = 4.05; 95% CI = 2.09–8.51, respectively); in the pre-frail and frail groups (OR = 1.47; 95% CI = 1.04–2.09 and OR = 3.15; 95% CI = 2.11–4.74, respectively).

Conclusions:
Visit-to-visit BPV, other than comorbid conditions with complex medication used and personal frailty, is shown to be a risk factor for hospitalization. Regular measurement of blood pressure is recommended to better understand BPV levels.
RESTING HEART RATE AS A PROGNOSTIC MARKER OF HYPERTENSION AMONG SUDANESE ADULTS
Authors: Hassan Dina , Behairy Hind , Ali Ibtisam , Abdalla Asma , Abdalla Naema , Madani Safa , Elamin Maha 
Published: April 2021

Objective:
Hypertension remains one of the major health problems worldwide. Elevated HR increases the risk of cardiovascular disease and contributes to the total mortality in hypertensive patients. The current survey aims to estimate the correlation of increased resting HR level to hypertension and to evaluate its use as a predicting and prognostic marker of hypertension in Sudan

Design and method:
This is a cross-sectional study based on a survey conducted by Sudanese society of hypertension during the MMM, 2018 campaign. A total of 23981 participants were recruited through opportunistic sampling from six Sudanese states, all being more thant 18 years of age (F/M ratio 1:1). Average of three measurements of heart rate, systolic and diastolic blood pressure was calculated. Hypertensive patients were defined as those having systolic blood pressure (SBP) more than or equal 130 mmHg or diastolic blood pressure (DBP) more than or equal 80 mmHg, or being on antihypertensive medication.

Results:
The crude prevalence of hypertension in our study sample was 37.4 percent. Among hypertensive patients, only 10.9 percent were aware of having high blood pressure, among whom, 65.5 percent were already on treatment for hypertension and 40.3% have their BP controlled. Normal resting HR was observed among 90.0 percent while tachycardia (HR more than100 bpm) and bradycardia (HR less than 60 bpm) were observed among 8.5 percent and 1.5 percent respectively of all hypertensive patients. Hypertensive patients unaware of having high blood pressure constituted 74.6 percent. Among unaware hypertensives, resting HR was correlated with systolic, diastolic BP, age and gender and is significantly higher among known hypertensive not receiving medication. Among known hypertensive patients, a significant correlation was observed between HR was correlated to smoking, age, gender, BMI, SBP and DBP. The age group (18–39) showed the highest percentage of elevated HR and hypertension compared to other age groups.

Conclusions:
The prevalence of hypertension is alarming and the situation is aggravated by the poor control and lack of awareness. Based on the above results, resting heart rate can be used as a predicting and prognostic marker of hypertension specially among young adults.
INFLUENCE OF AGE, SEX AND AN OCCURRENCE OF CARDIOVASCULAR EVENT ON SEASONAL VARIATIONS IN BLOOD PRESSURES IN HYPERTENSIVE PATIENTS: INSIGHTS FROM THE ASCOT COHORT
Authors: Gupta Ajay , Godec Thomas , Mackay Judith , Whitehouse Andrew , Rostamian Somayeh , Collier Timothy , Poulter Neil , Sever Peter 
Published: April 2021

Objective:
In hypertensive patients, the extent to which patient-related characteristics influence seasonal blood pressure (BP) variations is unclear. We used repeated BP-measurements in the ASCOT trial to investigate the influence of age, sex, geographical residence and cardiovascular (CV) event occurrence, on the association between month-of-year and BP-level.

Design and method:
18,746 hypertensive patients, with 5-year median follow-up and a median (IQR) of 14 [12–17] visits, contributed to these analyses. We developed mixed effects models to estimate mean systolic-BP (SBP) for each month of the year. Models were adjusted for a priori confounders (age, sex, BMI, total cholesterol, presence of diabetes, smoking status, ethnicity, socio-economic status, randomized treatment-allocation) and in-trial period. Subgroup analyses were conducted by age-groups, sex, geographical residence, and occurrence of CV-event or not. Age was appropriately categorised (see figure) and geographical region was split into two-groups: Scandinavian countries and Scotland and England and Ireland. We estimated mean SBP-difference between the coldest pair of months (January/February) and warmest (July/August): overall; and separately by subgroups; evaluating for presence of interactions.

Results:
Mean SBP differs significantly across months of year, with higher BPs during winter and lower BPs during summer (mean SBP-difference between coldest and warmest pairs: 3.07 [95% CI 2.87, 3.27] mm Hg, p < 0.001). The trend was similar in each age-group, but with a significantly higher mean SBP-difference amongst older (= >75 years) patients (4.59 [3.87, 5.30] mm Hg) vs younger (<55 years) (1.97 [1.47, 2.46]) (interaction p-value < 0.001). The magnitude of mean SBP-difference differs substantially by geographical region with a mean SBP-difference of 1.99 [1.70, 2.27] mm Hg amongst those in Scandinavia and Scotland vs. 4.10 [3.82, 4.39] amongst those in England and Ireland (interaction p-value < 0.001). Those who had a CV-event had significantly higher seasonal BP-variability vs. those who didn’t, and amongst those with a CV-event: the seasonal BP-variability was higher after the event vs before (p-value = 0.034). No interaction with gender was apparent.

Conclusions:
The magnitude of seasonal BP-variability is influenced by age, residence, and an occurrence of CV-event in hypertensive patients. These findings may have important clinical implications for BP-control strategies.
HUMAN STOOL METABOLOMES DIFFER UPON 24-HOUR BLOOD PRESSURE LEVELS AND THE NON-DIPPING BLOOD PRESSURE PROFILE
Authors: Huart Justine , Cirillo Arianna , Taminiau Bernard , Julie Descy , Annie Saint -Remy , Georges Daube , Jean-Marie Krzesinski , Pierrette Melin , Pascal De Tullio , Francois Jouret 
Published: April 2021

Objective:
Dysbiosis of gut microbiota (GM) has been implicated in the pathophysiology of arterial hypertension (HT), via a putative role of food-derived short chain fatty acids (SCFAs) and other metabolites. Among the clinical manifestations of HT, the absence of a significant drop in blood pressure (BP) overnight (i.e. the non-dipping BP profile) has been associated with poor cardiovascular outcomes. The link between GM and the non-dipping BP profile is unknown.

Design and method:
After informed consent, 16 male patients (mean age = 52.3 ± 12.4 years; 1 patient under beta blocker) and their female partners (n = 10; mean age = 46.5 ± 13.2 years; 1 patient under thiazide diuretic and angiotensin-converting-enzyme inhibitor) were subjected to 24-hour ambulatory BP monitoring and categorized in 2 groups: HT (n = 6 men and 1 woman) and normotension (n = 19). According to the conventional night/day BP ratio >0.9, 15 individuals (n = 8 men and 7 women) were categorized as non-dippers. Metabolomics using Nuclear Magnetic Resonance was performed on stool samples, including the quantification of the 3 main SCFAs (i.e. acetate, propionate and butyrate).

Results:
Principal component analyses (PCA) discriminated HT versus normotensive individuals on the basis of the stool metabolomes of the entire cohort (Q2 = 0.10). PCA also discriminated dippers versus non-dippers upon the stool metabolomes of the male and female cohorts (Q2 = 0.76 and 0.98, respectively) or the entire cohort (Q2 = 0.27). Significant correlations between stool metabolomes and the mean 24-hour BP levels were highlighted in male and female cohorts (R2 = 0.63 and 0.79, respectively), as well as in the entire cohort (R2 = 0.54). Interestingly enough, a higher variation between stool metabolomes (represented by the measure of inertia) was found in couples with a different BP status (51.4% of inertia) compared to the couples in whom both individuals presented with the same BP status (37.5% of inertia). The propionate/butyrate ratio was higher in the stools of male HT patients versus male normotensive patients (p = 0.03), but no difference was observed in the female cohort or in the entire cohort.

Conclusions:
In conclusion, this 26-patient cohort highlights significant correlations between the stool metabolome and (i) BP levels and (ii) the non-dipping BP profile in both genders.
DECREASED BLOOD PRESSURE AND INCREASED HEART RATE IN WOMEN WITH BREAST CANCER AFTER COMBINED CHEMOTHERAPY LEADS TO PSEUDO-POSITIVE CHANGES IN ARTERIAL STIFFNESS AND PULSE WAVE
Authors: Zairova Alsu , Rogoza Anatoly , Avaljan Ani , Oshchepkova Elena , Zheleznova E 
Published: April 2021

Objective:
The aim of the study was to study the effect of combined chemotherapy in women with breast cancer (BC) on arterial stiffness and pulse wave by ultrasound examination of the common carotid artery (CCA) using echo tracking technology

Design and method:
40 women with triple negative breast cancer aged 27 to 75 years (47.5 ± 12.0) were examined initially and after chemotherapy with the inclusion of anthracyclines (doxorubicin),taxanes (paclitaxel) and platinum derivatives (cisplatin). Arterial stiffness parametres (beta-stiffness index, Ep-elastic modulus, AC-arterial compliance, PWV-pulse wave velocity) and AI – augmentation index were studied in the distal CCA at a distance of 2 cm from bifurcation on an Aloka ProSound alrha7 ultrasound machine using echo tracking technology.

Results:
After combined chemotherapy the parameters beta-index, Ep, PWV not significantly changed (9,3 ± 4,3 vs 8,9 ± 4,5, p = 0,63;128,73 ± 65,9 vs 119,0 ± 69,5 kPa, p = 0,29; 6,7 ± 1,5 vs 6,3 ± 1,5 m/s, p = 0,24 respectively).
Statistically significant decrease in AI from 14, 5 ± 11,3 to 11,1 ± 10,6% (p = 0,009) and an increase in AC from 0,72 ± 0,25 to 0,87 ± 0.3 mm2 /kPa (p = 0,004) were demonstrated as well as decrease in systolic blood pressure (SBP) from 129,5 ± 14,0 to 118,5 ± 14,5 mm Hg (p = 0,0001) and an increase in heart rate from 67,9 ± 10,7 to 76,6 ± 12,1 bpm (p = 0,0004),lower the level of hemoglobin from 129,6 ± 20,4 to 102,2 ± 16,3 g/ l (p = 0,00001) and red blood cells from 4,7 ± 0,4 to 3,3 ± 0,6 1012 / l(p = 0,00001). SBP levels decreased both in women with AH (n = 12) who received anti-hypertensive therapy – from 146,5 ± 9,9 to 130,0 ± 14,6 mm Hg (p < 0,01), and in eutonic women (n = 28) who received no antihypertensive treatment – from 122,2 ± 7,6 to 115,4 ± 8.3 mm Hg (p = 0,002).

Conclusions:
In women with breast cancer in the early period after combined chemotherapy with the inclusion of anthracyclines (doxorubicin),taxanes (paclitaxel) and platinum derivatives (cisplatin), there were no increased stiffness of the common carotid artery. Pseudo-positive changes in the form of an increase in the extensibility of the vascular wall and a decrease in the augmentation index are explained by general hemodynamic changes in the form of a decrease in the SBP, an increase in heart rate, as well as anemia during chemotherapy.
CARDIOVASCULAR STATUS REFERENCE VALUES OF RECENTLY DIAGNOSED AND NAÏVE TO TREATMENT HUMAN IMMUNODEFICIENCY VIRUS (HIV) PATIENTS. A PILOT STUDY
Authors: Triantafyllidi Helen , Fragkou Paraskevi , Mpirmpa Dionyssia , Benas Dimitrios , Thymis Ioannis , Kostelli Gavriella , Schoinas Antonios , Protopapas Konstantinos , Kavvatha Dimitra , Antoniadou Anastasia , Papadopoulos Antonios , Ikonomidis Ignatios , Iliodromitis Eystathios 
Published: April 2021

Abstract

Objective:
HIV infection is a well recognized risk factor for cardiovascular (CV) disease. Virus induced chronic inflammation plays a key role in the development of early CV disease. The aim of this study is to explore the baseline CV status of recently diagnosed and naïve to treatment HIV patients regarding arterial blood pressure parameters, target organ damage indices as well as aerobic capacity (AC).

Design and method:
Forty two (42) recently diagnosed and naïve HIV patients were evaluated regarding office and central blood pressure (SBP/DBP), carotid-femoral aortic stiffness estimated by PWV and endothelial function measured by endothelial glycocalyx integrity. Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (ranged from 5–9 micrometers) Using Sideview Darkfield imaging (Microscan, Glycocheck) was measured as a non-invasive accurate index of reduced EG thickness. Finally AC status was evaluated after a maximal cardiopulmonary exercise test (CPET). No one patient had ever received any treatment for HIV or any cardiovascular disease.

Results:
HIV patients were mostly males (38 men, 90%), young (mean age = 37 + 10 years), smokers (21, 42%) and normotensives (office SBP/DBP = 124 + 13/76 + 10 mmHg and central SBP/DBP = 116 + 12/77 + 10 mmHg). PWV was estimated as 9.2 + 1.7 m/sec. Endothelial glycocalyx intergrity was measured as PBR5–9 = 1.2 + 0.2 micrometers. During maximum aerobic CPET, HIV patients achieved 8 + 2 METS and 28 + 6 ml/kg/min peak VO2 which corresponds to 80 + 14% of peak VO2 predicted. Their SBP was measured as 112 + 10 mmHg at exercise initiation and 169 + 22 mmHg at peak exercise. Two male patients (5%) had a hypertensive response during CPET defined as SBP > 210 mmHg.

Conclusions:
It seems that recently diagnosed naïve HIV patients have a CV status similar to which corresponds to their age. We are going to re-evaluate those patients, one and three years after HIV treatment initiation, in order to explore any early differences regarding their CV status.
CARDIOVASCULAR RISK PROFILE IN YOUNG PATIENTS WITH EPILEPSY
Authors: Szczurkowska Patrycja , Wolf Jacek , Polonis Katarzyna , Becari Christiane , Pilarska Ewa , Hoffmann Michal , Chrostowska Marzena , Mazurkiewicz-Beldzinska Maria , Narkiewicz Krzysztof 
Published: April 2021

Abstract

Objective:
The risk of premature deaths in patients with epilepsy (approx. 50 mln. patients worldwide) is about 2–3 times higher as compared to general population. This phenomenon is mainly explained by cardiovascular causes as well as sudden unexpected deaths in epilepsy (SUDEP). Epilepsy is associated with sympathetic overdrive and renin-angiotensin-system abnormalities all of which may be implicated in organ damage (both directly and indirectly via high blood pressure; BP). In our study, we aimed at the evaluation of several cardiovascular risk factors and organ damage in patients with epilepsy; its’ relation to disease control and comorbid hypertension.

Design and method:
A total of 48 patients and matched controls were included in the study. Anthropometry, biochemical assessment, office and ambulatory blood pressure, structural and/ or functional vascular changes were recorded. One-way ANOVA and ANCOVA were employed (mean ± SE).

Results:
Patients were comparable in terms of age and BMI. Hypertensives were aware of high BP in 50% of cases. Study subgroups were comparable in terms of heart rate, serum uric acid, triglicerides, HDL, glucose, serum creatinine and eGFR, serum potassium (P = NS for all comparisons). Total cholesterol was the lowest in well-controlled epileptic patients which was followed by refractory disease and epilepsy with comorbid hypertension (167.6 ± 6.7 vs. 196.9 ± 7.4 vs. 223.5 ± 8.9; respectively). Patients with refractory epilepsy had comparable serum LDL and PWV to hypertensive well-controlled epileptics; both contrasted with values recorded in patients with well-controlled epilepsy who were free of hypertension (LDL: 121.7 ± 6.8 vs. 140.9 ± 8.2 vs. 99.2 ± 6.1; respectively, and PWV: 6.4 ± 0.24 vs. 6.8 ± 0.30 vs. 5.5 ± 0.22; respectively). Reported differences were valid after adjustment for age and BMI.

Conclusions:
Except for BP values, patients with refractory epilepsy who are free of hypertension have similar CV risk profile to patients with high BP. These findings along with underdiagnosed hypertension may explain higher CV mortality and morbidity documented in epilepsy.
“CHRYSIN” AMELIORATES CARDIAC HYPERTROPHY IN RATS
Authors: Sahu Anil Kumar , Meshram Sonali , Arya D.S. 
Published: April 2021

Abstract

Objective:
Cardiac hypertrophy: thickening of cardiac muscle which causes decreased pumping ability of heart, results in cardiac dysfunction. Chrysin, is a naturally occurring flavone, found in bee propolis and honey and possesses anti-oxidant, anti-inflammatory, anti-diabetic, anti-estrogenic, anti-tumour and anti-apoptotic properties. Present study investigates the effect of Chrysin on isoproterenol induced cardiac hypertrophy in male albino wistar rats.

Design and method:
Male wistar albino rats were divided into eight groups: Group 1 (Control); Group 2 (Isoprotorenol); Group 3; 4; 5 and 6 (Chrysin 15, 30, and 60 mg/kg and 60 mg/kg per se p.o. respectively), Group 7 (Losartan 10 mg/kg; p.o.) and Group 8 (Losartan 10 mg/kg; p.o. + Chrysin 60 mg/kg; p.o.) in which respective compound was given accordingly. ISO (3 mg/ kg; s.c.) was administered daily for 28 days to all groups except normal and per se to induce Cardiac Hypertrophy. On day 29, animals were anesthetized, blood was taken from heart and serum was separated for estimation of cardiac injury parameters and inflammatory cytokines level. Thereafter, rats were sacrificed and heart was isolated and preserved for biochemical, histopathological, ultra-structural, immuno-histochemical and western blot analysis.

Results:
Chrysin with Losartan treatment of 28 days significantly attenuated cardiac hypertrophy via. decreased cardiac injury markers, inflammatory cytokine, oxidative stress and apoptosis. The combination of Chrysin and Losartan exhibited significant effect to that of Chrysin or Losartan separately. The histopathological, Immunhistochemical and immunoblot analysis showed that the chrysin attenuates cardiac hypertrophy via modulation in MAPK pathways and showing anti-apoptotic effect. The combination of Chrysin and Losartan showed beneficial effect among all groups.

Conclusions:
Chrysin and Losartan reduce Isoprotorenol- induced cardiac hypertrophy by mitigating oxidative stress, inflammation and apoptosis resulting in improvement of cardiac function, structural changes and antioxidants levels. Chrysin and Losartan in combination attenuated DNA damage or apoptosis and showed best cardio-protection against Cardiac hypertrophy.