bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF CARDIOVASCULAR OUTCOME WITH THE SLOPE BETWEEN SYSTOLIC BLOOD PRESSURE AND PULSE RATE MEASURED BY AMBULATORY BLOOD PRESSURE MONITORING IN A JAPANESE GENERAL PRACTICE
Authors: Narita Keisuke , Satoshi Hoshide , Kazuomi Kario 
Published: April 2021

Objective:
Blood pressure (BP) and pulse rate (PR) usually show a physiologically negative correlations in terms of keeping cardiac output consistent. The relationship between BP and PR is associated with sympathetic activity. The higher PR corresponding to elevated BP measured by home BP monitoring reportedly elevates cardiovascular disease (CVD) risks. However, it remains unclear whether the relationship between ambulatory BP and PR predicts incident of CVD. We aimed to assess the predictive ability of the correlations between BP and PR for incident of CVD in clinical practice.

Design and method:
This is a prospective study, which recruited patients with a history of or risk factors of CVD. Participants underwent ambulatory BP monitoring and followed-up incident CVD, including stroke and coronary artery disease. The relationship between BP and PR was evaluated by the slope of correlation line between systolic BP (SBP) and PR in 24-hour, daytime, and nighttime which were assessed by each participant's diary. The association of the slope between SBP and PR with incident of CVD was assessed using Cox proportional hazards models.

Results:
Among 1422 participants (age, 64.6 ± 11.6 [mean ± SD], 47.6% male, 92.8% hypertensives), During a follow-up of 6.8 ± 3.5 years (9670 person-years), 49 stroke, 53 coronary artery disease (CAD), and 125 various CVD events (stroke, CAD, hospitalization due to heart failure, and aortic dissection) occurred. Although the slope between SBP and PR in daytime did not associated with CVD risks after adjustments for covariates, the slope between SBP and PR in nighttime was associated with an increase risk of stroke and various CVD events after adjustments for covariates (hazard ratios [95%CIs] for stroke: 1st quartile as reference; 2nd quartile, 1.45 [0.57–3.72]; 3rd quartile, 1.50 [0.60–3.74]; 4th quartile, 2.53 [1.05–6.11]; for various CVD events: 1st quartile as reference; 2nd quartile, 1.43 [0.83–2.47]; 3rd quartile, 1.56 [0.91–2.70]; 4th quartile, 1.96 [1.13–3.38]) (Table).

Conclusions:
Based on the results of this study, the slope between SBP and PR in nighttime was suggested to be associated to CVD outcomes.
ROLE OF SACUBITRIL/VALSARTAN IN THE TREATMENT OF CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION IN ELDERLY HYPERTENSIVES WITH COMORBIDITY: FROM CLINICAL TRIALS TO REAL WORLD
Authors: Mazza Alberto , Torin Gioia , Schiavon Laura , Rossetti Ciro , Cuppini Stefano 
Published: April 2021

Objective:
Sacubitril/Valsartan (SV) has been shown to reduce cardiovascular mortality in ambulatory patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (HFrEF). However there are few real-word evidences about its efficacy in elderly hypertensives with HFrEF and comorbidities.

Design and method:
In this prospective open-label study, 54 subjects (mean age 78.6 ± 8.2 years, 75.0% men), with HFrEF (29.8 ± 4.3%), in New York Heart Association (NYHA) class II-III were assigned to receive SV twice daily at different dosage of 24/26, 49/51, 97/103 mg. These patients were gender and age-matched with a control group of patients with HFrEF receiving optimal standard therapy for CHF. The office blood pressure (BP), the NT-pro-BNP, eGFR, blood glucose and glycated haemoglobin (HbA1c), uric acid (UA), left ventricular ejection fraction (LVEF) and NYHA class were evaluated at a mean follow-up of 14-months. Mortality and re-hospitalisation for HF were collected. Categorical variables were compared with the Pearson's test and difference of continuous variables, were evaluated by the analysis of variance for repeated measures.

Results:
NYHA class significantly improved in the SV than control group (24.9 vs. 6.4% moved from III-- > II and 55.4 vs. 25.2% from II-- > I classes, p < 0.05). A significant improvement of LVEF and eGFR levels was found in the ARNIs than controls (42.4 vs. 34.2%, 73.8 vs. 61.2 ml/min for all p < 0.001, respectively). The NT-pro-BNP, systolic BP, diastolic BP, blood glucose, HbA1c and UA values were lower in SV than controls (3107 vs 4552 pg/ml, 112.2 vs. 120.4 and 68.8 vs 75.6 mmHg, 108.4 vs 122.6 mg/dl, 5.4 vs. 5.9% and 5.9 vs 6.4 mg/dl, p < 0.05). Mortality and re-hospitalisation for CHF was lower in the SV than controls (20.1 vs. 33.6 and vs. 27.7 vs. 46.3%, p < 0.05).

Conclusions:
In elderly hypertensives with HFrEF and comorbidities SV treatment seems effective and safe. The improvement of LVEF, BP, eGFR, serum glucose, UA and HbA1c could be the mechanisms by which SV plays a beneficial role on clinical outcomes
LEFT VENTRICULAR STRUCTURE AND FUNCTION ARE RELATED WITH THYROID FUNCTION AND ELECTROLYTE LEVELS IN TREATMENT-NAIVE ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Catena Cristiana , Brosolo Gabriele , Da Porto Andrea , Colussi Gianluca , Vivarelli Cinzia , Desimini Angela , Sechi Leonardo A. 
Published: April 2021

Objective:
Left ventricular mass index (LVMI) and LV systolic and diastolic function are affected by a number of metabolic variables. Only a few studies have examined the relationship between LV structure and function of treatment-naive essential hypertensive (EH) patients with thyroid function and plasma electrolyte levels.

Design and method:
In 466 never treated EH patients (age 49 ± 13 years; 254 males), we measured BMI, waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, alcohol intake, glomerular filtration rate (GFR), and plasma levels of glucose, magnesium, calcium, 25OH-Vit.D, PTH, Free-T3, and Free-T4. In these patients we examined the cardiac structure and function by two-dimensional and Doppler echocardiography and tissue-Doppler imaging (TDI).

Results:
LV ejection fraction was directly correlated with Free-T3 and Free-T4 and inversely correlated with WC and DBP. LVMI was directly correlated with age, BMI, WC, SBP, DBP, serum glucose, magnesium, and PTH and inversely correlated with serum calcium. Transmitral E/A ratio was directly correlated with GFR and inversely correlated with age, WC, SBP, DBP, and serum glucose and magnesium. TDI e’ wave was directly correlated with GFR and serum calcium, and inversely correlated with age, WC, SBP, DBP, serum glucose and PTH. LV ejection fraction was independently associated with Free-T3 and Free-T4 (B = 0.134, P = 0.017 e B = 0.143, P = 0.007, respectively). Transmitral E/A ratio was independently associated with serum magnesium (B = -0.137, P = 0.015), while other relationships were lost in the multivariate analysis.

Conclusions:
In treatment-naive EH patients, LV systolic function is independently associated with higher circulating levels of thyroid hormones. LVMI is associated with lower serum calcium and higher serum PTH suggesting subtle secondary hyperPTH, but this association is lost when other variables that affect LVMI are considered.
ASSOCIATIONS OF SODIUM INTAKE WITH CENTRAL HEMODYNAMICS AND CHANGES IN VASCULAR STRUCTURE AND FUNCTION AT HIGH ALTITUDE LOCALITIES
Authors: Zhipeng Zhang , Xiaoping Chen , Xin Zhang 
Published: April 2021

Objective:
To investigate the associations of sodium intake with central hemodynamics and changes in vascular structure and function at high altitude localities.

Design and method:
From December 2018 to January 2019, a total of 383 monks who participated in cardiovascular risk factors screening were enrolled in four temples around Luhuo County, Ganzi Tibetan Autonomous Prefecture with an average elevation of 3,800 meters. Questionnaire, physical examination, blood and urine examination, electrocardiogram, echocardiography, intima-media thickness (IMT), Brachial ankle pulse wave velocity (BaPWV), Ankle brachial index (ABI), Central systolic blood pressure (CSBP), Central diastolic blood pressure (CDBP), Central pulse pressure (CPP), Central mean arterial pressure (CMAP), Augmentation pressure (AP), Augmentation index (AI) and other tests were performed on all participants. Estimated 24-hour urinary sodium excretion was measured by the Kawasaki formula using the urinary sodium/urinary creatinine ratio of the second morning fasting urine. Pearson correlation and multiple linear regression were used to analyze the associations between 24 h urinary sodium and central arterial hemodynamic parameters and BaPWV and IMT.

Results:
1. The estimated 24 h urinary sodium excretion in the temple was (5.26 ± 1.61)g, and the estimated salt intake was (13.36 ± 4.09)g. There was no significant correlation between 24 h urinary sodium and CDBP, AP and IMT (P > 0.05). After gender, age, CSBP, body Mass Index (BMI), fasting blood glucose (FBG), estimated glomerular filtration rate (eGFR), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were adjusted, 24 h urine sodium was positively correlated with CSBP (P = 0.018) and CPP (P < 0.001). After adjusting for gender, age, CSBP, BMI, eGFR, FBG, TG, HDL, LDL, 24 h urinary sodium was significantly negatively correlated with AIX75 and BaPWV (P = 0.028,P < 0.001, respectively). The line graph of means across the 24 h urinary sodium quartiles and the cubic fitting curve showed that the associations between 24 h urinary sodium excretion with AIX75 and BaPWV presented an approximate ’J’ shape.

Conclusions:
24 h urinary sodium was positively correlated with CSBP and CPP in the monks in this region. The associations between 24 h urinary sodium with AIX75 and BaPWV resembled a ’J’ shape.
LEFT VENTRICULAR STRUCTURE AND FUNCTION IN CENTENARIANS
Authors: Eruslanova Kseniia , Kotovskaya Julia , Runikhina Nadezjda , Tkacheva Olga , Bazaeva Ekaterina 
Published: April 2021

Objective:
Centenarians are still represented as underinvestigated population. There is a large proportion of studies showed the anatomical and functional changes of the heart with ageing, but very few data available for centenarians. The aim of the Moscow Centenarian Study (NCT02876809) was to perform a complex evaluation of centenarians living in Moscow. Preliminary results of the prevalence of arterial hypertension and echocardiography are reported in this abstract.

Design and method:
Echocardiography was performed with a portable device In 64 (8 male) aged from 97 to 105 years. Medical history, including the past medical history of arterial hypertension (AH), was collected during an interview with centenarians, their relatives/ carers, and from medical notes if available. The diameter of aorta, left atrium size and volume index (LAVI), systolic and diastolic dimensions and volumes of the left ventricle (LV), LV mass index (LVMI), ejection fraction (EF) and diastolic function were evaluated. LV hypertrophy was diagnosed if LVMI was > 95 g/m2 in females or > 115 g/m2 in males, concentric LV geometry if relative wall thickness (RWT) > 0,42. The data are presented as Mean+SD.

Results:
The prevalence of AH was 78% (n = 64). Mean aortic root diameter was 3,5 + 0,34 cm and in 8 subjects exceeded 3,8 cm. Mean LAVI was 41,8 + 14,3 ml/m2 and was > 28 ml/m2 in 57 subjects. Normal LVMI and RWT were found in 13 (20,3%) of centenarians. Concentric LV remodelling was observed in 15 (23,4%), concentric LVH 24 (37,5%), eccentric LVH in 12 (18,7%). Two subjects had EF < 40% (history of MI in both), 62 subjects had EF > 50%. Structural abnormalities typical for heart failure with preserved EF (LV end diastolic volume < 97 ml/m2 and LAVI > 34 ml/m2 or LVH) was observed in 46 (71,9%) centenarians.

Conclusions:
The prevalence of AH and the structural changes which are specific for elevated blood pressure are common in this age group, as well as diastolic dysfunction.
LEFT VENTRICULAR HYPERTROPHIE ASSOCIATED WITH HYPERTENSION: PREVALENCE, IMAGING AND FACTORS ASSOCIATED
Authors: Maaroufi Anass , Zahidi Hatim Amine , Mehdi Aqli , Hajar Bendahou , Salim Arous , Ghali Bennouna El , Drighil Abdenacer , Habbal Rachida 
Published: April 2021

Objective:
The prevalence of LVH increases with age, the severity of hypertension, and duration of hypertension. So, the presence of LVH indicates a long run of uncontrolled hypertension associated with many parameters.
The objective of the study is to determine prevalence and factors associated with LVH in the setting of Hypertension.

Design and method:
100 patients attending the outpatient department and those who were admitted from January 2016 to June 2017 were the study subjects.
All cases of hypertension, irrespective of the duration of hypertension and type of treatment received were included in the study. Patients with secondary hypertension, ischemic heart disease/myocardial infarction, ischemic cardiomyopathy, congenital heart disease, and valvular heart disease were excluded.

Results:
Out of 100 patients, 59 (59%) were males and 41 (41%) were females. Among 59 males, 36 (61.01%) showed LVH and among 41 females, 24 (58.53%) showed LVH. The majority of cases was in the age group of 50–59 years (n = 48, 48%). The youngest patient was aged 40 years and the oldest patient was aged 87 years and the mean age was 56.4 years.
Sokolow-Lyon criteria identified LVH in 24 patients. Among them, 18 (75%) were males and 6 (25%) were females.
ECHO identified LVH in 60 patients. Among them, 36 (60%) were males and 24 (40%) were females.
Out of 60 patients, 29 had mild LVH, 16 had moderate LVH, and 15 had severe LVH.
Out of 24 patients with blood pressure (BP) < 140 mmHg, 6 (25%) had LVH. Eighteen (58.08%) out of 31 patients had LVH with BP of 140–159 mmHg. Twenty-eight (77.78%) out of 36 patients had LVH in the BP group of 159–180 mmhg.
Among the 60 patients who had LVH at the echo only 15 patients had LVH at Electrocardiogram

Conclusions:
Left ventricular hypertrophy is a serious condition, so while managing a patient with hypertension the goal should be regression of LVH along with reducing BP to target level. ECG is not as good as Echocardiography to detect LVH, so wider use of Echocardiography is advocated.
CD153 VACCINE IS A NOVEL SENOTHERAPEUTIC OPTION FOR REMOVING SENESCENCE-ASSOCIATED T CELLS
Authors: Nakagami Hironori , Yoshida Shota , Morishita Ryuichi , Rakugi Hiromi 
Published: April 2021

Objective:
Senotherapy targeting for senescent cells is designed to attenuate age-related dysfunction and promote healthy aging. Senescence-associated T cells (SA-T cells), defined as CD4+ CD44high CD62Llow PD-1+ CD153+ cells, accumulate in visceral adipose tissues (VAT) in obese individuals. Here, we show the long-lasting effect of using CD153 vaccination to remove SA-T cells from high-fat diet (HFD)-induced obese C57BL/6J mice.

Design and method:
The peptide vaccines for mouse CD153 consisted of a short peptide sequence conjugated to KLH (keyhole limpet hemocyanin) as a carrier protein to induce the specific CD153 antibody, and knowing the CD153 epitope information allowed five candidate peptide to be selected as antigens. The five peptide vaccines (30 microg of the CD153 peptide per mouse) were conjugated to KLH and coadministered with the Alum adjuvant (Alhydrogel) to seven-week-old male C57BL/6J mice twice at two-week intervals. CD153#D vaccine-induced antibodies effectively recognize the rmCD153 protein, and we selected the CD153#D vaccine as a candidate for further experimental studies.

Results:
The number of CD153+ SA-T cells increases gradually and systemically with age. Indeed, more CD153+ SA-T cells were observed in the splenic tissues of male C57BL/6J mice at 20 months of age than at 3 months of age (18.7 ± 0.5% vs. 3.8 ± 0.2%; p < 0.0001; n = 3 in each group). In VAT (viceral adipose tissue), CD153+ SA-T cells tended to increase more in elderly mice than in young mice (8.2 ± 1.0% vs. 4.3 ± 1.4%; p = 0.08; n = 3 in each group). We administered a CD153 peptide-KLH conjugate vaccine with Alhydrogel (CD153-Alum) or CpG oligodeoxynucleotide (ODN) 1585 (CD153-CpG) and confirmed an increase in anti-CD153 antibody levels that was sustained for several months. After being fed a HFD for 10–11 weeks, adipose SA-T cell accumulation was significantly reduced in the VAT of CD153-CpG-vaccinated mice, accompanied by glucose tolerance and insulin resistance. A complement-dependent cytotoxicity (CDC) assay indicated that the mouse IgG2 antibody produced in the CD153-CpG-vaccinated mice successfully reduced the number of SA-T cells.

Conclusions:
These results suggest that the CD153-CpG vaccine might be an optional tool for senolytic therapy.
AMLOPIDINE AND DRESS SYNDROME: UP TO DATE WITH MY KNOWLEDGE?
Authors: Lopez-Sublet Marilucy , Magnan Benjamin , Le Jeune Sylvain , Rousset Laurie , Lazaridou Ingrid , Ghouiles Sabrina , Benramedane Ghouti , Lukina Elena , Leprieur Benedicte Giroux , Benainous Ruben , Suhl Jaehyo , Foudi Farid , Dhote Robin 
Published: April 2021

Objective:
Drug hypersensitivity syndrome or “Drug Reaction with Eosinophilia and Systemic Symptoms” (DRESS) is a severe form of cutaneous drug eruptions that combines skin manifestations and systemic damage. More than 50 drugs have been associated with this syndrome. Amlodipine is a long-acting calcium channel antagonist of type L (DHP), used as an antihypertensive drug. Peripheral edema remains one of the most common side effects of this drug, while dermatological events are very rare (1/100,000). We report a patient with DRESS syndrome who appeared under amlodipine treatment.

Design and method:
An 84-year-old hypertensive patient with eradicated chronic hepatitis C, chronic renal failure, idiopathic thrombocytopenia and dyslipidaemia was hospitalized with a febrile rash.
Treatment with amlodipine 5 mg/d is prescribed for hypertension and then stopped by the patient after 15 days. Resumption of treatment is an accompanied at 4 weeks by a diffuse and infiltrated erythematous skin rash (initially suggestive of a large mesh livedo), associated with facial edema and fever at 39°. EKG is normal. The biological parameters: progressive hypereosinophilia up to 9 G/l, lymphopenia at 0,9 G/l with hyperbasophilic activated T lymphocytes (TL), hepatic cytolysis, HHV6 PCR is positive. The autoimmune test remains negative. The skin biopsy shows an inflammatory infiltrate, rich in eosinophils, with a few rare necrosis areas leading to cutaneous drug eruption. There is no vasculitis. The RegiSCAR score was 4. The discontinuation of amlodipine and high-dose dermocorticoids allowed the rash and hypereosinophilia is reduced within a few weeks until complete disappearance. The pharmacovigilance survey retained this diagnosis with proscription from this drug class.

Results:
The pathogenesis of DRESS syndrome is still very controversial. A hypersensitivity cytokine mediation of TL, and the reactivation of HHV6 are involved. The RegiSCAR score (European register of Serious Adverse Skin Reactions) is used to categorize the imputability to a drug. Amlodipine remains an exceptional cause but should be known because of the very common frequency of prescribing this treatment.

Conclusions:
DRESS syndrome is a rare but serious side effect of calcium channel blockers. Lack of knowledge can leaf to diagnostic errors and unnecessary additional examinations.
GINGIVAL BLEEDING: A POSSIBLE INDICATOR OF HIGH BLOOD PRESSURE?
Authors: Del Pinto Rita , Pietropaoli Davide , Monaco Annalisa , D’aiuto Francesco , Aguilera Eva Muñoz , Ortu Eleonora , Giannoni Mario , Czesnikiewicz-Guzik Marta , Guzik Tomasz , Ferri Claudio 
Published: April 2021

Objective:
Cardiovascular disease (CVD) and related risk factors, including hypertension, are characterized by systemic inflammation. Periodontitis, a chronic inflammatory disease of the supporting tissues of the tooth, has recently been associated with hypertension. However, it is not clear whether the risk of hypertension can vary throughout the natural history of periodontal diseases, that is, if it is modified by gingival bleeding, an easily investigable indicator of local pathology.

Design and method:
Survey-based propensity score matching (PSM) incorporating major confounders shared between hypertension and periodontal diseases (age, gender, ethnicity, poverty, BMI, hypertension diagnosis and treatment, smoking habit, diabetic status, aspirin use) was applied to cross-sectional NHANES III data from adults > = 30 years who underwent BP measurement and periodontal examination, identifying two matched groups with/without gingival bleeding. The association of bleeding gums with systolic blood pressure (BP, mmHg) and high/uncontrolled BP according to the European Society of Hypertension (ESH) was then assessed with generalized additive models incorporating inflammatory markers (CRP, white blood cells, ferritin). Stratification by periodontal health status (healthy; gingivitis; stable/unstable periodontitis) was performed.

Results:
Gingival bleeding (gingivitis; unstable periodontitis) was independently associated with +2.6 mmHg (p < 0.001) systolic BP compared with no bleeding (healthy periodontium; stable periodontitis), and with greater odds (OR 1.42, p < 0.001) of high/uncontrolled BP. Participants with unstable periodontitis had higher systolic BP than those with stable periodontitis (+2.1 mmHg; p < 0.001) or gingivitis (+5.3 mmHg; p < 0.001). Unstable periodontitis and gingivitis, but not stable periodontitis, were associated with increased risk of high/uncontrolled BP (OR 1.29, p = 0.046; OR 1.98, p < 0.001 respectively).

Conclusions:
Gingival bleeding contributes to shaping the relationship between periodontal diseases and hypertension. Inflammatory pathways specific for acute and chronic settings and the immunological/metabolic effects of microflora fluctuations might explain differences among disease strata in the association. Guidelines now recommend oral and periodontal examination in patients with CVD, and warn of the increased cardiovascular risk in the presence of periodontitis. Whether periodontal treatment in hypertension is a cost-effective measure for CV prevention is still undetermined; our results add to the existing observational evidence in support of this possibility.