bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECTS OF CHANGING MEASUREMENT INTERVALS AND CUFFS ON BLOOD PRESSURE MONITOR VALIDATION
Authors: Lewis Philip , Smith Lara Jane , Budd Jayne , Curtis Janet , Wilkinson Helen , Adeyoju Joshua , Adeyoju Daniel Adedeji , Woodyatt Wiesia Krystyna , Rajai Azita 
Published: April 2021

Objective:
We investigated whether intervals between automated BP measurements (AutoBPMs) and alternating manual BP measurements (ManBPMs) might affect validation protocol results and if cuff changes had independent affects.

Design and method:
The BP of 72 healthy volunteers (59 female, 13 male; age 36–58 years; BMI 23–29 Kg/m2), SBP 90–180 mmHg, was measured manually by trained observers using an Accoson mercury sphygmomanometer alternating with automated readings with an Omron M6 AC monitor in 2 phases. In Phase 1, participants were randomised to 9 BPMs (ManBPMs with a Standard Adult Accoson cuff alternating with AutoBPMs with an Omron RML31 D-ring cuff) at 30 second intervals followed by 9 BPMs at 60 second intervals or vice versa.
In Phase 2, participants were randomised to 9 alternating ManBPMs and AutoBPMs at 60 second intervals using an Omron RML31 cuff for all, followed by 9 alternating ManBPMs and AutoBPMs using an equivalent sized D-ring cuff made with Accoson Standard cuff materials for all or vice versa.
Statistical analyses were made using RStudio with Mixed Model Repeated Measure (MMRM) modelling.

Results:
Phase 1 ManSBPs were significantly greater than AutoSBPs especially at 30 second intervals (ManSBP – AutoSBP = 2.76 mmHg [CI1.5, 4.01]) than at 60 second intervals (-0.92 [-0.58, 2.42]). ManDBPs were lower than AutoDBPs at 60 second intervals (-3.25 [-4.53, -1.97]) than at 30 second intervals (-1.19 [-2.17, -0.21]) 1.5, 4.01]) In Phase 2, AutoDBPs were lower than ManDBPs but AutoSBPs were not significantly different from ManSBPs. These results were unaffected by using either cuff.
There was no significant difference if ABPMs were compared with the mean of the preceding and subsequent readings or with the value of the preceding or subsequent readings nearest to the ABPM value. Comparisons were unaffected by excluding the first 2 of the 9 alternating BPMs at each stage

Conclusions:
Intervals between alternating manual and automated BPMs used in validation protocols may significantly affect the outcome of a validation unrelated to the cuff used. SBP differences are greater at 30 second intervals than at 60 second intervals whilst DBP differences are greater at 60 seconds.
PATIENTS’ PERCEPTIONS ON THE USE OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS: COMPARISON BETWEEN THE FIRST AND THE SECOND COVID-19 PANDEMIC WAVES
Authors: Ioannidis Antonios , Pechlevanis Apostolos , Fragkiskou Afroditi , Paraskelidou Maria 
Published: April 2021

Objective:
Since the outbreak of the SARS-COV-2 pandemic, concerns have been raised that RAAS inhibitors (RAAS-i) may increase susceptibility to coronavirus and likelihood of severe COVID-19 illness. This study aims to assess the patients’ perceptions on the risk or benefit of RAAS-I use focusing on the differences between the two waves of the pandemic in Northern Greece.

Design and method:
Patients visiting the emergency (non-COVID) department or the outpatient clinics of a tertiary hospital were invited to participate by completing a short questionnaire. This observational study was conducted during the first (April to June 2020) and the much more forceful second wave (November 2020) of the COVID-19 pandemic.

Results:
In total 341 patients (183 women, 53.7%) taking angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor type 1 blockers (ARBs) participated (mean age 64.7 ± 9.7 years). About half the patients (188, 55.1%) were taking RAAS-i for hypertension, while the rest for other indications (heart failure, coronary artery disease, etc.). The vast majority (319, 93.5%) were aware of the issue that some antihypertensive drugs might be harmful (mainly from TV reports). Several differences were noted between the participants of the first and the second wave (Table 1). In particular, more patients of the second wave, than of the first wave, knew if they were taking RAAS-I and had contacted their doctor with eventually 14 of them altering their therapeutic regimen. Moreover, the second wave patients, in contrast to the first wave participants, reported higher chances of getting COVID-19, with the majority of them believing they are more susceptible to SARS-COV-2 and expecting more severe disease course. Disturbingly, only few of the patients of the second wave and none of the first had been informed of the position of major scientific societies that patients should continue taking RAAS-i.

Conclusions:
Greek patients are aware of the issue relating the RAAS-i with the COVID-19 pandemic. Second wave participants seem more worried, seeking medical advice and inquiring drug substitution. Nevertheless they still lack information from scientific societies. Further research is warranted to assess whether patient oriented informative campaigns could comfort their concerns.
NUTRITIONAL STATUS IN OLDER HYPERTENSIVE PATIENTS DEPENDING ON COMORBIDITY
Authors: Efremova Elena , Shutov Alexander , Cheremnyh Anastasija , Hramova Anna , Samsonova Natal’ja , Bykova Alina , Antonova Elena 
Published: April 2021

Objective:
Obesity and the type of obesity are an important prognostic factor in older patients with hypertension and comorbidity (including chronic heart failure (CHF)). The aim of this study was to investigate nutritional status in older hypertensive patients with CHF.

Design and method:
119 older hypertensive patients withCHF (89 males, mean age was 68.9 ± 6.7 years) were studied. Arterial hypertension was defined according to ESC Guidelines for the diagnosis and treatment of arterial hypertension, 2018. Charlson comorbidity index (CCI) was estimated. Comorbidity was regarded as high at index less or equal 6 scores. Nutritional status was assessed: the presence of obesity, type of obesity, body composition, including percentage of lean and fat tissue.

Results:
The CCI was 5.9 ± 1.9 scores. 67 (56.3%) older hypertensive patients with CHF had high comorbidity. Chronic kidney disease (CKD) was more common in the comorbidity structure (57; 47,9%). Obesity was observed in 59 (81.9%) patients, 56 (77.8%) with abdominal obesity, 116 (97%) - had a higher percentage of body fat. Lean body mass index, body fat index, percentage of lean body mass and percentage of body fat did not differ in patients depending on the level of comorbidity (p > 0.05). There was a direct relationship between the percentage of body fat and CCI (r = 0.30, p = 0.006). However, patients with CKD had lower total water volume (42.4 ± 6.9 and39,1 ± 6.7 liters resp., p = 0,009) and lean body mass (58.0 ± 9.4and53,7 ± 9.3 kg resp., p = 0,01) compared to older hypertensive patients with CHF without CKD.

Conclusions:
Older patients with arterial hypertension and CHF are characterized by obesity (abdominal obesity) and sarcopenic obesity. Body composition is independent on comorbidity. However, patients withCKD had lower total water volume and lean body mass, which also causes a poor prognosis.
10-YEAR STROKE RISK PREDICTION: A CENTRAL REGION OF VIETNAM COMMUNITY-BASED RESEARCH
Authors: Doan Long , Huynh Van Minh , Hoang Anh Tien , Doan Phuoc Thuoc , Nguyen Thi Huong , Nguyen Thi Thuy Hang , Nguyen Thi Phuong Thao , Nguyen Minh Tam , Le Chuyen , Tran Thi Thanh Nhan 
Published: April 2021

Objective:
This study aim to predict the risk of cerebral stroke in the next 10 years with QStroke® tool in Thua Thien - Hue province, a central region province of Vietnam.

Design and method:
A cross-sectional study recruits 1,600 Vietnamese adults aged from 25 to 84 who were in 4 different eco-regions in many parts of Thua Thien Hue included city, delta, mountainous, and coastal region. We calculated the 10-year risk of stroke using QStroke® 2017.

Results:
According to data on clinical characteristics collected in 2018. By 2020, the risk prediction of stroke in all study subjects is <10%. In the following years, the proportion of below 10% risk subject group tends to decrease, and equal or more than 10% subject groups tend to increase. By 2028, 10-year of prediction, the risk of stroke is less than 10% in 84.2% of research subjects, 7.1% of subjects have stroke risk level of 10% to 14%, 4.6% of subjects have stroke risk of 15% to 19% and 4.1% of subjects have stroke risk level equal or more than 20%. Analysis of the next 10 years risk prediction by ecological region showed that there is a difference in the risk of stroke prediction in the next 10 years between the delta region and coastal region (p < 0.0125), the difference between delta region and city area (p < 0.0125). The delta region has the highest risk of stroke in the next 10 years compared to the rest. Thereby, it is necessary to study in-depth the risk factors for stroke in the delta region to have the next intervention programs to improve the health of the people generally.

Conclusions:
The proportion of people at risk of stroke increasing year-by-year if they do not have any effective prevention intervention. The delta region has the highest risk of suffering a stroke in the next 10 years compared to the rest. A comprehensive intervention strategy for risk factors is the answer in reducing the risk of stroke in the community.
THE LEFT VENTRICULAR FUNCTIONALITY IN ARTERIAL HYPERTENSION ASSESSED THROUGH THE PERFORMANCE MYOCARDIAL INDEX CALCULATED BY THE TISSULAR DOPPLER ECHOCARDIOGRAPHY
Authors: Caruso Giuseppe , Paoli Vera Delli , Ciarambino Tiziana , D’Avino Maria 
Published: April 2021

Objective:
The aim of this study was to determine whether the TDE, which directly assesses the systo-diastolic movement of the cardiac wall rather than the hematic flow movement, would allow us to ascertain the IMP and the various cardiac cycle times that contribute to its assessment, such as: the Isovolumetric Contraction Time (ICT), the Isovolumetric Relaxation Time (IRT) and the Ejection Time (ET).

Design and method:
we selected 95 healthy voluntaries (61 M and 34 F –1st group) aged 36 - 65 and 94 patients (59 M and 35 F) aged 38–70 suffering from 1–2 grade AH for at least two years. 26 patients showed conventional echocardiographic signs of left ventricular hypertrophy (LVH) while the remaining 68 did not report any (2nd group). All patients underwent a TDE test with apical approach whereby the standard volume was placed onto the lateral portion of the mitral anulus in order to record the diastolic and systolic phase. IRT and ITC were also measured separately.

Results:
Table I below shows the results for the two groups including the statistical significance:

Conclusions:
hypertensive patients with or without LVH reported a ventricular dysfunction shown by an increase in MPI. This increase was a consequence of an extension of IRT while ICT and TE did not change in comparison with normal values. This indicates that any ventricular functionality impairment exclusively regards the diastolic phase. These results demonstrate that the ventricular dysfunction in these patients was mainly of diastolic type whereas the systolic functionality appeared to be preserved.
RESISTENT ARTERIAL HYPERTENSION (RAH): FOLLOW UP
Authors: Caruso Giuseppe , Ciarambino Tiziana , Ciaburri Filippina , Paoli Venere Delli , Vitolo G , D’avino Maria 
Published: April 2021

Objective:
Resistent arterial hypertension (RAH) shows a 3 times higher risk for cardiovascular events. We evaluated the occurrence of fatal and non-fatal cardiovascular events during a follow-up period of 2 years.

Design and method:
From January 2018 to January 2020, 139 patients (79 M; mean age 57 ± 7) with RAH were followed at the Cardiovascular Medicine Department, AORN Cardarelli, Naples. All were on low-sodium diet and drugs therapy. We subdivided patients in 4 groups: Group A with left ventricular hypertrophy (IVS); Group B with carotid mid-intimal thickening (IMT major 0.9 mm); Group C with both signs of IVS and IMT, and, Group D with no signs of organ damage. BP values were controlled by Home Ambulatory Monitoring/24 hours (MAPA) at T0, T1 (after 12 months) and T2 (after 24 months).

Results:
In Group D, during the follow-up, 2 patients presented a myocardial infarct, 3 a Stroke, 5 a TIA and 7 an Atrial Fibrillation. In group C, 3 patients, underwent coronary angiography and treated with angioplasty. Only at T2, a significant reduction in BP values was obtained (p < 0.05). Similarly, a reduction in the BP was also recorded, with the MAPA, both in the 24 hours and in the day and night hours, especially at T2 (p < 0.05).

Conclusions:
Group D experienced greater cardiovascular events. The reduction of PA plays a crucial role in the evolution of the damage itself. The identification of organ damage in patients with resistant hypertension must lead us to be particularly careful in optimizing therapy.
EFFECT OF BEETROOT JUICE INGESTION ON POST-EXERCISE HYPOTENSION AND HEART RATE VARIABILITY IN HYPERTENSIVE POSTMENOPAUSAL WOMEN
Authors: Carrijo Victor Hugo Vila , Amaral Ana Luiza , Mariano Igor Moraes , Souza Tállita Cristina Ferreira de , Batista Jaqueline Pontes , Oliveira Erick Prado de , Puga Guilherme Morais 
Published: April 2021

Objective:
To compare the acute effects of a single dose of beet juice (BJ), with different nitrate concentration (NO3-) in post-exercise hypotension (HPE) and in heart rate variability (HRV) in postmenopausal hypertensive women.

Design and method:
Thirteen hypertensive postmenopausal women (58.1 ± 4.6 years and 27 ± 4 kg/m2) completed the protocol that consisted of three visits with different beverage ingestion in a randomized and crossover design: beetroot juice (BJ) with a high content of nitrate (high-NO3-), BJ with a low content of nitrate (low-NO3-), and an orange flavored non-caloric drink (OFD). After overnight fasting, women drank one of the beverage, rested in siting position for 120 min and then performed 40 min of aerobic exercise at 65–70% of the heat rate (HR) reserve on a treadmill. Blood Pressure (BP) and HR were measured in rest sitting position at 7:20 am (baseline) and during 90 min after exercise. HRV index were analyzed in time (RMSSD, SDNN, PNN50), frequency (HF, LF, LF/HF), and non-linear (SD2, SD1, and SD2/SD1) domains.
Two-way ANOVA were used to compare BP and HRV time and sessions responses.

Results:
No interaction effects (time∗sessions) in BP responses nor any of the HRV indexes after exercise in all among three sessions. However, after aerobic exercise, systolic BP and diastolic BP decreased (p < 0.05), and HRV indexes (LF, LF/HF, SDNN, SD1, SD2, and SD2/SD) increased (p < 0.05) similarly in all three sessions (high-NO3-, low-NO3-, OFD) when compared with the baseline time point.

Conclusions:
A single dose of BJ, independent of NO3- content, does not change acute aerobic exercise-mediated improvements responses in BP or HRV in hypertensive postmenopausal women.
ASSOCIATION BETWEEN SERUM URIC ACID LEVEL AND CARDIOVASCULAR RISK FACTORS AND THEIR CLUSTERING RISK IN CHILDREN AND ADOLESCENTS IN YINCHUAN CITY
Authors: Cai Rongrong , Dong Yangyang , Zhou Jinyu , Bai Ling , Jia Leina , Ding Wenqing 
Published: April 2021

Objective:
To explore the relationship between serum uric acid (SUA) levels and cardiovascular risk factors and their clustering risk among children and adolescents in Yinchuan City, China, so as to provide scientific evidence for the prevention and treatment of cardiovascular diseases in children and adults.

Design and method:
The design of cross-sectional study was adopted, and 1486 children and adolescents aged 10–18 in Yinchuan City were selected as the research objects by convenient sampling methods. All the research objects completed questionnaire survey, physical measurement and biochemical examination.

Results:
The detection rate of hyperuricemia (HUA) was 29.8%, including 39.4% for boys and 20.5% for girls. The detection rate for boys was higher than girls (χ2 = 63.01, P < 0.001); SUA were positively correlated with BMI, WC, SBP, DBP, TC, TG and LDL-C (P < 0.01). Except for hyperglycemia in the general population, hyperuricemia increased general obesity (OR = 4.48,95%CI: 3.46–5.81), abdominal obesity (OR = 4.91, 95%CI: 3.76–6.42), hypertension (OR = 1.92,95%CI: 1.43–2.57), hyperlipidemia (OR = 2.72, 95%CI: 1.96–3.79) and dyslipidemia (OR = 1.67,95%CI: 1.30–2.14). The risk of cardiovascular clustering greater than or equal to 2 and 3 in children with high uric acid was 3.64 times (95%CI: 2.74–4.84) and 6.88 times (95%CI: 3.83–12.40) of children with normal uric acid, respectively, both P < 0.01, similar results were obtained in boys and girls.

Conclusions:
High uric acid in children and adolescents in Yinchuan City is significantly associated with cardiovascular risk factors and their clustering risk. The serum uric acid level of children and adolescents should be paid attention to in time.
ARTERIAL HYPERTENSION MAY INVOLVE SARCOPLASMIC RETICULUM CALCIUM ATPASE (SERCA) PROTEOLYSIS BY MATRIX METALLOPROTEINASE (MMP)-2
Authors: De Mello Marcela Maria Blascke , Parente Juliana Montenegro , Pernomian Laena , Silva Pedro Henrique Leite , Schulz Richard , De Castro Michele Mazzaron 
Published: April 2021

Objective:
Aortic SERCA protein level and activity are reduced in hypertension. Increased MMP-2 activity may cleave SERCA in acute myocardial ischemia and reperfusion injury. Our objective was to verify whether increased vascular MMP-2 activity in hypertension proteolyzes SERCA to alter cytosolic calcium, thus causing enhanced vasoconstriction or maladaptive remodeling.

Design and method:
Male Sprague-Dawley rats were submitted to two kidney-one clip (2K-1C) or sham surgery and treated with doxycycline (Doxy, 30 mg/kg/day) by gavage from the third to seventh day post-surgery. Systolic blood pressure (SBP; tail-cuff plethysmography) was daily measured, and after seven days aortas were collected and processed for gelatin and in situ zymography, SERCA protein levels by Western blot and calcium immunofluorescence using Rhod-2AM. Aortas were isolated from normal rats were incubated at 37°C for 6 or 12 hours in DMEM with angiotensin (Ang) II (0.1 μM) +/- MMP inhibitors, ONO-4817 (10 μM) or Doxycycline (30 μM). Aorta segments were processed as above and used for co-immunoprecipitation of SERCA and MMP-2. Statistical analysis was done by two-way ANOVA followed by Tukey post-hoc test. The Ethics Committee for Animal Research of the Ribeirao Preto Medical School approved all protocols (122/2019).

Results:
MMP-2 activity in 2K-1C aorta was elevated 1.5-fold vs. controls and Doxy decreased it by 1.3-fold (n = 5–8; p < 0.05). SERCA proteolysis was 3-fold increase in 2K-1C aorta (n = 4–8; p < 0.05 vs. controls). Treatment with Doxy seemed to prevent this effect (0.49 ± 0.07 2K1C+Doxy vs 1.42 ± 0.42 2K1C). These effects were not associated with changes in SBP as Doxy did not alter it. Cytosolic calcium concentrations trended to increase in 2K1C aorta from 13 to 19 a.u. (n = 3; p = 0.08) and Doxy decreased it (n = 3; p < 0.05). In AngII treated aorta, MMP-2 activity also increased by 1.5-fold (n = 4-5; p < 0.05 vs. controls) and both ONO-4817 and Doxy reduced its activity by the half (n = 4-5; p < 0.05). MMP-2 was co-immunoprecipitated with SERCA in the incubated aortas, and AngII seemed to increase it.

Conclusions:
SERCA levels may be decreased by MMP-2 activity in the aortas of hypertensive rats which may contribute to calcium-induced vascular alterations in hypertension. These effects are currently being investigated.
NON-INVASIVE ASSESSMENT OF CENTRAL AORTIC PRESSURE, AORTIC FLOW AND VASCULAR LOAD IN PATIENTS WITH AORTIC STENOSIS BEFORE AND AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT
Authors: Adji Audrey , Song Ning , Hungerford Sara , Namasivayam Mayooran , Hayward Christopher , Jabbour Andrew , Muller David 
Published: April 2021

Objective:
The left ventricle (LV) faces a dual afterload in patients with aortic stenosis (AS), both from the narrowed valve and age-related arterial stiffening. Variability in indices of AS severity assessment suggests an inter-relationship of the valvular pressure gradient on systemic arterial pressure and flow. Our study aims to evaluate the dynamic vascular load (VL) non-invasively in AS patients before and after transcatheter aortic valve replacement (TAVR) using the approach of simultaneous cardiac magnetic resonance (CMR) and radial applanation tonometry (AT).

Design and method:
Ascending aortic pressure, flow and VL were measured in 3 patients at baseline and post-TAVR using a previously reported simultaneous CMR/AT technique. CMR provided aortic flow, and radial AT waves were converted offline to aortic pressure using SphygmoCor 8.1 (AtCor Medical) and calibrated using brachial cuff values. VL was determined as the relationship of derived aortic pressure to CMR aortic flow velocity, by calculating the average modulus of pressure divided by flow. Following the acquisition of post TAVR data, 300 micrograms of sublingual nitroglycerine (GTN) was introduced to investigate the effect on changing vascular load.

Results:
At 38 ± 3 days post TAVR, mean aortic pressure (MP) and mean systolic flow (MF) both increased (100 ± 17 pre, 109 ± 12 post, mmHg; 178 ± 44 pre, 230 ± 74 post, ml/s). Following GTN administration, MP (95 ± 3 mmHg) decreased but not MF (228 ± 57 ml/s) – see figure.
The steady state systemic vascular resistance (SVR) reduced post TAVR (22501 ± 5929 pre, 20484 ± 6232 post, dynes.s/cm3), but not VL (1082 ± 219 pre, 1111 ± 483 post, dynes.s/cm3). Conversely, GTN administration significantly reduced VL (838 ± 295 dynes.s/cm3) with little effect on SVR (19313 ± 5631 dynes.s/cm3).

Conclusions:
Our study demonstrates that our novel technique can be reliably replicated in patients to evaluate the changes to aortic pressure, flow and VL before and after TAVR. VL appears to be a dynamic measurement of vascular stiffness independent of AS and may prove to be a useful measure to predict haemodynamic responses and ventriculo-arterial coupling in AS patients post TAVR. Larger longitudinal cohort studies are warranted.