bluuebunny/crossref_metadata_2025_split huggingface dataset:
URINE METABOLITES OF CORTISOL CORRELATES WITH AMBULATORY BLOOD PRESSURE VALUES IN OBESE CHILDREN
Authors: Tagetti Angela , Danese Elisa , Pucci Mairi , Minuz Pietro , Antoniazzi Franco , Maffeis Claudio , Fava Cristiano 
Published: April 2021

Abstract

Objective:
Obesity is considered a pseudo-Cushing state and often elevated levels of cortisol and its metabolites can be found; however, the relationship between cortisol metabolites and blood pressure (BP) in obese children is understudied. 11b-hydroxysteroid dehydrogenase type 2 (11b-HSD-2) catalyses the reversible conversion of physiological glucocorticoids (tetrahydrocortisol, THF and allo-tetrahydrocortisol, allo-THF) to inactive products (tetrahydrocortisone, THE). An increase in the THFs/THE ratio reflects 11b-HSD-2 impairment and has been associated with BP elevation. Ambulatory blood pressure monitoring (ABPM) provides an accurate measurement of BP during 24 hours. We aimed to investigate the relationship between BP measured by ABPM, urinary cortisol and its metabolites, in a sample of obese children.

Design and method:
50 obese children aged between 8 and 17 years (mean age 11.5 ± 3.3 years, 66% males), were included in the present study. Children underwent ABPM. Cortisol, sodium, THF, allo-THF and THE were measured on urinary 24-hour collection. Cortisol urinary metabolites were quantified by liquid chromatography tandem mass spectrometry (Nexera Shimadzu, 4500 MD Sciex).

Results:
The THF + alloTHF/THE ratio negatively correlates with 24-hours urinary sodium excretion (p = -0.346; r = 0.015) and to SBP and DBP load (% of measure of PAS > 130mmHg or % of PAD > 80mmHg) (respectively r = 0.283 p = 0.047 and r = 0,284; p = 0.046). No correlation between THFs/THE ratio and daytime or nighttime SPB or DBP were found. The sum of urinary cortisol and its metabolites, a gross index of relative excess of cortisol, is directly correlated with SBP load (r = 0.355; p = 0.029).

Conclusions:
In our sample of obese children, both the impaired activity of the 11b-HSD-2 and the amount of cortisol and its metabolites excreted by urine are associated with an excessive 24-h BP load. Reduced urinary sodium excretion mediated by increasing of THF/THE ratio could be involved.
THE OPTIMAL NIGHTTIME HOME BLOOD PRESSURE MONITORING SCHEDULE IN CHILDREN AND ADOLESCENTS: ASSOCIATION WITH AMBULATORY BLOOD PRESSURE AND PRECLINICAL ORGAN DAMAGE
Authors: Kollias Anastasios , Stambolliu Emelina , Bountzona Ioanna , Servos George , Vazeou Andriani , Stergiou George S. 
Published: April 2021

Abstract

Objective:
To evaluate the optimal schedule of nighttime blood pressure (BP) assessed by home monitoring (HBP) in children and adolescents in terms of agreement with nighttime ambulatory (ABP) and association with preclinical target-organ damage.

Design and method:
Apparently healthy children and adolescents (age 6–18 yeas) referred for elevated BP were subjected to (i) 24 h ABP monitoring (Microlife WatchBP O3), (ii) HBP monitoring during daytime (7 days, duplicate morning and evening measurements) and nighttime (3 nights, 3 hourly readings/night; Microlife WatchBP Home-N), (iii) carotid intima-media thickness (cIMT) measurement, (iv) carotid-femoral pulse wave velocity (PWV; Complior device; duplicate measurements), and (v) echocardiographic left ventricular mass index (LVMI).

Results:
49 children and adolescents were analysed (mean age 13.4 ± 2.7 years, 25 males, BMI 24.3 ± 4.9 kg/m2, 14 with 24 h ABP > 95th percentile).). There was no difference in nighttime HBP between the 3 nights (1st 109.7 ± 10.9/60.8 ± 7.3 mmHg, systolic/diastolic; 2nd 109.1 ± 11.7/59.7 ± 8.6; 3rd 109.1 ± 11.5/60.4 ± 8.4, p = NS). By averaging an increasing number of nighttime systolic HBP readings, there was a consistent trend towards stronger association of nighttime HBP with nighttime ABP (correlation coefficients r increased from 0.65 to 0.81), and with target-organ damage (for LVMI r increased from 0.21 to 0.30; cIMT from 0.38 to 0.57; PWV from 0.60 to 0.69). No further improvement in the associations was observed by averaging more than 4 nighttime HBP readings.

Conclusions:
In line with findings in adults, in children and adolescents 2-night HBP schedule (6 readings) appears to be the minimum requirement for a reliable assessment of nighttime HBP, which gives reasonable association with ABP and preclinical organ damage.
NOCTURNAL HOME VERSUS AMBULATORY BLOOD PRESSURE MONITORING IN CHILDREN AND ADOLESCENTS: FEASIBILITY AND PATIENTS PREFERENCE
Authors: Bountzona Ioanna , Stambolliu Emelina , Kollias Anastasios , Ntineri Angeliki , Servos George , Vazeou Andriani , Stergiou George 
Published: April 2021

Abstract

Objective:
To evaluate the feasibility of nighttime blood pressure (BP) assessed by home (HBP) monitoring in children and adolescents and compare with ambulatory (ABP) monitoring.

Design and method:
Apparently healthy children and adolescents (age 6–18 yeas) referred for elevated BP were subjected to (i) 24 h ABP monitoring (Microlife WatchBP O3), (ii) HBP monitoring during daytime (7 days, duplicate morning and evening measurements) and nighttime (3 nights, 3 hourly readings/night; Microlife WatchBP Home-N). Participants filled a questionnaire (Likert-type scale questions) evaluating the acceptance and compliance, stress, inconvenience, sleep disturbance, ease, feasibility, and preference regarding nighttime ABP and HBP monitoring. Score for each question ranged from 0 to 4 (4 indicating highest disturbance/difficulty).

Results:
84 subjects were analyzed (mean age 13.3 ± 2.8, BMI 25.2 ± 4.9 kg/m2, 49 males, 15 with 24 h ABP >  = 95th percentile). Nighttime HBP monitoring was feasible in all subjects (average number of monitoring nights 2.9 ± 0.4 [range 1–3] and nighttime HBP readings 7.9 ± 1.6 [range 2–9]). Participants reported a worse score regarding stress and inconvenience with nighttime ABP than HBP (1.2 ± 0.8 vs. 0.9 ± 0.7 respectively, p < 0.01), despite similar sleep disturbance (1.7 ± 1.4 vs. 1.6 ± 1.3, p = NS). 12% reported severe sleep disturbance with nighttime ABP and 8% with nighttime HBP. Worse ease and feasibility score was reported for nighttime ABP than HBP (1.3 ± 1.1 vs. 0.9 ± 1.0, p = 0.02). Optimal compliance with doctor's instructions was reported by 67% for nighttime HBP vs. 68% for ABP (p = NS). 74% reported that they prefer nighttime HBP versus ABP for their next assessment.

Conclusions:
These results indicate that in children and adolescents nocturnal HBP monitoring is feasible and tends to be superior to nocturnal ABP in terms of overall acceptance and preference.
COMMON HEART RHYTHMS AMONG SCHOOL CHILDREN IN ENUGU, SOUTH EAST NIGERIA
Authors: Okorie Pamela , Isiguzo Godsent , Anyaehie Bond 
Published: April 2021

Abstract

Objective:
The aim is to study the different heart rhythms among school children in Enugu Nigeria

Design and method:
This is a descriptive cross-sectional study of 341 apparently healthy children aged 6–12 years with no previous history of fits, fainting spells, dizziness and related illness. It involved interviewer-administered questionnaires, physical examination and ECG using a 12-lead ECG machine. All collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Values of p < 0.05 at 95% confidence interval were taken as significant.

Results:
None of the children had structural evidence of heart disease, and throughout the duration of the study, no abnormal events occurred. The prevalence of normal sinus rhythm was 79.1%, abnormal rhythm was seen in 20.9%. During the study, the following were recorded, premature complexes consist 8.44%; atrial tachycardia 5.64%; first degree atrioventricular block, 5.63%); bradycardia (2.82%) and incomplete right bundle block 2.82%.

Conclusions:
This study shows that abnormal rhythms are present amongst apparently healthy school children, and these could be missed without cardiovascular screening. With reported cases of sudden death during sports in children and young adults, it is important to encourage routine screening to aid early detection and prevention.
PREVALENCE OF HYPERTENSION IN ADOLESCENTS: DIFFERENCES BETWEEN 2016 ESH AND 2017 AAP GUIDELINES
Authors: Mule’ Giuseppe , Sorce Alessandra , Tranchida Valeria , Peritore Luigi , Cottone Santina 
Published: April 2021

Abstract

Objective:
The objective was to assess the differences about the prevalence of high blood pressure values in adolescents by applying the 2016 ESH and the 2017 AAP hypertension guidelines and analyze the relationship of pressure increases with lifestyles and potentially risky behaviors, which in Italy are little investigated.

Design and method:
Blood pressure levels of 1301 students aged between 13 and 20 were recorded. Two questionnaires were administered, one related to anamnestic data and anthropometric parameters and a second one, combined with the measurement of blood pressure, investigated the prevalence of hypertension and its relationship with lifestyle. Three blood pressure and heart rate measurements were taken and the average of these measurements was calculated. For the diagnosis of increased blood pressure both ESH and AAP criteria were considered. For the definition of the height centiles as well as for the BMI, reference was made to the tables produced by WHO 2007.

Results:
The main result concern the greater prevalence of high blood pressure values by applying new AAP criteria (14,8%)than ESH guidelines (7,5%).
In our study we found significant correlation of systolic values and anthropometrics variables: weight (r = 0,342) height (r = 0,321) and BMI (r = 0,318) in the entire population.
The condition of overweight in hypertensive subjects in comparison to normotensive was evident, while the prevalence of obesity despite being tendentially greater in hypertensives was not significantly higher. Higher SBP (systolic blood pressure) and DBP (diastolic blood pressure) values are associated with a higher mean heart rate (88 ± 18 bpm). No significant correlations was found with smoking, height and sex.

Conclusions:
At the best of our knowledge, this study is the first in our country, which investigates the prevalence of hypertension in adolescents, after the publication of 2017 AAP guidelines. Results shows how hypertension is not a rare phenomenon in this age group and confirm that it deserves more attention and following studies.
PREMATURE AND FAVORABLE VASCULAR AGING IN YOUNG PEOPLE TAKING INTO ACCOUNT BLOOD PRESSURE
Authors: Evsevyeva Maria , Rostovtseva Maria , Fursova Elena , Rusidi Anjelika , Shtsetinin Evgenij 
Published: April 2021

Abstract

Objective:
Features of vascular aging in young people have been studied very poorly to date. Meanwhile, increased vascular stiffness is regarded by experts as a realized risk factor. Purpose was to assess the representation of different variants of elastic vascular potential in young people depending on the level of blood pressure and taking into account sex.

Design and method:
243 freshmen students including 81 boys and 162 girls were examined on the basis of the Health Center of StSMU within the framework of the National Preventive Project University is Territory of Health. All the examined patients were divided into quartile groups according to such an indicator of vascular stiffness as cardiovascular vascular index or CAVI, which was determined using the diagnostic complex VaSera-1500, Fucuda Denshia, Japan. According to some experts, the fourth quartile of this distribution corresponds to early vascular aging or EVA syndrome. The first quartile corresponds to favorable vascular aging. Then the representation of carriers of prehypertension (PH) and arterial hypertension (AH) in each of the four quartile groups was analyzed. The same analysis was carried out among carriers of normotension and hypotension. Data processing was carried out using the software package Statistica 10.0, StatSoft Inc, USA.

Results:
The representation of both boys and girls with normal and reduced blood pressure is slightly higher in the first quartile CAVI-group. The representation of young men with increased blood pressure is also somewhat greater in the first quartile CAVI-group. The bulk of girls with high blood pressure is represented in the first and second quartile CAVI-groups.

Conclusions:
Among freshmen with different levels of blood pressure there are carriers of different variants of elastic vascular potential. At the same time, regardless of the BP level, carriers of favorable vascular aging dominate among young people. Cases of premature vascular aging also occur among individuals with any level of blood pressure. This suggests the need for an optimized approach to the formation of youth groups of cardiovascular risk, taking into account not only traditional risk factors such as hypertension, but also the characteristics of vascular elastic status.
OBESITY, HYPERTRIGLYCERIDAEMIA AND ENDOTHELIAL DYSFUNCTION ARE RISK FACTORS OF HYPERTENSION IN SOUTH AFRICAN ADOLESCENTS
Authors: Engwa Godwill , Letswalo Prescilla , Nkeh-Chungag Benedicta 
Published: April 2021

Abstract

Objective:
Obesity, dyslipidaemia, endothelial dysfunction and chronic low-grade inflammation are suggested to be risk factors of hypertension in adolescents. Though reports suggest relationship between hypertension and endothelial dysfunction, the exact role of the former in hypertension has not been clarified. Thus, this study assessed the relationship between hypertension, metabolic syndrome and vascular function in South African adolescents.

Design and method:
Two hundred and thirty four adolescents (234) aged 13–16 years were recruited from schools around Mthatha, an under-privileged area of South Africa. Measures of obesity, lipid profile as well as endothelial function indices (PWV, nitric oxide (NO) and asymmetric dimethyl arginine (ADMA)) were determined and assessed for association with blood pressure parameters.

Results:
More than one third of adolescents, both males and females, were pre-hypertensive or hypertensive (39%) and obese (32%). Almost half of all adolescents were identified as being at risk of hypertension, either through obesity or hypertriglyceridemia as these measures were significantly higher (p less than 0.05) in pre-hypertensive/hypertensive (pre-HT/HT) subjects compared to normotensive subjects. More so, pre-HT/HT was associated with measures of obesity. Endothelial dysfunction may have influenced pre-HT/HT and vice versa as PWV greater than 50 percentile was associated with SBP while ADMA was associated with DBP. On the other hand, pre-HT/HT was associated with NO. PWV and ADMA both showed and independent relationship with hypertension.

Conclusions:
This finding suggests that obesity, hypertriglyceridemia and endothelial dysfunction are risk factors of hypertension in Adolescents living in Mthatha. Hence the need for lifestyle changes to prevent development of cardiovascular diseases later on in life.
CONCENTRATION OF ACTIVE RENIN IN CHILDREN WITH PRIMARY HYPERTENSION
Authors: Skrzypczyk Piotr , Pers Anna , Nowak Magdalena , Wronska Malgorzata , Szyszka Michal , Stelmaszczyk-Emmel Anna , Panczyk-Tomaszewska Malgorzata 
Published: April 2021

Abstract

Objective:
Renin-angiotensin-aldosetone system (RAAS) is a key player in regulation of blood pressure, vascular resistance, and fluid and electrolyte balance. Thus, activation of RAAS is considered as one of potential steps in development of primary hypertension (PH). Literature data suggest that active renin (AR) concentration is a precise marker of RAAS activation. The objective of the study was to assess the AR concentration in children with primary hypertension.

Design and method:
In this single-center cross-sectional study we evaluated AR [pg/mL], BMI Z-score, peripheral and central pressure, blood pressure in ABPM, biochemical parameters, ultrasonographic kidney image and arterial damage (cIMT, AIx75HR, PWV, elasticity of common carotid artery by E-tracking) in 98 children with PH (14.83 ± 2.92 years) and 45 healthy children.

Results:
Children with PH compared to healthy children had significantly higher: AR concentration (median: 34.3 [IQR:24.38–64.94] vs. 24.94 [IQR:16.81–34.32] [pg/ml], p < 0.001), BMI Z-score, peripheral and central blood pressure, blood pressure in ABPM, also cIMT, PWV, and uric acid and triglycerides concentrations. In the whole group of 143 children AR correlated significantly (p < 0.05) with office systolic (r = 0.24) and diastolic (r = 0.22) blood pressure, neutrophil count (r = 0.17), total (r = 0.20) and HDL (r = 0.20) cholesterol, heart rate (r = 0.17) and systolic pressure load in ABPM (r = 0.19); in 98 children with PH AR correlated also with number of hypotensive drugs (r = 0.42) and right and left kidney length (r = -0.23; r = -0.25); in 51 children with newly diagnosed PH also with ABPM MAP 24 h Z-score (r = 0.35) and central mean pressure (r = 0.41). In children with newly diagnosed PH AR in patients with isolated systolic hypertension was significantly lower compared to patients with systolic and diastolic hypertension (26.16 [IQR: 18.60–34.16] vs. 37.79 [IQR:27.03–49.58], p = 0.014) and did not differ from AR in healthy children.

Conclusions:
In this single-center cross-sectional study we evaluated AR [pg/mL], BMI Z-score, peripheral and central pressure, blood pressure in ABPM, biochemical parameters, ultrasonographic kidney image and arterial damage (cIMT, AIx75HR, PWV, elasticity of common carotid artery by E-tracking) in 98 children with PH (14.83 ± 2.92 years) and 45 healthy children.
RESISTANT ARTERIAL HYPERTENSION AND ARTERIAL STIFFNESS IN HYPERTENSIVE RENAL TRANSPLANTATION RECIPIENTS SUFFERING FROM PERIODONTITIS
Authors: Oreskovic Josip , Kovacevic Katja , Vuckovic Marijana , Raos Hrvoje , Roguljic Marija , Gelemanovic Andrea , Radic Josipa 
Published: April 2021

Abstract

Objective:
Previous studies showed a positive correlation between periodontitis, a chronic inflammation of gingival tissue, and arterial hypertension (AH), which is one of the main risk factors for cardiovascular diseases. The aim of this study was to evaluate the prevalence of resistant AH (RAH) and difference in parameters of arterial stiffness, blood pressure and body composition among hypertensive RTCs with periodontitis with special focus on RAH.

Design and method:
A comprehensive medical and periodontal examination was performed and for each RTR data was collected on various biochemistry and anthropometry.
To measure arterial pressure (both peripheral and central, systolic and diastolic) and parameters of arterial stiffness (pulse wave velocity (PWV) and augmentation Index (AIx)) Agedio B900 device was used. Tanita MC780 Multi Frequency segmental body composition analyser was used to measure content of body fat, muscle mass and visceral fat each study subject. Oral periodontal status included full mouth plaque score (FMPS), full mouth bleeding score (FMBS), periodontal probing depth (PPD) and clinical attachment loss (CAL), all measured at six sites of each tooth.

Results:
Out of 55 RTRs suffering from periodontitis, 45 (82%) had AH, out of which 31 (69%) had resistant AH (RAH). Those RTRs with periodontitis and RAH have statistically higher value of glucose (P = 0.007), PWV (P = 0.008) and AIx (P = 0.050). Two groups of patients did not show any statistically significant difference in other measured parameters (e.g. body composition and blood pressure parameters, etc.).

Conclusions:
Our study showed high incidence of RAH among hypertensive RTRs suffering from periodontitis. Also those patients with RAH had higher arterial stiffness. Results are suggesting that this patient population is especially vulnerable, which could lead to increased morbidity and mortality. Further studies are required to infer causality between periodontitis and AH.
ANALYSIS OF THE RELATIONSHIP OF COMORBID PATHOLOGY AND CORONARY DISEASES IN ACUTE MYOCARDIAL INFARCTION
Authors: Oralbekova Zhanar , Berkinbaev Salim , Junusbekova Gulnara , Tundybaeva Meiramgul , Utebaliyeva Dariya , Mamedguliyeva Zhannat , Leonovich Tatyana , Kabdulkaeva Aliya , Abenova Aliya , Kodasbaev Almat , Iskakova Gaukhar 
Published: April 2021

Abstract

Objective:
To identify the relationship of comorbid pathology and the degree of coronary lesion.

Design and method:
A retrospective analysis of cases of acute myocardial infarction (AMI) was carried out in 4 cardiology departments of the “City Cardiology Center” in Almaty (CCC) this year.

Results:
During the study period, 148 patients with AMI were treated, mainly men — 59.4% (88), the average age of the patients was 61.3 ± 7.8 years (p -0.0001), with the following average level of LDL-4.013 - mol / l and a preserved ejection fraction - average 52.375%. The most common comorbid pathologies were hypertension in 83.7% (124), diabetes mellitus (DM) 25% (37), chronic kidney disease (CKD) 25.6% (38), and cardiac arrhythmias (LDCs) 8.7% (13), COPD in 2.7% (4), and 38.9% (59) other diseases (gastrointestinal tract, thyroid gland, anemia, etc.). It was determined that according to the Charlson comorbidity index, these were mainly in 51.3% (76) cases - more than 8 points, which correspond to a very high risk of an unfavorable prognosis, in the remaining 26.3% (39) and 21.6% (32) cases high and moderate risk, respectively. It was revealed that only 4 patients had no comorbid pathology, while they were younger than 45 years old, had these risk factors: burdened heredity, smoking and dyslipidemia. 18.2% (4) cases had 1–2 concomitant pathology 37.1% (55), a combination of 3–4 comorbid pathologies was detected in 45.9% (68), 5 and more met 14.3% (21 cases).
By the results of coronarography, the most common multivascular lesion of the coronary vessels - 62.1% (92), single-vascular lesion - 27.7% (41), stem lesion - 10.2% (15). According to the linear regression analysis, a reliable relationship between the presence of a combined pathology of more than two nosological forms and a multivascular lesion of the coronary bed, especially the combination of AH + DM, AH + SD_KHB, was revealed (p < 0.05).

Conclusions:
The most common nosological forms of comorbid pathology were determined, the relationship between combined pathology and multivascular coronary lesion in patients with AMI in the conditions of the cardiological department of the CCC was revealed.