bluuebunny/crossref_metadata_2025_split huggingface dataset:
MORNING BLOOD PRESSURE SURGE POWER IS A BETTER PREDICTOR OF CARDIOVASCULAR DEATH OR EVENTS IN THE OHASAMA POPULATION THAN PRE-AWAKE VERSUS POST-AWAKE MEASURES
Authors: Head Geoffrey , Sata Yusuke , Ohkubo Takayoshi , Kikuya Masahiro , Imai Yutaka , Lukoshkova Elena 
Published: April 2021

Objective:
The morning surge in blood pressure has been associated with increased cardiovascular risk. However, there has been no direct comparison to determine which method has the best prognostic value. The Ohasama study with 1522 participants, 126 cardiovascular deaths and 165 events was used to compare different methods of calculating the morning blood pressure surge (MBPS).

Design and method:
After adjustment for age, mean 24-hr mean BP, smoking, body mass index, sex and antihypertensive therapy, we calculated i) Cosinor curve amplitude ii) Day-night difference iii) MBPS 1 (2 hours Post-awake minus pre-awake) iv) MBPS 2 (2 hours post awake minus night minimum) v) morning rate of rise (RoR) and vii) morning surge power (rate x amplitude). The latter 2 are calculated using a logistic equation (Am Hypertens 2010;23:1074–1081). The outcome of combined cardiovascular events including death and non-fatal events were distributed into quintiles according to each MBPS measure and linear and quadratic trends determined as an indicator of a predictive ability.

Results:
Cosinor curve amplitude for between quintiles, linear and quadratic trends were P = 0.036,P = 0.122 and P = 0.257. Day-night difference for between quintiles, linear and quadratic trends were P = 0.113, P > 0.5 and P = 0.087. MBPS 1for between quintiles, linear and quadratic trends were P = 0.083, P > 0.5 and P = 0.074. MBPS 2 for between quintiles, linear and quadratic trends were P = 0.013, P = 0.34 and P = 0.068. Morning Power for between quintiles, linear and quadratic trends were P = 0.001, P = 0.244 and P = 0.035. MBPS1 and day night difference did not predict cardiovascular events. Cosinor amplitude and MBPS 2 showed differences between quintiles mainly due to high risk in the lowest quartile in which participants had little nocturnal dipping. By far the strongest predictor was morning BP power which showed a U-shaped relationship with combined cardiovascular events. We also observed a high correlation between adjusted morning power and MBPS1 (r = 0.50) and also with MBPS2 (r = 0.45) suggesting that these measures are reflecting some similar aspects of the morning surge.

Conclusions:
We conclude however, that the morning BP power is a superior and valuable predictive measure of cardiovascular risk even after adjustment for cofounders.
ABDOMINAL AORTIC CALCIFICATION IN ALDOSTERONE PRODUCING ADENOMA AND IDIOPATHIC HYPERALDOSTERONISM
Authors: Shibayama Yui , Wada Norio , Baba Shuhei , Obara Shinji , Sakai Hidetsugu , Usubuchi Hiroaki , Terae Satoshi , Kameda Hiraku , Nakamura Akinobu , Atsumi Tatsuya 
Published: April 2021

Objective:
Aldosterone promotes vascular calcification, which leads to atherosclerosis and eventually cardiovascular disease via enhancing vascular osteoinductive signaling, oxidative stress, inflammation and apoptosis. As an independent prediction of coronary artery disease (CAD), abdominal aortic calcification has been useful as well as coronary artery calcification. It has been shown that patients with aldosterone producing adenoma (APA) have higher rate of CAD comparing patients with idiopathic hyperaldosteronism (IHA) at the diagnosis of primary aldosteronism (PA). However, no data have shown whether the degree of abdominal aortic calcification is different between APA and IHA. We aimed to clarify the degree of abdominal aortic calcification in each subtype of PA.

Design and method:
This retrospective observational study comprised 170 patients diagnosed with PA. We divided participants into APA (n = 48) and IHA (n = 132), according to the results of adrenal venous sampling (AVS) and pathological findings. Aortic calcification index (ACI) was evaluated by unenhanced abdominal computed tomography, focusing around the left renal artery and scanning 10 times at 10-mm intervals.

Results:
Age was not different between the two subtypes (p = 0.47). Duration of hypertension and plasma aldosterone concentration were significantly higher in APA than IHA (p < 0.001, p < 0.001, respectively). Neither smoking ratio, HbA1c, LDL-cholesterol, nor eGFR was different between the two subtypes (p = 0.86, p = 0.49, p = 0.20, p = 0.47, respectively). The percentage of patients with ACI > 1 was significantly higher in APA than IHA (APA vs. IHA; 17/48 (35.4%) vs. 25/132 (18.9%), p = 0.03). In patients with ACI > 1, ACI was correlated with duration of hypertension in both subtypes of PA (APA; r = 0.62, p = 0.01, IHA; r = 0.49, p = 0.02).

Conclusions:
Abdominal aortic calcification was progressed in APA than IHA. This result was concordant with higher rate of CAD in APA than IHA. In both subtypes of PA, patients with longer duration of hypertension tended to coexist abdominal aortic calcification, demonstrating an importance of early diagnosis and treatment before developing to aortic calcification in either subtype of PA.
HIGH LEVEL OF PLASMA ALDOSTERONE AFTER SALINE INFUSION TEST IN COMBINATION WITH FINDING OF ADRENAL NODE ON CT SCAN CAN PREDICT ALDOSTERONE-PRODUCING ADENOMA MORE PRECISE THAN FINDING OF NODE ALONE
Authors: Holaj Robert , Kvasnicka Jan , Rosa Jan , Zelinka Tomas , Petrak Ondrej , Strauch Branislav , Kratka Zuzana , Indra Tomas , Forejtova Lubomira , Kavan Jan , Waldauf Petr , Widimsky Jiri 
Published: April 2021

Objective:
Idiopathic aldosteronism due to bilateral hyperplasia and unilateral aldosterone-producing adenoma of adrenal gland are two main forms of primary aldosteronism. The discrimination between unilateral and bilateral aldosterone overproduction is crucial for an appropriate management of patients with primary aldosteronism. This study tests the reliability of plasma aldosterone after the postural stimulation test and after the saline infusion test in combination with finding of adrenal node on CT scan for the identification of these two common forms of primary aldosteronism.

Methods:
One hundred and fifty patients with laboratory diagnosis of primary aldosteronism (96 patients with confirmed diagnosis of aldosterone producing adenoma and 54 patients with idiopathic aldosteronism were enrolled into the study. All of patients underwent CT scan, the postural stimulation test, the saline infusion test and adrenal venous sampling.

Design and method:
Plasma aldosterone concentration in the supine or in the standing position and after the saline infusion were higher in patients with aldosterone-producing adenoma than in those with idiopathic aldosteronism (P < 0.001; P < 0.01 and P < 0.001, respectively). The largest area under the curve = 0.83 (for a cut-off of 165 ng/l) suggesting the diagnosis of unilateral aldosterone overproduction was found for finding of adrenal node on CT scan in combination with plasma aldosterone concentration after the saline infusion test with a sensitivity of 83%, specificity of 61%, positive-predictive value of 79% and negative-predictive value of 67%.

Results:
The study found that the value of plasma aldosterone concentration ?165 ng/l after the saline infusion test in combination with finding of node on CT scan can predict aldosterone-producing adenoma more precise than finding of node alone, nevertheless, results of adrenal venous sampling remain to be crucial in the identification of two common forms of primary aldosteronism. The study found that the value of plasma aldosterone concentration ?165 ng/l after the saline infusion test in combination with finding of node on CT scan can predict aldosterone-producing adenoma more precise than finding of node alone, nevertheless, results of adrenal venous sampling remain to be crucial in the identification of two common forms of primary aldosteronism.
ADDITIONAL VALUE OF OXIDATIVE STRESS-RELATED SKIN CHANGES IN CARDIOVASCULAR RISK MANAGEMENT
Authors: Voicehovska Julija , Janovska Jana , Skesters Andrejs , Voicehovskis Vladimirs , Silova Alise , Kisis Janis , Lejnieks Aivars 
Published: April 2021

Objective:
Oxidative stress (OS) associated with Metabolic syndrome (MetS) is one of the important focuses of recent research related to pre-diabetes, diabetes and cardiovascular diseases (CVD) risk prediction. OS supports a chronic inflammatory reaction in the skin. Associations among OS biomarkers, malondialdehyde (MDA) and superoxide dismutase (SOD) levels, as well as skin alterations

Design and method:
The prospective study of random, age- and sex-stratified population sample was conducted during 2017–2018 at the Department of Internal Medicine, Riga Stradins university, Latvia. Detailed examination of the skin for the presence of acanthosis nigricans, Lentigines, Seborrheic keratosis, Actinic keratosis, Aging wrinkles, Gravity wrinkles, Teleangiectasias was performed. Skin biopsy assessment has been performed as well. Serum MDA and SOD were measured by RANSOD, Randox

Results:
Statistical analysis (SPSS 21.0 for Windows) showed a direct linear relationship (Positive Pearson correlation, Chi-square test, p < 0.05) between skin alterations and intensity of MDA and SOD. Increased MDA(p < 0.05) was associated with Lentigines, Seborrheic keratosis, Actinic keratosis, Aging wrinkles, Gravity wrinkles. tracellular matrix degradation correlates with increased MDA activity.
MDA and SOD levels appear to be linked to several skin manifestations of MS
Increased SOD was associated with Lentigines and Seborrheic keratosis.

Conclusions:
Skin alterations associated with elevated MDA and SOD levels could become a convenient characteristic additionally to routine cardiovascular risk assessment. Clinical add-on value of MDA and SOD as early biomarkers seems to be relevant significant in individualized CVD risk management. Such approach could help to identify apparently healthy patients among those who already have clinical damages caused by metabolic disorders, whilst prevention is still effective.
We believe that our clinical study will contribute to the essential process of evidenced based practice and would help to guide anti-aging treatment decisions for both health care professionals and patients.
ASSOCIATION RELATIVE TELOMERE LENGTH AND TELOMERASE ACTIVITY WITH LIFESTYLE RISK FACTORS IN HYPERTENSIVE PATIENTS
Authors: Pavlova Olga , Ogurtsova Svetlana , Karabko Irina , Barbuk Olga , Liventseva Maria , Mrochek Alexander 
Published: April 2021

Objective:
To determine association relative telomere length (RTL) and telomerase activity with lifestyle risk factors in hypertensive patients (pts) and normotensive individuals.

Design and method:
80 people (34 hypertensive patients and 46 normotensive individuals) were examined. Mean age of hypertensive pts was 55.5 ± 8.7 and of normotensives was 49.7 ± 9.9 years. Smoking status, alcohol abuse, level of physical activity, body mass index, waist circumference, presence of obesity, dietary habits, blood pressure (BP), glucose and cholesterol levels, depressive episodes and psychological stress were evaluated. Arterial stiffness performed by volume sphygmography with assessing cardio-ankle-vascular index (CAVI) and ankle-brachial index. The RTL of peripheral blood leukocytes performed by previously validated real-time PCR. Telomerase activity was determined by enzyme immunoassay.

Results:
The association was found between RTL and CAVI (r = −0.414; p = 0.021) in the group of hypertensive pts. However, there were no association with age, levels of glucose and cholesterol, BP, obesity, diet and psychological risk factors. Sedentary work was related with shortening RTL in hypertensive patients (p = 0.043) and in normotensives (p = 0.003). Telomerase activity was related with fruit consumption (r = 0.520; p = 0.004) in hypertensive patients. Among normotensives telomerase activity was associated with consumption of fish (r = 0.344; p = 0.024) and vegetables (r = 0.302; p = 0.004). In hypertensive patients and in normotensives also was found trend toward relation between telomerase activity with dietary salt (r = −0.312; p = 0.08 and r = −0.270; p = 0.07, accordingly).

Conclusions:
The data suggests that lifestyle risk factors such as sedentary work and rare fruit consumption can influence on RTL and telomerase activity in hypertensive pts as well as sedentary work, low intake of fish and vegetables in normotensive people.
THE POSITIVE EFFECT OF MOXONIDINE ON TELOMERASE ACTIVITY
Authors: Eruslanova Kseniia , Dudinskaya Ekaterina , Bazaeva Ekaterina , Tkacheva Olga 
Published: April 2021

Objective:
To estimate the effect of moxonidine versus bisoprolol on cellular senescence processes in postmenopausal women with arterial hypertension (AH).

Design and method:
There was an open randomized control study. The study group was represented by 56 women with AH and a mean age of 63 ± 9.217 years, with SBP of 146.72 ± 7.127 mm Hg and DBP of 84.38 ± 7.941 mm Hg, who received moxonidine treatment (average dose 0.515 mg/day [0.4; 0.6]) for 12 months. The control group was comprised of 59 female patients with AH and a mean age of 61 ± 9.117 years, with SBP of 145.59 ± 6.102 mm Hg and DBP of 86.18 ± 6.682 mm Hg, who received treatment with bisoprolol (average dose 5.0 mg/day [5.0; 7.5]) for 12 months. For all patients, the measurement of telomerase activity was performed using genomic DNA real-time PCR at baseline and after 12 months of treatment. Statistical analysis was carried out using the SPSS/PASW Statistics software (version 18, SPSS Inc., Chicago, Illinois, USA).

Results:
In both groups there was a substantial and significant BP reduction, in the moxonidine treatment group: SBP – 126.93 ± 8.086 mm Hg (p < 0.001), DBP – 73.64 ± 7.522 mm Hg (p < 0.001); in the bisoprolol treatment group: SBP – 125.83 ± 8.097 mm Hg (p < 0.001), DBP – 73.31 ± 7.964 mm Hg (p < 0.001). Patients from the moxonidine treatment group demonstrated a significant reduction of body weight, on average, by 1.89% (from 75.7 ± 12.77 kg to 74.5 ± 11.7 kg,p < 0.001) and of BMI (from 29.359 ± 4.7 kg/m2 to 28.6 ± 4.4 kg/m2, p < 0.001). By contrast, in the bisoprolol treatment group patients’ average body weight increased by 2.22% (from 76.655 ± 13.754 kg to 78.13 ± 13.728 kg, p < 0.001) as well as BMI (from 29.037 ± 4.6 kg/m2 to 29.609 ± 4.7 kg/m2, p < 0.001).
TA in the moxonidine treatment group increased from 0.87 [0.16; 1.18] to 1.1 [0.74; 1.5] (p < 0.001), and, conversely in the bisoprolol treatment group TA decreased from 1.1 [0.5; 1.6] to 0.94 [0.56; 1.5] (p < 0.001).

Conclusions:
The preliminary data suggests that moxonidine can be used as telomerase activator and effective geroprotective agent. Increased TA against the backdrop of moxonidine treatment may be explained by increased insulin sensitivity, decreased body weight, and, consequently, lower intensity of chronic inflammation.
ATRIAL FIBRILLATION INFLUENCE ON LEFT VENTRICULAR FUNCTION IN HYPERTENSIVE PATIENTS WITH PRESERVED EJECTION FRACTION
Authors: Petre Ioana , Diaconeasa Alexandra , Onciul Sebastian , Iancovici Silvia , Zamfir Diana , Onut Roxana , Stoian Monica , Scarlatescu Alina , Vijiiac Aura , Fronea Oana Gheorghe , Dorobantu Maria 
Published: April 2021

Objective:
Atrial fibrillation(AF) may affect left ventricular function, causing abnormal diastolic filling and variable degrees of systolic abnormality. We tried to find the influence of AF on left ventricular function in a group of hypertensive patients with preserved ejection fraction.

Design and method:
108 subjects were prospectively enrolled. All had a history of essential hypertension(HTN), without any other important comorbidity and with preserved ejection fraction(LVEF>50%). 67 patients without any history of arrhythmia formed group one(group HTN) and 41 subjects with a recent AF episode, but in sinus rhythm at the enrollment, group two(group HTN and AF). By performing a standard echocardiography, we evaluated LV mass, LV ejection fraction, diastolic function and LA maximal volume. Also, global longitudinal strain of left ventricle(GLS) was analyzed, using the current recommendations of speckle tracking method.

Results:
In arrhythmia group, we observed a longer history of HTN diagnosis(62.2 versus 40.4months, p = 0.04) and a more severe form of HTN(grade 3 HTN for 48.8 % patients). LV ejection fraction, though normal, was lower in group2 (58.44% versus 60.75% in HTN group, p = 0.02). Also, GLS was more affected in group2 in comparison with group1, suggestive for a mild myocardial dysfunction(-16.71% in group 2 versus -18.85% in group1, p = 0.02). We found a greater diastolic dysfunction in AF patients based on mitral E/A ratio(p = 0.04) and smaller values of A’ septal and lateral velocity(p < 0.0001 and p = 0.002) in this group.

Conclusions:
Even paroxysmal or persistent types of AF can cause an incipient form of LV systolic dysfunction and diastolic dysfunction in asymptomatic hypertensive patients with preserved left ventricular ejection fraction.
IS TAILORED ANTICOAGULATION MANAGEMENT FEASIBLE IN PATIENTS WITH ARTERIAL HYPERTENSION AFTER THEIR FIRST CLINICAL ECG-DOCUMENTED PAROXYSMAL ATRIAL FIBRILLATION EPISODE?
Authors: Papakonstantinou Panteleimon , Simantirakis Emmanuel , Kanoupakis Emmanuel , Parthenakis Frangiskos , Vardas Panos 
Published: April 2021

Objective:
Long-term anticoagulation therapy is usually recommended for most of the patients with hypertension as the CHA2DS2-VASc score is at least 1. However, this is to some extent arbitrary, because it is not known if these patients will continue to present AF episodes. Furthermore, recent data showed that only AF episodes with a duration >24 hours increased significantly the risk of ischemic stroke. We tested the hypothesis whether the identification of the exact natural course of AF would have a favorable impact on AF-personalized anticoagulation, by facilitating the selection of patients in need of antithrombotic treatment on the basis of their AF recurrence profile.

Design and method:
Consecutive patients who received an implantable loop recorder-ILR (Reveal XT 9529; Medtronic, Minneapolis, Minnesota, USA) after their first ECG-documented symptomatic episode of paroxysmal AF were enrolled. Low recurrence rate and short durations episodes of the arrhythmia was defined as <5 AF episodes/year and </=24 h AF episodes respectively.

Results:
Thirty (30) consecutive patients (mean age 66.9 +/− 10 years; 14 men); 25/30 (83.3%) with arterial hypertension, were included in the study. The follow-up period lasted for 34,63 +/− 2,96 months after the implantation of the ILR. The mean CHA2DS2-VASc score was 2.83 ± 1.66. Three patients (10%) had no AF recurrence, while 4 patients (13.3%) presented only one episode during the three-year follow-up period. Almost half of the patients (46.7%) had a low recurrence rate (<5 episodes/year), while the majority of patients (19/30) suffered from episodes with maximum duration of </=24 h. Eleven patients (36.7%) presented either no episode or a low recurrence rate with episodes lasting </=24 h.

Conclusions:
A significant percentage of patients either suffer 0–1 AF recurrence (23.3%) after their first episode or show a low recurrence rate (46.7%). Most patients present episodes of short duration (<24 h). If these findings are confirmed by larger studies, they could have an impact in the strategy towards a more personalized approach, in the long-term AF anticoagulation management, especially in the era of non-Vitamin K antagonists and devices that provide long-term cardiac rhythm monitoring.
BLOOD PRESSURE AT ADMISSION PREDICTS SHORT-TERM AND LONG-TERM CLINICAL OUTCOMES IN PATIENTS HOSPITALIZED FOR HEART FAILURE
Authors: Huang Xinghe , Liu Jiamin , Hu Shuang , Li Jing 
Published: April 2021

Objective:
Hypertension is the leading risk factor for the development of heart failure (HF). However, the association between admission blood pressure (BP) and clinical outcomes in patients hospitalized for HF remains uncertain. The study aimed to investigate the association between BP at admission and 1-month, 6-months and 1-year clinical outcomes in patients hospitalized for HF.

Design and method:
This study was based on the China PEACE Prospective Heart Failure Study, which prospectively enrolled 4,930 patients hospitalized primarily for HF in 52 hospitals from 20 provinces in China. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at admission were categorized by 10 mmHg increments. The outcomes were the composite of all-cause death or HF readmission within 1 month, 6 months and 1 year after admission. The association between BP at admission and the outcomes was estimated with Cox proportional hazards models, adjusted by age, gender, insurance type, etiology, cardiovascular risk factors, comorbidities, clinical presentation, patient reported health status and medications during hospitalization.

Results:
We included 4,841 HF patients with available admission BP and 1-year follow up data. The mean age was 65.1 ± 13.5 years, 37.4% were female, and the mean admission BP was 133.2 ± 24.6/81.0 ± 16.0 mmHg. Compared to patients with SBP of 120–129 mmHg, patients in the lower SBP groups had higher risk of 1-year outcome (the adjusted HR 1.41, 95% confidence interval (CI) 1.19–1.66 for SBP< 110 mmHg and HR 1.29, 95% CI 1.09–1.54 for SBP of 110–119 mmHg) (Table 1). A significant decrease in the risk of 1-year outcome was observed for DBP of 80–89 mmHg (HR 0.87, 95% CI 0.76–0.99), 90–99 mmHg (HR 0.83, 95% CI 0.71–0.98) and > = 100 mmHg (HR 0.71, 95% CI 0.59–0.85) compared with DBP of 70–79 mmHg (Table 1). Similar results for SBP and DBP for outcomes at 1 month and 6 months have been observed in Table 1.

Conclusions:
In patients hospitalized for HF, admission SBP and DBP predict 1-month, 6-month, and 1-year clinical outcomes after adjusting for known confounders.