bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON AND IMPLICATION OF THE CONTEMPORARY BLOOD PRESSURE GUIDELINES ON KOREAN POPULATION
Authors: Cho So Mi Jemma , Lee Hokyou , Kim Hyeon Chang 
Published: April 2021

Objective:
With continued effort to provide optimal prevention and management of high blood pressure (BP), we compared the potential impact on prevalence of hypertension, recommended antihypertensive treatment, and achievement of target BP according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 Korean Society of Hypertension (KSH) guidelines.

Design and method:
We analyzed the 2007–2017 Korea National Health and Nutrition Examination Survey data to calculate guideline-specific hypertension prevalence and treatment implications on adults aged 20 years or older by sex, age, and atherosclerotic cardiovascular disease risk.

Results:
The prevalence of hypertension was markedly higher 46.3% (95% confidence interval (CI) 45.6–46.9) by the ACC/AHA guideline due to the lowered BP cutoff than 25.9% (95% CI 25.4–26.5) by the KSH guideline; the increase was most pronounced in young adults. Yet, when incorporating age, atherosclerotic cardiovascular risk, comorbidity/target organ damage, there was only a marginal 1.6% (95% CI 0.9–3.0) increase in the percentage of adults who are suggested pharmacological approach by the ACC/AHA guideline, notably in the eldest subgroup. In addition, 45.6% (95% CI 44.4–46.8) of Korean adults currently undergoing antihypertensive treatment would fail to satisfy BP goal according to the 2018 KSH guideline, which would extend to 61.7% (95% CI 60.5–62.9) of participants according to the 2017 ACC/AHA guideline; the underachievement was contributed primarily by the younger subgroup.

Conclusions:
Despite a considerable increase in the prevalence of hypertension, the adoption of ACC/AHA guideline, regardless of sex and age, would leave modest percentage increase in adults recommended for antihypertensive medication and similar percentage of suggestions for nonpharmacological interventions, otherwise suggested also by the KSH guideline. Yet, in adherence to the ACC/AHA guideline, over half of the treated individuals would fail to achieve target BP especially in younger adults, thereby be laden with more intensive antihypertensive treatment. Despite accumulated evidence suggesting substantial cardiovascular risk reduction benefit with rigorous pharmacological approach, BP management should consider comprehensive aspects of the intended target. Future studies should assess differences in subclinical cardiovascular incidence and the benefits of long-term primary prevention of hypertension by various BP cutoffs.
BLOOD PRESSURE PATTERN AND VARIATIONS IN A PREDOMINANTLY FARMING RURAL REGION IN SOUTH-WEST NIGERIA
Authors: Arije Ayodeji , Ajayi Ssamuel , Raji Yemi , Michael Obaro , Bello Nike , Adewole David , Abiola Busayo , Efuntoye Femi , Aminu Segun 
Published: April 2021

Objective:
The prevalence of high blood pressure in rural communities has been on the rise as reported in many previous studies. A number of factors are implicated in these studies including dietary habits, smoking and alcohol use. In this cross sectional descriptive study we evaluated blood pressure pattern in a predominantly farming rural region comprising three communities, as well as intercommunity variation of blood pressure.

Design and method:
A total of 572 rural dwellers were studied. An interviewer administered questionnaire was used to obtain information from the participants on socio-demographic data. Blood pressure was measured twice after 5 minutes interval in accordance with WHO guidelines. Height and weight were recorded for BMI calculation. Data was analysed using SPSS version 2018.

Results:
Four hundred and thirty three (76%) participants were not aware whether they were hypertensive or not, while 139 (24%) were aware and using medications. Only 47 (7.2%) of participants ever had their BP checked at home. Using the WHO cut-off of 140/90mmHg for the diagnosis of hypertension, 315 (55%) had normal BP <140/90; 134 (23%) had both systolic and diastolic BP above cut-off values, 98 (17%) had only systolic elevation, while 25 (4.4%) had only diastolic BP elevation. Among those with elevated systolic pressure alone (n = 98) 28 (28.6%), and 70 (71.4%) either knew they were hypertensive and using medications, or did not know and were not on any medication respectively. Similarly among those with elevated diastolic BP alone (n = 25) only 6 (24%) knew they were hypertensive and were on medications while 19 (76%) did not know they were hypertensive and were not on any medication. BMI did not vary significantly among the various communities, and did not show any significant effect on blood pressure in all the communities.

Conclusions:
The overall crude prevalence of high blood pressure in this study was high and seemed to be in consonance with some previous rural community studies. There is need for more intensified blood pressure awareness campaign and treatment services to rural community dwellers in Nigeria.
INPATIENT HYPERTENSION PREDICTS AMBULATORY HYPERTENSION IN PREVIOUSLY NORMOTENSIVE PATIENTS
Authors: Zanuzzi Matías Gabriel , Álvarez José Ignacio , Garay Sofía Belén , Peñaranda Gabriela Estefan , Romero César Andrés 
Published: April 2021

Objective:
To determine the prevalence of uncontrolled hypertension (HTN) in hospitalized patients.
To establish if uncontrolled hypertension during hospitalization impacts on the outcomes of the hospitalization.
To evaluate if in-hospital hypertension is a risk factor for diagnosis of ambulatory hypertension.

Design and method:
Retrospective, analytical and cohort study. All patients admitted to the general inpatient ward of the Hospital Privado Universitario de Córdoba (Argentina) between March 1st and April 30th, 2016 were analyzed. Blood Pressure (BP) values were recorded at admission, all measurements during the hospital stay, at discharge, at 1 month and 3 years after discharge. Inpatient HTN was defined through two different methods: (a) at least two BP measurements greater or equal to 140/90 mmHg on at least two different days; (b) average of all measurements during hospitalization greater or equal to 130/80 mmHg.

Results:
1073 patients were included. Mean age was 56.2 (18 - 95) years. 50.3% were female. 46.6% had previous HTN diagnosis, 88.4% were under treatment. The prevalence of the inpatient hypertension was 59.1% with method (a) and 27.5% with method (b). 62.9% did not receive specific treatment during hospitalization. Apparent HTN triggers were present in 22.8% of the patients. Patients with HTN during hospitalization had a longer stay (6.0 ± 5.1 vs. 4.7 ± 6.2 days; p < 0.01), doubling the risk of prolonged hospitalization (OR 1.77; [1.37 - 2.29]; p < 0.01). Among patients without history of HTN prior to hospitalization, having inhospital hypertension was associated with a higher risk of presenting outpatient hypertension at month (method a= RR: 3.38; [0.60 - 19.16]; p = 0.15 and method b = RR: 7.5; [1.32 - 42.5]; p = 0.03) and 3 years after hospitalization (method a = RR: 3.25; [1.15 - 9.20]; p: 0.02 and method b = RR: 3.34; [1.27 - 8.77]; p = 0.02).

Conclusions:
Despite the high prevalence of HTN during hospitalization most patients dońt receive specific treatment. The development of HTN is not conditioned only by factors inherent to hospitalization. Inpatient HTN is associated with a longer stay and predicts ambulatory HTN.
METABOLIC SYNDROME AMONG HYPERTENSIVE PATIENTS: PREVALENCE AND ASSOCIATED RISK FACTORS AMONG ADULTS OF SOUTHERN RAJASTHAN, INDIA
Authors: Verma Anjana , Patyal Ashish 
Published: April 2021

Objective:
The present study was designed to estimate the prevalence of metabolic syndrome and evaluate other associated risk factors among hypertensive adults of the southern part of Rajasthan, India.

Design and method:
A total of 2100 hypertensive patients were interviewed using a pretested and validated questionnaire about lifestyle practices and medical history. The diagnosis of Metabolic Syndrome (MS) was done using National Cholesterol Education Program – Adult Treatment Panel III criteria with an anthropometric modification of waist circumference (WC) value that is specifically applicable to South Asians. Hypertension (HTN) was diagnosed with BP over 130 and/or > 85 mm Hg, abdominal obesity (AO) according to waist circumstance (WC) > 90/80 cm men/women, hypertriglyceridemia (HTG) > 150 mg/dl, hyperglycemia > 110 mg/dl, decreased HDL < 40/50 mg/dl for men/women. Biochemical parameters (lipids and glucose) were measured using sphectrometry on COBAS (ROCHE) equipment. All calculations and statistical analyzes are processed by the SPSS 21.0.

Results:
The study subjects were 58% males and 42% females, with a mean age of 46.21 ± 9.40 years. Abdominal obesity was found in 57.3%, HTG 31.8%, hyperglycemia 32.6%, decreased HDL 29.2%, MS 31.4%. Diabetes prevalence was found to be 21.2% including 17% of known cases and 4.2% of new cases. Regarding the risk factors, 28.7 % were tobacco smokers; Physical inactivity 49%, more frequent in men than women (p = 0.04); Abdominal obesity was significantly higher in women; diabetes was associated with abdominal obesity and dyslipidemia in 59% of cases; 67.8% of subjects had at least three associated risk factors.

Conclusions:
Indian subcontinent has highest rates of CVDs worldwide. This study reveals high prevalence of metabolic syndrome as well as other risk factors. It is necessary to do nation wide surveys to formulate effective preventive strategies.
EPIDEMIOLOGY OF HYPERTENSION IN NORTH INDIA: A COMPREHENSIVE STUDY OF ANTHROPOMETRIC, DEMOGRAPHIC AND SOCIO-ECONOMIC FACTORS AFFECTING HYPERTENSIVE PATIENTS
Authors: Rastogi Smriti , Verma Narsingh , Patel Munnalal 
Published: April 2021

Objective:
To find out relation & effect of various anthropometric, demographic and socio-economic factors influencing blood pressure.

Design and method:
800 secondary hypertensives (18–60 years) from Medicine OPD, KGMU, Lucknow were studied for anthropometric measurements, 3 readings of blood pressure were taken in each arm (right and left) from OMRON HEM CR-24 BP monitor and average was calculated. Patients with Systolic Blood Pressure (SBP) greater than or equal to one hundred and forty mm Hg, Diastolic Blood Pressure (DBP) greater than or equal to 90 mmHg were enrolled. A sociodemographic, medical history proforma and Goldberg questionnaire (for depression) was filled. Place of residence (low/high population density), village/city, colony/individual house/apartment/multi storeyed building, park nearby/not, living with family/alone, vegetarian/ not, meal timings, alcohol & or tobacco intake, physical activity, meditation/yoga, office hours, self- driving/not, marital status, time spent on social media, exposure to artificial light, online gaming, frequency of fasting, pets, leisure hours,per month income, medical history, duration and quality of sleep was recorded.

Results:
65 % hypertensive males, hypertensive females 35% 96.6 % (773 out of 800) of the secondary hypertensives were found to be living with their families and only 27 patients were living alone. 60 % of 800 secondary hypertensives that is 300 patients were found to living in a joint family set up whereas40 percent were living only with their immediate family.
All respondents were married, 23% were widowed. Age > 46 years for males > 52.4 years for females BMI > 21.3 for males and > 26.4 for females Male gender showed a predilection < 5 hrs / week of physical activity (walking) Living in individual houses Education level (less than class 10) were significantly associated with hypertension.

Conclusions:
Hypertension is significantly associated with the above mentioned socioeconomic factors.
BLOOD PRESSURE CONTROL IN A HIGH-COMPLEXITY OUTPATIENT SERVICE WAS LESS THAN ADHERENCE TO ANTIHYPERTENSIVE TREATMENT
Authors: Guimaraes Mayra Cristina Luz Pádua , Coelho Juliana Chaves , Da Silva Giovanio Vieira , Pierin Angela 
Published: April 2021

Objective:
To evaluate the blood pressure control, adherence to antihypertensive treatment and associated variables.

Design and method:
A cross-sectional study was performed in a hypertension outpatient clinic from a Hospital in São Paulo, Brazil. Inclusion criteria were: age over 18 years old, in treatment for at least six months and also that accepted to participate signing the Informed Consent Form. Patients diagnosed with secondary hypertension, pregnant and unable to answer the interview were excluded. The sample calculation based on 60% of control rate and 5% of significance level was 253 participants. The blood pressure control was systolic blood pressure < 140 and diastolic blood pressure < 90 mmHg. The adherence to treatment was assessed by Morisky MMAS-8. Biosocial data, risk factors, habits, lifestyles, anthropometric measurements, comorbidities and psycho-emotional characteristics were evaluated. Multivariate analysis was performed by the Logistic Regression and the significance level was <0.05.

Results:
The blood pressure control was 69.2% and 82.2% had a high adherence to treatment. The characteristics of hypertensive patients were: 65.0 (13.3) years, 61.7% were female, 63.2% were white, 52.8% were married, 44.3% had completed high school studies, body mass index 29.5 (5.3) Kg/m2 (81.4% overweight or obesity), 47.4% had a low socio economic classification, 55.7% had never smoked, 60% hadn’t drunk alcoholic beverage currently, 84.5% hadn’t had common mental disorders, 39.9% had physical activity irregularly and 8.0 (4.0) number of drugs in use. The main comorbidities were: Dyslipidemia (71.5%), Diabetes Mellitus (40.7%), Chronic Kidney Disease (19%), Stroke (8.7%), Coronary Insufficiency (13.4%). The systolic blood pressure was 138.6 (12.1) mmHg and diastolic was 80.8 (7.2) mmHg. The most used antihypertensive drugs were: diuretics (78.3%), calcium channel blockers (68.8%), AT1 receptor blockers (61.7%), beta-blocker adrenergic inhibitors (50.2 %) and angiotensin-converting enzyme inhibitor (30.4%). The associated variables to blood pressure control were: married marital status (OR 2.3; IC95%:1.34 – 4.28), calcium channel blockers (OR 0.4; IC95%: 0.19–0.92) and number of antihypertensive drugs in use (OR 0.78; IC95%:0.66–0.92).

Conclusions:
The blood pressure control were more elevated than data from majority of Brazilian studies, although not coincident to the adherence to the treatment evaluated.
CAFFEIC ACID AMELIORATES ANGIOTENSIN II-INDUCED INCREASE IN BLOOD PRESSURE BY ACTIVATING VASCULAR SARCO-/ENDOPLASMIC RETICULUM CA-ATPASE2A
Authors: Wu Hao , Zhang Liting , Gao Peng , Liu Daoyan , Zhu Zhiming 
Published: April 2021

Objective:
Many studies have focused on reporting the beneficial effect of consumption coffee or caffeine on cardiovascular disease. However, caffeic acid, a component of coffee, which has a completely different structure from caffeine, was rarely studied in cardiovascular metabolic diseases. In this study, we investigated the effect of caffeic acid on vascular function and blood pressure of mice.

Design and method:
Tension of endothelium-free mesenteric arteries from 8-week-old male wild-type (WT) mice was measured using wire myograph. Cytoplasmic Ca2+ and sarcoplasmic reticulum (SR) Ca2+ were measured from primary vascular smooth muscle cells (VSMCs) using fura-2AM and mag-fura-2AM, respectively. Molecular docking was performed by AutoDock to determine the binding force and sites of caffeic acid with sarco-/endoplasmic reticulum Ca-ATPase (SERCA, a channel transporting Ca2+ from the cytosol into the SR lumen. PDB: 2YFY). 8-week-old male SERCA2a knockout mice and WT littermates were surgically implanted with mini-osmotic pumps filled with angiotensin II (Ang II) solutions. Then these mice were fed with normal diet or 0.05% caffeic acids in drinking water for 8 weeks. The tail-cuff blood pressure (BP) and 24-hour ambulatory BP were measured.

Results:
First, we found that caffeic acid relaxed mesenteric artery pre-contracted with norepinephrine (NE) with half-effective dose of 26.7uM. Furthermore, pre-treatment with 50uM caffeic acid for 5 min completely smoothed NE-induced vasoconstriction. Specifically, we found that caffeic acid reduced intracellular Ca2+ in a concentration-dependent manner as well as resisted the increase of intracellular Ca2+ induced by thapsigargin, a SERCA inhibitor, whereas caffeic acid increased SR Ca2+ uptake. Molecular docking revealed caffeic acid binds to SERCA to form strong hydrogen bonds at ASN-359, TYR-389, ARG-604 and ASP-738. Eventually, we found that compared with the normal diet group, the intervention of caffeic acid significantly attenuated AngII-induced increases of tail BP and ambulatory BP in mice, but the hypotensive effect of caffeic acid disappeared in SERCA2a knockout mice.

Conclusions:
These results suggest that caffeic acid has a beneficial effect on vascular function and blood pressure by activating SERCA2a on VSMCs. Consumption coffee or caffeic acid may be an effective lifestyle to prevent and treat hypertension.
BLOOD PRESSURE CONTROL-RATES THROUGH MONOTHERAPY WITH FOUR DIFFERENT ANTIHYPERTENSIVE AGENTS IN TREATMENT-NAÏVE PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Vischer Annina , Socrates Thenral , Mayr Michael , Haschke Manuel , Burkard Thilo 
Published: April 2021

Objective:
Four different antihypertensive agent classes are equivalently recommended in the guidelines for first-line treatment of arterial hypertension (AHT). However, it is unclear, if one of these agents is more potent than the others to reach blood pressure (BP) control. We sought to compare response rates and BP control in these four classes.

Design and method:
Patients with newly diagnosed grade 1 or 2 AHT on 24h-BP measurements (ABPM) were randomized in a 1:1:1:1 fashion to either perindopril (ACE), olmesartan (ARB), amlodipin (CCB) or hydrochlorothiazide (HCT). ABPM were checked at baseline (BL), after 4 weeks of half dose (TP1) and after 4 weeks of full dose (TP2), if BP control was not reached after TP1. Patients were classified as controlled if mean BP was < 130/80 mmHg, awake BP < 135/85 mmHg and night BP < 120/70 mmHg.

Results:
80 patients were randomized: 20 (25.0%) to ACE, 20 (25.0%) to ARB, 21 (26.3%) to CCB, and 19 (23.8%) to HCT. Mean age was 48 (±14) years, mean BMI 26.5 (±3.7) kg/m2. Mean 24 h systolic BP (sBP) was 141.8 (± 9.1) mmHg, diastolic BP (dBP) 87.8 (± 7.6) mmHg (Table). Mean decrease from BL to TP1 was -5.8 (± 10.9) and -2.7 (± 5.6) mmHg, from BL to TP2 -11.6 (± 11.2) and -5.6 (± 6.7) mmHg, from TP1 to TP2 -5.8 (± 12.0) and -2.8 (± 5.4) mmHg, for mean 24 h sBP and dBP, respectively. After TP1, 21 patients (26.3%) had a controlled BP overall (Figure). After TP2, the number of controlled patients increased to 24 patients (30.0%, p = 0.250, Figure). Control rates were significantly lower for HCT in comparison to the other agents for diastolic values after TP1 (p = 0.013) and after TP1 and TP2 (p = 0.003).

Conclusions:
Half dose of the most common antihypertensive treatments lead to BP control in 26% of patients with grade 1 or 2 AHT. Control rates were not significantly improved when increasing to full dose. HCT was the least effective, whereas ACE, ARB and CCB were comparably effective.
USE OF ALTERNATIVE MEDICINE IN A SAMPLE OF PATIENTS IN A CARDIOVASCULAR PREVENTION CLINIC
Authors: Spagnuolo Vitaliano , Pulicanò Martina , Maretta Alessia 
Published: April 2021

Objective:
Alternative medicine can play a role in improving the health and well-being of people and can be integrated with traditional medicine. It is often self-prescribed and it can expose to potential risks from drug interactions with conventional medicine drugs.

Design and method:
We evaluated, in a group of patients in a clinic dedicated to prevention for cardiovascular diseases, the use of alternative medicines in the last year.
We enrolled the first hundred patients, aged over 50, of outpatient visit to Cardiovascular Prevention Clinic (Lipid Center Cosenza). All hundred patients were given a questionnaire consisting of five simplified questions (validated questionnaire proposed in an AARP/NCAAM study).

Results:
Of the 100 patients, 55 were females. The average age was 66.6 ± 8.45 years; 68.2 ± 6.4 for females and 64.7 ± 10for males. Twenty-five of them reported the use, in the last year, of one of the alternative medicines recognized by our legal system. Osteopathy and chiropractic were the most used (15 patients), posturology (5 patients), herbs (5 patients). Females were more prone to use alternative medicines (20 vs 5). The most frequently given motivation to use alternative medicines was to solve a certain pathological condition (77%) rather than prevent a disease. Regarding to full awareness in carrying out alternative therapy, 15 patients out of 25 fully knew the indication for use before starting it, and the same fifteen had received precise indications from their doctor.
Seventy-five were already being treated with at least one drug before enrollment (average 2.35 ± 1.9). Of the 25 patients who used alternative medicines, all took at least two drugs (average 3.6 ± 1.2).

Conclusions:
The fact that they have taken substances without having informed a healthcare professional has potential for risk, given the possible interaction between medicines also in the field of complementary medicine. Alternative medicine is widely used in our reality, but often without the patient informing the doctor. Better management of counseling is therefore necessary to improve the indication and safety of the use of complementary medicines.
METOPROLOL COMPARED TO AMLODIPINE IMPAIRS MITOCHONDRIAL FUNCTION IN FOREARM SKIN IN HYPERTENSIVE PATIENTS
Authors: Pawlak-Chomicka Regina , Uruski Pawel , Krauze Tomasz , Markowska Malgorzata , Tykarski Andrzej , Guzik Przemyslaw 
Published: April 2021

Objective:
If oxygen is available, then mitochondria oxidase the reduced form of nicotinamide adenine dinucleotide (NADH) and produce energy. Oxygen delivery to mitochondria in skin cells depends on the function of microvascular circulation. Antihypertensive medications can modify both energy metabolism (e.g. gain of body weight) and microvascular function (cold fingers and toes). In this prospective study, we compared the effects of amlodipine vs metoprolol on the skin content of NADH in hypertensive patients.

Design and method:
Patients with newly diagnosed hypertension were randomly allocated to the six-week treatment with either 5 mg of amlodipine (20 patients) or 25 mg of metoprolol (17 patients) once a day. The 460-nm forearm skin fluorescence measured the skin mitochondrial content of NADH at rest, during transient 100-second ischaemia (by occlusion of the brachial artery with the inflated arm blood pressure cuff), and the following reperfusion. This measurement was made before and after the treatment initiation.

Results:
Hypotensive effects of both treatment were comparable after the six-week therapy. For NADH, amlodipine showed no significant change in the 460-nm fluorescence at rest (791.6 ± 281.1 to 733.7 ± 261.9 [kU] (p = 0.119), during ischemia (850.2 ± 292.2 to 805.6 ± 294.8 [kU] (p = 0.307), and reperfusion (662.3 ± 228.4 to 624.1 ± 225.0 [kU] (p = 0.210). In contrast, treatment with metoprolol significantly increased the 460-nm fluorescence at rest (678.2 ± 284.0 to 797.3 ± 247.0 [kU] (p < 0.01), during ischemia (736.5 ± 302.1 to 859.7 ± 264.9 [kU] (p < 0.01), and reperfusion (571.5 ± 243.2 to 662.2 ± 204.7 [kU] (p < 0.01).

Conclusions:
Metoprolol significantly impairs the function of skin mitochondria, causing a significant increase in the NADH content. In contrast, amlodipine shows neutral effects on this function.