bluuebunny/crossref_metadata_2025_split huggingface dataset:
A HYPERTENSIVE RESPONSE TO EXERCISE IS ASSOCIATED WITH AN ALTERATED CARDIOVASCULAR RISK PROFILE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Moore Myles , Climie Rachel , Otahal Petr , Sharman James , Schultz Martin 
Published: April 2021

Abstract

Objective:
A hypertensive response to exercise (HRE) is a risk factor for cardiovascular disease and reveals high blood pressure (BP) not detected at rest. Alterations to markers of cardiovascular risk may underlie associations between HRE and high BP, although this has not been systematically elucidated. This study aimed to assess relationships between HRE and cardiovascular risk markers via systematic review and meta-analysis of published literature.

Design and method:
Three online databases were searched from inception to July 2019 for studies reporting associations between exercise BP and cardiovascular risk markers (including lipid, metabolic, inflammatory and vascular stiffness markers). Pooled mean differences (random effects) were calculated for each cardiovascular risk marker between individuals with and without HRE. Univariable meta-regressions were performed to assess differences in pooled mean differences by resting hypertension and health status, intensity at the time BP was measured and exercise modality.

Results:
Overall, 37 studies with 37,878 participants (aged 50 ± 3years; 79% male) were included. On average, individuals with HRE had elevated total cholesterol (26 studies, pooled mean difference 0.13 ± 0.08mmol/L, p < 0.001), low-density lipoprotein cholesterol (17 studies, 0.12 ± 0.03mmol/L, p < 0.001), triglycerides (22 studies, 0.24 ± 0.04mmol/L, p < 0.001), glucose (21 studies, 0.15 ± 0.05mmol/L, p = 0.002), white blood cell count (4 studies, 0.49 ± 0.16x109 cells, p = 0.003), and aortic pulse wave velocity (3 studies, 0.8 ± 0.35m/s, p = 0.02), compared to those without HRE. Participants with HRE also had decreased high-density lipoprotein cholesterol (20 studies, -0.03 ± 0.01mmol/L, p = 0.003) and impaired flow-mediated dilation (2 studies, -4.13 ± 1.02%, p < 0.0001) compared to those without HRE. All pooled mean differences between HRE and no HRE were similar irrespective of resting hypertension and health status, exercise intensity and modality, except low-density lipoprotein cholesterol which had a greater mean difference during treadmill testing compared to cycling (p = 0.036), and aortic pulse wave velocity, which had a smaller mean difference in athletes compared to general populations (p = 0.018).

Conclusions:
HRE is associated with alterations in cardiovascular risk markers including increased lipid, metabolic, inflammatory and vascular stiffness and function markers. Associations varied with health status and test modality, but were consistent irrespective of resting hypertension status and exercise intensity. Results further highlight the advanced cardiovascular risk associated with HRE.
ARTERIAL HYPERTENSION MANAGEMENT TRENDS IN PAKISTAN; CROSS-SECTIONAL OBSERVATIONAL STUDY OF A SAMPLE OF PAKISTANI DOCTORS
Authors: Mohydin Bilal , Siddique Saulat , Mumtaz Khadija 
Published: April 2021

Abstract

Objective:
To look at the practice trends regarding Hypertension in Pakistani doctors and to find out the weak links in our diagnosis, management, care and followup.

Design and method:
Study Setting:
The study was conducted on 600 doctors practicing in different cities of Pakistan. These doctors came from all professional spheres, Fresh Graduates, Post graduate trainee, Consultants (of all ranks) and Family Physicians etc.

Study Design:
Observational cross-sectional.
Study Population and Sampling Technique:
We used cluster random sampling method to collect data.

Results:
Only 146 (24.3%) were following the guidelines while 235 (39.2%) were measuring it too early or 148 (24.6%) were measuring too late. Seventy one (11.8%) of the surveyed individual did not respond to this question.
According to latest guidelines, - A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, that facilitates achieving a desirable weight is recommended for adults with elevated BP or hypertension. Sodium reduction is recommended for adults with elevated BP or hypertension. Only 3.7% doctors talked about DASH diet in survey questionnaire, and not all the doctors are advising salt reduction to hypertensive patients comprising only 70.2%.
Only 2.5% doctors are advising to increase water intake and even alarming is that advising smoking cessation to hypertensive patients is talked about by only 4.3% of doctors.
Desired BP control is a difficult task even in developed countries. In Pakistan less than 3 % have adequate control Table 3 shows the responses to our inquiry - Grade each of the following separately which is in your opinion the most likely cause of inadequate BP control; from 1–5 (1 being somewhat common cause, and 5 being leas t common cause). The response shows the wide range of issues that we have regarding controlling the blood pressure.

Conclusions:
Issues in our society are multi-factorial. Need to emphasize to the physicians the importance of Continuance Medical Education and improving your practice skills. Also need to reach out to patients by all current mediums so they may be able to better understand the risks a person is under when he/she develop hypertension.
ASSOCIATIONS BETWEEN SMOKING HABITS AND MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS WHO UNDERWENT CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY
Authors: Miura Shin-Ichiro , Higashi Sara , Yano Masaya , Tashiro Kohei , Idemoto Yoshiaki , Suematsu Yasunori , Shiga Yuhei 
Published: April 2021

Abstract

Objective:
We analyzed that smoking could induce major adverse cardiovascular events (MACE) and the progression of coronary atherosclerosis as assessed by coronary computed tomography angiography (CCTA) as screening for coronary artery disease (CAD).

Design and method:
We enrolled 443 patients who had all underwent CCTA and either were clinically suspected of having CAD or had at least one cardiovascular risk factor. We divided the patients into smoking (past and current smoker) and non-smoking groups or males and females, and evaluated the presence of CAD and MACE (cardiovascular death, ischemic stroke, acute myocardial infarction and coronary revascularization) with a follow-up of up to 5 years.

Results:
%CAD in the smoking group was significantly higher than that in the non-smoking group. %MACE in males and smokers were significantly higher than those in females and non-smokers, respectively. Kaplan-Meier curves showed that smokers and females tended to show greater freedom from MACE than non-smokers and males, respectively (log-rank test p = 0.057 and p = 0.073, respectively). More interestingly, Kaplan-Meier curves also showed that non-smokers in females significantly greater freedom from MACE than smokers in females (p = 0.007), whereas there was no significant difference in freedom from MACE between non-smokers and smokers in males (p = 0.984). Although there were no significant predictors of MACE in all patients according to a multiple logistic regression analysis, smoking was useful for predicting MACE in females, but not males.

Conclusions:
Smoking was significantly associated with MACE in females, but not males, who underwent CCTA as screening for CAD. Various conventional risk factors may be associated with MACE in males.
MICE EXPOSED TO EARLY LIFE STRESS SHOW SEX-SPECIFIC EFFECT OF WATOKINES ON ENDOTHELIAL FUNCTION
Authors: Loria Analia 
Published: April 2021

Abstract

Objective:
The aim of this study was to determine the effects of Maternal Separation and Early Weaning (MSEW), a mouse model of early life stress, on leptin production from different fat depots and the capacity of fat conditioned media to modulate the endothelial function of aortic ring in a sex-specific manner.

Design and method:
At weaning, control and MSEW mice were fed a high fat (HF, 16-weeks, 60% Kcal from fat). In one subset of mice, white adipose tissue (WAT) was collagenase-digested and preadipocytes counted by flow cytometry. In another subset of mice, ∼50 mg of freshly-isolated WAT was incubated in DMEM + 2% fatty acid free BSA (1 hour, 37°C) to measure leptin levels.
Further, acetylcholine-induced relaxation in aortic rings from healthy mice (16-week-old fed a regular chow) was assessed to test how different fat depots media explants can modulate the endothelial function independently of the effects of MSEW on the vascular wall.

Results:
MSEW females showed a 20% increase in preadipocyte number in visceral-WAT vs. control (p < 0.05). Fat-derived leptin secretion was similar between control and MSEW mice fed a low fat diet. However, HF increased leptin secretion in subcutaneous-WAT from male MSEW mice and visceral-WAT from female MSEW mice (p < 0.05). Similarly, HF increased leptin mRNA in subcutaneous-WAT from male MSEW mice and visceral-WAT from female MSEW mice (p < 0.05).
Baseline vascular relaxation (48 ± 3 % relaxation at 5.5 x10–5mmol/L) was similarly impaired when aortic rings were incubated with perivascular adipose tissue (PVAT) media explants from female MSEW and control mice (25 ± 4 and 32 ± 2 % relaxation, respectively). However, rings incubated with visceral-WAT from female MSEW mice showed greater impairment of the vascular relaxation compared to controls (15 ± 3 and 29 ± 2 % relaxation, respectively, p < 0.05). Male MSEW mice also displayed endothelial dysfunction in isolated rings; however, PVAT and visceral-VAT media explant induced a protective effect on endothelial function.

Conclusions:
Taken together this data indicates that there is a sex and depot-specific release of WATokines that could be an important factor modulating the vascular function in mice exposed to early life stress.
CARDIOVASCULAR RISK FACTORS, LIFESTYLE AND SOCIAL DETERMINANTS IN A CROSS-SECTIONAL POPULATION STUDY- LAPARC STUDY
Authors: Leiria Vinicius , Muxfeldt Elizabeth Silaid , Pecly Inah Maria Drummond , Botelho Bruna Gopp , Barbalho Daniella Gomes , Mourão Maria Antonia Oakim 
Published: April 2021

Abstract

Objective:
To evaluate the relationship between the main CV risk factors and socioeconomic indicators in a population of adults registered in a Family Health Care (FHC) unit in the center of Rio de Janeiro.

Design and method:
Cross-sectional population study that included adults aged between 20 and 50 years living in the area covered by the FHC in Rio de Janeiro. Demographic data (gender and age), socioeconomic data (education level, profession, employment), CV risk factors (smoking, sedentary lifestyle, obesity, hypertension, diabetes, dyslipidemia) were recorded. The metabolic profile is evaluated through laboratory tests. Those who studied up to high school were considered poorly educated.

Results:
604 individuals were enrolled [39% male, mean age: 38.8 ± 8,9 years] The median of schooling was 12 years. 288 individuals had high schooling, 44.5% were male. A total of 130 individuals did not study or work. Women with low education had a higher risk of smoking, obesity and hypertension with no difference regarding labor or study activities. Otherwise, men with low education had higher risk of sedentary lifestyle and hypertension. Among men, not working or studying increased the risk of smoking and hypertension.

Conclusions:
We found an inverse association between socioeconomic conditions and the prevalence of CV risk factors. Women are more affected by low schooling, while men are more affected by their working occupation. The study suggests that socioeconomic factors influence the CV risk, affecting men and women differently, pointing to the need for public policies to reverse this situation.
IS BARIATRIC SURGERY A TREATMENT FOR HYPERTENSION AND FOR THE OTHER COMPONENTS OF THE METABOLIC SYNDROME?
Authors: Lechea Elena , Popescu Mihaela , Ploesteanu Rodica , Dimulescu Doina , Catalin Copaescu 
Published: April 2021

Abstract

Objective:
Our objective is to determine the impact of weight loss obtained by bariatric surgery on the components of the metabolic syndrome such as visceral obesity, atherogenic dyslipidemia, glycemic disorders and hypertension secondary.

Design and method:
This is a retrospective pilot study including 59 patients subjected to bariatric surgery (gastric sleeve laparoscopy) during 2016 at Ponderas Academic Hospital Bucharest, Romania. We have reviewed the hospital database for blood tests, diabetes, cardiologic and surgery consultations before surgery and at 12 months follow up. We tracked the evolution of the following parameters: body mass index, waist circumference, weight, blood sugar, triglycerides, high density cholesterol, low density cholesterol, glycated hemoglobin, liver enzymes, the presence or absence of hypertension, dyslipidemia and diabetes and the necessary for antihypertensive, lipid lowering and antidiabetic treatment. 51 of the patients (86%) were hypertensive, 48 of them had chronic antihypertensive oral treatment and 3 of them were equilibrated by low salt diet.

Results:
The need for antihypertensive treatment was reduced by 60%, only 19 out of 48 patients still had chronic blood pressure lowering treatment at 12 moths follow up. Patients still on treatment had lower doses or fewer classes of the initial drugs. BMI decreased by 38%; waist was reduced by 31%, weight declined by 41%; blood sugar was lowered by 16%, triglycerides decreased by 37%; high density cholesterol increased by 18%, low density cholesterol decreased by 9%. In diabetic patients glycated hemoglobin decreased by 28% and the necessity for antidiabetic medical treatment dropped by 69%. The decline was statistically significant for al variables (P < 0.001) except for low density cholesterol. Blood sugar values registered a more accelerated decrease in the first 6 months.

Conclusions:
Weight loss obtained by bariatric surgery in this study, improves metabolic syndrome in all of its components. The lower decrease in LDL Cholesterol in our study can be partly explained by the borderline values at the baseline. Longer retrospective analyses and prospective studies, expanding the number of patients are necessary and in progress, in order to determine the recurrence or new onset of hypertension.
THE EFFECT OF PILATES METHOD OF AUTONOMIC MODULATION IN OLDER WOMEN
Authors: Alves Tatiana Pereira , De Oliv Patrick Rodrigues Correia , Costa Ana Carolina , Belarmino Giliane , Lima Cintia Taniguti , Rodrigues Gabriel Dias , Waitzberg Dan Linetzky , Soares Pedro Paulo Da Silva , Busse Alexandre Leopold , Irigoyen Maria Claudia , Filho Wilson Jacob , Lacchini Silvia 
Published: April 2021

Abstract

Objective:
To verify the effects of the Pilates compared to Resistance method on autonomic modulation of heart rate of older women.

Design and method:
Twenty-four older women (60 to 80 y.o.) submitted to resistance training, W (RT, n = 12) or Pilates (PT, n = 12) for 12 weeks, twice a week, one hour per session. Physical evaluation was performed at the beginning (week 0, RT0 and PM0) and the end of training protocols (week 12, RT12 and PM12), to analyse body composition (bioimpedance, X-ray emission densitometry), and unipodal balance, hand grip strength, functional mobility (Timed Up and Go test–TUGT). Pulse pressure was obtained by using Finometer, and spectral analysis was performed by using Heartscoope Software to obtain normalized high frequency component (RRHFn), normalized low frequency component (RRLFn), LF/HF ratio, baroreflex sensitivity (BRS), harte rate (HR), diastolic blood pressure mean (DAP), and systolic blood pressure mean (SAP). Statistical analysis was performed by two-way ANOVA.

Results:
observed an improve of unipodal balance in both groups (RT1 = 12,9 ± 8 s vs. RT12 = 24,8 ± 8,4 s and PT1 = 8,6 ± 2,5 s vs. PT12 = 22 ± 9,23 s). Pilates was able to improve TUGT (PT1 = 5,5 ± 1.6 s vs. PT12 = 2,9 ± 0,5 s). No chances in body composition and hand grip strength were observed. Bood pressure evaluation showed no changes in RT (DAP 84.05 ± 10 and SAP: 135 ± 18mmHg) and PT (DAP 73.6 ± 8 and SAP: 135 ± 14mmHg); HR (RT: 62.7 ± 6 and PT: 60.1 ± 3 bpm) and BRS were also unchanged after training. Spectral analysis shows a decrease, but non significant, in RT of RRLFn (-14,6%) and RR LF/HF (-27,3%). Interstingly, RRHFn increased significantly (+27,3%). On the other hands, PT presented a significant decrease of RRLFn (-36,2%), RR LF/HF (-55,6%) and an increase of RRHFn (+33,9%).

Conclusions:
Both exercise protocols were effective to improve physical capacity, but Pilates method was also efficient to improve TUGT. Both methods were able to increase HF (parasimpathetic modulation). However, Pilates was also efficient to reduce LF, indicating a reduction of sympathetic modulation, combined to the increase of parasympathetic activity on the heart. The improve of autonomic modulation indicate a better efficiency to reduce cardiovascular risk.
RESPONSIBILITY AS ONE OF STRESS PARAMETERS AT WORK PLACE IN OPEN URBAN POPULATION: GENDER ASPECT
Authors: Akimov Aleksander , Kayumova Marina , Gafarov Valery , Kuznetsov Vadim 
Published: April 2021

Abstract

Objective:
To study responsibility, as one of the stress parameters in workplace, in males and females of open urban population from a gender perspective.

Design and method:
The study was conducted as a part of cardiological screening in open workable population of both sexes aged 25–64 years in Tyumen. A representative sample was formed from voting lists of 2,000 citizens of one of the administrative districts of Tyumen, 250 people in each of eight groups defined by sex and age (25–34, 35–44, 45–54, 55–64). Response to cardiac screening was 77.7%. To analyze stress at work, questionnaire WHO MONICA-psychosocial “Knowledge and attitude to your health” was applied. In this study, questions regarding workplace responsibility were used to determine stress in the workplace.

Results:
Statistically significant differences in answers to a question “Has your responsibility at work changed in the past 12 months?” were registered at young age in favor of women (25–34 years: 37.5–54.9%; 35–44: 39.5–53.1% in males and females, respectively, p < 0.01). Over the past 12 months, work responsibility was rated as “insignificant” by 7.9% of males and 3.4% of females in open population, p < 0.001. Similar trends in males and females in relation to this category of answers were detected in age groups of 25–34 (5.7–0.8%, p < 0.05) and 55–64 (18.7–3.7%, p < 0.001). Self-assessment of work responsibility as “high” over the past 12 months was significantly more often detected among females compared to males in general population (53.6–45.2%, p < 0.001) and in elder age group 55–64 (52.8–32.7%, p < 0.001).

Conclusions:
In open urban population, according to the model of Tyumen city, the highest self-assessment of responsibility in workplace was registered in females, mainly in elder group, and increased work responsibility as in elder age group 55–64 so as predominantly in females younger than 45 years. Thus, generating informational and educational technologies for heart diseases prevention in adult population of the city, top-priority orientation is to be focused on needs of “social risk” groups in population, exactly in young workable females.
THE MEASUREMENT OF MALONDIALDEHYDE LEVEL IN HEART TISSUE OF HYPERLIPIDEMIC RATS AFTER INTERVENTION OF COMBINATION OF JICAMA (PACHYRHIZUS EROSUS) CONCENTRATE AND KEFIR MILK AS A SYN
Authors: Khotijah Alfreda Amelia , Prabowo Rafik , Pramaningtyas Miranti Dewi 
Published: April 2021

Abstract

Objective:
This research aims to know the effect of synbiotic drink from jicama concentrate and kefir milk on malondialdehyde (MDA) level in heart tissue of hyperlipidemic rats.

Design and method:
Twenty five rats divided into 5 groups such as negative control (K-), positive control (K+), and intervention groups (P1, P2, and P3). All animal model was acclimatized for seven days. Group of K+, P1, P2, and P3 were given quail egg yolks 5 ml/200 grBW/day for 4 weeks to make the hyperlipidemic model. For next 4 weeks, the intervention groups (P1, P2, and P3) were given a different formulations synbiotic drink with 5 ml/ 200 grBW/day. There are three formulations of synbiotic drink, P1: 85% Kefir Milk (KM), 15% Jicama Concentrate (JC), P2: 75% (KM), 25% (JC), P3: 65% (KM), 35% (JC). In the end of experiment, the animal model was terminated to get the heart organs. The heart organs were saved in a cup which have filled with alcohol and began to measure MDA level in heart tissue. All data were statistically analyzed with One-Way Annova. Values were considered significant at p < 0,05.

Results:
Based on data, all of the data were expressed as mean ± SD. The mean of MDA level (nmol/gr) in negative control group (K-) was 1.50 ± 0.08 and positive control group (K+) was 10.70 ± 0.14. The groups of intervention were 6.60 ± 0.09 (P1), 4.56 ± 0.11 (P2), and 3.02 ± 0.13 (P3). The result showed there was significant differences between all groups (p < 0,001).

Conclusions:
Synbiotic drink from jicama concentrate and kefir milk significantly to improve MDA level in heart tissue of hyperlipidemic rats and can be considered for adjuvant therapy to decrease the risk of hypertension.
ARTERIAL STIFFNESS IN HYPERTENSIVE CRISIS DEPENDING ON PATIENT DIPPING PROFILE
Authors: Jug Juraj , Bencic Martina Lovric , Prkacin Ingrid 
Published: April 2021

Abstract

Objective:
Arterial stiffness and its value, approximated from pulse wave velocity, correlate with cardiovascular risk. Therapeutic restoration of normal physiologic blood pressure reduction by 10–20% during night-time sleep is the most significant independent predictor of decreased cardiovascular risk. The aim of this study was to present the difference in pulse wave velocity value between gender and their dipping profile.

Design and method:
We divided 205 patients (54% female) in four groups by their dipping profile and gender. Additionally, because pulse wave velocity depends on age, we created five main age groups (<50, 51–60, 61–70, 71–80 and over 80 years). We checked their dipping profile with 24-hour ambulatory blood pressure monitoring. Pulse wave velocity was checked by Agedio oscillometer. Also, serum creatinine and glomerular filtration rate was calculated by CKD-EPI formula in all patients.

Results:
An average glomerular filtrate rate in dipper patients was significantly higher than non-dippers (81.32 vs 72.82 ml/min/1.73m2; p < 0.05). The number of non-dippers was higher than dippers (103 vs. 39 patients, p < 0.01). Women were significantly older than men (69.02 vs. 62.01 years, p < 0.01). Comparing pulse wave velocity by age groups and dipping profile in men the results were: 1 – 8.20 vs 8.31m/s; 2 – 8.78 vs. 9.30m/s; 3 – 10.01m/s vs. 10.35m/s, p = NS; 4 – 11.70 vs. 13.27m/s, p < 0.01. In women we found statistically higher values of pulse wave velocity compared to men of the same age groups (11.71 vs. 10.44m/s, p < 0.05). By age groups and their dipping profile the results were: 1 – 9.01 vs. 9.04m/s; 2 – 9.66 vs 9.97m/s, p = NS; 3 – 10.35 vs. 11.34m/s, p < 0.05; 4 – 11.85 vs. 12.91m/s, p < 0.01).

Conclusions:
Non-dipping profile could be a potential risk factor for hypertensive crisis development. Pulse wave velocity values increased more rapidly in non-dippers compared to dippers and turned out to be higher in women compared to men of the same age. Treating and discovering non-dipper patients could decrease the level of the cardiovascular risk and potentially prevent the incidence of the hypertensive crisis events. Kidney function restoration also showed its importance in cardiovascular prevention.