bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE IMPORTANCE OF CHRONICK KIDNEY DISEASE IN A PORTUGUESE DIABETIC RESISTANT HYPERTENSION POPULATION
Authors: Pereira Flávio , Lopes Susana , Briosa Ana , Cavadas Susana , Mesquita José 
Published: April 2021

Abstract

Objective:
Introduction: Resistant hypertension (RH) isn’t well studied with Ambulatory blood pressure monitoring (ABPM).

Objective:
Study in a RH population obtained in hypertension department to characterize Diabetes Mellitus (DM) patients and identify cardiovascular (CV) outcome predictors.

Design and method:
ABPM - collected 1999–2018. Identified RH patients according to the ESC Guidelines 2018 and selected DM patients. Sample was characterized and analysed for predictors of CV events (CVe). CVe - ischaemic stroke (IS), acute coronary syndrome (ACS), acute heart failure (if hospitalized - AHF), peripheral arterial disease (PAD). Follow-up finished with event, the last evaluation of the patient or death. Statistical significance was assumed if p < 0.05.

Results:
Sample - 268 RH patients - 119 DM patients (80 males, 39 females). Age - 62.5 + /- 9.9 years (mean + /- SD), Follow-up - 5.1  + /- 4.6 years. Dyslipidaemia - 79.8%, obesity - 58.0%, Chronic Kidney Disease (CKD) - 36.1%, history of previous CVe – 47.9% (PCVe). CVe observed - 32 (8 IS, 10 ACS, 9 AHF, 5 PAD). 4 death from non-CVe. When the sample was analysed events vs no-event, those with event had higher creatinine, history of PCVe and CKD. In Univariate Cox analysis for the prognosis of future CVe, it was significant: age, PCVe, creatinine and 24 h Diastolic Blood Pressure (24DBP) (Table 1). In a multivariate Cox Analysis with the variables: age, gender, PCVe, glycaemia, creatinine, CKD and its staging, statistical significance was age, creatinine, CKD and its staging. Glycaemia was almost significant (Table 1). In Kaplan-Meier survival curve free of events, PCVe, CKD and CKD staging revealed worst survival prognosis (respectively log rank 7.85, p < 0.05; 7.72, p = 0.000; 49.5, p = 0.000). We analysed the CKD subgroup and verified that those with CKD were older, lower body mass index, less 24DBP and night-time blood pressure.

Conclusions:
In our diabetic RH population, CKD, elevated creatinine, increasing age and PCVe were independently associated with increasing incidence of CVe. It seems that our action in these patients should aim to stricter control in order to retard the progression of CKD, despite attention in glycaemic control.
STRESS AT WORK ENHANCES RISK OF ARTERIAL HYPERTENSION IN GENERAL POPULATION. WHO MONICA-PSYCHOSOCIAL PROGRAM
Authors: Gafarov Valery , Gromova Elena , Panov Dmitriy , Gagulin Igor , Gafarova Almira , Krymov Eldar 
Published: April 2021

Abstract

Objective:
To determine the effects of stress at work on the risk of arterial hypertension (AH) in population of 25–64 years in Russia/Siberia

Design and method:
Under the III screening of the WHO MONICA-psychosocial program, a random representative sample of a population of both sexes aged of 25–64 years in Novosibirsk was examined in 1994 (n = 1346, 48.8% males; mean age 44.9 ± 0.4 years, response rate - 77.3%). The screening program performed in frame budgetary issue # AAAA-A17-117112850280-2. It's included: registration of socio-demographic data, determination of stress at work. The duration of follow-up was 16 years.

Results:
A high level of stress at work was in 29.5% of men and 31.6% of women (p > 0.05). An increase in the level of high stress at the workplace was found for men - workers engaged in moderate physical labor (34.7%) compared with women (17.7%) in this group (p < 0.05). The risk of AH over a 16-year period in those who experiencing stress at work was 1.4-fold higher in men and 1.27-fold higher in women. An increase in the risk of hypertension was observed in widowed men HR = 2.5. Risk of AH gradually increased in women depending on age group: 35–44 years – HR = 1.699; 45–54 years – HR = 2.472 and 55–64 years – HR = 2.694 (p for all < 0.05).

Conclusions:
High levels of stress at work increased the risk of hypertension both in men and women.
CORONARY PLAQUE INSTABILITY SYNCHRONIZES WITH INFLAMMATORY ACTIVITY OF MULTIPLE ORGANS INCLUDING CAROTID PLAQUES AND VISCERAL ADIPOSE TISSUE
Authors: Pahk Kisoo , Kwon Hyun Woo , Eo Jae Seon , Seo Hong Seog , Kim Sungeun 
Published: April 2021

Abstract

Objective:
Positron emission tomography (PET) is very useful to determine inflammatory activity in the body including arterial plaque. Although many studies suggested that local and systemic inflammation could affect the arterial plaque instability, there were no direct evidences showing the inflammatory activity of other organs in acute myocardial infarction (AMI) patients.

Design and method:
Whole body combined fluorodeoxyglucose PET/computed tomography was performed in 32 patients with AMI (57 ± 12 years) within a week of disease onset, 33 patients with stable coronary artery disease (CAD) (61 ± 12 years), and 25 control subjects (57 ± 8 years). Maximal standard uptake value (SUV) of the highest regions of interest was calculated in the right carotid artery, bone marrow, liver, visceral (VAT) and subcutaneous adipose tissue (SAT).

Results:
The SUVs of AMI patients in the carotid artery and other organs except SAT were significantly higher than those of CAD patients or control group with and without adjustment for other covariates, whereas SAT SUVs were not significantly different among three groups. Furthermore, the SUVs of CAD patients in bone marrow, liver, and VAT were also higher than those of control group. In the overall population, hsCRP and the SUVs of all measured organs except SAT were significantly correlated to each other.

Conclusions:
These findings suggest that coronary plaque instability accompanying other vascular inflammation synchronizes with and might be attributed to increased innate immune surveillance by macrophage resident in different tissues such as VAT and reticuloendothelial system including bone marrow and liver.
THE ECONOMIC BURDEN OF CARDIOVASCULAR DISEASES ASSOCIATED WITH UNHEALTHY DIET IN THE RUSSIAN FEDERATION IN 2016
Authors: Mukaneeva Dinara , Kontsevaya Anna , Myrzamatova Azaliia , Balanova Yulia , Khudyakov Mikhail , Drapkina Oxana 
Published: April 2021

Abstract

Objective:
To estimate the economic burden of cardiovascular diseases (CVD) attributable to unhealthy diet in the Russian Federation (RF) in 2016.

Design and method:
According to the ESSE-RF epidemiological study, the prevalence of excess consumption of salt, processed red meat and sugar-sweetened beverages (SSB) in the Russian population was recorded in 49.9%, 22.5 %, 8.6% surveyed, respectively. We first obtained CVD risk estimates for intakes of harmful foods (salt, processed red meat, SSB). The relative risks (RRs) of morbidity and mortality from CVD associated with unhealthy diet were identified through a literature search. Based on the data on the prevalence of excess salt intake, processed red meat and SSB consumption in the Russian population and RRs, the population attributable fractions (PAFs) was calculated for CVD. Associations were presented as RRs and PAFs with 95% CIs. To assess the economic burden, the proportion of the analyzed risk factors in the morbidity and mortality from CVD was determined, and then the proportion in the economic burden of the CVD. The direct costs of the health care system and losses in the economy due to morbidity and mortality from CVD associated with unhealthy diet were determined. The calculations were performed in Microsoft Excel 10.0. (Microsoft, USA).

Results:
The calculated PAR, associated with excess salt intake, for CVD mortality and morbidity was 5% and 7% respectively; for stroke: in mortality — 17%, in morbidity — 10%. The daily of processed red meat consumption determine 8.6% contribution to the morbidity of coronary heart disease. PAR of SSB consumption for CVD mortality and morbidity – 2%. The economic burden of CVD associated with an unhealthy diet in the Russian Federation in 2016 amounted to 204.2 billion rubles (2.9 billion €). Excessive salt intake makes the largest contribution to this burden. The losses in the economy due to premature mortality (177.2 billion rubles) prevail in the structure of the main burden. Direct medical expenses amounted to 26.9 billion rubles.

Conclusions:
The significant economic burden associated with preventable disease provides an economic rationale for action to reduce the prevalence of lifestyle-related risk factors.
ASSOCIATIONS BETWEEN PREVALENCE OF ARTERIAL HYPERTENSION AND HIGH LEVELS OF HOSTILITY IN MALES OF OPEN URBAN POPULATION
Authors: Kayumova Marina , Gafarov Valery , Kuznetsov Vadim 
Published: April 2021

Abstract

Objective:
To establish associations of arterial hypertension (AH) prevalence and hostility (H) levels in open urban population in males aged 25–64 years.

Design and method:
A cross-sectional epidemiology study was conducted on representative sample, formed randomly from voting lists of males aged 25–64 years from one of Tyumen administrative districts in the amount of 1,000 people, including 250 individuals in each of four decades of life. The response was 85.0%. The study analysis included AH prevalence according to unified assessment criteria and the prevalence of low, medium and high levels of H according to the WHO MONICA-Psychosocial questionnaire. Statistical processing of study data was carried out using IBM SPSS Statistics 21.0. software applications for medical information. Pearson chi-square test was used in assessing statistical significance of differences between groups.

Results:
In open urban male population aged 25–64 years, age-standardized indicator of H level was 70.0%, with predominance of high H level (average H level - 23.7%, high H level - 46.6%). In younger age groups, statistically insignificant tendency to increase average and high levels of H regarding to general population indicators and indicators of elder age groups was revealed. AH prevalence was 48.7% in males aged 25–64. With the age increase, AH prevalence rose significantly escalating during transition from the third to the fourth and the fourth to the fifth decades of life (20.3–55.3%, p < 0.001; 55.3–68.8%, p < 0.01; respectively, in 25–34, 35–44 and 45–54 age groups). Statistically significant differences of AH prevalence with general population indicator were found in age groups of 25–34, 45–54 and 55–64 years. Statistically significant patterns regarding H levels and their associations with AH were established in open urban population. In groups with presence of AH, high level of H was significantly oftener, and its average level was significantly rarer.

Conclusions:
Thus, epidemiological criteria of psychosocial risk factors, including H, identified using standardized questionnaire methods, should be used during routine preventive examinations of male population and selection of workable people with cardiovascular diseases, who need in-depth and preventive medical examination.
INTERPRETING AND EXPANDING ON THE OBSERVED CORRELATION BETWEEN THE AMBULATORY ARTERIAL STIFFNESS INDEX AND THE LOWER LIMIT OF CEREBRAL AUTOREGULATION DURING CARDIAC SURGERY
Authors: Gavish Benjamin , Gottschalk Allan , Hogue Charles W. , Steppan Jochen 
Published: April 2021

Abstract

Objective:
The lower limit of cerebral autoregulation (LLA) refers to the mean arterial pressure below which cerebral blood flow becomes pressure dependent, resulting increased stroke risk. Thus, markers correlated with the LLA are highly desired. The LLA measured during cardiac surgery, correlates with the Ambulatory Arterial Stiffness Index (AASI) determined from intraoperative continuous radial blood pressure (BP) before cardiopulmonary bypass (‘baseline’). Using these data the present study investigated factors underlying this association and its potential refinement.

Design and method:
The study population included 181 patients undergoing cardiac surgery (age 71 ± 8 years, 68% males). Given the linear relationship between systolic BP (SBP) and diastolic BP (DBP), the AASI is defined as 1 minus the DBP-on-SBP regression slope. The analytic expression of AASI is 1-Rsd/K, where Rsd is the SBP-DBP correlation coefficient, and K = SD (SBP)/SD (DBP), where SD = standard deviation. K measures the relative increase in arterial stiffness during systole (‘stiffening’). Factors affecting the LLA were investigated using multilinear regression models with backward-stepwise procedure. Each model included age, sex, diabetes mellitus, heart rate, and one BP factor (average SBP, DBP, and pulse pressure) during baseline, called ‘group1’, and one or more of the factors including body mass index (BMI), Rsd, 1/K, AASI (equivalent to Rsd/K), and BMI∗Rsd/K (equals BMI∗(1-AASI), called ‘group2’.

Results:
BMI, Rsd and 1/K, alone or taken together, adjusted to group 1 factors, were found to be the only significant explanatory predictors. Results were insensitive to the BP factor used. These three predictors were either weakly- or not-correlated with one another. The table below shows the correlation coefficient r of a single predictor from group2 with the LLA and its P-value, and the P value adjusted for group1 predictors.

Conclusions:
Results explain the likelihood of an elevated LLA by a single- or combined predictors associated with the known effects on cerebral vasculature of obesity (lower BMI); elevated arterial stiffening (greater K) and reduced beat-by-beat BP control (lower Rsd). Thus, combining these predictors may be useful markers for cerebral autoregulation.
MILD CORTISOL HYPERPRODUCTION IS ASSOCIATED WITH IMPAIRED GLUCOSE HOMEOSTASIS AND INSULIN-RESISTANCE IN NON-DIABETIC ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Bulfone Luca , Catena Cristiana , Da Porto Andrea , Novello Marileda , Abrusci Rosangela , Colussi Gianluca , Presello Agnese , Frangipane Alessandro , Sechi Leonardo 
Published: April 2021

Objective:
Patients with Cushing syndrome (CS) and subclinical Cushing syndrome (SCS) have higher risk of cardiovascular events than the general population. Excess cortisol secretion might reduce insulin secretion, insulin sensitivity, glucose uptake, and increase gluconeogenesis. Data on cortisol secretion in patients with essential hypertension and on its relationships with glucose homeostasis are scanty. The aim of the study was to evaluate cortisol secretion and its relationship with glucose homeostasis and insulin-sensitivity in essential hypertensive (EH) patients.

Design and method:
In 155 EH patients (age 43 ± 13 years, 81 men) we measured fasting glucose and insulin, HOMA index, plasma cortisol levels at 8 AM, 5 PM and 11 PM, and after an overnight suppression test (DST) with 1 mg of dexamethasone, 24-h free urinary cortisol, and ACTH, and performed a standard oral glucose tolerance test (OGTT), calculating the area under the curve for glucose (G-AUC) and insulin (I-AUC).

Results:
Fasting glucose was positively related to 11 PM cortisol level (r = 0.221, P = 0.019) and post-DST cortisol levels (r = 0.244, P = 0.002). Post-DST cortisol level was positively related with fasting insulin (r = 0.264, P = 0.001), HOMA (r = 0.273, P = 0.001) and I-AUC (r = 0.185, P = 0.023). G-AUC was positively related to 11 PM cortisol (r = 0.246, P = 0.008) and post-DST cortisol levels (r = 0.216, P = 0.007). These associations were independent of age, body mass index, alcohol intake, physical activity, plasma potassium and ACTH levels.

Conclusions:
In non-diabetic patients with EH, relative cortisol hypersecretion is independently associated with impaired glucose homeostasis and insulin resistance.
LONGITUDINAL ASSOCIATION BETWEEN DEPRESSION AND INCIDENT HYPERTENSION-AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Alnakhli/Anwar Anwar , Bazuhair Mohammed , Padmanabhan Sandosh , Smith Daniel 
Published: April 2021

Objective:
Background: The association between depression and cardiovascular disease (CVD) is well documented. However, depression has also been proposed to be involved in the pathological pathways linking the main risk factors of CVDs. Several studies including one meta-analysis have suggested that depression may be an independent risk factor for hypertension. Objective:To evaluate the relationship between depression and incident hypertension

Design and method:
Bibliographic databases Medline, EMBASE, Web of Science and PsycINFO without language restrictions were searched from 2005 up to 2019. We included prospective cohort studies, involving normotensive subjects at baseline with diagnosis of depression measured using clinical evaluation or a standardised psychometric tool and recorded as a dichotomous variable. Outcome was new-onset hypertension. We excluded studies that enrolled participants with a history of antihypertensive medication at the time of study initiation. Methodological quality was assessed using the Newcastle-Ottawa Scale. Pooled hazard ratios (HR) were calculated using inverse variance method in random effects models.

Results:
We identified five studies with a total of 201,886 participants and an average follow-up of 7.52 years. Out of the five studies, only two reported a positive association between depression and incident hypertension. The pooled effect of three studies included in the meta-analysis showed that depression was associated with 20% increased risk of hypertension (HR = 1.20, 95%CI 1.01–1.43) but with a substantial heterogeneity (I2 = 70%). One study reported a null result for a dose-response relationship between depressive symptoms and incident hypertension. Quality analysis showed increased risk of bias notably in the ascertainment of the outcome as most studies relied on self-report and/or prescription of antihypertensive medication as a proxy for hypertension.

Conclusions:
Our findings indicate a possible increased risk of hypertension with depressive symptoms, but this result is limited by heterogeneity and ascertainment bias in the studies included.
THE IMPACT OF POLLUTION ON HYPERTENSION AND ECONOMY
Authors: De Rosa Maria Leonarda , De Vita Alessio , Piccolo Andrea , Ruggiero Federico , Ferrara Nicola 
Published: April 2021

Objective:
We investigated whether traffic-related air pollution and noise are associated with incident hypertension in Naples, Italy, our city. Given the pervasive nature and significant health effects of environmental noise pollution, the corresponding economic impacts may be substantial. Design and method We included 102 study our ambulatory patients for air pollution effects. The economic assessment developed a new approach to estimate the impact of environmental noise on the prevalence and cost of key components of hypertension. Noise data our exposure estimates were derived from are >30 years old. We modelled concentrations of particulate matter with aerodynamic diameter < = 2,5ƒÊm, PM2.5,< = 10ƒÊm, PM10, > 2,5,and < = 10ƒÊm, PM coarse, soot,PM2.5 absorbance, and nitrogen oxides at the addresses of participants with land use regression. Residential exposure to traffic noise was modelled in according to the EU Directive 2002 /49 / EC.We assessed hypertension as self-reported and measured (systolic BP = >140 mmHg or diastolic BP = >90 mmHg or intake of antihypertensive drugs We used Poisson regression to analyze associations of traffic-related exposures with incidence of hypertension, controlling for relevant confounders.

Results:
Among 102 participants free of self-reported hypertension at baseline, 11 incident cases occurred within 1.3 years of follow-up. Incidence of self-reported hypertension was positively associated with PM2.5 relative risk 1.22[95%-confidence interval:1.08; 1.37] per 5 ƒÊg/m3) and PM2.5 absorbance (relative risk 1.13[95%CI:1.02; 1.24] per10 P 5 m P 1. These estimates decreased slightly upon adjustment for road traffic noise. Road traffic noise was weakly positively associated with the incidence of self-reported hypertension. Among 102 participants at risk, 34 new cases of measured hypertension occurred. We found no clear associations with measured hypertension. The analyses suggested that a 5-dB noise reduction scenario would reduce the Hypertension prevalence by 1.4%

Conclusions:
Long-term residential exposures to air pollution and noise are associated with increased incidence of self-reported hypertension. These findings suggest significant economic impacts from environmental noise-related cardiovascular disease. Given these initial findings, noise may deserve increased priority and research as an environmental health hazard.
RELATIONSHIP OF P WAVE DISPERSION AND LEFT VENTRICULAR HYPERTROPHY AMONG HYPERTENSIVES
Authors: Inofomoh Francisca , Familoni Oluranti , Amadi Casmir , Kushimo Oyewole 
Published: April 2021

Objective:
Cardiovascular diseases constitute a global problem. Hypertension is the single most important cardiovascular risk factor for coronary heart disease, congestive heart failure and stroke.
Late detection, poor risk stratification and suboptimal management leads to increased mortality.
Electrocardiography (ECG) is cheap, easily accessible and useful tool to identify early markers of arrhythmias such as P wave dispersion (PWD) and hypertensive target organ damage like LVH.
This study aimed to assess the relationship of PWD and LVH among hypertensive subjects, comparing with normotensive controls and to analyse whether PWD correlates with other cardiovascular risk factors.

Design and method:
150 hypertensives; 25–75 years from cardiology outpatient clinic enrolled with 150 age and sex matched controls. Informed consent taken,clinical history, anthropometric measurements, standard 12 lead ECG and echocardiography were done for all 300 participants following standard operating procedures.
P-wave duration assessed using digital measurements of all leads; PWD calculated as difference between maximum and minimum P wave durations, LVH was determined using the sokolow-lyon criteria on ECG and Left Ventricular Mass Indexed to height2.7 on echocardiography. Left ventricular systolic and diastolic functions were assessed.

Results:
Of 300 participants; 49.3% were males. Mean age of total population was 42.26 ± 11.55 years. Mean Body Mass Index of subjects (26.84 ± 3.64 kg/m2) significantly higher than controls (25.32 ± 3.22)P = <0.001. Likewise the mean waist circumference of the subjects (95.74 ± 11.08 cm) vs. (92.24 ± 9.62 cm), p = 0.004.
Mean P wave dispersion among subjects was 38.29 ± 8.02ms compared to controls; 32.11 ± 4.72ms, P < 0.001. Mean Left Ventricular Mass Index(LVMI)to height was also significantly higher among subjects compared to control; 42.04 ± 15.55 g/ht2.7 vs. 34.24 ± 10.01 g/ht2.7, P < 0.001.
In this study, prevalence of prolonged P wave dispersion among subjects(105)70.0% was significantly higher than(49) 32.6% in the controls, P < 0.001. The correlation of P wave dispersion and left ventricular systolic function (EF) showed inverse relationship r = -0.17 and P = 0.03. A linear positive relations was observed between P wave dispersion and waist circumference r = 0.23, P = 0.004.

Conclusions:
PWD & LVMI are increased in hypertensives; prolonged P wave dispersion is an indicator of presence of other cardiovascular risk factors.