bluuebunny/crossref_metadata_2025_split huggingface dataset:
RELATION BETWEEN AMBIANT TEMPERATURE AND BLOOD PRESSURE: A CROSS SECTIONNAL ANALYSIS FROM THE GUBBIO RESIDENTIAL COHORT STUDY
Authors: Humbert Xavier , Puddu Paolo -Emilio 
Published: April 2021

Objective:
The aim was to investigate impact of ambient temperature (AT) on blood pressure (BP) in the Gubbio residential cohort.

Design and method:
Cross-sectional analyses were performed using data from 5 058 persons (45% men, 49 ± 18 years old). AT (indoor and outdoor) was collected at each inclusion. Three BP measurements were performed following a standard protocol. Linear regression was used to examine the relationships of AT with BP.

Results:
From June 1988 to July 1992, relationships of indoor temperature (r = -0.03 and r = -0.05 for systolic or diastolic BP respectively) and outdoor temperature outdoor temperature (r = - 0.05 and r = - 0.08 for systolic or diastolic BP respectively) with BP were inconsistent. The same relations were found in hypertensive subjects.

Conclusions:
In primary care, ambient (indoor and outdoor) temperature does not seem to influence blood pressure.
SEX DIFFERENCES IN LIFESTYLE FACTORS AND BLOOD PRESSURE: A CROSS-SECTIONAL ANALYSIS FROM THE GUBBIO STUDY, AN ITALIAN RESIDENTIAL STUDY
Authors: Humbert Xavier , Licaj Idlir , Puddu Paolo-Emilio 
Published: April 2021

Objective:
Hypertension is a well-established major risk factor for cardiovascular disease. Lifestyle behaviors for its prevention and control are recommended within worldwide guidelines. Their relationship with blood pressure (BP), and particularly sex differences, need more investigations. The aim was to investigate impact of lifestyle factors on BP and sex differences in the Gubbio residential study.

Design and method:
Cross-sectional analyses were performed using data from Gubbio study. Information's concerning lifestyle factors were collected using self-reported questionnaire and were further completed with a baseline clinical examination and blood exams. Three BP measurements were performed following a standard protocol. Age-adjusted and multiple linear regressions were used to examine the relationships between lifestyle parameters and BP. We used heterogeneity test to observe sex differences.

Results:
In Gubbio residential study, 3,183 persons were included (48% men, 43 ± 17 years old). Mean systolic BP (SBP) was 119 ± 16 mmHg and 10.6% were hypertensives. In multivariable analysis, age, BMI, uric acid and fast blood glucose (FBG) were positively associated with SBP in both sexes. Alcohol was positively associated in women while coffee in women and education level in men were negatively associated with SBP. We observed sex differences concerning education level (high versus low education, p = 0.03), BMI (overweight versus normal, p = 0.04), age (p < 10-4) and coffee consumption (p = 0.04) associated to SBP.

Conclusions:
Many different factors influence differently SBP in men and women (age, education level, BMI, coffee and alcohol consumptions).
THE EFFECTIVENESS AND SAFETY OF ISOMETRIC RESISTANCE TRAINING FOR ADULTS WITH RAISED BLOOD PRESSURE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Hansford Harrison , Parmenter Belinda , Wewege Michael , Mckleod Kelly , Smart Neil , Schutte Alette , Jones Matthew 
Published: April 2021

Objective:
Isometric resistance training (IRT) has demonstrated anti-hypertensive effects, but safety data is limited. Determine the effectiveness and safety of IRT compared to non-exercising control in adults with raised blood pressure.

Design and method:
We conducted a systematic review of published and unpublished trials up to August 2020. We included randomised control trials comparing IRT conducted for at least 3 weeks to a non-exercising, sham or lifestyle modification control in adults with raised blood pressure (systolic greater or equal to 130 and/or diastolic greater than or equal to 85mmHg). The outcomes were office, ambulatory and central blood pressure, as well as safety (adverse events). We assessed risk of bias with the Cochrane risk of bias tool and strength of evidence with GRADE. We conducted random-effects meta-analyses in R.

Results:
24 trials of 1143 participants were included, mean age = 56 ± 9yrs, 56% female. IRT resulted in clinical and statistically significant reductions in both office systolic (-6.72 mmHg, 95% CI -8.64 to -4.79, p < 0.0001) and diastolic blood pressure (-3.80 mmHg, 95% CI -5.22 to -2.38, p < 0.0001) however, the results of studies differed significantly, with the overall quality being very low. IRT also resulted in clinical and statistically significant reductions in central systolic (-7.48mmHg, 95% CI -14.89 to -0.07, p = 0.035) and diastolic blood pressure (-3.75mmHg, 95% CI -6.38 to -1.12, p = 0.005), though the quality of evidence was low. 24hr ambulatory systolic (-2.77mmHg, 95% CI -6.80 to 1.25, p = 0.18) blood pressure did not see a significant reduction but diastolic blood pressure did (-2.39mmHg, 95% CI -4.28 to -0.40, p = 0.02), with very low-quality evidence. The findings of 964 participants with data for adverse events there were 8 events in the IRT group and one in the control group; equating to one adverse event per 28,428 bouts of IRT. There were no serious adverse events. All trials were at a high risk of bias.

Conclusions:
IRT reduces office and central blood pressure with clinical and statistical significance although the quality of evidence is very low and low respectively. IRT appears safe with few adverse events occurring. High-quality trials are required.
CUFF-BASED AND INTRAARTERIAL BRACHIAL BLOOD PRESSURE MISMATCH AND ITS POTENTIAL IMPACT ON ANTIHYPERTENSIVE TREATMENT AND ESTIMATION OF AORTIC BLOOD PRESSURE
Authors: Goupil Remi , Kowalski Cedric , Yang Katie , Charron Thierry , Doucet Michel , Hatem Raja , Kouz Remi , Palisaitis Donald , Schampaert Erick , Terriault Paul , Tessier Pierre , Agharazii Mohsen 
Published: April 2021

Objective:
Cuff-based brachial blood pressure (BP) is universally used as a guide to treat hypertension, although it can differ from the intraarterial BP. In this study, we examine the potential impact of cuff-to-intraarterial brachial systolic BP (bSBP) mismatch phenotypes on BP treatment and its impact on determination of central BP.

Design and method:
In 379 hypertensive subjects undergoing cardiac catheterization through the radial artery, non-invasive brachial cuff and central BPs were measured using the Mobil-o-Graph device simultaneously to intraarterial brachial and aortic BP. According to the difference between cuff-based bSBP (CUFF-bSBP) and intraarterial bSBP (IA-bSBP), we identified three phenotypes: Underestimation Mismatch group (CUFF-bSBP < IA-bSBP by more than 10 mmHg); No Mismatch group (CUFF-bSBP within 10 mmHg of IA-bSBP); Overestimation Mismatch group (CUFF-bSBP > IA-bSBP by more than 10 mmHg). Influence on ACC/AHA BP categories was evaluated and accuracy was determined following ARTERY society recommendations (mean difference <=5 ± 8 mmHg).

Results:
The Underestimation (n = 190), No Mismatch (n = 155) and Overestimation (n = 34) groups, despite overall similar clinical characteristics, showed only minor differences in CUFF-bSBP (127 ± 17, 123 ± 15, 126 ± 19 mmHg) despite highly different IA-bSBP (147 ± 18, 126 ± 16 vs 108 ± 18 mmHg, p < 0.001) and aortic SBP (136 ± 20, 122 ± 16, 109 ± 18 mmHg, p < 0.001). ACC/AHA BP categories were concordant in 33%, 68% and 44% of the Underestimation, No Mismatch and Overestimation groups. The Underestimation Mismatch group had 64% of individuals at risk of undertreatment compared to 16% in the No Mismatch Group, while in the Overestimation Mismatch Group 50% were at risk of overtreatment compared to 17% in the No Mismatch group. Cuff bSBP accurately estimated the aortic SBP only in the No Mismatch Group (mean difference 1.7 ± 8.2 mmHg) whereas central BP with the Mobil-o-Graph device did not reach the strict ARTERY criteria for accuracy in any groups.

Conclusions:
Our study shows that the brachial cuff underestimates and overestimates intraarterial brachial BP in a significant proportion of hypertensive subjects, potentially leading to an increased risk of BP mismanagement, and inaccurate non-invasive estimation of central BPs. This underlines the importance of improving the accuracy of cuff-based brachial and central BP monitors, ideally taking into consideration invasive BP phenotypes.
CONTRIBUTING FACTORS OF INTRADIALYTIC HYPERTENSION IN MAINTENANCE HAEMODIALYSIS PATIENTS
Authors: Gathmyr Dewi , Nugroho Pringgodigdo , Awang Iqbal , Lydia Aida , Bawazier Lucky Azizah , Khumaedi Indri , Marbun Maruhum Bonar 
Published: April 2021

Objective:
The objective of this study was to determine the proportion of IDH and to evaluate its association with fluid overload using Bioimpedance Analysis (BIA).

Design and method:
A cross-sectional study involving 130 chronic haemodialysis patients in Cipto Mangunkusumo hospital Jakarta. This study is conducted between September to November 2019. IDH was defined as an increase in Mean Arterial Pressure (MAP) of at least 15 mmHg within or after dialysis or an increase of systolic blood pressure more than 10 mmHg after dialysis.

Results:
The prevalence of IDH was 17,7% (n = 23). There was a trend towards predialysis excess fluid in the IDH group with 10 (45,5%) samples when compared with NIDH with 35 (32,7%) samples respectively; as measured by BCM (p = 0.184). A trend towards use of more than 3 antihypertensives was noted in the IDH group [12 (52,1%) samples versus <3 types was 11 (47.8%) samples; p > 0.000]. On bivariate analysis, post dialysis blood pressure and post dialysis MAP are significantly greater in IDH group, as expected. None of the predialysis blood pressure, BMI, ultrafiltration, and serum sodium were associated with incident of IDH

Conclusions:
The prevalence of IDH in our treatment centres is 17,7%. Subclinical fluid overload was found higher in IDH patients, although statistically non significant. The use of BIA identifies patients who may benefit from additional UF.
SERUM MAGNESIUM CONCENTRATION IS REVERSELY ASSOCIATED WITH ARTERIAL STIFFNESS IN YOUNG ADULTS WITH HYPERTENSION
Authors: Khomova Irina , Ilinskaia Sofia , Kirpichnikova Ekaterina , Ezhova Nadezhda , Shavarova Elena , Bazdyreva Elena , Kobalava Zhanna 
Published: April 2021

Objective:
Magensium deficeincy is known as a risk factor for cardiovascular disease. However, the data on it's role in arterial stiffness developement is controversial. Our aim was to investigate the association of serum magnesium levels with arterial stiffness in young hypertensive patients.

Design and method:
We included 94 adults 18–45 years old with masked and sustained hypertension verified with 24-hours ambulatory blood pressure monitoring (ABPM). None of them were on blood pressure (BP) lowering treatment. We performed routine clinical investigation including anthropometry, biochemical blood assay, office BP measurement and ABPM. Atrerial stiffness was estimated with applanation tonometry and cardio-ankle vascular index (CAVI) measurement. To investigate the relationship between serum magnesium concentration and other variables we used Spearman's rank correlation coefficient.

Results:
Median age was 23[21–25] years, 79% were males, median body mass index - 24.9 [22.3;28.7].
Median serum magnesium level was 0,9 [0,84;0,94]. No significant associations were found for magnesium concentration and BP characteristics, neigher office, nor 24-hours. Pulse wave velocity was reversely associated with serum magensium level: (-0,184), p = 0,013. Magnesium concentration had also reverse significant correlation with CAVI (-0,300), p < 0,001. These findings were independent of blood pressure levels, body mass index and insulin resistance.

Conclusions:
Serum magnesium concentration is reversely associated with pulse wave velocity and cardio-ankle vascular index in young patients with hypertension.
LEFT VENTRICULAR GEOMETRY AND FUNCTION AND GLOMERULAR FILTRATION RATE DIFFERS IN YOUNG NEVER-TREATED PATIENTS WITH HIGH NORMAL AND NORMAL BLOOD PRESSURE
Authors: Ezhova Nadezhda , Kirpichnikova Ekaterina , Ilinskaia Sofia , Khomova Irina , Shavarova Elena , Bazdyreva Elena , Kobalava Zhanna 
Published: April 2021

Objective:
While ESC define individuals with systolic blood pressure of 130–140 mm Hg or diastolic blood pressure of 80–89 mm Hg as normotensive, AHA classify them as hypertensive. Already sophisticated, clinical decision making in young hypertensives becomes really tricky, especially in patients of gray zone.

Design and method:
We recruited 127 adults 18–45 years old with BP 130/80 mm Hg or higher registered during check-up. All of them had never taken any BP-lowering medication. In all those out-patients we performed routine medical examination, including repeated measurements of office BP, 24-hours ambulatory BP monitoring, anthropometry, blood and urine tests and echocardiography. The participants were divided into 3 subgroups: normotensives (with SBP < 130 and/or DBP < 80mmHg, n = 64), hypertensives (SBP 140 mm Hg and/or DBP 90 mm Hg, n = 25), and intermediate group (SBP 130–139 and/or DBP 80–89 mmHg, n = 38).

Results:
Median age was 23[21–25] years; 81,1% were males, 90,6% were Caucasians. The subgroups were comparable in age and BMI. Patients had different glomerular filtration rate (GFR): 105,85[102,64;121,79] vs 103,02[91,61;109,73] vs 96,85[84,50;104,85] ml/min/1.73 m2 for normotensive (group I), intermediate (group II) and hypertensive (group III) patients respectively, p = 0,001. We observed difference in left ventricular mass index (LVMI): 80,32[68,34;87,06] vs 87,06[78,87;99,98] vs 92,31[85,15;107,55] g/m2 in groups I, II and III, respectively, p < 0,001. In pairwise comparison of LVMI we observed significant difference between I and II groups (p = 0,002) and I and III (p < 0,001). LV concentric remodeling was more prevalent in hypertensive patients (52%) than in normotensive (20%) or patients with intermediate BP (46%), p = 0,004. Incidence of LV hypertrophy didn’t significantly differ in groups: 3,6% vs 6,5% vs 12%, for I, II and III, respectively, p = 0,352. E/A ratio was 1,68[1,38;1,86] vs 1,55[1,3;1,9] vs 1,86[1,48;2,22] for I, II and III, respectively, p = 0,044. In the pairwise comparison the difference in E/A between normotensive and patients with intermediate level of BP was significant: p = 0,016.

Conclusions:
Rate and severity of abnormal LV geometry and function and GFR decline is higher in young patients with high normal BP than in those with normal and optimal BP.
THE PROGNOSTIC VALUE OF MARKERS OF MYOCARDIAL AND RENAL DYSFUNCTION IN OLDER HYPERTENSIVE PATIENTS WITH COMORBIDITY
Authors: Efremova Elena , Shutov Alexander , Podusov Alexander 
Published: April 2021

Objective:
Comorbidity, including chronic kidney disease (CKD), chronic heart failure (CHF)and anemia, worsens the prognosis in older patients with arterial hypertension. Hypoxia is the leading link in pathogenesis. The aim of this study was to investigate the prognostic value of markers of myocardial and renal dysfunction in older hypertensive patients with CHF.

Design and method:
72 older hypertensive patients with CHF (27 males and 45 females, mean age 71.8 ± 8.4 years) were examined. Arterial hypertension was defined according to ESC Guidelines for the diagnosis and treatment of arterial hypertension, 2018. CKD was diagnosed and classified according to the KDIGO guidelines (2012). Serum levels of HIF-1, endogenous erythropoietin (eEPO), N-terminal propeptide of type B natriuretic hormone (NT-proBNP), cystatin C were assessed. The follow-up period was 12 months; the primary endpoint was total mortality.

Results:
CKD was diagnosed in 48 (66.7%) older hypertensive patientswith CHF. The HIF-1 levelwas significantly higher in the group of deceased patients than in the survivors (0.08 (IQR 0.06; 0.11) and 0.05 (IQR 0.04; 0.07) ng / ml, p = 0.02), as well as the level of NT-proBNP (1126.3 (IQR 551.8; 2750.0)and 164.4 (IQR 135.5; 1100.9) pg / ml, p < 0.0001), EPO(16.92 (ICR 5.43; 64.57) and 5.36 (IQR 1.65; 8.85) mIU / ml, p < 0.0001),cystatin C(1.49 (ICR 0.86; 2.13) and 0.99 (IQR 0.82; 1.32) Mg / l, p = 0.0005). Multivariate regression analysis showed an independent relationship between the eEPO level and patient survival (R = 0.61, ß = 0.49, p = 0.0037).

Conclusions:
The level of eEPOin older hypertensive patients with CHF has an independent and closer relationship with the mortality of patients than the traditional markers of myocardial and renal dysfunction.
A HIGHER FAT FREE MASS OF LEFT LEG WAS ASSOCIATED WITH AN INCREASED RISK OF CARDIOVASCULAR RISK FACTORS AMONG CHINESE CHILDREN AND ADOLESCENTS
Authors: Dong Yangyang , Cai Rongrong , Ma Ping , Yang Qingmei , Jia Leina , Ding Wenqing 
Published: April 2021

Objective:
The relationship between lean body mass (LBM) and Cardiovascular risk factors (CVRFs) in children and adolescents remains unclear. This study aimed to examine the association between LBM and risk of CVRFs among Chinese children and adolescents.

Design and method:
In this cross-sectional study, a total of 1159 children and adolescents aged 10 to 18 underwent a comprehensive assessment of CVRFs, including questionnaire surveys, physical examination, and biochemical tests. Lean body mass analysis was performed with bioelectrical impedance analysis (BIA). The number of CVRFs clustering greater than or equal to 1 was defined as CVRFs > = 1.

Results:
The individuals with CVRFs > = 1 showed higher level for all LBM indexes than those with no CVRFs (CVRFs < 1). The prevalence of CVRFs > = 1 increased, with the level of all LBM indexes increased, all P < 0.001. For example, the prevalence of CVRFs > = 1 increased with the increase of fat free mass (FFM), from 25.3% to 48.1%, P < 0.001. Compared to the lowest LLFFM tertile group, the adjusted OR and 95% confidence interval (CI) for CVRFs > = 1 were 7.16 (1.13–45.45) and 5.49 (1.40–21.58) in the second and highest LLFFM tertile group, respectively, after adjusting sex and age.

Conclusions:
A higher LLFFM was associated with an increased risk of CVRFs among children and adolescents. It is essential for children and adolescents to keep LLFFM at a low level to prevent cardiovascular disease (CVD) and take LBM into account when assessing the risk of CVD.
WHEN NOT TO NEGOTIATE RHYMES WITH TAKING RISKS
Authors: Caruso Giuseppe , Ciarambino Tiziana , Ciaburri Filippina , Paoli Vera Delli , D’Avino Maria 
Published: April 2021

Objective:
The ESH/ESC 2018 guidelines recommend lifestyle modifications in subjects with high-normal blood pressure (BP) values and low-moderate cardiovascular risk. The purpose of this study was to assess whether a population of subjects with high-normal BP could develop arterial hypertension or organ damage over a three-year follow-up.

Design and method:
In this study, 98 subjects (60 M), with mean age 42 ± 12.7 years, were randomized. In 34 subjects, silent signs of organ damage were highlighted, in the remaining 64 no anomalies were highlighted. ABPM (Ambulatory Blood Pressure Monitoring) was applied to the 64 subjects and, repeated annually.

Results:
Twelve of the 64 subjects, during the 3 years of follow up, became hypertensive grade 1, with no evidence of organ damage; 15 presented echography changes (rhythm disturbances, left anterior hemiblock, left axial deviation, left ventricular hypertrophy); 2 paroxysmal AF and only 1 subject, was subjected to tomography computerized investigations with evidence of adrenal adenoma. The remaining 34 subjects, with only lifestyle changes, presented, BP values controlled both by clinical measurement and by ABPM.

Conclusions:
Our results, in a small sample, show an evolution of high-normal BP in arterial hypertension grade 1, as well as the appearance of organ damage. The follow up of subjects with high-normal BP, must be constant over time, with visits, also carried out by dedicated nursing staff. In addition, a complete initial assessment would be desirable, for the exclusion of concomitant pathologies.
ISOLATED DIASTOLIC BLOOD PRESSURE AND RISK OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE IN A COMMUNITY DWELLING POPULATION
Authors: Cheng Di , Wang Qian , Tan Isabella , Butlin Mark , Avolio Alberto , Zuo Junli 
Published: April 2021

Objective:
Although the threshold of blood pressure (BP) for hypertension was lowered to 130/80 mmHg in the 2017 American college of cardiology (ACC)/American Heart Association (AHA) guidelines, the threshold of >=140/90 mmHg was still recommended in both the 2018 European Society of Cardiology (ESC) and 2019 National Institute for Health and Care Excellence (NICE) guideline. This study was to explore the clinical significance of isolated diastolic blood pressure for cardiovascular risk based on the two hypertension thresholds.

Design and method:
6768 participants without antihypertensive treatment were included in the analysis of the association between isolated diastolic hypertension (IDH) and atherosclerotic cardiovascular risk. IDH was defined respectively by 2017 AHA/ACA guidelines (systolic BP < 130mmHg, diastolic BP >= 80mmHg) and by the ESC/NICE definition (systolic BP < 140mmHg, diastolic BP >=90mmHg). Arteriosclerotic cardiovascular disease (ASCVD) was determined by the 2013 ACC/ AHA recommended guidelines.

Results:
The estimated prevalence of IDH was 24.0% by the 2017 ACC/AHA definition and 10.85% by the 2018 ESC/ 2019 NICE definition. Compared with normotensive individuals, those with IDH by both the 2017 ACC/AHA definition and the 2018 ESC/ 2019 NICE definition did not show any significant difference for the prevalence of ASCVD risk [Odds Ratio (OR) of 2017 ACC/AHA definition: 0.56, 95% confidence interval (CI):0.3–1.01; OR of 2018 ESC/ 2019 NICE definition: 1.43, 95%CI: 0.83–2.44]. The diagnostic efficiency of diastolic blood pressure is not significant (Area Under the ROC Curve: 0.51, 95%CI: 0.48–0.55). The dose-response relationship was validated by restricted cubic spline analysis (P for overall association = 0.57, P for non-linear association = 0.50).

Conclusions:
In this Chinese population, IDH is more prevalent when defined by the 2017 AHA/ACC definition compared with the 2018 ESC/ 2019 NICE definition. However, IDH as defined by either threshold is not significantly associated with increased ASCVD risk and its diagnostic efficacy is poor.
EFFECTS OF ACE INHIBITORS AND ANGIOTENSIN TYPE-1 RECEPTOR BLOCKERS ON ACE-2 EXPRESSION IN HUMAN ALVEOLAR EPITHELIAL CELLS
Authors: Caputo Ilaria , Caroccia Brasilina , Seccia Teresa Maria , Domenig Oliver , Poglitsch Marko , Rossi Gian Paolo 
Published: April 2021

Objective:
Angiotensin converting enzyme 2 (ACE-2) has regained widespread attention as the cellular receptor of SARS-CoV-2 virus that caused the COVID-19 pandemic. It was contended that ACE inhibitors (ACEis) and angiotensin type 1 receptor (AT1R) antagonists (ARBs) increase ACE2 expression in lung cells and their administration in Covid-19 patients could be detrimental and/or constitute a potential risk factor. As there were no evidences supporting this hypothesis we investigated the effect of ACEis/ARBs on ACE2 expression in lung cells.

Design and method:
Calu-3 cells, epithelial cells derived from lung adenocarcinoma, were treated with 10 μM irbesartan (ARB), or 10 μM ramipril (ACEi) alone or in the presence of 100 nM Angiotensin II (Ang II) for 12 hours in serum-free media. After 12 hrs ACE2 mRNA expression was evaluated by Digital droplet (dd)PCR.

Results:
We found that Ang II increased by two-fold ACE2 mRNA copies (vehicle 792.7 ± 161.3 vs Ang II 1475 ± 319.9; p < 0.001), while both irbesartan and ramipril did not affect ACE2 expression levels (722.3 ± 170.2 and 747.8 ± 313.8, respectively). Moreover, pretreatment with irbesartan abolished Ang II-induced ACE2 expression (722.3 ± 170.2 copies irbesartan vs 1046 ± 182.4 copies Ang II + irbesartan; p < 0.05), while pretreatment with rampiril had no such effect (1252 ± 246,4 copies Ang II + ramipril).

Conclusions:
ARBs and ACEis do not increase ACE2 expression at mRNA levels in human epithelial lung cells. Ang II increased ACE2 expression by acting via AT1R. Therefore, these results provided mechanistic support to a beneficial effect of both ACEi and ARB treatment in Covid19 patients with Sars-CoV-2 infection.