bluuebunny/crossref_metadata_2025_split huggingface dataset:
SODIUM HYDROGEN SULFIDE IMPROVES RENOVASCULAR HYPERTENSION-INDUCED MALADAPTIVE CARDIAC REMODELING AND DIASTOLIC DYSFUNCTION BY REDUCING OXIDATIVE STRESS AND MMP ACTIVITY
Authors: Pernomian Laena , de Mello Marcela Blascke , de Castro Michele Mazzaron 
Published: April 2021

Objective:
To evaluate whether treatment with sodium hydrogen sulfide (NaHS) improves cardiac function and remodeling of two kidney-one clip (2K-1C) rats through inhibition of matrix metalloproteinase (MMP) activity and oxidative stress.

Design and method:
2K-1C hypertension was surgically induced in male Wistar rats (200 g; ethics commitee #118/2019) by an implantation of a silver clip (0.2 mm) in the left renal artery. Control rats (2K) was submitted to laparotomy. SBP and echocardiograph were registered. The NaHS (0.24 mg/Kg/day; i.p.) treatment or vehicle (0.6% DMSO in saline; i.p.) was initiated in the second week after the surgeries and lasted for 28 days. Hearts were collected and western blotting to MMP-2, Nox2 and Nox4 were performed in the left ventricles. MMPs localization and activity were also evaluated by in situ zymography. Reactive oxygen species (ROS) were investigated by dihydroethidium (10 μM). Data are presented as mean ± S.E.M. of different experimental n. Two-way ANOVA with Bonferroni correction was used (P < 0.05).

Results:
SBP values of 2K-1C (165.47 ± 3.98mmHg, n = 12) were increased compared to 2K rats (133.28 ± 2.48mmHg, n = 10; P < 0.0001) in the first week after the surgery. NaHS treatment decreased SBP of 2K-1C NaHS (155.60 ± 5.72mmHg, n = 5) compared to 2K-1C vehicle (202.13 ± 5.57mmHg, n = 7; P = 0.0003). Isovolumetric relaxation time analysis showed increases in values from 2K-1C rats (40.31 ± 2.97ms, n = 7) and NaHS treatment (28.04 ± 1.05ms, n = 5) normalized this parameter (P = 0.0018). 2K-1C rats (2.30 ± 0.11 mm, n = 7) presented increased interventricular septum thickness and NaHS treatment (1.99 ± 0.0 mm, n = 5) reduced this parameter (P = 0.028). MMP-2, Nox2 or Nox4 expression was not different in all groups. The gelatinolytic activity of MMPs was higher in 2K-1C vehicle rats (18,029.31 ± 1,225.42U, n = 3) and NaHS (12,092.70 ± 868.22U, n = 3) reduced it (P = 0.021). In 2K-1C rats (33,868.95 ± 2,103.74U, n = 3), ROS were higher compared to control and NaHS treatment (22,019.50 ± 914.08 U, n = 3) decreased this value (P = 0.0021).

Conclusions:
Our results showed beneficial effects of NaHS treatment in 2K-1C rats, thus leading to SBP decrease, cardiac function improvement and reduction in both MMPs activity and oxidative stress.
ARTERIAL STIFFNESS PARAMETERS AS INDICATORS OF CORONARY ARTERY DISEASE IN YOUNG PATIENTS
Authors: Oleynikov Valentin , Khromova Angelina , Salyamova Lyudmila 
Published: April 2021

Objective:
To assess the state of the arterial bed in patients with CAD with varying degrees of coronary artery injuries (CA) and healthy peers.

Design and method:
The study included 92 patients with CAD (mean age 41.3 ± 8.2 years). Inclusion criteria: CAD verified by coronary angiography (CAG), ECG and/or biomarkers, hospitalization for unstable angina. After CAG, the patients were divided into 3 groups: the first - 30 people without hemodynamically significant stenoses (HSS1 < 50%) of CA, the second - 37 patients with HSS of 1 CA (HSS1 > 50%), the third group - 35 patients with HSS 2 or more CA (HSS2 > 50%). The control (C) group consisted of 28 healthy individuals. Regional arterial stiffness was assessed by volume sphygmography (Fukuda Denshi, Japan): R/L–PWV - PWV in elastic arteries, L-/CAVI-1 - cardio-ankle vascular index. Applanation tonometry (AtCorMedical, Australia) was used to record carotid-femoral PWV (cfPWV) and indicators of central aortic pressure: systolic (SBPao), pulse (PPao).

Results:
The lowest R/L-PWV values were in control - 10.1 ± 1.9 m/s; in patients with CAD, an increase in R/L-PWV was revealed in the HSS1 < 50% group - 11.9 ± 1.5 m/s and in the group HSS1 > 50% - 13.9 ± 0.9 m/s. The highest values were found in the group HSS2 > 50% - 13.9 (9.6;14.7) m/s (p < 0.05). The L-/CAVI-1 index in control was 6.4 (5.6;7.3), in group 1 - 7.2 (6.2;8.4), in group 2 - 8.3 (6.7;9.4) in group 3 - 9.5 (7.1;10.4) (p < 0.05). According to the applanation tonometry, in healthy people HSS1 < 50%, HSS1 > 50%, and HSS2 > 50%, a comparable level of central BP was recorded: SBPao - 100.9 ± 8.1mmHg, 100.5 ± 9.7mmHg, 100.3 ± 8.4mmHg 101.3 ± 7.7mmHg, PPao - 26.8 ± 6.1mmHg, 27.0 ± 5.9mmHg, 29.0 ± 5.3mmHg, 28.7 ± 6.4mmHg, respectively (p > 0.05), which is probably due to the examination in pharmacotherapy. The smallest cfPWV values were recorded in control - 6.5 ± 0.9 m/s compared with group 1 - 7.4 (6.2;8.7) m/s, in the group 2 - 8.5 ± 1.1 m/s, group 3 - 9.6 ± 1.4 m/s (p < 0.05).

Conclusions:
In patients with CAD, a significant violation of the vascular stiffness parameters was diagnosed, more pronounced in people with stenosis of two or more CA. The study results confirm that the CAD in young adult is a clinical manifestation of the widespread process of early vascular aging.
DETERMINANTS OF ADHERENCE TO ANTIHYPERTENSIVE MEDICATIONS AMONG PATIENTS ATTENDING TERTIARY CARE HOSPITALS IN ISLAMABAD
Authors: Noreen Nadia , Bashir Faiza , Safi Malik Mohammad , Khan Abdul Wali , Naveed Irum , Ahmad Waheed , Niazi Saeed Ullah Khan , Khan Naveed Ullah 
Published: April 2021

Objective:
Hypertension is one of the non-communicable diseases which reduces life expectancy and decreases productive years, accounting for almost 9·4 million deaths annually and 7·0% of global DALYs. The economic burden associated with NCD deaths will rise from $152 million in the year 2010 to $296 million in 2025. Nonadherence to medications leads to poor health outcomes. The annual cost of nonadherence was estimated to be at 100 million US dollars in 2011 or 70% of healthcare expenditure on drugs worldwide. We conducted this study to have an insight into our patient's behavior towards their treatment regimes.

Design and method:
A hospital-based analytical cross-sectional study involving adult hypertensive patients attending the cardiology clinic of tertiary care hospital in Islamabad Capital Territory (ICT), conducted from July 2019 to October 2019. The data was collected using a semi-structured pretested questionnaire. Proportionate to target population sample was calculated and 418 subjects were enrolled through systematic random sampling technique. Data analysis was done as descriptive statistics Bivariate analysis was carried out and a p-value of less than 0.05 considered as significant. Logistic regression was done to identify independent predictors of adherence

Results:
The mean age of respondents was 54.4 years SD ± 10.61. Participants were predominately male (56.2%). 327 (72.7%) of the respondents had High Bp Grade I, uncontrolled blood pressure. 218 (48.44%) were not able to afford to buy monthly medication, Average monthly cost of the medication was 7.42 USD (1150 PKR) ± 1136 Pak Rupees, with 28.89% were not able to buy the medications on their own. Multivariate logistic regression analysis revealed non-affordability of treatment (OR 2.2 p-value 0.0002) and testing, uncontrolled hypertension (OR 3.1 p-value 0.0001), as statistically significant determinants for being nonadherent, whereas being educated (OR O.6 p-value 0.02))and adequate counseling by a health practitioner (OR 0.2 p-value 0.000) were protective factors.

Conclusions:
For improving adherence to antihypertensive therapy, we concluded the prevalent paradigm of healthcare is nonsupportive in terms of enhanced and non-affordable treatment regimes, long waiting hours, non-availability of universal health coverage. Further, education and better counseling had a positive impact on the patient's altered attitude towards medications.
MENOPAUSAL HORMONE THERAPY AND RISK OF INCIDENT HYPERTENSION: IMPACT OF THE ROUTE OF ESTROGEN ADMINISTRATION AND PROGESTOGENS IN THE E3N COHORT
Authors: Madika Anne-Laure , Macdonald Conor-James , Fournier Agnes , Mounier-Vehier Claire , Beraud Guillaume , Boutron-Ruault Marie-Christine 
Published: April 2021

Objective:
Although menopausal hormone therapy (MHT) remains the most efficacious treatment for vasomotor symptoms of menopause, its effects on the development of arterial hypertension remain unclear. We sought to determine the effect of different formulations of MHT on incident hypertension among menopausal women in a large prospective cohort study.

Design and method:
We used data from the E3N cohort study, a French prospective population-based study initiated in 1990 of 98,995 women. Out of these, 49,905 menopausal women with complete information on the use of MHT, and without prevalent hypertension at inclusion were included. Hypertension cases were self-reported and validated using the national drug reimbursement database.

Results:
Among these women with a mean age was 54.2 ± 4.3 years, 10 173 cases of hypertension were identified in an average follow-up time of 10.6 years and 32 183 (64.5%) of the women reported ever using MHT. Compared with women who never used MHT, those who ever used it had an increased risk of incident hypertension (adjusted HR 1.07, 95% CI 1.02–1.12) after adjustment for body mass index and other potential confounders (Table 1). When formulation was taken into account, oral but not transdermal estrogen use was associated with an increased risk of hypertension (adjusted HR = 1.09; 95% CI: 1.04–1.14 and HR = 1.03; 95% CI: 0.99–1.07, respectively). Regarding the impact of concomitant progestogens, pregnane and norpregnane derivatives were significantly associated with hypertension risk (HR = 1.12; 95% CI: 1.06–1.19 and HR = 1.06; 95% CI: 1.01–1.13, respectively).

Conclusions:
Use of MHT was associated with an increased risk of incident hypertension, especially when using oral estrogen and pregnane and norpregnane derivative in case of combined treatment. Surveillance of blood pressure should be added to the medical surveillance of MHT users.
RENOVASCULAR HYPERTENSION-INDUCED CARDIAC CHANGES IN A RAT MODEL: FEASIBILITY OF CONVENTIONAL AND RECENT ECHOCARDIOGRAPHY
Authors: Ma Danfu , Mandour Ahmed S. , Hendawy Hanan , Yoshida Tomohiko , El-Husseiny Hussein M. , Ozai Yusuke , Takeuchi Aki , Takahashi Ken , Uemura Akiko , Tanaka Ryou 
Published: April 2021

Objective:
Renovascular hypertension (RH) is a major cause of secondary hypertension, and hypertension eventually led to cardiac remodeling in patients. Hypertension leads to concentric left ventricle hypertrophy, while hypervolemia originated from renal failure leads to eccentric hypertrophy. Both mechanisms occur in RH which results in complex cardiac remodeling. Uraemic cardiomyopathy results from RH is characterized by diastolic dysfunction, but traditional echocardiography was limited in evaluating the diastolic function due to unknown hemodynamic and morphologic status. Recently, non-invasive intraventricular pressure gradient (IVPG), a preload-independent diastolic function parameter, was established and showed higher sensitivity to evaluate diastolic dysfunctions, particularly during cardiomyopathy. However, no previous studies highlighted the feasibility of the IVPG in the diagnosis of RH.

Design and method:
Twelve rats were received subtotal nephrectomy in 1 week to produce progressive renal failure as the RH group. The other twelve rats were sham-operated as a control group. Conventional and color M-mode echocardiography was performed for isoflurane-anesthetized rats at 2nd, 4th, 6th, and 8th weeks post-operation. IVPG was evaluated based on the Euler equation.

Results:
Hypertension, polyuria and hypervolemia were observed in RH group from the 2nd, 4th, and 8th week, respectively. Marked left ventricle hypertrophy was evidenced at 6th (1.32 ± 0.28 vs 1.09 ± 0.09, p = 0.016) and 8th-week post-operation (1.34 ± 0.28 vs 1.16 ± 0.09, p = 0.014) that was more prominent in the posterior papillary muscle. Peak mitral E velocity in RH rats was higher than control at the 8th week (106.35 ± 16.04 vs 91.23 ± 10.82, p = 0.031). In contrast, tissue Doppler index, total IVPG, basal IVPG, and mid-to-apical IVPG showed no difference between groups throughout the experiment.

Conclusions:
Hypervolemia and RH lead to unclassified geometry in RH-associated cardiac remodeling. Blood pressure change precedes the change of preload during the development of RH cardiac remodeling.
CAN A SYNTHETIC PREDICTOR BASED ON CAROTID DISTENSION WAVE ACQUIRED WITH AN OPTICAL FIBER SENSOR IDENTIFY PAST CARDIOVASCULAR EVENTS?
Authors: Rebelo Pedro Damião dos Santos , Antunes Paulo Fernando da Costa , Pinto João de Lemos , André Paulo Sergio de Brito , Bastos Jose Adelino Mesquita , Leitao Catia Sofia Jorge 
Published: April 2021

Objective:
Exploratory study of the potential use of carotid distension pulses collected with a plastic optical fiber sensor (POFpen), for the identification of past cardiovascular (CV) events. The POFpen device working principle is based on the application of an optical signal on a reflector placed in the skin above the carotid surface, whose distension movements modulate the reflected signal, which is collected by the same fiber.

Design and method:
Carotid distension data were collected from 73 patients, where 68 were considered for this study (cases with no missing data), with 61 hypertensives. Exclusion criteria: cardiac arrhythmia, premature ventricular beats, respiratory problems, severe mental problems. 10 patients had a previous CV event (cerebrovascular accident or myocardial infarction). The study was approved by the local ethics committee.
The temporal sequences from the POFpen were studied in its raw form. The exploratory analysis of the data sets considered transformations of a segment per raw file with a length of 23 s. We extract 5 features that translate abstract geometric properties per raw data segment, namely: fractal dimension of the signal (FD_x); fractal dimension of the difference in the difference between 3 consecutive points (FD_2); signal entropy (entropy_x); the maximum frequency values (index_max_FFT), determined by FFT (Fast Fourier Transform), per segment; interquartile range of the Wavelet s5 (IQR_WT_S5) transforms (using R DWT package, wavDWT with filter type “s8”). We create a logistic model to predict the existence of previous CV event and the performance of the model was evaluated by Receiver Operating Characteristics (ROC) curve. All the statistical work was made with R version 3.6.3.

Results:
The features used by model which predicts CV event, are presented on figure a). The model achieved excellent discrimination with an area under the curve (AUC) of 0.849 [0.743, 0.955], see figure b).

Conclusions:
The results of this preliminary study show the potential of to use the raw data from the carotid distension data acquired with an optical probe to identify past CV event. In order to validate this methodology a new set of new patients’ data should be used.
PREVALENCE OF BLOOD PRESSURE CONTROL AND ITS DETERMINANTS AMONG ADULTS WITH HYPERTENSION IN URBAN PUDUCHERRY DISTRICT, PUDUCHERRY, INDIA, 2020
Authors: Lakshmanasamy Ravivarman , Kaur Prabhdeep 
Published: April 2021

Objective:
Hypertension exerts a substantial public health burden on cardiovascular health status and healthcare system of India. We did this study with the objective to find the prevalence, awareness, treatment, control rate of hypertension and the factors associated with the control for hypertension in the urban Puducherry district.

Design and method:
We did a cross sectional survey at the community level among adults aged 18 to 69 years in Urban Puducherry. Sample size was calculated using multi stage cluster sampling design. A total of 2700 individuals were to be surveyed, in twenty seven clusters. Data was collected using ODK based app. We used modified WHO STEPS questionnaire, collected anthropometric measurements and recorded blood pressure. We analyzed the proportion of all variables, using epi info software. The study was approved by the Institutional Ethics Committee.

Results:
A total of 2000 households were surveyed, of which 1755 (87.8%) agreed to participate in the study. We surveyed 1686 individuals of which 40.9 %were males. The mean age was 42(+13) years. Among them, 331 (19.6%) people had high blood pressure and 209 (63.1%) were already known hypertensives. Although 173 (52.3%) were on treatment, only 63 (19%) had their blood pressure under control. Among people with hypertension, nearly half were obese (BMI >27.50 kg/m2) and about 20% reported consumption of high salt foods. Nearly one third (36%) had diabetes mellitus. Majority (61%) utilized private clinics for hypertension treatment. Among public sector users, 71% reported medicines were always available in the facilities. Majority (80%) received medicines for one month. The odds of having comorbidities is 2.7 times more in people with blood pressure control than those without control.

Conclusions:
We observed high prevalence of hypertension, treatment among half of the patients and only one fifth had blood pressure control. More than half of the population utilized private doctor's clinic for hypertension treatment. People without other comorbidities are found to have less blood pressure control. We recommend frequent community level screening for hypertension and focus on compliance among people without other comorbidities.
RETINAL VASODILATORY RESPONSES ARE INVERSELY ASSOCIATED WITH PLASMINOGEN ACTIVATOR INHIBITOR-1: THE AFRICAN-PREDICT STUDY
Authors: Jacobs Adriaan , Pieters Marlien , Smith Wayne , Schutte Aletta 
Published: April 2021

Objective: Aims:
Plasminogen activator inhibitor-1 (PAI-1), traditionally associated with fibrinolysis, is increasingly implicated in impaired vascular function. However, studies on its association with microvascular function are limited to the cutaneous and coronary microvascular beds in older and diseased individuals. To better understand its potential involvement in the early stages of disease development, we investigated the associations of retinal vasodilatory responses to flicker light with PAI-1 activity (PAI-1act) in young and healthy individuals.

Methods:
We included healthy Black and White women and men (n = 518; aged 20–30 years), and measured plasma PAI-1act and retinal vasodilatory responses to flicker light provocation. We also collected demographic and lifestyle data, measured blood pressure, anthropometry, blood lipids, inflammatory and other biomarkers.

Results:
In multivariate regression analyses, maximal retinal venular dilation associated independently and inversely with PAI-1act (Adj. R2 = 0.11; ? = -0.15; p = 0.001) in the total group. In exploratory subgroup analyses, this association remained in White women (Adj. R2 = 0.07; ? = -0.23; p = 0.005), and was more robust with younger age and lower blood pressure and in non-smokers, but also with greater central adiposity, higher low-density lipoprotein cholesterol and inflammation (all p < 0.05).

Conclusions:
Our data suggest that in young individuals, PAI-1 may already be associated with subclinical microvascular dysfunction.
Factors Contributing to Lingering Pain after Surgery: The Role of Patient Expectations
Authors: Willingham Mark D. , Vila Molly R. , Ben Abdallah Arbi , Avidan Michael S. , Haroutounian Simon 
Published: April 2021

Background
Pain that lingers beyond the early weeks after the acute postoperative period is an important risk factor for chronic postsurgical pain. This study examined the hypothesis that patients’ expectations about their postsurgical pain would be independently associated with lingering postsurgical pain.

Methods
The study included 3,628 patients who underwent diverse surgeries between February 2015 and October 2016 in a single U.S. tertiary hospital and participated in the Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) observational study. Preoperatively, patients were asked about their expectations about pain 1 month after surgery. Patients were considered to have lingering postsurgical pain if they endorsed having pain in the area related to their surgeries during a follow-up survey obtained 1 to 3 months postoperatively. The independent associations between preselected perioperative variables and lingering postsurgical pain were evaluated.

Results
Of the cohort, 36% (1,308 of 3,628) experienced lingering postsurgical pain. Overall, two thirds (2,414 of 3,628) expected their postsurgical pain to be absent or improved from baseline, and 73% of these had their positive expectations fulfilled. A total of 19% (686 of 3,628) expected new, unabated, or worsened pain, and only 39% (257 of 661) of these had their negative expectations fulfilled. Negative expectations were most common in patients with presurgical pain unrelated to the reason for surgery, undergoing surgeries not typically performed to help alleviate pain. Endorsing negative expectations was independently associated with lingering postsurgical pain (odds ratio, 1.56; 95% CI, 1.23 to 1.98; P < 0.001). Additional major factors associated with lingering postsurgical pain included recollection of severe acute postoperative pain (odds ratio, 3.13; 95% CI, 2.58 to 3.78; P < 0.001), undergoing a procedure typically performed to help alleviate pain (odds ratio, 2.18; 95% CI, 1.73 to 2.75; P < 0.001), and preoperative pain related to surgery (odds ratio, 1.91; 95% CI, 1.52 to 2.40; P < 0.001).

Conclusions
Lingering postsurgical pain is relatively common after diverse surgeries and is associated with both fixed surgical characteristics and potentially modifiable factors like pain expectations and severe acute postoperative pain.

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