bluuebunny/crossref_metadata_2025_split huggingface dataset:
INVERSE SEASONAL VARIATIONS OF AMBULATORY BLOOD PRESSURE ARE ASSOCIATED WITH CARDIOVASCULAR OUTCOMES IN HYPERTENSIVE PATIENTS
Authors: Gorbunov Vladimir , Smirnova Marina , Koshelyaevskaya Yana , Furman Nikolai , Dolotovskaya Polina , Slepchenko Iuliia 
Published: April 2021

Objective:
The seasonal changes of blood pressure (BP) in hypertensive patients have been widely investigated and attracted an increasing scientific interest during the past two decades. However, it is unclear whether these BP variations are related to cardiovascular risk.

Design and method:
We included patients aged 40–79 years who visited ambulatory clinics for various reasons. The main inclusion criteria were office BP 130/85-139/89 mm Hg, hypertension stage 1, or long-term antihypertensive therapy. The ambulatory blood pressure monitoring (ABPM) was performed with the BPLab device (Nizhny Novgorod, Russia), twice in all patients: in winter (December-February 2012–2014) and in summer (June-August 2012–2014). The interval between ABPMs was 6 months ± 7 days. The selection criteria for ABPM records were: duration >23.5 hours, absence of data gaps >1 hour, and >55 readings per 24 hours. We analyzed the individual ambulatory and office seasonal BP differences in each patient. The participants were followed up until October 31st 2019 (mean follow-up 76.8 ± 5.1 months). The composite primary endpoint included death, myocardial infarction, stroke, transient ischemic attack, angina pectoris, and development of heart failure. The preliminary analyses included ANOVA, sensitivity analysis, and descriptive statistics.

Results:
770 patients completed both visits. The outcome information was available in 528 patients: 335 from Ivanovo and 193 from Saratov (mean age 55 ± 10 years, 220 men). The endpoints were registered in 50 patients. We found the inverse mean winter-summer BP difference in the group of patients with cardiovascular outcomes (see table). In contrast, this difference was positive in the other group (see table). The sensitivity analysis (the winter-summer BP difference classified into 4 groups: inverse (<0), small (0–5 mm Hg), medium (5–10 mm Hg), and large (>10 mm Hg) variation) confirmed the hypothesis for 24-hour diastolic BP. We found no significant associations for office BP.

Conclusions:
The inverse seasonal BP variability may be associated with a higher risk of cardiovascular events; compared to patients with standard BP variability (BP is higher in winter, than in summer). Our data provide the tentative argument in favor of additional ambulatory BP control. The problem of seasonal BP variability warrants further investigation.
THE RELATIONSHIP OF THE BLOOD PRESSURE VARIABILITY AND HEART RATE VARIABILITY: A CANONICAL CORRELATION STUDY
Authors: Li Yuan , Peng Liming , Deng Bin , Pei Zhifang , Xia Ke 
Published: April 2021

Objective:
To determine the association of the blood pressure variability (BPV) and heart rate variability (HRV) derived from ambulatory blood pressure monitoring (ABPM).

Design and method:
2886 patients who perfected the 24 hours ABPM from September 2018 to January 2020 were enrolled and we performed Pearson correlation analysis and Canonical correlation analysis (CCA) to identify the relationship of the dynamic blood pressure (BP) and heart rate (HR) in singer variable aspect and whole set of variate respect, respectively.

Results:
Pearson correlation analysis described the strong connection between the mean value of the systolic and diastolic BP and average value of HR during nighttime and morning surge(r = 0.438,0.475,0.504,0.547,P-value less than 0.01).Results of CCA showed a canonical correlation of 0.934 in the first canonical pair (P-value less than 0.01). Moreover, standard canonical coefficient marked the mean value of BP and HR with the largest efficiency compared to maximum, minimum and standard deviation. The value of BP and HR during nighttime and morning surge with loading approaching 0.5 are key factor of their own variable set. The nighttime average systolic BP attached importance to HRV set and nighttime HR mean value to BPV set(crossing loading:0.533,0.504).Redundancy analysis represent the total interpretative quantity of 12 valued correlation of BPV and HRV set are 58.3% and 90.4%.Whereas,14.6% and 18.8% are the total redundancy accounted by the opposite variable set. In addition, the association more than the reference substance comprising of age and gender.

Conclusions:
With regard to the result of 24 hours ABPM, we cannot neglect the circadian rhythms and tight relationships of BPV and HRV. To better manage the BP and autonomic nervous function, respectively, mitigating the mean value of the BP and HR during nighttime and morning surge should be put on the agenda.
IMPACT OF BREAST CANCER ON OUTCOMES AMONG PHASE 2 CARDIAC REHABILITATION PARTICIPANTS
Authors: Lang Katherine , Van Iterson Erik , Khan Asad , Laffin Luke Joseph 
Published: April 2021

Objective:
Treatment for breast cancer (BC) involves therapies with unclear long-term impacts on exercise physiology and prognosis. Additionally there is increasing support for the use of cardiac rehabilitation (CR) programs in patients with cancer. We sought to determine whether demonstrating a history of BC limits the physiological and clinical benefits of exercise training (ET) during cardiac rehabilitation (CR).

Design and method:
Between 2008 and 2017, 34 women with a history of BC participated in Phase 2 CR at a tertiary medical center. Patients were age-matched 1:1 with female CR participants without a BC history. Exercise capacity (EC) upon CR entry, rate of CR completion, and 5 year mortality differences were assessed.

Results:
Of CR participants with a BC history, 65% received chemotherapy and/or radiation, 32% also received adjuvant therapy (Table). Women with a BC history demonstrated increased EC compared to participants without BC (5.9 ± 1.8 vs. 4.9 ± 1.6 METs, respectively, p = 0.03). Only 18% of patients with BC completed CR compared to 38% of non-BC participants (p = 0.11). Twelve percent of BC patients died within 5 years of CR completion compared with 9% of matched counterparts (p = 0.71)

Conclusions:
CR participants with a history of BC demonstrate greater EC but similar 5 year mortality compared to age-matched patients without a history of BC. Although women with a history of BC benefit from CR, EC outcomes may not be an appropriate surrogate to reflect the impact of this therapy on mortality among this group of patients.
FREQUENCY AND IMPACT OF ADVERSE DRUG REACTIONS INDUCED BY CARDIOVASCULAR DRUGS AND AFFECTING CARDIOVASCULAR SYSTEM: A NATIONAL 10 YEARs OF SURVEILLANCE
Authors: Polonia Jorge , Marques Joana , Lobo Mariana , Vaz Ines , Oliveira Bruno 
Published: April 2021

Abstract

Objective:
Cardiovascular (CV) disorders are a leading cause of death. Adverse drug reactions (ADRs) are an important cause of morbidity and mortality. Drugs for treatment of CV disorders and antithrombotic drugs (AT) are commonly prescribed and a cause of serious ADR (SAR). CV system is also a target for non-CV prescribed drugs. In a national survey we identified the most reported ADR associated with CV and AT drugs and the non-CV drugs more prone to affect CV system.

Design and method:
From January 2006 to December 2015 in a observational retrospective study we analyzed all reports of ADRs (and their determinants) submitted to the National Medicines Regulatory Agency (NMRA).

Results:
In the study period, 10% (n = 2724) of all ADR reports submitted to the NMRA (N = 28061) were related to CV or Antithrombotic drugs, 73.9% of them were SARs and fatal, 55.6% (n = 1479) in women. Mean age was 62 years and 51% of the episodes occurred in subjects > 65 years. AT drugs were the class most frequently associated with SARS (mainly hemorrhages), 31.1% (n = 956, NOACs 251), followed by modulators of Renin-Angiotensin System (cough and dizziness), 19.97% (n = 544), and by lipid modifying agents (musculoskeletal disorders), 19.6% (n = 534). Reports/year to AT increased 7.7 from 2006 to2013 and 88.5 from 2013 to 2015. CV drugs also produced disorders at gastrointestinal (24,63%), skin (22,39%)and nervous system (20,74%). The most common CV ADR associated with non-CV drugs were hypotension (24.4%) and hypertension (16.5%) most commonly induced by antineoplastic, antibiotics and NSAIDs.

Conclusions:
Drugs used for treatment of CV disorders & antithrombotic are a common cause of serious ADRs. ADRS involving the CV system by non-CV drugs are also frequent. All can be detected and identified by current pharmacovigilance tools providing valuable information about the safety of post-marked drugs.
STUDYING THE SITUATION OF CAROTID ATHEROSCLEROSIS OF HYPERTENSIVE PATIENTS IN THE NORTH OF BINH DINH PROVINE, VIETNAM
Authors: Long Nhon Phan 
Published: April 2021

Abstract

Objective:
To evaluate the rate of carotid atherosclerosis in hypertensive patients and the correlations between age, blood pressure, BMI, total cholesterol and atherosclerotic plaque numbers.

Design and method:
A Cross-sectional descriptive study of 207 hypertensive patients in the North of Binh Dinh provine, Viet Nam (2019), examined by doppler ultrasound to evaluate atherosclerotic plaque numbers of the extra-cranial carotid arteries.

Results:
1. Carotid atherosclerotic results
- The rate of atherosclerosis in hypertensive patients: 69.6%
- The percentage of right carotid atherosclerosis is 14.6%.
- The percentage of left carotid atherosclerosis is 19.4%.
- The percentage of atherosclerosis on both of right and left carotid are 66%.
- Percentage of carotid atherosclerosis at before bifurcation: 75%
- The percentage of carotid atherosclerosis at bifurcation 46.52%.
- Percentage of carotid atherosclerosis at after bifurcation 4.16%.
- There are 29.2% of hypertension, have 01 atherosclerotic plaque, 54.2% have 02, 12.5% have 03, 3.5% have 04 vein and 0.7% have over 04 plaques.
2. Some correlation results
- There is no correlation between age, systolic blood pressure, diastolic blood pressure, height and atherosclerotic plaque numbers.
- There is a weak correlation between weight and atherosclerotic plaque numbers (r = 0.20), y = 47.9399 + 2,881 x, R = 0.22. p < 0.001.
- There is a weak correlation between total cholesterol and atherosclerotic plaque numbers (r = 0.18), y = 4.7018 + 0.2839 x, R = 0.19. p < 0.001.

Conclusions:
Carotid atherosclerotic injuries are 69.6% in hypertensive patients. That is very high rate. Should be examined early to treatment and prevent cardio-vascular complications.
FORTY-EIGHT HOUR AMBULATORY RECORDING OF ARTERIAL STIFFNESS IN PATIENTS ON HEMODIALYSIS
Authors: Matasin Marija , Premuzic Vedran , Katalinic Lea , Barisic Ivan , Mesar Ines , Jelakovic Bojan 
Published: April 2021

Abstract

Objective:
Our aim was to analyze circadian pattern of arterials stiffness by measuring 48-hours augmentation index (AIx) and pulse wave velocity (PWV) in patients undergoing chronic hemodialysis (HD).

Design and method:
We enrolled 85 HD patients (mean age 58 (21–86), 48m and 37w) and 75 healthy control subjects (mean age of 64 (20–84), 40m and 35). All patients were dialyzed by the European and KDIGO guidelines. PWV and AIx were measured for 48-hours with Arteriograph starting at the mid-week dialysis session. PWV dippers = nighttime PWV drop > 0.5 m/s; PWV risers = nighttime PWV rise > 0.5 m/s compared to the daytime period. Aix dippers = nighttime Aix drop > 10percentage; Aix risers = nighttime Aix rise > 10% compared to daytime period. ABPM was performed with (SpaceLab 90207) after mid-week dialysis.

Results:
Average values of PWV and Aix did not differ between dialysis and non-dialysis day. Significantly more patients were dippers and risers of Aix and PWV on non-dialysis day vs. dialysis day (Aix dippers 12 vs 3, risers 35 vs 17; non-dippers 38 vs 65,; PWV dippers 38 vs 17, risers 24 vs 18, non-dippers 2 vs 50).
PWV non-dippers and PWV risers had significantly higher ultrafiltration than PWV dippers.
On logistic regression age and duration of hypertension had increased OR of 1.03 and 1.01 for AIx rising pattern on non-dialysis day while age and iPTH had increased OR of 1.06 and 1.03 or PWV rising pattern on non-dialysis day. When AIx and PWV circadian patterns were compared with control group of patients we found that significantly more control subjects had both AIx and PWV dipping patterns than HD patients while significantly more HD patients had both AIx and PWV rising patterns on the non-dialysis day.

Conclusions:
This pattern is more frequently present the day before than after dialysis. Age, duration of hypertension and iPTH were associated with this pattern and those patients required more ultrafiltration. Our results should be confirmed with larger number of patients in a multicentric study.
MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION AND INCIDENT HYPERTENSION IN PREHYPERTENSIVE POPULATION: A CHINESE COHORT STUDY
Authors: Li Fei , Yan Guangyu , Lu Yao , Yuan Hong 
Published: April 2021

Abstract

Objective:
Aim to investigate the gender-dependent association of long-term mean corpuscular hemoglobin concentration (MCHC) with incident hypertension in prehypertensive population.

Design and method:
In this corhort study, a total of 7,753 participants without diabetes and cardiovascular disease were included. All the participants completed the medical examination every year during the follow up. MCHC was divided into groups by gender and quartile. A time-dependent, Cox proportional hazard model was applied to evaluate the association between the incident hypertension and MCHC.

Results:
Over a median follow-up of 5.02 years, 903 male participants and 607 female participants developed into hypertension, and hypertension incidence was 27.69% and 13.51% respectively. After multivarible adjustment, MCHC in the fourth quartile were significantly related to incident hypertension in male participants. Such an association was not found in female participants.

Conclusions:
Gender-dependent associations between MCHC and hypertension incidence exist in prehypertensive population. Mean corpuscular hemoglobin concentration is a risk factor in prehypertensive male participants.
COMPARING THE DISCRIMINATIVE ABILITY OF DIFFERENT ELECTROGRAPHIC CRITERIA FOR LEFT VENTRICULAR HYPERTROPHY IN PREDICTING CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS
Authors: Harvey George , Godec Thomas , Kapil Vikas , Mackay Judith , Whitehouse Andrew , Poulter Neil , Sever Peter S. , Gupta Ajay 
Published: April 2021

Abstract

Objective:
Several ECG criteria are used clinically to define Left Ventricular Hypertrophy (LVH), but there is no consensus on which of these criteria is better at predicting cardiovascular (CV) events in hypertensive patients. In this post-hoc analysis, our objective was to compare the discriminative ability and strength of association of different LVH criteria to predict the risk of CV-morbidity and mortality.

Design and method:
We used the database of the Anglo-Scandinavian Cardiovascular Outcome Trial Our primary outcome was composite of fatal and non-fatal CV event including: coronary heart disease, stroke and coronary re-vascularisation. We developed several cox regression models, separately for each LVH criterion (Modified Sokolov, Cornell, Framingham, Strain Pattern, Cornell-Strain, Cornell-Product), after adjusting for a-priori confounders (age, sex, smoking status, diabetes, pulse pressure, chronic kidney disease stage 3) and other confounders found using stepwise selection (number of anti-hypertensives, previous vascular disease, metabolic syndrome, atrial fibrillation). We compared discriminative ability using c-statistic, goodness of fit of the model using Bayesian information criterion (BIC), hazard ratios (HR) and z-statistics for strength of association of each one of these LVH criteria in respective models.

Results:
9.7% to 17.2% of 17959 hypertensive patients had LVH at baseline as defined by one or more LVH criterion (see Fig. 1). During a median follow up of 5.6 Years (IQR 5.2–6.1) there were 2736 CV events. Figure 1 shows that, whilst c-statistics and accuracy of most criteria are similar, strain pattern and the Cornell strain are better in improving the prediction models and with a higher strength of association with the CV-outcomes (HR 1.52 95% CI: 1.35 - 1.71, Z-statistic 6.88 and HR 1.37 95% CI: 1.226 - 1.519, Z-statistic 5.70, respectively). Both criteria had excellent BIC too.

Conclusions:
In hypertensive patients, compared to other ECG criteria of LVH, strain pattern and Cornell-strain index are stronger and better predictor of the risk of CV morbidity and mortality.
ASSOCIATION BETWEEN CARDIOVASCULAR RISK ESTIMATION BY THE ASCVD RISK ESTIMATOR AND CAROTID-FEMORAL PULSE WAVE VELOCITY IN OLDER INDIVIDUALS
Authors: Ferreira-Filho Sebastião , Souza Denis , Freitas Ercilhana , Peixoto Aldo , Araujo Lucio 
Published: April 2021

Abstract

Objective:
Carotid-femoral pulse wave velocity (c-fPWV) is a noninvasive indirect measure of central arterial stiffness, considered a predictor of cardiovascular events. However, it is not included in any cardiovascular risk calculator, such as the pooled risk equation for atherosclerotic cardiovascular disease (ASCVD) risk estimation. The study aimed to evaluate the association between c-fPWV and CVR in older individuals as determined by ASCVD Risk Estimator.

Design and method:
EVOPIU is a longitudinal study where c-fPWV and ASCVD risk were evaluated in 927 patients aged 60 or older. We measured c-fPWV with the SphygmoCor XCEL model EM4C device (AtCor Medical, Sydney, NSW, Australia). We calculated 10-year ASCVD risk using the pooled equation risk calculator that integrates information on age, gender, systolic BP (and treatment), total and HDL cholesterol, and history of DM. The total area under the ROC curve between ASCVD risk estimator and c-fPWV was identified.

Results:
Average age was 67.8 ± 5.2 years, 38% male, 13% diabetic; 56% hypertensive; total cholesterol 202 ± 37 mg/dl; HDL-cholesterol 52 ± 14 mg/dl, and LDL 119 ± 33 mg /dl. Baseline c-fPWV was 9,3 ± 0,9 m/s. The average ASCVD risk was 21.9%. There was a direct correlation between c-fPWV and ASCVD risk (Spearman's = 0.74 p < 0,0001. Survival analysis showed that CVR or c-fPWV detected higher number of deaths in the largest tertiles (chi2: 8.3; p = 0.002). The area under the curve was 0.86 with 77.4% sensitivity and 77.3% specificity with c-fPWV cutoff = 9.6 m / s.

Conclusions:
There is a positive association between c-fPWV and ASCVD risk estimator. The c-fPWV measurement could complement ASCVD risk estimator in older individuals.
ACTIVITY OF THE ANGIOTENSIN-CONVERTING ENZYME MEDIATES THE ASSOCIATION BETWEEN PLASMA VITAMIN D AND PLASMA ALDOSTERONE IN HYPERTENSIVE PATIENTS
Authors: Bulfone Luca , Catena Cristiana , Da Porto Andrea , Palomba Andrea , Colussi Gianluca , Duratti Andrea , Cavarape Alessandro , Scandolin Laura , Sechi Leonardo 
Published: April 2021

Abstract

Objective:
Deficiency of 25-OH Vitamin D (25OHD) and activation of the renin-angiotensin-aldosterone system (RAAS) are both known cardiovascular risk factors. Some studies have shown that 25OHD has a suppressive effect on RAAS but data in literature are conflicting. The aim of the study was to evaluate the relationships between 25OHD level and RAAS parameters in essential hypertensive (EH) patients without obesity and of severe impairment of renal function.

Design and method:
In 153 EH subjects (age 49 ± 12 years, 87 males, 123 naive, 30 after a wash-out period) we evaluated clinical characteristics, glomerular filtration rate (GFR), plasma levels of 25OHD, 1,25OHD, PTH, potassium, calcium, plasma aldosterone (PA), active renin (AR), angiotensin-converting-enzyme (ACE), 24-h urinary calcium (UCa) and 24-h urinary sodium.

Results:
25OHD level was significantly and directly related with UCa (r = 0.209, P = 0.024), ACE (r = 0.470, P < 0.001), PA (r = 0.272, P = 0.001), and inversely related with age (r = -0.301, P < 0.001) and PTH level (r = -0.188, P = 0.025). At multivariate analysis, 25OHD level was independently associated with levels of PTH (B = -0.213, P = 0.023), ACE (B = 0.488, P < 0.001) and PA (B = 0.201, P = 0.039). PA level was positively related with 25OHD, 1,25-OHD (r = 0.256, P = 0.026), and ACE (r = 0.296, P = 0.006) and inversely related with age (r = -0.260, P = 0.019), plasma potassium (r = -0.261, P = 0.001) and alcohol intake (r = -0.224, P = 0.007). In a multivariate model that did not include ACE, PA was independently associated with levels of plasma potassium (B = -0.227, P = 0.004) and 25OHD (B = 0.197, P = 0.018). After inclusion of ACE, PA level remained independently associated only with plasma potassium (B = -0.244, P = 0.015) and alcohol intake (B = -0.244, P = 0.016). At multivariate analysis with ACE as the dependent variable and 25OHD and PA as independent variables, ACE was independently associated with 25OHD level (B = 0.427, P < 0.001).

Conclusions:
In patients with EH, PA and 25OHD are directly related and this relationship appears to be mediated by the activity of ACE.
INTERVENTIONAL STUDY ON LIFE STYLE OF HEART DISEASES PATIENTS IN PAKISTAN
Authors: Arain Mudassar Iqbal 
Published: April 2021

Objective:
Cardiac diseases such as heart failure, cardio myopathies and arrhythmias are increase in our society. Our social habits like tobacco smoking, use of alcohol and sedentary life style are the major factors of cardiac diseases. Hypertension, diabetes, obesity are also contributing in high prevalence of heart diseases in world particularly Pakistan. on the basis of above facts, the current study was designed to analyze the impact of intervention on life style on cardiovascular problems in various areas of Pakistan.

Design and method:
Therefore; an interventional study was designed among 300 patients via purposive sampling for a period of one year from June 2018 to June 2019. An initial evaluation of patients’ lifestyles were performed using individual questions. Follow-up questionnaires were administered at different sessions. We defined successful cholesterol and level of blood pressure control i.e. blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.

Results:
Out of 300 patients, 68.4% of the patients were under the category of sedentary life style. 32.4% hypertensive patients with 30–35 kg/m2 were observed. The interventional technique was applied and results were assessing after six month. Patient's attitude (treatment, diet intake and sleeping and exercise habits) mean scores pre counselling and post counselling for patients were significantly different and improved. Post interventions results show that patients upgraded their practice by intermittently checking their blood pressure level, cholesterol, lipid profile, control smoking habit and maintain their life styles.

Conclusions:
The current study demonstrates the positive results were noted by life style modification and improvement in daily practice. Patient's attitude mean scores pre counselling and post counselling for patients were significantly different and improved. Post interventions results show that patients upgraded their practice by intermittently checking their blood pressure level, control smoking habit, daily exercise and healthy diet and maintain their life styles. This shows that our interventions had positive impact on the awareness, knowledge, life style, disease management and practice of cardiac patients