bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal association between serum uric acid level and carotid atherosclerotic plaques in patients with new cases of hypertension
Authors: Podpalova O , Kaliadka M , Mrochek A 
Published: October 2021

Abstract

Objective
To reveal the relationship between uric acid level and carotid atherosclerotic plaques in hypertensive subjects in randomized urban population according to 10-years prospective study.

Design and methods
A 10-years prospective study included 3,500 randomized individuals living in the district of Vitebsk (2007/2008 - 2017/2018). The coverage of the survey was 97,9% (3427 participants). There was revealed 2170 persons with normal blood pressure. 1862 of them were examined on the second stage in 2012/2013 (coverage of the survey was 85,8%). 286 new cases of hypertension were revealed and they had significant positive relationship with the IV quartile of uric acid level (≥339 μmol/l). A 10-years prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed on the second stage of the study. Specially developed registration form was filled in for all the participants and it included socio-demographic data, standard questionnaires for detection of cardiovascular risk factors, anthropometry, blood pressure measurements, electrocardiography, blood chemistry, ultrasound examination of brachiocephalic arteries and echocardiography.

Results
According to the results of 10-years prospective study serum uric acid level ≥339 μmol/l, revealed at the start of the study, is a predictor of the detection of carotid atherosclerotic plaques in 2017/2018 in subjects with new cases of hypertension (df=1; χ2 Wald=6,63; p&lt;0,05) adjusted for age and gender. Cross-sectional analysis of these subjects showed that the level of uric acid, regardless of age and gender, is associated with the level of triglycerides (p&lt;0,001), apo B (p&lt;0,001), apo A1 (p&lt;0,05), LDL (p&lt;0,05), VLDL (p&lt;0,05), HDL (p&lt;0,05), non-HDL-C (p&lt;0,05), total cholesterol (p&lt;0,05), high-sensitivity CRP (p&lt;0,05), TNF-α (p&lt;0,05), apoB/apoA1 ratio (p&lt;0,05), glycated hemoglobin percentage (p&lt;0,05), body mass index (p&lt;0,001), waist circumference (p&lt;0,05), metabolic syndrome (p&lt;0,05) and alcohol abuse (p&lt;0,05). In stepwise multiple linear regression model the most significant of these factors were the level of triglycerides (β=0,23, p&lt;0,05), alcohol abuse (β=0,18, p&lt;0,05), body mass index (β=0,18, p&lt;0,05), apoB/apoA1 ratio (β=0,17, p&lt;0,05) and level of high-sensitivity CRP (β=0,15, p&lt;0,05).

Conclusions
Serum uric acid level ≥339 μmol/l predicted detection of carotid atherosclerotic plaques in patients with new cases of hypertension in 10-years prospective study. The most significant factors, regardless of age and gender, associated with serum uric acid levels in these patients were level of triglycerides, alcohol abuse, body mass index, apoB/apoA1 ratio and level of high-sensitivity C-reactive protein.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Republican Scientific and Practical Centre of Cardiology
Home blood pressure monitoring detects unrevealed hypertension in women with a history of preeclampsia: results of the BP-PRESELF study
Authors: Muijsers H E C , Wu P , Van Der Heijden O W H , Wijnberger L D E , Van Bijsterveldt C , Buijs C , Pagels J , Toennies P , Heiden S , Roeleveld N , Maas A H E M 
Published: October 2021

Abstract

Background/Introduction
The risk of cardiovascular disease more than doubles after hypertensive disorders of pregnancy. As early onset chronic hypertension contributes to cardiovascular risk, implementation of screening strategies, using home blood pressure monitoring (HBPM), may help to improve long-term cardiovascular health.

Purpose
We evaluated whether HBPM among women with a history of preeclampsia/HELLP syndrome is feasible for early detection and management of hypertension.

Methods
The Blood Pressure after PREeclampsia by SELF monitoring (BP-PRESELF) is a multicenter randomized controlled trial. We recruited 198 women with a mean age of 45 years, approximately 12 years after the index pregnancy. Participants were randomized to intervention group with HBPM for the duration of one year or the control group with 'usual care' (Figure 1). The primary outcome was feasibility of HBPM during 1 year of follow-up, defined as protocol adherence, protocol persistence and patient acceptance. Secondary outcomes were blood pressure levels and prevalence of hypertension.

Results
The baseline characteristics did not show statistically significant differences between groups, except for years since index pregnancy. Especially blood pressure levels were very similar at time of inclusion.
Protocol adherence decreased during the first 6 months, after which it stabilized (Figure 2A). Protocol persistence remained high throughout follow-up (Figure 2B). During the study period, 33 women (34%) in the intervention group were diagnosed with hypertension versus only 10 women (11%) in the control group. At 1-year follow-up, mean systolic blood pressure (SD) was 120.4 (11.6) mm Hg in the intervention group versus 126.1 (14.3) mm Hg in the control group, P=0.003. Mean diastolic blood pressure (SD) values were 77.2 (8.0) mm Hg versus 81.7 (9.4) mm Hg, P&lt;0.001, respectively. Adjusted systolic and diastolic differences (95% confidence interval) were −6.81 (−10.17, −3.45) and −4.93 (−7.26, −2.61) mm Hg, with 80% less hypertension at 1-year follow-up in the intervention group.

Conclusion(s)
HBPM appears to be feasible for follow-up of blood pressure in women after preeclampsia/HELLP syndrome, while it detected hypertension and reduced blood pressure levels after intervention in one-third of women in this group.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): INTERREG-V-A program Germany-The Netherlands “Zorg Verbindt”, co-financed by the European Union (EU), Ministry for Economy, Innovation, Digitalization and Energy of the Federal State of Nordrhein-Westfalen (Germany), and the Province of Gelderland (The Netherlands). CONSORT flowchartProtocol adherence (A) and persistence (B)
Accuracy of a cuffless blood pressure measurement with a single-channel electrocardiogram monitor with photoplethysmography
Authors: Sagirova Z H N , Kuznetsova N O , Gogiberidze N A , Gognieva D G , Chomakhidze P S H , Kopylov P H Y U 
Published: October 2021

Abstract

Introduction
The accurate assessment of the blood pressure (BP) allows to diagnose of the cardiovascular diseases and correct their treatment timely. Cuff-less BP measurement can be more convenient to use and can also provide the blood pressure monitoring using with telemedicine. In this study, we evaluated the cuff-less BP measurement method based on photoplethysmography.

Purpose
To evaluate the accuracy of cuffless blood pressure measurement using with the single-channel electrocardiogram (ECG) monitor with photoplethysmography pulse wave registration.

Methods
The study included 500 patients aged from 32 to 88 years (mean 64±7,9 years) with arterial hypertension. We used the single-channel electrocardiogram monitor with photoplethysmography, this device looks like a phone case and records electrocardiogram (I standard lead) and photoplethysmogram (PPG) simultaneously. For each patient, blood pressure was measured using a sphygmomanometer with a cuff (3 times and the mean value was calculated). Then within 1 minute after blood pressure measurement, an electrocardiogram and photoplethysmogram were recorded for 3 minutes using the single-channel electrocardiogram monitor with photoplethysmography. ECG and PPG were recorded from the patient's fingers in a sitting position. According to the combination of the electrocardiogram signal and the photoplethysmogram signal, using a special algorithm based on machine learning, the levels of systolic and diastolic blood pressure were calculated. We compared measurement of blood pressure obtained using with the sphygmomanometer and the single-channel electrocardiogram monitor with photoplethysmography.We used the Bland-Altman method for statistical data analysis.

Results
In total of 1000 blood pressure measurements were obtained from 500 patients. According to the Bland-Altman analysis of systolic pressure the average discrepancy was 3,49 mmHg, the standard deviation was 4,21, the standard error of the average was 0,61. One-sampled 2-sided t-test was −0,477 (confidence interval −2.83; −4.33). The average discrepancy for diastolic blood pressure was 3,1 mm Hg, the standard deviation was 3,61 mm Hg, standard error of the average 0,52, One-sampled 2-sided t-test was −0,455 (95% confidence interval −2,64; −4,18). The correlation of the systolic and diastolic pressure using with two measurement methods was 0,89 (p=0,001) and 0.87 (p=0,002), respectively.

Conclusion
There is not significant difference between the results of cuffless measurement of the blood pressure by the single-channel electrocardiogram monitor with photoplethysmography and cuff-based sphygmomanometer measurement in patients with cardiovascular diseases.

Funding Acknowledgement
Type of funding sources: None.
Single pill combinations present a proven fast track in practice to reach the target blood pressure
Authors: Brguljan J , Chazova I E , Gaciong Z , Simic D , Vajer P , Zelveian P , Jelakovic B 
Published: October 2021

Abstract

Objective
To assess the efficacy of ambulatory blood pressure (BP) lowering with perindopril/amlodipine (dual SPC arm) and perindopril/amlodipine/indapamide (triple SPC arm) in newly diagnosed and uncontrolled hypertensive patients. Design and method: 450 adults with essential hypertension were assessed in the interventional, open-label, prospective, international, multicentre PRECIOUS trial. Treatment duration was 16 weeks, divided into four treatment periods. ABPM was performed at the baseline and end of the study (prior to the visit 1 and 5), with a validated automated portable BP-measuring device (Mobil-O-Graph PWA) worn on the non-dominant arm for a 24-hour period, measuring BP in 20 minutes interval during the day and 30 minutes interval during the night. At inclusion, naïve or patients uncontrolled on previous mono or dual therapy (other than perindopril/amlodipine (P/A)) were assigned to dual SPC arm with initial dose of 4/5 mg P/A. Those uncontrolled on previous dual or triple therapy were assigned to triple SPC arm with initial dose of 4/5/1.25 mg perindopril/amlodipine/indapamide (P/A/I). If office BP control was not reached, the initial dose was up titrated in 4-week intervals to 8/5 mg, 8/10 mg P/A or 8/10/2.5 mg P/A/I in dual SPC arm and to 8/5/2.5 mg, or 8/10/2.5 mg P/A/I in triple SPC arm.

Results
After 16 weeks of treatment the decrease in average ambulatory BP was −16.1/−10.8 mmHg (from 142.8/92.6 mmHg to 125.1/80.8 mmHg) in dual SPC arm and −21.8/−13.5 mmHg (from 147.3/93.3 mmHg to 124.2/79.0 mmHg) in triple SPC arm. The relative reductions in ambulatory BP were −11.1%/−11.3% in dual and −14.5%/−14.2% in triple SPC arm. The absolute as well as relative ABPM reductions were higher for the awake-time BP. All ambulatory BP reductions were statistically significant in both arms (p&lt;0.001). 71% of patients reached the normal 24h SBP levels and 45.6% the normal 24h DBP levels. At the end of the trial, the mean dose of perindopril was 6.4±2.0 mg and of amlodipine 6.5±2.3 mg in dual SPC arm. In triple SPC arm, the mean dose of perindopril was 6.66±1.89 mg, of amlodipine 6.51±2.30 mg, and of indapamide 2.08±0.59 mg. Treatment tolerability was good. 85% of patients experienced no adverse events; the recorded ones were clinically irrelevant.

Conclusions
Applying dual (perindopril/amlodipine) and triple (perindopril/amlodipine/indapamide) SPC treatment strategy resulted in a significant and fast BP reduction, measured by ABPM, in naïve and in patients uncontrolled on previous therapy. In even 71% of patients normal 24h SBP was reached. It seems that adding long acting diuretic in triple SPC enhanced drug efficacy even though the patients in the triple SPC arm had a more resistant hypertension.

Funding Acknowledgement
Type of funding sources: None.
Effect of the renin angiotensin system inhibitors on inflammatory markers: a systematic review and meta-analysis of 32 randomized controlled trials
Authors: Awad K , Zaki M M , Mohammed M , Banach M 
Published: October 2021

Abstract

Background
Inflammation plays a critical role in the etiology of cardiovascular disease (CVD). The renin-angiotensin system inhibitors including angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been shown to be effective in reducing elevated blood pressure. However, the information on their potential effect on inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) is still lacking.

Purpose
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to synthesize evidence about effect of ACEIs and ARBs on selected inflammatory markers.

Methods
PubMed, Scopus, and Embase were searched from inception until February 15, 2021. We included RCTs that assessed the effect of ACEIs or ARBs, compared with placebo, on any of the following markers: CRP, IL-6, or TNF-α. Mean changes in the relevant markers levels were pooled as a standardized mean difference (SMD) with a 95% confidence interval (CI) under the random-effects model. Heterogeneity was assessed using I2 and χ2 tests.

Results
Thirty-two RCTs (n=3,403 patients) were included in the analysis. Overall pooled analysis suggested that ACEIs significantly reduced plasma levels of CRP (SMD: −1.08 [95% CI: −1.57 to −0.59]; I2: 95%), IL-6 (SMD: −0.75 [95% CI: −1.41 to −0.09]; I2: 81%), and TNF-α (SMD: −1.77 [95% CI: −2.82 to −0.73]; I2: 95%). This lowering effect remained statistically significant by perindopril in terms of all relevant markers, by quinapril and ramipril in terms of IL-6 and by enalapril in terms of TNF-α. As for the ARBs as a class, they showed a statistically significant reduction only in terms of CRP (SMD: −0.14 [95% CI: −0.28 to −0.01]; I2: 0%) and did not significantly affect any of the other markers. Moreover, the ARBs individual drugs did not show any significant effect on any of the relevant markers except for valsartan that significantly reduced plasma levels of IL-6 (SMD: −0.42 [95% CI: −0.80 to −0.04]; I2: 0%).

Conclusions
Based on the results of this meta-analysis, ACEIs showed a beneficial lowering effect on CRP, IL-6, and TNF-α, while ARBs were effective as a class only in terms of CRP reduction. Further larger RCTs are warranted to confirm these results particularly in case of individual drugs and to assess the significance of these reductions in terms of CVD prevention.

Funding Acknowledgement
Type of funding sources: None.
Low testosterone accelerates vascular damage in hypertensive smokers with more than a 20-pack-year smoking history
Authors: Ioakeimidis N , Terentes-Printzios D , Sigala E , Xydis P , Gardikioti V , Gourgouli I , Georgakopoulos C , Tsioufis K , Vlachopoulos C 
Published: October 2021

Abstract

Purpose
Testosterone deficiency and cigarette smoking are both associated with increased cardiovascular (CV) mortality risk. Aim of the study is to investigate the impact of low testosterone level on vascular function and structure changes related to cumulative tobacco smoke exposure in patients with arterial hypertension.

Methods
Indices of vascular function and structure including carotid-femoral pulse wave velocity (PWV) and carotid intima media thickness (cIMT) were measured in 263 hypertensive males divided into 4 age-matched groups according to pack-years of smoking as never smokers (0.0 pack-years), light smokers (0.1–20.0 pack-years), moderate smokers (20.1–40.0 pack-years), and heavy smokers (&gt;40 pack-years). Plasma total testosterone (TT) levels were measured in all patients.

Results
PWV and cIMT progressively increased from never smokers and light smokers to moderate and heavy smokers (overall P&lt;0.001 and P&lt;0.01 respectively). The hypertensive males of each smoking group were further classified according to measured low or normal TT levels (low TT&lt;3.5 ng/ml). Figure shows mean PWV and cIMT of the smoking/TT groups. Systolic and diastolic BP was higher in patients with TD compared to subjects with normal TT in moderate and severe heavy smokers (all P&lt;0.05) and similar in light and never smokers. LDL-C levels were comparable between men with TD and normal TT across the four smoking groups. The difference in aortic PWV between TD and normal TT shows a progressive increase from light to moderate and heavy smokers. Similarly, the difference in cIMT between TD and normal TT is also positively correlated with cumulative tobacco exposure. All associations remained statistically significant even after adjustment for BP differences.

Conclusions
The deficiency in TT levels accelerates vascular wall damage of large arteries among hypertensive smokers with more than 20 pack-years tobacco exposure. Considering the predictive value of vascular biomarkers, the findings of this study imply the possibility that the measurement of baseline testosterone level could be an unfavourable marker of smoking-related cardiovascular risk among moderate and heavy smokers with arterial hypertension.

Funding Acknowledgement
Type of funding sources: None. TT, tobacco smoke exposure, PWV and IMT
Associations between serum triglycerides and abdominal aortic calcification in a cross-sectional study from the United States of America
Authors: Penson P , Javed S , Banach M , Lip G Y H 
Published: October 2021

Abstract

Background
Abdominal aortic calcification (AAC) has recently been recognised as a risk factor for cardiovascular disease, as it shares pathophysiological mechanisms with coronary artery disease.

Purpose
We investigated relationships between AAC and traditional cardiovascular risk factors in a cross-sectional epidemiological cohort from the USA

Methods
We used data from the National Health and Nutrition Evaluation Survey (NHANES) from the years 2103–2014. Dual-energy X-ray absorptiometry (DXA scans) were performed for a subset of 3140 NHANES participants over the age of 40. The images were scored according to ACC-24, a 24-point scale.
We performed binary logistic regression to investigate relationships between demographic variables (age, sex, poverty income ratio, & educational status) CV risk factors (triglycerides (fasting, and non-fasting) LDL-C, HDL-C systolic blood pressure, body mass index, smoking status & diabetes) medicine use (statins, antihypertensives and antiplatelets) and AAC status (patients with a score ≥2 on the 24-point scale were considered AAC positive). Non normally-distributed variables were categorised for the purposes of analysis.

Results
Participants with AAC were older (mean 65.5 years ± SD 11.7) than unaffected individuals (56.1±11.1) AAC was also associated with higher BMI (28.7±5.8 v. 27.6±4.8 kg/m2), and higher systolic blood pressure (131.3±19.5 v 125.8±18.4 mmHg).
We found a strong relationship between plasma triglyceride concentrations and AAC. In univariate analysis, fasting triglycerides above the first quartile were associated with approximately double the risk of AAC, compared to those in the first quartile (see table). This relationship persisted when the analysis was adjusted for demographics, risk factors and medicine use. A similar pattern was seen with non-fasting triglycerides (see table).

Conclusions
We found a strong relationship between triglycerides and AAC. Further work is required to determine whether this observation can be validated in other cohorts, and whether interventions to reduce triglyceides can alter the progression of AAC.

Funding Acknowledgement
Type of funding sources: None. Odds ratios (95% CI) for AAC
Impaired endothelial glycocalyx predicts adverse outcome in subjects without overt cardiovascular disease: a 6-year follow-up study
Authors: Ikonomidis I , Thymis J , Simitsis P , Katsanos S , Triantafyllou C , Kousathana F , Pavlidis G , Kountouri A , Polyzogopoulou E , Katogiannis K , Vlastos D , Kostelli G , Triantafyllidi H , Lekakis J , Lambadiari V 
Published: October 2021

Abstract

Aim
Endothelial glycocalyx is involved in the clinical course of atherogenesis. The purpose of this study was to investigate whether disturbance of glycocalyx integrity is related with increased cardiovascular risk.

Methods
Perfused Boundary Region (PBR), a marker of glycocalyx integrity, was measured non-invasively in sublingual microvessels with a diameter ranging from 5–25 μm using a dedicated camera (Sideview, Darkfield Imaging). Increased PBR indicates reduced glycocalyx thickness. We measured baseline PBR in 400 apparently healthy subjects, without established cardiovascular disease. We prospectively monitored the occurrence of major cardiovascular events (MACE-death, myocardial infarction, stroke and heart failure hospitalization) during a 6-year follow-up period using electronic records and clinic visits.

Results
Forty-three MACE were documented during follow-up. Subjects with PBR at 5–9 μm microvessel diameter greater than 1.15 μm (mean value of the study cohort) had 2-fold higher risk for MACE than those with lower PBR in a model including sex, age, hyperlipidemia, diabetes, hypertension, current smoking, family history of coronary artery disease and treatment with ACEi/ARBs or lipid lowering agents (hazard ratio (HR): 2.49; 95% CI: 1.23–5.02, p=0.011, net reclassification improvement (NRI): 25%; C-statistic: 0.738). PBR5-9 ≥1.15 was an independent and additive predictor of outcome when added in a model including SCORE, risk factors not included in SCORE (diabetes, family history of CAD) and medication (HR: 2.48 NRI: 23.8%, C-statistic increase from 0.629 to 0.678, for all cardiac events and HR: 4.19, NRI: 33.1%, C-statistic increase from 0.654 to 0.734 for death myocardial infarction and stroke, p&lt;0.01).

Conclusion
Endothelial glycocalyx integrity is an independent and additive predictor to atherosclerotic risk factors for adverse outcome at 6 years follow-up in individuals without diagnosed cardiovascular disease.

Funding Acknowledgement
Type of funding sources: None.