bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREVALENCE AND PREDICTORS OF PREHYPERTENSION AMONG MEDICAL AND ALLIED HEALTH COLLEGE (PARAMEDICAL) STUDENTS AT KING ABDULAZIZ UNIVERSITY IN JEDDAH, SAUDI ARABIA: A CROSS-SECTIONAL STUDY
Authors: Khawandanh Shahad , Alahmadi Reem , Alkhameesi Najwa , Alkhateeb Sarah , Alzahrani Ahad , Kurdi Lujain , Lamfon Ghadeer , Kadi Hanan Al 
Published: April 2021

Objective:
Introduction: Prehypertension is a risk factor for hypertension and other cardiovascular diseases. Determining its prevalence and associated risk factors in young populations may indicate appropriate preventive measures. We estimated prehypertension prevalence and risks among healthy medical and paramedical students.
Methods: This cross-sectional study was conducted on 437 students at King Abdulaziz University in Jeddah, Saudi Arabia. Socio-demographic characteristics and medical history were obtained by validated self-administered questionnaires. Weight, height, waist circumference, and body mass index were determined. Blood pressure was recorded under standardized conditions. Prehypertension was defined as systolic blood pressure of 120–139 mmHg and/or diastolic blood pressure of 80–89 mmHg. Significant prehypertension predictors were identified by multivariate logistic regression analysis.

Design and method:
Subjects’ average age was 21.1 ± 1.4 years. Prehypertension was more prevalent among male students (36%) than female students (7%) and was predominantly diastolic in female students (90.5%). Prehypertensive subjects (17%) had significantly higher body mass index. Male students had a higher prehypertension risk (odds ratio 8.4; 95% confidence interval 4.1?17.0). Mean heart rate significantly predicted prehypertension (1.05; 1.02?1.08).Current smoking and obesity (body mass index ?30 kg/m2) increased prehypertension risk (3.6; 1.1?12.3 and 2.3; 1.1?5.0, respectively), but not age, monthly income, physical activity, eating habits, and a family history of prehypertension.

Results:
Sex was the strongest prehypertension predictor. Efforts should be directed at other modifiable risk factors, such as obesity and smoking, to reduce prehypertension risk. Screening for prehypertension and advocating lifestyle modifications in young people is highly recommended to decrease progression to hypertension.
URIC ACID-ASSOCIATED CARDIAC TISSUE DAMAGE CAUSED BY HIGH FAT DIET IS REVERSED BY SODIUM BUTYRATE
Authors: Adeyanju Oluwaseun , Badejogbin Caroline 
Published: April 2021

Objective:
Increased global consumption of high-fat/high-calorie diet has led to higher incidence of the multifactorial cardiometabolic syndrome especially among women. The links between glucose deregulation and eventual mortal cardiac diseases are still being investigated. However, several reports have implicated elevated uric acid (UA) in the progression of metabolic disorders especially during high-fructose diet. Also, butyrate (BUT) a short-chain fatty acid is being identified with intriguing therapeutic potentials in metabolic disorders. We therefore hypothesized that high-fat diet-induced glucose deregulation and cardiac tissue damage are associated with elevated UA and attenuated by BUT in female rats.

Design and method:
Twenty-four 10-week-old female Wistar rats with weights ranging from 135 to 150 g were treated with normal rat chow and distilled water (po) or sodium butyrate (200 mg/kg; po) or high-fat diet and distilled water (po) or high-fat diet and sodium butyrate. Treatments lasted for 6 weeks.

Results:
Results showed that high-fat diet caused glucose dysmetabolism, elevated plasma triglyceride (TG), total cholesterol (TC), corticosterone, malondialdehyde (MDA), plasma and cardiac UA, and lactate dehydrogenase (LDH). High-fat diet also led to depressed reduced glutathione (GSH). Histological analysis of cardiac tissue showed cellular infarction, infiltration, and fibrosis in high-fat diet-fed rats. However, all these effects were ameliorated by BUT treatment.

Conclusions:
The findings here showed that high-fat diet resulted in glucose dysmetabolism and cardiac tissue damage through a uric acid (UA) - dependent mechanism and that butyrate (BUT) can protect against high-fat diet-induced cardiometabolic disorders through UA suppression and augmentation of glutathione antioxidant defenses. This study therefore demonstrates that UA is involved in high fat diet-induced cardiometabolic syndrome. However, data here shows that the UA - associated events in high fat diet will chronically engender cardiac tissue damage. Interestingly, with UA suppression, BUT treatment showed plausible beneficial glucoregulatory, anti-inflammatory and antioxidant properties which were potent enough to confer protection on the cardiac tissue preventing overt damage in high fat diet-fed rats. Therefore, BUT may be considered for the development of suitable therapeutic candidate in the treatment of metabolic syndrome and cardiac derangements associated with heightened UA.
DAY-TO-DAY HOME BLOOD PRESSURE VARIABILITY IS ASSOCIATED WITH CEREBRAL SMALL VESSEL DISEASE BURDEN IN A MEMORY CLINIC POPULATION
Authors: De Heus Rianne , Reumers Stacha , Van Der Have Alba , Tumelaire Maxime , Tully Phillip , Claassen Jurgen 
Published: April 2021

Objective:
High visit-to-visit blood pressure variability (BPV) has been associated with cognitive decline and cerebral small vessel disease (cSVD), in particular with cerebrovascular lesions. It is likely that the causes and consequences of high BPV depend on which temporal resolution is investigated. Day-to-day BPV has been related to cognitive function, but has not been investigated in relation to cSVD. Therefore, we aimed to investigate the cross-sectional association between day-to-day BPV and total cSVD MRI burden, in older memory clinic patients.

Design and method:
We included outpatients referred to our memory clinic, who underwent cerebral MRI as part of their diagnostic assessment. Four markers of cSVD were visually rated, resulting in a score between 0 and 4: presence of microbleed(s), presence of lacune(s), severe white matter hyperintensities and enlarged perivascular spaces in the basal ganglia. Home blood pressure (BP) measurements were performed for one week according to international guidelines. After removal of day 1, BPV was defined as the coefficient of variation (CV). We used multivariable ordinal logistic regression analyses adjusted for age, sex, smoking, diabetes, history of cardiovascular disease and mean BP to assess the association between total cSVD score and BPV.

Results:
In 82 patients (aged 71.2 ± 7.9 years), mean home BP was 140/79 ± 15/9 mmHg. Dementia and mild cognitive impairment were present in 46% and 34%, respectively. 22% of the study population had a total cSVD score of 0. These frequencies 24%, 26%, 20% and 8% for scores of 1, 2, 3 and 4, respectively. Systolic CV was associated with total cSVD burden, with the adjusted odds ratio per point increase in CV = 1.30, 95% confidence interval = 1.05–1.61, p = 0.018. There were no differences in diastolic CV and mean BP between the cSVD groups. When we differentiated between morning and evening BP, only evening BPV remained significantly associated with total cSVD burden.

Conclusions:
Day-to-day systolic BPV is associated with cSVD burden in memory clinic patients. Future research should indicate whether lowering day-to-day systolic BPV should be included in BP management in older people with memory complaints.
CAROTID VASCULAR RESISTANCE ASSOCIATED WITH COGNITIVE FUNCTION AMONG MIDDLE-AGE ADULTS
Authors: Chuang Shao -Yuan , Cheng Hao -Min , Ko Yu -Ting , Lau Wen -Ling , Wang Pei -Ning , Pan Wen -Harn , Chen Chen -Huan 
Published: April 2021

Objective:
Carotid flow velocity and peripheral blood pressure were independently associated with cognitive function among the elderly population, but unknown among middle-aged adults. We aimed to investigate the association between carotid hemodynamics and cognitive performance among the middle-age population.

Design and method:
A total of 490 middle-age adults (between 30 and 60 years) participated in the ongoing survey (2017–2020) of the Cardiovascular Disease Risk Factors two-Township study and received the Montreal Cognitive Assessment (MOCA) to evaluate the global cognitive function. Carotid-formal pulse wave velocity (cf-PWV) was measured using carotid and femoral arterial tonometry. Carotid vascular resistance was calculated by mean carotid pressure divided into mean carotid volume flow.

Results:
MOCA levels were similar between men and women (27.1 vs. 27.2, p = 0.6036). Age(r = -0.22, P < 0.001), and education(r = 0.39, p < 0.001) were associated with MOCA. Controlled for age, gender and education, peak systolic velocity (r = 0.077 @left; r = 0.012@Right, all p > 0.05), end diastolic velocity (r = 0.029, r = -0.062, all p > 0.05), mean flow (r = 0.060; r = -0.038, all p > 0.05), carotid resistive index (r = 0.020, r = 0.05, all p > 0.05), carotid pulsatility(r = 0.015; r = 0.058; p > 0.05), diameter(r = 0.060; r = -0.008, all p > 0.05) at both sides were not associated with MOCA. Only carotid vascular resistance (CVR) at left side was associated with MOCA (r = -0.158, p = 0.0010), but not at right carotid artery (r = -0.030, p = 0.5369). CVR@Left (standard beta = -0.144; p = 0.0022) remains associated with MOCA in the multivariable with further controlling glucose, low density lipoprotein and carotid-formal pulse wave velocity. Those with top, 2nd and 3th quartile of CVR@left had 2.4-fold [Odds Ratio = 2.40; 95% confidence intervals = 1.14–5.04], 1.95-fold(1.95;0.93–4.07) and 0.99-fold (0.99;0.45–2.17) risk for poor cognitive performance (MOCA < 26), compared to those with lowest quartile of CVR@left in the multivariable model.

Conclusions:
Carotid vascular resistance is a marker of cerebrovascular resistance and associated with cognitive performance in middle-aged adults.
HEMODIALYSIS REDUCES CEREBRAL BLOOD FLOW PULSATILITY AND SMALL VESSEL STIFFNESS
Authors: Paré Mathilde , Obeid Hasan , Labrecque Lawrence , Drapeau Audrey , Marquis Karine , Brassard Patrice , Agharazii Mohsen 
Published: April 2021

Objective:
Cognitive decline is highly prevalent amongst end-stage renal disease (ESRD) patients and is accelerated upon initiation of hemodialysis (HD). ESRD increases aortic stiffness and blood flow pulsatility, which may damage small vessels of target organs such as the brain. In this pilot study, we aimed to evaluate the acute effect of HD on cerebral blood flow and regional arterial stiffness.

Design and method:
Before, every hour during, and after HD (T0-T4), we measured cerebral flow velocity (FV) using transcranial Doppler, blood pressure (BP) via digital finger cuff (Nexfin), cardiac activity using ECG, and aortic pulse wave velocity (PWV) with Mobile-O-Graph. FV pulsatility index (PI) and transit times between ECG peak and the foot of both FV and BP waveforms (cerebral dT; digital dT) were computed using in house MATLAB-based analysis. Changes during HD were evaluated with Generalized Estimating Equation models adjusting for multiple comparisons in SPSS 26.0.

Results:
In eight participants aged 63 ± 17 y. old (4 diabetics, 3 women), peak FV decreased from baseline at T1 and T2 (-11.2 cm/s, p = 0.007; -12.2 cm/s, p < 0.001), PI decreased at T1 (0.81 to 0.77, p = 0.005), whilst minimum FV, mean BP and partial pressure of CO2 remained unchanged. Digital dT increased at T3 (0.19 to 0.22, p < 0.001) and cerebral dT increased early in HD (T1: p = 0.036; T2: p = 0.048), whereas aortic PWV did not change.

Conclusions:
During hemodialysis, cerebral and digital transit times increased, suggesting decreased stiffness of small peripheral vessels, without significant changes in aortic stiffness. Reduced stiffness of cerebral arteries may partially explain decreased cerebral flow pulsatility during HD.
ARTERIAL HYPERTENSION AND ATRIAL FIBRILLATION: THE DOUBLE TROUBLE AND STROKE
Authors: Gaspar Ludovit , Filipova Slavomira , Vestenicka Veronika 
Published: April 2021

Abstract

Objective:
Arterial hypertension (AH) and atrial fibrillation (AF) are very important risk factors of stroke. Vascular stroke is a very frequent cause of morbidity and mortality, and in patients who suffered stroke, subsequent long-term neurological deficit can persist. It is therefore important and necessary to influence these risk factors.

Design and method:
We retrospectively reviewed a group of patients hospitalized during six months period at our Department of Neurology with the diagnosis of stroke confirmed by imaging (CT, CT angiography, brain MRI). This group consisted of 218 patients, including 145 men (66.5 %) and 73 women (33.5 %). The average age was 70.8 years.

Results:
We detected AH in 199 subjects (91.2 %) and AF in 70 subjects (32.1 %). 182 patients (83.5 %) have been diagnosed with ischemic stroke and 36 patients (16.5 %) with hemorrhagic stroke. In the group of patients with AF only 33 patients (47.1 %) were treated by anticoagulants, what points out an inadequate indication of anticoagulant treatment. It is also noteworthy that in the group of patients with anticoagulant therapy who have developed ischemic stroke in spite of this treatment, we found that in 16 cases (48.5 %) the treatment was underdosed.

Conclusions:
Arterial hypertension and atrial fibrillation were highly prevalent in our cohort of stroke patients. Despite proven effect of anticoagulant treatment, many patients with atrial fibrillation were not anticoagulated and almost half of those on anticoagulation treatment were underdosed. These results emphasize the importance of effective management of arterial hypertension and atrial fibrillation, the most common modifiable risk factors of vascular strokes.
AORTIC AND CAROTID STIFFNESS IN CHILDREN AND ADOLESCENTS: RELATIONSHIP AND DETERMINANTS
Authors: Kollias Anastasios , Stambolliu Emelina , Bountzona Ioanna , Kyriakoulis Konstantinos , Vazeou Andriani , Stergiou George 
Published: April 2021

Abstract

Objective:
Arterial stiffness is an established surrogate measure of preclinical target-organ damage by elevated blood pressure (BP). This study assessed regional (aortic) and local (carotid) arterial stiffness measured by different noninvasive methods in children and adolescents and their relationship with BP levels.

Design and method:
Apparently healthy children and adolescents (age 6–18 years) referred for elevated BP were evaluated with: (i) office BP (OBP) measurement (3 visits, triplicate readings/visit), (ii) 24 h ambulatory BP (ABP) monitoring, (iii) home BP (HBP) monitoring during daytime and nighttime, (iv) M- and B-mode ultrasonography for the assessment of carotid distensibility coefficient (cCD) and carotid intima-media thickness (cIMT), (v) determination of carotid-femoral pulse wave velocity (cfPWV; Complior).

Results:
93 subjects were analyzed (mean age 13.1 ± 2.9 years, 55 males, BMI 24.7 ± 5.2 kg/m2, 18 with 24 h ABP >  = 95th percentile). There was an inverse association between cfPWV and cCD (r = -0.42, p < 0.01). Hypertensive subjects had higher PWV than normotensives (6.3 ± 1.0 vs. 5.3 ± 0.9 m/sec respectively, p < 0.01 after adjustment for age and gender), but similar cCD (57.1 ± 47.6 vs. 57.8 ± 18.4 kPa-1/103, p = NS). cfPWV compared to cCD tended to be more strongly correlated with age (r = 0.65 vs. -0.28, p < 0.01 for comparison), systolic OBP (0.60 vs. -0.31, p < 0.01), systolic ABP (24 h/day/nighttime 0.60/0.57/0.49 vs. -0.39/-0.38/-0.31, p = 0.02/0.04/0.07), systolic HBP (day/nighttime 0.48/0.55 vs. -0.33/-0.26, p = 0.13/ < 0.01), cIMT (0.24 vs. -0.08, p = NS), and similarly to BMI (0.28 vs. -0.26, p = NS for comparison).

Conclusions:
In young individuals aortic PWV as an index of regional stiffness appears to be more closely associated with age and BP levels than local carotid stiffness.
URINARY SOMATIC ANGIOTENSIN CONVERTING ENZYME AND SOLUBLE N-DOMAIN ISOFORMS (90 AND 65KDA) EXPRESSION AND CORRELATION WITH DIFFERENT NUTRITIONAL STATUS/CARDIOVASCULAR RISK PROFILE
Authors: Casarini Dulce Elena , Cruz Nayara , Oliveira Lilian , Fernandes Fernanda , Mill José 
Published: April 2021

Abstract

Objective:
Angiotensin converting enzyme (ACE) has been involved in physiopathology of several diseases including hypertension, diabetes, obesity and metabolic syndrome. The somatic ACE weights from 130–190 KDa and presents N- and C-domains. Two soluble N-domain isoforms have been described in human urine, weighting 65 and 90KDa. Studies have supported that N-domain ACE with 90KDa is a biomarker for hypertension, pre-eclampsia and inflammation.
We evaluated the expression of somatic ACE and soluble N-domain isoforms (90 and 65KDa) in urine of children and adolescents with different nutritional status and cardiovascular risk profile.

Design and method:
The participants aged from 6 to 19 years were classified into four groups according to their BMI percentile; underweight (n = 51), normal weight (n = 53), overweight (n = 53) and obese (n = 49). Waist-height-ratio (WHtR) was used to assess cardiovascular risk profile dividing the participants into normal risk (n = 105) and high risk (n = 101). The urines were concentrated 10-fold and dialyzed with Tris-HCl pH 8 and pure water. Then, we performed western blot analysis using 50 mg of lyophilized urinary protein. ACE expression was proved against the polyclonal antibody Y1. Protein detection was performed by chemiluminescent and analysis was done in Image Labâ (BioRad) software utilizing total protein stain for normalization.

Results:
ACE expression is augmented in obese children when compared with normal weight children (0.09 vs 0.53 arbitrary units, p = 0,04). The higher cardiovascular risk group also presented increased expression of ACE (0.27 vs 0.09 arbitrary units, p = 0.046). The 90KDa N-domain isoform is frequently found in the high cardiovascular risk children (p = 0.02). Additionally, according to Spearman correlation test, the expression of 90KDa N-domain isoform correlates positively with waist circumference (cm), WHtR, BMI percentile and Z-score of BMI.

Conclusions:
Increased ACE expression in obese children contributes to higher cardiovascular risk once this enzyme biosynthesizes Angiotensin II which promotes blood pressure increase, sympathetic nervous system activation and release of glucocorticoids from adrenal gland. ACE expression is also augmented in children with high cardiovascular risk. Presence of 90 KDa N-domain ACE in urine of children and adolescents is a biomarker of poor prognostic for cardiovascular disease in childhood obesity.
URIC ACID IN PEDIATRIC PATIENTS WITH PRIMARY HYPERTENSION
Authors: Szyszka Michal , Skrzypczyk Piotr , Panczyk-Tomaszewska Malgorzata 
Published: April 2021

Abstract

Objective:
Increased concentration of uric acid may play a role in the pathogenesis of primary hypertension (PH). Aim of the study was to assess concentration of uric acid and its correlation with selected clinical and biochemical parameters in children with PH.

Design and method:
In a group of 57 untreated pharmacologically children with PH (44 boys, 13 girls, mean age 14.99 ± 2.84 years) following parameters were assessed: serum uric acid concentration [mg/dL], blood pressure in office measurement and in 24-hour ambulatory blood pressure monitoring, and selected clinical and biochemical parameters. Control group consisted of 20 healthy children (mean 14.11 ± 2.99 years).

Results:
Serum uric acid concentration was significantly higher in children with PH compared to healthy children (5.72 ± 1.38 vs. 4.55 ± 1.07 [mg/dL]; p = 0.001). In patients with PH, its concentration was significantly higher in boys compared to girls ((6.12 ± 1.20 mg/dL vs. 4.35 ± 1.13 mg/dL, p < 0.001), no such difference was found in healthy children. In the PH group, uric acid concentration correlated positively with age (r = 0.426, p = 0.001), height (r = 0.557, p < 0.001), weight (r = 0.518, p < 0.001), weight Z- score (r = 0.296, p = 0.025), BMI (r = 0.316, p = 0.017), neutrophil count (r = 0.280, p = 0.035), systolic blood pressure (r = 0.375, p = 0.004) and pulse pressure (r = 0.444, p = 0.001) in ABPM and negatively with HDL cholesterol, heart rate (r = -0.310, p = 0.02 (1 = -0.309, p = 0.020) and nighttime diastolic blood pressure dip (r = -0.268, p = 0.044) in ABPM. In multivariate analysis, the determinants of uric acid concentration in children with PH were sex (beta = 0,367, 95%CI (0.122–0.611), p = 0.004) and weight Z-score (beta = 0.254, 95%CI (0.005–0.504), p = 0.046).

Conclusions:
Children with primary hypertension have increased serum uric acid concentration compared to healthy children. The risk factors for hyperuricemia in pediatric patients with primary hypertension are male sex and high body weight.
RELATIONSHIP OF HYPERTENSION WITH PATIENTS HAVING DIABETES AT CLINICAL SETUPS OF PAKISTAN
Authors: Ali Muhammad 
Published: April 2021

Abstract

Objective:
Hypertension and Diabetes both are the facets of metabolic syndrome, a pathologic condition that usually includes obesity and cardiovascular diseases. While in some patients Diabetes mellitus and hypertension both recurrently occurs and probably have synergistic disadvantageous effects on the cardiovascular system. The objective of the current study was to sort out the potential relationship and the impact of high blood pressure on patients who had diabetes.

Design and method:
This was a prospective, observational study in which 470 hypertensive patients who had confirmed diagnosis of diabetes type II were enrolled in this study. Samples were from age group of 30–60 years in which 130 males and 340 females were observed. All enrolled hypertensive patients had a diastolic blood pressure greater than 90 mmHg and systolic blood pressure greater than 138mmHg.

Results:
Findings shows that Calcium Channel Blockers, Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARBs) are preferred agents for Hypertension associated with type 2 Diabetes. In case if targeted blood pressure is not achieved addition of a thiazide diuretic occurs in regimen because it is the preferred 2nd line therapy for hypertension associated with diabetic patients. In another perspective weight loss also seems to be beneficial in the hypertension associated with obesity and diabetes. Candestran and Lisinopril was the most prescribed drugs in earlier patients with hypertension associated with the type 2 diabetes.

Conclusions:
According to the research findings with the usage of the prescribed drugs blood pressure was controlled while alteration of drugs has seen in some cases as well. Chlorthalidone, Candestran and Lisinopril were the most prescribed and seen to be most effective.