bluuebunny/crossref_metadata_2025_split huggingface dataset:
TWO DECADE'S TRENDS IN HYPERTENSION AMONG URBAN ADULT POPULATION OF EAST INDIAN COMMUNITY: OBSERVATION FROM A LONGITUDINAL COHORT
Authors: Chakraborty Kaushik , Chakraborty Nilanjana , Mitra Ramendra Nath , Saha Angana , Chatterjee Papri , Manna Subhankar , Mitra Dipra 
Published: April 2021

Objective:
Hypertension is one of the predominant major contributors of chronic disease burden among global non communicable diseases. The study evaluated trends in self-reported doctor diagnosed hypertension (DDH) and measured blood pressure (mBP) prevalence along with associated risk factors in an Indian urban population over 20 years.

Design and method:
Longitudinal cohort was established in 2001 with 3030 households based on the stratified multistage cluster sampling. Adult participants (N = 7275; Male = 3765, Female = 3510) were enrolled. Three household questionnaire surveys were performed in year 2001–02, 2011–12, 2018–19 with the same population size to determine DDH trend. Two representatives’ cross-sectional surveys were conducted (In 2014–15, n:5741, male = 2319, female = 3422; In 2018–19, n = 5741, male = 2204, female = 3537) to evaluate trends in hypertension based on the mBP value. Blood pressure and anthropometric data were also recorded according to the established protocol. mBP classification was derived from Joint National Committee (JNC-8) guideline.

Results:
Prevalence of DDH (%) in successive surveys increased from 9.70, 17.86, 22.67 and measured BP (%) among pre-hypertensive 32.12, 39.17, hypertension-stage1 14.41, 19.91, hypertension-stage2 7.05, 8.26 over the time. Gender specific prevalence of hypertension showed progressive rise of DDH [OR = 0.69, CI: 0.61,0.78, p < .0001]and mBP [In 2014, PreHTN: OR = 1.69, CI = 1.49, 1.91, p < .0001; HTNstg1: OR:1.43, CI = 1.22, 1.68, p < .0001, HTNstg2: OR = 1.44,CI = 1.17, 1.78, p = 0.0007; In 2018, PreHTN: OR = 2.04, CI = 1.79,2.32, p < .0001; HTNstg1: OR = 2.23, CI = 1.91,2.60, p < .0001; HTNstg2: OR = 1.948, CI = 1.58,2.40, p < .0001] in men when compared to women. Association of DDH with smoking [In 2001–02, OR = 0.62, CI = 0.52,0.74, p < .0001; In 2018–19, OR = 0.75, CI = 0.63, 0.90, p = .0020] and duration of sleep (>8 hrs.) [In 2001–02, OR = 0.71, CI = 0.61, 0.82, p < .0001; In 2018–19, OR = 1.18, CI = 1.01, 1.38, p = 0.0401] established. Trend revealed higher education was a lower risk of hypertension. Increasing trends were observed across all hypertension categories among obese compared to normal.

Conclusions:
In mBP group, HTNstg2 prevalence has increased marginally over 7 years, among remaining groups increasing prevalence trend was unequivocal. Most of the long-established reversible risk factors association prevalence also increasing. Higher education having lower risk may well suggest importance of increased awareness. A strategy to reverse the rising trend of the chronic disease burden is required.
EPIDEMIOLOGICAL PROFILE OF HYPERTENSE PATIENTS IN PRIMARY CARE SETTING IN RIO DE JANEIRO CITY
Authors: Oliveira Monica Amorim De , Rey Helena Cramer Veiga , Ribeiro Antonio Luiz Pinho 
Published: April 2021

Objective:
Observational study, to describe in the context of family medicine care, epidemiological data of a cohort of hypertensive patients.

Design and method:
Prospective cohort observational study of hypertensive patients selected from a randomized sample, conducted in primary care units in the city of Rio de Janeiro, where 1,000 patients aged over 18 years were allocated in 2016 and 2017 who were referred for electrocardiogram. Clinical evaluations were documented in a care form and recorded in a database. Follow-up by telephone following one year.
Continuous variables will be described as mean and standard deviation or median and interquartile difference. Categorical variables will be described as frequency and proportion, with their respective 95% confidence intervals. Statistical analyzes, to assess the significance of the differences found between the strategies, will be performed as recommended. The statistical program R was used.

Results:
In the selected sample of patients in basic health units, the prevalence of hypertension was 72.38%.
Of the total sample 35.6% were male, the average age was 57.75 years and the median age 59. Among the hypertensive 35.52% were male, the average The mean age was 60.97 years and the median age 61.5.
Most patients had primary education, 58.22%, and received less than 2 minimum wages, 78.69%.
In hypertensive patients the prevalence of risk factors was 64.35% of sedentary lifestyle, 25.63% of dyslipidemia, 24.51% of diabetes mellitus and 14.76% of smoking. And the prevalence of associated clinical conditions was 4.32% stroke, 1.53% chronic kidney disease, 2.3% heart failure and 1.25% atrial fibrillation. 5.71% of the patients had previous acute myocardial infarction (AMI), 2.65% had already undergone coronary angioplasty and 0.56% had myocardial revascularization surgery.
Among non-hypertensive, 36.03% were male, the average age was younger than hypertensive people, 49.12 years, even as the median age, 49. There were less people with some cardiovascular risk factors as dyslipidemia (11,4%) and diabetes (10.66%).

Conclusions:
Studies such as this are necessary to understand the population served and to implement strategies to improve the quality of the HA primary care program with measures to prevent or delay the onset of related complications.
CHARACTERISTICS OF DRAFT-AGE YOUTH WITH HYPERTENSION
Authors: Posokhov Igor , Uvarovskaya Basana , Melnik Maria 
Published: April 2021

Objective:
Identification of draft-age youth with hypertension (HTN) is crucial, since these individuals
may experience an exacerbation of their illness during training with dire consequences for them.
HTN may disqualify conscripts for military service. We aimed to evaluate characteristics of HTN in pre-conscripts.

Design and method:
Making office and ambulatory blood pressure measurements (BP and ABPM) we selected 150 men aged 17–27 years with normotension (group I, n = 19), masked HTN (II, n = 16); white coat HTN (III, n = 24) and sustained HTN (IV, n = 91). Then we evaluated height, BMI, echo and laboratory tests.

Results:
Characteristics of pre-conscripts are represented in the table.
The pre-conscripts in groups I and III are of normal weight and in groups II and IV are overweight. According to generally accepted reference values, there are no signs of LV hypertrophy. However, participants in group IV are revealed to to be significantly (p < 0,05) different than those of group I.

Conclusions:
More than 45% of pre-conscripts with measured normotensive office BP are revealed to have a masked HTN. Young men with masked HTN and sustained HTN are overweight. In 20% of draft-age youth with office HTN increased BP is caused by white coat HTN. It seems HTN-mediated heart damage begins already in the very early stages of hypertension.
BLOOD PRESSURE CHANGES OVER 18 MONTHS AFTER INITIATION OF ANTIRETROVIRAL THERAPY IN HIV INFECTED PATIENTS IN LILONGWE, MALAWI
Authors: Steffen Hans-Michael , Phiri Sam , Kasper Philipp , Chaweza Tom , De Forest Andrew , Heller Tom , Tweya Hannock , Mwagomba Beatrice , Nhlema Angellina , Chiwoko Jane , Fätkenheuer Gerd , Neuhann Florian 
Published: April 2021

Objective:
The improved survival of people living with HIV (PLHIV) and the economic and demographic changes in sub-Saharan Africa are accompanied by a rising number of patients suffering from cardiovascular disease. According to a recent meta-analysis hypertension prevalence is higher in PLHIV on antiretroviral therapy (ART) compared to ART-naïve patients. As part of the ongoing prospective LighTen Cohort Study (ClinicalTrials.gov NCT02381275) we examined blood pressure (BP) changes in ambulatory PLHIV who initiated ART in urban Lilongwe, Malawi.

Design and method:
Anthropometric measurements of adult study participants at baseline and during study visits after 1, 3, 6 and every 6 months thereafter were recorded in an electronic patient registry. For the present analysis we surveyed systolic and diastolic BP values (oscillometric measurements) and body weight (BW) from this data base for patients who were still alive and active study participants at month 18. Student's t-test was used to compare systolic and diastolic BP, BW and their changes between baseline and month 18. Pearson's r was calculated to test for correlations between changes in BW and BP.

Results:
Data from 995 (577 females, mean age 36.7 ± 9.2 years) of the originally included 1436 PLHIV were analyzed. BW (p < 0.001) and systolic BP (p < 0.01) differed significantly between baseline and month 18. The change in systolic and diastolic BP correlated with the change in BW (r = 0.312 and r = 0.220, respectively; p < 0.01). There were significant differences (p < 0.001) in the mean change of systolic/diastolic BP between the lowest (-9.6 ± 18.8/-3.8 ± 12.9 mmHg) and highest (6.8 ± 19.2/4.3 ± 13.9 mmHg) quartile of the distribution of BW changes (decrease >1.39 kg vs. increase >6.09 kg). Also, the mean change in BW for normotensive patients at baseline who still had a BP < 140/90 at month 18 (n = 722, 89.6%) compared to those whose BP values had increased to 140/90 mmHg or higher (n = 84, 10.4%) was significantly lower (2.3 ± 6.2 kg vs. 5.6 ± 7.6 kg, p < 0.001).

Conclusions:
Increasing body weight due to the improved health status after ART initiation was associated with hypertensive BP values. Counselling of PLHIV regarding measures to control body weight should be embedded into patient education programs at HIV centers in countries like Malawi.
COST-EFFECTIVENESS OF CARDIOVASCULAR RISK CLASSIFICATION BASED ON ANKLE-BRACHIAL INDEX TEST IN ASSOCIATION TO FRAMINGHAM RISK SCORE
Authors: Maloberti Alessandro , Cortesi Paolo , Micale M. , Mazzaglia G. , Occhi Lucia , Palazzini Matteo , Peretti Alessio , Cavasin Davide , Pansera Francesco , Grasso Enzo , De Chiara Benedetta , Vallerio Paola , Mantovani Lg , Giannattasio Cristina 
Published: April 2021

Objective:
An individual patient-data meta-analysis conducted on 24,955 men and 23,339 women showed that Ankle-Arm Index (ABI) in combination with FRS classifies female subjects with higher accuracy with no difference for male. The objective of this analysis is assessing the cost-effectiveness of ABI combine with FSR in primary prevention.

Design and method:
A decisional analytical model was developed to simulate CV risk of asymptomatic female subjects, stratified in 3 CV risk categories. The model compares the primary prevention intervention (treatment of subjects at intermediate and high risk) based on the classification with FRS alone or in association with ABI<0.9 (FRS-ABI). The cost-effectiveness model used 10 years time-horizon and the point of view of the Italian National Health System. Results were presented as incremental cost-effectiveness ratios (ICERs) per QALY gained. Cost and outcomes were discounted at 3%.

Results:
FRS-ABI determined a reclassification to higher risks in 7% of the female population, with an increase in costs per patient (€3,373 vs €3,198) but also greater efficacy (8,683 vs 8,689 QALYs) over a 10 years time horizon, with an ICER of €47.065 per QALY gained. While using an ABI<1.10 cut-off we obtained an ICER of €28.688 per QALY gained over 10 years simulation. In the probabilistic sensitivity analysis, the FRS-ABI reported a 50% probability to be cost-effective with ABI<0.9 cut-off and 80% probability with ABI<1.1 at a willingness to pay threshold of €50,000 per QALY.

Conclusions:
Our study showed that FRS and ABI combination is a potentially cost-effective CV risk classification approach in female population. Our results can help the healthcare decision makers in implementing better strategies for primary CV diseases prevention in Italy.
SODIUM AND POTASSIUM INTAKE, AND KNOWLEDGE ATTITUDES AND BEHAVIOUR TOWARDS SALT CONSUMPTION: A NATIONAL SURVEY OF ADULTS IN THE SULTANATE OF OMAN
Authors: Cappuccio Francesco , Al-Mawali Adhra , D’elia Lanfranco , Jayapal Sathish K. , Morsi Magdi , Al-Shekaili Waleed N. , Pinto Avinash D. , Al-Kharusi Hilal , Bulushi Zainab Al , Idikula John 
Published: April 2021

Objective:
High sodium (Na) and inadequate potassium (K) intake are important determinants of high blood pressure (BP) and cardiovascular diseases (CVDs). In Oman, CVD represents a common cause of morbidity and mortality, accounting for 33.0% of all deaths. However, there is no reliable measure of Na and K intake in the Sultanate of Oman. The aim of the present survey was to establish current baseline average consumption of Na and K, and explore knowledge, attitudes and behaviour (KAB) towards the use of salt, in a nationally representative random sample of Omani adult men and women living in Oman.

Design and method:
The study was a national cross-sectional population-based survey of proportional random samples, representative of Omani adults (18 yrs and older), obtained from all Governorates of Oman (Figure). Of the 999 who agreed to participate, after robust quality control, 569 (193 men, 376 women; response rate 57%; mean age 39.4 yrs [SD 13.1]) were included in the final analysis. The characteristics of those excluded were comparable to those included. Participants attended a screening including demographic, anthropometric and physical measurements by standardized methods. Dietary Na (salt) and K intakes were assessed by 24 h urinary Na (UNa) and K (UK) excretions. Urinary creatinine was also measured. KAB were assessed by questionnaire.

Results:
Mean UNa was 144.3 (78.8) mmoL/day, equivalent to 9.0 g of salt/day and potassium excretion 52.6 (32.6) mmoL/day, equivalent to 2.36 g/day. Men ate more sodium and potassium than women. Only 22% of the sample had a salt intake below the World Health Organization (WHO) recommended target of 5 g/day and less than a quarter met WHO targets for potassium excretion (>90 mmoL/day). Whilst 89.1% of those interviewed knew that consuming too much salt could cause serious health problems and only 6.9% felt they were using too much added salt, 1 in 2 participants use always or often salt, salty seasonings or salty sauces in cooking or when preparing food at home.

Conclusions:
In Oman, salt consumption is higher, and potassium consumption lower, than recommended by the WHO, both in men and in women.
SUB-CLINICAL DAMAGE TO THE TARGET ORGANS (TOD) IN HYPERTENSIVE PATIENTS, ABOUT 300 PATIENTS
Authors: Ouail Djamel Eddine , Tebbani Meriem , Ahmed Djamila Si , Bouali Fayçal 
Published: April 2021

Objective:
HTA is considered to be a silent killer. TOD is an indicator of cardiovascular risk in people with hypertension.
The main objective of our study is to describe the sub-clinical TOD in hypertensive patients.

Design and method:
This is a descriptive study, conducted between October 2016 and October 2019. It included all asymptomatic hypertensive patients over the age of 35 of both sexes.
Screening for infraclinical cardiac, vascular and renal damage is carried out with; the evaluation of the left ventricular hypertrophy (LVH) ultrasound and electric. Intima media thickness measurement by 2D carotid ultrasound and screening and evaluation of plaques. The measurement of pulsed pressure. Measuring the ABI for obliterating arterial disease. And finally, the estimate of urinary albumin excretion (UEA) and creatinine clearance according to MDRD.

Results:
300 patients included in our series, these are 120 men and 180 women. The average age is 59.75 years. The prevalence of TOD is estimated at 72.3%, the prevalence of electrical LVH is 17.3%, the ultrasound LVH is 29%.
Carotid hypertrophy is observed in 34.9% and the presence of stenotic plaques affect 9.1% of patients
AOMI is found in 9%. Pathological pulsed pressure is found in 34.3%.
UAE is pathological in 23.30% of our patients for A2 and 5.7% for A3. The creatinine clearance is less than 60 ml / min in 11%.
The main independent risk factors associated with TOD are the value of SBP and Age.
Pulse pressure> 60 mmHg is associated with all TOD and the IMT is correlated with all screening tests for TOD.
The SCORE score is predictive only for carotid lesions, it is not predictive for LVH or albuminuria. The SCORE score is not very predictive for AOMI and renal failure.

Conclusions:
Subclinical TOD is frequent in our series.
The major modifiable independent risk factor is the value of SBP. Special attention to pulse pressure as a cardiovascular risk factor and marker of arterial stiffness
A strategy for screening for target organ damage coupled with effective therapy targeting SBP is the only way to prevent cardiovascular, neurovascular and renal complications.
FRANCE'S PARTICIPATION IN MAY MEASUREMENT MONTH 2019: THE WHOLE STARTING POINT OF A COLLECTIVE WORK WITHIN THE FRENCH SOCIETY OF HYPERTENSION (SFHTA)
Authors: Lopez-Sublet Marilucy , Halimi Jean Michel , Bouhanick Beatrice , Boivin Jean Marc , Denolle Thierry , Mourad Jean Jacques , Vaisse Bernard , Fauvel Jean Pierre , Pathak Atul 
Published: April 2021

Objective:
May Measurement Month (MMM) is a global awareness campaign against hypertension launched by the International Society of Hypertension and supported by the World Hypertension League. In France, nearly 1 out of 3 people have hypertension, of which a large proportion remains undiagnosed. The aim of this work is to make data collected during MMM 2019 in France available for the global cohort and raise awareness through this screening action.

Design and method:
Screening was coordinated by each manager of the 7 different participating sites, while following the standardised MMM protocol. SFHTA (in partnership with Omron France) sponsored centres requesting blood pressure monitors, by offering Omron HEM-FL31/M3 Comfort® devices.

Results:
Baseline data for 818 subjects (including 66 teenagers) are summarized in joint table. Most participants reported having measured their BP at least once in the past year. 22% measured their BP at least a year ago or never. The number of patient with known hypertension was 208 (25.4%), 176 (21.5%) were treated, out of them 101 (57,4%) were controlled (BP < 140/90 mmHg).
In our cohort, 76 healthy subjects (9.2%) had unknown high normal BP and 109 healthy subjects (13.3%) have been screened as new hypertensive patients.

Conclusions:
Up to day, more than 2.7 million people have taken part in the MMM program worldwide. This first survey in France highlights how a scientific society, such as SFHTA, could beyond education and science also promote a non expensive hypertension screening program to support global awareness and local actions. A wider participation with ancillary studies are planned for 2020 with the need to clarify ethical issues, in order to use national data according to French legislation.
Thanks to all patients and the teams at each centre who took part in this campaign.
ACCESS TO SINGLE PILL COMBINATIONS IN NATIONAL HYPERTENSIVE CONTROL PROGRAMS: IS PRICING A BARRIER?
Authors: Negi Sagri , Sahoo Swagata Kumar , Mahajan Tanushree , Swaroop Kishan , Neupane Dinesh , Moran Andrew , Sharma Bhawna , Pathni Anupam Khungar 
Published: April 2021

Objective:
Most patients with hypertension require two or more medicines to control their blood pressure. Single pill combination (SPC) antihypertensive medicines facilitate simpler dosing schedules, decrease pill burden, increase patient medication adherence, simplify procurement and distribution. This study uses a private sector pharmaceuticals database to explore whether prices are a barrier to access SPCs in hypertension control programmes.

Design and method:
Trends in sales of anti-hypertensive medications in India were analysed in private sector pharmaceutical sales dataset from IQVIA Consulting. Price information was collated for medicines that attributed to 70% of sales in terms of number of tablets sold. Maximum Retail Prices of 11 SPCs and their associated Fixed Dose Equivalents (FDEs; same medications and doses as separate pills) were gathered through a publicly available website called “1mg” between November 2019-January 2020.

Results:
In India, the market share of 2-drug-SPCs and 3-or-more-drug SPCs increased from 2016–2018 at a compounded annual growth rate of 5.5% and 16.1% respectively. In 2018, 2-drug-SPCs (36.3%) had the highest market share in terms of quantity of medicines followed by FDE of SPC components, such as calcium channel blockers (18.3%), beta blockers (16.3%), angiotensin receptor blockers (14.6%), diuretics (5.3%), and ACE-Inhibitors (3.6%). Share of 3-or-more-drug SPCs (2.0%) was very small. While nine of 11 SPCs had an average price higher than sum of the average price of their component FDEs (Range 2.6% - 45.9% higher), a comparison of SPCs and FDEs by the same manufacturer showed that for eight 2-drug-SPCs there was at least one company for each molecule whose SPC was priced lower than the sum of the price of FDEs (Range -71.47% -124.73%).

Conclusions:
SPCs are increasingly preferred for hypertension treatment in the Indian private sector. The World Health Organization recently included four SPCs for hypertension management in its Essential Medicine List. India has a vibrant and competitive hypertensive medicines market. Examples discovered in this dataset of minimal-to-no price difference suggest that price need not be a barrier to accessing SPCs, and that market forces can further drive down prices with substantial advantages for patients and hypertension control programmes.
UNDERSTANDING THE COMPLEXITIES OF THE PREVALENCE AND CONTROL OF TRANS FAT IN THE FOOD SUPPLY IN PAKISTAN
Authors: Mukhtar Omer , Al-Jawaldeh Ayoub , Nishtar Noureen , Masuood Khawaja , Achakzai Baseer , Gulzar Yahya 
Published: April 2021

Objective:
Pakistan is among the nations that have a high intake of trans fatty acids (TFAs). TFAs are considered one of the major dietary risk factors of noncommunicable diseases (NCDs). Efforts are underway in the country to eliminate industrially-produced TFAs from the food supply in keeping with the priority targets of the World Health Organization (WHO) for 2019–2023. We reviewed the TFA content reported in industrially produced foods and discuss the regulatory landscape for TFAs, to facilitate the required policy changes in Pakistan and ultimately eliminate the TFA burden from industrial food products.

Design and method:
The study components included review of published research and product labels as well as review of prevailing food regulations for TFA-related information. A set of recommendations was also prepared to eliminate TFAs from Pakistan after national consultation workshops conducted in 2019.

Results:
Vanaspati ghee (partially hydrogenated oil), bakery shortening, hard margarines, and fat spreads were identified as the major sources of TFAs. Food products with partially hydrogenated vegetable oils or bakery margarine in their ingredients also contained high level of TFAs. Repeated use of oil for deep frying of potato and cereal products also caused an increase in TFA content. Federal and provincial food authorities have recently established the limits for TFAs in a few products; however, regulations do not include mandatory food labeling.

Conclusions:
A comprehensive national strategy for TFA elimination, based on knowledge of TFA prevalence associated regulatory control is suggested in this study. We recommend to: (1) promote actions towards replacement of traditional vanaspati ghee/bakery fats with healthier alternatives; (2) review national and provincial food standards to support development and implementation of legislative actions and their compliance; (3) amend food labeling laws so that clear information will be provided to inform consumers’ healthy food choices.