bluuebunny/crossref_metadata_2025_split huggingface dataset:
LEFT VENTRICULAR GLOBAL FUNCTION INDEX AND BLOOD PRESSURE PARAMETERS IN UNTREATED PATIENTS WITH HYPERTENSION
Authors: Minushkina Larisa , Brazhnik Victoria , Chumakova Olga , Alekhin Michail 
Published: April 2021

Objective:
The left ventricular global function index (LVGFI) is a novel marker that incorporates LV structure in the assessment of LV cardiac performance.Typically, LVGFI is assessed with MRI, but recently proposed a technique for calculating this index by echocardiography. It was previously shown that a decrease in LVGFI may be a predictor of adverse outcomes in young patients with hypertension and a preserved ejection fraction. The study aimed to elucidate the association between LVGFI and the features of the daily profile of blood pressure in untreated patients with essential hypertension (EH).

Design and method:
We included in the study 104 patients with EH (51 men (49%) and 53 women (51%)). Mean age 58,7 ± 11,73 years. All patients had no history of blood pressure-lowering treatment.
All patients underwent echocardiography and ambulatory blood pressure monitoring (ABPM). LVGFI (%) was defined as left ventricular (LV) stroke volume/LV global volume∗100% where LV global volume was calculated as the sum of the LV mean cavity volume ((LV end-diastolic volume + end-systolic volume)/2) and myocardium volume (LV mass/density). End-diastolic and end-systolic volume were obtained using Teichholz method.

Results:
The mean LVGFI was 30,21 ± 7,32%. We performed a correlation analysis of the main clinical characteristics and parameters of ABPM with LVGFI. We found slight correlation between age (r = -0,215, p = 0,028) and body mass index (r = -0,378, p < 0,0001) with the LVGFI. There were no significant associations between office blood pressure and echocardiography parameters. Also mean daily, daytime and night systolic and diastolic blood pressure were not correlated with LVGFI. The most significant associations were found between ABPM systolic (r = -0,307, p = 0,002) and diastolic (r = -0,355, p < 0,0001) blood pressure variability. Patients with the impaired circadian rhythm of blood pressure by type of over-dipper had the lowest LVGFI (26,84 ± 3,301%) compared with patients with normal circadian rhythm (32,43 ± 6,908%) and non-dipper patients (30,49 ± 7,773%), p = 0,041.

Conclusions:
Lowering of LVGFI is associated with high blood pressure variability and over-dipper circadian rhythm of blood pressure.
ASSOCIATION OF SHORT-TERM AND MID-TERM BLOOD PRESSURE VARIABILITY INDICES WITH LEFT VENTICULAR MASS INDEX IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Manousopoulos Konstantinos , Tsoutsoura Nefeli , Koromboki Eleni , Mitsikosta Efthalia , Spiliopoulou Sotiria , Malakou Anna , Zakopoulos Nikolaos , Manios Efstathios 
Published: April 2021

Objective:
Several studies have demonstrated that increased blood pressure (BP) variability is associated with target-organ damage development in hypertensive patients. However, the impact of BP variability (BPV) indices on target-organ damage in chronic kidney disease patients (CKD) is unclear. Aim of the study was to evaluate the association between short-term and mid-term BPV indices with left ventricular mass index (LVMI) in chronic kidney disease patients.

Design and method:
A total of 131 CKD patients, referred for evaluation at the Hypertension Unit of our department, underwent 24-h ambulatory BP monitoring, home BP monitoring and echocardiographic measurements. Short-term BPV was expressed by standard deviation (SD), time rate (TR) of BP variation and coefficient of variation (CV) of systolic and diastolic BP for both 24-h, daytime and nighttime intervals. Mid-term BPV was expressed by SD and CV of systolic and diastolic BP for morning and evening BP measurements. Statistical analysis was performed by means of bivariate correlations, simple and multiple linear regression analysis.

Results:
All home BPV indices did not correlated significantly with LVMI. Regarding short-term BPV, only 24-h systolic TR (r = 0.320, p < 0.001) and daytime systolic TR of BP variation (r = 0.310, p < 0.001) significantly correlated with LVMI. The multivariate analysis revealed that 24-h systolic TR of BP variation was the only variable that was significantly and independently associated with LVMI (B = 12.016 95%CI 4.981–19.052, p < 0.001). The association remained significant after adjustment for baseline characteristics and risk factors.

Conclusions:
Short-term BPV indices such as 24-h and daytime systolic TR of BP variation were significantly associated with LVMI in CKD patients. In contrast, no significant association was observed between mid-term BPV indices and LVMI.
CONTINUOUS BEAT TO BEAT AMBULATORY BLOOD PRESSURE MONITORING: INITIAL EXPERIENCE IN SUSTAINED UNCONTROLLED HYPERTENSIVES (SUCH)
Authors: Kotliar Carol , Obregon Sebastian 
Published: April 2021

Objective:
We aim to BP values obtained at interval periods versus beat to beat in sustained uncontrolled hypertensives (SUCH) by analysing the role of BP variability, sympathetic-vagal balance, relation of nocturnal-diurnal pattern,and oxygen desaturation index.

Design and method:
30 consecutively patients (66% male; 59,2+-11 years) with uncontrolled hypertension at office and ABPM were included. For 24 hours ABPM we used a beat to beat, cuff less monitor (Somnotouch NIBP Germany). We analysed: a) continuous BP records and also averages at conventional interval period (15–30 minutes’ day/night), b) BP variability, c) RR interval and sympathovagal balance (SVB) through evaluation of frequency domain by spectral analysis, d) oxygen saturation.

Results:
We obtained an average of 54.978 BP values per patient. Office versus 24 hs BP: 158 +-9.1/96.7 +-11.0 versus 144,9+-8,2/90,1+-5,1 mm Hg. Beat to beat continuous monitoring was well tolerated with no disturbances on daily activity. Interval data was associated with significant higher values of SBP (24 hrs. 145,9+-9.4 vs 144,9+-8,2; wake 147,8+-8,4 vs 147+-7,8; sleep 135,4+-7 vs 134,5+-5,8) (p.04) and DBP (24 hrs. 91.2+-5.6 vs 90,1+5,1, wake 93,5+-5 vs 92,6+-4,5, sleep 88+-6.2 vs 87,1+-5) (p.01). We classified SUCH patients in tertiles according to their increasingly 24 hrs. systolic average record and their data are shown in table 1. A positive direct association was found as expected with SBP and BMI, PP and MAP. When sympato-vagal balance was evaluated an increased sympathetic tone or decreased vagal tone was observed with a reverse or an absence of the expected reduction of SVB during sleep. (table 1). SUCH patients received a median of 2.8 antihypertensive drugs was observed but no differences in BP nocturnal behaviour was observed among different drugs.

Conclusions:
BP values obtained at interval periods were higher than those obtained continuously beat by beat. In our sample of patients, SUCH was associated with nocturnal hypertension and nocturnal lack of the expected sympato-vagal balance.
We need further studies including normotensives, white uncontrolled hypertensives and controlled hypertensives for a better understanding of populations behaviour and different epigenetic influences.
MORNING SURGE IN BLOOD PRESSURE AS A PREDICTOR OF WORSENING HEART FAILURE IN HEART FAILURE WITH REDUCED EJECTION FRACTION
Authors: Komori Takahiro , Hoshide Satoshi , Kario Kazuomi 
Published: April 2021

Objective:
Abnormal circadian blood pressure (BP) rhythm is observed in heart failure (HF) patients. Rising BP in the morning known as the morning surge (MS) is one of the abnormal circadian BP rhythm, and a cardiovascular risk factor in hypertensives. However, the significance of MS is not established in patients with HF.

Design and method:
We performed a prospective, observational cohort study of hospitalized HF patients who underwent ambulatory BP monitoring (ABPM). Four hundred fifty seven hospitalized HF patients (age, 68 ± 13 yrs; 63.9% males [n = 292] and 36.1% females [n = 165]) were followed up for 20.0 (median) months.

Results:
HF with reduced ejection fraction (HFrEF) was 197 (43.1%), HF with mid-range ejection fraction (HFmrEF) was 101 (22.1%), and HF with preserved ejection fraction (HFpEF) was 159 (34.8%). The composite outcome consisting of all-cause mortality and worsening HF was observed in 143 patients. In a Kaplan-Meier analysis, the MS group had a significantly higher incidence of the composite outcome than the non-MS group in HFrEF and HFmrEF patients.(figure) However, in multivariate Cox regression analysis, MS was a significant predictor for adverse outcomes only in HFrEF patients (HR 2.63, 95%CI 1.11–6.25, p = 0.03).

Conclusions:
The MS was found to be a novel predictor of worsening HF in patients with HFrEF.
NON-DIPPING BLOOD PRESSURE VARIATIONS IN JUVENILE KAZAKHS MIGHT BE DERIVED FROM INCREASED SYMPATHETIC ACTIVITY AND DECREASED PARASYMPATHETIC ACTIVITY AND DAYTIME PHYSICAL ACTIVITY
Authors: Kawamura Hiroshi , Ozawa Yukio , Izumi Yooichi , Kasamaki Yuji , Nakayama Tomohiro , Mitsubayashi Hiromi , Ichimaru Yuhei 
Published: April 2021

Objective:
A large number of adult and elderly Kazakhs were reported to exhibit hypertension and non-dipping blood pressure variations (BPV). However, no study has been performed to see whether non-dipping BPV still exist in juvenile Kazakhs. The purpose of this study was to investigate whether non-dipping BPV still exist in juvenile Kazakhs.

Design and method:
We performed ambulatory blood pressure (BP) monitoring and studied autonomic nerve activity by performing a frequency domain analysis of the subjects’ heart rate variability (HRV). We also assessed the subjects’ physical activity with accelerometry. The power spectral density (PSD) of the subjects’ HRV was calculated using fast Fourier transformation. We analyzed systolic BP (SBP) variations with the maximum entropy method (MEM).

Results:
MEM analysis of juvenile Kazakhs revealed that the SBP variations of the non-dippers exhibited a 24-hour periodicity with a very weak PSD. Among juvenile Kazakhs, the non-dippers displayed higher low-frequency (LF)/high-frequency (HF)(LF/HF) ratios and lower HF/(LF+HF) ratios than the dippers over 24 hours (dippers vs. non-dippers: 0.43 (0.37, 0.57) vs. 0.51 (0.44, 0.61)(median, Q1, Q3), P = 0.0001). The non-dippers’ HF/(LF+HF) ratios were lower than those of the dippers (dippers vs. non-dippers: 1.87 (1.11, 2.34) vs. 1.30 (0.92, 1.75)(median, Q1, Q3), P = 0.0001). Furthermore, the daytime physical activity scores of the non-dippers were lower than those of the dippers (dippers vs. non-dippers: 1.27 (1.06, 1.38) vs. 1.00 (0.80, 1.20)(median, Q1, Q3), P = 0.0733).

Conclusions:
Non-dipping BPV still exist in juvenile Kazakhs. The differences in cardiac autonomic function and physical activity seen in non-dipping juvenile Kazakhs might contribute to the generation of weak circadian variations in SBP, leading to non-dipping SBP variations.
THE EFFECTS OF SYSTOLIC ARTERIAL PRESSURE ON LOCOMOTOR ACTIVITY IN CONGENIC RATS DERIVED FROM STROKE PRONE SPONTANEOUSLY HYPERTENSIVE RATS AND WISTAR KYOTO RATS
Authors: Kawamura Hiroshi , Mitsubayashi Hiromi , Ikeda Katsumi , Kawakami Kohhei , Nabika Toru 
Published: April 2021

Objective:
The systolic arterial pressure (SAP) levels of congenic rats were reported to be intermediate between those of stroke-prone spontaneously hypertensive (SHRSP) rats and Wistar Kyoto (WKY) rats, and the congenic rats were reported to exhibit higher locomotor activity than SHRSP and WKY rats. Locomotor activity in the early morning was higher in the congenic rats than in the other two strains. However, no study on the relationship between SAP and locomotor activity in congenic rats has been performed. Therefore, we aimed to examine this topic.

Design and method:
We used 10 mature male congenic rats and age- and gender-matched SHRSP and WKY rats (n = 10 each) as the controls. We measured the SAP and locomotor activity of the rats telemetrically. We estimated best-fit curves of locomotor activity using the maximal entropy method.

Results:
The congenic rats exhibited the highest locomotor activity counts (congenic rats vs. SHRSP rats vs. WKY rats: 58 (23, 89) vs. 18 (4, 40) vs. 4 (1, 8) counts/10 seconds (median, Q1, Q3), P = 0.0010). The congenic rats also exhibited SAP levels that were intermediate between those of the SHRSP and WKY rats (congenic rats vs. SHRSP rats vs. WKY rats: 194 ± 7 vs. 229 ± 7 vs. 117 ± 4 mmHg (mean ± SD, P = 0.0098). The strongest correlation between locomotor activity and SAP was seen in the congenic rats (Y = -1851.3 + 9.87X, rS = 0.592, P = 0.00001). The ratio of the increase in locomotor activity to the increase in SAP was highest in the congenic rats (congenic rats vs. SHRSP rats vs. WKY rats: 7.05 (4.92, 10.20) vs. 0.04 (0.87, 0.88) vs. 0.11 (3.46, 3.55)(median, Q1, Q3); SHRSP rats vs. congenic rats: P < 0.01; SHRSP rats vs. WKY rats: n.s.; congenic rats vs. WKY rats: P < 0.05).

Conclusions:
Among these three rat strains, the response of locomotor activity to increases in SAP was strongest in the congenic rats.
ANALYSIS OF FACTORS RELATING TO DAY-TO-DAY HOME BLOOD PRESSURE VARIATION IN HYPERTENSIVE PATIENTS
Authors: Ishimitsu Toshihiko , Furuichi Masahito , Sato Yuka , Wakabayashi Haruna , Satonaka Hiroshi , Iwashima Yoshio , Honda Takeaki , Tojo Akihiro 
Published: April 2021

Objective:
In order to prevent cardiovascular events and organ injuries in hypertensive patients, strict blood pressure (BP) control over 24 hours is of primary importance. In addition to the BP level, it has been indicated that the variabilities of blood pressure during a day or between visits also influence the risk of cardiovascular disorders. This study aimed to delineate the factors relating to the variations of office and home BPs throughout a year in hypertensive outpatients under antihypertensive therapy.

Design and method:
The subjects enrolled in this study were 83 hypertensive out-patients who recorded home blood pressure measurements. Office BP and the home BP records within 7 days before each visit were collected for the analyses calculating the coefficient of variation (CV). In addition to the physical findings such as blood pressure and body mass index, laboratory data of blood and urine samples were collected.

Results:
The office BP value (131/77mmHg) was comparable to the morning home BP (130/76) and higher than the evening home BP (126/73), however, the CV values were comparable between the office and the morning and evening home BPs. Correlations of BP and CV were stronger between the morning and the evening home BPs than between the office and the home BPs. The CV of systolic office BP was greater in patients with diabetes mellitus than patients without diabetes (7.8 vs 6.1%). In patients with chronic kidney disease, the CVs of diastolic office BP and diastolic evening home BP were greater than patients without chronic kidney disease (8.0 vs 6.2% and 8.1 vs 6.7%, respectively). In addition, The CVs of diastolic morning and evening home BP were positively correlated with serum creatinine and negatively correlated with estimated glomerular filtration rate. Patients with cardiovascular diseases such as stroke and coronary artery disease showed greater CV of diastolic morning home BP than patients without cardiovascular diseases (8.2 vs 6.6%).

Conclusions:
These results suggest that the home BP exhibits different variability from the office BP and the BP variability is increased in high-risk hypertensive patients with diabetes mellitus, chronic kidney disease and cardiovascular diseases.
BLOOD PRESSURE VARIATION IS DEPENDENT ON THE BALANCE OF SYMPATHETIC AND PARASYMPATHETIC ACTIVITY
Authors: Hano Takuzo , Koike Yumi 
Published: April 2021

Objective:
Blood pressure variability is an independent risk factor for cardiovascular complications in hypertension. There were reports that sympathetic nervous system was involved in the regulation of blood pressure, whereas beta-blocker was not involved in blood pressure variability. Therefore, the relationship between autonomic nervous system and blood pressure variability is unclear. We reported the usefulness of the pupillary function test as an index of sympathetic and parasympathetic nerves. In the present study, we clarify how the autonomic nervous system is related to blood pressure variability using the pupillary function test.

Design and method:
For 23 patients undergoing outpatient visits, blood pressure and heart rate variability factors were measured at 14 consecutive outpatient visits. The coefficient of variation of systolic blood pressure, diastolic blood pressure, and heart rate was calculated. In the pupillary function test, mydriatic velocity was used as an index of sympathetic nerve function, and miotic speed was used as an index of para-sympathetic function.

Results:
The average age is 66 ± 6 years old. The coefficient of variation for systolic blood pressure, diastolic blood pressure, and heart rate was 5.57 ± 2.13, 6.78 ± 2.96 and 6.73 ± 2.79, respectively. Mydriatic velocity and contraction velocity were 3.29 ± 0.79 ms and 1.69 ± 0.58 ms. Variation coefficient of systolic blood pressure, diastolic blood pressure and heart rate were not significantly correlated with mydriatic and miotic velocity. On the other hand, there was a significant negative correlation between coefficient of variation of systolic blood pressure, diastolic blood pressure and heart rate and ratio of mydriatic and miotic velocity.

Conclusions:
Visit-to-visit variability of systolic pressure, diastolic pressure and the heart rate was not related to sympathetic or parasympathetic activity alone but balance between both are involved in these variabilities.
THE EFFECT OF METFORMIN ADMINISTRATION ON BLOOD PRESSURE VARIABILITY IN HYPERTENSIVE SUBJECTS WITH PREDIABETES RECEIVING LISINOPRIL
Authors: Hakim Abdul , Hersunarti Nani , Soerarso Rarsasi , Siwanto Bambang Budi , Kuncoro Ario S. , Atmadikoesoemah Celly , Indriani Suci , Adiarto Suko , Sukmawan Renan 
Published: April 2021

Objective:
To determine the effect of adding metformin to lisinopril as well as an oral antidiabetic drug that has antihypertensive effects and influence on blood pressure variability in the hypertensive population and prediabetes.

Design and method:
Method: This study was a randomized clinical trial conducted at National Cardiac Center Harapan Kita Hospital (NCCHK) in hypertensive employees with prediabetes. Divided into 2 groups that received Lisinopril 5 mg (open) and Metformin 2x500 mg (disguised) or placebo for 8 weeks. Examination of Home Blood Pressure Monitoring (HBPM) is carried out before and after therapy is given.

Results:
Results: A total of 64 patients completed the study (31 placebo groups, 33 metformin groups). After 8 weeks of follow-up, the blood pressure variability of the metformin group had lower blood pressure variability (3.8 ± 2.2 mmHg, p = 0.03) than in the placebo group. The mean change in mean systolic and diastolic blood pressure in the metformin group decreased significantly (p < 0.05)

Conclusions:
Conclusion: Addition of metformin to hypertensive subjects with prediabetes who received lisinopril decreased morning blood pressure variability and morning mean blood pressure which was statistically significant.
AUGMENTED BLOOD PRESSURE VARIABILITY FOLLOWING CONTINUOUS INFUSION OF NORADRENALINE IN RATS
Authors: Jiang Danfeng , Kawagoe Yukiko , Asada Yujiro , Kitamura Kazuo , Kato Johji 
Published: April 2021

Objective:
Augmented blood pressure (BP) variability has been shown to be an independent cardiovascular risk factor. Activity of the sympathetic nervous system is an important determinant factor of the 24-h profile of BP variability, although it is unknown whether persistent adrenergic activation causes augmented BP variability or not. Here we report that continuous infusion of noradrenalin augments 24-h BP variability in rats, and our efforts were also made to explore the mechanism of action through which noradrenalin exerted this effect.

Design and method:
Nine-week-old male Wistar rats maintained under a 12-h light and 12-h dark cycle were continuously infused with subcutaneous 30 mg/h noradrenalin, 150 mg/h of the a1-adrenergic agonist phenylephrine, or 30 mg/h of the non-selective b-agonist isoproterenol, for 14 days. Noradrenalin-infused rats were also administered either oral 5 mg/day prazosin, an a1-blocker, or 50 mg/day atenolol, a b1-blocker, during the infusion period. BP variability was evaluated before and after 7 and 14 days of the infusion, using a coefficient of variation (CV) of BP recorded every 15 min under an unrestrained condition via an abdominal aortic catheter by a radiotelemetry system.

Results:
Continuous infusion of noradrenalin significantly increased BP variability at 7 and 14 days, slightly elevating BP levels, and this increase was observed similarly in the light and dark cycles. Noradrenalin-induced augmentation of BP variability was partially attenuated by oral administration of prazosin, but not by atenolol. This action of noradrenalin was mimicked by continuous infusion of phenylephrine, while isoproterenol failed to affect the BP variability.

Conclusions:
Continuous infusion of noradrenalin increased BP variability in rats through an a1-adrenergic receptor-mediated mechanism, suggesting that the noradrenalin-infused rat is an animal model of augmented BP variability induced by persistent adrenergic activation. This model could be useful in pharmacological screening of the suppressive action of candidate drugs on augmented BP variability in vivo.
HOME BLOOD PRESSURE MONITORING (HBPM) IN CLINICAL PRACTICE: A SYSTEMATIC REVIEW AND EXPERIENCE REPORT OF ONLINE TOLL FOR RESULTS REPORT IN BRAZIL
Authors: De Melo Kamilla Correia , Nascimento Loreanne G. , Vieira Pedro H. S. , De Brito Jaques Lais A. , Do Nascimento Emerson B. , Maciel De Figueirêdo Anne G. , Lins Lais Pinheiro , Magno Isabella Maria Figueiredo , De Andrade Lucas G. , Neto Inácio De Barros Melo , De Oliveira Thárcia Kiara Beserra , Veiga Da Silva Joelmir L. , Torres Rodrigo De L. , Silva Jose Sergio N. 
Published: April 2021

Objective:
Perform a systematic review of systemic arterial hypertension (SAH) diagnosis and follow-up using home blood pressure monitoring (HBPM) and report the experience of using an online tool (TeleMRPAÔ) for results report in Brazil.

Design and method:
The MedlineÔ, EmbaseÔ, and Cochrane LibraryÔ databases were searched for randomized studies on the effectiveness of the monitoring and diagnosis of SAH with HBPM from 2014 to 2018. The keywords used were hypertension, blood pressure, home blood pressure monitoring. A full review of 132 articles was performed and 36 studies were considered potentially eligible. Out of the 36 potentially eligible studies, 25 studies were published from 2014 to 2018, conducted in North America and Europe and included a wide variety of hypertension assessment methods. Only 10 studies aimed to analyze HBPM as a tool for the diagnosis and / or follow-up of SAH. TeleMRPAâ is an online tool (www.telemrpa.com) developed in Brazil to facilitate HBPM results reporting by cardiologists. Through this tool, it is possible to standardize the report and, from the data entered online, it is possible to generate a final report that gives greater feasibility, reproducibility of the method, minimizing errors.

Results:
The regular use of HBPM decreases the rates of cardiovascular events and SAH related mortality, as well as lower health care costs when compared to the monitoring of SAH only with office measurements. There was a consonance of the studies indicating a low sensitivity of the blood pressure measurement in the office to detect the optimal control of SAH when compared to the addition of HBPM. Thus, TeleMRPAâ made it possible for HBPM to be extended to more cardiologists and their patients.

Conclusions:
The use of HBPM showed to be effective. The HBPM should be included in the diagnosis and follow-up of SAH more routinely. Still, HBPM encourages the increase of patient participation in their self-care, as it reinforces patient-centered care, improving SAH control. In addition, in Brazil, the TeleMRPAâ has made SAH monitoring more comprehensive.