bluuebunny/crossref_metadata_2025_split huggingface dataset:
RENAL DENERVATION MAY SLOW THE PROGRESSION OF SUBCLINICAL BRAIN DAMAGE IN DIABETIC PATIENTS WITH RESISTANT HYPERTENSION DURING 3 YEARS FOLLOW-UP
Authors: Falkovskaya Alla , Mordovin V. , Pekarskiy S. , Zyubanova I. , Manukyan M. , Lichikaki V. , Sukhareva A. , Baev A. , Moiseeva A. , Caraus A. 
Published: April 2021

Objective:
Patients with resistant hypertension and type 2 diabetes mellitus (DM) accelerate the subclinical brain damage and the age-related brain atrophy, which leads to a more rapid decrease in cognitive functions. Brain MRI can detect expansion of liquor spaces and white matter lesions (PWMLs), which are patterns of brain atrophy. Renal denervation (RDN) is an effective treatment for resistant hypertension (RHTN), but the key question is whether RDN can slow the progression of brain damage. The aim of this study was to evaluate the effect of renal denervation on the MRI- sing of brain damage in patients with RHTN with type 2 DM over a 3-year follow-up.

Design and method:
The study included 17 diabetic patients with RHTN (mean age 61,3 ± 6.2 years; 9 males, mean 24 hour (systolic/diastolic) blood pressure (BP) 161.3 ± 19.4/82.2 ± 13.5 mmHg, HbA1c 7 ± 1,2%) from single-arm prospective interventional study (NCT02667912 on ClinicalTrial.gov) in whom 1.5T magnetic resonance imaging (MRI) of the brain and 24-hour BP monitoring were performed at baseline and an annually for 3 years follow up. We measured linear dimensions of liquor spaces (subarachnoidal spaces (SAS), lateral ventricles (LV), both III and IV ventricles) and calculated the number of focal white matter lesions. Periventricular white matter lesions (PWMLs) were evaluated semi-quantitatively on a scale of 0 to 4. On average, patients were taking 4.3 ± 1.0 antihypertensive drugs and were instructed not to change their medication regimen for the duration on the study. The mean number of ablations was 13 ± 1.8 (10–16).

Results:
Three years after RDN, there was a significant decrease in the average 24-hour systolic/diastolic BP by 14.1/8.6 mm Hg (p = 0.03/0.04). The linear dimensions of liquor spaces (SAS, LV, both III and IV ventricles), number of focal white matter lesions, as well as the mean PWMLs score did not change (p > 0.05).

Conclusions:
This is the first study to demonstrate that RDN can prevent progression of brain damage in diabetic patients with RHTN during 3 years follow-up and therefore has a potentially beneficial effect on the brain.
THE RELATION BETWEEN ANTIHYPERTENSIVE DRUGS AND SLEEP DISORDERS IN PATIENTS WITH HYPERTENSION
Authors: Shalimova Anna , Buriakovska Olena , Isayeva Ganna 
Published: April 2021

Objective:
Sleep disorders are one of the most frequent non-cardiac complains in hypertensive patients. At the same time insomnia, short sleep duration and obstructive sleep apnea are well documented risk factors of hypertension and diabetes mellitus. However, the effects of antihypertensive drugs on sleep quality are little known. The aim of the study was to assess the impact of ACE inhibitors, ARB II and diuretics (indapamide) on sleep quality and duration.

Design and method:
Cross-section study included 118 patients aged 54.5 ± 9.7 years old. Insomnia was diagnosed according to criteria of International Classification of Sleep Disorders,3rd Edition. Epworth scale was used to assess day sleepiness. SOMNOcheck micro (WM 94500) was used to verify obstructive sleep apnea. Blood lipids (total cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, and high density lipoprotein (HDL) cholesterol), body mass index (BMI), waist and hip circumference were assessed. Physical activity was measured using Omron Walking Style III step counter HJ-203-EK. Patients with myocardial infarction or stroke in history, heart failure III-IV functional class (NYHA), treated with steroids hormones, thyroid disease and obesity grade II-III. Control group included 23 healthy subjects and 19 subjects without hypertension or cardiovascular disease but presence of insomnia. Data were analyzed by ANOVA test or Mann–Whitney U-test. Odd ratio was calculated for studied parameters.

Results:
Insomnia was diagnosed in 57 (48.3%) patients with hypertension; 24 (20.3%) had obstructive sleep apnea; circadian sleep disorders were diagnosed in 33 (27.9%) and moving disorders associated with sleep had 9 (7.6%). It was find out that therapy with ACE inhibitors (OR 0.26 (0.06–0.95; p = 0.04)) and diuretics (OR 0.23 (0.05–1.14; p = 0.03)) with better sleep quality. The effect was prominent in patients with high physical activity. ARBII neutrally impact sleep quality.

Conclusions:
In patients with hypertension therapy with ACE inhibiters and indapamide had positively effect on sleep quality.
SLEEP PATTERNS AND CARDIOVASCULAR HEALTH IN CHINESE CHILDREN AND ADOLESCENTS
Authors: Dong Hongbo , Yan Yinkun , Liu Junting , Zhao Xiaoyuan , Cheng Hong , Hou Dongqing , Huang Guimin , Mi Jie 
Published: April 2021

Objective:
Despite accumulating evidence showing that sleep patterns are correlated with cardiometabolic risks, their relations to cardiovascular health (CVH) in children and adolescents remains inconclusive. Therefore, we aimed to investigate the associations of sleep duration and bedtime with CVH among Chinese children and adolescents.

Design and method:
Data were obtained from a population-based cross-sectional study, with 7,220 Chinese children and adolescents aged 6–18 years were included for analysis. The scores and levels of behavioral (smoking, body mass index, physical activity, and diet), biological (total cholesterol, blood pressure, and glucose), and global CVH were evaluated according to the American Heart Association's recommendation. Information on sleep duration and timing were collected by questionnaires. Subjects with sufficient sleep duration (> = 9 hours in individuals aged 6–12y or >8 hours in those over 13y) and early bedtime (22:00 before) were defined as having optimal sleep patterns. Generalized additive models and logistic regressions were performed to estimate the relationship between CVH and sleep patterns.

Results:
For boys, positive dose-response relations were found between sleep duration and all three CVH scores, but negative associations were observed for bedtime. Compared with boys with optimal sleep patterns, those with insufficient sleep duration and late bedtime had lower odds of ideal biological CVH (OR = 0.680, 95% CI: 0.525–0.881, p = 0.004) and ideal global CVH (OR = 0.681, 95% CI: 0.525–0.883, p = 0.004). Though similar results were also showed in girls, no statistically significant association was noted between sleep pattern variables (duration and timing) and any CVH scores or levels.

Conclusions:
Sufficient sleep duration and early bedtime are associated with desirable cardiovascular health in children and adolescents, especially for boys. However, causal interpretation cannot be made and associations might be bidirectional.
NO SIGNIFICANT DIFFERENCE SEEN IN QUALITY OF LIFE MEASURED BY SF-36 QUESTIONNAIRE BETWEEN PATIENTS WHO REACHED TARGET 24 HOUR BLOOD PRESSURE AND WHO DID NOT
Authors: Kantola Ilkka , Kantola Taru 
Published: April 2021

Objective:
To clarify if a difference is noticed in quality of life between Finnish drug-treated hypertensive patients who reached target daytime systolic and diastolic blood pressure (below 140/90 mmHg) compared to those who did not.

Design and method:
SF-36 quality of life questionnaire was filled out by 106 hypertensive patients (47 females, 59 males, aged 66.2 (7.5) years). All used at least one antihypertensive agent. 24 hour ambulatory blood pressure (ABPM) and pulse wave- velocity (PWV) were performed and laboratory tests taken. Sixty-four of the patients reached ABPM daytime systolic and diastolic blood pressure (<140/90 mmHg) and 42 did not.

Results:
No significant difference was seen between the groups in any SF-36 quality of life parameters (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, mental health or the mean of them).
The mean 24-hour ambulatory systolic blood pressure (SBP) was 142.9 (10.3) mmHg and diastolic blood pressure (DBP) 79.9 (7.1) mmHg in the patients who did not reach the target and 129.1 (7.7) mmHg and 77.4 (6.1) mmHg in the patients who reached (p = 0.0001). No significant difference was seen in age, weight, waist-hip ratio, carotid-femoral PWV, lipid values, GHbA1c or serum creatinine. Carotid-femoral PWV was 11.8 (3.8) and 11.5 (2.9) m/s. The mean (SD) of the eight SF-36 questionnaire scores was 71.8 (19.1) and 73.3 (19.8) (maximum 100). All SF-36 parameters correlated significantly (p < 0.001) to each other.
The high mean of the quality of life parameters correlated in the patients who did not reach the target to male gender, low 24-hour ABPM SBP standard deviation (SD), mean arterial BP SD, low daytime SBP SD and diastolic BP SD and mean BP SD. The high mean of the quality of life parameters correlated in the patients who reached the target to waist-hip ratio, type 1 diabetes mellitus, no change in carotid artery, low carotid-radial PWV and high 24-hour heart rate.

Conclusions:
The SF-36 scores of the Finnish drug-treated hypertensive patients did not differ markedly between those who reached blood pressure target and those who did not reach.
CILNIDIPINE DECREASES LEFT ATRIAL VOLUME INDEX SUPERIOR THAN ATENOLOL IN THE PATIENTS WITH HYPERTENSION
Authors: Chung Wook-Jin , Jang Albert Youngwoo , Ryu Seung-Kee , Park Su Jung 
Published: April 2021

Objective:
This study was designed as a prospective, randomized, double-blind, parallel-group to test whether cilnidipine achieves greater left ventricular (LV) mass reduction and improves LV diastolic function than does atenolol.

Design and method:
Seventy-two patients with uncomplicated essential hypertension and increased LV mass index at screening echocardiography were randomly assigned and forced-titrated to 20 mg/d cilnidipine or 100 mg of atenolol for 36 weeks. Echocardiography, ambulatory blood pressure monitoring, biochemical studies including NT pro-BNP and 24-hours urine microalbumin were measured at baseline and after 36-weeks therapy.

Results:
Clinical examination and blinded echocardiogram in a per-protocol analysis of 28 cilnidipine-treated and 26 atenolol-treated patients revealed similar reductions in systolic/diastolic pressure (-16.5/8.9 mmHg versus -23.9/14.8 mmHg) and LV mass index (-21.4 g/m2 versus -19.5 g/m2). Interestingly, cilnidipine-treated group showed reduction on left atrial (LA) volume index but atenolol-treated group showed more enlarged LA (-5.1 % versus 7.3 %, p = 0.035).

Conclusions:
Both cilnidipine and atenolol similarly and effectively reduced blood pressure and LV mass index. However, only cilnidipine reduced LA volume index, whereas atenolol increased. Cilnidipine may provide more beneficial effect on the management in essential hypertension with diastolic dysfunction.
IN PATIENTS'S PREFERENCES TO ASPIRIN COMPARING WITH ANTIHYPERTENSIVE MEDICATION AND STATINS FOR PRIMARY PREVENTION
Authors: Rotar Oxana , Alieva Asiiat , Boiarinova Mariia , Erina Anastasia , Tolkunova Kristina , Solntsev Vladislav , Konradi Alexandra 
Published: April 2021

Objective:
According to recent data of Russian epidemiological studies and screening campaigns hypertension control and statins use in primary prevention is still poor. The aim of our study was assess of aspirin and statin use comparing with antihypertensive medication in Russian residents in terms of MMM19.

Design and method:
An opportunistic cross-sectional survey of volunteers aged 18 years from 21 Russian Regions (n = 5274) was performed in terms of international campaign MMM19. 1,834 of the residents were men (34.8%). 49.2% of the respondents were younger than 25 years, therefore, considering significant differences in age, further analysis of the data was performed among participants over 25 years (n = 2681). The questionnaire was being completed on presence of diabetes mellitus, history of cardiovascular complications, smoking and alcohol intake. Information regarding intake and omission of antihypertensive medication, aspirin, statins were clarified. Blood pressure (BP) was measured three times with automated and manual sphygmomanometers and mean value was calculated.

Results:
Only 73.6% hypertensive patients take antihypertensive therapy and 44.8% of them achieved target BP of less than 140/90 mm Hg. Data regarding statins and aspirin intake in participants with hypertension and diabetes is presented in table.

Conclusions:
Despite insufficient hypertension control and current guideline positions against aspirin prescribing for primary prevention – 42,7% of hypertensives take aspirin. Only half of the patients having diabetes with automatically indicated high or very high risk are taking statins. Independently of diabetes presence patients are more likely to take aspirin comparing with statins. It is remarkably that 18,3% of hypertensives prefer aspirin than antihypertensive medication.
ACUTE MYOCARDIAL INFARCTION AND STROKE PREVENTION WITH AMLODIPINE/ ATORVASTATIN SINGLE-PILL THERAPY FOR PATIENTS WITH HYPERTENSION AND DYSLIPIDEMIA
Authors: Nakaya Hideaki , Sasamura Hiroyuki , Saito Ikuo , Inoue Yukie , Kobayashi Makoto , Itoh Hiroshi 
Published: April 2021

Objective:
To evaluate the effect of suppressing the onset of Acute Myocardial Infarction (AMI) and Stroke by using combination tablet of Amlodipine Besilate/ Atorvastatin Calcium Hydrate (Caduet Combination Tablets) or combined use of Amlodipine Besilate and Atorvastatin Calcium Hydrate against patients with Hypertension and Dyslipidemia.

Design and method:
We build a Markov Model of considering the long-term treatment by using combination tablet of Amlodipine 5 mg/ Atorvastatin 10 mg or combined use of Amlodipine 5 mg and Atorvastatin 10 mg.
The target patients were 60 years old with Hypertension (Systolic Blood Pressure 152mmHg) and Dyslipidemia (Total Cholesterol 288 mg/dL).
The analyzed cycle was set for one year and we performed the simulation for the lifetime treatment.
The medication adherence for the well treated group was 82.4% in the Combination Tablet treatment group and 61.0% in the combined treatment group. Medication adherence for the poor treated group was based on hypothesis as each clinical efficacy index was the same as before treatment.

Results:
The incidence of AMI and stroke during the lifetime in combination tablet treatment group was estimated to be 21.8% in male and 24.1% in female for patients without diabetes or smoking. For patients without diabetes but smoking, it was 35.8% and 40.6%. For patients with diabetes but no smoking, it was 31.1% and 48.5%. For patients with both diabetes and smoking, it was 47.4% and 68.5%.
On the other hand, the incidence of AMI and stroke during the lifetime in combined treatment group was 24.7% in male and 27.5% in female for patients without diabetes or smoking. For patients without diabetes but smoking, it was 39.4% and 44.9%. For patients with diabetes but no smoking, it was 34.5% and 53.1%. For patients with both diabetes and smoking, it was 51.0% and 72.0%.
The incidence of AMI and stroke was lower in the combination tablet treatment group compared to the combined treatment group in both men and female.

Conclusions:
Treatment with combination tablet against patients with hypertension and dyslipidemia improves the medication adherence which resulted in suppressing the onset of AMI and stroke.
COMMUNITY PHARMACIST INTERVENTION (PHARMAFIT PROTOCOL) SIGNIFICANTLY REDUCES CARDIOVASCULAR RISK IN OBESE PATIENTS
Authors: González Leonor Huete , Lista Francisco Javier Manzano , Alonso Isabel Aránguez , Alfonso Marisol Férnandez 
Published: April 2021

Objective:
Cardiovascular disease is the leading cause of death worldwide and is strongly associated with obesity. Health education, nutritional follow-up, and modification of life style habits are key interventions for achieving reduction of cardiovascular risk (CVR) in obese patients. The hypothesis of this study is that an intervention in the community pharmacy prevents and/or reduces metabolic alterations associated with obesity thus leading to a reduction in CVR in this population.

Design and method:
A before-and-after interventional study was performed in a Spanish community pharmacy. Obese patients (BMI > 30 kg/m2 and waist circumference > 102 cm for men or >88 cm for women) with (group A, n = 30) or without (group B, n = 14) comorbidities were asked to participate. In the first visit following variables were determined on-site: anthropometric values (weight, height, waist circumference), blood pressure, glycemic (glucose, HbA1c) and lipid parameters (total cholesterol, HDL-c, LDL-c, triglycerides). Interventions (PharmaFit Protocol) consisted in a 24-month follow-up focusing i) on adherence to nutritional guidelines and modification of life style habits (monthly), and ii) on anthropometric variables, blood pressure, and biochemical determinations (bi-monthly). Feedback was provided to the primary care physician or specialist. CVR was estimated by REGICOR score.

Results:
Anthropometric variables significantly decreased in all groups. Plasma glucose levels were significantly reduced in group A without changes in HbA1c. Lipid parameters significantly improved in group A, whereas HDL-c significantly raised in all groups. REGICOR score was significantly reduced in group A female (13.8 ± 1.6 vs 5.8 ± 1, p < 0.0001) and male (12.7 ± 1.7 vs 4.4. ± 0.6, p < 0.005) patients, and in group B female patients (3.5 ± 0.7 vs 1.9 ± 0.4, p < 0.001).

Conclusions:
Community pharmacist intervention, delivered as a 24-month follow-up combining health and dietary education has a highly positive impact on CVR reduction in obese patients. This study stresses the importance of pharmacist intervention in both the reversal and prevention of CV disease when targeting obese patients.
VARIANT GAMMA 6+ GAMMA-DELTA T CELLS PLAY A ROLE IN ANGIOTENSIN II-INDUCED HYPERTENSION
Authors: Mahmoud Ahmad Usama Moha , Caillon Antoine , Paradis Pierre , Schiffrin Ernesto 
Published: April 2021

Objective:
We previously demonstrated that a small subpopulation of T cells considered (innate-like), expressing the γδ T-cell receptor (TCR) plays a key role in hypertension and vascular injury. γδ T cells can be subdivided according to the TCR variant (V) subtype that is generally specific for a tissue. A subpopulation of lungs and skin γδ T cells that are Vγ6+ and produce interleukin (IL)-17A was shown to respond promptly to pneumococcal infection and skin inflammation. However, γδ T cell Vγ subtypes involved in hypertension are still unknown. We hypothesized that the Vγ6+ γδ T cell may play a role in angiotensin (Ang) II-induced hypertension and vascular injury.

Design and method:
Eleven- to 13-week-old C57BL/6J male mice were infused or not with Ang II (490 ng/kg/min, SC) for 14 days, (n = 5–14). The γδ T cell Vγ subtypes were profiled and markers of activation of Vγ6+ γδ T cells were determined by flow cytometry.

Results:
In spleen and mesenteric lymph nodes (MLNs) the most abundant γδ T cells Vγ were Vγ1/2+ and Vγ4+ followed by Vγ6+,Vγ5+ and Vγ7+. In thoracic aortic (TA) perivascular adipose tissue (PVAT), the most abundant γδ T cell Vγ was Vγ6+ followed by Vγ4+, Vγ1/2+, Vγ5+ and Vγ7+. In mesenteric artery (MA) PVAT, the most abundant γδ T cell Vγ subtype was Vγ6+ followed by Vγ4+, Vγ7+, Vγ5+ and Vγ1/2+. Ang II increased the frequency of Vγ6+ γδ T cells in the spleen (1.5-fold, P < 0.01) and TA PVAT (1.6-fold, P < 0.01), whereas it only tended to increase them in MA PVAT. The frequency of IL-17 producing effector memory (CCR6 + CXCR3–CD44 + CD69 + ) Vγ6+ γδ T cells were increased in spleen (1.7-fold, P < 0.01) and trended to be elevated in mesenteric PVAT in Ang II-infused mice compared to control mice.

Conclusions:
Vγ6+ γδ T cells were the most abundant Vγ subtype in PVAT. IL-17 producing effector memory Vγ6+ γδ T cells may play a role in Ang II-induced hypertension. Targeting a γδ T cell variant subtype could be a therapeutic approach to reduce inflammation in hypertension.
CLINICAL CHARACTERISTICS OF YOUNG ADULTS WITH HYPERTENSION REFERRED TO A SPECIALIST HYPERTENSION CLINIC
Authors: Kennedy Cormac , Farnan Richard , Aftal Zainab , Hall Mary , Hemyrck Linda , Stinson John , O’Connor Patricia , Hennessy Martina , Barry Michael 
Published: April 2021

Objective:
Objective: Compared to older adults, young adults (18–39 years) with hypertension have poorer awareness of their conditions, are less likely to be treated and much less likely to have their blood pressure (BP) controlled as a result. The objective of this study was to identify the clinical characteristics of the young hypertensives, the extent of treatment and its success in achieving guideline BP targets.

Design and method:
Design: A pragmatic observational study of patients referred with hypertension to our clinic.

Method:
Consent for inclusion in the study was be requested from all patients attending the specialist hypertension clinic at St James Hospital from June to September 2019. Clinical details will be recorded to characterise the groups of interest. Details to be recorded from the patients first and most recent visit including demographics, referral information, co-morbidities, investigations and treatments. The study was approved by the local research ethics committee (Tallaght hospital, Dublin). T-tests and Chi-squared tests were applied as appropriate.

Results:
Results: 236 patients were recruited for the study of which 63 (26.7%) were young adults. The mean age of the young group was 32.1 years and the BMI was 30.3 kg/m2. 75% were either obese or overweight, both in line with the rest of the study cohort. 76% had a family history of hypertension. The young group were more likely to have controlled BP at a cut-off of 140/90mmHg (69.5 v 50.3%;p = 0.014) but this group were taking less anti-hypertensive medications compared to those forty years or older (1.41 drugs v 2.28;p < 0.001). While the young group were more likely to have controlled BP according to the new AHA guidelines (27.1% v 13.3%;p = 0.025; cut-off 130/80mmHg), the figures were similar for both groups when the ESH guidance was used due to a higher cut-off for those over 65 years (27.1 v 28.5%).

Conclusions:
Conclusions: This study suggests that younger patients with hypertension require less anti-hypertensive treatment to achieve BP control. It did not identify subgroups of patients within the young group, however, the group is notable for the extent of overweight and obese patients referred to the clinic.