bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPERTENSION AND INCIDENCE OF MORTALITY IN GENERAL POPULATION OF A MEDITERRANEAN REGION
Authors: Ruiz Adrian , Fernandez Antonio , Holgado Jose Luis , Lopez Cristina , Sauri Inmaculada , Uso Ruth , Trillo Jose Luis , Vela Sara , Bea Carlos , Martinez Fernando , Redon Josep 
Published: April 2021

Objective:
Hypertension is the most relevant risk factor of mortality over the world. Assessment of the impact has been analysed in a great variety of studies, but the Electronic Health Recordings, including hole populations, provide a more precise information. The objective was to assess the mortality associated to adult hypertensive patients from a Mediterranean population. The associated impact of diabetes (DM) and chronic kidney disease (CKD) has been presented.

Design and method:
The sample was recruited from beneficiaries of the Valencian Health Agency's health care system, with a population of 3799884 people older than 25 years in 2012. The observational study was undertaken as part of routine clinical practice from 2012 until 2016. Hypertension was defined by a recorded physician diagnosis or antihypertensive medication use. Diabetes was defined as a non-fasting glucose higher or equal to 200 mg/dl, a recorded physician diagnosis, medication use or an HbA1c higher or equal to 6.5%. Estimated glomerular filtration rate (eGFR) was calculated from calibrated creatinine, age and sex using the CKD-EPI and CKD was defined when eGFR <60 ml/min/1.73m2. Participants were followed for all-cause mortality until 31st December 2016. Vital status was determined by matching records and death certificates from the Spanish National Death Index.

Results:
Among the total population, 1247467 hypertensives were included. Among them, 387590 (%) were diabetics and 272800 (%) CKD. A total de 204629 casualties were recorded (crude rate of 2.2% in the GP and 12% in HTN, 16% in DM and 23% in CKD. Mortality incidence per 10000 patients/year of general population and the hypertensives, in each decade of age and by sex, with and without diabetes and CKD are in the Table.

Conclusions:
The increment of mortality risk due to the presence of HTN increases in all age groups. Although the higher increment in risk occurs in population beyond 60 yr, the number of subjects in risk largely increases over 60 and extent until the ninety decade. Diabetes, and more CKD, further increases the risk in hypertensive subjects.
PHARMACISTS INTERVENTION FOR IMPROVING BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS BY PHARMACEUTICAL INTERVIEWS: IS FRANCE READY?
Authors: Lopez-Sublet Marilucy , Pourrat Xavier , Bardet Jean Didier , Ruspini Eric , Sergent Sophie , Zaragoza Laura , Blacher Jacques , Halimi Jean Michel , Sallerin Brigitte , Allenet Benoit 
Published: April 2021

Objective:
The French Society of Hypertension, in collaboration with the French Society of Clinical Pharmacy, published in 2016 a recommendation concerning the management of hypertension in pharmacies. Three years later, the objective of the study was to learn about pharmacist's daily practice regarding pharmaceutical interviews (PI) and their knowledge and vision of hypertension in PI.

Design and method:
187 pharmacists practising in French pharmacies answered our self-questionnaire (10 questions), generated by Google Forms with an automatic recording of responses.

Results:
In this population, 62.5% (n = 117) of pharmacists perform PI (for anticoagulants and asthma) and more than half (60.7%)(n = 71) do not produce more than one per month. The shared medication assessment is carried out by 60.4% (n = 113) of them, 48.7% (n = 55) of whom no more than one per month.
The existence of a PI recommendation for hypertension is unknown to most pharmacists (78.8%, n = 145). Although these PIs do not have an economic support in France, hypertension is considered very important for 80.7 % of the 151 respondents and 42.7 % (n = 79) of them estimate that 10 to 20 patients per month and per pharmacy could benefit from a PI for antihypertensive drugs. The majority of pharmacists surveyed (88.2%, or n = 165) are familiar with home blood pressure measurement (HBPM) and 75.5 % (n = 74) finds it interesting in their practice. According to them, the HBPM promotion in pharmacies could mainly help BP control (72.2%, n = 136) and patient adherence (72.2%, n = 135).

Conclusions:
Recent systematic review and meta-analysis have demonstrated that pharmacist interventions can significantly reduce the risk factors of cardiovascular such as hypertension. This pilot study confirms the need to disseminate more widely the recommendations for the practice of PI in hypertension, which remains unknown to a majority of pharmacists in France. HBPM known by the majority of pharmacists can be the key to improve BP control and adherence to treatment. Involving pharmacist as healthcare providers of multidisciplinary management of hypertension is no longer to be demonstrated but the effective economic model on which there involvement is based must be a priority for the BP control of patients.
ACCURACY OF SHORTER PROTOCOLS FOR AUTOMATED OFFICE BLOOD PRESSURE MEASUREMENTS
Authors: Burkard Thilo , Hug Rebecca , Meienberg Andrea , Socrates Thenral , Mayr Michael , Vischer Annina 
Published: April 2021

Abstract

Objective:
Blood pressure measurement (BPM) is one of the most often performed procedures in clinical practice but especially office BPM is prone to errors. Automated office BPM (AOBPM) is highly standardised and compares well to ambulatory BPM but is time and space consuming since the patient is placed alone during the procedure. With this analysis we compared the accuracy of different calculation methods to evaluate if an abbreviation of the AOBP protocol is possible.

Design and method:
In our retrospective single centre study, we used all AOBPM (AOBPM protocol of the SPRINT study), collected over 14 months. Three sequential BPM (after 5 minutes of rest, spaced 2 minutes) were automatically recorded with the patient alone in a quiet room resulting in three systolic (S1S2S3) and diastolic (D1D2D3) values. We compared the result of the first BPM (S1/D1) and the mean of the first two BPM (S1S2/D1D2) with the mean of all three BPM (S1S2S3/D1D2D3) which was regarded as goldstandard for AOBPM.

Results:
We analysed 413 AOBP sets from 210 patients with a median age of 52 years (IQR 38–66). Median mmHg (IQR) for S1, S1S2 and S1S2S3 were 128.0 (117.0–142.0), 127.5 (117.0–140.0), 127.7 (116.8–139.2) and for D1, D1D2 and D1D2D3 80.0 (75.0–86.5), 80.0 (75.5–86.5), 80.3 (75.7–86.5), respectively. A Wilcoxon signed rank test determined that there was a statistically significant median increase of systolic blood pressure (BP) applying S1 compared to S1S2S3 (0.3mmHg, z = 2.315, p = 0.021) but not for S1S2 vs S1S2S3. For diastolic BP there was a no statistically significant difference for D1 vs. D1D2D3 but for D1D2 vs. D1D2D3 (0.2mmHg, z = 2.05, p = 0.040). Regarding agreement absolute difference was within 2 mmHg in 85.5% of the AOBPM comparing S1S2 vs. S1S1S3 and 93.2% for D1D2 vs D1D2D3, respectively (for all comparisons see table). Bland-Altman plots for all comparisons are shown in the figure.

Conclusions:
Based on our results differences between S1S2 vs S1S2S3 and D1D2 vs D1D2D3 are minimal and within acceptable limits of agreement. Therefore the automated procedure may be shorted to 2 measurements.
AMBULATORY BLOOD PRESSURE MONITORING BY A NOVEL CUFFLESS DEVICE: POTENTIAL ROLE IN OVERWEIGHT PATIENTS
Authors: Margonato Davide , Scalise Filippo , Gallone Giuseppe , Fracchioni Ilenia , Bruni Fabio , Ballabeni Cinzia , Mancia Giuseppe 
Published: April 2021

Objective:
Inappropriate cuff size can lead to erroneous blood pressure (BP) measurements and, therefore, to misclassification and potential unnecessary treatment; this problem has a particular relevance in overweight patients. We assessed whether a new cuffless BP device was equally effective for BP measurements over the 24 hours compared to a standard oscillatory BP device in overweight patients (BMI >25).

Design and method:
BP was measured simultaneously by the cuffless (CL-BP, Rooti RX TM) and by a standard device (C-BP, SpacelabsTM,90207) over the 24 hours in 100 consecutive patients. Calculations included 24 hour mean systolic (S) and diastolic (D) BP and heart rate (HR). Correlations between the CL-BP and C-BP measurements were sought using Pearson's correlation coefficients and Bland-Altman plots.

Results:
Using the C-BP device, the 24 hour SBP value was 125.4 ± 10.9 mmHg (mean  ± SD); the corresponding DBP value being 75 ± 8.3 mmHg. Mean SBP/DBP with the CL-BP device were 131.1 ± 15.9/80.2 ± 9.7 mmHg. The correlation coefficients between the two sets of values was significant (SBP: r = 0.58, p = 0.006 - DBP: r = 0.65, p = 0.0002). Mean absolute SBP and DBP disagreements between CL-BP and C-BP were 5.7 ± 13.1 mmHg and 5.2 ± 7.7 mm Hg, respectively. In the 54 patients classified as overweight, C-BP mean SBP value was 126.4 ± 10.6 and mean DBP value was 76,2 ± 8,5; in the CL-BP device arm SBP was 130 ± 14,1 and DBP was 80,9 ± 9,9. Better SBP and DBP correlations for SBP and DBP was found in patients with BMI > 25 (SBP: r = 0.65, p = 0.13 - DBP: r = 0.70, p = 0.009) compared to those with BMI <25 (SBP: r = 0.52, p = 0.02 - DBP: r = 0.51, p = 0.06).

Conclusions:
Our results show that a CL-BP device was accurate in estimating 24 hours BP in overweight patients, compared to a classical oscillometric device. Therefore, if confirmed on a larger population scale, CL-BP device could be used to provide accurate standardized BP measurements, independently by the arm size of the patients, and avoid a significant number of BP quantification mistakes.
DETECTING PATTERNS OF HYPERTENSION AMONG LIVE RELATED KIDNEY DONORS USING OFFICE AND AMBULATORY BP MONITORING: DATA FROM A TERTIARY CARE CENTER IN INDIA
Authors: Aditya Kapoor , Saklecha Abhishek , Bhadauria Dharmendra , Sahu Ankit , Khanna Roopali , Kumar Sudeep , Garg Naveen , Tewari Satyendra , Goel Pravin 
Published: April 2021

Objective:
Live related renal donation is associated with significant benefits compared to cadaveric donations. Increase in BP, mild proteinuria, gestational HT, rare progression to ESRD and higher mortality among donors are important concerns. The aim of the study was to assess BP prior to surgery and 3–6 months later in healthy kidney donors using office BP measurement (OBPM) and ambulatory BP monitoring (ABPM).

Design and method:
Voluntary kidney donors (n = 50, age > 18 years, age 48.72+ 12.49, 92% F) at a tertiary care institute in India were studied 1 week before nephrectomy & 3–6 months post surgery. BP definitions for OBP and ABPM were based on ESC 2018 guidelines.

Results:
Baseline OBP was 121.2+8.53/77.2+3.12 mm Hg; mean 24 hour ABPM was 115.74+16.84/65.22+13.1 mmHg. None of the subjects had HT on OBPM while 3/50 (6%) had high ABPM values.
Three months post nephrectomy, mean OBP was 125.6+6.26/78.1+4.11 mm Hg; mean ABPM values were 118.21+14.61/67.11+ 12.4 mmHg. HT was documented in 8/50 (16%) on ABPM and two had HT by OBPM (grade 1 HT). Of the 3 subjects with high baseline ABPM, all had high ABPM at 3 months. Masked HT was observed in 6/50 (12%).
At 6 months, 1more subject demonstrated stage 1 HT on OBPM (n = 3) and 10 (20%) had high ABPM values. Masked HT was noted in 7/50 (14%) and white coat HT in 1/50 (2%)
Serum creatinine increased at 3 months (0.82 ± 0.13 vs 1.34 ± 0.18 mg/dl, p < 0.01), while at 6 months levels were similar to baseline (1.11 ± 0.16 mg/dl). A parallel trend in eGFR was observed (92.86 ± 19.1 ml/min, 79.9 + 15.4 ml/min, 87.8 + 14.5 ml/min, p = ns). Significant (>300 mg/day) proteinuria was noted in 5/50 donors at 3 months; all of them had hypertension on ABPM recordings. No new-onset proteinuria was observed at 6 months.

Conclusions:
High ABPM recordings are not uncommon in healthy kidney donors following surgery. At 3–6 months, 15–20% had high ABPM values; masked HT was observed in 14% and new onset proteinuria in 10%. Close follow up is mandatory in healthy kidney donors following surgery.
SEASONAL VARIABILITY OF PULSE WAVE VELOCITY IS ASSOCIATED WITH CARDIOVASCULAR OUTCOMES IN HYPERTENSIVE PATIENTS
Authors: Yana Koshelyaevskaya , Smirnova Marina , Gorbunov Vladimir , Deev Alexander , Volkov Dmitry , Furman Nikolay , Dolotovskaya Polina 
Published: April 2021

Objective:
The seasonal changes of blood pressure in hypertensive patients have been investigated and attracted an increasing scientific interest during the past years, but seasonal changes of pulse wave velocity (PW) in hypertensive patients have not been studied. And it is unclear whether PW variations are related to cardiovascular risk.
The aim of the study was the examination of prognostic value of individual variability of PW in 24-hour, daytime and nighttime periods of hypertensive patients from two regions of the Russia (Ivanovo and Saratov).

Design and method:
Patients aged 40–79 years who visited ambulatory clinics for various reasons we. All participants provided written informed consent. The ambulatory blood pressure monitoring (ABPM) was performed with the BPLab device, twice in all patients: in winter (December-February 2012–2014) and in summer (June-August 2012–2014). The interval between ABPMs was 6 months ± 7 days. The selection criteria for ABPM records were: duration > = 23.5 hours, absence of data gaps >1 hour, and > = 56 readings per 24 hours. We analyzed the individual PW in 24-hour, daytime and nighttime differences in each patient. The participants were followed up until October 31-st 2019 (mean follow-up 6.4 ± 0.4 years). The complex endpoint included death (from any reasons), stroke, myocardial infarction, transient ischemic attack, angina pectoris, and development of heart failure. The preliminary analyses included ANOVA and descriptive statistics.

Results:
In total, 770 patients completed both visits. The outcome information was available in 528 patients: 335 from Ivanovo and 193 from Saratov (mean age 55 ± 10 years, 220 men). The endpoints were registered in 50 patients. We found the mean winter-summer PW difference in the group of patients with cardiovascular outcomes. In contrast, this difference was positive in the other group (see Table1).

Conclusions:
The inverse seasonal PW variability, which could reflect the abnormal biological response to outside temperature, may be associated with a higher risk of cardiovascular events, compared to patients with standard PW variability (PW is higher in winter, than in summer). Our data demonstrate the preliminary argument in favor of additional ambulatory BP and PW control. The problem of seasonal PW variability is needed further studying.
IN-HOSPITAL BLOOD PRESSURE VARIABILITY AS A PREDICTOR OF CARDIOVASCULAR OUTCOMES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: ONE-YEAR FOLLOW-UP STUDY
Authors: Konstantinou K. , Tsioufis K. , Koumeli A. , Dri E. , Kalos T. , Kouremeti M. , Vogiatzakis N. , Magkas N. , Mantzouranis M. , Kolokathis K. , Leontsinis I. , Tolis E. , Tousoulis D. 
Published: April 2021

Objective:
The impact of blood pressure variability (BPV) on cardiac function has been examined through the prism of congestive heart failure and hypertension, but not in the setting of an acute coronary syndrome (ACS). The aim of this study is to determine the association between in-hospital short-term BPV and long-term cardiovascular morbidityin patients with myocardial infarction (MI).

Design and method:
A total population of 260 MI patients [82.2% male; mean age: 63.8 years;71.3% hypertensives, 29.5% with diabetes mellitus (DM), 48.1% with STEMI]underwent 24-h ambulatory BP measurement during hospitalization.At one year a follow-up visit was scheduled in order to assess major cardiovascular outcomes. These included hospitalization for heart failure (HF), stroke, ACS, life threatening arrythmias. BPV was assessed using the average real variability (ARV) of systolic and diastolic BP.

Results:
Univariate analysis demonstrated that both ARV SBP and ARV DBP were predictors of overall hospitalizations for cardiovascular events in the entire population[(HR = 1.045; 95% CI: 0.542–1.547; P = 0.001) and (HR = 0.991; 95% CI: 0.536–1.446; P < 0.001)] but also in the STEMI [(HR = 1.138; 95% CI: 0.487–1.789; P = 0.001) and (HR = 0.947; 95% CI: 0.318–1.576; P = 0.003) respectively] and NSTEMI [(HR = 1.035; 95% CI: 0.278–1.793; P = 0.008) and (HR = 1.061; 95% CI: 0.394–1.728; P = 0.002) respectively] groups separately. Regarding hospitalization for HF, both ARV SBP and ARV DBP emerged as predictors in the entire population [(HR = 1.027; 95% CI: 0.093–1.960; P = 0.031) and (HR = 1.798; 95% CI: 0.972–2.624; P < 0.001) respectively] and in STEMI patients [(HR = 1.664; 95% CI: 0.517–2.811; P = 0.005) and (HR = 2.408; 95% CI: 1.360–3.455; P < 0.001) respectively], but not in the NSTEMI group.Independency of all the above predictors was confirmed in multivariate models including gender, age, hypertension, DM, smoking, low density lipoprotein (LDL-C) and GFR.

Conclusions:
In the setting of MI, in-hospital ARV was associated with increasedcardiovascular morbidityduring one-year follow-up. These findings could suggest a closer monitoring of patients suffering a MI and exhibiting increased BPV during hospitalization.
NORMAL-TENSION GLAUCOMATOUS OPTIC NEUROPATHY IS RELATED TO BLOOD PRESSURE VARIABILITY IN THE MARACAIBO AGING STUDY
Authors: Melgarejo Jesus , Maestre Gladys E. , Mena Luis J. , Lee Joseph H. , Petitto Michele , Chavez Carlos A. , Calmon Gustavo , Silva Egle , Thijs Lutgurde , Al-Aswad Lama A. , Terwilliger Joseph , Moraes C. Gustavo De , Wei Fang -Fei , Vanassche Thomas , Verhamme Peter , Staessen Jan A. , Zhang Zhen-Yu 
Published: April 2021

Objective:
Optic nerve hypoperfusion might play a role in the pathogenesis of normal-tension glaucomatous optic neuropathy. Although the ocular perfusion pressure is partly determined by blood pressure levels, no previous study have addressed the risk of glaucomatous optic neuropathy in relation to blood pressure (BP) variability, independent of the BP level. We aimed this study o assess reading-to-reading BP variability of mean arterial pressure (MAP) in 24 h ambulatory BP recordings as risk factor for normal-tension glaucomatous optic neuropathy.

Design and method:
The Maracaibo Aging Study is a population-based epidemiological study conducted to investigate age-related diseases and which currently includes more than 3000 participants =>40 years of age assessed between 1998 and 2015. For the present study, we selected 93 participants who underwent cross-sectional optical coherence tomography, visual field assessment and 24 h ambulatory BP monitoring (2011–2016). Glaucoma cases were defined as normal-tension glaucomatous optic neuropathy with and without visual field defects. BP variability was reading-to reading variability of 24 h MAP, a determinant of ocular perfusion pressure, captured by a variable independent of the BP level (VIMmap). ORs were expressed per 2 mm Hg (1 SD) increment in VIMmap. Odds ratios (ORs) were adjusted for BP level and confounders summarized or not in a propensity score.

Results:
Among the 93 participants (87.1% women; mean age, 61.9 years), 26 had open-angle glaucomatous optic neuropathy at both eyes; 14 with and 19 without visual field defects. The ORs ratios for glaucomatous optic neuropathy, expressed per 1 SD increment in VIMmap (2 mm Hg), were 2.17 (95% confidence interval, 1.33–3.53) unadjusted; 2.20 (1.35–3.61) adjusted for 24 h MAP level only; 1.93 (1.10–3.41) with additional adjustment for age, educational attainment, high-density lipoprotein cholesterol and office hypertension, and 1.95 (1.10–3.45) in models also including intraocular pressure.

Conclusions:
We confirmed our a priori hypothesis that BP variability, most likely operating via hypoperfusion of the optic nerve, is a risk factor for normal-tension glaucomatous optic neuropathy. 24-H ambulatory BP monitoring might therefore help in stratifying for risk of normal-tension glaucomatous optic neuropathy.
ASSOCIATION OF DIFFERENT TYPES OF BLOOD PRESSURE VARIABILITY WITH ARTERIAL STIFFNESS MARKERS 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:
It is well known that blood pressure (BP) variability is associated with development of target-organ damage in hypertensive patients. However, the significance of this association in chronic kidney disease patients (CKD) remains unclear. Aim of the study was to examine the association between BPV indices derived from ambulatory and home BP monitoring and arterial stiffness markers such as pulse wave velocity (PWV) and augmentation index (AI) in CKD patients.

Design and method:
A total of 105 CKD patients, referred for evaluation at the Hypertension Unit of our department, underwent 24-h ambulatory BP monitoring, home BP monitoring and measurements of PWV and AI. Short-term BPV was expressed by standard deviation (SD), time rate (TR) of BP variation, average real variability (ARV) 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:
The mid-term BPV indices of systolic home SD (r = 0.286, p = 0.003) and CV (r = 0.216, p = 0.027) were significantly correlated with AI. Regarding short-term BPV, nighttime systolic SD (r = 0.238, p = 0.016), nighttime systolic TR of BP variation (r = 0.194, p = 0.050) and nighttime systolic ARV (r = 0.264, p = 0.007) were significantly correlated with PWV.

Conclusions:
Short-term nighttime systolic BPV indices such as SD, TR of BP variation and ARV were significantly associated with PWV in CKD patients. The mid-term BPV indices of systolic SD and CV were significantly associated with AI.