bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of target organ damage in subjects with high-normal blood pressure without known cardiovascular and kidney disease
Authors: Ruzzenenti G , Maloberti A , Rebora P , Occhino G , Alloni M , Musca F , Belli O , Spano' F , Santambrogio G M , Casadei F , Moreo A , Valsecchi M G , Giannattasio C 
Published: October 2021

Abstract

Background
Heterogeneous results have been obtained regarding the presence of Target Organe Damage (TOD) in subjects with high-normal Blood Pressure (BP) value (sistoly 130–139, diastolic 85–89 mmHg).

Purpose
Aim of our study was to assess the prevalence of TOD in healthy subjects with high-normal BP comparing them with subjects with BP values that are considered normal (&lt;130/85 mmHg) or indicative of hypertension (≥140/90 mmHg).

Methods
755 otherwise healthy subjects participated at the present analysis. TOD was evaluated as Pulse Wave Velocity (PWV), Left Ventricular Mass Index (LVMI) and carotid Intima-Media Thickness (IMT) and plaque.

Results
When subjects were classified according to BP levels we found that high-normal BP group showed intermediate values of PWV and LMVI with higher value of IMT. This corresponds to intermediate prevalence of arterial stiffness (PWV&gt;10 m/s: 3.4% vs 2.3% for normal and 9.6% for high BP groups, p=0.0014), Left Ventricular Hypertrophy – LVH (32.4% vs 25.7% for normal and 46.6% for high BP groups, p=0.0001) while there were no differences for IMT&gt;0.9 or carotid plaque. At multivariable analysis the odds of having a PWV&gt;10 m/s (OR=1.75, 95% C.I. 0.59–5.16), an IMT&gt;0.9 mm (OR=1.81, 95% C.I. 0.60–5.00) or a LVH (OR=1.1, 95% C.I. 0.72–1.67) in the high-normal group resulted not different to the normal group.

Conclusions
In our otherwise healthy population, high-normal BP values were not related to aortic, carotid or cardiac TOD.

Funding Acknowledgement
Type of funding sources: None.
Magnetic resonance imaging of the aortic wall as a risk index for acute ischemic stroke in patients with resistant arterial hypertension
Authors: Ryumshina N , Sukhareva A E , Mochula O V , Shelkovnikova T A , Maksimova A S , Ussov W Y U , Falkovskaya A Y U 
Published: October 2021

Abstract

Aim
To value the possible relationship between the intensity of neoangiogenesis in the aortic wall in patients with resistant arterial hypertension and the subsequent development of ischemic cerebral disorders in them over a three-year follow-up.

Materials and methods
This study comprised 36 patients with resistant hypertension, in whom the renal denervation was carried out. MRI of the brain and also with contrast enhancement of the aorta and kidneys were examined. MRI studies included T2 and T1 spin-echo MRI, and also coronal slices, with suppression of the signal from adipose tissue (TR=150 ms, TE = 4 ms), before and in 12–15 minutes after contrast-enhanced. The diameter and thickness of the wall of the descending aorta were measured. Index of the enhancement of the aortic wall was calculated as the ratio of intensities of the wall after, and before contrast-enhanced. 9 according to MRI data - developed an acute ischemic stroke during this period, and 27 had no cerebral circulation disorders. The control group consisted of individuals without hypertension (n=12).

Results
After renal denervation, the systolic blood pressure significantly decreased in all patients for more than 15 mm Hg. In groups of patients with ischemic stroke, and without it, the diameter of the aortic lumen at the level above the renal arteries was 22,1±2,4 mm and 22,8±2,7 mm, respectively; the aortic wall thickness was 3,9±0,7 mm and 3,7±0,8 mm. In control subjects without hypertension, the wall thickness was less than 2,7 mm (on average 2,2±0,4 mm), with an aortic diameter of 21,3±0,9. As to the index of enhancement (as a marker of neoangiogenesis intensity) in the control group, in everybody, the IE was &lt;1,12. In patients with stroke within 3 years after renal denervation, IE = 2,12±0,31, and in patients without stroke IE = 1,66±0,19. The value of IE = 1,82 was the best for separating groups with and without stroke in the three years endpoint, as from the ROC analysis.

Conclusion
Contrast enhancement of the aortic wall in MRI is associated with the risk of brain ischemic stroke in patients with resistant arterial hypertension, even when blood pressure control is achieved by renal denervation. This makes it possible to predict the risk of stroke in these patients more reliably and encourages the inclusion of agents that reduce the activity of inflammation and pathological neoangiogenesis in the aortic wall, to the spectrum of antihypertensive therapy.

Funding Acknowledgement
Type of funding sources: None. Brain MRI T2WIMRI of the kidneys and aorta, T1WI
Evaluation of the effectiveness of statin and spironolactone by the influence on indicators of vascular stiffness in patients with arterial hypertension
Authors: Fedorishina O , Protasov K , Torunova A 
Published: October 2021

Abstract

Introduction
The possibility of slowing down vascular remodeling in hypertensive patients with the combined effect of antihypertensive drugs and statins has been studied in unitary studies. The effect of spironolactone on vascular stiffness in relation to the severity of the hypotensive effect in combination therapy has also been insufficiently studied.
The aim of the research was to study the dynamics vascular stiffness parameters in hypertension patients of high/very high cardiovascular risk in addition rosuvastatin or spironolactone to combined two-component amlodipine and lisinopril therapy.

Methods
90 patients (46 men and 44 women aged 51.6±8.5) with hypertension were randomized into groups: the first group received a fixed combination of amlodipine/lisinopril, the 2nd one followed the same regimen of therapy with addition of 20 mg rosuvastatin, the third - in addition to the combination of amlodipine / lisinopril received 25 mg of spironolactone. The office and ambulatory blood pressure (BP), central (aortic) BP, augmentation index (AIx), carotid-femoral and carotid-radial pulse wave velocity (PWV) were evaluated before and after a 24-week follow-up period.

Results
The office and average daily blood pressure decreased against the background of all therapy regimens (all p&lt;0.0001). The degree of decrease in the above parameters was more pronounced under the influence of spironolactone, compared with taking a combination of amlodipine / lisinopril (office systolic BP (SBP) p=0.04 and diastolic BP (DBP) p=0.002, average daily SBP p=0.02 and DBP p=0.014) and office DBP in comparison with the group of additional administration of rosuvastatin (p=0.02). A decrease in central BP and AIx was noted in all groups. A more pronounced decrease in AIx occurred in the statin supplementation group relative to the standard treatment group (−5.8% and −9.0%, respectively, p=0.036). Carotid-femoral PWV significantly decreased in all groups (−0.9±1.5 m/s, −0.7±1.4 m/s, −2.2±2.6 m/s, respectively), in greater degree in the spironolactone addition group compared with the statin supplementation group (p=0.036). Carotid-radial PWV to the same extent significantly decreased only in the second (from 9.5±1.8 to 8.8±1.1 m/s (p=0.034)) and the third (from 9.8±1.3 to 8.4±1.3 m/s (p=0.0002)) groups.

Conclusions
The addition of a statin to a two-component combination of amlodipine / lisinopril in the treatment of hypertensive patients had an additional effect on the elastic properties of the aorta, in the form of a decrease in the augmentation index, and peripheral arteries, in the form of a decrease in PWV. The addition of spironolactone to standard therapy was accompanied by a significant increase in the antihypertensive effect and a decrease in aortic stiffness in the form of a more pronounced decrease in PWV in the carotid-femoral and carotid-radial areas.

Funding Acknowledgement
Type of funding sources: None.
Reasons for antihypertensive medication nonadherence influence physician preferences for hypertension management
Authors: Schmieder R E , Kandzari D E , Wang T.-D , Lee Y.-H , Haro C , Pathak A 
Published: October 2021

Abstract

Background/Introduction
Patient nonadherence to prescribed antihypertensive medications is a major contributor to low global hypertension control rates. Attitudes toward renal denervation vary between physicians and patients, with recent data showing that side effects from medications is a key factor influencing both patient nonadherence to prescribed medications and preferences for interventional treatment. The influence of patient nonadherence on physician recommendations for renal denervation is not well understood.

Purpose
To examine whether specific reasons for patient nonadherence influence physician preferences for renal denervation as a treatment option for hypertension.

Methods
Online surveys were fielded to general and interventional cardiologists in Europe and the United States. Physicians were asked to position their willingness to recommend renal denervation in the hypertension management pathway based on three factors of nonadherence: patients' preference not to take antihypertensive medications, medication side effects, and nonspecific nonadherence to medication. The surveys followed the highest industry standards ISO 20252. Results were compared using two-tailed Z tests.

Results
Over two-thirds of 501 physicians surveyed stated that they would recommend renal denervation for uncontrolled hypertension irrespective of the reason for nonadherence. This recommendation was significantly more common in the scenario of patient reported medication side effects as compared with desire not to take medications or other nonspecific reasons for nonadherence (p&lt;0.001 for both; Figure)

Conclusions
Surveyed physicians were more likely to recommend renal denervation to patients reporting side effects with their antihypertensive medications than for other reasons of nonadherence. These findings underscore the influence of patient-specific reasons for medication nonadherence on provider recommendations as part of a shared decision-making process when evaluating different options for hypertension management.

Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Medtronic
Hypertension as a prognostic factor in the prediction of mortality in patients with COVID-19: a systematic review and meta-analysis
Authors: Pagdanganan C D P , Juangco J ,   UERMMMCI College of Medicine
Published: October 2021

Abstract

Background
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) brought the majority of the world into a halt when it started to spread outside the virus epicenter in Wuhan, China. With the alarming increase in the number of cases and deaths worldwide, the possible risk factors should be determined in order to have a general idea on those who are more susceptible to have this disease. Hypertension, being one of the world's leading causes of noncommunicable diseases, was identified by the CDC to be one of underlying medical conditions that might pose an increased risk for severe illness from COVID-19.

Objective
The aim of this study is to determine the predictive value of hypertension as a comorbidity in COVID-19 mortality.

Materials and methods
Participants included all patients clinically diagnosed with COVID-19, and have hypertension as their pre-existing medical condition. Studies were selected based on study design, participants, exposure, outcome, timing, setting and language. The following databases were searched from June to August 2020 for case control and cohort studies on MEDLINE and CINAHL, ScienceDirect, Clinical Key, OVID database, Wiley Online library, and UpToDate. The criteria for evaluation of risk of bias were based on the selection bias, comparability bias and outcome bias. All information gathered were collated and evaluated using the Newcastle-Ottawa Quality Assessment Scale and CEBM.

Results
Individual studies all showed a significant relationship between hypertension and mortality in COVID-19 patients. Odds ratio ranging from 1.75 to 28.88, and hazard ratio ranging from 1.49 to 3.32 are present in the studies. For the data analysis, Mantel Haenszel method and random effects model was used for case control studies with odds ratio as effect measure; while Inverse variance method and fixed model was used for cohort studies with hazard ratio as effect measure. Both groups showed significant positive association between mortality and hypertension as a prognostic factor. Overall odds ratio is 5.25 (2.42–11.40) with a p value of &lt;0.ehab724.23931, and the pooled hazard ratio is 2.21 (1.75–2.80) with a p value of &lt;0.ehab724.23931. This shows that there is an increased risk of mortality among COVID-19 patients with hypertension as a comorbid condition.

Conclusions
Hypertension as a comorbid condition is a prognostic factor in the prediction of mortality in hospitalized COVID-19 patients. The ten included studies showed that there is a significant positive association suggesting an increased risk of mortality in COVID-19 patients with hypertension.

Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): University of the East Ramon Magsaysay Memorial Medical Center College of Medicine Forest Plot HR Hypertension COVID
Arterial stiffness measured according to the cardio-ankle vascular index in the persons with pre-diabetes and diabetes mellitus in the population sample of the Russian Federation
Authors: Bezdenezhnykh N A , Sumin A N , Bezdenezhnykh A V , Pervushkina A S , Fokin F A , Artamonova G V ,   "Research Institute for Complex Issues of Cardiovascular Diseases"
Published: October 2021

Abstract

Aims
To study the characteristics of the cardio-ankle vascular index (CAVI) and predictors of increased arterial stiffness in patients with carbohydrate metabolism disorders (CMD).

Methods
A cross-sectional study was conducted within the framework of the multicenter epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation” (ESSE-RF) from March to October 2013. The object was a random population sample of the adult male and female population of the Kemerovo region (Western Siberia, Russia) aged of 25–64 years. The standard protocol of the ESSE-RF has been expanded with investigation of peripheral arteries wall stiffness (VaSeraVS-1000, Fukuda Denshi, Japan) with automatic CAVI calculation. A total of 1617 subjects were divided into three groups: group 1 – patients with type 2 diabetes mellitus (n=272), group 2 – patients with pre-diabetes (n=44), group 3 –without any confirmed CMD (n=1301).

Results
A trend for the similarity of clinical, instrumental (including arterial stiffness measured by CAVI) and laboratory characteristics in patients with type 2 diabetes and prediabetes was revealed, with a significant difference from patients without CMD. A direct correlations of CAVI with age (p&lt;0.001), male gender (p&lt;0.001), type 2 diabetes (p&lt;0.001), prediabetes (p=0.002), visceral obesity (p&lt;0.001), level of total cholesterol (p&lt;0.001), triglycerides (p&lt;0.001), low density lipoprotein cholesterol (p&lt;0.001), and inverse correlations of CAVI with the glomerular filtration rate (GFR) using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula (p&lt;0.001) were revealed in the general sample.
Further, the patients were divided into 2 groups - with disorders of carbohydrate metabolism (prediabetes and diabetes) and normoglycemia, and in each group, predictors of increased arterial stiffness (pathological CAVI) were analyzed. According to the results of multivariate regression analysis in both groups, age, arterial hypertension, systolic and diastolic blood pressure, and a decrease in GFR CKD-EPI were predictors of pathological CAVI (Table). Male gender became a predictor of increased arterial stiffness only among patients with normoglycemia, and there was no effect among patients with CMD (Table).

Conclusions
An increase in CAVI is associated with diabetes mellitus 2, prediabetes, increasing age, systolic and diastolic blood pressure and decreased GFR. An increase in arterial stiffness occurs already in the prediabetes stage. Identifying of prediabetes is important because prediabetes and type 2 diabetes are similar in many ways.

Funding Acknowledgement
Type of funding sources: None. Correlations of CAVIPredictors of pathological CAVI
Risk factors, subsequent disease onset and prognostic impact of myocardial infarction and atrial fibrillation
Authors: Camen S , Csengeri D , Geelhoed B , Gianfagna F , Soderberg S , Kee F , Blankenberg S , Lochen M L , Iacoviello L , Tunstall-Pedoe H , Joergensen T , Salomaa V , Linneberg A , Kuulasmaa K , Schnabel R B ,   BiomarCaRE-consortium
Published: October 2021

Abstract

Background
Myocardial infarction (MI) is a known risk factor for incident atrial fibrillation (AF), while AF frequently complicates acute MI. Although both diseases share common cardiovascular risk factors, the direction and strength of the association of the risk factors with disease onset, subsequent disease incidence and mortality are not completely understood.

Purpose
Our goal was to define the temporal relationship of MI and AF and the association of cardiovascular risk factors with disease incidence in order to determine whether common clinical risk factors show different associations with incident MI or AF. We further aimed to investigate predictors of subsequent disease onset and the impact of subsequent disease diagnosis on mortality.

Methods
In pooled multivariable Cox regression analyses we examined temporal relations of disease onset and identified predictors of MI, AF and subsequent all-cause mortality in 108,363 individuals (median age 46.0 years, 48.2% men) free of MI and AF at baseline from six European population-based cohorts.

Results
Over a maximum follow-up of 10.0 years 3558 (3.3%) individuals were diagnosed exclusively with MI, 1922 (1.8%) with AF but no MI, and 491 (0.5%) individuals developed both MI and AF. Association of male sex, systolic blood pressure, antihypertensive treatment and diabetes mellitus appeared to be stronger with incident MI than with AF, whereas increasing age and body mass index showed a higher risk for incident AF. Total cholesterol and daily smoking were significantly related to incident MI but not AF. The combined population attributable fraction of the cardiovascular risk factors was over 70% for incident MI, whereas it was only about one quarter for incident AF. Subsequent MI after incident AF (hazard ratio1.68, 95% CI 1.03–2.74) and subsequent AF after MI (hazard ratio 1.75, 95% CI 1.31–2.34) both significantly increased overall mortality risk.

Conclusions
Subsequent diagnosis of MI and AF was associated with a significant increase in mortality, irrespective of the first event. We found different associations of common cardiovascular risk factors with incident MI and AF indicating distinct pathophysiological pathways in disease development.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme (grant agreement No 847770, AFFECT-EU) European Union's Horizon 2020 research and innovation programme (grant agreement No 648131)
Ultra-processed foods and ten-year cardiovascular disease incidence in a Mediterranean population: results from a population-based cohort study
Authors: Kouvari M , Chrysohoou C , Georgousopoulou E , Skoumas J , Pitsavos C , Panagiotakos D B 
Published: October 2021

Abstract

Background/Introduction
Although cardiovascular disease (CVD) guidelines emphasize consuming minimally processed foods, such as fruits, vegetables, whole grain products, nuts and seeds, less attention has been given to the importance of minimizing ultra-processed foods, probably due to the paucity of studies that exist.

Purpose
The aim of the present work was to investigate the association between the consumption of ultra-processed foods and ten-year first fatal/non fatal CVD event in a sample from Greece.

Methods
A prospective study was conducted during 2001–2012 studying n=1,514 men and n=1,528 women (&gt;18 years old) free of CVD. Baseline dietary assessment was based on a validated semi-quantitative food frequency questionnaire. Ultra-processed foods were defined according to a standardized procedure and included among others sweets and desserts, beverages, salty snacks, breakfast cereals and fast foods. Follow-up assessment of first fatal/non fatal CVD event (2011–2012) was achieved in n=2,020 participants (n=317 cases). Cox proportional hazards models were constructed to determine the multiadjusted association between ultra-processed food intake (energy-adjusted servings per week) and incident fatal/non fatal CVD.

Results
On average, participants consumed about 15 servings of ultra-processed foods per week. Ranking from 1st to 3rd ultra-processed food consumption tertile (low to high level of intake) CVD incidence was 8.1%, 12.2%, 16.6% (p=0.006). Each additional weekly serving of ultra-processed food was associated with 10% higher CVD risk within the decade (Hazard Ratio (HR)=1.10, 95% Confidence Interval (95% CI) (1.02, 1.21), p=0.04). This association was reexamined according to participants' level of adherence to a cardiac friendly dietary pattern i.e. Mediterranean diet (defined through MedDietScore, range 1–55). In particular, the aggravating effect of ultra-processed foods was retained and only slightly attenuated even in the subset of participants with moderate to high level of adherence to Mediterranean diet (defined as MedDietScore&gt;27) (HRper 1 serving/week=1.08, 95% CI (0.98, 1.19), p=0.09). On the other side, it became even stronger in case of low level of adherence to this pattern (HRper 1 serving/week=1.19, 95% CI (1.12, 1.25), p=0.02).

Conclusions
Current findings support that even in a population with Mediterranean origins and easy access to healthy least processed choices, systematic consumption of ultra-processed foods on a weekly basis was associated with increased risk of hard CVD events. Tailor-made public health initiatives and nutrition policies are demanded to promote healthy and sustainable dietary patterns with less-processed foods of high nutritional value.

Funding Acknowledgement
Type of funding sources: None.