bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPACT OF OVERWEIGHT AND OBESITY ON BLOOD PRESSURE CONTROL AMONG HYPERTENSIVE PATIENTS (RESULTS FROM NATURE HTN)
Authors: Hammami Rania , Bahloul Amine , Triki Syrine , Charfeddine Selma , Triki Faten , Zakhama Lilia , Addad Fawzi , Abdessalem Salem , Abid Leila 
Published: April 2021

Objective:
Given the increase of sedentarily and bad diet in our life, the prevalence of obesity and overweight has remarkably increased among the most of population, last years. We aimed in this work to assess the impact of weight on blood pressure control in hypertensive patients based on data from the Tunisian national registry Nature HTN

Design and method:
Nature HTN is a national multicentric study conducted by the Tunisian society of cardiology and including hypertensive patients who consulted their doctors during one month in 2019. We collected clinical data, blood pressure measurements and lab test. We defined Overweight.

Results:
We enrolled 25890 hypertensive patients, with female predominance (SR = 1.2) and mean age 64.4 ± 12.2 year-old. The hypertension was newly diagnosed in 2286 patients (8.8%) and known more than six months in 23601 persons. The mean BMI was 28.1 ± 4.57. Obesity and overweight were observed respectively in 25.8% and 44.6%. Female were significantly more obese than male (34.7% vs 17.6%, p < 10-3). Patients with uncontrolled BP were more frequently obese (30.5% vs 27.4%, p < 10-3) and have a higher BMI. Among patients with overweight or obesity there was a correlation the prevalence of uncontrolled BP and the severity of obesity (71.5% in overweight people, 74.8 in patient with moderate obesity, 79.4% in patients with severe obesity, p = 0.001). Moreover obesity was found as independent predictor of non-controlled BP in our cohort (OR = 1.14, 95% CI[1.07–1.21].

Conclusions:
Obesity is a health problem growing and should keep in mind when treating patients with hypertension because it is a strong predictor of non-controlled BP.
DISSOCIATION BETWEEN LONG-TERM WEIGHT LOSS INTERVENTION AND BLOOD PRESSURE. AN 18-MONTH RANDOMIZED CONTROLLED TRIAL
Authors: Gepner Yftach , Goldstein Nir , Shelef Ilan , Schwarzfuchs Dan , Zelicha Hila , Meir Anat Yaskolka , Tsaban Gal , Grossman Ehud 
Published: April 2021

Objective:
Obesity is associated with elevated blood pressure (BP). In patients with obesity and hypertension, weight loss lowers BP, but the long-term effect of weight loss on BP is less clear. We aimed to assess the effect of long-term weight loss intervention on BP in normotensive and hypertensive subjects.

Design and method:
In an 18-month trial, 278 subjects (mean age 47.9 ± 9.3 years, 89% male, 56% hypertensive) with abdominal obesity or elevated serum triglycerides and low high-density-lipoprotein cholesterol were recruited for weight loss intervention. Body weight and BP were measured at baseline, after 6 and 18 months.

Results:
After 6 months of intervention, in the weight loss phase, body mass index (BMI) decreased by an average of -2.2 ± 1.5 kg/m2 (p < 0.001) and both diastolic BP (DBP) and systolic BP (SBP) decreased by -2.1 ± 8.8 mmHg, and -2.3 ± 12.9 mmHg, respectively (P < 0.01 for both). The change in BMI was similar in normotensive and hypertensive subjects (-2.0 ± 1.6 and -2.3 ± 1.5, p = 0.246). However, DBP and SBP decreased significantly (-5.2 ± 7.1 mmHg, and -6.2 ± 12.5 mmHg, respectively, p < 0.001 for both) in hypertensive subjects, and increased in normotensive subjects (1.8 ± 9.3 mmHg, p = 0.041 and 2.7 ± 11.7 mmHg, p = 0.017, respectively). After 18 months, in the weight maintenance phase, BMI slightly increased (0.9 ± 1.3 kg/m2, p < 0.001) but remained significantly lower than at baseline (p < 0.0001). Unlike BMI, DBP and SBP increased significantly in hypertensive subjects (p < 0.001) and returned almost to baseline levels.

Conclusions:
Weight-loss intervention reduced BP in hypertensive patients, but this was not maintained in the long run.
THE MATCHED CASE CONTROL STUDY OF PREGNANCY HYPERTENSION PATIENTS AND THE NEONATAL BABY
Authors: Zhao Xu , Kou Chengkun , Yu Jing 
Published: April 2021

Objective:
To investigate the detection rate and effects of risk factors on gestational hypertension and the effect of maternal gestational hypertension on neonatal outcome.

Design and method:
This investigation study was proceeded on December 2013 -2014 November in Gansu Province maternal and child health hospital. The questionnaire covers the general situation of pregnant women and newborns, and describes the general characteristics of pregnancy-induced hypertension in Maternal and Child Health Hospital of Gansu Province. The first case-control study included pregnant women with pregnancy-induced hypertension as the case group.The second case-control study included mothers with a history of pregnancy-induced hypertension in the case of newborns.The second case-control study designed to explore the relationship between pregnancy-induced hypertension and newborns outcomes.

Results:
Of all 2143 pregnant women screened, 60 patients with pregnancy-induced hypertension were screened and the detection rate of pregnancy-induced hypertension was 2.7%. Univariate analysis showed that the weight gain during pregnancy was higher than normal, the age of less than 30 years old, and the two factors of pre-pregnancy BMI were related to the occurrence of hypertensive pregnancy. Multivariate logistic regression analysis showed that the weight gain during pregnancy was high in normal women. Pre-pregnancy BMI is a risk factor for gestational hypertension, age less than 30 years of age is the protective factor of gestational hypertension. Mothers with gestational hypertension may affect the growth and development of the newborns, newborns birth weight is low, pregnancy-induced hypertension newborns Apgar score lower than the control group. The study compared the data of newborns heart Doppler ultrasound, the study found that pregnant women with high blood pressure left ventricular ejection fraction lower than newborns who mother without pregnancy-induced hypertension.

Conclusions:
Pregnancy weight gain higher than normal, pre-pregnancy BMI is a risk factor for the occurrence of pregnancy hypertensive. Age less than 30 years is a protective factor of pregnancy-induced hypertension. Risk factors and protective factors of hypertension in pregnancy affect the occurrence and development of the disease.
BONE MORPHOGENETIC PROTEIN 2 PROMOTES HUMAN TROPHOBLAST CELL INVASION AND ENDOTHELIAL-LIKE TUBE FORMATION THROUGH ID1-MEDIATED UP-REGULATION OF IGF BINDING PROTEIN-3
Authors: Zhao Hongjin , Klausen Christian , Zhu Hua , Chang Hsun-Ming , Li Yan , Leung Peter C.K. 
Published: April 2021

Objective:
Extravillous cytotrophoblasts (EVTs) invade into the uterine wall and remodel spiral arteries for proper placentation. Insufficient EVTs invasion and poor spiral arterial remodeling are associated with preeclampsia occurrence. Studies from us and others have demonstrated that the transforming growth factor-beta superfamily member bone morphogenetic protein 2 (BMP2) plays important roles in endometrial decidualization and trophoblast cell invasion. However, BMP2 has also been shown to regulate endothelial cell migration and capillary-like tube formation, as has its downstream signaling molecule inhibitor of DNA binding 1 (ID1). Interestingly, insulin-like growth factor binding protein 3 (IGFBP3) also promotes endothelial precursor cell migration and angiogenesis. Moreover, Id1 shows regulatory effect on Igfbp3 expression in rat prostate epithelial cells. However, whether ID1 and IGFBP3 are integrated in BMP2 signaling and involved in the regulation of trophoblast invasive and endovascular differentiation remains unknown. The objective of our study was to examine the effects of BMP2 on ID1 and IGFBP3 expression and their roles in BMP2-regulated human trophoblast invasion and endothelial-like tube formation.

Design and method:
Primary and immortalized (HTR8/SVneo) cultures of human trophoblast cells were employed as study models. RT-PCR and Western blot assay were used to study mRNA and protein levels. Small interfering RNA (siRNA) was used to check the roles of key molecules. Matrigel-coated transwell assay and endothelial-like tube formation assay were used to examine cell invasiveness and angiogenesis respectively.

Results:
BMP2 treatment increased ID1 and IGFBP3 mRNA and protein levels in HTR8/SVneo and primary human EVT cells. Intriguingly, ID1 was essential for BMP2-induced IGFBP3 up-regulation in both study models, and BMP2-induced trophoblast invasion was attenuated by knockdown of either ID1 or IGFBP3. In addition, BMP2 significantly increased endothelial-like tube formation and knockdown of ID1 and IGFBP3 reduced basal and BMP2-induced tube formation in HTR8/SVneo cells. Similarly, BMP2 increased placenta growth factor (PlGF) production in HTR8/SVneo cells and these effects were attenuated by knockdown of ID1 or IGFBP3.

Conclusions:
Our results reveal that BMP2 promotes trophoblast cell invasion and endothelial-like tube formation by ID1-mediated IGFBP3 up-regulation.
IMPACT OF PREVIOUS HYPERTENSIVE DISORDER DURING PREGNANCY ON ANTHROPOMETRIC MEASUREMENTS, 24-HOUR BLOOD PRESSURE AND ARTERIAL STIFFNESS
Authors: Verardino Renata , Rodrigues Sara , Berger Ana , Costa-Hong Valeria , Macedo Thiago , Baptista Fernanda , Bortolotto Maria , Francisco Rossana , Zugaib Marcelo , Bortolotto Luiz 
Published: April 2021

Objective:
Preeclampsia (PE) increased the risk of cardiovascular diseases even in women without previous arterial hypertension (AH). The possible causes include changes in metabolic profile and vascular abnormalities, such as increased arterial stiffness. We aim to compare anthropometric measurements, 24-hour blood pressure profile, and arterial stiffness in women who developed PE during pregnancy with (superimposed PE) or without (isolated PE) a previous history of AH.

Design and method:
We selected from registries of a tertiary hospital women with a previous pregnancy complicated by isolated PE or superimposed PE that occurred 2 to 5 years earlier. Anthropometric measurements: weight, height, body mass index – BMI and waist circumference (WC); Blood pressure (BP) measurements: office Systolic BP (SBP) and diastolic BP (DBP); 24-ambulatory BP monitoring; Arterial stiffness: pulse wave velocity (PWV) measured by Arteriograph® method.

Results:
Twenty-five patients were evaluated.

Conclusions:
Women previous superimposed PE had higher values of WC, awake SBP and PWV when compared to women with isolated PE. These results indicate incremental impairment of vascular and metabolic profile of PE on women with previous chronic AH.
THE PROTEOME OF HIGH DENSITY LIPOPROTEIN CHANGES THROUGHOUT GESTATION IN HEALTHY PREGNANCY AND DIFFERS BETWEEN HEALTHY PREGNANCY AND PREECLAMPSIA IN THE THIRD TRIMESTER
Authors: Patanapirunhakit Patamat , Sulaiman Wan , Karlsson Helen , Ljunggren Stefan , Graham Delyth , Freeman Dilys 
Published: April 2021

Objective:
High-density lipoprotein (HDL) has well-established anti-atherosclerotic properties in the non-pregnant population. HDL may have a potential role in protecting maternal vascular function during pregnancy that fails to occur in preeclampsia. HDL function is determined by its protein and lipid composition. This study aimed to examine protein composition of HDL at different gestations throughout healthy pregnancy and to compare HDL proteome in the third trimester of healthy pregnancy and preeclampsia.

Design and method:
HDL was isolated from two cohorts of n = 10 healthy pregnant women at 8 different timepoints throughout pregnancy; pre-pregnancy, week 4.6, week 6.1, week 8.4, (cohort 1) and week 15, week 25, week 35 and 3 months post-natal (cohort 2), and from healthy pregnant (n = 10) and preeclampsia (n = 6) women at the third trimester. The proteome of HDL was measured by nano liquid chromatography coupled to tandem mass spectrometry (nLC-MS/MS).

Results:
There were 16 proteins in HDL that showed significant differences throughout healthy pregnancy which were apolipoprotein A-IV, apolipoprotein C-II, apolipoprotein C-III, apolipoprotein C-IV, apolipoprotein F, apolipoprotein L-I, angiotensinogen, alpha-1-acid glycoprotein 2, alpha-1-antitrypsin, cathelicidin antimicrobial peptide, fibrinogen alpha chain, fibrinogen beta chain, prenylcysteine oxidase 1, serum amyloid a-I, serum paraoxonase/lactonase 3 and vitronectin. In preeclampsia, HDL apolipoprotein A-I was lower than healthy pregnancy, while HDL alpha-1-antitrypsin, pigment epithelium-derived factor and vitamin D-binding protein were higher.

Conclusions:
There were significant differences in the protein composition of HDL during pregnancy and between healthy pregnancy and preeclampsia in the third trimester. These compositional differences may be involved in HDL function and may indicate HDL's role in vascular protection in pregnancy.
NIGHT DIASTOLIC VALUES OF AMBULATORY BLOOD PRESSURE ARE THE MORE PREDICTIVE OF THE OUTCOMES IN PREGNANCY COMPLICATED WITH HYPERTENSION
Authors: Bastos Jose Mesquita , Carvalho Diana , Aveiro Marcelo , Correia Ana , Damiao Pedro 
Published: April 2021

Objective:
The prognostic value of 24-hour ambulatory monitoring(ABPM) in pregnancy complicated with hypertension remains uncertain

Design and method:
Observational, 234 pregnant observed in appointment between 2007- July 2019 submitted to ABPM. Mean age 32.1 ± 5.5 years, follow-up 263.9 ± 16.5 days, was defined from gestation to delivery. Event defined: maternal death(MD), fetal or neo natal death(FD), pre-eclampsia (PE) or eclampsia(E), gestational diabetes(DG), prematurity or delayed fetal growth (PF), dystocic delivery(DD).It was observed 118 events((62 PE),32(DG),14 (PF),8(DD),2(FD))

Results:
Comparing pregnancies with events versus without, those with event were significantly older, more prevalence of risk factors for BP in PG, shorter follow up / days, higher 24 h Systolic BP(SBP), 24 h Diastolic BP (DBP),day SBP and DBP, night SBP and DBP, lower Systolic and Diastolic Dipping (table 1). In Cox's multivariate analysis for events and adjusted for: age, BMI, number of risk factors for HP in PG - [pre-existing HP, previous gestational HP, previous pre-eclampsia,restriction of previous intrauterine growth, previous membrane detachment, previous fetal death, previous gestational diabetes, smoking history, obesity, family history of preeclampsia, family history of cardiovascular disease, artificial insemination]classified has:(0,1,2,3,> = 4), office SBP, office DBP, gestation n°, give birth n°, were statistically significant for: 24 h SBP, 24 h DBP respectively HR 1.02 (IC1.00-1.03); 1.03 (IC1.01-1.05); Day DBP 1.02 (IC 1.00-1.05); Night SBP, Night DBP, Systolic BP dipping, Diastolic BP dipping respectively HR 1.02(IC1,01-1.03);1.03(IC1.01-1.05);0.96 (IC 0.94-0.98); 0.96 (IC 0.94-0.99) When DBP dipping was adjusted to night DBP, night DBP remains significant and DBP dipping loses respectively HR 1.03(IC 1.00-1.05) and 0.99(IC 0,95- 1.02). When analyzed DBP dipping by the pattern dipping (D)/non dipping (ND, (ND-35 D-198), in a crosstabs analysis, those with event ND pattern was found in 71% and 28,6 % with no event(X2 6.9 p < 0,05). In a survival curve free of events, the presence of the diastolic dipping ND_D pattern, ND was associated to a worst prognosis (log rank 11.2 p < 0.001)

Conclusions:
Night diastolic values are the best prognosis for prediction of events related to outcomes in pregnant woman's with hypertension, special DBP. Casual BP and even home ambulatory blood pressure are scanty for this period.
HYPERTENSIVE DISORDER OF PREGNANCY AND THE RISK OF AUTISM SPECTRUM DISORDER IN OFFSPRING: META-ANALYSIS
Authors: Greca Elona , Avdullari Oresta , Khan Abdul Haseeb , Marku Ndok , Dibra Graciela 
Published: April 2021

Objective:
Aim of this meta-analysis is to examine the association between Hypertensive Disorder of Pregnancy and ASD. ASD is the broad current designation for a group of conditions with deficits in social interaction and communication and RRBs(restricted repetitive behaviors), common severe pervasive neurodevelopmental disorder of undetermined etiology. Environmental exposures, especially pregnancy complications, have been increasingly recognized as a potential risk factor for ASD.

Design and method:
We conducted a systematic literature search onPubMed, Embase and PsycINFO databases were searched. Pooled relative risks (RR) with 95% confidence intervals were calculated. Subgroup and sensitivity analyses were performed. Heterogeneity was assessed using Cochran's Q- and the I test. The presence of publication bias was evaluated by Egger's test and visual inspection of the symmetry in funnel plots.

Results:
A total of t welve studies meet the inclusion criteria with more than 307146 participant,including 6209 ASD. Subgroup analysis of clinical classification include: gestational hypertension, pre-eclampsia, chronic hypertension complicating pregnancy. The risk of ASD in pre-eclampsia is with OR 1.47 and CHP with OR 1.37 slightly higher than those of mothers with gestational hypertension OR 1.2. In consistence with most previous researches, higher ASD prevalence was observed in male than female,indicating a potential role for gender in the pathophysiology of ASD.
The figure shows a Forest plot of the correlation between HDP and ASD

Conclusions:
This meta-analysis implies a possible link between Hypertensive Disorders of Pregnancy and the risk of Autism Spectrum Disorder in offspring. However, further investigation should be conducted to confirm this conclusion, and intensive prenatal surveillance and early prediction for ASD is needed.
ONE YEAR AFTER THE INTRODUCTION OF ESH/ESC GUIDELINES-IS THERE A CHANGE IN THE THERAPEUTIC INERTIA IN BULGARIA?
Authors: Grue Ivan , Tsanova Veska 
Published: April 2021

Objective:
Fixed dose combinations are the back bone of the 2018 ESH/ESC guidelines for management of AH, in order to achieve early and constant BP control and good adherence to the therapy. Therapeutic inertia remains a big obstacle, especially in primary care.
The aim of our study was to evaluate the changes in the therapy of ambulatory patients, sent for consultation with cardiologist, one year after the introduction of 2018 Guidelines.

Design and method:
We studied the medical records of 300 patients with grade II and III AH- 190 male and 110 female, aged between 34 and 83 years. The patients were sent for consultation with cardiologist after 3 months of unsuccessful therapy led by the GPs.

Results:
We found that despite of the poor BP control, at the first presentation in the cardiologists’ office, 48 % of the patients were still on monotherapy! Among them 40 % received ARB, 30 %- ACEI, 10%- Ca channel blocker 10 %, 10% beta –blocker and 10 % central-acting agents. In 20% of the patients the second step was to double the dose of the monotherapy. In the group of patients, that were prescribed a second drug as a next step of therapy, 60% received thiazide or thiazide-like diuretic, 20%- Ca channel blocker and 20% -moxonidine or other central-acting agent. Only 20% of patients received a single pill combination /SPCs/ but in 10% a combination of beta –blocker and diuretic was preferred. In 55% of the study group the cardio-vascular risk was calculated. Only 25 patients underwent ABPM. The good news is that after a consultation with cardiologist, 70% of the patients achieved good BP control in 4 weeks time.

Conclusions:
Therapeutic inertia is still a major problem in Bulgaria. 45% of the patients were left without cardio-vascular risk assessment. Monotherapy was the starting option in almost half of grade II and II hypertension patients. The intensification of the therapy was delayed and free combinations were preferred over SPCs. The use of central-acting agents and beta –blocker /diuretic combinations was greater than expected.
HYPERTENSION TREATMENT AND CONTROL IN NEPAL: A SYSTEMATIC REVIEW OF BARRIERS AND FACILITATORS
Authors: Dhungana Raja Ram , Pandey Achyut Raj , Shrestha Nipun , Pedisic Zeljko , De Courten Maximilian 
Published: April 2021

Objective:
Understanding country-specific factors influencing cascade of care for hypertension is critical to address the high unmet need for hypertension treatment and control. This study aimed to systematically synthesise the evidence on barriers and facilitators of hypertension treatment and control in Nepal.

Design and method:
We systematically searched for available literature in Embase, PubMed, Web of Science Cinahl, ProQuest and WorldCat. A total of 2131 identified documents were assessed against a predefined set of inclusion criteria. Studies that were carried out among healthcare providers and hypertensive persons and that investigated factors associated with hypertension treatment and control in Nepal were included in the review. We used the Mixed Methods Appraisal Tool (MMAT) to assess the methodological quality of the selected studies. For qualitative findings, we used the framework synthesis approach to generate themes on barriers and facilitators, and we framed them under the domains of “health system”, “provider”, and “patient”.

Results:
Six eligible studies, three qualitative, two quantitative and one mixed methods, were identified. Unaffordability of care and lack of resources were two pertinent barriers related to the health system. Lack of interest in counselling the patients on medication use, lifestyle modifications, and long-term monitoring were common barriers linked to healthcare providers. Poor help-seeking behaviour, poor adherence to medication, fear of long-term medication use, and adverse effects of drugs were the most cited impediments among patients. Availability of free essential healthcare services and family support were enablers of hypertension treatment and control.

Conclusions:
Several barriers and two facilitators of hypertension treatment and control in Nepal were identified. To improve management and control of hypertension in Nepal, comprehensive interventions are needed, because barriers exist at the health system, provider, and patient level.