bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expanding the potential benefits of colchicine for preventing postpericardiotomy syndrome and atrial fibrillation complications after cardiac surgery: meta-analysis of randomized controlled trials
Authors: Putra BP , Putra FN 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Postpericardiotomy syndrome (PPS) and atrial fibrillation (AF) are complications occurred in one-third of cardiac surgery patients that increase morbidity and mortality. Colchicine is an anti-inflammatory drug for treating acute pericarditis and pericardial effusion. Previous studies suggested that colchicine also may prevent PPS and AF after cardiac surgery although the results were still inconsistent.

Purpose
This study intends to determine the efficacy of colchicine for preventing PPS and AF in post-cardiac surgery patients.

Methods
We conducted comprehensive literature searching in online databases of Pubmed, EMBASE, ScienceDirect, and The Cochrane Library, to include all relevant studies until November 2020. We included all randomized controlled trials (RCTs) that access the incidence of PPS and AF after cardiac surgery in patients who received colchicine before cardiac surgery compared with placebo. We use revised Cochrane risk-of-bias tool (RoB 2) for accessing the bias risk of included studies. We performed analysis to provide pooled risk ratio (RR) with 95% confidence interval (CI) using fixed-effect heterogeneity test.

Results
We included 9 RCTs with total of 2,372 participants met our inclusion criteria. The administration of colchicine before cardiac surgery decreases the incidence of PPS significantly (pooled RR = 0.55, 95% CI 0.43 – 0.71, p &lt; 0.00001. I² = 0%). Besides, colchicine also significantly lowers the incidence of postoperative AF compared with placebo (pooled RR = 0.79, 95% CI 0.65 – 0.96, p = 0.02. I² = 20%).

Conclusions
Colchicine showed potential benefits for preventing PPS and AF after cardiac surgery. However, further trials are needed to establish the efficacies.
Risk of cerebrovascular accidents according to weather and pollution features
Authors: Biondi-Zoccai G , Anticoli S , Pezzella F , Di Giosa A , Marchegiani G , Calcagno S , Di Pietro R , Versaci F 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Despite mounting evidence, there is uncertainty on the impact of the interplay between weather and pollution features on the risk of acute cerebrovascular events (CVE).

PURPOSE
We aimed at appraising role of weather and pollution on the daily risk of CVE.

METHODS
Anonymized data from a hub CVE center in a metropolitan area were collected analyzed according to weather and pollution on the same and the preceding days. Generalized additive models were used to explore the impact of individual and combined factors on the risk of daily CVE.

RESULTS
We collected data from 2012 to 2017, including a total of 2534 CVE, with a 1.56 daily rate (bootstrapped 95% confidence interval 1.48-1.64). In particular, CVE were distinguished as follows: ischemic stroke, hemorrhagic stroke, arterial dissection, ruptured aneurysm, and transient ischemic attacks, with daily rates ranging from 1.422 for stroke to 0.005 for ruptured aneurysm. Unadjusted analysis showed that daily temperature, atmospheric pressure, and humidity, among weather features, were all significantly associated with CVE (all P &lt; 0.05). Similarly, concentrations of carbon monoxide, nitrogen dioxide, nitrogen oxides, ozone, and particulate matter &lt;10 µm (PM10), among pollution features, were all significantly associated with CVE (all P &lt; 0.05). Multivariable analysis, also adjusted for season, showed that CVE were significantly and inversely associated with same-day minimum temperature (P &lt; 0.001), atmospheric pressure (P = 0.007), and humidity (P &lt; 0.001), as well as significantly and positively associated with nitrogen dioxide (P = 0.005) and PM10 (P &lt; 0.001).

CONCLUSION
Cerebrovascular events, and stroke in particular, are more common in days with lower temperature, pressure and humidity, and higher concentrations of NO2 and PM10.
Abstract Figure. Association between PM10 and CVE
Assessment of the effectiveness of antihypertensive therapy in the early post-stroke period of ischemic stroke based on indicators of arterial stiffness
Authors: Mayorova S , Lipatova T 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Globally, stroke is the second leading cause of death, leading to a reduction in life expectancy and disability of patients. It seems important to study and introduce into practical health care both new approaches to stroke prevention and measures aimed at full recovery in the post-stroke period.

Purpose
To assess the antihypertensive therapy (AHT) in patients with arterial hypertension (AH) in the early post-stroke period of ischemic stroke (IS), based on indicators of arterial stiffness.

Methods
The study included 180 patients with hypertension (mean age 64 years) in the acute period of ischemic stroke (IS). Inclusion criteria in this trial: AH, age over 40 years, time from the onset of stroke no more than 48 hours. Arterial stiffness was assessed by an oscillometric method with an assessment of the 24-hour reflected wave transit time (RWTT), aortic augmentation index (AIxao)), arterial stiffness index (ASI), and pulse wave velocity (PWV). The indicators were assessed at the time of admission, at the time of discharge from the hospital (14-21 days) and 2 months after discharge. We determined endothelin-1 (ET-1) levels by ELISA at admission and 2 months after discharge. Retrospectively, patients were divided into 5 groups depending on the prescribed AHT: group 1 (48 patients) - ACEIs/ARBs, thiazide-like diuretics (TLDs), group 2 (46 people) - ACEIs/ARBs, nondihydropyridine calcium antagonists (ACs) and beta-blockers (BBs), group 3 (39 people) - ACEIs/ARBs and ACs, group 4 (26 patients) - ACEIs/ARBs and BBs, group 5 (21 people) - ACEIs/ARBs, TLDs and BBs.

Results
AHT showed a positive trend in terms of arterial stiffness in all 5 groups. Compared with the baseline values, the significant decrease in PWV (12.4 ± 1.7m/s vs 10.9 ± 1.8m/s, p &lt; 0.01), AIxao (39.8 ± 6.3% vs 36.8 ± 5,2%, p &lt; 0.001), ASI (167.9(127.0;174.5) vs 158.8(115.0;168.7)), p &lt; 0.05), increased RWTT (98.0 ± 9.8ms vs 105.3 ± 7.5ms) in group 2 of patients were found. After 2 months, when comparing indicators between groups the significant decrease in PWV to 9.1(8.7; 11.6)m/s, p &lt; 0.01), AIxao to 31.7(29.8;41.9)%, p &lt; 0.01, an increase in RWTT to 107.7(102.4; 110.2)ms, p &lt; 0.01 in the group of patients taking ACEIs/ARBs, ACs and BBs were detected. After 2 months after discharge, a significant decrease of ET-1 was also observed in group 2 (5.8 ± 2.2ng/ml vs 4.2 ± 1.8ng/ml). The combination of ACEs/ARBs and BBs showed the least effectiveness in reducing arterial stiffness.

Conclusions
The combination of ACEIs/ARBs, ACs and BBs showed the greatest efficiency in reducing the stiffness in patients with hypertension in the early post-stroke period of IS. It seems important for the functional recovery of patients in the post-stroke period to use the drug therapy aimed not only at lowering blood pressure, but also favorably affecting the arterial stiffness.
Life"s simple 7 and the risk of stroke in Finnish men: a prospective cohort study
Authors: Isiozor N , Kunutsor SK , Voutilainen A , Kurl S , Kauhanen J , Laukkanen JA 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): North Savo Regional Fund and Finnish Foundation for Cardiovascular Research

Background
Population-wide preventive measures constitute important approaches toward reducing stroke risk and its associated burden. We sought to examine the association between American Heart Association’s (AHA) Life’s Simple7 (LS7) score and the risk of stroke in men.

Methods
The study is based on the prospective population-based Kuopio Ischaemic Heart Disease cohort comprising men (42-60 years) without pre-existing history of stroke at baseline. LS7 was computed from AHA’s cardiovascular health metrics for 2520 men and includes data on diet, physical activity, body mass index, smoking status, blood pressures, total cholesterol and blood glucose. Participants were classified into three LS7 groups based on the number of ideal metrics: inadequate (0–2), average (3–4) and optimal (5–7). Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of LS7 scores for total and ischaemic stroke.

Results
During a median follow-up of 26years, 428 total and 362 ischaemic incident stroke events were recorded. The risk of both stroke outcomes decreased continuously with increasing LS7 scores across the range 2 to 6. Men with optimal LS7 had 48% (HR: 0.52; 95%CI: 0.32–0.86) lower risk of total stroke when compared with those with inadequate LS7. The association was similar for the risk of ischaemic stroke, with 50% (HR: 0.50; 95%CI: 0.29–0.87) lower risk among men with an optimal LS7 compared with those with inadequate LS7.

Conclusion
LS7 was strongly, inversely and linearly associated with risk of total and ischaemic strokes among a middle-aged male Caucasian population.
Life’s Simple 7 and the risk of stroke Total Stroke Ischaemic Stroke LS7 score 0-2† (inadequate) 3-4 (average) 5-7 (optimal) 0-2† (inadequate) 3-4 (average) 5-7 (optimal) n/N 224/1109 187/1273 17/138 192/1109 156/1273 14/138 Model 1 HR (95%CI) 1 0.65 (0.53 - 0.79) 0.49 (0.30 - 0.81) 1 0.63 (0.51 - 0.78) 0.47 (0.27 - 0.82) p value* &lt;0.001 0.005 &lt;0.001 0.007 Model 2 HR (95%CI) 1 0,69 (0.56 - 0.84) 0.52 (0.32 - 0.86) 1 0.67 (0.54 - 0.84) 0.50 (0.29 - 0.87) p value* &lt;0.001 0.01 &lt;0.001 0.014 n/N, number of events/Total; HR, hazard ratio; CI, Confidence interval *p-values for the HRs &lt;0.05 are considered statistically significant †Reference category Model 1: adjusted for age, alcohol consumption and socioeconomic status Model 2: Model 1 plus history of coronary heart disease and history of type 2 diabetes mellitus
An increase in blood levels of vascular endothelial growth factor and highly sensitive C-reactive protein in patients with hypertension and obesity is associated with the left ventricular hypertrophy
Authors: Koval S , Mysnychenko OV , Penkova M YU 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
In patients with essential hypertension (H) in combination with abdominal obesity (АО), there is a more frequent and earlier development of asymptomatic hypertension-mediated organ damage (HMOD). One of the prognostically unfarable HMODs is left ventricular hypertrophy (LVH). According to modern concepts, in the mechanisms of HMOD formation, a significant place is given to subclinical inflammation and disturbances in the processes of angio-arteriogenesis.

Purpose
To study blood levels of one of the powerful proangiogenic and proinflammatory factors vascular endothelial growth factor (VEGF) and a marker of inflammation highly sensitive C-reactive protein(hsCRP) in patients with H and AO and their relationship with asymptomatic HMOD.
Methods. The study involved 64 patients with grade 2 H and grade I-II AO (38 men and 26 women aged 35 to 60 years) and 23 practically healthy individuals in the control group (14 men and 9 women aged 18 to 50 years).The survey included standard clinical, anthropometrical, biochemical and instrumental methods. The blood levels of VEGF and hsCRP were determined by the enzyme immunoassay. Diagnostics of H, risk factors and HMOD was performed in accordance with the recommendations of the ESC/ESH (2018).
Results. There was a significant increase in the blood levels of VEGF (162,31 [102,67; 226,41] pg / ml) and hsCRP (3,11[1,17;5,82] mg/L) in patients with H and AO in general by group in comparison with practically healthy individuals (89,07 [61,43; 135,57] pg/ml (р=0,004) and 1,07 [0,46;2,99] mg/L (р=0,016), respectively). At the same time, the blood levels of VEGF (238,53 [138,31; 294,84] pg/ml) and hsCRP (3,94 [1,89;5,82] mg/L) were significantly higher in patients with LVH than in patients without LVH (149,96 [75,18; 174,96] pg/ml (р=0,035) and 2,30 [0,65; 5,31] mg/L (р=0,042), respectively). The following direct correlations were found: between the blood levels of VEGF and hsCRP (р =0,0018), between the blood levels of EGF, hsCRP and LV mass index (р =0,016, р =0,021, respectively), between the blood levels of VEGF and systolic blood pressure (р =0,035), as well as left atrial volume index (р =0,037).
Conclusion. In patients with H in combination with AO, there are manifestations of the activation of the production of proangiogenic and proinflammatory factors -VEGF and hsCRP, which can play an important role in the development of both LVH and in the progression of H in general.
Should we redifine Hypertensive response in stress test to better predict cardiovascular risk?
Authors: Silverio Antonio P , Alves Da Silva P , Valente Silva J , Brito J , Rodrigues T , Couto Pereira S , Cunha N , Santos R , Rigueira J , Aguiar-Ricardo I , David D , J Pinto J , G Almeida A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Systolic blood pressure (SBP) rise during exercise is normal, but some patients present with hypertensive response to exercise (HRE). The clinical implication of such phenomenon is not fully elucidated, and treatment strategies are still uncertain.

Purpose
To evaluate the relationship between HRE and the development of major cardiovascular events (MACE) - death, acute coronary syndrome (ACS) and stroke.

Methods
Single-center retrospective study of consecutive patients submitted to exercise test (ET) from 2012 to 2015. Patient’s demographics, baseline clinical characteristics, vital signs during ET and MACE occurrence during follow-up were analysed. HRE was defined as a peak systolic blood pressure (PSBP) &gt;210 mmHg in men and &gt;190 mmHg in women, or a rise of the SBP of 60 mmHg in men or 50 mmHg in women or as a diastolic blood pressure &gt;90 mmHg or a rise of 10 mmHg.

Results
We included 458 patients with HRE (76% men, 57.5 ± 10.83 years). The most frequent comorbidities were hypertension (83%) and dyslipidaemia (61%). During a mean follow-up of 60 ± 2 months, the incidence of MACE was 9.2% with ACS being the most frequent (4.2%), followed by mortality (3.8%) and stroke (2.1%). Patients with inconclusive ET had a fourfold higher risk of acute coronary events (OR 4.1, CI 95% 1.55-11.14, p = 0.005). Baseline SBP and PSBP were predictors of MACE occurrence (OR 1.022, CI 95% 1.004-1.04, p = 0.016, OR 1.031 CI 95% 1.012-1.051, p = 0.001, respectively) and were both associated with cardiovascular hospitalization (p = 0.006; p &lt; 0.001, respectively). PSBP had moderate ability to predict hospitalization of cardiovascular (CV) cause (AUC 0.71, p &lt; 0.001) with a cut-off of 193 mmHg (sensibility 91%, specify 40%) and had moderate ability to predict MACE (AUC 0.67, p &lt; 0.001) with a cut-off of 198 mmHg (sensibility 78.6%, specify 46.1%). Regarding mortality, antihypertensive therapy prior to ET was protective (p = 0.042), with no difference between different classes of drugs.

Conclusion
Our data reveal a high rate of MACE occurrence between patients with HRE. The finding of diagnosed hypertension as a protective factor of stroke may be explained by the cardioprotective effect of antihypertensive drugs. An increased risk of ACS between patients with an inconclusive ET should lead to consider then for further investigation. HRE should be considered as part of CV risk assessment and adjusted lower HRE cut-off values should be considered in order to better predict MACE occurrence, particularly in high risk patients.
Abstract Figure.
Is a single bout of exercise also a viable tool for blood pressure management in African and Asian populations? The HYPE2X trial protocol and design
Authors: Bersaoui M , Baldew SM , Toelsie J , Buys R , Cornelissen VA 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Current national and international guidelines recommend exercise as the first line treatment (class IA recommendation) for hypertension. These guidelines are based on research performed in predominantly Caucasian populations, yet the potency of exercise for lowering blood pressure (BP) is less studied in non-Caucasian populations. It is well-known that a great variability exists in the response to pharmacological antihypertensive treatments among ethnic groups. However, it is not clear whether this variability is also present regarding the BP response to exercise. The ‘Hypertension, Ethnicity and Exercise’ (HYPE²X ) trial will i) investigate whether a short bout of isometric strength or endurance exercise lowers blood pressure in African and Asian populations; ii) evaluate and compare differences in acute response to exercise between the Africans and Asians, and iii) increase our understanding on mechanisms related to blood pressure responses to exercise in these non-Caucasian populations.

Methods and analyses
A randomized controlled crossover trial will be conducted in 60 adults of African (n = 30; 50% female) or Asian (n = 30, 50% female) origin, ≥ 18 years. Healthy individuals with high to normal blood pressure (SBP: 130 – 139 mmHg or and DBP: 85 – 89 mmHg) or grade I hypertension (grade 1, SBP: 140 – 159 mmHg or DBP: 90 – 99 mmHg) will be recruited at outpatient clinics in Suriname between November 2020 – February 2021. Patients will complete three experimental sessions in a randomized order: a 30 minute walking/running bout at 40-60% of heart rate reserve; an isometric handgrip session at 30% of maximal handgrip strength and a sitting control session. (See Figure 1). Measurements will be performed before and immediately after each session. The primary outcome is daytime blood pressure measured by means of 24h blood pressure monitoring. Secondary outcomes include office BP, autonomic function (heart rate variability), cardiac function (left ventricle function), vascular function (pulse wave velocity and flow-mediated dilation) and the renin-angiotensin aldosterone system (plasma renin and aldosterone levels). Analyses will be performed using mixed models for repeated measures. A two-tailed p-value &lt;0.05 will be considered statistically significant.

Conclusion
It is anticipated that the HYPE²X trial will contribute to a better understanding of the response of non-Caucasians to lifestyle interventions, in particular exercise therapy.
Abstract Figure 1. Flowchart of the RCOT
Health education: the effects of an educational program on the health of hypertensive patients with low educational level
Authors: Sousa LAP , Campos APP , Araujo CM , Moreira IGS , Santos G , Costa JM , Vasconcellos JAC , Leal S , Souza AC , Ribeiro ALP 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): FAPEMIG

Introduction
Health education is one of the most complete practices for supporting of patients with chronic diseases such as hypertension. It is important, however, to investigate which strategies would be more assertive in this process, depending on the objective and profile of the patient. Objective: The aim of this study was to evaluate the effect of an interactive educational program on the health of hypertensive patients with low educational level in a Basic Health Unit in Brazil. Methods: This is an almost experimental study, with a multidisciplinary approach, with 6 months of duration. Interactive workshops were held where topics related to hypertension, such as: pathophysiology, complications, drug and non-drug therapeutic approach and lifestyle change. It is important to emphasize that the work used interactive and playful sessions, such as games, videos and group dynamics. The sample consisted of 35 hypertensive individuals submitted to blood pressure (systolic = SBP and diastolic = DBP) measurement, quality of life (Minichal), adherence to treatment (Martín-Bayarre-Grau), level of knowledge of the disease, physical activity (IPAQ) and anthropometric study evaluation. In addition, for analysis of the data, the sample was divided into two subgroups, according to the participation in the activities: adhered (n = 11) or not adhered (n = 24). Initially, descriptive statistics were used to present the study variables. Subsequently, the WILCOXON test was used to compare before and after and MANN-WHITNEY to compare the two groups, p = 0.05 was considered significant. Results: No significant difference was found relating the initial data in the two subgroups. After the educational program, a significant reduction was observed in relation to the SBP values: 9.8 mmHg in the adherent subgroup. On the other hand, there was increased 0.7 mmHg among non-adherents. The other evaluations did not change. It should be emphasized that the studied population demonstrated a satisfactory level of knowledge of the pathology and the therapeutic process necessary since the initial evaluation in both groups. Such finding, however, was not related to adherence to treatment. Conclusion: the findings suggest that an adapted educational approach could help to control blood pressure levels of hypertensive patients with low educational level. In addition, it was observed that knowledge does not seem to be associated with action, and it is necessary to develop strategies that can increase adherence to therapeutic interventions.