bluuebunny/crossref_metadata_2025_split huggingface dataset:
RELATIONSHIP BETWEEN ARTERIAL STIFFNESS AND RENAL FUNCTION DETERMINED BY CKD-EPI AND MDRD EQUATIONS IN A CHINESE COHORT UNDERGOING HEALTH ASSESSMENT
Authors: Tang Biwen , Zhao Jiehui , Deng Xueqin , Tan Isabella , Butlin Mark , Avolio Alberto , Zuo Junli 
Published: April 2021

Objective:
The relationship between the renal function and large arteries remains to be determined. Our study investigated the relationship between carotid-femoral pulse wave velocity (c-fPWV) as a measure of arterial stiffness and renal function in healthy participants.

Design and method:
Our cross-sectional study was conducted in healthy individuals in China. We enrolled participants from January 2017 to June 2019. c-fPWV and blood pressure were measured and blood samples taken in all participants. Estimated glomerular filtration rate (eGFR) was evaluated by four different formulae using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations: (i) CKD-EPICr formula based on Cr, (ii) CKD-EPICysC formula based on CysC, (iii) CKD-EPICrCysC formula based on Cr andCysC, (iv) MDRD.

Results:
Average age of 431 study participants was 53.1 ± 13.0 years (68.1% male), 23.7% had diabetes mellitus, 66.6% had hypertension. The average eGFR values of CKD-EPICr, CKD-EPICysC, CKD-EPICrCysC and MDRD equations were respectively 91.9 ± 15.6, 86.8 ± 21.4, 89.6 ± 18.3 and 90.7 ± 16.6 ml/min·1.73m2. c-fPWV was significantly and negatively correlated with eGFR of CKD-EPICr (r = -0.336), CKD-EPICysC (r-0.385), CKD-EPICrcysC (r = -0.378) and MDRD (r = 0.219) equations. After adjusting for confounding factors, c-fPWV remained significantly and negatively correlated with eGFR evaluated by CKD-EPICysC equation (β=-0.118), and significantly and positively correlated with age (β = 0.347), SBP (β= 0.275), HR (β = 0.086), FPG (β= 0.098).

Conclusions:
In normal individuals in China, c-fPWV is negatively correlated with eGFR evaluated in different four equations, however only the equation of CKD-EPICysC showed an independent relation with c-fPWV.
EVOLUTION OF RESERVOIR-WAVE ANALYSIS PARAMETERS AFTER KIDNEY TRANSPLANTATION
Authors: Côté Nadège , Philibert Emy , Paré Mathilde , Goupil Rémi , Fortier Catherine , Schultz Martin G. , Sharman James E. , Agharazii Mohsen 
Published: April 2021

Objective:
According to reservoir-wave analysis (RWA) arterial pressure is the sum of a reservoir pressure (RP) accounting for dynamic storage and release of blood from arteries, and an excess pressure (XSP) analogous to flow. RP is the minimal left ventricular work required to generate aortic flow, while XSP corresponds to surplus cardiac workload. We have previously shown that kidney transplantation (KTx) improves aortic stiffness. We now aim to determine how the improvement of aortic stiffness after kidney transplantation will translate on the reservoir-wave analysis parameters. We hypothesize that kidney transplantation will result in a decrease of excess pressure and of its integral.

Design and method:
This is a longitudinal observational study involving patients with kidney failure who were undergoing KTx. Before, 3, 6 and 24 months after KTx, carotid pressure waves were recorded using applanation tonometry, calibrated using brachial diastolic and mean blood pressure. Using pressure only approach, reservoir-wave analysis was used to derive RP, XSP and their integrals (RPI, XSPI).

Results:
75 patients (69% male, mean age 51 ± 13 years) were assessed. Post-KTx, PR (121.4 ± 2.4 vs. 98.1 ± 1.5; P < 0.001) and PRI (11,192.5[10,515.7–11,869.4] P < 0.001) decrease significantly and continuously. XSP (18.8 ± 1.1 vs. 18.6 ± 1.5; P = 0.898) doesn’t decrease significantly. XSPI (390.9[331.4–450.4] P = 0.023) decreases significantly at 6 months post KTx but increases after.

Conclusions:
Kidney transplantation results in a continuous decrease of reservoir pressure and of its integral (RP and RPI). As opposed to our hypothesis, the excess pressure (XSP) does not decrease. XSP is analogous to flow. Therefore, it is possible that adding renal vessels to existing vascular network during KTx increases cardiac output. This could explain why we do not see a decrease of excess pressure post KTx despite reduced arterial stiffness.
ASSOCIATION OF PARATHYROID HORMONE WITH PULSE WAVE VELOCITY PROGRESSION
Authors: Cheng Yi-Bang , Guo Qian-Hui , Zhang Dong-Yan , Wang Ying , Huang Jian-Feng , Huang Qi-Fang , Sheng Chang-Sheng , Xu Ting-Yan , Wang Ji-Guang , Li Yan 
Published: April 2021

Objective:
We recently demonstrated that carotid-femoral pulse wave velocity (cfPWV) was independently associated with both blood pressure and the serum level of parathyroid hormone (PTH) in untreated Chinese. We investigated in the same cohort whether baseline serum PTH predicted cfPWV and its progression at a 5-year follow-up.

Design and method:
Consecutive untreated outpatients referred for ambulatory blood pressure monitoring were recruited and followed-up. Serum PTH was measured with electrochemiluminescence immunoassay. cfPWV was measured using the SphygmoCor (AtCor, Australia) device. Pearson's correlation, single and multiple regressions were applied for analyses.

Results:
Totally 549 patients (mean age, 51.5 years; 49.2% women) had a follow-up at a median of 5 years. The prevalence of hypertension increased from 39.5% to 79.3%, and cfPWV from 7.79 m/s to 7.83 m/s, with an averaging progression rate of 0.01 m/s/y. With adjustments applied for sex, age, body mass index, heart rate and fasting plasma glucose, serum PTH predicted higher cfPWV at follow-up. Each double of serum PTH was associated with 0.20 m/s higher cfPWV at follow-up (P = 0.035). The association remained significant after further adjusted for eGFR, total-to-HDL cholesterol ratio and systolic blood pressure (P = 0.019). However, with similar adjustment applied, serum PTH was associated with neither cfPWV progression nor the progression rate (P > = 0.17).

Conclusions:
Serum PTH was positively associated with cfPWV both at baseline and 5-year follow-up, but not with PTH progression, indicating that PTH might be a marker but not a main culprit for arterial stiffening.
EARLY LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN DETERIORATION AFTER AORTIC ANEURYSM REPAIR IN HYPERTENSIVE PATIENTS: IMPACT OF AORTIC STIFFNESS
Authors: Marketou Maria , Papadopoulos George , Kontopodis Nikolaos , Patrianakos Alexandros , Nakou Elenh , Maragkoudakis Spyros , Stratakis Stavros , Tavlas Emmanuel , Ioannou Christos , Parthenakis Fragiskos 
Published: April 2021

Objective:
Invasive abdominal aortic aneurysm (AAA) replacement with an endograft interposes between the normal arterial tree which may acutely reduce overall systemic compliance. As a result, the input impedance is significantly increased, as are central systolic and pulse pressures. We evaluated changes in left ventricular global longitudinal peak strain (GLPS) in hypertensive patients undergoing repair of AAA in relation with the changes in arterial stiffness.

Design and method:
This was a single-center, nonrandomized, prospective, observational cohort study. Consecutive AAA hypertensive patients who underwent open or endovascular repair (EVAR) were enrolled. All patients were asymptomatic from their AAA and were admitted for elective treatment; there were no planned adjunctive procedures at the time of repair. A standard M-mode and 2-dimensional (2D) echocardiographic study was performed in all participants Left ventricular global longitudinal strain (GLS), and carotid-femoral pulse wave velocity (cf-PWV) were estimated 1 week preoperatively, as well as 1 and 6 months postoperatively. Left ventricular global longitudinal strain (GLS), and carotid-femoral pulse wave velocity (cf-PWV) were estimated 1 week preoperatively, as well as 1 and 6 months postoperatively.

Results:
A total of 70 men, mean age 70 ± 7 years, were evaluated. Of these, 58 underwent EVAR and 12 open repair. A significant time effect was found on cf-PWV, which showed an increase at 1 month and remained thereafter (p = 0.006). Additionally, a deterioration in GLS values was revealed, with a significant increase at 1 month that persisted 5 months later (p < 0.001). No significant group effect was observed between EVAR and open repair (p = 0.98) and there was no significant interaction (p = 0.96). Notably, the difference of global longitudinal strain (DGLS) between baseline and 6 months significantly correlated with the corresponding changes in cf-PWV (r = 0.494, p < 0.0001).

Conclusions:
AAA repair may have detrimental effects in cardiac systolic function. Our findings highlight the need a more intense cardiac surveillance program after aortic reconstruction. Further studies are needed to investigate how this may translate into long-term manifestations of cardiovascular complications and symptomatology.
MIXED-METHOD PROCESS EVALUATION PROTOCOL OF A RANDOMIZED CONTROLLED TRIAL OF AN APP-BASED EDUCATION PROGRAM TO REDUCE SALT INTAKE IN SCHOOL CHILDREN AND THEIR FAMILIES IN CHINA
Authors: Sun Yuewen , Luo Rong , Li Yuan , He Fengjun , Zhang Puhong 
Published: April 2021

Objective:
Dietary salt intake is a major risk factor for high blood pressure. It is extremely challenging to reduce salt intake in China, with about 80% being added by the consumers. In recognition this challenge, an innovated salt reduction intervention package (AppSalt) based on smartphone application with functional modules of education, evaluation, target setting and monitoring, decision support and management, was developed and applied among school children and their family members. Process evaluations are crucial for understanding how and why the interventions resulted in its observed effect in this setting, but also inform transferability and future implementation in many other countries. This protocol is to describe the methodology of the process evaluation of AppSalt program, to promote transparency and share the approach, which can be adapted for use in other complex interventions.

Design and method:
We describe the pragmatic methods on five process evaluation dimensions: The fidelity of the implementation, intervention dose delivered and received, reach of the intervention strategies, and the contextual factors influencing the intervention, informed by the theoretical framework of process evaluation proposed by Linnan and Steckler. Quantitative and qualitative data will be triangulated to provide a clearer picture of the AppSalt implementation in the real world.
Mixed methods will be used for collecting and analysis the process data. The APP usage log, activity logs, routinely collected monitoring data and mid-term survey will be the major quantitative process data source to analyse the fidelity, reach and dose of intervention strategies. To understand participants’ experiences and the causal mechanism of the intervention strategies, semi-structured interview will be used for purposively selected intervention participants and key stakeholders from local health and education authorities.

Results:
This is a protocol paper. Data collection is still ongoing. Therefore, there is no results in this abstract.

Conclusions:
This protocol provides a good example of how to integrate process evaluation into public health interventions. It will be helpful for other researchers and policy-makers to replicate the evidence of AppSalt program and design their own salt reduction program.
TISSUE NA+ EXCESS UPON EXPERIMENTAL SALT-LOADING IS SYSTEMIC AND REFLECTS ISOTONIC OEDEMA
Authors: Rossitto Giacomo , Mary Sheon , Chen Jun Yu , Boder Philipp , Neves Karla B. , Alves Rheure L. , Montezano Augusto , Petrie Mark C. , Graham Delyth , Touyz Rhian M. , Delles Christian 
Published: April 2021

Objective:
Skin was identified as a large depot for Na+ accumulation. Its proposed water-independent (hypertonic) nature has the potential to induce local pathogenic changes, including activation of the osmotic stress sensor TonEBP-mediated lymphangiogenic signalling. Blockade of this response led to salt-sensitive hypertension. Our study tested the hypertonic nature and organ-specific distribution of tissue Na+ accumulation upon salt-loading.

Design and method:
Twelve weeks-old male and female stroke-prone spontaneously hypertensive (SHRSP) and control Wistar-Kyoto (WKY) rats were treated with 1% NaCl in drinking water (high salt, HS) or normal water (NS) for 3 weeks (n = 8–10/sex/group). Tissue water and Na+/K+ content, as well as TonEBP gene expression in abdominal skin, liver, lung, myocardium and skeletal muscle were measured by gravimetric approach (wet–dry weight), flame photometry and qRT-PCR, respectively. The functional effects of in-vivo and ex-vivo exposure of resistance arteries to salt excess (HS treatment and incubation in +15 mM NaCl, respectively) were assessed and compared by wire myography.

Results:
Tissue Na+ increased in skin (+20.7%), but also liver (+10.3%), lungs (+14.8%) and skeletal muscle (+23.6%) in HS-SHRSP compared to NS; apart from skeletal muscle, it was consistently paralleled by water (skin: +14.1%; liver: +4.8%; lungs: +9.0%; p < 0.05 for all). Patterns were similar between males and females and absent in WKY. In both strains and all organs, K+ + Na+ concentration was not affected by HS and sat within physiological limits, thus pointing against hypertonicity. Nevertheless, TonEBP gene expression changes matched Na+ and water isotonic accumulation in SHRSP-HS skin, liver and lungs.
Hypertonic incubation did not induce hypercontractile responses but exacerbated the sensitivity to NO-mediated relaxation in arteries from both strains (δIC50, p < 0.001). The effect of in-vivo HS, in keeping with classic hypertensive vascular changes, was opposite (p < 0.001, in SHRSP only).

Conclusions:
If water independent, interstitial Na accumulation is unlikely to underpin the development of experimental hypertension via a direct impact on vascular function. Tissue Na+ excess upon HS rather reflects isotonic oedema accumulation and systemic changes in tissue architecture, not solely confined to skin, and sensed by TonEBP.
THE EFFECTS OF ADDING EXERCISE TO USUAL CARE ON BLOOD PRESSURE IN PATIENTS WITH HYPERTENSION, TYPE II DIABETES MELLITUS, AND/OR CARDIOVASCULAR DISEASE (PRELIMINARY RESULT)
Authors: Rijal Anupa , Nielsen Emil Eik , Neupane Dinesh , Olsen Michael Hecht , Jacokbsen Janus Christian 
Published: April 2021

Objective:
Exercise is one of the most commonly recommended interventions for hypertension, type II diabetes, and/or cardiovascular disease. However, previous reviews have shown conflicting evidence on the effects of exercise and especially the effects in low- and middle-income countries (LMICs) is debated. Our objective was to assess the beneficial and harmful effects of adding exercise to usual care for people with hypertension, type II diabetes, and/or cardiovascular disease in high-income countries (HICs) and LMICs.

Design and method:
We searched CENTRAL, MEDLINE, EMBASE, LILACS from inception to present time, and further searched the bibliography of retrieved articles and reviews. We included relevant randomised clinical trials and cluster randomised trials irrespective of trial duration, publication status, publication year, and language. Two independent investigators assessed each trial for methodological quality. A random-effects model was used to meta-analyse data, we used test of interaction to compare the effects of exercise in HIC and LMIC, and heterogeneity (I2) was assessed by the χ2 test on Cochran's Q statistic. Our protocol was registered with PROSPERO, number CRD42019142313 and published before our literature search was conducted.

Results:
We included 96 trials randomising 6002 participants with type II diabetes (34 trials), hypertension (26 trials), and rest were trials on CVDs. The mean follow-up for the trials was 5.21 (SD: ± 4.07) months. Meta-analysis including all trials showed that exercise compared with control decreased the systolic blood pressure (SBP) 4.66 mmHg (95% CI: -6.24 -3.07; I2 93.6, p < 0.001). Test of interaction showed that the decrease in SBP was higher in LMICs (-8.69; 95% CI -11.95 -5.43; I2 89.73, p < 0.001) compared to HICs (-3.315; 95% CI -5.002 -1.62; I2 93.05, p = 0.000) and the difference was significant (Q = 8.25 p < 0.001). Likewise, exercise decreased the overall diastolic blood pressure (DBP) 2.98 (95% CI; -4.04 -1.93; I2 = 93.35, p < 0.001) however the difference was not significant between LMICs and HICs (Q = 1.66 p = 0.198).

Conclusions:
This reiterates the possibility of implementing exercise on population level as a cheap, low risk, non-pharmacological cardiovascular prevention.
EFFICACY OF CINNAMON CONSUMPTION FOR REDUCING BLOOD PRESSURE IN ADULT HYPERTENSIVE MALES
Authors: Patil Mansi , Patil Vishal 
Published: April 2021

Objective:
To assess the efficacy of cinnamon consumption on change in weight, blood pressure, blood glucose levels and anthropometry [waist circumference (WC), Waist to hip ratio (WHR), Body mass Index (BMI)] after 30 days in obese, diabetic hypertensive males.

Design and method:
A cross-sectional study on 200 male patients with uncontrolled hypertension was conducted to assess the effect of consuming 2 gms of home ground cinnamon powder on blood pressure, weight and anthropometry. Patients (n = 200) were advised a 1800 kcals diet with 60% carbohydrates, 20% proteins and 20% fats. Patients (n = 100) were provided dietary advice including cinnamon and 100 patients (control group) were advised to continue the same advised diet without cinnamon. Diet diary was maintained by patients and monitored weekly. Clinic blood pressure, height, Weight, WC and hip circumference measured using the NHANES standard procedures. BMI and WHR were calculated.

Results:
At the commencement of the trial 68% (136/200) patients were obese and 22% (44/200) overweight. Significant weight loss was observed in both groups- cases (p < 0.0001) and control group (p < 0.05). The group ingesting cinnamon, after adjusting for other parameters, was associated with significant reduction in WC, WHR (p < 0.001) and both SBP and DBP (p < 0.0001). Significant reduction in SBP in group consuming cinnamon with reduction in WC and BMI (p < 0.001). Significant reduction in DBP associated with reduction in WHR, WC and BMI (p < 0.001). Change in BSL (F,PP) were not found to be significant in both groups.

Conclusions:
Cinnamon was found to be effective in weight loss and reduction of systolic and diastolic blood pressure in patients with uncontrolled hypertension. Weight loss, reduced WC and WHR in group ingesting cinnamon was positively correlated with a reduction in SBP and DBP.
THE EFFECT OF PLANT-BASED DIETS ON BLOOD PRESSURE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CONTROLLED CLINICAL TRIALS
Authors: Gibbs Joshua , Gaskin Eleanor , Ji Chen , Miller Michelle , Cappuccio Francesco 
Published: April 2021

Objective:
Strict vegetarian diets with no animal products are associated with low blood pressure (BP). It is not clear whether less strict plant-based diets (PBD) exert similar effects. We assessed whether less strict PBDs reduce BP in controlled clinical trials.

Design and method:
We carried out a systematic review and a meta-analysis of all published intervention trials assessing the effects of PBDs on BP according to PRISMA guidelines (PROSPERO: CRD42019153716). On 14 June 2019 we performed a systematic search of publications using MEDLINE (1966–2019), EMBASE (from 1980), CINHAL, WoS and manual searches without language restrictions. Inclusion criteria were age > 18 years, PBD as an intervention, defined as dietary patterns that support high consumption of fruits, vegetables, whole grains, legumes, nuts and seeds, and avoid the consumption of most or all animal products, mean differences in systolic/diastolic BP between PBD and control diet, controlled clinical trial. Standardised mean differences in BP and 95% C.I. were pooled using a random effect model. Quality, sensitivity, heterogeneity and publication bias were assessed.

Results:
Thirty-nine studies met the inclusion criteria. They included 8,203 participants (4,333 in intervention; 3,870 control groups). Median sample size was n = 65 (range 11–4,717) and mean age of the participants 50.5 yrs (range 25.6–71.0). All were controlled trials (duration 1.4 to 208 wks, median 12 wks). Of the 39 trials, 36 were randomised. Seven were crossover. Two were single-blinded. The interventions were DASH diet (n = 11), Mediterranean diet (MD, n = 8), vegan diet (VD, n = 8), lacto-ovo vegetarian diet (LOVD, n = 5), healthy Nordic diet (ND, n = 3), high fiber diet (HFD, n = 3), and high fruit and vegetables diet (FVD, n = 2). In the pooled analysis, PBDs were associated with lower systolic BP (DASH 5.53 mmHg [-7.95,-3.12], MD -0.95 mmHg [-1.70,-0.20], VD -1.61 mmHg [-4.53,1.31], LOVD -5.47 mmHg [-7.60,-3.34], ND -4.47 mmHg [-7.14,-1.81], HFD -0.65 mmHg [-1.83,053], FVD -0.57 mmHg [-7.45,6.32]. Similar effects were seen on diastolic BP. There was no evidence of publication bias and some heterogeneity was detected.

Conclusions:
PBDs with limited or no animal products lower both systolic and diastolic BP, across sex, age and body mass index.
THE EFFECT OF HEALTH CLASS ON BLOOD PRESSURE STATUS IN TARUMIZU CITY, KAGOSHIMA PREFECTURE OBTAINED FROM HOME BLOOD PRESSURE MEASUREMENT
Authors: Akasaki Yuichi , Kubozono Takuro , Higuchi Koji , Kawasoe Shin , Tokushige Akio , Sakoda Takashi , Ikeda Yoshiyuki , Ohishi Mitsuru 
Published: April 2021

Objective:
The mortality rate of cerebrovascular disease is 1.5 times higher than that of the whole country and the second highest treatment rate in Tarumizu City, Kagoshima, Japan. It is a region where the proportion of elderly people exceeds 40%, which is higher than the average of 27% in Japan. The average value of systolic blood pressure in Japan has been decreasing year by year, but in 2016, the treatment rate of hypertension was 50–60% or more, and the management rate of hypertension was only about 40% for men and about 45% for women.
In this study, we investigated the effects of home blood pressure measurement, and dietary and exercise guidance on blood pressure.

Design and method:
The blood pressure at the time of consultation of the prospective cohort study (Tarumizu Study) participants was measured, and home blood pressure was measured by using home sphygmomanometer (OMRON, HEM-9700T). The subjects were 342 people who measured home blood pressure for 4 months. After measuring for two months, home sphygmomanometer data was collected. At the same time, health care classroom about exercise, diet and salt reduction was given. Thereafter, home blood pressure was measured in the same manner for 2 months, and changes in blood pressure were examined.

Results:
The blood pressure was categorized by home blood pressure measurement for 2 months. As a result, 114 patients with hypertension and 64 patients with masked hypertension had an average blood pressure of 143.6 / 84.5 mmHg. The hypertension treatment rate was 48%. The average blood pressure after 2 months in the hypertensive group was 139.6 / 82.5 (-4.0 / -2.0) mmHg, indicating an improvement in blood pressure. The blood pressure management rate improved from 37% to 42%.

Conclusions:
The treatment rate for hypertension and blood pressure management rate were comparable to those reported in Japan. Measurement of home blood pressure, explanation of results, guidance on exercise, diet and salt reduction, improved blood pressure which was confirmed by home blood pressure measurement. This results confirmed that blood pressure measurement and guidance on hypertension were important.