bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of changes in left heart geometry on predicting new-onset atrial fibrillation in patients with hypertension
Authors: Kim H M , Hwang I C 
Published: October 2024

Abstract

Background
Hypertension-induced left ventricular hypertrophy (LVH) increases end-diastolic LV pressure and contributes to left atrial enlargement (LAE), which are associated with development of atrial fibrillation (AF). However, the impact of LVH and LAE and their regression following antihypertensive therapy on AF incidence remains unclear.

Purpose
This study aimed to investigate the impact of changes in the LVH and LAE status on the occurrence of new-onset AF (NOAF).

Methods
This retrospective analysis included patients with sinus rhythm who underwent echocardiography at hypertension diagnosis and after 6–18 months. LVH was defined as LV mass index &gt;115 g/m2 (men) and &gt;95 g/m2 (women), and LAE was defined as LA volume index &gt;42 ml/m2. LVH and LAE regression was defined as the absence of LVH and LAE on follow-up echocardiography, respectively. The occurrence of NOAF was assessed in relation to changes in LVH and LAE status.

Results
Among the 1,464 patients included in the study, 163 (11.1%) patients developed NOAF during a median follow-up of 63.8 months (interquartile range, 35.9–128.5 months). On average, 12 electrocardiograms per patient were reviewed for AF detection. New-onset LVH (adjusted HR 1.88, 95% CI 1.20–2.94, P=0.006) and LAE (adjusted HR 1.89, 95% CI 1.05–3.40, P=0.034) were significant predictors of NOAF. Conversely, regression of LVH (adjusted HR 0.51, 95% CI 0.280.91, P=0.022) or LAE (adjusted HR: 0.30, 95% CI 0.15–0.63, P=0.001) after antihypertensive therapy was associated with a reduced risk of NOAF. The risk of NOAF was higher in patients with LVH and LAE together (adjusted HR 4.30, 95% CI 2.81–6.56, P&lt;0.001) than in those with either LVH or LAE, or those with neither, as determined by follow-up echocardiography.

Conclusion
In patients with hypertension and sinus rhythm, regression of LVH and LAE following antihypertensive therapy is associated with a decreased incidence of NOAF, whereas newly developed LVH or LAE is associated with a higher risk of NOAF. The changes in left heart geometry can serve as a predictive marker for NOAF in patients with hypertension.
Conditional over-expression of heme-oxygenase 1 in myelomonocytic cells reduces AngII-induced hypertension and vascular inflammation in mice
Authors: Aluia M , Kuntic M , Daiber A , Lagrange J , Wenzel P 
Published: October 2024

Abstract

Background
Systemic arterial Hypertension is one of the most important risk factor responsible for morbidity and mortality world-wide. Angiotensin II (Ang II), a potent vasoconstrictor and key player in the renin-angiotensin-aldosterone system (RAAS) is responsible for vascular dysfunction, inflammation, and tissue damage. Heme oxygenase-1 (HO-1) overexpression may confer antioxidant and anti-inflammatory properties in Ang II-induced hypertension through its action on heme catabolism, generating carbon monoxide (CO), ferritin and biliverdin/bilirubin by the action of biliverdin reductase A (BLVRA).

Methods and results
Male 9–12-weeks-old HO-1indxLySMCre/wt and LySMCre/wt mice were infused with AngII (1mgAngII/Day/Kg) for 7 days to induce hypertension and compared to sham treatment. Blood pressure monitoring by tail-cuff method, and endothelium-dependent vasodilator studies via organ chamber system using acetylcholine (ACh) in isolated aortic segments (~4 mm), revealed that overexpression of HO-1 in myeloid cells resulted in decreased systolic blood pressure and improved endothelial function in AngII-infused HO-1indxLySMCre/wt mice compared to controls. Concurrently, increased BLVRA expression in liver tissue and elevated plasma bilirubin levels were detected by transcriptome analysis and high-performance liquid chromatography, respectively. These results were supported by a reduction in the expression of inducible cytokines and cell adhesion molecules (CAMs) in the aorta, assessed using qPCR. Bone marrow transplant experiments demonstrated that bone marrow from LysMcre mice in HO-1indxLySMCre/wt mice abrogated the protective effect of HO-1, resulting in endothelial damage and increased blood pressure, potentially due to decreased liver BLVRA expression and the accumulation of bone marrow-derived cells in the vessel wall in response to AngII. Additionally, adeno-associated viral vector (AAV) transfection targeting specifically BLVRA activity in liver lead to an increase in blood pressure values and worse endothelium relaxation, in parallel with higher oxidative stress and the blood neutrophils concentration, as assessed in whole blood by using oxidative burst method and blood count system respectively.

Conclusion
The overexpression of HO-1 in myeloid cells confers anti-inflammatory protection in AngII-induced arterial hypertension in mice. Myeloid cells bone marrow-derived overexpressing HO-1 regulate the differentiation and infiltration of pro-inflammatory immune cells in the vasculature. BLVRA expression and bilirubin levels downstream of HO-1 play a critical role in protecting against vascular damage by reducing leukocyte infiltration.
Bevacizumab-induced hypertension in patients with glioblastoma: a systematic review and meta-analysis
Authors: Machado Silva A , Menegaz De Almeida A , Bresciani Padilha L , Kendi Tsuchiya Sano V , De Oliveira Macena Lobo A , Alves Kelly F , Cezar Aquino De Moraes F , Morbach V 
Published: October 2024

Abstract

Background
Bevacizumab is a monoclonal antibody medication used as standard treatment for different types of cancers, one of them is glioblastoma, which is the most common primary brain tumor.

Purpose
We aimed to assess bevacizumab and its effects on inducing hypertension in patients with glioblastoma.

Methods
PubMed, Embase and Cochrane databases were searched until February 13th, 2024 for randomized control trials (RCTs) comparing bevacizumab alone with control or bevacizumab in combination with other chemotherapies in patients with glioblastoma. Data was examined using the Mantel-Haenszel method and we computed risk ratio (RRs) for binary endpoints and 95% confidence intervals (Cls). Heterogeneity was assessed using I² statistics. Meta-regression analysis was conducted to evaluate a possible link between the occurrence of hypertension and mortality or progression-free survival. R software version 4.2.3 was used for statistical analysis.

Results
5 RCTs and 1 non-randomized study were included with a total of 1402 patients, of whom 608 (43,36%) were assigned to the bevacizumab and 794(56,64%) composed the control group. Compared with bevacizumab, the control achieved statistically significant lower rates of hypertension occurrence (RR 6,31; CI: 2,13 - 18,65; p=0.000872; I²=54%). Subgroup analysis of bevacizumab alone versus bevacizumab in combination with other chemotherapies tended towards the combination group(RR 2,24; CI: 1,19 - 4,21; p= 0.012497; I² = 68%). Mortality was significantly higher in the bevacizumab group (OR 1,60; CI: 1,02 - 2,52; p=0,040443; I²= 0%). Progression-free survival did not reach a statistically significant difference between groups (OR 1,07; CI: 0,33 - 3,43; p= 0,907923; I²= 45%) and meta-regression analysis showed no significant link between hypertension and mortality or progression-free survival.

Conclusion
Concerning the treatment of glioblastoma, our results showed that induced hypertension is more likely to happen in patients treated with bevacizumab. Significant statistical difference in the mortality was observed between the use of bevacizumab and control. However, the current data is insufficient to determine a link between hypertension and prognostic value through meta-regression analysis.General Analysis
Trend in the prevalence, awareness, treatment and control of hypertension among adult over in Nigeria over a 4-year period
Authors: Shogade T T , Effiong B A , Udosen A U , Markson F E , Nkanga K E , Tanimowo M O , Ekrikpo U E , Ekpe E E , Ojji D B 
Published: October 2024

Abstract

Background
Hypertension is the commonest risk factor for most cardiovascular and cerebrovascular diseases, also the commonest cause of sudden unexpected death in the country. Despite concerted efforts to reduce the burden of this condition through increasing awareness, treatment and control rate of hypertension among adults in Nigeria. The rates of hypertension awareness (60%), treatment (34%), and control (12%) have been reported recently These figures need to change for the improved health of the citizens.

Objective
The study assessed the trend in the prevalence, levels of awareness, treatment, and control of hypertension among adults in urban setting in Nigeria, Sub-Sahara Africa.

Methods
This was a retrospective study. Data collected from opportunistic screening of adults aged 15 years and above in 4 urban communities during May Measurement Month from 2020 to 2023 was analyzed. Standardized protocol was used to collected data on socio-demographics and anthropometric measurements, blood pressure and pulse rate were measured using digital blood pressure monitors after patient have rested for at least 15 minutes. Hypertension was defined based on the 7th Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Data was analyzed using SPSS 22 and p-value &lt;0.05 was statistically significant

Results
We analyzed data of 2676participants. The mean age was 40.4years (SD 15·04), 68·5% of whom were women, 2.8% had diabetes mellitus, and 50·9% were overweight/obese. A third of the participants (33·9%) had hypertension, more than half of whom (57·2%) were aware that they were diagnosed of hypertension. The prevalence reduced from 39.7% in 2020 to 26.8% in 2023. Among those diagnosed, 66.5% were taking medication, and among those taking medication 32.5% had controlled blood pressure. We noted an increasing improvement in the rate of awareness from 35.4% to 72.5%, treatment from 46.7% to 82.6% and control from 5.7% to 52.3% over the 4-year period, p-value 0.000 (figure 1).
When comparing between the hypertensives and non-hypertensives; higher age group (55years and above), the presence of diabetic mellitus and overweight/obesity showed statistically significant association, all at p-value of 0.000 each (table 1).

Conclusion
Hypertension is still a major problem among urban dwellers in Akwa Ibom State, with almost every one out of three adults have the condition. Though there is a decreasing trend in the prevalence and increasing trend in the awareness, treatment and control of hypertension, these rates are still suboptimal. Urgent measures are needed to reduce the prevalence and improve hypertension control among this population.
Sleep pattern, behavior, duration and incident hypertension: results from two large prospective cohorts
Authors: Zheng Z , Liu Z , Song Y 
Published: October 2024

Abstract

Background
Poor sleep quality pose significant public health challenges globally. The objective of this study is to investigate the association between sleep quality, duration and the risk of hypertension.

Methods
284,250 adults from the UK Biobank (UKB) and 6,104 participants from the English Longitudinal Study of Ageing (ELSA) were analyzed. The exposures of interest were sleep quality and duration. Sleep quality was evaluated based on the number of healthy sleep behaviors (UKB cohort) or questionnaire adapted from the Jenkins Sleep Problems Scale (ELSA cohort). Participants were divided into three groups based on the assessment of sleep quality. Long sleep is characterized by a duration exceeding 8 hours, medium sleep ranges from 7 to 8 hours and short sleep denotes less than 7 hours of sleep. The primary endpoint was incident hypertension.

Results
In UKB cohort, participants with poor sleep quality showed significantly higher risk of hypertension compared those with healthy sleep quality (hazard ratio [HR] 1.276, confidence interval [CI] 1.21, 1.346). Short sleep duration (≤7h) was associated with an elevated hypertension risk in participants regardless of different sleep quality, and both short(≤7h) and prolonged sleep time (≥9h) were associated with an increased hypertension risk in the poor sleep quality group. Several factors were independently associated with a lower risk of hypertension, including appropriate sleep duration (7-8 hours per day), absence of frequent insomnia, no self-reported snoring(P&lt;0.001). Associations between sleep quality and an increased risk of hypertension remained significant regardless of genetic susceptibility to hypertension (P for interaction= 0.067).

Conclusions
Poor sleep quality is associated with an elevated risk of hypertension. Adjusting sleep behavior to enhance sleep quality within a recommended range could be a promising strategy for mitigating the risk of hypertension.
Systolic plood pressure response to ASi BI 690517 with and without empagliflozin in CKD
Authors: Rossing P , Hauske S J , Cronin L , Heerspink H J L , Meyerhoff J , Ji B , De Zeeuw D , Tuttle K R 
Published: October 2024

Abstract

Background and Aims: BI 690517 is a highly selective aldosterone synthase inhibitor (ASi) in clinical development for CKD treatment. Coadministration of BI 690517 with a sodium-glucose cotransporter-2 inhibitor may provide additive efficacy and also mitigate risk of hyperkalaemia. This multinational, randomised, dose-finding, Phase II trial (NCT05182840) investigated the efficacy and safety of BI 690517, given alone or in combination with empagliflozin (EMPA), for albuminuria reduction in people with CKD and with or without type 2 diabetes.1 Here, we present a secondary analysis for effects on systolic blood pressure (SBP).

Method
Adults with CKD receiving a maximally tolerated dose of a renin-angiotensin system inhibitor were randomised (R1) 1:1 to receive background EMPA 10 mg or placebo (PBO-EMPA) during an 8-week run-in. They were then re-randomised (R2) 1:1:1:1 to receive BI 690517 (3 mg, 10 mg, or 20 mg) or PBO-ASI for 14 weeks, in addition to their assigned EMPA or PBO-EMPA therapy. Participants had mean baseline SBP ≥110 and ≤160 mmHg. Elevated blood pressure (BP) was defined as SBP ≥140 mmHg or DBP ≥90 mmHg and receiving ≥2 classes of anti-HTN medication. Changes in SBP from R2 baseline to Week 14 were analysed to assess BI 690517 effects with and without EMPA use.

Results
Of 714 people randomised at R1, 586 were randomised at R2, and the treated set consisted of 583 people. Demographics and clinical characteristics were similar between dose groups.1 At R2 baseline, 169 (29.0%) people had elevated BP. Mean SBP was 142.7 mmHg in the elevated BP group versus 129.2 mmHg in the non-elevated BP group. Treatment with BI 690517 consistently reduced SBP with reductions that were comparable in people with and without elevated BP (p-value for interaction not significant) (Table).

Conclusions
In people with CKD, BI 690517 reduced SBP in people with and without elevated BP.(Table)
Prevalence and prognostic implication of left ventricular hypertrophy defined by different echocardiographic criteria
Authors: Cai A , Zheng C Y , Song Q J , Qiu J Y , Feng Y Q F , Wang Z W 
Published: October 2024

Abstract

Objective
Echocardiographic criteria of left ventricular hypertrophy (LVH) recommended in the international guidelines are derived from Caucasian population, which could be less accurate in estimating the LVH burden in other ethnic groups. LVH is a well-known prognostic factor and assessing the LVH burden based on ethnic-specific criteria have important implications. To evaluate the prevalence and prognostic implications of LVH in general Chinese population according to the criteria of the Echocardiographic Measurements in Normal Chinese Adults (EMINCA) study and the international guidelines.

Methods
Nationally representative populations aged ≥ 35 years (n=20210, mean age 56.0 years, women 53.3%) were enrolled from the China Hypertension Survey. LVH criteria of the EMINCA study was left ventricular mass index (LVMI) &gt; 109 g/m2 for men and &gt; 105 g/m2 for women; and the international guidelines was LVMI &gt; 115 g/m2 for men and &gt; 95 g/m2 for women.

Results
The prevalence of LVH defined by the EMINCA study and international guidelines was 8.3% (≈ 56.8 million) and 11.7% (≈ 80.1 million) respectively. LVH defined by the EMINCA study was associated with adjusted hazard ratio (HR) of 1.58 (95% CI 1.18-2.12; P-value=0.002) for cardiovascular death and 1.21 (95% CI 0.98-1.49; P-value=0.07) for all-cause death; while defined by the international guidelines, LVH was associated with adjusted HR of 1.33 (95% CI 0.98-1.80; P-value=0.07) for CV death and 1.22 (95% CI 1.00-1.50; P-value=0.054) for all-cause death.

Conclusions
Prevalence and prognostic implications of LVH in general Chinese population differ by different echocardiographic criteria, supporting the application of ethnic-specific criteria.Cumulative rate of outcomes at follow-upLVH and CV death and all-cause death
Gender disparities and infective endocarditis burden in the United States and European Union: a comparative analysis
Authors: Milutinovic S , Escarcega R O , Lopez-Mattei J , Petrovic M 
Published: October 2024

Abstract

Background
Despite improvement in diagnostics and treatment options, infective endocarditis (IE) remains a significant burden for healthcare systems. While high-income countries have improved diagnosis of IE, the progress in interventional cardiology with a rise in cardiac devices associated infections, and people migrations offset some of these gains.

Purpose
To the best of our knowledge, there is a lack of comparative data between high-income countries, including the United States (US) and European Union (EU).

Methods
We collected the age-standardized rates of incidence (ASIR), deaths (ASDR), and disability-adjusted life years (ASDALYs) in the US and EU from 1993 to 2019 with the Global Health Data Exchange query tool. The Bayesian geospatial regression analysis and estimated annual percentage change (EAPC) to quantify the trends in age-standardized rates (ASR) were used. The data were stratified based on the gender, year, and location.

Results
Males in the US had an overall ASIR of 17.2/100k with an increasing trend between 1993 and 2019, and an annual average rate of change of 0.8 % (EAPC of 0.8%). A similar trend and higher rates were noted in males in the EU, with ASIR of 20.9/100k and EAPC of 2.0%. For the same period, females in the US had lower ASIR than females in the EU (11.9/100k vs. 13.6/100k) , and lower annual percent change (1% vs. 1.3%).
In the US, ASDR was higher in males than females (1.6/100k vs. 1.28/100k), but females had higher annual percentage change (EAPC of 2.7% in males and 3.3% in females). Compared to US, males and females in the EU had lower ASDR in 2019 (1.2/100k in males, and 1.0/100k in females) with lower annual percentage changes of 2.5% and 1.7%, respectively.
The ASDALY was significantly higher in the US, for both males (34.6/100k) and females (25.5/100k), with a greater increase in an annual average rate of change of 2.7% in females than in males (2.2%). EU males had ASDALY of 24.9/100k with an EAPC of 1.8%, while females had 16.7/100K with an annual average increase of 1.2%. Figure 1, Table 1

Conclusion
ASIR of IE appears to be higher in the EU for both males and females. Conversely, ASDR and ASDALY manifest higher rates in the US across both genders, with females notably demonstrating a higher annual percentage increase for these metrics. Further studies are needed to assess the nature of these differences and to inform health policies.The age-standardized rates in US and EUThe differences in the EAPC
Patient reported outcomes, control of hypertension and dyslipidemia: results of two epidemiological studies in Romania, conducted during pandemia (Snapshot-1) and post-pandemic (Snapshot-2)
Authors: Ciobanu A , Vittos O , Dolofan B M , Trambitas N , Tanasescu R , Guja C , Vinereanu D 
Published: October 2024

Abstract

Background
Coexistence of hypertension and dyslipidemia is commonly found in daily practice. Patient reported outcomes (PRO) are increasingly used to guide clinical decision-making, as well as public reporting of health system performance.

Purpose
To assess patient reported outcomes (PRO: socio-economic factors, depression level, and treatment adherence) and control of blood pressure (BP) and LDL-cholesterol (LDL-C) during pandemia and in the post-pandemic period.

Methods
Two real-world, cross-sectional, multicentre, observational studies, with a similar design, were conducted in Romania during pandemia, in June 2021 (SnapShot-1), and post-pandemic, in June 2022 (SnapShot-2). They included 5004 consecutive outpatients diagnosed with both hypertension and dyslipidemia, addressing cardiologists, diabetologists, and general practitioners: 2469 in SnapShot-1 and 2535 in SnapShot-2. Patients completed a three-part questionnaire including: (1) questions on socio-economic factors; (2) Patient Health Questionnaire (PHQ-9) (Depression scale); and (3) Hill-Bone Medication Adherence Scale (HBMAS) for hypertension and dyslipidemia.

Results
Characteristics of patients were similar between studies: 65.0±10.0 years and 40.9% men (SnapShot-1), 63.6±10.7 years and 43.3% men (SnapShot-2). Most of the patients declared themselves as "adherent" to the prescribed treatment: 91.8% (SnapShot-1) and 93.0% (SnapShot-2) adherent to antihypertensive treatment; 89.6% (SnapShot-1) and 90.9% (SnapShot-2) adherent to lipid lowering treatment. Socio-economic factors were similar between studies, except education, with higher education rates in SnapShot-2 (Table 1). Compared to SnapShot-1, depression scores evaluated by PHQ-9 scale were lower in SnapShot-2, conducted post-pandemic: 5.9±4.9 for SnapShot-1, suggesting a "mild" depression level, vs. 4.9±4.6 for SnapShot-2, which is below the "mild" depression threshold. Similarly, the adherence scores measured by HBMAS were lower in SnapShot-1 vs. SnapShot-2: 33.8±3.0 vs. 34.0±2.9 for antihypertensive medication, and 33.5±3.5 vs. 33.7±3.4 for lipid lowering treatment (Table 2).

Conclusion
Data collected from two large epidemiological studies in Romania showed an improvement of post-pandemic depression rates, as well as an improvement of adherence scores. Use of PRO assessment in routine clinical practice could support identification of patients on risk for uncontrolled BP or LDL-C, in need of more intense medical care.