bluuebunny/crossref_metadata_2025_split huggingface dataset:
P053 ANGIOTENSIN II RECEPTOR TYPE 1 (AT1) AUTOANTIBODIES IN PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Waraich Ms. Jotinder , Kline Gregory A. , Choi May Y. , Sigal Ronald J. , Caughlin Cori , Przybojewski Stefan J. , Leung Alexander A. 
Published: September 2024

Background:
Primary aldosteronism (PA) is a common cause of hypertension and is characterized by excessive aldosterone secretion. Determination of PA subtype (i.e., unilateral vs. bilateral) is clinically important to inform treatment. Immune mechanisms may have a role in the pathogenesis of PA. The aim of this study was to examine whether angiotensin receptor type 1 (AT1) autoantibodies predict the underlying subtype of PA.

Methods:
We conducted a cross-sectional study of patients with PA who were referred for adrenal vein sampling (AVS). Patients had AT1 autoantibody titres measured. AT1 antibodies were defined as present when >17 U/mL, negative if <10 U/mL, and indeterminate if between 10-17 U/mL. AVS was used as a standard to determine PA subtype. The frequency of AT1 autoantibodies was determined according to PA subtype and major clinical predictors of lateralization.

Results:
54 patients with successful AVS were included (mean age, 52.7 years; 46.3% male). Positive AT1 antibodies were detected in 14 (25.9%), negative antibodies in 32 (59.3%), and indeterminate antibodies in 8 (14.8%) patients. There was no significant association detected between AT1 antibody status and lateralization (p=0.39). There were no associations found between AT1 autoantibody status and any of the major clinical factors traditionally predictive of PA severity or prognosis, including sex (p=0.94), age (p=0.76), hypokalemia (p=0.91), estimated glomerular filtration rate (p=0.46), or aldosterone-to-renin ratio (p=0.58).

Conclusion:
AT1 autoantibodies are common in patients with PA; over a quarter of patients who underwent AVS in our study. However, AT1 autoantibodies were not predictive of PA subtype.
P060 A NOVEL NON-INVASIVE METHOD FOR ESTIMATING CENTRAL SYSTOLIC BLOOD PRESSURE USING AMBULATORY BLOOD PRESSURE MONITORING
Authors: Álvarez-Montoya Diego , Gallo-Villegas Jaime , Aristizábal-Ocampo Dagnovar 
Published: September 2024

Background and Objective:
Central blood pressure (BP) holds superior prognostic value compared to peripheral BP in predicting cardiovascular events. Despite its significance, measuring central BP in outpatient settings is impractical. To address this limitation, our research group devised a novel non-invasive method for estimating central systolic blood pressure (cSBP) using peripheral data based on the equation proposed by Chemla et al. However, its validity remains uncertain. The objective was to assess the validity of our new non-invasive method for estimating cSBP by comparing it to a validated brachial oscillometric method.

Methods:
A cross-sectional study was conducted, involving 132 patients who underwent 24-hour ambulatory blood pressure monitoring (24-h ABPM). A total of 8,112 BP records were obtained. The cSBP was measured during 24-h ABPM using a Custo Screen 310 device (Custo, Ottobrunn, Germany), which has been validated. The cSBP was estimated using the formula: cSBP= MAP2/DBP, where MAP2 represents the estimated mean arterial pressure using the equation: MAP2=(Ts/T) × SBP + (Td/T) × DBP, where T, Ts, and Td denote the cardiac, systolic, and diastolic periods, respectively. The SBP indicate systolic blood pressure and DBP denote diastolic blood pressure. Ts was calculated as: Ts=0.2061+ (Age/2244) + (T/8.17).

Results:
Among the participants, 53.8% were men, with an average age of 55±16 years. The average height was 1.65±0.1 m, weight 74±12 kg, heart rate 71±12 bpm, SBP 125±19 mmHg, DBP 79±12 mmHg, and cSBP 120±19 mmHg. The agreement of cSBP between the new method and the brachial oscillometric method was very good. Bland-Altman plots revealed that the differences between the methods were randomly distributed along the mean difference line (Figure).

Conclusions:
The new non-invasive method to estimate cSBP from peripheral BP data, using MAP2 and cardiac periods, has been demonstrated to be valid. The equation, which allows for the estimation of cSBP without a pulse wave, could be easily implemented in conventional 24-h ABPM systems.
P061 AMBULATORY BLOOD PRESSURE MONITORING (ABPM) CHARACTERIZATION IN PATIENTS CONSULTING A CARE CENTER IN THE CITY OF POPAYÁN, COLOMBIA BETWEEN JANUARY 2019 AND JUNE 2021
Authors: Salazar Camilo Chará , Eraso Andrés Andrade , López Nelson Adolfo , Pinzón María Virginia , Patiño Valentina 
Published: September 2024

Background:
Ambulatory blood pressure monitoring (ABPM) provides important information on the circadian behavior of this variable. This measure provides different phenotypes that can be analyzed in more depth than office blood pressure measurement. Several associations have been identified between altered circadian phenotypes, such as non dipper, and adverse cardiovascular outcomes, such as cardiovascular mortality, coronary heart disease, cerebrovascular disease, chronic kidney disease, and hospitalization for heart failure. To date, the behavior of blood pressure according to the MAPA is unknown in the population of the department of Cauca, Colombia. Therefore, our objective was to characterize the arterial hypertension profiles in a sample of this population.

Materials and methods:
A cross-sectional descriptive study was conducted in patients over 18 years of age, undergoing ambulatory BP monitoring from 2019 to 2021; data were recorded in an instrument containing sociodemographic, clinical, and therapeutic characteristics. The data were analyzed with the SPSS 25 program.

Results:
A total of 440 blood pressure monitoring (ABPM) records were obtained, of which, 80.4% of the records were found to be compatible with a diagnosis of arterial hypertension. The distribution of the profiles included: normal dipper (55.2%), attenuated dipper (non-dipper) (23.6%), inverted dipper (13.6%) and extreme dipping (1.4%). Most of the overweight and obese patients presented arterial hypertension in the ABPM records, with 41.1% being overweight patients and 25.2% obese. Regarding the arterial hypertension profiles, there were no statistically significant differences in relation to overweight and obesity.

Conclusions:
Among the BP profiles measured by ABPM in the population studied, the most prevalent was the normal dipper profile, followed by non-dipper, inverted dipper, and extreme dipper. There was a tendency for the overweight and obese population to present abnormal circadian BP profiles more frequently; however, in our study these results were not statistically significant.
P062 INITIAL EXPERIENCE WITH 24-HOURS AMBULATORY BLOOD PRESSURE MONITORING IN KEFFI NASARAWA STATE
Authors: Musango Dennis Anthony , Ebom Augustine 
Published: September 2024

Objective:
In the last 30 years or so, the techniques for measuring blood pressure to ascertain wether an individual bas hypertension or not have undergone substantial change. The traditional method of taking blood pressure in the clinic is very useful especially on the population basis but provides poor estimate of risk in an individual subject. Ambulatory blood pressure measurement has been developed to estimate the true blood pressure of an individual over prolonged periods. There is paucity of report on the experience with this technology in Nigeria. We are therefore reporting on our initial experience with ambulatory blood pressure monitoring at cardiac unit of the department of medicine, of the federal medical center keffi.

Methods:
All the procedures where carried out with Schiller BR - 102 Plus ambulatory pressure monitors and analysis done with Schiller SDS- 200 Computer system.

Results:
We report different forms of abnormalities: poor blood pressure control, non- keeping patterns, White cost effects, normal blood pressure patterns, blood pressure patterns in autonomic dysfunction etc.

Conclusion:
Ambulatory blood pressure monitoring is a useful tool in blood pressure management especially in specialized units.
P068 IDENTIFYING THRESHOLD BIAS IN RECORDED BLOOD PRESSURE
Authors: Foti Kathryn , Zhao Di , Marklund Matti , Pathiravasan Chathurangi , Choudhury Sohel , Amin Robed , Bhuiyan Mahfuzur Rahman , Jubayer Shamim , Miller Edgar R. , Appel Lawrence J. , Matsushita Kunihiro 
Published: September 2024

Background and Objective:
Even when blood pressure (BP) is measured accurately, BP may be misrecorded. “Threshold bias” occurs when BP measurements are intentionally or unintentionally recorded at values just below BP control goals and may occur due to incentives to improve BP control or to avoid medication titration. Our objectives were to 1) examine the potential for threshold bias in datasets with and without a BP control goal from two countries and 2) propose a method for detecting threshold bias.

Methods:
We examined the distribution of recorded BP measurements among individuals taking antihypertensive medication in clinical practice or trials with a BP goal <140/90 mmHg and population-based surveillance studies without a BP goal from Bangladesh and the US. Then, we explored whether surveillance data could be used as a reference to evaluate the likelihood of threshold bias in clinical data. We calculated the ratio of BP measurements recorded 10 mmHg below versus above thresholds of interest (i.e., the “threshold ratio,” or number of systolic BP [SBP] measurements 130-139 mmHg over 140-149 mmHg) and used bootstrapping to determine the probability of observing ratios that may indicate threshold bias. We compared the “threshold ratio” from clinical data to the probabilities determined from surveillance data.

Results:
Visually, we observed a cluster of measurements below SBP 140 mmHg in the clinical but not the surveillance datasets from Bangladesh and the US (Figure). Based on 10,000 random draws of 100 observations in the Bangladesh surveillance dataset, the probability of observing a “threshold ratio” of 3.56 in the clinical dataset was <2%, indicating a high probability of threshold bias. Using the same procedure in the US surveillance dataset, the probability of observing a “threshold ratio” of 2.26 in the clinical dataset was <10%, indicating potential concern.

Conclusions: Threshold
bias may be an underrecognized but common problem in clinical settings with a BP goal. Our proposed approach to detecting threshold bias should be tested in other settings.
P072 VALIDATION OF A NOVEL METHOD FOR NONINVASIVE ESTIMATION OF CARDIAC OUTPUT USING BRACHIAL OSCILLOMETRIC BLOOD PRESSURE MEASUREMENTS IN PATIENTS WITH VARIOUS CLINICAL CONDITIONS
Authors: Madrid-Muñoz Camilo , Álvarez-Montoya Diego , Fernández-Ruíz Ricardo , Gallo-Villegas Jaime , Aristizábal-Ocampo Dagnovar 
Published: September 2024

Background and Objective:
Estimating cardiac output (CO) and other hemodynamic parameters from blood pressure (BP) measurements could aid in selecting appropriate antihypertensive treatments in clinical settings. Our research group has developed a non-invasive method to estimate CO based on total arterial compliance (Ct). However, its validity in populations with various cardio-metabolic chronic diseases remains uncertain. The objective of this study is to assess the validity of our CO estimation method across different patient with varied clinical conditions.

Methods:
A cross-sectional study was conducted involving 217 adult patients who underwent ambulatory transthoracic Doppler echocardiograms, irrespective of valvular or cardiac pathology, or medication use, provided they had normal aortic valvular anatomy. Stroke volume was calculated as the product of the cross-sectional area of the aortic annulus and the average velocity of the left ventricular outflow tract. Simultaneously, oscillometric BP measurements were obtained. Subsequently, the CO values obtained via Doppler echocardiography and those estimated based on Ct were compared to determine validity. Ct was estimated as: Ct/BSA= 38/PPth + 4/5 × Td/T - 3/7, where BSA denotes body surface area, Td signifies diastolic time, T represents the cardiac period, and PPth refers to the theoretical pulse pressure.

Results:
Of the participants, 49.7% were men, with an average age of 54.0±14.0 years. Among them, three had a history of acute myocardial infarction, one had a pacemaker, nineteen were diabetic, and one hundred thirty-six were hypertensive. CO by echocardiography averaged 4.9±1.0 L/min, ranging from 2.0 to 8.5 L/min. The agreement of CO between the new method and Doppler echocardiography was good. Bland-Altman plots showed that the differences between the methods were randomly distributed along the mean difference line (Figure).

Conclusions:
The novel method for noninvasive estimation of CO based on Ct with brachial oscillometric BP measurements in patients with various clinical conditions is deemed valid. Its implementation in clinical practice has the potential to transform patient assessment.
P073 KNOWLEDGE OF HYPERTENSION AND HOME BLOOD PRESSURE MONITORING AMONG HYPERTENSIVE PATIENTS IN INDIA: RESULTS FROM THE GRAND STUDY
Authors: Maheshwari Anuj , Verma Narsingh 
Published: September 2024

Background and Objective:
Hypertension remains a significant risk factor for cardiovascular diseases in India, contributing substantially to cardiovascular mortality. Despite the rising prevalence of hypertension, blood pressure control among hypertensive patients remains low, emphasizing the need for improved hypertension management and treatment. Home blood pressure monitoring (HBPM) serves as a vital tool in hypertension management, yet its recognition and utilization in developing countries like India remain limited. This study aimed to assess the knowledge of hypertension and HBPM among hypertensive patients across 18 medical centers in 12 States in India.

Methods:
A survey was conducted among 1,920 hypertensive patients, analyzing the patients’ background, the reasons for home blood pressure (HBP) measurement and non-HBP measurement, and associated factors to knowledge levels of hypertension and HBPM.

Results:
Findings revealed that 47.5% were measuring HBP, with reasons mainly attributed to physicians’ recommendations, while cost and lack of physician guidance were common reasons for non-HBP measurement. High knowledge levels of hypertension and HBPM significantly associated with measuring HBP (OR 16.23; 11.28-23.35, P-value <0.001), however, a significant gap existed in adherence to the optimal guidelines-based procedures of HBPM with only 40.7% following any 2 out of 8 steps to measure HBP.

Conclusions:
These results highlight the necessity for increased physicians’ recommendations of HBP measurement and providing clear instructions for measuring HBP aligned with guideline-based procedures.
P075 IS OFFICE BLOOD PRESSURE MEASUREMENT SUFFICIENT FOR DIAGNOSING HYPERTENSION IN PRIMARY HEALTH CARE?
Authors: Muxeldt Elizabeth , Vasconcellos Clara , Guimarães Luana , Leite Thiago , Westgarth Harrison , Vianna Gabriel , Rezende Pedro Paulo , Neno João , Monteiro Maria Eduarda , Duarte João Felipe , De Souza Thomás , Pecly Inah , Fernandes Ana Cristina 
Published: September 2024

Background and Objective:
Recent guidelines have recommended out-of-office blood pressure (BP) measurement to improve the accuracy of the diagnosis of hypertension (HTN) but there are few studies evaluating its use in the scope of primary care. Our objective is to assess the degree of agreement between office BP and HBPM, evaluating their use in a young population assisted in primary care.

Methods:
This is a cross-sectional population study with adults between 20-50 years old registered in the Family Health Strategy. Sociodemographic, anthropometric data and CV risk factors were recorded. Office BP was the mean of 2 measurements and HBPM followed the 7-day protocol. HBPM < 135 x 85 mmHg and office BP < 140 x 90 mmHg were considered normal, identifying the 4 phenotypes: Normotension (controlled office BP and HBPM); white-coat HTN (uncontrolled office BP and controlled HBPM); masked HTN (controlled office BP and uncontrolled HBPM) and sustained HTN (uncontrolled office BP and HBPM).

Results:
475 individuals were included (male sex: 38%; mean age: 37.6 years ± 8.8 years, of which 93 (20%) had their diagnosis modified after HBPM (43 with white-coat and 47 with masked HTN). In multiple logistics regression, male gender (OR 3.87: 95%CI 1.70-8.82) was independently correlated with white-coat HTN, while obesity and prehypertension increased the risk of masked HTN by 2 and 5.5 times, respectively. Uncontrolled office BP has high specificity (89%) and low sensitivity (49%) for detecting sustained HTN, with a low concordance in the diagnosis of HTN (kappa=0.388) Among men with uncontrolled office BP, 55.6% had a diagnosis of white-coat HTN and among women, 37.1%.

Conclusion:
Office BP was not a sufficient measurement to diagnose hypertension. HBPM was a useful procedure in this young and apparently healthy population in primary care, especially in those with uncontrolled office BP to identify white-coat HTN and in those with high normal office BP, especially if they are male or obese for early diagnosis of masked HTN.
P077 IS THERE A DIFFERENCE IN THE ACCURACY OF AUTOMATED BLOOD PRESSURE DEVICES DESIGNED FOR HOME OR IN-CLINIC USE? A SYSTEMATIC REVIEW AND META-ANALYSIS OF VALIDATION STUDIES
Authors: Bothe Tomas , Bui Tan , Bao Yueyang , Chapman Niamh , Sharman James , Picone Dean 
Published: September 2024

Background and Objective:
Advances in technology mean that accurate BP measurements can be automatically performed, allowing widescale use of BP measurement at home. Despite these advances, some health professionals and patients question the accuracy of devices that are designated for use at home compared to in-clinic BP devices.
This study sought to determine if there were differences in the accuracy of home BP devices compared with in-clinic BP devices.

Methods:
A systematic review of BP measurement validation studies of automated, upper-arm devices in adults published between 1987-2023. Intended primary use of each device was extracted from the published validation study. A random effects meta-analysis was performed to estimate pooled mean BP differences across validation studies for home BP and in-clinic BP devices, compared to manual BP.

Results:
There were 210 home device, and 77 in-clinic device validation studies that met inclusion criteria. In comparison to manual systolic BP, the mean difference for home device systolic BP was 0.11 mmHg (95% CI: 0.09, 0.13), and the mean difference for in-clinic device systolic BP was 0.18 mmHg (95% CI: 0.16, 0.21). There was no significant difference in the accuracy of home vs. in-clinic systolic BP (p=0.88).
In comparison to manual diastolic BP, the mean difference for home device diastolic BP was 0.15 mmHg (95% CI: 0.13, 0.17), and the mean difference for in-clinic device diastolic BP was -0.93 mmHg (95% CI: -0.96, -0.90). There was a small difference in the accuracy of home vs. in-clinic device diastolic BP (1.08 mmHg, 95%CI: 0.44, 1.72; p<0.01).

Conclusion:
There were no meaningful differences in accuracy between home BP devices and in-clinic BP devices, showing that any validated device will yield accurate BP results if used according to standardized measurement principles.
P078 EVALUATION OF THE FREQUENCY AND GEOGRAPHICAL DISTRIBUTION OF THE USE OF AMBULATORY BLOOD PRESSURE MONITORING IN COLOMBIA
Authors: Herrera Leaño Nancy Muriel , Calvo Betancourt Lauren Sofia , Beltrán España Jesús Andres , Porras Bueno Cristian Orlando , Camargo Abello Andrés Felipe , León Sanabria Nicolas , García Peña Ángel Alberto 
Published: September 2024

Background and Objectives:
Hypertension is the main modifiable cardiovascular risk factor. However, 46% of adults with hypertension are unaware of their diagnosis. Ambulatory blood pressure monitoring (ABPM) can be very helpful in the identification of white coat and masked hypertension, offering advantages when compared to in-office measurement. Unfortunately, this method is not available at all levels of care. Particularly in Colombia, there is no information regarding the frequency of use or geographic distribution; however, it's inferred that it's more available in the most developed regions. Therefore, the purpose of this study is to evaluate the frequency of use, geographic distribution, and demographic characteristics of patients who underwent ABPM in Colombia.

Methods:
Cross sectional study, carried out through the review of the SISPRO records of Colombians aged 18 years or older, with indication of performing ABPM between 2019 and 2023.

Results:
405,396 individuals in Colombia underwent ABPM (7.7 ABPMs per 1000 inhabitants per year). 63.1% were females. The departments with the highest number of ABPM studies were Bogotá (71,709 ABPMs – 9.9 ABPMs per 1000 inhabitants per year), followed by Antioquia (45,097 ABPMs - 7.5 ABPMs per 1000 inhabitants per year) (Figure 1). Concerning age groups, the highest number of ABPM requests was between 70 and 74 years (50,103 patients), followed by the 55-59 years group (46,944 patients). 72.25% of the requests were for patients older than 50 years.

Conclusions:
Although Colombia has improved in the implementation and use of ABPM at the national level, its use predominates in women, patients aged between 70 and 74 years, and at the level of the 2 largest cities in the country. Collective efforts are required at national level to improve the implementation and registration of the ABPM.
P080 THE IMPORTANCE OF ADEQUATE BLOOD PRESSURE MEASUREMENT: ERROR IN APPROXIMATION OF THE TREND TO 120/80 MMHG
Authors: Quintero-Baiz Adalberto , Cáceres-Maldonado Sergio , Hernández-Nieto Bryan , Soler-Vanoy Luis , Mercado-Marchena Riguey , Urina-Triana Miguel 
Published: September 2024

Background and Objective:
In clinical practice, errors in blood pressure (BP) measurement are all too common carrying significant implications. Accurate BP measurement is vital, yet inaccuracies in recording can skew clinical decisions. This study investigates the widespread practice of documenting BP as 120/80 mmHg, aiming to gauge its prevalence and repercussions within a comprehensive dataset from Colombia.

Methods:
A cross-sectional analysis was conducted using data from Colombia's “High-Cost Account” in the period from 2014 to 2018 on 18,481,259 BP measurements from 4,576,091 patients, the study performed a descriptive examination, centering on the most frequently reported (medians) systolic blood pressure (SBP) and diastolic blood pressure (DBP).

Results:
The findings revealed 120 mmHg (IQR 120-130) as the median SBP and 80 mmHg (IQR 80-70) as the median DBP over the five years. This behavior was maintained consistently in the 5 regions of Colombia, except the systolic median in the Eastern Region.

Conclusions:
The tendency to approach 120/80 mmHg in BP in primary care centers in Colombia suggests a potential for underestimation or overestimation of hypertension control. This highlights the need to enhance BP measurement accuracy for effective hypertension management. Reviewing the correct methodology and using validated electronic devices is crucial to mitigate diagnostic and therapeutic errors, ensuring precise management of this prevalent condition.