bluuebunny/crossref_metadata_2025_split huggingface dataset:
P121 ROLE OF AMBULATORY BLOOD PRESSURE MONITORING (ABPM) IN THE EVALUATION OF PATIENTS WITH SUSPECTED SLEEP APNEA
Authors: Geliz-vilaro Carlos , Valle Carlos Campos-Del , Mercado-Marchena Riguey , Hernandez-Nieto Bryan , Barrios-Agamez Wilfrido , Quintero-Baiz Adalberto , Urina-Triana Miguel 
Published: September 2024

Background and Objective:
Obstructive sleep apnea (OSA) often coexists with hypertension. Ambulatory blood pressure monitoring (ABPM) is essential for detecting significant blood pressure fluctuations, especially during nighttime. This study seeks to assess the role of ABPM in identifying OSA.

Methods:
We analyzed a database of patients with suspected OSA using the STOP-BANG questionnaire at a cardiology center from July 2020 to April 2024. Anthropometric characteristics, blood pressure behavior through ABPM, and sleep patterns via polysomnography were evaluated. The influence of risk predictors on OSA development was assessed using multinomial logistic regression.

Results:
The study included 38 men (50.6%) and 37 women (49.3%); 48 hypertensive patients (64%) and 27 without hypertension (27%). The average STOP-BANG score was 3.8. Of these, 92% had some degree of OSA. The mean age was 60±13.2 years. Neck circumference (NC) and total apnea-hypopnea index were 37.5 cm and 19.7 events/hour, respectively, with a predominance of REM OSA. Only NC and nocturnal diastolic pressure were significant variables. For the development of moderate OSA, NC showed significant relative risk ratios (RRR) (p=0.045). Severe OSA development was influenced by mean nocturnal diastolic blood pressure (MNDAP) and NC, with significant RRRs (p=0.007 and p=0.041, respectively). This means that for each mmHg increase in nocturnal diastolic pressure, the risk of severe OSA increases by 1.3 times compared to healthy patients, predominantly during REM sleep. Conversely, increased daytime diastolic pressure decreases this risk by 25%.

Conclusions:
An increase in mean nocturnal diastolic pressure measured by ABPM is a significant predictor of severe OSA development. This underscores ABPM's importance in evaluating patients with suspected OSA. While the STOP-BANG questionnaire is useful for initial OSA suspicion, it has limitations in identifying the most severe cases, necessitating tools like ABPM for more accurate assessment. The use of ABPM improves accuracy in detecting severe OSA and enhances understanding of hypertension phenotypes’ pathophysiology.

Table 1. Obstructive Sleep Apnea (OSA) Severity Classification and Its Correlation with Mean Nocturnal Diastolic Blood Pressure (MNDAP), Mean Daytime Diastolic Blood Pressure (MDDAP), and Neck Circumference (NC)
P125 WORKING LONG HOURS DURING MIDLIFE IS LATER ASSOCIATED WITH INCREASED ARTERIAL STIFFNESS
Authors: Milot Alain , Sisti Carolina Braga , Gilbert-Ouimet Mahée , Lavigne-Robichaud Mathilde , Brisson Chantal , Trudel Xavier 
Published: September 2024

Background and Objectives:
Arterial stiffness is an asymptomatic cardiovascular disease (CVD) risk marker, resulting from reduced ability of large proximal arteries to dilate and retract. Arterial stiffness is associated with increased CVD, independently of blood pressure (BP). Evidence suggest that tackling modifiable risk factors may alter the pathogenic process leading to CVD, by reducing arterial stiffness progression. Long working hours is a frequent and modifiable risk factor from the work environment, shown to increase the risk of CVD. There is sparse evidence about the effect of long working hours on arterial stiffness. No previous study have used carotid-femoral pulse wave velocity (PWV), recognized as the reference assessment method. This study aims to examine whether long working hours, repeatedly assessed at midlife, is associated with increased arterial stiffness at older age in a 24-year prospective study of white-collar workers in Quebec City, Canada.

Methods:
This study relied on a prospective cohort, initiated in 1991-1993 (T1) with two follow-ups after 8 years (T2, 1999-2000) and 24 years (T3, 2015-2018). Participants (N=1,629) were randomly selected for arterial stiffness measurement at T3 using carotid-femoral pulse wave velocity (PWV). Long working hours (>40 h/week) were assessed at baseline (T1) and at the first follow-up (T2). Mean differences in PWV were estimated using generalized linear models, accounting for sociodemographic factors, lifestyle-related risk factors, clinical factors and psychosocial stressors at work.

Results:
Among participants who remained actively employed over the study period, baseline (+0.54 m/s, 95% CI: 0.05 – 1.02) and repeated (+1.54 m/s, 95% CI: 0.83 – 2.26) exposures to long working hours were associated with increased arterial stiffness. No association was observed among participants who retired between follow-ups.

Conclusions:
Working long hours during midlife is associated with increased arterial stiffness, among aging workers. Workplace preventive strategies reducing long working hours may be effective to mitigate long-term arterial stiffening.
P126 LONG WORKING HOURS ARE ASSOCIATED WITH INCREASED BLOOD PRESSURE VARIABILITY
Authors: Sylvain-Morneau Marc-Antoine , Lavigne-Robichaud Mathilde , Trudel Xavier , Milot Alain 
Published: September 2024

Background and Objectives:
Elevated blood pressure variability (BPV) is associated with an increased risk of cardiovascular morbidity and mortality, independently of blood pressure values. Long working hours increase the risk of hypertension and cardiovascular diseases. The present study aims to determine whether long working hours have a detrimental effect on BPV.

Methods:
The present study relied on a prospective cohort of 3 639 white-collar workers in Quebec City evaluated at three visits: at recruitment, 3 years, and 5 years. At each visit, participants wore an ambulatory blood pressure monitor during working hours and answered a questionnaire. Work hours per week were divided into the following categories: 21 to 34 hours, 35 to 40 hours (reference group), and 41 hours or more. Working hours BPV was calculated using average real variability.

Results:
A total of 7 056 observations (n = 4 234 in women and n = 2 822 in men) were available. Systolic and diastolic BPV were higher in participants working long hours (41 hours and more per week) than in participants working 35 to 40 hours per week. These associations were robust to adjustment for socio-demographics, lifestyle-related and clinical risk factors as well as psychosocial stressors at work (psychological demand – job control and reward).

Conclusions:
Participants exposed to long working hours showed higher BPV than non-exposed participants. Intervention aiming at reducing long working hours should be considered for the primordial prevention of hypertension and cardiovascular diseases.
Average real variability of systolic and diastolic blood pressure during working hours according to hours worked per week
P133 ALTERED P-WAVE DISPERSION IN NEWLY DIAGNOSED YOUNG HYPERTENSIVES
Authors: Rufino Nuñez Harline Raquel , Carmona Puerta Raimundo , Lorenzo Martinez Elizabeth , Gonzalez Katia Hurtado , Batista Yajaira A. Flete , Sanchez Marielys Del Carmen Martinez , Calderon Jose Bernardo Gomez , Batista Joel Peñaló 
Published: September 2024

Background and objective:
P wave dispersion (Pd) is a useful electrocardiographic marker for predicting the onset of atrial fibrillation. It has been little studied in recent hypertension. The aim was to determine the behavior of maximum P wave duration (Pmax) and Pd in young hypertensive patients with recent onset and its relationship with other variables.

Methods:
A cross-sectional, prospective, comparative study was performed in 60 young men (30 hypertensive and 30 non-hypertensive). P wave measurements were obtained with 12-lead electrocardiogram. Statistical analysis included applications of simple linear correlation, sample means were compared by Student's t-test.

Results:
There were no significant differences in the baseline characteristics of both groups. Pmax (78.67 ± 5.71 ms) and Pd (42.33 ± 6.26ms) were found to be significantly prolonged (p<0.001) in the hypertensive group compared to normotensive subjects (Pmax 61.00 ± 7.69 ms; Pd 25.00 ± 8.61 ms). Pd correlated significantly (r = 0.716; p<0.001) with systolic and diastolic blood pressure (r = 0.696; p<0.001).

Conclusions:
Pmax and Pd are found to be increased in young patients with recent-onset hypertension, and these values increase in direct proportion to blood pressure figures.
P134 CHARACTERIZATION OF RISK FACTORS IN RELATION TO THE INCREASE IN CARDIOVASCULAR RISK
Authors: Moya Luis , Escobar Hugo , Santoyo Gutierrez Ana Maria , Cely Leidy Bolena , Perez Maria Valentina Martinez , Lopez Claudia Milena Alvarez , Lombo Ricardo , Castro Mauricio , Chamie Katya , Saenz Ludy , Jimenez Oscar 
Published: September 2024

Objective:
Identify risk factors and their relationship with 10-year cardiovascular risk evaluated using the modified Framingham scale, in order to promote education and healthy lifestyle habits, generating an impact on the incidence of this disease.

Methods:
A descriptive study was carried out to characterize risk factors related to a high cardiovascular risk at 10 years, based on a cross-sectional study consisting of information collection with modified Framingham surveys, for risk assessment at 10 years.

Results:
A total of 3,025 people were surveyed, where the following factors were associated with a high cardiovascular risk: diabetes with 221 people and 6.7% at high risk, obesity with 242 people with 11.2% at high risk, alcohol consumption with 938 people with 15.3% high risk and smoking with 333 people with a high risk of 5.8%.

Conclusions:
Cardiovascular diseases are the most common non-communicable diseases with considerable morbidity and mortality worldwide, especially in low- and middle-income countries. As a fundamental part of the study, the importance of risk factors and their relationship with high cardiovascular risk in a capital city of Colombia is considered, within these diabetes, obesity, alcohol consumption and tobacco consumption, the alcohol consumption as the risk factor with the biggest impact linked to high cardiovascular risk with 15.3%. On the other hand, a negative impact is evident in the relationship between obesity associated with high cardiovascular risk with 11.2% of the total the obese population, the results of this study demonstrate the association with high cardiovascular risk, revealing alcohol consumption and obesity and how it is related to the increase in cardiovascular risk according to the Framingham scale, revealing the importance of education as a fundamental pillar for the prevention of risk and development of the disease, generating new educational campaigns and studies about the relationship of the factors and their modification with healthy lifestyle habits
P135 FITNESS INFLUENCES THE RELATIONSHIP BETWEEN EXERCISE BLOOD PRESSURE AND LEFT VENTRICULAR STRUCTURE: EVIDENCE FROM THE EXERCISE STRESS TEST COLLABORATION (EXERTION) STUDY
Authors: Silva Ruiz Catalina , Sharman James E. , Otahal Petr , Staton Tony , Wahi Sudhir , Hare James L. , Selvanayagam Joseph , Venn Alison , Marwick Thomas H. , Schultz Martin 
Published: September 2024

Background.
A hypertensive response to exercise is associated with left ventricular (LV) remodelling, a principal sign of hypertensive heart disease. Fitness may modify this relationship, making clinical interpretation of peak exercise systolic blood pressure (SBP) challenging. This study examines the influence of fitness on the relationship between peak exercise SBP and LV structure.

Methods.
Cardiovascular structure and function (LV mass index (LVMI), LV relative wall thickness (RWT), cardiac output (CO) and total peripheral resistance (TPR)) were assessed at rest by echocardiography on 4,309 individuals (aged 58.6±12.7 years,52.0% male). SBP was measured at peak treadmill exercise, and fitness (exercise duration (minutes)) was grouped into thirds. Multiple regression analysis was conducted with fitness as an interaction term with peak exercise SBP, adjusted for age, sex, pre-exercise SBP, and cardiovascular disease (CVD) history.

Results.
Peak exercise SBP was similar across low (180±26.5mmHg), moderate (181±26.3mmHg) and high (182±24.5mmHg) fitness groups. Fitness modified the relationship between exercise SBP and LVMI; each 5mmHg increase in exercise SBP was associated with LVMI in moderate [0.27(0.10–0.43) and high [0.25(0.06–0.43)] fitness groups, which was not observed among those with low fitness [-0.05(-0.22–0.12)]. RWT increased with higher peak exercise SBP at all fitness levels (all p<0.001), with higher values among those with low fitness. Prevalence of LV concentric remodelling was highest in those with low fitness (29.9%) and lowest in those with high fitness (10.8%). A lower CO and higher TPR were observed in the low fitness group (7.5±2.5L/min and 14.3±5.1mmHg min/L) compared to those with high fitness (10.9±3.1L/min and 9.2±2.09mmHg min/L). Conclusion. Whilst a small effect, fitness modified the peak exercise SBP-LV structure relationship, such that for similar peak exercise SBP, those with low fitness exhibit a more adverse LV remodelling, with lower CO and higher TPR, compared to those with higher fitness. Considering fitness when interpreting SBP and cardiac imaging results from exercise stress testing may be relevant in identifying CVD risk and optimal patient management.
P144 PHENOTYPIC CHARACTERISATION OF HEART FAILURE WITH PRESERVED EJECTION FRACTION ACCORDING TO BODY MASS INDEX: SUBANALYSIS OF THE ARGENTINE ARFEY-PRESER REGISTRY
Authors: Renna Nicolás Federico , Coronel María Lorena , Echazarreta Diego , Moris Maria Cecilia , Ceballos A , Cursack Guillermo , Colque Roberto , Brocal L , Poy Carlos , Perna Eduardo 
Published: September 2024

Background:
Nutritional status, characterised by body mass index (BMI), may influence therapeutic decisions in heart failure with preserved ejection fraction (HFpEF). The objectives of this study were to identify clinical and echocardiographic characteristics associated with nutritional status and to analyse therapeutic strategies in HFpEF patients in Argentina.

Materials and Methods:
This prospective, multicentre observational registry enrolled outpatients or those discharged from hospitals, with prior informed consent. The study spanned from December 2022 to February 2024. Inclusion criteria were: 1) presence of current signs and symptoms, LVEF ≥50%, 2) structural heart disease with LVH, LAE, or average E/e’ ≥15 on Doppler, 3) elevated natriuretic peptides: sinus rhythm: NTproBNP >125 pg/ml or BNP >35 pg/ml; Atrial fibrillation/flutter: NTproBNP >375 pg/ml or BNP >105 pg/ml; and 5) commitment to 6-month and 1-year follow-ups. Exclusion criteria comprised: 1) acute coronary syndrome, 2) coronary artery bypass grafting, or valve replacement within the preceding 3 months, 3) confirmed infiltrative or hypertrophic cardiomyopathy, severe valvular disease, 4) severe illness with <1-year prognosis, and chronic renal failure on permanent dialysis.

Results:
A total of 449 patients were enrolled, with 440 having available BMI data for this analysis. Patient enrolment was consistent across centres and nationwide. BMI analysis revealed 0.7% undernutrition, 16.6% normal weight, 32% overweight, and 50.7% obesity. In Figure1 showed the analysis of clinical, laboratory, echocardiographic, and HF severity variables according to BMI. Significant differences were found in treatment, with lower use of RAS inhibitors and beta-blockers in non-normal weight patients compared to those with overweight and obesity.

Conclusions:
For a similar HFpEF severity profile, the phenotype according to BMI suggests different clinical characteristics. Underweight/normal weight patients were older, with more LAE and pulmonary hypertension, and fewer risk factors. Obesity was present in half of the cases, characterised by younger patients with a high burden of cardiovascular risk factors. This impacts the use of certain heart failure medications.
P152 PHYSICIANS’ KNOWLEDGE OF HYPERTENSION CLINICAL PRACTICE GUIDELINE AND ITS CORRELATION WITH ADHERENCE
Authors: Cruz Cuevas José D. , Villar Juan Carlos , Moreno Angélica M. 
Published: September 2024

Background:
Hypertension remains the main cardiovascular risk factor. Despite the availability of high-quality clinical practice guidelines (CPG), their implementation is suboptimal pending on several factors, including clinicians’ knowledge of the guideline. The purpose of this study is to report clinicians’ knowledge the Colombian hypertension CPG, their adherence to it and the correlation between them.

Methods:
We performed a cross-sectional study with clinicians from 5 health-care institutions in Bogotá, Colombia, who voluntarily accepted to participate. A panel of experts selected seven recommendations from the Colombian hypertension CPG and designed a 17-item questionnaire to evaluate knowledge of the CPG. We consulted electronic health-records of a consecutive sample of 20 patients with hypertension treated by the clinicians to evaluate adherence (percentage of applicable recommendations that were fulfilled) and the questionnaire was sent via email to evaluate CPG knowledge (percentage of correct answers). Pearson correlation coefficient was calculated for clinicians’ knowledge and adherence.

Results:
From 266 physicians screened, 239 agreed to participate, 68 reported treating patients with hypertension and 38 answered the questionnaire (52% male, mean age and clinical experience 35.1 and 9.8 years, respectively). The mean score of CPG knowledge was 57.9% (95%CI 56.3-59.4%) and it did not differ according to clinicians’ sex or experience. Of the 38 physicians, 27 had available records of patients with hypertension. There was no difference in the mean knowledge score of clinicians who had eligible patients and those who did not (p=0.55). The mean adherence to the recommendations of clinicians who had eligible records (n=37) was 25.81% (IC95% 20.3-31.2%). This was similar for physicians who did and did not answer the knowledge questionnaire. A moderate positive correlation was shown between knowledge and adherence to recommendations (r 0.55, 95%CI 0.19-0.76, p=0.003) (Figure 1.)

Conclusions
Clinicians’ knowledge of CPG was moderate but adherence to recommendations was poor. While adherence could be partially explained by clinicians’ knowledge of CPG, correlation was at best moderate and other factors must be considered.
P160 MODELLING CARDIOVASCULAR TOXICITY IN CELLULO ASSOCIATED WITH ANTITUMORALS
Authors: Sánchez-pérez Isabel , Herrero Jorge Melones , Villacampa Alicia , Figueiras T Sofia , Calés Carmela , Sanchez Ferrer Carlos F. , Quiroga Adoración Gómez , Peiro Concha 
Published: September 2024

Background and Objective:
Gastrointestinal cancer (GIC) stands as a leading cause of cancer-related mortality worldwide. Currently combination chemotherapy, particularly metal-based drugs, often induces side effects, limiting their clinical efficacy. Cardiotoxicity, a common complication associated with various therapeutic agents, manifests through vascular endothelial dysfunction, a hallmark of ischemic coronary disease.
Our aim is to design novel metal-based drugs with enhanced efficacy, specificity, and mitigated off-target cytotoxicity. We identified the isomers trans and cis-[PtI2(isopropylamine)2] (I5 and I6, respectively), as promising candidates against GIC, both in vitro and in vivo 1. RNA seq was performed in 6 different GIC cells. The Gene Set Enrichment Analysis (GSEA) revealed a significant enrichment of inflammation-related genes and downregulation of angiogenesis-associated pathways in treated cells.
Our objective now is to develop preclinical studies of the cardiovascular toxicity of I5 and I6.

Methods:
Cardiovascular effects of these drugs were studies using a in cellulo model system (AC16, HUVEC cell lines). Biological and biochemistry approaches and techniques were used to assess senescence, mitochondrial respiration, viability by MTS and wound healing assays.

Results:
Our findings indicate that both I5 and I6 decrease cellular viability, induce senescence (as evidenced by β-galactosidase activity), and generate reactive oxygen species compared to commonly used cisplatin. Additionally, I5 impact oxidative phosphorylation (OXPHOS) and glycolysis metabolism. Furthermore, a wound healing assay suggests that the migration of cells is modulated in response to treatment with these compounds.

Conclusions:
Accurate preclinical assessment of the effects of novel drugs on the vascular endothelium is imperative to address treatment-induced endothelial dysfunction before envisioning clinical trials. Understanding the impact of anti-cancer agents on the vascular endothelium will not only inform therapeutic strategies to prevent or reverse treatment-induced cardiotoxicity but may also serve as a vital tool for predicting, monitoring, and preventing adverse cardiovascular outcomes in patients undergoing cancer treatment.
1 Commun Biol 7, 353, doi:10.1038/s42003-024-06052-5 (2024).
P168 CHARACTERIZATION OF THE HEMODYNAMIC PATTERN OF CONTROLLED HYPERTENSIVE PATIENTS
Authors: Bang Joon Ho , Obregon Sebastian , Koretzky Martin , Dileva Ana , Fischerson Gabriela , Botto Fernando , Kotliar Carol 
Published: September 2024

Background:
Hemodynamic alterations have been described in hypertensive disease. However, we still do not know if the identification of an altered hemodynamic pattern in patients with controlled hypertension could predict cardiovascular risk or evolution of hypertension.

Objective:
to identify the hemodynamic pattern of hypertensive patients with BP values in goals.

Methods:
Controlled hypertensive subjects were recruited (n = 107) and included a control group of normotensive subjects (n: 35.9). A non-invasive hemodynamic study (Z Logic, lying down / standing) was performed, and the cardiac index (CI) and vascular resistance index (VRI) data were recorded for the determination of the hemodynamic pattern. Hypodynamic pattern was considered: CI <2.5 L / min / m2 and VRI> 2500 dynas.seg.cm-5.m2; Hyperdynamic pattern IC> 4,4 L / min / m2 and VRI <2500 dynas.seg.cm-5.m2

Results:
The SBP / DBP of the HTA group was 133.09 +/- 6.01 / 82.4 +/-7.2 mm Hg; and of the NT group was SBP/ DBP 123.6 +/- 9.7 / 75.5 +/- 8.9. The CI and VRI of the HTA group obtained was 2.81 l / m2 / min and 2842.31 dynas that, without corresponding to a hypodynamic pattern, showed a predominance of the VRI increase. In the control group of NT subjects, the values were 3.23 and 2289.23, respectively, corresponding to a normal pattern. The values obtained were different between both groups (p <.05).

Conclusions:
Controlled hypertensive patients with hypertension goals have a hemodynamics pattern with an increase in the VRI different from that of normotensive subjects. These results coincide with those reported by Ferrario and col. The relevance of the imbalance found could only be analyzed in the context of long-term follow-up to identify whether it is a predictor of CV events and / or complications.