bluuebunny/crossref_metadata_2025_split huggingface dataset:
P079 HOME BLOOD PRESSURE SCREENING IN MAY MEASUREMENT MONTH 2022 USING THE ZOE HEALTH STUDY APP
Authors: Kerr Gabriele , Beaney Thomas , Schlaich Markus , Schutte Aletta , Stergiou George , Berry Sarah , Spector Tim , Poulter Neil 
Published: September 2024

Background and Objective:
May Measurement Month (MMM) is a global blood pressure (BP) screening campaign with aims to raise awareness of raised BP. In 2022, MMM incorporated home BP measurements from UK users of the ZOE Health Study app. We compare rates of hypertension prevalence, treatment, and control amongst ZOE app users with other European non-ZOE MMM participants.

Methods:
Adult (≥18 years) UK ZOE app users were invited to participate in MMM in 2022. ZOE participants were advised on taking three home BP measurements and non-ZOE participants had three standardised seated BP measurements in a range of facilities outside the home. All participants completed a questionnaire including demographics and antihypertensive medication use. Hypertension was defined using thresholds for clinic BP (≥140/90 mmHg) for non-ZOE participants and thresholds for home BP (≥135/85 mmHg) for ZOE participants, based on the mean of the second and third measurements, and/or taking antihypertensive medication. Awareness was defined as having a previous diagnosis of hypertension or treatment with antihypertensive medication.

Results:
A total of 50,200 ZOE participants were screened in MMM22, of whom 94.0% were over 50 years of age and 65.8% were female. 24,967 (49.7%) were hypertensive, of whom 19,356 (77.5%) were aware, and 18,195 (72.9%) were taking antihypertensive medication, and 11,454 (45.9%) were controlled to <135/85 mmHg.
Compared to the other 64,256 MMM22 European participants (mean age 53.6 [SD 16.8] years, 58.7% female), ZOE participants had slightly higher rates of hypertension (49.7% vs 48.9%), and greater proportions of ZOE hypertensive participants were aware (77.5% vs 70.8%), treated (72.9% vs 63.3%), and controlled to <135/85 in ZOE participants and <140/90 mmHg in non-ZOE participants (45.9% vs 30.9%) (p<0.001 for all).

Conclusions:
In this large UK sample of ZOE users with hypertension, a higher proportion were aware, treated and controlled than amongst other European MMM screenees with hypertension. These digitally-enabled ZOE users apparently have greater access or engagement with effective BP management strategies.
P081 ASSOCIATION BETWEEN 24-HOUR BLOOD PRESSURE VARIABILITY AND FALLS
Authors: Reynolds Kristi , Wei R , Bowling C.B. , Cannavale K , Harrison TN , Qian L , Muntner P , Schwartz JE , Sim JJ , Shimbo D 
Published: September 2024

Background and Objective:
Clinicians may worry that fluctuations in blood pressure (BP) put older adults at risk for falling. While many adults taking antihypertensive medication have high BP variability (BPV), associations between higher BPV and risk of falls among older adults taking antihypertensive medication are unknown.

Methods:
We conducted a prospective cohort study of adults ≥65 years old taking antihypertensive medication recruited from a US integrated healthcare system. Information on demographics, clinical characteristics, geriatric assessments, mean clinic BP, and 24-hour ambulatory BP monitoring was collected at a baseline visit. Participants recorded falls over one year using monthly falls calendars. BPV was assessed as 24-hour standard deviation (SD) weighted for day-night BP. Participants were grouped into quartiles of 24-hour SD of systolic BP (SBP) and diastolic BP (DBP), respectively. We used multivariable Cox proportional hazards models to examine the association between BPV and time to first fall comparing the highest quartile to the three lower quartiles of these BPV measures.

Results:
We analyzed 608 participants [mean age 74.6 years, 14% Asian/Pacific Islander, 22% Black, 18% Hispanic, 45% White, and 57% female]. During follow-up, 238 participants (39%) experienced at least one fall. The incidence rate per 100 person-years of falls was 52.2 (95% CI, 44.9-60.6) in the lower quartiles of SBP variability and 65.0 (51.1-82.7) in the highest quartile. Higher 24-hour BPV was not associated with a higher risk of falls in the overall population (adjusted HR 1.17, 95% CI 0.86-1.58 for SBP and 1.09, 95% CI 0.81-1.48 for DBP). The results did not differ across subgroups defined by age, sex, race and ethnicity, and history of falls. However, higher BPV among individuals with clinic SBP ≥140 mmHg at baseline was associated with an increased risk of falls (Table).

Conclusions:
In this study of older adults with treated hypertension, higher BPV was associated with a two-fold increased risk of falls only among adults with clinic SBP ≥140 mmHg at baseline.
P090 VASCULAR GROWTH FACTORS AND ARTERIAL STIFFENING IN YOUNG PEOPLE FROM THE 1986 JAMAICA BIRTH COHORT
Authors: Bennett Nadia , Ferguson Trevor , Younger-Coleman Novie , Tulloch-Reid Marshall , Wilks Rainford , Cruickshank J Kennedy 
Published: September 2024

Background and Objective:
Vascular growth factors (GFs), as endothelial (VEGF), epidermal (EGF), and angiopoietin 1 (Angp1) and 2 (Angp2) promote blood vessel growth in early and later life. Increased arterial stiffness as aortic pulse wave velocity (PWV) is a powerful indicator of prognosis, independent of blood pressure (BP). Few studies have examined impacts of GFs epidemiologically although VEGF inhibitors eg; for macular degeneration, can cause steep BP rises. We tested the hypothesis that these factors measured aged 18-20y in a Caribbean cohort would be related to arterial function as PWV in the same people 10 years later.

Methods:
Participants were restricted to a cohort subset born in Jamaica September-October 1986 with PWV at 28-30y. Socio-demography and anthropometry were recorded at 18-20 and 28-30yo visits, with serum stored at -70o from 18-20y with GFs measured by Elisa assays. Analyses were mainly by linear regression, as separate then if significant, combined models. Other included risk factors (RFs) were age, sex, smoking education, BMI, mean BP and their change over follow-up.

Results:
In 387 participants (47% male) at 28-30y, median serum GF concentrations ranged from VEGF 103.7 pg/ml to EGF 949.6 pg/ml with Angp1 70.8pg/ml Angp2 907.8 pg/ml with male:female differences in BMI (26.3:28.5 kg/m2), smokers (29.7:2.4%) tertiary education (22: 38%), SBP (114:108mmHg), MAP (85.5:85.5mmHg) and PWV (6.4:6.8 m/s).
In the final multivariable model, VEGF (Beta, 95% CI) 0.13, 0.05-0.22; p=0.003, with gender, BMI, MAP and their changes over 10y were all independently and positively related to PWV (all p<0.001). EGF's marginal inverse relationship was not significant and Angp1 or Angp2 were unrelated alone, or jointly in the same model.

Conclusion:
At 18-20y, VEGF concentrations were positively and independently related to aortic PWV indicating arterial stiffening at 28-30y, as were other standard risk factors. These data suggest that VEGF may in part drive such stiffening/ remodeling over time, aggravated by other standard RFs.
P094 HYPERTENSION AT ADMISSION AFFECTS THE RESULTS OF CARDIAC SCINTIGRAPHY IN THE ELDER PATIENTS WITH ISCHEMIC HEART DISEASE
Authors: Sakida Miho , Hirai Takumi , Miyahara Yuiko , Kubo Kazuhiko 
Published: September 2024

Background and Objective:
The heart disease is the second most common cause of death after cancer in Japan. Since a myocardial ischemia leads directly to life prognosis, the evaluation of severity of myocardial ischemia is very important to reduce mortality in the patients with ischemic heart disease. The cardiac scintigraphy is less-invasive method to check it than cardiac catheter while results of cardiac scintigraphy are affected by aging and hypertension. The aim of this study is to evaluate the effect of both aging and hypertension at admission on the results of cardiac scintigraphy in the patients with ischemic heart disease.

Methods:
We recruited 102 patients with ischemic heart disease who were admitted to Chidoribashi General Hospital and underwent cardiac scintigraphy from April 2021 to March 2023. The various parameters such as patient's profile and results of cardiac scintigraphy were collected from electric medical records retrospectively. The comparison was statistically tested using JMP Pro 17. This study was approved by our ethical committee.

Results:
Thirty-one patients were under 70 years old and seventy-one patients were 70 years old or more. In elder patients, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and the difference of LVEDV from LVESV at rest were more in the patients with hypertension at admission than in the patients without that. In contrast, no difference existed in younger patients.

Conclusions:
These results suggest that aging may change the ischemic status affected by hypertension.
P102 PH-SENSOR GPR68 PLAYS A ROLE IN THE CARDIOPROTECTIVE EFFECTS OF A HIGH FIBRE DIET
Authors: Dinakis Evany , Xu Chudan , Jama Hamdi , Muralitharan Rikeish , Xie Liang , Mackay Charles , O’Donnell Joanne , Marques Francine 
Published: September 2024

Background/Objective:
Dietary fibre lowers blood pressure (BP) via short-chain fatty acids, acidic metabolites released from fibre fermentation by the bacteria in the large intestine. This acidic microenvironment may activate pH-sensing receptor GPR68, expressed primarily on immune cells, which play a crucial role in BP regulation. Here, we aimed to investigate whether GPR68 confers the cardioprotective effects of a high-fibre diet in hypertension by regulating inflammatory responses.

Methods:
6–8-week-old male wildtype (WT) and GPR68-deficient (Gpr68-/-) fed a control or high-fibre diet underwent subcutaneous implantation of minipumps containing Angiotensin II (0.75 mg/kg body weight/day, 4 weeks, n=8/group). BP was measured weekly by tail-cuff. Morphometric, histological, and flow cytometric analyses were performed following the 4-week protocol.

Results:
High-fibre-fed WT mice exhibited blunted elevations in systolic BP (week 4; p=0.0508) and lower cardiac interstitial collagen deposition (p=0.0495) compared to WT mice fed a control diet. However, high fibre did not lower BP (week 4; control vs high-fibre, p=0.689) or cardiac collagen deposition (p=0.842) in Gpr68-/- mice. High-fibre-fed WT mice exhibited improved aortic elastin content compared to control-fed WT mice (p=0.0503), whereas this remained negligible in Gpr68-/- mice (p=0.885). Flow cytometric analysis revealed that high fibre decreased aortic macrophage (p=0.0072) and neutrophil cell counts (p=0.0273) in mice, irrespective of genotype. High fibre also decreased overall renal immune cell counts (p=0.0213) and dendritic cells (p=0.0488) in mice, irrespective of genotype. Finally, high fibre-fed mice had overall decreased circulating immune cell counts (p=0.0264), specifically CD8+ T cells (p=0.0235), and γδ T cells (p=0.0264).

Conclusions:
High fibre intervention on Angiotensin II-treated GPR68-deficient mice did not lower their BP or cardiac fibrosis. All angiotensin II-treated mice fed a high-fibre diet exhibited prominent changes in various immune cell populations, irrespective of genotype. Nonetheless, this study provides novel insight that GPR68 is involved in the cardioprotective effects of a high-fibre diet. This is most likely via in an immune-independent manner, warranting further investigations into its underlying mechanisms of action.
P105 RENAL DENERVATION WITH SPYRAL SIMPLICITY SYSTEM: A SINGLE CENTER EXPERIENCE IN COLOMBIA
Authors: Sanchez Velásquez Alejandro , Jagua Ana María García , Dukón María del Pilar González 
Published: September 2024

Background and Objectives:
Hypertension is the leading cause of death with 10,4 million deaths and 218 disability adjusted life years (DALYs) worldwide in 2017. Despite GDMT, about 10 to 20% of hypertensive subjects will be poorly controlled, meeting the definition for difficult to treat (DTTH) and refractory hypertension (RH). Renal denervation (RDN) with Spyral
Simplicity SystemTM has become a promising nonpharmacological treatment for DTTH and RH, and it has shown to be an effective and safe procedure for RH patients in randomized clinical trials with up to 12 months follow-up.

Methods:
This is a single-center registry including 6 adults with DTTH and RH confirmed by ABPM and without secondary hypertension, underwent RDN in a tertiary hospital in
Bucaramanga, Colombia. A 6-months follow-up was performed, recording clinical data (symptoms, NYHA functional class, number and type of antihypertensive medications, heart rate and ER visits) and paraclinical tests (ABPM, eGFR and echocardiogram).

Results:
Mean age was 73 ± 4,64 years-old with 50% females. Main comorbidities were dyslipidemia (100%), cardiovascular disease (100%), and type 2 diabetes (83,3%). Pre-procedural medication average was 5. All patients were in NYHA II, with preserved left ventricular EF and mild to moderate diastolic disfunction. At 6 months of follow-up, there was a mean reduction in systolic blood pressure (SBP) of 10 mmHg (145 to 135 mmHg) in ABPM and 26 mmHg (169 to 143 mmHg) in office. There were not significant changes between pre- and post-procedural mean HR (68 vs. 61 bpm), neither short- or long-term complications associated with the procedure. In average, one drug withdrawal was observed. All the subjects improved their NYHA functional class. There were no ER visits in the 6-month follow-up.

Conclusions:
RDN is effective and safe for patients with DTTH and RH, achieving significant reduction in ABPM and office SBP, reducing medication number, improving NYHA functional class and avoiding visits to ER in the mid-term follow-up.
P114 SHORT-TERM EFFECTS OF BLOOD PRESSURE LOWERING DRUGS ON CARDIOVASCULAR EVENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED, PLACEBO-CONTROLLED, DOUBLED-BLIND TRIALS
Authors: Gnanenthiran Sonali , Kaistha Prachi , Pant Rashmi , Dhurjati Rupasvi , Kumar Amit , Haghdoost Faraidoon , Kota Vidyasagar , Wang Nelson , Rodgers Anthony , Salam Abdul 
Published: September 2024

Background and Objective:
There remains uncertainty about the short-term effects of blood pressure (BP) lowering drugs on cardiovascular events. This meta-analysis of double-blind, short-term randomised trials, evaluated the effect of BP-lowering drugs on cardiovascular events compared to placebo.

Methods:
A systematic search was performed in the following databases: MEDLINE, Cochrane Central Register of Controlled Trials, and Epistemonikos. Trials satisfying the following criteria were included: (i) randomized, double-blind placebo-controlled trials of 2-26 weeks published in English language; (ii) adults (age ≥18 years) with hypertension (BP ≥140/90 mmHg) or taking BP-lowering drugs; (iii) intervention: oral fixed dose of BP-lowering drug(s) as either monotherapy or combination therapy from five major classes (angiotensin converting enzyme, angiotensin-II receptor blockers, calcium channel blockers, beta-blockers, and diuretics); (iv) placebo comparator; (v) reported data on cardiovascular events; (vi). The primary outcome was major adverse cardiovascular events (MACE), defined as stroke, transient ischaemic attack (TIA), myocardial infarction, heart failure, angina or coronary revascularisation.

Results:
451 trials (93121 participants [mean age 54yrs, 56% males, mean follow-up 8 weeks] were included. There was no effect of the intervention compared to placebo on MACE (0.19% versus 0.43%; relative risk [RR] 0.89, 95% CI 0.69-1.14, p=0.35). There was a significant reduction in stroke (0.01% versus 0.05%; RR 0.37 [0.19-0.72]; p<0.001) and TIA (0.001% versus 0.01%; RR 0.26 [0.08-0.82]; p=0.02). Subgroup analysis suggested combination therapy provided the most benefit in stroke reduction (RR 0.21 [0.04-1.01], p=0.05), but benefits were observed across all anti-hypertensive groups for TIA outcomes. There were no between group differences in all-cause or cardiovascular mortality, myocardial infarction, heart failure hospitalization, angina or coronary secularization.

Conclusions:
This meta-analysis of placebo-controlled RCTs demonstrated reduced stroke and TIA events with BP-lowering drugs even at short-term follow up. These findings suggest BP lowering treatment should be initiated as soon as possible in at risk individuals because even 8 weeks of treatment can significantly reduce the risk of stroke/TIA.
P127 TO INVESTIGATE THE ASSOCIATION BETWEEN BODY MASS INDEX(BMI) AND NECK CIRCUMFERENCE FOR ASSESSING THE RISK OF DEVELOPING HYPERTENSION
Authors: Patil Mansi , Patil Vishal 
Published: September 2024

Background:
This study investigates the association between body mass index (BMI) in combination with neck circumference and the risk of developing hypertension.

Methods:
Participants (35,000) were selected from the 2021 May Measurement Month participants, comprising normotensive individuals. We categorized participants into four groups based on BMI and neck circumference. Neck circumference was then analyzed for its association with BMI in both females and males. Receiver operating characteristic (ROC) analysis was conducted to determine the best cut-off values for predicting central obesity, and the area under the curve (AUC) was compared between neck circumference and BMI.

Results:
Following a median observation period of 2.1years, hypertension was diagnosed in 22,400 (64%) participants. Groups 2, 3, and 4 displayed notably elevated hypertension risks compared to Group 1, exhibiting hazard ratios (HRs) of 1.066 (95% CI: 1.025, 1.110), 1.322 (95% CI: 1.235, 1.415), and 1.422 (95% CI: 1.337, 1.512), respectively. Moreover, integrating BMI into a conventional model yielded a more substantial enhancement in hypertension prediction than neck circumference alone. Concurrently assessing BMI and neck circumference further improved hypertension risk estimation accuracy.
Neck circumference demonstrated significant correlations with waist circumference in both females and males, with respective b-coefficients of 1.03 (95% CI: 0.85, 1.21) and 0.74 (95% CI: 0.54, 0.70). Receiver operating characteristic (ROC) analysis identified neck circumferences ≥36 cm in females and ≥40 cm in males as optimal thresholds for predicting central obesity. Additionally, the area under the curve (AUC) for neck circumference (0.71; 95% CI: 0.72–0.77) in predicting central obesity surpassed that of BMI (0.77; 95% CI: 0.78–0.82).

Conclusion:
Individuals with elevated BMI and neck circumference face an increased risk of developing hypertension. While BMI proves to be a predictor of hypertension risk, neck circumference is a superior predictor. Utilizing both measures together enhances hypertension risk prediction accuracy. This underscores the importance of considering both BMI and neck circumference in assessing hypertension risk among individuals.
P151 RECOMMENDATIONS FOR HOME BLOOD PRESSURE MEASUREMENT ARE INCONSISTENT BETWEEN INTERNATIONAL GUIDELINES
Authors: Clapham Eleanor , Slater Kaylee , Picone Dean , Chapman Niamh 
Published: September 2024

Background and objective.
Recommendations made across blood pressure (BP) guidelines should use consistent messaging to inform patient education for home BP measurement. It is not known if recommendations for home BP measurement are consistent across BP guidelines, which was the aim of this study.

Methods.
Recommendations for home BP measurement were extracted verbatim from six BP guidelines and expert consensus statements (Australian, United States, Canadian, European, International and Japanese). Consistency between BP guidelines was assessed by head-to-head comparison of recommendations and classified as inconsistent if the recommendation was not differed from one or more other recommendation. Analysis was conducted independently by two investigators (EC, KS) and conflicts adjudicated by two other investigators (NC, DP).

Results.
In total, 101 recommendations for home BP measurement were identified, and each guideline contained a median of 33 recommendations. Forty-four recommendations (44%) were present in two or more of the six guidelines. The only recommendation made by all six guidelines was to measure BP in a seated position. Forty-nine recommendations (49%) were inconsistent with at least one other recommendation. Twenty-nine of these recommendations (59%) contained a time parameter such as how many days to measure BP at home and how long to abstain from caffeine or tobacco usage prior to measurement. All recommendations on choosing and fitting a BP cuff were inconsistent, except the recommendations to fit the cuff to a bare arm and choose an appropriately sized cuff.

Conclusion.
There is a lack of consistency in the recommendations made for home BP measurement by international guidelines. Harmonisation across BP guidelines is needed to create clear, unambiguous messaging in guideline recommendations to support implementation of evidence-based care for home BP measurement and management.
P154 GETTING OPTIMAL AND TARGET BLOOD PRESSURE IS MORE CHALLENGING FOR HYPERTENSIVE PATIENTS WITH ANOTHER CARDIOVASCULAR DISEASE
Authors: Vachulova Anna , Simkova Adriana , Sidlo Rastislav 
Published: September 2024

Home blood pressure monitoring (HBPM) compared with office-based monitoring could be better at predicting cardiovascular morbidity and mortality.

Patients and Methods:
This project aimed to evaluate HBPM in adult pts with AH. It was conducted from April to June 2022 at 178 general physicians practices in Slovakia.

Results:
4375 pts with AH were enrolled (2089 women, 51,8%), mean age 61,1 ± 19,1 years. BP values at HBPM decreased over the period of seven days by -2.2/-1.4 mm Hg (p < 0.01). The first treatment goal, office BP ≤ 140/90 mm Hg, was achieved by 67% of patients. The second treatment goal, based on patients’ age was achieved by 35% of patients. The number of patients with CV comorbidities surpassed 48.8%. They were significantly older 67,3± 15,2 years vs 57,1 ± 12,6 years (p<0,01), with a higher BMI of 30,1± 5,2 kg/m2vs 28,7 ± 3,8 kg/m2 (p<0,01) in comparison with patients without CV comorbidities. In HBPM patients with CV comorbidities have higher both systolic BP (SBP) and diastolic BP (DBP) 134,8 ± 11,2/80,3± 7,6 mmHg vs 131,9±8,2/80,4 ±6,4 mmHg (p<0,01). To compare with office blood pressure measurements: higher SBP was in patients with CV comorbidities 137,1 ±18,1 mmHg vs 135,2 ±16,3 mmHg (p 0,516), higher DBP was in patients without CV comorbidities 81,5 ±6,4 mmHg vs 80,3 ± 5,1 mmHg (p<0,01). Dyslipidemia was present in 67% of patients. Women were more likely to have dyslipidemia and hypertension 68,8% vs 65,5% (p=0.03) in men.

Conclusions:
The results of office and home BPM 2022 demonstrated active involvement of patients in the management of AH can have a significant impact. We need to be more consistent in treating AH, according to 2023 ESH guidelines, mainly in patients with cardiovascular comorbidities. By achieving a 67% success rate in control of AH patients, The Charter 70/2023 is imminent.