bluuebunny/crossref_metadata_2025_split huggingface dataset:
P129 ASSESS THE ACCURACY OF FOUR RISK ASSESSMENT MODELS (RISKFRS, RISKWHO, RISKACC/AHA, AND RISKJBS) IN PREDICTING 10-YEAR CARDIOVASCULAR EVENT RISK IN INDIAN ACUTE MYOCARDIAL INFARCTION PATIENTS
Authors: Patil Vishal , Patil Mansi 
Published: September 2024

Background:
Despite numerous risk assessment models available for estimating the 10-year risk of cardiovascular (CV) events in individuals requiring primary prevention of CV disease, their applicability and accuracy in the Indian population remain inadequately studied. Objective of the study is to Assess and compare the predictive accuracy of four cardiovascular risk assessment models—RiskFRS, RiskWHO, RiskACC/AHA, and RiskJBS—in determining the 10-year cardiovascular event risk among Indian acute MI patients.

Methods:
In this study, 250 participants (mean age 59.4 ± 10.6 years; 205 males) without prior cardiovascular disease who experienced acute myocardial infarction (MI) were assessed using four established risk assessment models: Framingham Risk Score (RiskFRS), World Health Organization risk prediction charts (RiskWHO), American College of Cardiology/American Heart Association pooled cohort equations (RiskACC/AHA), and the 3rd Joint British Societies’ risk calculator (RiskJBS). These models estimated the participants’ predicted 10-year risk of cardiovascular events if assessed before the acute MI.

Results:
RiskWHO provided the lowest risk estimates, with 86.6% of patients estimated to have less than 20% 10-year risk. Conversely, RiskFRS and RiskACC/AHA yielded higher risk estimates (61.7% and 69.8% with less than 20% risk, respectively; p values <0.001 compared to RiskWHO). However, RiskJBS identified the highest proportion of patients as high-risk (only 44.1% at less than 20% risk, p values < 0.01 compared to all other three risk scores).

Conclusions:
In Indian patients experiencing acute MI, RiskJBS identifies a larger proportion of patients as ’high-risk’ compared to RiskWHO, RiskFRS, and RiskACC/AHA. However, further validation through large-scale prospective studies is necessary. These findings underscore the importance of tailoring risk assessment models to the unique characteristics of the Indian population and highlight the need for additional research to optimize cardiovascular risk prediction and management strategies in this demographic.
P136 EMOTIONAL DISORDERS AND CARDIOVASCULAR RISK PROFILE IN YOUNG ADULTS IN PRIMARY HEALTH CARE – MULTICENTRIC LAPARC STUDY
Authors: de Araujo Sousa Randerson José , Bernardes Gabriel Parente , e Silva Clara Serique Massaranduba , Silva Bruno Antônio Gomes , da Cruz Emilly Pinheiro , da Silva Victor Fernando Xavier Laurindo , Lima Luiz Emanuel Batista , Guizzo Maria Eduarda Bazzanelli , Fernandes Ana Cristina Tenório , Filgueiras Ligia Amaral , Muxfeldt Elizabeth Silaid 
Published: September 2024

Introduction:
Several factors are associated with the diseases genesis that affect heart and blood vessels, and emotional disorders, such as depression and anxiety, are progressively related to an increase in cardiovascular risk.

Objective:
to evaluate the cardiovascular risk profile and the prevalence of anxiety and depression in young adults receiving primary care in the Brazilian Unified Health System.

Methods:
This is a multicenter cross-sectional population study (arm of the LapARC study–Rio de Janeiro) developed in a center in Santarém, Pará, located in the Brazilian Amazon. Young adults (20 to 50 years old) were evaluated in relation to their cardiovascular risk profile, sociodemographic characteristics, anthropometry, electrical bioimpedance and laboratory tests. Blood pressure (BP) was measured in the office and Home Blood Pressure Monitoring (HBPM) was performed with a 7-day protocol. In screening for depression and anxiety, the PHQ-9 and GAD-7 questionnaires were applied, respectively.

Results:
161 individuals were included (81.4% female; mean age 39.6 ± 7.9 years). More than half of the population has 3 or more risk factors (55.9%), with dyslipidemia being the most prevalent (60.2%), followed by hypertension (55.9%) and obesity (41.0%). Women had significantly more abdominal obesity (67.2% vs 30.0%, p<0.001), with a higher percentage of body fat (42.2 ± 7.5 vs 28.7 ± 7.8%, p<0.001). Men have a higher prevalence of dyslipidemia (80.0% vs 55.7%, p<0.05). Regarding emotional disorders, we observed high prevalence in the moderate/severe category of depression (51.6%) and anxiety (57.8%), both conditions being significantly higher among women (55.7% vs 33.3%, p<0.05|63.4% vs 33.3%, p<0.05), respectively.

Conclusion:
the population, although apparently young and healthy, presented moderate and high risk, which associated with the high prevalence of symptoms of depression and anxiety, can increase the risk for the emergence of cardiovascular diseases, which supports the importance of continuing the study, in order to understand the behavior of these variables in this age group and draw attention to psychological screening and monitoring in primary health care.
P139 THE GUT MICROBIOME AS A PREDICTOR OF INCIDENT HYPERTENSION: DATA FROM A POPULATION SAMPLE OF 3055 INDIVIDUALS WITH A FOLLOW-UP OF 20 YEARS
Authors: Niiranen Teemu , Palmu Joonatan , Havulinna Aki , Jousilahti Pekka , Knight Rob , Salomaa Veikko 
Published: September 2024

Background and Objective:
Our goal was to examine the previously unknown long-term association between gut microbiome composition and incident hypertension in a representative population cohort.

Methods:
We collected fecal samples from a population sample of 3,055 non-hypertensive Finns (mean age 43.1 years; 60.8% women) in 2002. These individuals were followed up for incident hypertension until 31 December 2021 using nationwide register data. The samples were sequenced using shotgun metagenomics. We examined associations between gut microbiome composition and incident hypertension using Cox regression (alpha diversity and microbial taxa), permutational multivariate ANOVA (beta diversity) and Analysis of Compositions of Microbiomes with Bias Correction (ANCOM-BC; microbial taxa) models adjusted for conventional hypertension risk factors.

Results:
Altogether, 587 cases of incident diabetes occurred over the median follow-up of 19.8 years. Gut microbiome alpha diversity (Shannon index; p=0.98) and beta diversity (R2=0.49%; p=0.99) were not associated with incident hypertension. Furthermore, the associations between microbial taxa and incident hypertension were non-significant. In Cox regression models (Figure), two species reached an FDR-corrected P-value <0.1: Eubacterium G Ventriosum (hazard ratio per 1-SD increase 0.89; 95% CI 0.83-0.96; P=0.07) and Hespellia Stercorisuis (hazard ratio 1.16; 95% CI 1.05-1.27; P=0.098). In ANCOM-BC models, three species reached an FDR corrected P-value of <0.1: Merdousia sp000438015 (log2 fold change 0.32±0.09; P=0.06), Mitsuokella multacida (log2 fold change -0.32±0.09; P=0.06), and Scybalousia sp900543675 (log2 fold change -0.28±0.09; P=0.07).

Conclusions:
In this first-ever analysis on the association between the gut microbiome and long-term hypertension incidence, we observed that the associations between overall gut taxonomic composition and incident hypertension are weak. In addition, only a few microbial taxa reached a borderline level of significance with inconsistent results between two statistical methods. These findings suggest that the gut microbiome is not a strong predictor of future hypertension.
P140 PREVALENCE OF HYPERTENSION IN A RURAL COMMUNITY IN THE FEDERAL CAPITAL TERRITORY ABUJA (GBESSA) NORTH CENTRAL NIGERIA
Authors: Musango Dennis Anthony , Olufue Gerry 
Published: September 2024

Background:
High Blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan Africa. This has been attributed to acculturation of the populace who are rapidly adopting modern lifestyle changes.

Aim
This study aimed to describe the prevalence and identify risk factors for hypertension in rural community in the Federal capital territory in Nigeria.

Methods
A cross sectional survey of 491 households with 1,739 adults aged 18 years and above was carried out. Information about health and lifestyle was obtained from structured questionnaire interviews, followed by assessment of blood pressure (BP) and anthropometry.

Results:
There were 18.1% (95% confidence interval (CI), 16.0-20.6% participants with hypertension (defined as a systolic BP-140, diastolic BP-90mmHg or on antihypertensives medication). This prevalence of Hypertension was found to rise with age. Between the sexes males recorded a higher prevalence of 19.6% compared to 17.4%: females but this was not statistically ×2 P-value =0.34. Single and widowed subjects recorded high prevalence of 32.2% and 30.0% of Hypertension while students had low rate of 5.6%. The prevalence of Hypertension was 20.5% among farmers.Whereas, obesity (measured by WHR), alcohol intake, cigarette smoking, and family history of hypertension had no valid statistical evidence, chewing tobacco/ snuff, previously diagnosed diabetes mellitus or family history of diabetes showed statistically significant differences.

Conclusion:
This findings underscore the need for public health campaign at community levels to prevent increasing blood pressure and it's sequelae. This will involve campaigns to maintain the age- long tradition of exercise, avoidance of smoking, alcohol and weight maintenance.
P143 IMPACT OF THE NUMBERS OF COMPONENTS OF CARDIO-RENO-METABOLIC SYNDROME PLUS OBESITY ON PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION: A SUB-ANALYSIS OF THE ARFEY-PRESER REGISTRY
Authors: Renna Nicolás Federico , Cursack Guillermo , Morris Cecilia , Echazarreta Diego , Coronel Maria Lorena , Castiello G , Hernandez D , Picchio D , Brasca Daniela García , Dagun V Botelli , Canella JP Cimbaro , Escalante Juan Pablo , Franchi V , Mandredi C , Perna Eduardo 
Published: September 2024

Background and Objectives:
The primary objective was to evaluate whether the presence of combined cardio-reno-metabolic syndrome and obesity (CRM+O) in patients with heart failure with preserve ejection fraction (HFpEF) had a greater impact on cardiovascular disease (CVD).

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 of heart failure and LVEF ≥50%, 2) structural heart disease, 3) elevated natriuretic peptides. CRM+O was defined according with the number of components defined as: coronary artery disease (myocardial infarction, revascularization or ≥ 50% in one coronary artery), chronic renal disease (TFG ≤60 ml/min/1.72m2), diabetes mellitus and obesity (BMI ≥30 kg/m2)

Results:
This sub study included 388 patients, and at least one component of CRM+O was identified in 333 (86.9%), with 1, 2, 3 and 4 components in 23.8%, 30.8%, 27.7% and 4.7%. Demographics and clinical profile comparison is presented in Table 1. With the increasing number of components of CRM+O there was a higher proportion of women, sedentarism (p=0.001), smoking (p<0.001), OSA (p<0.001), hypothyroidism (p=0.010), coronary artery disease on angiography (p<0.001) and peripheral artery disease (p=0.010).

Conclusions
In patients with HFpEF, a high prevalence of combined components of CRM+O was observed, and 1 out of 3 presented at least three of them. A positive correlation between increasing in the severity and comorbidities was observed, except by inverse relationship with atrial fibrillation. These findings support the interaction among HFpEF and CRM+O syndrome and suggest the need of comprehensive, multidisciplinary management.
P145 EFFICACY AND SAFETY OF PERINDOPRIL/INDAPAMIDE/AMLODIPINE/BISOPROLOL SINGLE PILL COMBINATION IN PATIENTS WITH ESSENTIAL HYPERTENSION UNCONTROLLED ON TRIPLE THERAPY: AN INTERNATIONAL, RANDOMIZED, DOUBLE-BLIND, PHASE III TRIAL
Authors: Taddei Stefano , Bricout-Hennel Stéphanie , Asmar Roland , Petrova Parvoleta 
Published: September 2024

Background and objectives:
In hypertensive patients uncontrolled on triple therapy, guidelines recommend the addition of a fourth drug such as mineral corticoid receptor antagonists, or alternatively, a betablocker. They also support the use of SPCs at any step of the treatment to increase treatment adherence and BP control. Currently, no SPC of 4 drugs is available. This 4-month phase III trial aimed to demonstrate the superiority in BP reduction, ofperindopril/indapamide/amlodipine/bisoprolol (Per/Ind/Aml/Biso) SPC versus a free combination of Per/Ind/Aml in hypertensive patients uncontrolled on triple therapy at optimal doses.

Methods:
After a 2-month run-in period on the combination of Per/Ind/Aml at optimal doses (10/2.5/5 or 10/2.5/10 mg), patients with sustained uncontrolled essential hypertension with office SBP≥140mmHg and SBP at 24h-ambulatory blood pressure monitoring (ABPM)≥130mmHg received the quadruple SPC of Per/Ind/Aml/Biso (10/2.5/5/5 or 10/2.5/10/5 mg) or continued the same triple therapy for two additional months. Efficacy was assessed on office-SBP (primary endpoint), DBP, BP control, 24h-ABPM and home-BPM (HBPM).

Results:
183 patients were randomized: 53.0% were men, mean age was 57.4±10.6 years, mean BMI was 28.2±2.6 kg/m2, and mean office SBP/DBP was 150.35±8.49/90.09±8.23mmHg. After two months, significantly greater decrease in office-SBP (-8.0mmHg, 95%CI [-11.9; -4.0]; p<0.0001) was observed in the quadruple SPC group (n=80) versus the triple therapy group (n=83). Greater decrease in the 24h-systolic ABPM was achieved with the quadruple SPC therapy (-7.5mmHg, 95%CI [-10.9;-4.1]; p<0.0001). Higher percentage of patients achieved 24h-ABPM and HBPM control in the SPC group 51.2% vs 20.7% (p<0.0001) and 60.7% vs 25.4%, (p<0.0001) respectively. After intentional 1-day SPC omission in patient volunteers (n=28), mean 24h-ABPM remained below the 130/80mmHg target, supporting the sustained efficacy of the SPC. Both treatments were well tolerated.

Conclusion:
The first quadruple SPC of Per/Ind/Aml/Biso demonstrated its superiority to the free combination of Per/Ind/Aml, offering a new alternative to treat effectively and safely patients with hypertension uncontrolled with a combination of Per/Ind/Aml at optimal doses.
P149 HYPERTENSION AS A SILENT KILLER: DOES OUR MANAGEMENT REACH THE RECOMMENDED TARGETS: SUDAN MMM 2022?
Authors: Ahmed Amjad M. , Beheiry Hind , Abukaraig Egbal , Ahmed Medical Practitioner Omer , AbdelFatah Microbiologist Deena , Ali Internal Medicine specialist Walleed , Mahmoud Medical Practitioner Mohamed , Hago Cardiologist specialist Maha 
Published: September 2024

Introduction:
Several explanations might address the failure of antihypertensive medications: poor compliance, excessive salt ingestion, drug interactions, or an unsuspected secondary cause for hypertension. Resistant hypertension, as an additional failure cause, is relatively rare, but all patients should be considered medically treatable until proven otherwise. Therefore, we aim to explore the blood pressure readings and the current control status in hypertensive Sudanese patients.

Methods:
Utilizing the MMM 2022 Sudan screening data, participants’ BP >18 years was measured using a standard device by trained physicians for three consecutive measures, and a single mean value was calculated excluding the first reading. Participants with a history of hypertension were included in the analysis. Continuous data was presented in mean and standard deviation, and categorical data was presented in frequencies and percentages. According to current guidelines, several antihypertensive medications used were counted for each patient. All participants completed a structured questionnaire after obtaining their approval.

Results:
The study included 2,292 participants with an established diagnosis of hypertension. The mean age at diagnosis was 46±13 years, around 60% were females, and the median duration of hypertension was 5 (2, 10) years. Of these, 936 (40.9%), 790 (34.5%), and 543 (23.7%) had blood pressure exceeding SBP≥140 mmHg, DBP≥90 mmHg, and BP≥140/90 mmHg, respectively. Table 1 shows the baseline characteristics for each group. Despite the guideline recommendations to control hypertension, 78 (14.4%) were not adherent to medications, and 56 (10.3%) were taking three or more antihypertensive drugs.

Conclusions:
BP screening enables future decisions to control hypertension-related burden. Adherence to the internationally recommended guidelines will lead to achieving BP targets and prevent undesired outcomes. The subgroup of resistant hypertensive patients needs close monitoring and appropriate medical evaluation.
P150 HYPERTENSION URGENCY: GUIDELINES INDICATIONS AND IMPLEMENTATION IN CLINICAL PRACTICE
Authors: Roytberg Grigory , Bulanova Natalia , Sharkhun Olga 
Published: September 2024

Background and objective:
Unreasonable admissions to hospital increase costs of the health care system. The maximum transfer of medical care to outpatient setting is a trend in modern medicine. Hypertension urgency (HU) is not accompanied by acute hypertension-mediated target organ damage and is not an indication for hospitalization of the patient. In 2018-2020 ISH/ESH Guidelines have revised the term “HU” for “uncontrolled hypertension”, approaches to its diagnosis and treatment. The purpose of the study is to evaluate the implementation of the Guidelines in real clinical practice.

Methods:
A single-center retrospective study was conducted in a private family medicine clinic, which has been observing a large number of patients of different age and gender for more than 30 years. The clinic has an emergency department, a hospital with 60 beds. Medical records of consecutive patients aged ≥18 years admitted to hospital in 2018 and 2023 with systolic blood pressure at admission ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg were collected and analyzed.

Results:
The prevalence of patients admitted according to the chosen criteria was 0.8% (n=25) in 2018 and 0.9% (n=26) in 2023. According to the clinical characteristics and signs of acute damage to target organs (acute coronary syndrome, acute stroke, pulmonary embolism), 4% and 7.7% of cases in 2018 and 2023, respectively, were considered as hypertension emergencies. HU was diagnosed in other cases — 96% and 92.3%. HU was the direct cause of admission in 23.1% of cases in 2018 and in 28% of cases in 2023, in other cases - 69.2% (2018) and 64% (2023) hospitalization was due to another disease (pneumonia, neurological diseases, etc.). The probable causes of HU were patient non-compliance with antihypertensive drug therapy- 50% (2018) and 57% (2023), resistant hypertension, stress.

Conclusions:
The prevalence of patients admitted due to HU has not significantly changed. The most probable cause of HU is non-compliance with antihypertensive treatment, self-termination of treatment.
P153 NATIONAL SURVEY OF ARGENTINE DOCTORS ON HYPERTENSION
Authors: Sabio Rodrigo , Renna Nicolas , Valdez Pascual , Pablo Rodriguez , Camera Luis , Delucchi Alejandro , Mirofsky Matias , Diego Fernandez , Diego Marquez , Barochiner Jesica , Marin Marcos 
Published: September 2024

Background and Objective:
Hypertension (HTN) is the leading cardiovascular risk factor, yet its control remains low. Identifying factors influencing diagnosis, potential clinical inertia, and the measuring devices used is crucial.

Objective:
This study aims to understand factors in medical practice affecting HTN knowledge and control, and to assess the availability and use of blood pressure (BP) measurement devices.

Methods:
This observational, cross-sectional study is based on a 25-question self-administered survey by the Argentine Society of Hypertension (SAHA) and the Argentine Society of Medicine (SAM), targeting doctors treating HTN patients in Argentina. This report focuses on BP measurement.

Results:
A total of 1,042 responses were received, with women comprising 45.8% (n:471). Responses came from 430 cardiologists (41.7%), 380 internists (36.8%), 68 HTN specialists (6.6%), 54 primary care physicians (5.2%), and 100 from other specialties (9.7%). An own validated automatic arm BP monitor was used by 44.5%, a manual aneroid by 36.5%, an institution's validated automatic arm monitor by 10.9%, and a fixed wall aneroid by 8.2%. BP was measured in all patients by 89% of respondents, sometimes by 8.5%, and only if the patient was hypertensive by 1.7%. Ambulatory blood pressure monitoring (ABPM) was always requested before treatment by 25.2%, sporadically by 34%, never by 4.1%, and only for BP between 130/85 mmHg and 159/99 mmHg by 36.7%. The 24-hour ABPM values for initiating pharmacological treatment were >140/90 mmHg (40.9%), >135/85 mmHg (39%), and >130/80 mmHg (20.1%).

Conclusions:
Discrepancies exist in HTN patient care. Only 20% of doctors start pharmacological treatment at 24-hour ABPM values above 130/80 mmHg. Enhancing education and information could improve HTN control strategies.
P155 WHAT ARE THE SEX DIFFERENCES IN THE USE OF SINGLE-PILL COMBINATIONS IN THE TREATMENT OF ARTERIAL HYPERTENSION? RESULTS FROM HOME BLOOD PRESSURE MONITORING IN SLOVAKIA IN 2022
Authors: Vachulova Anna , Simkova Adriana , Sidlo Rastislav 
Published: September 2024

Arterial hypertension (AH) is the leading risk factor for cardiovascular morbidity and mortality for both, men and women.

Aim of the trial:
To evaluate the share of single-pill combinations (SPC) according to the gender of doctors and their patients. To evaluate the efficacy of the AH treatment with HBPM and education.

Patients and Methods:
This project was conducted from April to June 2022 at 178 general physician practices. We have enrolled consecutive adult patients willing to complete a questionnaire and take office BP and HBPM measurements.

Results:
4375 pts with AH were enrolled (2089 women, 51,8%), mean age 61,1 ± 19,1 years. The mean office BP was higher in male (136,7 ± 10,9/ 81,9 ± 7,2 mmHg), vs female patients (135±7,2/ 80,2 ± 6,2 mmHg). Mean blood pressure at home (HBP) was also higher in males (134,1± 7,2/ 81,1± 6,3 mmHg). There were 72% (129) of female doctors, participating in the trial.
The widest use of SPC was when male doctors treated male patients (70,7%). The lowest use of SPC was when female doctors treated female patients (52,1%). 44,6% of patients were treated with double SPC and 14,3% with triple. Dual SPC was the most preferred treatment when male patients were treated by male doctors (52,3%). Triple SPC strategy was used mostly when female doctors were giving care to male patients (16,8%). More patients reached optimal BP at home when treated by a male doctor (68%).

Conclusion:
Appropriate education of patients and their engagement via HBPM, led to 67% BP control. The preference for SPC by male doctors led to significantly better BP control at home, regardless of the gender of patients. By systematic rationalization of pharmacotherapy according to the 2023 ESH Guidelines, using SPC has the potential to improve adherence and increase the BP control rate in Slovakia to fulfill the initiative Charter 70/2023.