bluuebunny/crossref_metadata_2025_split huggingface dataset:
P084 BLOOD PRESSURES MEASUREMENT WITH SITTING ON THE FLOOR POSITION FOR THE HOME BLOOD PRESSURE MONITORING FOR ASIAN LIFESTYLE
Authors: Shin Jinho , Kim Byung Sik , Heo Ran , Kim Hyun-Jin 
Published: September 2024

Objectives:
The current standard method for home blood pressure (BP) measurement involves taking measurements while sitting in a chair. In cultures where floor sitting is common as like in Asian countries, the protocol only using sitting on the chair position can not be applied because of a lack of research for interchangeability.

Methods & Materials:
Among the participants who visited for evaluation of central blood pressure or pulse wave velocity, a total of 116 participants who agreed to participate in the study were randomly selected. All subjects rested for 5 minutes, and BP measurements were taken at 1-minute intervals according to a randomly assigned order of standard method (chair-sitting) and BP in a seated on the floor (floor-sitting).

Results:
Of the 116 participants, the median age was 67.5 (with an interquartile range of 59.0 to 75.0), and 82% were male. There were no significant differences in systolic BP (SBP, 127.0 [115.0, 142.2] mmHg in chair-sitting and 129.0 [115.5, 142.2] mmHg in floor-sitting, P = 0.228) and diastolic BP (DBP, 73.5 [66.0, 83.0] mmHg in chair-sitting and 72.0 [66.8, 81.3] mmHg in floor-sitting, P = 0.839) between the two positions.

Conclusions:
These findings provide important insights into securing the reliability of home BP measurements through the commonly practiced floor-sitting posture in cultures where floor sitting is common. Furthermore, this could serve as substantial evidence for providing specific home BP measurement guidelines to patients who adhere to a floor-sitting lifestyle.
P091 PROENKEPHALIN CONCENTRATION AND ITS DETERMINANTS IN PATIENTS WITH END-STAGE KIDNEY DISEASE TREATED WITH HEMODIALYSIS AND PERITONEAL DIALYSIS
Authors: Jakubowska Zuzanna , Grycuk Wiktoria , MaŁyszko Jolanta 
Published: September 2024

Background and Objective.
Proenkephalin (PENK) has been recently shown to reflect glomerular dysfunction and predict new-onset acute kidney injury and heart failure. While previous studies investigated PENK utility in individuals with preserved renal function, PENK concentration in patients with end-stage kidney disease (ESKD) remained to be established. The study aimed to assess plasma PENK concentration in patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) and peritoneal dialysis (PD) and to investigate its correlation with heart failure. Additionally, we aimed to determine whether PENK is removed during a hemodialysis session.

Methods.
88 patients with ESKD (41 females) undergoing HD (n=66, 75%) and PD (n=22, 25%) were enrolled in this cross-sectional study. Blood samples for PENK determination were collected before and at the end of the hemodialysis session in HD patients and at a single time point in PD patients. Plasma proenkephalin concentration was assessed using a sandwich ELISA immunoassay. Samples for measurement of creatinine, urea, and NT-proBNP were drawn simultaneously.

Results.
The median (IQR) plasma PENK concentration in the overall population was 1.492 ng/ml (1.071-4.380). Both median eGFR (5 mL/min/1.73 m2 [4-7] vs. 5 mL/min/1.73 m2 [4-8], p=0,856) and plasma PENK levels (1.368 ng/ml [1.068-4.030] vs. 1.706 ng/ml [1.211-5.858], p=0.305) did not differ significantly between HD and PD patients. In HD patients, median PENK concentration was significantly higher before than after hemodialysis (1.368 vs. 2.061; p=0.003). No correlation was found between PENK level and urea (p=0.192), eGFR (p=0.922), duration of dialysis (p=0.637), and residual urine output (p=0.784). Heart failure (p=0.961), EF (p=0.361), and NT-proBNP (p=0.949) were not associated with increased PENK concentration.

Conclusions.
Our study proved that PENK is not removed during hemodialysis session. PENK concentration does not reflect renal function and cardiac status in patients with ESKD. The fact that PENK is not removed by hemodialysis calls into question the usefulness of PENK as an everyday use biomarker in acute kidney injury.
P106 ENZYMES INVOLVED IN THE CATABOLISM OF TRYPTOPHAN IN THE PROGNOSIS OF BLADDER CANCER
Authors: Lemes Douglas Edgard , de Oliveira Jéssica Lopes , de Souza Gomes Gabriela , De Faria Felipe Cunha , Ramos Henrique Roman , Dellê Humberto 
Published: September 2024

Bladder cancer (BC) ranks third among the most common carcinomas in Brazil. Tumor immunology opens up perspectives for treatment, where the enzyme indoleamine 2,3-dioxygenase-1 (IDO1) stands out for degrading the amino acid tryptophan, initiating a cascade that culminates in the generation of catabolites (derived from kynurenine). These catabolites, in different associations, determine degrees of local immunosuppression. These catabolites are generated by other enzymes that have not yet been studied in BC.
We analyzed the expression of enzymes involved in tryptophan catabolism in order to correlate them with the stage, recurrence, and progression of BC.
Analysis of published microarray databases was performed using the NCBI (National Center of Biotechnology Information) and accessed through GEO Datasets (Gene Expression Omnibus). The descriptor “Bladder cancer” was used. Series that provided analysis of normal bladder tissue (Normal) versus BC, including cases of non-muscle invasive BC (CBNMI) and muscle invasive BC (CBMI), recurrence and progression. Statistical analysis was performed using the GEO2R and ROC curve was used. The transcripts were: Tryptophan 2,3-dioxygenase (TDO2), Indoleamine 2,3-dioxygenase (IDO1), Kynurenine Formamidase (AFMID), Kynureninase (KNYU), Kynurenine-oxoglutarate-transaminase 1 (KYAT1), and Kynurenine Monooxygenase (KMU).
GSE13507 series was selected, with ten Normal samples and 165 BC samples, including 104 CBNMI and 61 CBMI cases. CBNMI was predicted by KYNU, AFMID, and KYAT1 (AUC of 0.625, 0.589, and 0.638, respectively; p<0.05), while for CBMI were, IDO1, TDO2, and KMO (AUC of 0.662, 0.633, and 0.601, respectively; p<0.05). No enzyme was found to be important in predicting progression; however, the IDO1 enzyme was predictive of recurrence (AUC of 0.366; p<0.05). A relationship between the two IDO1/KYNU was established, which improved the prediction of stage for CBNMI (AUC of 0.733, p<0.05), non-progression (AUC of 0.619, p<0.05), and non-recurrence (AUC of 0.626, p<0.05).
The expression of enzymes involved in tryptophan catabolism may aid in the prognosis of BC. It is likely that these enzymes are involved in tumor immunomodulation, which will be explored in future studies.
P107 THE EFFECT OF MELDONIUM ON THE ENDOTHELIAL FUNCTION ASSESSED BY PLASMA ENDOCAN LEVEL IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Rekhviashvili Ann , Ratiani Nana 
Published: September 2024

Background and Objective:
Endothelial dysfunction is one of the main findings in patients with arterial hypertension. It is associated with atherosclerosis initiation and progression. Lately, a soluble dermatan sulfate proteoglycan Endocan is used as a marker of endothelial dysfunction in patients with big variety of diseases. Hence, aim of our study was to assess effect of competitive inhibitor of carnitine-dependent fatty acid oxidation and promoter of anaerobic oxidation via the glycolytic pathway, Meldonium, on endothelial function in patients with arterial hypertension.

Methods:
30 nonsmoker, non-obese male patients with stage II hypertension (ESH/ESC 2018) were involved in a study. 15 patients were put on recommended antihypertensive treatment plan and other 15 patients on conventional plus Meldoneum 1000 mg per day treatment for 3 months. Endocan level was tested before and after 3 months of treatment period. Hypertension was diagnosed as an average office blood pressure of three different visits equal or more than 140/90 mmHg. Written informed consent letters were obtained from all the participants.

Results:
Mean age and average blood pressure of study groups were not different between conventional and conventional plus Meldonium groups (48.6±6.94 vs 51.53±7.22 years old and 148/94 vs 151/95; P= NS for both). Initial plasma endocan level also was similar between the two groups (1.920±0.625 for Meldonium and 1.854±0.391 for conventional treatment; P=NS). In comparison with initial level, plasma endocan level significantly decreased after 3 months of treatment with conventional plus Meldonium treatment (1.920±0.625 vs 1.344±0.041; P<0.05). Statistically significant difference of endocan level change after 3 month of treatment with conventional antihypertensive agents was not observed (1.854±0.391 vs 1.75±0.649; P=NS).

Conclusion:
Obtained results indicate, that 1 g/day Meldonium on top of conventional guideline recommended antihypertensive regimen significantly improves endothelial function assessed via plasma endocan level. Further studies are needed to confirm these results on a bigger population samples.
P124 CARDIOVASCULAR RISK RE-CLASSIFICATION BY IMPLEMENTING CAROTID ULTRASONOGRAPHY IN PRIMARY CARE
Authors: Kyriakoulis Konstantinos , Menti Ariadni , Komnianou Aikaterini , Stathopoulou Panagiota , Ntousopoulos Vasileios , Mariglis Dimitrios , Theodosiadi Aikaterini , Stergiou George , Kollias Anastasios 
Published: September 2024

Background and Objective:
The accurate assessment of the total cardiovascular risk (CVR) using risk calculation algorithms in individuals with CVR factors in the primary prevention setting is essential for optimal management decisions, including drug treatment initiation and treatment goals. The aim of this study was to evaluate the contribution of ultrasonographic identification of asymptomatic carotid atherosclerosis in the re-classification of the CVR assessed with the reference SCORE2/2-OP algorithm.

Methods:
In individuals aged ≥40 years without established cardiovascular disease, the 10-year CVR was calculated using the SCORE2/2-OP algorithm (3 risk categories: low/moderate, high, and very high). Carotid ultrasound study was applied using a portable handheld device (Lumify, Philips) to classify CVR as follows: (i) low/moderate (absence of atherosclerotic plaque), (i) high (atherosclerotic plaque with <50% stenosis), (iii) very high (atherosclerotic plaque with ≥50% stenosis).

Results:
Data from 332 participants were analysed [age 59±7.5 years, men 41%, current smokers 26%, body mass index 28±5 kg/m2, office blood pressure 125±15/77±10 mmHg (systolic/diastolic), LDL-cholesterol 111±33 mg/dl]. Based on SCORE2/2-OP, 49/46/5% participants were categorised as of low/moderate, high, and very high CVR, respectively. Based on carotid ultrasound, the rates were 39/59/2%, respectively. 44% of individuals categorized as of low/moderate CVR based on SCORE2/2-OP were re-classified into a higher CVR category based on carotid ultrasound. The agreement between the 2 methods (ultrasound versus algorithms) in categorizing low/moderate and high CVR was 67% (kappa 0.35, P<0.001) and 61% (kappa 0.23, P<0.001), respectively. Among 204 participants categorized as of high/very high CVR according to carotid ultrasound, only 15 (7%) had LDL-cholesterol levels <70 mg/dl.

Conclusions:
These findings suggest that carotid ultrasonography using a portable handheld device may significantly contribute to assess CVR more accurately in primary care, especially in individuals classified as of low/moderate CVR using reference algorithms.
P132 CARDIOVASCULAR RISK ASSESSMENT IN HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES: A CROSS-SECTIONAL EPIDEMIOLOGICAL STUDY IN COLOMBIA (SNAPSHOT STUDY)
Authors: Quintero-Baiz Adalberto , Ceron Benavides Juan Alberto , Correa Ricardo Cesar Restrepo , Conta Lopez John Alexander , Ocampo Jose Dagnovar Aristizabal , Rodriguez Augusto Melendez , Triana Eric Hernandez , Serrano Osmán Alberto Perez , Cardenas Juan Mauricio , Perez Perez Julio Emiro , Rozo Vanstrahlen Jose Medardo , Gutierrez Tomasa Bermudez 
Published: September 2024

Background and objective:
Cardiovascular (CV) risk is determined by an interplay of risk factors. The goal of the study was to assess CV risk in hypertensive patients with type 2 diabetes in Colombia.

Methods:
SNAPSHOT, a cross-sectional, observational, multicenter, epidemiological study, involved patients enrolled by 20 investigators (mostly cardiologists [75.0%] and internists [20.0%]) in Colombia. CV risk was assessed by investigators and compared to the calculated CV risk based on ESC 2021 (SCORE2&2-OP) guidelines.

Results:
The analysis set included 459 patients; mean age (SD) was 68.7 (10.5) years, most patients were female (58.0%), and overweight/obese (73.4%), 21.4% were former smokers and 2.4%, active smokers. A combination of risk factors (male gender, age ≥65years, BMI≥30 kg/m2, smoking) was reported for most patients: 43.8% of patients had 1 of these risk factors, 38.1% had 2 risk factors, 6.1% had 3 risk factors, and 0.2% had all 4 risk factors. Most patients (91.7%) had at least 1 comorbidity in addition to hypertension and type 2 diabetes. Overall, 85.6% of patients had dyslipidemia, 39.7% had chronic kidney disease, and 33.8% had at least one additional CV comorbidity, mainly coronary or other arterial revascularization (18.1%) and acute coronary syndromes (13.5%). 48.4% of patients had diabetes-related target organ damage.
CV risk perceived by investigators was low (0.7%), moderate (20.9%), high (35.7%) or very high (42.7%), whereas calculated CV risk according to SCORE2&2-OP was either high (34.6%) or very high (65.4%) (Figure). The prevalence of high and very high CV risk was similar when calculated according to the 2016 (SCORE1) guidelines. Investigators estimated CV risk accurately versus SCORE2&2-OP in only 41.6% of patients, while they underestimated it in 47.9% of patients.

Conclusions:
Hypertensive patients with diabetes in Colombia are at very high risk of CV disease, but this risk is frequently underestimated by physicians. Enhancing physician education on guideline recommendations and treatment intensification could improve risk factor control.
P137 ACE AND ACE 2 ENZYMES POLYMORPHISM IN DIFFERENT CLINICAL COVID-19 MANIFESTATIONS IN HOSPITAL-ADMITTED PATIENTS
Authors: Gomes Roberto , Gomes Andreia Febba , da Silva Martins Mariana , Bello Marina Moura , Magri Lucas , dos Santos Lilian , de Oliveira Lilian Gonçalves , Torres Leuridan Cavalcante , Casarini Dulce Elena 
Published: September 2024

Introduction:
The affinity of SARS-CoV-2 for the Angiotensin Converting Enzyme 2 (ACE2), component of the Renin-Angiotensin System (RAS), is responsible for the COVID-19 virus internalization, and the ACE and ACE2 genes polymorphisms may contribute for the disease outcome. Objective: To correlate the I/D ACE and the G8790A ACE2 polymorphisms and their enzymatic activity to the virus susceptibility and the disease's clinical severity.

Methods:
408 patients from Alfa Hospital, Recife – PE, were assessed. ACE activity was measured by fluorometry and the real time PCR technique was used to assess ACE's DD, ID, and II polymorphisms.

Results:
71.9% of COVID-19 affected patients needed hospitalization, with 56.8% being male ranging from 40 to 59 years old. In the positive group, there were more patients with blood hypertension (80.6% vs 19.4%), diabetes (88.2% vs 11.8%), and obesity (87.5% vs 12.5%). ACE activity was higher in positive patients (46.5 vs 43.5 nmol/mL/min), with greater prevalence of the DD genotype, 85.6% of frequency between negatives and positives. When it comes to DD genotype, ACE activity was higher (48.5 nmol/mL/min). In patients with blood hypertension, ID genotype was more frequent than the DD one.

Conclusion:
The interaction of genetic and risk factors may lead to different COVID-19 symptomatology. The scientific literature states that ACE polymorphism may contribute for the development of blood hypertension, as the DD genotype being the susceptible one for developing cardiovascular complications by the higher concentration of Angiotensin II converted from Angiotensin I by ACE, increasing the hypertensive effects in relation to the anti-hypertensive ones of Angiotensin 1-7. The positive group showed more incidence of blood hypertension, diabetes and obesity, as well as higher frequency of the DD genotype, which is already established in literature to lead to blood hypertension due to increased ACE activity. From the observed in these results, it is suggested a correlation between ACE polymorphism and the factors that may aggravate COVID-19
P138 CORRELATION OF THE NDUFV2 RS874250 LOCUS OF THE MITOCHONDRIAL RESPIRATORY COMPLEX I NUCLEAR GENE WITH SUSCEPTIBILITY TO ESSENTIAL HYPERTENSION IN YUNNAN REGION
Authors: Guo Hao , Wu Yu Xian , Guo Li 
Published: September 2024

Background and Objective:
Essential hypertension is a multifactorial disease characterized by the interaction of genetic and environmental factors, with genetic factors accounting for 30-50%. Currently, the relevant SNPs identified through genome-wide screening analysis explain only 2-3% of the blood pressure variance. It is suggested that there is a large number of undiscovered genetic variants associated with essential hypertension. The NADH-ubiquinone oxidoreductase core subunit V2 (NDUFV2) is one of the key subunits of mitochondrial respiratory Complex I, which plays an important role in oxidative stress, inflammation, and cell death, and those are associated with endothelial cell damage, vascular remodeling, and hypertension. The study aims to investigate whether the NDUFV2 rs874250 is associated with essential hypertension.

Methods:
In total of 1437 subjects, were Chinese-Han from Yunnan province, including 824 patients with essential hypertension (378 males and 446 females) and 613 healthy controls (240 males and 373 females). NDUFV2 rs874250 was selected for genotyping and establishing 2 genetic models: a genotypic model (GG vs GA vs AA) and a super-dominant model [GA vs (GG+AA)] for all subjects.

Results:
In this study, the frequency distribution of genotypes conformed to the HWE test (p>0.05). The super-dominant model was the best genetic model for the rs874250 locus of the NDUFV2 gene. Under the super-dominant model, we found that the distribution frequency of the GA genotype in the essential hypertension group was higher than that in the control group (P<0.05), and the GA genotype was a risk factor for hypertension (OR=1.30, P<0.05). Diastolic blood pressure (DBP) and mean arterial pressure were significantly higher in GA genotype carriers than in GG+GA genotype carriers after correction for sex, age, and BMI (P<0.05).

Conclusions:
Our study indicated that the NDUFV2 rs874250 is likely to be involved in essential hypertension, especially in diastolic pressure. We postulate that GA genotype may be a risk factor for elevated DBP, which requires further validation.
P141 CHARACTERIZING HYPERTENSION AMONG RECREATIONAL CYCLISTS: THE ATLÁNTICO CYCLISTS STUDY (ACS)
Authors: Hernández-Nieto Bryan , Urina-Jassir Manuel , Mantilla-Morrón Mirary , Charris Carolina , Granadillo Anamileth , Martinez Yuliana , Mercado-Marchena Riguey , Urina-Jassir Daniela , Urina-Triana Manuel , Urina-Triana Miguel 
Published: September 2024

Background and Objective:
Physical activity is a crucial component for the prevention of chronic diseases including hypertension, diabetes, and coronary artery disease. Recent studies suggest a higher prevalence of hypertension among young athletes and active individuals. Exercise-induced hypertension (EIH), defined by elevated systolic blood pressure during exercise, is now recognized as a potential risk factor for sudden cardiac death. Cycling, a high-impact dynamic exercise, is associated with EIH. Our study aimed to determine the frequency of hypertension, EIH, and pre-exercise medical evaluation among recreational cyclists.

Methods:
A cross-sectional study was conducted on adult (≥18 years) recreational cyclists in the Department of Atlántico, Colombia. Participants were selected via convenience sampling and a structured survey was applied including demographic data, past medical history, and exercise habits. Blood pressure was measured using a validated automatic sphygmomanometer, with two post-exercise measurements taken 3 minutes apart. Weight, height, waist circumference, heart rate, and oxygen saturation were also collected. Descriptive statistics were used to summarize the findings (SPSS version 26 for Mac).

Results:
A total of 355 individuals were included. They were mostly male (84.5%) and older than 45 (75.8%). The most common comorbidities and risk factors were hypertension (22%), hypercholesterolemia (11.8%), and hypertriglyceridemia (7.3%). Furthermore, 10.4% had tobacco use disorder and 65.3% had a body mass index consistent with overweight/obesity (Table 1). No patients fulfilled the criteria for EIH (defined as systolic blood pressure exceeding 210 mmHg for men and 190 mmHg for women). Only 20.6% (n=73) underwent medical evaluation before starting to cycle.

Conclusions:
In this sample of recreational cyclists, we did not identify any cases of exercise-induced hypertension. Despite the number of comorbidities, only one of every five participants had a prior medical evaluation before exercising. Further measures to encourage routine health screening in this population are needed.

Table 1. Baseline characteristics and blood pressure results among recreational cyclists (n = 355)
P146 EFFECT OF HOME BLOOD PRESSURE TELE-MONITORING PATHWAY WITH PHARMACIST CASE MANAGEMENT TO SUPPORT PATIENTS DISCHARGED FROM EMERGENCY DEPARTMENT WITH ASYMPTOMATIC HYPERTENSION: A STUDY PROTOCOL FOR MULTICENTRE RANDOMIZED CONTROLLED TRIAL (TEC4HOME-BP)
Authors: Tran Karen , Kuyper Laura , Mangat Birinder , Ringrose Jennifer , Kim-Sing Chad , Lindsay Heather , Dahri Karen , Dawes Martin , Wong Hubert , Coderio Jennifer , Mak Meagan , Novak-Lauscher Helen , Khan Nadia , Ho Kendall 
Published: September 2024

Background and Objectives:
Severely elevated blood pressure (BP) in the emergency department (ED) has recently been associated with undiagnosed hypertension and adverse cardiovascular outcomes, regardless of the initial reason (e.g.: pain or anxiety) for the ED visit. Clinical uncertainty exists on how best to manage severe asymptomatic BP post-discharge from the ED. In this study protocol, we propose home BP telemonitoring with pharmacist case management intervention on participants discharged from the ED with severe asymptotic hypertension. The overall purpose of this trial is to evaluate whether home BP telemonitoring and pharmacist case management can improve BP management in participants discharged from the ED with severe asymptotic hypertension and whether participants find this intervention to be acceptable.

Methods:
The study is a multi-centre, randomized controlled trial of 408 participants discharged from the ED with severe hypertension (defined as average of 3 readings systolic blood pressure [SBP] ≥ 160 mm Hg and/or diastolic blood pressure [DBP] ≥ 100 mm Hg over 3 readings). Participants will be randomized to either usual care or home BP telemonitoring and pharmacist case management for 12-months. The primary outcome is proportion achieving disease specific SBP control using 24 h ambulatory BP monitoring (ABPM) at 12-months. Secondary outcomes are change in SBP and DBP based on 24 h ABPM and home BP averages at 6- and 12-months. Patient acceptability and satisfaction will be assessed using EuroQoL 5-level EQ5 version and patient Satisfaction Questionnaire Short Form. Exploratory outcomes include adverse events, prescription of anti-hypertensive medications, fidelity of interventions and health care utilization.

Conclusions:
Results from this study will advise the integration of home blood pressure telemonitoring and pharmacist case management pathway as key clinical strategy to improve patient flow in the ED, reduce length of stay in the ED, and improve BP control in patients with asymptomatic severe hypertension in the ED.

Trial registration:
ClinicalTrials.gov: NCT 06303206