bluuebunny/crossref_metadata_2025_split huggingface dataset:
O101 THE ANGIOTENSIN II TYPE 1 RECEPTOR-BIASED AGONIST REDUCES BLOOD PRESSURE IN SPONTANEOUSLY HYPERTENSIVE RATS AND RESTORES VENTRICULAR HYPERTROPHY BY AFFECTING THE CONNEXIN 43 PATHWAY
Authors: Fan Xin , MA Jie , Yu Jing 
Published: September 2024

Purpose:
Hypertension is one of the common causes of cardiovascular diseases. Long-term hypertension can lead to structural and functional impairment of the heart. Therefore, active treatment of hypertension is highly significant in preventing target organ damage. Angiotensin II (AngII) plays a crucial role in hypertension-induced cardiac hypertrophy. Reportedly, TRV027, an AngII type 1 receptor (AT1R) biased agonist, can competitively bind to AT1R and inhibit the AngII-induced damage. Whether TRV027 could lower blood pressure and treat hypertensive cardiac hypertrophy remains unknown.

Methods:
Spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats were selected, and some of the SHRs were administered with TRV027. H9C2 cells were utilized for in vitro study to explore the underlying mechanism of TRV027. A multidisciplinary approach combining pathology and molecular techniques was used to explore the role and mechanism of TRV027 in reducing blood pressure and restoring ventricular hypertrophy.

Results:
Our studies revealed that TRV027 reduced blood pressure and restored hypertension-induced ventricular hypertrophy in SHRs. Moreover, the modulated expression of Connexin43 (Cx43) and phosphorylation of the MAPK/ERK pathway were normalized by TRV027. After the inhibition of Cx43 expression, cardiomyocytes recovered from hypertrophy and damage, followed by the modulation of phosphorylation of the MAPK/ERK pathway.

Conclusion:
TRV027 demonstrates a potential to lower the blood pressure in SHRs and ameliorate hypertension-induced cardiac hypertrophy. While AngII stimulated cardiomyocyte injury by decreasing Cx43 expression and increasing the phosphorylation of the MAPK/ERK pathway, TRV027 repaired the hypertrophy by restoring the expression of the Cx43/MAPK/ERK pathway.
O105 ISOLATED NOCTURNAL HYPERTENSION AND TARGET ORGAN INJURY IN YOUTH
Authors: Hill-Horowitz Taylor , Flynn Joseph , Ferguson Michael , Hanevold Coral , Lande Marc , Meyers Kevin , Mitsnefes Mark , Samuels Joshua , Sethna Christine , Urbina Elaine , Basalely Abby Abby 
Published: September 2024

Background and Objective:
New American Heart Association (AHA) recommendations in 2022 for pediatric ambulatory blood pressure monitoring (ABPM) established static blood pressure (BP) cutoffs to define hypertension with an optimal sensitivity-specificity balance to best capture target organ injury (TOI). This increased the prevalence of ABPM hypertension, specifically isolated nocturnal hypertension. We utilized ABPM data from the SHIP-AHOY cohort to describe the epidemiology of INH in youth and to evaluate associations between INH and TOI.

Methods:
We defined INH as wake BP <130/80 mmHg and sleep BP >110/65 mmHg. INH was also evaluated by the 2014 AHA definition: wake BP <95th percentile with sleep BP >95th percentile. Primary outcome was left ventricular hypertrophy (LVH), defined as left ventricular mass index >38.6 g/m2.7. Cardiovascular risk factor (CVRF) scores described the number of risk factors for cardiovascular disease (dyslipidemia, obesity, hypertension by clinic systolic BP, insulin resistance) fro each participant. Logistic regression models assessed the association of INH with LVH, adjusted for age, sex, CVRF score, and ABPM tolerability.

Results:
Of 397 participants, 77 had INH, mostly (62%) due to elevated systolic BPs only. Median age and height were higher in INH than normotension (16.1 v 15.1 years, P=0.022) (height z-score 1.13 v 0.23, P=0.039). Other characteristics did not differ significantly between groups (Table 1). Estimated glomerular filtration rate was lower in INH. Among those with INH, 27% (N=19/71) had LVH, a greater proportion than found with 2014 definitions (21%, N=7/33). Children with INH had 2.61-fold adjusted odds of LVH compared to normotension (95%CI [1.20,5.69], P=0.016).

Conclusions:
Over 20% of the SHIP-AHOY cohort had INH, accounting for >1/3 of hypertension overall. INH was associated with older age and taller height, mostly due to systolic BP. Compared to 2014 guidelines, the 2022 definition of INH captured a higher prevalence of LVH. INH was independently associated with increased odds of LVH. Future studies should follow children with INH longitudinally for potential development of daytime hypertension.
Table 1: Demographic, Anthropomorphic, and Clinical Characteristics of Isolated Nocturnal Hypertension vs Normotension
P010 HYPERTENSION CONTROL CASCADE AMONG OLD AND VERY OLD POPULATION OF NEPAL: A FRAMEWORK TO IMPROVE HYPERTENSION AWARENESS, TREATMENT, AND CONTROL
Authors: Mehata Suresh , Thapa Astha , Mehta Ranju Kumari 
Published: September 2024

The older population of Nepal increased from 6% to 10% from 1971 to 2021 census. The prevalence of NCDs increases with the increase in age. This study aimed to assess the prevalence and predictors of hypertension, awareness, treatment and control rate in Nepal.
Nepal demographic and health survey data 2022, a nationally representative survey data was used for this analysis. 1716 (unweighted sample) participants aged 60 years and above were used for this analysis. Multivariate logistic regression was used to assess the predictors (sex, education, place of residence, province and wealth quintile) of hypertension control cascade. All the inferential analysis was carried out considering the cluster sampling design. Sample weight was used to estimate the population statistics. P<0.05 were considered statistically significant.
Study revealed that 44% participants were hypertensive, among them 60% were aware of their status and 45% were under treatment. Among those who were under treatment, 57% respondents blood pressure were under control (Table 1).
The higher prevalence of hypertension was observed among the urban dwellers (49%) compared to rural counterparts (37%) (AOR: 0.65;95%CI:0.52-0.81). By wealth quintile, 55% of the richest quintile population were hypertensive compared to the poorest counterparts (38%) (AOR:1.68;95%CI:1.13-2.50). Study revealed that the dose-response relationship between wealth quintile and hypertension awareness as well as treatment rate. Compared to the poorest, the higher odds of awareness rate were observed among the poor (AOR:2.08(1.19-3.64)), middle quintile (AOR:2.97(1.65-5.36)), richer (AOR:2.50(1.29-4.84)) and richest (AOR:4.05(2.02-8.14)) population. Likewise, compared to the poorest, the higher odds of treatment rate were observed among the poor (AOR:2.47(1.27-4.83)), middle (AOR:2.63(1.41-4.92)), richer (AOR:3.29(1.63-6.65)) and richest (AOR:7.20 (3.43-15.14)) population.
The prevalence of hypertension is high among the Nepalese old population with low awareness, treatment and control rate. The gap between awareness and treatment was 15%. The lowest awareness and treatment rate were observed among rural and poorest population need focused, targeted, tailored intervention through integration of NCDs programming with the primary care.
P012 THE EFFECT OF AGE AND LONG-TERM BLOOD PRESSURE CONTROL ON DIASTOLIC CARDIAC FUNCTION IN MASTERS ATHELETES
Authors: Hedke Nick , Hoffmann Fabian , Hoenemann Jan-Niklas , Moestl Stefan , Rittweger Joern , Tank Jens , Jordan Jens , Reuter Hannes 
Published: September 2024

Background & Objectives:
Arterial hypertension and age underlie the risk for diastolic dysfunction and heart failure with preserved ejection fraction. Blood pressure control and physical exercise are known to ameliorate age related cardiac adaptation. Therefore, we assessed diastolic function including left atrial (LA) strains in Masters Athletes as a model for healthy ageing.

Methods:
At the World Masters Athletics Championships 2022 in Tampere, Finland 108 Masters Athletes partook in this field-study. Baseline data included body measures, blood pressure, age, sex and sport disciplines. Transthoracic echocardiography was performed analogous to clinical standards. Additionally, LA reservoir strain (LA-Sr) and conduit strain (LA-Scd) were assessed by speckle tracking.

Results:
Complete data were acquired in 108 (42, 39% female) athletes with a mean age of 62±12 (35-91) years and a body-mass-index of 23,8±2,8 kg/m2. Mean systolic blood pressure was 125±16mmHg, one third (n=36) had values ≥130mmHg. 29 performed endurance, 79 resistance disciplines. LA strain was not influenced by sport discipline nor blood pressure, neither in dichotomization for clinical thresholds nor in linear correlation. Female athletes showed higher LA reservoir and conduit strain (LA-Sr: 29.1±5.3% versus 27±5.5%, p=0.046; LA-Scd: 16.6±6% versus 13.9±5.4%, p=0,018). With increasing age, body-mass-index and left-ventricular-mass-index, LA reservoir and conduit strains declined significantly, independent of blood pressure. In Masters Athletes that did not meet echocardiographic criteria of diastolic dysfunction we found significantly higher LA reservoir and conduit strains than in those with 2 criteria met (LA-Sr 29.8±5.2% versus 25.4±6.6%, p=0.007; LA-Scd -17.3±6% versus -13.4±6.5%, p=0.030).

Conclusion:
In the specialized cohort of Masters Athletes LA reservoir and conduit strain showed the same dependency from age, body-mass-index and left-ventricular-mass-index as other parameters of diastolic function with higher values in females. Furthermore, impaired diastolic function was associated with decreased LA strain. Therefore, assessment of LA strain seems beneficial beyond classical echocardiographic measurements in determining diastolic function in the elderly. Surprisingly, long-term blood pressure control by physical exercise had no effect on LA strains.
P013 EXPLORING THE BIDIRECTIONAL CAUSAL ASSOCIATION BETWEEN FRAILTY AND HYPERTENSION: FROM ASSOCIATION TO CAUSATION
Authors: Yin Zheng , Miao Huanhuan , Zhou Zhanyang , Yang Shijie , Zhang Yuqing 
Published: September 2024

Background:
Studies have shown an association between frailty and hypertension. However, it remains uncertain whether this association reflects causality. We performed a Chinese Longitudinal Health Longevity Survey (CLHLS) analysis and a bidirectional Mendelian randomization (MR) study to assess the relationship between frailty and hypertension. Corroborative evidence for other heart diseases, including atrial fibrillation (AF), coronary artery disease (CAD), and heart failure (HF), was also analyzed.

Methods:
We performed the cross-sectional analysis based on CLHLS 2018 and used multivariable logistic regression to analyze the association between frailty and HTN. Then, we extracted independent single nucleotide polymorphisms for each phenotype at genome-wide significance levels from the latest genome-wide association summary data of European descent, including FI (N=175,226), HTN (N=462,933), AF (N=138,994), and HF (N= 977,323). The inverse variance weighted method was primarily used, followed by sensitivity and validation analyses.

Results:
In the cross-sectional study, compared to non-frail individuals, frail patients revealed a significantly higher risk of HTN (OR 5.32, 95% CI 3.46-8.17 P< 0.001) and heart disease (OR 13.50, 95% CI 8.18-22.28 P = 0.017) after full adjustment. In the MR study, higher FI significantly increased the risk of HTN (OR 1.12, 95% CI 1.07-1.16 P<0.001) and CAD (OR 2.57, 95% CI 1.72-3.84 P<0.001). FI suggestively increased the risk of AF (OR 1.83 95%CI 1.11-3.01 P<0.05). No association between FI and HF was observed (OR 1.30, 95% CI 1.00-1.71 P>0.05). In the reverse analysis, genetic predisposition to HTN (β 0.662, 95% CI 1.71, 2.19 P<0.001) and CAD (β 0.067, 95% CI 01.049-1.090 P<0.001) significantly increased FI. A suggestive causality from HF (β 0.088, 95% CI 1.000-1.192 P<0.05) to FI was also observed. No causality between AF to FI was observed (β 0.014, 95% CI 0.998-1.030 P>0.05).

Conclusion:
Our findings add new evidence to support the bidirectional causality between frailty and HTN. A deeper exploration of such associations is imperative to optimize the management of older patients.
P018 IMPLEMENTATION CONSIDERATIONS FOR SMS REMINDERS TO IMPROVE ANTIHYPERTENSIVE MEDICATION ADHERENCE IN BANGLADESH AND ETHIOPIA: A QUALITATIVE EVALUATION
Authors: Ogungbe Bunmi , Ayensu-Asiedu Christabelle , Berhane Hanna Y. , Tewahido Dagmawit , Fasil Rediet , Choudhury Sohel Reza , Bhuiyan Mahfuzur Rahman , Abrar Ahmad , Parvej Md. Aslam , Sultana Sarmin , Neupane Dinesh , Commodore-Mensah Yvonne Commodore-Mensah , Matsushita Kunihiro , Appel Lawrence , Riekert Kristin 
Published: September 2024

Background:
Poor medication adherence remains a significant barrier to hypertension control, particularly in resource-limited settings.

Objective:
To qualitatively explore the feasibility and acceptability of SMS reminders to support antihypertensive medication adherence and identify local nuances of barriers, facilitators, and implementation considerations in resource-limited settings.

Methods:
Patients with hypertension and providers in primary care clinics in Ethiopia and Bangladesh were interviewed to assess perceptions and experiences with SMS reminders. Interviews were transcribed and translated, an inductive codebook was developed, thematic content analysis was used to identify key implementation considerations. The Consolidated Framework for Implementation Research (CFIR) constructs of innovation, outer, inner settings, individual-level factors were used to synthesize findings.

Results:
Fifty patients (mean age 53.1±13.1 years, 28(56%) female, 28(56%) from Ethiopia) and 50 providers (mean age 32±7.5 years, 24(48%) female, 27(54%) from Ethiopia) were interviewed. Facilitators included the perceived value of SMS reminders for adherence (patients) and improved patient-provider communication (providers). Patients and providers generally viewed SMS reminders as valuable for supporting adherence (innovation). However, concerns were raised about the timing of message delivery and the potential for missed messages. Unreliable network infrastructure was identified as a potential barrier, particularly in rural areas (outer setting). The absence of electronic medical and pharmacy records in many clinics was a reported challenge for automating reminders; providers highlighted the need for dedicated IT support and staff (inner setting). Focusing on the highest-need patients was suggested as a practical approach to begin implementation. Patient's access to mobile phones, literacy levels, and receptiveness to reminders were key individual-level factors that could influence engagement with SMS reminders. Providers emphasized that reminders may not be effective for all patients (Table).

Conclusions:
SMS reminders can potentially improve antihypertensive medication adherence in resource-limited settings, but several implementation barriers need to be addressed. Tailoring SMS reminders to patient needs, strengthening infrastructure, and providing adequate IT and staff support are essential for successful implementation.
P023 THE CLINICAL SPECTRUM OF COVID-19 SEVERITY AND OUTCOME ON HOSPITALIZED PATIENTS AT JABRA ISOLATION CENTRE – SUDAN, 2021
Authors: Almarrani Zakarya , Alhusen Ahmed , Muhyadin Mariam , Hazaea Shehab , Elbashir Omer , Hamdan Gaafar , Mahyoub Omar , Farhan Osman , Elhassan Marwa , Nouri Saada , Jaber Mohammad , Jebreel Waleed , Ahmed Amjad , Elmadhoun Wadie , Beheiry Hind 
Published: September 2024

Background:
The COVID-19 pandemic has highlighted how crucial to comprehend the various clinical presentations of the illness to improve patient treatment and healthcare resources.
Objective: To investigate potential gender-based disparities in the severity and outcome of COVID-19 patients in Jabra Isolation Center 2021

Methodology:
A descriptive-analytic record-based study was conducted at Jabra Isolation Centre, Sudan, 2021. A random selection of 317 patients was performed. The three zones of severity were: mild (ward stay, Green Zone), moderate (high dependence unit, Yellow Zone), and severe (intensive care unit, Red Zone). Fever, SOB, cough and SPO2, and mortality based on the 3 zones and gender distribution were analyzed by MOH triage procedure checklist using SPSS(version 21)

Results:
The age ranged between 25-91 years. The findings were as follows: At Green Zone, 46.63% of patients were admitted, with 65.91% being males, The hypertensive patients were 38.16%, and the diabetic were 39.47%. The presenting signs were fever, SOB, cough, and SPO2 (77.39%, 67.11%, 56.58%, and 92% respectively). The mortality rate was 52.63%. While at Yellow Zone, 15.64% of patients were admitted, with 75% being males. The hypertensive patients were 49.02%, and the diabetic were 39.22%. Fever, SOB, cough, and SPO2 were (78.43%, 74.51%, 70.59% and 90% respectively). The mortality rate was 49.02%. At the Red Zone, 37.73% of patients were admitted with males 61.05%. The hypertensive patients were 45.53%, and the diabetic were 36.59%. Fever, SOB, cough, and SPO2 (65.85%, 71.54%, 43.9%, and 92% respectively). The mortality rate was 62.6%. The mortality rate across all 3 zones of severity was 55.83% of which males were 66.0%.
Conclusions: This study showed that COVID-19 hospitalized patients at Jabra Isolation Centre in 2021 were predominately males and associated with hypertension and diabetes at 3 zones of severity. The mortality rate was highest at the Red Zone. The overall mortality rate was 55.83% of which males were 66%.
P024 NEPAL TAKES ACTION FOR BLOOD PRESSURE SCREENING: RESULTS FROM MAY MEASURE MONTH 2022
Authors: Kumar Payal Rajender , Koirala Sweta , Paudel Kiran , Inagaki Yoko , Neupane Dinesh 
Published: September 2024

Objective:
To present the result of May Measure Month (MMM) 2022 in Nepal.

Methods:
An opportunistic cross-sectional survey of adults ≥ 18 years was conducted in 32 districts from Jun-October 2022. Trained volunteers administered the structured questionnaire into the local language and took 3 BP readings in a sitting position at 1-minute intervals. The mean of the second and third BP readings was calculated. Hypertension was defined as a systolic BP ≥ 140 mmHg or a diastolic BP ≥90 mmHg or being on antihypertensive medication. Ethical approval was obtained from the Nepal Health Research Council.

Results:
MMM 2022 included 13,125 participants. The mean age of the participants was 38.8(±16.1) years. There were 52.2% females. The mean was 118.6 mmHg ±15.8 for systolic BP, and 78.8 mmHg ±10.67 for diastolic BP. Around one-fifth (19.5%) of participants were found to be hypertensive. The odds of hypertension in young males were 1.49 times than females (OR=1.49, 95% CI: 1.37 to 1.63). Only about 43.5% of the population were aware, 37.5% were on medication and only 21.5% of hypertensive had controlled blood pressure (< 140/90 mm Hg). Less males were aware and on medication as compared to females (OR = 0.86, 95% CI: 0.74 -1.01). 26.3% hypertensive females have controlled blood pressure as compared to 17.7% in males (p<0.05). Among all participants, 11.3% (n= 1473) had their BP measured for the first time, and nearly 22.6% (n= 2953) did not measure it within the last one year. More than 90% of individuals taking medicine reported that they took medicine regularly and more than 80% reported that they did not pay for medicine.

Conclusions:
MMM seems to be a promising community-based program for increasing awareness and identifying high risk population. As more than 50% of participants were unaware of their hypertension status, there is an opportunity in Nepal to identify these patients and increase awareness by adopting nationwide screening campaign such as MMM.
P025 GLOBAL, REGIONAL AND NATIONAL BURDEN OF HIGH SYSTOLIC BLOOD PRESSURE, 1990-2021: FINDINGS FROM THE GLOBAL BURDEN OF DISEASE STUDY 2021
Authors: Razo Christian , Johnson Catherine , Decleene Nicole , Roth Gregory A 
Published: September 2024

High systolic blood pressure (SBP) is the leading preventable global health risk. As part of the Global Burden of Disease Study 2021, we quantify the SBP-associated burden (relative to a theoretical risk exposure level of 105-115 mmHg) among adults over 25, by age and sex, for 204 countries from 1990 to 2021.
Standard GBD Bayesian methods were used to estimate SBP mean, standard deviation and corresponding distribution from 1,116 studies. Meta-analyses of 70 randomized controlled trials and cohorts were used to estimate the relative risks for seven outcomes: ischemic heart disease (IHD), stroke, chronic kidney disease (CKD), atrial fibrillation, aortic aneurysm, peripheral arterial disease (PAD) and hypertensive heart disease. Then, the population attributable fraction and SBP attributable burden were computed with 95% uncertainty intervals (UI).
In 2021, 10.9 million deaths (9.2-12.5 million) and 225 million (190 - 259 million) disability-adjusted life years (DALYs) were attributable to elevated SBP worldwide, a decrease, since 1990, of 32% and 30% in age-standardized rates, respectively. In 2021, high SBP accounted for 7.8% of total DALYs; 49.9% (40.6 - 58.2%) of DALYs due to IHD; 57.3% (42.7-68.4%) due to stroke; 24.8% (13.0-36.1%) due to CKD; 30.1% (10.7-47.6%) due to atrial fibrillation; 17.1% (12.9-21.4%) due to aortic aneurysm; 13.0% (2.7-23.8%) due to PAD and 100% of the DALYs due to hypertensive heart disease. Globally, the burden attributable to SBP was higher in men than in women (3,162.9 [2,654.8-3,666.4] vs 2,167.3 [1857.4 -2510.9] age-standardized DALYs per 100,000).
Age-standardized DALYs attributable to high SBP were highest in Central Asia and Eastern Europe, rates above six thousand per 100,000. The lowest levels were observed in high-income Asia Pacific, Australasia and Western Europe with less than 1000 DALYs per 100,000.
Despite a decrease in age-standardized rates since 1990, high SBP remains a major global health risk with considerable regional variations. Targeted interventions are crucial to address these disparities and reduce SBP-related health impacts.