bluuebunny/crossref_metadata_2025_split huggingface dataset:
P148 EFFICACY AND SAFETY OF SACUBITRIL/ALLISARTAN FOR THE TREATMENT OF PRIMARY HYPERTENSION: A PHASE 3 RANDOMIZED, DOUBLE-BLIND STUDY
Authors: Zhang Wei , Zhang Jin , Yan Jie , Ge Qian , Lu Xiao-Hong , Chen Shao-Xing , Xu Wen-Jie , Sun Jing-Chao , Li Jin-Feng , Liu Zi-Chen , Wang Qiang , Zhou Xiang-Nan , Li Yan , Wang Ji-Guang 
Published: September 2024

Background:
This randomized, double-blind, phase 3 study assessed the efficacy and safety of sacubitril/allisartan, an angiotensin receptor neprilysin inhibitor, compared with olmesartan in Chinese patients with mild to moderate hypertension.

Methods:
Eligible patients aged 18-75 years (n=1197) with mild to moderate hypertension were randomized to receive sacubitril/allisartan 240 mg (n=399), sacubitril/allisartan 480 mg (n=399), or olmesartan 20 mg (n=399) once daily for 12 weeks. Patients who completed the 12-week treatment then received another 12-week extended treatment (n=1084) and 28-week prolonged treatment (n=189). The primary end point was a reduction in clinic mean sitting systolic blood pressure (msSBP) from baseline with various doses of sacubitril/allisartan versus olmesartan at 12 weeks. Secondary efficacy variables included clinic and 24-h ambulatory blood pressure for the comparison between sacubitril/allisartan and olmesartan at week 12, 24, and 52.

Results:
Sacubitril/allisartan 240 mg/day provided a greater reduction in msSBP than olmesartan at 12 weeks (between-group difference: -1.9 mmHg [95% confidence interval -4.2 to 0.4 mmHg], P=0.0007, for non-inferiority). Sacubitril/allisartan 480 mg/day provided a significantly greater reduction in msSBP than olmesartan at 12 weeks (between-treatment difference: -5.0 mmHg [95% confidence interval -7.3 to -2.8 mmHg], P<0.001, for superiority). Greater reductions in 24-h, daytime and nighttime systolic and diastolic blood pressure were also observed with both doses of sacubitril/allisartan compared with olmesartan (P≤0.001 for 480 mg/day). The blood pressure reductions tended to be dose-dependent for sacubitril/allisartan. Sacubitril/allisartan was well tolerated, and no cases of angioedema or death were reported.

Conclusions:
Sacubitril/allisartan is effective for the treatment of hypertension and well tolerated in Chinese patients.
P162 THE CORRELATION BETWEEN VITAMIN D WITH ARTERIAL HYPERTENSION, ARTERIAL STIFFNESS AND CORONARY CALCIUM SCORE
Authors: Sokolovic Sekib , Sokolovic-Tahtovic Imana 
Published: September 2024

Background Introduction:
Vitamin D plays significant role in calcium metabolism and in bone and vascular calcifications.

Objective:
To investigate the association between vitamin D level, arterial hypertension, arterial stiffness and coronary calcifications detected by MSCT. Method: A 2 female case report comparative to each other investigated the correlation between vitamin D serum level, blood pressure, arterial stiffness and severity of the coronary calcification using MSCT diagnostic tool estimating the calcium score.

Results:
The first case report showed that decreased level of vitamin D is correlated with increased blood pressure, increased arterial stiffness and with a severe coronary calcifications. The second case report showed normal blood pressure, normal vascular age and low calcium score in a no-defficient vitamin D female.

Conclusion:
Vitamin D has impact on blood pressure, arterial stiffness, coronary calcifications and coronary heart disease. The lower vitamin D, the higher arterial blood pressure, arterial stiffness and coronary calcium score.
P167 DIFFERENCES IN PULSE WAVE VELOCITY ESTIMATED USING TOTAL ARTERIAL COMPLIANCE BETWEEN SUBTYPES OF ARTERIAL HYPERTENSION
Authors: Aristizabal-Ocampo Dagnovar , Alvarez-Montoya Diego , Fernandez-Ruiz Ricardo , Madrid-Muñoz Camilo , Gallo-Villegas Jaime 
Published: September 2024

Background and Objective:
Different clinical phenotypes of arterial hypertension (AH) are identified through current oscillometric blood pressure (BP) measurements. Recently, our group described hemodynamic characteristics of AH subtypes utilizing 24-hour ambulatory blood pressure monitoring (24-h ABPM). It remains unclear whether differences in PWV exist among AH subtypes, which could potentially enhance diagnostic accuracy and guide antihypertensive treatment selection. The objective was to assess the relationship between PWV, estimated using Ct, and AH subtypes.

Methods:
A cross-sectional study was conducted, involving 13,027 untreated patients referred for 24-h ABPM. PWV was estimated using a novel method based on Ct, derived from BP and heart rate measurements obtained during 24-h ABPM. This estimation method was developed based on the relationship between Ct and PWV as described by Vardoulis et al., utilizing the Bramwell-Hill theory and experimental research. The formula used for PWV estimation was PWV = √(36.7/(Ct/(log[age]))).

Results:
Among the participants, 46.5% were men, with an average age of 50.2±14.1 years and a body mass index of 27.1±4.1 kg/m2. Isolated systolic hypertension (ISH) (3.9%) exhibited the highest arterial stiffness, with the highest PWV (10.2±1.4 m/s) and pulse pressure (PP) (60.0±6.6 mmHg), and the lowest Ct (0.67±0.16 mL/mmHg). In contrast, isolated diastolic hypertension (IDH) (26.3%) showed the lowest PWV (7.9±0.8 m/s) and PP (40.6±3.6 mmHg), and the highest Ct (1.01±0.18 mL/mmHg). As Ct decreased, PWV increased. Thus, PWV based on Ct from 24-hour ABPM showed clear differences between AH subtypes (ANOVA; p value < 0.001) (Figure).

Conclusions:
PWV is related with AH subtypes, exhibiting a progression from IDH to ISH. Patients with IDH typically have the lowest PWV, whereas those with divergent systolic-diastolic hypertension (D-SDH) and ISH have the highest PWV values. These findings underscore the significance of Ct in determining PWV values and carry diagnostic and prognostic implications concerning arterial function across various AH subtypes.
P177 MICROBIAL TRYPTOPHAN-INDOLE PATHWAY REGULATES BLOOD PRESSURE (BP) IN A SEX SPECIFIC MANNER
Authors: Bardhan Pritam , Mei Xue , Lai Khanh , Mell Blair , Tummala Ramakumar , Atluri Rohit , Kyoung Jun , Joe Bina , Yang Tao 
Published: September 2024

Introduction:
Aberrant tryptophan absorption promotes hypertension as gut microbiota converts tryptophan to pro-hypertensive indole. Intestinal Ace2 regulates tryptophan homeostasis, but its role in salt-sensitive hypertension is unknown. Ace2 functions differently in males and females. Therefore, we hypothesized that sex-specific intestinal ACE2 dependent transport of tryptophan contributes to salt-sensitive hypertension via microbiota-indole axis.

Methods:
10-week-old Dahl salt-sensitive (S) rats and novel Ace2 KO S rats of both sexes were maintained on either a low (LS) or high (HS) salt diet for 21 days. BP was measured by radiotelemetry. Gut microbiota and indole were analyzed.

Results:
Mean arterial BP of S Ace2 KO rats on LS was elevated in females by 38 mmHg (SAce2KO 170 ± 10 vs. S 132 ± 3; P=0.0028) and in males by 18 mmHg (SAce2KO 140 ± 6 vs. S 122 ± 1.5; P=0.01), and further elevated on HS by 68 mmHg in females (SAce2KO 211 ± 14 vs. S 143 ± 4.5; P=0.0003) and by 40 mmHg in males (SAce2KO 182 ± 9 vs. S 142 ± 3; P=0.0009). These were associated with elevated serum indole mainly in male SAce2KO rats, compared to S rats on both LS (1.2 ± 0.2 vs. 0.3 ± 0.2 μM; P=0.02) and HS (1.5 ± 0.25 vs. 0.2 ± 0.03 μM; P=0.0001). Microbiota analysis revealed significant shifts in β-diversity in Ace2 KO rats of both sexes with more changes in HS males; and Ace2 KO induced more tryptophan-utilizing, indole-producing bacteria Escherichia-Shigella in males on both LS (P<0.05) and HS (P<0.0001). Strikingly, none of these differences were found in females.

Conclusions:
Lack of Ace2 increased BP regardless of sex and salt. In males, Ace2 KO increased indole levels and abundance of Escherichia-Shigella. Microbial changes by salt and ACE2 KO were found mainly in males, suggesting a more resilient microbiota in females. Thus, the microbiota-indole axis may be a therapeutic target for BP control in males with altered tryptophan metabolism.
P181 AGE-RELATED CHANGES IN THE PROTECTIVE AXIS OF THE RENIN-ANGIOTENSIN SYSTEM IN THE BRAIN OF NORMOTENSIVE AND SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Pineda Angélica , Rukavina-Mikusic Natalia , Sirri María F. , Nuñez Myriam , Dominici Fernando , Gironacci Mariela M. 
Published: September 2024

Background and Objective.
Aging is a major risk factor for the development of hypertension, that leads to end organ damage and cognitive dysfunction. The axis of the renin-angiotensin system composed of angiotensin (Ang) (1-7) the Mas receptor (MasR) and angiotensin converting enzyme 2 (ACE2) plays a cerebroprotective role by increasing blood flow, angiogenesis and improving cognitive function among others. Evidence on the expression of this axis with age is limited. We investigated Ang-(1-7)/Mas/ACE2 axis in different areas of the brain from normotensive and spontaneously hypertensive rats (SHR).

Methods.
Hypothalamus (HT), brainstem (BS), hippocampus (HC) and cerebral cortex (CC) were isolated from Wistar normotensive rats and SHR of 1, 3 and 12 months. Ang-(1-7) levels were measured by radioimmunoassay and ACE2 and MasR abundance was determined by immunoblotting.

Results.
Ang-(1-7) levels decreased with age in all the areas from normotensive rats and in CC from SHR, while it increased from 1 to 3 months but then decreased at 12 months in BS, HC and HT from SHR. There was no difference in Ang-(1-7) levels between normotensive and SHR except at 1 month of age where Ang-(1-7) levels were lower in BS, HC and HT but the same in CC from SHR compared to normotensive rats. MasR and ACE2 expression did not change with age in all the investigated areas from normotensive rats and in CC from SHR. However, MasR and ACE2 increased with age in HC from SHR and they were higher than in normotensive rats.

Conclusions.
Our results showed changes in the expression of the brain Ang-(1-7)/Mas/ACE2 axis which may contribute to deleterious functions observed in the brain with age.
P183 PERIPARTUM CARDIOMYOPATHY: MONOCENTRIC DESCRIPTION AT THE NORTHERN REGIONAL MATERNITY HOSPITAL OF THE DOMINICAN REPUBLIC
Authors: Rodríguez-Román Allyson , Fernandez-Mendez Lisbeth , Gómez-Jackson Julia , López-Zabala Luis Ariel , Gutiérrez-Martínez Anthony , Cruz Licurgo 
Published: September 2024

Background:
Peripartum cardiomyopathy (PPCM) is a pathology in which the woman's heart dilates and displays signs and symptoms of heart failure. It is a rare pathology, with a high mortality rate, and predominance in black patients. Its diagnosis and management are not standardized, nor adapted to low income countries. This leads to barriers in identifying and treating the disease in higher-risk countries such as Haiti, making it a relevant issue in the Dominican Republic due to high immigration of haitians to the country. Therefore we aimed to evaluate the association of risk factors and the pharmacological regimen of patients in a public healthcare center in the Dominican Republic.

Methods:
An observational, retrospective, cross-sectional study was carried out with convenience sampling. This included patients who had been admitted to the Presidente Estrella Ureña Regional Hospital with suspected PPCM during the last 3 years. Variables studied include: sociodemographic factors, toxic habits, pathological and gynecological-obstetric history, cardiovascular, pulmonary and general signs and symptoms.

Results:
A sample of 19 patients with a median age of 27 years was obtained, 73.4% of them were black. All of the patients who had illness onset in the peripartum period (first 28 days after labor) presented adverse events, infectious comorbidities and “other comorbidities” while 75% of them presented cardiac and pulmonary comorbidities. Regarding treatment, only 77.8% of patients with antepartum onset received treatment in this period. Additionally, 66.7% of patients with antepartum onset developed adverse events that required oxygen-supplementation, versus only 33% of those without adverse events.

Conclusions:
It is relevant to design tools for calculating the risk of developing PPCM and standardize its disparate diagnosis and treatment, particularly aimed at countries with limited resources. This aims to improve the prognosis in patients with risk factors such as: black race, age over 30 years and living in low/middle-resource countries.
P189 HYPERTENSION AND OBSTRUCTIVE SLEEP APNOEA SYNDROME IN ADULTS WITH HEART FAILURE IN NIGERIA: CLINICAL CORRELATES AND ASSOCIATION WITH CLINICAL OUTCOMES
Authors: Amusa D Ganiyu , Chun-Gyang S.D , Awokola Babatunde 
Published: September 2024

Rationale:
Heart failure (HF) is a common endpoint for cardiovascular diseases. It is a major cause of morbidity and mortality worldwide. Hypertension is a leading cause of HF; a significant proportion of HF patients also have obstructive sleep apnea syndrome (OSAS) which is known to impact clinical outcomes adversely. The diagnosis of OSAS is often missed due to inadequate clinical diagnosis and diagnostic backup. This study aims to add to the body of evidence thereby improving outcomes in HF patients.

Methods:
This cross-sectional descriptive study involved 200 consenting adults with HF at Jos University Teaching Hospital, Nigeria. Each participant had relevant medical history, physical examination (including a six-minute walk test distance) and relevant investigations. OSAS was diagnosed using high-risk scores obtained using Berlin and STOP-Bang questionnaires, daytime somnolence was assessed by Epworth questionnaire and quality of life by Minnesota living with HF questionnaire. Comorbidities were assessed using Charlson comorbidity index (CCI)) and hospitalizations in the preceding 12 months documented. Data was analyzed using Stata version 13.

Results:
Hypertension was the aetiology of HF in 41% of the study population and 62.8% of the subset with OSAS (p=0.001). OSAS was identified in 47% and 45.5% by high-risk scores obtained using Berlin and STOP-Bang questionnaires respectively. Significant daytime somnolence was identified in 56.0% of the study population and 93.6% of those with OSAS, (p<0.001). Those with OSAS had a significant association with hypertension (p=0.001), atrial fibrillation (p<0.001), obesity (p=0.002), higher comorbidity index (p=0.001), HF with preserved ejection pattern (p=0.001) and NYHA ≥3 (p<0.001). OSAS was significantly associated with six-minute WTD ≤ 300m, hospitalizations (p<0.001) and sub-optimal quality of life (p=0.003).

Conclusion:
Hypertension and OSAS are significantly associated and are common in HF. It is recommended to routinely screen HF patients for OSAS as the diagnosis is often missed with consequent adverse clinical outcomes. This will facilitate prompt diagnosis, enhance management and favourable clinical outcomes in HF patients.
P198 SOCIODEMOGRAPHIC, ANTHROPOMETRIC, PHYSIOLOGICAL, AND ELECTROCARDIOGRAPHIC RISK FACTORS ASSOCIATED WITH ELEVATED SYSTOLIC BLOOD PRESSURE IN YOUNG POPULATION
Authors: Villa Andrea Navarro , Álvarez Santiago Garzón , Suárez Brochero Óscar Felipe , Toquica Alex Rivera , Nieto García Carlos Eduardo 
Published: September 2024

Background:
Hypertension is a major challenge today. Although young individuals present lower risk, it's important to identify factors predisposing to elevated blood pressure from early years.

Objectives
Identify associated factors with elevated systolic blood pressure (SBP) in medical students, Pereira-2022.

Methodology
A cross-sectional study was conducted on medical students at a public university in Pereira, in which sociodemographic, anthropometric, physiological, and electrocardiographic variables were collected. A bivariate analysis was made comparing individuals with an SBP>130mmHg to those below. A multivariate analysis was performed using logistic regression.

Results:
201 medical students were interviewed (mean age=21.4 years), 56.7% women. 17.4% presented high-normal blood pressure or grade I hypertension. 24 students were found with an SBP>130mmHg (11.9%). The factors significantly related with this variable were being a woman (OR= 0.11 95% CI= 0.03-0.39), family history of deceased by chronic kidney disease (OR= 3.83 95% CI= 1.05-12.86), a parent with hypertension (OR=3.91 95% CI=1.41-10.80), diastolic blood pressure >85mmHg (OR=6.60 95% CI= 1.96- 22.27) and wrong progression of the R-wave on the anteroseptal wall (OR=11.03 95% CI= 2.32-52.22).

Conclusions:
even though the population of youth has a lower prevalence of arterial hypertension, in this study, it was found that 11.9% of the participants present an SBP>130mmHg. In this demographic group, there must be considered certain factors, such as a family history of chronic kidney disease and hypertension, a personal finding of elevated diastolic blood pressure, and electrographic changes, like a wrong progression of the R-wave on the anteroseptal wall.
P201 SEVERITY OF STRESS DISORDERS IN UKRAINIAN REFUGEE WOMEN: IS THERE ANY ASSOCIATION WITH THE PRESENCE/ABSENCE OF HYPERTENSION?
Authors: Shalimova Anna , Stoenoiu Maria S. , CubaŁa WiesŁaw J. , Burnier Michel , Persu Alexandre , Wilgusz Mariusz S. , Narkiewicz Krzysztof 
Published: September 2024

Background and Objective:
Refugees exhibit a notably high prevalence of post-traumatic stress disorders (PTSD). PTSD has been associated with hypertension, particularly in military servants, war veterans and more recently in populations exposed to chronic violence. In this prospective study, we explored the association between hypertension and the severity of emotional distress and PTSD in Ukrainian women seeking asylum in Poland.

Methods:
The study included 504 refugee women: 301 non-hypertensive and 203 hypertensive subjects (mean blood pressure (BP) levels: 119±11.8 and 144±11.7 mmHg, respectively). BP was measured using validated oscillometric devices. Participants filled validated questionnaires to assess emotional distress (DASS) and PTSD (PCL-5). Subjects with and without hypertension were compared for both general and psychological characteristics.

Results:
There were no significant differences in non-hypertensive and hypertensive subjects in terms of socio-economic status before the war and the intensity of hostilities in the regions of Ukraine where the refugees came from. Compared to non-hypertensive subjects, hypertensive refugees had significantly higher DASS score (26.8±14.3 vs. 23±14.2,p=0.003) and general emotional distress (72.4 vs 50.4%,p<0.0001). Significant differences were found between groups for all indicators of DASS questionnaire (depression, anxiety and stress) with a predominance of their severity among hypertensive women (p<0.01). Hypertensive refugees had also significantly higher PTSD score (29.9±14.7 vs. 25.5±14.6,p=0.001) and presence of PTSD (41.1 vs 28.3%,p=0.01). Dimensions of all PTSD clusters were significantly higher in hypertensive women: intrusion (cluster B,p<0.0001), avoidance (cluster C,p=0.027), negative alteration in cognition (cluster D,p=0.036) and hyper-arousal (cluster E,p=0.028). At the same time, logistic regression analysis revealed a significant relation between hypertension and only one indicator of stress – PTSD cluster B (p<0.0001).

Conclusion
Hypertensive refugee women had more pronounced emotional distress and PTSD than non-hypertensive participants. Among all studied indicators of emotional distress and PTSD, re-experiencing traumatic events was the stress element most strongly associated with hypertension. Our findings will be further explored with a detailed cardiovascular assessment, re-evaluation of stress questionnaires and psychiatric consultation of refugees.
P204 BANGLADESH HEARTS: LESSONS LEARNED FROM A NATIONAL HYPERTENSION CONTROL PROGRAM, 2018-2024
Authors: Jubayer Shamim , Ahsan-uz-zaman  , Abrar Ahmad Khairul , Aimiosior Obehi , Bhuiyan Mahfuzur Rahman , Banigbe Bolanle , Gupta Reena , Moran Andrew E. , Amin Mohammad Robed , Choudhury Sohel Reza 
Published: September 2024

Background and Objective:
In Bangladesh, 21% of all adults aged >=18 years have hypertension but among hypertensives, only 14.1% have blood pressure (BP) controlled (<140/90 mmHg) .1 To improve hypertension control and prevent cardiovascular disease, the Non-Communicable Disease Control Program under the Ministry of Health & Family Welfare launched the Bangladesh Hypertension Control Initiative (BHCI) with technical support from the National Heart Foundation of Bangladesh and Resolve to Save Lives.
Method: The BHCI gradually implemented the World Health Organization (WHO) HEARTS standardized hypertension control package in 172 sub-district facilities (35% of all sub-district facilities) & 10 district-level facilities in 23 districts from 2018 to 2024. BHCI facilities implemented a simple, evidence-based, step-by-step, and drug & dose-specific hypertension treatment protocol, a reliable supply of protocol medicines free of charge to patients, team-based care including non-physician members, and the Simple digital hypertension management app to collect real-time data and facilitate patient and program monitoring over time. A continuous quality improvement initiated in 2020 focused on lowering missed visit rate and raising blood pressure control. Missed visit rate was the proportion of all enrolled patients failing to attend a scheduled clinic visit in the prior three months; BP control was proportion with BP <140/90 mmHg at their last visit in the prior three months.

Results:
From March 2019 to February 2024, the BHCI had enrolled 364,038 hypertensive patients in treatment (Figure). Facility-based BP control increased from 37% in July 2020 when the quality improvement program started to 57% by April 2024. Missed visits decreased from 53% in July 2020 to 29% by April 2024.

Conclusion:
BHCI is on track for national scale-up in Bangladesh and can serve as a model for WHO-HEARTS hypertension control programs in other LMIC countries.

Reference:
1. World Health Organization. National STEPS survey for non-communicable diseases risk factors in Bangladesh 2018.
Panel A: number of hypertension patients enrolled in treatment.
Panel B: rates of missed hypertension management visits and blood pressure controlled <140/90