bluuebunny/crossref_metadata_2025_split huggingface dataset:
O68 ATRIAL SEPTAL ANEURYSM IN IDENTICALS TWINS
Authors: López-Aldazoro Ysabel Cecilia , Tellez Mendez Ramon Dario 
Published: September 2024

Introduction:
Interatrial septal aneurysm (ISA) is a dilatation of saccular tissue, generally located in the foramen ovale area, which moves freely and protrudes into the right or left atrium, or even both. Today it is estimated that 85% of children born with congenital heart disease survive to adulthood, however, we have not found cases of ISA reported in identical twins in adulthood.

Methods:
Two 55-year-old female patients, identical twins EAM and RAM, body surface area 1,899 and 1,826 m2 respectively, consulted for elevated blood pressure (160/90 and 160/95 mmHg respectively). One of them reported headache accompanied by joint pain and mild dyspnea, the other patient reported palpitations and mild dizziness. His parents are hypertensive. They were hospitalized at 5 months of age due to viral meningitis, with no further consequences. Antihypertensive treatment, laboratory, stress test, and echocardiogram/Doppler were prescribed.

Results:
Laboratory tests were found to be normal. The stress test (protocol: Bruce) was reported to be negative for induced myocardial ischemia. Echocardiography revealed ISA in both patients.

Conclusions:
Twins, particularly monochorionic twins, are at increased risk of congenital anomalies compared with singleton pregnancies, and the risk of cerebrovascular disease (CVD) or transient ischemic attack (TIA) in patients with ISA is 6.7% in adult patients. ISA has been associated with acquired cardiac diseases, such as valvular heart disease, cardiomyopathies, pulmonary and systemic hypertension, ischemic heart disease, arrhythmias, and thrombus formation. More recently, an association with embolic cerebrovascular pathology has been observed, both in TIA and CVD. For this reason, we consider that in adult patients who are identical twins when one of them is found with ISA, an evaluation should be carried out in their twin for its appropriate treatment and thus avoid future cardiovascular complications derived from this anomaly. According to our reviews, this is the first case of ISA in identical twins. New observations on ISA in twins are needed.
O90 EFFICACY AND SAFETY OF DUAL COMBINATIONS OF ANTIHYPERTENSIVE DRUGS AS FIRST-LINE THERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Dhurjati Rupasvi , Pant Rashmi , Kumar Amit , Rodgers Anthony , Haghdoost Faraidoon , Salam Abdul 
Published: September 2024

Background:
Hypertension remains the primary cause of mortality worldwide, resulting in about 11 million deaths annually. Despite recent hypertension guidelines advocating for dual combination of antihypertensive drugs as the first-line therapy for most patients, many patients do not receive this therapy.

Objective:
To assess, among adults with hypertension, dual combinations of AHTDs compared to monotherapy as first-line treatment for blood pressure (BP)-lowering efficacy and safety.

Methods:
We systematically searched multiple electronic databases until December 2022 to identify relevant randomized, double-blind trials. We included trials involving adults with hypertension who were either treatment naive or untreated for at least 2 weeks, compared dual combinations of drugs with monotherapy from 5 major classes of AHTDs (angiotensin converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers, and diuretics), for a duration of at least 4 weeks and reported data on BP reduction. AHTDs and their combinations were categorized based on standard daily doses. Outcomes were reduction in BP, treatment related adverse events (TRAE) and withdrawals from the treatment due to adverse events (WDAE). Meta-analyses were conducted using random-effects model.

Results:
We included 98 trials (636 comparisons and 25892 participants). Overall, baseline mean BP was 159/102 mmHg. Overall BP reduction with dual combination compared to monotherapy was 4.4 (CI: 3.8-5.1)/3.5 (CI:3.2-3.9) mmHg. Compared with standard-dose monotherapy, dual combinations of <1 + <1, 1 + <1 and 1 + 1 (i.e. low-to-standard dose), showed a dose-response relationship in reducing BP by 1.4 (CI: 0.01-2.7)/2.3 (CI: 1.4-3.1), 4.4 (CI: 3.6-5.2)/ 3.3 (CI: 2.9-3.8) and 7.8 (CI: 6.2-8.9)/5.2 (CI: 4.4-5.9) mmHg, respectively. TRAEs [4.8% vs 4.9%; RR 0.92 (0.80 to 1.06)] and WDAEs [0.8% vs 0.9%; RR 1.8 (1.5 to 2.1)] were uncommon with low-to-standard dose dual combinations, with no significant difference compared with standard-dose monotherapy.

Conclusion:
First-line treatment with low-to-standard dose dual combination therapy is more efficacious and equally safe compared to monotherapy to reduce BP.
O102 RELATIONSHIP BETWEEN AGTR1 (c.1166 A>C) POLYMORPHISMS AND KIDNEY INJURY IN HYPERTENSION
Authors: Zeng Yiyao , Jiang Yufeng , Huang Ziying , Zhou Yafeng 
Published: September 2024

Background:
High blood pressure is the main cause of cardiovascular diseases. Kidney damage is one of the most common organ secondary damage to hypertension. The study of hypertension gene polymorphisms is an important means of precision treatment of primary hypertension. Objectives: The objective of this study was to explore the relationship between AGTR1 (c.1166 A>C) gene polymorphisms and hypertension combined with kidney damage, while exploring the relationship between codominant, dominant and recessive gene model and hypertension with kidney injury and the susceptibility of different genotypes to hypertension with kidney injury.

Methods:
The distribution of AGTR1 polymorphism in the AGTR1 in hypertensive patients (hypertension group, 292 patients) and hypertension with kidney injury patients (44 patients) were detected and compared by PCR-melting curve method.

Results:
The genotype distribution of hypertension and combined groups met Hardy-Weinberg equilibrium (p > 0.05); the distribution difference between the three genotypes was statistically significant (p < 0.05), the codominant, dominant and recessive distribution frequency of genotypes (p < 0.05), and no difference between A allele and C allele (p > 0.05).

Conclusions:
Our study identified the relationship of AGTRA (c.1166 A>C) with hypertension combined with renal injury, and compared the susceptibility of different genetic models, which may provide novel targets for precision gene therapy of hypertension.
O104 OPTIMAL NIGHTTIME BLOOD PRESSURE MONITORING SCHEDULE USING HOME MONITORS IN CHILDREN AND ADOLESCENTS: ASSOCIATION WITH AMBULATORY BLOOD PRESSURE AND PRECLINICAL TARGET-ORGAN DAMAGE
Authors: Stambolliu Emelina , Kollias Anastasios , Bountzona Ioanna , Ntineri Angeliki , Servos George , Vazeou Andriani , Kyriakoulis Konstantinos , Stergiou George 
Published: September 2024

Background and Objective:
To evaluate the optimal schedule for nighttime blood pressure (BP) assessed using home monitors (HBP) in terms of agreement with nighttime ambulatory BP (ABP) and association with indices of preclinical organ damage in children and adolescents.

Methods:
Apparently healthy children and adolescents (6-18 years) referred for elevated BP were subjected to (i) 24-hour ABP monitoring using a validated upper-arm cuff oscillometric device (Microlife WatchBP O3), (ii) HBP monitoring during daytime (7 days, duplicate morning and evening measurements) and nighttime (automated measurements, 3 nights, 3 hourly measurements/night) using a validated upper-arm cuff oscillometric device (total of 9 nighttime readings, Microlife WatchBP HOME N), (iii) carotid intima-media thickness (cIMT) measurement (ultrasonography), (iv) carotid-femoral pulse wave velocity (cfPWV) (Complior device; duplicate measurements), and (v) echocardiographic determination of left ventricular mass index (LVMI).

Results:
Forty-nine individuals were included (mean age 13.4±2.7 years, 51% males). There were no differences in nighttime HBP among individual readings or the average of different nights (night 1: 109.7±10.9/60.8±7.3 mmHg, systolic/diastolic BP; night 2: 109.1±11.7/59.7±8.6 mmHg; night 3: 109.1±11.5/60.4±8.4 mmHg, p=NS for all comparisons). By averaging an increasing number of nighttime systolic HBP readings, there was a consistent trend towards a stronger association of nighttime HBP with nighttime ABP (correlation coefficients r increased from 0.65 to 0.81), and with indices of preclinical organ damage (LVMI: 0.21 to 0.30; cIMT: 0.38 to 0.57; cfPWV: 0.60 to 0.69). There was no further improvement in these associations by averaging >4 nighttime readings. The diagnostic agreement between the two methods in detecting nocturnal hypertension was progressively improved by averaging more nighttime HBP readings with near plateau at 4 measurements.

Conclusions:
A two-night HBP monitoring schedule (6 readings) appears to be the minimum requirement for a reliable assessment of nighttime HBP in children and adolescents, which provides reasonable agreement with nighttime ABP and association with preclinical organ damage.
P006 AGE-RELATED DIFFERENCES IN PULSE PRESSURE AND AMBULATORY ARTERIAL STIFFNESS INDEX MEASURED BY AMBULATORY BLOOD PRESSURE MONITORING
Authors: Córdoba Laura Fernanda Gilón , Gómez Valencia Aura Maria , Póveda Henao Claudia Marcela , Villegas Claudia Jaramillo , Beltrán Fernan Mendoza 
Published: September 2024

Background:
Hypertension is a prevalent public health concern, particularly affecting older adults. Beyond optimal blood pressure (BP) control, ambulatory blood pressure monitoring (ABPM) offers valuable insights into additional cardiovascular parameters like pulse pressure (PP), arterial stiffness index (AASI), and heart rate (HR). Studies have shown that PP correlates with systolic blood pressure and predicts cardiovascular mortality in older adults (1). Furthermore, AASI, a readily measured indirect marker of arterial stiffness, has demonstrated predictive power for cardiovascular mortality (2).

Objective:
This study investigates the differences in PP, AASI, and HR measured through ABPM across age groups (younger than 50 years, 50-65 years, and over 65 years) and between genders.
Methods: This cross-sectional descriptive study analyzed ABPM data collected between 2018 and 2024 from a cardiovascular institution in Colombia. Mean systolic and diastolic BP, heart rate, AASI, and PP were evaluated based on age and sex. Normality testing was performed using the Kolmogorov-Smirnov test. For continuous variables, parametric ANOVA tests compared values across age groups. Categorical variables were analyzed using Chi-square tests.

Results:
A total of 150 patients participated in the study, with females comprising 76 (50.7%) of the group. The age distribution was: 23.3% younger than 50 years, 41.3% between 50-65 years, and 34.0% over 65 years old. Significant differences were found in diastolic BP, PP, AASI, and HR between the age groups. Importantly, no significant differences were observed in these measures based on gender, nor in systolic BP by age or sex.

Conclusions:
Our findings align with previous research, demonstrating an increase in PP and AASI with advancing age. Given its widespread availability, ABPM offers a valuable tool. Incorporating additional parameters like PP and AASI provides further information potentially linked to cardiovascular mortality risk.
1. Glynn RJ et al. Pulse Pressure and Mortality in Older People. Arch Intern Med. 2000;160(18):2765–2772.
2. Li, Y. et al. Ambulatory arterial stiffness index derived from 24-hour ambulatory blood pressure monitoring. Hypertension, 47(3), 359–364.
P007 HIGH PREVALENCE OF HYPOTENSION IN OLDER ADULTS ON AMBULATORY BLOOD PRESSURE MONITORING (ABPM)
Authors: Córdoba Laura Fernanda Gilón , Valencia Aura Maria Gómez , Villegas Claudia Jaramillo , Henao Claudia Marcela Póveda , Beltrán Fernan Mendoza 
Published: September 2024

Background:
Hypertension, a prevalent public health concern, disproportionately affects older adults. Effective blood pressure (BP) control is crucial to preventing cardiovascular complications such as heart attack, stroke, and heart failure. In recent years, there has been a discussion about the optimal BP control strategies in older adults (1). While some studies advocate for intensive BP control, others emphasize the importance of considering individual patient characteristics, such as age and frailty (2,3).

Objective:
This study aims to describe the prevalence of hypotension in ambulatory blood pressure monitoring (ABPM) in older adult patients compared to younger patients.

Methods:
This cross-sectional descriptive study analyzed ABPM records from 2018 to 2024 at a cardiovascular institution in Colombia. The difference in systolic (SBP) and diastolic (DBP) blood pressure was evaluated according to the age group (younger or older than 80 years) to determine the presence of hypotension in older adults defined as pressure less than 90/60 mmHg. Normality was assessed using the Kolmogorov-Smirnov test. Comparisons of continuous variables across age categories were performed using the non-parametric Mann-Whitney U test. For categorical variables, the Chi-square test was employed.

Results:
Among the 653 participants, 57.3% (374) were women. The average age was 63 years, with 60 patients (9.18%) being over 80 years old. Table 1 shows a significant difference in systolic and diastolic blood pressure (SBP and DBP) between the age groups. Notably, 47.5% of patients over 80 had SBP less than 130 mmHg, and a high prevalence (84.7%) had DBP less than 90 mmHg. DBP below 60 mmHg was more common in this age group. Additionally, 20 older adults had SBP between 130-139 mmHg.

Conclusions:
This study demonstrates a high prevalence of hypotension, especially low DBP, in older adults. Considering these findings, re-evaluating current blood pressure control targets for older adults is crucial to avoid overtreatment and minimize the risk of complications like symptomatic hypotension and falls.
P008 COMPARISON OF CLINICAL OUTCOME OF ELDERLY (AGED >65 YEARS) VS NON-ELDERLY HYPERTENSIVE STEMI PATIENTS: RESULTS FROM NAMI REGISTRY
Authors: Kalimuddin Md , Malik Fazila Tun-Nesa , Ishraquzzaman Mir , Ahmed Nazir , Badiuzzaman Mohammad , Ahmed MN , Dutta Ashok , Banik Dhiman , Rahman MH , Huq TS , Kanungo Smita , Laila Nazmun , Ara Esmat , Choudhury SR , Mamun Mohammad Abdullah Al 
Published: September 2024

Background and Objective:
Elderly hypertensive ST-segment elevation myocardial infarction (STEMI) patients had increased morbidity and mortality. Little is known regarding clinical outcome of elderly hypertensive STEMI patients worldwide. This study aimed to compare clinical outcome of elderly and non-elderly hypertensive STEMI Bangladeshi patients.

Methods:
This prospective observational study- National Heart Foundation Hospital Acute Myocardial Infarction (NAMI) Registry was carried out in our hospital over eight years (2015-2022). All hypertensive STEMI patients were included in this study. Clinical outcome of elderly (aged >65 years) and non-elderly (aged ≤65 years) patients were compared.

Results:
NAMI registry enrolled 10488 STEMI patients. Among them 6890 (65.69%) patients were hypertensive and included in this study. Of them 1127 (16.4%) patients were elderly, and 5763 (83.6%) patients were non-elderly. The mean age of the elderly patients was 72.93 ± 5.5 years and non-elderly patients 52.54 ± 8.69 years. Although male were predominant in both groups (79.3% vs 85.0%; p=0.001), significantly more female were in elderly group (20.7% vs 15.0%; p=0.001). Most of the elderly patients had chronic kidney disease (85.1% vs 41.3%; p=0.001). Most of the non-elderly patients were smokers (52.8% vs 41.3%; p=0.001), dyslipidemic (81.1% vs 76.0%; p=0.001), and obese (38.8% 31.4%; p=0.001). Elderly patients received less invasive therapy (thrombolytic therapy- 14.3% vs 19.0%, p=0.002; primary percutaneous coronary intervention- 10.6% vs 11.6%; pharmaco-invasive therapy-5.9% vs 11.4%, p=0.001; only percutaneous coronary intervention- 18.4% vs 20.0%) and more medical therapy (50.9% vs 38.1%; p=0.001). Elderly patients were more prone to complications (cardiogenic shock- 14.8% vs 10.8%, p=0.001; acute left ventricular failure- 33.9% vs 22.7%, p=0.001; conduction disturbance- 15.2% vs 9.7%, p=0.001; arrhythmias- 13.1% vs 8.2%, p=0.001; cardiac arrest-7.5% vs 4.7%, p=0.001; in-hospital death- 7.9% vs 4.2%, p=0.001).

Conclusions:
Most of the elderly hypertensive STEMI patients had chronic kidney disease, less risk factor, received less invasive therapy but more medical therapy and were more prone to complications in comparison to younger counterpart.
P009 CORRELATION BETWEEN PLASMA ALDOSTERONE CONCENTRATION AND BONE MINERAL DENSITY IN HYPERTENSIVE PATIENTS: POTENTIAL IMPACT ON OSTEOPOROSIS AND FUTURE FRACTURE RISK
Authors: Li Nanfang 
Published: September 2024

Background:
Previous studies have suggested that aldosterone may play a major role in calcium-phosphorus homeostasis and bone metabolism. However, the relationship between plasma aldosterone concentrations (PAC) and bone mineral density (BMD) in hypertensive patients remains unclear. Therefore, this study sought to investigate the relationship between PAC levels and BMD and explore PAC's potential impact on osteoporosis and future fracture risk in hypertensive patients.

Methods:
Our study included a total of 1430 participants. Associations are tested using multiple linear and logistic regression models. Nonlinearity was investigated using the restricted cubic spline (RCS). We also performed mediating analyses to assess mediating factors mediating the relationship between PAC and osteoporosis.

Results:
The multiple linear regression showed a negative correlation between PAC and BMD and was generally positively associated with FRAX scores. Meanwhile, logistic regression analyses indicated that osteoporosis was highly correlated with PAC levels. In addition, a clear non-linear dose-response relationship was also shown in the constructed RCS model. Finally, mediation analyses showed that serum potassium played an important role in the development of osteoporosis.

Conclusion:
This study demonstrates that elevated PAC levels are strongly associated with decreased BMD, increased prevalence of osteoporosis, and the risk of future fractures in hypertensive patients. Further studies are needed to confirm this relationship and reveal its underlying mechanisms.
P011 PREVALENCE OF HYPERTENSION AND ASSOCIATION WITH RED MEAT AND VEGETABLE CONSUMPTION IN A MEGACITY IN NIGERIA: A POPULATION-BASED SURVEY
Authors: Ogunremi Olufemi , Olanrewaju Timothy Olusegun , Adewumi Enoch Babatunde , Dada Samuel Ayokunle , Idris Olajide , Okeanyaego Ifeyinwa Courtney , Ndukwe Maryanne , Dada Adedamola A. , Oyedepo Dapo S. , Adekoya Adebowale , Adesola Sunday O. , Ige Elisha , Awobusuyi Olugbenga 
Published: September 2024

Background and Objectives:
Hypertension is a growing burden worldwide, but the impact is worse in developing countries especially in cities, due to epidemiologic transition, rapid urbanization and socioeconomic dynamics. We determine the current prevalence of hypertension, and association with red meat and vegetable consumption in Lagos, a megacity in Nigeria.

Methods:
This was a population-based opportunistic cross-sectional survey of 2244 voluntary adults ≥ 18years residents of Lagos megacity in Nigeria. Socio-demographic and clinical characteristics were obtained. We measured blood pressure by Omron M3 automatic upper arm monitor after ≥5 min of rest. We defined hypertension as systolic blood pressure of ≥140 mmHg and/or diastolic blood pressure of ≥90 mmHg or use of antihypertensive drugs. Qualitative information on meat and vegetable consumption was documented. Chi squared and multiple logistic regression methods were used to determine association and predictor of hypertension respectively, and odds ratio with confidence interval as the measure of effect size. P value of < 0.05 was taken as statistical significance.

Results:
2244 participants were analyzed, with mean age of 46±14 years, and 75% were women. More than 26% were overweight or obese, 43.2% drinks alcoholic beverages, and 30.3% men and 3.5% women smoked cigarettes. The overall prevalence of hypertension was similar in males (38.1%) and females (37.4%), and it increases with age, reaching 46.7% in ≥ 60years. Daily consumption of meat (38.6% versus 28%(rarely), p =0.03), and infrequent consumption of vegetables (47.7%% versus 19.2%9 (daily intake), p = 0.006) were associated with higher prevalence of hypertension. Older age (OR, 2.133(CI, 1.61 – 2.83)), and family history of hypertension (OR, 1.51(CI, 1.20 – 1.92)) were the predictors of hypertension.

Conclusions:
The prevalence of hypertension is high among middle age urban dwellers in Lagos, Nigeria. Avoidance of red meat, and increased consumption of vegetables, may reduce the burden of hypertension in the population.
P014 APPLICATION OF AI IN HYPERTENSION MANAGEMENT: A REVIEW
Authors: Damodaran Pavithran 
Published: September 2024

Background and Objective:
The integration of artificial intelligence (AI) in healthcare has revolutionized the management of various diseases, including hypertension. This review explores the potential of AI applications in improving hypertension diagnosis, treatment, and patient outcomes.
Methods: A comprehensive literature review was conducted using databases such as PubMed, Scopus, and IEEE Xplore. Studies published between 2010 and 2023 were included, focusing on AI models used for hypertension management, such as machine learning algorithms and predictive analytics.

Results:
AI has demonstrated significant accuracy in predicting hypertension risk factors, optimizing treatment plans, and monitoring patient adherence. Machine learning models, such as neural networks and decision trees, have shown up to 95% accuracy in early hypertension detection. Furthermore, AI-driven personalized treatment plans have resulted in improved patient outcomes and reduced healthcare costs.

Conclusions:
AI holds tremendous potential in transforming hypertension management by enhancing diagnostic precision and personalizing treatment strategies. Future research should focus on integrating AI with electronic health records and developing real-time monitoring systems to further improve patient care.