bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREFERENCE IN USING HOME VERSUS AMBULATORY BP MONITORING FOR THE ASSESSMENT OF NOCTURNAL HYPERTENSION IN HEMODIALYSIS PATIENTS
Authors: Leonidou K , Georgianos P , Kollias A , Vaios V , Divanis D , Georgianou E , Chrapis P , Anastasiou S , Stergiou G , Zebekakis P , Liakopoulos V 
Published: May 2024

Objective:
Although ambulatory blood pressure (ABP) monitoring is for long considered as the unique method for the diagnosis of nocturnal hypertension, novel home BP (HBP) monitors have been developed to facilitate the assessment of BP during the period of sleep. This study aimed to investigate the preference in using HBP versus ABP monitoring for the assessment of nighttime BP in hemodialysis patients.

Design and method:
A total of 70 stable hemodialysis patients underwent assessment of BP with 2 methods: (i) 44-hour interdialytic ABP monitoring (20-min intervals; Microlife WatchBP O3 device) and (ii) HBP monitoring for 7 days (duplicate morning and evening BP measurements) and 3 nights (3 BP measurements per night over the 3-day interdialytic interval; Microlife WatchBP Home N). After the completion of these measurements, patients were asked to complete a questionnaire on their preference in using HBP vs. ABP monitoring for the assessment of nighttime BP.

Results:
The mean age of study participants was 65.3±13.3 years, 45 patients (64.0%) were males, and 62 patients (88.7%) were receiving antihypertensive treatment. Moderate-to-severe anxiety with respect to the diagnostic procedure was reported by 10.0% vs. 24.3% of patients for HBP and ABP monitoring (P<0.001), respectively. Moderate-to-severe discomfort (15.7% vs. 44.3%, P<0.001) and disturbance of the quality of sleep (30.0% vs. 48.6%, P<0.001) was reported less commonly with the use of HBP than with the use of ABP monitoring. Furthermore, severe restriction of daily activities occurred in 4.3% of patients during the period of HBP monitoring versus 12.9% of patients during the period of ABP monitoring (P=0.343). HBP monitoring was the preferred method for the assessment of nighttime BP in 67.1% of study participants.

Conclusions:
The present study shows that relative to interdialytic ABP monitoring, nocturnal HBP recordings are preferred by a higher proportion of hemodialysis patients for the diagnosis of nocturnal hypertension.
INCREMENTAL VALUE OF A CUFF-LESS BLOOD MEASUREMENT DEVICE COMPARED TO CLINIC BLOOD PRESSURE MEASUREMENT
Authors: Vischer Annina , Hotz Leana , Derendinger Felicia , Krisai Philipp , Socrates Thenral , Schumacher Christina , Mayr Michael , Burkard Thilo 
Published: May 2024

Objective:
Cuffless, pulse-transit-time based 24-hour blood pressure measurement (BPM) lacks clinical validation based on recent protocols. It tends to higher values than cuff-based BPM, making standard hypertension cut-off values inapplicable. Additionally, the cuffless device exhibits a lower ability to track 24-hour blood pressure changes than standard devices. Due to these limitations, this study aims to evaluate if there is an advantage of cuffless BPM over clinic BPM (CBP).

Design and method:
166 participants were prospectively enrolled for simultaneously performed cuffless (TestBP, Somnotouch NIBP) and cuff-based (RefBP, Spacelabs or Mobil-o-graph) 24h-BPM. CBP was defined as the mean of 3 cuff-based BPM: after 5 min of rest, BP was measured sequentially at both upper arms. Then, first, RefBPM was used as calibration for cuffless TestBP. We compared the TestBP and CBP to mean awake RefBP including calculation of test characteristics for the diagnosis of elevated BP using ROC curve analysis to identify ideal cut-off values for the TestBP. Gold standard for the detection of elevated BP was mean awake RefBP (>134/84 mmHg).

Results:
Median age was 51 years (IQR 40-63). Mean awake systolic and diastolic RefBP was 134±15 mmHg and 83±10 mmHg, respectively. Mean differences between TestBP and RefBP were 6±13/5±8 mmHg and mean absolute differences 11±9/7±6 mmHg, for systolic/diastolic values, respectively, whereas for CBP 7±13/5±7 mmHg and 12±10/7±5 mmHg. There was a linear relationship between TestBP/CBP and RefBP (Figure, panels A-D). In ROC analysis CBP and TestBP showed an AUC for the diagnosis of hypertension on awake RefBP of 0.845/0.873 and 0.862/0.877 for systolic/diastolic values, respectively. Best cut-off for hypertension was at 133/88 mmHg for mean 24h, 137/88 mmHg for awake and 136/80 mmHg for asleep cuffless TestBP values. Misclassifications compared to RefBP with these (ASV) and previously published (TS) cut-offs for TestBP and usual cut-offs for CBP are shown in the figure (panels E-F).

Conclusions:
We found a low incremental value of the TestBP device in relation to CBP, with comparable AUCs and correlation coefficients. With the application of the adapted awake BP cut-off of 137/88 mmHg, masked hypertension misclassification may be reduced
VALIDATION OF THE SMARTPHONE BLOOD PRESSURE MEASUREMENT SOLUTION OPTIBP™ TO TRACK BLOOD PRESSURE CHANGES IN PREGNANT WOMEN
Authors: Almeida Pedro , Cuènoud Alexia , Othenin-girard Alexandra , Hoang Harry , Christen Urvan , Schoettker Patrick 
Published: May 2024

Objective:
Hypertensive disorders present significant morbidity and mortality during pregnancy. While ambulatory blood pressure measurement remains the standard of care for normotensive women, self-monitoring at home is increasingly prevalent. The widespread use of smartphones worldwide has sparked interest in mobile applications that leverage the built-in hardware for blood pressure estimation, yet few trials have assessed their accuracy.

Design and method:
This prospective, longitudinal and monocentric study evaluated the accuracy of the OptiBP algorithm against standard oscillometric blood pressure measurements in a sample of pregnant women. Patients scheduled for elective caesarean sections were enrolled during the preoperative anesthesia consultations. Paired blood pressure measurements using OptiBP and the reference method were obtained at multiple time-points in late pregnancy and the post-partum period. Agreement between methods was assessed using the AAMI/ESH/ISO 81060-2:2018 standard thresholds of 5±8 mmHg for mean ± standard deviation of the error (criterion 1) and patient-specific standard deviation of the mean error (criterion 2) and represented graphically by Bland-Altman scatterplots.

Results:
Twenty-four women were enrolled of which 15 completed the protocol, yielding 166 total valid measurement pairs. Mean and standard deviation of the error were -0.74 ± 8.38 and 0.99±6.88, and the patient-specific standard deviation of the mean error was 5.84 and 3.36, for SBP and DBP respectively.

Conclusions:
Compared with blood pressure measure with an oscillometric device, OptiBP's blood pressure estimates meet the AAMI/ESH/ISO 81060-2:2018 criteria for DBP.
POOR TOLERABILITY OF THE STANDARD, EXTENDED, 48H AMBULATORY BLOOD PRESSURE MONITORING IN HEMODIALYSIS PATIENTS
Authors: Torino Claudia , Mallamaci Francesca , Sarafidis Pantelis , Papagianni Aikaterini , Ekart Robert , Hojs Radovan , Balafa Olga , Giudice Antonio Del , Aucella Filippo , Morosetti Massimo , Tripepi Rocco , Marino Carmela , Tripepi Giovanni , Zoccali Carmine 
Published: May 2024

Objective:
44h or 48h Ambulatory blood pressure monitoring (ABPM) is recommended for diagnosing hypertension in dialysis patients. Because the longer recording period, the notorious sleeping disturbances and the symptom burden of the ESKD population, the feasibility of the technique may be limited in this population. However, its large-scale tolerability of ABPM in hemodialysis patients has never been investigated.

Design and method:
We performed a survey of the feasibility and tolerability of 48h ABPM in 6 European centres, led by motivated nephrologists members of the EURECA-m working group. 48h ABPM recording was proposed to a representative sample of the dialysis population of these centres. Recordings were made at 15-minute (day) or 30-minute (night) intervals. Reasons for refusal to undergo the test, for not completing the monitoring, and symptoms developed during the ABPM study were systematically recorded.

Results:
In the whole hemodialysis population of participating centers including 735 patients, 440 (60%) were invited to participate in the study. Among these patients 119 patients (27%) refused to undergo ABPM recording. Reasons for refusal are detailed in the table. Among the 321 patients who performed the 48h ABPM recording, 29 patients (9%) did not complete it and the main reason for interrupting the recording were discomfort (41%) and device failure (34%). Frequent interruption of sleeping because of noise or discomfort was a symptom reported by 32% of patients, followed by itching (24%) and pain during the measurements (20%). The detailed list of symptoms is reported in the table.

Conclusions:
About 25% of hemodialysis patients consider 48h ABPM a laborious and discomforting test and prejudicially refuse to undergo it. Among patients who undergo 48h ABPM, itching and interruption of sleeping are complained by about 1/3 of patients. These figures are substantially higher than those reported in studies in the general population and in hypertensive patients and point to peculiar barriers at applying extended ABPM recordings in the hemodialysis population. Studies applying more tolerable instruments and a minimum set of measurements over a shorter time are clinical research priority for extending the use of ABPM in the hemodialysis population.
AUTOMATED ATRIAL FIBRILLATION DETECTION DURING ROUTINE BLOOD PRESSURE MEASUREMENT: DIAGNOSTIC ACCURACY OF THE OSCILLOMETRIC BLOOD PRESSURE MONITOR MICROLIFE BP B3 AFIB ADVANCED
Authors: Ntousopoulos Vasileios , Menti Ariadni , Kyriakoulis Konstantinos , Tsiachris Dimitrios , Kollias Anastasios , Stergiou George 
Published: May 2024

Objective:
To evaluate the diagnostic accuracy of the oscillometric upper-arm cuff home blood pressure (BP) monitor Microlife BP B3 AFIB Advanced in detecting atrial fibrillation (AF) during automated BP measurement.

Design and method:
Participants with permanent AF aged >60 years (AF group) and others with sinus rhythm (SR) matched for age and sex (control group) were recruited. Electrocardiography (ECG) recording and blood pressure (BP) measurements were simultaneously conducted twice for each participant. Using an AF specific diagnostic algorithm of the BP monitor, the rhythmicity of heart rate was evaluated three times during each automated BP measurement. When AF is detected in at least 2 of the 3 assessments, the device reports the presence of AF detection. A single wide-range cuff of the test device was used for arm circumference 22-42 cm.

Results:
A total of 108 individuals were analyzed, (50%/50% with AF/SR, 59%/59% men, mean age [SD] 76±10.5/73±9.5 years for AF/SR, systolic BP 123.4±19.6/131.5±17.9 mmHg [p<0.01], diastolic BP 74.2±11.7/73.4±10.6 mmHg [p=NS]). False negative and false positive AF detection in AF and control group respectively are shown in Table. The sensitivity of the test device in detecting AF was 87%, specificity 100%, positive predictive value 100% and negative predictive value 88.5%.

Conclusions:
These findings indicate that the Microlife BP B3 AFIB Advanced automated BP monitor equipped with an AF detecting algorithm with triplicate assessment of the cardiac rhythm during each automated BP measurement, has an exceptional diagnostic accuracy. Thus, this novel technology can be employed as a reliable screening tool for detecting asymptomatic AF in elderly adults during routine screening or long-term monitoring of treated hypertension.
ARTERIAL STIFFNESS AND LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH WHITE COAT HYPERTENSION
Authors: Solé Ricardo Cabrera , Lucas Caridad Turpin , Luepke Erick 
Published: May 2024

Objective:
White coat hypertension (WCHTA) is not a benign process as previously believed. In many cases they end up being true hypertensives. Little has been published on the index of arterial stiffness and pulse pressures, as well as central pressures in such patients.
To assess the arterial stiffness index, left ventricular hypertrophy and central pressures in patients with WCHTA and compare them with normotensive (PN) patients (P).

Design and method:
MATERIAL AND METHODS: we studied 100 P with WCHTA and compared them with another group of 100 normotensive P in whom a study was performed with ABPM, an echocardiogram to assess hypertrophy and central pressures were measured (Central sys, Central diast), as well as the augmentation index (AI). The results were compared and shown below:

Results:

Conclusions:
P with WCHTA have higher blood pressures than those considered normotensive in both peripheral and central measurements. Likewise, these P have greater arterial stiffness than normotensives, more hypertrophy of the left ventricle and there is more diastolic dysfunction measured by the E/A index of mitral flow, which we will have to take into account when we encounter this type of P, since they also entail a greater cardiovascular risk.
ASSOCIATION OF SUBCLINICAL INFLAMMATION MARKERS WITH PRIMARY HYPERTENSION IN CHILDREN - A SYSTEMATIC REVIEW WITH META-ANALYSIS
Authors: Dziedzic-jankowska Katarzyna , Kolodziej Maciej , Skrzypczyk Piotr 
Published: May 2024

Objective:
Primary hypertension (PH) is a growing threat to children's health. The pathogenesis of this phenomenon is not fully known, and subclinical inflammation and activation of the immune system are potential explanations. This systematic review and meta-analysis aimed to systematically determine whether there is an association between low–grade inflammation markers and PH in children.

Design and method:
The MEDLINE, EMBASE, and Cochrane databases were searched up to March 2023, with no language restrictions, for cohort, cross-sectional, and case-control studies; additional references were obtained from reviewed articles. The included studies needed to investigate an association between any inflammation markers and PH defined by the authors. Participants of the study were children (<18 years old) with PH and healthy controls. The main outcome measured was the concentration of any subclinical inflammation markers in children with PH and in healthy controls. This meta-analysis included 12 studies published between 2005 and 2022, enrolling 1220 patients (689 with PH and 531 healthy controls). The data were analyzed using Review Manager. Pooled mean difference (MD) with 95% confidence interval (95% CI) was used to assess the differences in inflammation markers levels. All analyses were based on the random-effect model. The risk of bias was assessed using the Newcastle-Ottawa Scale.

Results:
There was a significant difference between hypertensive and control groups in high-sensitivity C-reactive protein (hsRCP) concentration (MD: 0.07 95%CI [0.04,0.09]), intercellular adhesion molecule 1 (ICAM-1) (MD: 85.28 95%CI: [50.57-119.99]), vascular cell adhesion molecule 1 (VCAM-1) (MD: 259.78 95%CI: [22.65-496.91]), neutrophil count (MD: 0.80 95%CI [0.53-1.07]), monocyte count (MD: 0.07 95%CI: [0.02-0.12]), and neutrophil-to-lymphocyte ratio (NLR) (MD: 0.49 95%CI: [0.32-0.65]). There was no difference in terms of interleukin 6 (IL-6), lymphocyte count, platelet count, mean platelet volume (MPV), as well as in platelet-to-lymphocyte (PLR) and monocyte-to-lymphocyte (MLR) ratios.

Conclusions:
Some easily accessible markers of low-grade inflammation might be used as an additional tool for diagnosis and screening for hypertension in pediatric patients. These promising results should be validated in large and well-conducted studies.
ASSOCIATION BETWEEN TRAJECTORIES OF SYSTOLIC BLOOD PRESSURE AND FRAILTY OUTCOME IN MIDDLE-AGED AND OLDER ADULTS
Authors: Yu Bingyan , Ou Yanqiu , Dong Haojian 
Published: May 2024

Objective:
The association between blood pressure and frailty outcome in the middle-aged and older population remains controversial. This study aimed to examine the relationship between trajectories of systolic blood pressure (SBP) and new-onset frailty.

Design and method:
From the China Health and Retirement Longitudinal Study, 6168 subjects were recruited in 2011 with follow ups in 2013, 2015 and 2018. The frailty index (FI) was constructed based on 40 scored items, with FI more than or equal to 0.25 defined as frailty. We identified the 5-year trajectory of SBP by latent class trajectory modeling. The association between SBP trajectories and frailty was explored based on hazard ratios (HR) by four Cox proportional hazards models. Restricted cubic splines were used to clarify the relationship between SBP and systolic blood pressure variability (SBPV) and frailty.

Results:
6168 participants were included in this study with a mean age of 59 years. We identified five trajectories based on SBP, which are maintained low-stable SBP (T0), moderate-stable SBP (T1), remitting then increasing SBP (T2), increasing then remitting SBP (T3), and remaining stable at high SBP levels (T4). During the 7-year follow-up period, frailty outcome occurred in 1415 participants. After adjusting for other confounders, the two trajectories labeled “T2” and “T4” were associated with a higher risk of frailty compared with T0. In addition, elevated SBP and increased SBPV were associated with risk of frailty.

Conclusions:
Higher risk of frailty occurred in two trajectories, remitting then increasing and remaining stable at high SBP levels, were associated with a relatively higher risk of frailty.
HIGH-SODIUM DIET INCREASE THE LIKELIHOOD OF BEING NON-DIPPING: ROLE OF 24H PRESSURE MONITORING IN THE DIAGNOSIS OF SALT SENSIVITY
Authors: Tunesi Francesca , Simonini Marco , Citterio Lorena , Zagato Laura , Manunta Paolo , Lanzani Chiara Livia 
Published: May 2024

Objective:
Sodium sensitivity is a change in blood pressure (BP) depending on Na+ intake. Either a salt load test or a sodium dietary protocol can be used to stratify the population into 3 groups based on BP variation: sodium sensitive (SS), sodium resistant (SR), inverse sodium sensitivity (ISS), based on an increase, a non-significant variation or a decrease in BP following the administration of Na+. SS and ISS subject have increase Cardiovascular (CV) risk. BP has a circadian rhythm, detectable with ABPM, characterized by a blood pressure drops by 10% to 20% while sleeping at night (normal dipping), the loss of this phenomenon is associated with increased CV. We evaluate the relationship between sodium sensitivity and ABPM, in particular dipping in untreated hypertensive subjects.

Design and method:
We recruited 844 patients stratified as SS, SR or ISS through acute salt load test carried out at the San Raffaele Hospital in Milan. 600 patients of our cohort also performed ABPM in order to evaluate their dipping pattern.

Results:
The proportion of SR patients is 33.6%, SS is 34.1%, and ISS is 32.2%. 25.8% were dippers while 74.2% were non-dippers. The non-dipper condition is significantly more frequent (p=0,049) in the SS (31.8%). By evaluating the natriuresis during the test, we found that non-dipping subjects excreted more sodium than the others.
The assessment of 24 hours pre-test natriuresis, which reflects the patient's diet, showed that high salt diet is correlated with the non-dipping condition (p= 0,007). The risk of non-dipping in hypertensive patients is increased 1.417 times by a natriuresis greater than 150, which is the upper recommended values for patients with hypertension. Moreover no differences in 24-hour urine sodium were found between the three groups of salt sensitivity.

Conclusions:
A high-salt diet does not determine sodium sensitivity, but increases the likelihood of non-dipping. The data suggests that sodium sensitivity and non-dipping are associated, and a high-salt diet also predisposes to the non-dipping condition.
RIGHT VENTRICLE IN PATIENTS WITH ARTERIAL HYPERTENSION AND B STAGE HEART FAILURE
Authors: Tsverava Mikheil , Tsverava Dimitri , Ungiadze Sophio 
Published: May 2024

Objective:
According to ACC/AHA Heart failure (HF) classification the A stage of HF is a high risk for HF but without structural heart disease or symptoms; B stage is a structural heart disease but without signs or symptoms of HF. One of the most important risk factors of HF is Arterial Hypertension (AH). There is no information about Right Ventricular (RV) structure and function, in patients with stage A and B of HF.
The aim of our research was to study RV structure and function in patients with AH and stage A or B HF.

Design and method:
We studied 163 patients with AH (female-76, male 87). 45 in stage A and 118 in stage B HF. All patients undergone standard EchoCG examination. RV outflow tract (RVout) was examined by M-mode from parasternal short axis and PW TDI from subcostal position (RVoutTDI). The shape of RWoutTDI was different from the Tricuspid anulus TDI. It consists from positive isometric contraction (ICTs), isotonic contraction (s), negative early diastolic (e) late (a) diastolic waves velocities, two negative (e1) positive (e2) isometric relaxation waves. We measured the pick velocities of these waves in cm/sec and isometric contraction (ICT), ejection (RVET) and isometric relaxation time (IRT) intervals in msec.
On M-mode EcoCG of RVoutRV we measured Diastolic Diameter (Dd) systolic diameter (Ds), fractional shortening (RWoutFS) and RW wall systolic excursion (RWexc).

Results:
We did not find any significant differences between in RV EcoCG, RVout, RVoutTRI and Tricuspid annulus TDI parameters between the A and B Heart Failure groups in patients wit Arterial Hypertension.

Conclusions:
There is no difference in EchoCG parameters between A and B Heart Failure groups in patients with Arterial Hypertension.
RIGHT VENTRICULAR OUTFLOW FUNCTION IN ARTERIAL HYPERTENSION
Authors: Tsverava Mikheil , Tsverava Dimitri , Ungiadze Sophio 
Published: May 2024

Objective:
Anatomically and functionally the Right Ventricle (RV) differs from Left. Its structure is complex, and consists of 2 anatomically and functionally different parts, inflow, and outflow tract. The aim of the research was to study the changes of RV Outflow Tract (RVOT) in patients with Arterial Hypertension (AH)

Design and method:
We studied 163 patients with AH. RV outflow tract (RVout) was examined by M-mode from parasternal short axis and PW TDI from subcostal position (RWoutTDI). On RVout M-mode we measured diastolic (Dd) systolic diameters (Ds), fractional shortening (RWoutFS= RVoutDiastD-RVoutSystD)/RVoutDiastD%.) and RW wall systolic excursion (RWexc); The shape of RWoutTDI was different from the Tricuspid anulus TDI (TrTDI). It consists of positive isometric contraction(s1), isotonic contraction (s), negative early diastolic (e) late (a) diastolic waves velocities and two (negative-e1, positive-e2) isometric relaxation waves. We measured the pick velocities of waves in cm/sec and duration of isometric contraction (ICT), ejection (RVET) and isometric relaxation time (IRT) intervals in msec. Control group consist from 192 normal persons.

Results:
In AH RV wall thickness was significantly greater (3.47±0.7 vs 4.56±0.8), RVoutFS% shorter (55.0±6.0 vs 57.4±5.9%) and outflow Dd and Ds greater than in control. On RWoutTDI the velocities of s1, s2, e and e1 valves vas significantly lesser in hypertensives (5.3±1.9;8.7±1.5;5.6±1.6;versus 6.6±2;9.4±0.1;6.2±1.6;7.6±1.9;6.2±1.7) the duration of ICT and IRT longer and RVER shorter (55.8±12.9; 92.1±19.3; 287.1±29.3 versus 62.0±20.1; 107.4±26.8; 273.2±37.2 msec) than in controls.

Conclusions:
Despite no difference in RV inflow and cavity parameters, there are prominent changes in RV outflow tract in AH, which may be an early sign of structural and functional remodeling of the right heart.