bluuebunny/crossref_metadata_2025_split huggingface dataset:
ARTERIAL HYPERTENSION IN THE METABOLIC SYNDROME ADULT POPULATION OF ROMANIA AND CURRENT TREATMENT ADHERENCE - SUBANALYSIS OF DATA FROM THE SEPHAR IV STUDY
Authors: Stanciulescu Diana Irena , Dorobantu Maria 
Published: May 2024

Objective:
Cardiovascular disease (CVD) remains to be the leading cause of mortality worldwide with significant increase in cardiovascular mortality trends in Eastern Europe. Romania's burden primarily stems from arterial hypertension and its complications, which account for 62% of all deaths. Metabolic syndrome (MS) arises from a combination of genetic and acquired factors that contribute to insulin resistance and chronic inflammation. When left unaddressed, it poses a substantial risk for the development of diabetes and cardiovascular disease, therefore our study aims to analyze the cardiovascular status of the adult population of Romania.

Design and method:
We evaluated a subgroup of 835 subjects from the total 1477 of SEPHAR IV population (Study for Evaluation of Prevalence of Hypertension and Cardiovascular Risk in an Adult Population in Romania) enrolled during May 15t–July 20th 2021, diagnosed with metabolic syndrome using the The National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (NCEP-ATP III) criteria (MS was present if at least three criteria were met): waist circumference of 102 cm in men and 88 cm in women, hypertryglyceridemia (150 mg/dL) or under specific treatment, low HDL-cholesterol (less than 40 mg/dL in men and less than 50 mg/dL in women), blood pressure readings higher than 130/85 mmHg, fasting blood glucose levels greater than 110 mg/dL or under specific treatment. We collected data regarding the presence of antihypertensive treatment at least 2 weeks prior to inclusion with two or more drugs.

Results:
There was a significanly higher prevalence of NCEP-ATP III arterial hypertension criteria in men (70.5%) compared to women (55.1%). MS was significantly more prevalent in women than men in the general study population, and was significantly more prevalent in the population first diagnosed with arterial hypertension or under current antihypertensive treatment. Previous treatment rate among the hypertensive MS patients was 66.8% and the control rate was 40.1%.

Conclusions:
The burden of cardiovascular risk disease is still very high in Romanian population, similar to other Eastern European countries, because of the insufficient prevention and control and firmly requires active changes.
ASSOCIATIONS OF 25-HYDROXYVITAMIN D WITH FOLATE, COBALANIN AND HOMOCYSTEINE LEVELS AND METHYLENE TETRAHYDROFOLATE REDUCTASE (MTHFR) GENE POLYMORPHISMS, IN HEALTHY GREEK ADULTS
Authors: Papadakis Ioannis , Papadomanolaki Maria , Charizani Aikaterini , Keramaraki Eleni , Malikides Vironas , Mazokopakis Elias 
Published: May 2024

Objective:
The aim of this study was to investigate the associations of serum 25-hydroxyvitamin D [25(OH)D] with various demographic, anthropometric, genetic characteristics, and biochemical parameters, in healthy Greek adults.

Design and method:
Demographic (age, sex), anthropometric [body mass index (BMI)], genetic (MTHFR gene polymorphisms) characteristics, and biochemical parameters [serum folate, cobalamin (Cbl) and total homocysteine (tHcy) concentrations], which had been recorded and measured, among others, in the framework of periodic medical examination (military personnel) or check-up (non-military personnel) of 383 Greek healthy adults (199 men) were analyzed. Serum 25(OH)D, tHcy, folate and Cbl levels were determined using immunoassays methods. The MTHFR C677T and A1298C gene polymorphisms were genotyped using polymerase chain reaction and reverse hybridization.

Results:
Serum 25(OH)D concentrations were correlated with Cbl levels and MTHFR C677T gene polymorphism; while, they had a reverse correlation with serum tHcy levels, age, and BMI. There was no significant correlation between the serum 25(OH)D concentrations and sex, serum folate levels or smoking status. The individuals with 677TT genotype had statistically significant lower serum 25(OH)D levels than those with 677CC or 677CT genotype, while the individuals with 1298CC genotype had statistically significant higher serum 25(OH)D levels than those with 1298AA or 1298AC genotype. Moreover, the reverse correlation between the serum 25(OH)D and tHcy levels was statistically significant in all six MTHFR genotypes.

Conclusions:
Serum 25(OH)D levels are associated with age, BMI, serum tHcy and Cbl levels, and MTHFR C677T gene polymorphism. The most significant finding of our study is the observed reverse correlation of serum 25(OH)D levels with serum tHcy levels. Considering that vitamin D deficiency and hyperhomocysteinemia are associated with an increased risk for cardiovascular disease, we suggest that individuals with high serum tHcy levels should be further investigated, among others, for their serum 25(OH)D levels.
THE ARTERIAL STIFFNESS AS RISK FACTOR FOR THE OCCURRENCE OF ARTERIAL HYPERTENSION IN POSTOPERATIVE CRITICALLY ILL PATIENTS
Authors: Gatsori Panagiota , Intas George , Skopelitis Hlias , Katsoulas Theodoros , Stergiannis Pantelis 
Published: May 2024

Objective:
The aim of the present study is to investigate the predictive value of arterial stiffness in the occurrence of arterial hypertension in critically ill patients. Also, the study investigates the risk factors of arterial hypertension in ICU patients.

Design and method:
This is a prospective observational study. The study included postoperative patients who were admitted to the ICU. We collected demographic characteristics of the patients, their clinical characteristics (i.e. hemodynamic status), clinical severity (APACHE II, SOFA score), lifestyle data (i.e. smoking, alcohol, drugs), and medical history (diabetes mellitus, cardiovascular diseases). Arterial stiffness assessment is performed by recording and analyzing the pulse wave in postoperative patients during the first 24 hours of admission to the ICU. The Sphygmocor software was used for pulse wave analysis and IBM SPSS v.27.0 software was used for statistical analysis.

Results:
The sample of the study consisted of 74 patients. Most of them were males (70.3%) aged 59.3±18.6 yrs and the rest were females (29.7%) aged 63.3±16.9 yrs. Totally, 54.1% of patients had emergency surgery, 60.8% survived and discharged from ICU, 52.7% had arterial hypertension, 70.3% had diabetes mellitus, 58.1% were smoking, and 63.5% had hypercholesterolemia. The APACHE II score of patients was found 21.2±7.2 and the SOFA score 7.5±2.8 The value of peripheral systolic blood pressure (PSBP) was 138.7±19.4 mmHg, peripheral diastolic blood pressure (PDBP) was 67.1±13.2 mmHg, mean peripheral blood pressure (MPBP) was 90.7±14.6 mmHg, pulse pressure (PP) was 53.1±15.3 mmHg and AIX@75 was 22.3±13.1%. Older patients (69.1±14.9 vs. 52.7±17.3, p=0.001), patients with diabetes mellitus (92.3% vs. 7.7%, p=0.001), patients with hypercholesterolemia (92.3% vs. 7.7%, p=0.001), patients with higher value of Albumin (2.9±0.5 vs. 2.5±0.6, p=0.025), and patients with a higher value of AIX@75 (26.8±10.5 vs. 18.3±14.1, p=0.004) had statistically significant higher percentages of arterial hypertension. Higher AIX values are associated with a greater likelihood of arterial hypertension (OR: 1.027; 95%CI: 1.004-1.049, p=0.018).

Conclusions:
The arterial stiffness is an independent risk factor for arterial hypertension in postoperative critically ill patients.
COMPARATIVE ANALYSIS OF ERGOSPYROMETRIC VARIABLES BETWEEN SEDENTARY AND NON-SEDENTARY PATIENTS WITH METABOLIC SYNDROME AND ESTABLISHED CARDIOVASCULAR DISEASE
Authors: Ingaramo Roberto , Lencinas Maria Florencia , Herrera Miriam Priscila , Chavarrea Tony Pilco , Bello Andrea 
Published: May 2024

Objective:
To analyze the ergospirometric prognostic variables of VO2MAX, OUES, SLOPE VE/VCO2, and ventilatory class, between sedentary and non-sedentary patients with metabolic syndrome all suffering from any kind of established cardiovascular disease.

Design and method:
From November 2022 to September 2023, 99 patients, with an average age of 70 years, 51.5% women and 48.5% men, underwent an ergospirometry study. They were divided into two groups: sedentary (SP) and non-sedentary (NSP) according to the responses obtained from the IPAQ survey. Subsequently, the ergospirometric variables that measure cardiorespiratory and cardiovascular capacity related to maximum exercise capacity O2 metabolism (VO2MAX), the increase in oxygen consumption according to minute ventilation (OUES) and the response to ventilation according to CO2 production (slope VE/VCO2) were analyzed in both groups. For statistical analysis, the Student's t test and the Fisher exact test were used. The R v4.0.3 software was used.

Results:
The level of exercise was low in 56 (56.6%) and moderate or high in 43 patients. (43.4%). The NSP group presented higher levels of maximum oxygen consumption (18.3 vs 12.7, p=0.001), higher mean percentage of OUES (92 vs 63.9, p=0.001) and lower mean VE/VCO2 SLOPE ratio (26 vs 31, p=0.001). Among the NSP, 14% were found in ventilatory class 2 and 86% in class 3 and in the SP, 25% were found in class 1, 21.4% in class 2, and 48.2% in class 3. Although that a high percentage of NSP were in functional class 3 (86%) the same presented better values than those SP with better ventilatory class. We did not obtain statistical differences between both groups with respect to their underlying cardiovascular pathologies.

Conclusions:
A sedentary lifestyle is associated with higher erogospirometric variables risk in patients with metabolic syndrome and established cardiovascular disease. The level of physical activity is a factor that modifies this cardiovascular risk. Ergospirometry is an effective tool to measure cardiovascular prognosis.
ASSOCIATION OF C-REACTIVE PROTEIN LEVEL WITH THE RISK OF TYPE 2 DIABETES: SYSTEMATIC REVIEW AND A DOSE-RESPONSE META-ANALYSIS
Authors: Chien Kuo -LIONG , Hsu Jui -YUN , Tsai Szu -YING 
Published: May 2024

Objective:
The relationship between C-reactive protein (CRP) levels and the risk of type 2 diabetes were positive; however, the non-linearity pattern was still unknown. We conducted a systematic review and a dose-response meta-analysis to examine the association between CRP levels and the risk of diabetes and the dose-response curve pattern.

Design and method:
A comprehensive search was conducted in PubMed and Embase databases from the inception to March 7, 2023. We treated CRP as both a continuous and a categorical variable to analyze the risk ratio of incident diabetes. In addition, we performed a dose-response meta-analysis to explore the pattern of the dose-response curve, and a meta-regression analysis for potential effect modifiers.

Results:
A total of 17 studies with high study quality were collected. The CRP level as a continuous variable was associated with a 12% increase in the risk of diabetes [95% confidence interval (CI), 1.06-1.17] per 1 mg/L increase. The high-low comparison showed a significantly higher risk of 71% (95% CI, 1.42-2.06). The dose-response analysis showed a saturation curve pattern, suggesting a high risk among CRP levels within 5 mg/L. In addition, we found that smoking played a modest effect modifier for the association between CRP and diabetes risk (p, 0.11).

Conclusions:
We validated that a high CRP level was associated with the risk of diabetes, and the pattern was likely to be a saturation shape.
ARTERIAL HYPERTENSION AND DYSLIPIDEMIA: ROLE OF LIPOPROTEIN(A)
Authors: Caprnda Martin , Jantosik Matej , Kromka Peter , Tomasik Juraj , Puska Marek 
Published: May 2024

Objective:
Dyslipidemia is a common risk factor in patients with arterial hypertension (AH). Besides LDL cholesterol, also increased levels of Lipoprotein(a) (LpA) are associated with higher risk of cardiovascular events. Despite this, there are no established ways to treat LpA, because traditional hypolipidemic drugs have none or only modest effect on LpA levels; however, several promising drugs are in testing. Contrary to the current guidelines, due to absence of effective therapy, LpA levels aren’t routinely evaluated at clinical practice. Aim of our study was to measure LpA in outpatients with AH to see how many of them would be eligible for future treatment.

Design and method:
We included 55 outpatients who were examined at our department between October and December of 2023. Standard laboratory tests including LpA, basic history, anthropometric and clinical evaluation were carried out. LpA was measured using Randox kit and reported in mg/dl. LpA levels were expressed as median and interquartile range (IQR). Patients with normal LpA levels were defined as < 30 mg/dl and patients with elevated levels were defined as > 50 mg/dl.

Results:
We examined 55 patients with AH (29 men, 26 women) aged 71,36±10,19 years. Median level of Lp(a) was 18 mg/dl [IQR 8-46]. Normal LpA levels were in 65,5% patients and elevated LpA levels in 23,6% patients. There were no significant differences of LpA between genders, nor we found any significant correlation between LpA and total, LDL and HDL cholesterol, glycemia, creatinine, ALT, TSH, BMI or NTproBNP. However, there was a significant correlation between LpA and triacylglycerols (r = 0,307; p=0,024). We did not find higher levels of LpA in patients with previous myocardial infarction, stroke, or peripheral artery disease.

Conclusions:
In our study we found 23,6% patients with AH had LpA > 50 mg/dl. Some of these patients might be eligible for targeted LpA treatment in future.
HUNGARY'S COMPREHENSIVE HEALTH SCREENING PROGRAM 2010-2021 - ANALYSIS OF BLOOD PRESSURE VALUES
Authors: Barna István , Daiki Tenno , Kékes Ede , Dankovics Gergely 
Published: May 2024

Objective:
The Comprehensive Health Screening Program of Hungary 2010-2020-2030 (MÁESZ) (http://www.egeszsegprogram.eu) is the only complex screening program in Hungary, in whose aim was to map the health status of our country.

Design and method:
Between 2010 and 2021, the truck screening program was present at 2,212 locations nationwide and performed more than eight million screening tests for more than 643,172 citizens. Based on the data obtained in the period between 2010-2021, we analyzed the parameters reflecting the state of health and the effect of the factors affecting them in different age groups.

Results:
Results In the period between 2010-2021, we processed the data of a total of 204,748 individuals (119,433 women and 85,315 men). The average age of women (n=119,433) who participated in the screening tests was 42.85 years, and for men (n=85,315) it was 40.43 years. We measured abnormal values in 32% of men and 21% of women. During the evaluation of each stage, we measured values above 160/100 mmHg in more than 21,000 individuals, nearly 13%, of which more than 5,000 visitors (2,439 women, 2,679 men) had a blood pressure above 180/110 mmHg. During the questionnaire evaluation, 38% of the respondents by comparing the measured values and the questionnaires, 13.7% of all women and 30.5% of all men did not know about their elevated blood pressure. During the questionnaire evaluation, 38% of the respondents indicated that there is a hypertensive patient in the family. In all age groups and in groups with elevated blood pressure in both sexes, higher body mass index and abdominal circumference values occur in greater numbers. The correlation of BMI and diabetes with the amount of body fat and blood pressure was significant. (by chi2 test p < 001). Based on the risk assessment questionnaire, 26% of those who appeared in the family had a heart attack, and 18% had a stroke.

Conclusions:
Based on the blood pressure data of the screening program, in the light of its statistical data, it can be stated that a large proportion of those participating in the tests belong to the high-risk group.
LEAD-ASSOCIATED MORTALITY IN THE US 1999-2020: A TIME-STRATIFIED ANALYSIS OF A NATIONAL COHORT
Authors: An Dewei , Yu Yuling , Hara Azusa , Martens Dries , Yang Wen -Yi , Cheng Yi -Bang , Huang Qi -Fang , Asayama Kei , Stolarz-skrzypek Katarzyna , Rajzer Marek , Verhamme Peter , Nawrot Tim , Li Yan , Staessen Jan 
Published: May 2024

Objective:
We undertook time-stratified analyses of the National Health and Nutrition Examination Survey in the US to assess time trends (1999-2020) in the associations of blood lead (BL) with blood pressure (BP), mortality, the BL-associated population attributable fraction (PAF).

Design and method:
Vital status of participants, 20-79 years old at enrolment, was ascertained via the National Death Index. Regressions, mediation analyses and PAF were multivariable adjusted and standardized to 2020 US Census data.

Results:
In time-stratified analyses, BL decreased from 1.76 ug/dL in 1999-2004 to 0.93 ug/dL in 2017-2020, while the proportion of individuals with BL <1 ug/dL increased from 19.2% to 63.0%. Total mortality was unrelated to BL (HR for a 4-fold BL increment: 1.05 [95% CI: 0.93-1.17]). The HR for cardiovascular death was 1.44 (1.01-2.07) in the 1999-2000 cycle, but lost significance thereafter. BL was directly related to cardiovascular mortality, whereas the indirect BL pathway via BP was not significant. Low socioeconomic status (SES) was directly related to BL and cardiovascular mortality, but the indirect SES pathway via BL lost significance in 2007-2010. From 1999-2004 to 2017-2020, cardiovascular PAF decreased (P < 0.001) from 7.80% (0.17-14.4%) to 2.50% (0.05-4.68%) and number of lead-attributable cardiovascular deaths from 53,878 (1,167-99,253) to 7,539 (160-14,108).

Conclusions:
Due to implementation of strict environmental policies, lead exposure is no longer associated with total mortality, and the mildly increased cardiovascular mortality is not associated with blood lead via blood pressure in the US.
ASSOCIATION OF PLASMA ALDOSTERONE CONCENTRATION AFTER CAPTOPRIL SUPPRESSION TEST WITH LEFT VENTRICULAR REMODELING AND DIASTOLIC DYSFUNCTION IN PRIMARY ALDOSTERONISM
Authors: Tsai Cheng -HSUAN , Chen Uei -LIN , Wu Vin -CENT , Lin Yen -HUNG 
Published: May 2024

Objective:
Cardiac remodeling is a critical pathological manifestation in primary aldosteronism (PA) attributed to excessive aldosterone secretion. The plasma aldosterone concentration (PAC) following the captopril suppression test (CCT) may serve as an indicator of unregulated aldosterone and could potentially offer improved predictive value for cardiovascular outcomes. This study aimed to explore the association between nadir aldosterone levels post-CCT and left ventricular remodeling as well as diastolic dysfunction.

Design and method:
We conducted a retrospective analysis of PA patients within the TAIPAI (Taiwan Primary Aldosteronism Investigation) cohort with complete baseline and post-CCT plasma renin activity (PRA), PAC, aldosterone-to-renin ratio (ARR), and echocardiography data for further investigation.

Results:
A total of 540 patients were included in the study. Among baseline and post-CCT PRA, PAC, and ARR, post-CCT PAC exhibited the strongest correlation with left ventricular mass index (LVMI) and diastolic dysfunction (E/e’). In multivariable regression analysis, post-CCT PAC emerged as an independent predictor of LVMI (beta: 24.6, 95% CI: 9.6 to 39.5, P=0.001) and diastolic dysfunction (beta: 1.9, 95% CI: 0.5 to 3.3, P=0.006). Restricted cubic spline analysis revealed significant correlations between both baseline and post-CCT PAC with LVMI, whereas only post-CCT PAC exhibited a significant correlation with diastolic function.

Conclusions:
Plasma aldosterone concentration following CCT, reflective of unregulated aldosterone excess, is significantly associated with left ventricular hypertrophy and diastolic dysfunction. PA patients with elevated post-CCT PAC may face increased cardiovascular risks, underscoring the importance of timely and appropriate management.
FIBROMUSCULAR DYSPLASIA IN CHILDREN – A SINGLE-CENTER EXPERIENCE
Authors: Skrzypczyk Piotr , Bujanowicz Adam , Ofiara Anna , Szyszka Michal , Tutka Agnieszka , Wabik Anna Maria , Zagozdzon Ilona , Krysiak Remigiusz , Zylkowski Jaroslaw , Panczyk-tomaszewska Malgorzata 
Published: May 2024

Objective:
Fibromuscular dysplasia (FMD) is a stenotic disease of the arteries - most often renal, carotid, and cerebral. The disease can occur at any age and is the most common cause of renovascular hypertension in children. The study aimed to present the clinical course of FMD in patients of our Department.

Design and method:
In 2016-2023, the Department took care of 8 patients with FMD (4 boys, 4 girls). In all patients, we analyzed: age, sex, clinical symptoms, biochemical parameters, renin and aldosterone concentrations, imaging studies (ultrasonography, computed tomography), pharmacological and invasive treatment, and outcome.

Results:
Age at diagnosis ranged from 10/12 to 15 9/12 years. All patients were referred due to arterial hypertension (7/8 of 2nd degree). Patients presented various symptoms: hypertensive crisis with heart failure (patient 10/12 months), headache (2 patients), vomiting (1 patient), hyperactivity (1 patient), polydipsia and polyuria (1 patient). All patients had normal renal function, 5/8 hypokalemia, 1/8 hyponatremia, and 5/8 metabolic alkalosis; all had hyperreninemia with hyperaldosteronism. Imaging examinations showed critical stenosis of the renal artery trunk in 3 patients, slight stenosis in 1 patient, and stenosis of accessory arteries or branches of main arteries in the remaining patients. Stenosis in other vessels was found in 2 patients (left middle cerebral artery in one patient and abdominal aorta, celiac trunk, superior mesenteric artery, and inferior mesenteric artery in another one). Invasive treatment was performed in 6/8 patients - in 2 patients nephrectomy was necessary; in 2 – embolization of the vessel; in 2 – angioplasty, one patient is waiting for the procedure. Before the procedure, the patients required 3 (max. 5) antihypertensive drugs. After the procedure, antihypertensive treatment was discontinued in 3 patients, and the number and dose of drugs were reduced in the remaining patients.

Conclusions:
1. Renal artery stenosis should be excluded in all pediatric hypertensive patients, regardless of age and symptoms.
2.Patients with FMD require an individually selected therapeutic plan.
3.Vessel embolization is an effective method of treating stenoses of the peripheral branches of the renal arteries in the course of FMD in children.