bluuebunny/crossref_metadata_2025_split huggingface dataset:
STUDY OF ARTERIAL PRESSURE LEVELS AT CONSULTATION IN TREATED HYPERTENSIVE ALGERIAN PATIENTS (PACT II STUDY)
Authors: Belhamidi Sofiane , Nibouche  , Amara  , Larbi  , Ziani  
Published: May 2024

Objective:
The main objective was to describe the management of arterial hypertension in Algeria through the distribution of patients treated for HTN, according to predefined arterial pressure levels reached under treatment. Secondary objectives were: To estimate the mean of systolic blood pressure and diastolic blood pressure according to the 6 levels of AP, to evaluate the frequency of BP target reaching according to the s ESC 2018, both in all hypertensive patients treated, as well as in diabetic hypertensive patients treated and in hypertensive patients treated with renal failure.

Design and method:
The PACT II study is a national, observational, descriptive, cross-sectional, multicenter and noninterventional study of therapeutic strategy, conducted in Algeria on hypertensive patients treated for at least 3 months, followed by 100 specialists and general practitioners.

Results:
2000 eligible patients were recruited in the study. 63.5% and 36.4% of patients were female and male respectively. The average age was 62.4 years +/- 10.7. The most affected age group (65.2%) was between 55 to 75 years old. Most of the patients had an elevated blood pressure (BP) with 49.30% at level III AP (130 – 139 mmHg of SBP or 80 – 89 mmHg of DBP), with 49.6% for diabetic patients and 48.8% for nondiabetic patients, then followed by 20.35% at the level IV AP (140 – 159 mm Hg of SBP or 90 – 99 mm Hg of DBP) with 21.4% for diabetic and 18.3% for non-diabetic patients. Also, 47.32% were at AP level III in patients with renal failure. Regarding the achievement of the blood pressure target, it was 17.4% for the overall population with 18,3% for diabetic's patients and only 12.64% for renal failure patients.

Conclusions:
The PACT II study updated national data on hypertension in Algeria, highlighting important information's on the reality of the management of this disease in routine medical practice.
AN EXPLANATION FOR UNDERESTIMATION OF SYSTOLIC PRESSURE IN CUFF-BASED MEASUREMENT
Authors: Bassil Kate , Agarwal Anurag , Celler Branko 
Published: May 2024

Objective:
Auscultatory blood pressure measurement is the gold standard used to calibrate other measurement devices. However, auscultatory tests systematically underestimate systolic blood pressure (SBP) and overestimate diastolic blood pressure (DBP). While there is some literature explaining overestimation, there is no physical understanding of the underestimated SBP.
Our objective is to understand why auscultatory measurement results in the underestimation of SBP. The SBP is recorded when the artery first begins to reopen, during cuff deflation. Prior to this, the cuff cuts off the blood supply and the pressure in the distal part of the artery drops to the venous pressure. We propose this low pressure as a cause of underestimation and investigate this through a controlled variation of the downstream pressure in an experimental rig.

Design and method:
Figure 1 shows a schematic of the rig. The tube representing the artery is compressed under an inflatable cuff. The downstream pressure is varied between tests. The upstream pressure is fixed with a header tank for simplicity. Therefore, the ‘blood pressure’ measured in the rig is constant rather than oscillatory, resulting in only a single opening of the artery as the cuff is deflated, rather than repeated opening and closing. This single opening is equivalent to the first opening of the artery in the body and so represents the systolic measurement.
Figure 2 depicts an example test run. The cuff around the artery is gradually deflated, and the reopening of the artery is indicated by the rise of the downstream pressure (point a). The cuff pressure at this timestamp is recorded (point b), representing the measured SBP.

Results:
Figure 3 shows that the recorded cuff pressure is a function of downstream pressure, with the cuff reading giving greater underestimation of SBP when the downstream pressure is lowered.

Conclusions:
The delay in artery reopening which results from lowering the downstream pressure provides an explanation for the systematic underestimation of SBP. This information may lead to recommendations for new measurement protocol which avoid a drop in the pressure distal to the cuff, and the resulting underestimation of SBP.
THE ASSOCIATION BETWEEN LONG-TERM BLOOD PRESSURE MANAGEMENT AND THE DEVELOPMENT OF CHRONIC KIDNEY DISEASES IN PATIENTS WITH PRIMARY ALDOSTERONISM FOLLOWING TREATMENT
Authors: Abuduheilili Zulihumaer , Luo Qin , Wang Menghui , Li Nanfang 
Published: May 2024

Objective:
The effect of optimal blood pressure control on the decline of renal function in patients with primary aldosteronism (PA) following treatment are still needed to confirm in large sample cohort studies. The present study aimed to investigate the association between long-term blood pressure management and the development of chronic kidney disease in patients with PA following treatment.

Design and method:
In this retrospective chort study, patients with confirmed PA,and aged >20 years who visited the hypertension center of People's hospital of Xinjiang Autonomous Region between 2011 to 2022 were enrolled and were followed up until June 2023. We analyzed the association between the mean blood pressure control and the development of CKD. The mean blood pressure control depended on the mean of three follow-up visits,in-office BPs after diagnosis of PA and treatment at least three months. Multifactorial analysis was performed using logistic regression, with demographic variables (age, sex, and body mass index,etc.), and clinical characteristics (including smoking, alcohol consumption,etc.) as adjusted. Restricted cubic spline regression was used to find the optimal blood pressure cut-off point. SPSS 27.0 and R4.3.1 were used for the above statistical analysis.

Results:
This study finally included 4406 PA patients with at least three follow-up blood pressure visits at intervals greater than three months, and after adjusting related confounders, the mean follow-up time was 5.08 years, the mean age was 49.5 years,mean systolic blood pressure was significantly associated with CKD (OR: 1.018 [1.008-1.029], P < 0.001). Compared with the group with SBP >=140 mmHg, 120 =< SBP <130 mmHg(OR: 0.561 [0.406-0.777],P<0.001), 130 =<SBP<140 mmHg(OR: 0.593 [0.445-0.791], P<0.001). The RCS showed that systolic blood pressure in the 119-133 mmHg range.

Conclusions:
Control of SBP at 120-130 mmHg in patients with PA is associated with better renal outcome. Compared with the group with SBP >=140 mmHg, the risk was reduced by 44% and 41% in the groups with 120 =<SBP<130 mmHg and 130 =<SBP<140 mmHg, respectively.
WHO IS MORE ACCURATE AT MEASURING BLOOD PRESSURE, A GP OR A SPECIALIST? IS OFFICE BLOOD PRESSURE CORRELATED WITH BETTER MANAGEMENT OF ARTERIAL HYPERTENSION?
Authors: Vachulova Anna , Simkova Adriana , Sidlo Rastislav 
Published: May 2024

Objective:
The measurement of blood pressure (BP) is the key to diagnosing and managing arterial hypertension (AH). Despite this, there is still a lack of studies evaluating and comparing the accuracy of measurement of office BP (OBP) in the GP and specialist offices.
The aim was to evaluate the accuracy of OBP measurement in various types of offices.

Design and method:
This project was conducted from April to June 2023 at 103 general physicians’ offices (GPO) and 51 specialists’ offices (SPO) (cardiology, internal medicine) in Slovakia. We have enrolled all 18-year-old pts with AH who are willing to complete a short questionnaire and take office BP based on 2018 ESC/ESH.

Results:
3147 pts with AH were enrolled (1652 women, 48%), from GPOs, and 514 pts (215 women, 42%), from SPOs. The mean OBP was higher in SPO (134,9 ± 10,9/ 80,3 ± 7,2 mmHg), vs GPO (133,3±7,2/ 80,1 ± 6,2 mmHg). All 3 OBP measurements (M) were higher in SPO. The differences in OBP in SPO were in M1 vs Ø M23 8,01/4,75 mmHg. Even with the correct measurement technique, up to 28% of pts in SPO did not reach the target BP. Adjusting to the age and comorbidities even up to 63% of pts in SPO did not reach the target BP. At GPO, up to 26% of pts did not reach the target BP, even up to 62% of pts in GPO did not reach the target BP adjusting to the age.

Conclusions:
In our study, the office BP levels were higher in SPO compared to GPO. A single BP measurement assessed more pts as not reaching BP targets Our study revealed that therapy optimization needs to be rigorous, in both GP and SPO, and we would subsequently achieve an increased BP control rate in Slovakia to meet, not only the main goal of the initiative Charter 70/2023, 70% of patients with BP lower than 140/90 mm Hg), which was achieved by both GP (74%) and SPE (72%), but tight BP control adjusted to the age of patients.
NEUROPROTECTIVE EFFECTIVENESS OF 12-MONTH COMBINED ANTIHYPERTENSIVE THERAPY IN HYPERTENSIVE PATIENTS WITH COGNITIVE IMPAIRMENT
Authors: Yusupova Khafiza , Abdullaeva Guzal , Khamidullaeva Gulnoz 
Published: May 2024

Objective:
to determine the comparative effectiveness of combination antihypertensive therapy including nitrendipine in patients with essensial hypertension with cognitive impairment.

Design and method:
The study included 58 male and female patients with I–III AH degree (ESC/ESH, 2018). The average age of the patients was 54.6±10.8 years, the average duration of AH was 8.8±5.52 years. The patients were divided into 2 groups: 1 group – hypertensive patients with cognitive impairment, n=40, 2 group – hypertensive patients without cognitive impairment, n=18. Cognitive function was assessed using the Montreal Cognitive Assessment Scale (MOCA) and Mini-Cog test.

Results:
Analysis of neuroprotective effectiveness of combined AHT in patients with EH, taking into account the presence/absence of cognitive impairment, revealed that according to the MOCA scale, cognitive functions improved only in 1 st group of patients, initially 22.35± 2.46 points in dynamics - 24.47 ± 2.44 points (p<0.001), in comparison with the group of patients without cognitive impairment: initially 27.3±1.19 points versus 26.3±1.84 points, respectively (p>0.05). And also using the Mini-Cog test, it was determined that the scores significantly increased only in 1 st group of patients: initially amounting to 3.75± 1.12 points, over time - 4.35 ± 0.86 (p < 0.02), then as in group 2, there was no significant increase in score.

Conclusions:
Positive dynamics of cognitive functions against the background of 12 months of AHT with the inclusion of nitrendipine was noted in the subgroup of patients with cognitive impairment.
BLOOD PRESSURE VALUES ACCORDING TO HOME AND CLINIC MEASUREMENTS AND INTRACRANIAL WAVEFORM ASSESSMENT IN HYPERTENSIVE PATIENTS
Authors: Costa Matheus , Sousa Ana Luiza , Morangoni Bárbara , Correia Mikaelle , Barbosa Letícia , Vitorino Priscila , Frigieri Gustavo , Inuzuka Sayuri , Barroso Weimar 
Published: May 2024

Objective:
Evaluate the Association between Non-Invasive Intracranial Pressure (ICP) Values and Blood Pressure (BP) Values According to Home and Clinic Measurements

Design and method:
Cross-Sectional Study evaluating the association of variables, including Age, Gender, Office Systolic Blood Pressure (OSBP), Office Diastolic Blood Pressure (ODBP), Home Blood Pressure Measurements (HBPM), Time since Hypertension Diagnosis, P2P1, TTP, Intracranial Hypertension (IC) (P2P1 >1.2), Office Hypertension (Office BP 140/90mmHg), and HBPM Hypertension (HBPM 130/80mmHg). Data collected from participants and medical records. Data analysis conducted using chi-square test, Mann-Whitney U test, and bivariate correlation analyses. Blood pressure values adjusted for hypertension diagnosis time; P2P1 and TTP values adjusted for age. Confidence interval of 95% and p<0.05.

Results:
240 patients were evaluated, with average age of 63.4 years (±11.8), 73.3% were female. The average time of diagnosis of arterial hypertension was 19.1 years (±11.9). Uncontrolled blood pressure - 54.2% (n=130) via HBPM and 42.1% (n=101) in the clinic. The proportion of IC was 67.9%, higher in women (71.6%). There was negative correlation between P2P1 and age (r=-0.261; p=0.037). Correlations between P2P1 and systolic blood pressure (HBPM) (-0.152, p=0.019) as well as with morning systolic blood pressure (HBPM) (-0.175, p=0.006). Correlation between P2P1 and morning systolic blood pressure (HBPM) (rho= -0.192, p=0.011), and evening systolic blood pressure (HBPM) (rho= 0.157, p=0.037) was found only among women. Correlation between TTP and systolic blood pressure (HBPM) (rho= -0.194, p=0.003), The correlation between TTP and clinic diastolic blood pressure (rho= 0.313, p=0.012) was found only among men. Correlation between TTP and systolic blood pressure (HBPM) (rho= -0.201, p=0.007), morning systolic blood pressure (HBPM) (rho= -0.237, p=0.002), clinic diastolic blood pressure (rho= 0.157, p=0.038), and nighttime systolic blood pressure (HBPM) (rho= -0.202, p=0.007) was found only among women.

Conclusions:
The blood pressure control rates were similar when evaluated by different methods. There was no association between blood pressure control rates and IC. P2P1 and TTP values correlated with home blood pressure values, but only with clinic diastolic blood pressure values. The associations of P2P1/TTP values and home blood pressure measurements exhibited different patterns between men and women.
DIETARY SODIUM/POTASSIUM INTAKE AND COGNITIVE IMPAIRMENT IN ELDERLY PATIENTS WITH HYPERTENSION: DATA FROM NHANES 2011-2014
Authors: Kou Chengkun , Zhao Xu , Fan Xin , Wang Qiongying , Yu Jing 
Published: May 2024

Objective:
Salt is a widely used condiment throughout the world. Sodium chloride is the main salt component. Sodium is an essential macronutrient that maintains fluid balance and cellular homeostasis.
It is suggested that dietary sodium may influence cognition by cerebrovascular and cerebral blood flow. This study aimed to assess the relationship between dietary sodium/ potassium intake and cognition in elderly individuals with hypertension.

Design and method:
We designed a cross-sectional study based on the 2011–2014 National Health and Nutrition Examination Survey (NHANES). Cognitive performance was assessed using the Digit Symbol Substitution Test (DSST), Consortium to Establish a Registry for Alzheimer's Disease test (CERAD), and Animal Fluency Test (AFT). Multivariate logistic regression and restricted cubic spline (RCS) was used to assess the relationship between dietary sodium/ potassium intake and cognition.

Results:
After excluding participants with incomplete data, 1670 out of 2276 participants had confirmed hypertension. Compared with the lowest quartile of dietary sodium, the lowest weighted odds ratio (OR) of cognitive impairment in DSST was observed in Q4 (OR=0.45, 0.29–0.70), and a similar trend was observed in AFT (OR=0.34, 0.18–0.65). After adjusting the covariates, the lowest weighted multivariate adjusted OR of cognitive impairment in DSST were also observed in Q4 (OR=0.47, 0.26–0.84) compared with the lowest quartile of dietary sodium. The RCS results showed that dietary sodium was U-shaped and associated with the risk of cognitive impairment in the DSST (Pnon–linearity=0.0067). No significant association was observed between dietary potassium and cognitive performance.

Conclusions:
Too high and too low dietary sodium levels were associated with impairment of specific processing speed, sustained attention, and working memory for hypertension among the elderly in the United States. However, no association was observed between the dietary potassium intake and cognition.
NON-INVASIVE CENTRAL BLOOD PRESSURE AND INTRACRANIAL WAVEFORM ASSESSMENT IN HYPERTENSIVE PATIENTS
Authors: Inuzuka Sayuri , Costa Thiago , Correia Mikaelle , Costa Matheus , Vitorino Priscila , Piza Polyana , Frigieri Gustavo , Sousa Ana Luiza , Coca Antonio , Barroso Weimar 
Published: May 2024

Objective:
Hypertension (HT) remains as the leading cause of death around the globe and brain diseases, such as cognitive decline. The association between HT and cerebrovascular diseases is strong, mainly with stroke and cognitive impairment, but the mechanistic bases remain to be established.
The objective of this study is to observe central blood pressure, arterial stiffness and intracranial pressure in long-term chronic hypertensive patients.

Design and method:
Patients above 18 years were assessed from November 2022 to August 2023 with non-invasive central blood pressure and intracranial pressure waveform measurements in a cross-sectional analysis. Peripheral and central blood pressure parameters were obtained using a validated oscillometric device (Mobil-O-Graph). Non-invasive intracranial pressure measurement was performed with the validated Brain4Care (B4C) sensor. Using the B4C non-invasive evaluation, the cut-off point identified to define ICHT by the P2/P1 ratio was > 1.2, and the cut-off for time to peak (TTP) was > 0.25 seconds. To compare P2/P1 and TTP values between the categories of quantitative variables, the chi-square test was used; the Mann Whitney or ANOVA tests were used for bivariate analyses; and for correlations, the Spearman test was used. It was adopted as significant at p < 0,05.

Results:
Non-invasive central blood pressure, arterial stiffness, and intracranial pressure waveform assessment were performed in 145 patients with essential long-term hypertension over a period of ten months. The median age was 69.0 (61.8 – 75.7) years, 77.9% were female, and the median BMI was 29.0 (25.4 – 33.1) kg/m2. The average time since the hypertension diagnosis was 20.0 years. The median value of P2/P1 ratio for all cohort was 1.4 (1.2 – 1.5) and TTP 0.24 (0.21 – 0.29) seconds. A bivariate analysis was performed considering ICHT or not and the parameters of central BP and PWV assessments, with findings of higher central SBP, central DBP, and peripheral DBP among patients with ICHT by the parameter of P2/P1.

Conclusions:
Central systolic blood pressure levels are more linked to intracranial hypertension, while diastolic blood pressure values are similar, raising questions about the most suitable blood pressure assessment method for brain disorders.
LONG-TERM SURVIVAL AFTER AN ISCHEMIC STROKE. THE ESH STROKE SURVEY
Authors: Cifkova Renata , Wohlfahrt Peter , Krajcoviechova Alena Hrubes , Mayer Otto , Vanek Jiri , Hlinovsky David , Kielbergerova Lenka , Lanska Vera 
Published: May 2024

Objective:
Identification of factors affecting long-term survival following ischemic stroke is of utmost importance. The aim of the present study was to assess long-term survival and factors associated with increased mortality after an ischemic stroke.

Design and method:
Consecutive patients hospitalized between March 2009 and January 2012 for their first-ever ischemic stroke in 2 large university hospitals in the Czech Republic were enrolled in this survey. Baseline data were obtained from hospital medical records. The median follow-up was 10.2 years. Vital status was determined using the death registry on July 28, 2023.

Results:
In total, 736 patients (mean age 66 ±11 years; 58% men) were included in this analysis. The cumulative risk of death at 1, 3, 5 and 10 years was 13.6%, 20.8%, 29.3% and 48.4%, respectively. After adjusting for age and sex, patients with discharge systolic blood pressure between 110 and 150 mmHg had the lowest mortality risk (Figure 1). Increased age, higher NIHSS and increased functional impairment, diabetes, and current smoking were associated with higher mortality risk, while lacunar stroke subtype, reperfusion therapy, and renin-angiotensin system blockers were associated with a lower mortality (Figure 2).

Conclusions:
Despite several advances in stroke management, the mortality remains high. Timely reperfusion therapy applied together with renin-angiotensin system blockers may reduce the risk of mortality.
BRAIN LOCAL ANGIOTENSIN II FORMATION DEPENDS ON RENIN ACTIVITY
Authors: Rodrigues André Felipe , Domenig Oliver , Danser A.H. Jan , Alenina Natalia , Poglitsch Marko , Bader Michael 
Published: May 2024

Objective:
The blood-brain-barrier limits the traffic of all components of the renin-angiotensin system. Brain-localized production of angiotensin II (Ang II) has been challenged because the rate-limiting enzyme, renin, is expressed at very low levels in the brain. Our group has developed a transgenic mouse line that selectively overexpresses rat angiotensinogen (Agt) in brain astrocytes (Agt-Tg) yielding detectable levels of Ang II.

Design and method:
To confirm that Ang II is locally produced in the brain, the endogenous mouse Agt gene was deleted from Agt-Tg (Agt-Tg/Agt-KO) by breeding Agt-Tg with Agt-deficient mice (Agt-KO). To determine if renin is involved in the local production of Ang II in the brain, the genes (Ren1d and Ren2) encoding for renin of Agt-Tg were genetically deleted by crossbreeding with renin-deficient mice (Ren-KO). The resulting mouse line overexpresses Agt specifically in the brain but globally lacks renin (Agt-Tg/Ren-KO). All lines were backcrossed to the FVB/N inbred background for at least 8 generations. Whole brains and blood were collected from males and females aging between 15-22 weeks. Angiotensin peptides (Ang I, Ang II, Ang III and Ang 1-7) were quantified using LC-MS/MS by Attoquant Diagnostics GmbH

Results:
Ang II was detected in the brain, but not in the blood of Agt-Tg/Agt-KO mice suggesting local synthesis. Interestingly, Ang II was not detectable in brain samples of Agt-Tg/Ren-KO in contrast to their littermates Agt-Tg indicating that renin is essential for brain Agt processing into Ang II. Moreover, Ang I, Ang II were not detected in the blood of Agt-Tg/Ren-KO as expected but detectable in Agt-Tg. Finally, FVB/N wildtype controls presented no detectable levels angiotensin peptides in brain samples but in the blood.

Conclusions:
Collectively, the results from mice with brain-specific Agt overexpression support the notion that the brain locally and renin-dependently produces Ang II. The specific involvement of central or peripheral renin remains to be determined.