bluuebunny/crossref_metadata_2025_split huggingface dataset:
WHO USES MHEALTH IN HYPERTENSION CARE? - INSIGHTS FROM A QUANTITATIVE SURVEY AMONG HYPERTENSION APP USERS
Authors: Mühlensiepen Felix , Petit Pascal , Vuillerme Nicolas , May Susann , Seifert Frances , Wengemuth Eileen , Johannsen Olen , Middeke Martin , Heinze Martin , Spethman Sebastian , Bruch Dunja 
Published: May 2024

Objective:
Digital health technologies, particularly mHealth apps, are proving to be effective tools for both prevention and monitoring of hypertension therapy. The aim of this study is to gain an in-depth understanding of the profiles and adoption patterns of mHealth users in hypertension care.

Design and method:
From January to October 2023, a quantitative, standardized questionnaire-survey was conducted with users of a hypertension-focused mHealth app (Hypertension.App). The data analysis included descriptive statistics as well as Bayesian univariate and multivariate logistic regressions. The study is part of the Innovation Fund Project DiPaH.

Results:
Overall, 255 questionnaires were included in the analysis. The mean age of the app users was 53.6 ± 13.9 years. Most participants were male (54.3%, 139/255), 42.9% (109/255) were female and 0.79% (2/255) non-binary. Most participants had a university degree (44.5%, 113/255) or high school diploma (22%, 56/255). The majority reported that they live in an urban environment (57.8%, 147/255). Overall, 44.5% (113/255) of the participants reported a monthly net income of more than 2500 € per month and 20.1% (51/255) an income between 1500-2500€ per month. The mean eHEALS score (eHealth literacy / 1-40) was 31.0 ± 4.91. Most users received a hypertension diagnosis more than 10 years ago (60.2%, 153/255) or more than 10 years ago.
The most common method of discovering the app was personal searches on the web or app store (44.1%, 112/255). The majority reported using the app at least once a week (80.7%, 205/255), with daily usage reported by 52.4% (133/255). However, the app's integration into formal medical treatment was limited, with only 11.8% (30/255) of participants having their medication adjusted based on app entries.

Conclusions:
The high frequency of app usage suggests that users find it a valuable tool in monitoring their blood pressure. The results indicate that people with a high level of education, high income and in urban regions are more likely to use mHealth in hypertension care. Additionally, the limited integration of the app into medical treatment indicates a gap between personal health monitoring and formal healthcare.
FUTURE BLOOD PRESSURE PREDICTION ARTIFICIAL INTELLIGENCE PROGRAM: THE DR. ANSWER MEDICAL SOFTWARE
Authors: Ahn Joon Ho , Oh Seok , Lee Ki Hong , Kim Ju Han 
Published: May 2024

Objective:
Current guidelines recommend home blood pressure (HBP) monitoring in patients diagnosis with hypertension and those with white coat hypertension or masked hypertension. Delicate classification of these patients are important because the intensification of antihypertensive drug therapy for patients with white coat uncontrolled hypertension or white coat hypertension may not be needed because cardiovascular risk seems not to be greater. Therefore, its detection is important to avoid overtreatment. Meanwhile patients with masked hypertension or masked uncontrolled hypertension and uncontrolled hypertension need further intensification of antihypertensive treatment. Dr. Answer project consists of 21 artificial intelligence (AI) medical software that cover eight major diseases including hypertension. The main object of Dr. Answer hypertension project is to predict the patients next visit office BP according to the home BP data and provide effective and precise treatment plan.

Design and method:
2,057 patients and 156,117 pure HBP data were collected in the Dr. Answer hypertension project. Patients were enrolled in 1 tertiary center (Chonnam National University Hospital) and other 21 non-tertiary centers from January 2022 to September 2022. 1,447 patients and 153,712 were excluded due to insufficient HBP data and follow up loss. Finally 610 patients and 2,405 HBP data were evaluated in the AI program model.

Results:
Patients were 66.7 ± 14.4 years and proportion of women was 24.1%. and patients enrolled in tertiary center was 73.4%. Mean HBP 8weeks of systolic blood pressure and 4 weeks of diastolic blood pressure data were evaluated in the AI program model. Recurrent Neural Network, Long Short-term Memory, Attention algorism were selected in AI model program. Mean Absolute Error (MAE) and Root Mean Square Error (RMSE) and Accuracy data were used as the AI model parameter. MAE of systolic BP was 3.96 and MAE of diastolic BP was 2.1. Meanwhile, RMSE of systolic BP was 5.81 and RSME of diastolic BP was 2.88. Accuracy data showed 74.1% and 91.4% respectively.

Conclusions:
Dr. Answer hypertension AI medical software showed promising results for predicting future blood pressure data in hypertension patients. Further advancement in the AI program model would be needed.
CORRELATIONS OF BLOOD PRESSURE AND ANTHROPOMETRIC BIOMARKERS IN THE BRAZILIAN FEMALE AND MALE POPULATION FROM THE FIRST BRAZILIAN REGISTRY OF ARTERIAL HYPERTENSION
Authors: Euzébio Maicon Borges , Vitorino Priscila , Rosa Lorena , Sousa Ana , Inuzuka Sayure , Jardim Paulo , Barroso Weimar 
Published: May 2024

Objective:
To correlate blood pressure and anthropometric biomarkers in the Brazilian populations of biological sexes female and male from the First Brazilian Registry of Arterial Hypertension (1RBH), highlighting similarities or divergences in these correlations between these populations.

Design and method:
This is a descriptive multicenter cross-sectional study of 1RBH, with data collection conducted from June 2013 to October 2015. The Shapiro-Wilk test was used to check the distribution of variable data, and a significance level of p <0,05 was adopted. In the correlation analysis, the Spearman test was used if p <0,05 and the Pearson test was used if p >0.05. For the interpretation of correlation indices, the following ranges were considered: 0.00 to 0.19 (very weak correlation), 0.20 to 0.39 (weak correlation), 0.40 to 0.69 (moderate correlation), 0.70 to 0.89 (strong correlation), and 0.90 to 1.00 (very strong correlation). We decided to compare correlation indices >0.70. The anthropometric variables were: age (Age), in years; Body Mass Index (BMI) in Kg/m2; Waist Circumference (WC) in cm. For biomarker variables, we used: Peripheral Systolic Blood Pressure (SBP); Peripheral Diastolic Blood Pressure (DBP); Central Systolic Blood Pressure (cSBP); Central Diastolic Blood Pressure (cDBP).

Results:
Out of a total of 2,643 participants from 45 locations in Brazilian regions, 1,472 (55.7%) were female, and 1,171 (44.3%) were male. The median age of the female population was 62.9 years (54.7-70.3); BMI 28.9 Kg/m2 (25.6-32.6); and WC 97.0 cm (89.0-105.0). The median age of the male population was 61.1 years (53.5-68.1); BMI 28.4 Kg/m2 (25.5-31.5); and WC 100.0 cm (92.8-109.0). In both female and male populations, SBP-cSBP, DBP-cDBP, WC-BMI showed significance with p <0.05 and strong correlations, and Age-PWV showed very strong correlation with statistical significance in both populations.

Conclusions:
Comparing the correlations of blood pressure and anthropometric biomarkers in the hypertensive Brazilian female and male population, we conclude that SBP-cSBP, DBP-cDBP, WC-BMI, and Age-PWV exhibit similar strong and very strong correlations, respectively, with statistical significance in both populations.
METABOLIC SPECIFICITIES AND CARDIOVASCULAR MORBIDITY AND MORTALITY BETWEEN BLACK AND WHITE HYPERTENSIVE POPULATIONS OF SOUTHERN ALGERIA
Authors: Cherif Abdelghani Bachir , Bennouar Salam , Temmar Mohamed 
Published: May 2024

Objective:
The objectives of the study are to analyze the long-term fate of the black hypertensive subjects in Algerian oases in southern Algeria, in terms of morbidity and mortality, comparing the morphometric profile, metabolic and cardiovascular complications with the white population of the same oases.

Design and method:
One thousand two hundred and twenty-nine subjects of both sexes were included (618 blacks and 611 white subjects), aged 40 and older, living in the Algerian Sahara and were reviewed after six years of decline. The control consisted of filling a questionnaire oriented on civil status, metabolic balance, target organ damage, the number of hospitalizations and mortality. All calculations and statistical analyzes are processed by the SPSS 25.0 software.

Results:
The mean age for the black population and the white population was 60.3 ± 11.1 and 58.6 ± 10.6 years, respectively. The metabolic syndrome (MS) frequency is 20.8%, more frequent among women than among men, with a significant difference (28.4% versus 15.1%, P < 0.001). We found out a difference between black and white populations in terms of obesity (37.6% versus 31.1%), hypertension (60.6% versus 55.0%), diabetes (25.2% versus 19.2%) or other MS criteria. The most frequent complications according to decreasing frequency are: hospitalization for cardiovascular diseases 8.9%, stroke 6.3%, heart failure 5.8%, myocardial infarction 3.6%. The mortality rate is 5.7% among the blacks and 4.3% among the whites with difference. The survival rate of the population is influenced by the MS and by a non-checked blood pressure by an antihypertensive treatment.

Conclusions:
These data on hypertension black subjects emphasize the importance of a policy of adequate local health issues raised, both in terms of the management of hypertension, as in investment in local medical research. It is necessary to elaborate an adequate strategy to prevent such cardiovascular morbidity and mortality.
EVALUATION OF PROGNOSTIC BIOLOGICAL MARKERS ON PATIENTS WITH HEART FAILURE
Authors: Ouankou Christian Ngongang 
Published: May 2024

Objective:
This study aims to determine the clinical and biological risk factors and the prognostic biological markers of heart failure at the cardiology service of the Yaoundé University Hospital Center and at the Yaoundé Medical Cardiology Center.

Design and method:
This was a descriptive cross-sectional study that targeted patients who came for consultation at the cardiology department of the Yaoundé University Hospital over the period from March to May 2021. The data was collected using a semi-structured questionnaire administered in face-to-face after obtaining informed consent from the participants. Subsequently, a blood sample was taken and the serum was analyzed by spectrophotometry. Several functions have been explored by measuring different biological markers. Data were stored in Ms-Excel software and statistical analyzes were performed using SPSS and EpiInfo 7.2.2.16 software.

Results:
A total of 51 patients agreed to participate in our study, of which 54.9% (28/51) were women with a sex ratio of 1.22 in favor of women. The age ranged from 17 to 94 years with an average of 64 ± 15 years. In total 68.62% (35/51) of the patients were hypertensive, 35.29% (18/51) had stage 4 dyspnea with or without orthopnea and 88.24% (45/51) had an NT- high pro-BNP. The association between biological markers and prognostic factors showed that GFR and a high INR value were respectively associated with the presence of atrial fibrillation and high PAPS. Our study recorded 11.76% (6/51) of deaths and all of its patients had at least two abnormal prognostic markers, both biological and non-biological. The most frequent etiological factor was arterial hypertension and hyperuricaemia. Other markers, such as the elevation of NT-Pro-BNP, impaired renal and hepatic functions, hyponatremia were related to echocardiographic and electrocardiographic prognostic parameters and could be used as alternative solutions in our context.

Conclusions:
The elevation of NT-Pro-BNP, impaired renal and hepatic functions, hyponatremia were related to echocardiographic and electrocardiographic prognostic parameters and could be used as alternative solutions in our context.
GENDER DIFFERENCES IN CARDIAC ORGAN DAMAGE IN ARTERIAL HYPERTENSION: ASSESSING THE ROLE OF DRUG NONADHERENCE
Authors: Aune Arleen , Ohldieck Annbel , Halvorsen Lene V. , Brobak Karl Marius , Olsen Eirik , Rognstad Stine , Larstorp Anne Cecilie K. , Søraas Camilla L. , Rossebø Anne B. , Rossner Assami , Grytaas Marianne Aa. , Gerdts Eva 
Published: May 2024

Objective:
Cardiac organ damage is more prevalent in women than men with hypertension, however, the mechanisms underlying this gender difference remain unclear. A possible role of gender differences in drug adherence has recently been suggested.

Design and method:
We assessed left ventricular (LV) hypertrophy and left atrial (LA) enlargement by echocardiography in 186 women and 337 men with uncontrolled hypertension defined as daytime systolic blood pressure (BP) </= 135mmHg despite the use of at least two antihypertensive drugs. Drug adherence was assessed by measurements of serum drug concentrations interpreted by an experienced pharmacologist. Aldosterone-renin-ratio (ARR) was measured on actual medication.

Results:
Women had a higher prevalence of LV hypertrophy (46% vs. 33%) and LA enlargement (79% vs 65%, both p<0.05) than men. Women were older, and had lower serum renin concentration and higher ARR, whereas the prevalence of obesity (43% vs. 50%), 24-h systolic BP (141±9 mmHg vs. 142±9 mmHg), and drug nonadherence (8% vs. 9%, all p>0.10) were comparable between genders. After adjusting for these potential confounders, female gender was independently associated with a two-fold increased risk of LV hypertrophy (OR 2.01[95% CI 1.30-3.10], p=0.002) and LA enlargement (OR 1.90 [95% CI 1.17-3.10], p=0.010), while no association with drug adherence was found. Higher ARR was independently associated with LV hypertrophy in men only (OR 2.12 [95% CI 1.12-4.00] p=0.02).

Conclusions:
Among patients with uncontrolled hypertension, the higher prevalence of LV hypertrophy and LA enlargement in women compared to men was not associated with drug nonadherence.
ASSOCIATION OF THE METABOLIC SCORE FOR INSULIN RESISTANCE WITH INCIDENT HEART FAILURE IN PATIENTS WITH HYPERTENSION
Authors: SHEN DI , Cai Xintian , Li Nanfang 
Published: May 2024

Objective:
The association of the metabolic score for insulin resistance (METS-IR) with heart failure (HF) risk in hypertensive patients remains uncertain. This study aimed to examine the relationship of the METS-IR with incident HF in hypertensive patients.

Design and method:
A total of 12,066 patients, free of prior HF, were enrolled. Using multivariable Cox regression models, hazard ratios (HRs) and 95% confidence intervals (CIs) for HF were calculated.

Results:
464 incident HF events were identified over a median follow-up of 5.00 years. Increases in METS-IR per SD were linked to a higher risk of HF (adjusted HR: 1.17; 95% CI: 1.07, 1.28). When METS-IR was evaluated as quartiles, compared with those in the first quartile, the adjusted HRs (95% CI) of incident HF in participants in the second, third, and fourth quartiles were 1.02 (0.77, 1.35), 1.26 (0.97, 1.64), and 1.43 (1.10, 1.85), respectively. Each 1 SD increase in METS-IR was significantly associated with a 17% increase in HF incidence after multivariate adjustment using Model 3. However, restricted cubic spline analysis showed no dose-response connection between METS-IR and HF risk (P for non-linearity = 0.113).

Conclusions:
In summary, the current investigation has discovered that elevated METS-IR is associated with an increased risk of HF in hypertensive patients. If more research supports our findings, METS-IR might be a helpful and practical indicator for the early identification of hypertensive patients at high risk of HF.
EFFECTS OF PROTEINURIA ON MUSCLE OXYGENATION AND MICROVASCULAR REACTIVITY IN PATIENTS WITH PRE-DIALYSIS CKD: A POST-HOC ANALYSIS
Authors: Theodorakopoulou Marieta , Zafeiridis Andreas , Dipla Konstantina , Faitatzidou Danai , Koutlas Aggelos , Iatridi Fotini , Karagiannidis Artemios , Stamatiou Anastasia , Doumas Michael , Papagiannid Aikaterini , Sarafidis Pantelis 
Published: May 2024

Objective:
Vascular dysfunction is a hallmark of CKD. Previous studies showed an impaired microvascular reactivity in the skeletal muscles, which deteriorates in advanced CKD stages. This analysis aims to examine the impact of proteinuria on skeletal muscle oxygenation and microvascular reactivity at rest, during an occlusion-reperfusion maneuver, and during exercise in patients with pre-dialysis CKD.

Design and method:
66 patients with CKD stage 2-4 were included in this post-hoc analysis; 24-h urine samples were used for evaluation of proteinuria. Continuous measurement of muscle oxygenation [tissue saturation index (TSI%)] via near-infrared-spectroscopy at rest, during occlusion-reperfusion and during a 3-min handgrip exercise (at 35% of maximal-voluntary-contraction).

Results:
The study groups were similar in terms of age (proteinuric vs nonproteinuric: 68.4±10.6 vs 67.2±10.8; p=0.676), eGFR (41.3±18.9 vs 46.3±14.8; p=0.248) and BMI (28.4±4.9 vs 28.1±4.8; p=0.803). Resting muscle oxygenation did not differ between study groups (proteinuric vs nonproteinuric: 63,35±4,09 vs 62,34±3,21; p=0.280). During occlusion, proteinuric CKD patients had marginally lower TSI occlusion magnitude (25,77±7,87 vs 29,95±10,34; p=0.074) but no difference in occlusion slope (-0,09±.,03 vs -,10±.,04; p=0.134). During reperfusion, the TSI reperfusion slopes were significantly lower in proteinuric CKD (slope to max 1,03±.,45 vs 1,39±.0,69; p=0.035 and 10-sec slope: 1,34±.,63 vs 1,92±.,75; p=0.002); hyperemic response was numerically lower in proteinuric CKD (7,13±.4,27 vs 8,89±.4,68; p=0.131). Finally, during exercise no differences were detected in the average muscle oxygenation between-group (10,76±6,05 vs 10,65±5,39; p=0.943).

Conclusions:
Although no differences in resting muscle oxygenation were detected, CKD patients with proteinuria showed more impaired skeletal muscle oxidative capacity (as suggested by lower TSI magnidute during occlusion), and miscrovascular reactivity during reperfusion.
ARE THERE ANY ASSOCIATION BETWEEN DIASTOLIC AREA INDEX MEASURED BY ARTERIOGRAPH, RENAL FUNCTION AND N-TERMINAL PROHORMONE OF BRAIN NATRIURETIC PEPTIDE IN CHRONIC KIDNEY DISEASE?
Authors: Sági Balázs , Vas Tibor , Csepregi Rita Klaudia , Horváth-szalai Zoltán , Csiky Botond , Nagy Judit , Kovács Tibor József 
Published: May 2024

Objective:
IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide. Arterial stiffness may predict cardiovascular (CV) mortality and morbidity in chronic kidney disease (CKD). Diastolic area index (DAI) shows the diastolic cycle interval and may deduce to the coronary perfusion. There is limited data in the literature about the association between the DAI, the renal function and N-terminal prohormone of brain natriuretic peptide (NT-proBNP).

Design and method:
In our cross-sectional study, we examined 89 patients who cared for IgAN in our clinic. Arterial stiffness was determined by measuring pulse wave velocity of the aorta (PWVao) and aortic systolic pressure (SBPao) and DAI was calculated using the Arteriograph. NT-proBNP was measured using ELISA kits. Renal function was detected by the estimated glomerular filtration rate (eGFR-CKD-EPI). Furthermore, a routine echocardiography examination was performed.

Results:
Of the 89 patients included in the study, 50 were male, with a mean age of 54.9 ± 14.4 years. Patients were divided into five groups based on eGFR (CKD 1,2,3,4 and 5). There were significantly higher NT-proBNP (p=0.022, p=0.001) and lower DAI (p=0.007 and p=0.003) in CKD 4 and 5 compared to CKD 1 group. The PWV (p <0.001, p=0.022), and central aortic systolic pressure (p = 0.043, p=0.085), showed significant elevation with the worsening renal function. DAI showed a negative correlation with NT-proBNP (corr. coeff:-0,282, p=0.012), and a postivie correlation with eGFR (corr. coeff.: 0.331, p=0.003). SBPao and PWVao showed negative correlations with DAI (corr. coeff:-0,307, p=0.029 and -0,366, p=0.001) by Spearman's correlation. Only eGFR was an independent predictor of DAI and NT-proBNP by linear regression analysis.

Conclusions:
Decreasing DAI could be a possible mechanism for the development of abnormal myocardial remodelling in CKD patients, in which may help the elevation of the central aortic systolic pressure causing increased PWV and more CV complications in CKD.
ASSOCIATION BETWEEN LOW LEVEL BLOOD LEAD EXPOSURE AND MORTALITY IN US ADULTS WITH CHRONIC KIDNEY DISEASE
Authors: Wang Tianbo , Huang Gang , Xu Junbo , Wu Jin , Liu Xiaohan , Zhang Zhen 
Published: May 2024

Objective:
This study aimed to explore the association between blood lead and both chronic kidney disease (CKD) and cardiovascular and all-cause mortality among participants with or without CKD in the US adults.

Design and method:
Date from the National Health and Nutrition Examination Survey (2007-20018) was used and all participants were followed up regularly until December 31, 2019. CKD was defined as an eGFR <60 ml/min/1.73 m2 and/or a urine albumin and creatinine ratio >= 30 mg/g. Logistic regression models were constructed to explore the associations between blood lead and CKD. The Kaplan–Meier analysis with a log-rank test was performed to estimate the cumulative incidence of mortality between groups. Cox proportional-hazards models were used to explore the associations between blood lead and cardiovascular and all-cause mortality.

Results:
Totally, this study enrolled 22,951 participants, including 4,078 CKD participants. Multivariable logistic regression analysis showed that higher level of blood lead (>=1.82 vs. <0.73) was associated with the increased risk of CKD (OR:1.35, 95% CI: 1.13–1.62, p=0.001). During a mean follow-up duration of 85.21±43.58 months, a total of 2,139 all-cause mortality and 525 cardiovascular mortality were recorded. In multivariable Cox model, compared with the lowest quartiles, highest blood lead level (>=1.82 vs. < 0.73) was associated with a higher risk of cardiovascular mortality (HR:3.36, 95% CI: 1.32–8.53) and all-cause mortality (HR:1.85, 95% CI: 1.18–2.90) in participants with CKD.

Conclusions:
In conclusion, in this US cohort, low level blood lead exposure may also be a predictive factor for CKD, and increasing blood lead concentrations significantly contributed to enhanced risk of cardiovascular and all-cause mortality in CKD patients. Hence, the reduce of blood lead exposure may reduce risk of mortality in high-risk individuals with CKD.