bluuebunny/crossref_metadata_2025_split huggingface dataset:
OBESITY PARADOX, WEIGHT-FREE ANTHROPOMETRIC MEASURES, AND MAJOR ADVERSE CARDIOVASCULAR EVENTS IN THE ELDERLY: INSIGHT FROM THE NORTHERN SHANGHAI STUDY
Authors: Xu Chong , Zhao Song , Tang Jiamin , Xiong Jing , Yu Shikai , Zhang Han , Xu Yawei , Zhang Yi 
Published: May 2024

Objective:
Many studies have investigated the obesity paradox in the elderly. However, besides body mass index (BMI), many other anthropometric measures, such as the waist-to-hip ratio (WHR), provide a better indication of body fat distribution and may be more useful in a geriatric population.

Design and method:
3285 participants aged over 65 years old from the Northern Shanghai Study were included in this analysis. Eight anthropometric measures, including weight-related measures (BMI, weight-adjusted-waist index, body shape index and body surface area) and weight-free measures (WHR, waist-to-height ratio, body roundness index, relative fat mass) were measured and calculated with standard methods. Major adverse cardiovascular events (MACEs) included the non-fatal myocardial infarction, non-fatal stroke or cardiovascular death.

Results:
Participants had an average age of 71.4 years and 1428 (43.47%) were men. The median follow-up was 5.4 years (IQR, 4.4-7.3 years) and 218 events occurred. Participants with obesity were associated with a higher risk of MACEs compared with the normal (adjusted Hazard ratio = 1.54, 95% confidence interval (CI): 1.07-2.22, P=0.020). Restricted cubic splines also highlighted the robust correlation between high BMI and high MACEs risk (Pfor overall=0.025, Pfor nonlinear=0.339). Similarly, the aHR for the incidence of MACEs in WHR quartile 4 versus quartile 1 was 1.96 (95% CI: 1.26-3.05, P=0.003). When WHR was examined as a continuous variable, the result remained unaltered (Pfor overall=0.020, Pfor nonlinear=0.353). In adjusted model, all four weight-free measures were significantly associated with increased risk of MACEs (all P<0.05), while only two weight-related measures were related to the risk of MACEs.

Conclusions:
In the elderly, BMI and alternative anthropometric measures showed no evidence of an obesity paradox. Weight-free measures were more relevant to a risk of MACEs.
ECTOPIC ADIPOSE TISSUE: INCIDENCE OF PERICARDIAL AND PERIVASCULAR OBESITY AND RELATIONSHIP WITH METABOLIC AND ANTHROPOMETRIC OBESITY INDICES
Authors: Vasilchenko Maria , Bragina Anna , Rodionova Yulia , Osadchiy Konstantin , Avanesyan Milena , Fomin Alexander , Smagulova Aliya , Podzolkov Valery 
Published: May 2024

Objective:
To study the incidence of pericardial and perivascular obesity and their relationship with metabolic and anthropometric indices of obesity.

Design and method:
The study included 100 patients (49 men, 51 women, mean age 58,5±12 years). Anthropometric data (Body Mass Index (BMI), Waist Circumference (WC)), degree and type of obesity, lipid profile and blood glucose were evaluated, and anthropometric (Body Adiposity Index (BAI)) and metabolic indices (Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), Triglyceride-Glucose Index (TyG)) were calculated in all patients. All patients underwent chest computed tomography with the calculation of perivascular adipose tissue (PVAT) and pericardial adipose tissue (PAT) volumes using Tissue Composition Module QCTPro (Mindways Software, USA) after tomograph calibration using a special phantom. Statistical processing was performed using IBM SPSS Statistics 27.

Results:
Obesity of different degrees was detected in 43 (43%) patients, all of them had abdominal type of obesity (AO). High prevalence of hypertension (HTN) was revealed in the study group – 69%. PAT volume greater than or equal to 3,2cm3 and PVAT volume greater than or equal to 0,4cm3 was considered as diagnostic criteria for pericardial and perivascular obesity, respectively. Isolated pericardial obesity (iPCO) was detected in 13(13%) patients, isolated perivascular obesity (iPVO) in 17(17%) patients, mixed ectopic obesity (iPCO + iPVO) in 33(33%) patients, and 25(25%) patients had isolated AO. While analyzing the distribution of ectopic obesity (EO) phenotypes according to BMI, it was found that mixed EO was significantly more common in obese individuals (51,2%) compared to (19,2%) normal weight (p=0.017) and (19,4%) overweight (p=0.016) patients. Patients with HTN were significantly more likely to have iPCO (p=0.005) and mixed EO (p=0.004) compared to patients without HTN. Patients with iAO had significantly higher anthropometric parameters: WC, SAD, BAI compared to those with ectopic obesity (p<0.005). At the same time, no significant differences between metabolic parameters (VAI, LAP, TyG) were found in these groups.

Conclusions:
The results suggest a higher prevalence of mixed EO among patients with obesity and HTN, and the metabolic significance of EO along with AO.
ABDOMINAL OBESITY IS ASSOCIATED WITH DIASTOLIC DYSFUNCTION IN YOUNG PRE- AND HYPERTENSIVE SUBJECTS INDEPENDENTLY OF BLOOD PRESSURE LEVELS AND INSULIN RESISTANCE
Authors: Hawpage Manuli , Ezhova Nadezhda , Shavarova Elena , Kazakova Olga , Bagmanova Nazilya , Shavarov Andrey , Shkolnikova Ekaterina , Kobalava Zhanna 
Published: May 2024

Objective:
Metabolic syndrome is one of the most important conditions affecting diastolic function. We aimed to investigate early associations of abdominal obesity and lipid and carbohydrates metabolism with preclinical decline of diastolic function in treatment-naive young patients with hypertension. The aim of our study was to investigate the association of abdominal obesity and insulin resistance with diastolic function in young patients with first time diagnosed hypertension.

Design and method:
We evaluated anthropometric and metabolic characteristics, clinical blood pressure (BP) and 24-hours ambulatory blood pressure monitoring and performed echocardiography in 106 young (18-45 years old) never treated hypertensives (age 22 [21; 25] years, 85% males, body mass index (BMI) 25,8±4,9 kg/m2) free of diabetes mellitus. We divided all patients into subgroups according to median e’ and E/e’. Then we compared main clinical variables including obesity characteristics, common markers of lipid and carbohydrates metabolism and blood pressure levels in derived subgroups. We used Student's t-test and Mann-Whitney U-test to compare variables with normal and non-normal distribution, respectively.

Results:
There was no difference in age, lipids, HbA1c, HOMA-IR, clinical and ambulatory BP levels between subgroups divided according to median e’ and E/e’. We observed significant differences in body mass index, waist circumference and waist-to-height ratio. Then we compared main variables of diastolic function in patients with or without abdominal obesity (AO). Patients with AO had lower e’ and higher E/e’ than patients without AO: 10,5 vs 12,0 (<0,0001) and 7,7 vs 6,5 (<0,0001), respectively. There was no difference in tricuspid regurgitation velocity and left atrial volume index as in BP levels. We performed multiple regression analysis with e’ as dependent variable and age, sex, low density lipoproteins, glucose, HOMA-IR, office systolic and diastolic blood pressure and AO as independent variables. AO along with age remained independently associated with e’ (β= -1,716, p = 0,002 and β= -0,173, p < 0,001, respectively).

Conclusions:
In young hypertensive treatment-naive patients myocardial relaxation and left ventricular filling pressure estimated with e’ and E/e’ significantly differ between patients with or without AO irrespective of the presence of arterial hypertension and insulin resistance.
HYPERTENSION WITH HEALTHY OBESITY IS FAVORABLE IN CIRCADIAN RHYTHM OF BLOOD PRESSURE AND HEART RATE COMPARED WITH PATHOLOGIC OBESITY: KOREAN REGISTRY OF TARGET ORGAN DAMAGES IN HYPERTENSION (KORHR)
Authors: Cho Eun Joo , Yoo Byung Su , Shin Mi Seung , Sung Ki Chul , Kim Eung Ju , Han Seong Woo , Ryu Kyu Hyun 
Published: May 2024

Objective:
Metabolically healthy obesity is more advantageous in cardiovascular outcomes than pathologic obesity. This study was to evaluate blood pressure (BP) and heart rate (HR) using 24-hour ambulatory BP monitoring and to compare various types of obesity and non-obesity hypertensives.

Design and method:
The Korean Registry of Target Organ Damages in Hypertension (KorHR), established in March 2013 was a nationwide prospective observation study including 16 tertiary care hospitals. A total of 1654 hypertensive subjects aged more than 30 years old without a history of obvious cardiovascular disease were divided into 4 groups according to body mass index (BMI) and waist circumference (WC). (table) Office BP and 24-hour ambulatory BP with HR were measured with other laboratory data.

Results:
A total of 1096 subjects [mean age = 51.4±11.9 years, including 699 (63.8%) male and 524 (47.8%) naïve hypertensives] BMI and WC data were available. There were no significant differences in lipid profile, hs-CRP, and HbA1C levels among various obesity groups (group 1, 2, and 3). However, the 24-hour mean SBP was significantly lower in group 3 compared with other groups. (138.7±15.0 vs. 137.8±12.7 vs. 133.1±17.6∗ vs. 136.5±14.0, ∗p=0.016 vs. other groups) Early morning HR was significantly lower in group 3 (71.1±11.4 vs. 66.2±12.2∗ vs. 66.2±11.8∗ vs. 69.6±11.9 bpm, ∗p=0.026 vs. group 1) and dipper pattern showed a strong tendency of more prevalent in group 3 and 4 with intermediate significance. The results were consistent in both naïve population and patients with anti-hypertensive medications.

Conclusions:
Healthy obesity hypertensives showed more favorable circadian rhythm in BP and HR than pathologic obesity regardless of metabolic profiles and history of anti-hypertensive medication. This would be a mechanism of advantageous cardiovascular outcomes in healthy obesity hypertensives.
INCREASED IN VIVO INTERSTITIAL HYDROXYL RADICAL GENERATION IN A HIGH-FAT DIET RAT MODEL OF OBESITY: A MICRODIALYSIS STUDY IN SUBCUTANEOUS WHITE ADIPOSE TISSUE
Authors: Graiani Gallia , Bongrani Alice , Verzicco Ignazio , Calvi Anna , Tedeschi Stefano , Cavazzini Stefania , Cacciola Giovanna , Coghi Pietro , Binno Simone , Vicini Vanni , Regolisti Giuseppe , Montanari Alberto , Cabassi Aderville 
Published: May 2024

Objective:
Obesity development associates with oxidative stress imbalance. We monitored in a model of obese rat (high fat fed Sprague Dawley rats) the in vivo interstitial hydroxyl radical (an oxidative stress parameter) measured through microdialysis procedure and trapping techniques in subcutaneous white adipose tissue. Hydroxyl radical generation mainly relates to Haber-Weiss-Fenton chemistry that involves iron oxidation. We also monitored plasma and tissue (through a small adipose tissue biopsy) Ceruloplasmin (CP), an alpha2-glycoprotein that owns antioxidant and ferroxidase properties oxidizing ferrous to ferric iron and preventing hydroxyl generation.

Design and method:
At 10 weeks of age, two batches for a total of 54 male Sprague Dawley rats started a high fat diet (D12451; Research Diets, New Brunswick, NJ, USA) for 24 weeks. A control group (n=23) was maintained for the same period on standard diet. The high fat diet contained 24 g % fat (45% of total calories), 24 g% protein, (20%); 41 g% carbohydrate (35%). Control diet fat content was 4.25 g%. At the end of the diet period, body weight increase in high fat diet group was in average 14.7% as compared to controls (mean 515 g vs 449 g). Rats underwent a microdialysis procedure of subcutaneous white adipose tissue at the basal time, after 3, 12 and 24 weeks, to evaluate hydroxyl radical generation by trapping this radical through analysis of 2,3-and 2,5-dihydroxybenzoic or 2-hydroxylterephthalic acid.

Results:
High fat fed rats had a stable rise of hydroxyl radical generated in adipose tissue as compared to control diet rats as well as a higher tissue expression of CP, presumably acting as antioxidant adipokine. CP circulating levels were also elevated.

Conclusions:
High fat fed rats show an increased in vivo free radical generation in subcutaneous adipose tissue that associates with a presumably compensatory increase in Cp in an attempt to buffer the local excess generation of hydroxyl radical. Even if the observed increase in local and systemic Cp could represent the counter response to the activated inflammatory-oxidative pathway in these high fat diet-treated rats its effectiveness seems quite limited.
EFFECT OF TIRZEPATIDE ON OFFICE BLOOD PRESSURE LEVELS IN OVERWEIGHT OR OBESE INDIVIDUALS WITHOUT TYPE 2 DIABETES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Patoulias Dimitrios , Koufakis Theocharis , Stavropoulos Konstantinos , Karakasis Paschalis , Imprialos Konstantinos , Katsimardou Alexandra , Varouktsi Anna , Zografou Ioanna , Petidis Konstantinos , Doumas Michael 
Published: May 2024

Objective:
Tirzepatide is a novel, dual, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, recently approved for the treatment of obesity, regardless of concomitant type 2 diabetes (T2D). The aim of the present meta-analysis was to assess the effect of tirzepatide on blood pressure (BP) levels in overweight/obese individuals without baseline T2D.

Design and method:
We searched PubMed and Cochrane Library databases, along with grey literature sources, from inception to December 2023, in order to retrieve randomized controlled trials (RCTs) assessing the effect of tirzepatide versus control on office systolic and diastolic BP (SBP and DBP, respectively) levels in patients with overweight/obesity without T2D at baseline.

Results:
We finally pooled data from 3 placebo controlled RCTs in a total of 3,788 randomized overweight/obese participants. Approximately one-third of enrolled participants had baseline hypertension. Baseline SBP and DBP levels across all eligible RCTs were within normal range. Subjects treated with tirzepatide (all doses) versus placebo experienced a significant reduction in both SBP by 7.3 mm Hg (p < 0.001) and DBP by 4.35 mm Hg (p < 0.001). Overall risk of bias was low for all eligible RCTs included in this analysis.

Conclusions:
In conclusion, preliminary evidence suggests that tirzepatide might produce a significant, beneficial effect on BP levels in overweight/obese subjects without T2D at baseline.
SILENT ATRIAL FIBRILLATION CORRELATES WITH COGNITIVE PERFORMANCE IN OLDER PERSONS
Authors: Rewiuk Krzysztof , Piotrowicz Karolina , Gasowski Jerzy , Sredniawa Beata , Kalarus Zbigniew , Kazmierczak Jaroslaw , Opolski Grzegorz , Zdrojewski Tomasz , Grodzicki Tomasz 
Published: May 2024

Objective:
Atrial fibrillation (AF) coexists with dementia in older population. AF often remains undiagnosed due to the occurrence in an asymptomatic form - silent AF (SAF). The aim of the study is to evaluate the relationships between cognitive performance and AF both symptomatic and silent in a representative Polish older population.

Design and method:
The study was conducted as a sub-analysis of the NOMED-AF, a cross-sectional observational study aiming to evaluate the epidemiology of AF in a representative, community-dwelling Polish sample of adults aged 65 years or more. Mini-Mental State Examination (MMSE) was used to assess cognitive disorders. Each study participant, regardless of AF history, was equipped with a continuous electrocardiogram wearable recording system and encouraged to wear it for up to 30 days.

Results:
A sample of 2203 participants from the NOMED-AF study was enrolled in the analyses (mean age 77.1 years, 48.4% female); 491 (22.3%) were diagnosed with AF (41.3% of them with SAF). The mean number of points obtained by the respondents in the MMSE was 25.8±0.1 and was significantly lower in patients with AF (25.2±0.22 vs 26±0.11) This difference between patients with arrhythmia and those without AF was present in the subgroup of subjects aged 65-79 years (26.8±0.21 vs 27.4±0.08) and absent in the older subgroup (23.6±0.36 vs 23.3±0.24) (Fig. 1a). There was a significant difference in the number of points obtained between patients with the symptomatic and silent forms of arrhythmia, with a lower score obtained in the latter group (25.8±0.26 vs 24.3±0.38), which was consistent in both age subgroups (Fig. 1b). Finally, in the multivariate logistic regression model, the impact of SAF (but not overall AF) on MMSE scores has been demonstrated.

Conclusions:
In the older population the presence of AF is associated with a lower MMSE score. As for the silent form of arrhythmia, this relationship is deeper and independent of other risk factors, what suggests the need for a particularly thorough assessment of cognitive disorders in patients with AF and, on the other hand, active search for asymptomatic AF in the group of patients with dementia.
TRENDS IN THE PREVALENCE OF POSSIBLE SARCOPENIA IN PEOPLE AGED 45 YEARS AND OLDER IN CHINA FROM 2011 TO 2015-BASED ON DATA FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
Authors: Ma Weiping , Zhu Huarui , Zhang Ling 
Published: May 2024

Objective:
To compare the prevalence of possible sarcopenia in people aged 45 years old and above in China from 2011 to 2015, to increase the epidemiological evidence of possible sarcopenia for early detection and targeted intervention of sarcopenia, and to provide a partial reference basis for the prevention and treatment of sarcopenia in China in the future.

Design and method:
Based on CHARLS data for 2011,2013 and 2015, we analyzed the possible prevalence of sarcopenia in our 45-year-old middle-aged and elderly population using the diagnostic criteria of AWGS 2019.

Results:
The overall prevalence of possible sarcopenia in China was 16.6%,16.6%, and 20.3% in 2011,2013, and 2015, respectively, and was higher in 2015 than in 2011 and 2013 (P<0.05). The prevalence increased with age, and was significantly higher in the elderly population aged 60 years and older than in the middle-aged population aged 45 to 59 years (P< 0.05). The comparison of prevalence between different regions was west > central > east > northeast in both 2011 and 2015, with prevalence decreasing and then increasing in central and west from 2011 to 2015, and the opposite in east and northeast (all P<0.05).

Conclusions:
The detection rate of possible sarcopenia in elderly patients in China was high from 2011 to 2015, and the prevalence varied among different age groups and regions. Awareness of possible sarcopenia should be improved, and timely intervention, early screening, and targeted preventive measures should be provided for specific groups.
THE BENEFICIAL EFFECT OF CARDIORESPIRATORY FITNESS ON THE RISK OF ATRIAL FIBRILLATION IN HYPERTENSIVES OLDER THAN 75 YEARS
Authors: Pittaras Andreas , Kokkinos Peter , Faselis Charles , Grassos Charalampos , Doumas Michael , Maria Papavasileiou , Kyfnidis Konstantinos , Kallistratos Emmanouil , Kapsokoli Chrysoula , Manolis Athanasios , Kypreos Kyriakos , Patrikios Ioannis 
Published: May 2024

Objective:
The risk of atrial fibrillation (AF) is strongly associated with age, increasing the risk of both cardiovascular events and mortality. Evidence suggests an inverse, independent and graded association between cardiorespiratory fitness (CRF) and AF incidence in younger individuals. However, information on the association between CRF and AF incidence on hypertensive individuals >75 years of age is limited.

Design and method:
We identified of 57,137 hypertensive individuals ages >75.0 years (mean age 79.4±4.0), with no diagnosis of AF or ischemic cardiac disease prior to or upon completion of a standardized exercise treadmill test (ETT) as a part of clinical evaluation. We established four fitness categories based on age-stratified quartiles of peak METs achieved: Least-fit (3.7±0.8 METs; n=14,518); Low-Fit (5.9±0.9 METs; n=14,518); Moderately-Fit (7.0±0.72 METs; n=11,390); and Highly-Fit (9.8±1.4 METs; n=11,463). Multivariable Cox proportional hazard models were applied after adjusting for age, resting blood pressure, smoking, race, sleep apnea, chronic kidney disease, dyslipidemia, and medications. P-values <0.05 using two sided tests were considered statistically significant.

Results:
During 482,967.0 person-years of follow-up (median 7.8 years), there were 6,645 new AF cases occurred (11.6%) or 13.8 events per 1000 person-years of follow-up. In multivariable-adjusted analyses, CRF was inversely with the risk of developing AF, independent of all traditional comorbidities. For every 1-MET increase in exercise capacity the AF-risk was 9% lower (HR=0.91; CI: 0.90-0.93; p<0.001). The association across CRF categories was graded. Compared to the Least-Fit category (referent), the risk was 22% lower (HR=0.78; CI: 0.74-0.83; p<0.001) for the Low-Fit; 32% lower (HR=0.68; CI: 0.63-0.73; p<0.001) for the Moderately-Fit, and 40% lower (HR=0.60; CI: 0.56-0.65; p<0.001) for Highly-Fit individuals.

Conclusions:
Increased CRF reduces the risk of AF in individuals ages >75 years. The association is inverse, independent, and graded. For every 1-MET increase in exercise capacity the AF-risk was 9% lower.
ARTERIAL HYPERTENSION IN ONCOLOGY
Authors: Bendiab Nabila Tale B , Khedim Nesrine 
Published: May 2024

Objective:
Cancer is a public health problem (20 million new cases in 2025 and 9 million deaths. There is a significant toxicity, including cardiac involvement, frequent and sometimes serious. High blood pressure is the most common co-morbidity in cancer patients. It is a possible complication of chemotherapy, especially targeted therapies. It is part of the definition of cardiotoxicity according to the ESC 2016.

Design and method:
An epidemiological, prospective descriptive study over a period of 18 months from June 2018 to December 2019 for 197 cancer patients, received at the cardiology department of the Tlemcen teaching hospital for a pre-therapeutic assessment; oriented: from the hematology department and from the oncolgy department.

Results:
The mean age of population was 49 years, 29.3% of our patients have known hypertension. 64.5% of our patients had malignant hemopathy and 35.5% had solid tumors 92% received poly chemotherapy.
Cyclophosphamide is prescribed in 81%, cisplatin in 12%, targeted therapy in 66%. Before chemotherapy, there was 18.5% systolic hypertension and 10.4% diastolic hypertension with a total of 23.6% hypertension., During chemotherapy, there was 10.3% hypertension systolic and 13.8% diastolic hypertension in total 19% of new hypertension cases according to the ESC 2017, The increase in BP during Chemotherapy was significant; speciallly in elderly women. An alkylating agent such as cyclophosphamide or platinum salt is included in the protocol for new hypertensives. Corticosteroids are present in 46.8%%, and targeted therapy in 3.2%.

Conclusions:
In oncology, high blood pressure is the most common comorbidity. It is a risk factor for certain cancers including kidney, brain. It predisposes to LV dysfunction under anti mitotics.and represents a possible complication of chemotherapy, and in particular targeted therapies. Regular monitoring of BP and the search for proteinuria are essential. The introduction of antihypertensive therapy allows in most cases the continuation of oncological treatment.19% of our population have developed hypertension with chemotherapy. It predominates in women, the elderly and in the group of alkylating agents.