bluuebunny/crossref_metadata_2025_split huggingface dataset:
AN ALTERNATIVE PROTOCOL TO IMPROVE ACCESSIBILITY TO ISOMETRIC EXERCISE TRAINING TO TREAT UNCOMPLICATED HYPERTENSION
Authors: Wiles Jonathan , Rees-roberts Melanie , Santer Ellie , Lea John , O’Driscoll Jamie , Macinnes Douglas , Pellatt-higgins Tracey , Mills Ashley , Gousia Katerina , West Alan , Darby John , Borthwick Rachel , Doulton Tim , Swift Pauline , Farmer Chris 
Published: May 2024

Objective:
Isometric exercise training (IET) is consistently shown to reduce blood pressure (BP). We recently investigated the feasibility of delivering a personalised isometric wall-squat protocol to patients with Stage-1 hypertension within a free-to-access healthcare setting. Whist healthcare professionals (HCP) and patients thought the intervention was feasible, any exercise prescription requiring HCP input and specific resource allocation was not deemed viable. This study aimed to examine the effect of a low resource IET prescription using rating of perceived exertion (RPE) versus HCP prescription and control group upon BP.

Design and method:
30 participants with normal to high-normal BP were randomised into either a (heart rate) HR-Exercise (HR-EX), RPE-Exercise (RPE-EX) or control (CON) group. IET groups undertook a 4-week home-based wall-squat programme with intensity prescribed either directly by a HCP using our established HR method (HR-EX), or self-prescribed using a RPE selection protocol (RPE-EX). The CON group maintained their normal lifestyle. Clinic BP was measured at baseline and post-IET.

Results:
Clinic systolic (SBP) and diastolic (DBP) were significantly reduced (p < 0.001) in both intervention groups following IET compared to baseline. Group mean reductions for the HR-EX (SBP: -14 ± 6, DBP: -6 ± 4 mmHg) and RPE-EX (SBP: -9 ± 6, DBP: -6 ± 4 mmHg) were greater (p < 0.001) than CON (no differences) group. There were no differences between intervention groups in the magnitude of the BP reductions; however, at baseline HR-EX had greater SBP (p < 0.001) results compared to RPE-EX, but following the IET there were no significant differences between these groups.

Conclusions:
RPE prescribed wall-squat IET provides an efficacious method for reducing BP at home, delivering reductions comparable to the HR-based prescription method. This new RPE-based method, developed because of difficulties in delivering IET prescription in a general healthcare setting, demonstrates great potential as an effective lifestyle intervention to lower BP mainly due to improved access. It requires minimal resource to deliver and implement in any environment and could be provided entirely online.
PROMOTING CARDIOVASCULAR HEALTH IN THE WORKPLACE: RESULTS OF A LIFESTYLE INTERVENTION ON BLOOD PRESSURE AND CARDIOVASCULAR RISK FACTORS
Authors: Gonçalves Lurdes Costa , Lau Beatriz , Costa Carlos , Amaro António , Ribeiro Fernando 
Published: May 2024

Objective:
The workplace is a pivotal setting for implementing lifestyle interventions aimed at improving blood pressure management and cardiovascular health. This study aims to evaluate the impact of a comprehensive lifestyle intervention on blood pressure and other cardiovascular risk factors among employees of a kitchen appliances manufacturing company.

Design and method:
A total of 266 adults (39.2±10.6 years; 75.9% women) employed in the company were divided into three groups: Lifestyle intervention (n= 86), Health Education (n= 85), and Active Breaks (n = 95). All groups received guidance on healthy lifestyle behaviors. Moreover, the lifestyle group participated in a weekly session of resistance exercises tailored to their workstations and a daily 10-minute active break comprising stretching, coordination, and range of motion exercises. The active breaks group engaged in the daily active break, while the education group solely received guidance on healthy lifestyles. Resting blood pressure, body weight, body mass index, waist circumference, total cholesterol, and physical activity were evaluated at baseline and after the 7-month intervention.

Results:
At baseline, participant characteristics (e.g., age, body mass index, resting blood pressure, total cholesterol) were similar across the three groups. Systolic blood pressure (mean difference: 117.8 ± 15.8 to 118.1 ± 14.8 mmHg, p<.05) did not change from baseline to the end of the intervention in either group. However, diastolic blood pressure significantly decreased in all groups from baseline to the end of the intervention (mean difference: 1.9 ± 6.2 mmHg, 95% CI: 1.2 – 2.7 mmHg), without a group X time interaction. Waist circumference and total cholesterol also decreased in all the groups by 0.7 cm (95% CI: 0.2 – 1.0 cm) and 5.5 mg/dL (95% CI: 3.8 – 9.3 mg/dL), respectively, without a group X time interaction. Moderate intensity physical activity levels increased from 330.5±543.4 to 390.5±562.3 MET-min/wk, with a significant group X time interaction; only the Active Breaks group demonstrated a significant increase in moderate-intensity physical activity.

Conclusions:
Among middle-aged adults, a workplace lifestyle intervention, irrespective of its intensity, led to significant improvements in diastolic blood pressure, total cholesterol, waist circumference, and moderate physical activity.
ASSOCIATION OF HEALTHY LIFESTYLE INDEX AND ANTIHYPERTENSIVE MEDICATION USE WITH BLOOD PRESSURE CONTROL AMONG EMPLOYEES WITH HYPERTENSION IN CHINA
Authors: Zhen Huzhen , Xin Xin Wang , Congyi Congyi Zheng , Xue Xue Cao , Yixin Yixin Tian , Runqin Runqing Gu , Jiayin Jiayin Cai , Ye Ye Tian , Zengwu Zengwu Wang 
Published: May 2024

Objective:
We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.

Design and method:
A cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China. Workplaces were randomly divided into intervention (n = 40) and control (n = 20) groups. Basic information on employees at each workplace was collected by trained professionals, including sociodemographic characteristics, medical history, family history, lifestyle behaviors, medication status and physical measurements. After baseline, the intervention group received a 2-year intervention to achieve BP control, which included:(1) a workplace wellness program for all employees; (2) a guidelines-oriented hypertension management protocol. HLI including nonsmoking, nondrinking, adequate physical activity, weight within reference range and balanced diet, were coded on a 5-point scale (range, 0-5, with higher score indicating a healthier lifestyle). Antihypertensive medication use was defined as taking drug within the last 2 weeks. Changes in HLI, antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.

Results:
After 24 months of the intervention, there was a significant improvement in lifestyle [smoking (0.65, 95% CI, 0.43∼0.99; P=0.045), drinking (OR=0.52, 95% CI, 0.40∼0.68; P<0.001), regular exercise (OR=3.10, 95% CI, 2.53∼3.78; P<0.001), excessive intake of fatty food (OR=0.17, 95% CI, 0.06∼0.52; P=0.002), restrictive use of salt (OR=0.26, 95% CI, 0.12∼0.56; P=0.001)]. Compare to employees with a deteriorating lifestyle after the intervention, those with an improved lifestyle had a higher BP control. In the intervention group, compared with employees not using antihypertensive medication, those who consistent used (OR, 2.34; 95% CI, 1.16∼4.72; P=0.017) or changed from not using to using antihypertensive medication (OR, 2.24; 95% CI, 1.08∼4.62; P=0.030) had higher BP control. Those who used antihypertensive medication and had a high HLI had the highest BP control (OR, 1.88; 95% CI, 1.32∼2.67, P<0.001).

Conclusions:
These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
MAGNESIUM SUPPLEMENTATION REDUCES INERLEUKIN-6 AND BLOOD PRESSURE IN METABOLIC SYNDROME
Authors: Kisters Klaus , Werner Tanja , Tokmak Faruk , Predel Hans -GEORG , Reuter Hannes , Kisters Sophia 
Published: May 2024

Objective:
Due to a metabolic syndrome cardiovascular morbidity and mortality is increased. Recent data show that a magnesium supplementation can decrease inflammation and atherogenic vessel damage via calcium magnesium antagonism and reducing elevated interleukin-6 levels, hereby improving metabolic parameters. The blood pressure lowering effect of magnesium has been described in several studies before, both in systolic and diastolic values.

Design and method:
In this context we conducted a double-blinded, controlled, prospective study on magnesium, blood pressure and interleukin-6 levels in 27 patients (13 male/14 female, age: 60.2+/-12.5 years) with a metabolic syndrome. The study was performed in accordance with the declaration of Helsinki and approved by the ethic committee of the University of Münster, Germany (2015-493-f-S9). Registration in clinicaltrials.gov (NCT03002545). All patients, with normal renal function, were supplemented with orally given 400 mg magnesium citrate daily. Interleukin-6 concentrations were measured before and after 6 and 12 weeks of treatment. 27 metabolic patients served as controls without an additional magnesium therapy (10 male/17 female, age: 64.6+/-13.2 years).

Results:
In the magnesium treated group interleukin-6 values decreased significantly from 4.94+/-3.30 to 4.53+/-6.89 after 6 weeks to 3.01+/-1.32 pg/mL after 12 weeks (means+/-s.d.)(p< 0.01).
In the control group interleukin-6 was 3.73+/-4.36 before start of supplementation, 4.87+/-4.35 after 6 weeks, 4.41+/-3.15 pg/mL after 12 weeks (means+/-s.d.)(n.s.).
In the magnesium treated group there was a significant decrease in both systolic and diastolic blood pressure values after 12 weeks (systolic 134.6+/-6.8 to 126.3+/-5.6 mmHg, diastolic: 84.1+/-3.9 to 79.4+/-1.6 mmHg)(means+/-s.d.)(p< 0.01). In the control group blood pressure values did not change and were similar to the supplemented group at beginning.
Mann-Whitney-U-Test was used for statistics analysis.

Conclusions:
In metabolic syndrome magnesium supplementation significantly improved systolic and diastolic blood pressure values and interleukin-6 levels. Magnesium acts anti-inflammatory and anti-arteriosclerotic, hereby a benefit for metabolic patients at high risk for vascular damage inclusive stroke is given. A magnesium deficiency has to be corrected in every metabolic patient. A long-lasting magnesium supplementatio (12 weeks) has to be preferred. The daily amount of oral magnesium sujpplementation should be 300 to 500 mg.
PREVALENCE OF ABDOMINAL OBESITY AND ITS ASSOCIATED COMORBID CONDITION IN ADULT YEMENI PEOPLE OF SANA’A CITY
Authors: Bamashmos Mohammed 
Published: May 2024

Objective:
Abdominal obesity is a metabolic problem that has become increasingly common worldwide over the past several decades. Its prevalence is increased in both advanced and developing countries including Yemen. The aim of this cross sectional study was to investigate the prevalence of Abdominal obesity in a sample of Yemeni adult individuals and its association with other comorbid conditions namely, hypertension, diabetes, dyslipidemia (high triglyceride, low high density lipoprotein) and metabolic syndrome (MS).

Design and method:
A sample of 1118 adult Yemeni people equal to or over 18 years was randomly chosen to represent the population living in Sana’a City during a period of two years from April 2016 to April 2018. All the study group underwent full clinical history and examination which included measurement of BP and waist circumference and the following laboratory investigations (FBS, serum TG, HDL, and LDL).

Results:
The prevalence of abdominal obesity in this study was 24.5% (7.9% male and 44.2% female). Central obesity in this study was significantly correlated with age and sex. The highest prevalent comorbidity in patients with abdominal obesity was high BP (41.3%), followed by high serum TG (40%), higher prevalence of MS (40%), low serum HDL (37.8%) high LDL (20.1%) raised fasting blood glucose (22.1%) than those without abdominal obesity (5.5%, 31.3%, 16.6%, 8.5%, 12.5% and increased FBS 10% respectively).

Conclusions:
Hypertension, diabetes, dyslipidemia and MS are strongly correlated with abdominal obesity.
SYSTEMIC INFLAMMATION RESPONSE INDEX AS A PREDICTOR OF STROKE RISK IN ELDERLY PATIENTS WITH HYPERTENSION: A COHORT STUDY
Authors: Song Shuaiwei , Cai Xintian , Hu Junli , Li Nanfang 
Published: May 2024

Objective:
Little research has investigated the relationship between the systemic inflammation response index (SIRI) and stroke, especially in elderly hypertensive patients. This study aimed to evaluate the relationship between the SIRI and the risk of stroke and its subtypes in elderly patients with hypertension and to explore its predictive superiority and any potential effect modifiers.

Design and method:
The study included 4749 participants with no history of stroke at baseline. Cox regression was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CIs). Interaction tests and subgroup analyses were conducted. The predictive performance of various inflammatory indicators for stroke was compared using the area under the curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

Results:
During a median follow-up period of 3.2 years, 640 strokes were recorded, of which 526 were ischemic and the remainder hemorrhagic. After adjustment for confounders, compared to the reference group, the HRs (95% CI) of stroke were 1.29 (95% CI, 1.01–1.65) and 1.48 (95% CI, 1.15–1.90) for participants in the second and third tertiles, respectively. We observed interactions between SIRI and homocysteine levels (< 15 vs > = 15 umol/L) (P for interaction = 0.014) on ischemic stroke risk. Furthermore, the AUC, NRI, and IDI analyses demonstrated that SIRI exhibited better predictive value for stroke risk when compared to other indicators. Similar results were observed for both ischemic and hemorrhagic strokes.

Conclusions:
Elevated SIRI levels were significantly associated with the risk of stroke and its subtypes in elderly patients with hypertension, suggesting their potential as a promising indicator for stroke risk in this population. However, larger prospective studies are needed to confirm these findings.
BLOOD PRESSURE VARIABILITY AS PREDICTOR OF CANCER THERAPY-RELATED CARDIOVASCULAR TOXICITY IN PATIENTS WITH MULTIPLE MYELOMA
Authors: Fanelli Elvira , Picca Giulia , Airale Lorenzo , Astarita Anna , Mingrone Giulia , Catarinella Cinzia , Votta Simona , Colomba Anna , Cesareo Marco , Leone Dario , Paladino Arianna , Rabbia Franco , Bringhen Sara , Gay Francesca , Veglio Franco , Milan Alberto , Vallelonga Fabrizio 
Published: May 2024

Objective:
Blood pressure variability (BPV) is an independent predictor of cardiovascular (CV) events and overall mortality. The potential role of BPV in defining CV risk of patients undergoing anticancer therapy with a potential cancer therapy-related cardiovascular toxicity (CTR-CVT) is currently unknown.
The aims of this study were: (i) to assess the predictive value of BPV indexes for CTR-CVT development and defining the corresponding cut-off values; (ii) to identify subgroups of subjects based on BPV, through clustering analysis.

Design and method:
Patients with Multiple Myeloma, who were eligible to anticancer therapy with Carfilzomib, were consecutively enrolled and underwent a baseline evaluation, including office blood pressure (BP) measurement, 24h-Ambulatory Blood pressure Monitoring (ABPM), PWV, and Echocardiography.
Short-term BPV was assessed through standard deviation (SD), weighted standard deviation (wSD), coefficient of variation (CoV), average real variability (ARV), and variability independent of the mean (VIM), evaluated on ABPM measurements.

Results:
The study population included 124 patients (50% female). During follow-up, CTR-CVT occurred in 70 subjects (56.5% of the total population), including both BP and CV events. Night-time BPV was associated to CTR-CVT, independently by BP, age, smoking, and comorbidities as diabetes and renal dysfunction (night-time systolic CoV: adjusted OR 1.11 [1.01-1.22]; night-time systolic VIM adjusted OR 1.17 [1.03-1.35]; night-time diastolic VIM adjusted OR 1.18 [1.01-1.40]). Cut-off for these BPV parameters were identified as predictor of CTR-CVT occurrence: 10.5 for night-time systolic CoV (sensibility 73%, specificity 47%); 7.8 and 6.4 for systolic and diastolic night-time VIM (sensibility 85% for both; specificity 35% and 39%, respectively).
Clustering analysis identified a subgroup of subjects characterized by the highest BPV, who had a greater prevalence of events during follow-up, but no differences in other conventional CV risk factors, as BP, dyslipidaemia, diabetes, renal function, and smoking habit, as well as left ventricular mass and global longitudinal strain.

Conclusions:
Short-term BPV is an independent predictor of CTR-CVT in patients with Multiple Myeloma undergoing therapy with Carfilzomib. The inclusion of these indexes improves CV risk prediction in these subjects and higher BPV is a distinctive feature predicting adverse events, on top of conventional CV risk factors.
EARLY IMPACT OF AN OUTPATIENT HYPERTENSION CLINIC IN A DISTRICT HOSPITAL
Authors: Matos Maria , Madeira Daniela , Monteiro Miguel , Costa Mariana , Negrão Catarina , Nunes Filipa , Orfão Ana , Sukhoviy Anna , Santos João , Brandão Rodrigo , Silva Maria , Tomás Ana Rita , Dutschmann Rita , Branco Teresa 
Published: May 2024

Objective:
Arterial hypertension (HTN) is a major preventable cause of cardiovascular morbidity and mortality. To address this issue, we implemented an outpatient HTN clinic at our hospital, mainly focused on patients with suspected secondary and complex HTN (including HTN associated with oncology treatments, dysautonomy or autoimmune disease). We aim to characterize the patients followed at our clinic and to analyze the effectiveness of this consultation in relation to HTN etiological classification, blood pressure (BP) control and emergency department episodes.

Design and method:
We designed a retrospective cohort study, concerning all patients who were evaluated in our clinic from June 2022 until December 2023. We excluded patients who abandoned the follow-up after the first evaluation.

Results:
We evaluated 238 patients with a mean age of 48.3±15.1 years. Although the majority of patients were caucasian (56.8%, n=138), our population is characterized by a significant proportion of patients of african ancestry (36%, n=85). We observed a slightly higher prevalence of resistant HTN in these patients, when compared to other groups (21.8% vs 18.8%). Of the patients who have concluded the etiologic study, a secondary cause of HTN was found in 64.5% (n=80). When evaluating the effectiveness in BP control, we observed that there was a significant reduction in both systolic (mean variation of -14.1±25.4mmHg, p<0.001) and diastolic BP (mean variation of -7.7±16.4mmHg, p<0.001) between the first and last patient evaluations. The proportion of patients with controlled BP improved significantly from 26.9% to 55.6% (p<0.001). Additionally, the emergency department episodes due to hypertension crisis were also significantly reduced after initiating follow-up at the outpatient clinic (mean 0.5±0.6 vs. 0.1±0.4 episodes/patient, before and after follow-up respectively, p<0.001).

Conclusions:
Monitoring selected patients with HTN in a hospital outpatient setting is an effective way to improve their BP control and to investigate any underlying causes that may require targeted treatment. This approach not only benefits individual health but may also reduce the number of hypertensive crisis admissions in the emergency department, thereby reducing the burden on the health system.
AT1R/ROS/ENOS/AT2R AXIS IN ANGIOTENSIN II UPREGULATION OF NEURONAL NITRIC OXIDE SYNTHASE IN CARDIOMYOCYTES
Authors: Zhang Yin Hua 
Published: May 2024

Objective:
Angiotensin II (Ang II) is a potent precursor of hypertrophy and heart failure. However, neuronal nitric oxide synthase (nNOS or NOS1) is upregulated by Ang II, suggesting pro-protective mechanisms of Ang II signaling in the heart. Until recently, the mechanisms mediating Ang II-inducing nNOS remained unclear. The main purpose was to identify cellular mechanisms of Ang II type I and type II receptors and the subsequent signaling cascades mediating nNOS upregulation in cardiomyocytes.

Design and method:
nNOS expression was detected in left ventricular (LV) myocytes from SD rats (8-10 weeks, male) pre-treated with Ang II with and without antagonists of AT1R or AT2R (losartan, PD123319) and ROS scavengers (apocynin, tiron or PEG-catalase). Surface biotinylation and immunocytochemistry experiments were conducted to examine AT1R expression in plasma membrane. eNOS inhibitors and LV myocytes from eNOS gene deletion mice were used to test the effects of eNOS in the signaling pathway. Site-specific mutagenesis analysis was used to specify s-nitrosylation cysteine residue of AT2R for its membrane translocation.

Results:
Our results showed that Ang II increased nNOS protein expression but losartan, PD123319 and apocynin, tiron or PEG-catalase blocked Ang II-upregulation of nNOS. AT1R expression was progressively internalization with Ang II treatment accompanied by membrane trafficking of AT2R. Inhibition of AT1R or ROS scavengers prevented Ang II-induced translocation of AT2R to plasma membrane. Furthermore, eNOS-Ser1177 was increased by Ang II but eNOS-Thr495 was decreased, and ROS scavengers prevented Ang II-activation of eNOS. L-NG-Nitroarginine Methyl Ester (L-NAME) or eNOS gene deletion abolished Ang II-induced membrane trafficking of AT2R, nNOS protein expression and activity. Mechanistically, NO induces S-nitrosation of AT2R and site-specific mutagenesis analysis reveals that C-terminal cysteine 349 in AT2R is essential in AT2R translocation to plasma membrane.

Conclusions:
Here, we demonstrate that Ang II upregulates nNOS protein expression and activity via AT1R/ROS/eNOS-dependent S-nitrosation and membrane translocation of AT2R. Crosstalk between
AT1R and AT2R in regulating nNOS via eNOS is important in cardiac protection under pathogenic stimuli.