bluuebunny/crossref_metadata_2025_split huggingface dataset:
IN NORMOTESIVE SALT SENSITIVE SUBJECTS, INSULIN RESISTANCE IS ASSOCIATED TO FUTURE HYPERTENSION. A 3 YEAR FOLLOW-UP STUDY
Authors: Sanchez Ramiro A. , Sanchez Maria J. , Pessana Franco M. , Ramirez Agustin J. 
Published: May 2024

Objective:
Salt sensitive hypertension (SS) is associated to insulin resistance even in lean individuals. However, no data has been shown in normotensive offspring of hypertensive salt sensitive parents.
In a 3 year follow-up, we evaluated in normotensive SS or salt resistant (SR) offspring of hypertensive parents (offSS-HT or offSR-HT, respectively), the frequency to develop hypertension. In addition, a complete metabolic panel was performed in both groups, as well as urinary albumin excretion and creatinine clearance was calculated, as markers of kidney function.

Design and method:
43 offSS-HT (29±2 years; 20 female), and 36 offSR-HT (26±2 years; 16 female) were followed-up for 3 years. Both groups were considered lean with a BMI Higher than 25kg/m2 and a waist circumference Greater than 98 cm in males or <105 cm in females). Creatinine clearance (CrCl), 24h urinary albumin excretion, Glycemia and insulinemia before and after 60 and 120 min a glucose overload (75 g; OGTT) was measured at baseline. The area under the curve (AUC; mg/dl.min) and the HOMA index (fasting glucose (mg/dl) × fasting insulin (μU/ml)/405),were also calculated. Blood pressure (BP) and 24h urine sodium excretion were measured each year.

Results:
Blood pressure rose significantly, after 3 years in offSS-HT (11.5±4.27/9.5±3.3mmHg) compared to offSR-HT, (-0.3±2.8/-0.9±3.6; p<0.0001).
In offSS-HT, UAE was significantly higher (53±3μ.min, p<0.01) than in offSR-HT.(12±4μ.min)
At baseline fasting, 60 min and 120-min, glycemia and insulinemia post OGTT were higher in offSS-HT(140.1±18; 130±15 mg.dl and 31.8±11; 31.8±11 IU) than in offSR-HT (116.5±5: 6.5±3 mg.dl and 18.8±7; 21.3±4IU, p<0.01).
Glycemia AUC was significantly higher (258.80±25mg/dl.min) in offSS-HT compared to offSR-HT (194.39±6mg/dl.min, p<0.0001).
Similarly, HOMA-IR was higher in offSS-HT (3.26±1.36; p < 0.002) than in offSR-HT (1.52±0.27).
In offSS-HT the CrCl was significantly higher (136±8 ml.min; p<0.05) than in offSR-HT (107±6 ml.min).

Conclusions:
In offSS-HT blood pressure rise was associated to insulin resistance and glomerular hyperfiltration suggesting a familiar aggregation and a higher cardiometabolic risk when compared with offSR-HT.
THE EFFECTS OF DIFFERENT INTERDIALYTIC INTERVALS ON CARDIORESPIRATORY FITNESS ASSESSED WITH CARDIOPULMONARY EXERCISE TESTING IN HEMODIALYSIS PATIENTS
Authors: Pella Eva , Boulmpou Aristi , Boutou Afroditi , Theodorakopoulou Marieta P. , Haddad Nasra , Karpetas Antonios , Giamalis Panagiotis , Papagianni Aikaterini , Papadopoulos Christodoulos E , Vassilikos Vassilios , Sarafidis Pantelis 
Published: May 2024

Objective:
Long interdialytic interval in thrice-weekly hemodialysis is associated with excess cardiovascular and all-cause mortality risk. Impaired cardiorespiratory fitness is a strong predictor of mortality in hemodialysis. This study investigated differences in cardiorespiratory fitness assessed with cardiopulmonary exercise testing (CPET) between the end of the 2-day and the 3-day interdialytic interval.

Design and method:
A total of 28 hemodialysis patients, randomized in two different sequences of evaluation underwent CPET and spirometry examination at the end of the 2-day and the 3-day intervals. The primary outcome was the difference in oxygen uptake at peak exercise [VO2peak(ml/kg/min)] assessed with CPET. Volume status was assessed with interdialytic-weight-gain (IDWG), lung ultrasound, bioimpedance spectroscopy (BIS), and inferior vena cava measurements. A total of 14 age- and sex-matched controls were also evaluated.

Results:
Hemodialysis patients at the end of both 2-day and 3-day intervals presented lower values in all major CPET parameters than controls. VO2peak(ml/kg/min) was significantly higher at the end of the 2-day than the 3-day interval (15.24±4.18 vs 13.64±2.76;p<0.001); similar were the results for VO2peak(ml/min) (1188±257 vs 1074±224;p<0.001) and VO2peak(%predicted) (58.9±9.2 vs 52.3±8.6;p<0.001). Numerical but no statistically significant differences were detected in VO2-anaerobic-threshold(ml/kg/min) and VO2-anaerobic-threshold(ml/min) between the two time-points. Maximal work load (90.1±23.2 vs 79.3±25.1;p<0.001), exercise duration, HR at peak exercise and oxygen pulse also showed lower values at the end of the 3-day interval. FEV1 levels were similar between the two evaluations. Generalized-linear-mixed-model analysis including IDWG as random covariate attenuated the observed differences in VO2peak(ml/kg/min). Changes in BIS-derived overhydration indexes were moderately correlated with changes of VO2peak(ml/kg/min).

Conclusions:
The 3-day interval was associated with further impairment of VO2 at peak exercise. This effect was predominantly driven by excess fluid accumulation during the extra interdialytic day.
PREVALENCE AND CONTROL OF ARTERIAL HYPERTENSION AMONG PATIENTS WITH GLOMERULAR DISEASES
Authors: Mustedanagic Matea , Paponja Kristina , Jelakovic Bojan , Stambuk Sandra Karanovic 
Published: May 2024

Objective:
Glomerular diseases (GD) are strongly associated with arterial hypertension (AH). Increased blood pressure(BP) contributes to the pathogenesis and progression of kidney damage and impacts patients’ outcomes and overall morbidity and mortality. Our aim was to analyse the prevalence and control of AH among patients with GD hospitalized for native kidney biopsy.

Design and method:
This retrospective analyses included 189 consecutive subjects who underwent kidney biopsy during a 5-year period(2015-2019). The patients were grouped according to the presenting clinical syndrome: rapidly progressive glomerulonephritis (RPGN), nephritic syndrome(NiS), nephrotic syndrome(NS), chronic azotaemia+/-erythrocyturia/proteinuria (CA), syndrome of asymptomatic erythrocyturia+/- proteinuria (AEP). Data on office BP values measured according to the ESH guidelines upon admission as well as other clinical and laboratory values were collected from medical records.

Results:
Median BP value for the whole group was 140/85 (100-220/56-114) mmHg. AH was present in 98.9% of all patients. 77.0% were treated and BP control was achieved in 43.1% treated patients, while resistant hypertension was present in 23.6%. Median number of medications was 2 (0-6) with predominance of RAAS blockers (49,7%), CCBs (44,4%) and loop diuretics (33,8%). The subgroup data are shown in Table 1.
Important statistically significant correlation of both systolic and diastolic BP with proteinuria (rho = 0.327, p < 0.001, rho = 0.237, p = 0.002) and eGFR (rho = - 0.298, p < 0.001, rho = - 0.224, p= 0.002) was found in the whole group.

Conclusions:
High prevalence of AH, low rates of its’ control partially due to therapeutic inertia and 23,6% of resistant hypertension was found among our patients with glomerular diseases. BP was associated with severity of kidney damage and proteinuria. We observed a difference with regards to the clinical presentation which necessitates further investigation with inclusion of ABPM findings.
DIALYSATE SODIUM AND SHORT-TERM BLOOD PRESSURE VARIABILITY IN PATIENTS WITH INTRADIALYTIC HYPERTENSION: A RANDOMIZED CROSSOVER STUDY
Authors: Iatridi Fotini , Ekart Robert , Xagas Efstathios , Karpetas Antonios , Theodorakopoulou Marieta , Karkamani Eleni , Chalkioti Ioanna , Revela Ioanna , Giamalis Panagiotis , Sarafidis Pantelis 
Published: May 2024

Objective:
Increased blood pressure (BP) variability (BPV) is associated with high cardiovascular risk in hemodialysis. Patients with intradialytic-hypertension (IDH) also exhibited an increased cardiovascular risk than hemodialysis patients without this condition. The impact of non-pharmacological BP-lowering interventions on BPV in this population remains unknown. This analysis evaluated the effect of low (137 mEq/L) compared to standard (140 mEq/L) dialysate sodium concentration on short-term BPV in patients with IDH.

Design and method:
In a randomized cross-over manner, 29 patients with IDH underwent 4 hemodialysis sessions with low (137 mEq/L) followed by 4 sessions with standard (140 mEq/L) dialysate sodium or vice versa according to randomization arm. 48-h ABPM was performed from the start of the 4th session on each dialysate sodium. BPV indices during the 48-h, 24-h, day-time and night-time periods were calculated with validated formulas.

Results:
Mean 48-h BP was lower by 5.3/2.6 mmHg with low compared to standard dialysate sodium concentration, (p=0.005/p=0.007) respectively). All 48-h systolic BPV indices examined showed non-significant differences between low and standard dialysate sodium (SBP-SD: 16.99±5.39 vs. 16.98±4.33 mmHg; p=0.982; SBP-wSD: 15.93±5.02 vs. 16.12±4.16 mmHg, p=0.769; SBP-ARV: 11.99±3.67 vs. 11.45±3.35 mmHg, p=0.392 and SBP-CV: 12.36±3.65 vs. 11.92±3.18%, p=0.302, with low vs. standard dialysate sodium, respectively). Diastolic BPV indices were numerically, but not statistically, lower with low dialysate sodium. Overall, significant differences were observed in some further comparisons relevant to a trend for lower BPV during daytime 2 and higher BVP during nighttime 2 during treatment with low dialysate sodium.

Conclusions:
Low dialysate sodium concentration does not affect BPV levels in patients with IDH. Future research should further explore alternative interventions to reduce BP and BPV in this high-risk population.
EFFECT OF LOW VERSUS STANDARD DIALYSATE SODIUM ON 48-H AMBULATORY BLOOD PRESSURE IN PATIENTS WITH INTRADIALYTIC HYPERTENSION: A RANDOMIZED CROSSOVER STUDY
Authors: Iatridi Fotini , Ekart Robert , Xagas Efstathios , Revela Ioanna , Karpetas Antonios , Theodorakopoulou Marieta , Karagiannidis Artemios , Georgiou Areti , Malandris Konstantinos , Tsouchnikas Ioannis , Sarafidis Pantelis 
Published: May 2024

Objective:
Intradialytic hypertension (IDH) is associated with increased risk for cardiovascular events and mortality. Patients with IDH exhibit higher 48-h blood pressure (BP) levels than patients without this condition. Volume and sodium excess are considered a major factor contributing in the development of this phenomenon. This study evaluated the effect of low (137mEq/L) compared to standard (140mEq/L) dialysate sodium concentration on 48-h BP in patients with IDH.

Design and method:
In this randomized, single-blind, crossover study, 29 patients with IDH underwent 4 hemodialysis sessions with low (137mEq/L) followed by 4 sessions with standard (140mEq/L) dialysate sodium or vice-versa. Mean 48-h BP, pre-/post-dialysis and intradialytic BP, pre-dialysis weight, interdialytic weight gain (IDWG) and lung ultrasound B-lines were assessed.

Results:
Mean 48-h SBP/DBP were significantly lower with low compared to standard dialysate sodium concentration (137.6±17.0/81.4±13.7mmHg with low vs 142.9±14.5/84.0±13.9mmHg with standard dialysate sodium, p=0.005/p=0.007 respectively); SBP/DBP levels were also significantly lower during the 44-h and different 24-h periods. Low dialysate sodium significantly reduced post-dialysis (SBP/DBP: 150.3±22.3/91.2±15.1mmHg with low vs 166.6±17.3/94.5±14.9mmHg with standard dialysate sodium, p<0.001/p=0.134 respectively) and intradialytic (141.4±18.0/85.0±13.4mmHg with low vs 147.5±13.6/88.1±12.5mmHg with standard dialysate sodium, p=0.034/p=0.013, respectively) BP compared with standard dialysate sodium. Pre-dialysis weight, IDWG and pre-dialysis B-lines were also significantly decreased with low dialysate sodium.

Conclusions:
Low dialysate sodium concentration significantly reduced 48-h ambulatory BP compared with standard dialysate sodium in patients with IDH. These findings support low dialysate sodium as a major non-pharmacologic approach for BP management in patients with IDH.
Registered at ClinicalTrials.gov with study number NCT05430438.
PREDICTORS OF KIDNEY EVENTS IN TYPE 2 DIABETES MELLITUS PATIENTS WITH CHRONIC HEART FAILURE PATIENTS
Authors: Berezin Alexander , Fushtey Ivan , Berezina Tetiana , Berezin Oleksandr 
Published: May 2024

Objective:
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have a favorable impact on the kidney function in patients with heart failure (HF), while there is no clear evidence of what factors predict this effect. The aim of the study was to identify plausible predictors for kidney function outcome among patients with HF and investigate their association with SGLT2i.

Design and method:
We prospectively enrolled 480 patients with type 2 diabetes mellitus (T2DM) treated with diet and metformin and concomitant chronic HF and followed them for 52 weeks. We determined kidney outcome as a composite event that includes >40% reduced estimated glomerular filtration rate from baseline, newly diagnosed end-stage CKD or kidney replacement therapy. The relevant medical information and measurement of the biomarkers were collected at baseline and at the end of the study.

Results:
The composite kidney outcome was detected in 88 (18.3%) patients of the entire population. All patients received guideline-recommended optimal therapy, which was adjusted to phenotype/severity of HF, cardiovascular risk and comorbidity profiles, and fasting glycaemia. Levels of irisin, adropin and apelin significantly increased in patients without clinical endpoint, whereas in those with composite endpoint the biomarker levels exhibited a decrease with borderline statistical significance (Figure 1). Multivariate logistic regression revealed that use of SGLT2i (OR=0.92 p=0.048), baseline serum levels of irisin <4.50 ng/ml (OR=1.51, p=0.001) and adropin <2.10 ng/ml (OR=1.15, p=0.001) along with and a <15% increase in the levels of these biomarkers (OR=1.60, p=0.001)and <6% (OR=1.21, p=0.001), respectively, remained an independent predictor for composite kidney endpoint. We established that irisin <4.5 ng/ml and <15% increase in irisin serum levels added more valuable predictive information than the reference variable. However, the combination of irisin <4.5 ng/ml at baseline and <15% increase in irisin serum levels (area under curve = 0.91, 95% confident interval = 0.87-0.95) improved the discriminative value of each biomarker alone.

Conclusions:
We suggest that low levels of irisin and its inadequate increase during administration of SGLT2i are promising predictors for unfavorable kidney outcome among patients with T2DM and concomitant HF
IMPACT OF LONG-TERM CONSUMPTION OF POTASSIUM -ENRICHED SALT ON BLOOD PRESSURE AND MORTALITY IN THE NURSING HOME POPULATION
Authors: Zhang Hongye , Wang Xingyu , Dou Xianfeng , Meng Xianmin , Wei Hua , Li Weiwei , Zhao Jingguo , Guo Yu , Li Dongfeng , Zhao Sufang , Dong Yuehong , Liu Yongjuan , Zhang Buqiang , Huang Xiuxian , Liu Xin , Liu Lisheng 
Published: May 2024

Objective:
To examine the effects of long-term consumption of potassium-enriched salt (KCl: NaCl=1:1 by weight) on various health outcomes, including blood pressure, urinary sodium-potassium ratio, stroke, cardiovascular disease (CVD), and all-cause mortality, among individuals living in nursing homes.

Design and method:
In northern China, a total of 29 nursing homes were selected using cluster random sampling, with each county representing a cluster. These nursing homes were then divided into two groups: the intervention group, which consumed potassium-enriched, low-sodium salt, and the control group, which consumed regular salt. Baseline and seven follow-up surveys were conducted using standard cardiovascular disease epidemiological survey methods from 2011 to 2018. For the purpose of survival analysis, the population considered consisted of individuals aged 40 years or older who had stayed in the nursing home for at least six months.

Results:
In the baseline assessment, there were no significant differences in the average blood pressure between the two groups. However, during the follow-up surveys, it was observed that the intervention group had significantly lower systolic blood pressure (SBP) and a lower sodium-potassium ratio. The survival analysis was conducted on a total of 3543 participants, with 1065 death events recorded. After adjusting for age and sex using Cox proportional hazards models, the intervention group had an HR of 0.883 (95% CI 0.782-0.997) compared to the control group for all-cause mortality. Subgroup analysis was also performed for individuals aged 40-70 years, which revealed that the intervention group had lower HRs for all-cause mortality, CVD (including stroke), and stroke death, with HRs of 0.780 (95% CI 0.633-0.964), 0.664 (95% CI 0.489-0.903), and 0.681 (95% CI 0.473-0.981), respectively. For individuals aged over 70 years, the results were not statistically significant.

Conclusions:
Long-term consumption of potassium-enriched salt in northern China is safe and feasible. It significantly reduces blood pressure, and urinary sodium-potassium ratio, and lowers the risk of mortality in individuals aged 40-70. These results support the potential benefits of using potassium-enriched, low-sodium salt as a public health intervention to improve cardiovascular health outcomes in this population.
THE EFFECT OF HIGH VERSUS LOW ADHERENCE TO THE DASH DIET ON BLOOD PRESSURE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Theodoridis Xenophon , Chourdakis Michail , Papaemmanouil Androniki , Chrysoula Lydia , Mermigkas Fotis , Chroni Violeta , Dipla Konstantina , Triantafyllou Areti 
Published: May 2024

Objective:
The objective of our study was to systematically review the current literature and perform a meta-analysis to evaluate the effect of the level of adherence to the DASH diet on blood pressure.

Design and method:
The identification of relevant studies, data extraction and critical appraisal of the included studies were performed independently by two reviewers. A random-effects model was employed to synthesize the available evidence using the standardized mean difference (SMD) as the appropriate effect size.

Results:
A total of 37 and 29 articles were included in the qualitative and quantitative analysis, respectively. The pooled effect for systolic blood pressure was SMD = -0.18 (95%CI: -0.32 to -0.04; I2 = 94%; PI: -0.93 to 0.57) and for diastolic blood pressure it was SMD = -0.13 (95%CI: -0.19 to -0.06; I2 = 94%; PI: -0.42 to 0.17).

Conclusions:
Our findings showed that greater adherence to the DASH diet has a beneficial effect on blood pressure compared to the lowest adherence. Increased compliance with DASH diet recommendations might also have a positive effect on cardiometabolic factors and overall health status. Future studies should aim to standardize the tools of adherence to the DASH diet and utilize rigorous study designs to establish a clearer understanding of the potential benefits of the level of adherence to the DASH diet in blood pressure management.
BLOOD PRESSURE CHANGES DURING SMOKING CESSATION ON DULAGLUTIDE AND PLACEBO TREATMENT – A SECONDARY ANALYSIS OF THE RANDOMIZED, DOUBLE-BLIND, PLACEBO- CONTROLLED SKIP TRIAL
Authors: Beck Julia , Hasenböhler Flavia , Lengsfeld Sophia , Burkard Thilo , Meienberg Andrea , Jeanloz Nica , Vukajlovic Tanja , Bologna Katja , Bathelt Cemile , Vogt Deborah , Werlen Laura , Christ-crain Mirjam , Winzeler Bettina 
Published: May 2024

Objective:
Smoking is an established major risk for atherosclerosis and cardiovascular mortality. However, the impact of smoking cessation on blood pressure remains controversial. Despite strong evidence linking smoking cessation to reduced cardiovascular risk, conflicting studies suggest potential increases in blood pressure after smoking cessation. Post cessational weight gain may contribute to these confliciting findings. We have recently shown that the glucagon-like peptide-1 (GLP-1) analog dulalgutide counteracts post-cessational weight gain. Therefore, the aim of this secondary analysis was to investigate blood pressure changes during smoking cessation in dulaglutide versus placebo treated individuals.

Design and method:
This is a predefined secondary analysis of the SKIP trial, a randomized, double-blind, placebo-controlled trial, conducted at the University Hospital Basel in Switzerland. Participants (n=218) underwent a 12-week smoking cessation program including standard of care and weekly injections of dulaglutide 1.5 mg or placebo. A mediation path analysis was performed to quantify the effect of predefined variables and relationships.

Results:
In the short term (12 weeks), smoking cessation led to a weight gain of +0.96 kg [CI 0.23, 1.70, p-value = 0.01], with each kilogram increase associated with a systolic blood pressure rise of +0.55 mmHg [- 0.0, 1.11, p-value = 0.055]. Dulaglutide treatment resulted in a weight reduction of -3.02 kg [CI - 3.69, - 2.63, p-value = 0.001], and each kilogram decrease lowered systolic blood pressure by -1.66 mmHg [-3.40, 0.08, p-value = 0.06]. No direct effect on systolic blood pressure was observed for smoking cessation or dulaglutide without weight influence. In the long term (52 weeks), smoking cessation led to a significant weight increase of +4.20 kg [2.67, 5.74, p-value < 0.001]. No direct effect of smoking cessation on systolic blood pressure was observed, either independently or through weight change.

Conclusions:
Our findings indicate that blood pressure changes during smoking cessation are primarily mediated by weight change. This underlines the importance of weight control and a potential beneficial role of GLP-1 analogues in the context of smoking cessation.
POOR LIFESTYLE HABITS IN NORMOTENSIVE SUBJECTS WITH POSITIVE FAMILY HISTORY OF ARTERIAL HYPERTENSION
Authors: Abramovic Inga , Alagic Marieta , Andelic Ana Marija , Horvat Petra , Ivankovic Iva , Zdilar Ana Marija , Domislovic Marija , Glavic Mihaela Marinovic , Jelakovic Bojan 
Published: May 2024

Objective:
Lifestyle habits and genetic predisposition are the main factors in the development of various diseases, including arterial hypertension. The study aimed to analyze differences in lifestyle habits among the normotensive patients, based on having a positive or negative family history of hypertension.

Design and method:
The study included 350 normotensive participants, of which 191 reported a positive family history of arterial hypertension (AH) (69.6% of women) and 159 reported no family history (64.1% of women). The participants were randomly selected as part of the „Epidemiology of Hypertension in Croatia- 2“project (a random sample of general adult population in Croatia). Data were systematically collected through a structured questionnaire.

Results:
The consumption of fast food, ranging from several times a month to every day, showed statistical difference between participants with a positive family history of AH compared to those with a negative history of AH (72% vs. 66.1%; p=0.037). No statistical significance was found between groups and the consumption of red meat, daily consumption of fruits and vegetables, and alcohol consumption (hard liquor) (p=0.162; p= 0.506; p=0.091, respectively). There were no differences in physical inactivity (occasional or no physical activity weekly) between participants with a positive family history of AH compared with a negative history of AH (47.8% vs. 54.7%; p=0.863). Significantly fewer smokers were observed in those with a positive family history of AH compared with those with history of AH (34.5% vs. 40%, p=0.052). There were no differences in consumption of more than three cups of black coffee (p=0.450).

Conclusions:
Positive family history of AH is associated with fewer smokers and more physical activity which may indicate greater awareness of the impact of lifestyle habits on health. However, subjects with positive family history consumed fast food more frequently. Education of the whole population about the healthy lifestyle is crucial for reducing the increasing trend for the prevalence of AH, and this should be even more emphasized in subjects with positive family history of AH.