bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECTS OF ALLISARTAN ON URIC ACID, LEFT ATRIAL, LEFT VENTRICULAR AND ARTERY STIFFNESS IN MILD-TO-MODERATE ESSENTIAL HYPERTENSION
Authors: Sun Yancui , Wu Hanqiong , Song Wei , Jiang Yinnong 
Published: May 2024

Objective:
Our study aimed to explore the effects of allisartan on blood pressure, uric acid (UA), left atrial, left ventricular structure and function and artery stiffness in mild-to-moderate essential hypertension.

Design and method:
Our study is a randomised, double-blind, crossover design involving 98 patients with mild-to-moderate essential hypertension. Participants were administered allisartan (240mg) or olmesartan (20mg) once daily for 12 weeks each in varying sequences.

Results:
Both allisartan and olmesartan led to a significant decrease in systolic blood pressure (SBP) levels from baseline, with no significant difference between the two drugs (δ= 6.5mmHg, P<0.001 and δ= 5.64mmHg, P=0.002). Notably, allisartan exhibited a more pronounced reduction in diastolic blood pressure compared to olmesartan (δ= 3.66mmHg, P=0.001), with superior efficacy in lowering diastolic blood pressure (DBP) (δ= 3.39mmHg, P=0.016). Allisartan significantly dropped serum UA levels (δ= 26.37 μmol/L, P<0.001), whereas olmesartan did not achieve a significant reduction compared to allisartan (δ= 33.63 μmol/L, P<0.001). In terms of cardiac and artery stiffness, allisartan demonstrated significant reductions in left atrial volume index (LAVI) (δ= 2.86 ml/m2, P<0.001), left ventricular mass index (LVMI) (δ= 4.82 g/m2, P=0.010) and ankle-brachial pulse wave velocity (baPWV) (δ= 154.49 cm/s, P<0.001), all-surpassing olmesartan significantly (all P<0.01).

Conclusions:
In conclusion, compared to olmesartan, allisartan demonstrates significant reductions in serum UA, blood pressure, LAVI, LVMI and baPWV in patients with mild to moderate essential hypertension. This study provides new evidence supporting the efficacy of allisartan in treating mild-to-moderate essential hypertension and reducing serum UA levels in this population.
SYNERGISTIC EFFECT OF SODIUM AND WATER BALANCE POLYMORPHISMS ON THE DEVELOPMENT OF ARTERIAL HYPERTENSION
Authors: Henriques Carolina , Sousa Ana Célia , Miranda Rubina , Barreto Francisco , Fernandes Rui , Carvalhinha Carolina , Henriques Eva , Rodrigues Mariana , Freitas Sonia , Borges Sofia , Oliveira Maria Joao , Guerra Graça , Ornelas Ilidio , Mendonça Isabel , Reis Roberto Palma Dos 
Published: May 2024

Objective:
Arterial hypertension (AHT) is a multifactorial pathology in which environmental and genetic factors interact leading to the development of this pathology. The genetic influence on the onset of AHT has been addressed in candidate gene studies. Polymorphisms that interfere with sodium and water balance are described in the literature as associated with increased risk of AHT. However, there are few studies that study the synergism between them in the risk of AHT.
Objective: Evaluate whether there is a synergistic effect between two polymorphisms that interfere with sodium and water balance, alpha adducin (ADD1 G460W rs4961) and sodium epithelial channel (SCNN1G G(-173)A rs5718), in the increased risk of AHT.

Design and method:
A case-control study was conducted with a population of 1712 individuals (mean age of 51.0±7.9), depending on whether or not they had AHT. We obtained two groups: 860 hypertensive patients and 852 controls. All subjects collected blood for analytical tests and DNA for genetic analysis. The polymorphisms rs4961 and rs5718 were evaluated in both groups. The Odds Ratio (OR) with 95% confidence intervals were calculated. Data analysis was performed using SPSS for Windows, version 25.0. The significance threshold was set at p<0.05.

Results:
The WW genotype of ADD1 was more frequent in the hypertensive group than in the control group (OR 2.76; 95%CI:1.38-5.55; p=0.004). The GG genotype of SCNN1G was not statistically significant between both groups (OR 0.95; 95%CI: 0.78-1.16; p=0.597). However, when we associate the two genetic variants, there is an increased risk of AHT, with an OR of 7.68 (95% CI 1.75-33.73) with statistical significance (p=0.007).

Conclusions:
With our results, we can conclude that the alpha adducin polymorphism (ADD1 G460W) is a statistically significant risk factor for AHT, and the sodium epithelial channel polymorphism (SCNN1G G(-173)A) alone is not associated with AHT onset. However, when together, these two polymorphisms increase the risk of AHT to na OR of 7.7. These results lead us to conclude that AHT is not explained in a simple way with a single polymorphism, since there are synergistic effects between genes that favor the development of AHT.
THE EFFECTS OF RENIN-ANGIOTENSIN SYSTEM BLOCKERS IN REAL-LIVE HEMODIALYZED PATIENTS
Authors: Symonides Bartosz , Zaborska-dworak Maria , Lewandowski Jacek , Marcinkowski Wojciech , Zawierucha Jacek , Prystacki Tomasz , Malyszko Jolanta 
Published: May 2024

Objective:
The prevalence of hypertension among patients with end-stage kidney disease (ESKD) undergoing hemodialysis (HD) ranges from 82-89% depending on applied diagnostic criteria and chosen method of blood pressure measurement. Despite the guidelines recommendations suggesting the wide use of renin-angiotensin system blockers (RASB) in patients with kidney disease, using RASB in patients on hemodialysis (HD) may be suboptimal, especially in patients with preserved diuresis.
Aim:This study aimed to compare hypertensive HD patients on multiple antihypertensive drug regimens, including diuretics, treated with RASB (RASB(+) group) or without RASB (RASB(-)).

Design and method:
From the database of 5879 patients receiving hemodialysis (mean age 65.2±14.2 yrs., 60% of males) of the biggest provider of HD in the country, we selected the subgroup treated with at least 3 antihypertensive medications including diuretics and compared patients treated with RASB(+) with counterparts (RASB(-)).

Results:
RASB(+) have similar age and gender proportions as well as BMI and bioimpedance compared with. However, dry body mass was significantly lower in RASB(+) group (78.1±18.3 kg vs. 80.0±18.2 kg, p<0.017). Diabetes mellitus prevalence was similar in both groups, but RASB(+) patients have cardiovascular diseases more frequently (70.1% vs. 60.8%; p<0.001). Systolic blood pressure and the number of antihypertensive drugs used were significantly higher in RASB(+) patients than in counterparts (146±16 mmHg vs. 144±15 mmHg; p<0.001 and 4.1±0.9 vs. 3.5±0.5; p<0001 respectively). RASB(+) patients have significantly longer dialysis vintage (52.7±44.4 months vs. 40.2±40.9 months; p<0.001) and dialysis time (722±87.1 min./week vs. 713±93.4 min./week; p<0.017) than counterparts. Also ultrafiltration was similar in both groups with even slightly higher eKt/V in RASB (+)(1.37±0.3 vs 1.33±0.3). Serum potassium was slightly, but significantly higher in RASB(+) (5.3±0.8 mmol/L vs. 5.1±0.7 mmol/L; p<0.01).

Conclusions:
In the real-life world, RASB can be safely used in HD patients treated with diuretics without compromising HD. Since many HD patients present numerous compelling indications for RASB, these drugs should not only be used as another drug for the treatment of poorly controlled hypertension, but also in a broader spectrum of HD patients.
BAROREFLEX SENSITIVITY AND HEMODYNAMIC RESPONSES DURING PHYSICAL AND MENTAL TESTS: A COMPARATIVE STUDY BETWEEN HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS
Authors: Faitatzidou Danai , Theodorakopoulou Marieta , Dipla Konstantina , Koutlas Aggelos , Karagiannidis Artemios , Georgiou Areti , Dimitriadis Chrysostomos , Pateinakis Panagiotis , Papagianni Aikaterini , Zafeiridis Andreas , Sarafidis Pantelis 
Published: May 2024

Objective:
Cardiac arrhythmias and sudden death are the leading causes of mortality in end-stage kidney disease (ESKD) and autonomic dysfunction is considered to play a predominant role. This is the first study to compare baroreflex sensitivity (BRS) and hemodynamic responses after mental- and physical-stimulation maneuvers between hemodialysis (HD) and peritoneal (PD) patients.

Design and method:
68 ESKD patients (34 HD and 34 PD patients matched for age, sex, and dialysis-vintage) were included. Continuous recordings from Finometer-PRO at rest and during mental-arithmetic, orthostatic, and handgrip-exercise tests were used for calculation of BRS and hemodynamic responses in each individual.

Results:
The two groups were similar in terms of age, sex, dialysis vintage and major comorbidities. BRS during mental (HD 3.59±2.62 vs PD 5.50±9.40 ms/mmHg, p=0.280) and physical stress tests (orthostatic: HD 3.23±2.42 vs PD 2.07±2.69 ms/mmHg, p=0.777) was similar between HD and PD patients. During mental test, both groups presented increases in SBP/DBP levels compared to rest (SBP HD: 156.3±27.7 vs 142.7±20.0mmHg, p<0.05; PD: 158.0±25.6 vs 143.1±23.6mmHg, p<0.05, respectively), but without significant between-group differences (p=0.853/p=0.611 respectively for SBP/DBP). Similarly, no significant between-group differences were noted in stroke volume, cardiac output, and total peripheral resistance during the same testing period. The mean SBP levels during the orthostatic test were significantly decreased compared to rest in both groups (HD: 135.4±26.8 vs 142.2 ±20.1 mmHg; p<0.05; PD 135.3±21.9 vs 143.1±23.6 mmHg; p<0.05), but the overall response was not different between-groups (p=0.937). Similarly, the responses to the other hemodynamic parameters were similar between HD and PD. Finally, the hemodynamic responses during handgrip exercise and recovery were not differed between HD and PD.

Conclusions:
BRS and hemodynamic responses to mental and physical stress tests were similar between HD and PD patients, suggesting that ANS function in ESKD is not affected by dialysis modality.
IMPACT OF HYPERTENSION ON OUTCOMES IN PATIENTS WITH MEMBRANOUS NEPHROPATHY
Authors: Sener Yusuf Ziya , Jabrayilov Jabrayil , Celebi Gorkem , Haberal Guldehan , Erdut Arda , Ayhan Arzu Saglam , Yeter Haci Hasan , Yildirim Tolga , Yilmaz Seref Rahmi , Altun Bulent , Erdem Yunus , Arici Mustafa 
Published: May 2024

Objective:
Hypertension often accompanies glomerular diseases. There is existing data regarding the relationship between hypertension and worse outcomes in primary membranous nephropathy (MN). We aimed to evaluate the impact of hypertension on both renal and cardiovascular outcomes in cases with primary MN.

Design and method:
All patients diagnosed with MN between 2001 and 2022 were screened and cases with accessible data were enrolled. Coronary revascularization, occurence of atrial fibrillation, stroke, venous thromboembolic events and all-cause mortality were determined as cardiovascular outcomes. Progression to end-stage renal disease was described as the renal outcome.

Results:
A total of 172 patients were included. Mean age of the study population was 47.6±14.2 years and 57.6% of them were male. Hypertension was present in 74 (43%) patients. Patients with hypertension were older (54.8±12.1 vs. 41.5±13.2; p<0.001) and baseline glomerular filtration rate (85 vs. 110; p<0.001) was lower in cases with hypertension. Median follow-up was 109.4 (4.8-265.6) months. Baseline characteristics and outcomes are presented in Table 1. Coronary revascularization (16.2% vs. 3.1%; p=0.005) and all-cause mortality rates (24.3% vs. 8.2%; p=0.007) were significantly higher in patients with hypertension. There were no differences in the rates of stroke, atrial fibrillation, progression to end-stage renal disease and venous thromboembolic events between the two groups (Table 1). The predictors of all-cause mortality were coronary artery disease (HR:3.8, 95% CI=1.1-12.6; p=0.027) and albumin level (HR:0.4, 95% CI=0.18-0.86-12.6; p=0.019).

Conclusions:
Coronary revascularization and all-cause mortality rates are higher in primary MN cases with hypertension. Hypertension is not an independent predictor of all-cause mortality however increased comorbidity burden, accompanied coronary artery disease and low serum albumin levels indicating higher amounts of albuminuria seems to be the underlying causes of increased mortality.
HIGH BLOOD PRESSURE IN HEMODIALYSIS: PREVALENCE AND PROGRESSION
Authors: Saidi Fouzia , Bouaichi Yugarithen , Kherraz Sabrina , Ziani Mouloud 
Published: May 2024

Objective:
High blood pressure (hypertension) is frequently found in chronic hemodialysis patients. It affects the prognosis by increasing the morbidity and mortality of patients.
The objective of our study was to assess the prevalence of hypertension and to study its evolutionary profile in chronic hemodialysis patients at the University Hospital of Béjaia

Design and method:
This is a three-year retrospective cross-sectional study of 40 patients who have been chronic hemodialysis patients for at least one year and are over 18 years of age. For each patient, we recorded age, sex, initial nephropathy, date of start of hemodialysis, blood pressure balance, fluid status and different treatments prescribed.

Results:
We included 40 haemodialysis patients: 24 men and 16 women. The average age of our population was 54.37± 15.33 years. The duration of hemodialysis was 08.17± 7.5 years. High blood pressure was found in 67.5%. All of our patients were on antihypertensive therapy at the start of dialysis. After 3 years of evolution, 55% of patients had reached the blood pressure target, 30% had a correct blood pressure without any therapy and 15% had not reached the blood pressure targets despite triple therapy.
Blood pressure balance in dialysis patients; Of course, it depends on adherence to treatment and hygienic and dietary rules, but also on effective dialysis and strict control of fluid balance in order to fight against volo-dependent hypertension.

Conclusions:
The control of hypertension in dialysis patients is essential and must include, in addition to adherence to treatment and dietary rules, adequate dialysis and strict control of dry weight, which must be assessed and adjusted periodically.
AMPK ACTIVATION AMELIORATES ANGIOTENSIN II-INDUCED DOWNREGULATION OF PODOCYTE ZO-1
Authors: Ha Tae Sun 
Published: May 2024

Objective:
Angiotensin II (Ang II) promotes the development and progression of proteinuria and renal diseases and induces podocyte apoptosis. ZO-1 (zonular occludens-1) protein as a component of the slit diaphragm plays a pivotal role in glomerular permeability by connecting slit diaphragm structure and actin cytoskeleton. AMP-activated protein kinase (AMPK), as a sensor of cellular energy status, has been known to play an important role in the pathophysiology of metabolic diseases, including diabetes, and its renal complications. We investigated the role of AMPK on the changes of ZO-1 of podocyte induced by Ang II.

Design and method:
Mouse podocytes were incubated in media containing various concentrations of Ang II and AMPK-related agents. The changes of ZO-1 and permeability were observed by confocal imaging, western blotting, and permeability assay in the presence of Ang II.

Results:
Ang II induced the fusion of microvilli and the gap pores on podocytes, which were improved by AICAR, an AMPK activator. Ang II also reduced and disrupted the intercellular ZO-1 staining, resulting in increased podocyte intercellular permeability. The intensities of fluorescences and bands of ZO-1 protein were decreased by Ang II in a dose-dependent manner by confocal microscopy and western blot analysis, respectively. AICAR and metformin, AMPK activators, ameliorated the abnormal distributional changes and the protein of ZO-1. Losartan, Ang II type I receptor blocker, also ameliorated the decrease of ZO-1 protein.

Conclusions:
Our findings suggest that Ang II induces the relocation and suppression of podocyte ZO-1 via Ang II type 1 receptor which is ameliorated by AMPK-activating agents.
ALBUMINURIA IS AN IMPORTANT PREDICTOR FOR ALL CAUSE MORTALITY IN GENERAL RURAL POPULATION
Authors: Domislovic Marija , Capak Krunoslav , Gellineo Lana , Jelakovic Ana , Dika Zivka , Prlic Margareta Fistrek , Stambuk Sandra Karanovic , Brinar Ivana Vukovic , Dapic Kresimir , Jelakovic Bojan 
Published: May 2024

Objective:
Albuminuria stands as a robust predictor of both cardiovascular and all-cause mortality, despite that there remains a notable gap in understanding how albuminuria's association with mortality varies across subgroups defined by sex, comorbidities and estimated glomerular filtration rate (eGFR). The aim of this study was to determine whether the association between albuminuria and mortality differs according to eGFR, sex, and comorbidities.

Design and method:
This prospective observational study includes 857 adult subjects from the ENAH rural study in Croatia. Albuminuria, the ratio of urinary albumin to creatinine (ACR) was subsequently categorized into two levels as >30mg/g (group A) and <30mg/g (group B).

Results:
Subjects from the group A were older (70.5 vs. 49.0 years), had a higher BMI (29.7 vs. 27.4 kg/m2), and lower eGFR (69.3 vs. 85.2 ml/min/1.73m2). They had higher prevalence of arterial hypertension (AH) (78.2% vs. 53.3%) and diabetes (DM) (30.8% vs. 11.9%) (p<0.001 for both). A significantly higher mortality rate (64.1% vs. 27.3%, p<0.001) was observed in Group 1 compared to the group 2.
In logistic regression analysis the highest odds of mortality were observed for ACR>30mg/g (OR=2.43, 95%CI=1.40-4.19, p=0.002), followed with male gender (OR=1.79, 95%CI=1.28-2.49, p<0.001), DM (OR=1.71, 95%CI=1.10-2.67, p=0.018), eGFR < 60 (OR=1.71, 95%CI 1.00-2.94 and AH (OR=1.55, 95%CI=1.06-2.27, p=0.025).

Conclusions:
Our study underscores the significant impact of albuminuria on all-cause mortality in general rural population indicating that this diagnostic tool should be included in everyday clinical work.
DOSE-RESPONSE EFFECT OF SODIUM REDUCTION ON BLOOD PRSSURE IN TREATED HYPERTENSIVES: A SYSTEMATIC REVIEW AND INSTRUMENTAL VARIABLE META-ANALYSIS
Authors: Song Jing , Chen Liangkai , Xiong Hui , Ma Yuan , Pombo-rodrigues Sonia , Macgregor Graham , He Feng 
Published: May 2024

Objective:
To evaluate the dose-response effects of a reduction in dietary sodium intake on blood pressure (BP) in hypertensive individuals who were on antihypertensive treatments. The impact of antihypertensive-drug class was also examined.

Design and method:
We searched Medline (via Ovid), Embase, Scopus, Cochrane Central Register of Controlled Trials, and reference lists of relevant articles up to 12 November 2023. We included randomised controlled trials (RCTs) comparing the effect on BP between different levels of dietary sodium intake in adults who were diagnosed as primary hypertension and treated with constant antihypertensive medications during the study period. We excluded RCTs with duration < 2 weeks. Dietary sodium intake was measured using 24-hour urinary sodium excretion. Instrumental variable meta-analyses were conducted to evaluate the dose-response effects of sodium reduction on BP. Subgroup analysis and multivariate meta-regression analysis were performed to examine the impact of antihypertensive-drug class.

Results:
35 studies with 2885 participants were included. The pooled estimates of mean reduction in 24-hour urinary sodium excretion, systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were 68.74 (95% confidence interval: 62.30-75.19) mmol, 4.33 (3.37-5.29) mmHg, 2.60 mm Hg (2.04-3.17), and 3.19 (2.50-3.87), respectively. For every 100 mmol reduction in 24-hour urinary sodium excretion, SBP, DBP, and MAP decreased by 6.81 (4.96-8.66) mmHg, 3.85 (2.26-5.43) mmHg, and 4.83 (3.22-6.44) mmHg, respectively (Fig 1). The observed dose-response effects differed across class of antihypertensive medication (P-diff = 0.084 for SBP, and P-diff<0.05 for DBP and MAP). In Beta-blockers, Renin-Angiotensin-Aldosterone System (RAAS) inhibitors, and dual therapy groups, significant dose-response effects of sodium on SBP, DBP and MAP were observed. In Calcium Chanel Blockers (CCB) group, the dose-response relationship was only found for SBP. No dose-response effect on BP was observed in diuretics monotherapy group.

Conclusions:
Pooled evidence of RCTs suggests a dose-response relationship between sodium reduction and BP in treated hypertensives, which is impacted by class of antihypertensive medications.
PERSISTENT EFFECT OF SALT REDUCTION IN SCHOOLCHILDREN AND THEIR FAMILIES: ONE-YEAR FOLLOW-UP AFTER A RANDOMISED CONTROLLED TRIAL
Authors: Li Yuan , Zhang Puhong , He Feng J , Luo Rong , Song Jing , Wang Changqiong 
Published: May 2024

Objective:
A previous 12-month randomised controlled trial (RCT) demonstrated the effectiveness of an application-based education program, conducted through schoolchildren, in reducing the salt intake and systolic blood pressure of their adult family members. This study aimed to assess whether the effect at 12 months persisted at 24 months.

Design and method:
As a follow-up survey of a cluster RCT with 54 schools randomly assigned to either the intervention or control group, all participants who completed the baseline survey were contacted again at 24 months, following a 12-month non-intervention period after the RCT. The primary outcome was the difference in salt intake change between the intervention and control groups at 24 months versus baseline and 12-month follow-up, measured by the mean two consecutive 24-hour urinary sodium excretions. The secondary outcome was the difference in blood pressure change.

Results:
At 24 months, 542 children and 974 adults were followed up, accounting for 91.6% and 82.3% of the participants, respectively. The mean salt intake in adults at baseline, 12 months and 24 months was 10.0 g/day (standard deviation 3.5), 8.9 g/day (standard deviation 3.2) and 9.4 g/day (standard deviation 3.5) in the intervention group and 10.0 g/day (standard deviation 3.6), 9.8 g/day (standard deviation 3.9) and 9.8 g/day (standard deviation 3.9) in the control group. The mean difference in salt intake change in adults between the intervention and control groups after adjusting for confounding factors is -0.38 g/day at 24 months versus baseline (95% confidence interval -0.81 to 0.05, P=0.086), and 0.45 g/day at 24 months versus 12 months (95% confidence interval 0.01 to 0.85, P=0.046). The mean difference in systolic blood pressure change after adjusting for confounding factors is -2.19 mm Hg (95% confidence interval -3.63 to -0.76, P=0.003) at 24 months versus baseline and -0.40 mm Hg (95% confidence interval -1.86 to 1.07, P=0.596) at 24 months versus 12 months.

Conclusions:
The effect of the education program on adults’ salt intake faded, but the systolic blood pressure lowering effect remained 12 months after the RCT. Continuous salt reduction education is recommended to maintain the effect.