bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ASSOCIATION BETWEEN SODIUM AND POTASSIUM ON DIFFERENCES IN RENIN AND ALDOSTERONE LEVELS AMONG GHANAIAN POPULATIONS IN RURAL GHANA, URBAN GHANA AND AMSTERDAM
Authors: Tonkin-hill Gina , Appiah Lt , Shafer La , Van Der Linden El , Vriend Emc , Danser Ah , Vogt Liffert , Agyemang Charles , Van Den Born Bert -Jan 
Published: May 2024

Objective:
To identify if differences in dietary, and serum, sodium and potassium levels are associated with differences in aldosterone, renin and the aldosterone-renin ratio. Secondly, to assess the contribution of confounders, and site-specific factors.

Design and method:
A multi-site analytical cross-sectional study using baseline data from the RODAM (Research on Obesity and Diabetes among African Migrants). Adult Ghanaians (aged over 25 years) were recruited across rural Ghana, urban Ghana and Amsterdam, the Netherlands. Both food questionnaires and renin and aldosterone measurements occurred in a subset of the baseline RODAM population: rural Ghana (n=193), urban Ghana (n=199) and Amsterdam (n= 69). Dietary behaviour was collected by a RODAM-specific Food Propensity Questionnaire (FPQ) which assessed the usual intake of 134 food items over the preceding 12 months. Three outcomes were investigated: aldosterone (pg/mL), renin (pg/mL) and the ARR, aldosterone-renin ratio (pg/mL/pg/mL).

Results:
Sodium intake was highest in urban Ghana (2.9g/day) and Amsterdam (2.8g/day), followed by rural Ghana (2.5g/day). Potassium intake was highest in rural Ghana (4.8g/day) and Amsterdam (4.7g/day), followed by urban Ghana (3.9g/day). Sites had similar renin levels; however, differences in aldosterone, led to a median ARR of 13.2, 12.2 and 22.0 pg/mL/pg/mL in rural, urban Ghana and Amsterdam respectively. Generalised linear models both with and without covariates, revealed no significant associations between dietary or serum sodium and potassium levels with either aldosterone, renin nor ARR. Associations were more pronounced in subgroup analyses among participants not taking blood pressure medication, although they remained weak or non-significant.

Conclusions:
Unlike previous research, no clear association between salt and hormone levels was found. However, bias from missingness, a possible healthy volunteer effect and medication use may have masked results. The findings may suggest that increased medication usage could benefit these populations in reducing blood pressure-related issues. These findings encourage the development of further longitudinal and intervention studies in people of African descent, to investigate the interaction of specific medications on dietary intake and renin, aldosterone levels.
DEPRESSION AND ANXIETY IN HYPERTENSIVE PATIENTS UNDER THE CONDITIONS OF WAR IN UKRAINE: COHORT STUDY
Authors: Sydorchuk Andrii , Lytvyn Bohdan , Sydorchuk Larysa , Yarynych Yulia , Voronyuk Ksenia , Sydorchuk Ruslan 
Published: May 2024

Objective:
The prevalence of hypertension in Ukraine is 29.6% among city residents and 36.3% in rural areas. Currently, the situation with hypertension in Ukraine has worsened due to the full-scale military aggression of the russian federation. Acute and chronic stress provoke a more frequent crisis course of hypertension, way more difficult control of elevated blood pressure (BP). Therefore, the aim of the study was to assess anxiety and depression value in the Ukrainian population before and during the war to establish the life quality changes in essential arterial hypertensive (EAH) patients.

Design and method:
100 EAH patients with hypertensive-mediated organ damage (moderate-very high cardiovascular risks, aged 45-65 years) participated in the cohort study. All participant underwent a complex of clinical and laboratory examinations and determined the frequency of EAH exacerbations, crisis course, the Charlson comorbidity index, anxiety and depression level after GAD-7 and PHQ-9 tests, the Cumulative Illness Rating Scale CIRS, life quality (SF-36) compared to the pre-war period. Additionally, 191 respondents preferably from the western part of Ukraine, filled out an online questionnaire form that included tests for depression, anxiety and life quality.

Results:
The war significantly affected the life quality of Ukrainians with EAH: both the physical and mental health of patients according to the SF-36 test (by 19.65% and 23.01%), as well as social activity (by 19.71%) worsened. The frequency of EAH exacerbations and crises course against the background of military aggression increased 2.25 times (χ2=14.25; p<0.001 and χ2=4.42; p=0.035), as well as the reactive and personal anxiety levels – by 13.37% (p=0.002) and 19.80% (p=0.042), respectively; 29% of respondents show symptoms of moderate, severe and very severe depression (PHQ-9); 37% had generalized anxiety disorder (GAD-7).

Conclusions:
This study presents unique experience. The russian invasion in Ukraine greatly affected well-being of the general population: the frequency of persons with moderate and significant deterioration of health (according to SF-36) increased by 18%, as well as the number of those with moderate and severe depression and anxiety disorders symptoms; the frequency of the EAH crisis course increased by 10%.
ASSOCIATION BETWEEN HYPERHOMOCYSTEINEMIA AND VITAMIN D DEFICIENCY AND THE RISK OF HYPERTENSION
Authors: Smiljic Sonja , Ilic Aleksandra , Stevanovic Angelina , Nestorovic Vojkan , Sapic Srna 
Published: May 2024

Objective:
Cardiovascular risk factors simultaneously affect the premature onset of hypertension. The aim of our study was to indicate the frequency of cardiovascular risk factors and coherency of dyslipidemia, elevated values of homocysteine and vitamin D deficiency with the arterial hypertension.

Design and method:
In a prospective study, we have included 230 respondents, of which 199 are being treated for hypertension, and 31 had normal blood pressure. All patients were divided into three groups, patients between 22-39 years old, 40-49 years old and 50-59 years old. We have processed socio-epidemiological data, clinical exam, and biochemical analyses.

Results:
In the group of patients between 22 and 39 years of age were significantly less female respondents, and younger patients significantly less had HTA (p >0.05). Compared to people with normal blood pressure, patients treated for HTA are physically inactive (p >0.17), smokers (0.002) and have BMI above 25 kg/m2 (p>0.02). Total cholesterol and triglycerides were elevated at patients with hypertension, and the value of HDL cholesterol was significantly higher in patients with normal blood pressure (P>0.05). Vitamin D deficiency and hyperhomocisteinemia were more common in people with hypertension and between 50-59 years of age (p<0.001).

Conclusions:
Patients with arterial hypertension have association of more cardiovascular risk factors at the same time. Association of arterial hypertension, dyslipidemia, hyperhomocisteinemia and vitamin D deficiency, speeds up the process of atherosclerosis, leads to coronary heart disease and premature death. Prevention has an important place in the early diagnosis of hypertension and prevention of complications.
PREVALENCE OF RISK FACTORS AND TARGET ORGAN DAMAGE CAUSED BY HYPERTENSION IN RESIDENTS OF THE ARAL SEA REGION OF UZBEKISTAN
Authors: Khamidullaeva Gulnoz , Ataniyazov Khurshid , Fozilov Khurshid , Abdullaeva Saodat 
Published: May 2024

Objective:
Analysis of the results of screening the population over 40 years of age for early detection of risk factors and target organ damage caused by hypertension in real clinical practice of family clinics in the Aral Sea region.

Design and method:
The results of screening of 2430 respondents were analyzed according to the modified PEN WHO protocol, which 1020 people with blood pressure (BP) 140/90 mm Hg or more included in the study. The average age was 57.68±8.06 years, women 61.4%, men 38.6%. Additionally, we determined echocardiography, ultrasound examination of the brachiocephalic arteries, microalbuminuria, creatinine and uric acid in blood serum. Statistical data are presented as M±SD.

Results:
Among the patients with high BP, 24 (2.4%) were under 40 years old, 847 (81%) were aged 40-65 years, 169 (16.6%) were over 65 years old. Obesity was detected in 46.2% of patients, left ventricular hypertrophy in 96%, microalbuminuria in 76%, proteinuria in 21%, thickening of the intima-media of the common carotid artery >0.9 mm in 92% of the examined. It was revealed that low cardiovascular risk was 2 times more common among women compared to men: 11.3% versus 5.6% (χ2=8.990; p=0.003); almost 4 times fewer patients with coronary artery disease: 7.4% versus 28.9% (χ2=14.939; p=0.0001); there are no tobacco users or regular alcohol drinkers, whereas among men these risk factors were identified in 59.4% (χ2=178.848; p=0.0001) and 35% (χ2=82.238; p=0.0001), respectively. Hyperuricemia prevailed in men compared to women: 23.3% versus 6.4% (χ2=60.243; p=0.0001) but the incidence of type 2 diabetes is 2 times higher in women compared to men: 13.7% versus 7.4% (χ2=9.205; p=0.002)

Conclusions:
The study showed a wide distribution of CVD risk factors among the hypertensive population of the Aral Sea region and significant target organ damage caused by hypertension. Among hypertensive men, there was a significant prevalence of tobacco and alcohol use, a significantly frequent detection of coronary artery disease, and hyperuricemia compared to women; type 2 diabetes mellitus is significantly more frequently detected in the female population.
A POSITIVE FAMILY HISTORY, PARTICULARLY IN THE MOTHER, IS AN IMPORTANT DETERMINANT FOR THE DEVELOPMENT OF ARTERIAL HYPERTENSION
Authors: Horvat Petra , Alagic Marieta , Andelic Ana Marija , Abramovic Inga , Ivankovic Iva , Zdilar Ana Marija , Domislovic Marija , Glavic Mihaela Marinovic , Jelakovic Bojan 
Published: May 2024

Objective:
A positive family history is one of the non-modifiable risk factors directly linked to arterial hypertension (AH). This study aimed to show the influence of a positive family history of AH on the incidence of AH in the studied population.

Design and method:
A total of 1784 participants (a random sample of the general adult population in Croatia included in the ’Epidemiology of Hypertension in Croatia -2’ project) were examined. Data were systematically collected through a structured questionnaire.

Results:
Analysis showed a statistically significant difference in having a positive family history of AH in at least one parent between those having AH and the normotensive group (59.2% vs. 51.6%; p=0.002). Furthermore, 14.5% of subjects with AH and 9.4% of normotensive subjects reported at least one of the grandmothers with a history of AH (p=0.001). A significant correlation was observed for individuals reporting a positive history of AH in their paternal grandmother (p=0.004) and maternal grandfather (p=0.009), reported by 8.8% and 6.4% of subjects with AH, respectively, as opposed to 5.5% and 4.5% of the normotensive subjects. The most significant difference was found for a positive family history of AH in the mother, reported by 46.5% of subjects with AH and 38.5% of normotensive subjects (p<0.001). Regression analysis indicated a statistically significant association between a positive family history of AH in the mother and an increased odds ratio for developing AH (OR 1.36 95% CI 1.11-1.66, p=0.003). Conversely, a positive family history on either the paternal or maternal side, at least one of the grandfathers, father, and paternal grandfather failed to exhibit a significant correlation with the occurrence of AH.

Conclusions:
Our study affirmed the importance of family history for arterial hypertension, which should be an elementary part of taking medical history. Subjects who had mothers with arterial hypertension were at higher risk of having AH themselves which is in line with the previous notion that the mother's hypertensive status is more important than the father's.
DIFFERENCES BETWEEN SCORE, FRAMINGHAM RISK SCORE AND ESTIMATED PULSE WAVE VELOCITY-BASED VASCULAR AGE CALCULATION METHODS - DATA FROM THREE GENERATIONS HEALTH PROGRAM IN HUNGARY
Authors: Gyöngyösi Helga , Szollosi Gergo József , Csenteri Orsolya , Jancsó Zoltán , Móczár Csaba , Torzsa Péter , Andréka Péter , Vajer Péter , Nemcsik János 
Published: May 2024

Objective:
Early vascular ageing contributes to cardiovascular (CV) morbidity and mortality. There are different possibilities to calculate vascular age including methods based on CV risk scores, but different methods might identify different subjects with early vascular ageing. We aimed to compare SCORE and Framingham Risk Score (FRS)-based vascular age calculation methods on subjects that were involved into a national screening program in Hungary. We also aimed to compare the distribution of subjects identified with early vascular ageing based on estimated pulse wave velocity (ePWV).

Design and method:
The Three Generations for Health program focuses on the development of primary health care in Hungary. One of the key elements of the program is the identification of risk factors of CV diseases. Vascular ages based on SCORE and FRS were calculated based on previous publications and were compared with chronological age and with each other in the total population and in patients with hypertension or diabetes. ePWV was calculated based on a method published previously. Supernormal, normal, and early vascular ageing were defined as <10%, 10-90% and >90% ePWV values of the participants.

Results:
99 231 subjects were involved in the study and among them 49 191 patients had hypertension (HT) and 15 921 patients had diabetes (DM). Chronological age of the total population was 54.0 (48.0 – 60-0) years, while SCORE and FRS vascular ages were 59.0 (51.0 – 66.0) and 64.0 (51-80) years, respectively. In HT patients chronological, SCORE and FRS vascular ages were 57.0 (51.0 – 62.0), 63.0 (56.0 – 68.0) and 79.0 (64.0 – 80.0) years, respectively. In DM patients chronological, SCORE and FRS vascular ages were 58.0 (52.0 – 62.0), 63.0 (56.0 – 68.0) and 80.0 (76.0 – 80.0) years, respectively. Based on ePWV, FRS identified patients with elevated vascular age with high sensitivity (97.3%), while in case of SCORE, the sensitivity was much lower (13.3%).

Conclusions:
In conclusion, different vascular age calculation methods can provide different vascular age results in a population-based cohort. The importance of this finding for the implementation into CV preventive strategies requires further studies.
THE EFFECT OF THE PRESENCE OF ACCESSORY RENAL ARTERIES ON BIOCHEMICAL PARAMETERS OF RENAL FUNCTION AND BLOOD PRESSURE REGULATION
Authors: Delalic Didi , Jug Juraj , Brezni Tanja , Prkacin Ingrid 
Published: May 2024

Objective:
The effect of having accessory renal arteries on hemodynamics and renal function has been studied in different populations, yielding variable results – from a significant correlation between the presence of accessory renal arteries and increased arterial blood pressure and/or serum creatinine and renin to no correlation whatsoever. The aim of this study was to evaluate the effects of the presence of accessory renal arteries on biochemical parameters related to renal function and hemodynamics in a Croatian population.

Design and method:
This was a retrospective single-center study. Data was collected from the hospital informatics system on patients with accessory renal arteries managed in the arterial hypertension clinic of a tertiary care center. Patient data obtained between 2012 and 2023 was included. In order to be included into the study, patients needed to have available data on laboratory parameters, hemodynamics and an image of a multi-slice computed tomography intravenous contrast-enhanced scan of the aorta and renal arteries. Patients without all of the aforementioned data were excluded from the study. Data was analyzed using the JASP open-source statistical software. Statistical significance was set at a threshold of p < 0.05.

Results:
155 patients in total were included in the study – 80 without accessory renal arteries and 75 with one or more accessory renal arteries. The distribution of age and gender was equivalent between the two groups. The group with accessory renal arteries had significantly higher mean arterial pressures (100 mmHg vs 95.7 mmHg, p = 0.016), lower estimated glomerular filtration rates calculated by CKD-EPI 2021 formulas (80 mL/min/1.73m2 vs 96 mL/min/1.73m2, p < 0.001) and had a significantly higher number of antihypertensive medications in their therapy (3 vs 1.5 different types of medications, p < 0.001). There were no significant differences between other measured parameters (serum electrolytes, renin, aldosterone, aldosterone/renin ratio).

Conclusions:
The results of this study indicate that the presence of accessory renal arteries might have an effect on the success of antihypertensive therapy and that these patients may represent a distinct phenotypic group that requires a personalized approach.
POLYCYSTIC OVARY SYNDROME (PCOS) AND ITS TREATMENT AS CAUSE OF SECONDARY ALDOSTERONISM: A DOG CHASING ITS TAIL
Authors: Cozzo Domenico , Ferrier Claudia , Ogna Valentina Forni 
Published: May 2024

Objective:
Polycystic Ovary Syndrome (PCOS) is a complex endocrine-metabolic disorder affecting about 7% of childbearing women. PCOS is characterized by anovulation, hyperandrogenism, insulin resistance and it is associated with an increased cardiovascular risk.
PCOS patients may exhibit high blood pressure and signs of hydro-saline retention. Therefore, clinicians would be interested in performing hormonal screening for secondary hypertension.

Design and method:
We perform the aldosterone/direct renin concentration ratio as a screening test for primary aldosteronism (PA). The test was proceed after serum potassium correction and previous a wash-out period of interfering medications.
The recumbent saline suppression test was performed with infusion of 2L NaCl 0.9% in 4 hours under standardized salt intake (9gr/24h).
Aldosterone and direct renin were determined by chemiluminescent immunoassay technology (DiaSorin®).

Results:
A 33yrs old woman attended our renal outpatient clinic because of recurrent episodes of generalized swelling, diuresis contraction and fluid retention. The patient, known for PCOS, was treated with combined oral contraceptives and loop diuretics. She had no history of hypertension, but she repeatedly displayed very high aldosterone values.
Clinical examination was unremarkable, in-office and home blood pressure values were normal. Laboratory data showed normal renal function and the absence of acid-base disorders; serum potassium was at lower limit of normal. A CT-scan showed normal adrenal glands.
We performed a recumbent saline suppression test, previous a wash-out period of oral contraceptives (> 6 weeks) and loop diuretics (> 2 weeks).
The results listed below are consistent with a baseline hyperaldosteronism with normal aldosterone adrenal response to volume expansion, excluding PA.
Several years before, the same results were presented, without suspension of the oral contraceptives.

Conclusions:
In patients with PCOS the increased adrenal production of aldosterone is usually secondary and independent from the renin-aldosterone axis (direct stimulation of adrenal zona glomerulosa via testosterone).
Other iatrogenic factors may affect the renin-aldosterone values, such us the use of oral contraceptives and diuretics.
Therefore, a confirmatory test performed under standardized conditions is often required, in order to exclude primary versus secondary forms of hyperaldosteronism.
ASSESSMENT OF ANGIOTENSIN II-INDUCED CALCIUM SIGNALS IN PRIMARY HUMAN ADRENOCORTICAL CELLS
Authors: Ajjour Hala , Lenzini Livia , Pallafacchina Giorgia , Carrocia Brasilina , Rosii Gian Paolo 
Published: May 2024

Objective:
Primary aldosteronism (PA), a common form of secondary hypertension, is characterized by an increase of cytosolic intracellular Ca2+ concentrations [Ca2+]i.
Our aim is to investigate transients and oscillations of [Ca2+]i in a human model of isolated CD56+ aldosterone-producing adenoma (APA) cells and normal surrounding adrenocortical (NAC) cells.

Design and method:
We monitored [Ca2+]i, in CD56+ NAC and APA cells in basal condition and after Angiotensin II (Ang II) stimulation using Fura-2 dye and live confocal microscopy, and we developed a custom-made pipeline to analyze calcium signals in terms of frequency and peak parameters like amplitude, full width at half maximum (FWHM) and area under the curve (AUC). To investigate the potential role of the two-pore domain K+ TASK- 2 channel in regulating Ca2+ signals, TASK-2 channels of NAC cells were pharmacologically inhibited using Quinidine (20 microM) 20’ prior to [Ca2+]i imaging acquisition.

Results:
Resting [Ca2+]i basal levels in NAC (n=11) were higher (0.76 a.u.+- 0.04) than in APA (n=12) (0.56 a.u.+- 0.05, p= 0.0087). NAC TASK-2 inhibition decreased resting [Ca2+]i to 0.58 a.u. +- 0.07 (p > 0.05). Spontaneous Ca2+ activity was higher in NAC with significant higher amplitude and AUC parameters compared to APA cells. Quinidine further increased spontaneous activity in NAC while decreased Amplitude and AUC. For both cell types stimulation with 2 doses of Ang II concentrations [10 -8 and 10 -9 mM], higher Ang II doses promoted higher Ca2+ peak parameters, amplitude and AUC, and a significant decrease in events frequency. Comparison between APA and NAC revealed that, regardless of Ang II dose, first Ca2+ transient parameters are intensified in NAC. However, APA showed consistent elevated subsequent Ca2+ oscillations parameters (Amplitude and AUC), frequency, and degree of oscillation compared to NAC cells stimulated with similar Ang II doses. NAC TASK-2 inhibited cells, when stimulated with [10 -9 mM] Ang II, displayed only increased subsequent peak parameters.

Conclusions:
The bias-free approach designed to quantitatively assess [Ca2+]i signals, revealed significant differences in [Ca2+]i dynamics of human NAC and APA cells.