bluuebunny/crossref_metadata_2025_split huggingface dataset:
MISSION 70/26 HAS SUCCESSFULLY STARTED IN CROATIA. DO YOU KNOW YOUR NUMBERS?
Authors: Jelakovic Bojan , Capak Krunoslav , Bubas Marija , Pajic Ivana Portolan , Pecin Ivan , Reiner Zeljko , Lang Valerija Bralic , Milicic Davor , Soldo Dragan , Rahelic Dario , Budincevic Hrvoje , Demarin Vida , Soldo Ana , Jelakovic Ana , Josipovic Josipa , Mihalic Mirjana , Vrkic Tajana Zeljkovic , Bilajac Lovorka 
Published: May 2024

Objective:
Approximatively 50% of Croatia's adult population suffers from arterial hypertension (AH). One-fifth of patients do not know that they have AH, and control has been achieved in less than 50% of treated patients. It is our aim to achieve controlled values of blood pressure (BP) in 70% of treated patients with AH by 2026. This mission is part of the permanent campaign of the Croatian Hypertension League called “The Hunt for the Silent Killer”.

Design and method:
The whole mission is devoted to increase health literacy in both health care workers and in general population (including patients with AH).

Results:
For the general population we will organize: 1) classical public-health activities; BP will be measured and educative materials will be distributed at the public places; 2) using Croatian Hypertensive League educative web platform (Hunting the Silent Killer) and social networks; and 3) via different media (Vecernji list, the biggest daily newspaper in Croatia is partner of the League). For health care workers 1) school for communication in hypertension; 2) monthly newsletters with information about therapeutic inertia, promotion of health literacy, and education on treatment persistence. For this purpose, we have developed special educative sub-portal 70/26. All healthcare workers will be invited to visit our scientific educative web portal Healthmed with plenty of recent information on cardio-kidney-metabolic syndrome where members of the editorial board are key opinion leaders in hypertension, nephrology, cardiology, neurology, diabetology and family physicians. In parallel with hypertension we will analyze success in treatment of dyslipidemia in our sister mission “Do you know your numbers?”

Conclusions:
At the end of this program, we are going to organize a nationwide study (EHUH 3) where a representative sample of random adult population will be enrolled. In this study we will use the same methodology as in recently ended nationwide EHUH 2 study where we obtained current information on hypertension and dyslipidemia prevalence, awareness, treatment and control. Using the same methods we will be able to make conclusion about our success following evidence-based medicine postulates.
Acknowledgement: This program is supported by a grant from Servier.
OBSTRUCTIVE SLEEP APNEA IN RELATION TO BEAT-TO-BEAT, READING-TO-READING, AND DAY-TO-DAY BLOOD PRESSURE VARIABILITY
Authors: Cheng Yi-Bang , Guo Qian-Hui , Xia Jia-Hui , Zhang Jin , Li Yan , Wang Ji-Guang , Xu Ting-Yan 
Published: May 2024

Objective:
We investigated blood pressure (BP) variability as assessed by beat-to-beat, reading-to-reading and day-to-day BP variability indices in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).

Design and method:
In 786 hospitalized hypertensives (mean age, 53.2 years; 42.2% women), we performed 10-minute beat-to-beat (n=705), 24-hour ambulatory (n=779), and 7-day home BP (n=445) measurements and the full overnight polysomnography. Mild, moderate and severe OSAHS were defined as an apnea-hypopnea index of 5-14, 15-29, and >= 30 events per hour, respectively. BP variability indices including variability independent of the mean (VIM), average real variability (ARV), and maximum–minimum difference (MMD), were compared across the OSAHS severity groups.

Results:
In univariate analysis, beat-to-beat systolic VIM and MMD, reading-to-reading asleep systolic and diastolic ARV and MMD increased from patients without OSAHS, to patients with mild, moderate and severe OSAHS. This increasing trend for beat-to-beat systolic VIM and MMD remained statistically significant after adjustment for confounders (P <=0.047). There was significant (P <=0.039) interaction of the presence and severity of OSAHS with age and body mass index in relation to the beat-to-beat systolic VIM and MMD and with the presence of diabetes mellitus in relation to asleep systolic ARV. The association was stronger in younger (age < 50 years) and obese (body mass index >= 28 kg/m2) and diabetic patients. None of the day-to-day BP variability indices reached statistical significance (P>=0.16).

Conclusions:
BP variability, in terms of beat-to-beat recordings, were higher with the more severe OSAHS, especially in younger and obese and diabetic patients.
COMPARISON OF OFFICE-BASED BLOOD PRESSURE TO DAYTIME CUFFLESS BLOOD PRESSURE IN A POPULATION-BASED STUDY
Authors: Zahnd Joachim , Chelbi Sonia T. , Gagliano Jvan Gianini Vanessa , Marot Peggy , Ackermann Daniel , Durer Isabelle , Beuschlein Felix , Suter Paolo , Vogt Bruno , Gabutti Luca , Bochud Murielle , Wuerzner Gregoire 
Published: May 2024

Objective:
The latest ESH 2023 guidelines still recommend the use of office blood pressure (BP) measurement for the diagnosis and the follow-up of arterial hypertension. Although cuffless (BP) devices are attractive for patients due their practicality and easy to use, they are not yet recommended by international guidelines. The aim of this project was to test the diagnostic performance of a cuffless device in the adult Swiss population.

Design and method:
This was a multicentric sub-study nested within a nationwide population-based survey on dietary salt intake in Switzerland. Blood pressure was measured 5 times with a validated oscillometric device (Omron HEM-907) on two separate visits according to a standardized protocol. Cuffless blood pressure using the Aktiia® bracelet was measured intermittently over 24 hours in between visits. The device was calibrated on the first visit using an independent oscillometric device. The average of the last four office BP at each visit was compared to the daytime average BP from the cuffless device with a Bland-Altman plot.

Results:
Of the 863 individuals included in the study, 511 (46% women, age: 48.6±15.8 years) had their BP taken with both devices. The median number of BP measurements with the cuffless device was 46(IQR 28-90)). Bland and Altman analysis revealed a difference of 0.015 (CI -0.734 to 0.763) in systolic BP and of 0.380 (CI -0.216 to 0.975) in diastolic BP (Figure 1). The agreement for the diagnosis of hypertension was 92.4% with a kappa of 0.61±0.04 for systolic BP and 94.7% with a kappa of 0.50±0.04.

Conclusions:
In this adult population-based study, the accuracy and the diagnostic performance of a cuffless device were promising. The differences may be secondary to either accuracy or to white coat/masked effect reflecting the different environments of BP measures.
SLEEP BLOOD PRESSURE MEASURED WITH A HOME BLOOD PRESSURE MONITOR WAS INDEPENDENTLY ASSOCIATED WITH INCIDENCE OF CARDIOVASCULAR DISEASES: THE NAGAHAMA STUDY
Authors: Tabara Yasuharu , Matsumoto Takeshi , Murase Kimihiko , Setoh Kazuya , Kawaguchi Takahisa , Wakamura Tomoko , Hirai Toyohiro , Chin Kazuo , Matsuda Fumihiko 
Published: May 2024

Objective:
Nocturnal blood pressure (BP) was reported to be associated with cardiovascular diseases. However, nocturnal BP measured using ambulatory monitoring device usually includes BP without sleep. We investigated an association between sleep BP measured using a timer-equipped home BP monitor and cardiovascular diseases in a general population.

Design and method:
Study population was 6,037 middle-aged and older community residents (mean age: 57.8 years old, men: 30.9%). Participants were required to sleep with wrapping cuffs in the upper-arm and sleep BP was measured automatically at 0:00, 2:00, and 4:00. Actigraph was used to determine BP measured during sleep. Participants were also measured home morning BP manually using a same device. Incidence of cardiovascular diseases including stroke and myocardial infarction were assessed by reviewing personal hospital records.

Results:
Mean morning systolic and diastolic BP was 126 ± 18 and 77 ± 11 mmHg, respectively, while sleep systolic and diastolic BP was 112 ± 15 and 66 ± 9 mmHg. During 5.0 years mean follow-up period, we observed 80 cases of cardiovascular diseases (stroke and myocardial infarction). Morning hypertension (>135/85 mmHg) [hazard ratio (HR) = 3.22, P < 0.001] and sleep hypertension (>120/70 mmHg) [HR = 2.21, P = 0.002], but not office hypertension (>140/90 mmHg) [HR = 1.44, P = 0.127], was significantly associated with incidence of cardiovascular diseases independently of age, sex, and body mass index. Clinical characteristics including sleep efficiency (normotension: 91 ± 4%, sleep hypertension: 89 ± 5%, morning hypertension: 90 ± 4%, sleep and morning hypertension: 89 ± 5%, P< 0.001) and oxygen desaturation index (5.9 ± 4.8, 8.3 ± 6.6, 9.3 ± 7.1, 11.1 ± 9.0 times/h, P < 0.001) differed significantly by the hypertension status. However, sleep hypertension [HR = 2.94, P = 0.015], morning hypertension [HR = 4.81, P < 0.001], and sleep and morning hypertension [HR = 4.71, P < 0.001] was identified as significant factors for cardiovascular diseases after adjustment of covariates including the sleep parameters.

Conclusions:
High sleep BP measured home BP monitoring device was independently associated with incidence of cardiovascular disease in a general population.
PROGNOSTIC SIGNIFICANCE OF 24-H AMBULATORY SYSTOLIC AND PULSE PRESSURE LOAD AND VARIABILITY IN OCTOGENARIANS WITH ARTERIAL HYPERTENSION
Authors: Curcio Rosa , Giacinti Chiara , Turri Paolo , Poliseno Chiara , Pucci Giacomo , Vaudo Gaetano , Sarzani Riccardo , Spannella Francesco 
Published: May 2024

Objective:
Limited data exist on the prognostic implications of blood pressure (BP) components derived from ambulatory BP monitoring (ABPM) in octogenarians with arterial hypertension. This study aimed at investigating whether metrics of 24-h BP load and variability are significantly associated with all-cause mortality.

Design and method:
Octogenarian outpatients (>80 years) undergoing ABPM at two ESH Hypertension Excellence Centers (Ancona, Terni) for a better assessment of BP status between April 2019 and December 2022 were enrolled. ABPM was performed with SpaceLabs 90217 at both centres. Patients with atrial fibrillation or with inadequate number of measurements (<20 valid awake or <7 asleep BP) were excluded. The primary end-point was all-cause mortality. Prognostic significance was assessed for 24-h mean systolic and diastolic BP, as well as 24-h BP variability metrics (24-h standard deviation (SD), weighted SD and average real variability).

Results:
174 patients (mean age 83±3 years, 46% men, mean 24-h BP 129/67±16/8 mmHg) were analyzed. Most (94%) received anti-hypertensive treatment (76% ACEi-ARBs, 50% CCBs, 42% diuretics, 36% beta-blockers, 11% other drugs). Main comorbidities were previous cardio-/cerebrovascular events (34%), chronic kidney disease (20%), type 2 diabetes mellitus (15%), and heart failure (12%). During a median follow-up of 26 [20-38] months, 17 deaths (10%) occurred. Deceased patients were older (85 vs 83 years), predominantly male (78% vs 43%), and exhibited higher 24-h SBP (133 vs 128 mmHg), 24-h PP (67 vs 61 mmHg), and Charlson Comorbidity Index (CCI, 7.6 vs 6.4, all p<0.05). In a multivariate Cox-regression model adjusted for age, sex, CCI and renal function, only 24-h SBP (aHR 1.053, 95% CI 1.004-1.104, p=0.03) and 24-h PP (aHR 1.067, 95%CI 1.011-1.126, p=0.02) predicted prognosis. Conversely, neither 24-h SD of SBP (p=0.06), DBP (p=0.09), nor other short-term BP variability metrics showed significant association with mortality.

Conclusions:
In this cohort of octogenarians attending outpatient hypertensive clinics, 24-h SBP and 24-h PP emerged as independent predictors of all-cause mortality. These findings suggest that targeting 24-h SBP could be a priority in the treatment of hypertensive octogenarians. While 24-h BP variability exhibited marginal associations, further data are warranted to establish their prognostic significance.
AN UPDATED REPORT FROM THE HUNGARIAN AMBULATORY BLOOD PRESSURE MONITORING REGISTRY
Authors: Pásztor Dorottya Tímea , Nemcsik János , Takács Johanna , Kekk Zsófia , Farsang Csaba , Simon Attila , Páll Dénes , Torzsa Péter , Dolgos Szilveszter , Koller Ákos , Járai Zoltán 
Published: May 2024

Objective:
Ambulatory blood pressure monitoring (ABPM) is recommended by current European guidelines for the early diagnosis of hypertension and to monitor the efficacy of antihypertensive treatments. The Hungarian Society of Hypertension has initiated a 5-year, nationwide program in 2021 to promote the routine use of ABPM and to improve the motivation of doctors and patients. This is an updated report on the Hungarian ABPM Registry.

Design and method:
This is an ongoing, multicenter, open-label, observational study. Adult (age >18 years) patients with known hypertension(HT), or with suspected/newly diagnosed hypertension(nHT) can be involved in the study. ABPM monitoring is performed by GPs, internists, and cardiologists using validated Meditech ABPM-06 monitors. Current report analyzed ABPM data between 21.02.2021-16.11.2023, that were collected into an electronic case report. Overall, 40621 ABPMs were performed, due to protocol deviation 1901 patients were excluded from the analysis.

Results:
26315 patients were HTs(68.3%), 12193 patients were nHTs(31.5%). In the HT group 95.5%, in the nHT group 21.5% were treated. 63.6% of all patients were hypertensives according to the 24-hour average blood pressure(BP) values. Mean 24-hour systolic and diastolic BP was 133.84±14.5 mmHg and 79.2±10.3 mmHg, respectively. There was no difference in the 24-hour mean systolic BP between HT and nHT patients (133.75±13.96mmHg vs. 133.86±14.72mmHg, respectively, p=NS). Obesity(BMI >30 kg/m2) increased the risk of hypertension(OR=1.82[1.73;1.92]for 24-hour average). Coffee consumption(more than 3/day)(OR=1.22[1.16;1.29]for 24-hour average), snoring(OR=1.39[1.33;1.46]for 24-hour average)and smoking(OR=1.10[1.03;1.18]for 24-hour average)all increased the risk of hypertension, primarily affecting more the daytime BP values(OR=1.24[1.18;1.31]for daytime in coffee consumption, OR=1.13[1.07;1.19]for nighttime in coffee consumption; OR=1.42[1.36;1.49]for daytime in snoring, OR=1.31[1.25;1.38]for nighttime in snoring; OR=1.09[1.01;1.16]for daytime in smoking, OR=1.01[0.94;1.08]for nighttime in smoking (NS)). Lack of regular sport(less than 3x30 minutes weekly)increased the risk of hypertension(OR=1.11[1.05;1.18]for 24-hour average), primarily affecting more the nighttime values(OR=1.19[1.12;1.26]for nighttime, OR= 1.02[0.96;1.07]for daytime(NS)).

Conclusions:
Hypertension is highly prevalent in both HT and nHT patients, irrespectively of gender or treatment. Obesity, lack of regular sport, coffee consumption, snoring and smoking are all significant risk factors in developing hypertension, latter ones affecting more the daytime BP values, whereas lack of regular sport affects more the nighttime BP values.
COMPARATIVE EVALUATION OF THE AKTIIA CUFFLESS MONITOR AND STANDARD 24-H AMBULATORY BLOOD PRESSURE MONITOR
Authors: De Almeida Tiago Paggi , Perruchoud David , Alexandre Jérémy , Vermare Pascale , Sola Josep , Shah Jay , Marques Luisa , Pellaton Cyril 
Published: May 2024

Objective:
Cuffless blood pressure (BP) monitors provide an innovative approach for BP assessment, transcending the episodic nature of traditional cuff-based, oscillometric modalities like ambulatory BP monitors (ABPM). However, the performance of these cuffless devices compared to their cuff-based counterparts remains debated. In this study, BP readings from a continuous cuffless BP monitor were compared against those from a standard 24-hour ABPM.

Design and method:
The study enrolled 63 subjects (NCT04548986, 53.1±7.2 years, 21.2% female, arm circumference 29.0±2.5 cm) participating in a 12-week cardiac rehabilitation (CR) program (Réseau Hospitalier Neuchâtelois, Switzerland). Comparisons encompassed 24-h, daytime (9am– 9pm), and night-time (11pm–7am) systolic and diastolic BP (SBP, DBP) using a 7-day average BP measurement from a cuffless monitor (Aktiia SA, Switzerland) overlapping with a 1-day average from the ABPM (Dyasis 3, Novacor, France), both recorded at the start and end of the CR program. Two sessions were analyzed: session 1 compared the first day's ABPM data with the first week's Aktiia data; session 2 compared the last day's ABPM data with the last week's Aktiia data. Only sessions with at least 20 daytime and 7 night-time valid measurements from both monitoring modalities were included in this analysis.

Results:
From the initial cohort, 51 subjects fulfilled the requirements of data availability of this analysis (Figure 1, 44 in session 1, 35 in session 2). No significant differences were found between Aktiia and ABPM monitors in 24-h and daytime SBP readings (24-hour: mean ± SD [95% CI] 2.6±12.3 [-0.2, 5.4] mmHg, correlation r=0.57, P=0.06; daytime: 1.2±12.4 [-1.6, 4.0] mmHg, r=0.60, P=0.38). However, night-time SBP readings showed more pronounced differences (12.5±14.4 [9.3, 15.8] mmHg, r=0.39, P<0.001). DBP readings were significantly different but within clinical acceptance for 24-h and daytime (24-hour: -2.9±7.9 [-4.7, -1.1] mmHg, r=0.63, P=0.002; daytime: -3.1±8.2 [-5.0, -1.3] mmHg, r=0.64, P=0.001), with notable night-time differences (4.1±8.5 [2.2, 6.0] mmHg, r=0.57, P<0.001).

Conclusions:
The findings reveal the Aktiia monitor's promising performance in continuous, long-term BP monitoring, especially during daytime, while noting important differences at night. Further research is underway to investigate nocturnal measurements.
BLOOD PRESSURE DIGIT PREFERENCE IN HYPERTENSIVE PATIENTS ATTENDING PRIMARY HEALTH CARE IS ASSOCIATED WITH FUTURE CARDIOVASCULAR EVENTS
Authors: Norrman Anders , Schiöler Linus , Carlsson Axel C , Boström Kristina Bengtsson , Hjerpe Per , Ljungman Charlotta , Mourtzinis Georgios , Qvarnström Miriam , Wettermark Björn , Wändell Per , Kahan Thomas , Hasselström Jan 
Published: May 2024

Objective:
Digit preference refers to rounding blood pressure (BP) values more often than would occur by chance. Studies show that practices with high digit preference are linked to fewer antihypertensive prescriptions, and patients attending such practices have an increased cardiovascular (CV) event risk.
The objective is to investigate how the fraction BP digit preference in hypertensive patients in primary health care centres relates to future CV events.

Design and method:
From the Swedish Primary Care Cardiovascular Database, 74,751 patients (41,728 women) in 48 primary care centers in Sweden with a recorded diagnosis of hypertension during 2001–2008 were included. The fraction of systolic and diastolic BP values ending in 5 or 10 during 2007–08 at each center was calculated. Cox regression analysis assessed the relation between digit preference at each primary health care center and CV events (ischemic heart disease, cerebrovascular disease, CV death) during 2009–2013, i.e. follow-up was 1–5 years. Covariates included age, gender, income, diabetes, ischemic heart disease cerebrovascular disease, and region.

Results:
Patient mean age in 2008 was 70±14 years. The fraction of digit preference varied between 32% and 100% between centres (Figure 1). There was a significant association between the utilization of digit preference at a primary health care centre and risk for future CV events for these patients (Figure 2). A proxy for quality of care by centre was estimated as fractions of patients with lipids, creatinine, and microalbuminuria assessed during 2007–2008. This revealed no association between markers of quality of care and prevalence of digit preference.

Conclusions:
BP digit preference is associated with future CV events. This may be attributed to inaccurate measurements procedures for BP measurements, faulty evaluation of actual BP levels and risk, treatment not offered appropriately, or other means of possible inappropriate quality of care.
DIAGNOSTIC ACCURACY OF ATTENDED AND UNATTENDED BLOOD PRESSURE MEASUREMENTS IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Mancusi Costantino , Maloberti Alessandro , Fucile Ilaria , Manzi Maria Virigina , Pengo Martino , Bertacchini Fabio , Monticone Silvia , Pucci Giacomo 
Published: May 2024

Objective:
Purpose: To evaluate the concordance between the measurement of blood pressure values in unattended, OBP and ABPM modes.

Design and method:
Methods: 232 patients were enrolled in 6 hypertension centers belonging to the Italian society of arterial hypertension, as part of a research coordinated by the SIIA youth group. Patients underwent blood pressure measurement in AOBP and OBP modes before and after ABPM. AOBP and OBP measurements were performed in alternating mode before and after ABPM, and the mean values were calculated. Blood pressure was defined as controlled if the 24-hour average blood pressure was <130/80 mmHg on the ABPM.

Results:
Results: The mean age of the patients was 59±13.6 years, with a female prevalence of 49% and a duration of hypertensive disease of 11.6±8.4 years. The AOBP and OBP blood pressure values were 137.1±17.3/ 78.5±12.4 mmHg and 139.8±19.5/ 83.1±12.8 mmHg, respectively (p<0.01). In ROC curve analysis, the AOBP measurement mode showed an accuracy in correctly identifying patients with controlled hypertension equal to 0.71, higher than that shown by the OBP measurement equal to 0.67 (p<0.05). This difference was higher for older patients (>65 years old) (AUC of 0.73 versus an AUC of 0.65, (p<0.05)) and for diabetic patients (AUC of 0.73 versus an AUC of 0.65, (p<0.05)) the OBP modality.

Conclusions:
Conclusions: Our data suggest that AOBP may be particularly useful in identifying patients with more accurately controlled blood pressure than OBP mode. This advantage, due to a virtual elimination of the white coat effect, is more marked in older and diabetic patients.