bluuebunny/crossref_metadata_2025_split huggingface dataset:
BLOOD PRESSURE AND WEIGHT CHANGES AND INCIDENCE OF ARTERIAL HYPERTENSION 3 YEARS AFTER SWITCHING TO DOLUTEGRAVIR IN TREATMENT-EXPERIENCED HIV-INFECTED PATIENTS IN LILONGWE, MALAWI
Authors: Steffen Hans -Michael , Viola Evelyn , Mahanani Melani Ratih , Rambiki Ethel , Thawani Agness , Kasper Philipp , Wallrauch Claudia , Neuhann Florian , Heller Tom 
Published: May 2024

Objective:
The increased survival of people living with HIV (PLHIV) is accompanied by a rising number of aging patients at risk of cardiovascular disease. Dolutegravir (DTG), recommended in WHO guidelines, was reportedly associated with excess gain in body weight (BW). We evaluated changes in BW and blood pressure (BP) of PLHIV who had initiated tenofovir/lamivudine/efavirenz (TLE) and were followed for 36 months during the LighTen Cohort Study (ClinicalTrials.gov NCT02381275). As per Malawian National protocols, patients were switched almost universally to tenofovir/ lamivudine/dolutegravir (TLD) and medical care continued after completion of the study.

Design and method:
We retrieved data on BW, BMI, systolic and diastolic BP (sBP, dBP) of the LighTen Cohort study participants (age =>18 years) from the electronic medical record system at the Lighthouse Clinic for those, who were still in care at the clinic over a 36±4 months period after initiation of TLD. Student's t-test was used to compare changes (δ) in sBP, dBP, BW, and BMI between baseline (0m) and month 36 (36m) on TLE vs. TLD, respectively. Incident hypertension was defined as office blood pressure =>140/90 mmHg using =>2 measurements on =>2 consecutive visits.

Results:
Within the defined time frame, data of 590 PLHIV (348 females; 59%) could be analyzed. At the DTG switch their age (mean±sd) was 41.3±8.9 years with a median CD4 count of 467 cells/μl (interquartile range 325-623 cells/μl) and suppressed viral replication in 95% of cases. Incident hypertension was confirmed in n=24 of 497 and n=53 of 473 initially normotensive PLHIV during TLE and TLD periods, respectively (4.8% vs. 11.2%; p<0.001). The increase in BW and BMI was significantly higher on TLE compared to TLD while the changes in BP were significantly higher with TLD (see table; ∗p<0.001 TLE vs. TLD).

Conclusions:
Following the initial increase in BW on TLE, a higher risk of hypertension among PLHIV was associated with a switch from efavirenz to dolutegravir with only modest additional weight gain. In view of their inherent high cardiovascular risk, regular BP control with lifestyle counselling and timely initiation of antihypertensive drug treatment seem clearly indicated.
ASSOCIATION BETWEEN OFFICE BLOOD PRESSURE AND LONG-TERM CLINICAL EVENTS IN PATIENTS WITH CORONARY ARTERY DISEASE AFTER PERCUTANEOUS CORONARY INTERVENTION
Authors: Shin Jeong -HUN , Kim Byung Sik , Shin Jinho , Lim Young -Hyo 
Published: May 2024

Objective:
The optimal blood pressure (BP) target for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains unclear. This study aimed to identify the optimal BP target by investigating the association between average office BP and future clinical events after PCI in patients with CAD.

Design and method:
Consecutive patients undergoing PCI from 2012 to 2016 were included. They were divided into five groups according to the average follow-up BP after discharge. The co-primary outcome was major adverse cardiac and cerebrovascular event (MACCE: all-cause death, non-fatal myocardial infarction, non-fatal stroke, or any revascularization) and net adverse clinical events (NACE: MACCE, or major bleeding) up to 5 years.

Results:
A total of 2,845 patients were included in the analyses, and among them, 787 (27.7%) experienced the NACE during the follow-up period. Patients in the highest SBP group (adjusted hazard ratio [HR] 1.495, confidence interval [CI] 1.189–1.880) and lowest SBP group (adjusted HR 1.625, CI 1.214–2.176) had a significantly higher risk of 5-year NACE. Similar associations were observed between SBP and the risk of MACCE, and similar results based on DBP categories were also observed. There was a J-curve relationship observed between SBP and DBP with respect to 5-year NACE and MACCE. The nadir point of risk for NACE and MACCE was found at 121.4/74.8 and 120.4/73.7 mmHg.

Conclusions:
In patients underwent PCI, there is a significant correlation between office BP level and clinical events, which indicates the importance of efforts for optimal BP control to reduce ischemic and bleeding events.
HIGH PREVALENCE OF THE CARDIOVASCULAR-KIDNEY-METABOLIC SYNDROME
Authors: Tian Zhejia , Schmidt-ott Kai , Melk Anette , Schmidt Bernhard 
Published: May 2024

Objective:
The cardiovascular-kidney-metabolic (CKM) syndrome has defined recently as the clinical picture characterized by obesity, diabetes, chronic kidney disease (CKD) and the cardiovascular (CV) sequelae including coronary heart disease, stroke, peripheral arterial disease, heart failure and atrial fibrillation. The continuum of CKM reaches from stage 0 with no risk factors to stage 4 with clinical CV disease. The aim of this study was to define the prevalence of the stages 0 – 2 of the CKM syndrome in the general population, according to age and sex and to explore the development of the prevalence over the last twenty years.

Design and method:
We used data provided by NHANES. NHANES is a biannual survey, which is representative for the non-institutionalized, civil population of the United States of America. We included non-pregnant participants aged 18 or older from 10 NHANES cycles between 1999 and 2020. We accounted for the complex survey design, as specified in the National Center for Health Statistic analytic guideline. All analyses were conducted using R version 4.3.2.

Results:
7.9% of US adults were without any CKM risk factors and fulfilled the inclusion criteria for CKM Syndrome Stage 0, with the majority being female, comprising 64% of this subgroup. A higher percentage of younger participants were categorized in this group, with 74.9% being under the age of 45. 18.3% of the population encountered issues related to excess or dysfunctional adiposity (Stage 1) with a similar distribution between sexes. Over half of the US adult population (56.5%) exhibited either metabolic risk factors, CKD, or a combination of both and met the criteria for inclusion in stage 2. 49.3% were female and 50.7% were male. Older individuals were more prevalent in Stage 2.

Conclusions:
CKM syndrome is highly prevalent in the general population. Its prevalence rises with age and is modified by sex. Given the high prevalence of the CKM syndrome, especially in stage 2, reflecting patients at varying risk without subclinical or clinical CV disease, additional risk assessment is mandatory to tailor preventive measures on the population level to efficiently reduce cardiovascular morbidity and mortality.
TRUE REFRACTORY HYPERTENSION IN 2023- LESSONS LEARNED FROM A NATIONAL REGISTRY OF 1.82 MILLION ADULTS
Authors: Leiba Adi , Lencovsky Ori , Azran Carmil , Hadad Orpaz , Rappoprt Vladimir , Niddam Naomi Nakash , Korman Avital Angel 
Published: May 2024

Objective:
Refractory hypertension (refHTN) is defined as blood pressure that remains uncontrolled on maximal therapy, which is defined as the use of 5 or more antihypertensive agents of different drug classes.
We aimed to define the prevalence of apparent and true refHTN in a real life national registry of an Health Maintenance Organization (HMO).

Design and method:
In this real-life observational study we utilized the Maccabi Healthcare Services (MHS) database during 2023. Data includes pharmacy prescriptions and purchases.
Apparent refHTN was defined as patients included in the Maccabi “Hypertension Registry” during 2023 and taking 5 different antihypertensive medications of different classes, of which four were from pre-specified groups (diuretics, CCB, RAAS inhibitors and MRAs).
True refHTN (unlike apparent refHTN) was defined as being fully adherent to the antihypertensive medication regimen with at least 6 prescriptions and purchases (refills) during 2023 as well as blood pressure which was not optimally controlled during the year (less than 80% of blood pressure measurements equal or below the well-defined target of 130/80mmHg).

Results:
Out of 1,821,685 adult members of Maccabi HMO during 2023, 361,721 patients were defined as hypertensive patients (20%) and included in the registry. 0.5% (1750) of the hypertensive population were at some stage during 2023 on at least 5 anti-hypertensive medications (i.e., apparent refHTN). Of those only 264 patients (15%) were adherent to their medications during the whole year. Mean age was 71.3 years. Of the well adherent group, 205 patients (77%) were not optimally controlled and thus regarded as true refHTN.
Therefore in total, true refHTN was evident in 0.056% of hypertensive population in Maccabi HMO.

Conclusions:
In an “optimal world” which lacks physician inertia, four medication regimen is prescribed (Diuretics, CCB, RAAS inhibitors and MRAs) and there is willingness to prescribe a fifth and a sixth medication, if needed (alpha blockers, beta blockers, central alpha-2 agonists or direct vasodilators). In the unlikely case of full adherence to all medications, true refHTN is extremely rare (0.056% of hypertensive patients). This suggests that most hypertensive patients can be well controlled using the current anti hypertensive armamentarium.
PREVALENCE, AWARENESS, TREATMENT AND CONTROL OF DYSLIPIDEMIA (LDL-CHOLESTEROL > 3.0 MMOL/L) IN CROATIA – EHUH 2 STUDY PRELIMINARY REPORT
Authors: Jelakovic Bojan , Pecin Ivan , Bilajac Lovorka , Bilobrk Matea , Domislovic Marija , Gellineo Lana , Jelakovic Ana , Leskovar Dunja , Glavic Mihaela Martinovic , Paponja Kristina , Perica Drazen , Capak Krunoslav , Bubas Marija , Reiner Zeljko 
Published: May 2024

Objective:
Cardiovascular mortality is leading cause of death in Croatia. Beside hypertension, high prevalence and poor control of dyslipidemia is the main cause for this shameful medical failure. Our aim was to analyze prevalence, awareness, treatment and control of dyslipidemia (defined here as LDL cholesterol > 3.0 mmol/l) in general adult population.

Design and method:
EHUH-2 study is nationwide study in which representative random sample of adult population was enrolled. Structured questionnaire was applied, subjects were clinically examined, fasting blood was drawn and urine samples were collected. In this preliminary analyses from the EHUH-2 study we are reporting data collected from 1313 subjects.

Results:
Prevalence and awareness on high dyslipidemia were non-significantly higher in women than men (65.6% vs 63.4%; 34.6 vs 33.7%). On contrary, treatment and control were higher in men than in women (29.0% vs 24.1%, 88.4% vs 77.7.%; p< 0.05). Dyslipidemia was treated in only 25.2%, 29.9% and 33% patients with diabetes, hypertension and chronic kidney disease, respectively. In treated and controlled hypertensive patients, targets of LDL cholesterol were achieved in only 30.2% pointing on poor adherence to statin therapy. In untreated hypertensive patients dyslipidemia was treated in only 16.3% indicating on common clinical inertia. We observed significant differences in the prevalence, treatment, and control of dyslipidemia between urban and rural areas (58.7% vs. 74.5%, 29% vs. 19.7%, 25.6% vs, 14.4%, respectively, all p<0.001).

Conclusions:
Dyslipidemia (LDL > 3.0 mmol/l) is highly prevalent in Croatia. Poor control (less than 30% in high risk population) is mostly due to poor adherence and clinical inertia. Rural population has higher prevalence and lower rates of treatment and control. Medical scientific community including public health experts and health care providers have to work harder at first place increasing health literacy which will hopefully improve adherence and diminish clinical inertia. Special focus should be on remote areas where medical care is lacking.
HIGH PREVALENCE OF METABOLIC SYNDROME AND HIGH INCIDENCE OF NEW ONSET HYPERTENSION IN RURAL POPULATION WITH NORMAL BLOOD PRESSURE RISE THE QUESTION WHETHER NORMAL IS REALLY NORMAL
Authors: Prlic Margareta Fistrek , Brinar Ivana Vukovic , Dika Zivka , Kos Jelena , Jelakovic Ana , Ivandic Ema , Fucek Mirjana , Ivkovic Vanja , Knezevic Tamara , Jelakovic Bojan 
Published: May 2024

Objective:
High blood pressure (BP) is an independent risk factor for cardiovascular (CV) disease. The current ESH guidelines consider normal BP from 120-129/80-84 mmHg, and high-normal BP 130-139/85-89 mmHg. Metabolic profile, kidney function, and other risk factors determine the global CV risk which is important for proper treatment tailoring. We aimed to analyze the metabolic profile, white blood cell (WBC) count and high-sensitive C-reactive protein (hs-CRP), albuminuria (ACR), as well as endothelial damage marker; hepatocyte growth factor (HGF) in subjects with optimal BP, normal, and high-normal BP.

Design and method:
Data from 612 subjects (a random sample of adult rural population included in the ENAH study; 58% women, average age 41±14 years) were analyzed. Fasting blood and urine samples were collected. BP was measured using oscillometric device according to the ESH guidelines. Subjects were divided into two groups: OBP (optimal BP<120/80 mmHg, N=295), NHN (normal BP - normal and high-normal BP 120/80-140/90 mmHg, N=317).

Results:
Subjects in NHN group are older than subjects in OBP group (p<0.001). A significantly higher number of subjects with metabolic syndrome were observed in the NHN group (p < 0.001). There was no difference in inflammatory markers (WBC, hs-CRP) between groups. Albuminuria (ACR) was not higher in the NHN group. We found a positive correlation of HGF concentration and BP only in the NHN group. At the end of 7-years-follow up period 12.6% and 48.2% developed AH in the OBP and the NHN group, respectively (p< 0.001). The average annual incidence of AH for subjects with OBP was 2%, and for NHN subjects was 8%.

Conclusions:
Metabolic disturbances are significantly more frequent in subjects with NHN compared with those with OBP. In addition, in this group, we found a positive correlation between endothelial damage and BP. There is a higher incidence of new-onset AH in NHN the group during the follow-up period. Lifestyle changes should be implemented in all subjects with NHN BP aiming to reduce the risk of developing sustained AH, and drug therapy should be considered particularly in those with other risk factors.
PREVALENCE OF PA IN OSA AND HYPERTENSION, AND THEIR EFFECTS ON MACE WHEN CO-EXISTENT, UROSAH COHORT
Authors: Heizhati Mulalibieke , Li Nanfang , Zhu Qing , Zhang Delian , Yao Xiaoguang , Luo Qin , Aierken Xiayire 
Published: May 2024

Objective:
To explore 1) the prevalence of PA in OSA and hypertension, and 2) whether the risk of MACE is increased in co-existent PA and OSA, compared to those without the both or with either alone

Design and method:
Participants were the patients in UROSAH cohort, adults who visited the Hypertension Center between Jan 2011 and Dec 2013 and followed up until Jan 2021. Prevalence of PA between without OSA and OSA groups was compared in total patients and in sex-specific patients. MACE encompassed cardiac and cerebrovascular events, and death from CV causes. We performed Cox proportional hazard regression models to evaluate HR and 95% CI for MACE, and cardiac and cerebrovascular events in coexistent PA and OSA group by setting non-PA and OSA group, and PA or OSA group as the reference.

Results:
We included 3306 patients with hypertension. PA prevalence was significantly higher in hypertensives with OSA in total participants (13.2 vs 10.0%, P = 0.018) and in men participants (13.8 vs 7.7%, P = 0.001). PA prevalence was significantly higher in hypertensive men with OSA aged <45 years (12.7 vs 7.0%), 45–59 years (16.6 vs 8.5%), and with overweight and obesity (14.1 vs 7.1%) than did their counterparts (P < 0.05). For OSA severity, men participants showed increased PA prevalence from non to moderate OSA and a decrease in the severe OSA group (7.7 vs 12.9 vs 15.1 vs 13.7%, P = 0.008). Per 1000 person-year incidence of MACE was the highest in the co-existent OSA and PA group (18.8), followed by OSA or PA (17.8), and the lowest in those without the both (11.0). In Cox regression, patients with co-existent PA and OSA showed 1.61- and 1.99- fold risk for MACE and for cardiac events, compared to those without both PA and OSA, and consistent in PSM.

Conclusions:
Cardiovascular risk in co-existent PA and OSA is higher than that of non-OSA and PA but similar to that of OSA or PA alone in patients with hypertension, suggesting clues for specific treatment of OSA, specially when co-existent with PA.
CARDIOVASCULAR RISK FACTORS AND ARTERIAL HYPERTENSION IN QOM (TOBA) POPULATIONS OF TWO PUBLIC INSTUTIONS IN NORTHERN ARGENTINE
Authors: Romano José René , Yegros Olga , Anair Fernandez , Elieen Ynfante Maira , Camilo Cerruti , Carmen Flores , Ines Perez , O. Marañon Rodrigo 
Published: May 2024

Objective:
To evaluate cardiovascular risk factors and control of high blood pressure in Qom (indigenous) populations of northern Argentina.

Design and method:
A descriptive, prospective and observational study was carried out through a survey directed at patients who attended 2 public institutions in the Province of Formosa: one carried out in the city of Formosa (Capital) and another in the town of Las Lomitas, in the interior of the province. It was carried out between the months of July and December 2023. A survey was carried out based on the risk factor variables of the Heart study and others useful for the population studied. The study was carried out under local and international ethical standards and under signed informed consent.

Results:
Of 34 patients surveyed (80% women), 25% were from the capital of Formosa and 75% from the rural area of Las Lomitas. Of the CVRFs, it was observed that 50% had high blood pressure (HTN) at some point, although 22% assumed that they currently had it and the rest did not know it. 97% of the population took their blood pressure at some point and 61% did so in the last year. 51% of hypertensive patients take medication regularly, using one (1) drug in 14%, two (2) drugs in 28% and three (3) drugs in 42%. Regarding the body mass index, it was observed that 55% were obese, having values above provincial and national surveys. In addition, it was found that 8% are active smokers, 23% are diabetic and the same percentage (23%) had cholesterol alterations. 2.9% had chronic renal failure and 5.9% had atrial fibrillation.

Conclusions:
The present study highlights adherence to treatment, the high proportion of diabetes and the lack of cholesterol controls, taking into account the percentage of obese individuals. Although the number of patients is limited, the present study retrieves valuable information to continue with future research that can improve the cardiovascular quality of life of this specific population.
MISSION 70/26 PROJECT: IMPROVING BLOOD PRESSURE CONTROL IN PORTUGAL, THE NUMBERS AFTER ONE YEAR OF ACTIVITY
Authors: Pinho Rosa , Ribeiro Heloisa , Damião Pedro , Viana Manuel , Nogueira José Lima , Abecasis Francisca , Cunha Vitoria , Gonçalves Fernando Martos 
Published: May 2024

Objective:
To describe the evolution of the proportion of controlled hypertensive patients under Primary Care after one year of the implementation of a multifaceted program.

Design and method:
We have designed a multifaceted program to promote health literacy and awareness for the prevention, management and control of cardiovascular diseases and health conditions associated with hypertension. The actions are aimed at healthcare professionals and population and includes governmental and organizational intervention. We used the Primary Care national database to address the proportion of hypertensive patients (18-65 years) with blood pressure < 140/90 mmHg and the proportion of hypertensive patients with at least one blood pressure recorded in the last semester.

Results:
In december 2022 there were 52,8% of patients aged 18-65 years with blood pressure <140/90 mmHg in Primary Care following. In december 2023, this number rised slightly to 55,3%. Along the year there were variations, with a peak control level of 61,5% in september 2023. In this last year there was an increase in the number of observed patients and a reduction in the asymmetry of the geographic distribution of the degree of control.

Conclusions:
There has been an improvement in the blood pressure control in hypertensive patients under Primary Care since the beginning of the program. A seasonal variation of the control levels were noted which will require a specific approach.
LOWER MIR-126 PLASMA CONCENTRATIONS IN HUMAN PULMONARY ARTERIAL HYPERTENSION
Authors: Babiak Emil , Vysocanský Samuel , Luknár Milan , Goncalvesova Eva , Pivácková Lenka Bies , Dóka Gabriel , Stollárová Natália , Klimas Ján 
Published: May 2024

Objective:
Pulmonary arterial hypertension (PAH) is a fatal incurable disease with complicated and lengthy diagnosis. However, its early detection is a prerequisite for better treatment and longer survival of patients. Therefore, the goal is not only to find new treatment procedures, but also ways to diagnose PAH faster and easier by biomarkers specifically involved in disease progression.
Tissues of the cardiovascular system produce, among others, hsa-mir-126-3p (endothelium) and hsa-mir-423-5p (cardiac muscle). These microRNAs are specific for these tissues and therefore we expect a change in their concentration in patients with PAH. The choice of these molecules was conditioned by a literature search and their sufficient occurrence in human plasma.

Design and method:
MicroRNAs were obtained from the plasma of patients (n = 29) undergoing right ventricular catheterization with observed suspected deteriorated heart conditions in a specialized center (NÚSCH a.s). The samples were processed by modified isolation of nucleic acids using Trizol reagent, transcribed into a DNA sequence by reverse transcription and their expression was determined by PCR reaction.

Results:
In our research, we observed in the plasma of patients with pulmonary hypertension (n = 18, mPAP = 34.61 ± 1.75, PAWP = 22.49 ± 1.72, PVR = 3.21 ± 0.26) and PAH (n = 11, mPAP = 43.73 ± 3.21, PAWP = 9.04 ± 1.04, PVR = 8.29 ± 1.55) a trend of decrease in hsa-mir-423-5p and a statistically significant decrease in hsa-mir-126-3p (p = 0.0188) in patients with PAH.

Conclusions:
The results may indicate that change in expression may be caused by dysregulation of endothelial cells in patients suffering from PAH.