bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMBINED EFFECTS OF CHILD AND ADULT ELEVATED BLOOD PRESSURE ON ADULT SUBCLINICAL KIDNEY DAMAGE AND ALBUMINURIA: A 36-YEAR PROSPECTIVE COHORT STUDY
Authors: Wang Yang , Jia Hao , Du Ming -Fei , Sun Yue , Wang Dan , Hu Gui -Lin , Man Zi -Yue , Chu Chao , Desir Gary , Safirstein Robert , Zheng Xiao -Wei , Mu Jian -Jun 
Published: May 2024

Objective:
Elevated blood pressure (BP) is associated with increased risk of chronic kidney disease. However, it is uncertain whether this risk is attenuated in individuals who acquire normal BP by adulthood. The present study examined the effect of child and adult BP levels on subclinical kidney damage (SKD) and albuminuria in adulthood.

Design and method:
Using data from the longitudinal cohort of Hanzhong Adolescent Hypertension Study, 1897 participants aged 6 to 18 years were enrolled and followed up for 36 years. Childhood elevated BP was defined according to the tables from the National Health Commission of the People's Republic of China. In adulthood, BP was classified as elevated if systolic BP greater than or equal to 140 mmHg, diastolic BP greater than or equal to 90 mmHg, or self-reported use of antihypertensive medications. Presence of SKD was defined as estimated glomerular filtration rate between 30 and 60 mL/min per 1.73 m2 or elevated urinary albumin-to creatinine ratio at least 30 mg/g. Albuminuria was defined as urinary albumin-to creatinine ratio greater than or equal to 30 mg/g.

Results:
Individuals with persistently elevated BP and individuals with normal childhood BP, but elevated adult BP had increased risk of SKD [odds ratios (ORs) 95% confidence interval (CI) were 2.46(1.68-3.60) and 3.28(1.85-5.82), respectively] in comparison with individuals with normal child and adult BP. In contrast, individuals with elevated BP as children but not as adults did not have significantly increased risk [OR 95% CI, 0.93(0.58-1.50)]. In addition, these individuals had a lower risk of increased SKD [OR 95% CI, 0.28(0.14-0.57)] in compared with those with persistently elevated BP. Consistent findings were observed in the risk of albuminuria.

Conclusions:
Individuals with persistently elevated BP from childhood to adulthood had increased risks of SKD and albuminuria. These risks were reduced if elevated BP during childhood resolved by adulthood.
CENTRAL AND BRACHIAL PULSE PRESSURE PREDICTS CARDIOVASCULAR AND RENAL EVENTS IN TREATED HYPERTENSIVE PATIENTS
Authors: Takenaka Tsuneo 
Published: May 2024

Objective:
Central blood pressure is a stronger predictor of cardiovascular prognosis rather than brachial blood pressure. Reflection wave reaches abdominal aorta sooner than ascending aorta. Thus, the contribution of central pulse pressure (cPP) to renal events may differ from that to cardiovascular events.

Design and method:
The subanalysis of ABC-J II study was performed. Subjects were 3434 treated hypertensive patients with mean follow-up of 4.7 years. Left ventricular hypertrophy, an index of cardiovascular risk, correlated with cPP better than central systolic blood pressure in this cohort. The contribution of brachial pulse pressure (bPP) and cPP to cardiovascular and renal events were analysed.

Results:
Results: Cox proportional-hazard analysis revealed that sex (p<0.001), height (p<0.05), history of cardiovascular diseases (p<0.001), numbers of antihypertensive drugs (p<0.05) and cPP (p<0.05) contributed to cardiovascular events. However, Cox proportional-hazard analysis disclosed that baseline serum creatinine (p<0.001) and bPP (p<0.05) predicted renal events.

Conclusions:
The present findings support our previous data that the absence of cardiovascular or renal diseases is an important determinant for event-free survival, and suggest that cPP and bPP contribute to cardiovascular and renal events in treated hypertensive patients.
NON-INVASIVE PRESSURE GRADIENT ESTIMATION OF STENOTIC LESIONS IN RENAL MULTIFOCAL FIBROMUSCULAR DYSPLASIA: A PILOT STUDY
Authors: Robberechts Tom , Giudici Alessandro , Kadziela Jacek , Stoenoiu Maria S , Donkers Kim M. , Van Leeuwen Jojanne E. , Januszewicz Andrzej , Januszewicz Magdalena , Spronck Bart , Persu Alexandre 
Published: May 2024

Objective:
Currently, there is no validated method to assess the haemodynamic significance of renal artery stenosis in fibromuscular dysplasia (FMD) patients. A translesional pressure gradient >10 mmHg during catheter-based angiography has been proposed as a cut-off for considering angioplasty. However, for reasons of invasiveness, time, accessibility and cost, this approach is seldom used. Therefore, development of a non-invasive method to evaluate the hemodynamic impact of FMD lesions is urgently needed.

Design and method:
We developed a computer application to quantify FMD-related stenoses and estimate the resulting pressure gradient based on angiography images. Based on analysis of images of 55 patients from the FEIRI database, the application allows 1) binary segmentation (vessel vs. background) of the image, 2) identification of vessel centreline through skeletonisation, 3) tracking of vessel diameter, and 4) quantitative characterisation of beads and stenoses. We used empirical fluid dynamics laws and the obtained vessel geometry to estimate pressure drops across lesions, also accounting for turbulences and vessel tortuosity. Retrospective image analysis and subsequent gradient estimation were performed blinded for clinical data and in vivo pressure gradients. Calculated pressure gradients were validated against those measured in vivo through invasive catheterisation in 9 patients from the ARCADIA-POL study.

Results:
We analysed angiographic images from FMD-related lesions of n=9 female patients aged 27–59 years, in whom translesional pressure gradients were available. n=18 distinct images were obtained: thirteen pre-angioplasty (four patients with bilateral lesions) and five post-angioplasty. Predicted pressure gradients showed a strong correlation with in vivo pressure gradients (r=0.88, Figure 1). Furthermore, in 11/13 (85%) pre-angioplasty images, the software correctly discriminated between significant (>10 mmHg) vs. non-significant pressure gradients. Our software also reliably predicted the decrease in pressure gradients pre-to-post-angioplasty.

Conclusions:
We show for the first time the feasibility of pressure gradient prediction based on the anatomy of renal FMD lesions. The next steps will consist in expanding our study population and adapting our approach (currently depending on catheter-based angiography), to non-invasive imaging such as CT- or MR-angiography. Finally, we will correlate estimated pressure gradients with clinical outcomes such as blood pressure response to angioplasty.
RENAL SAFETY ASSESSMENT OF TELMISARTAN/S-AMLODIPINE SINGLE-PILL COMBINATION IN KOREAN HYPERTENSIVE PATIENTS: A MULTICENTER RETROSPECTIVE OBSERVATIONAL STUDY
Authors: Cho Hyuk , Han Seung Seok , Kim Hee -Seok , Min Soung -Jun , Kwon Sung Uk , Kim Hyung -Kwan , Hyon Min -Su 
Published: May 2024

Objective:
Telmisartan/S-Amlodipine (TEL/S-AML) single-pill combination (SPC) may effectively lower blood pressure (BP) lowering and exhibit renal protective effects, as angiotensin receptor blockers are acknowledged for such benefits. However, there is a scarcity of studies validating these effects in real-world settings. Herein, we assessed the BP-lowering effects and safety, with a specific focus on renal function, after over 6 months of administration in Korean hypertensive patients.

Design and method:
This study constitutes a non-interventional, multicenter, retrospective observational investigation that includes individuals diagnosed with essential hypertension and treated with the TEL/S-AML SPC for a period exceeding 6 months. We analyzed the serial changes in BP, serum electrolytes, and creatinine-based estimated glomerular filtration rates (eGFRs). We additionally collected data on serious and other adverse events (AEs) and assessed their relationship to TEL/S-AML SPC.

Results:
A total number of 4,934 patients were enrolled in this study. Following the administration of TEL/S-AML SPC, both of systolic and diastolic BPs showed a significant decrease throughout the study period (Ps <0.05). AEs were reported in 352 cases among 282 subjects (5.72%), while serious AEs were reported 74 cases among 62 subjects (1.26%). Serious AEs with a potential relation to TEL/S-AML SPC were reported in 3 subjects (0.06%). No change in eGFR was observed over the study period.

Conclusions:
The study findings suggest that the TEL/S-AML SPC is effective in lowering BP and may contribute to the preservation of renal function, showing a low incidence of renal complications after over 6 months of administration in Korean hypertensive patients. These results provide support for the assertion that this agent is well-tolerated.
ROLE OF ANGIOTENSIN CONVERTING ENZYME 2 FOR ANGIOTENSIN-(1-7) SIGNALING IN HUMAN PODOCYTES EXPOSED TO FLUID FLOW SHEAR STRESS
Authors: Bolbrinker Juliane , Kaiser-graf Debora , Domenig Oliver , Poglitsch Marko , Kreutz Reinhold 
Published: May 2024

Objective:
Glomerular hyperfiltration is linked to increased fluid flow shear stress (FFSS) on podocytes, potentially causing irreversible podocyte impairment and subsequently altering the permeability and integrity of the glomerular filtration barrier. Angiotensin II (AngII) plays a significant role in chronic kidney disease. The adverse effects of AngII are partially countered by alternative signaling pathways in the renin-angiotensin system (RAS), comprising angiotensin-converting enzyme 2 (ACE2), angiotensin-(1-7) (Ang-[1-7]), and the Mas1 receptor (MAS1). This antagonistic pathway might confer renoprotective effects, e.g. by facilitating anti-inflammatory processes. Given the incomplete understanding of the pathomechanisms and signaling pathways triggering podocyte damage due to FFSS, our objective is to elucidate the influence of ACE2 in human podocytes in the context of glomerular hyperfiltration.

Design and method:
Gene expression analyses and immunofluorescence staining of ACE2 and MAS1 were conducted on conditionally immortalized human podocytes (hPCs). For mechanistic studies, hPCs were cultured on collagen IV-coated Culture Slips®, placed in a Streamer® Shear Stress Device and subjected to FFSS of 1 dyne/cm2 for 2 hours. Control cells remained unexposed to FFSS. Subsequently, the rate of spiked AngII conversion to Ang-[1-7] in presence and absence of the specific ACE2 inhibitor MLN-4760 was assessed in whole cell lysates and at the cell surface.

Results:
In vitro, hPCs express ACE2 and MAS1 as central elements of the alternative RAS-signaling pathways. RNA-expression levels of ACE2 did not exhibit significant alterations under FFSS compared to the control. FFSS exposure elevated the rate of AngII conversion to Ang-[1-7] in cell lysates compared to control conditions, while the conversion rate at the cell surface remained unaltered. The formation of Ang-[1-7] at the cell surface was diminished by MLN-4760, whereas the inhibitor displayed no significant effect in whole cell lysates.

Conclusions:
Our findings show an increased rate of AngII conversion to Ang-[1-7] in hPC lysates following FFSS, which is independent of ACE2. On the cell surface, Ang-[1-7] formation is mediated by ACE2 but remains unchanged under FFSS. These results indicate that ACE2 regulation does not play a central role for Ang-[1-7] formation upon FFSS in human podocytes.
PULSE WAVE VELOCITY IS CORRELATED WITH PLASMA CREATININE LEVELS AND GLOMERULAR FILTRATION RATE IN PATIENTS WITH CARDIOVASCULAR RISK FACTORS
Authors: Baba Mirela , Bucur Adina , Maris Mihaela , Jianu Daniela , Luca Constantin Tudor , Moroz Simina Mariana , Stoian Dana , Mozos Ioana 
Published: May 2024

Objective:
Scientific evidence suggests that the kidneys’ role in hypertension is mostly linked to the association between mean arterial pressure (MAP) and vascular resistance. In recent publications, two key indicators of arterial stiffness, pulse pressure (PP) and pulse wave velocity (PWV) have been found to be important predictors of the cardiovascular risk and decline in glomerular filtration rate (GFR). We aimed to study the relationship between variables of pulse wave analysis and renal function in patients with cardiovascular risk factors.

Design and method:
Our cross-sectional, descriptive study included patients referred to the clinic within a National Screening Programme for cardiovascular risk factors. The patients underwent anthropomorphic measurements, office blood pressure measurements, pulse wave analysis using a Mobil-O-Graph and standard blood tests such as lipids, glucose and creatinine.

Results:
76 patients entered the study aged 63±10 years, 53% males, 47% females, mean systolic blood pressure (SBP) of 133.8 mmHg (±18.8), mean diastolic blood pressure (DBP) of 84.1mmHg (±11.5), mean arterial pressure (MAP) of 105.6mmHg (±17.7), mean pulse pressure (PP) of 49.8mmHg (±13.2), mean pulse wave velocity (PWV) of 9.3m/s (±1.5) and mean augmentation index (AI) of 24.7 (±16.2). In linear regression analysis, blood creatinine level was significantly correlated with PWV (r= 0.328, p= 0.004), PP (r= 0.249, p= 0.03), MAP (r= 0.297, p= 0.009), SBP (r= 0.337, p= 0.003) and DBP (r= 0.267, p= 0.02). Glomerular filtration rate (GFR) was significantly negatively correlated with PWV (r= -0.465, p= 0.0001) and SBP (r= -0.227, p= 0.049). Multiple regression analysis revealed significant associations of creatinine with PWV and SBP (multiple correlation coefficient (MCC) = 0.402, p=0.0016) and GFR with PWV after adjusting for SBP (MCC = 0.468, p<0.0001).

Conclusions:
Pulse wave velocity can predict blood creatinine and glomerular filtration rate in patients with cardiovascular risk factors.
PRIMARY CARE PHYSICIAN'S APPROACH TOWARDS LIFESTYLE CHANGES IN HYPERTENSIVE PATIENTS
Authors: Nahdi Ghaida , Merghni Syrine , Arfaoui Farah 
Published: May 2024

Objective:
The role of lifestyle and diet changes in hypertension management is very well known. Economic constraints, additional benefits, and few or almost no side effects have made it an attractive option for hypertension control. However, it is still not widely used in primary care.
This study was conducted to assess the knowledge and approach of primary care physician (PCP) towards the D.A.S.H (Dietary approaches to stop hypertension) in Tunisia.

Design and method:
We surveyed 132 PCPs among the 148 PCPs. We used a questionnaire on Google forms, with 16 questions assessing practices regarding the D.A.S.H, its use and source of information about it.

Results:
The participants had a mean duration of practice of 9.2 years (+/-3.4SD). They all receive hypertensive patients daily with an average of 6.12 (+/-2.7SD). Most of the PCPs (60.7%, n=80) recommend the lifestyle changes. However only 82.5% (n=65) of them based their recommendations on guidelines. The D.A.S.H is used by 60% (n=48), these participants knew the D.A.S.H diet through internet. Weight loss, low salt intake, daily physical activity and stop smoking were recommended by most of the PCPs. For the low salt intake, few (35%, n=28) precised that it includes sauces and cold cuts. Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut and sugar-sweetened beverages and sweets was recommended by only 12 PCPs. Most (74%) said that lifestyle changes can alone, if well conducted, help to lower the blood pressure. Ninety percent (90%) said that they are more effective with the medication, and it could help lowering the number and the doses of the drug used. All the PCPS(n=132) said that their informations about the DASH diet and others heart-healthy diets are incomplete which may lead to the failure of the lifestyle changes.

Conclusions:
PCPs’ knowledge and management of lifestyle in hypertensive patients is poor in Tunisia. Our data point to a need for continually updating about the non-pharmacological treatment of hypertension
THE SENOLYTIC QUERCETIN PREVENTS AGE-ASSOCIATED VASCULAR STIFFENING, REDUCES BLOOD PRESSURE AND IMPROVES COGNITIVE FUNCTION IN DAHL SALT-SENSITIVE RATS CONSUMING A NORMAL SALT DIET
Authors: Fedorova Olga , Dos Santos Carla Rocha , Barnett Mackenzie , Mcdevitt Ross , Wei Wen , Zernetkina Valentina , Juhasz Ondrej , Morrell Christopher , Lakatta Edward 
Published: May 2024

Objective:
Quercetin (QRC), a flavonoid with anti-oxidant, anti-inflammatory and senolytic effects, reduced BP in salt-induced hypertension in Dahl salt-sensitive (DSS) rats. The increases in central arterial stiffness (CAS) and blood pressure (BP) occur, as manifestation of early vascular aging (EVA), in DSS rats even consuming a normal salt (NS) diet, moreover, EVA is associated with cognitive impairment in humans. We hypothesized that as age advances, a decline in cognitive function will accompany EVA in DSS rats consuming a NS diet, and that QRC will not only retard EVA, but also will improve cognitive function.

Design and method:
A NS diet (0.5% NaCl), supplemented with QRC (100 mg/kg BW/day) was administered to male DSS rats at 6-mo of age (n=24) for a 3-month period. DSS without QRC supplementation served as a control group (n=12). Systolic and diastolic BP (SBP, DBP), pulse wave velocity (PWV, an index of CAS), echocardiography, and a visuospatial attention test were assessed prior to and following QRC treatment.

Results:
At 6-mo of age none of the measured parameters differ between control and QRC rats. During aging from 6- to 9-mo in the control group, SBP, DBP and PWV significantly increased, ESLV.vol showed a statistically borderline trend to increase, HR and EF showed a statistically borderline trend to decrease, and attention behavior did not change. QRC treatment reduced SBP, PWV, and ESLV.vol, and increased EF and attention (Table). The QRC effect to increase the number of correct attention test responses was inversely correlated with PWV (Pearson r=-0.420, P=0.02) but not with BP or cardiac parameters, indicating that CAS but not BP is linked to cognitive function.

Conclusions:
QRC reduces EVA and improves cognition assessed as an attention behavior. Although both BP and CAS are manifestations of EVA, a positive association between attention decline with PWV, but not BP, suggests that CAS is linked to cognitive function via mechanisms that are not directly related to BP. Further studies are required to determine whether the effects of QRC on EVA in DSS rats, consuming a NS diet, are linked to its anti-oxidant, anti-inflammatory or senolytic properties.
ASSOCIATION OF OXIDATIVE BALANCE BURDEN WITH ALL-CAUSE MORTALITY AMONG PATIENTS WITH HYPERTENSION: A PROSPECTIVE COHORT STUDY FROM NATIONAL HEALTH AND NUTRITION EXAMINATION
Authors: Jia Shanshan , Huo Xingwei , Liu Lu , Chen Xiaoping 
Published: May 2024

Objective:
Oxidative stress assumes a crucial role throughout the entire trajectory of hypertensive patients. This study aimed to evaluate the association between oxidative balance score (OBS) and all-cause mortality among hypertensive patients.

Design and method:
We conducted a cohort study, including 9,735 hypertensive patients from the NHANES spanning from 2007 to 2018. Relevant mortality data were linked until December 2019. The burden of oxidation balance was derived through computation of the OBS. It was obtained by assessing the levels of 15 antioxidants and 5 pro-oxidants for each gender. Survey-weighted multivariable Cox proportional hazards regression and Kaplan-Meier survival curves were employed to examine the association between OBS and all-cause mortality. Restricted cubic spline was used to investigate whether there is a nonlinear relationship between OBS and all-cause mortality in hypertensive patients. Moreover, we conducted a subgroup analysis taking into consideration age, gender, BMI, and history of diabetes. Patients who died within two years of follow-up were excluded for sensitivity analysis to verify the robustness of the results.

Results:
After a median follow-up period of 79 months, 973 hypertensive patients experienced all-cause deaths (9.99%). We found that every 5 scores increment in OBS was associated with an 11% reduction in the risk of all-cause mortality (HR = 0.89, 95% CI: 0.82-0.98). Restricted cubic spline failed to yield evidence supporting a nonlinear association between OBS and all-cause mortality (P nonlinear = 0.181). After stratifying the OBS into tertiles, it was found that the highest OBS group had a significantly lower risk of all-cause mortality compared to the lowest group (HR=0.72, 95% CI: 0.54 to 0.96, p for trend=0.025). Subgroup analysis revealed a significant negative correlation between OBS and all-cause mortality among individuals aged 60 years and above, males, with BMI<25kg/m2 and those without diabetes. Sensitivity analysis suggested that our results remained stable.

Conclusions:
Higher OBS was significantly associated with decreased all-cause mortality in adults with hypertension. OBS could serve as a prognostic assessment tool in ameliorating prognosis and enhancing survival outcomes. increasing antioxidant levels is an effective strategy to prevent the risk of all-cause mortality in hypertensive patients.
BODY ROUNDNESS INDEX IMPROVES THE PREDICTIVE VALUE OF CARDIOVASCULAR DISEASE RISK IN HYPERTENSIVE PATIENTS WITH OBSTRUCTIVE SLEEP APNEA: A COHORT STUDY
Authors: Song Shuaiwei , Cai Xintian , Hu Junli , Li Nanfang 
Published: May 2024

Objective:
Obesity, especially visceral obesity, plays an important role in the progression of cardiovascular disease (CVD). The body roundness index (BRI) is a new measure of obesity that is considered to reflect visceral obesity more comprehensively than other measures. This study aims to evaluate the relationship between BRI and CVD risk in hypertensive patients with obstructive sleep apnea (OSA) and explore its superiority in predicting CVD.

Design and method:
The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CVD. The area under the curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to assess which measures of obesity had the best predictive value for CVD risk.

Results:
During a median follow-up period of 6.8 years, 324 participants suffered a CVD event. After multivariable adjustment, compared with the reference group (the first tertile), the HRs (95% CI) of CVD were 1.25 (95% CI, 0.93-1.70) and 1.74 (95% CI, 1.30-2.33) for subjects in the tertile 2 and tertile 3 groups, respectively. Compared with other measurement indicators, BRI has the highest predictive value for CVD risk [AUC: 0.627, 95% CI: 0.593-0.661]. The addition of the BRI to the fully adjusted multivariate model improved the predictive power for CVD, which was validated in the continuous NRI and the IDI (all P < .05).

Conclusions:
BRI was significantly associated with the risk of CVD in hypertensive patients with OSA. Furthermore, BRI may improve CVD risk prediction in hypertensive patients with OSA.