bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMMUNITY PHARMACY-BASED HYPERTENSION SCREENING: MAY MEASUREMENT MONTH 2023 IN 3 CANADIAN PROVINCES
Authors: Tsuyuki Ross , Gysel Stephanie , Lee Tiffany 
Published: May 2024

Objective:
Elevated blood pressure (BP) is the largest contributing risk factor for premature death and disability. Approximately 50% of individuals with hypertension are unaware they have the condition; therefore, BP screening is essential. Canadian health professionals have previously participated in the annual global BP screening campaign, May Measurement Month (MMM); however this has never been completed in community pharmacies, which have the advantage of being highly accessible to the public.
Our objective was to examine the prevalence of elevated (BP) in Alberta (AB), British Columbia (BC), Newfoundland and Labrador (NL) during MMM 2023.

Design and method:
This cross-sectional study enrolled consenting members of the general public 18 years of age, recruited through signage, media and social media. Data collection took place between May 1 and July 31, 2023 in 52 community pharmacies across AB, BC, and NL. Participants completed a questionnaire that included demographic information, medical history, and use of antihypertensives. Pharmacy personnel completed 3 blood pressure readings, with readings 2 and 3 used to estimate BP. We used an automated blood pressure device recommended by Hypertension Canada's Device Recommendation Program. Elevated BP was defined as >140/90mmHg or >130/80mmHg for individuals with diabetes.

Results:
We enrolled 736 participants. The mean age of participants was 52 (SD 18.6) years, 66% were female, 34% had a history of hypertension, and 14% had diabetes. Overall, 21% (152/733) had elevated BP. In subgroups of interest, elevated BP was found in 20% (96/480) of females, 35% (88/251) of those with a history of hypertension (13% (64/482) in those with no history of hypertension), and 52% (53/103) in those with diabetes.

Conclusions:
Identifying individuals with elevated BP is the starting point for better BP management. Community pharmacy screening of BP was effective in identifying individuals with elevated BP warranting further assessment. Our experiences from MMM 2023 will guide the future scale-up of a national community pharmacy-based screening program for MMM 2024.
IMPACT OF ADMISSION HYPERGLYCEMIA ON IN-HOSPITAL MORTALITY IN ACUTE AORTIC DISSECTION
Authors: Mutailifu Saimire 
Published: May 2024

Objective:
report suggests that admission hyperglycemia is associated with cardiovascular and cerebrovascular disease. However, there are limited studies on admission hyperglycaemia and in-hospital mortality in patients with acute aortic dissection (AAD) hypertension. Therefore, our study aimed to investigate these associations.

Design and method:
In this survey, we obtained data from an electronic database for analysis from January 1, 2010 to January 1, 2023, 1239. Patients were divided into two groups based on their blood glucose level (BGA) at the time of admission. The outcome was all-cause mortality during hospitalization. Multivariate regression analysis was performed to explore the relationship between hyperglycemia and inpatient mortality.

Results:
The study analyzed 1239 patients, of whom 77.1% were male, with a mean age of 53.0 years and a mean BGA of 6.1 mmol/L. The logistic regression analysis revealed that the in-hospital mortality for individuals with hyperglycemia was 2.53 times greater compared to those with the normoglycemia group (95% CI:1.68-3.80, P < 0.001), which remained statistically significant even after adjusting. However, significant interactions were not found in subgroup analyses. The sensitivity analysis did not alter the association between the two variables. Furthermore, it was observed that patients who were using insulin experienced a decrease in in-hospital mortality.

Conclusions:
Admission hyperglycemia has been found to have a positive correlation with an elevated risk of hospital mortality in hypertensive patients with AAD. It has been observed that using insulin to manage admission hyperglycemia can help reduce the risk of in-hospital mortality.
PRECLINICAL AND CLINICAL EFFICACY AND SAFETY OF A NOVEL MULTI-TARGET SMALL MOLECULE MT-1207 FOR HYPERTENSION
Authors: Li Yutai , Jia Dechao , Miao Chaoyu , Wang Jiguang , Zhang Jin , Wang Peng 
Published: May 2024

Objective:
To develop a novel multi-target small molecule agent for the treatment of hypertension with potential renal protection.

Design and method:
Part I (preclinical): MT-1207 was tested in the in vitro and in vivo preclinical models to evaluate mechanisms of action, hypertension efficacy, and renal protection. The in vitro activity of MT-1207 was evaluated in enzyme and radioligand binding assays. In vivo Spontaneously Hypertensive Rats (SHR) and two-kidney two-clip (2K2C) rat models were used to evaluate antihypertensive effects and renal protection of MT-1207. Preclinical safety evaluation of MT-1207 was conducted in rats and dogs following ICH guidelines.
Part II (clinical): MT-1207 in clinical phases I and II were completed based on the clinical protocols. Phase Ia was a single center, randomized, double-blind, placebo-controlled, dose escalation study to evaluate safety, tolerability, pharmacokinetic of single oral dose of MT-1207 in healthy adult subjects. Phase Ia doses were 5, 10, 20, 40, 60, 90 mg. Similarly, Phase Ib study was conducted in patients with hypertension at 10 and 20 mg (BID) for 10 days. Clinical phase II was a multi-center, randomized, double-blind, placebo- and active-controlled, multiple-dose study to evaluate safety and pharmacodynamics of MT-1207 in patients with hypertension for 8 weeks.

Results:
Preclinical (part I): MT-1207 showed potent selective inhibitions of Adrenergic 1alpha and Serotonin (5-HT2A) receptors with IC50 < 1 nM. The efficacy of antihypertension of MT-1207 in SHR model was evident with a well-defined dose-response relationship at 2.5, 5, and 10 mpk. In 2K2C rat model, both blood pressure and serum uric acid decreased post-dose at 4-week and 9-week, indicating antihypertensive effects and potential kidney protection, respectively.
Clinical (part II): in Phase I, healthy volunteers had good tolerability at 40 mg and below. Rapid blood pressure decreases were observed 1-2 hr post dose in patients with 10 and 20 mg doses. Results from Phase II (10 and 20 mg (BID)) with placebo and active drug (amlodipine) study will be presented including summary of adverse effects (AE) and efficacy data.

Conclusions:
Clinical data (phases I and II) demonstrated antihypertensive effects of MT-1207 with mild adverse effects.
ZILEBESIRAN AS ADD-ON THERAPY IN PATIENTS WITH HYPERTENSION INADEQUATELY CONTROLLED WITH A STANDARD ANTIHYPERTENSIVE MEDICATION: EFFICACY AND SAFETY RESULTS FROM THE KARDIA-2 STUDY
Authors: Saxena Manish , Aswad Ahmad , Badariene Jolita , Kazi Farhana , Karns Adam D , Neutel Joel M , Park Wansu , Stiglitz Daniel , Makarova Nune , Havasi Andrea , Zappe Dion , Bakris George 
Published: May 2024

Objective:
Zilebesiran is an investigational RNA interference therapeutic that targets hepatic angiotensinogen, the most upstream precursor of the renin-angiotensin system. In the Phase 2 KARDIA-1 study, single subcutaneous (SC) doses of zilebesiran monotherapy significantly reduced 24-hr mean ambulatory and office systolic blood pressure (SBP) from baseline to Months 3 and 6 versus placebo. The objective of KARDIA-2, a Phase 2 randomized, double-blind, placebo-controlled study, was to assess efficacy, safety, and pharmacodynamics of zilebesiran in combination with a standard-of-care antihypertensive medication class in patients with uncontrolled hypertension.

Design and method:
KARDIA-2 enrolled adults with mild-to-moderate hypertension who were untreated or receiving stable therapy with up to two antihypertensives. Patients entered a run-in period, where previous antihypertensives were discontinued, and were subsequently randomized to open-label, once-daily oral olmesartan 20 or 40 mg, amlodipine 5 mg, or indapamide 2.5 mg as background antihypertensive therapy. After at least 4 weeks of run-in, patients with 24-hr mean ambulatory SBP of 130–160 mmHg were randomized 1:1 to single-dose SC zilebesiran 600 mg or placebo as add-on therapy. Escape antihypertensives could be initiated after Month 3 if a patient's SBP met pre-specified escape criteria. However, assessments while patients were on or within two weeks of stopping any escape medication were excluded in analyses. The primary endpoint was change in 24-hr mean ambulatory SBP from baseline to Month 3, assessed as the least-square mean difference between zilebesiran and placebo. Key secondary endpoints were change from baseline to Month 3 in office SBP, time-adjusted change from baseline to Month 6 in 24-hr mean ambulatory and office SBP, and proportion of patients with 24-hr mean ambulatory SBP less than 130 mmHg and/or a reduction of at least 20 mmHg without escape medication at Month 6.

Results:
KARDIA-2 enrolled 672 patients and is currently ongoing. Primary, secondary, safety, and pharmacodynamic endpoints will be presented at the meeting.

Conclusions:
KARDIA-2 will provide insights into the potential benefit of adding zilebesiran to patients with hypertension inadequately controlled with standard-of-care antihypertensive monotherapy, building on efficacy and safety learnings from previous Phase 1 and 2 studies of this novel therapeutic strategy.
EPLERENONE VS IRBESARTAN AS FIRST LINE THERAPY IN OBESE HYPERTENSIVE PATIENTS: PRELIMINARY RESULTS OF HEBRO TRIAL IN ECHOCARDIOGRAPHIC DIASTOLIC FUNCTION INDEXES
Authors: Kouremeti Maria , Iliakis Panagiotis , Drogkaris Sotirios , Stathoulopoulou Maria , Andrikou Ioannis , Kariori Maria , Siafi Eirini , Sakalidis Athanasios , Tatakis Fotis , Manta Eleni , Fragkoulis Christos , Vossos Ioannis , Konstantinidis Dimitrios , Thomopoulos Costas , Kasiakogias Alexandros , Dimitriadis Kyriakos , Tsioufis Konstantinos 
Published: May 2024

Objective:
Obesity is significantly associated with hypertension and cardiovascular outcomes. However, little is known about the impact of aldosterone blockade using eplerenone on hypertensive obese patients as first line therapy. The aim of this study is to compare the efficacy between eplerenone-based strategy and irbesartan-based strategy in obese hypertensive individuals, regarding blood pressure reduction and change of echocardiographic diastolic function parameters.

Design and method:
HEBRO (antiHypertensive treatment with Eplerenone vs. irBesartan in hypeRtensive Obese patients) is a prospective, randomized, open-labeled, multicenter trial enrolled 112 obese hypertensive patients aged 30-75 years old, evaluated by office and out-of-office BP measurements. Patients were randomized to either 25 mg eplerenone twice (59) or 150 mg irbesartan (53) once daily. The primary endpoint is the difference in ambulatory BP measurements after 6 months follow-up period and secondary endpoint is difference in diastolic function parameters.

Results:
We enrolled 112 patients, 54.6 years old, 53% female, mean BMI 34.4 kg/m2 and mean eGFR 82.5 ml/min/1.73m2. Diastolic function was assessed at baseline and 6 months, by calculating left ventricular mass index (LVMI) and left atrial volume index (LAVI). At baseline, mean LVMI was 102.9 g/m2 ± 18.1 in the irbesartan group vs. 110.1 g/m2 ± 30.5 in the eplerenone group, p=0.237. The change of LVMI was – 5.6 ± 17.8 vs. -4.5 ± 22.6, p=0.843. At baseline, mean LAVI was 30.6 ml/m2 ± 16.9 in the irbesartan group vs. 30.7 ml/m2 ± 11.1 in the eplerenone group, p=0.979. The change of LAVI in the two study arms was +0.9 ± 6.7 vs. -3.6 ± 11.5, p=0.063, respectively. Although, the result was not statistically significant, there was a numerical trend towards the eplerenone arm.

Conclusions:
There were no statistically significant differences at baseline and follow-up evaluation of changes in left ventricular and left atrial geometry, though there is a numerical trend towards eplerenone arm, regarding reduction of LAVI after 6 months follow-up period. Patients are currently still enrolled and data on larger pool are anticipated.
ANTI-ISCHEMIC EFFECTIVENESS OF TRIMETAZIDINE 80 MG ONCE DAILY IN PATIENTS WITH STABLE ANGINA AND A HISTORY OF MYOCARDIAL INFARCTION. RESULTS OF THE METHOD STUDY
Authors: Elyubaeva Irina , Barbarash O L , Polikutina O M , Khomitskaya Y V , Kvasnikov B B , Burtsev Y P 
Published: May 2024

Objective:
To describe the anti-ischemic effectiveness of trimetazidine 80 mg once daily (TMZ OD) in outpatients with symptomatic stable coronary artery disease (CAD) and a history of myocardial infarction (MI) in real clinical practice.

Design and method:
The METHOD (NCT05210465) was a 6-month single-center observational study. Adult outpatients with symptomatic stable CAD and a history of MI who had been recommended to initiate TMZ OD in addition to the standard antianginal therapy were included. Myocardial ischemia was assessed by stress echocardiography (STE) in speackle tracking mode (STM). Primary outcome was the mean change in left ventricular global longitudinal strain (LV GLS) at visit 2 (∼ 6 months) compared to baseline (BL). Main secondary outcomes were mean changes in regional peak systolic deformation (RPSD), global post systolic index (PSI) and the number of anginal attacks per week. Data from patients who completed the study were analyzed.

Results:
Of 36 included patients, 41.7% (15/36) were female, mean age was 62.3 (±7.6) years. Mean time since CAD diagnosis and occurrence of MI was 4.5 (±5.3) and 2.9 (±3.4) years, respectively. Proportions of patients with diabetes, coronary percutaneous revascularization or hypertension were 30.6% (11/36), 88.9% (32/36) and 88,9 (32/36), respectively. Before initiation of TMZ OD, all patients had been taking beta-blockers (36/36), and 33.3% (12/36) calcium channel blockers. LV GLS was significantly improved by -2% (p <0,001) from -13.3% (3.6) at BL to -15.3% (3.7) at V2. There was a significant improvement in RPSD of apex (-1.2., p = 0,042), apical anterior (-2.6% p <0,001) and lateral (-1.5%, p= 0,032) segments of LV myocardium. Compared to BL, mean PSI was significantly changed from 33.3% to 28.9% (-4.3%, p=0,004) at V2. Angina frequency significantly decreased from 1.0 (1.4) to 0.1 (0.4) attacks per week (p<0.001). No adverse events were reported.

Conclusions:
Treatment with TMZ OD demonstrated significant decrease in myocardial ischemia and improvement in angina control in patients with CAD and a history of MI and was well tolerated.
THE PRONOSTIC VALUE OF NOCTURNAL BLOOD PRESSURE IN UNTREATED ADULT HYPERTENSIVES FROM ALGERIAN POPULATION
Authors: Bounab Lyamine , Gacemi Sofiane , Chemli Mourad , Bouamra Abderezak 
Published: May 2024

Objective:
The aim of our work is to study the prevalence of nocturnal blood pressure patterns in our Algerian population of untreated adult hypertensives and its impact on target organ damages.

Design and method:
We recruited 304 untreated adult hypertensives. All our patients underwent 24-hour ABPM, and the following target organe damages assessment: ACR (urinary albumin/creatinine), echocardiography, fundoscopy, and carotid ultrasound. Our patients were classified according to nocturnal blood pressure into two groups: nocturnal hypertensive (NH: BP> or = 120/70) and nocturnal normotensive (NN: BP<120/70). We carried a descriptive study of hypertension prototypes, followed by an analytic study in search of predictors of target organ damages (cardiac, renal and vascular).

Results:
The mean age was 46±12 years, with 82% males. The prevalence of patterns according to nocturnal blood pressure were: NH (n=250; 82.2%) vs NN (n=54; 17.3%). In the bivariate analysis, there was a significant difference between two groups for the following damages: cardiac (HN=52% vs NN=34.6; P=0.01), renal (HN=27.5% vs NN=12.8%; P=0.02) and vascular (HN=25% vs NN=2%; P<0.001). On multivariate analysis, indexed LV mass was correlated with waist circumference (B=0.34, P=0.01) and diurnal systolic BP (SBP) (B=1.37; P<0.001). ACR was correlated with glycemia (B=0.33; P=0.002) and nocturnal SBP (B=0.64; P=0.01). Intima-media thickness was correlated with age (B=0.009, P<0.001) and nocturnal SBP (B=0.004, P<0.001). On logistic regression, cardiac damage was correlated with age (OR=1.05; P=0.02), BMI (OR=1.21; P=0.02) and diurnal SBP (OR=1.08; P=0.003). Renal damage was correlated with glycated hemoglobin (OR=1.6; P=0.04). Vascular damage was correlated with age (OR=1.3; P<0.001) and nocturnal diastolic BP (DBP) (OR=1.07; P=0.002).

Conclusions:
The nocturnal hypertension are prevalent in our population. nocturnal hypertension is a predictor of renal and vascular damages. In contrast, diurnal hypertension is a predictor of cardiac damage. These results confirm the literature data on the prognostic value of nocturnal blood pressure. We suggest an active screening for nocturnal hypertension by using ABPM in the hypertensive population with high cardiovascular risk.
CLINICAL FEATURES OF MANAGEMENT OF PATIENTS WITH HYPERURICEMIA IN COMBINATION WITH ARTERIAL HYPERTENSION AND CHRONIC HEART FAILURE
Authors: Zalem Irina 
Published: May 2024

Objective:
To evaluate clinical and diagnostic features of patients with AH and CHF combined with hyperuricemia.

Design and method:
The study included 49 patients divided into two groups: Group 1 - 32 patients with AH and CHF on the background of elevated uric acid (UA) 24(75%) men, 8 (25%) women, median age 66.0 (59.0;75.0) years and Group 2 - 20 patients with AH and CHF without hyperuricemia: 13 (65%) men, 7 (35%) women, median age 69.0 (63.0;73.5) years). Clinical data, laboratory and instrumental investigations were analyzed.

Results:
Comparative analysis showed that patients in the group with normal MC levels compared to patients in the hyperuricemia group had higher SCF (62 and 57 ml/min/1.73 m2 (p=0.04) respectively). A negative correlation of medium strength between blood MC level and LVEF was also observed, with lower values in group 1 patients (52.4 and 59.5, respectively). Differences were also observed when NTproBNP level was determined (385.5-2500.4) (R=-0.64 p<0.01). Separately it should be noted that out of 32 patients included in the study, 6 patients showed resistance to standard doses of diuretics, which required intensification of therapy in the form of increasing their dose. In a comparative analysis, MC levels were significantly higher in patients who subsequently underwent intensified therapy compared with patients with a satisfactory response to standard diuretic doses [543.8 (459.4-719.9) and 485(422.4-605.4), respectively; p=0.011].

Conclusions:
The performance of this study further confirmed the high prevalence of hyperuricemia in AH and CHF. Moreover, the severity of hyperuricemia increased in parallel with the increase in the severity of CHF (according to NYHA FC and NUP concentration). Therefore, the patient management strategy should include screening and correction of purine metabolism. One of the main tasks in the algorithm of management of patients with hyperuricemia is rationalization of therapy with the main focus on cardiovascular risk factors and metabolic safety of drugs.
PULSE WAVE ANALYSIS VARIABLES CAN PREDICT ATRIAL FIBRILLATION, HYPERTENSION, HEART FAILURE AND BUNDLE BRANCH BLOCKS
Authors: Mozos Ioana , Baba Mirela , Moroz Simina , Bucur Adina , Jianu Daniela , Maris Mihaela , Gug Cristina , Luca Constantin Tudor 
Published: May 2024

Objective:
Pulse wave velocity is a known surrogate marker of cardiovascular events. The present study aimed to find variables of pulse wave analysis able to predict cardiovascular disorders.

Design and method:
A total of 76 patients, aged 63±10 years, with cardiovascular disorders, underwent pulse wave analysis using a Mobil-O-Graph. The following variables were assessed: augmentation index (AI), pulse wave velocity (PWV), mean arterial pressure (MAP) and pulse pressure (PP).

Results:
Hypertension, atrial fibrillation, heart failure and bundle branch blocks were diagnosed in 65 (85.53%), 6(7.89%), 5(6.58%) and 5(6.58%) patients, respectively. PWV, AI, MAP and PP were, as follows: 9.29±1.46 m/s, 24.71±16.2%, 105.57±17.71 mmHg and 49.78±13.17 mmHg, respectively. AI was a significant predictor of atrial fibrillation (AUC=0.74, 95%CI: 0.627 to 0.834, p= 0.0332). PWV significantly predicted hypertension (AUC=0.738, 95% CI: 0.624 to 0.832, p=0.0001), while MAP and PP significantly predicted bundle branch blocks (AUC=0.763 and 0.663, 95% CI was 0.652 to 0.853 and 0.546 to 0.768, p was 0.0046 and 0.0489, respectively.

Conclusions:
Pulse wave velocity, augmentation index, pulse pressure and mean arterial pressure are valuable predictors of hypertension, atrial fibrillation and bundle branch blocks, respectively.
DOPAMINE-DEPENDENT FORM OF ARTERIAL HYPERTENSION IN PATIENTS WITH A HIGH DEGREE OF NUTRITIONAL-CONSTITUTIONAL OBESITY
Authors: Lizogub Viktor , Dolynna Olga , Sobol Viktoria , Kupchynska Olena , Motsak Tetiana 
Published: May 2024

Objective:
Despite significant advances in the study of the pathogenesis, clinical picture and treatment of arterial hypertension (AH), the role of the dopaminergic system in obese patients remains insufficiently studied.
Aim: To evaluate the effectiveness of the use of D2 receptor agonists in patients with arterial hypertension (AH) and nutritional-constitutional obesity (NCO) of the 3rd degree.

Design and method:
We examined 151 patients aged 30-60 years (65 men, 86 women) with AH and NCO. The control group (CG) consisted of 78 hypertensive patients. Daily monitoring of blood pressure (BP), body mass index (BMI), daily excretion of dopamine, plasma levels of aldosterone, prolactin, leptin, adrenaline, creatinine, lipid spectrum - obese patients were divided into two groups. In addition to basic antihypertensive therapy, patients 1 group (n=74) were prescribed bromocriptine (0.08 mg/kg in three doses), patients 2 group (n=71) – pramipexole (0.125 mg 3 times/day).

Results:
During the baseline examination, daily dopamine excretion in obese patients was 1.6 times lower (p<0.001) than in control group patients. A negative correlation was found between dopamine excretion and BMI (r=-0.6; p<0.001). In patients with hypertension and NCO, a basic examination revealed a significant (p<0.001) increase in the plasma concentrations of prolactin (2.5 times), aldosterone (1.5 times), leptin (3.4 times) and adrenaline (by 1.3 times) compared to CG. Taking bromocriptine for 8 weeks in patients 1 group led to a decrease in blood pressure, BMI and plasma levels of prolactin and aldosterone. In 41.9% of patients 1 group with dopamine excretion levels less than 300 nmol/day, normalization of blood pressure was observed. In patients 2 group pramipexole was discontinued due to side effects.

Conclusions:
In the majority of patients with hypertension and NCO (58.1%), the main pathogenetic factor in increasing blood pressure is a low level of dopamine and a compensatory increase in prolactin, aldosterone, and adrenaline in plasma. The use of the D2-dopamine receptor agonist bromocriptine helps to normalize the daily excretion of dopamine, reduce the levels of prolactin, aldosterone and adrenaline, blood pressure and BMI. The use of pramipexole in patients with hypertension and NCO seems inappropriate