bluuebunny/crossref_metadata_2025_split huggingface dataset:
NO DIFFERENCE IN RENIN BETWEEN NORMOTENSIVE AND HYPERTENSIVE PATIENTS WITH RENAL FIBROMUSCULAR DYSPLASIA
Authors: Kroon Abraham A , Schutten Monica Tj , Zelis Piet , Houben Alphons Jhm , De Leeuw Peter W 
Published: May 2024

Objective:
Fibromuscular dysplasia (FMD) of the renal arteries is considered to be a cause of renovascular hypertension. However, a substantial portion of patients with renal FMD remains normotensive. We hypothesized that hypertensive patients with renal FMD secrete more renin than their normotensive counterparts.

Design and method:
In patients scheduled for renal angiography, we simultaneously collected blood samples for renin determination from the renal artery (A) and renal vein (V) of both kidneys. Renin was measured by a direct immunoradiometric assay. In each patient, we calculated the arterial-venous concentration increment in renin as (V-A)/A for both kidneys separately. In addition, we determined renin secretion rate as (V-A) times flow in those patients in whom we could measure renal blood flow by the xenon-washout technique.

Results:
A total of 132 FMD patients were studied of whom 62 (47%) were normotensive. There were no differences between the two groups in age (on average 54 years in both) and in the proportion of females (91%). Most patients had experienced a spontaneous coronary artery dissection earlier.
Arterial renin levels were 24.4+6.3 mIU/L in the normotensive group and 27.2+5.1 mIU/L in the hypertensive group (difference not significant). Likewise, no differences in renal venous renin from either kidney were apparent between the groups. The renin concentration increments across the kidney varied from 13 to 64% but again without a difference between normotensives (13-62%) and hypertensives (15-64%). Finally, in the 53 patients in whom renal blood flow was measured, no difference in renin secretion rate between normotensives and hypertensives was found.

Conclusions:
Although blood pressure may vary substantially between patients with renal FMD, there is no difference in renin release between the normotensive and the hypertensive ones. Thus, other factors besides renin must contribute to the development of high blood pressure in such patients.
HYPERTENSIVE NEPHROPATHY: TRANSCRIPTOMICS OF KIDNEY BIOPSIES PREDICTS LONG TERM OUTCOME AND IDENTIFIES THERAPEUTIC TARGETS
Authors: Chen Tony , Furriol Jessica , Landolt Lea Zoe , Hallan Stein Ivar , Øvrehus Marius Altern , Knoop Thomas , Scherer Andreas , Eikrem Øystein , Marti Hans -PETER 
Published: May 2024

Objective:
Hypertensive nephropathy (HN) represents a major cause of chronic kidney disease, but it is incompletely understood why some patients show disease progression. Our project aim is to identify potential markers of disease progression and novel therapeutic targets.

Design and method:
Adult patients (n=43; n=16 females, mean age 53 years) with biopsy-verified HN were categorized as ’early’ (estimated glomerular filtration rate (eGFR) >45 ml/min/1.73m2) or ’late’ disease (eGFR <45 ml/min/1.73m2) at the time of biopsy. Patients were further divided into “stable” (eGFR decline <3 ml/min/year) or “progressive” (eGFR decline >3 ml/min/year or start of renal replacement therapy) after median follow-up of 10 years (5-22). TruSeq Exome sequencing was executed after RNA extraction (miRNeasy FFPE kit, Qiagen) at Novogene, Cambridge, UK. Quality control and data analysis was performed using R Studio (v4.2.0) and QIAGEN Ingenuity Pathway Analysis.

Results:
We analyzed the following subgroups of HN patients: early stable (ES, n=11), early progressive (EP, n=11), late stable (LS, n=9) and late progressive (LP, n=12). Differentially expressed genes (DEG, fold change (FC) >1.5 and p-value < 0.05) were identified, with n=265 in ES vs. EP, and n=674 in LS vs. LP.
Principal component analysis (PCA) showed separation of ES vs. EP and LS vs. LP, as depicted in Figure 1A and B. K-nearest neighbour (KNN) analysis of DEG identified a 6-gene classifier in LS vs. LP (19/21 samples correctly classified), while IER5L and CNTNAP5 were the top 2-gene classifier in ES vs. EP (20/21 samples). These classifiers, as well as other DEGs such as PER1, YB1, TIMP3, ADAMTS4, IGFBP5 and EGF could represent novel targets to inhibit disease progression.
Differentially regulated pathways were associated with regulation of TP53 activity and circadian rhythm involving melatonin metabolism in ES vs. EP, and metabolic processes related to water-soluble vitamins, glutathione and sphingolipids in LS vs. LP.

Conclusions:
Transcriptomic profiling from diagnostic kidney biopsies with HN can distinguish future disease progression from non-progression and may identify novel therapeutic targets.
HIGHER 24-HOUR URINE SODIUM-TO-POTASSIUM RATIO IS ASSOCIATED WITH WORSE RENAL OUTCOME, INDEPENDENT OF HYPERTENSION
Authors: Zwager Charlotte , Vliet Myrthe Van , Slagmolen Famke , Kwok Kevin , Vogt Liffert , Engberink Rik Olde 
Published: May 2024

Objective:
Low sodium and high potassium intake are advised to control blood pressure and may improve long term cardiorenal outcomes. The optimal potassium intake for patients with chronic kidney disease remains to be defined. We investigated whether the 24-hour urine sodium-to-potassium ratio (Na/K-ratio), which incorporates estimates of both sodium and potassium intake, could predict long-term renal outcome.

Design and method:
We selected adult outpatients of a Dutch tertiary hospital who collected at least one 24-hour urine collection with available sodium and potassium measurements between 1998-2023. Patients with a history of dialysis or kidney transplantation were excluded. We examined the need for persistent renal replacement therapy (RRT), defined as dialysis or kidney transplantation, using Cox regression. The association between the 24-hour urine Na/K-ratio and the estimated glomerular filtration rate (eGFR) slope was assessed using linear regression in patients who had >2 eGFR measurements available in >2 years. The linear regression analysis was adjusted for age, sex, baseline eGFR, diabetes mellitus and hypertension. In the Cox regression analysis, we additionally adjusted for the interaction between the 24-hour urine Na/K-ratio and baseline eGFR. Hypertension was defined as a clinical diagnosis or an office blood pressure >139/89 mmHg.

Results:
We included 720 patients aged 50±15 years, of whom 52% were male, 58% had hypertension and 31% diabetes mellitus. The baseline eGFR was 64±34 ml/min/1.73m2. The 24-hour urine Na/K ratio was 2.5±1.2 in a median number of 1 (IQR=1-2) urine collection. During a median follow-up of 11.2 (14.0) years, 29% of patients needed RRT. In 575 patients with sufficient eGFR measurements (mean 12±8 measurements per subject) the median annual eGFR decline was 1.51(IQR=0.49-3.98) ml/min/1.73m2.
Every unit increase in the 24-hour urine Na/K-ratio was associated with a 19% higher risk for persistent RRT need (HR 1.19, 95% CI 1.03-1.39; p=0.02) and an additional 0.44 ml/min/1.73m2 (95% CI -0.83, -0.04; p=0.03) decline in eGFR.

Conclusions:
This study suggests that higher 24-hour urine Na/K-ratio is associated with faster kidney function decline and the need for RRT, independent of hypertension, in a selected group of outpatients.
INFLUENCE OF MULTIPLE RISK FACTOR CONTROL LEVEL ON CARDIOVASCULAR OUTCOMES IN HYPERTENSIVE PATIENTS
Authors: Zhuang Miaomiao , Peng Xinyi , Cai Jun 
Published: May 2024

Objective:
The relationship between level of baseline risk factor control and cardiovascular outcomes in hypertensive patients with blood pressure intervention is not well understood.
It is unclear whether the level of baseline risk factor control is persuasively associated with cardiovascular outcomes in hypertensive patients with blood pressure lowering strategy.

Design and method:
We performed a post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. 8337 participants with complete demographics and clinical data were involved in the analysis and analyzed for seven risk factors (BMI, low-density lipoprotein cholesterol, fast blood glucose, smoking, alcohol consumption, physical activity, and renal function). The primary outcome was a composite of cardiovascular events and death from any causes. Cox proportional hazards models were used to calculate hazard ratio and estimate association between risk factor control and cardiovascular outcomes.

Results:
A total of 8337 participants were involved in the analysis and the mean follow-up period of 3.19±0.66 years. Patients were categorized according to numbers of risk factors control: more than(or including) 6 risk factor control, 4 risk factor control, 5 risk factor control, and less than(or including) 3 risk factor control. Adjusted hazard ratio for patients in group with most risk factor control were1.95 (95% confidence interval [CI]: 1.37-2.77) compared with controls. In this analysis, protective effects of multiple risk factor control were not modified by systolic blood pressure (SBP) intervention (P for interaction=0.71).

Conclusions:
A stepwise association was observed between decreasing number of risk factor control and increasing risk of cardiovascular outcomes and all-cause mortality in hypertensive patients. Comprehensive risk factor control strategies are needed to reduce the risk of cardiovascular diseases and mortality.
WORLD HYPERTENSION DAY 2023 – THE PRO-HEALTH CAMPAIGN IN BIALYSTOK, POLAND
Authors: Piotrowska Weronika , Gawryluk Mateusz , Zbroch Aleksandra , Bazarewicz Jakub , Anikie Katarzyna , Malinowska Dominika , Skorulska Iwona , Siwik Marcin , Panas Zuzanna , Szczerbinska Natalia , Zdanska Adrianna , Wilk-sledziewska Katarzyna , Zbroch Edyta 
Published: May 2024

Objective:
The study was based on a pro-health campaign of World Hypertension Day 2023.
The aim of the study was to evaluate the incidental blood pressure (BP), heart rate (HR), glycemia and electrocardiography (EKG) among residents of Bialystok, Poland and the surrounding region.

Design and method:
192 random participants were included (53.3% female). Each person completed a survey consisting of weight, height, age, education status, place of residence, smoking, physical activity, diagnosed cardiovascular disease and diabetes. BP, HR, glycemia and ECG were assessed by the medical team.
Data were analyzed by dividing by sex, age above 65 years or below, BP above 140/90 mmHg, body mass index (BMI) above 30, glycemia above 120 mg/dl and comorbidities.

Results:
Average systolic blood pressure (SBP) was 135.7 mmHg, diastolic blood pressure (DBP): 79.9 mmHg, HR: 76/min, glycemia: 99.3 mg/dl, BMI: 26.7. 85% of participants resided city. 30% were higher educated. 33.3% performed no physical activity.
Men had significantly higher SBP and DBP than women. Participants with BP above 140/90 mmHg presented significantly elevated BMI and HR. 63% of them were diagnosed with hypertension, and ECG abnormalities were 1.6 times more common here.
In the age above 65years vs. lower then 65 years group, SBP was not significantly different while DBP was lower (77.5 vs 83.1 mmHg, p-0.002). Diabetics had higher BMI and SBP compared to non-diabetics.
Participants diagnosed with hypertension had higher BMI, SBP and DBP.
BMI above 30 was not associated with higher BP or HR. No significant differences in BP and HR were found between smokers vs nonsmokers, physically active vs non-active, or according to place of residence. The awareness of prevention of hypertension was not satisfactory in all studied group.

Conclusions:
BP values of Bialystok's, Poland female residences were in satisfactory ranges while male had it in-creased, specially SBP. BP above 140/90 mmHg was related to higher BMI and HR as well as to abnormalities in ECG. Surprisingly, persons with diagnosed hypertension or diabetes had worse BP values.
There is a sustained need to increase a general awareness of hypertension prevention and a healthy lifestyle.
RENAL POTASSIUM EXCRETION IS NOT A FIXED PERCENTAGE OF INTAKE
Authors: Vliet Myrthe Van , Rauh Manfred , Vogt Liffert , Titze Jens , Engberink Rik Olde 
Published: May 2024

Objective:
Because of its blood pressure lowering effects, high potassium intake could help to reduce cardiovascular events. As a significant amount of potassium is lost via stool, the World Health Organization advices to multiply 24-hour renal potassium excretion by 1.3 for estimation of dietary intake. We analyzed whether this 1.3 factor varies over time in healthy volunteers and tested whether factors associated with tissue cation storage, namely sodium intake, aldosterone, cortisol and urine volume, affect the renal potassium excretion.

Design and method:
We performed a post-hoc analysis of the Mars sodium balance studies in which ten healthy male participants consumed a fixed salt (6, 9 and 12 grams/day for periods >29 days) and potassium intake (4 grams/day) for 105 (n=4) and 205 days (n=6). For the entire study period, all urine was collected in 24-hour aliquots. We calculated the percentage of potassium intake that was excreted in the corresponding 24-hour urine collection during steady-state. Using a multivariable mixed-effects model, we assessed whether this percentage was associated with sodium intake, potassium intake, urinary aldosterone, urinary cortisol and urine volume.

Results:
Overall, the median renal potassium excretion was 80% of potassium intake, but percentages ranged from 24% to 304%. Within participants the interquartile range of renal potassium excretion was 25% and between participants 21%. Increased sodium intake was associated with a higher percentage of renal potassium excretion (P<0.05), whereas increased potassium intake was associated with a lower percentage of renal potassium excretion (P<0.001). There was a significant positive interaction between the effects of sodium and potassium intake (P<0.001; figure A). Additionally, urinary aldosterone (figure B), urinary cortisol (figure C) and urine volume (figure D) were associated with a higher percentage of renal potassium excretion (P<0.001).

Conclusions:
The percentage of ingested potassium that is excreted in urine varies considerably within and among subjects. Sodium intake, potassium intake, urinary aldosterone and cortisol levels, and urine volume independently affect the fraction of the ingested potassium that is excreted by the kidneys during steady-state. Our results suggest that the WHO's standard 1.3 conversion factor may lead to inaccurate estimation of potassium intake.
EFFECTS OF CHRONIC CANNABIDIOL DOSING ON BRAIN BLOOD FLOW: INSIGHTS FROM THE HYPER-H21-4 TRIAL
Authors: Kumric Marko , Supe-domic Daniela , Vrdoljak Josip , Dujic Goran , Urlic Hrvoje , Dujic Zeljko , Bozic Josko 
Published: May 2024

Objective:
HYPER-H21-4 was a randomized, triple-blind, crossover study that demonstrated that 5 week cannabidiol (CBD) supplementation reduces average 24h blood pressure (BP) in patients with arterial hypertension. The aim of this sub-study was to establish whether CBD elicits significant effect on the brain blood flow and memory in these patients.

Design and method:
The trial was designed as a triple-blind randomized crossover trial. For this prespecified sub-analysis, we included 15 hypertensive patients. Patients were randomized to receive either oral CBD or placebo for the period of 5 weeks. After a 2-week washout, patients were crossed over to alternate therapy (CBD/placebo) (Figure 1). Patients visited the lab at the start and at the end of each dosing period (four times in total). Magnetic resonance imaging (MRI), with specific focus on measurement of the blood flow through internal carotid artery using 4D flow technique. Variables of interest were mean flow (mL/min) and Pulsatility Index (AU). In addition, at each visit, venous blood samples were obtained. Finally, patients fulfilled a Memory Complaint Questionnaire (MAC-Q) at the start at the end of the study (after 12 weeks).

Results:
After 5 weeks of CBD supplementation, no significant changes in mean flow (time: P = 0.461, group: P = 0.657, interaction: P = 0.285) or Pulsatility Index (time: P = 0.573, group: P = 0.640, interaction: P = 0.970) in internal carotid artery in comparison to 5 weeks of placebo. In addition, significant reduction after in MAC-Q score was observed (25.8 ± 2.4 vs. 22.6 ± 3.8, P = 0.036), indicating reduced complaint on memory loss.

Conclusions:
The results of the HYPER-H21-4 trial indicate that chronic CBD supplementation leads to BP reduction. However, despite the fact that CBD supplementation improved self-reported memory abilities, no differences in comparison to placebo were noted in terms of blood flow through internal carotid artery, indicating lack of CBD-mediated effect.
ASSOCIATION OF SOCIEOCONOMIC FACTORS, LIFE STYLE WITH CHOLESTEROL IN GENERAL ADULT POPULATION
Authors: Bilobrk Matea , Bilajac Lovorka , Glavic Mihaela Marinovic , Jelakovic Ana , Fucek Mirjana , Pecin Ivan , Jelakovic Bojan 
Published: May 2024

Objective:
The relationship between socioeconomic factors, behavior and LDL cholesterol values is a complex process that includes various aspects of an individual's life and environment. The aim of the work is to determine the association of socioeconomic factors and health behavior with LDL cholesterol values.

Design and method:
Through cross-sectional research, we analyzed 1,800 subjects from the general adult population of Croatia (random sample of general adult population in Croatia included in the Epidemiology of Hypertension in Croatia -2 project). For the purposes of the research, a structured questionnaire was used, which consists of data on socioeconomic status and lifestyle. Cholesterol and LDL values were determined from fasting blood samples.

Results:
In the whole group 58.2% of respondents had increased total cholesterol values. However, only 24.96% declare that they had dyslipidemia, which indicates a low awareness of the existence of risks. Total cholesterol values were positively correlated with personal monthly income (r=0,41 p=0.041), professional education (p=0.021), type of work (p=0.011) and are also associated with an unhealthy lifestyle. We found a negative correlation with physical activity (r=-0,10 p<,05). Elevated LDL cholesterol showed association with socioeconomic factors such as personal monthly income, professional education, but there was no significant correlation with drinking black coffee, alcohol consumption, or physical activity. The consumption of fruits and vegetables was related to the occurrence of dyslipidemia and the correlation was statistically significant (r=-0,10, p <0.05).

Conclusions:
Poor awareness for hypercholesterolemia was observed in our general population. Socioeconomic factors and health behavior are interrelated in influencing total and LDL cholesterol levels. General population should be more educated to increase awareness about this important cardiovascular risk factor.
POOR LIFE STYLE IS ASSOCIATED WITH SOCIOECONOMIC STRATA - TARGETED PUBLIC HEALTH INTERVENTIONS ARE NEEDED
Authors: Bilobrk Matea , Bilajac Lovorka , Glavic Mihaela Marinovic , Jelakovic Ana , Fucek Mirjana , Jelakovic Bojan 
Published: May 2024

Objective:
The socioeconomic distribution of modifiable risk factors for cardiovascular disease (CVD) is an important aspect of public health research. Understanding how these risk factors vary between different socioeconomic strata is crucial for the development of targeted interventions and policies to reduce the burden of CVD. The aim of the study is to determine the relationship between socioeconomic factors and variable factors for CVD.

Design and method:
The cross-sectional survey included 1,800 participants (random sample of general adult population in Croatia included in the Epidemiology of Hypertension in Croatia -2 project). Socioeconomic status and lifestyle data (physical activity, smoking, alcohol, black coffee) were collected using a structured questionnaire. Blood pressure was measured using an oscilometric device and the data collected was analysed using appropriate statistical methods.

Results:
In the whole group there were 25% smokers and 25% ex-smokers. Only 34.5% reported that they practice physical activity at least twice a week with a very low (51.7%) or moderate intensity (48.3%). A correlation was found between alcohol consumption and average monthly personal income (r=0.24, p<0.05), educational level (r=0.18, p<0.05), and type of work (r=-0.10 p<0.05). Black coffee consumption is complex and depends on individual preferences, cultural practices and other factors not necessarily related to socioeconomic status, but a relationship was found between black coffee consumption and income (p<0.05). and marital status (r=-0.20 p<0.05). The results show that the type of work has a significant influence on the amount and type of physical activity (p<0.05.).

Conclusions:
Understanding links between socioeconomic status and modifiable lifestyle risk factors is crucial for the development of targeted public health interventions. Eliminating inequalities in access to resources and opportunities can contribute to more equitable cardiovascular health outcomes between different socioeconomic groups.
DISPARATE IMPACT OF PRIMARY HYPERTENSION ON RIGHT VERSUS LEFT HEART VENTRICLES OF MALES AND FEMALES WILD TYPE AND HAIRLESS STRAIN OF SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Andelová Katarína , Sykora Matus , Bacova Barbara Szeiffova , Farkasova Veronika , Stankovicova Tatiana , Knezl Vladimir , Pravenec Michal , Tribulova Narcisa 
Published: May 2024

Objective:
Poor adherence to lifestyle changes and antihypertensive drugs contributes to increase a risk for malignant cardiac arrhythmias. Hypertension contributes to myocardial structural remodeling, abnormalities in connexin43 (Cx43) which promote electrical instability and mechanical dysfunction. However, it is not known whether changes are confined solely to left heart ventricle (LV) or there is response of right heart ventricle (RV). SHR mimic human primary hypertension and hairless SHR is model of temperature acclimation characterized by increase thermogenesis. Aim of the study was to explore key factors involved in development of malignant arrhythmias and progression to heart failure, in left and right heart ventricles, of males and females wild type (WT) and hairless SHR.

Design and method:
6-month-old males and females WT and hairless SHR and normotensive WKY strain of rats were housed at standard 22°C. Biometric parameters, including electro- and echo-cardiographic were registered. LV and RV tissue was used for immuno-labelling of Cx43 to detect its topology and western blotting for determination protein levels of Cx43, PKA, PKC∊, PKCδ and markers of extracellular matrix (ECM) remodelling: TGFβ, SMAD2/3, MMP-2 and collagen-1. Susceptibility of the heart to electrically-inducible VF was tested using isolated perfused heart technique.

Results:
Comparing to WKY, QT and QRS intervals were prolonged in WT SHR with normalisation in hairless SHR. Hypertension resulted in decrease in Cx43 with its abnormal topology in LV of males and less in hairless SHR but not in females. Cx43 levels and its topology were preserved in RV regardless rat strain and sex. There were no differences in protein levels of ECM-markers when comparing LV and RV in all strains. PKC∊ and PKCδ were increased in RV versus LV in both SHR strains. Hairless SHR males and females were less prone to inducible VF compared to WT SHR.

Conclusions:
Findings point out that hypertension-induced pro-arrhythmic disorders of Cx43 are related to the left while not to right heart ventricle in both hypertensive strains. There is a benefit of cold acclimation in hypertension that may contribute, to the protection from malignant cardiac arrhythmias and mechanical dysfunction. Supported by Vega2/0002/20,2/0006/23 and APVV21-0410.