bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF TWO SINGLE-PILL DUAL COMBINATION ANTIHYPERTENSIVE THERAPIES IN CHINESE PATIENTS
Authors: Huang Qi -FANG , Zhang Di , Luo Yihong , Hu Kun , Wu Qiong , Qiu Hailong , Xu Fei , Wang Mei -Ling , Chen Xin , Li Yan , Wang Ji -Guang 
Published: May 2024

Objective:
Current hypertension guidelines recommend combination of an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker with a calcium-channel blocker or thiazide diuretic as initial antihypertensive therapy in patients with monotherapy uncontrolled hypertension. However, to what extent these two different combinations are comparable in blood pressure (BP) lowering efficacy and safety remains under investigation, especially in the Chinese population. We investigated the BP lowering efficacy and safety of the amlodipine/benazepril and benazepril/hydrochlorothiazide dual therapies in Chinese patients.

Design and method:
In a multi-center, randomized, actively-controlled, parallel-group trial, we enrolled patients with stage 1 or 2 hypertension from July 2018 to June 2021 in 20 hospitals and health centers across China. Of the 894 screened patients, 560 eligible patients were randomly assigned to amlodipine/benazepril 5/10 mg (n = 282) or benazepril/hydrochlorothiazide 10/12.5 mg (n = 278), with 213 and 212 patients, respectively, who completed the study and had a valid repeat ambulatory BP recording during follow-up and were included in the efficacy analysis.

Results:
In the efficacy analysis (n = 425), the primary outcome, 24-h ambulatory systolic BP reduction, was -13.8±1.2 mmHg in the amlodipine/benazepril group and -12.3±1.2 mmHg in the benazepril/hydrochlorothiazide group, with a between-group difference of -1.51 (p = 0.36) mmHg. The between-group differences for major secondary outcomes were -1.47 (p = 0.18) in 24-h diastolic BP, -2.86 (p = 0.13) and -2.74 (p = 0.03) in daytime systolic and diastolic BP and 0.45 (p = 0.82) and -0.93 (p = 0.44) in nighttime systolic and diastolic BP. In the safety analysis (n = 560), the incidence rate of dry cough was significantly lower in the amlodipine/benazepril than benazepril/hydrochlorothiazide group (5.3% vs 10.1%, p = 0.04).

Conclusions:
The amlodipine/benazepril and benazepril/hydrochlorothiazide dual therapies were comparable in ambulatory systolic BP lowering. The former combination, compared with the latter, had a greater BP lowering effect in the daytime and a lower incidence rate of dry cough.
EFFECTIVENESS OF CONSERVATIVE TREATMENTS ON CHRONIC VENOUS DISEASE SYMPTOMS AND QUALITY OF LIFE IN HYPERTENSIVE PATIENTS: A SUBGROUP ANALYSIS FROM THE VEINSTEP OBSERVATIONAL STUDY
Authors: Feodor Toni , Mezalek Zoubida Tazi , Ochoa Alejandro José González , Ulloa Jorge Hernando 
Published: May 2024

Objective:
Chronic venous disease (CVeD) and arterial hypertension (HTA) are common circulatory system disorders associated with significant patient and healthcare burdens. Despite their high prevalence, patients presenting with both conditions are poorly studied resulting in a lack of evidence regarding optimal CVeD management in this specific group. This VeinStep sub-analysis evaluates the effectiveness of conservative treatments on CVeD symptoms and QoL in hypertensive patients.

Design and method:
VeinStep was an international, observational, prospective study, involving outpatients with symptomatic CVeD. Patients underwent a clinical examination to identify CVeD signs using CEAP classification. Main outcomes after 4 weeks were intensity of symptoms (VAS) and QoL using CIVIQ14. Changes over time were analyzed using a Wilcoxon test. Between-group comparisons for most prescribed venoactive drugs (VADs) used ranked ANCOVA with baseline value as covariate, adjusted on main baseline characteristics.

Results:
Among the 6084 patients analyzed in VeinStep, 1230 had HTA. They were more frequently men (28.9% vs 20.3%), older (Mean age±SD: 61.5±11.5 vs 47.9±13.0 yrs), obese (BMI>30 kg/m2: 43.9% vs 27.0%) and had more severe CEAP class (>=C4:26.6% vs 9.5%) than non-HTA patients. Most prescribed treatments involved VADs (97.2% of patients) mainly combined with compression and/or topicals: Micronized Purified Flavonoid Fraction (MPFF):77.5%, diosmin:17.7%, compression:59.1%, topicals:43.7%. VADs treatment resulted in significant decreases vs baseline in global symptoms intensity:- 2.39±1.78 (p<0.001) and in each symptom intensity (p<0.001) along with significant improvement in QoL: CIVIQ-14 score decreased by -10.49±8.21 (p<0.001). For MPFF- or diosmin-based therapy, global symptoms intensity decreased by -2.50±1.73 and -1.87±1.85, respectively (p<0.001 in favor of MPFF). MPFF-based therapy showed a higher beneficial effect on pain:-2.42±1.83 vs -1.77±1.69 (P=0.002); heaviness:-2.53±1.86 vs -1.79±1.75 (P<0.001); swelling:-2.46±1.92 vs - 1.76±2.03 (P<0.001); cramps:-2.15±1.96 vs -1.53±1.76 (P=0.002) and QoL:-10.94±8.02 vs - 9.07±8.87 (P=0.012) compared with diosmin-based therapy.

Conclusions:
This VeinStep sub-analysis offers valuable insights into the patient characteristics with both CVeD and HTA in real-life settings, guiding clinicians in selecting optimal treatments for improved outcomes. The findings suggest that VADs, particularly MPPF, significantly reduce CVeD symptoms and improve QoL in this population.
LEFT VENTRICULAR STRAIN IN PATIENTS WITH HYPERTENSIVE HEART DISEASE AND NORMAL EJECTION FRACTION ASSESSED BY SPECKLE TRACKING ECHOCARDIOGRAPHY
Authors: Drissi Hamed Bazrafshan , Khesali Hamideh , Barzegar Sara , Kaviani Raheleh , Askarinejad Amir , Ghaznavi Mohamad Ali 
Published: May 2024

Objective:
Hypertension is a major risk factor for cardiovascular diseases and is associated with increased all-cause and cardiovascular mortality. Cardiac changes such as impaired left ventricular (LV) function, left ventricular hypertrophy (LVH), and heart failure are consequences of chronic exposure to elevated blood pressure. Speckle tracking echocardiography (STE) is a sensitive method for detecting early regional and global myocardial dysfunction missed in asymptomatic patients with cardiovascular disease by conventional modalities.
This study aimed to assess the ability of 2D-STE in assessing regional and global LV strain to diagnose subclinical LV dysfunction in patients with systemic hypertension and preserved ejection fraction.

Design and method:
This prospective observational study included 80 hypertensive patients and 30 healthy controls. In the hypertensive group, at least six months had passed from diagnosis of hypertension according to AHA guidelines. 2D echocardiographic LV images were acquired in apical 4, 2, and 3-chamber and parasternal short axis views. Left ventricular global longitudinal strain (LVGLS) and circumferential strain (LVGCS) were quantified in all segments using a Philips Affiniti 70 device. Differences between hypertensive patients and controls were analyzed using the independent t-test. A P-value less than 0.05 was considered statistically significant.

Results:
In comparison, LVGLS and LVGCS were significantly (P < 0.001) lower among the hypertensive group (GLS: -17.43 ± 1.71, GCS: -23.76 ± 3.35) than the control group (GLS: -20.18 ± 1.11, GCS: -27.46 ± 4.33). LVGLS was significantly (P < 0.001) lower in uncontrolled hypertension (-16.91 ± 1.70) vs. controlled hypertension (-17.96 ± 1.57). Similarly, LVGLS was significantly (P < 0.001) lower among the cases with LVH on 2D echocardiography (16.23 ± 1.69) compared to those without LVH (17.96 ± 1.6). In the hypertensive group, LVGLS was significantly lower in males (-16.84 ± 1.42) than in females (-18.02 ± 1.78; P < 0.05).

Conclusions:
This study demonstrates the potential benefits of using STE as a noninvasive imaging technique in assessing cardiac remodeling and providing a further risk assessment of hypertensive patients.
UNVEILING THE HEART'S VULNERABILITY: HOW PDE4 INHIBITION CAN INTENSIFIES MYOCARDIAL INJURY
Authors: Verma Vipin Kumar , Narayanan Susrutha P , Prajapati Vaishali , Bhatia Jagriti , Arya D S 
Published: May 2024

Objective:
The dysregulation of beta-receptor signaling in heart diseases, like arrhythmias and heart failure, is a concern due to sustained elevation of cAMP levels, impacting cardiac function. Phosphodiesterase (PDEs) regulate cAMP levels, with PDE4 linked to chronotropic signaling through beta-receptors. Apremilast, a PDE4 inhibitor used in psoriasis, theoretically could heighten arrhythmia risk by prolonging catecholamine effects and increasing cardiac workload. In our study, we sought to confirm this theory, exploring PDE4 inhibition's impact on cardiomyocytes, especially in ischemic heart disease scenarios where it might exacerbate myocardial injury during acute ischemic events.

Design and method:
Male albino Wistar rats were randomly distributed into 7 groups – Normal control, ISO control, ISO+ 2.5mg/kg AP, ISO + 5mg/kg AP, ISO + 10mg/kg AP, ISO + 20mg/kg AP and 20mg/kg AP perse. Corresponding doses of Apremilast were administered to the animals for a period of 21 days. On the 20th and 21st day, isoproterenol was administered at a dose of 85 mg/kg to induce myocardial necrosis. Hemodynamic parameters, histopathological and ultrastructural appearances, levels of oxidative stress markers, inflammatory cytokines, and apoptotic markers across the groups were investigated on 22nd day from the blood and myocardium after surgery.

Results:
Pretreatment with AP before inducing myocardial necrosis using ISO led to notable hemodynamic instability and no improvement during surgery. These groups showed increased damage, evident in hemodynamic measures, oxidant-antioxidant balance, and cardiac injury markers. Inflammatory and apoptotic proteins were notably elevated after AP followed by ISO administration compared to the ISO-Control group, indicating heightened adverse effects. A subsequent pilot study focusing on AP's direct impact on cardiomyocytes revealed 21 days administration resulting in hemodynamic instability, histopathological and ultrastructural damage, increased cardiac injury markers, and elevated inflammatory and apoptotic proteins in rats, indicating detrimental effects on the heart.

Conclusions:
Apremilast may cause myocardial injury and exacerbate myocardial necrosis in rats. Hence, there are concerns of AP use in patients with concomitant ischemic heart disease.
IMPACT OF SLEEP APNEA SYNDROME ON THE EARLY OCCURRENCE OF HYPERTENSIVE HEART DISEASE
Authors: Bendiab Nabila Tale B , Ghalmi Abdallah , Khedim Nesrine , Benkhedda Salim 
Published: May 2024

Objective:
Sleep apnea-hypopnea syndrome (OSAHS) is an emerging disease with a high prevalence.
OSAHS has been recognized to cause several adverse effects on the cardiovascular system, to be associated with heart failure, in this case in the hypertensive population. the early detection of this hypertensive heart disease by new myocardial deformity tools could have an impact on the establishment of a preventive therapeutic strategy including the correction of various predictive factors, in this case OSAHS.

Design and method:
This is a cross-sectional, analytical study with prospective recruitment aimed at screening for OSAHS in a population of 150 hypertensive patients using the Epworth score and polygraphy, and subsequently carrying out an assessment. Complete echocardiography in the two subgroups of hypertensive patients, in order to detect subclinical hypertensive heart disease.

Results:
We detected 45 cases of OSAHS among the 150 hypertensive patients.
We note that obesity and diabetes were significantly more prevalent in the hypertension + OSAHS arm. Likewise, the mean blood pressure figures were significantly higher.
LVH was clearly predominant in the hypertension + SAHS arm with a more substantial decrease in the index of longitudinal contraction. In hypertensive patients with OSAHS, the LVH was most often concentric (53.4%). An increase in filling pressures was found in 19 hypertensive patients with OSAHS versus only 4 hypertensive patients without OSAHS (p = 0.0001), with a good correlation with the decrease in GLS.
These results suggest that the association of OSAHS and hypertension is closely associated with an increased risk of non-control of blood pressure figures with anticipation of the onset of hypertensive heart disease, and a perfect correlation with the impairment of longitudinal systolic function and diastolic function compared to the control group.

Conclusions:
Finally, systematic screening for OSAHS in hypertensive patients, especially obese, makes it possible, on the one hand, to identify subgroups at risk, and to correct it by continuous positive pressure ventilation on the other hand.
This will have a positive impact on the delay in the onset of hypertensive heart disease and therefore a decrease in cardiovascular morbidity and mortality.
ARTERIAL STIFFNESS ASSOCIATES WITH MALNUTRITION IN HYPERTENSIVE PATIENTS WITH CONCOMITANT CHRONIC PANCREATITIS
Authors: Sirenko Oksana , Filippova Olexandra 
Published: May 2024

Objective:
The association between pancreatitis and cardiovascular diseases remains incompletely understood. Malnutrition in chronic pancreatitis may be associated with an increase in arterial stiffness in hypertension.
Objective: to evaluate interaction between malnutrition markers and arterial stiffness in patients with hypertension and chronic pancreatitis.

Design and method:
Methods: 70 non-diabetic patients with 1st degree hypertension with concomitant chronic pancreatitis (median age – 52,4 [43,8;63,7] years) were included in the study. We divided all included patients into two groups: 1st group – 41 patients with malnutrition, 2nd group – 29 patients without malnutrition. Standard laboratory blood tests, haematological parameters, lipid profile, glucose, renal and liver function tests, pancreatic fecal elastase-1, total protein, serum albumin, serum iron, vitamin 25(OH)D, serum zinc and magnesium detection were performed for all patients. The groups were comparable in terms of age, gender structure, functional state of the kidneys. Non-parametric methods were used for statistical data analysis. To determine the prognostic significance, the ROC analysis was performed. Significant differences were considered when the p-value was p<0.001

Results:
In patients with a combined course of hypertension and chronic pancreatitis with established malnutrition, an increase in arterial stiffness was significantly more often compared to patients with normal nutritional status - 83% and 62%, respectively (p<0.001). A significantly lower level of brachial artery augmentation index was established by 43% (p<0.001) in the first group. It was established that patients with malnutrition had a significantly higher caritid-femoral pulse wave velocity
by 17.5% (p<0.001). Correlations were established between brachial artery augmentation index and serum levels of zinc (R=0.63, p<0.001), magnesium (R=0.66, p<0.001), albumin (R=0.58, p<0.001), vitamin 25(OH)D (R=0.68, p<0.001) in patients with the combined course of hypertension and chronic pancreatitis. ROC analysis revealed that serum zinc level had an excellent diagnostic power for arterial stiffness in hypertensive patients with chronic pancreatitis (AUC = 0.910). Serum albumin had very good diagnostic power for arterial stiffness in hypertensive patients with chronic pancreatitis (AUC = 0.859).

Conclusions:
Arterial stiffness may be associated with malnutrition in hypertensive patients with concomitant chronic pancreatitis.
DETECTING OBSTRUCTIVE SLEEP APNEA IN HYPERTENSIVE PATIENTS – ABPM DATA
Authors: Dumitrescu Silviu Ionel , Ionescu Ruxandra , Prisacariu Irina , Buican Luiza , Hantulie Ileana , Boingiu Rares , Cecoltan Serghei , Ciobanu Diana , Savoiu Dragos , Popovici Claudia , Stefanescu Dragos , Gurzun Magda , Stanciu Silviu , Munteanu Alice 
Published: May 2024

Objective:
Obstructive sleep apnea (OSA) increases cardiovascular risk in hypertensive patients and decreases the efficacy of treatment. Our study looked at the ABPM data that could be used to diagnose OSA.

Design and method:
We evaluated 117 hypertensive patients who were previously screened for subclinical organ damage for the presence of OSA using the Epworth Sleepiness Scale (ESS), Berlin Questionnaire, and the STOP-BANG questionnaire who underwent home respiratory polygraphy (HRP). For each questionnaire, patients were divided into high-risk and low-risk. The Apnea-Hypopnea index (AHI) was scored according to AASM 2012 criteria. Patients were classified based on the AHI values without OSA (AHI <5), mild OSA (5<= AHI <15), moderate OSA (15<=AHI <30), and severe OSA (AHI =>30). After this, a 24-hour noninvasive ABPM was recorded on a working day. Subjects recorded a journal of the activities performed and the time of retiring to bed, ABPM recordings being divided into ’awake’ or ’asleep’ periods based on diary entries.

Results:
After HRP, frequencies of without OSA, mild OSA, moderate OSA, and severe OSA were 19 (16.2%), 25 (21.4%), 51 (43.5%), and 22 (18.8%), respectively. There is widespread subclinical organ damage in hypertensive patients with moderate to severe OSA (95.7%). We compared the diagnostic accuracy of the three scores in detecting moderate to severe OSA and found that Berlin had the highest sensitivity (87%) and STOP-BANG had the highest specificity (84%), area under the curve (AUC), and PPV. ESS had the lowest sensitivity (63%) and the specificity was intermediate. The hypertensive patients with moderate to severe OSA (OSA positive) compared with those without it (OSA negative) had significantly higher systolic and diastolic BP, significantly increased variability of both systolic and diastolic BP, and a significantly reduced decrease of both nocturnal systolic and diastolic BP. Almost all (94.5%) patients with a riser nocturnal profile had moderate to severe OSA.

Conclusions:
Hypertension and OSA are a common association that is frequently missed. Assessment of patients, based on clinical scores, is essential for the proper management of each case. ABPM results can be an important tool in OSA diagnosis.
INFLUENCE OF LIVER FIBROSIS ON LIPID METABOLISM IN PATIENTS WITH ARTERIAL HYPERTENSION AND NON-ALCOHOLIC FATTY LIVER DISEASE
Authors: Antyukh Karina , Grigorenko Elena , Mitkovskaya Natalya 
Published: May 2024

Objective:
To study the effect of liver fibrosis on lipid metabolism in patients with arterial hypertension (AH) and non-alcoholic fatty liver disease (NAFLD).

Design and method:
A cross-sectional comparative single-center study was conducted, which involved 72 patients of working age (age 25-59 years) with stage I-II AH and NAFLD. The patients were divided into two groups depending on the presence/absence of liver fibrosis: group 1 – patients with hypertension, NAFLD+liver fibrosis (n=34), average age 47.1±8.9 years and group 2 – patients with hypertension, NAFLD without liver fibrosis (n=38), average age 48.6±8.5 years. To analyze lipid metabolism, a detailed lipid profile was performed to determine the content of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and atherogenic coefficient (AC). All patients underwent abdominal ultrasound and liver elastography to determine the degree of fibrosis according to the METAVIR scale. Statistical analysis of the obtained data was carried out using the statistical program package SPSS 27.0 (IBM, USA). Differences were considered statistically significant at p<0.05.

Results:
When studying lipid metabolism, it was shown that the group average values of TC (5.90±0.90 mmol/l vs. 5.60±0.94 mmol/l, p<0.05), LDL-C (4.07±0.82 mmol/l vs. 3.68±0.82 mmol/l, p<0.05), TG (1.75 [1.33-2.55] mmol/l vs. 1.48 [1.17- 2.4] mmol/l, p<0.05), KA (4.36 ± 1.36 vs. 3.82 ± 0.95, p <0.05) in patients with AH and fibrosis were higher relative to the group without fibrosis. When assessing the level of HDL-C (1.10 [0.92-1.38] mmol/l versus 1.16 [1.02-1.33] mmol/l, p>0.05) in the compared groups there were significant differences not installed.

Conclusions:
The results obtained indicate a high prevalence of lipid metabolism disorders among patients of working age with arterial hypertension, non-alcoholic fatty liver disease and developed liver fibrosis, in comparison with persons with high blood pressure syndrome without fibrotic changes in the liver, which indicates an unfavorable pro-atherogenic lipid profile in this category of patients.
FEATURES OF THE DAILY BLOOD PRESSURE PROFILE IN PATIENTS WITH ARTERIAL HYPERTENSION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Authors: Mullabaeva Guzal , Mukhamedova Shokhista , Maksudova Laziza 
Published: May 2024

Objective:
To study the features of the daily blood pressure profile (DBPP) in patients with combination of arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD).

Design and method:
The study included 47 patients (average age 53.1±2.5 years), 31 women, 16 men with hypertension I-II degrees. Patients were divided into 2 groups: with COPD (n=22) and without COPD (n=25). Duration AH in the group of patients with COPD was 6.5±0.54 years, without COPD 5.1±0.66 years. Exclusion criteria's were: symptomatic hypertension, cerebrovascular accidents in history, valvular heart disease, severe rhythm and conduction disorders, endocrine disorders, severe pathologies of the liver and kidneys, receiving systemic glucocorticosteroids actions. All patients underwent a study of pulmonary function (RPF) and SMAD recorders. Applied the following patient classification scheme: “dippers” (Daily index (DI) from 10 to 20%); “nondippers” (DI from 0 to 10%); “overdippers” (DI>20%); “nightpickers” (DI<0).

Results:
We identified a direct correlation between the level of PBP and age patients with a combination of hypertension and COPD during all monitoring periods (r=0.629, p=0.000 (days), r=0.645, p=0.000 (day), r=0.564, p=0.000 (night)). The same dependence was noted in individuals with hypertension without lung pathology (r=0.298, p=0.021 (days), r=0.266, p=0.04 (day), r=0.346, p=0.007 (night)). Thus, we not only did not identify significant differences in the level of PBP, but also noted general regular features of its dynamics with increasing age of patients of both groups. Comparative assessment of the heart rhythm. DBP also showed significant intergroup differences. Thus, we have established the predominance of “dippers” among patients with AH without lung pathology (51.9%), while among persons with a combination of hypertension and COPD, adequate nocturnal decrease in blood pressure was observed slightly more than in a third of patients (37.4%, p=0.125). Besides, among these patients a significantly higher number of “night pickers” was identified (25% vs. 7.5%, p=0.002), the number of “nondippers” and there were “overdippers” in the compared groups was approximately the same.

Conclusions:
Presence of COPD in patients with hypertension worsens the course of the latter, which is expressed in a significant predominance of “nightpickers” and “non-dippers” patients.