bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL ASSOCIATIONS AND ON-TREATMENT CHANGES OF CENTRAL SYSTOLIC BLOOD PRESSURE AND AR TERIAL STIFFNESS IN PATIENTS WITH DECOMPENSATED HEART FAILURE
Authors: Chudarova Irina , Troitskaya Elena , Kozlova Anna , Andreeva Ekaterina , Galochkin Svyatoslav , Tereshchenko Ekaterina , Kobalava Zhanna 
Published: May 2024

Objective:
Heart failure (HF) remains one of the major causes of cardiovascular mortality worldwide. The results of studies on arterial stiffness (AS) and central blood pressure (cBP) in HF are contradictory.
The aim of this study was to evaluate clinical associations of cBP and parameters of AS and their on-treatment changes after 6 months of stable guideline-directed medical therapy (GDMT) in patients with acute decompensated HF (ADHF).

Design and method:
In 54 patients (61% males, 69.6±10 years, HTN 100%, median (med) EF 51% (IQR 38;55%), NTproBNP 623 (500;1842)pg/ml; HFrEF 37%, HFmrEF 13%, HFpEF 50%), apart from routine tests (including congestion assessment by bioimpedance vector analysis, lung ultrasound, liver density by FibroScan, and venous excess ultrasound) we assessed cBP and AS with applanation tonometry (SphygmoCor) within 3-4 days after admission and after 6 months. cSBP>/=individual reference values, carotid-femoral pulse wave velocity (cfPWV)>10 m/s and >individual reference values, AS gradient (cfPWV/carotid-radial PWV) >/=1 were considered abnormal. p<0.05 was considered significant.

Results:
At admission and after 6 months med brachial (b)BP was 117(106;130)/70 (68;80) mmHg 116 (108;130) mmHg, bPP 47 (37;56) mmHg and 47 (39;55) mmHg (p>0.05); cBP 109.5(96;120.5)/71.5 (68;80) mmHg and 106.5(95;113)/73 (65;79) mmHg (p=0.02 for cSBP), cPP 35 (25;43) mmHg and 32.5 (24;38) mmHg (p>0.05), cfPWV 9.9 (6.8;13) m/s and 11.4 (8.5,14.4), m/s (p=0.04), augmentation index (AI@HR75) 20% (13;33%) and 24.5% (18;29%), (p=0.05), PP amplification 129 (120;146) mmHg and 126 (121;136) mmHg, (p=0.02), AS gradient 1.2 (0.9;1.8) and 1 (0.8;1.4) (p>0.05), respectively. Elevated cSBP at admission was observed in 33%, at 6 months – in 38.1%, PWV>10 m/s-in 48.1% and 61.9% respectively, cfPWV>individual reference values–in 33.3% and 66.7% respectively, AS gradient>/=1–in 70.3% and 95.2% respectively. There were no differences in parameters of AS and cSBP and frequencies of their elevation across EF phenotypes and no differences between groups with normal and elevated AS by characteristics of congestion.

Conclusions:
Patients admitted with ADHF had high frequency of CBP elevation and abnormal AS gradient. The significant increase in cSBP, cfPWV and decrease in PP amplification on stable GDMT needs further evaluation.
AORTIC STENOSIS AND ULTRASOUND EVALUATION OF RENAL VESSELS IN HYPERTENSIVE PATIENTS
Authors: Puato Massimo , Furlanis Giulia , Bardelli Moreno , Bernardi Stella , Grillo Andrea 
Published: May 2024

Objective:
Aortic stenosis (AS) and arterial hypertension often clusterize and increase cardiovascular disease burden. Renal artery (RA) stenosis, the main form of secondary hypertension, can act as an upstream factor of resistance at the same way of AS. Aim of the study: to investigate if the presence of AS is able to interfere with the ultrasound (US) parameters in the diagnosis of RA stenosis.

Design and method:
In hypertensive subjects with AS we evaluated US indirect parenchymal parameters: resistive index (RI) and index of maximal systolic acceleration (AImax: the maximal acceleration of flow waveform in early systole divided by the peak systolic velocity), and US direct RA parameters: peak systolic velocity (PSV) and Renal/Aortic Ratio (RAR).

Results:
We compared hypertensive patients (mean age 74 years) with preserved left ventricular function with severe AS (n=18) or mild AS (n=21). No statistically differences were detected between groups regarding gender, age, smoke, ABI, CV risk factors, lipids, and renal function.
Direct US parameters of RA did not differ significantly between patients with severe or mild AS (mean PSV 113 vs 127 cm/sec; mean RAR 1.3 vs 1.6). RI showed the same behavior (0.75 vs 0.73). AImax was significantly lower in patients with severe vs mild AS (8.74 vs 15.56 1/sec, p<0.0005). We found an inverse correlation between AImax and the mean (r2=0.435) and peak (r2=0.424) transvalvular gradient.
Among 14 patients with severe AS underwent correction of valvular disease. At 6 months, US showed a significant increase in AImax (from 10.0 to 19.8 1/sec, p<0.005), while RI did not differ significantly (0.74 vs 0.73).

Conclusions:
Severe AS act as a proximal resistance that can attenuate the systolic acceleration phase of the flow profile of the renal intraparenchymal vessels, in particular of AImax, which is restored after surgical correction of the valve defect. Presence of AS may affect the diagnostic workup of RA stenosis.
ASSOCIATION BETWEEN CHINESE VISCERAL ADIPOSITY INDEX AND RISK OF CARDIOMETABOLIC MULTIMORBIDITY IN MIDDLE-AGED AND ELDERLY CHINESE POPULATION: EVIDENCE FROM A NATIONAL COHORT STUDY
Authors: Yang Fuli , Jin Junguo , Lu Xiaoqin , Jiang Huyi , Tan Huixin 
Published: May 2024

Objective:
This cohort study was designed to investigate the associations between Chinese visceral adiposity index (CVAI) and Cardiometabolic multimorbidity (CMM) among middle-aged and elderly Chinese population.

Design and method:
A national cohort study that consisted of 6419 participants was conducted during a median follow-up time of 4 years. Three obesity- and lipid-related indices, including visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP) were recorded. Our study used multivariate adjusted Cox proportional hazard models, sensitivity analysis and restricted cubic spline analysis to investigate the associations of the Chinese visceral adiposity index with Cardiometabolic multimorbidity. Results were reported in log-relative hazard ratios and associated 95% CIs.

Results:
Of the 6686 participants included in the analysis, 6419 participants did not develop CMM and incident CMM occurred in 267 participants during the study period. Using multivariable-adjusted restricted cubic spline analyses, it was found that there was a significant nonlinear relationship between the levels of CVAI and the incidence of cardiometabolic multimorbidity (P<0.0001). The risk of CMM gradually increased when the CVAI increased, and rapid upward after exceeding 91.2. After adjustment of multiple covariates, a U-shaped association between CVAI and CMM was evident in all participants. The HR of CVAI gradually increases and is positively correlated with the increase of CVAI.

Conclusions:
The CVAI are independent predictors of CMM in the middle-aged and elderly Chinese population. Higher CVAI is positively associated with CMM risk.
NATIONAL EXAMINATION SURVEY ON BLOOD PRESSURE OF OLDER AND VERY OLD PEOPLE IN GERMANY 2022-2023: WHY SELF-REPORTS, MEASUREMENTS AND MEDICATION DATA ARE NEEDED
Authors: Neuhauser Hannelore , Bueschges Julia , Sarganas Giselle , Gaertner Beate , Perlitz Hanna , Fuchs Judith 
Published: May 2024

Objective:
The National Study on Health of Older People in Germany “Gesundheit 65+” aimed to provide up-to-date information on the health of older adults in Germany including blood pressure (BP) measurements at home by a study nurse.

Design and method:
Nationally representative examination survey of the population aged 65 years and older residing in Germany and with sufficient German language skills, using two-stage population registry sampling from 128 sample points from June 2022 to April 2023. Participation of physically or cognitively impaired persons was possible via proxy interviews and consent from legal representatives. Recruitment and data collection used a mixed-mode design. Three standardized blood pressure measurements at two-minute intervals were taken after 5 minutes rest with an oscillometric device (Mobil-O-Graph) using one of five cuffs according to upper arm circumference. The mean of the second and third measurement was used for analysis. Hypertension was defined as mean systolic BP (SBP) at or above140 mm Hg, or mean diastolic BP (DBP) at or above 90 mm Hg, or the use of antihypertensives (ATC-codes C02 antihypertensives, C03 diuretics, C07 beta-blockers, C08 calcium-channel blockers or C09 ACEI and ARB) in participants with self-reported hypertension diagnosis. Provisional weights account for unequal sampling and participation probabilities.

Results:
The “Gesundheit 65+” examination survey included 1,493 participants and 1,475 (98.8%) had successful BP measurements (763 men and 712 women aged 65 to 100 years). External quality control showed very good standardization of BP measurements in the home environment. Central BP data were available from 1,356 participants. Based on self-reported diagnoses alone the prevalence of hypertension would be 58.3% [95% CI 53.2-63.3] in men and 59.5% [53.8-64.9] in women. However, overall hypertension prevalence was estimated at 70.4% [65.8-74.7] in men and 72.3% [66.9-77.1] in women based on the study definition which combines self-reported physician diagnoses, standardized BP measurements and medication.

Conclusions:
Our study shows very good feasibility, acceptability and data completeness of standardized BP measurements using home visits. The prevalence of hypertension would be greatly underestimated in the absence of examination survey data with standardized measurements and detailed recording of medication.
THE INVESTIGATION OF TRANSFERABILITY OF DEFINITIONS OF CARDIOMETABOLIC AND VASCULAR AGING PHENOTYPES ACROSS MULTIPLE COHORTS
Authors: Moguchaia Ekaterina , Usoltsev Dmitrii , Boiarinova Maria , Alieva Asiyat , Vasilyeva Elena , Rotar Oxana , Konradi Aleksandra , Shlyakhto Evgengy , Artomov Mykyta 
Published: May 2024

Objective:
According to the European guidelines for the prevention of cardiovascular diseases (CVD) (2021), Russia was identified as a country with a very high CV risk. We aimed to investigate the applicability of the standardized definitions of vascular aging phenotypes (VP) in Russian population and align them with the existing reference datasets.

Design and method:
In 2012-2013 1,600 residents of St. Petersburg (age 21-67) were randomly examined as a part of the multicenter epidemiological study. Anthropometry, blood pressure measurement, blood biochemistry analysis were taken. Subjects completed questionnaires describing their lifestyle, current health condition and medication usage. 618 patients (42% men) from initial cohort with a mean age of 48 [37;55] years were randomly subsampled for carotid-femoral pulse wave velocity assessment (Sphygmocor). The VP were defined using the ‘Reference Values for Arterial Stiffness’ Collaboration database which included 16,867 measurements from eight European countries populations15 to 97 years. According to the criteria, patients with overt CVD, diabetes mellitus and the use of antihypertensive, lipid-lowering therapy were excluded from the analysis of VP.

Results:
The Russian cohort had significantly higher prevalence of CVD (11,4% compared to 6,9% in the Nreference population, p=5.65x10-5), intake of antihypertensives (28,1% compared to 14,3% in the reference, p<1x10-16) and lipid-lowering therapy (6,1% compared to 4,1%, p=0.025, Figure 1A). Additionally, our cohort had significantly higher prevalence of optimal BP (40,2% vs 28%, p=4.6x10-7) and lower prevalence of first-degree (p=0.048) and second degree (p=0.00084) hypertension (Figure 1B). Comparison of the prevalence of VP between the European and Russian cohorts showed a significant decrease of the early vascular aging (EVA) phenotype with age in the Russian population (p=0.011). The prevalence of the supernormal vascular aging phenotype (SUPERNOVA) in the group of 60-69 years old was higher in the Russian population (p=0.0035)

Conclusions:
A higher prevalence of CVD was demonstrated in the study cohort despite lower hypertension burden and higher CV drugs intake compared to the European cohort. Multidirectional trajectories of EVA and SUPERNOVA VP with age were detected in Russian population, potentially indicating the presence of the clearing selection pressure at the older age (Agreement No 075-15-2022-301).
PREVALENCE, PATTERNS OF TREATMENT AND CONTROL OF INTERDIALYTIC AMBULATORY HYPERTENSION IN HEMODIALYSIS PATIENTS
Authors: Leonidou K , Georgianos P , Kollias A , Vaios V , Roumeliotis S , Kontogiorgos I , Leptokaridou E , Kourtidou C , Stergiou G , Zebekakis P , Liakopoulos V 
Published: May 2024

Objective:
Studies using routine predialysis or postdialysis blood pressure (BP) recordings have provided considerably variable estimates of the prevalence and control of hypertension in the hemodialysis population. The aim of the present study was to investigate the epidemiology of hypertension in hemodialysis patients using the reference-standard technique of interdialytic ambulatory BP monitoring (ABPM).

Design and method:
A total of 70 hemodialysis patients underwent ABPM over an entire 44-hour interdialytic period (BP measurements at 20-minute intervals; Microlife WatchBP O3 device). Hypertension was defined as 44-hour ambulatory BP equal or higher than 130/80 mmHg or current use of antihypertensive medications.

Results:
The study included 70 patients (45 males and 25 females) with a mean age of 65.3±13.3 yeas and a median dialysis vintage of 15 months (range: 6, 33). Interdialytic ambulatory hypertension was prevalent in 90% of patients. Notably, isolated nocturnal hypertension was diagnosed in 27.1% of patients, whereas just 1.4% of patients had abnormal BP levels only during the daytime period. In all, 61 out of 63 hypertensives (96.8%) were receiving treatment with an average of 1.5±0.6 BP-lowering medications daily. Beta-blockers (75.4%) were the most commonly prescribed antihypertensive drug class, followed by dihydropyridine calcium-channel-blockers (42.6%) and renin-angiotensin-system inhibitors (8.2%). Lack of adequate ambulatory BP control was identified in 28.5% of hypertensives.

Conclusions:
This study shows that among patients on hemodialysis, the burden of interdialytic ambulatory hypertension is very high. The use of interdialytic ABPM enables the identification of isolated nocturnal hypertension, which is a very common BP phenotype in this patient population.
CARDIOMETABOLIC RISK FACTORS AND LIFESTYLE HABITS IN THE GENERAL POPULATION: RESULTS OF AN AWARENESS-RAISING EDUCATIONAL CAMPAIGN FOR HEALTH EMPOWERMENT
Authors: Del Pinto Rita , Serio Leandra , Campanozzi Elena , Marrone Enrica , Moronti Veronica , Santilli Jessica , Martini Cecilia , Bellisario Federico , Santilli Federico , Di Ruscio Evy , Altieri Piera , Baldini Gianluca , Di Gregorio Nicoletta , Ferri Claudio 
Published: May 2024

Objective:
Most individuals have little awareness of their health status and do not engage in prevention measures to reduce the risk of future cardiovascular diseases (CVD. We conducted an observational study to assess the prevalence of common cardiometabolic risk factors and modifiable lifestyle measures in the general population.

Design and method:
During an awareness-raising educational campaign for cardiovascular prevention (October 10th, 2023), a cross-sectional study on consecutive volunteer individuals was conducted. Participants self-presented at local sites and accepted to undergo standard blood pressure (BP) measurement with automated devices and to complete a questionnaire on self-reported demographic and clinical features and lifestyle habits. Open seminars were held to educate on cardiovascular risk factors and related non-pharmacological preventive measures (including diet, physical exercise, smoking cessation). As part of the prevention of peripheral artery disease (PAD), participants received education on how to perform arterial pulses autopalpation. Here, stratification based on self-reported symptoms suggestive of PAD is reported. Descriptive analysis was performed with R.

Results:
A total of 160 participants took part in the survey, of whom 154 (113 F; mean age 38.5(18.7) years; 83.3% <=70 years) with no PAD symptoms. Their mean BP was 120/3(14.2)/76.2/(11.5) mmHg. Of them, 16.7% had DM2, 40% had hypertension, 50% had hypercholesterolemia, 49.3% were current/former smokers; 67% reported to exercise >=150’/week; 9.1% never/rarely consumed vegetables/fruit. Only 3.7% participants (mean age 56.5(15.5) years) declared symptoms compatible with PAD. Their mean BP was 145(18.7)/89.6(5) mmHg; 83.3% reported having hypertension, diabetes, high cholesterol, and/or never or rarely eating vegetables/fruits; 50% were smokers; 33.3% were sedentary; approximately 4 in 5 had measured their BP in the previous month. All participants were educated on the prevention of common cardiometabolic risk factors and self-examination of peripheral pulses.

Conclusions:
In the examined relatively young sample of the general population, cardiometabolic risk factors were common in individuals with and without symptoms of PAD, and lifestyle habits could be largely improved. Awareness-raising educational campaign represent a powerful opportunity for health empowerment.
COMPARATIVE ANALYSIS OF ATRIAL FIBRILLATION EPIDEMIOLOGY IN YOUNG ROMANIAN ADULTS IN SEPHAR II-IV SURVEYS
Authors: Cojocaru Cosmin , Vijiiac Aura , Gheorghe-fronea Oana , Dorobantu Maria 
Published: May 2024

Objective:
Atrial fibrillation (AF) is increasingly prevalent in all European countries, particularly in those strongly associated with high cardiovascular risk. We sought to evaluate AF epidemiology in Romanian adults recruited in three consecutive editions of the SEPHAR national survey (Study for Evaluation of Prevalence of Hypertension and Cardiovascular Risk in an Adult Population in Romania) aged eighteen to fifty years.

Design and method:
We performed a post-hoc analysis of 5422 subjects randomly recruited to ensure a nationally representative distribution by age, sex and area of residence during three consecutive editions of a cross-sectional national survey assessing hypertension epidemiology in Romania. AF prevalence and potentially contributing factors to AF burden were assessed in all subjects aged 18 to 50 years. The presence of AF was defined either by study EKG diagnosis or by documented medical history of AF.

Results:
There were 52.4% (n = 2845) subjects aged less than fifty years (mean 35.4 ± 8.64 years, 45.5% males, 57.5% from urban areas). AF prevalence was 1.7% (n = 49) and significantly increased throughout the study (1% (n = 11) vs. 1.6% (n = 17) vs. 3.3% (n = 21), p = 0.001). AF prevalence was similar in males vs. females (1.9% vs. 1.6%, p = 0.47) and in urban vs. rural areas (1.7% vs. 1.8%, p = 0.77). There was a two-fold higher prevalence in hypertensives vs. normotensives (2.8% vs. 1.4%, p = 0.01). AF was significantly more frequent in diabetic subjects (4.3% vs. 1.4%, p = 0.02). The mean CHA2DS2-VASc score was significantly higher in AF patients (1.32 ± 1.21, p < 0.001) and was higher than 2 points in 49% (n = 24) of AF patients.

Conclusions:
Based on data stemming from three consecutive editions of SEPHAR, AF prevalence seems to have demonstrated a two-fold increase in Romanians aged less than fifty years and is significantly more frequent in diabetics and hypertensives.
ASSOCIATION OF TOTAL MORTALITY AND CARDIOVASCULAR ENDPOINTS WITH THE TIMING OF THE FIRST AND SECOND SYSTOLIC PEAK OF THE AORTIC PULSE WAVE
Authors: Cheng Yi -BANG , An De -Wei , Aparicio Lucas S. , Huang Qi -Fang , Li Yan , Staessen Jan A. 
Published: May 2024

Objective:
Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill defined.

Design and method:
Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (n=5529). Model refinement was assessed by the integrated discrimination (IDI) and net reclassification (NRI) improvement.

Results:
Over 4.1 years (median), 201 participants died and 248 and 159 patients experienced cardiovascular or cardiac endpoints. Mean TP1 and TP2, standardized for cohort, sex, age and heart rate, were 103 and 228 ms. Shorter TP1 and TP2 were associated with higher mortality and shorter TP1 with higher risk of cardiovascular and cardiac endpoints (trend P<0.004). The HRs relating total mortality and cardiovascular endpoints to TP2 were 0.82 (95% CI: 0.72-0.94) and 0.87 (0.77-0.98), respectively. The HR relating cardiac endpoints to TP1 was 0.81 (0.68-0.97). For total mortality and cardiovascular endpoints in relation to TP2, NRI was significant (P<0.010), but not for cardiac endpoints in relation to TP1. IDI was not significant for any endpoint. The HRs relating total mortality to TP2 were smaller (P<0.026) in women than men (0.67 vs 0.95) and in older (>60 years) vs younger (<60 years) participants (0.80 vs 0.88).

Conclusions:
Our study adds to the evidence supporting risk stratification based on aortic pulse analysis by showing that TP2 and TP1 carry prognostic information.
TRENDS AND DISPARITIES BY AGE, SEX, REGION, AND SOCIOECONOMIC STATUS IN HYPERTENSION PREVALENCE, AWARENESS, TREATMENT, AND CONTROL IN CHINA, 2012-2020
Authors: Cao Xue , Tian Yixin , Wang Xin , Zhang Linfeng , Zheng Congyi , Hu Zhen , Gu Runqing , Yu Xue , Pei Xuyan , Turdi Nurgul , Zhang Yujie , Wang Zengwu 
Published: May 2024

Objective:
Hypertension has consistently maintained a high prevalence rate in China, however, comprehensive evidence for recent hypertension trends across specific population subgroups was limited. Our study aimed to examine trends in prevalence, awareness, treatment, and control of hypertension in China.

Design and method:
Data was derived from two cross-sectional nationally representative surveys, which enrolled 455770 participants aged 18 years or older in the 2012-2015 and 297065 participants in the 2020-2022. Hypertension was defined as a systolic blood pressure >= 140 mmHg, and/or a diastolic blood pressure >= 90 mmHg, and/or taking antihypertensive medication. The main outcome were prevalence of hypertension and awareness, treatment, and control rates for hypertension. We classified regions by socioeconomic status using the human development index (HDI). We also decomposed changes in hypertension prevalence into population growth, shift in population age structure, and changes in age-specific rate.

Results:
The mean age[SD] were 45.5 (17.6) years in 2012-2015, and 47.9 (18.1) in 2020-2022 in China. The weighted prevalence of hypertension increased from 23.2% (95% confidential interval [95%CI] 22.2%-24.3%) in 2012-2015 to 31.9% (95%CI 30.3%-33.4%) in 2020-2022, with the prevalence among 25-34 years old more than doubling. The gap in hypertension prevalence between urban and rural areas has widened, and the prevalence in rural areas exceeded that in urban areas in 2020-2022. In both surveys, the highest age-standardised prevalence was observed in very-high HDI region, north and northeast China, with the largest increase areas with upper-middle HDI level. In 2020-2022, the awareness, treatment, and control of hypertension were 43.8% (95%CI 41.4%-46.1%), 38.3% (95%CI 36.0%-40.6%), and 13.6% (95%CI 11.9%-15.5%), respectively. Higher age-standardised awareness, treatment, and control rates was observed in high and very-high HDI region in 2020-2022, and improvements were noted in very-low HDI and high HDI region. Nationally, changes in age-specific hypertension prevalence were the primary driver of increased prevalence of hypertension.

Conclusions:
Hypertension prevalence was still high in China, with an upward trend from 2012 to 2022. Awareness, treatment, and control of hypertension remained low. Findings in this study highlight the necessity for a more targeted strategy in addressing hypertension management.