bluuebunny/crossref_metadata_2025_split huggingface dataset:
First-in-human study for evaluating the accuracy of blood pressure measurement using the ring-type device with a photoplethysmography
Authors: Kim J , Park S W 
Published: November 2023

Abstract

Background
Early diagnosis of hypertension and optimal blood pressure (BP) control are important for prevention of cardiovascular morbidity and mortality. The 24-hour BP is better predictive of cardiovascular outcome than the office BP. However, conventional non-invasive BP measurement by sphygmomanometer has limitations in obtaining continuous BP and its variability in daily life. Recently, a ring-type BP measuring device, CART-I Plus (Sky Lab Inc, South Korea) without a cuff has been developed.

Purpose
This study was a prospective, single arm, first-in-human pivotal trial to evaluate accuracy of blood pressure measurement by the new device.

Methods
The ring-type smart wearable blood monitoring device measures photoplethysmography signals from the proximal phalanx and transmits the data wirelessly to the connected smartphone, to monitor the BP (Figure 1). A cuff was worn on arm to check the reference BP by auscultation, while the test device was worn on the finger of the opposite arm to check the test BP simultaneously. Measurements were repeated for up to three sets each on the left and right arms. The primary outcome measure was mean error and standard deviation of BP differences between the test device and the reference readings.

Results
The final analysis included 89 subjects, 47% of whom were male, with a mean age of 40.1 years. We collected 526 sets of systolic BP (SBP) and 513 sets of diastolic BP (DBP), with ranges of 80 to 175 mmHg and 43 to 122 mmHg, respectively. In sample-wise comparison (Figure 2), the mean error between the test device and the reference was 0.16 ± 5.90 mmHg (95% limit of agreements [LOA] -11.41 to 11.72) in SBP and -0.07 ± 4.68 (95% LOA -0.26 to 9.10) in DBP. The test device showed a good correlation with the reference for SBP (r=0.94, p&lt;0.001) and DBP (r=0.95, p&lt;0.001). In subject-wise comparison, the test device showed a good correlation with the reference for SBP (r=0.98, p&lt;0.001) and DBP (r=0.98, p&lt;0.001), with a mean error of 0.17 ± 3.67 mmHg (95% LOA -7.04 to 7.7) in SBP and 0.02 ± 3.21 mmHg (95% LOA -6.27 to 6.31) in DBP.

Conclusion
The new ring-type BP measuring device had a good correlation for SBP and DBP with minimal bias compared with a auscultation method. It has the potential to provide accurate BP in daily life.
Effect of arterial hypertension in cardiopulmonary status and right ventricle function after hospitalization for Sars-Cov-2
Authors: Kariori M , Fragoulis C , Chrysochoou C , Konstantinidis D , Leontsinis I , Andrikou I , Iliakis P , Mantzouranis E , Konstantinou K , Kalos T , Grigoriou K , Aggeli C , Thomopoulos C , Tsioufis K 
Published: November 2023

Abstract

Introduction
There is little data concerning the impact of SARS-Cov-2 infection on the cardiopulmonary status and right ventricle (RV) function of patients with arterial hypertension (HTN).

Purpose
The purpose of our study was to investigate whether hospitalization for COVID19 affects the functional status of hypertensive patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the first day of infection.

Methods
All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol where all cardiorespiratory parameters were evaluated. Echocardiographic parameters including right ventricle longitudinal strain were analyzed using an offline program. Subjects with history of HTN were divided into two groups according to hospitalization for Covid-19 infection. Group I included 34 subjects who were hospitalized for Sars-Cov-2 infection and Group II included 28 subjects without need for hospitalization.

Results
Out of total population of 198 patients with COVID19 infection, sixty-two subjects were hypertensives (mean age: 61±10 years, 58.1 % males, history of coronary artery disease: 16.1%) who were evaluated 3 months after the symptoms onset. Of demographic characteristics in hospitalized patients, only age (63±8 vs. 52±11 years, p&lt;0.001) was significantly higher. When analyzing cardiopulmonary test parameters, oxygen consumption (ml/kg/min) both maximum (21±4 vs. 23.5±4, p:0.01) and during the 1st minute of recovery (15.5±2 vs. 21±25, p: 0.02), VO2_AT (17±4 vs. 27.5±32) and PETCO2 (39±4 vs. 38±19 mmHg, p:0.03) were impaired comparing to non-hospitalized subjects. Out of echocardiographic parameters, diameter of left atrium (mm), differed significantly between two groups (41±6 vs.38±5 p: 0.02). The absolute mean value of right ventricle strain (RVLS, (%): 13±8 vs. 23±3, p:0.04) was impaired to hypertensives despite the fact that left ventricle ejection fraction was similar between two groups probably due to small sample size. Using linear regression analysis adjusted for age, gender, hospitalization, and LVEF, hospitalization (p: 0.001) proved to be independent predictive factor for RVLS in hypertensive patients.

Conclusion
To conclude our study highlighted negative impact of hospitalization for Sars-Cov-2 infection in the capacity for exercise and in right ventricle functionality, implying the severity of disease as a negative independent predictive factor in hypertensive patients.
Efficacy and safety of perindopril/indapamide/amlodipine single-pill combination in essential hypertension
Authors: Wang J , Bricout S , Zhu H , Li X , Zhang X , Sun Y , Zhao X , Li Z , Zhao R , Sun Y , Yao Z , Li H , Lu W , Jiang Y , Han Q 
Published: November 2023

Abstract

Background
In hypertensive patients uncontrolled with dual therapy, perindopril, indapamide and amlodipine triple therapy form one of the core drug treatments recommended by the latest European (ESC/ESH 2018) and International (ISH 2020) Guidelines, ideally used as single-pill combination (SPC) to improve adherence to treatment.

Purpose
To assess efficacy and safety of the SPC of Perindopril arginine 5 mg/Indapamide 1.25 mg/Amlodipine 5 mg (P5/I1.25/A5) compared to the free combination of Perindopril tert-butylamine 4 mg/Indapamide 1.25 mg (P4/I1.25) plus Amlodipine 5 mg (P4/I1.25 +A5) and of the titration to higher doses up to P10/I.2.5/A10 for SPC and P8/I.2.5+A10 for free combination, in patients with essential uncontrolled hypertension.

Methods
A randomized, double-blind, controlled, 7-month phase III study in hypertensive Asian patients uncontrolled with dual therapy (Systolic Blood Pressure (SBP) ≥140 and &lt;180mmHg and Diastolic Blood Pressure (DBP) ≥90 and &lt;110 mmHg). After a 1-month run-in period on P4/I1.25, patients were randomized to a 6-month parallel group period to receive the triple therapy either as SPC (P5/I1.25/A5) or as free combination (P4/I1.25+A5), potentially up-titrated to higher doses after 2 and 4 months if BP remained uncontrolled.

Results
532 patients (mean SBP/DBP 150.4/97.2 mmHg, mean age 56 years) were randomized to receive SPC or free combination.
After 2 months of randomized treatment, a large decrease in office SBP/DBP was observed in both the SPC (-15.0/-8.6mmHg) and the free combination group (-14.5/-8.7mmHg). The SBP-lowering effect of the SPC was shown to be non-inferior to the free combination (study primary endpoint, p&lt;0.001). In patients uncontrolled on SPC after 2 and 4 months, titration to P10/I2.5/A5 then to P10/I2.5/A10 (in 46.1 and 17.6% patients in SPC group, respectively) led to additional SBP/DBP decrease (-9.0/-5.9 mmHg and -6.1/-3.6 mmHg, respectively). After 6 months, 64.4% of patients reached BP control. ABPM data corroborated these findings. Similar results were observed in the free combination group.
Over the 6-month randomized period, treatments were well tolerated, even at the highest doses of the SPC. The most frequently reported treatment-related adverse events were those already described for indapamide, perindopril and amlodipine, i.e., hyperuricemia, hypokalemia and cough, and were observed with a similar frequency in both groups. Peripheral edema and hypotension or orthostatic hypotension remained low.

Conclusion
Perindopril/Indapamide/Amlodipine SPC is as effective and safe as the free combination in hypertensive patients uncontrolled with dual therapy of Perindopril/Indapamide. The uptitration to higher dosages of the triple-drug SPC provided additional benefit on BP lowering and BP control without increasing pill burden.
Treatment patterns in a population of 1.4 million individuals qualifying for initiation of dual-combination blood pressure lowering therapy representing usual clinical practice
Authors: Coca A , Borghi C , Stergiou G S , Ly N F , Lee C , Tricotel A , Castelo-Branco A , Khan I , Blacher J , Abdel-Moneim M 
Published: November 2023

Abstract

Background
Guidelines recommend dual-combination therapy (DCT) in most hypertensive patients requiring initiation of blood pressure (BP)-lowering treatment. This strategy is proven to be more effective as compared to monotherapy in achievement of BP goals, is associated with improved adherence, persistence and reduces risk of cardiovascular (CV) events.

Purpose
To describe the patterns of treatment with BP-lowering therapies in a large hypertensive population qualifying for initiation of DCT.

Methods
The study utilized following linked databases in England: Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics. Adults qualifying for DCT as per the 2018 ESC/ESH guidelines were identified during a 15-year period (2005-2019). The index date is the first date when patient became eligible for initiation of DCT as per the guidelines-based criteria. Patients were followed for 5 years from the index date and were categorized into 4 groups: (1) no treatment, (2) monotherapy, (3) combination therapy with 2 agents, (4) combination therapy with ≥3 agents. For each year during follow-up, the percent of patient-time (Pt) on these categories was summarized for the overall population and two main subgroups i.e., atherosclerotic cardiovascular disease (ASCVD) and diabetes at baseline. In addition, we estimated the 15-year event rate for the composite endpoint of nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, and CV death via the Kaplan Meier method.

Results
Overall, 1,426,079 individuals met the selection criteria. Mean (SD) age was 62.9 (14.1) years and ∼50% were male. Approximately 15.9% and 13.8% had ASCVD and diabetes at baseline, respectively. In overall population during 5-year follow-up (Table 1), nearly 25% of Pt during follow-up reported non-treatment with any BP-lowering therapy. Monotherapy was most common treatment pattern accounting for nearly 50% of Pt while only 25% of Pt represented DCT. Percent of Pt on monotherapy decreased from 56.7% to 42.6% (year-1 to -5), and the percent of Pt on dual-combination therapy increased from 14.9% to 25.5% (year-1 to -5). Percent of Pt on any combination therapy (≥2 agents) increased from 17.5% to 32.4% (year-1 to -5). Similar pattern was observed in ASCVD and diabetes subgroups. The 15-year event rate for the composite endpoint was 27.1% for the overall population and was 57.5% and 40.1% in ASCVD and diabetes subgroups, respectively (Table 2).

Conclusion
Our findings indicate an opportunity for substantial improvement in BP control and CV risk reduction in this population, by ensuring appropriate guideline-based initiation, of dual combination BP-lowering therapy.Table 1Table 2
Comparative evaluation of renal denervation versus pharmacological treatment on diastolic function in patients with resistant hypertension: three years follow-up
Authors: Moiseeva A , Caraus A , Moscalu V , Ciobanu N , Abras M , Cociu M , Cotelea A 
Published: November 2023

Abstract

Background
Several recently published sham-controlled trials of high methodological quality confirm the safety and antihypertensive effectiveness of radiofrequency renal denervation. However, special clinical interest represents a suggestion that this type of treatment may improve hypertension-mediated organ damage.

Purpose
Comparative evaluation of renal denervation versus pharmacological treatment on diastolic function in patients with resistant hypertension.

Methods
The study enrolled 125 hypertensive patients who, following 4 weeks of standardized treatment with three antihypertensive remedies, one of which were a thiazide-like diuretic in maximum tolerated daily doses (Losartan, Amlodipine and Indapamid) and confirmation of their resistance, were randomly assigned into three groups depending on the treatment supplemented to the previously administered one: group I – Moxonidine, group II – Bisoprolol and group III – renal denervation (RDN). All patients were evaluated by transthoracic echocardiography at baseline, one, two and three years follow-up. A renal denervation was performed in the main renal arteries and their branches.

Results
At 1-year follow-up Bisoprolol and RDN treatment groups showed an authentic improvement in all diastolic function parameters, while Moxonidine group noted amelioration of only E/A ratio, LAVI and TR velocity. Two years of evaluation were marked by statistically significant changes of all diastolic parameters in all three observational groups. The improvement of diastolic function parameters continued until the end of the study, when the difference in dynamics between groups is evident thanks to the inferior effect of Moxonidine compared to Bisoprolol, RDN demonstrating superiority over both pharmacological treatment groups (Table 1).

Conclusions
Renal denervation demonstrated efficacy in improving of all parameters of diastolic function starting with 12 months of evaluation, the beneficial effect being maintained until the end of the surveillance period. At the same time, minimally invasive treatment has been shown to be superior to pharmacological treatment with SNS- blockers in improving diastolic function.
Association of ultra-processed foods with cardiovascular disease and hypertension in australian women
Authors: Pant A , Gribbin S , Machado P , Hodge A , Moran L , Marschner S , Zaman S 
Published: November 2023

Abstract

Background
Ultra-processed food (UPF) intake has increased in the past few decades, yet knowledge around the long-term effects on cardiovascular disease (CVD) risk is limited. Moreover, the magnitude of the impact of UPF intake on CVD in Australia has not been established.

Objective
To investigate the association of UPF intake with incident CVD and hypertension in a population-based cohort of middle-aged women.

Methods
Women aged 46-55 years were prospectively recruited into the Australian Longitudinal Study on Women’s Health and followed for 15 years. UPFs were defined according to the NOVA classification, and the contribution of these foods to total dietary intake was estimated. Outcomes were incident CVD (self-reported heart disease/stroke) and/or hypertension. Logistic regression models assessed the association between UFP intake and endpoints with adjustment made for confounders.

Results
A total 10,006 women (mean age 52.5±1.5) with an average UPF intake of 26.6% of total food dietary intake (mean 347.8 g/d) were included. Over 15 years of follow-up, 1,038 incident CVD and 4,204 hypertension cases occurred. Higher UPF intake was associated with higher risk of CVD (ptrend=0.05) and hypertension (ptrend=0.02). The highest intake of UPF (mean 42% of total food intake) versus the lowest UPF intake (mean 14.2% of total food intake) was associated with incident CVD [odds ratio (OR) 1.35, 95% confidence interval (CI) 1.03-1.78; p=0.03)] and hypertension [OR 1.33, 95% CI 1.06-1.66; p=0.01].

Conclusion
In middle-aged women, a higher intake of ultra-processed food was associated with increased CVD risk and hypertension. These findings lend support to minimising UPF intake as a component of a heart-healthy diet.
Physical activity and sedentary behavior patterns in individuals with a bicuspid aortic valve compared to healthy controls
Authors: Schreurs B A , Hopman M T E , Van Kimmenade R R J , Eijsvogels T M H 
Published: November 2023

Abstract

Background
A bicuspid aortic valve (BAV) is the most common congenital heart disease and associated with a higher lifetime risk of cardiovascular morbidity and mortality. Management of cardiovascular risk factors, including habitual physical (in)activity, is therefore key. However, little is known about physical activity (PA) and sedentary behavior (SB) patterns in individuals with BAV compared to healthy controls while there is debate how PA may influence BAV related cardiovascular complications.

Purpose
To compare objectively measured PA and SB characteristics between individuals with BAV and healthy age- and sex-matched controls.

Methods
Adults with BAV from our outpatient clinic were approached to participate and matched with age and sex- matched controls from the general population. SB, moderate-to-vigorous PA (MVPA) and step count were objectively assessed for 24 h/day during 8 consecutive days using an accelerometer (activPAL3 micro®) attached to the subject’s thigh. Transthoracic echocardiograms of the BAV participants were used to determine the presence of valvular dysfunction and to measure aortic diameters. Aortic dilatation was defined as &gt;40 mm at the sinus of Valsalva or in the ascending aorta, whereas valvular dysfunction was defined as moderate-to-severe aortic stenosis or regurgitation according to current ESC guidelines.

Results
We recruited 100 BAV individuals (45±16 years old; 59% male), of which n=12 had valve dysfunction, n=22 had aortic dilatation and n=20 had a combination of valve dysfunction and aortic dilatation. We also included 100 healthy age- and sex-matched controls.
SB was comparable between the BAV and control group (9.3 [8.5-10.2] vs 9.3 [8.2-10.2] hrs/day, p=0.84), whereas time spent in MVPA (72 [59-89] vs 98 [75-116] min/day, p &lt;0.001) and daily step count (4,826 [4,004-5,801] vs 6,252 [4,784-7,484] steps/day, p&lt;0.001) were markedly lower in individuals with BAV (Figure 1). Furthermore, no significant differences in SB, MVPA or step-count were found across BAV disease severity subgroups (Figure 2).

Conclusion
Individuals with BAV are less physically active compared to age- and sex-matched healthy controls. These differences were independent of disease severity, indicating that the lower activity patterns were not due to functional or disease-related limitations.Figure 1.Figure 2.
Excessive daytime sleepiness, morning tiredness, loud snoring, and prognostic biomarkers in patients with chronic coronary syndrome
Authors: Olszowka M , Hagstrom E , Hadziosmanovic N , Ljunggren M , Denchev S , Manolis A J , Wallentin L , White H D , Stewart R A H , Held C 
Published: November 2023

Abstract

Background
Sleep-related breathing disorders (SRBD) are related to cardiovascular outcomes in patients with chronic coronary syndrome (CCS). Whether SRBD-related symptoms are associated with prognostic biomarkers in patients with CCS is not established.

Methods
Associations between frequency (never/rarely, sometimes, often, always) of self-reported SRBD-relatedsymptoms (excessive daytime sleepiness [EDS]; morning tiredness [MT]; loud snoring [LS]; multiple awakenings/night; gasping, choking, or apnea when asleep) and levels of biomarkers related to cardiovascular prognosis (high-sensitivity C-reactive protein [hs-CRP], interleukin 6 [IL-6], high-sensitivity cardiac Troponin T [hs-cTnT], N-terminal pro B-type natriuretic peptide [NT-proBNP], cystatin C, growth differentiation factor 15 [GDF-15] and lipoprotein-associated phospholipase A2 activity) were assessed at baseline in 15,640 patients with CCS on optimal secondary preventive therapy in the STABILITY trial. Cross-sectional associations were assessed by adjusted linear regression models with never/rarely as reference.

Results
EDS was associated (geometric mean ratio, 95% confidence interval) with increased levels of IL-6 (often 1.07 [1.03-1.10], always 1.15 [1.10-1.21]), GDF-15 (often 1.03 [1.01-1.06], always 1.07 [1.03-1.11]), NT-proBNP (always 1.22 [1.12-1.33]), and hs-cTnT (always 1.07 [1.01-1.12]). MT was associated with increased levels of IL-6 (often 1.05 [1.01-1.09], always 1.09 [1.04-1.15]), and GDF-15 (always 1.06 [1.03-1.10]). LS was associated with decreased levels of NT-proBNP (sometimes 0.94 [0.90-0.98], often 0.92 [0.87-0.97], always 0.87 [0.81-0.92]), and hs-cTnT (always 0.94 [0.91-0.98]).

Conclusions
In patients with CCS, gradually increased frequency of SRBD-related symptoms, such as EDS, MT, and LS, were independently and consistently associated with varying levels of IL-6, GDF-15, and NT-proBNP, each reflecting distinct pathophysiological pathways or underlying pathology of cardiovascular disease.
Figure 1. Adjusted analysis of associations between sleep-related breathing disorder-related questions and geometric mean ratios of prognostic biomarkersFigure 1A.Excessive Daytime SleepinessFigure 1B.Loud Snoring
Inferior vena cava wall thickness is associated with the presence and severity of cardiovascular disease
Authors: Fujiyoshi K , Tojo T , Ishida K , Ishida M , Yamaoka-Tojo M , Ako J 
Published: November 2023

Abstract

Background
Venous hypertrophy is a pathological condition that is commonly observed as individuals age. However, the clinical index and significance of venous hypertrophy are not yet fully understood.

Purpose
The purpose of this study was to clarify the relationship between clinical venous hypertrophy and cardiovascular disease (CVD).

Methods
A total of 407 patients who underwent echocardiography and evaluation of their endothelial function during a medical checkup were included in the study. Clinical venous hypertrophy was evaluated by measuring the thickness of the inferior vena cava wall (IVCWT) using echocardiography. Endothelial function was evaluated using flow-mediated dilation (FMD). CVD included ischemic heart disease, heart failure, and atrial fibrillation. The patients were divided into two groups based on the median value of IVCWT and their clinical characteristics were compared.

Results
The IVCWT was found to be normally distributed with a median value of 1.25 mm (p &lt; 0.001). The high-IVCWT group was found to be older (62.1 ± 13.1 years versus 58.1 ± 12.0 years, p = 0.001), had a higher ratio of males (72.4% versus 60.3%, p = 0.010), a higher ratio of CVD (7.4% versus 2.7%, p = 0.002), a lower left ventricular ejection fraction (62.1 ± 10.9% versus 64.6 ± 7.6%, p = 0.009), higher levels of B-type natriuretic peptide (21.0 [12.1-48.4] pg/mL versus 14.0 [8.9-33.5] pg/mL, p = 0.039), and lower FMD values (5.36 ± 2.33% versus 5.99 ± 2.73%, p = 0.012) compared to the low-IVCWT group. Multivariate analysis revealed that IVCWT and age were independent factors for the prevalence of CVD (IVCWT: Odds ratio 2.563, 95% confidence interval 1.258-5.563, p = 0.009; age: Odds ratio 1.049, 95% confidence interval 1.021-1.078, p &lt; 0.001). The receiver-operating characteristic analysis found that the best cut-off values for IVCWT and FMD to identify CVD were 1.60 mm and 0.49, respectively (IVCWT: area under the curve 0.731, p &lt; 0.001, sensitivity 51%, specificity 90%; FMD: area under the curve 0.739, p &lt; 0.001, sensitivity 80%, specificity 61%).

Conclusion
The results of this study suggest that IVCWT is associated not only with age, but also with the presence and severity of CVD.Figure 1Figure 2