bluuebunny/crossref_metadata_2025_split huggingface dataset:
MEDICATION ADHERENCE IN PATIENTS WITH UNCONTROLLED HYPERTENSION AND HYPERTENSIVE CRISIS PRESENTING TO AN HOSPITAL SETTING IN KARACHI, PAKISTAN
Authors: Yousuf Fatimah Sireen , Khan Muhammad Arbaz Arshad , Bibi Raheela , Arif Aiman , Arshad Ainan , Almas Aysha 
Published: June 2023

Objective:
Hypertension is an established risk factor for cardiovascular disease. Non-adherence to antihypertensive medications contributes to poorly controlled hypertension while also increasing the risk of hypertensive crisis. The aim of our study was thus to estimate the frequency of adherence to antihypertensive medications and also see if an association exists between adherence and the development of hypertensive crisis.

Design and method:
This cross-sectional study was undertaken on patients admitted to Aga Khan University Hospital between July 2020 and March 2022. All patients with uncontrolled hypertension with systolic blood pressure (BP) > 140 and diastolic BP > 90 were included. Hypertensive crisis was defined as a systolic BP over 180mm Hg or diastolic BP over 120mm Hg, with or without end organ damage. Adherence to medications was assessed using the 4 item Morisky Green Levine scale. A cumulative score of more than and equal to 3 signified adherence while a score of 0, 1 or 2 was classified as non-adherence.

Results:
We found that 64% of the cohort were adherent to their medications while 93(36%) were non-adherent. Depression was seen in 133(51.2%) while 147(56.5%) had anxiety. Similar rates were seen amongst males (49.1%) and females (50.9%) when stratified by adherence. The highest level of adherence was seen in the 61-75 years age group (34.9%). We also found statistically significant association of adherence to antihypertensive medications with anxiety (p value = 0.048). Moreover, in the hypertensive crisis group, 40.7% of the patients were adherent to their antihypertensive medications while 54.8% were found to be non-adherent, with p value reaching statistical significance (p = 0.028).

Conclusions:
We found a higher rate of adherence (64%) in this inpatient hypertensive population as compared to previous studies in our population. We also found that non adherence is a risk factor for the development of hypertensive crisis. Therefore, at clinic visits, physicians should assess their patient's adherence to antihypertensive medications to prevent the development of a hypertensive crisis, which is a potentially life threatening complication of uncontrolled hypertension.
PREDICTION OF ATHEROSCLEROSIS DEVELOPMENT AND MODIFICATION OF ITS RISK FACTORS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Iaremenko Oleg , Koliadenko Daria , Stepanova Natalia , Matiyashchuk Iryna 
Published: June 2023

Objective:
Early-onset atherosclerosis with cardiovascular (CV) sequelae is the major cause of death in systemic lupus erythematosus (SLE); that cannot be explained only by traditional Framingham risk factors as SLE-related factors may also have an impact. The present study aimed to analyze the determinants of atherosclerosis development and risk factors modification by statin therapy in SLE patients.

Design and method:
This prospective randomized study included 100 SLE patients aged 40.9±1.4 years (90 females, 10 males) and 32 age-, sex-matched healthy controls. Brachial artery flow-mediated dilation (FMD), ultrasound of extracranial and peripheral arteries, and cardiac calcium scoring were used for the identification of atherosclerosis. 52 SLE patients with dyslipidemia were randomized to receive simvastatin 40 mg/day (n = 27) or placebo (n = 25). Lipid panel, FMD, and inflammatory markers were assessed at baseline and after 6 months.

Results:
The mean duration of SLE was 9.9±0.88 years. The disease activity index (SLEDAI) and SLE damage score (SLICC) were 11.8±0.6 and 1.85±0.13 points, respectively. In 66% of SLE patients, atherosclerosis was present in at least one vascular area which was 3.5 times more frequently compared with controls. Atherosclerosis of carotid arteries was detected in 41% of SLE patients, lower limb arteries, and coronary arteries in 58% and 39% of patients, respectively. FMD was significantly decreased in SLE patients compared to controls (7.95±0.49% vs 11.6±0.3%, p<0.001). In multiple linear regression, age (p<0.001), nephritis (p = 0.001), polyarthritis (p = 0.019), and Raynaud's syndrome (p = 0.045) were associated with low FMD. In binary logistic regression, independent determinants of the atherosclerosis development in SLE were age (p<0.001), body mass index (BMI) (p = 0.001), anti-dsDNA (p = 0.023), FMD (p = 0.017) and malar rash (p = 0.02). After simvastatin treatment, the level of LDL-Cholesterol reduced by 42%, erythrocyte sedimentation rate, C-reactive protein, and interleukin-6 decreased by 34.7%, 51.1%, and 47.7% respectively, while FMD increased by 26.0% (p<0.05); in the placebo group, there were no significant changes.

Conclusions:
The independent determinants of atherosclerosis in SLE patients were both traditional CV risk factors (age, BMI) and SLE-specific factors (anti-dsDNA, malar rash, FMD). In SLE patients with dyslipidemia, simvastatin may have not only lipid-lowering but also potentially anti-inflammatory benefits.
EFFECT OF YOGA ON RISK FACTORS IN POST MYOCARDIAL INFARCTION CASES
Authors: Prasad Avneesh , Dwivedi Shridhar , Sharma Vinod 
Published: June 2023

Objective:
To study the effect of yoga on risk factors and Beck's Depression Inventory score after myocardial infarction

Design and method:
Our study that comprised of 300 patients were randomized into test group (n = 150) who were subjected to conventional treatment and yoga and control group (n = 150) subjected to conventional treatment only.
The study included patients diagnosed as myocardial infarction above 18 years with their consent to participate. Patients with hemodynamic instability, heart failure, pregnancy, prior yoga practice, arrhythmia, cardiac pacemaker, autonomic neuropathy and musculoskeletal disease were excluded.
Initially, assessment of clinical & biochemical parameters and routine investigations were performed. Beck's depression score was calculated. Yoga was started on 4th day after MI (test group) and there were sessions of 10 minutes of pranayam, 15 minutes of shavasan and 15 minutes of transcendental meditation. The patients were followed after 24 weeks for assessment of clinical & biochemical parameters. Carotid doppler & depression score was evaluated.

Results:
After 24 weeks of intervention, a significant improvement was noted among yoga group in comparison to control group for BMI (p = 0.04), heart rate (p = 0.01), systolic & diastolic blood pressure (p<0.05), fasting & post prandial blood sugar (p<0.05), HbA1c (p = 0.03), Beck's depression score (p = 0.001) and lipid profile (p<0.05). In contrast, no improvement was seen for carotid intima media thickness.

Conclusions:
On the basis of the study, it was concluded that conventional therapy with yoga has a positive impact on risk factors of MI and psychosocial stress including blood pressure. Therefore, yoga can be recommended to reduce morbidity and mortality after MI. Large trials with more number of cases and long term follow up are needed so that yoga as an intervention, can be added for secondary prevention and rehabilitation in myocardial infarction cases.
LEUKOCYTE INDICES IN NON-DIABETIC HYPERTENSIVES CAMEROONIANS MODESTLY PREDICT CARDIOVASCULAR RISK. PRELIMINARY RESULTS OF THE HYRICCA PROJECT
Authors: Liliane Kuate Mfeukeu , Nkeck Jan Rene , Ndedi Claudine Jessca Yondo , Moor Vicky Ama , Menanga Alain , Kingue Samuel 
Published: June 2023

Objective:
study the contribution of leukocyte parameters in cardiovascular risk assessment of non-diabetic hypertensive adults

Design and method:
we carried out a cross sectional study including non-diabetic hypertensive patients followed up at the cardiology unit of the Yaoundé Central Hospital from November to June 2022. The collected data included cardiovascular risk factors, biomarkers of risk (Hs CRP and atherogenic indices) and cardiovascular risk scores (Framingham 2008, European SCORE 2003, WHO CVD risk laboratory-based charts 2019, ASCVD 2013 and Reynolds score).

Results:
we included 165 participants (102 females) with a mean age of 57.6 ± 10.4 years. The median duration of hypertension since diagnosis was 7 years and only 27% of participants on treatment had a controlled blood pressure. There was a significantly weak and positive correlation between neutrophil to lymphocyte ratio and systolic blood pressure (rho = 0.24, p = 0.02). Participants with dyslipidaemia had significantly raised levels of granulocyte count, eosinophil count and their corresponding leukocyte ratios (p < 0.05). Highly sensitive CRP and the atherogenic index of plasma were significantly correlated respectively with the eosinophil to lymphocyte ratio (rho = 0.28, p = 0.01) and granulocyte to lymphocyte ratio (rho = 0.18, p = 0.03). There were also weak positive correlations between leukocyte parameters, Reynolds and ASCVD 2013 scores.

Conclusions:
leukocyte indices could be useful in cardiovascular risk assessment of hypertensive patients.
EFFECT OF COENZYME Q10 ON MUSCULAR STRENGTH IN ELDERLY PATIENTS WITH STATIN-ASSOCIATED ASTHENIA: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED CLINICAL TRIAL
Authors: Cicero Arrigo , Fogacci Federica , Giovannini Marina , Tocci Giuliano , Borghi Claudio 
Published: June 2023

Objective:
Statin treatment has been associated with decreased serum level of coenzyme Q10 (CoQ10). This double-blind, randomized, placebo-controlled clinical study aimed to investigate the effect of chronic dietary supplementation with CoQ10 phytosome on muscular strength in elderly patients with statin-associated asthenia.

Design and method:
Participants were randomized to receive daily either 2 indistinguishable pills of placebo or 150 mg CoQ10 phytosome (i.e. 300 mg CoQ10 phytosome per day, equivalent to 60 mg CoQ10; Ubiqsome®). Asthenia and handgrip strength (HGs), 1-minute sit-to-stand (STS) repetitions and 2-minute steps (2MST) were performed at baseline and at 8-week follow-up.

Results:
All enrolled patients successfully completed the trial. After the first 4 weeks of dietary supplementation, CoQ10 phytosome supplementation correlates with more significant improvement in asthenia compared placebo (p< 0.05). At 8-week follow-up, patients undergoing CoQ10 dietary supplementation experienced significant improvements in asthenia (-30.0±20.0%), HGs (+29.8±3.6%), 1-min STS repetitions (+36.4±3.9%), and 2MST (11.1±1.8%) (p <0.05 versus baseline and versus placebo).

Conclusions:
According to the present observations, chronic dietary supplementation with CoQ10 phytosome is able to effectively improve muscular strength in elderly patients with statin-associated asthenia.
SUBCLINICAL TARGET ORGAN DAMAGE IN PATIENTS WITH RESTLESS LEGS SYNDROME. A PRELIMINARY OBSERVATIONAL STUDY
Authors: Biasotto Andrea , Franzin Angelica , Rosin Elena , Burrei Giulia , Sabba’ Giulia Elena , Bonafini Sara , Giontella Alice , Cattazzo Filippo , Minuz Pietro , Antelmi Elena , Fava Cristiano 
Published: June 2023

Objective:
Restless legs syndrome (RLLS) is a frequent and often underdiagnosed type of insomnia. Since other types of insomnia present a strict association with cardiovascular disease, our study aimed to evaluate the possible association of RLLS with some early markers of cardiovascular organ damage.

Design and method:
Patients with other types of insomnia and those with central nervous system diseases were excluded. Twenty-eight patients (mean age: 63,1±13,9 years; 28.6% males) participated in the study. Fourteen subjects with diagnosis of RLLS according to International diagnostic criteria (Allen RP et al. 2014 Sleep Medicine) (disease mean duration 9.6±9.2 years; International Restless Legs Scale score 22.9±5.2) were matched for sex, age and major cardiovascular risk factors with 14 controls. In both groups, peripheral Blood Pressure (pBP), central Blood Pressure (cBP) and Pulse Wave Velocity (PWV) were assessed by the SphygmoCorXCEL. Carotid Intima-Media Thickness (cIMT) and the carotid Distensibility Coefficient (cCD) were assessed by ultrasound connected with an image acquisition and analysis system (CardiovascularSuite).

Results:
We did not find any significant difference between the two groups in the indices of subclinical vascular damage. In the RLS group, blood pressure measurements significantly correlated with all the markers of subclinical vascular damage, particularly pSBP was associated with PWV (r = 0.53, p = 0.009), Pulse Pressure correlated with cIMT (r = 0.58, p = 0.01) and cDBP was inversely related to cDC (r = -0.53; p = 0.03).

Conclusions:
Our data did not show significant differences in markers of early vascular damage between patients with RLS and matched controls. As expected, the markers of vascular damage were associated with BP. The present is only a pilot study; further studies with a larger sample size are required to confirm our findings.
ASSOCIATION OF TRANSITION IN METABOLIC HEALTH AND OBESITY WITH AGE AT ONSET FOR INCIDENT CARDIOVASCULAR DISEASES
Authors: Zhao Maoxiang , Hao Xue , Wu Shouling 
Published: June 2023

Objective:
The cardiometabolic risk associated with metabolically healthy obesity (MHO) remains the subject of debate. It is unclear whether changes in MHO status affect premature cardiovascular disease (CVD) risk. In this study, we aimed to investigate the association of MHO and its transition over time with incident CVD by age at onset.

Design and method:
In a community-based prospective cohort study, 54441 adults who were free of CVD in or before 2010 were followed up for incident CVD until 2020. Four age groups were examined (<55, 55-65, 65-75, and > = 75 years) for CVD onset. In each age group, participants were cross-classified by BMI categories and metabolic health. The Cox proportional hazards model with age as the underlying time scale was used to examine the associations of metabolic health status and its transition with CVD across BMI categories.

Results:
During a median follow-up of 9.59 years, 3038 participants developed CVD. Individuals with metabolic unhealthy obesity (MUO) had the highest hazard ratio (HR) for CVD onset at any age, ranging from 2.68 (95% CI, 2.02-3.55) for CVD onset in those younger than 55 years to 1.55 (95% CI, 1.09-2.10) for CVD onset in those older than 75 years. Individuals who were MHO at baseline or even remained metabolically healthy were still at increased risk of premature CVD, and the association attenuated with increasing onset age.

Conclusions:
In this cohort study, the association between metabolically healthy and obesity status and incident CVD appeared to differ by age at CVD onset and the associations were more evident for premature onset of CVD.
ASSESSMENT OF SST2 BEHAVIORS TO EVALUATE SEVERITY/CLINICAL IMPACT OF ACUTE PULMONARY EMBOLISM
Authors: Petramala Luigi , Concistrè Antonio , Sarlo Francesca , Baroni Silvia , Suppa Marianna , Servello Adriana , Circosta Francesco , Galardo Gioacchino , Gandini Orietta , Marino Luca , Cavallaro Giuseppe , Iannucci Gino , Letizia Claudio 
Published: June 2023

Objective:
Pulmonary embolism (PE) is a potentially life-threatening disorder. Beyond its usefulness in the prognostic stratification of heart failure, sST2 can represent a biomarker with high utility in several acute conditions. Our study was aimed to investigate whether sST2 can be used as a clinical marker of severity and prognostic outcome in acute PE.

Design and method:
We enrolled 72 patients with documented PE and 38 healthy subjects; we measured the plasma concentrations of sST2 to evaluate the prognostic and severity performance of different levels of sST2 according to its association with the pulmonary embolism severity index (PESI) score and several parameters of respiratory function.

Results:
PE patients had significantly higher levels of sST2 compared with healthy subjects (87.74 ± 17.1 vs. 17.1 ± 0.4 ng/mL, p < 0.001); we found higher PESI scores and serum lactate values in the group of patients with sST2 > 35 ng/mL compared with patients with sST2 < 35 ng/mL (138.7 ± 14.9 vs. 103.7 ± 15.1 and 2.43 ± 0.69 vs. 1.025 ± 0.05 mmol/L, respectively; p < 0.05). Patients with sST2 > 35 ng/mL showed higher radiological severity of PE compared with patients with sST2 < 35 ng/mL. Moreover, sST2 was the strongest parameter with a discriminative capacity for the development of acute respiratory failure and a PESI score >106 with respect to C reactive protein (CRP), creatinine, d-dimer, and serum lactate.

Conclusions:
We clearly demonstrated that sST2 significantly increased in PE and that its elevation was associated with disease severity. Therefore, sST2 may be used as a clinical marker in the evaluation of PE severity. However, further studies with larger patient populations are required to confirm these findings.
SCREENING FOR ARTERIOPATHY OBLITERANTS OF THE LOWER LIMBS BY MEASUREMENT OF THE SYSTOLIC PRESSURE INDEX IN PATIENTS LIVING WITH HIV ON ANTIRETROVIRALS
Authors: Alassane Ngaide Aliou , Diaba Gaye Ngone , Salvador Mingou Joseph , Tening Diouf Marguerite , Houda Haimed , Rassoul Diop Khadim , Youssou Diouf , Karim Diop , Bara Diop El Hadji , Abdoul Kane 
Published: June 2023

Objective:
The objectives of this study were to evaluate the frequency of obliterating arteriopathy of the lower limbs in HIV-positive patients on antiretrovirals by measuring the systolic pressure index, to describe the epidemiological and diagnostic aspects and to see the links between the field of HIV, the administration of antiretrovirals and the associated cardiovascular risk factors.

Design and method:
This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2022 to June 30, 2022. Included were HIV-positive patients on antiretrovirals, followed on an outpatient basis at the Regional Research Center and Training of the FANN Hospital Center, after having signed a free and informed consent. The data was collected on a pre-established survey sheet and included cardiovascular risk factors and especially those of the measurement of the systolic pressure index in a systematic and bilateral. Data analysis was performed with SPSS version 18 software. Any difference less than 0.05 was considered statistically significant.

Results:
Our study was conducted on 150 patients. The predominance was female with a sex ration of 0.58. The average age was 46.78 years. The main cardiovascular risk factors found were dyslipidemia (51.6%), hypertension (19.5%), smoking (6.9%) and diabetes (3.4%).
Fifty-five percent (55%) had PAD (systolic pressure index < 0.9). Among them, 72.4% had a well-compensated PAD and 37.6% a poorly compensated PAD. The right lower limb was most often affected with a proportion of 37.9% and mainly concerned the anterior tibial artery (40.5%). The left lower limb was affected in 25.3% of cases with a predominance of involvement of the anterior tibial artery (35.5%). PAD was more frequent in women with a proportion of 68.5%, either. a sex ratio F/M of 2.17 and in patients under 50 (50.8%). All patients were on triple therapy with Tenofovir, Lamivudine and Dolutegravir.
There was a correlation between smoking (p = 0.029), dyslipidemia (p = 0.02) and duration of HIV infection between 6-10 years (p = 0.039).

Conclusions:
Our study has highlighted the interest of systolic pressure index in the detection of PAD in patients living with HIV.
CHARACTERISTICS OF THE HIGH BLOOD PRESSURE IN A TYPE 2 DIABETIC POPULATION IN THE AREA OF BLIDA (ALGERIA)
Authors: Cherif Abdelghani Bachir , Bennouar Salam 
Published: June 2023

Objective:
The association diabetes-high blood pressure (BP) is frequent. It increases the cardiovascular risk and accelerates the onset of degenerative complications of diabetes. The aim of the present study was to test the effect of the hypertension-diabetes association on the degenerative complications of diabetes and to determine the proportion and the factors associated with uncontrolled hypertension.

Design and method:
This was a cross-sectional study conducted among 2129 type 2 diabetic hypertensive patients aged 40 years or over, followed in the internal medicine department of hospital of Blida (Algeria), between February 2020 to November 2022.

Results:
The average age was 46 ± 6.6 years, with a female predominance (73.5%). Hypertension was present in 60.4% of normal weight patients, in 55.1% of overweight patients and 62.8% of obese patients with a significant difference (p = 0.03). Macroangiopathy was observed in 57% of patients with mainly ischemic heart disease (44%). It was significantly more frequent in patients with LDL-c greater than 1.3 g/l and hypoHDLemia less than 0.35 g/l. The proportion of uncontrolled hypertension (BP > 140/90) was 55% including 13% of cases of severe hypertension (BP > 180/110). Resistant hypertension was found in 21% of cases. This poor blood pressure control was correlated with insulin treatment (p = 0.05), insufficient physical activity (p = 0.03), treatment duration greater than 10 years (p = 0.01) and a number of tablets greater than 2 (p = 0.031). We did not find a significant difference between the level of BP control and the seniority of diabetes, the body mass index, the presence of degenerative complications, the intellectual and socioeconomic level. The analytical study showed no positive association between the onset of hypertension and the following factors: the HbA1c level and the duration of diabetes progression. We found a strong correlation between the degenerative complications of diabetes and the presence of hypertension: retinopathy (p = 0.05), neuropathy (p = 0.02), nephropathy (p = 0.001), coronary artery disease (p = 0.001), cerebrovascular accidents (p = 0.01).

Conclusions:
Our study highlights the positive effect of hypertension on the degenerative complications of diabetes. Optimal control of blood pressure figures is imperative to limit the development of these complications and improve life expectancy.