bluuebunny/crossref_metadata_2025_split huggingface dataset:
S-31-3: BURDEN OF HYPERTENSIVE HEART DISEASE AND HIGH SYSTOLIC BLOOD PRESSURE IN AUSTRALIA FROM 1990–2019: RESULTS FROM THE GBD STUDY
Authors: Islam Sheikh Mohammed Shariful , Daryabeygi Reza , Ghaffari Payam , Xu Xiaoyue , Huxley Rachel , Maddison Ralph , Schutte Aletta E 
Published: January 2023

Background:
There is a dearth of comprehensive studies on the burden of hypertensive heart disease (HHD) and high systolic blood pressure (SBP) among the Australian population over time. We aimed to explore the burden of HHD and SBP, and how it changed over time from 1990 to 2019.

Methods:
We analysed the 2019 Global Burden of Disease data with a focus on Australia. We assessed the prevalence, mortality, disability-adjusted life-years (DALY), years lived with disability (YLD) and years of life lost (YLL) attributable to HHD and high SBP between 1990 and 2019 in Australia. GBD data sources included surveillance and survey data, published, and unpublished research articles and reports, vital registration and hospital data. Data were presented as point estimates with their corresponding 95% uncertainty intervals (UI).

Results:
From 1990 to 2019, the burden of HHD and SBP in Australia decreased. Age standardized prevalence rate of HHD was 119.3 cases per 100,000 people (95% UI 86.6 to 161.0) in 1990, compared to 80.1 cases (95% UI 57.4 to 108.1) in 2019. HHD death stood at 3.4 cases per 100,000 population (95% UI 2.6 to 3.8) in 1990, compared to 2.5 (95% UI 1.9 to 3.0), 32.0 cases (95% UI 26.1 to 38.8) in 2019. HHD contributed to 57.2 cases per 100,000 population (95% UI 46.6 to 64.7) of DALYs in 1990 compared to 38.4 cases per 100,000 population (95% UI 32.0 to 45.2) in 2019. Death rates per 100,000 population attributable to high SBP declined significantly over time for both sexes from 1990 (155.6 cases; 95% UI 131.2 to 177.0) to approximately one third in 2019 (53.8 cases; 95% UI 43.4 to 64.4).

Conclusion:
Over the past three decades, the burden of HHD and high SBP in Australia reduced, but remains relatively high, particularly HHD. The contribution of HHD and high SBP to mortality, DALYs, and YLLs reduced significantly from 1990 to 2019. Efforts to identify people with high blood pressure early and population level measures for improving the management of blood pressure should be a priority for Australia.
S-31-6: CURRENT STATUS AND FUTURE PERSPECTIVES OF ELDERLY HYPERTENSION IN ASIA
Authors: Cho Myeong-Chan 
Published: January 2023

Because of rapid aging and unhealthy life style in most of Asian countries, non-communicable diseases are increasing gradually and become significant disease burden and socioeconomic burden in Asia. However, the level of hypertension management is not good especially in the young adults.
Clinical decision-making for hypertension in the elderly should not depend on chronological age alone. Global risk assessment for individual patients, including comorbidities, frailty, functional status, polypharmacy, cognitive impairment, and variable life expectancy and the risk of orthostatic hypotension should be done for better management of hypertension and outcome. There are many conflicting results and discrepancies on the optimal target BP in elderly hypertensive patients.
Asians are different from Caucasians in genetic background, pathophysiology, clinical phenotypes, respond to medication, prognosis and etc. Although there are several hypertension guidelines in Asia, development of hypertension management guidelines for Asians is needed through pooled national cohort data, big health data analysis for precision medicine of hypertension. Hypertension is also good candidate for the digital smart healthcare in the near future.
S-32-3: RECENT IDACO ANALYSIS ON THE RISK OF PROGRESSION TO SUSTAINED HYPERTENSION FROM WHITE-COAT HYPERTENSION OR MASKED HYPERTENSION
Authors: Stolarz-Skrzypek Katarzyna 
Published: January 2023

In the general population, the cardiovascular risk is increased in patients with masked hypertension (MH), whereas in individuals with white-coat hypertension (WCH) it is virtually the same as in the normotensive individuals. However, no conclusive evidence exists as to whether WCH and MH are accompanied by a greater rate of development of a sustained hypertensive state, i.e. hypertension both in and outside the clinical environment. We investigated the risk of progression to sustained hypertension in initially untreated participants of cohort studies included in the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcome (IDACO) study.
Within the IDACO, 5 populations comprising 1081 individuals had ambulatory (ABP) and conventional (CBP) blood pressure measured at baseline and at follow up. We excluded from the analysis subjects on BP-lowering treatment at baseline (n = 252) and individuals with untreated sustained hypertension at baseline (n = 80), leaving 749 subjects included in the current analysis. The cut-off value for elevated CBP was > = 140/90 mm Hg and for daytime ABP > = 135/85 mm Hg.
At baseline, 110 individuals (14.7%) was defined as MH, 64 subjects as WCH (8.5%), and 575 (76.8%) as normotensives. MH patients were older (50 vs 45 years compared to normotensives, P < 0.01) and more frequently male (50.9 vs 31.5% compared to normotensives, P < 0.01). During median follow-up of 9.7 years, there were 264 incident cases of sustained hypertension. In the analyses adjusted for cohort, sex, age, body mass index, smoking and drinking, both MH (HR 2.23, 95%CI 1.57 to 3.17) and WCH (HR 1.84, 95%CI 1.37 to 2.47) significantly increased risk of progression to sustained hypertension.
In conclusion, long-term risk of progression to sustained hypertension is 2-fold higher in individuals with masked hypertension or white coat hypertension at baseline as compared to normotensive subjects at baseline. However, this observation might be due to more frequent initiation of antihypertensive therapy in both groups.
S-34-3: THE HEALTH AWARENESS AND SPILLOVER EFFECTS OF A COMMUNITY INTERVENTION BY HOME BLOOD PRESSURE MEASUREMENT: NOSE STUDY
Authors: Kabayama Mai , Wada Arisa , Godai Kayo , Kido Michiko , Hashimoto Sumiyo , Higashi Makiko , Hatanaka Hiromi , Kikuchi Takeshi , Dodo Takayuki , Tabara Yasuharu , Asayama Kei , Okubo Takayoshi , Rakugi Hiromi , Kamide Kei 
Published: January 2023

Objective:
This study examined participants’ health-related awareness, changes in health consciousness, and their spillover effects observed through community-wide home blood pressure (BP) monitoring intervention.

Method:
This study was based on an ongoing community-based intervention study in Nose, Osaka, which was designed to assess the effect of home BP measurement on prolonging healthy life expectancy. This study included 446 participants aged 40–91 years. We asked participants to measured their home BP with an electronic oscillometric device (HEM-7281; Omron Healthcare CO., Ltd) twice in morning and evening and record the values in the diary. About six months later, we asked the participants by mailed questionnaire about the status of continued measurement and changes in medication and health awareness.

Results:
The responded participants were 414(93.8%), and we analyzed 400 without missing data. Of the analyzed participants, 30% were on hypertension treatment. The number of participants who continuously measured every morning and evening was 348(87.0%).Of those, 301 (75.3%) newly started measuring as a result of the intervention. In their responses, the changes in health awareness or consciousness resulting from continued home BP measurement were, in descending order, “became more aware of my own and family members’ BP,“ “became more aware of my own physical condition,“ and “became more conscious of dietary content,“. In addition, a spillover effect of further measurement promotion in the household was recognized, such as “family members started taking measurements“ and “couples are calling out to each other to take measurements. After the start of HBP measurement, 32 (8%) of the participants newly started taking antihypertensive medication based on the home BP values.

Conclusion:
We found that home BP measurement can help even non-hypertensive individuals to become aware of changes in their physical condition and improve their health awareness. In addition, BP measurement behavior in the home was found to have spillover effects, such as increasing family members’ interest in BP and promoting home BP measurement behavior. It was suggested that measuring home BP for everyone, including non-hypertensives, is effective in health promotion and disease prevention for the entire community, including those who are indifferent to their own health.
S-34-5: PERSPECTIVES FROM LONGITUDINAL COHORT STUDY IN NORTHERN JAPAN -HYPERTENSION, METABOLIC DISORDERS AND CARDIOVASCULAR DISEASE-
Authors: Saitoh Shigeyuki 
Published: January 2023

The percentage of obese in the population of middle-aged Japanese has been increasing in recent years. With obese, population of metabolic disorder to be accompanied with diabetes mellitus, IGT increases explosively.The similar tendency is observed in the whole Asian countries. Recently, for the purpose of preventing cardiovascular disease, the conception of metabolic syndrome is proposed. Obesity, hypertension, glucose intolerance and lipid metabolism abnormality are included in this conception.
On the basis of data obtained through annual health examinations on about 2,000 residents in the two communities, we performed analysis and are currently reviewing cardiovascular disease and its relevant risk factors in this population. On the basis of the analysis, at this seminar, I will lecture on metabolic syndrome among the Japanese population in terms of frequency and characteristics as well as its impact on the onset of cardiovascular disease. Diagnosis of metabolic syndrome is based on the Japanese Criteria. When the sample consisted of those without a history of cardiovascular disease and not undergoing treatment for hypertension, diabetes, or hyperlipidemia, frequency of the syndrome was 20–25 percent for men and 5–7 percent for women, levels that have remained unchanged over the past 10 years. Those frequencies appeared to be on a level with those observed in other regions around the country. We also conducted a six-year follow-up of the male group. We found as a result that the relative risk of cardiovascular disease development, including coronary heart disease, was 2.3 times higher in syndrome males than in non-syndrome males.These studies suggest that the Japanese population exhibited a certain level of metabolic syndrome incidence due to accumulation of visceral fat, even though the rate of obesity is lower in this population than in the U.S., that metabolic syndrome affected a variety of atherosclerosis-related factors, and that the syndrome could practically serve as a predictive factor for cardiovascular disease.
Obesity is a basic factor in the onset of metabolic syndrome, and the BMI average among the Japanese population has increased over time. The significance of coronary heart disease against the backdrop of diabetes and metabolic syndrome will likely increase in the future. It is therefore necessary to develop primary preventive measures against coronary heart disease, tailored for the Japanese population, with a particular focus on improvement of lifestyle.
S-35-3: HAMA, AN EUROPEAN REGISTRY OF MALIGNANT HYPERTENSION SUPPORTED BY THE EUROPEAN SOCIETY OF HYPERTENSION: PRELIMINARY RESULTS AND CURRENT PERSPECTIVES
Authors: Rubin Sebastien , Lorthioir Aurelien , Halimi Jean Michel , Tharaux Pierre Louis , Antoine Cremer , Debeugny Stephane , Persu Alexandre , Philippe Gosse , Romain Boulestreau 
Published: January 2023

Introduction:
Malignant hypertension (MH) is one of the most severe acute forms of hypertension. It is very high blood pressure and an acute lesion of target organ damage. Incidence is currently increased in high-income countries and is higher in low-income countries due to difficulty with antihypertensive drug access. Causes of MH are very various, and probably prognosis of MH depends on the etiology. However, MH is not well known. We are conducting a multicentric prospective registry of MH patients started in 2019, primarily in France and is currently undergoing a European expansion with the support of the European Society of Hypertension (ESH) to describe the different forms and prognosis of MH and increase our knowledge of the disease (NCT03755726).

Method:
From 2019, in the 36 centres in France, Patients with a BP > 180/100 mmHg AND Severe Hypertensive Retinopathy - stade II or III of Kirkendall classification - OR with three criteria among the following: 1) Heart damage (Left ventricular Mass > 140 g/m2 for men of > 120 g/m2 for women); 2) Brain damage (PRES or acute stroke or severe white matter lesions (WML) with a Fazekas score > 2 before 60 years old); 3) Kidney damage (acute kidney injury defined by KDIGO criteria) 4) presence of Thrombotic Microangiopathy (TMA) with the presence of schizocytes and low haptoglobin or high LDH) were included.

Results:
To date, 278 patients were enrolled. The reason for hospital admission was symptomatic hypertension for 210/272 (77%) and asymptomatic hypertension for 62/272 (23%) BP was 218 ± 28 / 127 ± 23 mmHg. The mean age was 48 ± 15 years old. Males were 186/278 (67%). Non-Caucasians were 114/278 (41%), 101/278 (36%) smoked and 45/278 (16%) had diabetes. Before enrollment, 108/278 (39%) patients had chronic hypertension. Severe retinopathy was present in 251/278 (90%), Heart damage in 172/278 (62%), kidney damage in 176/278 (63%), and creatinine was 261 ± 326 μmol/l at admission. Brain damage was present in 105/278 (38%), 47/105 (45%) patients had severe WML. TMA was present in 40/278 (14%) patients. At discharge, BP was 148 ± 19 / 89 ± 15 mmHg; creatinine was 248 ± 274 μmol/l. The etiology of hypertension was assessed in 181/278 (65%), and a specific cause was found in 75/181 (41%).

Conclusion:
This multicentric prospective cohort is the opportunity to considerably increase our knowledge of MH, a non-uncommon severe disease. A biobank is currently being started to identify patients clustering to differentiate the etiology, prognosis and pathogenesis of each form of MH.
S-35-4: PEAK OF NOCTURNAL BLOOD PRESSURE SURGE IN SECONDS IS ASSOCIATED WITH LEFT VENTRICULAR MASS INDEX IN OBSTRUCTIVE SLEEP APNEA PATIENTS
Authors: Kokubo Ayako , Kuwabara Mitsuo , Ota Yuki , Tomitani Naoko , Yamashita Shingo , Shiga Toshikazu , Kario Kazuomi 
Published: January 2023

Background:
Nocturnal blood pressure (BP) surge in seconds (sec-surge), which is characterized as acute transient BP elevation over several tens of seconds, could be a predictor of target organ damage and trigger cardiovascular events. Sec-surges are induced by sleep apnea (SA) or sympathetic nerve activity. However, it is not clear that the severity of sec-surge is different between sec-surges induced by SA (apnea/hypopnea detected by polysomnography (PSG) or oxygen desaturation) and those induced by non-SA factors (rapid eye movement, micro arousal, etc.). Furthermore, it is also not clear whether the sec-surge increases the cardiac overload.

Methods and Results:
Firstly, we assessed the sec-surge severity between sec-surges induced by SA and those induced by non-SA factors by comparing the sec-surge variables. Secondly, we assessed the association between sec-surges and left ventricular hypertrophy (LVH) independently of conventional BP variables. We assessed these points with 41 patients (mean age 63.2 ± 12.6 years, 29% female) who underwent full PSG, beat-by-beat (BbB) BP, and cuff-oscillometric BP measurement during the night. All patients were included for the analysis comparing sec-surge severity between inducing factors (SA and non-SA factors).
There were no significant differences in the number of sec-surges/night, the peak of sec-surges defined as the maximum systolic BP in each sec-surge, and the amplitude of sec-surges defined as peak of sec-surge minus start point systolic BP in each sec-surge between SA-related sec-surges and non-SA-related sec-surges (19.5 ± 26.0 vs. 16.4 ± 29.8 events/night; 148.2 ± 18.5 vs. 149.3 ± 19.2 mm Hg; and 26.0 ± 4.3 vs. 25.8 ± 5.7 mm Hg, respectively).
Eighteen subjects who had inspection results of cardiac magnetic resonance imaging out of the 41 patients (mean age 65.0 ± 12.5 years, 33% female) were included for the analysis assessing the association between sec-surges and LVH. The peak of sec-surge was significantly and strongly correlated with left ventricular mass index (LVMI) (r = 0.607, p < .01). As a result of multiple regression analysis (n = 18), the peak of sec-surge was significantly and strongly associated with the LVMI (standardized β = 0.62, p = .02), compared with the mean nocturnal SBPs measured by oscillometric method (standardized β = -0.04, p = .87).

Conclusions:
This study suggests that peak of sec-surge could be a better predictor of LVH compared to parameters derived from regular nocturnal oscillometric SBP.
S-35-6: LONG-TERM REDUCTION IN MORNING AND NIGHTTIME BLOOD PRESSURE AFTER RENAL DENERVATION: 36-MONTH RESULTS FROM SPYRAL HTN-ON MED PILOT TRIAL
Authors: Kario Kazuomi , Mahfoud Felix , Kandzari David E , Townsend Raymond R , Weber Michael A , Schmieder Roland E , Tsioufis Konstantinos , Pocock Stuart , Fahy Martin , Boehm Michael 
Published: January 2023

Objective:
Elevated morning and nighttime blood pressures (BP) are associated with increased risk of cardiovascular events such as stroke. Furthermore, those with resistant hypertension (hypertension despite > = 3 antihypertensive medications) are at particular risk. We compared the long-term changes in morning, daytime and nighttime blood pressure (BP) in patients prescribed > = 3 antihypertensive medications 36 months after radiofrequency renal denervation (RDN) vs. sham control in the SPYRAL HTN-ON MED pilot trial.

Design and method:
The SPYRAL HTN-ON MED pilot trial enrolled patients with uncontrolled hypertension and office systolic BP (SBP) between 150 and < 180 mmHg, office diastolic BP > = 90 mmHg and mean ambulatory SBP between 140 and < 170 mmHg, with 1–3 prescribed antihypertensive medications. Patients were randomized 1:1 to RDN or sham control. Long-term safety and efficacy of the RDN procedure was assessed at 36 months through collection of adverse events and BP assessment. Differences in BP changes were compared between RDN and sham control using ANCOVA, adjusting for baseline measurements.

Results:
There were 80 patients randomized to RDN (N = 38) or sham control (N = 42). The number of antihypertensive medications at baseline was 2.13 ± 1.40 for RDN vs 1.98 ± 1.14 for sham control (p = 0.59). At 36 months, RDN patients were prescribed 3.03 ± 1.20 antihypertensive medications compared to 3.05 ± 1.43 in sham control (p = 0.76). Major adverse events through 36 months were rare in both groups, and there were no renal artery re-interventions or major vascular complications. Baseline morning (7:00–9:00 AM), daytime (9:00AM-9:00PM) and night-time (1:00–6:00 AM) SBP measurements for patients prescribed 3 or more antihypertensive medications at 36 months were similar between RDN and sham control (Figure). However, morning and night-time SBP were significantly reduced from baseline for the RDN group compared to sham control (morning SBP: -23.9 vs. -8.0 mmHg, p = 0.029; night-time SBP: -20.8 vs. -7.2 mmHg, p = 0.001; (Figure). Difference in daytime SBP was not significantly different between groups (-19.6 vs. -13.7 mmHg, p = 0.13). Additional analyses of BP reduction in patients with varying antihypertensive medication burden will be presented for the first time at ISH 2022.

Conclusions:
Morning and nighttime SBP were significantly reduced in patients prescribed at least 3 antihypertensive medications at 36 months in the SPYRAL HTN-ON MED pilot trial after RDN compared to sham control. The results suggest RDN has significant benefit when the risk of cardiovascular events is highest.
S-37-1: PROGNOSTIC UTILITY OF MORNING BLOOD PRESSURE SURGE
Authors: Chen Chen-Huan 
Published: January 2023

Morning blood pressure surge (MBPS), defined as the difference between morning systolic blood pressure and the lowest nighttime systolic blood pressure, is a normal physiological phenomenon of diurnal blood pressure variability (BPV). Exaggerated MBPS is associated with morning hypertension and has been associated with adverse cardiovascular and cerebrovascular events, especially hemorrhagic stroke. However, MBPS has low reproducibility and there is an ethnic difference in the amplitude of MBPS and its prognostic value. More evidence is needed to prove its clinical usefulness in the management of hypertension. Since the risk of MBPS is mainly attributable to the elevated morning blood pressure, the focus therefore has shifted from MBPS to the control of morning hypertension.
Because MBPS focuses only on the amplitude rather than the rate of blood pressure rise, we calculated the MBPS rate as the slope of linear regression of sequential systolic blood pressure measures on the time intervals within the MBPS period. We found the reproducibility for the MBPS rate was better than the MBPS amplitude. The MBPS rate was a more sensitive and reliable prognostic factor of long term mortality than the MBPS amplitude. The prognostic values of MBPS rate were comparable in subjects with or without morning and nocturnal hypertension. Because the MBPS rate can easily be calculated from the ambulatory blood pressure monitoring data, it could become a routine parameter in daily practice in conjunction with other routinely derived parameters including MBPS amplitude.