bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C24-1: EFFECTS OF ANGIOTENSIN RECEPTOR-NEPRILYSIN INHIBITOR ON CAROTID ARTERIAL IMT AND ELASTIC MODULUS, BAPWV IN HYPERTENSIVE PATIENTS WITH HEART FAILURE
Authors: Yamagishi Toshio 
Published: January 2023

Objective:
Sacubitril/valsartan is a first-in-class, novel-acting, angiotensin receptor neprilysin inhibitor (ARNI) that provides inhibition of neprilysin and the angiotensin (AT1) receptor. Effects of Sacubitril/valsartan on carotid arterial IMT and elastic modulus, baPWV in hypertensive patients with heart failure

Methods:
Thirty-three hypertensive patients with chronic heart failure (mean age 79 years, male 15) were assigned to receive Sacubitril/valsartan (gradual increase depending on the condition) of Sacubitril/valsartan added to existing drug therapies (average number of antihypertensive agents 3) or switched from ARB or ACE inhibitor for 6 months. Changes in home BP, BNP, NT-proBNP, hANP, estimated glomerular filtration rate (eGFR), baPWV and central blood pressure (cSBP) were evaluated. EΘ was obtained by the phased-tracking method (Kanai, Circulation 2003). At four locations of bilateral common carotid arteries, IMT and Etheta; were measured simultaneously.

Results:
The basal values before Sacubitril/valsartan administration of Body weight(BW), BNP, NT-proBNP, hANP, EF, serum K, eGFR, home early morning blood pressure, home early morning heart rate, baPWV, cSBP, IMT, EΘ were 63 ± 16 kg and 310 ± 237 pg /,mL, 1981 ± 237 pg / mL, 475 ± 514 pg / mL, 51 ± 14%, 4.2 ± 0.4 mEq / L, 46 ± 14 ml / min / 1.73 m2, 141 ± 8/75 ± 11 mmHg, 76 ± 14 bpm, 1526 ± 245 cm / sec, 137 ± 13 mmHg, 0.84 ± 0.12 mm, and 301 ± 141 kPa respectively. ARNI s reduced BW (-4%), BNP (-32%), NT-proBNP (-38%), home early morning blood pressure-17 / -10mmHg, and baPWV (-4%) significantly (p < 0.05). In addition, EF (+ 5%) and hANP were significantly increased, and serum K and eGFR were unchanged. On the other hand, IMT (-5%) in carotid echo decreased, and EΘ decreased significantly.

Conclusions:
Sacubitril/valsartan was effective for BP control improved cardiac function and arterial stiffness in hypertensive patients with chronic heart failure. EΘ is a good surrogate marker for the early detection of vascular remodeling such as improvement of endothelial dysfunction prior to changes in IMT.
PS-C27-11: HYPERTENSION AND LOW EGFR AMONG MALE OCCUPATIONAL AUTO-RICKSHAW DRIVERS FROM NORTH INDIA- SCREENING FOR CHRONIC KIDNEY DISEASE RISK FACTORS
Authors: Gupta Anish Kumar , Singh Narinder Pal , Khanna Tripti , Aggarwal Neeru P , Gandhi Pratibha , Kaul Shaurya , Sarkar Taposh , Khullar Dinesh 
Published: January 2023

Objective:
To find out the prevalence of low estimated Glomerular Filtration Rate (eGFR) and major Chronic Kidney Disease (CKD) risk factors such as hypertension, Diabetes Mellitus, obesity among male occupational auto-rickshaw drivers as they are highly exposed to air pollution.

Design and method:
The study population included male auto-rickshaw drivers of more than or equal to 18 years of age and driving for at least one year. Participant's demography (height, weight, waist circumference), and blood pressure were measured and medical history, history of substance abuse, and occupation history was obtained in a structured questionnaire. Blood and urinalysis were performed for measurement of serum creatinine, uric acid, and proteinuria respectively. eGFR was measured using the CKD-EPI equation.

Results:
A total of 900 male auto-rickshaw drivers were enrolled in the study. Age varied from 19 to 75 (mean 39.56 ± 10.5 years). 59.6% had less than 15 years of experience in driving an auto-rickshaw (mean 13.1 ± 9.7 years) with daily working hours of 10.3 ± 2.1. Among 900 participants, 3.9% had low eGFR (less than 60 ml/min), and 8.7% had proteinuria (more than 30 mg/dl). Prevalence of CKD, hypertension, and diabetes was found to be 3.9% (stage - 1 to stage - 4; 6.4%, 1.3%, 3.4%, 0.5% respectively), 37% and 8.4% respectively. One-third (33.6%) of auto-rickshaw drivers were newly diagnosed with hypertension and 15 (2.7%) were new-onset diabetic. Around one-fourth (24.5%) of autorickshaw drivers were prevalent with hyperuricemia (serum uric acid more than 7 mg/dl) and 5% were anemic (Hb (less than 13 gm/dl). Approximately 42% of the participants were overweight or obese (BMI more than 25 kg/m2) and central obesity was found in 7.4% (more than 102 cm) participants. Tobacco products and alcohol use among auto/taxi drivers were high (63% and 23.5% respectively).

Conclusion:
High prevalence of CKD and associated risk factors such as hypertension, diabetes, obesity hyperuricemia, and anemia were observed in male occupational auto-rickshaw drivers. A routine screening program should be implemented for primary prevention and management of risk factors of CKD among such populations that are highly exposed to air pollution.
PS-P07-1: TERATOGENIC RISK OF FIRST TRIMESTER EXPOSURE TO ANTIHYPERTENSIVES, INCLUDING AMLODIPINE AND METHYLDOPA: AN ANALYSIS OF AN ADMINISTRATIVE DATABASE 2010–2019
Authors: Ishikawa Tomofumi , Nishigori Hidekazu , Akazawa Manabu , Miyakoda Keiko , Noda Aoi , Ishikuro Mami , Metoki Hirohito , Iwama Noriyuki , Saito Masatoshi , Sugawara Junichi , Kawame Hiroshi , Yaegashi Nobuo , Kuriyama Shinichi , Mano Nariyasu , Obara Taku 
Published: January 2023

Objective:
No firm conclusions on the teratogenic risk of antihypertensives have been drawn, although methyldopa and amlodipine are relatively frequently prescribed in the first trimester (FT) in Japan [1]. The primary objective was to evaluate the teratogenic risk of FT exposure to antihypertensives, including amlodipine and methyldopa.

Design and method:
This study used a large claims database from JMDC Inc. The dates of pregnancy onset and delivery were estimated using published algorithms [2] and infant birth months. The prevalence of antihypertensive prescriptions during pregnancy was described in 91,390 women who gave birth between 2010 and 2019. The time trends of antihypertensive prescription were evaluated using a multivariate logistic regression model adjusted for maternal age. The teratogenic risk of FT antihypertensive exposure was evaluated in 1,185 women diagnosed with hypertensive disorders in the FT. The teratogenic risk of FT exposure to amlodipine and methyldopa was evaluated in 178 women who were prescribed antihypertensives in the FT. Logistic regression analysis was used to estimate the odds ratios (ORs) for overall major congenital malformations (MCMs). The results were presented for analyses adjusted for multiple confounding factors. The MCMs in claims were validated and the overall positive predictive value was 91.5% [3].

Results:
Antihypertensives were prescribed to 278 (0.30%) women during their FT. The prescription prevalence in the FT was highest for methyldopa (0.13%), followed by amlodipine (0.06%), oral hydralazine (0.03%), and nifedipine (0.02%). Antihypertensives were prescribed to 2,955 (3.23%) pregnant women. Nifedipine (0.99%) was the most frequently prescribed oral antihypertensive medication, with a significant increase in annual prevalence (P < 0.0001), followed by methyldopa (0.78%), hydralazine (0.34%), and furosemide (0.14%) during pregnancy. Nicardipine (0.83%) was the most frequently prescribed injectable antihypertensive agent, with a significant increase in annual prevalence (P < 0.0001), followed by furosemide (0.42%), nitroglycerin (0.26%), and hydralazine (0.20%) during pregnancy. The adjusted OR (aOR) of MCMs in the FT prescription of any antihypertensive medication was 1.096 (95% confidence interval [CI], 0.612–1.964). The aORs of MCMs in the FT prescription of amlodipine and methyldopa were 1.161 (95% CI, 0.347–3.882) and 0.937 (0.313–2.809), respectively.

Conclusions:
FT exposure to antihypertensive drugs, including amlodipine and methyldopa, was not associated with MCM risk in infants.

REFERENCE
1. Pharmacoepidemiol Drug Saf 2018; 27:1325–1334.2. Pharmacoepidemiol Drug Saf 2018; 27:751–762.3. Pharmacoepidemiol Drug Saf 2021; 30:975–978.
PS-P07-4: THE USE OF SPECIFIC ANTIHYPERTENSIVE MEDICATION AND SKIN CANCER RISK: A SYSTEMATIC REVIEW OF THE LITERATURE AND META-ANALYSIS
Authors: Heisel Annalena GU , Vuurboom Mart D , Daams Joost G , de Rie Menno A , Vogt Liffert , van den Born Bert Jan H , Engberink Rik HG Olde 
Published: January 2023

Objectives:
The use of hydrochlorothiazide has recently been linked to skin cancer in observational studies. This may be explained by its photosensitizing properties, but photosensitivity has also been reported for other antihypertensive drugs. We conducted a systematic review and meta-analysis to compare skin cancer risk among antihypertensive drug classes and between individual blood pressure lowering drugs.

Methods:
We searched Medline, Embase, Cochrane and the Web of Science to 9th of February 2022 and included studies that investigated the association between antihypertensive medication exposure and non-melanoma skin cancer (NMSC) or cutaneous malignant melanoma (CMM). We combined the extracted adjusted odds ratios (OR) using a random effects model. We performed sensitivity analyses comparing study type, population and studies with and without correction for important covariates.

Results:
We included 43 studies. Diuretics (n = 17,729,595), in particular hydrochlorothiazide (n = 17,710,679), and calcium channel blockers (CCB, n = 8,413,919) were examined more frequently than beta-blockers (n = 94,872) or renin-angiotensin system inhibitors (n = 2,019,786). Exposure to diuretics (OR 1.30, 95% CI [1.12–1.52]) and CCB (OR 1.06, 95% CI [1.04–1.09]) was associated with an increased risk for NMSC. No antihypertensive drug class was associated with an increased risk for CMM. Within every drug class, at least 1 individual drug was associated with an increased risk for NMSC: nifedipine, hydrochlorothiazide, sotalol, verapamil, enalapril and bendroflumethiazide. Increased NMSC risk was only observed in case-control studies and in studies that did not correct for important covariates. No increased NMSC risk was observed in cohort studies and studies that did correct for the covariates sun exposure, skin phototype or smoking. (Figure) Only 2 out of 43 studies provided information about antihypertensive co-medication. Eggers test revealed a significant publication bias for the subgroup of diuretics and hydrochlorothiazide concerning NMSC (both p < 0.001).

Conclusion:
Of all antihypertensive drugs, diuretics and calcium channel blockers may be associated with an increased risk of NMSC, but causal inferences remain difficult to make because of aforementioned substantial limitations in available data and evidence of publication bias.
PS-P08-2: FACTORS RELATED TO PARTICIPATION IN HEALTH CHECKUPS AMONG MIDDLE-AGED JAPANESE COMMUNITY RESIDENTS IN THE PRECONTEMPLATION STAGE
Authors: Sonoda Nao , Furuki Hideaki , Morimoto Akiko 
Published: January 2023

Objective:
In Japan, all medical insurers are obliged to conduct annual specific health checkups. These checkups are part of the National Health Service system and target all insured people aged 40–74 years and aim to facilitate prevention and early detection of atherosclerosis-related diseases such as hypertension, diabetes, and dyslipidemia. However, the participation rate in specific health checkups is low in Japan, especially among middle-aged community residents with municipal National Health Insurance (NHI). Additionally, previous studies suggested that those in the precontemplation stage were at higher risk for non-participation in health checkups. Therefore, this study explored the factors related to participation in specific health checkups among middle-aged Japanese community residents with NHI in the precontemplation stage.

Design and Method:
This cross-sectional mail survey was conducted in 2020 that involved all community residents with municipal NHI aged 40–64 years in five cities in three areas of A Prefecture, Japan. This survey included 33,902 community residents, and 12,446 (36.7%) agreed to participate in the survey. After selecting those without missing data (n = 11,180) and those in the precontemplation stage, the analysis included 2,892 participants. Participants were classified into a participation group and a non-participation group. Those who selected “I underwent a specific health checkup in the past year” were classified as the participation group. The study protocol was approved by the Institutional Review Boards. Informed consent was obtained from all participants who were included in this study.

Results:
In this study, 994 (34.4%) participants were classified in the participation group, and 1,898 (65.6%) were classified in the non-participation group. Multivariable logistic regression analysis revealed factors related to participation in health checkups among those in the precontemplation stage. The factor with the highest odds ratio (OR) for participation in specific health checkups was recommendations from primary care physicians to participate in specific health checkups [multivariable-adjusted OR 3.19, 95% CI 2.45–4.15, presence of recommendations vs. absence of recommendations], followed by recommendations from public health nurses [multivariable-adjusted OR 2.07, 95% CI 1.26–3.41, presence of recommendations vs. absence of recommendations], and self-reported economic status [multivariable-adjusted OR 1.82, 95% CI 1.48–2.24, good vs. poor].

Conclusions:
In particular, recommendations from primary care physicians and public health nurses might be important factors related to participation in health checkups among middle-aged Japanese community residents with NHI in the precontemplation stage.
PS-P08-9: DEPRESSION IS ASSOCIATED WITH NEW-ONSET DIABETES MELLITUS, BUT NOT HYPERTENSION, IN THE GENERAL POPULATION
Authors: Konno Satoshi , Munakata Masanori 
Published: January 2023

Objective:
Epidemiological studies have shown that depression is a risk factor for cardiovascular disease, however, the mechanism underlying this association is yet unclear especially in the general populations. The aim of this study was to evaluate the relationship between depression and new-onset hypertension/diabetes mellitus in the general population.

Design and Method:
Individuals from the general population who participated in a medical check-up both in 2019 and 2020 were enrolled in this study. Fasting blood and urinary samples were taken for biochemical analysis, and depression was assessed by using Self-rating Depression Scale (SDS). Hypertension was defined as blood pressure of more than or equal to 140/90 mmHg or use of anti-hypertensive drugs. Diabetes mellitus was defined as fasting blood glucose of more than or equal to 126 mg/dL or HbA1c of 6.5% or use of anti-diabetic drugs. Multivariate logistic regression models were used to calculate odds ratios for new-onset hypertension and diabetes mellitus in 2020 after adjustment for possible confounding factors.

Results:
Among 550 participants without present hypertension in 2019, 124 developed hypertension in 2020. Similarly, among 890 participants without diabetes mellitus in 2019, 39 developed diabetes in 2020. Multivariate logistic regression analysis showed that severe depression (SDS score of more than or equal to 48) was significantly associated with new-onset diabetes mellitus (odds ratio: 2.558, 95%CI: 1.009–6.487, p = 0.048), but not with new-onset hypertension (odds ratio: 0.943, 95%CI: 0.434–2.051, p = 0.883) after adjustment for potential risk factors.

Conclusions:
In conclusion, severe depression may be a possible predictor of new-onset diabetes mellitus in the general population.
PS-P10-9: INCIDENCE OF DIALYSIS AFTER MASSIVE NATURAL DISASTER DUE TO END-STAGE KIDNEY DISEASE ASSOCIATED WITH HYPERTENSION
Authors: Abe Michiaki 
Published: January 2023

Objective:
The relationships between a massive disaster and the development of end-stage kidney disease (ESKD) is still unknown. We investigated the incidence and the causes of dialysis initiation in a city affected by the Great East Japan Earthquake (GEJE).

Design and method:
Single-center, retrospective observational study. All patients who initiated or were treated with dialysis in Kesennuma City Hospital between 2007 and 2021 were enrolled. The year of the dialysis initiation was determined retrospectively based on the initiation date. The causes of ESKD were clinically and conveniently divided into four groups; diabetic nephropathy (DN), hypertensive renal disease (HRD), glomerulonephritis (GN) and others.

Results:
The increasing number of dialysis initiation after GEJE were recognized around after the five years and peaked down after the ten years. The age at dialysis initiation among the four groups and the ratios of the four groups between before and after GEJE were significantly different (p = 0.0142, p = 0.0317). The age at the initiation by HRD was significantly increased than that by DN after GEJE (p = 0.0088), but not the before. The initiation by DN was high both before and after GEJE. No characteristic variation was seen in the initiation by GN. Notably the initiation by HRD was significantly increased around five years after GEJE and returned after the ten years. It looked like the increased initiation cause of HRD was related with GEJE.

Conclusions:
The influences of GEJE on dialysis initiations were sustained for up to 10 years after GEJE, that was probably associated with HRD. This is a first proposal the massive disaster could develop EKSD.
PS-R03-8: PARATHYROID ADENOMA PRESENTING AS UNEXPLAINED SINUS TACHYCARDIA AND REFRACTORY HYPERTENSION: A CASE REPORT
Authors: Senanayake Solith , Lokuketagoda Kasun , Hettiarachchi Chamath , Herath Jagath , Weerawardena Nethmi 
Published: January 2023

Introduction:
Primary hyperparathyroidism (PHPT) and malignancy account for most cases of hypercalcemia in clinical practice. They commonly occur in relation to a solitary parathyroid adenoma, parathyroid hyperplasia, or carcinoma. Majority of patients are asymptomatic, although some present with vague unusual symptoms.

Case:
We report a case of a 50-year-old lady presenting with unexplained resting tachycardia, uncontrolled hypertension and generalised ill-health for one year in the background of complicated type 2 diabetes, dyslipidaemia, and hypertension. She had marginally elevated serum ionized calcium with normal serum phosphate levels in the background of early chronic kidney disease. Intact parathyroid hormone level was elevated with concomitant low levels of vitamin D. Clinical evaluation revealed an anterior neck lump which was ultrasonically suspected as a thyroid enlargement with possibility of a deep-seated parathyroid mass. A sestamibi B scan confirmed the presence of a single parathyroid adenoma. The possibility of Multiple Endocrine Neoplasia (MEN) was ruled out. She underwent a successful partial thyroidectomy with removal of the parathyroid mass. Histology revealed a solitary benign parathyroid adenoma. Following surgery, her calcium levels returned to normal range and her unexplained tachycardia had settled, as well as her general wellbeing. Her blood pressure was controlled with 3 antihypertensive drugs.

Discussion:
Hypercalcemia should be suspected as a rare possibility in the workup of unexplained sinus tachycardia and hypertension, and could be masked with concomitant vitamin D deficiency.
PS-R03-9: PERIODIC PARALYSIS AS A PRESENTATION OF PRIMARY HYPERALDOSTERONISM: A CASE REPORT
Authors: Gulkevych Oksana Volodymyrivna , Mishchenko Larysa Anatoliivna , Matova Olena Oleksandrivna , Logvynenko Alla Oleksiivna 
Published: January 2023

Objective:
the typical clinical presentations of patients with primary aldosteronism (PA) include generalized weakness, fatigue, high blood pressure and potassium deficiency. However, onset of PA with periodic paralysis is rare.

Design and method:
herein, we present the case of a 40-year-old, Caucasian women (BMI 25,6 kg/m2) with severe resistance arterial hypertension (BP 200–190/110–120 mmHg while taking antihypertensive drugs: valsartan 320 mg/day, bisoprolol 5 mg, hydrochlorthiasid 12,5 mg, amlodipin 10 mg/day, spironolacton 25 mg/day) and muscle weakness. Over the last 2 years prior to presentation, she had multiple such episodes of generalized weakness and losing the ability to stand up, move limbs, wich typically lasted for few minutes to hours/days and resolved spontaneously. Her blood pressure was uncontroled despite taking antihypertensive drugs. She was hospitalized several times because of these conditions, but there is no data on potassium levels during that period. Due to misdiagnosis, she was operated on twice (discectomy C5-C6, C6-C7 and resection of the right internal carotid artery due to pathological tortuosity), but her condition did not improve.

Results:
At the presentation U waves were registered in the electrocardiography the laboratory examination revealed low plasma potassium level (3,05 mmol/l). Serum TSH, cortisol level were normal. Pasma aldosteron level was 38,6ng/dl (n. 4–31). CT abdomen: adenoma of left adrenal gland. Surgical adrenalectomy was performed. Pathological diagnosis was a bening cortical adenoma.

Outcomes:
Patient's serum potassium level became normalized after surgical removal of adrenal adenoma. Patient's blood pressue is controlled (130/80 mmHg) by taking a fixed combination perindopril 10 mg/indapamid 2,5 mg/amlodipin 10 mg daily and there is no muscle weakness.

Conclusions:
Patients with periodic acute muscles weakness and arterial hypertension should monitor electrolyte levels, especially potassium, and evaluate for primary hyperaldosteronism to avoid delayed diagnosis and treatment.