bluuebunny/crossref_metadata_2025_split huggingface dataset:
S-52-5: MEASURING DRUG LEVELS USING A DRIED BLOOD SPOT COMBINED WITH PERSONALIZED FEEDBACK TO IMPROVE RESISTANT HYPERTENSION: A RANDOMIZED CONTROLLED TRIAL
Authors: Peeters Laura EJ , Kappers Mariette HW , Hesselink Dennis A , Gelder Teun van , Koch Birgit CP , Versmissen Jorie 
Published: January 2023

Introduction:
Identification of non-adherence to antihypertensive drugs is crucial to improve resistant hypertension (RH). For this therapeutic drug monitoring is the most reliable method.

Objectives:
The primary objective of this study is to determine whether drug levels measured with a dried blood spot (DBS) method combined with personalized feedback leads to a decrease in prevalence of RH after 12 months due to an increase in adherence.

Design and method:
This is a multi-center single-blinded randomized controlled trial (RHYME-RCT, NL6736). Eligible patients based on previous blood pressure readings underwent DBS sampling and a 24-hour ambulatory blood pressure measurement (ABPM) simultaneously. Patients with a daytime systolic blood pressure (SBP) > 135 and/or diastolic blood pressure (DBP) > 85 mmHg were randomized to a standard treatment (control) arm or intervention arm. The intervention was performed by the treating physician and included information on drug levels and a personalized feedback conversation based on a feedback tool. The follow-up period was one year and included visits at 3, 6 and 12 (T = 12) months inclusion. At each visit an 24h-ABPM and DBS were performed.

Results:
A total of 141 patients were measured at baseline, of which 100 patients had blood pressures > 135/85 mmHg and were randomized to the intervention (n = 49) or control arm (n = 51). The adherence rate in the excluded population (n = 41) was 78.0%. The randomized patients had a mean age of 59.4 ± 11 years and were predominantly male (70.0%). The prevalence of RH decreased from 100% in both arms to 73.2% at T = 12 in the intervention arm (p = 0.002, n = 37) and 59.1% at T = 12 in the control arm (p < 0.001, n = 41). Adherence rates improved from 67.3% to 92.1% in the intervention arm (p = 0.021) and 68.6% to 71.4% in the control arm (p = 1.000). This increase in adherence was significantly higher in the intervention arm compared to the control arm (p = 0.018). No statistically significant difference was found after 12 months between the two arms in the degree of RH (p = 0.171), SBP (p = 0.297) or DBP (p = 0.655).

Conclusions:
Measuring blood pressure and drug levels led to a decrease in the prevalence of RH in both arms and improved non-adherence in the intervention arm. However, the improvements in adherence did not lead to a lower blood pressure and degree of having RH. The fact that one third was excluded at baseline because of normotension suggests that participation in a study already leads to improvement of adherence and thus blood pressure control.
S-53-3: DEVELOPMENT OF RISK SCORES TO PREVENT CARDIOVASCULAR DISEASES
Authors: Kokubo Yoshihiro , Kashima Rena , Teramoto Masayuki , Arafa Ahmed , Shimamoto Keiko , Nosaka Saya , Maeda Saori , Kawachi Haruna , Yasui Yuka , Matsumoto Chisa , Watanabe Emi , Sakai Yukie 
Published: January 2023

There are still many places where medical care does not reach. In this abstract, from the perspective of the SDGs, we can see that we should tackle the world through the problems that Japan has.
Social inequality faces many challenges that must be resolved in the future. First of all, as for income disparity, while absolute difficulties are declining worldwide, the number of relatively poor people in poverty compared to their standard of living is still increasing. Although Japan is the world’s third-largest economy, it is the worst in eight of the 41 OECD member countries.
Regional disparities and their associated population disparities are also major issues. When the population flows out, it becomes depopulated, and the town’s infrastructure deteriorates. The medical system in depopulated areas is a serious problem.
Educational disparities are caused by poverty, creating a chain of poverty. The digital divide is associated with educational inequality and can lead to health problems due to difficulty obtaining correct health and preventive information. The need for a nutritionally balanced diet to improve health is learned through education.
Gender inequality is also a serious problem that causes employment inequality, income inequality, and education inequality. Japan’s Gender Gap Index in 2019 was the lowest in the G7 and 121st among the 153 countries in the world. Japan needs to improve the gender gap radically.
As for the intergenerational disparity, Japan’s aging rate is about 30%, which is the largest in the world. Although it will continue to increase, the population will decrease sharply. As a result, the medical services received will become increasingly difficult for the elderly. Medical staff will be available when they really need it.
We have created a model for predicting incident cardiovascular disease and its subtypes. The results are returned to the participants as a joint project between Suita City and its Medical Association to prevent the aggravation of heart failure, and the results are returned on a paper basis as a personal health record. As for health guidance, we developed Lifelong Health Support 10 (LHS10) so that the examinee can objectively understand where to improve in their daily lives. We are considering creating a mechanism that allows multi-worker intervention, such as incorporating such tools on smartphones. By utilizing LHS10, it is possible to contribute to reducing social disparity as health information that is objectively simple and easy for anyone to understand.
S-53-4: HYPERTENSION AND ITS ASSOCIATIONS WITH MULTIMORBIDITY: AN ANALYSIS OF 4 MILLION PARTICIPANTS FROM MAY MEASUREMENT MONTH 2017–2019
Authors: Janssen Carolina , Wang Wei , Schlaich Markus , Schutte Aletta E , Stergiou George , Poulter Neil R , Beaney Thomas 
Published: January 2023

Objective:
Hypertension is a leading cause of global morbidity and mortality and is a principal risk factor for cardiometabolic multimorbidity. Evidence regarding the prevalence of hypertension, hypertension treatment and blood pressure (BP) control is scarce in people with cardiometabolic long-term conditions (LTCs). May Measurement Month is the largest annual, global BP screening campaign providing one of the largest datasets on BP and cardiometabolic status. This study explores the association between cardiometabolic LTCs and hypertension, hypertension treatment, BP control, and mean BP.

Design and methods:
A total of 3,397,746 participants (≧18 years) from the three MMM campaigns in 2017–2019 arising from 103 countries were included. Data on three LTCs were collected: diabetes, myocardial infarction and stroke. Participants were subdivided based on number of LTCs. Hypertension was defined as having a systolic BP≧140mmHg and/or diastolic BP≧90mmHg, using the average of the second and third of three readings and/or taking antihypertensive medication. Multiple imputation was used to estimate BP readings if any readings were missing. Controlled hypertension was defined as a BP< 140/90mmHg on treatment.

Results:
Amongst all participants, 316940 (9.3%), 62731 (1.8%), and 28491 (0.8%) reported having one, two or three LTCs, respectively. There was a graded effect of increasing number of LTCs on rates of hypertension: 29.6% in those with no LTCs, and 63.0%, 68.6% and 71.2% in those with one, two or three LTCs, respectively. A similar graded effect was seen for the percentage of hypertensive participants on antihypertensive medication: 44.0% in those with no LTCs, and 79.6%, 87.1% and 89.8% in those with one, two or three LTCs, respectively. Despite higher treatment rates, BP control rates (<140/90mmHg) were similar in those with no LTCs, one or two LTCs (57.6%, 56.4% and 56.0%, respectively) but higher in those with three LTCs (67.9%). This was reflected in the average BPs of participants on treatment, with similar average BPs in those with no LTCs, one, or two LTCs (134/82mmHg, 135/81mmHg and 135/81mmHg, respectively) compared with lower BP (129/78mmHg) in those with three LTCs.

Conclusions:
With an increasing number of cardiometabolic LTCs, there was a graded increase in the likelihood of having hypertension, and amongst hypertensives, of being treated. Control rates were similar in those with two or fewer LTCs but higher in those with three LTCs, although BP control was suboptimal in all groups. Focused efforts in the higher-risk population with cardiometabolic LTCs are needed to reduce the global burden of hypertension.
S-56-3: RESPONSE OF COMMUNITY RESIDENTS TO PROMOTION OF RECOMMENDING HOME BLOOD PRESSURE MEASUREMENT AND FACTORS ASSOCIATED WITH EVERYDAY-MEASUREMENT:NOSE STUDY
Authors: Wada Arisa , Kabayama Mai , Godai Kayo , Kido Michiko , Hashimoto Sumiyo , Higashi Makiko , Hatanaka Hiromi , Kikuchi Takeshi , Dodo Takayuki , Asayama Kei , Ohkubo Takayoshi , Rakugi Hiromi , Tabara Yasuharu , Kamide Kei 
Published: January 2023

Objective:
We clarify the status of home blood pressure (HBP) measurement during the first 90 days after recommendation of self-measurement and recording among community residents and factors associated with everyday-measurement.

Methods:
The study subjects were 677 participants from the intervention group of NOSE study, a intervention study of HBP measurement in community residents.NOSE study began fiscal 2020 as health and longevity project in local administration. We distributed HBP machine (Omron Healthcare HEM-7281) and recommended self-measurement and recording between August 2020 and August 2021. HBP records in the recording book were collected on March, October and December 2021. The background information included age, sex, on-site blood pressure, use of antihypertensive medications, present illness such as diabetes and dyslipidemia, smoke, drinking, exercise and employment. From HBP records, we obtained the percentage of measurement and morning HBP during the first 90 days. We divided the participants into two groups as following; Group including participants who measured HBP 6 or 7 days a week was defined as everyday-measurement group, the other participants were in not-everyday-measurement group. Each item was compared among the two group.

Results:
HBP records were obtained from 641 participants (response rate, 94.7%), of which 637 without missing data for relevant items were analyzed. Everyday-measurement group was present in 572 (89.8%) participants. About proportion of participants with treated hypertension 190 (93.6%) and 382 (88.0%) with non-treated hypertension were in everyday-measurement group. Participants in everyday-measurement group indicated significantly higher age, on-site systolic BP, and morning HBP than those in not-everyday-measurement group. There was also significantly more likely to be the proportion of hypertension treatment, no drinking habit, exercise habit, and rate of no employment.

Conclusion:
The study clarified that about 90% of the residents was able to measure their HBP almost every day, regardless of whether they are treated for hypertension or not, when recommended self-measuring and recording HBP by distributing HBP machine. Based on these results, it may be effective to reduce CVD by improving the environment for the promotion of self-measuring HBP measurement.
S-57-2: THE GUT MICROBIOME AND CARDIOVASCULAR RISK FACTORS IN HUMANS
Authors: Valdes Ana Maria 
Published: January 2023

Animal studies to date have demonstrated the functional link between gut microbiota composition and cardiovascular outcomes, with specific microbial metabolites being involved. Examples of this include trimethylamine oxide (TMAO) involved atherosclerosis and more recently, studies proving that short chain fatty acids (SCFAs) acetate, butyrate and propionate are involved in blood pressure regulation and cardiovascular outcomes in animal models.
At the same time, a number of epidemiological studies have highlighted the links in humans between gut microbiome composition and both hypertension and arterial stiffness. Additional factors involved in cardiovascular disease (CVD) risk that have come from human observational studies show that circulating levels of ceramides, GlycA (a marker of glycosylated acute phase proteins) and indole propionic acid (an antioxidant predictive of insulin resistance and arterial stiffness) are all modulated by the gut microbiome and alter cardiovascular risk in general. Dietary fiber supplementation results in reduced circulating levels of both GlycA and ceramides, both of which have been proven to be predictors of major acute cardiovascular events (MACE). Changes in gut microbiome composition induced by dietary interventions accompany decreases these markers of MACE. Formal mediation analyses of such data show that the effect of gut microbiome composition on the markers of MACE is mediated by increases in circulating levels of SCFAs.
Butyrate, propionate and acetate activate the short fatty acid receptors FFAR2 and FFAR3 with different affinities, which might explain the different roles that these compounds play in blood pressure regulation and CVD outcomes. Furthermore, some SCFAs but not others are involved in modulation of the endocannabinoid system. Specifically, butyrate, but not propionate or acetate, affects endocannabinoid circulating levels and is involved in the gene expression levels of enzymes that modulate degradation of endocannbinoids. Importantly, butyrate levels can be modulated by diet but also by exercise. In addition, circulating levels of different SCFAs have different bacterial and host contributions, with serum levels of acetate being negligibly determined by gut microbiota composition (Figure 1).
Joining together the evidence from human observational and interventional studies and the data from animal model data helps us delineate a complex series of interconnected pathways from bacterially produced SCFAs to blood pressure regulation and other cardiovascular outcomes, which are modifiable by both diet and exercise.
AW-AD-5: HEAVY METAL EXPOSURES, BRAIN GRAY MATTER THICKNESS, AND WHITE MATTER HYPERINTENSITIES
Authors: Woo Shinyoung , Bae Munjoo , Gwak Eun Sun , Yang Sung Hee , Jeong Da Hui , Kim Bo Ram , Cho Jaelim , Kim Changsoo 
Published: January 2023

Objective:
Exposure to heavy metals may affect various organs including the brain. Previous studies so far have reported mixed findings on the neurotoxicity of heavy metals. This study examined the associations of heavy metals with brain cortical thickness and subcortical volume. Additionally, check white matter hyperintensity to examine the effect of heavy metals on brain vascular.

Methods:
We included 50 year-old or older people dwelling in Seoul, Incheon, Wonju, and Pyeongchang. Airborne manganese concentration was estimated using universal kriging modelling of values from measurement at each participant's residential address. Blood heavy metals (manganese, aluminum, mercury, and lead) were also collected. Regional cortical thicknesses (frontal, parietal, temporal, occipital, insula, and cingulate) and subcortical volumes (thalamus, putamen, pallidum, caudate, hippocampus, amygdala, and nucleus accumbens) on brain magnetic resonance imaging were estimated (n = 936). White matter hyperintensity volume was additionally calculated from brain imaging data of part of the participants (n = 397). We constructed generalized linear models, adjusting for age, sex, years of education, intracranial volume, smoking history, drinking history, fasting blood glucose, systolic blood pressure, and diastolic blood pressure.

Results:
An 10 μm/m3 increase in airborne manganese concentration was significantly associated with thinner parietal (β = -0.02 mm; 95% CI, -0.04 to -0.01 mm; p = 0.012) and occipital lobes (β = -0.02 mm; 95% CI, -0.04 to -0.01 mm; p = 0.007), but with a greater volume of the nucleus accumbens (β = 18.17 mm3; 95% CI, 5.27 to 31.08 mm3; p = 0.006). An increase in log transformed blood manganese was associated with a smaller volume of the nucleus accumbens (β = -24.10 mm3; 95% CI, -39.98 to -8.23 mm3; p = 0.003).
None of the associations between airborne and blood manganese and white matter hyperintensity volume was statistically significant. Blood aluminum, mercury, and lead also did not exhibit significant associations.

Conclusion:
These findings suggest that exposure to manganese may affect the parietal lobe, occipital lobe, and nucleus accumbens. Further studies are needed on the neurotoxicity of manganese.
JS-FMD: FIBROMUSCULAR DYSPLASIA IN ASIA: A DISEASE TO (RE)DISCOVER
Authors: Zen Kan , Fanelli Elvira , Kawarada Osami , Matsubara Kentaro , Xu Jianzhong , Persu Alexandre 
Published: January 2023

The International Consensus on Fibromuscular Dysplasia (FMD) (Gornik, Persu et al. J Hypertens. 2019;37:229–252; Vasc Med. 2019;24:164–189) provided a comprehensive summary of the clinical history, diagnosis and management of FMD. However, the authors admitted that most of current knowledge on FMD has been acquired in patients of Caucasian descent. Accordingly, they expressed their commitment to include a higher proportion of patients of non-white ethnicities in existing registries. Along these lines, the European International FMD Registry and Initiative (FEIRI, coord. A. Persu, Brussels) has established collaborations with centres from Japan and China and begun to enrol patients from these countries. The 2022 meeting of the International Society of Hypertension in Kyoto is a unique opportunity to further develop the Japanese FMD initiative (coord. Kan Zen, Kyoto), the Chinese FMD initiative (coord. Jiguang Wang, Shanghai) and potentially initiatives in other Asian countries. This implies also raising awareness of Asian experts on FMD and identifying the specificities of FMD in Asia.
The objectives of the current session are: (1) to summarize the key messages of the international FMD Consensus; (2) to present preliminary data obtained in patients from Asian vs. Caucasian descent enrolled in the FEIRI registry; (3) to present current experience on the characteristics, diagnosis and management of FMD in centres from Japan (Kyoto, Osaka and Tokyo) and China (Shanghai); (4) to emphasize the specific challenges raised by FMD in Asia, particularly the differential diagnosis with Takayasu disease; (5) to open a debate with specialists of FMD in Japan and abroad, to expand the Japanese FMD initiative and to initiate new national initiatives on FMD in Asia, in collaboration with FEIRI.
RAG-SACA-2: EPIDEMIOLOGY OF HYPERTENSION IN SOUTH ASIA
Authors: Ralapanawa Udaya 
Published: January 2023

Hypertension is the one of major risk factor contributes to the burden of heart disease, stroke, kidney failure, disability and premature death. According to 2019 WHO fact sheet, an estimated 1.13 billion people worldwide have hypertension while only 21% of people have it under control. Further, more than one million deaths are related to hypertension. It is projected that 1.56 billion adults (29.2%) have hypertension globally by 2025 and 75% of them will be Asians and Africans.Hypertension is the most prevalent risk factor of stroke among Asians and cardiovascular complications associated with hypertension is steeper in Asians compared to west.
Asia is a diverse region with differences in prevalence, awareness, treatment and control of hypertension. The trend of prevalence of hypertension has been vividly increased over the past two decades in South East Asian countries and numerous factors contribute to the current hypertension burden including modernization, urbanization, lifestyle changes and socioeconomic status.
Hypertension prevalence in south East Asia is 25% and is slightly higher than the global prevalence (22%). According to the data from May-Measurement-Month 2018, the prevalence of hypertension in South Asia was 29.3% and only 46% of them aware about their hypertension while 43% was on medication. However, only 23.9% of them had controlled blood pressure either with medication, life style modification or both. East Asia had the lowest blood pressure average (117.0/75.4 mm Hg). In contrast, South Asia had the highest average (124.6/78.1 mm Hg).
According to a recent meta-analysis, the prevalence of hypertension was 17.9% in Bangladesh, 20.9% in Sri Lanka,23.9% in Bhutan,25% in Pakistan,31.4% in India,31.5% in Maldives and 33.8% in Nepal. As per WHO data in 2020 among South Asians, Pakistan had highest hypertensive related death whereas Sri Lanka had the lowest (nearly 20 vs 4 per 100,000).
Overweight and obesity in women and higher waist circumference in men are significantly associated with uncontrolled hypertension. Excess salt intake (average daily intake is higher than 12 g) associated with elevated blood pressure is also considered as a specific characteristic of hypertension in Asia.
A vital issue in Asia is not just the high prevalence of hypertension, especially in some countries, but also the low level of awareness and treatment rates in many regions. Future research are necessary to implement strategies for prevention and control of hypertension, especially in low-income populations and to precisely assess the prevalence and financial burden of hypertension in the region.
PS-B02-4: GLYCINE BETAINE ALLEVIATES MYOCARDIAL HYPERTROPHY IN SPONTANEOUS HYPERTENSION RATS BY REGULATING AMPK/NF-KAPPAB/STIM1/ORAI1 SIGNALING PATHWAY
Authors: Xiao Bing , Zhao Yan , Yang Xiuchun , LU Jingchao 
Published: January 2023

Background:
Spontaneous hypertension is one of the common cardiovascular diseases. Glycine betaine (GB) is a natural vitamin that has the potential to lower blood pressure. This work attempted to investigate the precise mechanism of action of GB in spontaneous hypertension.

Methods:
Spontaneous hypertension rats (SHRs) were administrated with 100, 200 or 400 mg/kg of GB by gavage, or followed by injection of lentivirus-mediated STIM1 overexpression vector. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart weight/body weight (HW/BW) of rats were monitored. The pathological changes of myocardium were examined by hematoxylin and eosin staining and Masson staining. The expression of gene and protein was detected by quantitative real-time PCR and western blotting.

Results:
GB at 200 and 400 mg/kg reduced the levels of HR, SBP, DBP and HW/BW in SHRs. GB decreased the cross-sectional area and fibrotic area in the myocardium, and down-regulated the expression of ANP and beta-MHC in the myocardium of SHRs. It indicated that GB treatment effectively alleviated myocardial hypertrophy in SHRs. Additionally, GB treatment enhanced p-AMPK expression and repressed the expression of p-NF-kappaB, STIM1 and Orai1 in the myocardium of SHRs. STIM1 overexpression reversed GB treatment-mediated inhibition of myocardial hypertrophy in SHRs.

Conclusion:
This study demonstrated that GB activated AMPK and repressed NF-kappaB/STIM1/Orai1 signaling pathway, which contributed to alleviate myocardial hypertrophy in SHRs. Thus, this work provides a theoretical basis for GB as an antihypertensive drug.