bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C35-9: THE EFFECT OF CEREAL MEAL (FRUGURAÂ) ON BLOOD PRESSURE
Authors: Matsushita Satoshi , Mitsui Kumi , Shoji Yayoi , Matsushita Yasushi , Matsushita Masakazu , Ueda Seiji , Kasai Takatoshi , Dohi Tomotaka , Fukao Kosuke , Fukushima Yasufumi , Amano Atsushi 
Published: January 2023

Background:
Although Japanese guideline recommends to reduce salt intake to less than 6 g per day for patients with hypertension, dietary salt intake is still high, being around 10–11 g. Cereal food contains much less salt compared to a Japanese breakfast (4–5 g of salt in general), predicting the effect to reduce the blood pressure.

Patients and Methods:
Patients who have a risk for atherosclerotic disease w eligible for enrollment in this study. The participants took a 50 g package of Frugura∨ (cereal meal, contains 0.2 g of salt) with milk or yogurt as a breakfast at least 4 days per week. Blood pressure (BP), body composition data, estimate dietary salt intake, and serum blood data were compared between before and 4 weeks after taking the meal.

Result:
Sixteen patients (9 male and 7 female) were enrolled in this study. The mean age was 68.2 years-old. BP in the morning was reduced from 128.7 to 127.8 [mmHg] (p = 0.635) in systolic, and from 79.8 to 77.3 [mmHg] (p = 0.124) in diastolic. Furthermore, BP in the night was reduced from 123.5 to 122.6 [mmHg] (p = 0.606) in systolic, and from 75.1 to 71.8 [mmHg] (p < 0.05) in diastolic. The estimate dietary salt intake was reduced from 9.3 g to 8.6 g, although there was no significant difference (p = 0.370). There was also no significant difference in body weight (62.0 vs 62.0, p = 0.914 [kg]) and body fat ratio (30.2 vs 31.5, p = 0.330 [%]). Serum interleukin-6 significantly decreased after 4 weeks (2.1 vs 1.5, p < 0.05 [pg/dL]). In note, there was no significant difference in liver, kidney, and diabetes marker (HbA1c) between groups. Moreover, 13 patients out of 16 claimed improvement of bowel movement.

Conclusion:
There could be a potential in Frugura∨ reducing blood pressure via low salt contents.
PS-C36-8: BLOOD PRESSURE REDUCTION AFTER RENAL DENERVATION IN PATIENTS WITH OR WITHOUT CHRONIC KIDNEY DISEASE: THE ERLANGER EXPERIENCE
Authors: Guenesaltan Dennis Or Merve Kannenkeril Or , Schmid Axel , Ott Christian , Bosch Agnes , Schiffer Mario , Uder Michael , Schmieder Roland E , Kannenkeril Dennis 
Published: January 2023

Background:
Hypertension is associated with major cardiovascular and renal adverse events and the 24h-ambulatory blood pressure (BP) is superior than the office BP in predicting these complications. Overactivitiy of the sympathetic nervous system is linked with elevation of systemic BP and is also present in patients with chronic kidney disease (CKD). The aim of this study was to compare the BP lowering effects of renal denervation (RDN) in patients with and without CKD.

Methods:
Radiofrequency or ultrasound device based renal denervation was performed in 47 patients with and 127 without CKD in our center. Office and 24h-ambulatory BP were assessed after 3, 6 and 12 months by validated devices. CKD was defined by clinical diagnosis or according to the estimated glomerular filtration rate (eGFR: 15–60 ml/min/1.73m2; CKD-EPI formula).

Results:
Until today, 174 patients with a mean age of 59.0 ± 10 were followed up for at least 12 months. At baseline mean eGFR was 55.8 ± 21 ml/min/1.73m2 in patients with CKD and 87.3 ± 13 ml/min/1.73m2 in patients without CKD. There was no significant eGFR decline in either of the groups during follow up. In patients with CKD eGFR was after 12 months 54.4 ± 23 ml/min/1.73m2 (p = 0.699 vs baseline). Office and 24h-systolic and -diastolic BP were significantly reduced from baseline in patients with or without CKD at all time points after RDN (all p < 0.01). There was no significant difference in the reduction of 24 h, day- and nighttime ambulatory BP between the 2 groups at any time point (see table below). With exception of rare local adverse events (e.g. haematoma at the puncture site), we had no safety signals, especially in our patients with CKD, e.g. there was no dissection, embolism or periprocedural cardiovascular complications.

Conclusion:
In our single center registry, we observed a similar BP reduction in 24 h, day- and nighttime ambulatory BP as well as in office BP in patients with and without CKD at any time point up to 12 months. There was no safety signal related to RDN. In particular, we did not observe a significant eGFR decline in both CKD positive or negative patients. We conclude that RDN is an effective and safe treatment option for patients with hypertension and chronic kidney disease.
PS-C37-5: NEW THERAPEUTIC PERSPECTIVES FOR BLOOD PRESSURE CONTROL: DEXFADROSTAT PHOSPHATE, A NOVEL ALDOSTERONE SYNTHASE INHIBITOR, IN PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Mulatero Paolo , Wurzner Gregoire , Groessl Michael , Vogt Bruno , Brunner Hans 
Published: January 2023

Objective:
Aldosterone, the primary mineralocorticoid produced by the adrenal gland, regulates fluid homeostasis by stimulating sodium reabsorption in exchange for potassium in the distal tubules and collecting duct of the kidney. Aldosterone synthase (CYP11B2) is the rate-limiting enzyme for aldosterone biosynthesis. Patients with primary aldosteronism (PA) are characterized by an uncontrolled, excess production of aldosterone and are at higher risk of stroke, atrial fibrillation, and heart failure compared to patients with essential hypertension. Furthermore, PA increases the risk of death even after initiation of medical treatment to control blood pressure. Therefore, PA is the compelling indication to demonstrate the value for an aldosterone synthase inhibitor (ASI) as targeted treatment. Previous attempts to eliminate the excessive spontaneous aldosterone synthesis defining PA have been unsuccessful, particularly due to the unintended inhibition of other steroid hormones. Dexfadrostat phosphate is a novel ASI that acts directly on CYP11B2, targeting the root cause of primary aldosteronism.

Design and method:
Dexfadrostat phosphate was first investigated in patients with PA diagnosed within 1 year of study entry according to medical guidelines including a suppression test to demonstrate autonomous aldosterone production. Eligibility was verified and approved by a Central Review panel. Following a 2-week placebo-controlled run-in period, enrolled patients were randomized to one of three doses of dexfadrostat taken orally, once daily. After 8 weeks of treatment, patients were switched to placebo and followed for an additional 2 weeks. Blood samples were taken at 2-week intervals and evaluated in a central laboratory for steroid and peptide hormone as well as electrolyte levels. Blood pressure was measured in the office during each clinic visit. Ambulatory systolic blood pressure (aSBP) was monitored over 24-hours at baseline and after 8 weeks of dexfadrostat treatment.

Results:
All endpoints of the study were met with high significance. Dexfadrostat phosphate treatment was safe and well tolerated. We present the effects on the aldosterone-to-renin ratio (ARR) and subsequent blood pressure reduction, the correction of hypokalemia, and the persistence and reversal of therapeutic effects upon drug withdrawal.

Conclusions:
The phase 2 study in patients evaluated the ability of dexfadrostat phosphate to deliver both biochemical (ARR, potassium) and subsequent clinical (aSBP) correction of the consequences of uncontrolled aldosterone production. By demonstrating its clinical utility in a rarely diagnosed indication of extreme aldosterone dysregulation, the potential of dexfadrostat phosphate may well expand to address essential hypertension, chronic kidney disease, hypokalemia, volume expansion and organ remodeling.
PS-P11-3: OBESITY, HYPERTENSION, DIABETES MELLITUS, AND HYPERCHOLESTEROLEMIA OF KOREAN ADULTS
Authors: Lee Ga Bin , Kim Yoonjung , Park Suyeon , Kim Hyeon Chang , Oh Kyungwon 
Published: January 2023

Objectives:
We investigated the trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the COVID-19 outbreak in the Korean adult population.

Methods:
Data from 60,098 individuals of the Korean National Health and Nutritional examination Survey between 2011 and 2020 aged> = 19 were used. The age-standardized prevalence and annual percent changes (APC) were calculated for obesity (body mass index> = 25 kg/m	2), hypertension (systolic/diastolic blood pressure> = 140/90mmHg or under treatment), diabetes (hemoglobin A1c> = 6.5%, fasting glucose> = 126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol> = 240 mg/dL or under treatment).

Results:
Over the past decade of 2011–2020, age-standardized APCs (95% confidence interval)during 2011–2020 for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8%), 0.1% (-1.3 to 1.5%), 1.5% (-1.0 to 4.0%) and 8.0% (5.7 to 10.3%), respectively in men; and -0.2% (-1.5 to 1.2%), -0.5% (-1.9 to 0.9%), -0.1% (-2.3 to 2.2%) and 5.9% (3.9 to 8.0%), respectively in women. In 2020 compared to the previous three years (2017–2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (+6.0, + 1.8, + 1.9 and + 2.8 percentage points, respectively), but the increase was not apparent in women (+2.5, -1.1, + 0.8 and + 0.7 percentage points, respectively).

Conclusion:
An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 epidemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.
PS-P11-5: BIOSOCIAL CORRELATES OF HYPERTENSION IN NORTHEAST INDIA INDIGENOUS POPULATION
Authors: Lalnuneng Abigail 
Published: January 2023

India is home to about 700 Indigenous and Tribal People with a population of 104.3 million. Over the years, displacement and rapid acculturation of the Tribal Peoples in India has led to dramatic changes in their social, cultural, economic and value systems. The rapid demographic, epidemiologic, nutrition and health transitions accompanied by economic development, stresses of urbanization and westernization of lifestyle predisposes the tribal population to overweight/obesity and hypertension.
A cross-sectional sample of 615 Hmar adults (18–70 years) from five rural villages of the Churachandpur sub-division and 592 urban adults were collected from Imphal East and Imphal West, Manipur. Data on socio-economic, demographic, behavioural parameters, blood pressure, height, weight, sitting height, mid-upper arm, waist and hip circumferences; and three skinfold thickness, namely, biceps, triceps and subscapular were taken from each participant.

JOURNAL/jhype/04.03/00004872-202301001-01269/figure1/v/2023-10-24T163949Z/r/image-jpeg

The results from the present study can be presented into two broad categories:
1. Intra-variation in hypertension by independent variables within each setting.
The findings of this study strengthen the case that for men, increasing age, overweight and/or obese, alcohol consumption, and household income significantly increase the odds of developing hypertension.
2. Inter-variation in terms of rural-urban differences in hypertension for each categorical independent variable
The prevalence of hypertension was significantly higher in urban than in rural areas. The urban Hmars likely have a higher level of bio-behavioural and psychological stress as compared to their rural counterparts. The rural and urban differences in the risk of developing hypertension are largely due to the differences in BMI and household income. These results should, however, be interpreted with caution. Firstly, while BMI may be a contributing factor to hypertension, the relationship between socioeconomic status and hypertension is highly inconsistent. Secondly, urbanization and economic development may be associated with hypertension, but they should not be considered the causal factors of hypertension.
The overall prevalence of hypertension in the present study is about 21%. Urban areas (25%) show higher risk of developing hypertension compared with their rural counterparts (17%). Obesity is the strongest predictor of hypertension in both the rural and urban Hmar adults which might require hypertension intervention at a lower BMI. The bio-behavioural and socio-economic factors taken in the present study are unevenly distributed across rural and urban settings presenting a formidable challenge to institute public health intervention strategies specific to rural and urban areas. Early diagnosis, increasing awareness and enhancing the frequency of screenings for hypertension are suggested.
PS-P11-7: DIABETES AND HYPERTENSION SELF-MANAGEMENT: CHALLENGES AND SOLUTIONS FROM SOUTH AFRICAN PATIENTS AND HEALTH CARE PROVIDERS: A QUALITATIVE STUDY
Authors: Masupe Tiny , Onagbiye Sunday , Puoane Thandi , Absetz Pilvikki , Alvesson Helle Molsted , Delobelle Peter 
Published: January 2023

Objective:
This study aimed to unravel experiences, identify barriers to self management of diabetes and hypertension and solicit solutions for enhancing chronic disease self management from patients and their healthcare providers.

Design and Methods:
This was a qualitative study which collected data from eight in-depth interviews conducted with healthcare providers and four focus group discussions among patients with type 2 diabetes and hypertension receiving chronic disease care from two health facilities in a large peri-urban Township in Cape Town, South Africa. The Self Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data

Results:
Patients experienced challenges across all three self management tasks of behavioural or medical management, role management and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients lived experiences and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management including dedicated multidisciplinary chronic disease management services, counselling services, strengthened family support, patient buddy system, patient-led community projects and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations.

Conclusions:
Patients experienced several barriers to self-management of their chronic disease. Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects towards healthy lifestyle and diet, and advocacy are needed to improve patient self-management. This will contribute towards SDG 3
PS-P12-1: SELF-CARE MANAGEMENT FOR HYPERTENSION IN SOUTHEAST ASIA: A SCOPING REVIEW
Authors: Irwan Andi Masyitha , Potempa Kathleen , Abikusno Nugroho 
Published: January 2023

Objective:
This scoping review aims to explore the current state of self-care management practices used by hypertension populations based on evidence from the existing scientific literature for SEA.
Self-care practices such as lifestyle modifications in diet, exercise, and stress management, are effective in reducing the incidence of and enhancing better management of hypertension. However, little is known about the self-care management practices of people with hypertension in Southeast Asia (SEA) countries where the prevalence of hypertension is sharply increasing.

Design and method:
A scoping review of research and grey literature (2006–2021) was performed using Scoping Review Frameworks by Arkey and O Malley. For the research literature, ten databases were searched followed by a manual search of the reference lists of relevant topical papers.

Results:
Results indicate that bodyweight management, physical exercise, dietary intake, and medication adherence were largely poorly practiced by hypertensive people. Stress-relieving methods such as sleep, rest, and spiritual fulfilment was described as alternative self-care management methods. Anecdotal evidence of factors that facilitated or inhibited the implementation of self-care practices were described.

Conclusion:
While the overall evidence review suggests that hypertensive people in SEA do not adequately implement self-care to better manage hypertension, the anecdotal information provided by several reports indicate that there is individual variation in the facilitators and barriers to implementing self-care practices. The facilitators and barriers are relevant to personal choice [internal factors] or to the environment or context [external factors]. Enhancing self-care management of hypertension in SEA may require a multi-focused approach including targeting personal choice as well as external factors such as cultural relevance, environment and resources.
Health workers working in the community in SEA countries should consider a multi-focused approach and cultural aspect in helping hypertensive patients to manage their self-care.
PS-P12-2: NEEDS ASSESSMENT OF LEADERSHIP AND GOVERNANCE IN CARDIOVASCULAR HEALTH IN NEPAL
Authors: Pradhan Pranil Man Singh , Bhatt Rajendra Dev , Pandit Rajan , Shrestha Archana , Maharjan Rashmi , Jha Niharika , Bajracharya Swornim , Shrestha Soniya , Karmacharya Biraj Man , Koju Rajendra 
Published: January 2023

Objective:
Good governance and leadership to address non-communicable diseases and minimization of their risk factors is crucial to improve healthy life expectancy particularly in low- and middle-income countries. The objective of this study was to understand and document cardiovascular disease (CVD) programs and policy formulation process and epitomize the challenges and opportunities for leadership and good governance for the health system to address non-communicable diseases particularly cardiovascular diseases in Nepal.

Design and method:
A national level task force was formed to coordinate and steer the overall needs assessment process. A qualitative study design was adopted using The Health System Assessment Approach Manual. Eighteen indicators under six topical areas of leadership and governance in cardiovascular health were assessed. Health laws, policies, regulatory standards, planning and strategy documents and reports on civil society engagement were reviewed. Seven key stakeholders from ministry, professional councils and non-governmental organizations working on CVD were identified and in depth interviews were conducted. Field notes and tape records of interview were compiled and transcribed. Strength, weakness, opportunities and threats in each topical area of leadership and governance were analyzed.

Results:
Voice and accountability exist in planning for health from the local level. The government has shown strong willingness and has a strategy to work together with the private and non-government sectors in health however, the coordination with non-state actors during policy formulation has not been effective. There are strong rules in place for regulatory quality, control of corruption and maintaining financial transparency. The government frequently relies on evidence generated from large-scale surveys for health policy formulation and planning but research in cardiovascular health has been below par. There is a scarcity of CVD-specific treatment protocols at all levels of government coupled with weak reporting from the private sector. Expensive health care with ineffective cost control over drugs and services, medical malpractice with commission system and lack of interest among donors to invest in CVD were important challenges for strong leadership and governance.

Conclusions:
Despite plenty of opportunities, much homework is needed to improve leadership and governance in cardiovascular health in Nepal. The government needs to designate a workforce for specific programs to help monitor the enforcement of health sector regulations, allocate enough funding to encourage CVD research and work towards developing CVD-specific guidelines, protocols, and capacity building. The government needs to leverage the opportunities associated with the current decentralized health system.
PS-P12-5: CHALLENGES FOR REGISTERED PATIENTS RECEIVING HYPERTENSION CARE FROM PRIMARY HEALTH CENTERS IN BANGLADESH
Authors: Jubayer Shamim , Luna Mahfuja , Islam Shahinul , Bhuiyan Mahfuzur Rahman , Choudhury Sohel Reza 
Published: January 2023

Introduction:
One in every five adults in Bangladesh suffers from Hypertension. There is a high prevalence of undetected hypertensive patients. Among the detected cases, the control rate of hypertension is poor. Since 2018, the National Heart Foundation of Bangladesh has undertaken an intensive hypertension control program along with the Non-Communicable Disease Control (NCDC) program, the Government of Bangladesh at primary health care settings. This control program implements a number of proven strategies which are a standard simplified treatment protocol, community-based care and task sharing, regular supply of medication, and patient-centered care. Irregular follow up visit and non-adherent to medication fail to control hypertension and increase premature death among patients.

Objectives:
To identify the challenges and barriers to the adherence of antihypertensive medication.

Design and method:
A cross sectional study where total number of 6498 registered hypertensive patients of four Upazila Health Complexes (UHC)s in Sylhet district, northeast part of Bangladesh is selected from April 2019 to August 2020 for this study purpose. These patients are identified since they missed all of their three consecutive monthly follow-up visits at their respective UHCs.. A digital android based application is used as the monitoring tool in the program through which patients are identified as overdue. Data were collected by a questionnaire through an interview over telephone.

Result:
Among 6498 registered hypertensive patients, 3548 patients were contacted. Among those 47% mentioned the distance to the UHCs and long waiting time as challenging factors for receiving antihypertensive medications monthly from their assigned facilities. Due to poor treatment compliance, a number of patients (2.9%) did not return. Moreover, 3.3% of the respondents switched to private practitioners and 0.2% moved to the secondary or tertiary hospital. 0.6% of the respondents could not receive the antihypertensive medication from UHC due to their physical illness and 0.3% migrated to another location. The interviewer found 0.4% overdue patients dead. 12.9% did not receive the call and 8.6% did not mention any reason. 23.5% of the overdue patients gave wrong phone number during their registration.

Conclusion:
This study revealed a number of challenges mentioned by the respondents receiving hypertension care from primary health centers. Addressing these challenges might be effective to improve the hypertension care. Hypertension treatment at community level from the nearest health facility should be included to overcome the barriers.