bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-B09-13: PHARMACOLOGICAL INHIBITION OF INTERLEUKIN-18 REDUCES DEOXYCORTICOSTERONE/SALT-INDUCED HYPERTENSION AND RENAL INFLAMMATION
Authors: Wickramasinghe Buddhila , Jelinic Maria , Huuskes Brooke , Diep Henry , Drummond Grant , Vinh Antony 
Published: January 2023

Objective:
Circulating levels of the pro inflammatory cytokine, interleukin18 (IL18), are elevated in patients with hypertension and chronic kidney disease (CKD). Moreover, genetic deficiency of IL18 prevents the development of one kidney deoxycorticosterone acetate and high salt (DOCA/salt) induced blood pressure (BP) elevation and renal injury. Thus, the current study aimed to determine if pharmacological inhibition of IL18 is similarly protective against elevations in BP, renal inflammation and dysfunction in the DOCA/salt model of hypertension and CKD.

Design and method:
Male C57BL/6 mice were randomly assigned to receive either control IgG or anti IL18 neutralising monoclonal antibody (control IgG and mAb; 30 mg/kg, i.p., Novartis, bolus every 3 days). Three days after the first injection, mice were uninephrectomised and treated for a further 21 days with either DOCA (2.4 mg/d, s.c. pellet) with high salt (0.9% in drinking water), or a placebo pellet (s.c.) plus normal drinking water. BP was measured weekly (tail cuff, starting at baseline). Transdermal glomerular filtration rate (tGFR) measurements were recorded at baseline and at endpoint to determine kidney function. Kidneys were harvested at endpoint for histopathological staining, quantitative reverse transcription PCR (RT qPCR) and flow cytometry to assess fibrosis, inflammation and immune cell infiltration, respectively.

Results:
Baseline systolic BP was not different between mice treated with anti IL18 mAb (118 ± 2 mmHg) versus control IgG (122 ± 3 mmHg). However, anti IL18 mAb treatment significantly blunted hypertensive responses to DOCA/salt, with systolic BP only reaching 139 ± 6 mmHg compared to 159 ± 6 mmHg in control IgG treated animals (Figure; n = 11–12; P < 0.05). Anti IL18 mAb treatment also significantly reduced DOCA/salt induced leukocyte (CD45+) accumulation in the kidneys (0.9 ± 0.1x105 cells/kidney) compared to control IgG treatment (1.6 ± 0.3x105 cells/ kidney; n = 11–12; P < 0.05), which was largely attributed to reduced macrophage accumulation (CD11b+/F4/80+; n = 11–12; P < 0.05). A ∼30% decline in kidney function was observed in DOCA/salt-treated mice that received control IgG, which was associated with renal fibrosis and injury. Impaired kidney function decline (but not fibrosis and injury) appeared to be less severe in DOCA/salt treated mice that received anti IL18 mAb (n = 7). DOCA/salt treatment increased expression of genes associated with renal fibrosis (Col1al, Col3a1 and Col5a1), injury (Kim1 and Ngal) and inflammation (Ifng, Mrc1, II6, Ccl2 etc.). Surprisingly, DOCA/salt induced changes in gene expression were not prevented by anti IL18 mAb treatment.

Conclusions:
IL18 neutralisation affords protection against DOCA/salt induced hypertension and renal inflammation. Thus. IL18 may represent a potential therapeutic target to treat hypertension and CKD.
PS-C17-4: ASSOCIATION BETWEEN SERUM INSULIN LEVELS AND HEART FAILURE-RELATED PARAMETERS IN PATIENTS WITH TYPE 2 DIABETES AND HEART FAILURE
Authors: Tanaka Atsushi , Node Koichi 
Published: January 2023

Background:
Insulin resistance and hyperinsulinemia in patients with type 2 diabetes (T2D) are adversely associated with the development and worsening of heart failure (HF). Herein, we sought to investigate the effect of canagliflozin on insulin concentrations and the associations of changes in insulin concentrations with HF-related clinical parameters in patients with T2D and HF.

Methods:
This was a post hoc analysis of the investigator-initiated, multicenter, open-label, randomized, controlled CANDLE trial for patients with T2D and chronic HF (UMIN000017669). The endpoints were the effects of 24 weeks of canagliflozin treatment, relative to glimepiride treatment, on insulin concentrations and the relationship between changes in insulin concentrations and clinical parameters of interest, including New York Heart Association (NYHA) classification. The effects of canagliflozin on those parameters were also analyzed by baseline insulin level.

Results:
Among the participants in the CANDLE trial, a total of 129 patients (canagliflozin, n = 64; glimepiride, n = 65) who were non-insulin users with available serum insulin data both at baseline and week 24 were included in this analysis. Overall, the mean age was 69.0 ± 9.4 years; 75% were male; the mean HbA1c was 6.8 ± 0.7%; and the mean left ventricular ejection fraction was 59.0 ± 14.1%, with parameters roughly balanced between treatment groups. Canagliflozin treatment significantly reduced insulin concentrations at week 24 (p < 0.001), and the between-group difference (canagliflozin minus glimepiride) in those changes was -3.52 mU/L (95% confidence interval, -4.85 to -2.19; p < 0.001). Decreases in insulin concentrations, irrespective of baseline insulin level, were significantly associated with improvement in NYHA class in patients treated with canagliflozin.

Conclusion:
Our findings suggest that canagliflozin treatment in patients with T2D and HF ameliorated excess insulin overload, contributing to the improvement of clinical HF status.
PS-C18-6: THE IMPACT OF ANTIHYPERTENSIVE DRUG USE ON INTRADIALYTIC BLOOD PRESSURE DECLINE CONSIDERING SEASONAL VARIATION: A RETROSPECTIVE COHORT STUDY
Authors: Uchiyama Kiyotaka , Washida Naoki , Shibagaki Keigo , Yanai Akane , Nakayama Takashin , Morimoto Kohkichi , Itoh Hiroshi 
Published: January 2023

Objective:
Risk factors of intradialytic systolic blood pressure decline remain less understood. We aimed to identify clinical and laboratory predictors of intradialytic systolic blood pressure decline, considering its seasonal variation.

Design and method:
In a retrospective cohort of 47,219 hemodialysis sessions from 307 patients undergoing hemodialysis for 1 year in three dialysis clinics, seasonal variation and intradialytic systolic blood pressure decline predictors (predialysis systolic blood pressure - nadir intradialytic systolic blood pressure) were assessed using cosinor analysis and linear mixed models adjusted for baseline/monthly hemodialysis-related variables, respectively.

Results:
Intradialytic systolic blood pressure decline was highest and lowest in the winter and summer, respectively, following a clear seasonal pattern. In both models adjusted for baseline and monthly hemodialysis-related parameters, calcium channel blocker use was associated with a smaller decline (-4.58 [95% confidence interval (CI), -5.84 to -3.34], P < 0.001; -3.66 [95% CI, -5.69 to -1.64], P < 0.001) and alfa blocker use, with a greater decline (3.25 [95% CI, 1.53–4.97], P < 0.001; 3.57 [95% CI, 1.08–6.06], P = 0.005). Baseline and monthly serum phosphorus levels were positively correlated with a decline (1.55 [95% CI, 0.30–2.80], P = 0.02; 0.59 [95% CI, 0.16–1.00], P = 0.007) and baseline and monthly normalized protein catabolic rate, inversely correlated (-22.41 [95% CI, -33.53 to -11.28], P < 0.001; 9.65 [95% CI, 4.60–14.70], P < 0.001)

Conclusions:
Calcium channel blocker use, alfa blocker avoidance, and serum phosphorus-lowering therapy may attenuate intradialytic systolic blood pressure decline and should be investigated in prospective trials.
PS-C18-11: HYPERTENSION AS A CAUSE OF MORTALITY IN PATIENTS WITH CKD ON DYALISIS; A REPORT ON RURAL HOSPITAL
Authors: Mulia Deddy Primadona , Rico Rico Irawan , Herleni Herleni Kartika , Wangsa Syahpri Putra , Akbar Kgs M Yusuf Arief , Ida Ida Trikandiani , Firda Firda Ariyanti , Sugihartono Sugihartono Sugihartono , Adhi Adhi Permana , Amrizal Amrizal Amrizal , Ian Ian Effendi , Novadian Novadian Suhaimi , Suprapti Suprapti Slamet , Zulkhair Zulkhair Ali 
Published: January 2023

Objective:
Chronic kidney failure is an important issues because its increased in a recent years and impacted the high cost medical financing. This is directly related to social, economic and public health problems. it can be prevented as soon as possible to prevent progression to dialysis. A survey conducted by the Indonesian Nephrology Association stated that CKD occurred in 12.5 ‰ of the population with high risk, namely hypertension, proteinuria, and or diabetes.
The aetiology of CKD in Indonesia is different from other countries, One of the comprehensive efforts in the management of chronic kidney disease in Indonesia is an analysis of the causes of mortality in chronic kidney failure patients undergoing haemodialysis. Hypertension as the main cause of CKD is also important to study, especially the mortality rate is also a priority for health workers in hemodialysis installations.

Design and Method:
This research is descriptive analytic. The target population is all chronic kidney failure patients undergoing haemodialysis at the East OKU Hospital recorded in the Indonesian Renal Registry from 2020 to 2022, including 68 patients undergoing routine haemodialysis for more than 6 months.

Result:
The most common aetiology of CKD is hypertension with 34, followed by type II diabetes in 31 patients, and the rest are other diseases such as stones, gout, and others. There is no significant difference in the aetiology of CKD. Of the 34 patients who developed hypertension which resulted in end stage CKD with haemodialysis, more than 50 ‰ of patients were over 50 years of age. Unknown cause of hypertension causes complications of various diseases that aggravate the disease, such as kidney disease. The higher blood pressure measured for a many time, the more severe its complications, especially in the kidneys. If kidney failure continues and its progression continues, it will result in end-stage renal failure which requires renal replacement therapy, in this case was a haemodyalisis procedure. Patients with hypertension aetiology who underwent haemodialysis had a mortality rate of 20 patients or 58.8 ‰ and patients who survived as many as 41.2 ‰ patients.

Conclutions:
Hypertension as a cause of chronic kidney disease with haemodialysis is still the biggest contributor, followed by diabetes mellitus. The higher and longer the hypertension, the higher the risk of chronic kidney disease that requires renal replacement therapy in the form of dialysis. The mortality rate is also influenced by the aetiology of cardiovascular disease
PS-C19-2: AMLODIPINE/VALSARTAN EFFICACY IN HYPERTENSIVE PATIENTS - A REAL WORLD OBSERVATIONAL STUDY (ALERT)
Authors: Iqtadar Somia , Khan Khalid Mahmud , Malik Mahmood Nasir , Attiq ur Rehman Muhammad , Siddiqui Anum Sohail 
Published: January 2023

Objectives:
Hypertension is a significant public health problem and one of the major non-communicable diseases at the endemic level in Pakistan. This study was done to determine the efficacy of amlodipine/valsartan (Aml/Val) once-daily dose in reducing blood pressure (BP) after eight weeks of therapy.

Methods:
This study is an open-labeled observational study carried out for a period of 12 months. Some 769 participants of either gender between the ages of 18 and 70 years selected after taking written informed consent had a BP of > 139/89 mmHg (not controlled) on monotherapy with a minimum 30 days of treatment. Therapy to control their high BP was initiated with Aml/Val at the time of their enrolment in the study. Pregnant females and patients with secondary hypertension were excluded. Data were analyzed using SPSS version 20.0 and chi-square test was used for inferential analysis. p-values less than 0.05 were considered significant.

Results:
At the end of week one, less than half of the patients achieved the desired level of BP while the majority achieved this level by the end of the study. Some 75.6% patients achieved targeted BP with Aml/Val 80/5 mg tablet, 18.5% achieved targeted BP with Aml/Val 160/5 mg tablet, and 5.9% achieved the targeted BP with Aml/Val 160/10 mg tablet at the end of the eighth week. The compliance rate was 99.2% at the first week, 98.9% at the fourth week, and 99.9% at the eighth week of treatment.

Conclusion:
Our study concluded that Aml/Val combination therapy was very effective in controlling BP among patients who were uncontrolled with other monotherapies for at least one month.
PS-C19-11: ASSESSMENT OF ADHERENCE TO ANTIHYPERTENSIVE THERAPY AND BLOOD PRESSURE TARGETS ACHIEVING AMONG HYPERTENSIVE PATIENTS IN THE REPUBLIC OF KAZAKHSTAN
Authors: Mukhtarkhanova Dilyara , Junusbekova Gulnara , Tundybayeva Mira , Leonovich Tatyana , Baglanova Lyazat 
Published: January 2023

Introduction:
Arterial hypertension is one of most prevalent cardiovascular diseases and leading factor of mortality and morbidity due to higher cardiovascular risk. To prevent cardiovascular events: myocardial infarction, stroke, heart failure it is crucial to manage hypertensive patients carefully and to achieve blood pressure targets. The one of leading causes of not achieving control of blood pressure levels is low adherence to therapy.

Objective:
The objective of this investigation is to assess the level of adherence to antihypertensive therapy and blood pressure targets achieving.

Methods:
A prospective cross-sectional study was conducted from August 2021 to November 2021 in four regions of Kazakhstan, included 1805 adults of both sexes (1073 women (59.40%) and 732 men (40.60%)) of mean age 39 years. Special survey, including assessment of current antihypertensive therapy, blood pressure and heart rate measurement were performed. Statistical test was performed by the StatTech 2.6.1 (Russia, 2020), IBM SPSS statistics version 28.0, Epi Info, version 7.

Results:
The prevalence of arterial hypertension in the population was 37.06%. Of the 658 participants with hypertension, 333 (40.51%) were aware of their diagnosis and 227 (68.17%) of them were taking antihypertensive medications.
33.5% were on monotherapy; 36.1%, 17.6%, and 3% were taking 2, 3, and 4 classes of antihypertensive drugs, respectively. 113 (49.78%) had a blood pressure lower or equal to 140/90 mm Hg, and only 33 (14.54%) lower or equal to 130/80 mm Hg.
Among participants on monotherapy, 42% had blood pressure levels higher or equal to 140/90 mm Hg. Of all patients on therapy, only 152 (45.6%) were taking drugs regularly. A strong relationship was found between adherence to therapy and age (OR 1.049, 95% CI 1.031, 1.066, p < 0.001): adherence to therapy was higher in older patients.
It should also be noted that of the total number of participants on antihypertensive therapy, 95 (41.9%) were taking acetylsalicylic acid, of which only 16 (16.8%) had a history of myocardial infarction or stroke.

Conclusion:
To conclude, the level of adherence to therapy was 45.6%, more than half of the patients were not adherent to current antihypertensive therapy. When using the lower BP target of < 130/80 mm Hg as the definition of control, which more accurately reflects current guidelines the proportion controlled was 14.54%. It could be related to several different causes: low levels of adherence, little knowledge of healthcare specialists about target blood pressure levels and little knowledge of population about importance of control blood pressure. In conclusion, the study confirms the importance and relevance of arterial hypertension as socially significant disease.
PS-C20-3: MOBILE MEDICAL APP CAN BE MORE EFFECTIVE IN LONG-TERM MANAGEMENT OF HYPERTENSION PATIENTS
Authors: Li Na , Cheng wenli 
Published: January 2023

Objective:
The application of mobile medical application, APP, to manage patients with hypertension makes the contact between doctors and patients more convenient, saves the economic cost and time cost of patients, and also makes it easier for doctors to manage patients and improve their compliance. This study investigated the effect of APP on long-term management of hypertension patients.

Design and method:
This trial was a randomized, single-blind, parallel, controlled study. A total of 302 patients with hypertension were included in this study and observed for one year. All the enrolled patients received antihypertensive treatment of nifedipine controlled release tablets with or without telmisartan in outpatient or ward. The APP of the experimental group could be used to push health education information, remind patients to measure their own blood pressure and take medication, and consult doctors online. Blood pressure, improvement of hypertensive target organ injury, and sodium intake were assessed in both groups after one year treatment.

Results:
There were no significant differences in blood pressure, urinary microalbumin and 24-hour urinary sodium levels between the two groups at baseline. APP information push was more helpful to the control of blood pressure, systolic and diastolic blood pressure decreased significantly, after treatment, systolic blood pressure of experimental group vs control group 133 ± 6mmHg vs 141 ± 11mmHg, P < 0.05; Diastolic pressure 83 ± 7mmHg vs 89 ± 9mmHg, P < 0.05. APP information push was more helpful to improve target organ injury (decrease of microalbuminuria), and microalbuminuria after treatment was 31 ± 12 mg/L vs 47 ± 14 mg/L, P < 0.05. APP information push helped control sodium intake, and the urine sodium level at 24 hours after treatment was 123 ± 31 mmol/24 h vs 148 ± 28 mmol/24 h, P < 0.05.

Conclusions:
Using mobile medical APP for patient management can help control patients’ blood pressure level, improve the degree of renal damage caused by hypertension, and help control sodium intake. APP can be used as an auxiliary means for long-term management of hypertension patients, which can improve the quality of blood pressure management of patients more effectively, conveniently and economically.
PS-C20-5: WARM IV INFUSION IN HYPERTENSIVE URGENCY
Authors: Ray Abhijit , Chandana Thota 
Published: January 2023

Background:
Hypertensive Urgency is defined as marked elevation in systemic blood pressure without any evidence of end organ damage. At present, the condition is managed with intravenous (IV) antihypertensives, of which most common is Sodium Nitroprusside.

Aim:
In this abstract we explore the possibility of slow IV infusion of warm (37–38oC) Normal Saline along with IV antihypertensives for a better and faster management of Hypertensive Urgency.

Content:
The slow IV will gradually increase the core body temperature of the patient while preventing fluid overload. Homeostatic regulation of Systemic Blood Pressure is maintained by an intricate network of correlated mechanisms, most of which are temperature dependent. The raised body temperature will be useful to control the Blood Pressure through the following mechanisms -
Cardiac Output: reduces as core body temperature increases.
Baroreflex: decreased post-synaptic adrenergic vasoconstrictor responses.
Chemoreceptors: vascular responsiveness to adrenergic receptor stimulation reduces at higher temperatures.
RAAS: Kosunen et al recorded reduced Systolic and Diastolic Blood Pressures at raised body temperatures despite increased levels of Angiotensin II & Aldosterone.
Endothelin: Serum concentration of Endothelin-I reduces at higher temperatures.
Sweat: Thermal stimulation of sweat gland will help excretion of both salt and water, thus maintaining the sodium balance.
VEGF: VEGF-A, a potent vasodilator, is increased during elevated body temperature.
However, apart from Blood Pressure, a change in core body temperature causes change in many other parameters as well, which must be considered during this discussion.
Coagulation profile - Valeri et al noted no change in in-vivo coagulation states till 100oF
Effect on other visceral organs - Internal visceral organs like Liver, Kidneys and Brain were not affected till 100oF
Infection Control - Core body temperature close to 100oF has also been found to have a protective role against invasive fungal infections in the ICU

Discussion:
Though the effects of various antihypertensive drugs to raised body temperatures need to be tested, the above points prove that introducing a protocol of warm IV saline Infusion in patients of Hypertensive Urgency may be extremely beneficial, and also prevent clinical inertia.
PS-C21-2: PREDICTORS OF CLINICAL AND BIOCHEMICAL SUCCESS OF ADRENALECTOMY IN PATIENTS WITH UNILATERAL PRIMARY ALDOSTERONISM
Authors: Vaclavik Jan , Hartmann Igor , Hruska Frantisek , Kocianova Eva , Frysak Zdenek , Nesvadbova Marika , Tudos Zbynek , Ctvrtlik Filip , Benesova Klara 
Published: January 2023

Objective:
Our study aimed to evaluate clinical and laboratory predictors of outcome of unilateral adrenalectomy in patients with primary aldosteronism (PA).

Design and method:
Data from patients with unilateral PA verified by adrenal venous sampling who subsequently underwent transperitoneal laparoscopic adrenalectomy between 2008 and 2019 were analyzed. We assessed patient demographics, preoperative and postoperative clinical, pharmacological, laboratory, and radiological data. Antihypertensive drug use was quantified by estimating the daily defined dose (DDD) of antihypertensive medication. Statistical assessments included univariable and multivariable logistic regression analysis.

Results:
87 patients with PA were enrolled. Complete biochemical success of surgery, defined as normalisation of the aldosterone-to-renin ratio and correction of hypokalaemia, was reached in 67 patients (77%), 19 patients (22%) had partial biochemical success (please see the Figure). Complete clinical success with normalization of blood pressure and withdrawal of all antihypertensive drugs was achieved in 19 patients (22%). 57 patients (65%) exhibited a reduction of DDD after surgery and/or improvement of blood pressure - partial clinical success. Multivariable logistic regression showed that complete clinical success was independently associated with female gender (odds ratio: OR 3.71, 95% CI 1.16–11.87, P = 0.027) and baseline sum of antihypertensive drugs DDD < 4 (OR 5.30, 95% CI 1.68–16.67, P = 0.004). None of the analysed clinical or laboratory parameters was found to be a significant predictor of biochemical success.

Conclusion:
A majority of patients undergoing unilateral adrenalectomy for PA achieved markedly improved hypertension control while almost halving their antihypertensive medication. Females and patients using lower number of antihypertensive drugs preoperatively were more likely to be completely cured by the surgery.