bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGE-DEPENDENT INCREMENTAL PREDICTIVE VALUE OF CENTRAL BLOOD PRESSURE TO PREDICT CARDIOVASCULAR OUTCOMES: A COHORT STUDY INVOLVING 34,289 PARTICIPANTS USING THE UK BIOBANK
Authors: Wang Shuqi , Wong Samuel Ys , Yip Benjamin Hk , Lee Eric Kp 
Published: June 2023

Objective:
It remained unclear whether central blood pressures (BP) provided incremental prognostic information on cardiovascular disease (CVD) over brachial BP in different age groups. This study aimed to investigate the age-stratified association of CVD with brachial and central BPs, and to evaluate the corresponding improvement in risk prediction.

Design and method:
This longitudinal cohort study included 34,289 adults without baseline CVD from the UK Biobank dataset. Baseline characteristics were collected from May 2014 to March 2020 (last follow-ups, September 2021). Participants were categorized into middle-aged and older aged groups using the cut-off of age 65. Brachial systolic blood pressure (SBP) and pulse pressure (PP) were measured by digital oscillometric technique using the Vicorder system, and central SBP and PP were obtained from pulse wave analysis. The primary endpoint was a composite cardiovascular outcome consisting of cardiovascular mortality combined with non-fatal coronary events, heart failure and stroke. Multivariable-adjusted hazard ratios (HRs) expressed the risk of CVD events associated with BP increments of 10 mmHg. Akaike Information Criteria (AIC) was used for model comparisons.

Results:
In middle-aged (N = 17,383, median age = 57.5) and older adult (N = 16,906, median age = 70.4) group, 243 and 566 experienced a CVD event over the median follow-up of 42.4 and 36.9 months respectively. In both groups, CVD events were associated with brachial or central SBP (p< = 0.002). Model fitness was better for central SBP in middle-aged adults (AIC 4427.2 vs 4429.5), but model fitness was better for brachial SBP in older adults (AIC 10246.7 vs 10247.1). Central SBP remained significantly associated to CVD events (HR = 1.05; 95% CI: 1.0-1.1) and improved model fitness (AIC = 4426.6) after adjustment of brachial SBP only in the middle-age adults. These results were consistent for PP.

Conclusions:
In middle-aged adults, higher central BP were associated with greater risks of CVD events, even after adjusting for brachial BP indexes. For older adults, the superiority of central BP was not observed. Therefore, central BP may be considered as important measurement for estimating primary CVD risks for middle-aged individuals.
THE LONG-TERM REPRODUCIBILITY OF THE WHITE-COAT EFFECT ON BLOOD PRESSURE AS A CONTINUOUS VARIABLE: THE OHASAMA STUDY
Authors: Satoh Michihiro , Yoshida Tomoya , Metoki Hirohito , Murakami Takahisa , Tatsumi Yukako , Hirose Takuo , Takabatake Kyosuke , Tsubota-Utsugi Megumi , Hara Azusa , Nomura Kyoko , Asayama Kei , Kikuya Masahiro , Hozawa Atsushi , Imai Yutaka , Ohkubo Takayoshi 
Published: June 2023

Objective:
White coat hypertension is defined as a condition in which office blood pressure (BP), but not out-of-office BP, is elevated. However, the hypertension phenotype categorized by a determined threshold is generally fluctuant in individuals with BP readings close to the hypertension threshold. Furthermore, there is little information about the reproducibility of the white coat effect, which was a continuous variable, over more than a 1-year interval. The present study investigated the long-term interval reproducibility of the white coat effect.

Design and method:
We used the repeatedly measured white coat effect (office BP and home BP) at a 4-year interval in 153 participants not undergoing antihypertensive treatment (men, 22.9%; mean age, 64.4 years) from the general population of Ohasama, Japan. The reproducibility of the white coat effect as a continuous variable was assessed by testing the Bland–Altman plot and intraclass correlation coefficient (two-way random effect model single measures).

Results:
At baseline, the mean values were 127.5±15.8 mmHg for office systolic BP, 120.3±11.3 mmHg for home systolic BP, and 7.2±12.8 mmHg for the white coat effect based on systolic BP. The white coat effect for systolic BP decreased by 0.17±14.53 mmHg at the 4-year visit. The Bland–Altman plots showed no significant systemic error for the white coat effect (P > = 0.24) (Figure). The intraclass correlation coefficient (95% confidence interval) of the white coat effect for systolic BP, office systolic BP, and home systolic BP were 0.41 (0.27–0.53), 0.64 (0.52–0.74), and 0.74 (0.47–0.86), respectively. The difference in office systolic BP strongly contributed to the large change in the white coat effect. The agreements between hypertension phenotypes at baseline and the 4-year visit were minimal (kappa = 0.36; 95% confidence interval, 0.25–0.48).

Conclusions:
Long-term reproducibility of the white coat effect is limited in the general population not undergoing antihypertensive treatment. The change in the white coat effect is mainly caused by office BP variation.
PREVALENCE AND RISK FACTORS OF ORTHOSTATIC HYPOTENSION IN THE POPULATION-BASED SWISS LONGITUDINAL COHORT STUDY (SWICOS)
Authors: Schoenenberger-Berzins Renate , Hess Stephanie , Radovanovic Dragana , Muggli Franco , Bianchetti Mario , Gallino Augusto , Parati Gianfranco , Suter Paolo , Erne Paul , Schoenenberger Andreas 
Published: June 2023

Objective:
The prevalence of orthostatic hypotension (OH) ranges from 5% to 30%. Most of these previous studies embraced highly selected study populations and there is scare data obtained in population-based studies. Therefore, we examined the prevalence and correlates of OH in the population-based SWICOS study.

Design and method:
The 496 SWICOS participants underwent blood pressure (BP) measurements after adequate rest as well as 1 and 3 minutes after standing up with a validated oscillometric device. OH was defined as a reduction of systolic BP of at least 20 mmHg and/or diastolic BP of at least 10 mmHg within 3 min of standing up from the sitting position. To assess the associations between baseline characteristics and OH, multivariate logistic regression models were performed, adjusted for age, sex, and other variables that showed a significant association with OH in univariate analysis.

Results:
Among 496 participants, 72 (14.5%) had OH. Participants with OH were significantly older than participants without [mean age 62y vs. 48y; p<0.001)]. Among the participants older than 60 years (n = 129), 38 individuals (30%) had OH. Participants with OH were more often affected by arterial hypertension (32% vs 13%; p<0.001) diabetes (10% vs 3%; p = 0.009), obesity (22% vs. 12%; p = 0.023), their muscle mass was lower (65% vs. 71%; p<0.001), and shorter walking distance (160 m vs. 170 m ; p<0.001). Participants with OH had a higher seated systolic (148mmHg vs. 129mmHg) and diastolic BP (88mmHg vs. 80mmHg) (both p<0.001). From 28 participants with OH who were on a prescription for antihypertensive drugs, 12 (43%) were taking more than one antihypertensive drug and/or a diuretic. Independent predictors for OH were increased systolic BP (OR per mmHg increase 1.05 (95%CI 1.03-1.07; p<0.001), higher number of prescribed antihypertensive drugs (OR 3.35; 95%CI 1.17-9.56; p = 0.024) and reduced walking distance (OR 0.99; 95%CI 0.98-1.00; p = 0.037).

Conclusions:
In our study, a higher systolic blood pressure, more intensive antihypertensive drug treatment as well as reduced walking distance were associated with OH. Adequate BP measurement, adequate selection of antihypertensive drug classes and regular physical activity may be effective preventive measures to reduce OH.
PRETERM BIRTH IS ASSOCIATED WITH INCREASED CENTRAL SYSTOLIC PRESSURE IN PRIMARY HYPERTENSION - SINGLE CENTER EXPERIENCE
Authors: Prelevic Vladimir , Jelakovic Ana , Radunovic Danilo , Gallineo Lana , Domislavic Marija , Gasparovic Kristina , Josipovic Josipa , Jelakovic Bojan 
Published: June 2023

Objective:
Preterm birth (PB) and lower birth weight (LBW) are associated with higher risk for hyprtension, chronic kidney disease and cardiovascular (CV) morbidity and mortality in adulthood.
Our aim In this study was to analyze the association of PB and LBW with the parameters of arterial stiffness obtained during 24h measurement, with special focus on parameters of central hemodynamic (central aortic pressure).

Design and method:
In this study we included 154 adult patients (mean age 32, predominantly women (69.5%) with primary hypertension. In all of them we collected the data about term of birth and birth weight, and different antropological paramaters were measured. We determined various different laboratory data. Parameters of arterial stifness were measured in the office using Sphygmocor, and during the 24h using Mobil-o-Graph and Arteriograph.

Results:
In the whole group, 39 patients (25.5%) were born before the term. The corellation between pulse wave velocity (measured in office ambulatory during 24h) and term of birth was not found. The term of birth had low negative and statistically significant correlations with systolic central aortic pressure measured by Arteriograph during the night (r = -0.164, p < 0.05), as well as measured by Mobil-o-Graph during 24h (r = -0.167, p < 0.05), day (r = -0.172, p < 0.05) and night (r = -0.186, p < 0.05).

Conclusions:
Our findings suggest that preterm born is associated with increased systolic aortic pressure. We found this association fot the night time using two different devices. It could be speculated that this association might contribute to the global CV and kidney risk in subjects born before term. Further results are needed to answer whether ambulatory measurement of central hemodynamics have clinical importance.
ACCURACY OF FIXED 24-H AMBULATORY BLOOD PRESSURE RECORDINGS FOR DIAGNOSING HIGH 44-H AMBULATORY BLOOD PRESSURE IN HEMODIALYSIS PATIENTS: A DIAGNOSTIC TEST STUDY
Authors: Theodorakopoulou Marieta , Iatridi Fotini , Pella Eva , Karpetas Antonios , Georgiou Areti , Sampani Erasmia , Karkamani Eleni , Tsitouridis Alexandros , Papagianni Aikaterini , Sarafidis Pantelis 
Published: June 2023

Objective:
Hypertension is highly prevalent in hemodialysis patients. Ambulatory-BP-monitoring (ABPM) during the 44-h interdialytic interval is recommended for hypertension diagnosis and management in these subjects. This study assessed the diagnostic accuracy of fixed 24-h ABPM recordings with 44-h BP in hemodialysis patients.

Design and method:
242 Greek hemodialysis patients that underwent valid 48-h ABPM (Mobil-O-Graph NG device) were included in the analysis. We used 44-h BP used as reference method and tested the accuracy of the following BP metrics: 1st 24-h without HD period (20h-1st), 1st 24-h including HD period (24h-1st) and 2nd 24-h (24h-2nd).

Results:
All studied metrics showed strong correlations with 44-h SBP/DBP (20h-1st: r = 0.973/0.978, 24h-1st: r = 0.964/0.972 and 24h-2nd: r = 0.978/0.977, respectively). In Bland-Altman analysis, small between-method differences (-1.70, -1.19 and +1.45 mmHg) with good 95% limits-of-agreement ([-10.83 to 7.43], [-11.12 to 8.74] and [-6.33 to 9.23] mmHg, respectively) for 20h-1st, 24h-1st and 24h-2nd SBP were observed. The sensitivity/specificity and ↓-statistic for diagnosing 44-h SBP grater or equal to 130 mmHg were high for 20h-1st SBP (87.2%/96.0%, ↓-statistic = 0.817), 24h-1st SBP (88.7%/96.0%, ↓-statistic = 0.833) and 24h-2nd SBP (95.0%/88.1%, ↓-statistic = 0.837). Similar observations were made for DBP. In ROC-analyses, all studied BP metrics showed excellent performance with high Area-Under-the-Curve values (20h-1st: 0.983/0.992; 24h-1st: 0.984/0.987 and 24h-2nd: 0.982/0.989 for SBP/DBP respectively).

Conclusions:
Fixed 24-h ABPM recordings during either the first or the second day of interdialytic interval have high accuracy and strong agreement with 44-h BP in hemodialysis patients. Thus, ABPM recordings of either the first or the second interdialytic day could be used for hypertension diagnosis and management in these subjects.
24HOUR, HOME AND CLINIC BLOOD PRESSURE FOR THE PREDICTION OF LEFT VENTRICULAR HYPERTROPHY IN UNTREATED HYPERTENSIVE POPULATION
Authors: Antza Christina , Chovarda Eleni , Anagnostis Panagiotis , Kitsios Konstantinos , Trakatelli Christina , Stabouli Stella , Kotsis Vasilios 
Published: June 2023

Objective:
The aim of this study was to investigate which way of measuring blood pressure (BP), clinic, home or 24h-ABPM, can predict better left ventricular hypertrophy in the untreated hypertensive population.

Design and method:
175 consecutive subjects (42% male) aged 57.9±14.9 years were included in the study. Subjects were never treated before for hypertension. All subjects underwent 24h-ABPM on a usual working day. Home BP monitor was provided to all patients for 7 days, while office BP was measured in the clinic using a mercury sphygmomanometer. Left ventricular hypertrophy was evaluated by a cardiologist with the use of a 3D echocardiography.

Results:
In the univariate analysis, only home systolic and diastolic BP were independently associated with left ventricular hypertrophy, while both clinic and 24hour systolic and diastolic BP found not to be. From ROC curves for left ventricular hypertrophy, AUC of home systolic BP monitor (0.758, p<0.05) was larger than that of 24h (0.538, p>0.05) and clinic BP (0.497, p<0.05). As regards DBP, the ROC curves suggest no discrimination for the different ways of BP measurement.

Conclusions:
Home systolic BP can be a better predictor of left ventricular hypertrophy in untreated population, when compared to 24h and office systolic BP. This result shows the importance of home monitoring for the prediction of left ventricular hypertrophy, even in the untreated population.
ASSOCIATION OF OFFICE AND RESIDENTIAL BLOOD PRESSURE, PRESSURE CONTROL RATE AND NUMBER OF ANTI-HYPERTENSIVE AGENTS IN A BRAZILIAN MULTICENTRIC
Authors: Magalhaes Fabricio Galdino , Sousa Andrea Cristina , Batista Sandro Rodrigues , Amorim Kécia Cristina Faria De Oliveira , Inuzuka Sayuri , Barrroso Weimar Kunz Sebba , Sousa Ana Luiza Lima 
Published: June 2023

Objective:
Compare systolic (SBP) and diastolic (DBP) blood pressure, control rate, number of antihypertensive drugs (AH) and age group among hypertensive patients.

Design and method:
Analytical cross-sectional study, using the TeleMRPA platform database. Variables used: sex, age, SBP and DBP obtained by HBPM, office BP (PAc) and number of AH: 1 monotherapy, double, triple combination or with four or more. Elderly > = 60 years old and non-elderly <60 years old were considered. The chi-square test was used to compare proportions and the t-student test to compare means, 95% confidence interval and significance level p<0.05.

Results:
25,543 participated, 54.6% elderly (n = 13938; p<0.001), more women in the elderly group (66.9%) than among non-elderly (58.6% - p<0.001). The elderly group (71±8.0 years old) had a mean SBP of 136.7(±21.3) mmHg and DBPc of 80.6(±11.8) mmHg and MRPA SBP 129.0(±16) .0) mmHg and DBP 76.4(±9.6) mmHg. The non-elderly group (47±8.6 years old) had SBP of 129.6(±18.4) mmHg and DBPc of 86.4(±11.5) mmHg and by MRPA SBP 122.9(±14.6) mmHg and DBP 81.5(±9.5)mmHg; significant mean differences (p<0.001) in both groups. Controlled BP rate (HBPM) among the elderly was 56.2% and among non-elderly 43.8%. The number of antihypertensive drugs in the elderly group was 38.2%, 38%, 18.5% and 5.3% for monotherapy, double, triple combination or with four or more AH respectively; among non-elderly people it was 47.8%, 36.6%, 12.3% and 3.3% (p<0.001). Among the elderly, the BP control rate (HBPM) was 43.8% in monotherapy and 35.9% in four or more combinations (p<0.001); among the non-elderly, the rate of BP control (HBPM) was 41.7% in monotherapy and 25.8% in combination with four or more drugs (p<0.001).

Conclusions:
The elderly group had higher systolic values, both in the office and at home, and lower diastolic values, and a higher frequency of antihypertensive therapy in combination. The BP control rate was higher among the elderly and the greater the number of drugs used, the lower the BP control rate in both groups.
USEFULNESS OF AMBULATORY BLOOD PRESSURE MEASUREMENTS IN HAEMODIALYSIS PATIENTS: A MONOCENTRIC CROSS-SECTIONAL STUDY EXTENDED TO A 5- YEAR FOLLOW-UP
Authors: Huart Justine , Vanderweckene Pauline , Seidel Laurence , Bovy Christophe , Delanaye Pierre , Dubois Bernard , Grosch Stephanie , Xhignesse Patricia , Saint-Remy Annie , Krzesinski Jean -Marie , Jouret Francois 
Published: June 2023

Objective:
Blood pressure (BP) control in haemodialysis (HD) patients is crucial given their very high cardiovascular risk. Per-dialytic BP levels do not accurately predict the cardiovascular mortality. Here, we compare the prognostic yield of 2 ambulatory BP measurement techniques in prevalent HD patients.

Design and method:
We recruited adult patients who had been on chronic HD for more than 3 months. Seven-day home BP monitoring (HBPM) (values of Day 1 discarded) and 44-h interdialytic ambulatory BP monitoring (iABPM) were performed. Pre- and post-dialysis BP levels were measured during the 6 dialysis sessions prior to iABPM. A 5-year follow-up was carried out to assess all-cause and cardio-vascular mortality.

Results:
We recruited 43 patients including 15 women. Mean age was 68.3±13 years, mean body mass index was 24.1±3.8 kg/m2, median dialysis vintage was 2.4 years [0.25;11], and 67% of patients were under anti-hypertensive medications. In patients considered as normotensive in pre-dialysis (n = 17), masked hypertension was found in 24% (11.6% of the entire cohort) and 29%, based on iABPM and HBPM, respectively. Conversely, among hypertensive patients in pre-dialysis (n = 26), “white-coat” hypertension was noted in 23% (14% of the entire cohort), either by iABPM or HBPM. In treated hypertensive patients, ambulatory techniques detected a higher proportion of uncontrolled hypertension (76% of cases in iABPM and HBPM) compared to pre-dialysis measurements (65% of cases). Focusing on the first 24 hours of iABPM underestimated the proportion of hypertensive patients (49% of the entire cohort) compared to the 44-h coverage (58% of the entire cohort). Restricting HBPM for only 3 days decreased the concordance with iABPM from 86% (k = 0.79) to 76.7% of cases (k = 0.67). After a 5-year follow-up, 25 patients were deceased including 6 patients from cardiovascular causes. All-cause mortality was associated in an adjusted model for age and gender with day-time systolic BP measured by iABPM (p = 0.045).

Conclusions:
In chronic HD patients, 44-h iABPM and 7-day HBPM show a reliable concordance and help to re-classify ∼25% of cases miscategorised on the basis of pre-dialysis measurements. Day-time systolic BP levels using iABPM were significantly associated with 5-year all-cause mortality.
BENEFITS OF ANTIHYPERTENSIVE TREATMENTS IN PATIENTS WITH TYPE 2 DIABETES
Authors: Taleb/Abdelhalim Taleb , Nadia Dammene Debbih , Farah Hamida , Yousra Djebbar , Abdelghani Bachir Chérif 
Published: June 2023

Objective:
the objectives of this study are to describe the results of blood pressure obtained in a cohort of patients followed in consultation in the hospital center of blida, to compare them with the representative sample and to evaluate the conformity of the prescriptions of antihypertensive treatments.

Design and method:
this retrospective survey focused on t2dm patients seen in consultation between june and december 2022 in the internal medicine department of chu. On the occasion of this annual assessment of the complications of diabetes, an automated measurement of blood pressure is carried out.

Results:
the analysis covers 625 patients (men: n = 189 (54 ± 18 years); women: n = 436 (58 ± 17 years): the association of t2d and arterial hypertension (hta) is frequent (68%)
This situation is associated with cardiovascular and renal complications for respectively 18% and 33% of patients. Mean arterial pressure is 131.3/70.4 mmhg. The objective < 130/80 mmhg is achieved in 47.6% of patients. Anti-hta monotherapies are 95% compliant with standards (median ap = 130/72.5 mmhg). Anti-hta dual therapies are compliant in 99.5% (median = 132.5/74 mmhg) and triple therapies in 83% (median = 133.6/74 mmhg).

Conclusions:
the hypertensive patient should be considered a patient at risk of c-v complications. Diabetes is common in these patients. Although various dietary and pharmacological interventions targeting modifiable cardiovascular risk factors have largely proven their worth in terms of cardiovascular morbidity and mortality, the control of these risk factors remains very suboptimal in clinical practice. And this due both to an under-implementation of recommendations at the medical level but also to the low adherence of patients.
CARDIOLOGICAL HYPERTENSIVE EMERGENCIES: REAL WORD DATA COMPARED TO GUIDELINES INDICATIONS
Authors: Maloberti Alessandro , Elisa Andrian , Filippo Leidi , Massimiliano Monticelli , Michele Galasso , Valentina Colombo , Cristina Giannattasio 
Published: June 2023

Objective:
The 2018 ESH guidelines have revised the therapeutic goals of cardiological Hypertensive Emergencies (HE). Cardiac acute organ damage during HE includes acute myocardial infarction, pulmonary edema, unstable angina pectoris and aortic dissection. However, how much these indications have been applied in clinical practice to date it's unknown.

Design and method:
The first purpose of our study is to analyze the prevalence and clinical characteristics of cardiological HE in our institution. The second purpose is to compare the year before the release of the 2018 guidelines (2017) with the subsequent years (2019) trying to verify adherence to guidelines.
This is a single-center retrospective study conducted at the Niguarda Hospital. All patients aged > 18 years with Systolic BP > 180 mmHg and/or a Diastolic BP > 120 mmHg with Cardiological Emergency were enrolled. From the Emergency Department (ED) data clinical, anamnestic, blood pressure, symptoms, drug treatment and target achievement were registered.

Results:
Patients with BP > 180/120 mmHg in 2017 were 706 out of a total of 73795 accesses (0.96%) and 601 over 67273 (0.89%) in 2019. 246 (34.84%) in 2017 were HE of which 144 (58.53%) were cardiological: aortic dissection 1 (0.69%), acute coronary syndrome 52 (36.11%), acute pulmonary edema 35 (24.30%), cardiac decompensation 91 (63.19%). During 2019 similar figures were founded with 286 (47.58%) HE of which 286 (47.58%) were cardiological: aortic dissection 2 (1.43%), acute coronary syndrome 43 (30.93%), acute pulmonary edema 20 (14.39%), cardiac decompensation 76 (54.68%). The reduction in BP obtained in ED was significantly greater in 2017 than in 2019 (44.7±31.4 vs 35.4±24.5 mmHg, p = 0.011) with a lower target reaching in 2019 (28.9 vs 51.4%, p<0.001). Pulmonary edema is the cardiological HE on which a greater pressure reduction is obtained and therefore in which the target set by the guidelines is more frequently reached.

Conclusions:
The recommendation for a more intense and rapid BP reduction in cardiological HE seems to be not accepted from ED clinicians that persist to reduce BP accordingly to previous guidelines.