bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPC12-8: ASSOCIATION OF URIC ACID WITH BLOOD PRESSURE LEVEL IN ESSENTIAL HYPERTENSION: DIFFERENCES ACCORDING TO DIPPING PATTERN OF NOCTURNAL BLOOD PRESSURE
Authors: Koike Tsutomu , Tomoda Fumihiro , Ohara Maiko , Yamazaki Hidenori , Kinugawa Koichiro 
Published: January 2023

Objective:
In essential hypertensive patients, independent of the degree of hypertension, a non-dipping blood pressure pattern is a risk factor for the development of cardiovascular diseases. Serum uric acid level was demonstrated to be an independent predictor of developing hypertension. The increase of uric acid promotes oxidative stress and inflammation, which then enhances endothelial dysfunction. In this study, the association of serum uric acid with 24 hour average blood pressure level was investigated from differences in patterns of circadian blood pressure in patients with essential hypertensive patients.

Design and method:
In 154 untreated essential hypertensive patients (86 males, average age 56 ± 12 years) without chronic kidney disease (urinary albumin excretion less than 300 mg/g of creatinine and estimated glomerular filtration rate 60 mL/min/1.73m2 or more), 24 hour ambulatory blood pressure monitoring and blood sampling were performed. In blood samples, biochemical parameters including highly sensitive CRP (hsCRP) and nitric oxide metabolites (NOx) were measured. Non-dipper status was defined as a decrease in nocturnal systolic blood pressure < 10 %. The patients were divided into two groups according to their nocturnal systolic blood pressure status: 56 patients with non-dipper status and 98 patients with dipper status.

Results:
24 hour systolic blood pressure was higher in the non-dipper patients than in the dipper group (148 ± 17 vs 139 ± 16 mmHg, p < 0.001), whereas diastolic blood pressure and pulse rate did not differ between the two groups. The non-dipper group was characterized by increased serum uric acid and hsCRP and decreased plasma NOx level compared with the dipper group (6.0 ± 1.7 mg/dL, 0.10 ± 0.15 mg/dL, 41.4 ± 25.3 μmol/L in the non-dipper group vs 5.5 ± 1.5, 0.07 ± 0.11, 50.1 ± 31.3 in the dipper group, p < 0.05, respectively). 24 hour systolic blood pressure correlated positively with serum uric acid and hsCRP and negatively with plasma NOx in the non-dipper group (r = 0.25, 0.32, -0.25, p < 0.05, respectively), but did not so in the dipper group. Furthermore, in the non-dipper group, multiple regression analysis revealed that serum uric acid was an independent determinant for 24 hour systolic blood pressure level together with hsCRP, and plasma NOx (R2 0.25, p < 0.01).

Conclusions:
These data indicate that the elevation of serum uric acid could associate with persistently elevated blood pressure accompanied with micro-inflammation and vascular endothelial dysfunction in essential hypertensive patients with an attenuated nocturnal blood pressure dipping.
PS-BPP01-5: ASSOCIATION BETWEEN LENGTH OF DAILY SIESTA AND BRACHIAL-ANKLE PULSE WAVE VELOCITY (BAPWV): A COMMUNITY-BASED CROSS SECTIONAL STUDY IN NORTH CHINA
Authors: Zhao Xiaolei , Hu Aihua , Cai Qiujing , Dong Liguang , Wang Shuyi , Liu Lisheng , Zhang Xinmin , Wang Chenglong 
Published: January 2023

Background:
To date, many studies have proved the association between siesta and cardiovascular events. As the baPWV can assess the degree of atherosclerosis and the arterial stiffness, little is known about the association between siesta and baPWV levels. Thus we used a cross-sectional study to examine the association between siesta and baPWV levels.

Methods:
The baseline examination of 6,566 participants aged > 35 years included interviews, physical examinations, laboratory tests, and electron beam computed tomography. We compared the baseline data in 3 categories of siesta habits: irregular or no siestas; daily short siestas (1 hour or less); and daily long siestas (> 1 hour). Logistic regression models and multiple linear regression were applied to find the association between siesta and baPWV.

Results:
Among all participants, the different siesta groups have a significant difference of the prevalence of several AS degrees (P < 0.001). We also found a similar result in male or female (male P < 0.001, female P < 0.001). Daily long siestas had positive associations with prevalence of several cardiovascular risk factors and measures of subclinical atherosclerosis. Results from model3 (fully adjusted model) showed that long siesta (> 60 min, OR = 1.18, 95%CI: 1.06–1.31, P = 0.002) was associated with more severe level of the baPWV. For age or gender stratification, we found significant differences between non-siesta and > 60 min siesta groups from model3. Multiple linear regression analysis showed a positive relationship be¬tween siesta duration and baPWV (b; = 0.197, P = 0.038).

Conclusions:
Long siesta was associated with increased risk of atherosclerosis. These findings warrant further examination with prospective studies and laboratory investigations.
PS-BPP01-6: IMPACT OF THE DEGREE OF HYPERTENSION ON SUBCLINICAL CORONARY ATHEROSCLEROSIS IN ASYMPTOMATIC INDIVIDUALS
Authors: Park Gyung-Min , Kim Yong-Giun 
Published: January 2023

Objective:
This study sought to evaluate the association between degree of hypertension and subclinical coronary atherosclerosis

Design and method:
We analyzed 9,459 asymptomatic individuals (mean age 53.8 ± 8.0 years; 6,126 [64.8%] men) with no prior history of coronary artery disease (CAD) who voluntarily underwent coronary computed tomography angiography (CCTA) as part of a general health examination. The classification of hypertension was adapted from the American College of Cardiology/American Heart Association 2017 guideline. The degree of subclinical coronary atherosclerosis was evaluated by CCTA, and classified into normal coronary arteries, non-obstructive CAD (diameter stenosis < 50%), and obstructive CAD (diameter stenosis > = 50%).

Results:
Subjects were classified into 4 groups: normal (systolic blood pressure [SBP] < 120 mm Hg and diastolic blood pressure [DBP] < 80 mm Hg; n = 2,944), elevated (SBP 120–129 mm Hg and DBP < 80 mm Hg; n = 1,237), stage 1 hypertension (SBP 130–139 mm Hg or DBP 80–89 mm Hg; n = 3,827), and stage 2 hypertension (SBP > = 140 mm Hg or DBP > = 90 mm Hg; n = 1,451). After adjustment for cardiovascular risk factors, the stage 1 hypertension group was significantly associated with non-obstructive CAD (adjusted odds ratio [aOR] 1.384; 95% confidence interval [CI], 1.223–1.567; P < 0.001). Furthermore, the stage 2 hypertension group had a significant association with both non-obstructive CAD (aOR, 1.433; 95% CI, 1.227–1.675; P < 0.001) and obstructive CAD (aOR, 1.463; 95% CI, 1.110–1.928; P = 0.007).

Conclusions:
In this large cross-sectional study, the degree of hypertension was associated with increased risk and severity of subclinical coronary atherosclerosis. These findings suggest the importance for control of blood pressure in asymptomatic individuals.
PS-BPP02-1: EFFECTS OF INCREASED ARTERIAL STIFFNESS ON HEMODYNAMIC RESPONSE DURING AND AFTER SUBMAXIMAL STEP EXERCISE TEST IN MIDDLE-AGED NORMOTENSIVE INDIVIDUALS
Authors: Miyai Nobuyuki , Zhan Yan , Sakaguchi Masato , Terada Kazufumi , Mure Kanae , Utsumi Miyoko , Miyashita Kazuhisa , Arita Mikio 
Published: January 2023

Objective:
This study was designed to examine the effects of increased arterial stiffness on hemodynamic response during and after simple step exercise test in middle-aged normotensive individuals.

Design and method:
The study participants consisted of 819 untreated normotensive individuals (aged 54.8 years; 39.6% men) without a history of cardiovascular disease, stroke, and renal disease. The participants underwent a submaximal step exercise test (25 steps/min for 2 min). Brachial arterial blood pressure (BP) and pulse rate were measured at 1-min interval before, during, and after the step exercise test. During the end of exercise (exercise SBP) and 2 min after exercise (recovery SBP) were evaluated. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness using an oscillometric device.

Results:
The mean values of resting SBP, exercise SBP, and recovery SBP were 121 ± 12 mmHg, 153 ± 17 mmHg, and 130 ± 14 mmHg, respectively. The individuals with increased baPWV (> = 1400 cm/s, n = 305) showed significantly higher exercise SBP and recovery SBP than those with normal baPWV (Exercise, 162 ± 16 mmHg vs. 148 ± 16 mmHg, P < 0.001; Recovery, 138 ± 13 mmHg vs. 125 ± 13 mmHg, P < 0.001). The odds ratios for an exaggerated exercise SBP (> = 180 mmHg) and delayed recovery SBP (> = 150 mmHg) in individuals with increased baPWV were 2.7 (95%CI, 1.8–4.9; P = 0.001) and 3.3 (95%CI, 1.8–6.2; P < 0.001) after adjusting for age, gender, body mass index, and resting SBP. When participants were divided according to a combination of exercise SBP and recovery SBP, the baPWV of the subgroup with exaggerated exercise SBP and delayed SBP recovery was higher than that of those with only exaggerated exercise SBP and delayed SBP recovery (Both, 1585 ± 301 cm/s; Exercise, 1505 ± 232 cm/s; Recovery, 1475 ± 160 cm/s).

Conclusion:
Exaggerated BP increase and delayed BP recovery during submaximal step exercise test are associated with increased arterial stiffness in normotensive individuals. Subclinical vascular impairment may influence vascular reactivity to a greater degree than basal tone and could be identified by an abnormal BP response to exercise even before clinical manifestation of hypertension.
PS-BPP02-2: BLOOD PRESSURE VARIABILITY PREDICTS THE DEVELOPMENT OF HYPERTENSION IN NORMOTENSIVE INDIVIDUALS
Authors: Takase Hiroyuki , Machii Masashi , Hayashi Kazusa , Kin Fumihiko , Nakano Suguru , Takayama Shin , Sugiura Tomonori , Dohi Yasuaki 
Published: January 2023

Objective:
Hypertension is one of the important risk factors for atherosclerosis leading to cardiovascular diseases. Although several factors have been reported as predictors of new onset of hypertension, the association of blood pressure (BP) variability in normotensive subjects with future development of hypertension is not intensively discussed. We tested the hypothesis that the yearly variability of BP in normotensive subjects predicts new onset of hypertension.

Design and Methods:
Subjects who participated in our annual physical check-up program for 5 years in a row during 2008 and 2013 were screened (screening period) and those under antihypertensive medication or with the average BP for the 5 visits ≧ 140/90 mmHg were excluded. The rest of 2006 participants (male = 1287) were eligible in the present study. Standard deviation (SD) and coefficient of variation (CV) of their systolic BP (SBP) during the 5 consecutive visits were calculated (screening period) and, then, they were followed up for the next 5 years (follow-up period). The onset of hypertension was defined as average BP during the follow-up period ≧ 140/90 mmHg or the use of antihypertensive medications.

Results:
The average, SD, and CV of SBP were 118.7 ± 10.0 mmHg, 7.44 ± 2.98 mmHg, and 6.30 ± 2.54%, respectively. During the follow-up, hypertension developed in 259 subjects, with the incidence being more frequent in male (n = 180, 14.0%) than female subjects (n = 79, 11.0%). In retrospective analysis, the average (128.7 ± 7.7 vs. 117.2 ± 9.5 mmHg, p < 0.001) and SD (8.05 ± 3.48 vs. 7.34 ± 2.89 mmHg, p < 0.001) were higher in subjects with than without future hypertension, whereas CV was not different in the both groups (6.28 ± 2.73 vs. 6.30 ± 2.51%). Non-adjusted odds ratio (OR) (95% confidence interval [CI]) of average, SD and CV for the incident hypertension were 1.169 (1.146–1.193), 1.078 (1.034–1.124) and 0.997 (0.947–1.050), respectively. Multivariate logistic regression analysis adjusted for age, gender, family history of hypertension, frequent alcohol consumption (six or seven times per week), current smoking, body mass index, heart rate, serum creatinine, fasting plasma glucose, LDL-cholesterol, and triglyceride at baseline demonstrated that average (OR [95%CI] = 1.193 [1.138–1.187]) and SD (1.058 [1.014–1.105]), but not CV (0.992 [0.941–1.046]), were associated with new onset hypertension. Similar results were obtained using diastolic BP (data not shown).

Conclusions:
In normotensive subjects, an increase in year-to-year variability as well as average of SBP may be a predictor of the new onset of hypertension. Careful interpretation of year-to-year BP variability is necessary for evaluation of future cardiovascular risk in normotensive individuals.
PS-BPP03-4: METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE (MAFLD) PREDICTS NEW ONSET OF CHRONIC KIDNEY DISEASE BETTER THAN DOES FATTY LIVER OR NAFLD
Authors: Tanaka Marenao , Mori Kazuma , Takahashi Satoko , Higashiura Yukimura , Ohnishi Hirofumi , Hanawa Nagisa , Furuhashi Masato 
Published: January 2023

Background:
Possible associations of chronic kidney disease (CKD) with fatty liver (FL) and nonalcoholic fatty liver disease (NAFLD) have recently been focused on. Metabolic dysfunction-associated fatty liver disease (MAFLD), defined as FL with overweight/obesity, type 2 diabetes mellitus or metabolic abnormalities, has been proposed as a new feature of chronic liver disease. However, the relationship between MAFLD and new onset of CKD has not been fully addressed.

Methods:
We investigated the associations of FL, NAFLD and MAFLD with the development of CKD, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 or positive for urinary protein, over a 10-year period in 28,890 Japanese subjects who received annual health examinations. After exclusion of subjects with no data for abdominal ultrasonography and subjects with CKD at baseline, a total of 13,159 subjects (men/women: 8,581/4,578, mean age: 48 years) were recruited.

Results:
The prevalences of FL, NAFLD and MAFLD were 34.6% (men/women: 45.1%/15.1%), 32.8% (men/women: 42.7%/14.5%) and 32.3% (men/women: 42.4%/13.4%), respectively. During the 10-year follow-up period, 2,163 subjects (men/women: 1,475/688) had new onset of CKD. Multivariable Cox proportional hazard model analyses showed that MAFLD (hazard ratio [95% confidence interval]: 1.12 [1.02–1.26], p = 0.027), but not FL or NAFLD, was an independent risk factor for new onset of CKD after adjustment of age, sex, eGFR, current smoking habit, ischemic heart disease, diabetes mellitus, overweight/obesity, hypertension and dyslipidemia. The addition of MAFLD (continuous net reclassification improvement [NRI]: 0.154, integrated discrimination improvement [IDI]: 0.0024) to traditional risk factors without metabolic abnormalities significantly improved the discriminatory capacity better than did the addition of FL (NRI: 0.138, IDI: 0.0018) or NAFLD (NRI: 0.132, IDI: 0.0017).

Conclusions:
MAFLD is independently associated with new onset of CKD and predicts the risk for development of CKD better than does FL or NAFLD.
PS-BPP04-6: DIASTOLIC BLOOD PRESSURE LEVELS AND CARDIOVASCULAR EVENTS: THE JAPAN EPIDEMIOLOGY COLLABORATION ON OCCUPATIONAL HEALTH STUDY
Authors: Kuwahara Keisuke , Ohkubo Takayoshi , Inoue Yosuke , Kabe Isamu , Dohi Seitaro , Mizoue Tetsuya 
Published: January 2023

Objective:
In Japan, data are sparse as to the association of diastolic blood pressure (DBP) within the elevated blood pressure range (i.e., DBP of 80 to 89 mm Hg) with risk of cardiovascular diseases (CVD) in young to middle-aged adults. We examined this association by using prospective data collected in the Japan Epidemiology Collaboration on Occupational Health (JECOH) Study.

Methods:
Participants were 81,876 workers (67,150 men and 14,636 women, aged 20 to 64 years) without taking antihypertensive medication who underwent periodic health checkup in 2011 or 2010 (baseline). Blood pressures categories at baseline were used as exposure. Data on fatal and non-fatal cardiovascular events (ICD10: I21 to I25, I46, I48 to I50, I60 to I69, I71 to I72) that occurred between April 2012 and March 2021 were retrieved from a within-study registry. Multivariable-adjusted hazard ratios according to DBP levels were calculated using Cox regression.

Results:
Over the 9 years of follow-up (0.5 million person years), 319 cardiovascular events (hemorrhage or ischemic stroke [ICD10: I60/I63], 177 cases; myocardial infarction [ICD10: I21], 77 cases) including 74 cardiovascular deaths were documented. Higher levels of DBP were associated with increased risk of cardiovascular events. As compared with DBP of < 80 mm Hg, multivariable adjusted hazard ratios (95% confidence intervals) of cardiovascular events were 1.58 (1.12, 2.22), 2.25 (1.75, 2.91), 2.85 (1.97, 4.11), 2.89 (1.52, 5.48), and 5.60 (2.52, 12.42) for DBP of 80 to 84, 85 to 89, 90 to 99, 100 to 109, and ≧ 110 mm Hg, respectively (P value for trend < 0.001). Risk of CVD mortality was also increased, albeit not significantly, at DBP of 80 to 84 and 85 to 89 mm Hg (19% and 59% increase, respectively).

Conclusion:
The present data from JECOH Study showed that DBP of 80 to 84 mm Hg was associated with a significantly higher risk of cardiovascular events. Our results support the blood pressure classification in the Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH2019) for CVD prevention.
PS-BPP06-1: ESTIMATION OF SALT INTAKE AND REMOVAL IN HEMODIALYSIS PATIENTS
Authors: Ishii Takeo , Hagiwara Yasuhiro , Tagawa Hitoshi , Arimura Yoshiriro , Wakui Hiromichi , Matsuyama Yutaka , Tamura Kouichi , Oyama Kunio 
Published: January 2023

Background:
Measurement of salt intake is difficult in dialysis patients, and prognosis analysis is insufficient. Recent studies have also reported that excessive salt intake leads to muscle wasting by activating the urea cycle. Hence, the removal of sodium via electrical force may lead to a favorable outcome by preventing urea cycle activation, thereby preserving tissue nutritional status, and avoiding tissue inflammation.

Subject method:
A cohort of 6,883 maintenance dialysis patients was followed up for 3 years. The salt intake removal (SALT i/r) was estimated, using the formula previously reported by Watson and Ramdeen, and was classified into five groups. Statistical analysis: Cox hazard analysis, cubic spline curve for outcomes, and generalized estimation equation (GEE) were used.

Results:
A total of 1,209 deaths were reported. The average baseline value of SALT i/r was 7.74 g. In the multivariate Cox hazard analysis, SALT i/r showed no correlation with all cause mortality but had significant correlation with CVD events; hazard ratio (HR) 1.02 (95% CI: 1.005 1.036). The cubic spline curves indicated that SALT i/r levels above 6.0 g decreased the risk of all cause mortality but increased the risk for CVD events and heart failure. GEE analysis suggested that baseline SALT i/r values correlated positively with time dependent serum creatinine (Cr) and CGR%. Additionally, SALT i/r values from the previous month also correlated positively with current serum Cr and CGR%.

Discussion:
Although a Kaplan Meier curve indicated that lower baseline salt intake caused more deaths, this may be attributed to age or malnutrition. Multivariate Cox hazard analysis showed that salt intake does not predict all cause mortality but has a positive correlation with new onset heart failure. We also described the nonlinear relationship between salt intake and risk of all cause mortality/CVD events by using cubic spline curves. This suggested that salt intake above 6 g decreased the risk of all cause mortality while increasing the risk of CVD events. In GEE, there was a significant correlation between previously measured high SALT i/r and current increase in muscle mass. Thus, we hypothesize that salt removal by dialysis without involvement of the urea cycle causally leads to muscle preservation.

Conclusion:
In this large cohort, estimated SALT i/r had a significant correlation with prognosis. We found that salt retention induces heart failure in dialysis patients. However, salt removal by dialysis may causally preserve tissue nutritional status.
PS-BPP06-5: PREVALENCE AND DETERMINANTS OF HYPERTENSION AMONG ADULTS: A CROSS SECTIONAL SURVEY OF ONE TRIBAL AREA IN BANGLADESH
Authors: Majumder Abdullah Al Shafi , Ghosh Rajib , Reza Md Alimur 
Published: January 2023

Introduction:
The prevalence of hypertension gradually has become a serious public health threat globally as it is a very pertinent risk factor for non communicable diseases. The prevalence of non communicable diseases is not well known in tribal areas of Bangladesh. Lifestyle and food habits are quite different from majority of population living in plain lands (recognized as Bengali). Though data are available regarding the latter, data on the tribal population is scanty. Purpose: This study was aimed to assess the prevalence and risk factors of hypertension in a tribal area in Bangladesh.

Materials and Methods:
We conducted a cross sectional study of 637 men and women aged 18 years or more located in Rowangchhari THC of Bandarban, a hilly district of Bangladesh. We collected data on demographics, behavioral factors, physical measurements and health history. Data collection was done using a pretested questionnaire and clinical examination. Prevalence and 95% confidence interval were estimated for hypertension. SPSS version 25.0 was used. A value of P less than 0.05 was considered statistically significant.

Results:
Among all 637 participants, 52% patients were male and mean age was 35.4 plus/minus 13.4 years. Almost 78% participants were from different tribal community (e.g. Marma, Tonchonga, Bom, Tripura, Chakma etc.). Hypertension prevalence was 28.9% (95% CI 25.4 to 32.6) and was significantly higher among male than female (33.1% vs 24.3%; p value is 0.014). The highest prevalence of hypertension was observed among aged 60 years or more at 41.3%. Hypertension was higher among Bengali (33.6%) than tribal population (28.1%), but not statistically significant. Determinants of hypertension included male gender, older age, higher income, nature of job, increasing body mass index and waist circumference. More than 85% of the participants has knowledge of harmful effect of Hypertension (86.9%) and smoking (91.2%).

Conclusion:
Our study suggests that the prevalence of hypertension is significant among the population living in tribal area. Specific interventions should be developed to inform adults of the necessary lifestyle changes and the importance of early screening, awareness campaigns for early health seeking and improvement in health access.