bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE IMPACT OF OBESITY ON THE CONTROL OF TREATED HYPERTENSIVE PATIENTS
Authors: Hamdani Achref , Bayar Mohamed Fehmi , Ajra Zaineb , Gheni Refaat , Rashikou Lamia , Hmida Riadh Ben , Ounissi Taha , Elhadj Zied Ibn 
Published: June 2023

Objective:
Obesity is as a risk factor for hypertension, but there are few studies evaluating its impact on the response to antihypertensive drug and on the control of hypertensive patients. The aim of our study was to determine the effect of obesity on the control of treated hypertension.

Design and method:
We analyzed recordings of ambulatory blood pressure measurement (ABPM) in 84 treated hypertensive patients aged > 18 years, in the cardiology department of Mohamed Taher Maamouri University hospital in Nabeul. Patients were stratified into two groups: obese (Body Mass Index (BMI) >30 kg/m2) and non-obese. Hypertension control is defined by 24-hour ambulatory blood pressure (BP) = < 130/80 mmHg, daytime = < 135/85 mmHg and nighttime = < 120/70 mmHg.
The comparisons of percentages were carried out by the Chi-square test.

Results:
Our Population was composed of 33 obese and 51 non-obese patients. The mean age of our population was 59.37±13.1 years. BMI in obese was significantly higher than in non-obese (34.47±5.4 versus 25.36±2.5; p<0.001). The prevalence of uncontrolled patients was significantly higher in obese patients detected in 24-hour ABPM (75.8% versus 51%; p = 0.039), in daytime ABPM (69.7% versus 41.2%; p = 0.014) and in night-time ABPM (90.9% versus 68.6%; p = 0.018) than in normal weight patients.

Conclusions:
Prevalence of uncontrolled hypertension was higher with higher BMI values. The level of blood pressure control in our sample remains relatively insufficient. To achieve a better control of hypertension, we must insist on therapeutic compliance and on the correction of risk factors, particularly obesity, which is significantly associated with an increase in BP.
APNEA-HYPOPNEA INDEX AND CAROTID ATHEROMATOSIS
Authors: Mateus Sónia , Cavaco Mariana , Rocha Daniela , Carvalho Lucinda , Coelho Patricia , Rodrigues Francisco , Pires Joana 
Published: June 2023

Objective:
Verify the relationship between degrees severity of the apnea-hypopnea index and carotid atheromatous disease; identify risk factors in individuals with pathological apnea-hypopnea index and carotid atheromatous disease.

Design and method:
Observational, longitudinal, retrospective and quantitative study of a non-probabilistic convenience sample consisting of 67 adult individuals with diagnosed sleep apnea, submitted to a polysomnographic study and cervical triplex scan, in two years in a district hospital.

Results:
In a sample of 67 individuals, 37 male and 30 female, aged between 35 and 82 years, with an average age of 61.90 ± 12.594 years.
In the degrees severity of the apnea-hypopnea index, it was observed that 14 individuals had mild degree (20.9%), 23 moderate degree (34.3%) and 30 severe degree (44.8%).
One-fifth of the sample (n = 20, 29.9%) had intima-media thickening (>1mm). In the relationship between the intima-media index and the degrees of severity of the apnea-hypopnea index, it was found that of the 20 individuals (29.9%) with thickening, more than half (n = 11, 16.4%) had an severe apnea index - hypopnea. With moderate degree, 6 individuals (9.0%) and mild degree 3 individuals (4.5%) (p = 0.523).
In cervical triplex scan results, 39 individuals (58.2%) had carotid atheromatosis without hemodynamic repercussions, 2 (3%) had severe stenosis and 1 (1.5%) had pre-occlusive stenosis.
From the total number of individuals with atheromatous disease, 25 (37.3%) had a severe apnea - hypopnea index, 17 (25.4%) had a moderate apnea - hypopnea index and 4 (6.0%) had apnea - hypopnea index mild (p = 0.029).
The most frequent risk factor in the 46 individuals with the two pathologies under study were arterial hypertension (n = 36, 53.7%), dyslipidemia (n = 26, 38.8%) and diabetes mellitus (n = 20, 29.8%).

Conclusions:
Individuals with moderate and severe degrees of the apnea-hypopnea index have a significant relationship with the phases of more advanced atheromatous disease, however, there is an increase in the frequency of more severe degrees of the apnea-hypopnea index in individuals with atheromatous disease in the early stages.
The most prevalent risk factors in individuals with sleep apnea and carotid atheromatous pathology are male gender, arterial hypertension, dyslipidemia and diabetes mellitus.
LEGACY OF ARTERIAL HYPERTENSION OF WOMEN WITH A PAST HISTORY OF PREECLAMPSIA
Authors: Ouankou Christian Ngongang , Koubouratou Oumy Aboubacar Hawa , Njonnou Sylvain Raoul Simeni , Kuate Liliane Meufeu , Wandji Boris Kom , Danwe Dieudonne , Tebeu Pierre Marie , Choukem Simeon Pierre 
Published: June 2023

Objective:
Preeclampsia increases the longterm risk of cardiovascular disease. Some of the women affected by this condition remain hypertensive after delivery. Hypertensive phenotypes can be detected with ambulatory BP monitoring (ABPM). This study aimed to determine the prevalence of hypertension using ABPM and office measurements.

Design and method:
We conducted a cross- sectional study which included women who delivered between January 2015 and June 2021 and were diagnosed and followed up for preeclampsia in three major obstetrical and gynaecologic units in Yaounde. We excluded from the study all women who had a history of chronic hypertension or a known Cardiopathy. Sociodemographic data and past history were recorded, a physical exam,ecg, an ultrasound and ABPM was performed to all participants.

Results:
101 participants were included. The mean age was 30.56 years. 40.6% of women had hypertension (sustained hypertension, with sometime masked hypertension) with ABPM. Sustained hypertension was most common (26.7%), followed by masked hypertension (11.9%) and white-coat hypertension (2%). With office BP measurement, only 28.7% of women would have been diagnosed hypertensive. 29.8% of women had a disadvantageous dipping pattern. Among those that develop chronic hypertension, 18.8% had LVH at electrocardiography, 7.9% had both LVH and an abnormal left ventricular geometry on ultrasound while in normotensive women 1.9% had LVH at Ecg with 1% having both LVH and abnormal geometry at ultrasound. 20.8% of these women were obese during the follow up compared to 11.9% in the normotensive group. We had 26 patients (25,74%) with severe office hypertension and 32,3% were obeses. The fundus was normal in the majority of cases and we had no signs of neurological deficits or impaired cognition. Renal function was always normal or subnormal. Finally, we had two cases of heart failure.

Conclusions:
Many women affected by preeclampsia remain hypertensive after delivery. Masked hypertension and white-coat hypertension are risk factors for future cardiovascular disease and can only be diagnosed with ABPM. It is important to provide adequate follow-up for these women in order to intervene on the factors leading to this outcome.
GESTATIONAL HYPERTENSION AND PERIPARTUM CARDIOMYOPATHY: EPIDEMIOLOGICAL, CLINICAL AND EVOLUTIONARY PROFILE IN THE REFERENCE HOSPITALS OF YAOUNDE
Authors: Ouankou Christian Ngongang 
Published: June 2023

Objective:
peripartum objective (CMPP) is a primary dilated cardiomyopathy responsible for congestive heart failure that occurs during the last two months of pregnancy or during the first five months of postpartum. However, little is known about the data in Cameroon, justifying our descriptive study.
Our main objective was therefore to describe the epidemiological, clinical and progressive symptoms of women with peripartum cardiomyopathy and the influence of gestational hypertension.

Design and method:
We conducted a prospective descriptive study over a six-month period. It was conducted in six referral hospitals in Yaoundé. The study population consisted of pregnant women with dyspnoea and women who had given birth with dyspnoea. All pregnant or postpartum women (from month 32 GA to month 5 postpartum) who had LVEF <45% and/or FS <30% with or without left ventricle dilatation were included. They were placed on treatment with a follow-up over 3 months, where they had a second cardiac ultrasound to highlight the evolutionary profile.

Results:
We recruited 10 patients from 26 women. The mean age was 25.9 years ± 4.9 years. The average parity was 1.6 ± 1.17 (extreme 0-3). Multiparas were the most represented. History of gestational hypertension was the main predisposing factor (50%); followed by multiparity (30%), twin pregnancy and advanced maternal age (20%). Heart failure was the clinical expression in 60% of cases. The echocardiographic regimen described hypokinetic dilated cardiomyopathy (mean LVEDD 61.2 ± 8.6 mm) with mean systolic function of 27.1 ± 10.6%. The main complications were acute pulmonary oedema (60%), thromboembolic events including pulmonary embolism (10%), ischemic stroke (10%) and death (10%). Treatment is mainly based on the use of diuretics, ACE inhibitors, beta-blockers, Aldactone (1/3 of patients) without forgetting anticoagulation performed with Rivaroxaban (n = 4) for some and aspirin (n = 6); and bromocriptine (initiated in 3 patients).

Conclusions:
MPPC is a serious disease because of its (significant morbidity and mortality rate) and its complications, both hemodynamic and thromboembolic.
MATERNAL LEFT VENTRICULAR ADAPTATION IN TWIN PREGNANCY
Authors: Pellegrino Alessio , Toncelli Loira , Pasquini Lucia , Masini Giulia , Mecacci Federico , Pedrizzetti Gianni , Modesti Pietro Amedeo 
Published: June 2023

Objective:
During pregnancy, a maternal left ventricular (LV) remodeling occurs to face significant hemodynamic changes. Although twin pregnancy can require greater modifications than in singleton, limited data are currently available. The aim of the study was to longitudinally investigate maternal changes of LV function and compliance in twin pregnancy.

Design and method:
35 uncomplicated twin pregnancy women underwent transthoracic echocardiography at first (T1, 10-15 weeks) and third trimester (T3, 30-35 weeks) of gestation. Left atrial (LA) and LV dimensions, LV volumes, systolic and diastolic function were measured, LV mass was calculated. Speckle-tracking imaging was used to evaluate global longitudinal strain (GLS). Non-invasive pressure-volume curves (PV loops) were reconstructed using a dedicated software.

Results:
Maternal LA and LV dimensions, LV volumes and mass increased from T1 to T3. Ejection fraction and GLS showed no changes between visits. Assessment of diastolic function (at pulsed wave Doppler and tissue Doppler) showed no changes in E/A ratio, while E/e’ ratio was higher at T3. At PV loops analysis, ventricular-arterial coupling (VAC) was stable due to the reduction of both LV end-systolic elastance (Ees) and arterial elastance (Ea). An increase in stroke work was observed. The increase in LV end-diastolic volumes from T1 to T3 with no changes in LV end-diastolic filling pressure suggested enhanced LV cavity compliance (rightward shift of the end-diastolic pressure-volume relationship, EDPVR).

Conclusions:
Maternal heart in uncomplicated twin pregnancy adapts to the increased hemodynamic load with an increase in stroke work and enhancement of LV volumes without altering ventricular filling pressure.
EARLY DETECTION AND TREATMENT OF IMPAIRED GLUCOSE AND HYPERINSULINEMIA IN EARLY PREGNANCY TO PREVENT DIABETES AND CARDIOVASCULAR DISEASE IN ADULTS
Authors: Jain Rajesh , Seshiah Veeraswamy , Chandeshekar Anjalakshi , Shanmugam A , Balaji Vijayam , Geethalakshmi A , K Kalaivani , Dharmarajan P , Meena S , Prabhu Karthiga , Paneerselvam Arunachalam , Bhavatharini N , Saxena Pickee , Yadav Akshama , Chawla Rajeev , Jaggi Shalini , Sharma Puja , Mishra Archana , Agarwal Shally , Tiwari Sadhana 
Published: June 2023

Objective:
So far, no attempt has been made the Prevention of Diabetes and CVD in the community. There is a concept that GDM is the mother of Non-Communicable Diseases. Hence, the aim is to decide the glycemia level which predicts the development of GDM.
The suggestion is that HbA1C of more than 5.3 (110mg/dl) during the 10th week of pregnancy predicts GDM. HBA1C 5.7 during pregnancy establishes GDM in Asian ethnicity, and HbA1c measured in the first trimester is helpful for early prediction of GDM.
A blood test performed at the 10th week of pregnancy and if PPBS >110 mg% may help identify a pregnant woman at risk of GDM. Hence in the 8th week itself, PPBS has to be estimated. If the PPBS is >110 mg%, a grace period of two weeks is available to maintain PPBS<110mg% at the 10th week.
Another essential physiology is that at the 11th week, Fetal beta cell insulin secretion starts. If PPBS remains, more than 110 mg% fetal hyperinsulinemia occurs, which is undesirable.

Design and method:
Testing for PPBS at the 8th week with 110mg/dl so that enough time is available before fetal insulin secretion starts in the 11th week. If PPBS more than 110mg/dl in the 8th week, the PPBS should be controlled with MNT and Exercise and, if necessary, with Metformin so that PPBS should be maintained at less than 110mg/dl (99 +/- 10) till the 12th week. At the 16th week, 75gm OGCT (DIPSI Test) should be done to know whether she develops GDM and, if negative, be repeated at the 24th and 32nd weeks.
Points to Remember:PPBS more than 110mg/dl around the 10th week predicts GDM Fetal Beta Cell starts secreting insulin in the 11th week. The maternal PPBS should be less than 110mg/dl till the 12th week.

Results:
The Pregnant woman is unlikely to develop Gestational Diabetes if 2-hour PPBS around the 10th Week is less than <110 mg/dl with MNT or Metformin

Conclusions:
Early Pregnancy hyperglycemia at 8th Weeks detection and treatment may prevent future Diabetes and NCDs especially CVD.
DEVELOPMENT OF A MULTIANALYTE MASS SPECTROMETRY METHOD FOR QUANTITATION OF ANTIHYPERTENSIVES IN MILK
Authors: Bernieh Dennis , Larwood Louise Ann , Gill Henry , Lane Dan , Jones Don , Gupta Pankaj 
Published: June 2023

Objective:
Hypertension in pregnancy is common and affects about 10% of women. One third of cases persist into the postnatal period requiring treatment with antihypertensive medications to control blood pressure. However, there is a lack of quality evidence to quantify the transfer of antihypertensives into human milk and to therefore recommend their safe use during breastfeeding. Current reviews on this subject are opinion driven or formed upon recommendations from expert working groups based on anecdotal case reports. No antihypertensives are licensed for use during breastfeeding in the UK and many have not been tested during pregnancy or breastfeeding.

Design and method:
A multi-marker liquid chromatography coupled with triple quadrupole mass spectrometry (LC-MS/MS) assay was developed and optimised to simultaneously quantify 24 antihypertensives and their metabolites (enalapril (and enalaprilat), lisinopril, perindopril, ramipril (and ramiprilat), trandolaprilat, azilsartan, candesartan, irbesartan, olmesartan, telmisartan, valsartan, atenolol, bisoprolol, carvedilol, labetalol, metoprolol, propranolol amlodipine, diltiazem, dehydronifedipine, eplerenone and bumetanide) in milk.
Whole, unpasteurised cow's milk was used as surrogate matrix for method development. Analytes were extracted from milk by protein precipitation. Chromatographic analyses were performed on an Agilent Technologies Zorbax Rapid Resolution C18 column using gradient elution. Identification and quantitation were carried out using electrospray ionisation (positive) on an Agilent Technologies 6410 Triple Quad Mass Spectrometer by monitoring specific precursor and fragment ions in multiple reaction monitoring mode using internal standards. The “Standard Practices for Method Validation in Forensic Toxicology” criteria was used for validation.

Results:
The method passed validation with accuracy (relative error) and precision (coefficient of variation) values were within the pre-defined limits of < or = 15% at all tested concentrations for the analytes. The assay sensitivity of 10ng/ml was sufficient to detect the analytes in milk.

Conclusions:
To the best of our knowledge, this is the first assay that permits simultaneous quantitation of 24 commonly prescribed antihypertensives and their metabolites from milk to enable safe use in breastfeeding. The results could be used to guide research on which antihypertensives are safe to use whilst breastfeeding and which require an abstinence period prior to continuation of breastfeeding.
ASSOCIATION BETWEEN A HISTORY OF CHRONIC DISEASES AND AMBULANCE USE AT THE ONSET AMONG FIRST-EVER STROKE PATIENTS. THE SHIGA STROKE AND HEART ATTACK REGISTRY STUDY
Authors: Kiyohara Maiko , Miyamatsu Naomi , Harada Akiko , Takashima Naoyuki , Tanaka-Mizuno Sachiko , Tsuji Atsushi , Urushitani Makoto , Nakagawa Yoshihisa , Miura Katsuyuki , Nozaki Kazuhiko 
Published: June 2023

Objective:
It is essential to immediately call an ambulance and visit the medical institution specializing stroke. This study aimed to examine the differences in ambulance utilization at the onset of stroke, depending on the pre-stroke history of hypertension, diabetes, dyslipidemia, and atrial fibrillation.

Design and method:
First-ever stroke patients over 20 years old enrolled in part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry from January 1 to December 31, 2011, were analyzed. A logistic regression analysis was performed using the presence or absence of a history of each disease (hypertension, diabetes, dyslipidemia, atrial fibrillation), the independent variable (with the no history group as the reference group), and ambulance use at the onset of stroke as the dependent variable, and odds ratios (ORs) and 95% confidence intervals (95%Cis) for ambulance use in the no history group as the reference group was calculated.

Results:
Of the 2054 first-ever stroke patients analyzed, 1212 (59.0%) used an ambulance. The prevalence of each disease (percentage of patients who used an ambulance according to whether they had the disease or not, %) was 45.5% for hypertension (56.3%, 61.3%), diabetes 14.0% (46.7%, 61.0%), dyslipidemia 12.5% (51.0%, 60.2%), and atrial fibrillation 7.3% (68.5%, 58.3%). The multivariate-adjusted odds ratios and 95% confidence intervals for ambulance use at the onset of stroke for each disease were hypertension (ORs and 95% CI: 0.91, 0.73-1.12), diabetes (0.61, 0.45-0.81), and dyslipidemia. (0.90, 0.66-1.21) and atrial fibrillation (1.35, 0.89-2.04).

Conclusions:
From this regional stroke registry survey, it was not observed that patients with a history of hypertension, diabetes, dyslipidemia, and atrial fibrillation tend to use an ambulance at the onset of a stroke compared with those without it. Our study indicated that patient education regarding appropriate reaction/ response at the stroke onset might not be efficient among patients with chronic diseases, including hypertension. In addition to the information for primary disease control, information on the importance of requesting an ambulance at the onset of a stroke should be provided.
ANGIOTENSIN II INDUCES MITOCHONDRIAL OXIDATIVE STRESS IN PODOCYTE
Authors: Ha Tae Sun 
Published: June 2023

Objective:
Oxidative stress induced by non-hemodynamic effects of angiotensin II in podocyte participates in the development of glomerular injury and proteinuria. We studied the pathophysiologic roles of oxidative stress in angiotensin II-induced podocyte apoptosis.

Design and method:
Mouse podocytes were incubated in media containing various concentrations of angiotensin II and at different incubation times and transfected by Nox4 or negative control scrambled siRNA for 24 h. The changes of the intracellular and mitochondrial ROS production were measured using respective assays and observed by confocal imaging and western blotting according to the presence of angiotensin II.

Results:
Angiotensin II increased NADH/NADPH oxidase 4 protein and expression in a transcriptional mechanism that was also reversed by probucol. In addition, the suppression of NADH/NADPH oxidase 4 by siRNA reduced the oxidative stress induced by angiotensin II. Angiotensin II also significantly increased the generation of superoxide anions and suppressed the superoxide dismutase (SOD) activity that were significantly recovered with probucol. Furthermore, angiotensin II increased the intracellular ROS levels in dose- and time-dependent manners that were also recovered with probucol.
The quantitative data of MitoSOX index demonstrated that mitochondrial superoxide production was significantly higher in angiotensin II -treated condition compared with that in untreated conditions with or without probucol at 24 h. When angiotensin II increased mitochondrial superoxide production by more than 2-fold, it was significantly recovered with probucol. We also found that cytoplasmic 8-oxo-dG immunoreactivity was significantly increased in angiotensin II -treated condition by 2-fold compared with that in untreated conditions with or without probucol at 24 h that was significantly recovered with probucol.

Conclusions:
Our findings suggest that angiotensin II increased the generation of mitochondrial superoxide anions and ROS levels via the downregulation of the SOD activity and via the upregulation of NADH/NADPH oxidase 4 that were reversed by an antioxidant, probucol.
RESISTANT HYPERTENSION AS A RISK FACTOR FOR CARDIOVASCULAR EVENTS IN PATIENTS WITH HYPERTENSIVE CRISES AFTER 12-MONTH FOLLOW-UP: A GREEK REGISTRY
Authors: Fragoulis Christos , Thomopoulos Costas , Polyzos Dimitrios , Mavroudis Andreas , Tsioufis Panagiotis , Leontsinis Ioannis , Sakalidis Athanasios , Mantzouranis Emmanouil , Kouremeti Maria , Drogkaris Sotirios , Tatakis Fotis , Kachrimanidis Ioannis , Vlachakis Panayotis K. , Manta Eleni , Siafi Eirini , Dimitriadis Kyriakos , Konstantinidis Dimitrios , Tsioufis Konstantinos 
Published: June 2023

Objective:
Currently, evidence on the prognosis of patients with hypertensive crises (HC) and resistant hypertension (RH) is limited. The purpose of our study was to register the prevalence, and clinical phenotype of patients with HC admitted to the emergency department (ED) and a 12-month follow-up to record cardiovascular outcomes in a Greek tertiary hospital.

Design and method:
The study population included patients visiting the ED with acute an increase in blood pressure (BP) (systolic BP > or = 180mmHg and/or diastolic BP > or = 120mmHg). HC patients were classified as hypertensive emergencies or urgencies depending on the presence or absence of acute hypertension-mediated organ damage, respectively. In all patients, the baseline characteristics were registered for 12 consecutive months. After stratification of the HC population by RH (excluding non-adherence to medication as a cause for HC), we created two subgroups, those with and without RH. Finally, we compared outcomes (composite endpoint of deaths or hospitalizations from cardiovascular causes) by RH during a 12-month follow-up.

Results:
Out of 38,589 patients assessed in the ED, 353(0.91%) had HC, of whom 256 had hypertensive urgencies, and 97 had emergencies. The clinical status of 81 patients was not available during follow-up. The mean age of the remaining HC patients was 68±13 years, 49.6% were males, and 80.3% had a history of hypertension (58 patients had RH). More patients with RH had composite events (27.6% vs. 12.8%, p<0.001), deaths (10.3% vs. 0.6%, p = 0.002), and hospitalizations (27.6% vs. 12.1%, p<0.001) from a cardiovascular cause. RH vs. non-RH phenotype was associated with OR 1.437 (95% CI 1.006-2.012) after adjustment for confounders.

Conclusions:
RH is an independent risk factor of increased cardiovascular risk in patients with HC.