bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C19-4: NOCTURNAL HYPERTENSION AMONG TREATED HYPERTENSIVE PATIENTS
Authors: Sukhbaatar Pagmadulam , Badrakh Burmaa , Sodovsuren Naranchimeg , Unurjargal Tsolmon 
Published: January 2023

Nocturnal hypertension among treated hypertensive patients Pagmadulam sukhbaatar t, Burmaa Badrakh 2, Naranchimeg Sodovsuren, 2Tsolmon Unurjargal2 t Mongolia-Japan University Hospital of MNUMS 2 Mongolian National University of Medical Sciences
Objectives of this study were to determine the prevalence of nocturnal hypertension in treated hypertensive patients and factors associated with its presence.

Methods:
This hospital based cross-sectional study included 160 hypertensive patients, who underwent 24-h ambulatory blood pressure monitoring. According to the national guideline for hypertension nocturnal hypertension was defined as mean night-time systolic blood pressur ≧ 120 mm Hg or mean night-time diastolic blood pressure ≧ 70 mm Hg. Cardiovascular risk factors (smoking, alcohol use, obesity, diabetes, lack of physical activity) were compared in hypertensive patients with and without nocturnal hypertension.

Results:
The mean age of the participants was 62.4 years and 42.5% were men. Approximately 15% and 16.2% of all patients were current smokers and alcohol over users. 61.2% and 75% had obesity and physical activity lacking and 11.2% had diabetes. All patients were on blood pressure lowering medications, but 43.7% of patients were taken only one medication for high blood pressure.
Mean night-time systolic blood pressure and diastolic blood pressure were in men and women 140.6 ± 20.2 mm Hg and 86.5 ± 11.2 mm Hg and 145.6 ± 17.1 mm Hg and 79.8 ± 7.3 mm Hg respectively. The nocturnal hypertension was detected in 61.6% of patients (64% in male, 60% in female). Our study revealed that nocturnal hypertension was significantly higher in patients with diabetes and obesity than in patients without diabetes and obesity.

Conclusion:
The prevalence of nocturnal hypertension was high. Nocturnal hypertension among treated patients was associated with diabetes, obesity and mono therapy.
PS-C20-1: NIGHT-TIME BLOOD PRESSURE-LOWERING DRUG TREATMENT FOR THE PREVENTION OF CARDIOVASCULAR DISEASE IN DIABETES: A PROPOSED RANDOMISED CONTROLLED TRIAL
Authors: Ho Chau , Nelson Mark , Doust Jenny , Chowdhury Enayet Karim , Schlaich Markus , Xu Dan , Reid Christopher 
Published: January 2023

Rationale:
An increase of 20 mmHg in night-time blood pressure (BP) and a pattern of a higher BP at night than during the day was independently associated with an increased risk of 21% and 48% cardiovascular disease respectively. This association was more likely to present in type 2 diabetes mellitus (DM) patients.

Objectives:
This proposed study aims to examine the effect of taking night-time BP lowering drug treatment targeting night-time BP profile as compared to the conventional once-daily morning dose on the prevention of cardiovascular disease event in diabetes.

Design:
A Prospective Randomized Open-label with Blinding of Endpoint assessment.

Methods:
Men and women diagnosed with type 2 DM patients who are 60 years or over in Australia will be included in the trial. As per the current Australia guideline, these individuals meet the criteria to initiate BP lowering drug treatment for CVD prevention. The trial will be conducted as a “digital clinical trial” for participant recruitment, retention and data collection through an interactive web page platform. Participants will be referred by their health practitioners. Eligible participants will be randomised to either night-time or morning dosing treatments with a 1:1 ratio: a) Taking all of their usual once-daily dose of BP-lowering medications at bedtime (between 20:00 and midnight) or b) Taking a once-daily dose of BP-lowering medications upon awakening (between 06:00 and 10:00). The primary endpoint is the occurrence of any first major CVD events after randomisation. We expect to complete the participant recruitment over the first two years and finalise the analysis after an average follow-up of 5 years.

Results:
We are finalising the project protocol and have applied the proposed project to relevant research grants. An ethics application has also been prepared. We plan to run a one -year pilot trial and then transfer to the full study.

Conclusion:
The outcomes of this study will contribute to Level 1 evidence on the effect of night-time BP-lowering drug treatment in the prevention of cardiovascular disease in diabetes. Due to the nature of pragmatic design, our research outcomes are straightforward and could be adopted in current practice without any further cost. Changing the ingestion time of BP-lowering drug treatment from morning to night-time is very cost-effective and promises to reduce the financial and clinical burden of CVD and DM on the healthcare system.
PS-C20-6: SINGLE-PILL COMBINATION ENABLES FAST TARGET BP ACHIEVEMENT
Authors: Brguljan Jana , Chazova Irina E , Gaciong Zbigniew , Simic Dragan , Vajer Peter , Zelveian Parounak Harutyun , Jelakovic Bojan 
Published: January 2023

Objective:
To assess the treatment response and time to reaching the target clinical blood pressure (BP) with the single-pill combinations (SPCs) of perindopril/amlodipine (P/A) and perindopril/amlodipine/indapamide (P/A/I) in naïve and uncontrolled hypertensive patients.

Design and method:
440 adults with essential hypertension were assessed in the 16-week interventional, open-label, prospective, international, multicentre trial PRECIOUS. Office BP was measured with a validated automated BP-measuring device by qualified health professionals following guidelines protocol. At inclusion, naïve or patients uncontrolled on previous mono or dual therapy other than perindopril and amlodipine were assigned to dual SPC arm with initial dose of 4/5 mg P/A. Those uncontrolled on previous dual or triple therapy were assigned to triple SPC arm with initial dose of 4/5/1.25 mg P/A/I. If not reaching office BP control, initial dose was up titrated in 4-week intervals to 8/5 mg, 8/10 mg P/A or 8/10/2.5 mg P/A/I in dual SPC arm and to 8/5/2.5 mg or 8/10/2.5 mg P/A/I in triple SPC arm.

Results:
In the first 4-week interval, 43.6% of the FAS population reached the target BP with a significant decrease by -16.1/-10.1 mmHg from the mean baseline office BP of 157.0/98.1 mmHg (p < 0.001). The proportion of patients reaching BP control increased after each up-titration interval to 63.9%,78.0% and 79.8% after 8, 12 and 16 weeks, respectively. The mean BP values decreased further till the end of the trial, reaching the mean BP value of 128.1/81.1 mmHg after 16 weeks. Interestingly, in subgroup of patients who did not need up-titration (n = 154), a decrease of -24.2/-16.2 mmHg (-15.4%/-16.3%) was already achieved in the first 4 weeks and grew moderately to -28.2/-17.7 mmHg (-18.1%/-17.9%) till the end of the trial. On the other hand, in the first 4 weeks, in subgroup of patients who needed up-titration (n = 274) the decrease was a moderate -11.8/-6.9 mmHg (-7.1%/-6.6%), but grew with every up-titration step at the same pace to reach a decrease of -28.4/-16.7 mmHg (-17.6%/-16.4%) at the end of the trial.

Conclusions:
In only 4 weeks 43.6% of patients who responded to the initially prescribed therapy achieved target BP, exhibiting more than 2x bigger BP decrease than non-responders who needed further intensification of therapy. BP decrease from the baseline was similar in both groups, however following a different pattern. At the end of the trial, almost 80% of patients reached BP control with the SPC treatment strategy.
PS-C21-4: EPIGENETIC ALTERATION OF 11B;-HYDROXYSTEROID DEHYDROGENASE 1 IN THE ADIPOSE TISSUE OF PATIENTS WITH ENDOCRINE HYPERTENSION
Authors: Takeda Yoshiyu , Takeda Yoshimichi , Demura Masashi , Kometani Mitsuhiro , Karashima Shigehiro , Aono Daisuke , Konishi Seigo , Yoneda Takashi 
Published: January 2023

Objective:
11Beta-hydroxysteroid dehydrogenase 1 (11β;-HSD1) is a key enzyme involved in metabolic syndrome. The epigenetic control of 11β;-HSD1 is unclear. We examined the 11β;-HSD1 mRNA level and methylation status of the promoter region of the 11β;-HSD1 gene in the adipose tissue of patients with endocrine hypertension.

Methods:
We evaluated 8 adipose tissue specimens from patients with subclinical Cushing syndrome (SCS) due to cortisol-producing adenomas, 10 tissue specimens from patients with primary aldosteronism due to aldosterone-producing adenoma (APA) and 7 tissue specimens from patients with non-functioning adrenal adenoma (NFA). SCS and primary aldosteronism were diagnosed according to the guideline of the Japanese Endocrine Society. The mRNA level of 11β;-HSD1 was quantified using a real-time PCR. Isolated DNA was treated with bisulfite and amplified using primers specific for the human 11β;-HSD1 promoter region.

Results:
The glycohemoglobin level was significantly higher in patients with SCS or APA compared with those with NFA (p < 0.05). Blood pressure was significantly elevated in patients with APA compared with those with SCS or NFA (p < 0.01). The 11β;-HSD1 mRNA level was significantly increased in the adipose tissues of SCS and APA compared with NFA patients (p < 0.05). The methylation ratio was significantly lower in SCS compared with APA or NFA patients (p < 0.05).

Conclusion:
11β;-HSD1 gene expression is partly controlled by an epigenetic mechanism in human tissues. The pathophysiological roles of epigenetic control of 11β;-HSD1 gene expression in adipose tissue requires further study.
PS-C22-7: RENAL FUNCTION AND URINARY PROTEIN 1 YEAR AFTER INITIATION OF ESAXERENONE
Authors: Aoyama Kazuki , Nakajima Yuya , Meguro Shu , Itoh Hiroshi 
Published: January 2023

Objective:
It has been two years since the prescription of esaxerenone was started in Japan, but there are currently limited reports on clinical data after administration. The purpose of this study is to examine the real-world clinical data on renal function, urinary protein, and other clinical data on the esaxerenone-treated group compared to the non-administration group.

Design and method:
In this study, research subjects were selected from the patient population attending the Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Japan between March 1, 2021 and January 31, 2022. 354 patients treated with esaxerenone and 14,480 patients not treated with esaxerenone were compared on clinical indices 1 year after the initiation of treatment. Covariate adjustment by propensity score-matched analysis was carried out.

Results:
In the analysis of all patients, serum creatinine tended to increase after treatment with esaxerenone compared to before, but the difference was not significant. No consistent trend was observed for urinary protein and serum potassium.

Conclusions:
We are currently performing propensity score-matched analysis stratifying for blood pressure and urinary albumin to creatinine ratio at the start of treatment.

COI:
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work in this report.
PS-C22-10: SERUM SOLUBLE (PRO)RENIN RECEPTOR CONCENTRATION AS A PROGNOSTIC FACTOR IN PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS
Authors: Morimoto Satoshi , Amari Yoshifumi , Bokuda Kanako , Suda Chikahito , Ichihara Atsuhiro 
Published: January 2023

Objective:
The (pro)renin receptor [(P)RR)] is a multifunctional protein with roles in angiotensin II-dependent and -independent intracellular cell signaling and as an adaptor protein between the Wnt receptor complex and vacuolar proton-translocating adenosine triphosphatase. The (P)RR is cleaved to generate soluble (P)RR [s(P)RR], reflecting the status of the tissue renin-angiotensin system and/or activity of the (P)RR. Patients undergoing hemodialysis (HD) have poor prognosis because of the increased prevalence of cardiovascular and malignant diseases. This study was conducted to investigate whether the s(P)RR level is associated with new onset of cardiovascular events or malignant diseases and prognosis in patients undergoing HD.

Design and method:
A total of 258 patients undergoing maintenance HD who were enrolled in our cohort study investigating the relationships between serum s(P)RR levels and background factors were prospectively followed up for 60 months. We investigated the relationships between s(P)RR levels and new onset of cardiovascular events or malignant diseases and mortality during the follow-up period.

Results:
The cumulative incidence of new onset of cardiovascular events (P = 0.009) and cardiovascular deaths (P < 0.001), but not of malignant diseases, was significantly greater in patients with higher serum s(P)RR level (≧ 29.8 ng/ml) than in those with lower s(P)RR level (< 29.8 ng/ml). A high serum s(P)RR level was independently correlated with cardiovascular mortality (95% CI 1.001 - 1.083, P = 0.046).

Conclusions:
These data showed that the serum s(P)RR level is associated with cardiovascular events and mortality, suggesting that the serum s(P)RR level could be used as a biomarker for selecting patients requiring intensive care.
PS-C23-3: POSTPRANDIAL HYPERKALEMIA AFTER K RICH DIET IN HEALTHY HUMAN
Authors: Nakagawa Hiromi , Inaba Miho , Goto Yumi , Sasadate Natsuki , Suzuki Takahiro , Shimosawa Tatsuo 
Published: January 2023

Objective:
Dietary potassium is known to lower the blood pressure but high attentions should be paid not to induce hyperkalemia in patients with renal impairment. Recently we experienced a case postprandial hyperkalemia (from 4.8 to 6.0mmol/L). We investigated the pathophysiology of postprandial hyperkalemia in healthy volunteers.

Design and method:
Twelve healthy volunteers (age: 23 to 58 years old, eGFR: 76.1 to 119.9 mL / min / 1.73 m2) who obtained informed consent took potassium-rich diet (2000 mg, with avogado, tomato juice and banana), serum K, urinary K, and urinary creatinine (CRE) were measured before, 1 hour and 2 hours after the meal. Urinary K was corrected by urinary CRE.

Results:
The serum K level increased significantly at 1 hour (p < 0.01) and 2 hours (p < 0.05) after the meal, and the urinary K / CRE increased 2 hours (p < 0.01) compared to the pre-meal value. In two cases, serum K level increased by 0.7 mmol / L 1 hour after the meal and urinary K / CRE increased by 60 mmol / g · CRE 2 hours after meal. Other 10 cases, those with little change in serum K levels urinary K/CRE were constant during the examination.
In 5 of 12 patients, the serum K level increased by 0.3 mmol / L or more, and in this group, the excretion of urinary K 1 hour after meal was small and increased significantly 2 hours after the meal.

Conclusions:
Potassium-rich diet may increase serum K levels in healthy human. We can not predict the postprandial elevation of K by regular biomarkers. The delay of urinary excretion plays a role in postprandial hyperkalemia. To assess K status, we should consider the status of fasting in patients. Further investigations are required to reveal precise mechanism in alteration of K handling in the kidney.
PS-C23-4: I CHOOSE ULTRA PROCESSED FOOD SINCE MORE PRACTICAL AND TASTIER: A QUALITATIVE STUDY OF ULTRA-PROCESSED FOOD CONSUMPTION AMONG ADULTS
Authors: Faza Farah , Fikha Idri Iqra , Bafani Unun Fitry Febria 
Published: January 2023

Objective:
Industrialization, as an impact of globalization, produced more ultra processed food (UPF) which triggered a nutrition transition. The UPF, which is dominated by instant and junk foods, caused a higher risk of metabolic diseases. Although the UPF consumption was not high (±15%) among Indonesian adults yet the factors of choosing UPF should be explored to design the best nutrition intervention for improving diet quality.

Design and method:
We performed four focused group discussions (FGD) and observations in four administrative cities in a province during December 2021. Each group of the FGD consisted of 8 to 10 adults aged above 20 years. The FGD session was conducted by a trained moderator and assisted by two trained enumerators. The data were transcribed verbatim and analyzed using an inductive thematic approach. An FGD lasted between 50 to 60 minutes, covering three topics regarding dietary patterns, the type of food commonly consumed, including the reason for consuming UPF during the last month. Simultaneously, a market survey was performed at street vendors, food outlets, and supermarkets around the sampling areas to check the food availability, especially the UPF mentioned by the subjects in the FGD.

Results:
There were 24 adults, which was dominated by females (87.5%). Four initial themes determined UPF consumption, namely (1) family preferences, (2) practical reason, (3) taste, and (4) nutrient content. The UPF commonly consumed was instant noodles, canned sardines, biscuits, white bread, sugar-sweetened beverages (SSB), sausages, instant coffee drinks, and packaged milk. Those food and drink were easily found around their dwelling area. The frequency of consuming UPF was not often. I choose instant foods when I or my family was in a hurry and have no time to cook fresh food (Mrs. R, 45 years, a housewife). Some adults were already aware of the negative side of UPF, yet the good taste kept them consuming the food. I know that instant food is bad for health. However, I thought that if we did not consume the food frequently, it would still be safe (Mrs. Y, 40 years, a local cadre).

Conclusions:
The main factors that triggered UPF consumption were preferences, practicality, taste, and nutrient content. Instead of avoiding the bad effects of UPF on health, some adults still attach importance to other aspects related to preferences and sensory appeal. Beyond nutrition education and campaign, creating a healthier food environment is also important to support the habitual changes for better diet quality.
PS-C23-12: DIETARY INTERVENTION WITH THE PROCESSED LOW PROTEIN GENMAI (BROWN RICE) AGAINST CHRONIC KIDNEY DISEASE.
Authors: Adachi Keika , Wakino Shu , Itoh Hiroshi 
Published: January 2023

Background:
Although protein-restricted diets have shown to preserve the renal function, there are a couple of challenges such as (1) the intake of vegetable protein, which is useful for maintaining renal function, is insufficient due to potassium restriction, and (2) caloric intake tends to be inadequate. Therefore, we investigated the effects of diets that may solve these problems with maintaining the current dietary restrictions and may also be additional effects on renal protection. Another study also has shown that patients with CKD are under a chronic inflammatory state and those uremic toxins produced by the gut microbiota are the causes of increased inflammatory cytokine production. We sought to intervene in renal function via modulating this kidney-gut axis in CKD. We thus focused on the processed low protein genmai (brown rice) (PLPG), marketed since 2018 by Follica Foods, Inc. as a candidate food that retains the fiber and GABA characteristic of brown rice, reduces protein to less than 20% of conventional rice, and also limits potassium and phosphorus.

Methods:
The study was conducted in a before-and-after trial. Thirty patients with eGFR of 59 or less were recruited. PLPG was a retort pack of 150 g for one meal. The patients ate provided with about 10 servings of PLPG per week for 3 months.

Results:
One patient withdrew due to poor health after participation, and a final total of 29 patients were analyzed. The median age of the participants was 73 years, the mean eGFR was 35.41 ml/min/1.73 m2. The median in BMI decreased by -0.31 (P = 0.037). The median change in the Constipation scoring system score improved by -1.00 (P = 0.032). The change in eGFRcreat decreased with a mean value of -1.241 ml/min/1.73 m2. (P = 0.044), but the monthly eGFRcreat slope was not significantly different. Indoxyl sulfate did not differ significantly, but it showed a decreasing trend with a median change of -0.20 (P = 0.050). The median change in IL-6 was 0.300 pg/mL (P = 0.004). Among short-chain fatty acids, only acetic acid showed an increase with a median change of 7.401 μmol/g (P = 0.010).

Conclusion:
Participants’ protein intake did not decrease. Therefore, it was thought that the effects of PLPG itself was observed, independent of the effect of low protein. The increase in acetic acid may have contributed to this change. The decrease in e-GFR along with the decrease in urinary protein levels indicated an initial dip due to correction of glomerular hypertension. Long-term follow-up is plausible to establish the novel dietary treatment.
PS-C24-3: INSUFFICIENT VITAMIN D LEVELS IN PATIENTS WITH HEART FAILURE.
Authors: Kozlova Irina Qriqoryevna , Samedov Rza Ismayil 
Published: January 2023

Chronic heart failure despite the development of new treatment methods, remains the most common and prognostic adverse complication of all cardiovascular diseases.
Studies conducted in different countries over the past decades have convincingly proved that vitamin D deficiency is one of the important factors in the development of CCC diseases. Vitamin D (VDR) receptors were detected in more than 40 target tissues, including cardiomyocytes, smooth muscle and endothelial vascular cells and have convincingly proved, that eliminating vitamin D deficiency improves blood pressure in hypertension and also reduces myocardial hypertrophy.
The above studies also confirmed the effect of vitamin D on the development of prediabetes, diabetes, metabolic disorders. The effect of vitamin D on the prevention of atherosclerosis has also been confirmed. One of the mechanisms for the development of atherosclerosis is currently considered an inflammatory process. The effect of vitamin D on the course of inflammatory processes in the body was clearly manifested during the pandemic caused by the new coronavirus infection COVID-19. There was a clear correlation between vitamin D levels and the severity of infection.
In severe COVID-19, as a rule, either a deficiency or a lack of vitamin D in the body was determined. In addition, low vitamin D levels increase the risk of developing severe forms of coronary heart disease.
The study involved 30 patients < n = 30>diagnosed with heart failure(I-III NYHA)
In 12 < 40%> patients out of 30, vitamin D levels were below 20.0 ng/mL, consistent with this vitamin deficiency. In 14 < 46,67%>the level of vitamin D in the blood was between 20.0 ng/mL and 30.0 ng/mL and this corresponded about the lack of vitamin D. Only 4 < 13,33%> patients has level of vitamin D in reference values and this was due to the use vitamin D due to comorbid pathology: thyroid disease, autoimmune diseases or previously identified vitamin D hypovitaminosis. Vitamin D partially enters the body with food mainly found in animal products-liver, milk, eggs, butter, etc and is formed in the skin under the influence of ultraviolet rays.
However, patients with CHF often have concomitant diseases: kidney disease, diabetes, disorders and others, forcing them to adhere to a strict diet poor in vitamin D. Also, due to CHF, these patients mainly lead a sedentary lifestyle, and, as a result, receive little ultraviolet rays.
This explains the frequently detected deficiency and deficiency of vitamin D in patients with CHF, if, they do not receive drugs that compensate for its deficiency.