bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C05-8: ERYTHROCYTE SEDIMENTATION RATE LEVELS AND ITS ASSOCIATION WITH CORONARY ARTERY INVOLVEMENT IN KAWASAKI DISEASE
Authors: Sadicon Merian Doyenne Revillosa 
Published: January 2023

Objectives:
The general objective of this study is to determine association of ESR with cardiovascular involvement in Kawasaki Disease (KD) patients.

Specific Objectives:

Design and method:
This is a cross sectional study conducted at National Childrens Hospital (NCH), a tertiary pediatric hospital. Data was gathered using charts from the medical records of patients diagnosed with KD. Study population included patients diagnosed with KD with classical presentation from year 2013–2018.
The diagnostic criteria for KD require presence of fever for five days or more and at least four of five of the following: bilateral conjunctival infection without exudates, polymorphous exanthema, strawberry tongue, desquamation of palms and soles, and cervical lymphadenopathy. ESR levels were recorded both as a numerical variable and categorical variable based on the level (below 80 mm/hr, more than 80 mm/hr). Patients with coronary artery involvement included perivascular brightness, coronary artery dilatation, or coronary aneurysm on two-dimensional echocardiography done during admission for KD.
Descriptive statistics was done using frequency and percentages for categorical variables, and standard deviations for continuous variables was calculated to describe the profile of the respondents. Determination of the association between ESR and CAD among KD patients was analyzed using Chi square test and stratified analysis. Odds ratio and the 95% confidence interval was also calculated. Significance was set at p value of < 0.05.

Results:
Of the 116 patients, 72.4% of the population were noted to have cardiac involvement and 50% had coronary artery involvement. The most common coronary artery involvement was on the proximal right coronary artery. Moreover, pericardial effusion and valvular regurgitation mostly involving the mitral valve were the most common cardiac involvement. In the population, 61 (52.6%) were male, and 26 (42.6%) of which developed CAD however no correlation between sex and CAD was revealed.

Conclusion:
This study showed no correlation between the level of ESR and the development of CAD. It is not recommended to obtain ESR in patients who qualify as complete KD. Hence the study does not support the practice of obtaining ESR upon admission of KD patients. Further studies on the association of ESR with CAD with higher sample size and adjusting for other confounding variables are needed.
PS-C05-9: COMBINED EFFECT OF INTER-ARM SYSTOLIC BLOOD PRESSURE DIFFERENCE AND CAROTID ARTERY PLAQUE ON CARDIOVASCULAR EVENTS
Authors: Yun Cuijuan , Xin Qian 
Published: January 2023

Objectives:
Previous studies have confirmed the relations between inter-arm systolic blood pressure difference (IASBPD) and carotid artery plaque with the risk of cardiovascular diseases (CVD) respectively. But it is unclear whether the combined effect of IASBPD and carotid artery plaque further increases the risk of CVD and all-cause mortality.

Methods:
We enrolled 4970 participants (≧ 40 years old) in the prospective Kailuan Study. All participants underwent dual-arm blood pressure and carotid artery ultrasounds. IASBPD was the absolute value of the difference between dual-arm blood pressure. All the participants were divided into four groups according to their IASBPD levels and the presence or absence of carotid artery plaque, Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for incident CVD and all-cause mortality.

Results:
During a median follow-up of 7 years, 179 CVD events and 266 deaths occurred. Multivariable Cox Regression showed that participants with IASBPD ≧ 10mmHg and plaque had a significantly higher incidence of CVD, cerebral infarction (CI) and myocardial infarction (10%, 7.27%, 1.36%, respectively). After adjusting for covariates, the IASBPD ≧ 10mmHg and carotid plaque group significantly increased risks for CVD (HR 2.38; 95% CI, 1.40∼4.05), CI (HR, 2.47; 95% CI, 1.31∼4.67), and all-cause mortality (HR, 2.08; 95% CI, 1.20∼3.59).

Conclusions:
Our study indicated that the combination of IASBPD and carotid artery plaque was associated with incident CVD and all-cause mortality.
PS-C07-9: BLOOD PRESSURE MONITORING IN THE COMMUNITY: A SURVEY WHETHER RURAL GPS ARE USING VALIDATED BLOOD PRESSURE MONITORS IN THEIR PRACTICES
Authors: Voll Jessika , Grace Gary , Gupta Ankur 
Published: January 2023

Objective:
Poorly controlled hypertension is a leading cause of morbidity and mortality around the world. Chronically elevated blood pressure contributes to vascular disease, cardiac events, strokes and renal disease. Blood pressure (BP) measurement is therefore a critical part of a patients clinical assessment. BP needs to be measured accurately with validated equipment in order to avoid mismanagement of hypertensive patients.
STRIDE BP is a non-profit research and educational organization providing international scientific guidance for BP measurement, methodology and technology.
This study surveyed rural New Zealand General Practices (GP) investigating the equipment they used to meet these standards.

Design:
Local GP practices were invited to participate in our survey via e-mail. The survey established what blood pressure monitoring equipment was being used and whether they provided any monitors for home use. 10 out of 15 GP regional practices responded to the survey and their BP monitoring equipment data was collected and collated in a Microsoft Excel data sheet.

Method:
BP monitors provided by GP practices were compared against the STRIDE BP validated blood pressure monitoring equipment available at https://stridebp.org/bp-monitors.

Results:

Office Blood Pressure monitors

All of the practices who responded reported that they have BP monitors for use in their offices. However only 3 practices were using blood pressure monitors validated by STRIDE.Home blood pressure monitors

Only five of the ten practices who responded report providing blood pressure monitors for their patients to use at home. Of these five practices only one practice used validated BP machine. This practice provides four validated home BP devices for patients to loan for home use. The four other practices that provide devices for home use are providing equipment that has not been validated as per STRIDE BP criteria.Ambulatory blood pressure monitors

Seven out of the ten practices do not provide these for their patients, and the three practices who do all provide equipment that does comply with STRIDE BP validation criteria.

Conclusions:
Our pilot survey on BP monitors for GP practices in rural New Zealand demonstrated minimal use of STRIDE BP validated equipment for BP measurements in hypertension management. This puts a lot of our GPs at risk of making decisions based on inaccurate information. Our primary conclusion from this pilot study is that there is a clear need for an education programme in our region to provide information to GPs on up to date BP monitoring technology.
PS-C08-5: VALIDATE-CKD - PRELIMINARY FINDINGS ON CENTRAL BLOOD PRESSURE DEVICES ACCURACY IN PATIENTS WITH STAGES G4-G5 CHRONIC KIDNEY DISEASE
Authors: Cote Nadege , Abbaoui Yasmine , Spanneut Theo , Agharazii Mohsen , Goupil Remi 
Published: January 2023

Objective:
Measurement of brachial cuff blood pressure (BP) was designed as a convenient surrogate to the aortic BP, which is the BP that dictates perfusion to target organs. In the general population, brachial cuff systolic BP (SBP) has a somewhat acceptable accuracy towards aortic BP but less is know in populations with marked high arterial stiffness, such as in G4-G5 CKD. Central BP devices were designed to directly estimate the aortic BP through pulse wave analysis to a greater accuracy than brachial cuff BP. The aim of the ongoing VALIDATE-CKD study is to compare the accuracy of brachial and central BP readings towards the intraarterial aortic SBP, in patients with and without Stage G4-G5 CKD.

Design and method:
In patients with and without Stage G4-G5 CKD (eGFR < 30 ml/min/1.73m2) undergoing non-urgent coronary angiograms, invasive aortic and non-invasive (WatchBP and Mobil-o-graph devices) BPs were measured simultaneously following the ARTERY Society protocol. Accuracy was defined by the mean difference (± SD) between the aortic SBP and the corresponding non-invasive SBP.

Results:
To date, 8 individuals with Stage G4-G5 CKD and 26 control subjects are enrolled. The following table presents clinical characteristics and non-invasive BPs accuracies in patients with and without Stage G4-G5 CKD.

Conclusion:
These preliminary results indicate that brachial SBP significantly underestimates aortic SBP in patients with Stage G4-5 CKD as compared to control subject. Furthermore, central BP devices provide a highly accurate estimation of aortic SBP in this population. The ongoing VALIDATE-CKD study may support that the use of central BP devices could be beneficial for the management of patients with advanced CKD.
PS-C09-6: FEATURES OF DAILY BLOOD PRESSURE PROFILE IN PATIENTS WITH ARTERIAL HYPERTENSION WITH CHRONIC KIDNEY DISEASE
Authors: Duysenbaeva Aziza Ikhtiyarovna , Mirakbarova Kamola Abdusattarovna , Srojidinova Nigora Zaynutdinovna 
Published: January 2023

Purpose of the study:
To study the daily profile of blood pressure in patients with arterial hypertension (AH) with chronic kidney disease (CKD).

Materials and methods of the study:
The study included 120 patients with AH I-III degree, who received inpatient treatment. CKD stages were determined according to the modern KDIGO 2013 classification. Daily blood pressure profile (DAP) was assessed using the Medicomcombi device (Russia).

Results of the study:
Among the examined patients, preserved renal function of CKDC1 (eGFR> 90 ml/min/1.73 m2) was observed in 20.8% (n = 25); CKDC2 (eGFR 60–89 ml/min/1.73m2) in 50.8% (n = 61); CKDC3A (eGFR 45–59 ml/min/1.73m2) in 19.2% (n = 23); CKDC3B (eGFR 30–44 ml/min/1.73m2) in 9.2% (n = 11) p < 0.001. CKDC4 and terminal stages were not detected. When analyzing ambulatory blood pressure monitoring (ABPM), it was revealed that according to increasing of degree of CKD, values of the average daily SBP (122.52 ± 9.25 vs 122.13 ± 12.30 vs 121.74 ± 9.43 vs 134.36 ± 15.32 mm Hg, p < 0.013) average daytime SBP (123.56 ± 8.99 vs. 124.00 ± 611.89 vs 123.74 ± 9.73 vs 134.27 ± 15.12 mmHg, p < 0.04), mean night SBP (119.80 ± 13.39 vs 116.75 ± 14.59 vs 116.09 ± 12, 04 vs 135.09 ± 16.66 mm Hg, p < 0.001) significantly rises. The load index of elevated daytime and nighttime SBP was high in AH patients with lower eGFR values. Index of SBP daytime: 13.00 ± 14.05 vs 15.43 ± 21.22 vs 10.70 ± 15.04 vs 35.10 ± 34.14% respectively, p < 0.01. Index of SAP nighttime were 33.75 ± 29.35 vs 26.04 ± 31.07 vs 26.58 ± 27.87% vs 66.10 ± 36.05% respectively,p < 0.001. A normal daily profile of SBP/DBP had 28%/32% of patients of the 1st group vs 24.61%/37.70% of patients of the 2nd group vs 37.78%/21.73% of patients of the 3rd group vs 0% /0% of patients of the 4th group, SBP p < 0.01; DBP p < 0.001. The number of non-dippers in SBP was somewhat higher in the group of patients with CKDC3b: night reduction speed (NRS) SBP 40% in group 1 vs 49.1% in group 2 vs 52.17% in group 3 vs 54.54% in group 4 group, p < 0.02. In the group of patients with CKDC3b, individuals with a daily profile of SBP/DBP “night-pickers” significantly prevailed: 32%/20% vs 14.75%/13.11% vs 13.04%/13.04% vs 45.45%/ 54.54% (in groups 1, 2, 3 and 4, respectively) in SBP p < 0.001, in DBP p < 0.001. There was a significant increase in patients with a daily profile of “over-dipper” according to DBP in patients with CKDC3b:0% vs 4.91% vs 13.04% vs 27.27% p < 0.001.

Conclusion:
AH patients with CKD have more pronounced disturbances in the daily blood pressure profile, which contribute to an increased risk of developing complications of arterial hypertension.
PS-C09-11: THE EFFICACY OF SACUBITRIL/VALSARTAN FOR NONDIPPER AND EXTREME DIPPER HYPERTENSION USING 24 AMBULATORY BP MEASUREMENT
Authors: Kihara Hajime 
Published: January 2023

Sacubitril/Valsartan increases natriuresis and diuresis and makes superior blood pressure control compared with usual RAS inhibitors. In Japanese clinical cicumstances,ideal blood pressure control to attain BP < 130/80mmHg is difficult for next reasons. 1, Japanese predisposition towards high sodium intake. 2, Salt sensitivity due to Gene Polymorphism. 3, Increasing morbidity of obesity and Metabolic syndrome. 4, Clinical inertia to attain ideal blood pressure control especially in high risk hypertension patients ex. CKD and DM.
These high risk patients often suggest nocturnal hypertension by 24 hour ambulatory blood pressure monitoring,24Hr ABPM. Nocturnal hypertension consists of non-dipper pattern, riser pattern, and often associated with cardiovascular event. On the contrary, extreme dipper pattern is sometimes found by24 Hr ABPM and it suggests high systolic BP during daytime in spite of night systolic BP decline. iIt sometimes results in stroke. Therefore antihypertensive therapies to these high risk patients by monitoring only clinic BP are surely insufficient to prevent CVD. Furthermore checking Home BP immediately after wake up is off course necessary, but still inadequate. Without monitoring by 24hr ABPM during nighttime,it is impossible to distinguish between non-dipper pattern, riser pattern and morning surge pattern. Quoting from literature, superiority of Ambulatory over Clinic Blood pressure measurement is proved in predicting mortality,The Dublin Outcome Study. It is essential to check 24hr ABPM to high risk patients. These high risk CKD or DM patients are accompanied by the diminished renal capacity to excrete sodium during daytime and compensate sodium excretion by elevating night blood pressure. This mechanism could be a component of the non dipper or riser pattern. Sacubitril/Valsartan `s effect of natriuresis and diuresis effect could be effective to excrete sodium excretion at daytime and Np makes vasodilatory effect and prohibits of aldosterone production.,and valsartan is anAT1 receptor blockade and prohibits of angiotensin2 effect. Sacubitril/Valsartan is very effective for characteristic “salt sensitive hypertension” Japanese patients.
In our clinic, we prescribed 250 patients,120 patients are RAS inhibitor naive, and the rest of130 patients are switched from RAS inhibitor. We present 2 clinical cases prescribing Sacubitril/Valsartan 400 mg every morning and monitored 24hrABPM before and after prescription.
1st case is 48yrs old male, HT, DM and CKD showing non dipper-pattern. 2nd case is 86 yrs female, HT and old cerebral lacuna and left common iliac aneurysma showing extreme dipper pattern. 2 weeks after administration of Sacubitril/Valsartan, 24hr ABPM were checked and non dipper pattern disappeared in Ist patients and extreme dipper pattern disappeared in 2nd case,. Normal circadian rhythms are attained in both patients.
PS-C10-2: POTENTIAL IMPACT OF THE 2017 AMERICA COLLEGE OF CARDIOLOGY/AMERICAN HEART ASSOCIATION HIGH BLOOD PRESSURE GUIDELINES ON SECONDARY PREVENTION POPULATION
Authors: Mahmud Azra , Guidan Musab , Iyad Farah , Mukhtar Abdul Majed 
Published: January 2023

Objective:
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Hypertension Guidelines for adults have redefined blood pressure (BP) thresholds for diagnosis and treatment initiation as well as BP goals. We wanted to explore the potential impact of these recommendations on the prevalence of uncontrolled hypertension and target achievement in a secondary prevention population receiving anti-hypertensive treatment in line with the previous Guidelines.

Design & Methods:
This was a retrospective study in ambulatory patients attending a secondary cardiovascular disease prevention programme(mean age 62 ± 14, 77% male)using prospectively collected data from electronic medical records (Apollo Lx). Data analysed using JMP, version 7.1(SAS for Windows). Hypertension and target achieved were classified on the basis of previous International (BP < 140/90 mm Hg) as well as the new ACC/AHA Guidelines (BP < 130/80 mm Hg). Results were analysed using JMP Version 7.1(SAS for Windows).

Results:
Applying the new ACC/AHA cut-offs for BP, the proportion of patients with high normal BP decreased from 63% to 28% (p < 0.001), which translated into an increase in the prevalence of Stage I (39% vs. 15%, p < 0.0001) and Stage II hypertension (14.7% vs. 0.9%, p < 0.001). Overall, BP target was achieved in 75% of the patients using the old definition, compared with 43% with the new ACC/AHA Guidelines. Using the old definition, men were more likely to achieve target BP (78% vs. 72%, P < 0.0001) than women; however with the new cut-offs, BP target achieved was similar in men(42.8%) and women(43%). Using the old definition, some 84% of diabetics achieved BP control, decreasing to 52%with the new Guidelines. 71% of patients with renal impairment had BP targets achieved using the previous definition, compared with 41% in line with the new Guidelines.

Conclusions:
Compared with the previous European, British and American Guidelines, the new 2017 ACC/AHA recommendations resulted in a substantial increase in the prevalence of uncontrolled hypertension and reduction in patients achieving BP targets in our population. If taken up, these recommendations carry significant implications of increase in the number of anti-hypertensive drug prescribing, issues like polypharmacy, non-adherence and adverse drugs effects, with resultant escalation in health care costs.
PS-C10-4: ARE HOME BLOOD PRESSURE DEVICES ACCURATE? A SYSTEMATIC REVIEW OF THE EVIDENCE
Authors: Hiremath Swapnil , Gaur Aditi , TurnerPatry Jamie 
Published: January 2023

Background:
Out of office blood pressure (BP) measurements, especially home BP monitoring, are recommended for diagnosis and management of hypertension by many societies including by the Canadian Hypertension Education Programme (CHEP). Though validation protocols exist for individual monitors, little data exists on the real world accuracy of home BP monitors, in actual use. We undertook this systematic review to estimate the accuracy of home BP monitors as reported in the literature.

Methods:
We undertook a literature search of MEDLINE and EMBASE from 1946 and 1947 until April 2021 respectively. We included studies that evaluated the accuracy of home BP devices against a mercury sphygmomanometer considered as the gold standard. Two reviewers independently selected studies, extracted data and assessed quality. Disagreements between the two reviewers were resolved by a third author.

Results:
Our search revealed 797 non-duplicate citations. After applying selection criteria, nineteen studies, involving 4954 patient-devices (median 91, interquartile range 69, 489) were included in the systematic review. The reported inaccuracy of home BP monitors compared to mercury sphygmomanometer ranged from 10% to 72% for systolic BP, with each study using different thresholds for inaccuracy. The absolute mean difference for systolic BP between home BP monitor and the standard ranged from 2.4 mm Hg to 10.4 mm Hg and for diastolic BP from 1 to 8.7 mm Hg.

Conclusion:
The existing literature reports a relatively high degree of inaccuracy in home BP monitors being used. Data is limited by varying definitions being used for reporting inaccuracy. Consideration should be given to standardised definitions of accuracy, and real world monitoring of accuracy as home BP monitors use for clinical decision making becomes widespread. Research into predictors of inaccuracy is also necessary.
PS-C11-2: FACTORS AFFECTING HOME BLOOD PRESSURE AND HEART RATE VARIABILITY POST-COVID INFECTION
Authors: Patil Vishal , Patil Mansi 
Published: January 2023

Objective:
There is a scarcity of data on the factors that influence home blood pressure (BP) and heart rate (HR) variability. This study was undertaken to determine the factors that influence home BP and HR fluctuation post COVID infection in the urban Indian population.

Designs and Methods:
We conducted a cross-sectional study among 1000 patients between the ages of 30 and 80 who were previously infected with COVID-19 infection, but not hospitalized. These patients were guided and trained to measure BP at home. BP and HR readings were taken at home twice a day, in the morning and evening, for seven days (28 measurements). The SD of morning minus evening, and first minus second readings was used to calculate BP and HR variability.

Results:
Old age, cardiovascular illness, diabetes, and high home blood pressure were all found to be independent predictors of an increased morning than evening home blood pressure variability. Old age, and high home blood pressure were all independent determinants of greater day-to-day home blood pressure variability, while old age, female sex, cardiovascular disease, and high home blood pressure were all independent determinants of greater first versus second home blood pressure variability. Young age, and high home HR, on the other hand, were all independent drivers of increased morning vs evening variability. Young age, female sex, and a high home HR were also independent predictors of first versus second home HR variability.

Conclusion:
Considering home BP and HR fluctuation have prognostic value, it is critical for clinicians to understand the underlying reasons for these variables. Doctors should focus on alcohol, diabetes, and cardiovascular disease prevention counseling for their high-risk patients.
PS-C12-1: HEATED TOBACCO PRODUCTS VS TRADITIONAL TOBACCO CIGARETTES EFFECTS ON BLOOD PRESSURE AND OTHER CARDIOVASCULAR RISK PREDICTORS AMONG SMOKERS: A META-ANALYSIS
Authors: Barrientos Marie , Reano Joan Dymphna , Arimado Reginald , Castillo Rafael 
Published: January 2023

Introduction:
Over the last decades, a large body of evidence has already demonstrated the association between traditional tobacco cigarette (TTC) smoking and cardiovascular events. More recently, heated tobacco products (HTPs) have been introduced, to potentially reduce exposure to harmful constituents in cigarette smoke and reduce the health burden of smoking-related diseases.

Methods:
Randomized controlled trials comparing TTCs and HTPs with outcomes on blood pressure (BP), heart rate (HR) and other predictors of cardiovascular risk such as flow mediated dilatation (FMD), pulse wave velocity (PWV), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (Tg) and total cholesterol (TC) were searched through PubMed, Google Scholar and Cochrane database. A total of 13 studies were included.

Results:
Pooled analysis of studies showed that HTPs showed significant difference compared to TTCs on HR (MD -3.16 beats per minute [bpm] with 95% CI of -5.41 to -0.91, p = 0.006), FMD (in % change) (MD + 2.53% with 95% CI of 0.17 to 4.89, p = 0.04) and HDL (MD 0.18 mg/dL with 95% CI of 0.07 to 0.28, p = 0.0009). No significant differences were noted on systolic BP, diastolic BP, LDL, Tg and TC. Only 1 study had complete report of outcomes on PWV, showing no significant difference.

Conclusion:
Evaluating the effects on BP, HR and other known predictors of cardiovascular risk, HTPs, compared to TTCs, showed significant reduction in HR, and significant increases in FMD and HDL cholesterol, which may impact favorably in terms of cardiovascular risk reduction. There are no statistically significant differences in BP, LDL cholesterol, Tg, TC and PWV. Larger and long-term studies are still needed to support the cardiovascular benefits of HTPs.