bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-P13-2: ASSOCIATION BETWEEN TRIGLYCERIDE-GLUCOSE INDEX AND TARGET ORGAN DAMAGES IN HYPERTENSIVE PATIENTS
Authors: Liu Changyuan , Zheng Shuping , Chen Xin 
Published: January 2023

Objective:
To investigate the association between triglyceride-glucose index (TyG index) and albuminuria and left ventricular hypertrophy (LVH) in adults with hypertension.

Methods:
The study participants were recruited from a residential area in the suburb of Putuo district in Shanghai. We administered a standard questionnaire for basic information and history of diseases. Clinic blood pressure was measured by an experienced physician with the Omron HEM-7124 monitor (Omron HealthCare, Kyoto, Japan). Venous blood samples were drawn after overnight fasting for biochemical measurements, electrocardiogram (ECG)- left ventricular hypertrophy (LVH) was defined according to the Cornell product index and urinary routine test was performed on fresh urine samples.

Results:
The 5 190 subjects had a mean age of (66.41 ± 7.77) years, and included 2 423 (46.7%) men. Compared with women, men has a little lower TyG index (8.64 ± 0.58 vs 8.69 ± 0.55, P = 0.001). when divided the patients into three groups according to the tertile of TyG index (TyG index less than 8.39, 8.39 - TyG - 8.85, TyG index greater or equal to 8.85), the prevalence of LVH were 4.0%, 3.7% and 6.0%, P for trend = 0.004, and the prevalence of albuminuria were 1.9%, 2.0% and 3.0%, P for trend = 0.03, respectively. After adjustment for related risk factors, the risk for LVH elevated 64% with one unite increase of TyG index, the odds ratio (OR) and 95% confidence interval (CI) was 1.64 (1.31–2.04, P = 0.001). However, there was no significant association between the prevalence of albuminuria and TyG index (OR 0.92, 95% CI 0.56–1.50, P = 0.73).

Conclusions:
TyG index was associated with LVH and albuminuria, and was an independent risk factor for LVH in hypertension.
PS-P14-1: EFFECT OF MONOSODIUM GLUTAMATE ON DIETARY SALT REDUCTION IN FEMALE STUDENTS FROM EAST AND SOUTHEAST ASIA: AN INTERNATIONAL COMPARISON
Authors: Morita Rieko , Ohta Masanori , Hayabuchi Hitomi 
Published: January 2023

Objective:
High sodium intake is a leading dietary risk factor for mortality, especially in China, Japan, and Thailand. Salt reduction is imperative in East and Southeast Asia. The use of umami (glutamate) can effectively decrease salt intake while maintaining food palatability. However, it is unclear whether different eating habits and lifestyles among various nationalities influence the effect of glutamate. This study compared the effects of monosodium glutamate (MSG) on the saltiness and palatability of low-salt solutions among students from East and Southeast Asia.

Design and method:
A total of 77 female students, stratified into four groups by nationality (from Japan [N = 28], China [N = 17], South Korea [N = 15], and Southeast Asia [Vietnam, Malaysia, and Thailand, N = 17]), tasted 0.3, 0.6, and 0.9% NaCl solutions with or without 0.3% MSG to evaluate saltiness and palatability. Saltiness and palatability were assessed using a visual analog scale. Then, the participants were asked for their height (cm), weight (kg), length of stay in Japan (for international students only), and degree of sodium intake. We analyzed the within-group and intergroup differences in ratings of saltiness and palatability.

Results:
Among the 77 participants (mean age of 21.6 years), only the 0.3% NaCl solution with MSG showed significantly higher saltiness and palatability ratings than those without MSG. The 0.6%, and 0.9% NaCl solutions with MSG showed significantly higher palatability ratings than solutions without MSG. The 0.6% NaCl solution with MSG had the highest palatability rating of the six solutions. The saltiness ratings for each NaCl solution with or without MSG differed significantly by their nationality (p < 0.05), except for the 0.9% NaCl solution without MSG. The saltiness rating was lowest in the Southeast Asian group. Participants in the Japan, China, and Southeast Asia groups rated the palatability of 0.3% NaCl solution as significantly higher with MSG than without MSG (all p < 0.05). In this regard, a higher but non-significant trend was noted in the South Korean group (p = 0.074). There was no intergroup difference in palatability in the six solutions (p > 0.05).

Conclusions:
Adding an appropriate amount of umami ingredients improved the palatability of low-salt solutions, regardless of the difference in salty taste rating by their nationality. It was clarified that the utilization of umami is effective for salt reduction in East and Southeast Asia, where excessive salt intake is a major issue.
PS-P14-6: SALTCON FESTIVAL IN KYOTO 2022 BY SALT REDUCTION PROMOTION TEAM OF JAPANESE SOCIETY OF HYPERTENSION PRACTITIONERS SUBCOMMITTEE
Authors: Hatta Tsuguru , Noma Gentoku , Takase Hiroyuki , Ozono Ryoji , Tsuge Toshinao , Minowa Hitoshi , Ando Katsuyuki , Narumi Jun , Aoki Soichiro , Yoshiikawa Hiroyuki , Mizuta Einosuke , Kudo Hiroshi , Tana Takeshi , Tsuchihashi Takuya , Kusaka Miho 
Published: January 2023

Background:
In September 2011, the United Nations and WHO, based on an article published in the Lancet, proposed five actions that the entire world should take to combat noncommunicable diseases (NCDs). In order of priority, they are: 1. Tobacco Control > 2. Salt Reduction > 3. Improved Diets and Physical Activity > 4. Essential Drugs and Technologies. However, looking back over the past decade, while Tobacco Control has made progress, Salt Reduction still has a ways to go. In fact, a Systematic Analysis published in the Lancet in 2019 places “salt” at the top of the list of dietary factors that negatively impact life expectancy and health span. Therefore, the Festival has identified “Salt Reduction” as a global issue to be addressed in the next decade, and will implement programs to accelerate Salt Reduction efforts.
*SOLCON: Abbreviated term for Salt Consious (visualize) and Salt Control (adjust).

Purpose:
Accelerate Salt Reduction efforts
(Involving people who have never had anything to do with salt before)
(1) Overview (three events will be held, each described in detail below)(2) Forums for organizations (sharing Population Approach), held on the web(3) Markets targeting individuals (practice of Individual Approach), holding Real

Public lectures for individuals, held on the web

Meeting Date:

(1) Forum: Thursday, November 24, 2022, 12:00 - 17:00(2) Market: Sunday, November 13, 2022, 10:00–15:00(3) Public Lecture: Saturday, November 19, 2022, 16:00–18:00

Reduce salt! is not enough to reach the health-unconcerned population, and to reduce salt consumption, we have planned an event like the Japanese version of CASH (the National Council on Salt and Health), a collaboration of industry, government, and academia. We hope that this project will be a catalyst for reducing salt consumption in Japan.
PS-P15-5: EFFECT OF SODIUM RESTRICTION ON LARGE ARTERY STIFFNESS AND DISTENSIBILITY OF SMALL ARTERIES IN HYPERTENSIVE PATIENTS: A RANDOMIZED TRIAL
Authors: Adolphi Camila Lumy , Gaeta Ludmila Nogueira Novaes , Lopes Heno Ferreira , Bortolotto Luiz Aparecido 
Published: January 2023

Objective:
Arterial stiffness is characterized by a decrease in arterial distensibility, resulting from the interaction between the extracellular matrix and cellular elements. Large and small arteries can be differently influenced by extrinsic factors, such as excessive sodium intake. This study aim to evaluate the impact of sodium restriction on large artery stiffness and distensibility of small arteries in young adults diagnosed with arterial hypertension.

Methods:
Randomized controlled clinical trial, including 20 hypertensive patients, aged between 30 and 59 years, followed up at the hypertension outpatient clinic of a tertiary hospital. Subjects were randomized into two groups: group 1 - low-sodium diet (2 g sodium/day); group 2 - usual diet. To analyze the stiffness and distensibility of the arteries, it was measured aortic pulse wave velocity by Complior®, elasticity of small arteries and vascular resistance by HDI®, and also through the measurement of metalloproteinase-9. For nutritional assessment it were considered blood glucose levels, 24-h urinary sodium, body mass index (BMI) and other anthropometric measurements. For nutritional intake we analized the 24-hour dietary recall.

Results and Discussion:
In comparison with group 2, it was observed a significant (p < 0.05) reduction in office blood pressure (p = 0,037) and pulse wave velocity (p = 0,010) in group 1 subjects. Also, in group 1 it occurred reduction in blood glucose levels, BMI, waist and neck circumference. Sodium intake was significantly reduced in group 1, taking into account 24 hs urinary sodium and evaluated by dietary recall. It is worth mentioning that excessive sodium intake linked to arterial hypertension causes a remodeling process, increased oxidative stress, inflammation and fibrosis of the arteries, contributing to arterial stiffness. Regarding the distensibility of small arteries, no significant differences were found between the two groups, but the intervention period and the number of individuals in the study should be taken into account, since these factors may have influenced the results.

Conclusion:
Sodium restriction for a short period of time promoted reduction of arterial stiffness, in parallel to reduction in obesity parameters and blood pressure in adults diagnosed with systemic arterial hypertension.
PS-P15-7: EFFECT OF ESAXERENONE ON UNCONTROLLED NOCTURNAL HYPERTENSION FIRST EVALUATED BY 2 UPPER-ARM/WRIST HOME MONITORING DEVICES (EARLY-NH STUDY)
Authors: Kario Kazuomi , Nishizawa Masafumi , Kato Mitsutoshi , Ishii Hajime , Uchiyama Kazuaki , Nagai Michiaki , Takahashi Nobuo , Asakura Taro , Shiraiwa Toshihiko , Taguchi Takashi , Shiosakai Kazuhito , Sugimoto Kotaro 
Published: January 2023

Objective:
Nocturnal hypertension is one of the phenotypes of masked hypertension, which affects 30–50% of hypertensive patients, and it cannot be adequately controlled with a single agent. The mineralocorticoid receptor (MR) is activated in an aldosterone-independent manner in diabetes, obesity, salt sensitivity, and excessive salt intake. As all of these conditions are associated with nocturnal hypertension, MR blockers which exert not only antihypertensive but also organ-protective effects are considered the optimal antihypertensive option.
Recently, we have developed 2 types (upper-arm and wrist) of nocturnal home blood pressure (BP) monitoring (HBPM) devices. Using these devices, we evaluated the effects of esaxerenone on nighttime home BP and organ damage (UACR and NT-proBNP) in uncontrolled nocturnal hypertensive patients on medication using one drug, either angiotensin receptor blocker (ARB) or calcium channel blocker (CCB).

Design and method:
EARLY-NH study (jRCTs031200364) was a multicenter, open-label, interventional study in nocturnal hypertensive patients. Nighttime BP was automatically measured at 2, 3, and 4AM with upper-arm (OMRON HEM-9700T), and wrist (OMRON HEM-9601T) HBPM devices. The BP data were electronically collected. Inclusion criteria were: 1) aged ≧ 20 years, 2) receiving one ARB or CCB, 3) nighttime home systolic BP (SBP) ≧ 120 mmHg. Over the 12-week study period, esaxerenone was started at the initial dose of 1.25 or 2.5 mg/day, and could be titrated up to 5 mg/day at weeks 4 and 8, based on the individual patient's condition. The primary efficacy endpoint was the change from baseline in nighttime home BP [SBP and diastolic BP (DBP)] measured by the upper-arm device at week 12. Secondary endpoints included changes in nighttime home BP measured by the wrist device, and levels and control rate of office and home BPs, %change in UACR and NT-proBNP, and safety variables including adverse events, eGFR, and serum potassium.

Results:
The 93 patients with uncontrolled nocturnal hypertension were successfully enrolled [age: 67.6 years; man: 50.5%; ARB/CCB: 48.4/51.6%; nighttime home SBP/DBP (upper-arm: 132.4/78.4 mmHg; wrist: 130.4/73.1 mmHg); morning home SBP/DBP: 143.8/86.7 mmHg; office SBP/DBP: 147.2/84.1 mmHg; UACR: 110.4 mg/gCr; NT-proBNP: 83.7 pg/mL; serum potassium: 4.0 mEq/L; eGFR: 69.7 mL/min/1.73m2]. Results for the efficacy, safety, and exploratory analysis will be presented.

Conclusions:
EARLY-NH study will provide the first clinical evidence of the efficacy and safety of esaxerenone on uncontrolled nocturnal hypertension evaluated by 2 newly developed different upper-arm and wrist HBPM and on organ damage. These results will contribute to digital management of hypertension using home BP.
PS-P16-3: DIFFERENTIAL RISK FACTORS FOR WORSENING RENAL FUNCTION AND FOR PROGRESSION OF PROTEINURIA-DATA FROM SPECIFIC HEALTH SURVEYS OF TOYOOKA CITY
Authors: Kishimoto Ichiro 
Published: January 2023

Objective:
To assess the difference between risk factors associated with a decline in renal function without a progression of proteinuria and those associated with a progression of proteinuria without a decline in renal function.

Design and method:
Retrospective longitudinal data from 2014–2017 specific health surveys among participants of National Health Insurance in Toyooka City were analyzed (n = 5,169 at baseline). Associations of risk factors at baseline and a ≧ 1.2-fold increase in creatinine or a progression of dip-stick proteinuria during follow-up were determined with a Cox proportional hazard analysis.

Results:
Multiple regression models revealed that a ≧ 1.2-fold increase in serum creatinine without a progression of proteinuria during 3-year follow-up was significantly associated with age, male gender (risk ratio (RR):2.2), proteinuria, and hypertension (RR:3.6), independently each other. After adjustments, qualitative tests for proteinuria revealed that, compared to (negative), (2 +) and (3 +) were associated with 7.7- (95% confidence interval (CI):1.2–25.8, p = 0.03) and 28- (95% CI:1.6–140, p = 0.03) fold increases in the risks for a worsening of renal function, respectively, while (±) or (1 +) did not show a significant difference. In addition, there was no significant association between a decline in renal function without a progression of proteinuria and body mass index (BMI), diabetes, or dyslipidemia. On the other hand, a progression of proteinuria to ≧ (1 +) without a decline in renal function was significantly associated with age, male gender (RR:1.8), higher BMI, hypertension (RR:1.6), dyslipidemia (RR:1.7) and diabetes (RR:1.7) at baseline after adjustments of baseline serum creatinine or proteinuria levels. Compared to the qualitative test proteinuria (negative), (±) and (1 +) were significantly associated with 4.3- (95% CI: 2.8–6.5, p < 0.0001) and 5.3- (95% CI: 2.8–9.4, p < 0.0001) fold increases in the risks for the further progression of proteinuria, respectively.

Conclusions:
Community data from specific health surveys among participants of National Health Insurance revealed differential risk factors associated with a worsening of chronic kidney diseases with respect to renal function and to proteinuria. Hypertension is one of the major risks for a decline in renal function, while a constellation of multiple risk factors was associated with a progression of proteinuria. In the present study, compared to (negative), even (±) of the qualitative test for proteinuria is associated with the 3-year risks not for a decline in renal function but for a further progression of proteinuria, while proteinuria ≧ (2 +) is significantly associated with a worsening of renal function.
PS-R06-1: A CASE OF PATIENT WITH END-STAGE KIDNEY DISEASE INTRODUCED HEMODIALYSIS AFTER CEREBRAL HEMORRHAGE.
Authors: Aso Mitsuhiro , Yamaguchi Shintaro , Yasuda Itaru , Nishioka Ken , Kaneko Kenji , Kanda Takeshi , Itoh Hiroshi 
Published: January 2023

A 46-year-old male had been treated for end-stage kidney disease due to diabetic nephropathy and adaptive FSGS, and underwent surgery of arteriovenous fistula 3 weeks before the admission. He was scheduled to be introduced hemodialysis, but was urgently hospitalized due to cerebral hemorrhage. The head CT scan showed a subcutaneous hematoma of about 45 ml in the left frontal lobe, and the patient had impaired consciousness and worsening respiratory status. There were no surgical indications for cerebral hemorrhage, we initiated blood pressure control with nicardipine. Hyperkalemia was also seen, but urgent dialysis was not necessary, and we planned to introduce dialysis the next day or later. The next day hemodialysis was introduced, but soon after hemodialysis completed, worsening of respiratory condition and dilated pupil were observed. The head CT scan showed worsening cerebral edema compared to pre-dialysis CT scan on the same day. Thereafter, respiratory and general condition did not improve, and he died 11 days after the admission.
It is recommended that dialysis should be avoided within 24 hours of the onset of cerebral hemorrhage because of the high risk of hematoma expansion. In addition, in the acute phase of cerebral hemorrhage, it is considered to choose a dialysis method that causes less intracranial pressure increase, such as peritoneal dialysis or continuous hemodiafiltration dialysis, if possible. Administration of hypertonic glycerol may also be helpful. When a patient with end-stage kidney disease is introduced hemodialysis soon after cerebral hemorrhage, control of blood and intracranial pressure should be cared.
PS-R07-7: USE OF GADOLINIUM CONTRAST MEDIUM ENABLES ADRENAL VEIN SAMPLING IN A FLORID PRIMARY ALDOSTERONISM PATIENT WITH IODINE ALLERGY
Authors: Nagai Satoshi , Yoshida Yuichi , Shibuta Kanako , Miyamoto Shotaro , Ozeki Yoshinori , Okamoto Mitsuhiro , Gotoh Koro , Masaki Takayuki , Shibata Hirotaka 
Published: January 2023

Case:
A 35-year-old woman was allergic to iodine contrast medium and was diagnosed with primary aldosteronism (PA) based on functional confirmatory tests. She was suspected to have unilateral PA because of marked hypertension, spontaneous hypokalemia, high plasma aldosterone, reduced plasma renin activity, and a right hypodense adrenal tumor. She wanted to become pregnant and requested adrenalectomy instead of medical treatment with mineralocorticoid receptor antagonists. Localization of PA by adrenal vein sampling (AVS) was necessary, but angiography with iodine contrast medium was not possible because of her allergy. AVS was performed using gadolinium contrast agent (gadoterate meglumine) instead of iodine, in combination with computed tomography angiography (CTA) because the American College of Radiology manual does not recommend prior steroid administration for high-risk patients who have already exhibited adverse reactions to iodine contrast medium. In AVS, before and after adrenocorticotropic hormone (ACTH) loading, 12 blood samples were drawn from the right adrenal vein, left adrenal central vein, left adrenal common duct, left and right renal veins, and the lower inferior vena cava with only 5 mL of gadolinium medium. There were no complications during AVS. Examination revealed an elevated aldosterone/cortisol ratio on the right side, lateralized ratio of 7.4, and contralateral ratio of 0.76; the patient was diagnosed with right unilateral PA. She underwent right adrenalectomy and showed improvements in aldosterone level from 312.4 pg/mL to 83.0 pg/mL, potassium from 3.0 mEq/L to 3.9 mEq/L, and systolic blood pressure from 138 mmHg to 117 mmHg. She is currently off her medications.

Conclusion:
In PA patients with iodine allergy, AVS can be performed safely and precisely using gadolinium contrast combined with CTA.
PS-R07-9: A CASE OF ADRENAL VEIN SAMPLING IN PRIMARY ALDOSTERONISM WITH DISCREPANT RESULTS OF ALDOSTERONE-OVERSECRETION-LATERALITY UNDER BASAL CONDITIONS AND COSYNTROPIN STIMULATION
Authors: Nozato Yoichi , Akasaka Hiroshi , Takami Yoichi , Yamamoto Koichi , Rakugi Hiromi 
Published: January 2023

Background:
Adrenal venous sampling (AVS) is regarded as the gold standard for diagnosis of primary aldosteronism (PA) subtypes before surgery. Cosyntropin stimulation during AVS improves the success rate of bilaterally selective catheterization and outcome prediction for PA. However, in some cases cosyntropin stimulation may obscure the judgement of laterality of aldosterone oversecretion.

Case presentation:
A 66-year-old Japanese man was referred to our hospital for evaluation and management of hypertension and hypokalemia. His home blood pressure was 160/80 mmHg and poorly controlled with a calcium channel blocker, and a serum potassium level was 3.3 mEq/L under oral potassium administration. Plasma aldosterone concentration (PAC) was 249 pg/mL. Abdominal computed tomography scan revealed a 7 mm nodule on the left adrenal gland. Both captopril challenge test and saline infusion test revealed positive test results, which confirmed a diagnosis of PA. The AVS was performed both under basal conditions and during cosyntropin stimulation, which revealed discrepant results of laterality (Table 1). Since the absolute value of aldosterone secretion was significantly higher on the right adrenal gland, suggesting autonomous secretion from the right, AVS was performed again. The second procedure showed unilaterality in the right under basal AVS and bilaterality during cosyntropin stimulation (Table 2). Similarly, aldosterone levels were clearly higher on the right side, leading to the diagnosis of microadenoma of the right adrenal gland, and a laparoscopic right adrenalectomy was performed. Histopathology of the removed right adrenal gland revealed a diagnosis of a 2 mm adenoma. After adrenalectomy, his blood pressure control and hypokalemia improved.

Conclusions:
Cosyntropin stimulation during AVS is believed to increase the local diagnostic value of aldosterone oversecretion, but in rare cases, as in this case, basal and cosyntropin-stimulated AVS results yielded contrary findings. Cosyntropin-stimulated AVS should be interpreted with caution.
Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease
Authors: Beeson Summer A. , Neubauer Daniel , Calvo Richard , Sise Michael , Martin Matthew , Kauvar David S. , Reid Chris M. 
Published: January 2023

Background:
Mortality rates following major lower extremity amputations (LEAs) 30 days–365 days postoperative have decreased, but 5-year rates remain high at 40.4%–70%. These data may not reflect recent advances in peripheral arterial disease (PAD) care, and comorbidities of chronic PAD may lead to mortality more frequently than the amputation itself. Mortality rates between diabetic and nondiabetic patients were also analyzed.

Methods:
The California Office of Statewide Health Planning and Development hospital database was queried for patients admitted January 1, 2007–December 31, 2018. ICD-9-CM codes identified patients with vascular disease and an amputation procedure.

Results:
There were 26,669 patients. The 30-day, 90-day, 1-year, and 5-year major LEA mortality rates were 4.82%, 8.62%, 12.47%, and 18.11%, respectively. Weighted averages of 30-day, 90-day, 1-year, and 5-year major LEA mortality rates in the literature are 13%, 15.40%, 47.93%, and 60.60%, respectively. Mortality risk associated with vascular disease after amputation (hazard ratio = 22.07) was 11 times greater than risk associated with amputation-specific complications from impaired mobility (hazard ratio = 1.90; P < 0.01). Having diabetes was associated with lower mortality at 30 days, 90 days, and 1 year (P < 0.01) but not at 5 years (P = 0.22).

Conclusions:
This study suggests that people may be living longer after their major LEA than was previously thought. This study suggests that patients’ PAD may play a bigger role in contributing to their mortality than complications from loss of mobility postamputation. Although having diabetes was associated with lower postamputation mortality, the difference was no longer significant by 5 years.