bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPB10-6: THE RELATION BETWEEN PERICYTE DETACHMENT AND INTERSTITIAL FIBROSIS IN DAHL SALT-SENSITIVE HYPERTENSIVE (DAHLS) RATS
Authors: Ito Hiroki , Hirose Takuo , Sato Shigemitsu , Endo Akari , Yabana Ikuko Oba , Takahashi Kazuhiro , Mori Takefumi 
Published: January 2023

Background:
Congestive heart failure produces the state of fluid volume overload, central venous pressure (CVP) elevation, and consequently renal venous pressure (RVP) elevation. We have recently developed a novel rat unilateral renal venous congestion model, in which ligation of the inferior vena cava between both renal veins artificially induced renal congestion in the left kidney only. In this model, pericyte detachment and pericyte-myofibroblast transition (PMT) around the vasa recta were involved in interstitial injury and fibrosis. Dahl salt-sensitive hypertensive (DahlS) rats on high salt diets exhibit hypertension, congestive heart failure, fluid volume overload, CVP and RVP elevation, and renal damage, considering to be a non-artificial renal congestion model. The relation, however, between renal interstitial injury and fibrosis, elevated RVP, and pericyte detachment in DahlS rats has not been reported. In the present study, we assessed the relation of pericyte detachment around the vasa recta and PMT with interstitial fibrosis in DahlS rats.

Methods:
Eight-week-old DahlS rats (Dahl/Mcwi) were divided into three groups: normal diet, 4% NaCl diet, and 8% NaCl diet groups, and their kidneys were analyzed after 2 weeks. Total mRNA and protein expression levels were quantified by real-time PCR and western blot, respectively. Tubulointerstitial damage and fibrosis were identified by histological analysis. Furthermore, we evaluated pericyte detachment around the vasa recta by low-vacuum scanning electron microscopy (LV-SEM).

Results:
The expression of KIM1, a tubulointerstitial damage marker; CNN1 and αSMA, interstitial fibrosis markers; and TAGLN, a smooth muscle protein22 and PMT marker; was significantly increased in a salt-dependent manner in DahlS rats. In histological analysis, hyperplasia of the extracellular matrix and renal tubular injury were detected in 4% and 8% NaCl diet groups. The positive area of PMT markers in the interstitial space around the vasa recta was also increased in the NaCl diet groups. Pericyte detachment from the vasa recta was observed in the NaCl diet groups by LV-SEM.

Conclusions:
Pericyte detachment and PMT are involved in tubulointerstitial injury and fibrosis of DahlS rats. Renal venous congestion and subsequent physiological changes could have a role in renal damage and fibrosis. Arterial hypertension has been emphasized for a long time in renal injury, and venous hypertension must also be focused on with the concept of renal congestion. Further understanding of this concept may lead to new therapeutic strategies for renal injury.
PS-BPC03-5: OFFICE AND HOME BLOOD PRESSURE AND CARDIOVASCULAR DISEASE IN PATIENTS WITH DIABETES, PREDIABETES AND NORMAL GLUCOSE METABOLISM
Authors: Suzuki Daisuke , Hoshide Satoshi , Kario Kazuomi 
Published: January 2023

Objective:
Few studies have investigated whether the association between home blood pressure (BP) and cardiovascular disease (CVD) events is different according to prediabetes and diabetes populations.
The main purpose of this study is to clarify the impact of home BP and office BP on CVD events in prediabetes and diabetes.

Design and method:
We used the database of the J-HOP (Japan Morning Surge-Home Blood Pressure) study, which enrolled 4,310 patients having at least one cardiovascular risk. We classified the patients with a self-reported clinical history of a physician's diagnosis, using of medication of diabetes mellitus, a fasting plasma glucose greater than or equal to 126 mg/dL, a casual plasma glucose level greater than or equal to 200 mg/dL or hemoglobin A1c (HbA1c;NGSP) greater than or equal to 6.5 % as diabetes (n = 1,034), those with HbA1c 5.7–6.4 % as prediabetes (n = 1,167), and the remaining patients as the patients with normal glucose metabolism (NGM) (n = 2,024). Outcome was measured against composite CVD outcome (first occurrence of coronary artery disease, stroke and heart failure).

Results:
During a median 6.2 ± 3.8 year follow-up, 259 CVD events occurred. Prediabetes was a risk of CVD events (Unadjusted Hazard ratios [uHR],1.43; 95% confidence interval [CI], 1.05–1.95) and this association was followed by diabetes (uHR, 2.13; 95%CI, 1.59–2.85) compared to NGM. In NGM group, the adjusted HR expressing the risk of composite CVD events, were 1.15 (95%CI, 1.01–1.31) and 1.18 (95%CI, 1.03–1.36), 1.01(95%CI, 0.88–1.15) per 10 mmHg increase of morning and evening home systolic BP (SBP), office SBP, respectively. In diabetes, increased home SBP as a risk of composite CVD events had similar tendency and office SBP was also associated with a risk of CVD (adjusted HR, 1.16; 95%CI, 1.02–1.31). In prediabetes group, only morning home SBP was associated with a risk of CVD events (uHR, 1.15; 95%CI, 1.00–1.31), but was not in adjusted model.

Conclusion:
Prediabetes was a risk for CVD events as well as diabetes. Increased home BP contributes to CVD risk in diabetes, albeit weakly in prediabetes.
PS-BPC05-5: ATRIAL FIBRILLATION PREVALENCE IN HOSPITALIZED PATIENTS WITH CORONARY ARTERY DISEASE AND HYPERTENSION: A CROSS-SECTIONAL STUDY 2008–2018
Authors: Xin Qian , Wang Chi , Xue Hao 
Published: January 2023

Background:
The prevalence of inpatients with comorbid of hypertension and coronary artery disease (HT-CAD) and AF are largely unknown. The aim of our study is to investigate the prevalence and clinical characteristics of patients with comorbid of HT- CAD and AF.

Methods:
This cross-sectional study was conducted in Chinese PLA General Hospital in Beijing, China, and included 20,747 HT-CAD inpatients with or without AF from August 2008 to July 2018. We explored the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns and blood pressure control of patients with HT-CAD and AF. Multivariate logistic regression was used to investigate the association of cardiovascular risk factors and AF in patients with HT-CAD.

Results:
The overall prevalence of AF in patients with HT-CAD was 4.9%, and increased with age. The AF prevalence was increased from 0.78% and 1.02% in aged < 45years old to 8.83% and 10.28% in age > 65 years for women and men, respectively. HT-CAD patients with AF had higher incidence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, men, obesity, heart failure, and chronic kidney disease were independently associated with the risk of AF in HT-CAD patients. In patients with HT-CAD and AF, 73.4% of the subjects had CHA2DS2-VASc score > = 4, indicating a high risk of thrombo-embolism stroke. However, the use of oral anticoagulation (OAC) increased during the study period (6.0% vs 22.5%, p < 0.01), but remained at a relatively low level.

Conclusion:
Patients with comorbid of HT-CAD and AF had higher prevalence, with more cardiovascular-related comorbidities and lower the use of OAC. Emphasizing of OAC therapy and cardiovascular-related comorbidities management are urgent needs to reduce the recurrence of cardiovascular events.
PS-BPC05-7: HEMODYNAMIC MANAGEMENT OF RESISTANT HYPERTENSION
Authors: Lozsan Francisco Jose Chacon , Rojas Ruben Dario , Rodriguez Maryan Johanna 
Published: January 2023

Background:
Hypertension is the most prevalent chronic disease worldwide and is related to a high probability of cardiac disease, kidney disease and cerebrovascular events. Blood pressure measurement was used in the last decades to diagnose and guide antihypertensive therapy; however blood pressure is the result of the interaction of more complex hemodynamic parameters previously reserved for experimental studies or critical care patients management using invasive methods. Since 1996 few studies have proposed the use of hemodynamic parameters to classify and guide hypertension therapy with good results.

Purpose:
The present study's purpose was to measure hemodynamic parameters in patients with non-controlled resistant hypertension and use it to guide pharmacologic treatment to archive control blood pressure values according to the European Society of Cardiology guidelines.

Methods:
A total of 84 patients between 32 and 95 years old diagnosed with non-controlled primary resistant hypertension were recruited and after previous therapy washout hemodynamic parameters were measured using noninvasive

Methods:
preload by central venous pressure (CVP) using inferior vena cava diameter, cardiac index and systemic vascular resistance using Lyljestrand & Zander modified formula. Patients were classified into 3 basic groups depending on which parameter was above normal value: hyperdynamic (HD) for high cardiac index > 3.5 L/min/m2, fluid overload (FO) for CVP > 8cmH2O and high systemic vascular resistance index (HSVRi) > 2500 dynes/sec/m2/cm5, also 3 combined groups were a patient had 2 simultaneous hemodynamic alterations (HD+FO, HD+HSVRi and FO+HSRVi), according to this classification pharmacotherapy was guided indicating Bisoprolol in HD group, Amlodipine to HSVR patients and Hydrochlorothiazide to FO patients, in combined groups, combined therapy was given. Patients were observed for 6 months period taking as primary endpoint blood pressure control, acute cardiovascular events and hypotension.

Results:
A significant reduction of hemodynamic parameters and blood pressure was observed in the first month of treatment obtaining a 100% hemodynamic and blood pressure goals in all patients in the third month of therapy without hypotension or acute cardiovascular event during this period, the HD+FO group reach goals at the 6th month of treatment without reported complications.

Conclusions:
In this preliminary study we observed that hemodynamic guided high blood pressure control may be a valuable tool for a better understanding, classification and treatment in patients with resistant hypertension; however larger outcome studies confirm this hypothesis.
PS-BPC06-8: FACTORS ASSOCIATED WITH POTENTIAL COGNITIVE FUNCTIONAL CHANGES IN OLDER PATIENTS WITH HYPERTENSION
Authors: Akasaka Hiroshi , Yamamoto Koichi , Yasunobe Yukiko , Shimizu Atsuya , Kozaki Koichi , Kuzuya Masafumi , Ohishi Mitsuru , Akishita Masahiro , Rakugi Hiromi 
Published: January 2023

Objective:
There are many cases of potentially impaired cognitive function in older patients with hypertension. Therefore, we investigated factors associated with one-year changes in cognitive function in older hypertensive patients during outpatient visits.

Design and method:
We included 223 hypertensive patients (age 76.3 ± 6.3 years, 106 males) aged 65 years or older who attended outpatient hypertension clinics at six specialized institutions nationwide and had no prior diagnosis of dementia. We obtained the mini-mental state examination (MMSE) from all participants. We defined the impaired cognitive function as an MMSE score of 27 or less. At baseline and one year later, the participants were evaluated for comprehensive geriatric assessment, including MMSE, and muscle strength, with the converted group defined as having new cognitive decline at one year and the reverted group as having cognitive improvement one year after the cognitive decline. All participants gave informed consent, and our institutional review board approved the study protocol.

Results:
At baseline, 81 of 223 elderly hypertensive patients had impaired cognitive function. At one-year follow-up, 40 of 142 patients in the maintained cognitive function group were classified as converted, and 33 of 81 patients in the impaired cognitive function group were classified as converted. The converted group was older than the cognitively intact group (76.8 vs. 73.9 years, p < 0.05), had higher home blood pressure, and had more significant grip strength loss over the year. Multivariate analysis identified age (odds ratio 1.1, 95% CI 1.0–1.2) and change in grip strength (odds ratio 0.84, 95% CI 0.72–0.99) as factors associated with the converted group. The reverted group was younger, had a higher percentage of males, and had weaker grip strength than the group with persistent cognitive decline. In multivariate analysis, grip strength (odds ratio 0.80, 95%CI 0.68–0.94) was extracted as a factor associated with the revert group.

Conclusions:
Potential cognitive decline was observed in 36% of older patients with hypertension. Furthermore, we examined a high rate of cases of cognitive function change over one year. Age and grip strength decline was considered responsible for cognitive conversion and baseline grip strength for revert, respectively.
PS-BPC06-10: FATTY LIVER INDEX AND CARDIOVASCULAR RISK IN HYPERTENSIVE PATIENTS
Authors: Siafi Eirini , Andrikou Ioannis , Thomopoulos Costas , Konstantinidis Dimitrios , Kakouri Niki , Tatakis Fotis , Kariori Maria , Filippou Christina , Zamanis Ioannis , Manta Eleni , Drogkaris Sotirios , Liatakis Ioannis , Polyzos Dimitrios , Tsioufis Konstantinos 
Published: January 2023

Objective:
The prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing rapidly worldwide affecting 25–30% of population. Fatty liver index (FLI) is a validated marker of NAFLD and can be used as a screening tool for hepatic steatosis. The purpose of the study was to evaluate the relationship between FLI and the risk of major cardiovascular events in hypertensive patients.

Design and method:
903 hypertensive patients without history of cardiovascular disease participated in the study (mean age 52.7 ± 11.4 years; males 55%; baseline clinic BP 149.8 ± 15.2/95.5 ± 10.1 mmHg). Participants were prospectively evaluated for a mean follow-up period of 6.0 ± 3.3 years with at least one annual visit. The diagnosis of NAFLD was based on FLI and consequently patients were divided in two groups according to the presence of NAFLD. The primary endpoint was a composite of major cardiovascular events.

Results:
The incidence of cardiovascular events during the follow up was 8.5% (n = 77). Patients without NAFLD (n = 625) had better BP control compared to their counterparts with NAFLD (n = 278) during follow up (43% vs 33%, p = 0.02). A Cox-regression analysis indicated that age (hR 1.09 CI 1.04–1.13, p < 0.01), smoking (hR 2.4 CI 1.1–5.2, p = 0.03) and FLI (hR 2.7 CI 1.9–4.1, p < 0.001) were significant independent determinants of the outcome. The presence of NAFLD at baseline visit was also a significant independent determinant of the outcome (hR 5.2 CI 2.4–11.1, p < 0.001).

Conclusions:
In conclusion, FLI has an independent prognostic value for the incidence of cardiovascular events in hypertensive patients. Therefore, it could be useful in identifying patients at higher risk of cardiovascular events. Further studies will clarify whether the early treatment of NAFLD could reduce the incidence of cardiovascular disease.
PS-BPC07-5: A REAL-WORLD ANALYSIS OF PHARMACO-UTILIZATION AND OUTCOMES OF PATIENTS ON PERINDOPRIL/AMLODIPINE/INDAPAMIDE FREE VS SINGLE-PILL COMBINATION IN ITALY
Authors: Borghi Claudio , Jayagopal Pathiyil Balagopalan , Konradi Alexandra , Bortolotto Luiz Aparecido , Esposti Luca Degli , Perrone Valentina , Snyman Jacques R 
Published: January 2023

Objective:
To evaluate and compare medication adherence, cardiovascular (CV) events and mortality incidence among 2 cohorts of patients treated with Perindopril/Amlodipine/Indapamide (PER/AML/IND) as a free or single-pill combination in a real-world setting in Italy.

Design and method:
Data were extracted from administrative databases of Italian Healthcare Entities. Adult patients treated with PER/AML/IND as single-pill or free combination (during the period 2010–2020) were included and categorized into 2 cohorts. The index date (ID) corresponded to the first prescription of a single-pill combination (single-pill cohort) or the first prescription of the 3 drugs simultaneously (within 30 days) (free cohort). Patients were characterized in the year prior to ID and followed up from ID to the end of data availability. Patients who died during the first 12-month period were excluded. Propensity score matching (PSM) was applied to minimize selection bias and to reduce potential imbalances between the two cohorts. Adherence was calculated as the proportion of days covered (PDC: PDC < 40% non-adherence; PDC = 40–79% partial adherence; PDC> = 80% adherence). Incidence of mortality and CV events was analyzed after the first year of follow-up and reported as event rate per 1,000-person/year.

Results:
The analysis included 37,365 patients (54.3% male) in the single-pill cohort and 6,105 (50.8% male) in the free cohort. The post-PSM cohorts were balanced for their characteristics and comprised 6,105 (free-cohort) and 12,105 (single-pill-cohort) patients. The adherence to medication (PDC > = 80%) was better in the single-pill cohort compared to the free cohort (59.9% vs 26.9% adherent patients, p < 0.001). Accordingly, there were more non-adherent patients in the free (54.0%) than in the single-pill (20.8%) cohort (p < 0.001), while similar values were observed for partial adherence (19%, both cohorts). The mortality rate was higher in the free-cohort versus single-pill-cohort patients (33.7 vs 29.9 per 1,000-person/year, p < 0.05). The same effect was reported for incidence of death and CV events as a composite endpoint: 139.0 (free-cohort) versus 105.8 (single-pill-cohort) per 1,000-person/year (p < 0.001).

Conclusions:
This real-world analysis among hypertensive patients showed that the treatment with PER/AML/IND as a single-pill, as opposed to free combination, could be associated with better medication adherence in the single-pill cohort at one year and with a lower incidence of cardiovascular events and mortality.
PS-BPC07-9: BLOOD PRESSURE LOWERING EFFICACY OF THE HYPERTENSION EDUCATION PROGRAM OF THE GERMAN SOCIETY OF HYPERTENSION AND PREVENTION
Authors: Hausberg Martin , Krämer Bernharnd , Sanner Bernd , Tholl Ulrich , Krieger Horst , Zidek Walter , Krönig Bernd , Lohmann Friedrich , Eckert Siegfried 
Published: January 2023

Objective:
In 2013 the German Society of Hypertension and Prevention initiated a hypertension education program (HEP) - Mein Blutdruck - OK!
(https://www.hochdruckliga.de/hypertonie-schulung-fuer-patienten.html).
The objective of this study was to evaluate the blood pressure lowering efficacy of the HEP.

Design and method:
The HEP consists of 5 modules (blood pressure regulation, non-pharmacological treatment 1 and 2, pharmacological treatment, adherence) of group (4–6 patients) teaching, held by trained physicians and medical staff who underwent a specially designed train the trainer program. Each module consisted of 90 minutes training and patients underwent all 5 modules within 4 weeks.
The validation study was performed in 8 hypertension outpatient clinics. Patients with mild (stage 1) hypertension, treated or untreated were included, and pharmacologic antihypertensive treatment was not altered during 6 months. The clinics were randomized to HEP or standard care. Blood pressure was monitored at baseline and after 6 months by standardized office measurements, home measurements (automatic oscillometric device, patients training) and 24 h ABPM. Primary endpoint was an at least 5 mmHg greater reduction of systolic office blood pressure by HEP compared to usual care.

Results:
4 hypertension outpatient clinics were randomized to HEP, including 35 patients, 4 hypertension outpatient clinics were randomized to usual care, including 53 patients in the study. ABPM data were available in only 71 out of 88 patients. Data are presented in tables 1 and 2.

Conclusion:
The HEP resulted in significantly greater reductions of office and home blood pressure values as compared to usual care. The primary endpoint was met. Changes in ABPM daytime means did not differ significantly between groups, possibly due to insufficient available data. These results were obtained in patients with mild hypertension, either treated or untreated, and may differ in patients with severe or resistant hypertension.
PS-BPC08-1: VALIDATION OF PRIMARY ALDOSTERONISM DIAGNOSIS DURING THE TRANSITIONAL PERIOD OF ALDOSTERONE ASSAY AND GUIDELINE CHANGES IN JAPAN
Authors: Yoshida Sumiko , Endo Furi , Toujima Yuuki , Asai Takahito , Yamagami Hiroki , Hara Tomoyo , Mitsui Yukari , Kurahashi Kiyoe , Endo Itsuro , Fukumoto Seiji , Abe Masahiro 
Published: January 2023

Objectives and Methods:
In Japan, the plasma aldosterone concentration (PAC) measurement method was changed from RIA to CLEIA method in April 2021. From then until August 2021, when the 2021 clinical practice guidelines for the diagnosis and management of primary aldosteronism (PA) were published, we diagnosed PA using the RIA-converted PAC value (conversion formula from CLEIA (X) to RIA (Y): Y = 1.174X + 42.3) and the conventional positive decision criteria of the screening and confirmatory tests in PA diagnosis. The new criteria were then used to re-determine and confirm the agreement.

Results:
PAC(CLEIA) and renin activity (PRA) or active renin concentration (ARC) were measured simultaneously for PA screening at our hospital from April to August 2021 in 122 patients (135 measurements in total). PAC values (CLEIA) were less than 4 pg/mL in 21 measurements (16%). This value was converted to PAC(RIA) at 47 pg/mL based on the formula. (i) PA screening tests: 10% of the measurements were found to be ‘not excluded’ by the conventional criteria and negative by the new criteria. This was due to the fact that the calculated PAC(RIA) values were higher than they should be when the conversion formula to RIA was applied to cases with low PAC(CLEIA) values, resulting in higher estimated ARR values (PAC(RIA)/PRA or PAC(RIA)/ARC ratio). (ii) PA confirmatory tests: In the captopril challenge test, one case was found to be positive by the conventional criteria and negative by the new criteria due to the same reason as that on point (i). In the saline infusion test, PAC(CLEIA) of 12–15 pg/mL was determined to be less than PAC(RIA) 60 pg/mL by the conversion formula, which was deemed negative by the conventional criteria but borderline by the new criteria. (iii) PA diagnosis using the confirmatory tests: In one case, the diagnosis did not match the positive (borderline) classification based on the new criteria, although the patient was deemed negative by the conventional criteria. This was due to discrepancies of the saline infusion test results.

Conclusion:
During the transition period of PA diagnosis from the RIA to CLEIA method, it was necessary to review the data and retest the patients according to their symptoms because of possible inconsistencies between the new and conventional criteria-based diagnostic results. PA diagnosis and treatment should be judged comprehensively on a case-by-case basis, without relying entirely on the values of the criteria.