bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPC02-1: PCSK-9-INHIBITOR THERAPY IMPROVES ENDOTHELIAL FUNCTION IN HIGH-RISK PATIENTS WITH CARDIOVASCULAR DISEASE
Authors: Kannenkeril Dennis , Bosch Agnes , Kolwelter Julie , Striepe Kristina , Pietschner Robert , Ott Christian , Schiffer Mario , Achenbach Stephan , Schmieder Roland E 
Published: January 2023

Background:
Impaired endothelial function predicts cardiovascular events. The aim of this study was to analyse the effect of evolocumab on endothelial function in patients with cardiovascular disease and on obligatory statin therapy.

Methods:
This was a prospective, double-blinded, randomized, controlled, single center study (NCT03626831) including patients with cardiovascular disease (diagnosis of coronary artery disease, non-hemorrhagic stroke, transient ischemic attack or symptomatic peripheral artery disease) and treated with statins, similar to the inclusion criteria of the FOURIER study. Patients were consecutively randomized (1:1) to either evolocumab treatment (420 mg was administrated in monthly intervals, twice during the study) or placebo. All patients underwent examination of endothelial function at baseline, and after 1, 4 and 8 weeks of treatment by a semi-automatic high-resolution ultrasound system (UNEX EF 18G; Unex Co., Nagoya, Japan). Endothelial function parameter such as flow-mediated vasodilation (FMD; vasodilator responsiveness), low flow-mediated vasocontriction (L-FMC; vasoconstrictor responsiveness) and vasoactive range (VAR; total vasomotor responsiveness) were measured.

Results:
103 patients with a mean age of 66.2 (±7.7) years and a mean LDL-cholesterol of 98.2 (±19.1) mg/dl completed the study. 83.5% of the study population was known to have coronary artery disease. Endothelial function parameter (VAR) increased after 8 weeks of treatment with evolocumab compared to baseline (p = 0.034), whereas there was no significant change at 1 and 4 weeks after treatment. Moreover, an improvement in VAR from baseline at week 8 was found with evolocumab compared to placebo (p = 0.045).
In a subgroup analysis, in patients with age < 67 years, lower systolic blood pressure (< 125 mmHg) or higher baseline LDL-cholesterol (> 95 mg/dl), significant evolocumab treatment effect was found in VAR improvement (p = 0.006, p = 0.049 and p = 0.042, respectively) from baseline at week 8. No serious adverse event related to study medication occurred during the study.

Conclusion:
Our data indicate that endothelial function could be improved with evolocumab treatment in high-risk patients with preexisting cardiovascular disease and on statin therapy. Our results contribute to the mechanistic explanation why lower incidence of the cardiovascular composite endpoint has been demonstrated in the FOURIER study.
PS-BPC02-5: IMPACT OF LONGITUDINAL CHANGES IN METABOLIC SYNDROME STATUS OVER TWO YEARS ON 10-YEAR INCIDENT TYPE 2 DIABETES MELLITUS
Authors: Koh Kwang Kon 
Published: January 2023

Background:
Temporal changes in MetS status over two years may modify the 10-year risk of incident diabetes mellitus (DM).

Methods:
A prospective cohort study was conducted in 7,317 adults aged 40–70 years without DM at baseline. Subjects were categorized into four groups based on repeated longitudinal assessment of metabolic syndrome (MetS) status over two years, as defined by ATP III guidelines: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models.

Results:
During the 10-year follow-up, 1,099 (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted hazard ratios (95% confidence interval) for new-onset DM were 1.27 (1.01–1.61) in the resolved MetS group, 1.78 (1.43–2.22) in the incident MetS group, and 1.85 (1.52–2.26) in the persistent MetS group (P for trend < 0.001). The 10-year risk of DM in subjects with resolved MetS was attenuated compared to those with persistent MetS over two years (P < 0.001). The adjusted hazard ratio for 10-year incident DM gradually increased according to the number of MetS components two years later.

Conclusions:
Temporal changes in MetS status over two years influenced the 10-year risk of incident DM, suggesting that determining the status of MetS regularly and strictly controlling MetS are important in preventing DM.
PS-BPC02-7: RADIAL-DIGITAL PULSE WAVE VELOCITY: STIFFNESS OF SMALL CONDUIT ARTERIES INCREASES AFTER NITROGLYCERIN ADMINISTRATION
Authors: Fortier Catherine , Garneau Charles Antoine , Pare Mathilde , Obeid Hasan , Cote Nadege , Duval Karine , Goupil Remi , Agharazii Mohsen 
Published: January 2023

Objective:
The alteration of the physiological stiffness gradient within larger vessels would increase the transmission of greater pulsatility to the microcirculation, thus explaining the damage to the pressure-sensitive organs. We aimed to describe the response of small conduit arteries of the hand (radial-digital PWV, rd-PWV) following the pharmacological alteration of the stiffness gradient using nitroglycerin.

Design and method:
Simultaneous application of piezoelectric sensors (Complior) at the level of the carotid (c), the radial artery (r) and the tip of the index finger (d) was used to calculate the rd-PWV by the following formula (rd-PWV = cd-cr direct distances/cd-cr transit times). Rd-PWV was obtained before and 4 minutes after a sublingual administration of 0.4 mg of NTG, in healthy adults (controls, n = 36) and patients with moderate chronic kidney disease (CKD, n = 30). Changes in arterial stiffness pre-post NTG and comparisons between the two groups were analyzed respectively with paired or independent samples t-tests.

Results:
Compared to controls, the CKD group was older (69 ± 15 years vs. 41 ± 20 years) and more hypertensive. Despite similar cd-PWV and cr-PWV, rd-PWV was significantly lower in CKD than in controls (3.6 ± 1.4 m/s vs. 4.5 ± 1.8 m/s, p = 0.024), but this difference faded (p = 0.145) after adjustment for age. Post NTG, brachial blood pressure decreased and heart rate increased similarly between groups (see Table 1). Cr-PWV decreased after NTG (both groups p < 0.001) while rd-PWV increased in controls (from 4.62 ± 1.49 m/s to 5.94 ± 2.29 m/s, p < 0.001) and in CKD (from 3.71 ± 1.60 m/s to 5.18 ± 2.12 m/s, p < 0.001), in a similar extent (p = 0.111 for interaction term). Cd-PWV significantly increased post-NTG only in the CKD group (p = 0.009).

Conclusions:
Again, we observed opposing changes in the regional stiffnesses of two distinct vascular territories following the administration of a vasodilator. Here, the two segments were mid-size and small conduit muscular arteries. This technique, adapted by our team for short peripheral arterial segments, may broaden our understanding of the consequences of the inversion of the stiffness gradient.
PS-BPC03-3: CARDIOVASCULAR EVENTS PREDICTION RELATED TO GENDER IN PATIENTS WITH HYPERTENSIVE EMERGENCIES IN 12-MONTHS FOLLOW-UP GREEK STUDY
Authors: Fragoulis Christos , Polyzos Dimitrios , Dimitriadis Kyriakos , Konstantinidis Dimitrios , Mavroudis Andreas , Leontsinis Ioannis , Kariori Maria , Drogkaris Sotirios , Tatakis Fotis , Manta Eleni , Siafi Eirini , Papakonstantinou Pantelis , Zammanis Ioannis , Thomopoulos Costas , Tsioufis Konstantinos 
Published: January 2023

Objective:
Currently, epidemiological data on prognosis of patients with hypertensive crises (hC) are limited. The purpose of our study was to register the prevalence and clinical characteristics of patients with hypertensive urgencies (hU) and emergencies (hE) admitting to the emergency department (ED) and during hospitalization and a 12-month follow-up to record new end points in a Greek tertiary hospital.

Design and method:
The study population included patients reporting to the ED with acute rise in blood pressure (BP) (systolic BP >or = 180mmHg and/or diastolic BP >or = 120mmHg), categorizing as hE and hU depending on the presence or absence of acute hypertension-mediated target organ damage, respectively. In all patients the demographic and clinical information were registered for 12 consecutive months. In addition, there was a 12-month follow-up for new events.

Results:
Out of 38,589 patients assessed in the ED during a period of 12 months, 353(0.91%) had HC, out of whom 256(72.5%) had hU and 97(27.5%) had hE. The mean age of the hE patients was 73 ± 12years, 51.5% were males and 86.4% had a history of hypertension. During the study period 3 hE patients did not complete the follow-up. After stratification of hE population by gender, we created two subgroups, males and females, and analyzed the composite end point involving deaths or hospitalizations by cardiovascular causality. Men reported more composite events than women (21 vs 11 events, p = 0.042, hR for males 2.2, 95% CI 1.03–4.6). Cox regression models were adjusted for age, gender, cardiovascular disease, chronic kidney disease and diabetes mellitus.

Conclusions:
The results indicate male gender as an independent risk factor for deaths or hospitalizations caused by cardiovascular disease in patients with hE. Our registry highlights the commitment for a more intensive follow-up of hE patients, especially for men, and underlines the need for further research in this pathological entity.
PS-BPC03-7: ARE OSCILLOMETRIC WAVEFORMS DIFFERENT IN PREGNANCY?
Authors: Ringrose Jennifer , Araneta Patricia , Chan Lillian , Kassam Jalisa , Wirzba Mira , Greef Kate , Ramsay Gillian , Sia Winnie , Khurana Rshmi , Bader Erin , Sridar Sangita , Padwal Raj 
Published: January 2023

Objective:
Hypertensive disorders of pregnancy are leading causes of maternal and perinatal morbidity and mortality. Automated blood pressure (BP) measurements are being used in clinical practice; however, understanding of how oscillometric waveform vary between pregnant and non-pregnant individuals remains low.

Design and Methods:
Pregnant individuals over 20 weeks gestational age and healthy, non-pregnant women were recruited. Healthy, non-pregnant women (HNP) were matched to healthy pregnant women (HP), and pregnant women with a hypertensive disorder of pregnancy (HDP) by age (± 10 years), arm circumference (± 6 cm), and BMI at the time of BP measurement (± 13 kg/m2). There were seven individuals in each group for a total of 21 participants. BP measurements were done per the International Organization for Standardization (ISO) protocol using a custom-built oscillometric device as the test device and 2-observer mercury auscultation as the reference measurement. Four pairs of auscultatory measurements and four oscillometric measurements were obtained for each participant. Baseline demographics, auscultatory BP and BP derived from slope-based and fixed ratio algorithms were determined. Oscillometric waveform and envelope features were compared among groups.

Results:
In HNP, HP, and HDP groups respectively: mean age was 31.3 ± 4.8; 32.1 ± 3.6; 32.0 ± 4.4 years; arm circumference 31.9 ± 3.3; 32.3 ± 4.9; 34.0 ± 3.3 cm; BMI 26.8 ± 3.8; 32.0 ± 7.2; 32.4 ± 3.7 kg/m2; mean auscultatory BP (systolic/diastolic) 103.3 ± 11.1/66.5 ± 7.4; 110.6 ± 4.0/56.9 ± 6.5; 132.6 ± 19.0/83.9 ± 13.3 mmHg. HDP had significantly higher auscultatory systolic (P < 0.05) and diastolic (p < 0.01) BP than the other groups. The pregnant groups (HP, HDP) had significantly higher heart rate (p < 0.01); higher pulses (p < 0.05) in the oscillometric waveform (OMV); lower average width in the pulses (p < 0.01); higher pressure amplitude at which the OMW peaks (p < 0.05) with longer time to reach this maximum pressure amplitude (p < 0.05); greater area under the curve (p < 0.01). Compared to HNP, the HDP showed significantly skewed OMW to the right (p < 0.01); greater spread in the OMW envelope (p < 0.05) and lesser random variation in the OMW envelope (p < 0.01). A typical OMV with the 3 groups superimposed is demonstrated in Figure 1.

Conclusion:
Significant differences in the oscillometric waveform morphology and parameters were found in pregnancy and in hypertensive disorders of pregnancy compared to healthy controls. These results suggest that pregnancy-specific algorithms may be required to optimize accuracy for oscillometric BP measurement.
PS-BPC03-8: MORNING BLOOD PRESSURE SURGE AND THE VASCULATURE: A COMPARISON BETWEEN YOUNG DIPPERS AND NON-DIPPERS FROM THE AFRICAN-PREDICT STUDY
Authors: Mokwatsi Gontse Gratitude , Schutte Aletta Elisabeth , Smith Wayne , Mels Catharina Martha Cornelia , Kruger Ruan 
Published: January 2023

Background and aim:
Adverse changes in large arteries and retinal microvascular calibres are predictors for hypertension and stroke. These adverse changes were reported in response to the suppressed night-time dipping as well as in hypertensive individuals with exaggerated morning surge. However, it is unknown whether young healthy individuals with normal morning surge, but with non-dipping night-time blood pressure profile, will already present with early onset of micro and macrovascular changes. We investigated the relationship of morning surge with retinal vessel calibres and large artery stiffness in healthy young dippers and non-dippers.

Methods:
We included black and white participants (N = 323), aged 20–30 years, determined sleep-trough surge. We determined central retinal artery and vein equivalents from fundus images, as well as carotid-femoral pulse wave velocity.

Results:
Dippers had a greater morning surge (within normal range) (p < 0.001) and a greater proportion of individuals with exaggerated morning surge (p < 0.001). In dippers only, we found a positive relationship between central retinal artery equivalent and morning surge (p = 0.040). In sensitivity analysis, the association between central retinal artery equivalent and morning surge in dippers lost significance (p = 0.09) when 24-hour diastolic blood pressure was replaced with night-time diastolic blood pressure. However, an independent negative association between central retinal artery equivalent and night-time diastolic blood pressure (p < 0.001) emerged. Normal morning surge of dippers was positively associated with central retinal artery equivalent (dependent on night-time dipping).

Conclusion:
Normal night-time dipping may therefore be involved in preserving retinal arteriolar diameter of dippers, which may reflect a lower vascular resistance.
PS-BPC03-9: EFFECTIVENESS OF MAY MEASUREMENT MONTH EDUCATIONAL PROGRAM ON KNOWLEDGE AWARENESS AND LIFESTYLE PRACTICES OF PATIENT WITH HYPERTENSION
Authors: Kaur Amrit 
Published: January 2023

Background:
Hypertension is not only an important risk factor for noncommunicable disease but also is a major cause of mortality and morbidity all over the world. Barriers to high blood pressure (BP) awareness and control are exacerbated by poor knowledge of the consequences and uncertainty regarding how to and who should direct care.

Aim:
To evaluates the effectiveness of educational program for improving knowledge awareness and health promoting lifestyle practices among patients with hypertension.

Objective:
1. to examine the knowledge and awareness about hypertension.in patient with hypertension.
2. To find out whether educational program is an effective tool for improving knowledge and promoting healthy lifestyle in patient with hypertension.

Methods:
This study was a case control intervention study on 100 patients with hypertension that were selected during may measurement month camp in our institute. Before the intervention both groups (50 subjects in each group) completed the HKLP questionnaire. (Hypertension knowledge and lifestyle practice scale).after completing the HKLP questionnaire case group an educational program was delivered through PPT and that group was provide one educational booklet. One month after the intervention both the group again completed the same questionnaire.

Results:
There was no significant difference in the mean age of both the groups. The mean of the total HKLP scores was significantly increased in the case group compared with the control group (p value is less than 0.05). Showed that mean score regarding hypertension knowledge and health promoting lifestyle behavior were significantly higher after than before program in case control group.

Conclusion:
In this study Hypertension educational program was effective in promoting knowledge and healthy lifestyle among patients with hypertension. Based on the relationship between lifestyle and hypertension it seems that implementing educational programs is essential to improve disease knowledge and lifestyle modification among patients with hypertension
PS-BPC04-4: PREVALENCE AND CLINICAL CHARACTERISTICS OF HYPERTENSION SUBTYPES ACCORDING TO HOME BLOOD PRESSURE CONTROL IN TREATED HYPERTENSIVE PATIENTS: A CROSS-SECTIONAL STUDY
Authors: Chotruangnapa Chavalit , Thammarux Tossaporn , Thongdang Piyawan 
Published: January 2023

Objective:
To identify the prevalence and clinical characteristics of the different hypertension subtypes according to home blood pressure (BP) control in treated hypertensive patients.

Design and method:
This study was conducted in Siriraj hospital, Mahidol University, Thailand during 2019 to 2020. We included treated hypertensive patients with at least 1 antihypertensive medications and had self-home BP measurement. Hypertension subtypes were normotension (NT) (all home BPs were less than 135/85 mmHg), isolated morning hypertension (MHT)(morning BPs were only at least 135/85 mmHg), isolated evening hypertension (EHT)(evening BPs were only at least 135/85 mmHg) and sustained uncontrolled hypertension (SHT)(all home BPs were at least 135/85 mmHg). We analyzed the clinical data to evaluate blood pressure control rate and identify the associated clinical factors in the other groups.

Results:
Our study included 1,435 participants. The prevalence of home BP control was 55.82%, 12.61%, 7.32%, and 24.25% in NT, MHT, EHT, and SHT, respectively. Overall mean age was 63 years. There were 39.58% men. SHT group had significantly the highest body mass index, proportions of alcohol drinking and evening administration of antihypertensive medications. The participants in EHT group used the highest number of antihypertensive medication classes and chronic kidney disease was most found in this group. The multivariable analysis showed the significant association of history of CVD with MHT (OR 2.93, 95%CI (1.46 to 5.85)). The albuminuria of at least 300 mg/g was the significant associated factor of EHT (OR 3.05, 95%CI (1.23 to 7.57)) and SHT (OR 2.20, 95%CI (1.14 to 4.27)). Aging (OR 0.98, 95%CI (0.96 to 0.99)), use of thiazide diuretics (OR 3.38, 95%CI (1.03 to 11.11)), sprironolactone (OR 5.68, 95%CI (1.38 to 23.33)) and peripheral alpha1 blockers (OR 3.90, 95%CI (1.16 to 13.11)) were also strongly associated with SHT.

Conclusions:
BP control rate was fair. There were different clinical characteristics and independent associated factors in each subtypes.
PS-BPC04-6: INCREASED VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY IS ASSOCIATED WITH LEFT ATRIUM ENLARGEMENT AND HIGH RDW-CV IN HYPERTENSIVE PATIENTS
Authors: Tsujino Takeshi , Ito Satoyasu , Naito Yoshiro , Asakura Masanori , Ishihara Masaharu 
Published: January 2023

Objective:
Visit-to-visit blood pressure variability (BPV) has been shown to be associated with incidence of atrial fibrillation and poor prognosis of heart failure with preserved ejection fraction (HFpEF). However, it is unknown why BPV induces AF or worsening of HFpEF. Objectives of this study are to investigate whether visit-to visit BPV affected cardiac remodeling and to explore the factors that associate with visit-to visit BPV.

Methods:
Out-patient with hypertension who received blood tests and echocardiography twice at an about 1-year interval in our hospital from 2014 to 2016 were included. Exclusion criteria were the number of blood pressure measurement less than 3, hospital admission between 2 tests, significant valvular heart disease, atrial fibrillation, hypertrophic cardiomyopathy, and hemodialysis. Visit-to visit BPV was evaluated with coefficient of variation of systolic blood pressure (SBP-CV) between 2 tests. Data were obtained from electronic health record of the hospital. Logarithmic transformations were used for values of red cell distribution width (RDW-CV) and left atrial volume index (LAVI) because they skewed to the left. Changing rate (Δ) of test value was calculated as follows: (2nd test value-1st test value)/[1st test value × test interval (years)]. This is a retrospective observational study and approved by the Institutional Ethics Committee.

Results:
One hundred and thirty-eight patients were included (median of age was 69, male 71%). In univariate analysis, SBP-CV was significantly correlated with age (P = 0.002), DBP-CV (P < 0.001), ΔlogLAVI (P = 0.001), logRDW-CV (P = 0.002), A wave (P = 0.011), and laxative use (P = 0.032). Multivariate analysis revealed that SBP-CV was significantly correlated with ΔlogLAVI (P = 0.009) and logRDW-CV (P = 0.022)

Conclusions:
Increase in visit-to-visit systolic BPV was associated with enlargement of left atrium and high red cell distribution width in patients with hypertension. Increased BPV was shown to be associated with impaired left ventricular (LV) diastolic dysfunction in cross sectional study. We found the association of increased visit-to visit BPV and enlargement of left atrium, the most sensitive marker of LV diastolic dysfunction, in longitudinal study for the first time. Experimental study using rats that received sinoaortic denervation showed that exaggerated BPV induced LV fibrosis and hypertrophy. BPV may cause LV diastolic dysfunction via LV fibrosis in patients with hypertension. We also found that SBP-CV was significantly correlated with RDW-CV. RDW-CV has been thought to be a marker of chronic inflammation. Chronic inflammation may causally relate to increased BPV.
PS-BPC04-9: IMPACT OF ATRIAL FIBRILLATION ON ACCURACY OF OSCILLOMETRIC BLOOD PRESSURE MONITORING IN CRITICALLY ILL PATIENTS FROM A LARGE REAL-WORLD DATABASE
Authors: Li Yuxi , Wang Beining , Fan Fangfang , Weng Haoyu , Zhang Long , Jiang Jie , Zheng Bo , Zhang Yan , Li Jianping 
Published: January 2023

Objective:
It is controversial to use oscillometric blood pressure (BP) monitors for BP measurement in atrial fibrillation (AF) patients due to the variation in stroke volume. Several recent studies revealed no significant difference in oscillometric and intra-arterial BP bias between AF and sinus rhythm (SR) patients, but the population sizes were limited. We performed a cross-sectional study based on an extensive real-world database to further demonstrate the impact of AF on the accuracy of oscillometric blood pressure monitoring in the intensive care unit setting.

Design and method:
Adult patients with AF or SR records were enrolled from Medical Information Mart for Intensive Care-III (MIMIC-III) database. Concurrently-recorded non-invasive oscillometric BPs (NIBPs) and invasive intra-artery BPs (IBPs) were extracted and classified as AF or SR group according to the heart rhythm. Pairwise comparison was performed on NIBP/IBP bias between AF and SR circumstances. Bland-Altmann plots were used to assess bias and limits of agreement. A multivariable linear mixed-effect model was used to adjust confounders. Subgroup and interaction analyses were performed.

Results:
2335 patients (71.95 ± 11.23 years old, 60.90% of male) were included. The systolic (SBP), diastolic (DBP), and mean (MBP) NIBP/IBP biases were not clinically different between AF and SR circumstances (SBP: AF vs. SR, 0.66 ± 19.64 mmHg vs. 1.21 ± 21.96 mmHg, P = 0.002; DBP: -5.29 ± 12.03 vs. -5.17 ± 11.54, P = 0.124; MBP: -4.45 ± 12.31 vs. -4.19 ± 12.61, P = 0.014). After adjusting age, gender, heart rate, arterial BP, and vasopressor usage, the effect of heart rhythm on NIBP/IBP bias was still within ± 5 mmHg for SBP and DBP [adjusted effect on SBP bias: 3.32 mmHg (95% CI 2.89 to 3.74), P < 0.001; DBP: -0.89 (-1.17 to -0.60), P < 0.001], while the effect on MBP bias was not significant [adjusted effect 0.18 mmHg (-0.10 to 0.46), P = 0.200].

Conclusions:
Atrial fibrillation would not significantly influence the accuracy of oscillometric monitoring in critically ill patients compared with sinus rhythm circumstance.