bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF CAROTID-FEMORAL PULSE WAVE VELOCITY AND RISK THRESHOLDS OF INDEX OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) IN HYPERTENSION
Authors: Chang Guili , Hu Yueliang , Ge Qian , Chu Shaoli , Avolio Alberto , Zuo Junli 
Published: June 2023

Objective:
As index of arterial stiffness, carotid-femoral pulse wave velocity (cfPWV) is strongly associated with cardiovascular risk. This study aimed to assess association of cfPWV and cardiovascular disease (CVD) in a Chinese hypertensive cohort and determine the cfPWV threshold value for assessment of future risk of CVD.

Design and method:
This cross-sectional study was conducted in hospital in-patients with multiple CVD risk factors or complications due to target organ damage. cfPWV was measured with the Complior device (Alam Medical, France) and central aortic pressure (cAP) with the SphygmoCor device (AtCor Medical [CardieX], Sydney) giving cAP indices: augmented pressure (AP), augmentation index (Aix), aortic pulse pressure, (aPP) aortic systolic pressure (aSBP). Framingham Risk Scores (FRS) were computed for all participants. Criteria specified by American College of Cardiology and American Heart Association were used to calculate atherosclerotic cardiovascular disease (ASCVD) risk scores. Patients were stratified by ASCVD risk threshold of 10% and divided into two groups: ASCVD >10% or ASCVD<10%. cfPWV cut-off value associated with or without ASCVD risk was obtained by receiver operating characteristics (ROC) curve.

Results:
All participants (n = 630; age 63.6 ± 8.6 years, 61.7% male) had primary hypertension. aAP, AIx, aPP, aSBP and were greater in females than in males (p < 0.001); ASCVD risk scores and brachial diastolic pressure (DBP) were higher in males (p<0.05). All hemodynamic indices showed significant correlation with ASCVD and FRS, except for AIx with no correlation with ASCVD. In multivariate logistic analysis, cfPWV was significantly associated with ASCVD risk (OR: 1.324, [1.119–1.565], p < 0.001) after adjusting for age, gender, smoking, body mass index, total cholesterol, fasting blood glucose, antihypertensive treatment, statin treatment, DBP. Area under the ROC curve was 0.758 and 0.672 for cfPWV and aortic SBP (p < 0.001 and p < 0.001, respectively); the critical value of cfPWV and aSBP was 12.5 m/s (sensitivity 63.2%; specificity: 77.8%) and 124.5 mmHg (sensitivity 63.9%; specificity: 65.3%). cfPWV significantly correlated with the ASCVD risk.

Conclusions:
The optimal cut-off value of cfPWV for assessing future CVD risk in the hypertensive population in China is 12.5 m/s.
PREVALENCE, AWARENESS AND TREATMENT OF CARDIOVASCULAR RISK FACTORS IN HEALTH PROFESSIONALS IN THE CARDIOVASCULAR FIELD: AN ITALIAN PILOT STUDY
Authors: Rosei Claudia Agabiti , Pinto Rita Del , Mengozzi Alessandro , Bressa Stefano , Malerba Paolo , Cacciatore Marco , Ghignatti Simone , Fama’ Francesca , Arenare Giulia , Curcio Rosa , Muiesan Maria Lorenza , Grassi Guido , Ferri Claudio 
Published: June 2023

Objective:
Physicians and researchers in the cardiovascular (CV) field are constantly engaged in the promotion of guidelines-directed preventive measures, but whether they are themselves adherent to the same recommendations was only sporadically assessed.

Design and method:
During the annual meeting of the Italian Society of Hypertension (October 2022), a pilot observational study on consecutive volunteer health professionals was conducted. Participants underwent three standard sitting and two standing (1-3 minutes) blood pressure (BP) measurements and answered a questionnaire regarding modifiable/not modifiable CV risk factors and related treatments. Hypertension was defined as BP more then 140 and/or 90 mmHg or as a pre-existing diagnosis. Orthostatic hypotension was defined as a decrease of systolic BP more then 20 mmHg or of diastolic BP more then 10 mmHg; orthostatic hypertension was defined as an increase of systolic BP more then 20 mmHg or of diastolic BP more then 11 mmHg.

Results:
In total, 62 participants (30F, mean age 43.2±14.8 years; 74.2% non-smokers) were enrolled; 79% reported regular physical activity; 53% of women and 38% of men were on a low-salt diet. Dyslipidemia was the most common risk factor (17.7%), but only 63.3% were on a statin; 22.6% had high BP, of whom 50% were unaware; 1.6% and 16.4% had orthostatic hypo- and hypertension, respectively.

Conclusions:
Despite the specific professional involvement, room for improvement in self CV risk factors awareness and management was detected in the examined exploratory sample of health professionals. This pilot research anticipates forthcoming, larger studies during national and international meetings.
EARLY MORNING HEMODYNAMIC CHANGES AND LEFT VENTRICULAR HYPERTROPHY AND MORTALITY IN HEMODIALYSIS PATIENTS
Authors: Mallamaci Francesca , Tripepi Rocco , Torino Claudia , Tripepi Giovanni , Sarafidis Pantelis , Zoccali Carmine 
Published: June 2023

Objective:
Amplified early morning increase in BP, a phenomenon accompanied by a parallel rise in heart rate (HR), is a marker of high cardiovascular risk in the general population. The early morning changes in these parameters have not been investigated in the hemodialysis population.

Design and method:
In a pilot, single center, study including a series of 58 hemodialysis patients we measured the pre-awakening BP and HR surges and the nocturnal dipping of the same parameters as well as other established indicators of autonomic function (weighted 24h systolic BP and HR variability) and tested their relationship with the left ventricular mass index (LVMI) and with the risk of death over a median follow up of 40 months.

Results:
The pre-awakening HR surge (r = -0.46, P = 0.001) was inversely associated with LVMI and the risk of death [HR (1 unit): 0.89, 95% CI: 0.83-0.96, P = 0.001] while the corresponding BP surge largely failed to associate with these outcomes. The link between the pre-awakening HR surge with LVMI and death was robust and largely independent of established risk factors in the hemodialysis population, including the nocturnal dipping of BP. Weighted 24h systolic BP and HR variability did not correlate with LVMI (all P>0.11) nor with the risk of death (P>0.11) and these parameters were also independent of the nocturnal dipping of systolic BP and HR.

Conclusions:
This pilot study suggests that the low early morning changes in HR, likely reflecting enhanced sympathetic activity, entail a high risk for LVH and mortality in the hemodialysis population.
COMPARING THE CARDIOVASCULAR RISK ESTIMATION IN YOUNG ADULT PATIENTS WITH TYPE 1 DIABETES: STENO F1RISKENGINE VS. ESC-EASD 2019 RISK TABLE
Authors: Kuzior Agnieszka , Rios-Gomez Carlos , Ojeda Borja Santana- , Leon-Durango Ricardo Jose De , Hernandez-Lazaro Alba , Arnas-Leon Claudia , Acosta-Calero Carmen , Ortiz-Hernandez Catherine Pino , Perez-Rivero Jennifer Maria , Martinez-Martin Francisco Javier 
Published: June 2023

Objective:
Adult patients with type 1 diabetes (T1DM) have very high cardiovascular risk, which is typically underestimated in daily clinical practice. The ESC-EASD risk table (2019) for both type 1 and type 2 diabetes is based on categorical variables, ignores specific variables such as HbA1c and yields an imprecise risk estimation (moderate, high or very high). The rarely used Steno T1RiskEngine predicts the 5-year and 10-year risks of a cardiovascular event and of terminal kidney disease, both absolute and relative to the reference population. We undertook to compare the results of both cardiovascular risk calculations in a group of young adult patients with T1DM.

Design and method:
Retrospective analysis of the data from consecutive patients with a sufficient collection of clinical data was performed. Informed consent was obtained from all patients. The ESC/EASD 2019 risk table is available at doi:10.1093/eurheartj/ehz486; the Steno T1RiskEngine is described in doi:10.1161/CIRCULATIONAHA.115018844 and the calculator is available online: (https://steno.shinyapps.io/T1RiskEngine1)

Results:
30 patients were included, 18 women (60%), aged 32±9 years. According to the ESC/EASD table, 2 (6.7%) had moderate risk, 16 (53.3%) had high risk and 12 (40%) had very high risk. With the Steno T1RiskEngine the median risk of cardiovascular event was 6.4% (IQR 2.7-9.3%) at 5 years and 12.4% (IQR 5.9-17.6%) at 10 years, with medians of 1.7% and 3.4% in the reference population (relative risks 376% and 365% at 5 and 10 years); the median risk of terminal kidney disease was 2.9% (IQR 1.2-6.7%) vs. 0.8% in the reference population (relative risk 362%). By cardiovascular risk categories, with the Steno T1RiskEngine we obtained 3 patients (10%) with moderate risk, 13 (43.3%) with high risk and 14 (46.7%) with very high risk, without significant difference vs. the ESC/EASD categorization (Chi2 p = 0.72).

Conclusions:
The cardiovascular and renal risk of our adult patients with T1DM is very high (>3.5x the reference population risk); the ESC/EASD categorisation of cardiovascular risk does not significantly differ from that of the T1RiskEngine. However, the Steno T1RiskEngine yields a more precise estimation of the individual risks and should be used more frequently.
VALIDATION OF AN OSCILLOMETRIC DEVICE FOR BRACHIAL-ANKLE PWV: PRELIMINARY RESULTS
Authors: Jadoon Maryam , Khettab Hakkim , Justin Junior , Boutouyrie Pierre , Bruno Rosa Maria 
Published: June 2023

Objective:
Arterial stiffness is independent and clinically relevant prognostic biomarker, which can be measured by different techniques, including carotid-femoral Pulse wave velocity (cfPWV), Branchial-ankle PWV baPWV. The aim of this study is to investigate if there is an agreement between ankle-branchial and Carotid-femoral pulse wave velocity.

Design and method:
The carotid- femoral and Branchio-ankle Pulse wave velocity of 30 patients coming for routine clinical checkup of cardiovascular risk evaluation were measured with SphygmoCor CVSM (Atcor Medical, Australia) and WatchBP Office Vascular (Microlife, Widnau, Switzerland). The mean of left and right leg measurements was used for calculating baPWV, whereas the mean of two measurements on the right side (median for 3) was used for cfPWV. The Bland-Altman Analysis was used for finding the agreement between the two types of pulse wave velocities.

Results:
30 patients (63% men, age 66.89 ± 12.75 years, BMI 25.73 ± 3.84 kg/m2, MBP 92.866 ± 10.13 mmHg). CfPWV was 9.80 ± 2.56 m/s and baPWV was 14.24± 2.37 m/s. cfPWV and baPWV were linearly correlated with each other (r = 0.598, p = 0.0005). Both were positively correlated with age (cfPWV: r = 0.6083, p = 0.0004; baPWV r = 0.4716, p = 0.0103). The two metrics showed significant bias (bias CI95% 4.836, 95.0% lower confidence limit 0.901, 95.0% upper confidence limit 8.77).

Conclusions:
In a population of individuals undergoing cardiovascular screening, a significant bias between Cf-PWV and Ba-PWV was found, in accordance with previous studies. cfPWV and baPWV are correlated each other and showed a similar correlation with age. Larger head-to-head studies are needed to explore differences in relationship with risk factors.
DAYTIME SUPINE BLOOD PRESSURE NORMALIZED BY 24-HOUR VALUES INDEPENDENTLY PREDICTS FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE
Authors: Gasecki Dariusz , Kowalczyk Kamil , Kwarciany Mariusz , Botouyrie Pierre , Laurent Stephane , Narkiewicz Krzysztof , Karaszewski Bartosz 
Published: June 2023

Objective:
Blood pressure (BP) after ischemic stroke (IS) may follow various patterns. Post-event acute BP alterations mirror both stroke and patient characteristics, and resolve over time, yet their clinical significance is low or uncertain. Whether individual BP variations, based on a single standardized measurement normalized by a background BP course, have a distinct significance for stroke outcome remains unknown. We hypothesized that the BP difference index (BPD) between daytime supine resting and a series of surrounding BP values (daytime, 24-hour (24h)) in the subacute phase of IS is associated with functional outcome.

Design and method:
we included 131 IS patients [age 60.8 ± 12.5 years, median (NIHSS) score 5 (3-8)]. Office BP measurements and continuous 24-hour BP monitoring were performed on day 7 after stroke onset. The daytime period was defined as the interval from 6 a.m. to 10 p.m. Functional outcome was evaluated 90 days after stroke using the modified Rankin Scale (mRS) with an mRS score of 3 to 6 (dependency or death) considered as a poor outcome.

Results:
In a univariate analysis, high BPD was significantly associated with a poor stroke outcome (p = 0.001, 0.003, and 0.002 for systolic, diastolic, and mean BP, respectively, irrespective of the normalization subperiod (daytime, 24h). In a multivariate analysis, the predictive value of BPD remained significant only for systolic BP [SBP] normalized by daytime or 24h mean (OR, 1.06; 95% CI, 1.01-1.11; p = 0.02) after adjustment for covariates. Moreover, the relationship was stronger in a subgroup of patients able to walk independently (mRS 0-2) on day 7 after stroke onset (adjusted OR, 1.08; 95% CI, 1.01-1.17; p = 0.049 for SBP normalized by daytime or adjusted OR, 1.09; 95% CI, 1.01-1.18; p = 0.03 for SBP normalized by 24h mean).

Conclusions:
We found that the higher difference between supine resting and daytime or diurnal mean BP in patients in the subacute phase of ischemic stroke is independently associated with a poor outcome. This BP index might be useful in clinical practice, including therapeutic decisions, but needs broader studies in patient populations of stroke subtypes.
RELATIONSHIP BETWEEN SKELETAL MASS INDEX AND DIFFERENT OBESITY METABOLIC PHENOTYPES AMONG ADOLESCENTS IN CHINA
Authors: Tong Lingling , Ma Xiaoyan , Tian Mei , Ding Wenqing 
Published: June 2023

Objective:
To explore the relationship between skeletal mass index (SMI) and different obesity metabolic phenotypes among adolescents,and to provide a theoretical basis for the prevention and control of obesity and related metabolic diseases in adolescents.

Design and method:
A total of 1352 adolescents aged 12-18 were randomly selected for questionnaire survey,physical measurements,body composition determination and laboratory testing. Multiple logistic regression analysis was used to analyze the correlation intensity between SMI and different metabolic phenotypes of obesity.

Results:
The metabolically unhealthy normal weight (MUNW) phenotype, metabolically healthy obesity(MHO) phenotype and metabolically unhealthy obesity(MUO) phenotype had lower levels of SMI compared to the metabolically healthy normal weight(MHNW) phenotype among adolescents,with all differences being statistically significant(P-values were all less than 0.001). Similar results were found after stratification by sex. Multiple logistic regression analysis showed that after adjusting for sex, SMI were protective factors for MUNW phenotype, MHO phenotype and MUO phenotype in adolescents(P-values were all less than 0.001),with the 0.86(95%CI:0.85,0.92),0.78(0.75,0.82) and 0.73(0.70,0.76) increased risks of MUNW phenotype, MHO phenotype and MUO phenotype associated with each unit rise in SMI, similar results were found after stratification by sex.

Conclusions:
SMI were protective factors for MUNW phenotype, MHO phenotype and MUO phenotype among adolescents. Attention should be paid to the assessment and supervision of adolescent skeletal muscle quality when prevented obesity and related metabolic risks,reducing the risk of abnormal cardiovascular metabolism in adolescents.
MEDIATING EFFECTS OF MUSCLE MASS ON THE ASSOCIATION BETWEEN FAT MASS AND BONE MINERAL CONTENT IN CHINESE ADOLESCENTS AGED 12-18 YEARS
Authors: Tong Lingling , Ma Xiaoyan , Tian Mei , Ding Wenqing 
Published: June 2023

Objective:
To explore whether muscle mass (MM) is a mediator in the pathway of fat mass (FM) on bone mineral content (BMC) and determine the proportion of the mediation effect.

Design and method:
A total of 1852 adolescents (1130 boys, 61.02%) aged 12 to 18 years in China were randomly selected through a stratified cluster sampling. BMC, FM and fat free mass (FFM) were assessed using bioelectrical impedance analysis (BIA), and calculated MM. Mediation analysis was applied to determine direct and indirect effects of FM on BMC through MM.

Results:
Mediation analysis results showed that,after controlling for gender and age, MM can partially explain the association of FM on BMC( = 0.028,95%CI: 0.025,0.030;P<0.001) and its proportion of mediation effect was 75.7%. Stratified by gender,after adjusting for age,indirect effects through MM on the FM-BMC association were estimated at 0.030(mediation effect = 73.2%) in boys and 0.027(mediation effect = 84.4%) in girls (P<0.001 for both).

Conclusions:
The association between fat mass and bone mineral content is in part mediated through increasing in muscle mass. Muscle mass mediates the effect of fat mass on bone mineral content.
THE ASSOCIATION OF CIRCULATING SERUM IRISIN LEVELS WITH GLUCOSE AND LIPID METABOLISM IN CHINESE ADOLESCENTS AGED 12∼18 YEARS
Authors: Tong Lingling , Ma Xiaoyan , Tian Mei , Ding Wenqing 
Published: June 2023

Objective:
Irisin is an exercise-regulated myokine inducing browning of white adipose tissue and has gained interest as a potential new strategy to combat type 2 diabetes mellitus and dyslipidemia. The aim of this study was to evaluate the possible relationships between circulating serum irisin levels with glucose and lipid metabolism in Chinese adolescents.

Design and method:
This cross-sectional study included 1219 adolescents aged 12 to 18 years. Serum irisin levels were evaluated by enzyme-linked immunosorbent assay and all participants’ fasting blood glucose (FBG) and lipids,including totalcholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) were measured. Multiple linear regression was used to study the effect of irisin on glucose and lipid metabolism.

Results:
There were several significant negative correlations between circulating irisin and FBG (r = -0.120, P<0.001), TC(r = -0.091, P<0.001), LDL-C(r = -0.088, P = 0.002) and HDL-C(r = -0.094, P<0.001) across the study. In multivariate linear regression analysis, after controlling for potential confounders such as gender, age and BMI, irisin levels were independently associated with FBG( = -0.115, P<0.001), TC( = -0.078, P = 0.003), LDL-C( = -0.073, P = 0.005) and HDL-C(r = -0.087, P = 0.001).

Conclusions:
We found that serum irisin levels were inversely correlated with glucose and lipid metabolic parameters including FPG, TC, LDL-C and HDL-C,suggesting that irisin may play a crucial role in glucose and lipid metabolism from an early age.
OFFICE BLOOD PRESSURE VARIABILITY AND INSTABILITY IN CHILDREN, ADOLESCENTS AND YOUNG ADULTS: ASSOCIATION WITH PRECLINICAL ORGAN DAMAGE
Authors: Theodosiadi Aikaterini , Ntineri Angeliki , Kollias Anastasios , Kyriakoulis Konstantinos , Menti Ariadni , Ntousopoulos Vasileios , Stathopoulou Panagiota , Zeniodi Maria , Stambolliu Emelina , Servos George , Moysakis Ioannis , Destounis Antonios , Vazeou Andriani , Stergiou George S. 
Published: June 2023

Objective:
To evaluate the association of systolic blood pressure (SBP) variability and instability within a single office visit with preclinical target organ damage in young individuals.

Design and method:
Apparently healthy individuals aged 6-25 years referred for elevated blood pressure (BP) were subjected to triplicate office BP measurements in a single visit and 24h ambulatory BP monitoring. SBP variability and instability were quantified using (i) standard deviation (SD) (ii) coefficient of variation (CV) (iii) average real variability (ARV) (iv) maximum office SBP (v) maximum-minimum office SBP difference (MMD) (vi) ratio of difference between 1st-3rd measurement to the average office SBP (Relative change). Preclinical organ damage was evaluated by (i) carotid intima-media thickness (cIMT), (ii) carotid-femoral pulse wave velocity (PWV; Complior device), and (iii) echocardiographic left ventricular mass index (LVMI).

Results:
301 individuals were analyzed (mean age 13.8±3.7 years, 66.8% males, BMI z-score 1.12±0.95, average office BP 122.6±16.9/72.5±10.7 mmHg, 24h ambulatory BP 119.1±11.4/67.8±6.8 mmHg). LVMI measurements were available in 258 participants, IMT in 208 and PWV in 60. LVMI, IMT and PWV were associated with office SBP (r = 0.30/0.23/0.42, respectively, p< = 0.001), 24h ambulatory SBP (r = 0.35/0.33/0.48, p< = 0.001) and maximum office SBP (r = 0.31/0.30/0.41, p< = 0.001). LVMI and IMT were associated with SD (r = 0.14/0.15, p<0.05) and MMD (r = 0.13/0.15, p<0.05), while IMT and PWV with age (r = 0.31/0.38, p<0.001). Other indices of variability were not associated with indices of organ damage. In stepwise multivariable linear regression models (independent variables: age, sex, BMI z-score, office SBP, 24h ambulatory SBP, maximum office SBP, SD, MMD), LVMI was determined by BMI z-score and 24h ambulatory SBP, IMT by age, male sex and 24h ambulatory SBP, and PWV by 24h ambulatory SBP.

Conclusions:
These results suggest that in young individuals the variability and instability of office SBP within a single visit are not associated with preclinical organ damage.
IMPACT OF THE NUMBER OF OFFICE VISITS ON DIAGNOSING HYPERTENSION PHENOTYPES IN YOUNG INDIVIDUALS
Authors: Stathopoulou Panagiota , Kollias Anastasios , Menti Ariadni , Ntineri Angeliki , Zeniodi Maria Elena , Theodosiadi Aikaterini , Ntousopoulos Vasileios , Kyriakoulis Konstantinos , Vazeou Andriani , Stergiou George S. 
Published: June 2023

Objective:
To investigate the impact of measuring office blood pressure (BP) in an increasing number of visits on diagnosing hypertension phenotypes in young individuals.

Design and method:
Young individuals referred for elevated BP and healthy volunteers aged 6-25 years were evaluated with office BP measurements (3 visits; triplicate measurements; average of the last 2) and 24-hour ambulatory BP monitoring (ABP). Normotension (NT) was defined as normal office and ABP; Sustained hypertension (HT) as elevated office and ABP; White-coat hypertension (WCH) as elevated office but normal ABP; Masked hypertension (MH) as normal office with elevated ABP.

Results:
Analysis included 273 individuals (mean age 13.9±3.8 years, 69.6% males, BMI 24.6±4.8 kg/m2). Average office BP at 1st visit was 122.0±16.4/72.9±10.7 mmHg, systolic/diastolic, average of first 2 visits 120.6±15.4/72.3±10.2 and average of 3 visits 119.8±15.1/72.0±9.7 mmHg. The prevalence of NT, HT, MH and WCH was: 1st visit 55/17/8/20% respectively; average of first 2 visits 61/16/10/13%; average of 3 visits 63/15/11/11% respectively. The agreement between the 1st and the average of 1st-2nd visit was 92% for NT diagnosis (kappa = 0.83), 98% for HT (kappa = 0.92), 98% (kappa = 0.87) for MH and 92% for WCH (kappa = 0.70). The agreement between the 1st visit and the average of all 3 visits was 91% for NT (kappa = 0.81), 97% for HT (kappa = 0.89), 97% for MH (kappa = 0.83) and 91% for WCH (kappa = 0.64). Last, the agreement between ABP and office BP measurements for BP elevation was 72% for the 1st visit (kappa = 0.35), 77% for the average of the 1st-2nd visit (kappa = 0.41) and 78% for the average of 3 visits (kappa = 0.44).

Conclusions:
These findings suggest that in young individuals at least 2 office visits are required for optimal office BP evaluation which has reasonable agreement with ABP.