bluuebunny/crossref_metadata_2025_split huggingface dataset:
S-37-2: CIRCADIAN RHYTHM OF PERIPHERAL AND CENTRAL ARTERIAL BLOOD PRESSURES IN RELATION TO ALL-CAUSE MORTALITY
Authors: Huang Jianfeng , An Dewei , Cheng Yibang , Li Mingxuan , Huang Qifang , Sheng Changsheng , Zhang Dongyan , Guo Qianhui , Wang Ying , Liu Chuhao , Xu Tingyan , Wang Jiguang , Li Yan 
Published: January 2023

Objective:
Brachial blood pressure (BP) presents a circadian rhythm. Abnormal rhythms are associated with adverse outcomes. However, it is not clear about the circadian rhythm of central BP and its predictive value.

Methods:
The study participants were patients referred to the outpatient clinic of Ruijin Hospital for 24-hour ambulatory BP monitoring from the year 2017 to 2020. The 24-hour brachial and central ambulatory BP monitoring were performed with the use of the Mobil-O-Graph (Germany) monitors. Dipping, non-dipping, reverse dipping and extreme dipping were defined as a night-to-day systolic BP ratio of 0.8–0.9, 0.9–1.0, > 1.0, and < 0.8, respectively. In cross-classification analysis of brachial and central dipping status, extreme dipping and reverse dipping were grouped with dipping and non-dipping, respectively. The vital status of patients until Dec 2020 was ascertained according to the vital statistics of the Shanghai Center for Disease Prevention and Control.

Results:
In 26,023 enrolled patients (men 47.4%, average age 53.0 years) followed up for a median of 1.8 years, 120 deaths occurred. The prevalence of non-dipping (46.7% vs. 43.7%, respectively) and reverse dipping (16.0% vs. 13.1%) was significantly (P < 0.001) higher for central than for brachial BP. The hazard ratios (95% confidence intervals, [CI]) for all-cause mortality were statistically significant for reverse dipping (1.95 [1.18–3.23] and 2.37 [1.43–3.94], respectively), but not other dipping status, versus dipping in brachial and central BP, respectively. In the brachial and central cross-classification analysis, the prevalence of consistent dipping, consistent non-dipping, isolated central non-dipping, and isolated brachial non-dipping was 34.7%, 54.2%, 8.6%, and 2.5%, respectively. Taking the consistent dipping as reference, the hazard ratios (95% CI) for all-cause mortality were 1.83 (0.77–4.31), 1.34 (0.46–3.95), and 1.94 (1.20–3.15) for isolated central, isolated brachial and consistent non-dipping, respectively. Furthermore, cross-classification significantly improved the risk prediction of all-cause mortality with a net reclassification improvement index (95% CI) of 0.193 (0.069–0.304).

Conclusions:
Non-dipping and reverse dipping were more common for central than for brachial BP, and were associated with a higher mortality risk irrespective of brachial or central BP. Cross-classification of brachial and central dipping status further improved risk stratification.
S-37-4: TRANSCATHETER AORTIC VALVE REPLACEMENT DOES NOT RESULT IN SUSTAINED LOAD TRANSFER WITH INCREASED VASCULAR LOAD
Authors: Song Ning , Adji Audrey , Hungerford Sara , Namasivayam Mayooran , Hayward Christopher , Jabbour Andrew , Muller David 
Published: January 2023

Objectives:
Transcatheter aortic valve replacement (TAVR) is an effective treatment for aortic stenosis (AS) by reducing the load placed on the left ventricle (LV) by the stenotic valve. Although systolic pressure is reported to increase in 50% of individuals after TAVR, its effects on steady and pulsatile vascular load represented by the systemic vascular resistance (SVR) and impedance of the proximal ascending aorta (Zc) respectively is less well understood. Using a previously validated non-invasive load estimation technique, we investigated the valvulo-arterial interaction in AS patients pre- and post-TAVR.

Design and Method:
In AS patients being assessed for TAVR, the proximal thoracic aorta flows, LV volume and function were recorded using 3T cardiac magnetic resonance (CMR) using phase-contrast velocity quantification. Simultaneous radial tonometric pressure was acquired during CMR and brachial cuff pressure was recorded. Aortic pressure was derived offline using SphygmoCor 8.1 (AtCor Medical, Sydney) from radial pressure, and calibrated to brachial pressure. Flow was acquired at 5 cm above the aortic valve at the level of the pulmonary artery bifurcation to avoid flow artefact from the TAVR prosthesis. Baseline and follow-up measurements were made before and after treatment with TAVR. Values pre- and post-TAVR were compared, and indices of pulsatile arterial load were calculated using frequency domain analysis.

Results:
A total of 17 patients (mean age 80 ± 6 years, 7 females) were recruited, with a median follow up of 54.5 days post-TAVR. In the post-TAVR measurements, a significant improvement in aortic peak volumetric flow (336 ± 79 ml/s vs 389 ± 110 ml, P = 0.011) was observed with an associated reduction in peak aortic velocity (189 ± 65 cm/s vs 126 ± 24 cm/s, P = 0.002). However, there was no statistical difference in heart rate (70 ± 9 beats per minute vs 68 ± 12 beats per minute), mean central aortic pressure (98 ± 13mmHg vs 99 ± 11mmHg), or the steady vascular load parameters of SVR (1860 ± 513 dynes.s/cm5 vs 1999 ± 561 dynes. s/cm5, P = 0.284) and pulsatile load Zc of the aorta (119 ± 51 dynes.s/cm5 vs 106 ± 43 dynes.s/cm5, P = 0.102).

Conclusion:
TAVR relieves valvular obstruction but does not result in significant alterations of vascular load in the short to medium term. The previously reported acute load transfer immediately following TAVR appears to resolve with time. Further study examining the effect of TAVR on external LV work may help to elucidate the energy consumption by the vascular system after correction of valvular obstruction from AS.
S-37-6: THE PROMISE OF CUFFLESS BLOOD PRESSURE MONITORING IN MANAGING HYPERTENSION
Authors: Schutte Aletta E 
Published: January 2023

Although blood pressure measurement is perhaps the most common measurement done in clinical practice, many have started to challenge this procedure and calling for transformation in blood pressure monitoring. This is because blood pressure measurement in primary care has many problems, whether clinic, 24-hour ambulatory or home blood pressures are taken.
Cuffless blood pressure measurement technologies have been knocking on the door for years, with the first patents already registered over 20 years ago. With advancements in data science, machine learning, artificial intelligence, and mobile phone technologies, many start-ups and major global tech giants are now presenting to the end-user an array of highly innovative technologies. Cuffless monitoring includes many devices from wrist-worn watch-type devices to mobile phone tech (transdermal optical facial video processing or oscillometric finger pressing), wearable ultrasound patches, temporary graphene electronic tattoos, glasses, and even from a toilet seat.
These technologies has a major benefit, namely blood pressure being taken without any user awareness. But it also has the potential to harness long-term prognostic cardiovascular information over and beyond blood pressure that may become particularly useful. Continuous long-term cuffless monitoring will provide for the first time the opportunity to move from averaging snapshot readings to capturing the continuous dynamic fluctuations of blood pressure in a high-definition video recording.
There are, however, still several hurdles that need to be overcome before cuffless technologies can be implemented in clinical care. While biomedical engineers may exert their energy on ensuring that a cuffless innovation can accurately reflect brachial blood pressure, this is not the only aspect to consider. Manufacturers of conventional cuff-based devices have to painstakingly follow the ISO 81060–2:2018 Universal Standard to validate the device for accuracy. The rules are different for cuffless devices. Novel cuffless technologies vary substantially and use many techniques such as pulse transit time, pulse wave analyses, and ultrasound. The key question is whether these devices can accurately track the dynamic changes in blood pressure over time. Currently, an ISO 81060–3 standard is being developed to validate cuffless devices but due to the heterogenous technologies used by cuffless manufacturers there are major challenges.
For this and other reasons, the European Society of Hypertension has released a consensus statement that due to fundamental questions regarding the accuracy, performance and implementation of cuffless devices in practice, these devices cannot be recommended for clinical use, while recognising the considering potential.
S-38-7: CONTINUOUS NON-MUTAGENIC DNA DAMAGE IN PODOCYTES ACTIVATES PATHOGENIC MEMORY T CELLS THROUGH ALTERED DNA METHYLATION
Authors: Nakamichi Ran , Hayashi Kaori , Hishikawa Akihito , Chikuma Shunsuke , Yoshimoto Norifumi , Sugita Erina , Yoshida Eriko , Itoh Hiroshi 
Published: January 2023

Objective:
Chronic kidney disease (CKD) is a common cause of hypertension and a complication of uncontrolled hypertension. Recent epigenome-wide studies suggested the association of altered DNA methylation in blood cells with kidney function. However, the mechanism and pathological significance has remained to be adequately elucidated.

Design and method:
To investigate the significance of DNA double-strand breaks (DSBs) in podocytes, we generated podocyte-specific I-PpoI-expressing mice (podocin-Cre ROSA26-STOP- I-PpoI, referred as I-PpoI-mice). I-PpoI is a homing endonuclease which causes non-mutagenic DSBs.

Results:
I-PpoI-mice showed severe albuminuria at 6 weeks of age and developed nephrotic syndrome. The mice died because of renal failure around 24 weeks of age following rapid deterioration of renal function. MeDIP-seq analysis using isolated podocytes revealed that 5219 DMRs were identified, and 5212 hypermethylated DMRs were detected in I-PpoI mice. No significant correlation between DNA methylation levels and the distance from I-PpoI cutting sites was observed. Single-cell RNA seq analysis using renal cortex revealed a marked expansion of immune cells, especially CD8+ T cells exhibited a KLRG1low IL-7Rhigh memory precursor effector cell phenotype, with high expression of NKG2D receptors in I-PpoI-mice. The expression of murine NKG2D ligands, which are upregulated by DNA damages, increased in I-PpoI-mice podocytes. In addition, the expression of human NKG2D ligands, MICB, in glomeruli was upregulated in patients with various kidney diseases including hypertensive nephropathy. Whole T cell depletion prevented exacerbation of albuminuria and attenuated glomerulosclerosis and fibrosis in I-PpoI mice, and similar results was obtained by NKG2D blocking. Me-DIP seq analysis using peripheral blood cells, which revealed hypermethylated DMRs in I-PpoI mice were enriched in binding sites for the STAT1 transcription factor. I-PpoI-mice showed a significant increase in CD44high memory/activated phenotype cells of peripheral CD8+ T cell populations, which was similar phenotype of STAT1 knockout mice. The chimeric WT mice with bone marrow (BM) cells of I-PpoI-mice exhibited an increase in albuminuria temporarily, whereas the chimeric I-PpoI-mice with BM cells of WT mice prevented renal fibrosis and renal death.

Conclusions:
Continuous non-mutagenic DSBs altered DNA methylation regardless of the distance from the primary DSB sites podocytes. Podocyte DNA DSBs also altered methylome of blood cells, including CD8+ T cells, leading sustained changes in immune microenvironment of the kidney and also BM. These results suggest the altered immune microenvironment in the kidney may be a therapeutic target preventing exacerbating glomerulosclerosis and renal fibrosis following podocyte DNA damage in CKD.
S-39-4: PLASMA FROM SARS-COV-2 PATIENTS INDUCES OXIDATIVE STRESS AND ENDOTHELIAL DYSFUNCTION VIA ANGIOTENSIN II TYPE 1 RECEPTOR (AT1R)/P38 MAPK PATHWAY
Authors: Almutlaq Moudhi , Mansour Fatmah A , Alamri Hassan S , Alroqi Fayhan , Barhoumi Tlili 
Published: January 2023

Background:
Acute respiratory distress syndrome (ARDS) is a distinctive feature of severe COVID-19 infections that occurs mainly in patients with coexisting health problems, such as hypertension, atherosclerosis, and diabetes. Endothelial dysfunction is a major contributing factor during ARDS development in COVID-19 patients with pre-existing comorbidities.

Objective:
Studying the mechanism by which endothelial activation and dysfunction could provide a therapeutic target for COVID-19 treatment.

Design and method:
The current study measured endothelial dysfunction and oxidative stress by incubating human umbilical vein endothelial cells (HUVECs) with plasma from patients with mild, moderate, severe and extremely severe COVID-19. Using flow cytometry, wound-healing assays and phosphokinase arrays,

Results:
We detected increases in cell apoptosis; reactive oxygen species (ROS) formation; hypoxia-inducible factor-1 alpha (HIF-1 alpha), vascular cell adhesion molecule-1 (VCAM-1), and vascular endothelial growth factor receptor-1 (VEGFR-1) expression; viral entry; and inflammatory-related protein activity. We also found an impairment in the wound-healing process. Moreover, we found that AT1R blockade and P38 MAPK inhibition reversed all of these effects, especially in the severe group.

Conclusions:
These findings indicate that AT1R/P38 MAPK-mediated oxidative stress and endothelial dysfunction occur during COVID-19 infection.
S-41-5: NEW INSIGHTS INTO THE OPTIMAL ANTIHYPERTENSIVE THERAPY IN CKD PATIENTS
Authors: Ishimitsu Toshihiko 
Published: January 2023

Chronic kidney disease (CKD) is defined as continuous existence of reduced renal function, estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2, and/or proteinuria including microalbuminuria. CKD patients are not only prone to progress to renal failure but also at high risk for developing cardiovascular diseases (CVD) as the concept of cardio-renal syndrome is assumed. As the cause of CKD, diabetic kidney disease and nephrosclerosis are dominating and their progression is promoted by aging and lifestyle-related diseases (LSD) such as hypertension and diabetes. Therefore, in order to maximally prevent renal failure and CVD in CKD patients, aggressive intervention achieving strict control of LSD starting at its earliest stage is important. Renal function is generally evaluated by eGFR, however, the fundamental aspect of renal function is renal blood flow or renal plasma flow (RPF), and the decrease of RPF is compensated by the increase in filtration fraction yielding the maintenance of GFR value. Accordingly, if eGFR is less than 60, it should be recognized that the extent of renal injury is not mild but moderate or worse. However, the measurement of RPF requires laborious and invasive procedure. Albuminuria may reflect the increase in glomerular capillary pressure (glomerular hypertension) elicited by reduced nephron number but the urinary albumin excretion is highly variable and is not necessarily parallel to the degree of renal injury.
Among LSD, hypertension plays a pivotal role as the risk factor for renal failure and CVD, and the strict blood pressure control targeting < 130/80mmHg is recommended in the guidelines. As antihypertensive agents, renin-angiotensin system inhibitors such as ARB and ACE inhibitors are preferred because of dilating the efferent arterioles resulting in the alleviation of glomerular hypertension and the reduction in albuminuria. Calcium channel blockers have advantage in preserving RPF and GFR by dilating the afferent arterioles. In addition, recent randomized controlled trials have demonstrated that sodium-glucose cotransporter 2 inhibitors retard the GFR decrease in diabetic and non-diabetic CKD patients. Angiotensin receptor neprilysin inhibitor, now used for hypertension, has also been shown to reduce the risks of GFR decrease and worsening of renal function in heart failure patients. Nonsteroidal mineralocorticoid receptor antagonists are expected to provide renoprotective effects such as albuminuria reduction with affordable risk of hyperkalemia.
Thus, in future strategy of antihypertensive therapy for CKD aiming maximum renal and cardiovascular protection, practical evaluation of renal injuries at early stages and incorporation of drugs with new evidence are the key issues.
S-42-7: TELEMEDICINE FOR POST-COVID-19 MANAGEMENT OF HYPERTENSION
Authors: Yatabe Midori 
Published: January 2023

The pandemic has led to changes in regulations and reimbursement rules to generally favor telehealth, as well as increased public awareness and acceptance of virtual visits.
In Japan, the adoption of virtual video visits has been slow, largely due to regulations and reimbursement policies. For the whole country, much less than 1% of total outpatient visits has used virtual video visits.
Compared to traditional care, hypertension management using online digital solutions has a potential to improve care access and reduce untreated hypertension population.
Notably, hypertension is one of the best fit conditions to be managed by virtual care among various acute and chronic illnesses because the primary index of treatment is self-measured home blood pressure and effective medications with minimal side effects are available.
However, currently implemented hypertension telemedicine includes different styles of care delivery that needs to be taken into account when discussing remote hypertension management.
According to a report, telephone visits and video visits had lower proportion of visits with recorded blood pressure compared to in-person visits (Ye, JMIR Formative Research, 2022).
An ideal ICT-assisted management likely involves home blood pressure monitoring, team care with interactive lifestyle modification guidance, and audio-video visits.
Post-COVID-19 management of Hypertension can be enriched by combining remote blood pressure monitoring and virtual visits with digital therapeutics and mHealth services promoting lifestyle modifications.
The remaining challenge includes cost considerations and disparities that may arise from economic status, internet availability, and digital service familiarity.
Especially for a patient population whose primary or sole health condition needing medical attention is hypertension, total care with online visits may have advantage over other forms of care, offering convenience, care effectiveness using accurate BP assessment, and good cost profile.
In addition, online hypertension care employing properly-planned data structure can help generate a high-quality real-world dataset which may be used to evaluate the advances in quality of care using technologies.
S-43-1: THE CHANGING EPIDEMIOLOGY OF HYPERTENSION IN CHILDREN AND ADOLESCENTS
Authors: Lurbe Empar 
Published: January 2023

Some scientific concepts take time to overcome initial disbelief before they are finally embraced by the research community. One of these concepts is hypertension in children and adolescents. Little was known about childhood hypertension until the early 1980 s, mainly because blood pressure was not commonly measured in pediatric clinical practice. In the few cases blood pressure levels were determined to be abnormal in children, they were considered to be secondary hypertension resulting from an underlying condition. Even though secondary causes of hypertension tend to occur more often in hypertensive children than in adults, its prevalence is only about 1 percent overall, leaving primary hypertension especially in adolescents as the most frequent type.
Even when there are many studies that have assessed the prevalence of hypertension in children and adolescents, scientists have faced difficulties to state this prevalence for three main reasons. To begin with, blood pressure normally changes with increasing age and body size. This makes establishing a fixed cutoff for values of systolic and diastolic blood pressure elevation rather challenging. This difficulty has led to the use of percentiles based on age, sex, and height to define the normal distribution, with a hypertensive level of blood pressure in the 95th percentile or higher. Another obstacle is that there is a variety of different definitions of hypertension used by the three most recent clinical practice guidelines coming from Europe, the United States and Canada. The last challenge is focused on the beat-to-beat blood pressure variability, the definition of hypertension requires that systolic and/or diastolic blood pressure to be persistently higher than the established thresholds on three separate occasions. Many cross-sectional studies with only one single measurement of blood pressure have not been able to define the prevalence of hypertension.
The epidemiology of hypertension in childhood and adolescence can be linked to the worldwide obesity epidemic. Hypertension is more prevalent than before, with primary hypertension being the main type. It is well known that the factors related to primary hypertension can be modified, therefore childhood is a period in which prevention could be effective. If prevention is followed throughout childhood, it could contribute to a healthier young adulthood in the long run. Therefore, primordial prevention is an opportunity not to be missed.
S-44-1: SALTING A BIRD'S TAIL
Authors: Shimosawa Tatsuo 
Published: January 2023

It is needless to stress high-salt intake threaten cardiovascular diseases because of inrement of hypertension and social activities to reduce salt intake is beneficial for healthy longetivity. The pathophysiology of salt-induced hypertension has been studied and innapropriate handling of salt in the kidney, vascular reaction to the salt and recently interstitial accumulation of sodium are proposed mechanism.
In addition to raise blood pressure, too much salt may cause systemic effect such as regulation of immune responses. Not all patients are salt-sensitive in terms of blood pressure and we do not know if there are salt-sensitive and resistant in other physiological effect of salt or not. It is required to develop the diagnositic tools to find who is salt-sensitive and tools to keep patients under appropriate salt intake chronically. In this review, I am going to discuss salt-sensitivity, pathological effect of high salt intake and possible markers for salt-sensitive hypertension.