bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPC05-4: DIASTOLIC FUNCTION AND STROKE VOLUME MEASURED BY ECHOCARDIOGRAPHY IS RELATED TO PROGRESSION OF FRAILTY IN ELDERLY HYPERTENSIVE OUTPATIENTS
Authors: Toba Ayumi , Ishikawa Joji , Harada Kazumasa 
Published: January 2023

Objective:
In hypertensive patients, echocardiographic measures of cardiac structure and function were related to cognitive dysfunction and frailty in cross sectional studies; however, longitudinal relationship of these parameters has not been elucidated. We investigated whether stroke volume and diastolic function in echocardiography was predictive of worsening of cognitive function and frailty for 3 years.

Design and Methods:
Among 330 hypertensive patients who were registered in the frailty clinic and underwent echocardiography, 93 patients were followed up for 3 years. We evaluated stroke volume and diastolic function in echocardiography, frailty status evaluated as Kihon checklist (KCL), and cognitive function measured as mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA).

Results:
Patients’ mean age was 78.8 ± 7.1 years old (58% male). KCL score remained or decreased in 50 (54 %) patients after 3 years of follow up (7.1 ± 4.7 points to 5.7 ± 4.7), and increased in 43 (46 %) patients (6.1 ± 4.1 to 8.9 ± 4.4). Between those whose KCL score increased and remained or decreased, there were no statistical difference in history of hypertension, heart failure, diabetes mellitus, stroke and type of antihypertensives; however, MMSE and MoCA score at follow up was higher in patients whose KCL score remained or decreased (MMSE: 27.8 ± 2.5 vs 26.7 ± 3.3, p = 0.24, MoCA: 22.2 ± 4.0 vs 20.7 ± 5.2, p¬ = 0.036). Ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e’) at baseline was lower in patients whose KCL score remained or decreased (E/e’ septal 11.8 ± 3.0 vs 14.4 ± 5.5 p = 0.01). Other value for diastolic function was not related to the change of KCL score. Logistic regression analysis revealed E/e’ septal was independently associated with an increased KCL score even after adjusting for age, sex, BMI, history of hypertension, diabetes mellitus, heart failure, and KCL score at baseline (p = 0.036, odds ratio = 0.89). On the other hand, E/e’ was not significantly different in the parallel analysis according to domains of physical function, nutritional state, cognitive function, and depressive mood in KCL. Systolic volume in echocardiography at baseline was related to change in physical function in KCL at follow up (r = -0.226, p = 0.028).

Conclusions:
E/e’ in echocardiography at baseline was predictive of worsening of frailty status, measured as KCL score, at 3 years later.
PS-BPC01-6: BRACHIAL-ANKLE PULSE WAVE VELOCITY IS USEFUL FOR CARDIOVASCULAR RISK ASSESSMENT IN WELL-TREATED HYPERTENSIVE PATIENTS WITH CORONARY HEART DISEASE
Authors: Maruhashi Tatsuya , Kajikawa Masato , Kishimoto Shinji , Harada Takahiro , Hashimoto Yu , Yusoff Farina Mohamad , Nakano Yukiko , Nakashima Ayumu , Takase Bonpei , Tomiyama Hirofumi , Yamashina Akira , Higashi Yukihito 
Published: January 2023

Objective:
Measurement of brachial-ankle pulse wave velocity (baPWV) has been performed for the assessment of arterial stiffness. The purpose of this study was to determine whether baPWV is useful for cardiovascular risk assessment in treated hypertensive patients with a history of coronary heart disease (CHD).

Design and method:
This study was a post hoc analysis of Flow-mediated Dilation Japan Study A, which is a prospective multicenter observational cohort study. A total of 447 treated hypertensive patients with a history of CHD were enrolled to assess predictive value of baPWV for future cardiovascular events. The primary outcome was a composite of coronary events, stroke, heart failure, and sudden death.

Results:
The primary outcome occurred in 64 patients during a median follow-up period of 47.6 months. When using a blood pressure ≧ 130/80 mmHg as a reference, blood pressure < 130/80 mmHg was significantly associated with a lower risk of the primary outcome after adjustments for other cardiovascular risk factors in treated hypertensive patients with CHD (hazard ratio, 0.59; 95% confidence interval [CI], 0.35–0.99; P = 0.04). In well-treated patients with CHD who had a blood pressure < 130/80 mmHg, baPWV ≧ 1736 cm/s, that was derived from receiver-operator characteristic curve analysis, was significantly associated with a higher risk of the primary outcome after adjustments for traditional cardiovascular risk factors (hazard ratio, 2.83; 95% CI, 1.02–7.91; P = 0.04).

Conclusions:
The achievement of the target blood pressure is important to reduce the risk of cardiovascular events in treated hypertensive patients with a history of CHD. In well-treated hypertensive patients with CHD, baPWV is useful for cardiovascular risk assessment.
PS-BPC07-8: ARTERIAL HYPERTENSION AS PROGNOSTIC MARKER IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION AND EARLY PERCUTANEOUS CORONARY INTERVENTION
Authors: Reuter Hannes , Fassbender Patricia , Zander Wilhelm , Halbach Marcel , Hoffmann Fabian 
Published: January 2023

Objective:
Strong evidence points to the prognostic value of renin angiotensin system (RAS)-inhibitors (ACE inhibitors or AT1-receptor blockers) and beta blockers (BB) in the secondary prevention after myocardial infarction (MI). However, adequate dosing of these drugs is often limited due to their blood pressure lowering effects, especially early after MI. The present study therefore sought to identify differences in rates of prescription, persistence and dosing of RAS-inhibitors and BB early after acute ST-elevation MI (STEMI) and its impact on survival in hypertensive and non-hypertensive patients.

Design and method:
1003 consecutive patients with adjudicated STEMI treated by early percutaneous coronary intervention (PCI) between 2007 and 2011 in a single centre as part of the Cologne Infarction Model (KIM) were retrospectively dichotomized according to their history of arterial hypertension at the time of hospital admission. Comparisons were made using students T-test. Qualitative analyses were done using Chi square-test or given as odds ratio (OR (95% KI).

Results:
Mean age was 63 ± 13 years, body mass index 27 ± 5 kg/m2, 24% were women. 749 patients were diagnosed with hypertension. Mortality was 11.3% at 30 days and 17.2% at 1 year follow up. History of hypertension at time of hospital admission was significantly associated with lower mortality on follow up (OR, at 30 days: 0.41 (0.27–0.64), at 1 year 0.37 (0.26–0.53)). Long term persistence to RAS-inhibitors was significantly higher in hypertensive patients compared to non-hypertensives (84% vs. 70%, p = 0.004). However, persistence to BB did not differ between groups (88% vs 86%, n.s.). At discharge the rate of prescription of RAS-inhibitors and BB was significantly higher in hypertensive patients (RAS-inhibitors: 87.3% vs. 69.8%, p < 0.001; BB: 92.8% vs. 84.3%, p < 0.001). In addition, the defined daily dose (DDD) among patients receiving RAS-inhibitors at discharge was higher in hypertensive versus non-hypertensive patients (DDD: RAS-inhibitors, 0.40 vs. 0.30, p < 0.001), whereas there was no difference for BB. At 30 days and at 1 year follow up survival was significantly associated with the prescription of RAS-inhibitors as well as BB at discharge.

Conclusion:
Patients with a history of hypertension show higher prescription rates at discharge, better long-term persistence as well as higher individual dosing of RAS-inhibitors after STEMI. This, as well as the higher prescription rates of BB, may contribute to the better survival that we observed in STEMI patients with history of hypertension compared to non-hypertensive controls.
PS-BPC08-3: CATHETER-BASED ADRENAL ABLATION: AN ALTERNATIVE THERAPY FOR PATIENTS WITH ALDOSTERONE-PRODUCING ADENOMA
Authors: Sun Fang , Liu Xiaoli , Zhang Hexuan Hexuan , Zhao Zhigang , He Hongbo , Yan Zhencheng , Li Yingsha , Li Qiang , Li Yaoming , Jiang Jun , Zhu Zhiming 
Published: January 2023

Objective:
Unilateral adrenalectomy is the standard treatment for patients with aldosterone-producing adenoma (APA), but it lacks an option for patients with APA who refuse or are not suitable for surgery. In this study, we studied whether catheter-based adrenal ablation for APA is comparable to adrenalectomy.

Design and method:
A total of 1180 hypertensive patients were screened, and 112 patients with APA were recruited and counseled on the treatment options. Fifty-two patients opted for catheter-based adrenal ablation, and 60 opted for adrenalectomy. Clinical and biochemical outcomes were assessed at 6 months after treatment. Factors associated with hypertension remission, advantages and limitations of this approach were evaluated.

Results:
According to the primary aldosteronism surgical outcome (PASO) criteria, complete and partial clinical success was achieved in 21 (40.4%) and 23 (44.2%)patients in the ablation group vs. 33 (55.0%) and 23 (38.3%) patients in the adrenalectomy group. Complete and partial biochemical success was achieved in 30 (57.7%) and 17 (32.7%) patients in the ablation group vs. 51(85.0%)and 5 (8.3%) patients in the adrenalectomy group, respectively. The overall clinical (84.6% vs 93.3%) and biochemical (90.4% vs 93.3%) success rates were not significantly different between the two groups (P > 0.05). Factors associated with adrenal ablation-mediated hypertension remission were hypertension duration and serum potassium level at baseline. Compared with surgery, adrenal ablation requires a shorter operating time and time to resume physical activity.

Conclusions:
Catheter-based adrenal ablation may bean alternative and feasible option for APA patients unwilling surgical treatment.
PS-BPC08-4: IMPACT OF TESTOSTERONE REPLACEMENT THERAPY ON 24-HOUR AMBULATORY BLOOD PRESSUR E MEASUREMENTS IN MALES WITH OPIOID-INDUCED ANDROGEN DEFICIENCY. A PLACEBO-CONTROLLED RCT
Authors: Olesen Thomas Bastholm , Glintborg Dorte , Olsen Michael Hecht , Andersen Marianne Skovsager 
Published: January 2023

Objective:
The primary aim was to investigate the effects of testosterone replacement therapy (TRT) on 24-hour ambulatory blood pressure (24hABPM) in opioid-treated men with relative hypogonadism. The secondary aim was to evaluate potential effect modification of baseline body composition and red blood cell measurements on the impact of TRT on 24hABPM.

Design and methods:
This was a double blinded and placebo controlled study. Men aged > 18 years, treated with an opioid dosage > 50 mg opioid/day were eligible for inclusion if total testosterone (TT) was < 12 nmol/L. Participants were randomized to TRT (1,000 mg testosterone undecanoate) or placebo at 0, 6 and 18 weeks. Participants were examined before and during 24 weeks of TRT/placebo.

Results:
The two groups (TRT, n = 15 and placebo, n = 20) were comparable at baseline. TRT was associated with numerical increase in 24hABPM. The difference in changes from baseline of daytime systolic blood pressure (SBP) was 5.2 mmHg (P = 0.134) between the TRT group and the placebo group. In subgroup analysis, baseline values of body mass index (BMI), hematocrit (Hct) and hemoglobin (Hgb) levels displayed significant positive interaction on the effect of TRT on change in SBP compared to placebo. In participants with BMI above the study median (30.7 m2/kg), daytime SBP change from baseline was 17.6 mmHg [10.6, 24.6] (P = 0.002) in the TRT group and 0.4 mmHg [-5.5, 4.7] (P = 0.864) in the placebo group. In participants with Hct levels above the study median (0.43%), daytime SBP increased 8.4 mmHg [-1.9, 18.8] (P = 0.09) in the TRT group and decreased -2.3 mmHg [-11.3, 6.8] (P = 0.564) in the placebo group. Similarly, in participants with Hgb> 8.7 mmol/L daytime, SBP change was 11.2mmHg [0.6–21.7] (P = 0.041) in the TRT group and -2.9 mmHg [-4.1, 9.9] (P = 0.367) in the placebo group. Baseline cIMT also increased the strength of association between TRT and change in SBP.
After adjusting for delta-BMI, delta-Hct remained significantly associated with increase in daytime SBP. An increase in 1 mmHg SBP was associated with an increase in Hct of 0.11% [0.10–0.22] (P = 0.032).

Conclusions:
Baseline levels of BMI, Hct, Hgb and cIMT, influence the effect of TRT on BP. The magnitude of BP increase is associated with increase in Hct levels.
PS-BPC08-8: SEX DIFFERENCES IN IN THE SCREENING CUTOFFS OF PRIMARY ALDOSTERONISM
Authors: Nozato Yoichi , Yamamoto Koichi , Akasaka Hiroshi , Takami Yoichi , Rakugi Hiromi 
Published: January 2023

Title:
Sex differences in in the screening cutoffs of primary aldosteronism

Objective:
In screening for primary aldosteronism (PA), simultaneous measurements of plasma aldosterone concentration (PAC; pg/mL) and plasma renin activity (PRA; ng/mL/hr) and the resulting PAC/PRA ratio (ARR) > 200 have been actively employed. Because of the low stability and reproducibility of PRA, screening using active renin concentration (ARC; pg/mL), which can overcome these problems, is desirable but has not become a mainstream screening method in practice. This study will clarify the association between ARC and PRA and examine the impact of sex differences on PA screening.

Methods:
1631 consecutive patients (1018 inpatients (51.5%; male) and 613 outpatients (58.1%; male)) who had measured PRA and ARC simultaneously at Osaka University Hospital from February 2017 to December 2020 were analyzed retrospectively. In the inpatients, blood samples were taken in the supine position at rest in the early morning. In outpatients, blood was collected without specifying the blood collection conditions. PRA, ARC, and PAC if blood was collected at the same time were analyzed. PRA was measured by enzyme immunoassay. Each of PAC and ARC was measured by chemiluminescent immunoassay. All results are represented as median (25th to 75th percentile). For the analysis of variables association Mann Whitney`s U t test was used for comparison of each measurement between the two groups, with 5% significance level.

Results:
PRA and ARC were correlated in the overall population and by sex (overall; r = 0.78 p < 0.0001, male r = 0.90 p < 0.0001, female r = 0.71, P < 0.0001). Analysis of covariance showed a significant difference in the regression line between PRA and ARC by sex (p < 0.0001) and PRA/ARC was significantly lower in males (0.17 [0.13–0.22] vs 0.19 [0.14–0.26] p < 0.0001). In the inpatients, PRA, ARC and PAC was significantly higher in males (PRA; 1.1 [0.4–2.9] vs 0.7 [0.3–1.7] p < 0.0001, ARC; 6.6 [3.0–16.8] vs 4.4 [1.8–8.3] p < 0.0001, PAC; 137 [100–196] vs 130 [88–185], p = 0.003,). PAC/PRA, PAC/ARC were significantly lower in males (PAC/PRA; 120 [47–307] vs 179 [81–335] p = 0.0002, PAC/ARC; 20 [8–45] vs 32 [16–63] p < 0.0001). In the outpatients, both PRA and ARC, PAC were also significantly higher, and PAC/PRA and PAC/ARC were significantly lower in males(PRA; 1.3 [0.6–3.4] vs 0.8 [0.4–2.4] p < 0.0001, ARC; 6.8 [3.4–15.1] vs 4.4 [2.0–11.1] p < 0.0001, PAC; 137 [98–198] vs 158 [116–220] p = 0.003, PAC/PRA; 106 [44–226] vs 179 [70–380] p < 0.0001, PAC/ARC; 20 [10–40] vs 36 [15–72] p < 0.0001).

Conclusion:
Significant differences in PRA, ARC, PAC, PRA/ARC, PAC/PRA, and PAC/ARC were observed by the sex. Sex differences should be considered in screening for PA by ARR and PAC/ARC.
PS-BPC09-6: THE IMPACT OF LOW VERSUS HIGH INTENSITY ISOMETRIC HANDGRIP EXERCISE TRAINING ON REDUCTION OF BLOOD PRESSURE IN INDIVIDUALS WITH HYPERTENSION-A RANDOMIZED DOUBLE BLINDED CONTROLLED TRIAL
Authors: Kharva Dharmishtha J. , Thakar Vidhi V. 
Published: January 2023

Title:
The Impact of Low Versus High Intensity Isometric Handgrip Exercise Training on Reduction of Blood Pressure in Individuals with Hypertension: A Randomized Double Blinded Controlled Trial

Objectives:
The primary objectives of the study are to investigate the effects of low and high-intensity isometric handgrip training in the reduction of blood pressure in individuals with hypertension and to identify which one out of three-intensity isometric handgrip training has a greater effect on blood pressure reduction. A secondary objective is to evaluate the extent of adherence to IHG exercise training among the three IHG training groups.

Design and Method:
Randomized controlled with parallel group, multiple arm trial. Participants and therapists were blinded to group allocations, with the allocation concealment handled by a Sequentially numbered, sealed opaque envelope method. Randomization with computer generated random number table was done into three IHG training groups. A total of 75 Individuals with hypertension were randomized into the following three isometric handgrip exercise groups: Group A 5% MVC (Control group) (n = 25), Group B 30% MVC (Intervention group) (n = 25), Group C 90% MVC (Intervention group) (n = 25). Participants were given 4-week of IHG exercise training at their homes by the therapist. At baseline and the end of 4 weeks, B/L blood pressure was measured and compared between groups. Adherence to the IHG exercise training was recorded in the exercise log after each exercise session. Trial Registration: CTRI/2022/01/039346 [Registered on: 12/01/2022] - Trial Registered Prospectively

Results:
A total of 60 participants completed the 4-weeks of IHG training and at baseline, they were similar (p > 0.05). From baseline to 4-weeks we have found statistical and clinically significant changes of > 7 mmHg in SBP and > 4 mmHg in DBP in all three groups. However, there was no significant difference was obtained between groups. For exercise adherence, 87% to 92% of participants completed the sessions.

Conclusion:
According to the findings of our study, Isometric handgrip exercise is effective in reducing blood pressure for individuals with hypertension but there is no significant difference in blood pressure for different intensities of IHG exercise training
PS-BPC10-4: THE CLINICOPATHOLOGICAL FINDINGS IN NON-DIABETIC CKD PATIENTS WITH CARDIOVASCULAR AUTONOMIC NEUROPATHY
Authors: Kuno Hideaki , Kanzaki Go , Oba Rina , Sasaki Takaya , Haruhara Kotaro , Koike Kentaro , Tsuboi Nobuo , Yokoo Takashi 
Published: January 2023

Background:
Cardiovascular autonomic neuropathy (CAN) is common as the process of kidney injury. Coefficient of variation of R-R interval (CVR-R) is one of the most convenient, noninvasive tests of heart rate variability, and is widely used to assess cardiac autonomic nerve function. However, the clinical and pathological findings in non-diabetic CKD patients with CAN has not been fully elucidated. This current study investigated the characteristics of non-diabetic CKD patients with CAN diagnosed by CVR-R.

Method:
Subjects who underwent percutaneous kidney biopsy and performed CVR-R test at the Jikei University School of Medicine Hospital, Tokyo, Japan were retrospectively examined. Patients with arrhythmia, diabetes, and post transplantation were excluded. CAN was defined using the reference values of CVR-R based on age and sex. The proportion of glomerulosclerosis (GS) and interstitial fibrosis/tubular atrophy (IF/TA) were assessed. The severity of arteriosclerosis was determined by the extent of thickening of the intima: grade0 = intimal thickening< thickness of media grade1 = intimal thickening> thickness of media.

Results:
Ninety subjects were identified (Age 45.7 ± 14.9 (mean ± SD) years old; Male 56%; heart rate 69 ± 11 /min; eGFR 60.0 ± 29.5 mL/min/1.73m2; 24h-urinary protein excretion 0.55 [0.24–1.30] (median [IQR]) g/day; CVR-R rest 3.7 ± 1.7%; GS 11.6 [3.6–24.8] %, IFTA 20 [10–30] %.) Eleven patients were diagnosed as CAN, with nephrosclerosis [n = 4], acute tubulointerstitial nephritis [n = 2], IgA nephropathy [n = 1], IgA vasculitis [n = 1], membranous nephropathy [n = 1], lupus nephritis [n = 1], and focal segmental glomerular sclerosis [n = 1]. Patients with CAN had a higher triglyceride (P = 0.030) and higher IF/TA(P = 0.005) than those without CAN. The severity of arteriosclerosis increased in patients with CAN. (P = 0.017)

Conclusion:
These results indicated that that arteriosclerosis and IF/TA were associated with CAN in non-diabetic CKD patients.
PS-BPC10-7: EFFECT OF ORAL POTASSIUM CHLORIDE SUPPLEMENTATION ON THE THIAZIDE-SENSITIVE SODIUM CHLORIDE COTRANSPORTER (NCC) IN HEALTHY HUMANS: A RANDOMISED CROSSOVER TRIAL
Authors: Wu Aihua , Wolley Martin , Mayr Hannah , Cowley Diane , Li Bo , Welling Paul , Campbell Katrina , Fenton Robert , Stowasser Michael 
Published: January 2023

Objective:
The putative “renal-K+ switch’’ mechanism links low K	+ intake with Na+-dependent Na+ retention and involves activation of NCC in the distal convoluted tubule in response to low K+ intake and suppression in response to high K+ intake. This study used urinary extracellular vesicles (uEVs) to examine NCC abundance and phosphorylation in healthy adults on a high Na+ diet to determine tubular responses to alterations in K+ (in the form of KCl) intake.

Design and method:
The study design was a double blind, randomised and placebo-controlled trial. Healthy adults maintained on a high Na+ (∼200mmol/day), low K+ (∼60mmol/day) diet underwent a run-in period of 1-week followed by a crossover study, with 5-day supplementary KCl (active phase, Span K, 24mmol thrice daily) or 5-day placebo administered in random order and separated by 2-day washout. After each phase, blood and 24-hour urine were collected for biochemistry, and spot urine for uEV analysis were collected for progressive ultracentrifugation. Participants who met dietary compliance (greater than 80%) and urinary response requirements were included in analyses.

Results:
Among the 23 (out of 28) participants who met inclusion criteria, supplementary KCl administration (verses placebo) in the active phase was associated with markedly higher levels of plasma K+ and 24-Hour urine levels of K+, Cl- and aldosterone, and lower levels of 24-Hour urinary Na+/K+ (Table 1). Among 18 participants who met inclusion criteria and whose uEV were successfully isolated, KCl intake was associated with less abundant NCC (fold change [FC](KCl/placebo) = 0.74 [0.30, 1.69], p < 0.01) and pNCC (FC = 0.81 [0.19, 1.75], p < 0.05) (Figure 1). Correlation analyses revealed an inverse correlation of plasma K+ with NCC (R2 = 0.11, p = 0.05) and delta urinary K+ with delta pNCC (R2 = 0.23, p = 0.04). Ambulatory systolic blood pressure positively correlated with timed urinary Na+/K+ (R2 = 0.08, p = 0.04) during interventions.

Conclusions:
In healthy adults on a high Na+ low K+ diet, supplementary KCl administration was associated with reductions in NCC and pNCC in uEVs, consistent with the “renal-K+ switch’’ mechanism, and offers a useful target for dietary intervention.