bluuebunny/crossref_metadata_2025_split huggingface dataset:
S-22-7: GENOMIC ANALYSES OF HYPERTENSION-ASSOCIATED DISEASES ACROSS ETHNIC GROUPS AND SPECIES
Authors: Kato Norihiro 
Published: January 2023

To explore genetic architecture of hypertension and end-organ damages, we performed integrative genomic analyses in both humans and inbred hypertensive rat strains.
In humans, noting that hypertension is more prevalent and contributes to the increased risk of stroke in people of East Asian ancestry, we performed a multi-stage GWAS for blood pressure (BP) principally in East Asians and meta-analysis in East Asians and Europeans. We reported 19 new genetic loci and ancestry-specific BP variants, conforming to a common ancestry-specific variant association model. Some of the ancestry-specific association signals are influenced by a selective sweep. These data provide new evidence for the role of common ancestry-specific variants and natural selection in ethnic differences in complex traits such as BP.
In rats, we also performed genomic analyses of BP and related phenotypes in spontaneously hypertensive rats (SHR) and their substrain, stroke-prone SHR (SHRSP). By integrating whole-genome sequencing, transcriptome profiling, genome-wide linkage scans (maximum n = 1415) and fine congenic mapping (maximum n = 8704) plus comparative analysis with human, transcriptome-wide association study (TWAS) datasets, we searched causal genes and causal pathways for the tested traits. The overall results validated the polygenic architecture of elevated BP compared with a non-hypertensive control strain, Wistar Kyoto rats (WKY). We identified 26 potential target genes, including rat homologs of human TWAS loci, for the tested traits. In this analysis, we re-discovered 18 genes that had previously been determined to contribute to hypertension or cardiovascular phenotypes. Notably, five of these genes belong to the kallikrein-kinin/renin-angiotensin systems (KKS/RAS), in which the most prominent differential expression between hypertensive and non-hypertensive alleles could be detected in rat Klk1 paralogs.
Furthermore, to unravel the mechanisms underlying antihypertensive drug-induced amelioration of end-organ damages, we performed transcriptomic analysis on the heart and the kidney, with administration of antihypertensive drugs to two inbred rat strains (SHRSP and WKY). Noticeable changes of mRNA expression were induced particularly by RAS blockade, for example, for genes in the natriuretic peptide system (Nppb and Corin) in the heart and for those in the KKS/RAS (Ren and rat Klk1 paralogs) and those related to calcium ion binding (Calb1 and Slc8a1) in the kidney.
Taken together, we provide genetic epidemiological evidence for ethnic differences in hypertension susceptibility and also in vivo experimental evidence supporting the presence of key disease pathways, such as KKS/RAS, likely across species.
S-23-2: CLINICAL SIGNIFICANCE OF WORK STRESS INDUCED INCREASE IN BLOOD PRESSURE IN HYPERTENSION MANAGEMENT
Authors: Munakata Masanori 
Published: January 2023

We usually spend about one third time of a day for working. So it is critically important for our health if the working condition is comfortable or stressful. In many developed countries including Japan, retirement age tended to be delayed due to several reasons. This means that we must spend more time for work in our life. Elderly people are vulnerable to brain and heart diseases. So the establishment of less stressful work condition and risk management is increasingly important to prevent work-related cardiovascular events or Karoshi.
Among 203 Karoshi cases received worker compensation in Japan, 60 % died of stroke while remaining cardiovascular diseases. For occupational factor, long working has been considered as a risk of Karoshi. Meta-analysis has also shown that long working hours are associated with increased risk of cardiovascular diseases, especially for stroke. In Karoshi cases, most prevalent risk factor was hypertension (40%). However, the review of literature has shown that the relationship between long working hours and blood pressure increase or hypertension is inconsistent. Interestingly, some data showed that long working hours are associated with lower risk of hypertension, suggesting that the relationship between working long hours and blood pressure increase is confounded by other factors like qualitative work stress. Karoshi unexpectedly occur. Therefore in a real world, we need to obtain an individual information on blood pressure response during work to adequately manage work-related hypertension.
Ambulatory blood pressure monitoring is an ideal method to monitor blood pressure behavior during work but is not practical to perform repeatedly with short duration. Self-measurement of blood pressure may replace ambulatory monitoring to examine work-related blood pressure variation. We studied 207 treated hypertensive subjects working for 29 Rosai hospitals. Blood pressures and heart rate were measured by themselves with an automated device at standardized conditions 4 times a day: after waking, 10:00 h, 16:00 h, and before sleep on three days (Monday, Friday, and Saturday or Sunday). We could observe clear daily and weekly variation of rate pressure product (systolic blood pressure × heart rate). The increase in rate pressure product on Monday morning was significantly correlated with urinary albumin excretion and job strain index in women. Our data showed the feasibility of self-monitoring of blood pressure and heart rate at workplace. This method would be useful to monitor work-stress related hypertension in several overwork situation.
S-24-3: CURRENT TREND OF HYPERTENSION PRACTICE BY SPECIALISTS AND NON-SPECIALISTS IN THE JAPANESE PRIMARY CARE SETTINGS - J-DOME STUDY
Authors: Eguchi Narumi , Asayama Kei , Katsuya Tomohiro , Hatori Yutaka , Miyakawa Masaaki , Noda Mitsuhiko 
Published: January 2023

Objective:
Measuring the quality of primary care practice in Japan is difficult due to insufficient clinical data. To change the situation, the first nationwide primary care registry trial in Japan called J-DOME was launched for type 2 diabetes mellitus in 2018, and expanded to assess hypertension by 2020. In this cross-sectional analysis, we compare the patients with hypertension managed by hypertension specialists with those by non-specialists in the primary care settings.

Design and Method:
A total of 2,161 patients with hypertension were registered in 2021 (1,583 by non-specialists and 578 by specialists). Data were registered to the web-based registry system directly by the participating doctors or their staff. Clinic office blood pressure (BP) captured at the last visit (mandatory item), and the most recent self-measured home BP (not mandatory) were registered. The registered data were analyzed and compared between the two groups classified by whether the physicians were hypertension specialists or not.

Results:
Average age, body mass index (BMI), and duration of hypertension were 69.7 years, 25.3 kg/m2, and 12.8 years in the non-specialist group and 70.5 years, 25.2 kg/m2, and 13.2 years in the specialist group, respectively. The average systolic/diastolic office BP was 134.9/75.2 mmHg in the non-specialist group and 134.9/75.7 mmHg in the specialist group, and patients with systolic BP > = 140 mmHg consisted of 34.2% and 35.8%, respectively. The average home BP was 127.9/75.7 mmHg in the non-specialist group (n = 722, 45.6% of this group registered home BP) and 125.9/74.9 mmHg in the specialist group (n = 419, 72.5%). The HbA1c in the hypertension non-specialist group averaged 6.6% compared with 6.2% in the specialist group (p < 0.001). The ratio of prescribed antihypertensive medications was significantly different between the non-specialist and specialist groups (Figure). As for education on sodium intake, 80.7% of the patients with non-specialists received the education compared to 91.8% of those with specialists, and the average daily sodium consumption was 9.0 g (n = 426) and 8.7 g (n = 365), respectively.

Conclusions:
Although the office BP and essential characteristics were similar, the evident differences between the specialist and non-specialist groups were identified in hypertensive medications and education on sodium intake. Furthermore, the number of home BP data registered in the non-specialist group was limited, which urges further promotion of home BP measurement. The J-DOME study will continue to call for far more registration to provide the benchmark of practice quality in Japanese primary care settings.
S-28-5: CIRCULATING ANGIOTENSIN CONVERTING ENZYME 2 ACTIVITY AS A CARDIOVASCULAR RISK MARKER IN A YOUNG HEALTHY POPULATION: THE AFRICAN-PREDICT STUDY
Authors: Gafane-Matemane Lebo F , Burrell Louise M , Patel Sheila K , Kruger Ruan , Schutte Aletta E 
Published: January 2023

Objective:
Cardiovascular disease (CVD) remains the major contributor to premature death globally, with black populations presenting with a disproportionate burden of CVD and early target organ damage. Renin angiotensin system dysregulation is a key factor involved in hypertension development and organ damage in black populations. Angiotensin converting enzyme 2 (ACE2) counteracts the deleterious effects of angiotensin II, and increased circulating ACE2 predicts cardiovascular events and mortality in the general population, and in patients with CVD. However, the role of ACE2 activity as a cardiovascular risk marker in young healthy individuals remains largely unclear. We explored ethnic and sex differences in ACE2 activity and associations between blood pressure (BP), left ventricular mass index (LVMi) and ACE2 activity in young healthy black and white adults.

Design and method:
We included 1134 black (men, N = 280; women, N = 285) and white (men, N = 277; women, N = 292) participants aged 20–30 years. The participants were normotensive at screening (BP≦140/90 mmHg) with no known CVD. Ambulatory systolic and diastolic BP were recorded and LVMi (m2.7) was obtained from echocardiography and plasma ACE2 activity measured using a validated assay.

Results:
Overall, mean plasma ACE2 activity was higher in black [1.33 pmol/min/ml (0.02; 19.6)] than in white [0.73 pmol/min/ml (0.02; 12.5)] participants, and higher in men [3.63 pmol/min/ml (0.02; 20.5)] than in women [0.28 pmol/min/ml (0.02; 9.87)] (both P < 0.001). When comparing ethnic groups according to sex, ACE2 activity was higher in black men and women than in white men and women (both P ≦ 0.012). After adjustments for covariates (ethnicity, sex, age, body mass index, socioeconomic status, physical activity, glucose, low density lipoprotein cholesterol, C-reactive protein, alcohol intake and smoking), 24-hour systolic BP was positively associated with ACE2 activity in the total group (R2 = 0.43; β=0.07; P = 0.019) and black men (R2 = 0.19; β=0.18; P = 0.007). There were no independent associations of diastolic BP and LVMi with ACE2 activity in any of the groups.

Conclusions:
24-hour systolic BP was independently and positively associated with ACE2 activity in the total group. When stratifying the group according to ethnicity and sex, a similar association was evident in black men, a group previously identified to be at high cardiovascular risk. The observed ethnic and sex differences in ACE2 activity and associations with BP suggest that ACE2 may be a useful biomarker in cardiovascular risk profiling in young populations.
S-28-8: THE ASCOT LEGACY COHORT: THE LONG-TERM EFFECTS OF BLOOD PRESSURE AND BLOOD PRESSURE VARIABILITY ON CARDIOVASCULAR AND RENAL OUTCOMES
Authors: Sever Peter , Gupta Ajay , Whiteley William , Godec Thomas , Rostamian Somayeh , Mackay Judith , Poulter Neil , Whitehouse Andrew 
Published: January 2023

Introduction:
We have previously shown that visit to visit systolic blood pressure variability (BPV) was the major predictor of cardiovascular outcomes in ASCOT, a trial in hypertensive participants randomised to amlodipine based or atenolol based treatment. Treatment differences in BPV accounted for the benefits of the amlodipine based regimen over the atenolol based regimen on cardiovascular (CV) events during the trial. We now report observations from the 20 yr follow up of UK participants to determine the long term impact of mean systolic blood pressure control during the trial and BPV on CV and renal outcomes.

Methods:
In the ASCOT Legacy Cohort, 7,092 hypertensive participants with hypertension, aged 40 to 79 years, with at least three other CV risk factors have been followed for up to 20 years. All available SBP visit records (n = 100,933) were included after excluding the first six months observations. The mean of SBP as a measure of BP control and the standard deviation (SD) of all SBPs as an estimate of visit to visit BPV were calculated for the five years of the trial. Participants were then followed for up to 15 years after the end of the trial using the UK National Health Service (NHS) electronic health records. CV and renal outcomes were measured using Cox proportional hazards model adjusted for confounding variables.

Results:
Although in trial mean SBP predicted long term CV and renal outcomes, SBP variability independent of mean SBP was a strong predictor of both CV and renal outcomes. (Table)
Those originally assigned amlodipine based (vs. atenolol based) treatment had a significantly reduced long term risk of risk of stroke [0.82, 0.72 to 0.93, p = 0.003], total CV events and procedures [0.93, 0.88 to 0.98, p = 0.008], total coronary events [0.92, 0.86 to 0.99, p = 0.024] and atrial fibrillation [0.91, 95% CI, 0.83 to 0.99, p = 0.030]. There was no significant difference in the incidence of heart failure, non fatal myocardial infarction and fatal CHD or renal events.

Conclusions:
Amlodipine based treatment conferred long term advantages over atenolol based treatment on several CV outcomes. Both mean SBP and BPV are strong predictors of long term CV and renal outcomes, but BPV, independent of mean BP, confers a significant additional risk and should be considered for future preventive and therapeutic strategies.
S-29-3: THE RELATIONSHIP BETWEEN VENTRICULAR-ARTERIAL COUPLING AND AEROBIC CAPACITY ACROSS THE CARDIOVASCULAR DISEASE CONTINUUM: FOCUS ON PROXIMAL AORTIC STIFFNESS
Authors: Pugliese Nicola Riccardo , Faita FRANCEsco , Ruschitzka Frank , Taddei Stefano , Williams Bryan , Canterin Francesco Antonini , Masi Stefano 
Published: January 2023

Objective:
Ventricular-arterial coupling (VAC) can be evaluated as the ratio between arterial stiffness (pulse wave velocity, PWV) and myocardial deformation (global longitudinal strain, GLS). We evaluated VAC across the cardiovascular disease continuum.

Design and method:
We introduced a Doppler-derived, single-beat technique to estimate aortic arch PWV (aa-PWV) in addition to tonometry-derived carotid-femoral PWV (cf-PWV). We measured PWVs and 3D-GLS in:
We evaluated peak oxygen consumption (VO2) and peripheral extraction (AVO2diff) using combined cardiopulmonary-echocardiography exercise stress.

Results:
aa-PWV was obtainable in all subjects and significantly lower than cf-PWV in all subgroups (p < 0.01). PWVs were directly related and increased with age (all p < 0.0001). cf-PWV/3D-GLS was similarly compromised in HFrEF (1.08 ± 0.36) and HFpEF (1.05 ± 0.22), while aa-PWV/3D-GLS was more impaired in HFpEF (0.69 ± 0.11) than HFrEF (0.60 ± 0.15; p < 0.01). Stage A-B had values of cf-PWV/3D-GLS and aa-PWV/3D-GLS (0.66 ± 0.25 and 0.47 ± 0.12) higher than controls (0.47 ± 0.10 and 0.40 ± 0.10) but lower than Stage C (all p < 0.01). Peak AVO2diff was inversely related with cf-PWV/3D-GLS and aa-PWV/3D-GLS (all p < 0.01). cf-PWV/3D-GLS and aa-PWV/3D-GLS independently predicted peak VO2 in the overall population (adjusted R2 = 0.32 and 0.35; all p < 0.0001) but only aa-PWV/3D-GLS was independently associated with flow reserve during exercise (R2 = 0.51; p < 0.0001).

Conclusion:
Abnormal VAC is directly correlated with greater severity of HF and worse functional capacity. HFpEF shows a worse VAC than HFrEF when expressed by aa-PWV/3D-GLS.
S-30-1: THE IMPORTANCE OF MULTIDISCIPLINARY INTERVENTION FOR THE PREVENTION OF CVD IN JAPAN
Authors: Kabayama Mai , Kamide Kei 
Published: January 2023

Preventing illness and promoting health is important for prolonging healthy life expectancy, and it also leads to the reduction of medical and long-term care costs. As Japan has entered a super-aged society, prevention of CVD, which causes stroke and dementia, the main causative diseases of the need for long-term care, is becoming more important. In addition, it is necessary to widely implement these CVD prevention strategy from an early stage. In other words, not only the tertiary preventive measures after the onset, but also the secondary preventive measures that extract high-risk populations and the primary preventive measures that approach the entire community are required.
Under these circumstances, the specific health checkup and specific health guidance system was started in 2008 in Japan. This system has a new concept in which medical insurers take the lead in implementing it, and aims to prevent the onset of illness by providing lifestyle modification support to people at high risk of metabolic syndrome. This system has been established nationwide and has been successful. On the other hand, there are not a few people who leave medical treatment of lifestyle-related diseases, discontinued treatment, or even have not received medical checkup, which is an urgent issue. It is expected that various medical professionals will provide health guidance for those undergoing treatment, encourage continuous treatment, support for improving adherence, along with the nationwide health promotion such as increasing the rate of people taking health checkup or improvement of healthy environment in the community and workplace.
The extension of healthy life expectancy for the entire nation will be realized by strengthening of cooperation between preventive intervention and medical care by various medical professionals. In the session, we will outline the current status of multidisciplinary collaboration efforts of health professionals in community, and introduce the examples of RCT results of nurse-led alcohol guidance effects in hypertensive outpatient clinics that we have conducted.
S-30-6: PROMOTION OF DIVERSITY AND INCLUSION (D&I) BY THE JAPANESE SOCIETY OF HYPERTENSION (JSH): JSH ASAHIKAWA DECLARATION
Authors: Nakamura Satoko 
Published: January 2023

The JSH D&I Committee has been developing various activities related to D&I since 2012. In 2018, we published JSH Statement: Asahikawa Declaration in Promotion of Diversity by the Japanese Society of Hypertension - the JSH Asahikawa Declaration in Hypertension Research. We would like to summarize the activities so far and make use of them in future activities.
First, we conducted a questionnaire on the web, grasped the current situation, and set numerical targets. Since then, we have promoted various activities in response to the needs of our members. (1) JSH Women Investigators Award presentation since 2015, (2) Setting up a committee booth at annual meetings to disseminate information, (3) As part of nurturing the next generation, cooperation with the nursery room, start of academic conference tours for children, and cooperation in plans for low-salt education, (4) Promoting website creation and publicity activities, (5) Holding unique lectures at annual meetings, (6) Discovering female human resources, and (7) Appointing medical professionals other than doctors to the committee.
Compared to 2014, the number of female members, medical specialists, councilors, chairpersons, speakers, committee chairs, etc. has increased.
In this way, D&I activities at JSH have started and are developing. As an activity for ISH2022, we will introduce the contents of a recent member awareness survey. We will continue to listen to the opinions and requests of our members, and we would like to develop it as a meaningful committee through concrete measures and initiatives.
S-31-4: STROKE BURDEN AND HYPERTENSION IN THE ASIA-PACIFIC REGION
Authors: Venketasubramanian Narayanaswamy , Chadachan Veerendra , Sule Ashish Anil , Tay Jam Chin , Chee Tek Siong , Wong Emmett Tsz Yeung , Koh Tian Hai , Low Lip Ping , Oh Vernon Min Sen , Wu Akira , Handa Pankaj , Teo Jimmy Boon Wee 
Published: January 2023

Background:
Stroke is a major cause of death and disability globally, especially in particular in the Asia-Pacific region, which is home to more than 4 billion people. Among the modifiable risk factors for stroke, hypertension is the strongest, but controllable to confer large outcome benefits.

Objective:
To investigate the association between hypertension and stroke burden in Asia-Pacific countries.

Design and Methods:
Stroke burden, as defined as age- and sex-standardised disability-adjusted life-years lost (DALYs) per 100,000 persons attributed to stroke, in Asia Pacific countries was extracted from the Global Burden of Disease (GBD) Study 2010. The age- and sex-standardised prevalence (%) of hypertension, defined as systolic blood pressure > 140 mmHg and diastolic blood pressure > 90 mmHg among adults aged 18 years or older, in these same countries was obtained from the World Health Organisation (WHO) database for 2015. Linear correlation was then estimated by calculating Pearson's product-moment correlation coefficient.

Results:
The stroke burdens expressed in terms of DALYs were obtained for 26 countries in the Asia Pacific region. The number of DALYs varied widely. being the lowest in Australia (398.2/100,000) and New Zealand (440/100,000), and the highest in Mongolia (4,409.8/100,000) and Indonesia (3,382.2/100,000). The prevalence of hypertension, also highly variable, was lowest in South Korea (11.0%) and Singapore (14.6%), and highest in Pakistan (30.5%) and Nepal (29.6%). There was a modest positive correlation between DALYs attributed to stroke and hypertension prevalence (r = 0.49). Approximately one-quarter of the variance in the DALYs due to stroke was predictable from the variability in hypertension prevalence across the Asia-Pacific region (r2 = 0.24).

Conclusion:
Both the burden of stroke and hypertension prevalence vary widely among Asian Pacific countries. There is a modest positive correlation between the two parameters. A significant amount of the variability in stroke burden is attributable to the variability in hypertension prevalence.