bluuebunny/crossref_metadata_2025_split huggingface dataset:
TESTOSTERONE INDUCES POSTMENOPAUSAL HYPERTENSIVE HYPERTROPHY THROUGH INHIBITING THE ACTIVATION OF AMPK- FOXO1/MURF1 SIGNALING PATHWAY
Authors: Zhu Lulu 
Published: June 2023

Objective:
It has been found that relative elevated level of testosterone could exacerbates postmenopausal hypertensive left ventricular hypertrophy(PM-HTN-LVH), but the mechanisms responsible are unknown. Moreover, MuRF1, a muscle-specific E3 ubiquitin ligase in the ubiquitination process, was newly identified as a negative regulatory factor of myocardial and muscle tissue in exerting a protective functions on the cardiomyocyte hypertrophy. There are little study to certify whether MuRF1 took part in testosterone-induced PM-HTN-LVH.

Design and method:
Femal spontaneously hypertensive rats (SHR) were ovariectomized (OVX group) or sham-operated (Sham group) at 12 weeks and then the OVX group were intramuscularly injected the testosterone (T 2.85 mg/kg/ quaque omni die im) (OVX+T group) or vehicle (OVX+ vehicle group) for 4 weeks. Futher, Cultured cardiomyocytes were respectively stimulated with different concentration gradients of testosterone for 24h, then measured the expression of myosin heavy chain (MHC) and MuRF1, as well as the phosphorylation levels of AMPK(p-AMPK) and Forkhead box O 1 (p-FOXO1), were separately measured using western blot.

Results:
After 4 weeks of testosterone supplementation, SHR heart exhibited significant increments in the heart weight/tibial length and the levels of IVST, LVPWT, LVM and the expression of MHC, and have a lower expression of the MuRF1, p-AMPK and p-FOXO1 in the OVX+T group, compared with OVX group and Sham group. Moreover, the expression level of p-AMPK and p-FOXO1 in the heart were at least twice as many as gastrocnemius muscle among the three group, but the MuRF1 was equivalent between heart and gastrocnemius muscle. In vivo, after the treatment of different gradients of testosterone for 24h, the protein expression of MHC showed an S-shaped growth trend and MuRF1, p-AMPK and p-FOXO1 presented with reverse S-shaped reduction along with increasing of testosterone concentration, peaking at 10-6M testosterone.

Conclusions:
The present study demonstrates that testosterone induces PM-HTN-LVH by modulating the atrophy related AMPK-FOXO1/MuRF1 signaling pathway in vitro and vivo. Increased the heart expression of MuRF1 by activation of AMPK may reverse testosterone-mediated PM-HTN-LVH, which might cause little change of MuRF1 expression in the skeletal muscle resulting in the muscle atrophy.
PULSE WAVE VELOCITY AND BLOOD PRESSURE VARIABILITY AS PROGNOSTIC INDICATORS IN VERY ELDERLY PATIENTS WITH DECOMPENSATED CHRONIC CONDITIONS
Authors: Sierra Alejandro De La , Sierra Cristina , Murillo Marcos , Aiello Francesco , Mateu Aina , Almagro Pedro 
Published: June 2023

Objective:
There is scarce evidence of the prognostic importance of hemodynamic measures, such as blood pressure (BP), BP variability and arterial stiffness in the very elderly population with advanced chronic conditions. We aimed to evaluate the prognostic importance of 24-hour BP, BP variability and arterial stiffness in a cohort of very elderly patients admitted to the hospital due to a decompensated chronic disease.

Design and method:
We studied 249 patients older than 80 (66% women), admitted due to a chronic disease decompensation (60% congestive heart failure). During admission, 24-hour brachial and central BP, BP and heart rate variabilities, aortic pulse wave velocity and BP variability ratio were determined through non-invasive 24-hour monitoring. The primary outcome was 1-year mortality. Secondary outcome was the composite of 1-year mortality or readmission.

Results:
Increased arterial stiffness (aortic pulse wave velocity and BP variability ratio) was associated with 1-year mortality. For each standard deviation (SD) increase in aortic pulse wave velocity and BP variability ratio, mortality increased 3.3 times and 31%, respectively, after adjustments for clinical confounders and BP. Increased BP variability (38% increase for each SD change) and reduced heart rate variability (32% increase for each SD change) also predicted 1-year mortality in fully adjusted models. No association was found between 24-hour BP (either brachial or aortic) and 1-year mortality.

Conclusions:
Increased aortic stiffness and BP and heart rate variabilities predict 1-year mortality in very elderly patients with decompensated chronic conditions. Measurements of such estimates could be useful in the prognostic evaluation of this specific population.
SUBPOPULATIONS OF LYMPHOCYTES AND MONOCYTES IN PATIENTS` VENOUS BLOOD WITH ATRIAL FIBRILLATION OR ATRIAL FLUTTER ASSOCIATED WITH HYPERTENSION
Authors: Ilchyshyna Olena , Sychov Oleg , Talaieva Tetiana , Stasyshena Oksana 
Published: June 2023

Objective:
The most common reason of arrhythmia onset nowadays is hypertensive desease. The aim of the study is to compare the subpopulations of lymphocytes (LCTs) and monocytes (MCTs) in blood of patients (pts) with paroxysmal and persistent forms of AF or atrial flutter (AFL) associated with arterial hypertension.

Design and method:
The study involved 103 patients with atrial fibrillation and flutter that occurred on the backdround of hypertension. Depending on the form of arrhythmia, patients were divided into three main groups: group I – with paroxysmal form of atrial fibrillation, group II – with a persistent form of atrial fibrillation, group III – with a persistent form of atrial flutter. The control groups included patients with hypertension, but without these arrhythmias and healthy individuals who entered groups IV and V, respectively. The lymphocytes and monocytes subpopulation in peripheral blood was assessed by flow cytometry.

Results:
Analyzing the lymphocyte subpopulations in peripheral blood of patients with atrial fibrillation and flutter (groups I, II and III), it was found that the number of cells with cytotoxic activity (NK and NKT) in both absolute count and percentage values was significantly higher than in healthy individuals. A statistically significant decrease of T-regulatory cells number was found in patients with arrhythmias compared to control groups (p < 0.05). In patients with AF and AFL associated with hypertension, compared to patients with hypertension without these rhythm disturbances or healthy individuals, there is an increased number of classical and intermediate monocytes subpopulations.

Conclusions:
1. In patients with atrial fibrillation or atrial flutter associated with hypertension, compared to patients with hypertension without these rhythm disturbances or healthy people, there is an increased number of classical and intermediate monocytes fraction and a decreased content of T-regulatory cells in peripheral blood, an increased number of cells with cytotoxic activity (NK and NKT) compared to healthy individuals. These changes can be one of the factors for the activation of systemic and local inflammatory processes that can lead to fibrosis in the myocardium and the associated electrical and structural remodeling typical for AF and AFL.
RAS BLOCKERS PLUS CCB COMBINATIONS ON HOMA-IR, HOMA-B, HOMA-S AND QUICKI INDICES IN PREDIABETIC HYPERTENSIVE PATIENTS, A RANDOMIZED 12-WEEK OPEN-LABEL COMPARATIVE STUDY
Authors: Liontos Angelos , Biros Dimitrios , Papagiannopoulos Christos , Veliani Cornelia , Tsiakas Ilias , Christaki Eirini , Elisaf Moses , Liberopoulos Evangelos , Milionis Haralampos , Liamis Georgios 
Published: June 2023

Objective:
Hypertensive patients often suffer from other metabolism related comorbidities characterized by insulin resistance (e.g., diabetes mellitus, metabolic syndrome). Dual combination treatment is advised with current treatment guidelines for the management of Hypertension. ARB or ACE-i plus CCB combinations are considered to have a beneficial effect on glucose homeostasis. We present comparative data of the effect of delapril/manidipine versus telmisartan/amlodipine versus valsartan/amlodipine combination treatments, in HOMA-IR, HOMA-B, HOMA-S and QUICKI indices before and after a 12-week treatment, in hypertensive prediabetic patients.

Design and method:
Data were collected from 158 patients from the outpatient clinic for patients with lipid disorders, hypertension and diabetes of our hospital, during the period 2014-2018. A total of 53 patients was randomized in the delapril/manidipine (DEL/MANI) group 30/10 mg per day while 51 patients had been randomized in the group of telmisartan/amlodipine (TEL/AMLO) 80/5mg per day and 54 patients in the valsartan/amlodipine (VAL/AMLO) 160/5 mg per day. All patients successfully completed the study. Baseline characteristics are presented in Table 1A.

Results:
The resulting alternations in HOMA-IR, HOMA-B, HOMA-S, QUICKI, before and after the 12-week treatment are presented on Table 1B for all treatment groups.

Conclusions:
comparison between the treatment groups showed a statistically significant difference in the change of HOMA-IR (from the beginning of treatment to its end) between the TEL/AMLO treatment group and the DEL/MANI treatment group (p-value<0.05), with increased insulin sensitivity in the TEL/AMLO group. Furthermore, HOMA-B was significantly increased in the DEL/MANI group compared with the TEL/AMLO group (p<0.05). No other significant changes were evident. Patients in the TEL/AMLO group had significantly lower insulin resistance as shown by the HOMA-IR index compared with the patients that received VAL/AMLO (p <0.001). Furthermore, QUICKI index was significantly increased in the TEL/AMLO group compared with the VAL/AMLO group (p<0.01).
LIPOPROTEIN(A) AND CARDIOVASCULAR RISK IN HYPERTENSION: A RETROSPECTIVE STUDY
Authors: Vythoulkas-Biotis Nikolaos , Kyvelou Stela -Maria , Lytra Thekla , Anastasiou Theocharis , Karpanou Evanggelia , Vyssoulis Gregory 
Published: June 2023

Objective:
Lipoprotein(a) [Lp(a)] has been shown to be a significant risk factor for cardiovascular disease (CVD) in the general population. However, its association with CVD risk in patients with hypertension remains unclear. This study aimed to compare the cardiovascular risk profiles of hypertensive patients with Lp(a) levels above and below 30 mg/dL.

Design and method:
This retrospective study included 34,280 consecutive hypertensive patients from a single center. Patients were divided into two groups based on their Lp(a) levels: Group 1 had 25,719 patients with Lp(a) < 30 mg/dL, and Group 2 had 8,561 patients with Lp(a) > 30 mg/dL. Stroke, cerebrovascular accident (CVA), transient ischemic attack (TIA), acute myocardial infarction (AMI), coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty were compared between the two groups. Furthermore, risks such as Stroke risk, HeartScore, InterHeart, 5-year risk, 10-year risk, and deep vein thrombosis (DVT) risk were also compared.

Results:
In the univariate analysis Group 2 (Lp(a) > 30 mg/dL) had significantly higher stroke rate (OR = 0.52, 95% CI [0.49, 0.63], p < 0.001), CVA (OR = 0.49, 95% CI [0.43, 0.55], p < 0.001), TIA (OR = 0.58, 95% CI [0.54, 0.63], p < 0.001), AMI (OR = 0.56, 95% CI [0.51, 0.63], p < 0.001), CABG (OR = 0.43, 95% CI [0.37, 0.52], p < 0.001) and PTCA (OR = 0.46, 95% CI [0.38, 0.55], p < 0.001) compared to Group 1 (Lp(a) < 30 mg/dL). Risk scores (Stroke risk, Heartscore, InterHeart, 5-year risk, 10-year risk and DVT risk) were also included in the univariate analysis where the difference is considered to be extremely statistically significant (p < 0.01). In the multivariate regression analysis the Lp(a) was the dependent variable and age, gender, glucose levels and total cholesterol levels were the independent variables. The correlation between the variables remained significant (p < 0.001).

Conclusions:
Our findings suggest that Lp(a) levels above 30 mg/dL is associated with a higher risk of CVD in hypertensive patients. These results may have implications for the management and treatment of hypertensive patients with elevated Lp(a) levels.
USEFULNESS OF BPN LEVELS IN IDENTIFYING DIABETIC HYPERTENSIVES WITH SYSTOLIC-DIASTOLIC LEFT VENTRICULAR DYSFUNCTION. ABILITY OF THE ANGIOTENSIN II INHIBITOR TO CONVERT IT BACK
Authors: Rosa Maria Leonarda De , Perrotti Maria , Corbia Luca , Ferrara Nicola 
Published: June 2023

Objective:
We tested the hypothesis that the renin-angiotensin system could convert left ventricular diastolic dysfunction in patients with type 2 diabetes.

Design and method:
Fifty asymptomatic patients with type 2 diabetes were recruited in this double-blind cross-over trial. Baseline left ventricular diastolic function was assessed with Doppler echocardiography; using velocity ratios of peak flow through the mitral orifice (E/A) and the integral velocity of before end diastolic transmitral flow (VTIE/VTIA). In addition, plasma brain natriuretic peptide (BNP) levels were measured.
Patients randomly received either zofenopril (15mg/day), or Olmesartan (10mg/day) or their combination for 3 months and each time after a 2-week washout period. Measurements were repeated at the end of each treatment period.

Results:
Both E/A and VTIE/VTIA ratios increased (29 and 20% with zofenopril, 25 and 23% with olmesartan, and 36 and 28% with combination treatment, respectively, p < 0.001), while levels plasma BNP levels were significantly reduced with all 3 regimens (9% with zofenopril, 25% with olmesartan, and 36% with combination, p < 0.001).

Conclusions:
Both olmesartan and zofenopril improve left ventricular diastolic echocardiographic indices and reduce plasma BNP levels in diabetic patients, their combination produces an even better therapeutic effect.
PERFORMANCE OF STANDARD, IMMEDIATE AND DELAYED UNATTENDED AUTOMATED BLOOD PRESSURE MEASUREMENTS DURING HOUSEHOLD-BASED SCREENING IN RURAL AFRICA: A DIAGNOSTIC ACCURACY STUDY
Authors: Firima Emmanuel , Retselisitsoe Lefokosane , Ikhetheleng Leisa , Manthabiseng Molulela , Mamorontssane Sematle , Matumaole Bane , Khomolishoele Makhebe , Gonzalez Lucia , Gupta Ravi , Lee Tristan , Chammartin Frédérique Frédérique , Leigh Bailah , Weisser Maja , Amstutz Alain , Burkard Thilo , Labhardt Niklaus 
Published: June 2023

Objective:
The World Health Organization's STEPwise approach to surveillance (STEPS) recommends three standard blood pressure measurements over five minutes (SBPM) to monitor trends of hypertension in low-income countries. The objective of this study was to assess the diagnostic accuracy of SBPM, same-day and next-day unattended automated measurement (uABP), with 24hr ambulatory measurement (24h-ABPM) as reference during a population-based prevalence survey in Lesotho.

Design and method:
Participants with elevated SBPM (> = 140/90 mmHg) and age- and sex-matched participants with normal SBPM during a household-based survey were recruited. For SBPM and uABP, participants sat and rested for 5 minutes before three measurements were taken each 2 min apart. For both, the mean of second and third measurements was taken as final blood pressure. 1st uABP readings were obtained on survey day. Afterwards participants received a 24h-ABPM device. 2nd uABP readings were taken 24h later after retrieval of the 24h-ABPM. Discrimination was determined for all screening measurements (SBPM, 1st, 2nd uABP) using area under the receiver operating characteristic curve (AUROC), and 24h-ABPM as reference.

Results:
We enrolled 275 participants [mean age 58 years, 163 (59%) female], 183 with elevated and 92 with normal SBPM. Mean difference between systolic daytime 24h-ABPM and screening measurements was highest for SBPM (mean difference: -12 mmHg; 95%CI: -14 to -9). Mean difference between diastolic daytime ABPM and diastolic SBPM was -2 mmHg (95%CI: -3 to -0.7), whereas no difference was found for mean diastolic 1st uABP (mean difference: -0.6 mmHg; 95%CI: -1.9 to 0.6); and mean diastolic 2nd uABP (mean difference: 1.0 mmHg; 95%CI: -0.4 to 2.4). Misclassification as having hypertension (Figure 1) was highest with SBPM (55 [20%]), followed by 1st uABP (27 [9.8%]) and 2nd uABP (18 [6.5%]). Using systolic daytime 24h-ABPM as reference, the uABPs had higher AUROC (1st uABP: 87% [95%CI: 83-91]; 2nd uABP: 88% [95%CI: 84-92]); SBPM: (79% [95%CI: 74-85]). This difference was significant between 1st uABP and SBPM (p = 0.002), and between 2nd uABP and SBPM (p<0.001).

Conclusions:
uABP measurements had better diagnostic performance compared to SBPM. Integration of uABP into the STEPS protocol should be considered.
KNOWLEDGE, PERCEPTION, AND PRACTICE OF QUEBEC HEALTH PROFESSIONALS REGARDING AMBULATORY AND CLINIC BLOOD PRESSURE MEASUREMENT METHODS
Authors: Todkar Shweta , Padwal Raj , Cloutier Lyne 
Published: June 2023

Objective:
Hypertension Canada Guidelines recommend using standardized methods of blood pressure measurement (BPM), namely home (HBPM), ambulatory (ABPM), office (OBPM), and automated (AOBP) for hypertension management. Health professionals (HP), namely nurses, physicians, and pharmacists, routinely perform BPM, but their knowledge, perception, and practice concerning all methods is understudied, including in Canada, and results show critical gaps with the guidelines. This descriptive study is the first to establish a portrait primary care HP's in Quebec concerning the four BPM methods.

Design and method:
All licensed primary care HP's in Quebec were targeted. A validated and pretested investigator-initiated BPM questionnaire in English and French was used for data collection. In December 2019, physicians and pharmacists were recruited through their associations’ monthly newsletter, while nurses received a personalized email invitation with a link to a secured platform. UQTR issued the certificate of ethics.

Results:
A total of 453 nurses, 45 physicians, and 30 pharmacists participated in the study. The median age was 40 ± 11 years for nurses, 50 ± 13 years for physicians, and 42 ± 12 for pharmacists. The overall knowledge and perception scores for BPM methods are presented in Table 1. In practice, physicians frequently use HBPM for diagnostic purposes (73%), treatment (91%), and follow-up (86%), while HBPM was recommended by 47% of nurses and 53% of pharmacists. Overall, ABPM was used less frequently (<50% of the time) by all HP's. In the clinic, the auscultatory method is still used by a significant percentage of nurses (11%), physicians (32%) and pharmacists (7%), while only 25% nurses, 13% physicians and 30% pharmacists use the AOBP method.

Conclusions:
Overall, knowledge was suboptimal for nurses and somewhat optimal for physicians and pharmacists. Practice was unsatisfactory for all HPs. Training and continuing education should be encouraged and should be renewed with the newest education methods along with practice assessment.
CORRELATION BETWEEN BLOOD PRESSURE RESPONSE TO SUB MAXIMAL EXERCISE AND LEFT VENTRICULAR HYPERTROPHY
Authors: Gaprindashvili Tamar , Agladze Rusudan , Botchorishvili Inga , Khajalia Sergo , Pagava Zurab 
Published: June 2023

Objective:
Currently, there is no common consent on what constitutes a normal increase in blood pressure (BP) during physical activity and, consequently, what constitutes an exaggerated increase in BP response to exercise. At this stage, the processes, and clinical consequences of hypertensive response to exercise (HRE) remain unknown. Even in those who do not have hypertension or other cardiovascular disorders, a hypertensive response to exercise (HRE) is common.
An increased blood pressure response to exercise is a legitimate risk marker for future hypertension, as previous research has demonstrated. HRE has among its contributors the endothelial dysfunction and an increase in afterload. in terms of neurohormonal aspects Excess sympathetic nervous system activation and an increase in angiotensin II appear to be crucial mechanisms in HRE, according to studies.

Design and method:
Of the 84 eligible participants, men (n 46) women (n 38) with I and II degree hypertension (n 32) and pre hypertension (n 22). The study analysis included the subjects with an age range of 18-64 years (mean age 42.1±12.7 years) With or without left ventricular hypertrophy (LVH) described as normal, Concentric hypertrophy, Eccentric hypertrophy, concentric remodeling.

Results:
For most of the subjects on the initial evaluation, we discovered echocardiographic evidence of concentric hypertrophy. Among the resting and exercise BP indices, submaximal SBP was the strongest correlate of LV mass (r = 0.40, P<0.04). In multivariate analysis, maximal SBP was independently associated with LV mass and concentric LV hypertrophy, after adjustment for lean body mass and gender. Submaximal exercise SBP is a modest but still independent predictor of LV remodeling (grade and type of LV geometry) in population with prehypertension, I and II grade hypertension.

Conclusions:
More frequent clinical control of resting BP, an echocardiogram, a 24-hour BP ambulatory monitoring as a more dynamic test, and at least annual repetition of the exercise test, to follow up the same abnormal response, as more studies are needed and a consensus regarding the abnormal response of the BP during exercise. Our study can be of clinical importance to prevent future adverse events linked to hypertension induced organ damage.
INTENSIVE BLOOD PRESSURE CONTROL MAY INCREASE THE RISK OF MORTALITY AMONG PATIENTS WITH PERITONEAL DIALYSIS AND HYPERTENSION
Authors: Liu Yifan , Chi Chen , Xu Yawei 
Published: June 2023

Objective:
Several clinical trials showed that intensive blood pressure (BP) control reduced the risk of mortality among hypertensive patients. We aimed to verify whether patients with peritoneal dialysis (PD) and hypertension could benefit from intensive BP control.

Design and method:
This is a retrospective single-center cohort study. 146 long-term PD hypertensive patients (81 male, mean age 60.2±11.7 years) with official sitting SBP 100 to <160mmHg at baseline were included in the present analysis. Patients were divided into the intensive group (100 to <130 mmHg) and the non-intensive group (130 to <160 mmHg). Kaplan-Meier curves and log-rank tests were performed to compare the survival rates of the two groups. Cox proportional regression was used to calculate the adjusted hazard ratios (HRs) and 95% CIs of all-cause and cardiovascular mortality of the intensive group compared to the non-intensive group.

Results:
41 patients were in the intensive group and 105 patients were in the non-intensive group. The median follow-up time was 28 (quartiles 19-56) months. 65 all-cause deaths and 28 cardiovascular deaths were identified in total. Kaplan-Meier curves showed that compared with the non-intensive group, patients in the intensive group were at higher risk of all-cause mortality (HR, 1.91 [95% CI, 1.10-3.31], P = 0.02) and cardiovascular mortality (HR, 2.56 [1.12-5.88], P = 0.03). Cox regressions showed that after adjustment for potential confounders including age, gender, BMI, LDL-C, diabetes, and creatinine clearance rate, intensive BP control was also associated with the increased risk of all-cause mortality (HR, 2.14 [1.18-3.86], P = 0.01) and cardiovascular mortality (HR, 3.35 [1.37-8,17], P = 0.01).

Conclusions:
Lower systolic BP (<130mmHg) in patients with PD and hypertension was associated with a higher risk of all-cause and cardiovascular mortality. Our results suggested that intensive blood control should be cautious in hypertensive PD patients, and more clinical studies especially random controlled trials focusing on the blood pressure target of PD patients are warranted in the future.