bluuebunny/crossref_metadata_2025_split huggingface dataset:
ANTIHYPERTENSIVE THERAPY INTAKE IN THE PURE COLOMBIA COHORT 2005-2021
Authors: Mora Paola Natacha Lanza , Lopez-Lopez Jose , Otero Johanna , Martinez-Bello Daniel , Castañeda-Hernandez Alvaro , Gonzalez Ana Maria , Camargo Karol Lizeth Vega , Lopez-Jaramillo Patricio 
Published: June 2023

Objective:
Describe changes in antihypertensive therapy in prevalent hypertension (HT) cases in the PURE cohort (The Prospective Urban Rural Epidemiology) Colombia in 2005-2021.

Design and method:
A prospective cohort study including 7552 participants from the baseline PURE Colombia cohort from 11 departments (Atlántico, Bolívar, Caldas, Casanare, Cauca, Cesar, Cundinamarca, Nariño, Quindío, Santander, Tolima). We conducted a descriptive analysis of the change in antihypertensive therapy between the 2005 baseline and the cut-off point to 2021.

Results:
At baseline, 2846 (37.7%) hypertensive participants were identified, 65.7% of which were women, with a mean age of 55.2 (SD 9.2) years. After 13 years of follow-up, 902 incident cases of HT were reported, 67.2% of which were women, increasing the prevalence within the cohort to 50.2%
Regarding the prevalences of antihypertensive drug use, in 2005 vs 2021 the observed changes were: angiotensin-converting enzyme inhibitors (ACEI) 23.7% vs 9.2%, thiazide diuretics (TD) 10.1% vs 6.0%, angiotensin receptor antagonists (ARBs) 4.5% vs 28.8% and lastly, dihydropyridine calcium channel blockers (DCCB) 4.0% vs 5.2%. The differences in the use of antihypertensive drugs between baseline and follow-up were significant, 55.7% of the patients reported no use of antihypertensive drugs at baseline vs 59.8% at follow-up, 20.0% were on monotherapy and the proportion dropped to 18.9%, 24.3% reported use of 2 or more drugs at baseline and 21.3% at follow-up.

Conclusions:
The significant increase in hypertension suggests the need to adopt recommendations for drug consumption that have abandoned the use of monotherapy; however, the changes in the management of hypertensive patients in the cohort show no improvement. There is a need to undertake strategies that encourage access to fixed-dose combination antihypertensive therapy.
IS IT REASONABLE TO DECREASE THE DEFINITION OF DIASTOLIC HYPERTENSION FROM 90 MMHG TO 80 MMHG IN THE ELDERLY? THE NORTHERN SHANGHAI STUDY
Authors: Hou Jingjing , Yu Shikai , Shi Jieying , Zhang Yi 
Published: June 2023

Objective:
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines decreased the definition of diastolic hypertension to 80 mmHg from 90 mmHg. However, this action may not be appropriate in the elderly, considering the limited value of increased DBP in predicting future cardiovascular risk and the worse prognosis associated with significant lower DBP in the elderly.

Design and method:
A total of 1178 participants with SBP<130 mmHg derived from the Northern Shanghai Study, a prospective study focusing on the cardiovascular risk of the community-dwelling elderly Chinese in the northern Shanghai, China, were included. Study participants were divided into Group 1 (DBP<80 mmHg) and Group 2 (80<DBP<90 mmHg) according to DBP level. Survival analysis and Cox proportional hazard regression were used to study the future cardiovascular risk of the two groups.

Results:
After 5.8 years of follow-up, a total of 172 events were observed. Survival analysis showed no significant difference in the rates of the primary endpoints between two groups (14.9%vs14.0%, P = 0.80). In multiple COX proportional hazard regression, after adjusted for covariates, participants in Group 2 showed similar future cardiovascular risk (Hazard Ratio 1.05, 95% Confidence Interval 0.75-1.48, P = 0.78), as compared with Group 1.

Conclusions:
No increased cardiovascular risk observed in the elderly with SBP<130 mmHg and DBP between 80-90 mmHg, compared with those with DBP<80 mmHg. Therefore, it is maybe unreasonable to downregulate the definition of the diastolic hypertension in the elderly.
RELATIONSHIP BETWEEN LONG-TERM VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND CHRONIC KIDNEY DAMAGE
Authors: Yuan Yue , Sun Wei , Kong Xiangqing 
Published: June 2023

Objective:
To assess the age- and sex-specific association between long-term visit-to-visit blood pressure variability (BPV) throughout adulthood and the development of chronic kidney damage (CKD).

Design and method:
A total of 1277 participants aged over 18 years old enrolled in the China Health and Nutrition Survey from 1991 to 2009 were included in the analysis. Long-term visit-to-visit BPV was evaluated by BP during seven visits. Renal damage was evaluated by estimated glomerular filtration rate.

Results:
After the eighteen-year follow-up, there were 110 (8.6%) participants with CKD. Adjusted analyses showed that renal function changes differed according to BPV. After full adjustment for the clinical characteristics plus cumulative exposure to BP from visit 1 to visit 7, subjects with higher standard deviation (SD)SBP had a significantly higher risk of renal damage (OR [95% CIs] = 1.05 [1.01–1.09]), average real variability (ARV)SBP (OR[95% CIs] = 1.04 [1.00–1.08]) and maximum and minimum difference (MMD)SBP (OR[95% CIs] = 1.02 [1.00–1.03], all P<0.05). Similar trends existed in the relationship when adjusting for the clinical variables plus mean BP across 7 visits. Subjects in late adulthood with higher SDSBP, DBP, MAP, PP, ARVSBP, DBP, MAP, PP, and MMDSBP, DBP, MAP, PP had significantly higher risks of chronic renal damage ( all P<0.05). Only females with higher SDSBP, DBP, MAP, PP, ARVSBP, DBP, MAP, PP and MMDSBP, DBP, MAP, PP had significantly higher risks of renal damage.

Conclusions:
This study suggested that long-term visit-to-visit BPV plays a predictive role in the development of renal impairment, especially in females and in subjects in late adulthood. Such evidence may help to direct potential strategies for preventing renal damage.
NIGHT-TIME BLOOD PRESSURE AND BLOOD PRESSURE VARIABILITY IN HYPERTENSIVE PATIENTS WITH OR WITHOUT INSOMNIA. A PILOT STUDY
Authors: Sartorio Andrea , Benedetti Elisa , Pont Chiara Dal , Bonafini Sara , Ferrante Lorenzo , Minuz Pietro , Fava Cristiano 
Published: June 2023

Objective:
Recent studies found that insomnia is an independent risk factor for cardiovascular diseases, particularly arterial hypertension. Among the hypertensive population, insomnia could contribute to a worse blood pressure (BP) profile. In a sample of hypertensive patients, we compared those with and without insomnia with the aim of evaluating possible differences in BP, its variability, and breathing pattern.

Design and method:
We conducted a case-control study on patients with and without insomnia, based on the Insomnia Severity Index (ISI) questionnaire. Patients were recruited from the general practitioner's registry and were sent an invitation e-mail. All of them had long-lasting hypertension. One-hundred-and-fifty patients replied to the ISI questionnaire. Among them, twenty people with insomnia were selected (ISI greater than or equal to 15) and matched, based on their gender and age (±3 years), to 20 controls (with ISI lower than 15). All participants underwent night-time cardiorespiratory and 24-hour blood pressure monitoring by using a new cuff-less device that can estimate beat-to-beat BP (SomnoTouch-NIBP).

Results:
Comparing the two groups (insomnia vs. non-insomnia), no differences were observed in BP profile and all the respiratory indices, including the apnea-hypopnea index(AHI), the number of desaturations, and peripheral oxygen saturation (SpO2) values. Even the average BP and the indices of BP variability, such as the standard deviation (SD), the pressure coefficient of variation (CV), the BP dipping, and the nocturnal BP fluctuations (NBPF), were similar between the groups. Interestingly, to obtain the same average BP control, the insomnia group required a greater number of antihypertensive drugs (2,85 ± 0,88 vs. 1,95 ± 1,00 in the non-insomnia group; p<0.01).

Conclusions:
Patients with insomnia may need more antihypertensive medications to achieve the same average BP as patients without insomnia. Anyhow, they did not show, as expected, higher BP variability. How much beat-to-beat BP estimations are reliable compared to BP measurements by standard cuff-based devices is still under debate.
A STUDY OF 24HOUR CENTRAL BLOOD PRESSURE VARIABILITY WITH MEASURES OF MACRO- AND MICROVASCULAR FUNCTION IN A POPULATION OF UNTREATED HYPERTENSIVE AND NORMOTENSIVE INDIVIDUALS
Authors: Malliora Anastasia , Lazaridis Antonios , Triantafyllou Areti , Anyfanti Panagiota , Zarifis Ippokratis , Mastrogiannis Konstantinos , Karamaounas Polykarpos , Zabulis Xenophon , Doumas Michalis , Gkaliagkousi Eugenia 
Published: June 2023

Objective:
Central blood pressure (cBP) has been more closely associated with target-organ damage compared with brachial BP, although a bidirectional interplay between central and peripheral arteries exists. Brachial short term BP variability (BPV) has been increasingly related to impaired macro- and microvascular function. However, scarce data exists regarding 24hour central BPV (cBPV) and its impact on organ damage. This study aimed to measure 24h cBPV in a population of untreated essential hypertensive (UHTs) and normotensive (NTs) individuals and evaluate its association with measures of macro- and microvascular function.

Design and method:
Newly-diagnosed UHTs and NTs were enrolled. 24hour cBP and 24h pulse wave velocity (PWV) were measured with the Mobil-O-Graph device. BPV including average real variability (ARV) of 24h central systolic BP (cSBP) and diastolic BP (cDBP) was calculated according to a standardized formula based on the ambulatory BP monitoring (ABPM) measurements. Urine albumin excretion (UAE) was measured in 24h samples.

Results:
We recruited 119 individuals including 79 UHTs and 40 NTs that didn’t differ in baseline characteristics. As expected, PWV was increased in UHTs compared to NTs [7.7 (1.5) vs 6.7 (1.2) m/s, p<0.001]. Similarly, in a subset of 60 individuals, UAE was increased [12.1 (9.7) vs 6.4 (4.5) mg/24h, p = 0.008]. UHTs presented higher ARV of 24h, daytime and nighttime cSBP/cDBP compared to NTs (p<0.05 for all comparisons). In total population, 24h PWV positively correlated with ARV of 24h cSBP (r = 0.353, p<0.001) and cDBP (r = 0.235, p = 0.010), ARV of daytime cSBP (r = 0.342, p<0.001) and cDBP (r = 0.235, p = 0.010), and nighttime cSBP (r = 0.297, p = 0.007). Furthermore, UAE correlated with ARV of nighttime cDBP (r = 0.372, p = 0.017). In multivariate analysis after adjusting for age, sex, and hypertension, ARV of 24h cSBP remained an independent predictor of PWV (beta = 0.109, p<0.001). Likewise, ARV of nighttime cDBP independently predicted UAE (beta = 0.480, p = 0.002).

Conclusions:
In a population of untreated hypertensives and normotensives, cARV indices are significantly and independently associated with measures of macro- and microvascular function including PWV and UAE, respectively. Further studies are warranted to ascertain the clinical value of cARV in terms of risk stratification and management.
MACHINE LEARNING CLASSIFICATION ON BLOOD PRESSURE VARIATION FOR THE RISK OF COGNITIVE IMPAIRMENT: A CROSS-SECTIONAL STUDY FROM A BLOOD PRESSURE MANAGEMENT COHORT IN HONG KONG
Authors: Jia Pingping , Yu Ruby , Chen Aaron , Yiu Karen , Tsoi Kelvin 
Published: June 2023

Objective:
The evidence for the association between blood pressure variability (BPV) with cognitive impairment is still uncertain in the Asia population. This study explored whether a machine learning classification on BPV is associated with cognitive impairment among the elderly in Hong Kong.

Design and method:
Random samples of 573 participants were selected from a community-based cohort for blood pressure management in July 2021. Participants regularly measured blood pressure. K-means clustering methods were applied to group the standard deviation of BPV into high, medium, and low variations. This method considered both systolic and diastolic blood pressure variations. For cognitive functions, participants were assessed by the shorted version of the Montreal Cognitive Assessment Version, i.e., 5-min MoCA (Hong Kong validated version). Mild cognitive impairment (MCI) was defined with adjustment of age and education according to the 5-min MoCA. BPV was defined as the standard deviation of systolic and diastolic blood pressure values. Logistic and quantile regression models were conducted to explore the association of MCI with systolic or diastolic BPV and a combined BPV classification. Odds ratios (OR) were adjusted for age, gender, educational background social economic status, and other medical histories, including hypertension, hyperlipidemia, diabetes, and stroke.

Results:
The 573 participants had a mean age of 72 years with 86% of females. The median follow-up period was eight months with a median number of 19 blood pressure records. Systolic BPV increases the risk of MCI (adjusted OR, 95% CI = 1.18, 1.05 to 1.31), but not diastolic BPV. The quantile regression found that the magnitude of association is more substantial among the population with lower cognitive function (Figure 1). With reference to the machine learning classification, participants with high BPV were shown to have a 5.5 times higher risk of MCI than those with low BPV.

Conclusions:
Participants with higher systolic BPV are shown to be associated with poorer cognitive function, and therefore, long-term management of blood pressure variability is also important to reduce the risk of cognitive impairment.
SEX DIFFERENCES IN SHORT-TERM BP VARIABILITY AMONG PATIENTS UNDERGOING PERITONEAL DIALYSIS
Authors: Vaios Vasilios , Georgianos Panagiotis , Vareta Georgia , Leptokaridou Eirini , Kontogiorgos Ioannis , Geropoulou Evangelia , Zebekakis Pantelis , Liakopoulos Vassilios 
Published: June 2023

Objective:
The present study aimed to explore potential differences in short-term blood pressure (BP) variability between men and women with end-stage kidney disease undergoing peritoneal dialysis (PD).

Design and method:
In this comparative study, 48 male PD patients from Northern Greece were matched for age and history of heart failure with 48 female patients in a 1:1 ratio. All patients underwent 24-hour ambulatory BP monitoring with the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). Short-term BP variability was assessed with the calculation of standard deviation (SD), coefficient of variation (CV) and average real variability (ARV) of systolic and diastolic BP during the 24-hour, daytime and nighttime periods.

Results:
Age, the duration of PD therapy and the prevalence of cardiovascular comorbidities were similar in men and women. During the 24-hour period, SD (13.4±3.8 vs. 14.6±3.1 mmHg, P = 0.091), CV (0.10±0.03% vs. 0.12±0.2%, P<0.05) and ARV (10.7±3.1 vs. 11.9±2.6 mmHg, P<0.05) of systolic BP were significantly lower in men than in women. Similarly, the variability of diastolic BP over the 24-hour period was numerically lower in men as compared with women (SD: 10.3±2.4 vs. 10.9±2.2 mmHg, P = 0.218; CV: 0.12±0.03% vs. 0.14±0.03%, P<0.05; ARV: 8.4±2.0 vs. 9.0±1.9 mmHg, P = 0.136). These sex differences in indices of short-term BP variability were consistent during both daytime and nighttime periods.

Conclusions:
The present study shows that among patients undergoing PD, SD, CV and ARV of systolic and diastolic BP are lower in men than in women. Longitudinal studies are needed to explore whether these sex-related differences in short-term BP variability are prognostically informative in the PD population.
ASSOCIATION BETWEEN VARIABILITY IN SYSTOLIC BLOOD PRESSURE AND CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS: DOES GENDER METTER?
Authors: Ilic Marina Deljanin , Stojanovic Sanja , Stojanovic Milovan , Krstic Ivana , Ilic Stevan 
Published: June 2023

Objective:
To investigate the association between variability in systolic blood pressure (SBPV) and development of cardiovascular events (CVE): angina pectoris, myocardial infarction, cerebrovascular accident in hypertensive patients (pts) according to gender, and to estimate whether SBPV could be a predictor of CVE.

Design and method:
300 hypertensive pts (148 men and 152 women) were studied. The study comprised 3 visits during a follow-up period of 30 months. Blood pressure values were defined by the arithmetic mean of three measurements at each visit. SBPV for each patient was defined using the standard deviation from 3 values of systolic BP (SBP-SD). In order to estimate distribution SBPV, quartiles of SBP-SD were introduced. High SBPV were defined as SBP-SD above the 4th and 3th quartile.

Results:
During 30 months follow up the incidence of CVE was higher in men than in women (22.3% vs 17.7%). The first quartile included SBPV values < 6.00 mmHg, the second quartile 6.01-10.00 mmHg, the third quartile 10.01-17.00 mmHg, and the fourth quartile >17.00 mmHg. The highest SBPV was recorded in 3rd and 4th quartile in men as well in women who had CVE, and SBPV was higher in men than in women (p<0.01 for both quartile). Logistic regression analysis showed that there was a significant relationship between SBPV and CVE in men (OR = 1.141; 95% CI 1.107-1.183, p<0.001), as well as in women (OR = 1.103; 95% CI 1.071-1.139, p<0.001). A cut-off value of SBPV = 12.48 mmHg predicted the CVE with a sensitivity of 68% and specificity of 64% in men (p<0.01), while cut-off value of SBPV = 12.03 mmHg predicted the CVE in women with a sensitivity of 65% and specificity of 67% (p<0.001).

Conclusions:
Our results showed a significant relationship between SBPV and CVE in hypertensive pts regardless of gender. Higher SBPV was recorded in men than in women. Lower value of SBPV in women >12.03 mmHg than in men >12.48 mmHg predicted future CVE.
CARDIAC MACROPHAGES EXACERBATE DOXORUBICIN-INDUCED CARDIOTOXICITY
Authors: Gambardella Jessica , Santulli Gaetano , Fiordelisi Antonella , Cerasuolo Federica Andrea , Wang Xujun , Prevete Nella , Sommella Eduardo , Avvisato Roberta , Buonaiuto Antonietta , Altobelli Giovanna Giuseppe , Rinaldi Laura , Feliciello Antonio , Piaz Fabrizio Dal , Campiglia Pietro , Ciccarelli Michele , Morisco Carmine , Sadoshima Junichi , Iaccarino Guido , Sorriento Daniela 
Published: June 2023

Objective:
The functional contribution of non-myocyte cardiac cells, such as inflammatory cells, in the setup of heart failure in response to doxorubicin (Dox) is recently becoming of growing interest. Objective: The study aims to evaluate the role of macrophages in cardiac damage elicited by Dox treatment.

Design and method:
C57BL/6 mice were treated with one intraperitoneal injection of Dox (20mg/Kg) and followed up for 5 days by cardiac ultrasounds (CUS), histological, and flow cytometry evaluations. We also tested the impact of Dox in macrophage-depleted mice. Murine cardiomyoblasts were directly treated with Dox (D-Dox) or with a conditioned medium from cultured murine macrophages treated with Dox (M-Dox).

Results:
In response to Dox, macrophage infiltration preceded cardiac damage. Macrophage depletion prevents Dox-induced damage, suggesting a key role of these cells in promoting cardiotoxicity. To evaluate the crosstalk between macrophages and cardiac cells in response to DOX, we compared the effects of D-Dox and M-Dox in vitro. In cardiomyoblasts, cell vitality was lower and apoptosis was higher in response to M-Dox compared with D-Dox. These events were linked to p53-induced alterations of mitochondria morphology, function, and autophagy. We identify a mechanistic role of catecholamines released by Dox-activated macrophages that lead to mitochondrial apoptosis of cardiac cells through b-AR stimulation.

Conclusions:
Taken together, our data indicate that crosstalk between macrophages and cardiac cells participates in cardiac damage in response to Dox.
INCREASED RISK OF NEW ONSET OF ARTERIAL HYPERTENSION IN PATIENTS WITH MULTIPLE MYELOMA TREATED WITH CARLFIZOMIB
Authors: Cicco Sebastiano , Fazio Giuditta De , Marozzi Marialuisa Sveva , Melaccio Assunta , Cavallo Michele , Solimando Antonio Giovanni , Vacca Angelo , Ria Roberto 
Published: June 2023

Objective:
Several new drugs are used nowadays to treat multiple myeloma (MM). Some drugs are loaded with an increased risk of developing cardiovascular diseases. Carfilzomib (K), a proteasome inhibitor, is well recognized to cause cardiovascular side effects. Also, arterial hypertension is a main factor leading to LV dysfunction. Purpose is to evaluate if patients who underwent the carfilzomib treatment may present an increased incidence of arterial hypertension.

Design and method:
We evaluated 34 patients (group K, 20M, 14F, aged 65.87±5.98) treated with carfilzomib: 25 patients were given 56 mg/m2 (group 1, 14M, 9F, aged 67.30±5.98) while 9 27 mg/m2 (group 2, 6M, 3F, aged 63.00±5.39). As controls, we recruited 34 patients (16M, 18F, aged 69.80±9.13) who underwent in the same period the MM treatment without carfilzomib. Hypertension was identified as new onset of disease or worsening of disease (need double the dose used, add a new drug, or no pressure control in at least 3 drugs treatments).

Results:
At baseline, the controls presented an increased arterial hypertension rate (76.47% vs group K 47.06%, p = 0.07). There was no difference in any other CVD risk factor. There was no difference in LV mass, volumes and ejection fraction. The group K experienced an increased incidence of arterial hypertension compared to controls (controls 0% vs group K 41.17 %, p = 0.001). This result was not related to the drug dose. Finally, there was no difference in mortality between the two groups also by analysing the CV death.

Conclusions:
Carfilzomib is a potent and effective drug in MM. Its cardiovascular toxicity relates to a vascular and endothelial damage leading to a new onset of arterial hypertension. This observation may be useful in preventing evolution of the CV dysfunction in survivors and long survivors MM patients. Also, it may be important for studies of vascular damage in arterial hypertension pathophysiology.