bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPC08-7: ORAL SALT LOADING TEST REFLECTS NOCTURNAL HYPERTENSION AND HIGH URINARY ALBUMIN EXCRETION IN PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Yoshimura Saki , Yoshida Yuichi , Kinoshita Mizuki , Miamoto Shotaro , Ozeki Yoshinori , Okamoto Mitsuhiro , Gotoh Koro , Masaki Takayuki , Shibata Hirotaka 
Published: January 2023

Objective:
In the present study, which confirmatory test was most useful for reflecting the severity of primary aldosteronism (PA) was determined by evaluating 24-h blood pressure (BP), urine albumin, left ventricular mass (LVM), and intima media thickness (IMT).

Design and method:
This study included 113 patients (80 PA and 33 non-PA hypertensive patients) who were admitted to Oita University Hospital and evaluated using ambulatory blood pressure monitoring (ABPM). First, casual blood pressure (BP) and ABPM parameters were compared between PA and non-PA patients. Second, patients were divided into PA-positive and PA-negative groups based on confirmatory tests including the saline infusion test (SIT), captopril challenge test (CCT), and oral salt loading test (OSLT), and casual BP and ABPM parameters were compared between the two groups. In addition, urine albumin excretion, LVM, and maximum IMT as markers of organ damage were compared between the two groups.

Results:
The ABPM parameters but not casual BP, were higher in PA patients than in non-PA patients (nocturnal SBP: 118.3 ± 1.6 mmHg, 107.6 ± 2.7 mmHg, p < 0.001; 24-h SBP: 123.4 ± 1.6 mmHg, 113.2 ± 2.6 mmHg, p < 0.001, respectively). Nocturnal and 24-h systolic BP (SBP) in OSLT-positive patients were significantly higher than in OSLT-negative patients (nocturnal SBP: 124.3 ± 3.2 mmHg, 114.4 ± 3.2 mmHg, p = 0.036; 24-h SBP: 129.2 ± 3.3 mmHg, 119.9 ± 3.0 mmHg, p = 0.044, respectively). ABPM parameters in other confirmatory tests were not different between the PA-positive and PA-negative groups. Urine albumin excretion in OSLT-positive patients was significantly higher than in the OSLT-negative patients (51.6 ± 22.5 mg/day and 3.0 ± 0.3 mg/day, p = 0.043). However, in other confirmatory tests, organ damage markers (such as LVM and IMT) were not different between the two groups.

Conclusions:
The OSLT is potentially useful not only for the diagnosis of PA but also for assessment of 24-h SBP and organ damage, as indicated by urine albumin excretion.
PS-BPC08-10: IMPORTANCE OF DIETARY SALT RESTRICTION IN PRIMARY ALDOSTERONISM DURING TREATMENT WITH MINERALOCORTICOID RECEPTOR ANTAGONISTS: ROLE OF POSTTREATMENT PLASMA RENIN LEVELS
Authors: Yoshida Yuichi , Fujiki Rika , Kinoshita Mizuki , Sada Kentaro , Miyamoto Shotaro , Ozeki Yoshinori , Mori Yumi , Noguchi Takaaki , Matsuda Naoki , Okamoto Mitsuhiro , Gotoh Koro , Masaki Takayuki , Shibata Hirotaka 
Published: January 2023

Objective:
The purpose of this study is to measure the estimated dietary salt intake (eU-NaCl) when primary aldosteronism (PA) is treated with mineralocorticoid receptor antagonists (MRAs) and to evaluate whether it is important to reduce salt intake even while on MRA medications.

Design and method:
The eU-NaCl values were investigated in 26 PA patients who were treated with MRAs at pre-treatment and 6-month treatment. The eU-NaCl was calculated as follows: eU-NaCl (g/day) = 21.98 * {urinary sodium (mmol / L) / <urinary creatinine (mg / dL) * 10> * (Body Weight (kg) × 14.89 + Height (cm) × 16.14 - age × 2.043 - 2244.45)}.

Results:
Data are shown as median {first quartile - third quartile}. Various clinical parameters of 26 PA patients were compared between pre-treatment and 6 months MRA treatment; Systolic blood pressure (138 mmHg {124.5–157.7} vs 125 mmHg {117.8–130.8}, p < 0.01) and diastolic blood pressure (86 mmHg {80.5–95.0} vs 78 mmHg {74.5–86.3}, p = 0.02) were decreased, serum potassium (3.9 mmol/L {3.8–4.3} vs 4.3 mmol/L {4.0–4.6}, p < 0.01) and active renin concentration (ARC) (2.6 pg/mL {1.2–3.8} vs 6.1 pg/mL {3.5–10.3}, p < 0.01) were increased significantly. The eU-NaCl (8.9 g/day {8.0–10.2} vs. 10.0 g/day {7.8–12.0}, p = 0.27) did not change. The correlation between the difference in eU-NaCl (ΔeU-NaCl) and the difference in ARC (ΔARC) before and after MRA treatment showed a significant inverse correlation (r = -0.418, p = 0.03). Furthermore, when the 26 patients were divided into 2 groups of ARC >5 pg/mL and ARC < 5 pg/mL after MRA treatment, ΔeU-NaCl and ΔARC showed no significant correlation in 16 patients with ARC ≧ 5 pg/mL (r = -0.481, p = 0.11), whereas a strong inverse correlation in 10 patients with ARC < 5 pg/mL (r = -0.7599, p = 0.01).

Conclusions:
The present data indicate that post-MRA treatment ARC of less than 5pg/mL reflects insufficient improvement of salt sensitivity, suggesting the importance of dietary salt restriction even in the presence of MRA treatment.
PS-BPC10-8: POST-VACCINATION SARS-COV-2 IGG ANTIBODY TITER IN DIALYSIS PATIENTS
Authors: Yoshida Sumiko , Tsuji Seijirou , Miya Keiko , Shima Hisato , Tashiro Manabu , Inoue Tomoko , Minakuchi Jun , Okada Kazuyoshi , Endo Itsuro , Abe Masahiro 
Published: January 2023

Background:
Dialysis patients have a higher COVID-19 fatality rate than the general population and are priority candidates for SARS-CoV-2 vaccination. However, dialysis patients are immunocompromised, suggesting that they may develop a less immune response to COVID-19 vaccination than healthy individuals.

Objective and Methods:
A total of 358 hemodialysis patients who were twice-vaccinated with BNT162b2 were included. SARS-CoV-2 IgG antibody titer was measured within 7 days to 1 month, 1∼2 months, and 3∼4 months after the second vaccination, and factors influencing antibody titer were statistically investigated. SARS-CoV-2 IgG measurement was performed using SARS-CoV-2 IgG II Quant Reagent (Abbott), which is a reagent to quantitatively measure IgG antibodies against the receptor-binding domain of SARS-CoV-2 spike protein.

Results:
The patients were 240 males (67%) and 118 females, ranging from 37 to 95 years old, with a median age of 70 years. Causes of kidney failure were diabetes mellitus in 35.2%, hypertensive kidney disease in 7.3%, glomerular disease in 30.5%, and polycystic kidney disease in 4.5% of the patients. Comorbidities were hypertension in 64.3% and diabetes in 48.9%. Steroids or immunosuppressive drugs were used in 9% of the patients. SARS-CoV-2 IgG antibody titers at 7 days to 1 month, 1 to 2 months, and 3 to 4 months (median 10, 42, and 98 days) after the second vaccination have the median of 4092 AU/mL(with interquartile range: 1354, 7592), 2199 (927, 4692), and 789 (323, 1559), respectively. Post-vaccination SARS-CoV-2 IgG titers were significantly correlated with Kt/V, the presence of autoimmune diseases, the use of steroids or immunosuppressive drugs, malignancy treatment, and serum albumin and hemoglobin levels. Multivariate analysis showed that the factors that decreased post-vaccination SARS-CoV-2 IgG titer were the use of steroids and immunosuppressive drugs, the presence of malignant tumors under treatment, and hypoalbuminemia.

Conclusion:
Compared to healthy subjects in previous reports, dialysis patients had lower SARS-CoV-2 IgG titers after COVID-19 vaccination, suggesting that the vaccine may not be sufficiently effective. In addition, SARS-CoV-2 IgG titers are likely to be even lower in patients at high risk for decreased immune response due to medications or comorbidities. Additional vaccination may be essential for hemodialysis patients who are expected to have low SARS-CoV-2 IgG titers.
PS-BPC11-7: SEX DIFFERENCES IN BLOOD PRESSURE CONTROL FOLLOWING REMOTE PATIENT MONITORING IMPLEMENTATION WITH AND WITHOUT CARE COORDINATION: A PROSPECTIVE COHORT STUDY
Authors: Persell Stephen D , Petito Lucia C , Anthony Lauren , Peprah Yaw , Lee Ji Young , Li Jim , Sato Hironori 
Published: January 2023

Objective:
Evaluate sex and race/ethnicity subgroup differences in the effects of care coordinator-assisted implementation of remote patient monitoring (RPM) and RPM implementation alone for hypertension in primary care compared to usual care.

Design and Methods:
Subgroup analysis of 3-arm pragmatic pilot cohort study. At two clinics, nurse care coordinators with physician approval, offered RPM to eligible patients and assisted with initiation. At two clinics, RPM was solely at physician discretion. Twenty clinics continued with usual care. Eligible patients were aged 65–85y with Medicare insurance and had uncontrolled hypertension (last two office BP > = 140/90 mm Hg). The primary outcome assessed at 6 months was controlling high blood pressure (< 140/90 mm Hg) at the most recent measurement. We tested for interactions between group and sex and between group and race ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic and others) in generalized linear models adjusted for age and baseline systolic BP.

Results:
In this cohort (234 RPM plus care coordination, 600 RPM only, 1617 usual care), we detected effect heterogeneity by sex (p = 0.02) but not race/ethnicity (p = 0.17). In sex-stratified analyses, the odds of controlling high blood pressure at 6 months in the RPM plus care coordination compared to control were 1.62 times higher (95% CI 1.09–2.41, P = 0.02) for women and 1.17 times higher (0.65–2.13, P = 0.6) for men. Corresponding odds comparing the RPM alone to control were 1.63 (1.24–2.13, P < 0.001) for women and 0.86 (0.55–1.34, P = 0.51) for men. RPM uptake in the care coordination group was 18% (27/153) for women and 14% (11/81) for men, compared with 0.7% (3/422) for women and 0% (0/178) for men in the RPM alone group. Among RPM-prescribed patients with baseline BP > = 140/90 mm Hg in the care coordination plus RPM group, usage following a RPM prescription was high (90% for women and 100% in men), antihypertensive medication intensification over the course of 6 months occurred for the plurality of patients (37% and 47%). SBP decline at 6 months was substantial (mean [SD] 23.6 [27.2] and 21.1 [21.2] mmHg).

Conclusions:
Introducing remote patient monitoring with and without care coordination appeared to have greater effects on BP control in women. Greater rates of RPM prescribing to women compared to men may account for these findings. Larger studies are needed to explore these differences.
PS-BPC11-8: ASSOCIATION OF CARDIOMETABOLIC INDEX AND SUBCLINICAL RENAL DAMAGE: A CROSS SECTIONAL STUDY
Authors: Sun Yue , Mu Jianjun 
Published: January 2023

Objective:
Subclinical renal damage (SRD) has become a major health issue due to its dormant onset and poor prognosis. Recent studies have found that cardiometabolic index (CMI) is closely related to diabetes, hypertension, stroke and cardiovascular disease. However, the correlation between CMI and SRD among adults without diabetes still remain unclear. The present study is aimed to investigate the association between CMI and SRD among non-diabetic individuals in a Chinese cohort.

Design and method:
A total of 2222 participants (male n = 1208) from our previously established cohort of Adolescent Hypertension Study were included in the cross-sectional survey. CMI was calculated by triglyceride to high density lipoprotein cholesterol ratio multiply waist-to-height ratio. Renal function was assessed with estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR). The participants were divided into three groups according to CMI scores. The logistic regression model was established to analyze the relationship between CMI and the risk of SRD.

Results:
CMI was positively correlated with SRD. Compared to participants in the lowest tertile of CMI, those in the highest tertile of CMI had higher risk of SRD(OR:1.918, 95%CI:1.391–2.643,P < 0.001). The association remained significantly after adjusting related factors such as sex, age, history of hypertension, smoking, alcohol use, heart ratio and fasting blood glucose(OR:1.458, 95%CI:1.023–2.079, P < 0.05).

Conclusions:
Our study showed that cardiometabolic index was significantly associated with the risk of SRD in Chinese adults without diabetes. CMI may be used as a simple marker for detection of subclinical renal damage in non-diabetic subjects.
PS-BPP01-1: OUTCOME-BASED THRESHOLD FOR CAROTID-FEMORAL PULSE WAVE VELOCITY: THE IDCARS STUDY
Authors: An Dewei , Cheng Yibang , Huang Qifang , Li Yan , Staessen Jan A 
Published: January 2023

Objective:
Current guidelines recommend a carotid-femoral pulse wave velocity (cf-PWV) > 10m/s of as a sign of large arterial stiffening, which was mainly based on cross-sectional analyses on the distribution of cf-PWV in healthy populations. Using data from the International Database of Central Arterial Properties for Risk Stratification (IDCARS), we aimed to determine an outcome-driven threshold for cf-PWV.

Methods:
Adults (> = 18 years) recruited from eight IDCARS centres and followed up for 6 months or longer were qualified for inclusion in the current meta-analysis. Cf PWV was measured using the Sphygmocor device. The primary endpoint consisted of fatal and nonfatal cardiovascular events. Secondary endpoints were total and cardiovascular mortality, and fatal and nonfatal coronary events. We calculated multivariable-adjusted hazard ratios (HRs) versus the average risk of the whole population for cf-PWV ranging from the 10th to the 90th percentile with an increment of 0.1 m/s. We plotted the HRs and their 95% confidence limits versus the increasing cutoff points of cf-PWV with the goal to determine at which level the lower confidence limit crossed unity.

Results:
Of 3494 participants (mean age: 52.2 years; women: 55.3%; mean cf-PWV: 7.8 m/s) followed up for a median of 5.0 years, 156 (4.5%) experienced the primary endpoint and 104 (3.0%) died. Multivariable adjusted outcome-driven thresholds of cf-PWV (m/s) were 8.6 for the primary cardiovascular endpoint, and 9.1, 8.7 and 8.6 for all-cause and cardiovascular mortality and coronary event, respectively. Subjects with a cf-PWV > = 9 m/s (n = 752, 21.5%), compared with the rest of the population, had an increased risk of the primary cardiovascular endpoint (HR: 1.75; 95% CI: 1.20–2.54, P = 0.004).

Conclusions:
The outcome-based threshold of > = 9 m/s for cf-PWV is close to the cut-off proposed by the current guidelines, according to which 20% of the IDCARS participants had arterial stiffness and were associated with increased cardiovascular risk.
PS-BPP04-9: THE RXPATH RANDOMIZED TRIAL OF THE HYPERTENSION CANADA PROFESSIONAL CERTIFICATION PROGRAM: A NOVEL IMPLEMENTATION STRATEGY FOR HYPERTENSION GUIDELINES
Authors: Tsuyuki Ross Tadao , Watson Kaitlyn Elizabeth , Pan Bo , Hamarneh Yazid Nabil Al 
Published: January 2023

The uptake of clinical practice guidelines into practice is poor for many chronic conditions, including hypertension. We designed a guidelines-based educational program for primary care clinicians, the Hypertension Canada Professional Certification Program (HC-PCP, www.hypertension.ca/professional-certification-program). It consists of four online modules, an online prospective patient registry, and expert evaluations of the blood pressure measurement technique and case management by the learner. We then evaluated its impact on patient level outcomes.

Objective:
The objective of RxPATH was to determine the effect of the HC-PCP for pharmacists on systolic blood pressure reduction in patients with poorly controlled hypertension.

Design and Methods:
Design: Stepped wedge cluster randomized trial (unit of randomization was the pharmacy).

Setting:
Community pharmacies in Alberta, Canada

Population:
Pharmacists with prescriptive authority volunteered to participate. We enrolled patients with poorly controlled hypertension (BP > 140/90mmHg or > 130/80mmHg in those with diabetes), identified by their pharmacist.

Intervention:
Pharmacists were enrolled in the HC-PCP. They then provided this care to their patients with poorly controlled hypertension.

Control:
Pharmacists were given a copy of the Hypertension Canada Guidelines and provided usual care to their patients prior to undertaking the HC-PCP.

Outcomes:
The primary outcome was difference in change in systolic blood pressure between intervention and control groups at 3 months. We also evaluated patient satisfaction using the Consultant Satisfaction Questionnaire (CSQ).

Results:
We enrolled 890 patients from 61 pharmacies (104 pharmacists). Mean age was 61.6 (SD 14.1) years, 46% were female, 35.5% had diabetes, and mean baseline BP was 152.4 (SD 13.8)/87.0 (SD 10.6)mmHg. Change in systolic BP was 9.9 (SD 16.5) for the intervention group, compared to 9.9 (SD 16.2) mmHg in the control group, p = 0.29. Patient satisfaction using the CSQ was high at 76 (of 90 maximum).

Conclusions:
Most educational programs do not get evaluated at the patient level. RxPATH demonstrated that the HC-PCP intervention did not result in a greater reduction in systolic BP compared to control. While both groups did have clinically meaningful reductions in BP, possible reasons for lack of a difference with the intervention include: COVID-19 staffing/workload issues in pharmacies, selection bias for pharmacists interested in hypertension/contamination of usual care group, and short follow-up duration. Feedback on the HC-PCP from pharmacists was positive, patient satisfaction was high, and we plan to make this program widely available to primary care providers.
PS-BPP05-9: IMPACT OF EVACUATION ON THE LONG-TERM TREND OF HYPERTENSION AFTER THE GREAT EAST JAPAN EARTHQUAKE
Authors: Eguchi Eri , Satou Haruka , Funakubo Narumi , Nakano Hironori , Imano Hironori , Iso Hiroyasu , Ohira Tetsuya 
Published: January 2023

Objective:
Increases in lifestyle-related diseases have been reported after the Great East Japan Earthquake, but the long-term effects are not clear. The aim of this study was to examine the trend of hypertension in the 10 years before and after the earthquake.

Design and method:
A cumulative total of 3,860,698 Fukushima residents aged 40 to 74 years who participated in specific health check-ups between 2008 and 2017, for whom blood pressure data were available were the subject of this study. Fukushima was divided into mountainous, central, coastal, and evacuation areas, and the age adjusted prevalence of hypertension in each area and years were calculated stratified by gender and age groups (> = 60 and < 60) and compared between before (2008–2010) and after (2011–2017) the disaster using Poisson regression models. Furthermore, inflection point analysis was used to calculate the annual percentage change (APC) in each year. Hypertension was defined as a systolic/diastolic blood pressure of 140/90 mmHg and/or taking antihypertensive medication.

Results:
The proportion of hypertension increased in 2011, the year of the earthquake, in coastal, central and evacuation areas, and the change in the prevalence in evacuation areas was particularly pronounced in men, with a 2.3-point increase in men and a 1.7-point increase in women. The prevalence of hypertension in the evacuation areas returned to its original level in 2013 for women, but not for men in which a significant upward trend was observed throughout the decade in all four areas, with an average APC (95% confidence interval) of 0.8 (0.2–1.4) in the evacuation areas. There were no significant differences according to age group stratification.

Conclusions:
Prevalence of hypertension in Fukushima Prefecture after the disaster was higher than before the disaster, especially in evacuated areas, and this trend continued for a long period of time, especially in men. Determinants of hypertension trends, such as lifestyles and overweight will be examined in detail.
PS-BPP06-2: ASSOCIATIONS BETWEEN URIC ACID LEVELS AND HYPERTENSION INCIDENCE IN AN APPARENTLY HEALTHY JAPANESE POPULATION
Authors: Salim Anwar Ahmed , Kawasoe Shin , Kubozono Takuro , Ojima Satoko , Kawabata Takeko , Ikeda Yoshiyuki , Miyahara Hironori , Tokushige Koichi , Ohishi Mitsuru 
Published: January 2023

Objective:
Uric acid (UA) has been linked to the development of hypertension. However, it is not known if this association is significant in men and women who are apparently healthy at baseline.

Design and Methods:
This retrospective cohort study included individuals who participated in a health checkup at the Kagoshima Kouseirin Hospital from October 2008 to April 2019. We excluded participants with hypertension, diabetes, dyslipidemia, obesity, estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2, history of gout, hyperuricemia medication, and missing data at baseline. To assess the association between baseline UA levels and 5 year hypertension incidence, we performed univariable and multivariable logistic regression analysis by sex according to their UA quartiles as follows: In men: 1st quartile ≧ 4.8 mg/dL, 2nd quartile 4.9 to 5.6 mg/dL, 3rd quartile 5.7 to 6.4 mg/dL, and 4th quartile ≧ 6.5 mg/dL; In women: 1st quartile ≧ 3.4 mg/dL, 2nd quartile 3.5 to 4.0 mg/dL, 3rd quartile 4.1 to 4.7 mg/dL, and 4th quartile ≧ 4.8 mg/dL. The ORs were adjusted for age, body mass index, systolic blood pressure (SBP), diastolic blood pressure (DBP), current smoking, alcohol consumption, exercise habit, serum triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting plasma glucose and eGFR. Hypertension incidence was defined as SBP ≧ 140 mmHg and/or DBP ≧ 90 mmHg at follow up, or newly prescribed antihypertensive medication during 5 years of follow up.

Results:
In total, 21,514 participants (age, 52.9 ± 10.9 years; men, 39.8%), were enrolled. During the 5 year of follow-up, 1415 (16.5%) men and 1408 (10.9%) women developed hypertension. In univariable analysis, the UA levels were significantly associated with hypertension in both men (OR for fourth to first quartile, 1.45; 95% confidence interval [CI], 1.24 to 1.70, P < 0.0001) and women (OR for fourth to first quartile, 1.62; 95%CI, 1.38 to 1.90, P < 0.0001). After adjusting for covariates, the UA levels were significantly associated with hypertension in men (OR for fourth to first quartile, 1.35; 95%CI, 1.13 to 1.62, P = 0.0011), but was not in women (OR for fourth to first quartile, 1.14; 95%CI, 0.95 to 1.36, P = 0.1541)

Conclusion:
Elevated UA levels are associated with hypertension incidence in Japanese men without hypertension, diabetes, dyslipidemia, obesity, and decreased kidney function.
PS-BPP06-6: THE ASSOCIATION BETWEEN CARBON AND NITROGEN STABLE ISOTOPE RATIOS OF HUMAN HAIR AND HYPERTENSION
Authors: Ahn Song Vogue , Lee Sihoon 
Published: January 2023

Background:
The relationship between stable isotope ratios and dietary protein sources has been reported. However, few studies have examined the effect of stable isotope ratios on metabolic risk in humans. We investigated whether the stable isotope ratios of carbon and nitrogen in human hair are associated with blood pressure and hypertension.

Methods:
We conducted a cross-sectional study of 392 subjects (228 men and 164 women). Hair samples of the subjects were used for the measurement of stable isotope ratios of carbon (Δ13C) and nitrogen (Δ15N).

Results:
The Δ13C and Δ15N values showed positive correlations with diastolic blood pressure in the subjects without antihypertensive medication. In the subjects without antihypertensive medication, the multivariable-adjusted odds ratio (95% confidence interval) for hypertension was 1.55 (1.04 - 2.30) per 1‰ increase in Δ15N and 1.22 (0.86 - 1.73) per 1‰ increase in Δ13C, respectively. However, in the subjects with antihypertensive medication, neither Δ13C nor Δ15N values showed a significant association with hypertension.

Conclusions:
The stable isotopic ratio of nitrogen in scalp hair is independently associated with hypertension in subjects without antihypertensive medication. The hair Δ15N value might be used as a surrogate marker to screen a high-risk population for hypertension.