bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF ATTENDED WITH UNATTENDED BLOOD PRESSURE MEASUREMENTS PERFORMED BY TWO DIFFERENT DEVICES
Authors: Filipovsky Jan , Seidlerova Jitka Mlikova , Gelzinsky Julius , Mares Stepan , Mayer Otto 
Published: June 2023

Objective:
Unattended blood pressure (uBP) is lower than blood pressure (BP) measured by physician or nurse (attended blood pressure, aBP). We aimed to compare the uBP values obtained in two population-based cohorts, where uBP was measured in different way.

Design and method:
In the MONICA Study, 1% random samples from general population were repeatedly examined. We selected two cohorts for the present analysis: cohort 1 (examined in 2016, n = 179), where uBP was measured by BPTru (six measurements, first skipped, with no pause before the measurements), and cohort 2 (year 2018, n = 166) where uBP was measured by Omron 907 (three measurements after a preset 5-minute pause). aBP was measured after uBP in triplicate by physician using auscultatory method.

Results:
The two cohorts did not differ in age (67 vs 69 years), sex distribution, prevalence of cardiovascular disease, prevalence of hypertension (74 vs 73%), atrial fibrillation, diabetes, antihypertensive or hypolipidemic treatment and smoking. Systolic aBP was 137.6 ± 16.6 vs 135.4 ± 17.8 mmHg (NS) and diastolic aBP was 81.4 ± 9.4 vs 77.2 ± 9.5 mmHg (<0.0001) in the two cohorts, respectively. Differences between aBP and uBP were significant in all cases (p < 0.001), ranging from 3.7 mmHg (diastolic aBP – BP by Omron) to 8.8 mmHg (systolic aBP – BPTru). When the BPTru and Omron uBP measurements were compared, no difference was found. This was true when the means of all measurements were compared (five by BPTru and three by Omron) and also when only two measurements were analyzed (2nd and 3rd one, available for both devices). Multiple regression of systolic aBP – uBP difference showed that the only significant determinant was aBP value (positive association, p < 0.0001).

Conclusions:
There was no difference between the uBP values measured by BPTru and Omron 907. The 2nd and 3rd measurements seem to be sufficient to be taken into account.
ABILITY OF A CUFFLESS 24 HOUR AMBULATORY BLOOD PRESSURE MEASUREMENT DEVICE TO TRACK BLOOD PRESSURE CHANGES COMPARED TO A CUFF-BASED DEVICE
Authors: Burkard Thilo , Derendinger Felicia , Krisai Philipp , Socrates Thenral , Schumacher Christina , Mayr Michael , Vischer Annina 
Published: June 2023

Objective:
There is an increasing number of cuffless blood pressure (BP) measurement devices on the market. Beneath the absence of generally accepted validation protocols for these devices, the ability of these devices to track changes in BP levels over 24h in relation to an initial calibration BP is unknown. Aim of this study was to analyse this ability in a cuffless 24h BP device using pulse transit time.

Design and method:
We prospectively enrolled 166 participants for simultaneously performed cuffless (TestBP, Somnotouch NIBP) and cuff-based (RefBP, Spacelabs 90217A or IEM Mobil-o-graph) 24h BD measurements. Main exclusion criteria were atrial fibrillation or an inter-arm difference of >10 mmHg. TestBP calibration was based on initial RefBP measurement (CalibBP). As surrogate parameters for tracking individual changes in BP levels after the CalibBP, we used the difference between CalibBP and mean 24h, awake and asleep BP measured by RefBP and TestBP. Additionally, we analysed the relationship between the difference of CalibBP and RefBP vs the difference between RefBP and TestBP.

Results:
Mean (±SD) age was 51.2 (15.1) years and 53% were male. Mean (±SD) difference between CalibBP and mean 24h BP by RefBP / TestBP were 7.4 (13.2) versus 1.8 (8.3) mmHg for systolic (p < 0.0001) and 6.6 (6.8) versus 1.6 (5.8) mmHg for diastolic (p < 0.0001). Corresponding ranges for CalibBP-RefBP were -35 – 55 mmHg vs. -14 – 34 for CalibBP-Test BP. Figure 1 shows a near linear relationship between the difference between CalibBP and RefBP and the difference between RefBP and TestBP for systolic and diastolic BP values. Red line indicates the theoretical situation that TestBP follows CalibBP without tracking changes in BP levels, green line an ideal agreement of RefBP and TestBP.

Conclusions:
This is the first study to show the lower ability of the cuffless BP device to track changes of BP levels after an initial calibration measurement compared to a standard cuff-based device over 24h. Additionally, the difference between the RefBP and the TestBP was nearly linearly associated with the difference between a CalibBP and the changes of the BP level.
DETERMINANTS OF WITHIN-VISIT OFFICE BLOOD PRESSURE VARIABILITY AND INSTABILITY: EUROPEAN DATA FROM 1.053 INDIVIDUALS
Authors: Theodosiadi Aikaterini , Kollias Anastasios , Ntineri Angeliki , Kyriakoulis Konstantinos , Niiranen Teemu , Lindroos Annika , Jula Antii , Schwartz Claire , Andreadis Emmanuel , McManus Richard , Stergiou George S. 
Published: June 2023

Objective:
Blood pressure (BP) variability is the physiological sequelae of the complex interaction of multiple neural, humoral, reflex, and behavioral factors. This analysis aimed to evaluate the determinants of BP variability and instability within a single office visit, which is routinely used for hypertension evaluation in clinical practice.

Design and method:
A retrospective analysis of cross-sectional data was performed, comprising adults with triplicate office BP measurements in a single office visit and 24h ambulatory BP monitoring collected within the context of prospective clinical studies in Finland, Greece, and United Kingdom. Indices of BP variability and instability included: (i) standard deviation (SD) (ii) coefficient of variation (CV) (iii) average real variability (ARV) (iv) maximum office BP (Max) (v) maximum-minimum difference (MMD) of office BP (vi) ratio of the difference between 1st-3rd measurement to the mean office BP (Relative change). White-coat effect was defined as the difference between office and daytime ambulatory BP.

Results:
Data from 1.053 individuals were analyzed (mean age 57.7 ± 11.3 years, males 50%, treated hypertensives 50.3%, average office BP 133.5 ± 18.7/83.5 ± 10.9 mmHg, daytime ambulatory BP 132.5 ± 14.1/80.7 ± 9.9 mmHg). All the indices of BP variability and instability were positively associated with average office BP, age, BMI, and white-coat effect, but with an inverse association between age and maximum diastolic BP (all p < 0.05). In multivariable linear regression analysis systolic BP variability was mainly determined by average office systolic BP, and treatment for hypertension, while diastolic BP variability was determined by office diastolic BP and female sex (Table).

Conclusions:
These results suggest that the variability and instability of BP within a single office visit is mainly influenced by the BP level, female sex and the administration of antihypertensive treatment.
VEGF INHIBITION-INDUCED PARP OVERACTIVATION LEADS TO ENDOTHELIAL DYSFUNCTION AND INFLAMMATION: ROLE OF SIRTUIN 1 SIGNALLING
Authors: Neves Karla , Alves-Lopes Rheure , Montezano Augusto C. , Touyz Rhian 
Published: June 2023

Objective:
Hypertension is a common unwanted effect of VEGF inhibitors (VEGFi), which are used as anti-angiogenic drugs in cancer treatment. Clinical observations indicate that the magnitude of blood pressure elevation is lower in patients with cancer who are treated with combination VEGFi and olaparib (PARP inhibitor [PARPi]), versus monotherapy. However putative vascular mechanisms are unknown. PARP plays major role in the activation of TRPM2, a redox-sensitive Ca2+ channel, which is associated with hypertension-induced vascular dysfunction. PARP also regulates sirtuin deacetylases activity, especially sirtuin 1 (SIRT1), which is involved in vascular homeostasis and diseases. Here our aim is to investigate whether VEGFi, via PARP activation, leads to vascular dysfunction through disruption of SIRT1 signalling.

Design and method:
Human aortic endothelial cells (HAEC) and mouse mesenteric arteries were studied. Cells were exposed to axitinib (VEGFi; 1uM) alone or in combination with olaparib (PARPi; 1uM) in the presence or absence of a SIRT1 activator (SRT1720; 2uM). Wire myograph was used to assess vascular function.

Results:
Axitinib increased PARP activity in a ROS-dependent manner in HAEC (au: [Veh]0.31 vs. [Axi]0.55; [Tiron+Axi] 0.38] whereas SIRT1 activity was reduced by VEGF inhibition (au: [Veh]33760 vs. [Axi]23367), which was prevented by olaparib. This was followed by an increase in expression of acetyl-p53. Activation of SIRT1 decreased levels of MCP-1 and IL-6 and VCAM-1 and ICAM-1 mRNA levels in HAEC exposed to axitinib, which, similarly to olaparib, was accompanied by a reduction in monocytes adhesion to HAEC. U46619- and ET-1-induced vasoconstriction were increased by axitinib, an effect not observed with axitinib plus Olaparib. Pre-incubation with SRT1720 exacerbated the anti-contractile effects of olaparib. Axitinib impaired ACh-induced vasodilation (% relaxation: 70.5 [Ct] vs. 34.8 [Axi]), which was blocked by olaparib and SRT1720. Phosphorylation of the inhibitory site of eNOS was also increased in HAEC (au: [Veh] 0.18 vs. [Axi] 0.37) and restored by SRT1720.

Conclusions:
Our data indicate that VEGF inhibition-induced PARP overactivation leads to endothelial dysfunction and inflammatory responses via disruption of SIRT1 signalling. We define a putative vasoprotective effect of olaparib that may ameliorate vascular injury induced by VEGFi in cancer treatment.
HYPERTENSION IN CANCER PATIENTS TREATED WITH ANTI-ANGIOGENIC BASED THERAPY: A POPULATION-BASED COHORT STUDY
Authors: Franchi Matteo , Torrigiani Ginevra , Corrao Giovanni , Mancia Giuseppe 
Published: June 2023

Objective:
Data from randomized clinical trials showed that new-onset hypertension is a common side effect of anti-angiogenic drugs. We compared the cumulative incidence of new-onset hypertension in cancer patients treated with either anti-angiogenic based therapy (AAG) or other chemotherapy only, and in patients who did not received antineoplastic agents (untreated).

Design and method:
Retrospective population-based cohort study based on the healthcare utilization databases of Lombardy Region (Italy). We identified the cohort of patients aged 40 years or older with a new diagnosis of cancer between 2009 and 2017. We excluded patients with antihypertensive treatment in the five years before cancer diagnosis. We 1:1:1 matched each patient who started a therapy with AAG (index case) with one patient treated with other chemotherapy only and with one untreated patient by date of cancer diagnosis, tumoral site and date of start of antineoplastic therapy. We followed-up each of the three matched patients from the date of start of AAG of the index case until the first date between onset of antihypertensive treatment with at least 3 prescriptions (the outcome of interest), death, migration or 2 years after the start of follow-up. We estimated the incidence cumulative function by considering death as competing event and we fitted a Fine and Grey regression model, adjusted for age, sex and Cancer Multimorbidity Score, in order to estimate the association between treatment and new-onset hypertension.

Results:
The final cohort included 3,333 1:1:1 matched patients (median age 62 years; 43.6% males). The cumulative incidence of new-onset hypertension was higher among patients treated with AAG, as compared to others. The cumulative incidence rapidly increased 1 year (26.3%) after starting therapy with AAG. The adjusted hazard ratios were 3.73 (95% CI 3.34 to 4.15) and 4.00 (3.56 to 4.48), when compared to patients treated with other chemotherapy and with those untreated, respectively. Moreover, patients treated with AAG also showed a significant increased risk of major cardiovascular events compared to others.

Conclusions:
Cancer patients treated with AAG showed a markedly higher risk of new-onset hypertension. The risk rapidly increased 1 year after the start of therapy.
FACTOR ASSOCIATED WITH HYPERURICEMIA DEVELOPMENT DURING A 25 YEARS FOLLOW-UP: THE PAMELA STUDY
Authors: Maloberti Alessandro , Quarti-Trevano Fosca , Dell’Oro Raffaella , Facchetti Rita , Mancia Giuseppe , Grassi Guido 
Published: June 2023

Objective:
HyperUricemia (HU) has been associated with future fatal and non fatal CV events as well as with hypertension and metabolic syndrome development. However, only few data exist regarding the change in Uric Acid (UA) and the development of HU during a population follow-up. In particular, no study analyzed the variations during a very long follow-up. The present study was aimed at evaluating the factors associated with UA changes and HU development during a 25-years follow-up in the PAMELA study. Both the classic cut-off for hyperuricemia and the newly one identified by the Uric Acid Right for Heart Health (URRAH) study were used to define HU.

Design and method:
We analyzed data collected in 561 subjects of the Pressioni Arteriose Monitorate E loro Associazioni (PAMELA) study with available SUA who complete the 3rd wave study (mean follow-up time 25.2 ± 0.5 years). The classic cut-off of 6/7 mg/dL (females and males respectively) and URRAH one (5.1/5.6 mg/dL for females and males) were used for HU definitions.

Results:
Mean UA value during follow-up increase from 4.7 ± 1.1 to 5.0 ± 1.2 mg/dL (p < 0.001) with a mean increase of 0.3 ± 1.1 mg/dL. UA changes significanlty correlated with baseline UA (r = -0.39, p < 0.001) and creatinine (r = -0 - 21, p < 0.001). With the classic cut-off (6/7 mg/dL) 9.1% of the subjects develop HU and this was associated at the multivariate model with age, sex (male), baseline diastolic Blood Pressure (BP) (OR 1.038, p = 0.02) and UA (OR 2.62, p < 0.001). With the new URRAH cut-off 19.1% of the subjects develop HU. At the multivariate model variables associated were gender (male) and baseline 24h systolic BP (OR 1.05, p < 0.001), tryglicerides (OR 1.01, p = 0.01) and UA (4.99, p < 0.001).

Conclusions:
The present study provide evidence that in the PAMELA study during the 25 year follow-up there is a progressive increase in UA. Baseline UA is the most important factor associated with HU development. However, also age, gender, triglycerides and BP could help to identify subjects that most probably will develop HU.
THE IMPACT OF THE 3-YEAR COVID-19 PANDEMIC IN THE HYPERTENSIVE POPULATION OF A EUROPEAN SOCIETY OF HYPERTENSION EXCELLENCE CENTER
Authors: Triantafyllidi Helen , Birmpa Dionyssia , Benas Dimitrios , Fambri Anastasia , Kavatha Dimitra , Iliodromitis Efstathios 
Published: June 2023

Objective:
The 3-year COVID-19 pandemic resulted in increased morbidity and mortality in patients with cardiovascular (CV) disease. We aimed to investigate the impact of COVID-19 pandemic in the hypertensive population of a European Society of Hypertension (ESH) Excellence Center.

Design and method:
We retrospectively studied 426 hypertensive patients (61 + 14 years, 48% males) visited our Hospital (March 2020-November 2022) regarding clinical characteristics, CV risk factors and comorbidities All patients were interviewed regarding COVID-19 disease by a phone call during a 2-month period (October-November 2022).

Results:
A small percentage of our population suffered from DM (17%) or had a history of CAD and/or previous stroke (11%). Regarding COVID-19 disease, 55% hypertensives were infected by SARS-CoV-2 virus (Group A, 58 + 14 years, 48% males), 43% patients were not infected (Group B, 65 + 14 years, 50% males) while 2% patients were lost. We found that Group A patients were younger (p < 0.001) while they didn’t differ as for BMI, systolic and diastolic BP, LDL, left ventricular EF, and the history of DM, CAD, stroke, CTD, CKD and cancer compared to Group B. A 89% of the population has received at least one dose of a COVID-19 vaccine. Regarding morbidity and mortality in Group A, 50% patients had minor/no symptoms, 43% patients had fever >38oC, 6% patients were hospitalized for pneumonia due to SARS-CoV-2 virus but only 2 patients (0.8%) died. We hypothesized that, 74% patients infected by the Omicron subtype (50% of them since May 2022), 13% patients by the Delta subtype and 13% patients by the Alpha subtype.

Conclusions:
Hypertensives showed an increased compliance regarding vaccination against COVID-19. Half of the population (the younger ones) affected by SARS-CoV-2 virus, mainly by the Omicron subtype, while just a small percentage was hospitalized or died. Interestingly, about 1/5 of the whole hypertensive population was infected during the last six months of COVID-19 pandemic when the strict protection measures were removed worldwide. We conclude that the majority of hypertensive patients protected themselves against COVID-19 while risk factors and comorbidities didn’t play a significant role regarding infection from SARS-CoV-2 virus.
POSITIVE ASSOCIATION BETWEEN BASELINE ARTERIAL STIFFNESS AND NEW-ONSET DIABETES: A POPULATION-BASED COHORT STUDY
Authors: Beros Angela , Sluyter John , Scragg Robert 
Published: June 2023

Objective:
The temporal relationship between increased arterial stiffness and diabetes remains unclear. This study aimed to investigate whether arterial stiffness was associated with new-onset diabetes.

Design and method:
The study population comprised participants from the Vitamin D Assessment (ViDA) Study, a randomised controlled trial of vitamin D supplementation that recruited participants mostly from family practices in Auckland, New Zealand from 5 April 2011 to 6 November 2012. Arterial stiffness was measured at baseline by aortic pulse wave velocity (aPWV), augmentation index (AIx) and pulse pressure (PP). Vitamin D did not affect the risk of the main study outcomes including cardiovascular disease. The final study population was 4479 participants after excluding those with existing diabetes (as determined by dispensed prescriptions and self-report). New-onset diabetes was determined by linkage to dispensed prescription and national hospital discharge registers. Cox proportional hazards regression was used to assess the incidence of diabetes in relation to aPWV, AIx and PP.

Results:
The mean (SD) age of participants at baseline was 66.2 (8.3), 2556 (57.1%) were male and 3880 (86.6%) were of European or other ethnicity, with the remainder being Polynesian (including indigenous Maori) or South Asian. During a mean (SD) follow-up of 6.86 ± 0.43 years, 364 (8.1%) participants developed diabetes. Following adjustment for age, sex, ethnicity, mean arterial pressure, body mass index and vitamin D supplementation (vitamin D vs placebo), aPWV and PP, but not AIx were associated with an increase in new onset-diabetes (per SD increase, aPWV hazard ratio, 1.36, 95% CI, 1.13 to 1.64; PP hazard ratio, 1.40 95% CI, 1.16 to 1.68; AIx hazard ratio, 1.02, 95% CI, 0.91 to 1.14).

Conclusions:
Arterial stiffness, as measured by aPWV and PP, independent of other risk factors, may be a useful predictor of new-onset diabetes.
VASCULAR FUNCTION AS POSSIBLE MARKER OF FUTURE SUSTAINED HYPERTENSION IN YOUNG TO-MIDDLE AGE STAGE I HYPERTENSIVES ACCORDING TO DIFFERENT HYPERTENSION SUBTYPES
Authors: Saladini Francesca , Rattazzi Marcello , Mos Lucio , Vriz Olga , Mazzer Andrea , Garbelotto Raffaella , Battista Francesca , Ermolao Andrea , Palatini Paolo 
Published: June 2023

Objective:
The risk of adverse CV outcomes in young patients with isolated systolic hypertension (ISH) or isolated diastolic hypertension (IDH) is still debated and whether these hypertension subtypes should undergo pharmacological treatment is unclear. Aim of the present the study was to investigate the vascular characteristics and the risk of progression to sisto-diastolic hypertension (SDH) associated with these hypertension subtypes from the HARVEST study.

Design and method:
We examined 1231 young-to middle age subjects (mean age 33.1 ± 8.6 years, 72.3% males). ISH (11.9%) IDH (22.8%) NT (6.6%) and SDH (58.7%) were defined using the office 140/90 mmHg cutoffs. Vascular stiffness was assessed by radial-carotid pulse wave velocity (PWV) and vascular compliance by radial tonometry among 371 participants. Risk of future hypertension needing antihypertensive treatment was assessed with Cox analysis adjusting for several clinical confounders.

Results:
Metabolic parameters did not differ significantly among subgroups. Peripheral resistance was 1297.1 ± 326 among NT, 1371.3 ± 281 among ISH, 1502.5 ± 261 among IDH and 1531.6 ± 308 dynesxsecxcm-5 among SDH (p = 0.048 IDH vs NT and <0.001 SDH vs NT), while did not differ significantly between ISH and NT. Large artery compliance was 15.0 ± 4.2, 15.5 ± 4.9, 15.1 ± 4.9 and 14.0 ± 4.3 ml/minx10 respectively, again with similar values between NT and ISH and a significant difference between IDH and SDH p = 0.016. PWV and AIx did not differ significantly among groups, while central SBP was similar among NT, ISH, IDH (122.2 ± 12.0, 122.6 ± 12.4 mmHg respectively, p = n.s.) and higher among SDH (p < 0.001 SHD vs IDH). Progression to sustained HT was 59.2%, 66.4%, 77.9% and 87.5%, in NT, ISH, IDH and SDH respectively, p < 0.001. At cox analysis, considering SDH as reference, ISH presented a lower risk of progression to unfavourable outcome (H.R. 0.70, 95%CI 0.58 - 0.88; p = 0.0023).

Conclusions:
Young-to-middle age hypertensives have different endothelial function according to different hypertensive subtypes and this may contribute to the future development of hypertension needing treatment. The assessment of vascular function may help to identify those patients who should be treated earlier.
RELATIONS OF PLASMA ALDOSTERONE CONCENTRATION TO CARDIAC STRUCTURE AND FUNCTION: ARE THERE ANY ETHNIC-RELATED DIFFERENCES?
Authors: Faconti Luca , Chowienczyk Philip , McNally Ryan , Farukh Bushra , Bacca Alessandra , Taddei Stefano , Buralli Simona 
Published: June 2023

Objective:
Plasma aldosterone concentration (PAC) is related to left ventricular hypertrophy (LVH) and diastolic dysfunction in primary hyperaldosteronism but conflicting data exists in primary hypertension. Here we investigated whether this association might differ in hypertensive subjects of African-origin background (black) vs Caucasian (white).

Design and method:
Subjects with hypertension and self-defined ethnicity (SDE) as black or white whose clinical assessment was not suggestive of secondary forms of hypertension and with an aldosterone/renin ratio < 90 pmol/mU were recruited in London (UK) and Pisa (Italy). Transthoracic echocardiography was used to calculate left ventricular mass index (LVMI) and diastolic function using the ratio of early (E)) transmitral filling velocity to tissue Doppler early diastolic velocity (E/e’).

Results:
167 black (51% male) and 273 white (69% male) subjects of whom 55% and 73% on pharmacological treatment were recruited. Compared to white individuals, black subjects had higher blood pressure (BP) (mean ± SD) (153/93 ± 15/12 mmHg vs 139/88 ± 15/11 mmHg) and lower prevalence of dyslipidaemia (9 % vs 38 %, both P < 0.05) but the two groups were similar for age, prevalence of diabetes, smoking, duration of hypertension. Compared to white subjects, black individuals had lower renin and PAC level (42.4 ± 11.2mU/L vs 79.5 ± 12.7 mU/L and 312 ± 26.5 pmol/L vs 420 pmol/L respectively) while LVMI and E/E’ were greater (95.9 ± 25.2 g/m2 vs 88.7 ± 20.5 g/m2 and 9.1 ± 2.8 vs 7.8 ± 2.4 respectively) all P < 0.001. In the entire population we found a significant interaction between ethnicity and PAC in relation to LVMI and E/e’. After stratifying the population according to SDE, PAC positively correlated with LVMI (R2 0.249, P = 0.01) and E/e’ (R2 0.207, P = 0.009) in black but not in white subjects. Multivariate adjustment for sex, BP, diabetes, dyslipidaemia, heart rate, pharmacological treatment, body mass index did not alter the relationship.

Conclusions:
Aldosterone is related to cardiac remodelling and diastolic function in patients with primary hypertension of African origin. The reasons behind the ethnic difference needs to be elucidated.