bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C10-10: AWARENESS AND RECOMMENDATION OF HOME BLOOD PRESSURE MEASUREMENT AMONG PHYSICIAN IN INDIA - RESULTS FROM ASIA HBPM SURVEY 2020
Authors: Verma Narsingh , Matsushita Noriko , Salman Ebtehal , Tomar Isha , Wander Gurpreet Singh 
Published: January 2023

Background:
In Asia Pacific region, 66% of deaths are caused from cardiovascular diseases (CVD) which are attributed to hypertension, and in India alone, ischemic heart disease and stroke are the top causes of death. Awareness of hypertension and blood pressure (BP) control rate are still low in India; therefore, physicians and patients hypertension education are important for increasing awareness and improving hypertension management. Home blood pressure monitoring (HBPM) is recognized as a valuable tool to diagnose and support hypertension treatment including prevention of CVD and target organ damage. We explored the prevailing knowledge and current recommendation of HBPM in daily practice by physicians in India.

Methods:
As part of Asia HBPM Survey-2020, a cross-sectional survey was conducted among health care professionals from India between December 2020 to June 2021. The questionnaire consisted of 37 questions, including sub-questions, related to HBPM awareness and recommendations to patients. All analyses were performed using the proper statistical software and results were presented as descriptive data.

Results:
A total of 832 physicians participated in the survey. Almost 83% were male, whereas age, specialty and workplace were well distributed. Among physicians who recommend HBPM in the morning, more than 60% of respondents are giving instruction to their patients in alignment with local Indian hypertension guidelines regarding the body position and time of rest before measurement. Nevertheless, only 31% of physicians instruct their patients to measure their BP before taking anti-hypertensive drugs, while around 30% of physicians gave no instructions. A noticeable percentage of the physicians gave no instructions related to home BP measurement to their patients. Reference value of hypertension diagnosis amongst the physicians was substantially low based on clinic BP (34%) and home BP (15%).
Among physicians who manage hypertensive patients, nearly 88% recommend HBPM to their patients, however, only 29% of their patients own HBPM device and 35% of the patients measure their own BP at home.

Conclusions:
The survey reveals that awareness of HBPM amongst physicians in India is low and instruction to their patients are either lacking or not well aligned with the local hypertension guidelines which may have led to the low HBPM rate among patients. Considering the challenges and limitations physicians face in daily practice, clear and practical educational material and sessions are needed to improve the understanding of HBPM amongst physicians.
PS-C11-11: DEGREE OF BRACHIAL AND CENTRAL ARTERIAL BLOOD PRESSURE IN HYPERTENSIVE PATIENTS WITH INTER-ARM BLOOD PRESSURE DIFFERENCE(IAD)< 10MMHG VERSUS≧ 10MMHG
Authors: Cheng Wen Li 
Published: January 2023

RuFei Liu, WenLi Cheng(Email:chengwenli2000@163.com)

Objective:
IAD ≧ 10mmHg has been proven to be a predictor of cardiovascular morbidity and mortality, especially in people with hypertension. Compared with brachial blood pressure, central blood pressure was more effective in reflecting hemodynamic changes and had a stronger relationship with target organ damage. No study has analyzed the degree of central blood pressure in hypertensive patients with IAD < 10mmHg versus ≧ 10mmHg. The objective of this study was to analyze differences in central and brachial arterial blood pressure and the proportion of brachial systolic blood pressure ≧ 140mmHg or central systolic blood pressure ≧ 130mmHg in hypertensive patients grouped by IAD.

Methods:
The study cohort comprised of 2103 eligible individuals. Their BPs were assessed simultaneously in both arms using an Omron BP-203RPEIII vascular profiler, and the IAD was measured as the absolute difference in these values (absolute value of left minus right). The CBP was noninvasively measured using an Omron HEM-9000AI device. Multivariate regression analysis was used to assess the association between the central SBP (cSBP) and the inter-arm systolic blood pressure difference (IASBPD).

Results:
Applying 130/140 mmHg as cSBP/bSBP thresholds delineated concordant central and brachial normotension (n = 1131;53.8%) and hypertension (n = 702;33.4%) versus isolated brachial hypertension (n = 178;8.5%) and isolated central hypertension (n = 92;4.4%). Women made up close to 70% of the patient with central systolic hypertension but normal bSBP. After adjusting for brachial SBP, brachial DBP, sex, age and BMI, patients with IAD ≧ 10mmHg had a higher risk of cSBP ≧ 130mmHg [OR (95%CI): 1.6 (1.3, 2.1), P < 0.001].

Conclusion:
Hypertensive patients with IAD *&ge* 10mmHg had higher cSBP, cDBP and a higher proportion of central systolic blood pressure.
PS-C12-3: OPEN-ANGLE GLAUCOMATOUS OPTIC DAMAGE IN RELATION TO SYSTEMIC AND OCULAR PERFUSION PRESSURE
Authors: Melgarejo Jesus D , Eijgen Jan Van , Wei Dongmei , Maestre Gladys E , Aswad Lama A Al , Mena Luis J , Vanassche Thomas , Janssens Stefan , Verhamme Peter , Zhang ZhenYu , Keer Karel V , Stalmans Ingeborg 
Published: January 2023

Objective:
Glaucoma is the leading cause of irreversible blindness worldwide. One of the pivotal physiopathological mechanisms involved is reduced ocular perfusion pressure (OPP) at the optic nerve head, which depends on the mean arterial pressure (MAP) and intraocular pressure levels. The interplay association of variability and dips in the 24-h MAP with OPP in relation to glaucoma progression remains undocumented. Therefore, we conducted a retrospective longitudinal study to investigate variability and dips in the 24-h MAP and OPP in relation to the progression of open-angle glaucoma damage.

Methods:
A total of 265 patients with normal-tension glaucoma (NTG; n = 155) and primary open-angle glaucoma (POAG; n = 110) followed at the University Hospital Leuven with longitudinal visual field tests (n = 7000 measures, including both eyes) who underwent ambulatory blood pressure monitoring were studied. The main outcome was longitudinal changes in the mean deviation (MD), expressed in decibels (dB), which was retrieved from visual field tests. The intraocular pressure (IOP) was measured with applanation tonometry. MAP variability independent of the mean (VIMmap) was computed and the five lowest dips in MAP readings were further analyzed. OPP was the difference between 2/3 of the 24-h MAP minus 24-h intraocular pressure levels. Statistics methods included mixed models.

Results:
The mean age was 64.0y (53% were women). The IOP during eight years of follow-up was 11.3 mmHg. All IOP measures were higher in POAG than NTG (P < 0.046). POAG patients had lower OPP than NTG (P < 0.045). In adjusted mixed models, higher 24-h VIMmap was associated with longitudinal changes in MD in POAG (-2.07 dB changes, P < 0.001). The longitudinal changes in MD associated with dip measures ranged from -2.84 dB (95% confidence interval [CI], -4.12, -1.57; P < 0.001) to -2.16 dB (95% CI, -3.46,-0.85; P = 0.001) in POAG. Lower 24-h MAP combined with high variability and extreme dips in MAP resulted in worse progression of MD (P = 0.009). Reduced OPP was associated with -2.51 to -2.00 dB changes in the MD (P < 0.001) in POAG. Progression in MD was worse in patients experiencing reduced OPP along with high variability and dips in MAP.

Conclusions:
Progression of open-angle glaucoma damage is associated with high variability and dips in MAP, and reduced OPP. This progression exacerbates if the lower OPP occurs along with extreme dips in the MAP. 24-h ambulatory blood pressure and intraocular pressure should be implemented in the follow-up of glaucoma patients experiencing progression of the disease despite the intraocular pressure remaining normal.
PS-C12-5: MATHEMATICAL COMPARISON OF THE SEQUENTIAL VARIABLE RATIOS AMONG THE BLOOD PRESSURE VARIABILITIES OF AMBULATORY, HOME, AND OFFICE BLOOD PRESSURE MONITORING
Authors: Ohno Yoichi 
Published: January 2023

Objective:
The importance of blood pressure variabilities (BPVs) is warranted; however, it seems difficult to discuss some blood pressure variabilities together since the definitions and pathophysiological meanings are different among the various BPVs. The aim of this study is the mathematical comparison of the sequential variable ratios among BPVs.

Design and method:
As previously reported (BMC Inform Decis Mak 2011, Internal Medicine 2016, Clin Exp Hypertens 2019, Ohno et al.), I assumed the systolic blood pressure values of a virtual Japanese male 1000 subjects at 60 to 69 years of age which were normally distributed around the corresponding measurements. From the epidemiological studies, I assumed the mean and the stand deviation (SD) of 24-hour ambulatory (ABP), 14-day home (HBP), and 12-month office blood pressure (OBP) monitoring as 134 ± 18, 134 ± 15, and 144 ± 20. I also assumed the median and 75-percentile BPVs for SD of the ABP, HBP and OBP as 15 and 18, 8 and 10, and 10 and 14. Using the numerical analysis of the sequential autoregressive model, at the 2nd term, BP was randomly changed according to the certain variability ratio (0.04∼0.09) for the sequential BP recordings to satisfy the normal stochastic distribution. At the 3rd term, BP was calculated as the sum of a third of the initial BP and two thirds of the 2nd BP values and so on. Considering the periodicity, the last three terms, BP was calculated as the sum of a third of the initial BP and the two thirds of the previous BP values. Time factors were 10 mmHg lower in the nighttime for ABP, 4 mmHg lower in the evening for HBP and 0.25mmHg lower for 1 temperature rise in Celsius for OBP. I calculated SD of BPV under the condition of several variability ratios for ABP, HBP and OBP.

Results:
The variability ratios were 0.05 and 0.06 for the corresponding median and 75 percentile of ABP, 0.04 and 0.05 for those of HBP, and 0.07 and 0.09 for those of OBP for the epidemiological studies.

Conclusions:
The variability ratios of the sequential BP recordings were 1.75 (0.07/0.04) to 1.8 (0.09/0.05) times greater in OBP than in HBP. Therefore, less than 10 mmHg (144 x 0.07) BPV in the sequential recordings for OBP should not be a cause for concern.
PS-C12-7: THE EFFECT OF RAMADHAN FASTING ON HYPERTENSIVE PATIENTS IN ASIA: A SYSTEMATIC REVIEW
Authors: Adnan Muhammad Luthfi , Pramaningtyas Miranti Dewi 
Published: January 2023

Objective:
Hypertension is a major risk factor for cardiovascular disease. Fasting in the month of Ramadan is a form of worship for Muslims, and the largest Muslim population is in Asia. Although the effect of fasting during the month of Ramadan on health has been widely studied, its effect on changes in blood pressure has not been widely studied. This study aims to determine the effect of Ramadan fasting on hypertensive patients in the Asian population.

Design and method:
The study subjects of this systematic review were derived from the original articles by previous systematic reviews (Alinezhad-namaghi and Salehi (2016) Effects of Ramadan Fasting on Blood Pressure in Hypertensive Patients A Systematic Review) which we then adjusted according to our inclusion criteria. Literature searches were conducted with the search engines PubMed, Google Scholar, and other search engines with limited publication between 2012 to 2022. The keywords used were “Ramadan fasting”, “blood pressure”, and “hypertension”. The inclusion criteria used were observational studies, cohort studies, retrospective analysis, or other non interventional studies with full text in English, the study conducted on hypertension patients during Ramadhan fasting, studies conducted in Asian countries, and blood pressure outcomes was reported. The exclusion criteria used were the study not conducted in Asian countries or not mentioned, and the outcome report was not blood pressure change.

Result:
The original systematic review previously found 5 studies. Based on literature search and data extraction based on inclusion criteria, we accumulated a total of 6 studies’ findings. Two studies were conducted on populations in India and Iran and one study in Iraq and Lebanon. A total of 220 subjects included in this study (Table 1). Our findings suggest that Ramadan fasting exerts a blood pressure changing effect despite results of inconsistent significance.

Conclusion:
Ramadan fasting can affect blood pressure change in hypertensive patients in the Asian population. Studies in a wider population are needed to assess the effect of Ramadan fasting on blood pressure in hypertensive patients.
PS-C13-2: UNCOMPLICATED ARTERIAL HYPERTENSION, FROM BLOOD PRESSURE TO A NEW APPROACH BASED ON SUBCLINICAL TARGET ORGANS DAMAGE
Authors: Ouail Djamel Eddine , Tebbani Meriem , Bouali Faycal 
Published: January 2023

Introduction:
High blood pressure remains asymptomatic for a long time until complications, which can be fatal from the outset. HTA is considered by the WHO as a silent killer. It's appropriate to directly assess subclinical vascular lesions.
The objective of our work is to classify uncomplicated hypertensive patients according to their target organ damage.

Material and method:
Prospective cohort of hypertensive patients seen in consultation.
Patients benefit from exploration of target organ damage.
Calculation of PP, Serum creatinine and estimation of GFR by MDRD and search for albuminuria.
ECG and Cardiac Doppler ultrasound for LVH.
Echo - Carotid Doppler with measurement of the IMT or the presence of a plaque.
Systolic pressure index (IPS) for AOMI. Fundus examination for hypertensive retinopathy.
We classified patients according to target organ damage into three categories:
TOD 0: no damage.
TOD 1 (beginner): IMT > 0.9 mm, EUA A2. Stage 1 and 2 retinopathy
TOD 2 (advanced): Carotid plaques, LVH, decrease in GFR, EUA A3, PP > 60 mmHg, AOMI and stage 3 hypertensive retinopathy

Results:
300 patients included in our series, 180 women and 120 men, the mean age is 59.75 years ± 10.54 [38, 87 years].
LVH is discovered in 20%, 30% on ECG and echocardiography respectively.
The EIM is pathological in 35% of cases, carotid plaques are present in 40% of cases.
PP is pathological in 34.33% of cases, and AOMI is found in 9% of patients.
Kidney disease is found in 34% of patients.
Retinopathy is found in 28% of cases.
At the end of our assessment, patients are classified according to their target organ damage as follows:
AOC 0: 29% of patients.
AOC 1 (beginner): 11.7%
AOC 2 (advanced): 59.3%
The correlation between AOC groups and cardiovascular risk categories is significant with p = 0.0001

Conclusion:
The approach based on the classification of uncomplicated hypertensive patients according to subclinical target organ damage is a precise, accessible and inexpensive method. It allows an individual assessment of the state of vascular, cardiac and renal remodeling of patients.
By validating this approach, hypertension no longer becomes a silent killer, the detection of the early stages of damage to the AOC 1 target organs, allows the slowing down or even the regression of the lesions. The intervention on the group of AOC 2 allows protection against the feared irreversible complication.
PS-C13-8: IMPACT OF SACUBITRIL/VALSARTAN ON NT-PRO BNP LEVELS IN HYPERTENSIVE PATIENTS
Authors: Imamura Teruhiko , Kinugawa Koichiro 
Published: January 2023

Background:
Even a slight increase in plasmasNT-pro BNP levels is associated with an incremental cardiovascular events in a healthy cohort. Sacubitril/valsartan has recently been reimbursed in Japan for hypertension. Its impact on reducing plasma NT-pro BNP levels in hypertensive patients remains unknown.

Methods:
Patients who received 3-month sacubitril/valsartan administration for their hypertension were retrospectively included. Changes in plasma NT-pro BNP levels during 3-month sacubitril/valsartan therapy (on-treatment period) were compared with those during pre-treatment 3-month period (pre-treatment period).

Results:
A total of 33 hypertensive patients (73 [64, 77] years old and systolic blood pressure 138 [134, 149] mmHg on median) were included. During a pre-treatment period, systolic blood pressure tended to decrease (p = 0.091) whereas plasma NT-pro BNP levels remained unchanged (from 204 [132, 412] pg/mL to 207 [107, 386] pg/mL, p = 0.84). During on-treatment period, both systolic pressure and plasma NT-pro BNP levels decreased significantly (p < 0.001 and p = 0.001, respectively, from 207 [107, 386] pg/mL to 119 [64, 355] pg/mL in NT-pro BNP). The amount of changes in plasma NT-pro BNP levels during on-treatment period was significantly higher than those during pre-treatment period (-51 [-158, -17] mmHg versus -12 [-28, 33] mmHg, p = 0.001).

Conclusions:
Plasma NT-pro BNP levels decreased significantly following 3-month sacubitril/valsartan therapy. Its clinical implication requires further long-term studies.
PS-C14-5: ECHOCARDIOGRAPHIC PHENOTYPES OF HYPERTENSIVE IN NORTH CENTRAL NIGERIA
Authors: Shidali Vincent Yaba 
Published: January 2023

Objective:
To describe the cardiac morphologic phynotypes in hypertensives as seen on echocardiography .

Design and Methods:
All patients presenting for echocardiography at the echocardiography lab were evaluated and documented alongside there biodata and anthropometry. The study was a cross sectional descriptive study done from 2019 t0 2022. Criteria for inclusion was hypertension and hypertension related cardiac morbidity. Data obtained was analyzed using SPSS version 16. Quantitative variables were presented as mean and standard deviation while qualitative variables were presented as frequencies and percentages. Level of significance p was at 0.05

Results:
Five hundred and eighteen patients were included consisting of 50.6% male and 49.4% female with mean age of 55.08 ± 12.62 years. Majority (54.97%) of patients were between 50 -70 years of age. The mean age and BMI of males and females were significantly different at p values of 0.029 and 0.0001 respectively. Most patients had hypertensive heart disease ((96.0%), preserved EF(80.04%), grade 1 diastolic dysfunction(76.64%) and normal RV systolic function(90.98%). The mean LVEF, LAD, LVID, IVSd and LVPWd for males and females were significantly different at p value of 0.0001. The predominant LV geometry was concentric LV hypertrophy (45.8%) and 14% of patients had a dilated cardiomyopathy.

Conclusions:
Echocardiographic findings in hypertensives showed predominant abnormal morphologies with significant differences between male and females. This calls for management of hypertension beyond the numbers
PS-C14-6: THE USEFULNESS OF C-REACTIVE PROTEIN TO PREDICT IMPROVING LEFT VENTRICULAR FUNCTION AFTER AORTIC VALVE REPLACEMENT IN AORTIC REGURGITATION PATIENTS
Authors: Oike Fumi , Yamamoto Eiichiro , Usuku Hiroki , Egashira Koichi , Sueta Daisuke , Tsujita Kenichi 
Published: January 2023

Background:
We aimed to clarify the predictive factors for left ventricular (LV) function after aortic valve replacement (AVR) in patients with aortic regurgitation (AR).

Methods and Results:
Among 555 patients who underwent AVR at our institution from January 2015 to December 2020, we enrolled 44 patients for whom only AVR (or AVR + aortic replacement) was performed. We defined LV dysfunction under any of the following criteria: LV ejection fraction (LVEF) < 50%, LV diastolic dimension> 65 mm, LV systolic dimension (LVDs) > 50 mm, or LVDs/body surface area > 25 mm/m2. Multivariable logistic regression analysis revealed high natural logarithm (ln) C reactive protein (CRP) and low LVEF in the pre AVR period significantly associated with LV dysfunction after AVR (ln CRP: odds ratio [OR] 4.15, 95% confidence interval [CI] 1.44 to 11.98, p < 0.01; LVEF: OR 0.79, 95%CI 0.65 to 0.97, p < 0.05). Receiver operating characteristic analysis revealed an area under curve of CRP and LVEF in the pre AVR period for LV dysfunction after AVR of 0.84 and 0.83, respectively. Upon dividing the patients into four groups according to cutoff values of CRP (0.13 mg/dL) and LVEF (50%) in the pre AVR period, no patients (0/19) had LV dysfunction in the low CRP (< 0.13 mg/dL) and high LVEF ( 50%) group, and all patients (5/5) in the high CRP ( 0.13 mg/dL) and low LVEF (< 50%) group had LV dysfunction after AVR.

Conclusion:
High CRP level was significantly and independently associated with LV dysfunction after AVR. Combination of CRP and LVEF values might be useful for predicting improvement in LV function after AVR.
PS-C15-11: HYPERTENSION AND ITS CORRELATES AMONG SCHOOL ADOLESCENTS IN DELHI
Authors: Grover Shekhar 
Published: January 2023

Background:
Hypertension is fast emerging as a major health problem amongst all school adolescents, particularly in urban areas. Regular screening of the students for this is required for preventing the emergence of complications later in life. Therefore the present study was undertaken with the objective to determine the prevalence of hypertension amongst urban school adolescents and its correlation with anthropometric measurements.

Methods:
A cross sectional study was conducted in a school in Central Delhi involving all 315 students of 9th and 11th standard. A proforma was filled by the students and anthropometric measurements along with blood pressure BP measurements were taken for each student. Data were analyzed using Epi info 2005 and SPSS 16.0.

Results:
Out of the total 315 students, 208 or 66% were boys and 107 or 34% were girls and the mean age was 14.31 SD 0.96 years. The overall prevalence of malnutrition was 24% and boys were found to be more obese as compared to girls. There were 5 students 1.6% who were found to have systolic hypertension while 17 or 5.4% were found to have diastolic hypertension while 4.1% n = 13 of the participants were systolic pre hypertensive and 26% n = 82 were in the stage of diastolic pre hypertension. Body mass index and gender were found to be independent predictors of systolic hypertension.

Conclusions:
Prevalence of hypertension and pre hypertension was high amongst the school children. BP check ups for children and adolescents are thus recommended to take remedial action on time
PS-P02-5: ENCOURAGING ONLINE MEDICAL CARE BASED ON ECG MEASUREMENTS FROM WEARABLE DEVICES
Authors: Yoneyama Akio , Takai Koichi , Hammarlund Hampus , Miyake Yoshinori , Nakanishi Takeshi , Sawada Ryousuke , Yatabe Junichi , Taguchi Kenta 
Published: January 2023

Background:
Apple Watch can measure electrocardiograms, which can be useful for detecting heart conditions. However, even if atrial fibrillation is detected, few patients will seek out further medical evaluation. In this paper, we evaluated the effectiveness of several methods for motivating users to receive online medical care based on the heart alert detected by Apple Watch.

Method:
In this study, we investigated multiple schemes that guide users to online medical care based on the ECG measurement results.
1) Alert messages from a smartphone application, 2) E-mail notification to multiple presets when heart alerts are detected, and 3) E-mail information provided by experts on heart disease.
In our experiment, we recruited people age 30 and up who regularly use Apple Watch and iPhone, for a total of 489 participants. We asked ECG measurement to be taken several times a day with the Apple Watch for 3 months. We recommended online medical care when a heart alert is detected.

Result:
In this experiment, 20 participants’ atrial fibrillation was detected, and 5 participants took online medical care. Effectiveness of each reminder is explained as follows:

Conclusion:
We evaluated guidance to online medical care using the ECG measurement of Apple Watch. As a result of evaluating the three types of guidance, it was confirmed that the effect of providing information by experts is high.