bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREDICTIVE FACTORS OF MACROANGIOPATHY IN HYPERTENSIVE DIABETIC PATIENTS WITH VITAMIN D DEFICIENCY
Authors: Cherif Abdelghani Bachir , Bennouar Salam 
Published: June 2023

Objective:
Several studies have shown an association between low levels of 25-hydroxyvitamin D and an increased risk of cardiovascular disease. Cardiovascular complications are the most prevalent cause of mortality in patients with type 2 diabetes mellitus and hypertension. The aim of our study was to determine the risk factors related to macroangiopathy among hypertensive diabetic patients with vitamin D deficiency.

Design and method:
Retrospective study, conducted on 1756 type 2 diabetics with hypertension in whom a vitamin D assay was done in the internal medicine department in the area of Blida during the period from April 2020 to November 2022.

Results:
63.1% of patients had high blood pressure at the first examination. In addition, hyperuricemia was present in 39.8% patients, NASH (non-alcoholic fatty liver disease) was also present in 34.6% patients, hypertriglyceridemia in 48.3% patients, hypercholesterolemia in 60.2% patients and mixed dyslipidemia in 46.7% patients. Microalbuminuria, as a cardiovascular risk factor was positive in 39.2% patients. 61 % patients had at least one macrovascular complication. The univariate analysis showed a significant association between macroangiopathy and male gender (p = 0.029), HbA1c > 9.5% (p = 0.008), the cumulative number of cardiovascular risk factors > 5 (p 24 pg / mL (p = 0.007). Multivariate regression analysis showed that cumulative cardiovascular risk factors > 5 (OR = 13.9 [95% CI: 1.4 -137.6], p = 0.024), presence of microangiopathy (OR = 22 [95% CI: 2.2 - 215.4], p = 0.008) and HbA1c > 9.5% (OR = 36.6 [95% CI: 2.6 - 505]; p = 0.007) were predictor factors of macroangiopathy among patients with type 2 diabetes mellitus and Vitamine D deficiency.

Conclusions:
In hypertensive diabetic patients, cardiovascular diseases were the consequence of the additive effects of traditional risk factors with the participation of vitamin D deficiency.
AMBULATORY BLOOD PRESSURE MONITORING BEFORE AND AFTER TREATMENT IN SECONDARY FORMS OF HYPERTENSION
Authors: Stojanovic Milos , Miletic Marija , Gajic Milina Tancic , Ivovic Miomira , Marina Lilja , Ciric Jasmina , Nedeljkovic Biljana Beleslin , Stojkovic Mirjana , Zarkovic Milos , Vujovic Svetlana 
Published: June 2023

Objective:
Studies using ambulatory blood pressure (BP) monitoring (ABPM) have reported that in some secondary forms of hypertension the normal nocturnal BP decrease is blunted.

Design and method:
The aim of our study was to compare the nocturnal BP decrease in patients with secondary hypertension before and after treatment. ABPM was performed using the validated Meditech ABPM-06. ABPM readings were obtained at 30-minute intervals for 24-hour in patients with secondary hypertension before and after treatment. The diagnosis of secondary hypertension was based on the history and laboratory data: plasma and urinary electrolytes, renal function, calcium-phosphorus system, the renin-angiotensin-aldosterone system, urinary free cortisol, suppressibility of cortisol after 1 mg dexamethasone, plasma adrenocorticotropic hormone, plasma D4 androstenedione, plasma dehydroepiandrosterone sulphate, plasma 17-alpha hydroxyprogesterone, plasma testosterone, and urinary metanephrine. BP decrease were studied in the following groups: 42 patients with primary aldosteronism (19 men and 23 women; mean age, 44±12 years), 25 patients with adrenal pheochromocytoma (11 men and 14 women; mean age, 42±13 years), and 55 patients with Cushing's syndrome (18 men and 37 women, mean age, 43±13 years).

Results:
Average systolic/diastolic BP decrease was: before 2/1 mmHg and after 8/6 mmHg treatment in patients with primary aldosteronism. Average systolic/diastolic BP decrease was: before 4/5 mmHg and after 9/12 mmHg treatment in patients with adrenal pheochromocytoma. Average systolic/diastolic BP decrease was: before 3/2 mmHg and after 11/9 mmHg treatment in patients with Cushing's syndrome. All differences in systolic/diastolic BP decrease were statistically significant, with a P value <.001

Conclusions:
The results of our study confirm that secondary causes of hypertension lead to a reduced decrease in blood pressure during sleep. After proper treatment reduction in nighttime BP normalizes. A detailed analysis of ABPM can lead us to find the accurate etiology of hypertension.
RISK FACTORS FOR INTRAOPERATIVE AND POSTSURGICAL HYPERTENSIVE CRISIS IN PATIENTS WITH PHEOCHROMOCYTOMAS AND SYMPATHETIC PARAGANGLIOMAS: RESULTS FROM THE PHEO-RISK STUDY
Authors: Araujo-Castro Marta , Sanz Iñigo García , Ojeda Cesár Minguez , Calatayud María , Hanzu Felicia , Vidente Almudena , Carrera Concepción Blanco , Novoa Paz De Miguel , Manjón-Miguelez Laura , Lamas Cristina , Centeno Rogelio García 
Published: June 2023

Objective:
To identify presurgical and surgical risk factors for intraoperative and postoperative hypertensive crisis in patients with pheochromocytomas and sympathetic paragangliomas (PGLs) (PPGLs).

Design and method:
A retrospective multicenter cohort study of patients with PPGLs from 18 tertiary hospitals was performed.

Results:
A total of 296 surgeries performed in 289 patients with PPGLs (276 pheochromocytomas and 13 sympathetic PGL) were included. Laparoscopic PPGL resection was performed in 85.1% (n = 252) of the whole cohort. Alpha presurgical blockade was employed in 93.2% of the cases (n = 276) and beta-adrenergic in 53.4% (n = 158). Phenoxybenzamine was the treatment of choice in 126, doxazosin in 148 and the other 7 were treated with amlodipine and 4 with other antihypertensive drugs. Presurgical intravenous volume expansion was performed in 79% (n = 218) of the cases. In addition, 77.2% (n = 169/219) received oral sodium repletion. Hypertensive crisis occurred in 20.3% (n = 60) of the surgeries: intraoperative crisis in 56 and postoperative crisis in 6 cases. We identified as risk factors of hypertensive crisis (intraoperative and postoperative), a higher presurgical body mass index (BMI) (OR 1.16 per each kg/m2 increase CI 1.01-1.33) and HbA1c levels (OR 3.79 per each unit increase, CI 1.44-9.99), presurgical glucocorticoid therapy (OR 2.9, CI 1.08-7.59), higher presurgical SBP (OR 1.22 per each 10-mmHg increase, CI 1.03-1.45) and absence of oral sodium repletion (OR 2.3, CI 1.11-4.65). Patients with hypertensive crisis had a higher rate of intraoperative bleeding (18.3% vs. 3.4%, P<0.001), intraoperative hemodynamic instability (36.7% vs. 8.5%, P<0.001) and of intraoperative hypotensive episodes (41.7% vs. 11.4%, P<0.001) than those without hypertensive crisis. Hospital stay was longer in patients experienced hypertensive crisis (9.7 vs. 6.8 days, P = 0.007) than those without crisis

Conclusions:
Intraoperative and postoperative hypertensive crisis occurs in up to 20% of the PPGL resections. Patients with higher BMI, HbA1c levels, pretreated with glucocorticoid therapy before surgery, with higher presurgical SBP and who do not receive oral sodium repletion had a higher risk for developing hypertensive crisis during and after PPGL surgery.
ASSOCIATION OF PLASMA METANEPHRINES LEVELS WITH CARDIOMETABOLIC RISK IN ESSENTIAL HYPERTENSIVE INDIVIDUALS
Authors: Concistrè Antonio , Petramala Luigi , Schifano Arianna , Servello Adriana , Circosta Francesco , Cavallaro Giuseppe , Letizia Claudio 
Published: June 2023

Objective:
The aim of the study was to evaluate a possible relationship between plasma metanephrine concentrations and some surrogate parameters of cardio-metabolic damage such as carotid intima media thickness (IMT), cardiac left ventricular mass (LVM) and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH).

Design and method:
From January 2021 to September 2022, we consecutively enrolled 719 essential hypertensive patients (367 men and 352 women, mean age 52.2 ± 15 years) without cardiovascular complications, distinguishing patients in quartiles according to plasma metanephrine concentration (PMC).

Results:
compared with the first quartile, the highest PMC quartile was associated with the highest levels of of 24-h μalbuminuria (20.1 ± 8.9 mg/24 h and 11.4 ± 6.2 mg/24 h, p = 0.04), serum creatinine (0.96 ± 0.2 mg/dl vs 0.90 ± 0.22 mg/dl; p = 0.002), plasma calcium (9.5 ± 0.4 mg/dl vs 9.38 ± 0.4 mg/dl; p = 0.004) and a lower prevalence of metabolic syndrome (18% vs 32%; p = 0.001). More male hypertensives belonged to the fourth quartile than to the first quartile (64% vs 43%, p<0.001). Moreover, we found that the fourth PMC quartile was associated with higher values of 24h-ABPM diastolic blood pressure (78.8 ± 9.0 mmHg vs 76.3 ± 9.1 mmHg; p = 0.007), higher values of left ventricular myocardial mass indexed for body surface area (LVMi) (89.0 ± 27.0 g/m2 vs 81.8 ± 21.9 g/m2; p = 0.01) and left ventricular hypertrophy (LVH) (18% vs 11%, p = 0.031) prevalence than the first PMC quartile. PMC was also found to be an independent predictor of the presence of LVH and μalbuminuria.

Conclusions:
Our results revealed that higher PMC values are strongly associated with increased LVMi and μalbuminuria that, together with elevated blood pressure values, are strictly correlated with higher risk of atherosclerosis and cardiovascular complications.
ASSESSMENT OF ENDOTHELIAL FUNCTION BY FLOW-MEDIATED DILATION IN WELL-CONTROLLED PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Anyfanti Panagiota , Nikolaidou Barbara , Triantafyllou Areti , Gavriilaki Eleni , Angeloudi Elena , Malliora Anastasia , Dimitroulas Theodoros , Doumas Michalis , Gkaliagkousi Eugenia 
Published: June 2023

Objective:
Endothelial dysfunction is considered as the primary pathophysiological process towards the development of cardiovascular disease (CVD). Patients with rheumatoid arthritis (RA) are at increased CVD risk attributed to the synergistic effect of chronic inflammation and traditional cardiovascular risk factors. However, it is uncertain whether endothelial function in RA is impaired even in the absence of cardiovascular comorbidities and pronounced inflammatory load.

Design and method:
Patients with RA who presented low levels of systemic inflammation and were free from cardiovascular comorbidities including hypertension, diabetes mellitus and established CVD, were studied. Non-RA individuals matched for age, sex and office systolic/diastolic blood pressure comprised the control group. Endothelial function was evaluated with the gold-standard flow-mediated dilation (FMD) in the brachial artery (Aloka ProSound A7 Ultrasound System).

Results:
A total of 22 female individuals were included in the study, of whom 10 were RA patients aged 57±13 years and 12 healthy volunteers aged 56±9 years. All patients with RA were at remission or low disease activity. Traditional CVD risk factors (age, systolic and diastolic blood pressure, smoking, body mass index and lipids) did not significantly differ between RA patients and controls. By contrast, significantly lower FMD values were observed in the RA group compared to controls [6.4 (5.0) vs 11.8 (5.2) %, p = 0.003]. The association between RA and FMD levels remained significant even after adjustment for age and systolic blood pressure (beta = 0.562, p = 0.009).

Conclusions:
Endothelial dysfunction is present in RA, even in a population characterized by the absence of hypertension and cardiovascular comorbidities and with relatively low systemic inflammatory burden. Further studies are warranted to verify the findings of this pilot study and delineate the role of endothelial dysfunction as a potential prognostic marker or therapeutic target.
HYPERTENSION SCREENING CAMPAIGN: THE STRENGTH OF A CITY NETWORK INVOLVING THE HOSPITAL AT MAY MEASUREMENT MONTH 2022
Authors: Lopez-Sublet Marilucy , Marck Marck Bouaziz , Soare Cynthia , Leprieur Benedicte Giroux , Bamiere Clement , Hilal Yassine , Lesage Sarah , Thomas Christian , Sariya Rashida , Nguyen Rosaline , Dhote Robin , Moysan Mathilde 
Published: June 2023

Objective:
The World Hypertension League (WHL) created the World Hypertension Day on May 17. This day gave way to the campaign called MMM (May Measurement Month), which each year raises awareness against hypertension. The objective of this study is to disseminate the data obtained from a sample of adults screened in Bobigny, France.

Design and method:
Following the MMM protocol adapted in France by the French Society of Hypertension (SFHTA), numerous volunteers from the network of territorial professional health communities (CPST) (physicians, nurses, pharmacists, dieticians, psychologists, social workers, and patients’ association) and in association with the hospital, carried out a screening campaign in a prefab adapted for this action. In addition and organized upstream, the CPTS and the city of Bobigny were able to offer self-measurement devices.

Results:
The general anonymous data of this population of 270 subjects (including 146 F) are summarized in the table. All participants reported having had at least one BP measurement within the last year. Of the 58% of participants reported as hypertensive, 37.3% were unaware of their antihypertensive treatment. CVD history was: diabetes (n = 101), myocardial infarction and hypertension pregnancy disorders (n = 25 each one), and stroke (n = 13).

Conclusions:
The organization of an MMM-type screening campaign by a CPTS and under the aegis of a ‘neighborhood”-attending attending physician seems to promote the participation of a population. A wide dissemination of information prior to such a campaign by a city-hospital network must be encouraged, as well as succeeding in obtaining the participation of health professionals.
REFLECTION MAGNITUDE AND ITS ASSOCIATION WITH INCIDENT HYPERTENSION AND BLOOD PRESSURE CHANGES IN A MULTI-ETHNIC COHORT: THE HELIUS STUDY
Authors: Bouwmeester Thomas , Ton Dennis , Collard Didier , Vriend Esther , Westerhof Berend , Galenkamp Henrike , Born Bert-Jan van den 
Published: June 2023

Objective:
A higher reflection magnitude (RM), defined as the ratio of the backward and forward moving pressure wave, is associated with hypertension and incident heart failure. Whether RM is predictive of future hypertension and blood pressure (BP) increase is unknown. We assessed the association between RM, incident hypertension and BP increase over time.

Design and method:
Data of the Healthy Life in an Urban Setting study was analysed focusing on the six major ethnic groups living in Amsterdam, The Netherlands, aged between 18 and 70 years. Central arterial blood pressure was reconstructed from non-invasive continuous finger BP measurements. RM was calculated through wave separation analysis. Logistic regression models were created to investigate the association between RM and incident hypertension in the normotensive individuals. Linear regression was used to investigate the association between RM and changes in BP, which was corrected for the use of antihypertensive medication. All models were corrected for age, sex, ethnicity and baseline BP. The association between RM and delta SBP was additionally corrected for BMI.

Results:
A total of 5,779 participants were included for analysis, median age was 48 years (IQR 37-55), 54.6% were female and 67% were normotensive at baseline. In normotensive participants aged < 50 years at baseline, a 10% increase in RM resulted in an increased odds ratio (OR) of 1.37 (95% CI 1.09 – 1.72 for developing incident hypertension, which attenuated to 1.12 (95% CI 0.88 – 1.42) following adjustment for baseline SBP. Additionally, in individuals below 50 years an increase in RM of 10% was associated with a 1.77 mmHg (95% CI 1.00 – 2.53) increase in SBP (figure 1). No significant association between delta SBP and RM was found in the participants aged 50 or older.

Conclusions:
In a multi-ethnic cohort, RM is positively associated with the development of hypertension in individuals aged < 50 years. However, additional correction for baseline SBP attenuated this association. In addition, RM is predictive of SBP increase, with significant interaction for ethnicity.
ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA SYMPTOMS AND INCIDENCE OF DE NOVO HYPERTENSION IN A LARGE FRENCH POPULATION-BASED EPIDEMIOLOGICAL COHORT
Authors: Vidal-Petiot Emmanuelle , Balagny Pauline , Kab Sofiane , Frija-Masson Justine , Steg Philippe -Gabrie , Goldberg Marcel , Zins Marie , D’Ortho Marie-Pia , Wiernick Emmanuel 
Published: June 2023

Objective:
There is a strong association between Obstructive Sleep Apnea (OSA) and hypertension but the effects of OSA symptoms on the risk of incident hypertension in previously normotensive individuals are not well documented.
The aim of this prospective cohort study was to examine whether OSA symptoms (snoring and sleepiness) are associated with the incidence of hypertension independently of confounding factors including body mass index.

Design and method:
Data from the French population-based CONSTANCES cohort were analyzed. Participants, aged 18 to 69 years, were included between 2012 and 2016, and screened for OSA in 2017 using the Berlin Questionnaire. Snoring and sleepiness were assessed from the questionnaire, and considered as severe when they were declared to occur at least three times a week. Individuals who had a history of treated OSA, cardiovascular diseases or hypertension (defined either by blood pressure of 140/90 mmHg or more at the inclusion visit, or by self-reported hypertension or antihypertensive drugs delivering until 2017) were excluded from these analyses. We used Cox models, adjusted for age, gender, smoking, alcohol consumption, physical activity, education level, household income and body mass index, to compute hazards ratios (HR) of incident treated hypertension (defined by antihypertensive drugs delivering through linkage to the National Health Data System (SNDS)) until December 2020.

Results:
Among 36,798 normotensive subjects, the prevalence of high risk of OSA according to Berlin questionnaire was 7.6% and the incidence of treated hypertension was 4.2%. Risk of de novo treated hypertension increased significantly in participants who declared symptoms of severe snoring (adjusted HR [95% CI] = 1.17 [1.04-1.31]), severe sleepiness after sleep (adjusted HR [95% CI] = 1.18 [1.03-1.36]) and severe sleepiness during waking time (adjusted HR [95% CI] = 1.40 [1.23-1.64]), and increased with the weekly frequency of these symptoms with a dose-dependent relationship (p for trend <0.005).

Conclusions:
Self-declared snoring and sleepiness are associated with an increased risk of developing de novo hypertension. Our results suggest that primary care patients should be routinely screened for these symptoms, not only to identify possible OSA, but also to encourage preventive measures and regular blood pressure monitoring.
THE INHIBITORY EFFECTS OF VALPROIC ACID ON RHOA-MEDIATED VASCULAR SMOOTH MUSCLE CELL CONTRACTION
Authors: Hwang Yun-Jin , Cho Du-Hyong 
Published: June 2023

Objective:
Valproic acid (VPA) has been used to treat epilepsy and bipolar disorder. Dysfunction of vascular smooth muscle cells (VSMCs) is well-established to contribute to the pathogenesis of various vascular diseases. Growing evidence indicates that increased VSMC contractility plays a primary role in the development of pathological artery spasms. Nevertheless, effect of VPA on VSMC contractility, and its mechanism of action remain unknown. Here, we investigated the mechanism by which VPA inhibits VSMC contractility and vessel contraction in rat VSMCs and endothelium-deprived aortas.

Design and method:
We performed quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR), RhoA activity assay, transfection of constitutively active (CA)-RhoA gene, and western blot analyses. We also conducted ex vivo studies using isolated rat aortas.

Results:
VPA inhibited phenylephrine (PE)-induced phosphorylation of myosin light chain (MLC) at Ser19 (p-MLC-Ser19) in VSMCs. VPA did not alter expressions of MLC kinase and Rho-associated kinase 1, the upstream kinases responsible for MLC phosphorylation. In addition, VPA did not affect phosphorylation of myosin phosphatase target subunit 1, a regulatory subunit of myosin phosphatase. VPA decreased RhoA mRNA expression and its protein levels in a time- and dose-dependent manner, and as expected, VPA decreased amount of active GTP-bound RhoA in a dose-dependent manner. Ectopic expression of CA-RhoA gene significantly reversed VPA-inhibited p-MLC-Ser19 and p-CPI-17-Thr38. Finally, VPA significantly attenuated PE-induced vessel contraction in endothelium-deprived rat aortas, and similar to the in vitro results, VPA decreased RhoA expression and levels of p-MLC-Ser19 and p-CPI-17-Thr38 in rat aortas.

Conclusions:
We demonstrate that VPA mitigates PE-induced VSMC contractility and vessel contraction by decreasing expressions of RhoA and p-MLC-Ser19 in rat VSMCs and aortas. These results suggest that VPA may be useful in the treatment of vasospastic diseases including coronary artery vasospasm and post-subarachnoid hemorrhage cerebral vasospasm.
CHLOROGENIC ACID CAN INHIBIT CATECHOLAMINE SECRETION FROM THE ADRENAL MEDULLA
Authors: Lim Dong Yoon , Koh Young Youp 
Published: June 2023

Objective:
Chlorogenic acid (CGA) is one of the most available phenolic acid compounds in foods, such as coffee and tea, which is known to be the most effective agent in lowering blood pressure and helpful in treating hypertension-related disorders. Thus the present study was aimed to determine the characteristics of CGA on secretion of catecholamines (CA) in the perfused model of the rat adrenal medulla, and also to validify its mechanism of action.

Design and method:
he adrenal gland was isolated and perfused with Krebs-bicarbonate. CA was measured directly by using the fluorospectrophotometer.

Results:
CGA, administered into an adrenal vein for 90 min, reduced ACh -induced CA secretion in a dose- and time-dependent manner. CGA also time-dependently depressed the CA secretion induced by McN-A-343, DMPP, and angiotensin II . CGA itself failed to influence spontaneous CA secretion. Also, During the perfusion of CGA for 90 min, the CA secretory responses induced by high K+, veratridine, cyclopiazonic acid, Bay-K-8644 were suppressed. However, in the simultaneous presence of CGA and L-NAME, the CA secretory responses induced by ACh, Ang II, Bay-K-8644 and veratridine was restored nearly to the control level compared to those of the inhibitory effects of CGA-treatment alone. Virtually, the adrenal NO release was significantly enhanced by CGA-treatment. Also, in the coexistence of CGA and olmesartan, ACh-induced CA secretion was markedly reduced compared to that of olmesartan-treatment alone.

Conclusions:
Taken together, we present the first evidence that CGA suppresses the CA secretion induced by activation of cholinoceptors as well as AT1-receptors. This CGA-induced inhibitory effect seems to be exerted by reducing both the influx of Na+ and Ca2+ through their ionic channels into adrenomedullary chromaffin cells as well as by suppressing the Ca2+ release from the cytoplasmic calcium store, through the elevated NO release by the activation of NO synthase, which is associated to the blockade of neuronal cholinonoceptors and AT1-receptors. Based on these results, the ingestion of CGA may be helpful to alleviate or prevent the cardiovascular diseases, via reduction of adrenal CA secretion and consequent decreased CA level in circulation.