bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL RISK FACTORS FOR SEVERE ESSENTIAL ARTERIAL HYPERTENSION IN PATIENTS WITH VITAMIN D DEFICIENCY
Authors: Semianiv Marianna , Sydorchuk Larysa , Biletsky Semen , Petrynych Oksana , Kazantseva Tatyana , Repchuk Yuliya , Semianiv Ihor , Sokolenko Alina , Yarynych Yuliya , Voroniuk Ksenia , Dzhuriak Valentyna 
Published: June 2023

Objective:
The aim of this study was to establish the role of clinical complains and symptoms as risk factors for severe essential arterial hypertension (EAH) in patients with vitamin D deficiency.

Design and method:
100 EAH patients with target-organ damage, moderate, high-very high cardiovascular risk were involved in the case-control study. 79.0% females and 21.0% males, mean age 59.87 ± 8.02. They were tested for total serum 25-hydroxyvitamin D concentration (immune luminescent test “MAGLUMI”, “SNIB”, China). All recruited patients were taken history, underwent complex examination and divided into groups depending on level of vitamin D and BP. Control group included 60 practically healthy persons of relevant age.

Results:
Hypertensive patients with vitamin D deficiency complained on heart pain 14.23% (⇙2 = 2.17; p>0.05), arrythmias – 20.86% (2 = 3.86; p = 0.049), headache – by 27.89% (⇙2 = 7.34; p = 0.007), sleep disturbance – by 29.77% (⇙2 = 7.97; p = 0.005), weakness and fatigue – by 20,59% (⇙2 = 3.88; p = 0.049) more frequent, than patients with normal 25-hydroxyvitamin D concentration. The frequency of patients with fatal cardiovascular risk SCORE >5.0 with vitamin D deficiency prevailed the ones with a normal level of vitamin D – by 20.94% (⇙2 = 3.98; p = 0.046). The risk for arrhythmias, weakness and fatigue increases 1.5 times [OR–2.36; 95% CI OR:1.0–5.61; p0.049 and OR–2.40; 95% CI OR:1.0-5.79; p = 0.049], sleep disturbance, headache and overweight increases 1.7-2.35 times [OR–3.43; 95% CI OR: 1.43-8.22; p = 0.005 and [OR–3.63; 95% CI OR:1.39-9.49; p = 0.007] and [OR–11.50; 95%CI OR:1.33-99.33; p = 0.038], respectively) in patients with 2nd-3d degree of BP elevation and vitamin D deficiency. The fatal cardiovascular risk SCORE >5.0 increases 1.5 times [OR–2.34; 95% CI OR:1.01-5.45; p = 0.046] in hypertensive patients with vitamin D deficiency.

Conclusions:
Vitamin D deficiency in patients with EAH is associated with severe clinical symptoms: the risk for arrhythmias increases 1.5 times [OR–2.36; p = 0.049], weakness risk increases 1.7 times [OR–2.40; p = 0.049], sleep disturbance risk elevates almost twice [OR–3.43; p = 0.005], risk for headache escalates 2.35 times [OR–3.63; p = 0.007], fatal cardiovascular risk SCORE >5.0 is 1.5 times high [OR–2.34; p = 0.046], respectively.
ACUTE PANCREATITIS REVEALING MAJOR HYPERTRIGLYCERIDEMIA
Authors: Mezghani Ines , Marrakchi Rim , Ayedi Mohsen , Boudaya Mariem , Lahiani Najeh , Jammoussi Kamel , Turki Mouna , Kacem Faten Hadj , Abid Mohamed 
Published: June 2023

Objective:
Severe hypertriglyceridemia is a common risk factor for acute pancreatitis and atherosclerotic vascular disease. Our aim was to report a rare case of acute pancreatitis due to major hypertriglyceridemia.

Design and method:
We report a case of acute pancreatitis revealing major hypertriglyceridemia.

Results:
A 53-year-old man, was hospitalized in May 2022 in endocrinology departement with abdominal pain, nausea,vomiting and alteration of general condition.
History: high blood pressure, type 2 diabetes, alcohol consumption and family history of high blood pressure, type 2 diabetes, dyslipidemia. Clinical examination showed defense on palapation in epigastrium and right flank. Biochemical analyses were as follows: hypertriglyceridemia at 76.42 mmol/L associated with hypercholesterolemia at 17.58 mmol/L, LDL-C = 2.25 mmol/L, HDL-C = 2.12 mmol/L, hyperglycemia = 10.62 mmol/L, HBA1C = 8.1%, Lipasemia = 281 UI/L. Abdominal ultrasound did not show lithiasis, abdominal CT scan revealed pancreatitis.
The diagnosis of acute pancreatitis due to major hypertriglyceridemia was made.
The patient was treated by plasmapheresis and triglyceride level was reduced to 2.5 mmol/L. The lipidogram showed an isolated elevation of VLDL and defined hypertriglyceridemia as Familial hyperlipoproteinemia type 4.

Conclusions:
Familial hyperlipoproteinemia type 4 syndrome is an uncommon condition. Acute pancreatitis secondary to severe hypertriglyceridemia is a condition with a high risk of mortality which requires prompt clinical suspicion and treatment.
PREVALENCE OF OVERWEIGHT AND OBESITY IN EAST KAZAKHSTAN
Authors: Markabayeva Akbayan , Kerimkulova Aiman 
Published: June 2023

Objective:
The prevalence of overweight and obesity is an increasing public health problem in many developing countries with varying ethnic- and gender specific patterns. Sporadic publications in local literature suggest that the prevalence of overweight in Kazakhstan is also increasing, although most of these studies were small and performed only in large cities (Alma-Ata, Astana) while the information from other parts of the country is scarce. Our aim was to assess the prevalence of overweight and obesity across genders and main ethnic groups in three administrative districts in East Kazakhstan.

Design and method:
Altogether, 1755 adults (59.7% women) aged 18-91 years living in in three administrative districts, i.e. the Maiskii and Lebiazhinskii districts of the Pavlodar region and Glubokovskii district of the East Kazakhstan region participated in a cross-sectional study. The study population was selected based on the automated state medical registry, covering the population exposed to nuclear test fallout. Height and weight were measured and body mass index (BMI) was calculated. The prevalence of overweight (BMI between 25.0 and <30.0 kg/m2) and obesity (BMI more 30.0 kg/m2) was studied across genders and main ethnic groups – Kazakhs, Russians.

Results:
The overall prevalence of overweight and obesity were 42.3% (95%CI: 41.2-43.5) and 17.4% (95%CI: 16.1-18.4) among men and 43,1% (95%CI: 42.4-43.8) and 23.3% (95%CI: 20.3-26.7) among women. The prevalence of overweight and obesity among Kazakhs (41.9%, 95%CI: 40.2-43.6; 18.7%, 95%CI: 17.3-20.0) and among Russians (44.5%, 95%CI: 43.1-45.9; 24.9%, 95%CI: 23.2-25.5).

Conclusions:
Our results suggest that more than a half of the population of East Kazakhstan is at least overweight and almost every fourth is obese. We have not observed ethnic or gender differences in the studied outcomes.
SERUM PARATHORMONE, VITAMIN D AND CARDIOVASCULAR RISK FACTORS
Authors: Mancusi Costantino , Fucile Ilaria , Luca Nicola De , Iaccarino Guido 
Published: June 2023

Objective:
The aim of this study is to evaluate the associations of serum 25-OHD and PTH concentrations with blood pressure and hypertension mediated target organ damage including left ventricular hypertrophy (LVH) and carotid intima-media thickness (IMT).

Design and method:
This observational retrospective study included 98 patients admitted at Hypertension Research Center of Federico II University Hospital in Naples without CKD. We collected serum 25-OHD, PTH, creatinine, BMI, lipid profile, blood glucose and office blood pressure. All patients underwent carotid doppler ultrasound and echocardiography.

Results:
Mean age of the participants was 53±17 years and 69% were men.
Pearson's correlation analysis indicated that PTH levels correlated directly with age, diabetes, dyslipidemia, hypertension, fasting glucose, on statin therapy, left ventricular mass and inversely with the GFR, total cholesterol, LDL and vit D level. Vit. D levels correlated inversely with PTH, diabetes and carotid plaque.
Multivariate regression models indicated that PTH was significantly associated with higher fasting glucose and with vit D while Vit D was associated with lower GFR and PTH level.

Conclusions:
In a population at high cardiovascular risk, Vit. D and PTH are not directly associated with hypertension but might influence association with other cardiovascular risk factors and markers.
PREVALENCE OF CARDIOVASCULAR RISK FACTORS, LIFESTYLE AND SOCIAL DETERMINANTS DURING SCREENING IN A PERIURBAN POPULATION
Authors: Malik Koussoh Simone , Amangoua Annita , Meless David , Ake Michèle , Guinan Jean - Claude , Oga Serges , Adoubi Anicet , Ndindin Claude 
Published: June 2023

Objective:
Analyze the relationship between some cardiovascular risk factors, which are hypertension, diabetes, obesity, and social and lifestyle determinants in a West African adult population during a screening.

Design and method:
This cross-sectional study was conducted in a peri-urban population in West Africa (Côte d’Ivoire) and included adults aged 18 and over. Sociodemographic data (age, sex, marital status, education, occupation) were collected. A history of diabetes and hypertension was sought. Lifestyle data (tobacco and alcohol consumption) and some cardiovascular risk factors were collected. Blood pressure was measured with an OMRON M6 electronic blood pressure monitor in the sitting position after 5 minutes of rest. Capillary blood glucose was measured with a glucometer in fasting participants. Weight was measured by a scale and the catch on the ID document.

Results:
The survey involved 380 persons, 39.8% were men and 60.2% women. The average age was 40.4 ± 13.8 years. Almost half of the population had no education. More than a quarter (25.20%) of the respondents drank alcohol and 46% of the individuals had a liberal profession. The prevalence of hypertension was 39.2%. Hypertension affected 41.6% of men and 58.4% of women; Women were more hypertensive than men (p = 0.03). Hypertension was present in about half of the individuals with no education (49%) and slightly more than a quarter of individuals living with a partner. Diabetes was present in about 10% of individuals. The prevalence of obesity was 17.1%. This obesity concerned 60.2% of women. Women were more likely to have hypertension than men. Individuals with no education were more likely to have hypertension than individuals with education.

Conclusions:
In this peri-urban population, the prevalence of hypertension is high, approaching two fifths of the population. Women, people with no education and those living in couples were more hypertensive.
AMBULATORY BLOOD PRESSURE LEVELS AFFECT THE ASSOCIATION OF INTRADIALYTIC HYPERTENSION WITH ADVERSE CARDIOVASCULAR EVENTS IN HEMODIALYSIS PATIENTS
Authors: Iatridi Fotini , Theodorakopoulou Marieta , Georgiou Areti , Karpetas Antonios , Pella Eva , Tsouchnikas Ioannis , Giamalis Panagiotis , Papagianni Aikaterini , Sarafidis Pantelis 
Published: June 2023

Objective:
Patients with intradialytic hypertension (IDH) display also higher ambulatory blood pressure (BP) levels during the whole 44-h interdialytic interval compared to patients without the phenomenon. Sustained high 44-h ambulatory BP levels is a potential risk factor for cardiovascular events and mortality in these individuals. The aim of this study is to evaluate the influence of elevated 44-h BP levels on the high cardiovascular risk of individuals with IDH.

Design and method:
A total of 242 hemodialysis patients with valid 48-h ABPM with Mobil-O-Graph-NG had an extended follow up for a median of 57.8 months. IDH was defined as: rise in SBP greater or equal to 10 mmHg from pre- to post-dialysis and post-dialysis SBP greater or equal to 150 mmHg. The primary end-point was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest, hospitalization for heart failure, coronary or peripheral revascularization procedure. The secondary endpoint was cardiovascular mortality.

Results:
45 patients with and 197 without were included in this prospective analysis. Cumulative freedom from the primary and secondary endpoint was significantly lower for patients with IDH (logrank-p = 0.019), while freedom from the secondary endpoint did not differ significantly between the two groups (logrank-p = 0.321). Patients with IDH presented a significantly higher risk for the composite endpoint (HR = 1.651, 95%CI[1.083, 2.516]), without, however, showing a significant difference in the risk for cardiovascular mortality (HR = 1.320, 95%CI[0.762, 2.288]). After adjustment for 44-h SBP, the association of IDH with the primary endpoint slightly attenuated, while the association with the secondary outcome had no significant changes (HR = 1.421, 95%CI[0.906, 2.228] and HR = 1.270, 95%CI[0.708, 2.276], for primary and secondary outcome respectively).

Conclusions:
IDH is associated with higher risk for adverse cardiovascular outcomes. High ambulatory BP during the interdialytic interval contributes to the excess cardiovascular risk observed in this population.
GLYCEMIC VARIABILITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: CLINICAL IMPLICATIONS AND PHARMACOLOGICAL CONSIDERATIONS
Authors: Howsawi Alanood , Alem Manal 
Published: June 2023

Objective:
Glycemic variability (GV), independently of glycemic control, has emerged as a prognostic marker in patients with type 2 diabetes mellitus (DM). In this study, we assessed the prognostic value of GV for predicting major adverse cardiovascular events (MACE) in our local population. We also assessed its prognostic value for diabetic microvascular complications (DMC) and its relationships with antidiabetic medications.

Design and method:
This was a retrospective cohort study that recruited 680 patients with type 2 DM across 2015-2017. MACE were defined as: the composite of; total death, myocardial infarction (MI), stroke, hospitalization due to heart failure, revascularization. GV was calculated for two glycemic control markers: glycated hemoglobin (G-Hb) and fasting blood sugar (FBS); via 3 metrics- standard deviation (SD), coefficient of variation (CV), and variability independent from the mean (VIM). Cox proportional hazard models and Kruskal-Wallis tests were used in the statistical analysis.

Results:
105 events classified as MACE were identified in 86 patients and 104 DMC in 98 patients in an average follow-up period of 78.43 months. GV was found to be an independent predictor of MACE, particularly for FBS-CV but not a predictor of DMC. FBS-CV > 17.51% as compared with < 17.51% was a significant and independent predictor of MACE, with HR 1.589 (95% CI; 1.022, 2.472) (P = 0.040) (Table 1 & Figure 1). DMC were predicted mainly by the duration of type DM, and by the glycemic control; similarly represented by G-Hb and FBS. Patients on metformin, and dipeptidyl peptidase (DPP) 4 inhibitors, had the lowest GV, as compared with patients whose treatments included insulin/sulphonylureas (P<0.001).

Conclusions:
In our population, GV predicted MACE: with FBS-CV superior to the “gold standard” glycemic control marker G-Hb. Further, GV may be explained, partially at least, by the choice of antidiabetic medications: this finding might contribute to the cardiovascular protection attributed to one class rather than another.
HYPERTENSION AS A RISK FACTOR FOR MORTALITY AND THE DEVELOPMENT OF CHRONIC KIDNEY DISEASE AFTER AN EPISODE OF ACUTE KIDNEY INJURY WITH FULL RECOVERY IN THE ELDERLY
Authors: Mahmoud Nouha Ben , Hamouda Mouna , Salem Meriem Ben , Salah Manel Ben , Bchir Sirine , Letaief Ahmed , Aloui Sabra , Skhiri Habib 
Published: June 2023

Objective:
Acute kidney injury (AKI) is a real public health problem due to its severity and its consequences in the short, medium and long term. Hypertension is a very common disease in our country.

Design and method:
We undergone a retrospective study which was carried out in the nephrology department of Fattouma Bourguiba hospital in Monastir.
We included patients aged > 65 years, who had an AKI with full recovery who had been hospitalized between January 2002 and December 2015. Our study aimed to assess the impact of hypertension on mortality and the development of chronic kidney disease (CKD) after an episode of AKI.

Results:
Our population was made up of 67 men and 60 women, 30.1% had multiple comorbidities. Pre renal Aki represented the predominant mechanism of AKI which was retained in our study with a rate of 40% and dehydration as the main aetiology in 70 patients.
In the short term, 15 patients had progressed to CKD. The mean overall survival in our study was 159 months with a high risk of mortality in elderly (patients aged >65 years), who had multiple comorbidites, hypertensive, diabetics, with vascular disease, Charlson Cmorbidity index >5, who presented with hyperkaleamia >5.5 and pre renal mechanism of the AKI episode.

Conclusions:
Hypertension is a real public health problem impacting the short, medium and long term prognosis of patients who have had an episode of AKI with full recovery
THE SIGNIFICANCE OF COMBINING INTER-LIMB BLOOD PRESSURE DIFFERENCES IN PREDICTING THE FUTURE CARDIOVASCULAR RISK IN ELDER CHINESE: THE NORTHERN SHANGHAI STUDY
Authors: Shi Jieying , Yu Shikai , Xu Yawei , Zhang Yi 
Published: June 2023

Objective:
The three indexes derived from the inter-limb systolic blood pressure difference (ISBPD), namely inter-arm (IASBPD) and -leg (ILSBPD) systolic blood pressure differences and ankle-brachial index (ABI), were proved associated with cardiovascular morbidity and mortality, respectively. Whether the combination of the three indexes can improve the prediction of future cardiovascular risk remains unclear. We aimed to explore the clinical significance of combining IASBPD, ILSBPD, and ABI in predicting future cardiovascular risk in a large cohort of elderly Chinese.

Design and method:
A total of 3095 participants (mean age: 71±6 years) derived from the Northern Shanghai Study were included in the present analysis. According to the number of abnormal ISBPDs (IASBPD> = 20 mmHg, ILSBPD> = 20 mmHg, and ABI< = 0.9), the participants were divided into three groups: Group 0 (without abnormal ISBPD, n = 2507), 1 (with 1 abnormal ISBPD, n = 418), and 2 (with> = 2 ISBPDs, n = 170). The study endpoint was defined as the composite major adverse cardiovascular events (MACEs) including non-fatal myocardial infarction (MI), and non-fatal stroke, and all-cause mortality. Survival analysis and Cox proportional hazards models were performed to compare the rates of the endpoint between groups. The discriminative ability of ISBPDs and ABI was compared using R2, C-index, NRI, and IDI.

Results:
During a median follow-up period of 5.4 years (interquartile range 4.4-7.3 years), 325 events (10.5%) were observed, with 40 non-fatal MI, 101 non-fatal stroke, and 205 deaths. Survival Analysis indicated the highest rates of the endpoint in Group 2, followed by Group 1 and Group 0 (P<0.001). In Cox regression model, after adjustment for possible confounding factors, Group 2 showed significantly higher risk of events than that of Group 0 (HR: 1.50, 95% CI: 1.06-2.13); Group 1 also showed higher risk of events compared to Group 0, but did not reach statistical significance (HR: 1.25; 95%CI: 0.94 to 1.65). The addition of IASBPD and ILSBPD on ABI improved the prediction of cardiovascular risk (net reclassification improvement 4%,95%CI: -0.05 to 0.13), after adjusted for potential confounders.

Conclusions:
The combination of ISBPDs may help to better predict the future cardiovascular risk in the elderly.
WHO BENEFITS MORE, IN TERMS OF LIPID PROFILE?
Authors: Barata Érica , Monteiro Filipa , Leão António , Abecasis Francisca , Beirão Pedro , Cunha Vitoria 
Published: June 2023

Objective:
As important as finding and treating the specific cause of a cerebral vascular event is gauging, monitoring and treating the cerebrovascular risk factors that may contribute to and/or aggravate it, with the lipid profile having particular prominence.
To comparatively analyse the control of the lipid profile, between gender, throughout the Hypertension Consultation

Design and method:
We conducted a retrospective study including patients who attended the Hypertension Consultation from 1 January to 31 May 2022. This group was divided into two subgroups (female or male) and subsequently compared regarding the evolution of the mean values of LDL-cholesterol, -HDL, and triglycerides from the first to the last appointment they attended.

Results:
Overall, a decrease in LDL-cholesterol and triglycerides was obtained in both subgroups. The reduction of these two parameters was greater in the female group. The values of LDL-cholesterol did not change substantially.

Conclusions:
Pharmacological and non-pharmacological therapy of dyslipidaemia proved to be effective, safe and well tolerated in the group of patients with cerebrovascular disease, regardless of gender. The female gender was the one that benefited most from these measures throughout the follow-up in hypertension consultation. The widely recognised difficulty in modifying HDL in these patients was also evident.
CEREBRAL OXYGENATION DURING EXERCISE DETERIORATES WITH ADVANCING CHRONIC KIDNEY DISEASE
Authors: Theodorakopoulou Marieta , Dipla Konstantina , Zafeiridis Andreas , Faitatzidou Danai , Koutlas Aggelos , Gkoura Eleni , Gakidi Katerina , Doumas Michael , Papagianni Aikaterini , Sarafidis Pantelis 
Published: June 2023

Objective:
Cognitive impairment and exercise intolerance are common in CKD. Cerebral perfusion and oxygenation play a major role in both cognitive function and exercise execution. This study aimed to examine cerebral oxygenation during a mild physical stress in patients at different CKD stages and controls without CKD.

Design and method:
Ninety-participants (18 per CKD-stage 2,3a,3b,4 and 18 controls) underwent a 3-min intermittent-handgrip-exercise at 35% of their maximal-voluntary-contraction(MVC). During exercise, cerebral oxygenation (oxyhemoglobin-O2Hb, deoxyhemoglobin-HHb, total-hemoglobin-tHb) was assessed by near-infrared-spectroscopy. Indices of microvascular (muscle-hyperemic-response) and macrovascular function (cIMT and PWV), cognitive and physical activity status were also evaluated.

Results:
No differences in age, sex and BMI were detected among-groups. The MMSE score was significantly reduced with advancing CKD stages (Controls: 29.2±1.2 Stage 2: 28.7±1.0 Stage 3a: 27.8±1.9 Stage 3b: 28.0±1.8 Stage 4: 27.6±1.5; p = 0.019). Similar trends were observed for physical activity levels and handgrip strength. The average response in cerebral oxygenation during exercise was lower with advancing CKD stages (O2Hb: Controls: 2.50±1.54, Stage-2: 1.30±1.05, Stage-3a: 1.24±0.93, Stage-3b: 1.11±0.89, Stage-4: 0.97±0.80micromol/l; p<0.001)). The average tHb response(index of regional-blood-volume) showed a similar decreasing trend (p = 0.003); no differences in HHb among groups were detected. In univariate linear analysis older age, lower eGFR, Hb, microvascular hyperemic response, and increased PWV were associated with poor O2Hb response during exercise; in the multiple model, eGFR was the only parameter independently associated with the O2Hb response.

Conclusions:
Brain activation during a mild physical task appears to decrease with advancing CKD as suggested by the smaller rise in cerebral oxygenation. This may contribute both to impaired cognitive function and reduced exercise tolerance with advancing CKD.