bluuebunny/crossref_metadata_2025_split huggingface dataset:
SINGLE-CELL TRANSCRIPTOMIC PROFILING OF THE HYPERTENSION MOUSE BRAIN
Authors: Huang Jun , Dingli Liqiang , Gui Menglu , Zhao Bing , Gao Pingjin 
Published: June 2023

Objective:
Chronic hypertension has devastating effects on the brain, being the major cause of stroke and a leading cause of dementia. The alterations of cerebral blood vessels structure and vasoregulatory mechanisms leading by hypertension have been recognized for decades. However, the specific cellular and molecular mediators that drive these alterations remain unclear.

Design and method:
After 4 weeks of continuous administration of angiotensin II, we performed a single-cell transcriptomic analysis of brain cellulome. The brain cellular ecosystem in response to angiotensin II was analyzed, the network of cells that forms the mouse brain was profiled after a proinflammation stimulus that drives pathological brain vascular remodeling.

Results:
We analyzed the transcriptomes of 52,856 single cells (28,078 normal and 24,778 angiotensin II) derived from the brains of 10 normal and 12 angiotensin II mice, and compared all the cellular composition and transcriptomes of the whole brain cells.
For all the major cell populations, we provide comprehensive datasets of genes and pathways whose transcriptional profiles change with hypertension. To reveal heterogeneity within each population, we grouped the cells into 14 classes based on the expression profile, lineage, function and anatomical organization. Of the 20718 total detected genes, 800 were significantly affected by hypertension in at least one cell type. Hypertensive- related cellular pathways and processes were also investigated, and we highlight changes in EC and EPC. Furthermore, the cellular responses to angiotensin II and the changes in intercellular communication were identified.

Conclusions:
These large-scale datasets provide a valuable resource for exploring the brain cellular landscape in health and after chronic cerebral vascular stress. These data provide insights into the cellular and molecular mechanisms that afford an additional discoveries of directed towards understanding the mechanisms by which hypertension disrupts cerebral blood vessels.
PREVALENCE AND DISEASE SPECTRUM OF FIBROMUSCULAR DYSPLASIA IN PATIENTS WITH SPONTANEOUS CEREBROVASCULAR ARTERY DISSECTION
Authors: Pappaccogli Marco , Mangeruga Martina , Eula Elisabetta , Bosco Giovambattista , Verzini Fabio , Cerrato Paolo , Paoli Alessandro De , Guarnaccia Carla , Rabbia Franco , Veglio Franco 
Published: June 2023

Objective:
Spontaneous cervical artery dissection (sCeAD) is the most frequent cause of ischemic stroke in young adults and has been associated to various arteriopathies, such as fibromuscular dysplasia (FMD). The aim of this study was to assess the prevalence of both cervical and extra-cervical FMD in patients with a diagnosis of CeAD.

Design and method:
All patients discharged from the Stroke Unit of A.O.U. Città della Salute e della Scienza of Turin from 2016 to 2020 with a diagnosis of CeAD underwent a contrast-enhanced CTA from chest to pelvis to look for FMD-related lesions (multifocal stenosis, aneurysms, dissections, arterial tortuosity). FMD diagnosis was assessed in the presence of at least a multifocal stenosis in one of the vascular beds explored.

Results:
Among 56 patients with spontaneous CeAD, 72.7% were male of middle age (52±8.5 y.o.). According to radiological findings, 43.2% of patients showed extra-cervical arterial lesions, with a prevalence of overall FMD (defined as the presence of at least a multifocal stenosis) reaching 47.3% of the studied sample and affecting carotid (36.4%), renal (18.9%), visceral (16.2%), iliac (22.2%) and coronary arteries (2.7%) respectively. Renal involvement included multifocal renal stenosis (13.5%) and arterial aneurysms (5.4%). Visceral involvement included multifocal stenosis (13.5%), visceral aneurysms (2.7%) and silent mesenteric artery dissection (5.4%). Iliac involvement included multifocal stenosis (2.7%), silent artery dissection (2.7%) and tortuosity (16.7%). Furthermore, two spontaneous dissections, one of the left external iliac artery and the other of the coeliac trunk, clinically asymptomatic, were reported in two males with no multifocal stenosis. Two women suffered also from SCAD. Multivascular extra-cervical involvement was observed in almost one third of the patients (27.0%) with sever lesions (multifocal high degree stenosis and/or arterial dissections) affecting 13.5% of the population.

Conclusions:
According to our results, we demonstrated that FMD is frequently associated to CeAD and that silent FMD-related lesions, even severe as arterial dissections, may coexist in such patients. Therefore, FMD should always be taken in consideration in the differential diagnosis of spontaneous arterial dissection, especially in young subjects without major cardiovascular risk factors.
DETERMINANTS OF ADOLESCENT OBESITY: PARENTAL INFLUENCE AND REGION OF RESIDENCE IN ITALY
Authors: Pellegrino Alessio , Bacci Samuele , Guido Francesco , Zoppi Andrea , Toncelli Loira , Stefani Laura , Boddi Maria , Modesti Alessandra , Modesti Pietro Amedeo 
Published: June 2023

Objective:
Childhood obesity is on the rise globally, and family environment and socio-economic factors can play a relevant role. In Italy, regional differences in the prevalence of childhood obesity are observed. This study aimed to investigate the interaction between geographical region of residence, family environment and obesity among Italian adolescents.

Design and method:
Students of primary or secondary schools and their parents, residing in Calabria (South Italy) and Tuscany (Central Italy), were enrolled in a cross-sectional study. All participants were asked to fulfill a questionnaire composed of four sections. First section investigated demography and anthropometry, while General and Sport Nutrition Knowledge questionnaire (GeSNK), Mediterranean Diet Score, and International Physical Activity Questionnaire (IPAQ) assessed nutritional knowledge, dietary habits and physical activity levels respectively. BMI was calculated and students were classified using WHO BMI-for-age charts. Determinants of students’ habits and BMI were investigated with multivariate regression analyses.

Results:
179 students and 113 parents from Tuscany, 247 students and 185 parents from Calabria participated in the study. Obesity prevalence was higher in Calabria than in Tuscany among both students and parents, however multivariate regression analysis showed that geographical region of residence was not in itself a determinant of the BMI of students. Although transmission of eating and physical activity habits from parents to sons appears to occur, parental BMI was the only parental characteristic identified as an independent determinant of the students’ BMI at multivariate regression analysis (adjusted for geographical area, students’ age and gender, parental BMI and education level, parents’ and students’ habits and nutritional knowledge).

Conclusions:
Prevention strategies oriented to reduce childhood obesity should also involve parents.
IMPACT OF DIFFERENT GUIDELINES ON THE PREVALENCE OF HYPERTENSION IN CHILDREN AND ADOLESCENTS
Authors: Calderon Jose Miguel , Ponce Francisco , Deutsch Christine , Alvarez Julio , Aguilar Francisco , Redon Josep , Lurbe Empar 
Published: June 2023

Objective:
To assess the prevalence of hypertension (HTN) in youth according to the criteria of the European Society of Hypertension (ESH) (Lurbe, 2016), the American Academy of Pediatrics (AAP) (Flynn, 2017), and the Canadian Guidelines (Rabi 2020).

Design and method:
Four thousand nine hundred and forty evaluations in 2957 Caucasians of both sexes (1459 females), of European origin, from 5 to 18 years of age (mean age 11.0 ±3.2) were included and grouped in 5-12 yr, 13-15 yr and 16-18 yr. Blood pressure (BP) was measured in the non-dominant arm with cuff and bladder size adjusted to upper-arm girth. The three measurements of each office visit were averaged for analysis. Subjects were qualified as hypertensive (SBP and/or DBP) based on the thresholds defined by ESH, AAP and Canadian guidelines and differences among them were calculated.

Results:
According to the ESH, Canadian and AAP criteria, the percentage of hypertensives was 6.2%, 6% and 9.9%, respectively. The percentages in boys were 7.2%, 8.2% and 12.3%, while in girls were 5.1%, 3.6% and 7.4%. According to age, between 5-12 yr the prevalence of HTN was 6.2%, 5.2% and 10%. In those with 13-15 yr, HTN ranged at 7.3%, 6.8% and 8.6%, while in those with 16-18 yr, HTN was observed in 1.6%, 9.2% and 13.2%. The graphic expression of the different prevalence is shown in the Figures. Significant differences were observed for the total and male prevalence between ESH and Canada with AAP (p<0.05). For girls, differences were observed among the 3 Guidelines.

Conclusions:
Overall, there are differences in the prevalence of HTN applying different Guidelines. Differences were largely dependent on age and sex.
THE PROFILE OF HYPERTENSION IN TYPE 2 DIABETICS PATIENTS
Authors: Rihab Zouaoui , Mariem Khadhar , Sarra Haddad , Mouna Jerbi , Hanen Gaied , Raja Trabelsi , Rim Goucha 
Published: June 2023

Objective:
Hypertension (HT) is associated with type 2 diabetes (T2D) in 80% of cases.
This association is explained by the same risk factors shared by these two pathologies, essentially obesity, lack of physical activity and smoking.
The aim of our work is to study the epidemiological, clinical and therapeutic characteristics of hypertension in type 2 diabetes patients at the first nephrology consultation.

Design and method:
It's a retrospective study of 42 patients with type 2 diabetes followed at the nephrology consultation of Mongi Slim Hospital over a period of three years (January 2013 - December 2016). HT was classified according to the ESH / ESC recommendations of 2021.

Results:
The study included 25 men and 17 women with a mean age of 63.3 [31-80].
At the first consultation, 88% of our patients had hypertension with a sex ratio M/F of 1.3.
The duration of the HT was 98 months [0-300] and that of the T2D was 170 months [2-480].
The diagnosis of HT and T2D was made at the same time in 7 patients (16.6%). In 8 patients (19.04%), HT preceded T2D.
HT was classified as grade 1 in 8 patients (19%), grade 2 in 12 patients (28.6%), grade 3 in 6 patients (14.3%) and systolic HT in 9 patients (21.4%).
Fourteen patients were on dual therapy, 12 patients were on triple therapy including a renin angiotensin system blocker and 2 were on quadruple therapy including a loop diuretic.
The mean systolic blood pressure was 161.78 mm Hg, 152.91 mm Hg and 175 mm Hg respectively and the mean diastolic pressure was 80.35 mm Hg, 68.75 mm Hg and 85 mm Hg respectively.

Conclusions:
Hypertension is frequently associated with type 2 diabetes. It increases the cardiovascular risk of type 2 diabetes patients. Thus, early diagnosis and good control of hypertension are of paramount importance.
HIGH BLOOD PRESSURE IN THE NEWLY DIAGNOSED TYPE 2 DIABETES PATIENTS
Authors: Nelaj Ergita , Gjata Margarita , Kecaj Irida , Gjermeni Ilir , Tase Mihal 
Published: June 2023

Objective:
Type 2 diabetes mellitus and hypertension often coexisted in type 2 diabetes patients. Hypertension is often present at the time of diagnosis of type 2 diabetes. Our study aim to evaluate the prevalence of arterial hypertension in newly diagnosed type 2 diabetics and to evaluate the comorbidities associated with hypertension at the time of diagnosis of diabetes.

Design and method:
Is a prospective study based on 126 newly diagnosed type 2 diabetics, 66 men, and 60 women, aged 45 to 70, hospitalized in Internal Medicine. Blood pressure is taken in consultation according to the recommendations of the ESH, based at least in two consecutive consultations. All patients underwent the assessment of the impact on the target organs, as well as a systematic evaluation for micro and macro-vascular complications.

Results:
At the time of diagnosis of type 2 diabetes mellitus, the prevalence of arterial hypertension is 56.2%. The patients were already followed for arterial hypertension in 24% of the cases, among them, only 11% considered for therapeutic objectives, and 3% presented with ketosis. Hypertensive diabetics are on average 61.2 years old and have metabolic syndrome in 81.1%. Women are more obese and have a significantly higher waist circumference. Men have higher blood sugar, lower HDL, higher coronary risk, and more frequently present with albuminuria. The level of blood pressure, both systolic and diastolic, rises significantly with the number of metabolic syndrome criteria, and the number of cardiovascular risk factors. We find microangiopathy in 59.1% of cases, and cardiovascular disease in 65.2% of cases. The association of microangiopathy with cardiovascular disease is significantly more frequent in hypertensive diabetics than in non-hypertensives (58% vs 31%, p = 0.005).

Conclusions:
High blood pressure is very prevalent in newly diagnosed diabetics. The hypertensive diabetic has a higher degree of morbidity, and presents a cardiometabolic profile with a very high cardiovascular risk compared to the non-hypertensive diabetic at the time of diagnosis of diabetes mellitus.
THE COURSE OF CHRONIC HEART FAILURE IN PERSONS WITH POST-INFARCTION CARDIOSCLEROSIS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS AND OBESITY ACCORDING TO A NUMBER OF MET
Authors: Dunaieva Inna , Kravchun Nonna , Kravchun Pavlo 
Published: June 2023

Objective:
To investigate the effect of lipid metabolism, biomarkers of fractalkin and clusterin inflammation on the development and progression of chronic heart failure (CHF) in patients with post-infarction cardiosclerosis, type 2 diabetes and obesity.

Design and method:
A retrospective analysis of a comprehensive examination of 67 patients with postinfarction cardiosclerosis with concomitant type 2 diabetes and obesity. All patients were divided into 3 groups depending on the functional class (FC) of CHF: 1 group (n = 22) - patients with CHF II FC; Group 2 (n = 23) - patients with CHF III FC; Group 3 (n = 22) - patients with CHF IV FC. All patients were examined clinically, they underwent instrumental, biochemical and hormonal examinations.

Results:
With the progression of CHF from FC II to FC III there is a deterioration of lipid metabolism: a significant increase in cholesterol levels by 5.5%, TG – by 15.7%, LDL cholesterol – by 74.4%, VLDL cholesterol – by 15.9%, reduction of HDL cholesterol by 27.6% (p<0,05). An analysis of the fractal equation showing that ailing on CHF is advised by FC; and the level of clusterine - on the contrary decreases. Classical changes in patients with postinfarction cardiosclerosis with CHF and concomitant type 2 diabetes mellitus and obesity, which are the formation of atherogenic lipid metabolism disorders associated with body weight, as well as changes in the latest indicators such as fractalkin and clusterin, indicating the role of these molecules in the progression of CHF.

Conclusions:
Due to the progression of chronic heart failure in patients with postinfarction cardiosclerosis and AH concomitant type 2 diabetes and obesity, an increase in all fractions of lipoproteins at stage III functional class was diagnosed, and then their decrease, which may indicate a deterioration in this category of patients, due to the progression of metabolic shifts, stagnation, dysfunction of the main parenchymal organs. Increased circulatory levels of fractalkin and decreased clusterin content in patients with postinfarction cardiosclerosis with concomitant type 2 diabetes mellitus and obesity is accompanied by an increase in the functional class of chronic heart failure.
PARAMETERS OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH HYPERTENSION DISEASE WITH CONCOMITANT TYPE 2 DIABETES MELLITUS
Authors: Dunaieva Inna , Bilovol Olexandr 
Published: June 2023

Objective:
To conduct analyzes of the peculiarities of left ventricular (LV) diastolic function in patients with hypertension disease with concomitant T2DM and without it before and after complex treatment with the inclusion of Eplerenone 50 mg per day and Trimetazidine 80 mg per day.

Design and method:
The study examined 25 patients with HT and DM in a subcompensated state, with an HbA1c level of 7.6±0.34% (main group) and 25 patients with HT stage II (HbA1c level of 5.01±0.13%), without T2DM aged 35 to 65 years, who were being treated at the clinic of the GI “L.T. Malaya Therapy National Institute of the NAMS of Ukraine”. The control group consisted of 20 healthy individuals (HbA1c level of 4.68±0.49%).

Results:
The data in Table 1 suggest that in patients with HT and HT with comorbid T2DM, the mean kinetics of diastolic flow of the fibrous ring was significantly lower in comparison with the control group. While the e`mean level in patients with T2DM and HT was significantly lower in comparison with patients with HT. Thus, the findings indicate that aggregate hemodynamic and metabolic alterations adversely affect the kinetic capabilities of the myocardium. Moreover, the lowest rates of the myocardial diastolic relaxation rate were probably found in patients with HT with T2DM. The latter proves that the comorbidity of these negative factors significantly reduces the functional capacity of the myocardium.

Conclusions:
P2Y12 INHIBITOR MONOTHERAPY OR DUAL ANTIPLATELET THERAPY AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH HYPERTENSION
Authors: Pil-Sang Song , Jin-Ok Jeong 
Published: June 2023

Objective:
P2Y12 inhibitor monotherapy after a brief period of dual antiplatelet therapy (DAPT, a combination of aspirin and a P2Y12 inhibitor) can reduce bleeding without increasing ischemic harm after percutaneous coronary intervention (PCI). The impact of this approach among patients with hypertension remains unknown. We sought to examine the effect of P2Y12 inhibitor monotherapy versus DAPT among patients with hypertension undergoing PCI.

Design and method:
This is a post-hock analysis of the hypertension cohort in the SMART-CHOICE trial. The SMART-CHOICE trial was a randomized trial that compared P2Y12 inhibitor monotherapy after 3 months of DAPT with prolonged DAPT (12 months or longer) in patients who underwent PCI. The primary endpoint was Bleeding Academic Research Consortium (BARC) 2 to 5 bleeding. The composite ischemic endpoint was all-cause death, myocardial infarction, or stroke. Treatment effects were estimated according to presence of hypertension with formal interaction testing to assess for effect modification.

Results:
Patients with hypertension comprised 61.5% (n = 1,840) of the randomized cohort and were characterized by more frequent comorbidities. At 3 years after randomization, patients with hypertension experienced higher rates of all-cause death (3.9% vs 2.5%; p = 0.039), stroke (1.6% vs 0.6%; p = 0.014), or MACCE (6.8% vs 3.8%; p<0.001) but similar BARC types 2 to 5 bleeding (5.4% vs 4.9%; p = 0.601) compared with patients without hypertension. The incidence of BARC 2 to 5 bleeding was 2.9% and 7.8% among patients with hypertension randomized to P2Y12 inhibitor monotherapy versus DAPT [hazard ratio (HR): 0.382; 95% confidence interval (CI): 0.243 to 0.600; p<0.001]. However, P2Y12 inhibitor monotherapy was not associated with an increase in ischemic events compared with DAPT (7.2% vs. 6.5%; HR: 1.135; 95% CI: 0.767 to 1.679; p = 0.527) in patients with hypertension. In the overall trial population, there was no significant interaction between hypertension status and treatment group for the primary bleeding (adjusted p for interaction 0.835) or ischemic endpoints (adjusted p for interaction 0.707).

Conclusions:
P2Y12 inhibitor monotherapy is associated with significantly lower risk for bleeding events compared with DAPT, without any compromise in ischemic prevention, among patients with history of hypertension undergoing PCI.
THE IMPACT OF HYPERTENSION ON IN-STENT RESTENOSIS IN POST-STEMI REVASCULARIZED PATIENTS
Authors: Munteanu Alice Elena , Ispas Irina , Ionita Iulia Theodora , Casian Mihnea 
Published: June 2023

Objective:
The current picture of cardiology is the result of great therapeutic advances and large clinical trials. Perhaps the most spectacular impact seen in recent decades has been among patients with coronary artery disease, whose life expectancy and quality of life have been profoundly altered by the introduction of percutaneous myocardial revascularization into practice.

Design and method:
The study was carried out in the Carol Davila Central Military Emergency University Hospital in Bucharest, on a group of patients with acute coronary syndrome with ST segment elevation, treated interventionally in our center through the RO-STEMI program. In the period 2015-2018, 1316 STEMI procedures were performed, of which 107 presented stent restenosis of various degrees, visually quantified by the angiographer.
The presented study is observational, analytical, retrospective. This study can be considered a real world one, because the phenomenon of stent restenosis was studied and objectively correlated with clinical practice, reflecting the experience of our center.

Results:
HT represented an indicator present in the current study in a significant proportion - 80% of the patients in the study, being more frequent in men. A higher prevalence of arterial hypertension was observed in smoking patients. It has been noted that the presence of HT in overweight or HT associated with dyslipidemia increases the risk of AMI or other acute events (stroke). In the hypertensive patients studied, the percentage of major events was 20% higher, but without a statistically significant influence. The main risk factor incriminated in the determination and occurrence of the process of intraluminal proliferation resulting in intrastent restenosis was diabetes mellitus. In patients with DM, the percentage of events was 20% higher than in patients without DM. Diabetes, dyslipidemia, stent characteristics were independent risk factors for in-stent restenosis (p <0.05).

Conclusions:
In conclusion, for patients with risk factors indicating PCI, identification and personalized patient management are warranted to prevent in-stent restenosis. Long-term follow-up of patients with STEMI is essential both for their prognosis and for the individualization of this population through studies.