bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C13-9: BLOOD PRESSURE CONTROL AND THE LEFT VENTRICULAR ECHOCARDIOGRAPHIC PROGRESSION IN HYPERTENSIVE PATIENTS: AN 18 MONTHS FOLLOW-UP STUDY
Authors: Yang Yan , Li Yan , Gao Pingjin 
Published: January 2023

Objectives:
The impact of blood pressure control on left ventricular (LV) geometry and function remains unclear. The present study was to assess whether BP control associated with conventional LV geometry and function indexes or global longitudinal strain (GLS) progression, and when the echocardiographic changes would occur in hypertensive patients.

Methods and Results:
A total of 62 participants (mean age 55.2 ± 11.5, male 71.0%) with uncontrolled hypertension were included in the longitudinal study. The follow-up study was performed at 6 months and 18 months, when echocardiographic measurements were performed and BP control was evaluated during the follow up period. At the 6- and 18-months examination, patients were divided into two groups: BP controlled group and uncontrolled group. Patients with BP uncontrolled group (n = 33) had higher LV mass index(P = 0.02), higher left atrial volume index (P = 0.01), worse GLS (P = 0.005) and GLS changes (P = 0.003) compared with BP controlled group (n = 29) at the end of 6 months follow-up period. Patients with BP uncontrolled group (n = 25) had higher LV mass index(P = 0.001), higher LV mass index changes(p = 0.01), higher relative wall thickness (P = 0.01), higher E/e’ (p = 0.046), worse GLS (P = 0.02) and GLS changes (P = 0.02) compared with BP controlled group (n = 24) at the end of 18 months follow-up period. GLS changes was associated with BP control (beta = 0.370, P = 0.004 at 6 months and beta = 1.531, P = 0.02 at 18 months) in stepwise multivariate regression analysis. LV mass index changes was associated with BP control (beta = 0.426, P = 0.003) at the end of 18 months in stepwise multivariate regression analysis.

Conclusions:
Our findings offer a new piece of evidence on the association of BP control with echocardiographic changes in hypertensive patients, especially support the view that GLS progression was superior to conventional LV geometry and function parameters, GLS changes were significant between BP controlled and uncontrolled patients even in 6 months follow-up period.
PS-C13-11: EFFECT OF HYPOKALEMIA ON LEFT VENTRICULAR STRUCTURE AND FUNCTION IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Wang Qiongying 
Published: January 2023

Object:
Analyzing the changes of left ventricular structure and function in essential hypertension patients with hypokalemia, we want to provide an evidence for clinical diagnosis and treatment of early heart damage caused by hypertension and hypokalemia.

Methods:
413 patients with hypertension who were hospitalized in the Hypertension Center of Lanzhou University Second Hospital from January 2015 to June 2021 were selected, including 270 cases of essential hypertension and 143 cases of essential hypertension with hypokalemia. Collect patient general information, biochemistry, urine routine, office blood pressure, 24 h ambulatory blood pressure, left atrial diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter, ventricular septal thickness, left ventricular posterior wall thickness and other indicators. After propensity score matching, 108 cases in the essential hypertension group and the essential hypertension with hypokalemia group were each, and statistical analysis was performed.

Results:
Albumin, and urea-creatinine ratio levels of the essential hypertension with hypokalemia group were significantly reduced, and the ratios of sodium ions and sodium potassium were lower than those of the primary hypertension group. Correlation analysis shows that the left ventricular mass index was positively correlated with and the course of hypertension, systolic blood pressure, diastolic blood pressure, mean arterial pressure, creatinine, sodium-to-potassium ratio, mean systolic blood pressure during the day, mean diastolic blood pressure during the day, mean systolic blood pressure at night, mean night diastolic blood pressure. Multiple linear regression analysis showed that the left ventricular mass index was independently positively correlated with systolic blood pressure, hypertension course, creatinine, sodium-to-potassium ratio, night systolic blood pressure, 24 h average systolic blood pressure, and 24 h systolic blood pressure load rate; potassium ion, low density Lipoprotein, angiotensin II and left ventricular mass index are independently and negatively correlated.

Conclusion:
There are more obvious ventricular structural changes in essential hypertension patients with hypokalemia; serum potassium ion concentration and sodium-to-potassium ratio are independent risk factors for left ventricular mass index in essential hypertension patients with hypokalemia.
PS-C14-3: HEART RATE RECOVERY IN CORONARY ARTERY DISEASE PATIENTS WITH HYPERTENSION: RELATIONSHIP WITH CLINICAL FEATURES AND LEFT VENTRICULAR REMODELLING
Authors: Tarsidin Najmi Fauzan , Tiksnadi Badai Bhatara 
Published: January 2023

Objective:
Heart rate recovery after treadmill exercise testing reflects autonomic dysfunction and is related to higher major adverse cardiac events. Numerous studies suggested the correlation of Heart rate recovery with hypertension and left ventricular remodeling. This study aimed to assess factors related to HRR in coronary artery disease patients who have undergone revascularization and Beta-blocker.

Design and method:
This cross-sectional study includes CAD patients who came to the outpatient clinic for six to 24 months after hospitalization in Dr. Hasan Sadikin General Hospital from February to August 2021. All patients undergo treadmill tests and transthoracic echocardiography. The treadmill stress test is conducted using Bruce or Modified Bruce Protocol. Transthoracic echocardiography is conducted using GE Vivid 7 ultrasound machine. Heart rate recovery at one minute defines as abnormal if < 18 beats per minute. The t test was used for continuous variables, and the Chi-square or Fisher exact test was used for categorical data. A p-value < 0.05 was considered statistically significant.

Results:
A total of 63 consecutive coronary artery disease patients with (n = 43, HP) and without (n = 20, NHP) were included in this study. All subjects underwent treadmill exercise testing. Up to 90% of patients have undergone revascularization by percutaneous coronary intervention or coronary artery bypass graft. All patients on Beta-blocker therapy. Peak heart rate (152 ± 29 vs. 132 ± 24, p = 0.010) and Heart rate recovery at one minute (129 ± 18 vs. 118 ± 19, p = 0.025) were significantly higher in the NHP group. Older age and lower peak heart rate were associated with lower heart rate recovery at one minute in the HP group. The previous history, such as diabetes, smoking history, ejection fraction, left wall mass index, and functional capacity, does not correlate with heart rate recovery at one minute in NHP or HP group.

Conclusion:
The present results demonstrate that heart rate recovery at one minute is affected by older age and peak heart rate. The left ventricular remodelling and other risk factors and their associations in coronary artery disease population who have undergone revascularization and are on beta-blocker medications should be investigated more with larger samples.
PS-C14-8: SINGLE GRAFT AFTER MALFUNCTIONING STENT IN CORONARY ARTERY DISEASE WITH DIABETES AND HYPERTENSION
Authors: Jain Rajesh , Husseini Siyamak Jalal , Shoghli Mohammadreza , Fesseha Hermon Eyob 
Published: January 2023

Introduction:
A 65-year-old woman was sent to the Heart Center Hospital emergency room because she had a history of persistent chest pain that had gotten worse during demanding conditions and strenuous activities. She has had diabetes and hypertension for ten years and is on medication with reasonable control. She had an angiography two years ago due to related complications. When the patient was taken to the Cath Lab for the second angiography it was discovered that the cardiology interventionist had wrongly put the stent after the LAD proximal and left the LAD artery stenosis significantly untreated. All of the specific symptoms of complications were, of course, connected to the stenosis of the LAD. The stenosis of the LAD was about 90% in the third stage.

Discussion:
The patient had an EF of 50% a PAP of 29 and no severe Echo issues were instantly found. Her stenosis was rapidly worsening, the angle of the stent used in the angioplasty was the standard size for the LAD and the fibrosis in the LAD pathway had unusual anatomy, making the second angioplasty exceedingly dangerous. An open-heart procedure seemed to be the only option to prevent a potential arterial rupture in angiography since the stenosis site was severely injured and fibrosis had developed due to the stent. The left internal mammary was anastomosed to the LAD artery after the stent had been implanted in a patient undergoing open-heart surgery. And only one incision was made for the bypass surgery.

Summary:
To be clear bypass surgery was the only viable option in this complex situation because removing the stent could have badly disrupted the intimal layer of the artery, progressively increasing the likelihood of thrombosis. It should be emphasized that the left and right coronary arteries were in good shape, with standard size and runup.
Given the significance of the LAD and that it supplies the heart with about 70% of its blood, myocardial infarction would have been quite likely in this case if there had been no surgery.
Past History: DM.HTN. MI RECENT
ECHO Finding
EF: 50% Normal
LV and RV the average size
S/P recent PCI on LAD average LV size with mild systolic dysfunction LVEF 50 % abnormal septal motion GI LV diastolic dysfunction, average RV size with mild systolic dysfunction MILD MAC Mild to moderate MR Thickened and mildly calcified AV
PS-C16-3: HYPERTENSION AND RISK FACTORS ASSOCIATED WITH IN-HOSPITAL DEATH IN PATIENTS WITH COVID-19
Authors: Elamin maha Ismail , Hassan Dina Ahmed , Bashir Intisar Abdelrahim , Mahmoud Tarig E 
Published: January 2023

Objective:
To explore the prevalence of hypertension and the common risk factors associated with increased death rate among (Covid-19) patients.

Design and method:
This is a retrospective cohort study using de-identified data retrieved from clinical records of patients from two COVID 19 isolation centers. Medical history, demographic data, self-reported comorbidities, symptoms, disease complications and laboratory investigations were extracted from clinical records of 406 confirmed COVID 19 hospitalized patients between Feb 2020 and July 2021. The outcomes of interest were death or discharge from the hospital. Logistic regression analysis was used to assess the impact of age, gender, associated comorbidities and some laboratory abnormalities on increased death rate among in-hospital (Covid-19) patients.

Results:
The prevalence of hypertension, was 59.6%, followed by diabetes (47.3%). COVID-19 patients with hypertension were older (67.0 ± 10.7vs 65.0 ± 13.0 P = 0.001). 70.4% were males. Undiagnosed high blood pressure was detected among 14.5%. Overall mortality was 46.2%, while mortality among normotensives, known hypertensives and undiagnosed hypertension was 47.7%, 54.7% and 37.6%, respectively (p < 0.005). Death was significantly higher among the age group > 65 years compared to ≦ 65 years old (53.6% % vs 39.0% (P = 0.005) irrespective of their blood pressure. Severe respiratory and gastrointestinal symptoms were significantly higher among hypertensives. Type I Respiratory failure 22.1%, and acute kidney injury 11.8% were the most typical complications among hypertensives. Leucocytosis (24.2%), Lymphopenia (56.8%) and higher levels of D-Dimer (47.7%) and C-reactive protein (49.7%) were mainly observed among hypertensive patients.
Logistic Regression analysis after adjusting for age significantly showed age OR: 1.81, 95% CI: (1.12: 2.73, p = 0.01), undiagnosed HTN OR: 5.65, 95% CI: (2.04:15.67, p = 0.00), low platelets count OR: 6.53, 95% CI, (1.23:35.23, p = 0.02), higher levels of urea OR:1.67, 95% CI, (1.04:2.63, p = 0.03) and creatinine OR:1.71, 95% CI, (1.063:2.70, p = 0.02), were associated with worse prognosis and in-hospital death among Covid- 19 patients.

Conclusion:
The age group, more than 65 years with undiagnosed BP of more than 140/90, is significantly associated with higher in-hospital death. Thrombocytopenia and elevated urea and creatinine levels were the most prominent laboratory markers and may be used as a potential indicator for prognosis and outcome among Covid 19 hypertensives.
PS-C16-8: CONSEQUENCES OF DISCONTINUING ANTIHYPERTENSIVE TREATMENT DURING THE FIRST WAVE OF A COVID-19 PANDEMIC
Authors: Vachulova Anna , Urban Lubos , Filipova Slavomira 
Published: January 2023

Arterial hypertension (AH), especially insufficiently and inadequately treated, is a disease with serious morbidity-mortality consequences. AH was the most common comorbidity in patients with COVID-19 infection. During the first wave of the COVID-19 pandemic, Slovakia has low number of COVID 19 patients. However, worldwide was reported 2-fold higher mortality in COVID 19 positive patients with untreated AH compared to patients with treated AH. Many patients have discontinued antihypertensive treatment due to changes in access to healthcare as well as the dissemination of unverified information.
The aim of our study was to evaluate the AH treatment in patients during the first wave of the COVID-19 pandemic, to analyze the consequences of changes in AH treatment.
It is a retrospective analysis of antihypertensive treatment of patients followed in the tertiary center. A total of 112 consecutive patients with AH who had a scheduled follow-up during the months of March-April 2020 were included. A telephone check-up was performed 6 months after the scheduled follow-up. These were patients with a mean age of 64 ± 18.1 years, 73 patients (65.2%) were male, and the mean number of antihypertensives per patient was 3.6 ± 2.2 drugs. Out of a total of 112 patients, 9 (8%) patients completely discontinued AH treatment, 15 (13.4%) patients discontinued ACEI / ARB without substitution, 5 (4.5%) patients discontinued ACEI / ARB with subsequent AH adjustment treatment. In the observed period March-April 2020, patients with newly diagnosed AH were absent. In our followed patient population (1.8%) were tested as COVID positive, 0 patients were hospitalized for COVID 19 infection. 4 (16,7%) patients overcame stroke, 1 (4.2%) patient overcame TIA, 1 (4.2%) was hospitalized for ACS, 2 (8.3%) for AF with rapid ventricular response, 2 (8.3%) for pulmonary edema, 2 (8.3%) patients died. In the group of patients who had adjusted treatment or did not discontinue AH treatment (a total of 88 patients) 1 (1.1%) patient overcame stroke, 1 (1.1%) was hospitalized for ACS, 1 (1.1%) for newly diagnosed AF, 1 (1.1%) patient died.
Unjustified complete or partial discontinuation of antihypertensive treatment during the first wave of the COVID-19 pandemic has led to an increase in complications of arterial hypertension. Achieving BP targets should also be crucial during the COVID 19 pandemic.
PS-C16-13: CARDIORESPIRATORY STATUS AFTER SARS-COV-2 INFECTION: THE ROLE OF HYPERTENSION AS RISK FACTOR
Authors: Kariori Maria , Fragoulis Christos , Polyzos Dimitrios , Siafi Eirini , Tatakis Fotis , Zamanis Ioannis , Kouremeti Maria , Leontsinis Ioannis , Drogkaris Sotirios , Manta Eleni , Grigoriou Kalliopi , Dimitriadis Kyriakos , Konstantinidis Dimitrios , Thomopoulos Costas , Tsioufis Costas 
Published: January 2023

Objective:
Few data have been published regarding the holistic approach of post-Covid patients, examining physical health. The purpose of our study was to examine the impact of arterial hypertension in the cardiopulmonary status of post-covid patients 3 months after the first day of infection.

Design and Method:
All participants who recovered Covid-19 infection underwent cardiorespiratory exercise using either Bruce or modified Bruce protocol where all parameters were evaluated and transthoracic echocardiogram. The population was separated into two groups based on history of hypertension. Group I (n = 29) included hypertensive subjects and Group II (n = 75) included normotensive subjects.

Results and Conclusion:
A total of 104 patients were assessed 3 months after the onset of COVID-19 symptoms. We recorded a mean age of 49 ± 15 years, 50.5% of them were males, 8.7% had a history of coronary heart disease. Hypertensives had higher BMI (29.24 ± 24 vs 26.64 kg/m2 p < 0.01) and BSA (2.09 ± 0.25 vs. 1.95 ± 0.58, p = 0.001). They were hospitalized in higher percentage comparing to normotensives (72.4% vs. 41.3%, p < 0.01). Left atrial diameter (41 ± 6 vs. 35 ± 5.5 mm, p < 0.001) was significantly larger in hypertensives. Furthermore, A wave (79 ± 21 vs. 58 ± 18 cm/s p < 0.001) and ratios of E/A (1.01 ± 0.42 vs. 1.28 ± 0.44, p < 0.01) and E/E (7.3 ± 3.7 vs. 5.9 ± 4.3, p < 0.01) differed between two groups. Finally, LVEF (%) was significantly impaired in hypertensive comparing to normotesive subjects (53 ± 13% vs. 59 ± 7%). This finding was depicted in lower maximum oxygen consumption (VO2 22 ± 4.5 vs. 28 ± 8 ml/kg/min p < 0.001), metabolic equivalents (METS) at peak, 9.1 ± 3 vs. 14 ± 20 p < 0.001), maximum heart rate (maxHR 147 ± 17 vs. 165 ± 21 bpm p < 0.001) and HR1st minute recovery (123 ± 28 vs. 138 ± 21 bpm, p: 0.02) comparing to normotensive. Systolic blood pressure (SBP 180 ± 29 vs. 165 ± 25mmHg, p: 0.02) during the 1st minute of recovery was higher in hypertensives. Finally, the duration of exercise was significantly lower in patients with hypertension (7.3 ± 2.7 vs. 9 ± 4 min, p:0.02). To conclude, the current study highlighted the negative impact of hypertension in the ability to exercise. Regardless of the disease severity, post-covid patients need a comprehensive approach for rehabilitation including the modification of risk factors like hypertension and obesity.
PS-P01-7: THE COHERENCE OF INFECTIOUS AND CHRONIC DISEASE EPIDEMICS; AMONG ELDERLY IN RURAL URBAN PERSPECTIVES
Authors: Waiswa Moses , Kavuma James , Mugabi Dennis 
Published: January 2023

Background:
Chronic diseases are the leading causes of disability and premature death among the elderly population in Uganda. The study, using data from the National Statistical office through censuses and surveys, examined the prevalence and determinants of chronic diseases among the population aged 60 + in Uganda by applying bivariate and logistic regression analyses and used a non-linear decomposition technique to understand the urban-rural differences in the coherence of chronic diseases.

Methods:
About 25% of the elderly in Uganda reportedly have at least one chronic disease. Seventeen percent elderly in rural areas and 29% in urban areas suffer from a chronic disease. Hypertension and diabetes account for about 68% of all chronic diseases. Those with higher levels of education, staying in urban areas, those who are economically dependent on others, staying alone or without spouse and children, and belonging to wealthy households have a higher likelihood of having a chronic disease.

Results:
The probability of having a chronic disease is 1.15 times higher among urban residents as compared to their rural counterparts. Elderly rural women, compared to elderly rural men, and never-married, widowed, and divorced elderly urban women, compared to married elderly urban men, are significantly more likely to suffer from chronic ailments. Differences in education, wealth status, and caste are the three most significant contributors to the urban-rural gap in chronic diseases.

Conclusion:
The high risk of chronic diseases among certain subsets of the elderly population must be recognized as a key public health concern. The findings of our study will likely help promote healthy ageing in Uganda.
PS-P03-5: QUALITATIVE INSIGHTS INTO THE BARRIERS TOWARDS BLOOD PRESSURE SCREENING, TREATMENT ADHERENCE AND LIFESTYLE MODIFICATIONS IN SINGAPORE
Authors: Lwin May Oo , Malik Shelly , Lim Fann , Kang Vernon 
Published: January 2023

In Singapore, despite numerous blood pressure (BP) campaigns, hypertension prevalence amongst adults has increased to 35%, exceeding the global rate of 31.1%. In light of the worrying trend, this research aims to examine major barriers faced by Singapore residents in their management of BP health. Through a novel reverse socialisation program, the study reached out to at-risk family members through their children and employed an in-depth qualitative lens to gain meaningful insights into the barriers faced at various stages of BP management care.
An intergenerational hypertension education program was launched among Singapore grade 5 students. Students were educated about hypertension and taught how to utilize a BP monitor. They then shared their knowledge and measured their family members BP at home. Family members found with borderline or high BP were invited for an interview and had their BP measurements validated by a medical professional. In-depth semi-structured interviews were conducted with 15 adults who were identified to have borderline hypertension or hypertension. Transcripts were analysed using the constant comparative approach, an analytic strategy based on grounded theory.
The study identified varying personal, psychosocial, and/or external barriers faced at three different stages of BP management care - regular screening, medical adherence and lifestyle modifications (Table 1).
Firstly, a major barrier towards regular BP screening was low perceived need to seek medical care due to a lack of physiological symptoms, suggesting that many respondents perceived themselves as being less susceptible to hypertension.
Secondly, barriers towards medical adherence were especially a concern for diagnosed hypertensives. A dominant factor was a lack of self-efficacy in following-up with the required care, such as fear of failing doctors expectations in follow-up appointments, lack of time and inability to comply with prescribed sudden changes to dietary and exercise habits
Thirdly, the inability to comply with recommended lifestyle modifications was nuanced by various factors related to ones identity such as age, job, familial obligations and culture.
The in-depth qualitative perspectives revealed a complex web of barriers to BP screening, adherence and lifestyle modifications. These have important implications for future health intervention designs. Particularly, health education and communication to at-risk communities require tailored interventions to overcome the varied personal, psychosocial, and external gaps at different stages of hypertension management care. For instance, threat-framed messages could be more effective in tackling the barrier of low perceived susceptibility to hypertension, while coping-framed interventions may be better suited for improving self-efficacy for treatment adherence.