bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECTS OF LIFESTYLE ADVICE ASSOCIATED WITH BEETROOT-BASED NUTRACEUTICAL ON 24-HOUR BLOOD PRESSURE IN A POPULATION WITH HIGH-NORMAL BLOOD PRESSURE OR GRADE 1 HYPERTENSION
Authors: Spannella Francesco , Giulietti Federico , Massacesi Adriano , Poliseno Chiara , Festa Roberto , Cavazzin Enrico , Sacco Giulio , Mazza Alberto , Sarzani Riccardo 
Published: June 2023

Objective:
2018 ESH hypertension guideline supports life-style changes as initial approach to be taken in both subjects with high-normal blood pressure (BP) and patients with grade 1 hypertension and low cardiovascular (CV) risk. Among many nutraceuticals, most with unproven or unlikely benefits, bioactive substances enriched with nitrates, sources of nitric oxide (i.e. red beets) exert proven vasodilator effects and may decrease BP levels. Aim: to evaluate the effect of lifestyle advice and beetroot-based nutraceutical on 24-h BP in a population with high-normal BP or grade 1 hypertension and low CV risk.

Design and method:
Longitudinal study on 43 consecutive subjects referred to two hypertension centers. A 24-h ambulatory BP monitoring (ABPM) was performed at baseline and after 3 month the introduction of lifestyle advice and beetroot-based nutraceutical [Cosmony, Servier, a nutraceutical based on Beta vulgaris L. (500 mg of dry beetroot extract)].

Results:
Mean age: 49.9±10.7 years. Male prevalence: 53.5%. Median follow-up: 98 (92-121) days. Overweight/obese prevalence: 58.1%. The 62.8% of subjects had a grade 1 hypertension. At baseline, 24-h BP, daytime BP and night-time BP were 127.2±6.8/79.6±5.6 mmHg, 131.3±7.5/83.4±5.5 mmHg and 117.8±7.7/70.2±5.0 mmHg, respectively. At follow-up, all BPs showed a statistically significant decrease (all p<0.005), except for diastolic night-time BP (p = 0.074) (-3.4±5.9/-2.2±3.7 mmHg for 24h BP; -3.9±6.0/-3.0±4.0 for daytime BP and -3.3±7.4/-1.3±4.7 for night-time BP). The percentage of subject with daytime BP <130/85 mmHg had increased from 25.6% at baseline to 48.8% at follow-up. The decrease in BP was independent of gender and overweight/obesity, whereas it was more evident in the group of grade 1 hypertensives compared with the group with high-normal BP.

Conclusions:
Lifestyle advice in association with a nutraceutical, source of nitric oxide, may be a valid initial non-pharmacological therapy in subjects with high-normal BP or grade 1 hypertension and low CV risk.
COFFEE CONSUMPTION RELATES TO A REDUCTION OF VASCULAR AND HEART DAMAGE IN WELL-CONTROLLED HYPERTENSIVES
Authors: Marozzi Marialuisa Sveva , Trani Miriam Di , Zotti Francesca , Rignani Federica , Gramegna Davide , Amodio Gianfranco , Santoro Giuseppe , Benedittis Lorenzo De , Schirosi Gabriella , Ranieri Giuseppe , Nazzaro Piero , Cicco Sebastiano 
Published: June 2023

Objective:
Nutritional interventions might prevent hypertension-related organ damage but are far to be fully defined. Coffee is one of the most used beverages all over the world. Many studies tried to define the optimal amount of coffee to understand whether coffee has a role in cardiovascular prevention. Thus, we evaluated heart and vascular damage in well-controlled hypertensives according to coffee consumption.

Design and method:
We evaluated 316 primary hypertensives (150F, 166M, aged 62.22±10.76) evaluated for target organ damage. The number of coffee cups per day was asked during the visit.

Results:
The median coffee consumption was 2 cups per day and patients were subdivided into tertiles: Group 1, 0-1 cups 112 patients (57F, 55M; 64.21±10.91 y.), Group 2, 2 cups, 101 patients (53F; 48 M; 61.95±10.10 y.), Group 3, >2 cups, 103 patients (40F; 63M; 60.32±10.95 y.). No differences were seen in BMI, systolic and diastolic BP. Group 1 had a higher left ventricular mass than the other two groups (p = 0.0008 and p = 0.019 respectively) while no difference there was between group 2 and 3. Similarly, Group 1 had a significant reduction in E/e’ ratio (p = 0.042 and p = 0.019, respectively). No significance was found between Group 2 and 3 for left ventricular mass and diastolic function. Group 3 had an increased intima-media thickness (p = 0.004 and p = 0.005 vs Group 1 and 2, respectively). Prevalence of carotid stenosis was lower in Group 3 (p = 0.011 and p = 0.039, respectively) and was comparable in Group 1 and 2.

Conclusions:
Coffee consumption at least of 2 cups/day may have a role in prevention of heart remodelling and diastolic dysfunction.
THE EFFECT OF PLANT-BASED AND MYCOPROTEIN-BASED MEAT SUBSTITUTES ON CARDIOMETABOLIC RISK FACTORS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CONTROLLED INTERVENTION TRIALS
Authors: Gibbs Joshua 
Published: June 2023

Objective:
Plant-based and mycoprotein-based meat substitutes are predicted to play a key role in the re-duction of meat intake, however, their impact on human health is unclear. The main objective of this meta-analysis was to assess the short-term effects of meat substitutes on important cardiometabolic biomarkers (total cholesterol, TC; LDL-cholesterol, LDL-C; HDL-cholesterol, HDL-C; Triglycerides, TG; Systolic blood pressure, SBP; Diastolic blood pressure, DBP; Fasting blood glucose, FBG; weight) in controlled clinical trials.

Design and method:
Embase and MEDLINE were searched to identify controlled clinical trials with meat substitute interventions and cardiometabolic biomarker outcomes. Standardised mean differences in TC, LDL-C, HDL-C, TG, FBG, SBP, DBP, and weight and 95% confidence intervals were pooled using a random effects model. Risk of bias, heterogeneity, sensitivity, and publication bias were assessed.

Results:
Of the 934 records identified, 12 studies met the inclusion criteria. In the pooled analyses the consumption of meat substitutes was associated with significantly lower TC (-0.50 mmol/L [95% CIs -0.70, -0.29]), LDL-C (-0.39 mmol/L [-0.57, -0.21]), and TG (-0.15 mmol/L [-0.29, -0.01]), non-significantly lower FBG (-0.08 [-0.23, 0.08]), SBP (-0.32 [-1.79, 1.41]), and weight (-0.12 [-1.52, 1.27]), and non-significantly higher HDL-C (0.01 [-0.02, 0.05]) and DBP (0.49 [-0.30, 1.28]). There was evidence of publication bias, and some heterogeneity was detected. The certainty of evidence was moderate for the TC and HDL-C results, low for the LDL-C, TG, SBP, DBP, and weight results, and very low for the FBG results.

Conclusions:
Replacement of some or all meat with plant-based or mycoprotein-based substitutes may lower TC, LDL-C, and TG.
LIPID DISORDERS BEFORE AND AFTER SUCCESFUL LIVER TRANSPLANTATION
Authors: Adamczak Marcin , Gojowy Damian , Urbaniec-Stompor Joanna , Adamusik Joanna , Wojcik Gabriela , Karkoszka Henryk , Krol Robert , Wiecek Andrzej 
Published: June 2023

Objective:
Liver transplantation (LTx) is the only successful treatment for end-stage liver disease. Long term results of liver transplantation not only depend upon graft survival but it may be also affected by superimposed cardiovascular morbidities. This single center, retrospective, clinical study was aimed to assess the prevalence of lipid disorders in patients before and after successful LTx.

Design and method:
One hundred eleven patients (mean age 49.7±12.2 years) who underwent Ltx because of liver cirrhosis and survived at least 2 years with functioning graft were included in this retrospective analysis. The prevalence of dyslipidemia was assessed before and two years after LTx. This was analyzed in relation to etiology of liver disease, including alcohol toxicity, viral or autoimmune diseases.

Results:
Before and after LTx the prevalence of hypertriglyceridemia, hypercholesterolemia and hypertriglyceridemia accompanied by hypercholesterolemia were 13.5% and 40.5%, (P<0.001), 17.1% and 51.4% r (P<0.001), as well as 7.2% and 27.9% (P<0.001) respectively.
There was no significant differences in prevalence of hypertriglyceridemia (7.4% vs 10.0% vs 16.2%), hypercholesterolemia (14.8% vs 16.7% vs 14.2%) as well as hypertriglyceridemia accompanied by hypercholesterolemia (3.7% vs 3.3% vs 10.8%) in patients before LTx with the autoimmune, alcoholic and viral cause of liver cirrhosis, respectively. Two years after LTx the prevalence of hypertriglyceridemia (18.5% vs 66.7%, P<0.001) and hypercholesterolemia (29.6% vs 70.0%, P = 0.002), as well as hypertriglyceridemia accompanied by hypercholesterolemia (14.8% vs 46.7%, P = 0.009) was significantly lower in patients with the autoimmune cause of liver cirrhosis in comparison to patients with the alcoholic liver disease.

Conclusions:
1. The prevalence of dyslipidemia is increased after LTx. 2. The prevalence of dyslipidemia after LTx may be related to the cause of liver injury before LTx.
THE MEDITERRANEAN DIET AND GLYCEMIC REGULATION IN PATIENTS WITH DYSLIPIDEMIA AND DIABETES MELLITUS TYPE 2
Authors: Mavrokefalou Evgenia , Kakou Anta - Monica , Konidari Diimitra , Theodosis Spyridon , Iasonos Maria , Marakomichelakis George 
Published: June 2023

Objective:
The Mediterranean diet is considered a cornerstone in the regulation of the person with dyslipidemia and diabetes mellitus.
The aim of the study is to record the eating habits of patients with dyslipidemia and type 2 diabetes mellitus and to correlate these habits with their regulation.

Design and method:
This study involved 948 patients (490 men and 458 women with an average age of 61.6±7 years). A registration questionnaire was used for their demographic, somatometric data, their eating habits, their medication and patients’ compliance with them was reassessed with a review after six months.

Results:
The duration of dyslipidemia was 12.7±14.2 years and DM2 was 12.8±14.4 years. The mean value of glycosylated hemoglobin was (HbA1c) 6.73±2.55%, with 57.1% of patients having HbA1c less than 7%. The body mass index (BMI) was 32.6±6.85 in both sexes (p = 0.440). 66.8% of patients were overweight, and obese with women having higher rates. 87.1% of patients consume breakfast, fruits more than 7 times a week consume 33.1%, vegetables at least 2 times 53.6%, meat 2 times 42%, fish 1 time 46.8%, legumes 65%, chicken 2 times 29.1% and sweets consume 16.6% of patients. A positive association with the regulation of dyslipidemia and DM2 is shown by the consumption of balanced breakfast (p = 0.001) and the presence of 2 main meals in the daily schedule (p = 0.008). The high consumption of junk food (p = 0.009), the consumption of soft drinks (p = 0.056) and the consumption of sweets (p< 0.001) had a negative impact. 27% of patients were in higher education, 43.5% in secondary education, and 31.5% in basic education. Insufficient control of dyslipidemia was in 60,5% of patients. The prevalence of metabolic syndrome was found to be less in those who followed the Mediterranean diet.

Conclusions:
The eating habits of people with dyslipidemia and DM2 affect their regulation having a positive effect especially on glycemic regulation. The adoption of the Mediterranean diet is accompanied by a reduction in the risk of developing metabolic syndrome.
MICROCIRCULATION AND BLOOD PRESSURE/HEART RATE RESPONSE DURING EXERCISE STRESS TESTING IN HYPERTENSIVE PATIENTS
Authors: Liatakis Ioannis , Konstantinidis Dimitrios , Tzorovili Evaggelia , Siafi Eirini , Tatakis Fotis , Leontsinis Ioannis , Drogkaris Sotirios , Zammanis Ioannis , Fragoulis Christos , Andrikou Ioannis , Filippou Christina , Kalos Theodoros , Grigoriou Kalliopi , Sakalidis Athanasios , Tsoumpou Ioanna , Manta Eleni , Kakouri Niki , Thomopoulos Costas , Dimitriadis Kyriakos , Tsioufis Konstantinos 
Published: June 2023

Objective:
A hypertensive response during exercise has been associated with adverse cardiovascular outcomes in general population and hypertensive patients. On the other hand, microcirculation is the major site of control of vascular resistance and thus has a key role in the etiopathogenesis of hypertension. The aim of our study was to investigate the presence of a possible correlation between blood pressure and heart rate response during exercise with a microcirculation index (capillary rarefaction) in a cohort of hypertensive patients.

Design and method:
We studied 105 untreated patients with stage I-II essential hypertension (70% men, mean age: 59.5 years, mean office blood pressure: 150/92mmHg). Patients with diabetes mellitus, secondary hypertension, atherosclerotic cardiovascular disease, heart failure, significant chronic renal or pulmonary disease and any other systemic illness or orthopedic problems that would not allow maximal effort on a treadmill were excluded. All participants underwent maximal exercise testing, using the Bruce protocol, as well as nail-fold videocapillaroscopy assessment by using VideoCap 3.0 videomicroscope.

Results:
A significant negative correlation between diastolic BP at minute-1 of the recovery phase and capillary density expressed in capillaries/mm was revealed (Pearson's r = -0.365, p = 0.043). A significant negative correlation was also observed between capillary density and peak heart rate (Pearson's r = -0.364, p = 0.024) as well as between heart rate increase from stage 1 to 2 and capillary density Pearson's r = -0.746, p = 0.013). Our study shows that in a small cohort of hypertensive patients, capillary rarefaction was associated with a steeper increase in heart rate during exercise, as well as with a higher peak heart rate and higher diastolic blood pressure values during the recovery phase.

Conclusions:
These findings suggest that new indices such as capillary rarefaction may provide insights into possible autonomic dysfunction and could also be taken into account in the assessment of hypertensive patients.
ARTERIAL STIFFNESS IN PREHYPERTENSIVE PATIENTS WITH PREDIABETES - A PILOT STUDY
Authors: Jug Juraj , Prkacin Ingrid 
Published: June 2023

Objective:
Prediabetes is associated with higher cardiovascular risk and increased all-cause mortality in the general population. The aim of this study was to determine whether there are differences in primary laboratory findings and pulse wave velocity (PWV) between prehypertensive patients with and without prediabetes.

Design and method:
This study included 58 patients (39 women, 19 men) with prehypertension according to the JNC7 criteria from 2003 (systolic blood pressure [SBP] 120-139mmHg or diastolic blood pressure [DBP] 80-89mmHg based on 2 or more seated measurements on each of 2 or more office visits) from one family practice in Health center Zagreb-west. Patients were divided into two groups depending on having prediabetes (fasting plasma glucose [FPG] 5.6-6.9 mmol/L – according to American Diabetic Association (ADA) criteria from 2014). Basic laboratory tests (cholesterol, creatinine, fasting glucose, and potassium), anthropometric, 24h ambulatory blood pressure, and pulse wave velocity (PWV) measurements (with Agedio B900) were done in all patients. Renal function was calculated with the CKD-EPI formula (KDIGO 2020). Mann-Whitney U test, multiple linear regression model, and descriptive statistics were used in data processing in Statistica v.12.0.

Results:
Normal FPG was found in 41 patients (70.7%), while 17 patients had prediabetes (29.3%). Prehypertensive patients with prediabetes were older (median 58 vs. 54 years; p<0.01), had significantly higher uric acid concentration (median 324 vs 282 mmol/L; p<0.05), and higher PWV (median 8.20 vs. 7.45m/s; p<0.01). No differences were found in the concentration of potassium, LDL cholesterol, triglycerides, and body mass index (median 24kg/m2). FBG levels were independently and significantly associated with PWV (beta = 0.33; p<0.05).

Conclusions:
This pilot study indicates the possible existence of accelerated atherosclerosis in prehypertensive individuals with prediabetes compared to those with normal FPG. Research on a larger sample is needed to confirm these findings.
ARTERIAL HYPERTENSION DOES NOT SLEEP
Authors: Pantea Rebecca , Zara Cornelia , Iancu Valeria , Baban Dominic 
Published: June 2023

Objective:
Sleep apnea is a secondary cause of hypertension and is suggested by non-dipper profile at ambulatory blood pressure monitoring (ABPM). The prevalence is estimated between 30-50% in hypertensive patients.

Design and method:
A 60 year-old man with cardiovascular risk factors (hypertension, diabetes, dislipidemia, obesity, transient ischemic attack) presented to the outpatient clinic with high values of self-monitoring blood pressure despide multiple lowering blood pressure therapy. On physical examination his body mass index was 39.6 kg/m2, neck circumference 50 cm. The ECG was in sinus rhythm with hypertrophic phenotype confirmed by echocardiogram, which also showed left ventricle preserved ejection fraction, grade III diastolic dysfunction, mildly enlarged left atrium. Laboratory tests exluded endocrinologic and renal causes. Despite lifestyle changes and a good adherence to multiple associated antihypertensive treatment, ABPM revealed a non-dipper profile (dipping index 4.86%) (figure 1). The patient underwent the polygraphy test which showed the apnea-hypopnea index (AHI) of 10.6, which led to a diagnosis of mild sleep apnea, the t90% of 57 pointed out severe hypoxia and high pulse variances 104 (figure 1). The further Holter monitoring revealed episodes of atrial flutter and atrial fibrillation.

Results:
After 3 months of continuous positive airways pressure (CPAP) therapy, on top of the same antihypertensive drugs and anticoagulation, led to optimal blood pressure values and normal ABPM profile (figure 2). The polygraphy parameters AHI, t90% and pulse variances normalised too. (figure 1)

Conclusions:
Obstructive sleep apnea is a prevalent secondary cause of hypertension and atrial arythmias, still greatly underdiagnosed. It is associated with abdominal obesity, large neck, snoring, daytime fatigue and a decrease in the quality of life. Polygraphy is a feasible method for diagnose sleep apnea and monitoring the treatment. CPAP treatment abolishes apnea, normalises blood oxigenation thereby prevents arterial pressure surges, restoring the nocturnal ‘dipping’ pattern and normal sinus rythm.
MINIMUM OXYGEN SATURATION LEVELS AND CAROTID ATHEROMATOSIS
Authors: Rocha Daniela , Cameirão Ana , Pós-De-Mina Vanda , Mateus Sónia 
Published: June 2023

Objective:
Verify the relationship between the presence carotid atheromatosis getting by cervical Doppler echo and the variation of minimum levels oxygen saturation assessed by polysomnography.

Design and method:
Analytical, observacional and cross-sectional study was conducted with a sample of 63 individuals who had cervical Doppler echo examination and polysomnography in one year, recording multiple modifiable and no-modifiable vascular risk factors.

Results:
The sample consisted of 63 individuals, 29 female and 34 male. The mean age was 61.83, aged between 35 and 82 years (+/- 12.64). Regarding the presence of other risk factors under analysis, most of the sample has high prevalence of hypertension (44 individuals - 69.8%), mellitus diabetes (23 individuals - 36.5%) and dyslipidemia (36 individuals - 57.1%). In cervical Doppler echo 51 individuals (81%) have thickening of the intima-media layer and in polysomnography the minimum oxygen saturation levels has a mean value of 77.7%, between the minim of 47% and the maxim of 90% (+/- 9.71). There is a significant relationship between the presence of minimum oxygen saturation levels and the presence of the intimae-media layer thickening (p = 0.0001) and with carotid atheromatosis with hemodynamic repercussions (p = 0.0001).

Conclusions:
In this sample, it is possible to conclude that the minimum levels of oxygen saturation are lower in presence of carotid atheromatosis, regardless of the degree of hemodynamic compromise, with hypertension being a common risk factor.
INVESTIGATING NEW THERAPEUTIC OPPORTUNITIES FOR HYPERTENSION THROUGH TRANSCRIPTOMIC AND PROTEOMIC ANALYSIS OF THE KIDNEY RENIN-ANGIOTENSIN SYSTEM
Authors: Saluja Sushant , Eales James , Xu Xioguang , Rubin Sebastien , Drzal Maciej , Scannali David , Prestes Priscilla , Danser A.H. Jan , Lennon Rachel , Cordell Heather , Keavney Bernard , Morris Andrew , Lay Abigail , Charchar Fadi , Tomaszewski Maciej 
Published: June 2023

Objective:
We systematically characterised the expression of all renin-angiotensin system (RAS) genes in the human kidney and searched in silico for new pharmacological therapeutic opportunities to modify RAS.

Design and method:
We compiled data from open access resources to characterise all components of the RAS pathway. We used transcriptomic profiles of 73 human kidney tissues from the Genotype-Tissue Expression Project, integrated genome-wide DNA genotypes and RNA-sequencing-derived transcriptome profiles of 478 human kidneys from Human Kidney Tissue Resource and, kidney tissue proteomics from 72 samples recruited by Clinical Proteomic Tumour Analysis Consortium. Additionally, we used an independent single-cell RNA sequencing data and gene expression datasets curated from the Kidney Precision Medicine Project (KPMP) and Enrichr (web-based enrichment analysis tool). Lastly, we integrated the Connectivity Map and Drug Gene Interaction Database to identify drug repurposing opportunities for treatment of hypertension targeting the RAS genes.

Results:
We identified 37 genes encoding components of the RAS pathway with measurable expression in human kidney tissue. 15% of these gene-pairs demonstrated a positive (r>0.5) correlation in kidney expression most consistent with a functionally integrated network of interacting molecules. Angiotensinogen (AGT), the key component of the pathway - showed the highest level of mRNA expression in the liver, and we demonstrated that its hepatic mRNA expression correlates most strongly with its mRNA expression in the kidney (r = 0.71, P = 2.60e-06). Expression levels of mRNA for 92% of RAS genes correlated positively with their protein abundance in the kidney, where renin had the strongest positive correlation (r = 0.64, P<0.01). Enrichr and KPMP revealed that RAS gene expression was enriched in mesangial and epithelial cell types. Existing genetic evidence for correlation between glutamyl aminopeptidase (ENPEP) and systolic blood pressure might relate to its capacity to generate angiotensin III acting on dilator angiotensin II type 2 receptors. This raises potential repurposing opportunities for ENPEP inhibitors like firibastat and tosedostat for the treatment of hypertension.

Conclusions:
Collectively, this study confirmed synchronized expression of RAS genes in the kidney at both mRNA and protein levels and identified new therapeutic opportunities for treatment of hypertension, through drug repurposing.