bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C27-6: HIGH BRACHIAL-ANKLE PULSE WAVE VELOCITY IS ASSOCIATED WITH THE RENAL OUTCOME IN CHRONIC KIDNEY DISEASE PATIENTS WITH HYPERTENSION
Authors: Ko Ye Eun , Jhee Jong Hyun , Lee Chan Joo , Park Sungha , Yoo Tae Hyun 
Published: January 2023

Background:
Increase in arterial stiffness is associated with increase in cardiovascular events and mortality. Although studies have shown an association between arterial stiffness and chronic kidney disease (CKD), the association between CKD progression and arterial stiffness has not been clearly defined. The aim of this study is to investigate the association between brachial-ankle pulse wave velocity and chronic kidney disease progression in CKD patients with hypertension.

Methods:
A total of 717 CKD (stage 3 to 5) patients with hypertension were enrolled from the prospective observational cohort of CMERC-HI (Cardiovascular and Metabolic Disease Etiology Research Center-High Risk). Patients were classified into tertile based on brachial-ankle PWV: low, intermediate, high. Primary outcome was progression of CKD, which was composite of at least 50% decrease in estimated glomerular filtration rate (eGFR) from baseline or end stage kidney disease requiring dialysis.

Results:
The mean age of study subjects was 60.7 ± 11.8 years and 404 (56.3%) were male. During a median follow-up of 42.5 months, CKD progression occurred in 213 (29.7%). There were statistically significant differences in age (54.0 ± 12.1, 61.0 ± 11.1, 67.1 ± 8.2 in low, intermediate, high group, respectively, P < 0.001) among brachial-ankle PWV tertile groups. In multivariate Cox analysis, brachial-ankle PWV above the median value was related to increased risk of CKD progression (HR, 2.29; 95% CI, 1.33–3.94, P = 0.003) compared to subjects with brachial-ankle PWV below the median. In addition, when the study population was divided into tertiles, the intermediate and high brachial-ankle PWV group were associated with progressively increased risk of CKD progression (HR, 2.03; 95% CI, 1.09–3.77, P = 0.03, HR, 2.51: 95% CI, 1.27–4.96, P = 0.008) compared to low brachial-ankle PWV group after adjusting for confounding factors. The Kaplan-Meier analysis also showed statistically significant association between brachial-ankle PWV and CKD progression. In contrast, there was no statistically significant association between CKD progression and femoral-ankle PWV, an index for peripheral arterial stiffness, which suggests that increase in central arterial stiffness is associated with CKD progression.

Conclusions:
High brachial-ankle pulse wave velocity may be an independent predictor of CKD progression in CKD patients with hypertension.
PS-C27-7: ELECTROCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY CAN PREDICT FUTURE DECLINE OF RENAL FUNCTION IN GENERAL POPULATION
Authors: Ikeda Shota , Shinohara Keisuke , Matsumoto Sho , Yoshida Daisuke , Nakashima Ryosuke , Ono Yoshiyasu , Toyama Kensuke , Tsutsui Hiroyuki 
Published: January 2023

Objective:
Electrocardiographic left ventricular hypertrophy (LVH) has been shown to be associated with future renal function decline in patients with chronic kidney disease. However, this association remains unclear in general population. We aimed to elucidate the association between baseline LVH on electrocardiogram and future renal function decline using health checkup data.

Design and method:
We used a dataset derived from the annual health-screening program from 2010 to 2019. Patients with baseline estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 were excluded. LVH was determined by the electrocardiographic voltage criteria at baseline. Association between LVH and renal function outcomes, specifically ≧ 30% decline in eGFR from baseline, eGFR decline less than 60 ml/min/1.73m2 and 45 ml/min/1.73m2, were analyzed using multivariate Cox proportional hazard models.

Results:
Among total of 19,825 participants, 1,263 had LVH and 18,562 no LVH. LVH group was older and more male and current smokers, and to complicated with more hypertension, and higher systolic (136.7 ± 20.9 vs 123.7 ± 19.1 mmHg, P < 0.001) and diastolic blood pressure (81.8 ± 12.6 vs 74.6 ± 12.0 mmHg, P < 0.001). Baseline eGFR and HbA1c were comparable between the groups. Incidence of ≧ 30% eGFR decline was significantly higher in LVH group (P < 0.001, log-rank test). LVH was associated with ≧ 30% eGFR decline (HR 1.92, 95% CI 1.26–2.91, P = 0.002) and eGFR < 45 ml/min/1.73m2 (HR 3.12, 95% CI 1.54–6.35, P = 0.002) after adjustment. LVH was not associated with eGFR < 60 ml/min/1.73m2 in the overall population. However, when analyzed this association in subpopulation stratified by baseline SBP (< 140 and ≧ 140 mmHg), LVH was associated with eGFR < 60 ml/min/1.73m2 in persons with SBP ≧ 140 mmHg (HR 1.40, 95% CI 1.10–1.79, P = 0.007) but not in those with SBP < 140 mmHg (HR 0.88, 95% CI 0.68–1.14, P = 0.32) (P for interaction between LVH and baseline SBP = 0.005). Similarly, LVH was significantly associated with ≧ 30% eGFR decline and eGFR < 45 ml/min/1.73m2 in persons with SBP ≧ 140 mmHg but not in those with SBP < 140 mmHg, although the interaction between LVH and baseline SBP was not significant in these renal outcomes.

Conclusion:
Electrocardiographic LVH was independently associated with the rate of renal function decline among general population. The association between LVH and future renal function decline might be stronger in people with SBP ≧140 mmHg.
PS-P07-5: PHARMACEUTICAL INFLUENCES ON IN-HOSPITAL DEATH IN PATIENTS WITH AND THOSE WITHOUT DIABETES AT A JAPANESE COMMUNITY GENERAL HOSPITAL
Authors: Hosoki Minae , Yamagami Hiroki , Hori Taiki , Yasui Saya , Hara Tomoyo , Kurahashi Kiyoe , Yoshida Sumiko , Nakamura Shingen , Otoda Toshiki , Yuasa Tomoyuki , Endo Itsuro , Abe Masahiro , Aihara Kennichi 
Published: January 2023

Background:
Diabetes mellitus (DM) is associated with increased risks of cancers, cardiovascular disease (CVD), liver disease and death. In recent years, cardiovascular and metabolic medications have been developed for reducing cardiovascular events and mortality. We examined mortality statistics by cause of in-hospital death in patients with DM and patients without DM and we analyzed the effects of cardiovascular and metabolic medications on the lifespans of patients in a Japanese community general hospital during the past decade.

Methods:
We performed a retrospective analysis of cause of death in hospitalized patients at Anan Medical Center, a community general hospital in Tokushima, Japan, during the period from 2011 to 2020. Information on clinical characteristics of the patients including age at death, cause of death, complications and medications used was obtained from medical records. Statistical comparisons were performed in patients with DM and those without DM. Multivariate analysis was also carried out to determine the effects of medications on age at death.

Results:
A total of 2336 deaths were recorded during the 10-year period. The mean age at death was not significantly different between diabetic and nondiabetic patients for both sexes (78.9 (DM) vs. 79.6 (non DM) years in males and 82.5 (DM) vs. 83.6 (non DM) years in females). The rates of hepato-pancreatic cancer and cardio-renal failure as a cause of death were significantly higher in patients with DM than in patients without DM (p < 0.01 and p < 0.05, respectively). The incidences of hepato-renal failure, CVD, hypertension and dyslipidemia as comorbidities were significantly higher in diabetic patients than in nondiabetic patients (all p < 0.01). The percentages of patients taking antihypertensive, antiplatelet, diuretic and statin medications were higher in diabetic patients than in nondiabetic patients (all p < 0.01). Multivariate analysis of medications for determinants of age at death showed that insulin was a negative contributor in diabetic patients. On the other hand, the use of an angiotensin receptor blocker (ARB)/angiotensin-converting enzyme inhibitor (ACEi) or Ca antagonists was a positive correlator for longevity in all of the subjects including diabetic and nondiabetic patients.

Conclusions:
In our community general hospital, DM had no influence on age at death. It is possible that comprehensive treatment for DM and its complications eliminates the difference between lifespans of individuals with DM and those without DM. In addition, treatment of hypertension with ARB/ACEi or Ca antagonists was positively associated with the longevity of Japanese community subjects.
PS-P07-7: IMPACT OF INORGANIC NITRATE ON ENDOTHELIAL FUNCTION IN ADULTS A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS AND META ANALYSIS
Authors: Celik Begum , Muriki Esther , Spencer Jeremy , Kuhnle Gunter , Mills Charlotte 
Published: January 2023

Aim:
Inorganic nitrate which is found in green leafy vegetables and beetroot reduces blood pressure via the nitrate-nitrite-NO pathway and may have other benefits such as improved endothelial function. It is assumed that endothelial dysfunction is key risk factor for CVDs. Therefore, in this systematic review and meta-analysis, we evaluated the impact of inorganic nitrate supplementation on endothelial function.

Design and method:
MEDLINE, Web of Science, and Scopus databases were searched by two independent authors up to November 2021. We included randomised controlled trials that test oral administration of dietary/non-dietary inorganic nitrate versus a control, adult male and female subjects with/without health conditions, measuring endothelial function by flow mediated dilatation (FMD) as an outcome. Risk and quality assessments were performed using a Cochrane risk of bias score and standardised mean differences of the outcomes were pooled using a random-effects model.

Results:
3,521 studies were identified after a database search, of which 12 studies met the inclusion criteria. The pooled sample size was 362 and the number of participants per trial ranged from 10 to 65. Eight studies were acute, four studies were chronic and most of them included healthy participant arms (n = 12) with (n = 4) focusing on unhealthy populations. The mean difference in %FMD for nitrate versus the control was 1.57% (95% CI: 0.76–2.37), p = 0.01; high heterogeneity (I2 = 98.3%) was observed (Figure 1). Subgroup analyses were performed in terms of, nitrate amount (< more or less than 600 mg), type of intervention (dietary or non-dietary), participants health status (healthy and unhealthy), and study duration (acute or chronic). All sub-analysis still showed significant increases in %FMD. In acute studies, FMD response was higher (2.13% (95% CI: 0.87–3.40), p < 0.01, I2 = 98.5%) than chronic studies (0.90% (95% CI: 0.48–1.31), p < 0.01, I2 = 68.6%). Only one study showed low risk of bias; the other studies were classified as “some concern” due to a lack of information about randomisation and lack of pre-specified analysis plans.

Conclusions:
The meta-analysis provides evidence that inorganic nitrate improves FMD response and may be a useful strategy for preventing further CVD. Change in 1.5% of FMD as seen in this review could results in a reduction in CVD risk of ∼15%. However, due to the high heterogeneity of the results, further studies are needed to build a robust evidence base to inform dietary recommendations.
PS-P08-4: FOXO3 LONGEVITY GENOTYPE ATTENUATES THE IMPACT OF HYPERTENSION ON RISK OF INTRACEREBRAL HEMORRHAGE
Authors: Nakagawa Kazuma , Randi Chen , Greenberg Steven M , Ross G Webster , Willcox Bradley J , Donlon Timothy A , Allsopp Richard C , Willcox D Craig , Masaki Kamal H , Morris Brian J 
Published: January 2023

Objective:
To determine the association between the longevity-associated G allele of FOXO3 SNP rs2802292 and risk of hypertension mediated intracerebral haemorrhage (ICH).

Design:
Prospective population-based longitudinal study.

Methods:
The cohort comprised Japanese American men living on Oahu, Hawaii, who were recruited from 1965 to 1968 for the Kuakini Honolulu Heart Program. Age adjusted incidence of ICH by hypertension status was assessed for the whole cohort after stratifying by FOXO3 genotype. Cox regression models, adjusted for age, cardiovascular risk factors, and FOXO3 and APOE genotypes, were utilized to determine the relative risk of effect of hypertension on ICH. All models were created for the whole cohort and stratified by FOXO3 G allele versus TT genotype.

Results:
Among 6,469 men free of baseline stroke, FOXO3 G allele was present in 3,009 (46.5%) participants. Overall, 183 subjects developed ICH over the 34 year follow-up period. Age adjusted ICH incidence rates were 0.90 and 1.32 per 1,000 person years followup in those without and with hypertension, respectively (p = 0.002). After stratifying by FOXO3 genotype, this association was no longer significant in G allele carriers. In the whole cohort, hypertension was an independent predictor of ICH (RR = 1.70, 95%CI 1.25, 2.32; p = 0.0007). In stratified analyses, hypertension remained an independent predictor of ICH among the FOXO3 TT genotype group (RR = 2.02, 95% CI 1.33, 3.07; p = 0.001), but not in those who were carriers of the protective (G) allele of FOXO3 (RR = 1.39, 95% CI 0.88, 2.19; p = 0.15).

Conclusions:
The longevity associated FOXO3 G allele mitigates the impact of hypertension on ICH risk. Our finding has implications for risk assessment of patients with hypertension.
PS-P08-5: METABOLIC SYNDROME RISK PREDICTION EQUATION AND A SIMPLE SCORE MODEL DERIVATION AND VALIDATION IN JAPANESE GENERAL POPULATION
Authors: Salim Anwar Ahmed , Kawasoe Shin , Kubozono Takuro , Ojima Satoko , Kawabata Takeko , Ikeda Yoshiyuki , Miyahara Hironori , Tokushige Koichi , Ohishi Mitsuru 
Published: January 2023

Objective:
Predicting metabolic syndrome (MetS) is important for identifying high risk cardiovascular disease individuals and providing preventive interventions. We aimed to develop and validate an equation and a simple MetS score according to the Japanese MetS criteria using Japanese health checkup data.

Design and Methods:
In total, 54,198 participants (age, 54.5 ± 10.1 years; men, 46.0%), with baseline and five year follow up data were randomly assigned to Derivation and Validation cohorts (ratio: 2:1). Multivariable logistic regression analysis was performed in derivation cohort and scores were assigned to factors corresponding to beta coefficients. We evaluated predictive ability of the scores using area under the curve (AUC), then applied them to validation cohort to assess reproducibility. For equation model, all variables were treated as continuous except for sex, current smoking, and alcohol consumption, which were treated as binary variables.

Results:
The primary model (including blood tests) ranged 0 to 27 points had an AUC of 0.81 (sensitivity: 0.81, specificity: 0.81, cut-off score: 14), and consisted of age, sex, blood pressure (BP), body mass index (BMI), serum lipids, glucose measurements, current smoking, and alcohol consumption. The simplified model (excluding blood tests) ranged 0 to 17 points with an AUC of 0.78 (sensitivity: 0.83, specificity: 0.77, cut off score: 15) and included seven variables: age, men, systolic BP, diastolic BP, BMI, alcohol consumption, and current smoking. We classified individuals with a score < 15 as low-risk MetS and ≧ 15 points as high risk MetS, respectively. The incidence of MetS increased constantly as the score increased. Furthermore, the equation model to predict MetS incidence from derivation cohort generated an AUC of 0.85 (sensitivity: 0.86, specificity: 0.55). Analysis of the validation and derivation cohorts yielded similar results.

Conclusion:
We developed a primary score, an equation model, and a simple score. The simple score is convenient, well validated with acceptable discrimination, and could be used for early detection of MetS in high risk individuals.
PS-P08-6: ESTIMATION OF TOTAL CARDIOVASCULAR RISK AMONG THE RURAL POPULATION OF BANGLADESH USING 2019 WHO CVD RISK PREDICTION NON-LABORATORY-BASED CHARTS
Authors: Mamun Mohd Abdullah Al , Bhuiyan Mahfuzur Rahman , Sultana Sharmin , Akhter Jubaida , Jubayer Shamim , Nabi Md Noor , Sobhan Sheikh Mohammad Mahbubus , Alim Abdul , Milon Sarowar Uddin , Amin Mohammad Robed , Choudhury Sohel Reza 
Published: January 2023

Objective:
Cardiovascular disease (CVD) is the leading cause of death globally, require immediate intervention. Package of Essential Noncommunicable diseases (PEN) intervention implemented by World Health Organization in primary care of low resource setting enables healthcare workers to tailor care for patients according to their risk level, thus decrease the health care cost as well as workload of health facility. The objective of this study was to estimate the distribution of 10-year CVD risk among rural Bangladeshi adults aged > 40 years by using the 2019 WHO CVD risk prediction non-laboratory-based charts.

Design and Methods:
Cross-sectional, population-based study. We estimated total CVD risk using 2019 WHO CVD risk prediction non-laboratory-based charts and categorized as very low (< 5%), low (5- < 10%), moderate (10- < 20%), high (20- < 30%) and very high risk (> 30%). Participants were selected from four rural areas of two administrative districts of Bangladesh. Participants age, gender, smoking status, blood pressure, height and weight for calculation of body mass index were recorded. Participants with hypertension and moderate and high CVD risk score were referred to respective primary health care facility for further assessment and management.

Results:
Total of 1234 participants (male 397, female 837) were included in this study. Mean age of the participants was 54.0 years. Among the respondents 42.9%, 33.5%, 18.9% and 4.7% were in the age group of 40 to 50, 51 to 60, 61 to 70 and > 70 years respectively. Among the participants 11.9% were current smoker (men 37.1% and women 0.1%). The mean systolic and diastolic blood pressure of the participants was 134.14 and 85.03 mm of Hg respectively. The prevalence hypertension was 62%. The prevalence of hypertension was much higher among the female participants (men 53.0% and women 66.2%). Three fourth (77.6%) of the participants had CVD risk score of very low and low below (< 10%) and none had CVD score of very high risk (> 30) and one fifth (21.3%) had moderate and high CVD risk score. Among the participants with very low (< 5%), low (5–10%), moderate (10–20%) and high (20–30%) CVD risk score had 20.6%, 38.3%, 57.1% and 95.2% high blood pressure respectively.

Conclusion:
High prevalence of hypertension may be the main contributor of CVD score in this selected rural adult population of Bangladesh. This population require an early intervention with priority to hypertension management at community level to prevent the epidemic of the cardiovascular events.
PS-P09-4: OBESITY AND ITS ASSOCIATION WITH HIGH SENSITIVITY C-REACTIVE PROTEIN AS AN INFLAMMATION MARKER AND THE RISK OF PREHYPERTENSION AMONG ADULTS
Authors: susetyowati susetyowati , faza Farah 
Published: January 2023

Objective:
It has been reported that obesity could trigger the elevation of serum high sensitivity C-reactive protein (hsCRP) and abnormal lipid metabolism, manifesting in the progression of metabolic diseases (hypertension, cardiovascular diseases, and type 2 diabetes). Regarding the high prevalence of obesity both in developed and developing countries, assessing hsCRP as an inflammation marker is essential to prevent the high risk of the diseases. We aim to assess the association between obesity with hsCRP and prehypertension among adults.

Design and method:
A cross-sectional study was conducted from July to September 2021 in urban and rural areas. A total of 109 healthy adults were involved with inclusion criteria: aged 19 to 64 years, did not have pregnancy or breastfeeding for women, and did not have any metabolic disease histories. The data was collected by trained enumerators and blood samples were taken by a trained phlebotomist, including socio-demographic, body mass index (BMI), waist circumference (WC), blood pressure, and hs-CRP. A BMI of 30.00 kg/m2 and above was categorized as obesity. A waist circumference of 88 cm above (female) and 102 cm above (male) was categorized as central obesity. A blood pressure of 120 to 139 mmHg (systolic) or 80 to 89 mmHg (diastolic) was classified as prehypertension. The hsCRP of above 3.0 mg/L was classified as a high level.

Results:
52.3% of the subjects were female, and 60.6% of them were living in urban. As 68.8% were obese, 78% were prehypertension, and 30.3% had high hsCRP. There was no association between obesity (BMI) with hsCRP (p > 0.05) yet central obesity (WC) was significantly associated with hsCRP (p = 0.028, PR = 2.8, 95% CI 1.1–6.9). Being female increases by 3.5 higher risk of prehypertension than male (p = 0.015, 95% CI 1.3–9.8) while age was not a risk factor for prehypertension. The nutritional status, determined by BMI and WC, and hsCRP were not significant risk factors for prehypertension, even after being adjusted with covariates.

Conclusion:
Adults with central obesity increased by 2.8 greater risks of high-level hsCRP than normal. Nutritional status and hsCRP were not the risk factors for prehypertension, even after being adjusted with covariates. Comprehensive nutrition intervention, including personalized nutrition and creating a healthier environment, is needed to encourage adults in improving their healthy habits and preventing negative health outcomes.
PS-P10-2: NON-LINEAR RELATIONSHIP BETWEEN CKD PROGRESSION AND SYSTOLIC AND DIASTOLIC BLOOD PRESSURE; IKI EPIDEMIOLOGICAL STUDY OF ATHEROSCLEROSIS AND CKD (ISSA-CKD)
Authors: Maeda Toshiki , Nishi Takumi , Shinohara Yukiko , Abe Makiko , Kawazoe Miki , Satoh Atsushi , Takahashi Koji , Tada Kazuhiro , Itoh Kenji , Yasuno Tetsuhiko , Yoshimura Chikara , Mukobara Shigeaki , Masutani Kosuke , Arima Hisatomi 
Published: January 2023

Objectives:
The aim of the study is to assess the non-linear relationship between systolic and diastolic blood pressure and chronic kidney disease (CKD) progression.

Design and Method:
This is a cohort study using annual health check-up data from 2008 to 2018 in Iki City, Nagasaki, Japan. After excluding those who had health check-ups only once or those with the missing value for serum creatinine or urinalysis, a total of 5919 participants were included in the present analysis. The outcome of the present analysis was CKD progression, which was defined as worsening either the glomerular filtration rate stage or albumin creatinine ratio stage according to KDIGO classification at a visit and at the end of follow-up. Non-linear effects of SBP and DBP on the progression of CKD were evaluated by Cox proportional analysis with a restricted cubic spline controlling for confounding factors.

Results:
During a mean follow-up of 4.9 years, 1167(19.7%) CKD progression was observed. As each SBP and DBP were classified into quartiles, there was a linear relationship between SBP and CKD progression (p < 0.001 for trend), on the other hand, there was no linear relationship between DBP and CKD progression (p = 0.534 for trend). For restricted cubic spline, we found a sigmoid curve-like relationship between SBP and CKD progression, in which CKD progression increased in accord with BP increase. For DBP, we found a U-like shape relationship between DBP and CKD progression, in which there was the lowest risk at nearly 70–80 mmHg, and then the risk for CKD progression increased to both lower and higher DBP.

Conclusions:
The findings of the present analysis showed a near-linear trend that higher SBP had a significant relationship with an increase in CKD progression. On the other hand, the relationship between DBP and CKD progression was not linear, and both lower and higher DBP could be related to CKD progression.