bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREVALENCE CHANGE IN THE PREVALENCE OF HYPERTENSION AND CARDIOMETABOLIC RISK FACTORS IN PURE COLOMBIA COHORT (2005-2021)
Authors: Gonzalez Ana María , López-López Jose , Otero Johana , Martínez-Bello Daniel , Giraldo Juan Carlos , Lanza Paola , -Jaramillo Patricio López 
Published: June 2023

Objective:
Describe the change in the prevalence of hypertension (HTA) and cardiometabolic risk factors (RF's) in PURE Colombia cohort during the period 2005-2021.

Design and method:
Design: Cohort study.

Methods:
7552 adults participants of the PURE Colombia cohort from 11 departments (Atlántico, Bolívar, Caldas, Casanare, Cauca, Cesar, Cundinamarca, Nariño, Quindío, Santander, Tolima) followed up for a mean of 13 years (SD 2.3). A descriptive analysis was used to document the changes in prevalence of HTA and associated RF's such as body mass index (BMI), waist-hip ratio (WHR), and level of physical activity (PA) in the follow-up period 2005-2021. PA is divided into three levels and measured in metabolic equivalent of task (METs).

Results:
Of the participants, 64% were women, with a mean age at follow-up of 65 years (SD 9.7). Overall, the prevalence of HTA increased by 12% (p<0.001), reaching values of 47.5% and 51.5% in men and women, respectively. In addition, there was an increase in obesity prevalence (BMI > 30) in both men and women (increases of 6.8 and 5.8 %, respectively, p<0.001,), reaching an overall prevalence of 25% in the population. Consist with this, WHR increased from 0.93 to 0.95 in men (p<0.001) and from 0.86 to 0.89 in women (p<0.001Finally, we found that there was a global increase in the number of people with a low level of PA (17.7 to 43.8% p<0.001).

Conclusions:
We observed a significant increase in the prevalence of cardiometabolic RF's and HTA after over a decade of follow-up of adults in a middle-income American country. Increases in modifiable RF's such as higher BMI and WHR and reduced numbers with adequate PA concurrent with the trends in HTA suggest a positive relationship between them and reaffirm the necessity to emphasize strategies focused on potentially modifiable lifestyle RF's.
ARTERIAL HYPERTENSION IN DIABETICS: FREQUENCY AND ASSOCIATED FACTORS
Authors: Dahak Amel 
Published: June 2023

Objective:
Diabetic patients have an increased risk of developing hypertension. Its pathogenesis in diabetes is complex. It generally takes place in a context of metabolism and insulin resistance.
The association of these 2 pathologies worsens the prognosis of these patients.
The objective of this work was to evaluate the frequency of hypertension in diabetics, as well as the factors associated with its occurrence.

Design and method:
A retrospective study was conducted on 70 diabetic patients followed in the department and internal medicine consultations.
All the patients benefited from an interrogation and a complete clinical examination.

Results:
A female predominance was noted (74.6%). The mean age was 55.8 ± 14 years.
Our patients were mainly type 2 diabetics (88%), insulin-treated (78%), with an average seniority of 11.7 ± 7 years. More than half of the patients were known to be hypertensive (57.3%).
Dyslipidemia was present in 66.7% of cases. The presence of hypertension was associated in a way statistically significant for age, BMI and presence of dyslipidemia, type and duration of diabetes. It was also significantly correlated with diabetic nephropathy, and the degree of renal insufficiency.
Discussion: Hypertension is frequently associated with diabetes. It increases cardiovascular morbidity and mortality and accelerates the progression of atherosclerosis. Hypertension is also a contributory factor to diabetic nephropathy and renal failure.

Conclusions:
The management of hypertension in diabetics and other risk factors is a vital prognostic element in a patient already at high cardiovascular risk.
OBESITIY AND HYPERTENSION IN PRIMARY BASIC SETTING
Authors: de Oliveira Monica Amorim , Rey Helena Cramer Veiga 
Published: June 2023

Objective:
Evaluate the prevalence of obesity in a group of 1000 patients over 18 years of age treated in primary care in the city of Rio de Janeiro and its relationship with Hypertension (HTN)

Design and method:
Prospective cohort of 1000 patients over 18 years selected in 21 primary care units in the city of Rio de Janeiro. At the initial consultation, the clinical form was filled out, in which medical history, socioeconomic variables, data on life habits and functional assessment were documented. Weight and height were measured at the initial visit, and, from these data, the Body Mass Index (BMI) was calculated in Kg/m2. The definition of HTN was bases on data from medical records.

Results:
Of the 1014 patients included, 737 (72.68%) were hypertensive. A sedentary lifestyle was present in 65.5% of the population studied and there was no difference between the group of patients with and without HTN. The average BMI of the general population was 29.6 ± 6.2 kg/m2. The average BMI among hypertensive patients was 30.1 kg/m2. Among non-hypertensive individuals, the mean was significantly lower, 27.8 kg/m2, but still above normal levels, 24.9 kg/m2.
Obesity was found in 41.2% of the population studied. The distribution according to the WHO BMI classification can be verified in the table below and showing the relationship between HTN and obesity.

Conclusions:
The present study showed a relationship between HTN and obesity. It is estimated that more than 2/3 of the incidence of HTN is related to obesity, which makes this condition an important a risk factor for the development of hypertension and an important public health problem. Obesity-related hypertension is often associated with other cardiovascular risk factors.
The treatment of hypertension in the obese requires a targeted approach to obesity. Adopting a healthy lifestyle facilitates weight loss, increases responsiveness to antihypertensive drug therapy, and produces independent beneficial effects on factors. The approach to obesity should be emphasized not only in hypertensive patients, but also in those who have not yet had HTN, as a measure to prevent its development and reduce the cardiovascular risk.
EXISTING STATE OF HYPERTENSION IN PAKISTAN - A REVIEW
Authors: Almas Aysha , Elahi Adil , Ali Arzina Aziz , Khan Aamir Hameed , Samad Zainab , Shaha Hunaina , Aziz Namra 
Published: June 2023

Objective:
This review aims to describe existing literature on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, barriers, and facilitators of the management of hypertension

Design and method:
A comprehensive systematic literature search was conducted electronically using PubMed and Google Scholar. Using specific screening methodology, 55 articles were selected to be included.

Results:
There is a lack of recent data on prevalence of hypertension in Pakistan, although several smaller studies revealed a high prevalence. Lifestyle risk factors such as obesity, unhealthy diet, decreased physical activity, and low socioeconomic status and lack of access to care were the main associated factors with hypertension. Lack of blood pressure monitoring practices and medication non-adherence were also linked to uncontrolled hypertension in Pakistan and were more evident in primary care setups. The evidence presented is essential for delineating the burden of the disease, hence allowing for better management of this underserved population

Conclusions:
There is a need for updated surveys to depict the true prevalence and management of hypertension in Pakistan. Cost-effective implementation strategies and policies at the national level must be conducted for both prevention and control of hypertension.
THE RELATIONSHIP BETWEEN SOCIOECONOMIC STATUS AND THE PREVALENCE OF OBESITY, HYPERTENSION AND DIABETES IN POPULATION LIVING IN THE CROATIAN RURAL AREA DAMAGED BY AN EARTHQUAKE
Authors: Abramovic Inga , Vuksan-Cusa Zrinka , Prgomet Luka , Jelakovic Bojan 
Published: June 2023

Objective:
Hypertension, diabetes and obesity are becoming increasingly common nowadays. Socioeconomic status differences and their effects on the prevalence of those conditions are, however, still unknown.
The aim of the study was to determine the effect of monthly income on the prevalence of hypertension, diabetes and obesity in the rural population from the earthquake damaged area.

Design and method:
This study included 249 patients who were a part of the Croatian Project ‘Chasing the Silent Killer’, a hypertension screening intervention in rural areas. Various anthropometric measurements were performed and a questionnaire was given to the participants. The participants were divided into two groups: those with an average monthly income of more than 500 Eu and those with less.

Results:
The average BMI was 28.9 kg/m2. Out of the 249 patients, 100 of them had a BMI > 30 kg/m2. The average blood pressure was 142/81 mmHg. Average systolic blood pressure was 6 mmHg lower in participants with a higher average monthly income in comparison to patients with a lower average monthly income (p = 0.056). Out of the total participants, 21 have type 2 diabetes. No significant association between BMI (p = 0.529), diabetes (p = 0.759) and the participants’ monthly income was proven.

Conclusions:
In this rural population we found a tendency for people with a higher average monthly income to have lower systolic blood pressure but no significant association between BMI, diabetes, and monthly income was noted. Lower monthly income, i.e. poor socioeconomic status is associated with higher systolic blood pressure, but not with obesity and diabetes. This result warrants further research.
MWF RAT AS A NOVEL ANIMAL MODEL OF CARDIORENAL SYNDROME TYPE IV
Authors: Sanz-Gómez Marta , Vega-Martín Elena , González-Moreno Daniel , Manzano-Lista Francisco Javier , Somoza Beatriz , Gil-Ortega Marta , Kreutz Reinhold , Fernández-Alfonso María S. 
Published: June 2023

Objective:
Cardiorenal syndrome type 4 (CRS type 4) is characterized by primary chronic kidney disease (CKD) leading to cardiac dysfunction and an increase in cardiovascular events. There is an unmet need for suitable animal models of CRS to further define the pathogenesis and progression of CRS to test new therapeutic strategies. We aim to determine if CKD in aged Munich Wistar Frömter (MWF) rat may translate to cardiovascular alterations of CRS.

Design and method:
Profibrotic markers and angiotensin receptor (ATR) expression was measured by RT-q-PCR in kidney, aorta and heart from 22 and 45-week-old (aged) male MWF rats (n = 7-10/group).

Results:
Aged MWF showed higher renal expression of tubular damage markers (Kim-1 and Ngal) and profibrotic factors (Col1A1, Col3A1, TGF-beta) together with lower levels of AT2R. Thoracic aorta also exhibited increased expression of profibrotic CTGF-1 and Col1-A1, as well as a lower AT2R expression. Both age groups were hypertensive with similar systolic and diastolic blood pressure levels. However, aged MWF had an increased PWV and heart weight, together with increased intrinsic arterial stiffness and an outward hypertrophic remodeling in mesenteric arteries. In 45-week-old MWF, levels of cardiac CTGF-1, AT1R and AT2R were higher, whereas TGF-beta expression was lower. No differences were observed for Col1A1 or Col3A1.

Conclusions:
The presence of renal and vascular fibrosis, hypertension, arterial stiffness and cardiac hypertrophy, together with inflammation, vascular remodeling and early profibrotic cardiac environment, potentially counterregulated by AT2R make aged-MWF rat an useful model for CRS study.
PRELIMINARY DATA ON THE ENDOGENOUS OUABAIN IN IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION PATIENTS
Authors: Manfrini Valerio , Badagliacca Roberto , Messaggio Elisabetta , Poscia Roberto , Torre Roberto , Vizza Carmine Dario , Manunta Paolo 
Published: June 2023

Objective:
The aim is to detect the endogenous ouabain (EO) in idiopathic pulmonary arterial hypertension (IPAH) patients.

Design and method:
EO is a steroid hormone secreted by the adrenal glands associated with adverse cardiovascular outcomes. However, EO plays other roles as brain protection against traumatic injury and seems involved in the adaptive response to hypoxia. Recently, we detected, for the first time, EO in a healthy human group of acute hypoxia (elite apnea divers) and in diving animals (common bottlenose dolphins, phocids and otariids, and loggerhead sea turtles). This study complements the above as we considered a human model of chronic hypoxia. We collected blood samples from five Caucasian males and measured EO with a Scintillation Proximity Assay.

Results:
We found that IPAH patients had higher plasma concentrations levels of EO than control subjects. In addition, EO plasma concentrations were negatively correlated with the mean pulmonary arterial pressure and total pulmonary vascular resistance (p-values <0.05). A positive correlation trend was observed with the cardiac index, a marker of healthy cardiac output. The results could suggest that high concentrations of EO are predictive of a better adaptation of the right ventricular afterload.

Conclusions:
Although these are preliminary results, they match data coming from other studies on clinical conditions that frequently occur in comorbidity with IPAH. It can represent a helpful hint for future investigations involving other pathological conditions for possible therapeutic and diagnostic approaches.
NON-PHARMACOLOGICAL INTERVENTIONS UP-REGULATE MYOCARDIAL CONNEXIN-43 AND DECREASE A RISK OF MALIGNANT ARRHYTHMIAS IN EXPERIMENTAL MODEL OF ESSENTIAL HYPERTENSION
Authors: Andelova Katarina , Bacova Barbara Szeiffova , Sykora Matus , Benova Tamara Egan , Knezl Vladimir , Tribulova Narcis 
Published: June 2023

Objective:
Available data suggest that meta-inflammation and oxidative stress as well as endogenous deficiency of omega-3 and melatonin may be involved in hypertension-induced myocardial abnormalities that increase propensity to cardiac arrhythmias. We aimed to explore whether supplementation with omega-3 and melatonin as well as cold acclimation may affect arrhythmogenicity of rats suffering from essential hypertension. We focused on myocardial connexin-43(Cx43) channel protein, which ensures cardiac cell-cell coupling for electrical signal propagation, thereby is crucial factor impacting susceptibility of the heart malignant arrhythmias.

Design and method:
Experiments were performed using adult, male, spontaneously hypertensive rats (SHR, wild type), hairless SHR (mutant strain) and normotensive Wistar rats. SHR were treated for two-month with omega-3 (Omacor,200mg/day) or melatonin (400ug/day) and compared with untreated rats. Hairless SHR adapted to cold were compared with wild type SHR and normotensive Wistar rats. Biometrical parameters were registered and left ventricular heart tissue was taken for analysis of Cx43 and PKC↙, which via phosphorylation affects Cx43 channel function. Isolated perfused heart was used for the examination of its susceptibility to electrically-induced sustained ventricular fibrillation (VF).

Results:
Supplementation with omega-3 or melatonin and cold acclimation did not affect significantly blood pressure as well as heart or left ventricular weights of SHR or hairless SHR. However, the electrical threshold to induce VF was significantly lower (∼20mA) in non-treated compared with treated SHR (∼35mA) as well as in wild type SHR compared to hairless SHR (∼40mA). Antiarrhythmic effect was associated with increased protein levels of Cx43 and its functional phosphorylated forms in left ventricles of treated SHR and hairless SHR compared to untreated wild type SHR. Moreover, pro-arrhythmic myocardial Cx43 distribution on lateral sides of the cardiomyocytes was attenuated by treatment or cold acclimation. In parallel, there was an increase of PKC↙ expression that may enhance cardio-protective Cx43 phosphorylation.

Conclusions:
In conclusion, findings indicate that non-pharmacological interventions can protect hypertensive rat heart from malignant arrhythmias, at least in part, by targeting myocardial Cx43. It is challenging to pay attention to non-pharmacological approaches in humans suffering from primary hypertension.
GINSENOSIDE-RG3 ENHANCES SOME ANTIHYPERTENSIVE AGENTS-INDUCED INHIBITION OF ADRENAL CATECHOLAMINE SECRETION
Authors: Koh Young Youp , Lim Dong Yoon 
Published: June 2023

Objective:
The present study was designed to examine the influence of ginsenoside-Rg3 (Rg3), one of panaxadiol-type saponins, which is isolated from Korean Panax ginseng, in some antihypertensive agents-induced inhibition on the secretion of catecholamines (CA) from the perfused rat adrenal medullae.

Design and method:
The adrenal gland was isolated and perfused with Krebs-bicarbonate. CA was measured directly by using the fluorospectrophotometer.

Results:
Ginsenoside-Rg3 (3∼30 μM) during perfusion into an adrenal vein for 90 min significantly inhibited the CA secretion evoked by acetylcholine (ACh). Also, olmesartan (AT1 receptor blocker, 15 μM), simvastatin (an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, 60 μM), enalapril (an inhibitor of angiotensin converting enzyme, 150 μM), and cilnidipine (a voltage-dependent L-type Ca2+ channel blocker, 3 μM) significantly reduced the CA secretion evoked by ACh and angiotensin II (Ang II), respectively. In the simultaneous presence of ginsenoside-Rg3 (10 μM) along with four antihypertensive agents (olmesartan, enalapril, simvastatin or cilnidipine), the CA secretion evoked by ACh and Ang II was more strongly inhibited compared with that of each antihypertensive agent-treatment alone.

Conclusions:
Collectively, these results demonstrate that ginsenoside-Rg3 as well as antihypertensive agents can inhibit the CA secretion evoked by activation of both cholinergic and AT1 receptors from the perfused rat adrenal medulla. When this ginsenoside-Rg3 was used in combination with different antihypertensive agents, their effects of antihypertensive agents on reduction of adrenal CA secretion were significantly enhanced, which may also be clinically beneficial for the treatment of cardiovascular diseases.
GENOME-WIDE DNA METHYLATION ANALYSIS IDENTIFIES SERUM HOMOCYSTEINE-ASSOCIATED CPG SITES IN HYPERTENSIVES
Authors: Zhu Min , An Dewei , Zhang Jin , Tang Xiaofeng , Wang Yan , Zhu Dingliang 
Published: June 2023

Objective:
Homocysteine (Hcy) is associated with DNA methylation in cardiovascular disease (CVD). Moreover, the relationship between Hyperhomocysteine (HHcy) and CVD risk is stronger in individuals with hypertension. However, no research has focused on the influence of Hcy on DNA methylation status in patients with hypertension. We performed an epigenome-wide association study to identify DNA methylation loci associated with Hcy among 218 hypertensive patients using the Illumina Infinium Methylation EPIC BeadChip (850k chip) and further explored their effects on arteriosclerosis.

Design and method:
Epigenome-wide methylation profiles were assessed using the Illumina Infinium Methylation EPIC BeadChip (850k chip) in peripheral leukocyte DNA from 218 patients with hypertension. Differentially methylated positions (DMPs) associated with serum homocysteine levels were identified using a mixed linear regression with adjustment for potential confounders. Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted to explore the possible functions of the identified DMPs. The association of these differentially methylated loci with hypertension- and Hcy- related arteriosclerosis, Cf-PWV (Carotid-femoral pulse wave velocity) was further analyzed.

Results:
Five DMPs at cg13169662, cg03179312, cg21976560, cg25262698, and cg09433843 showed significant association with serum Hcy levels (FDR-corrected p <0.05). Six additional CpG sites met the threshold for suggestive significance (p<1 × 10-6), among which three DMPs (cg25781123, cg26463106, and cg06679221) were annotated to the THUMPD3 gene. Furthermore, the methylation levels of cg13169662 and cg25262698 (RPRD1A) were significantly associated with Cf-PWV.

Conclusions:
Our study provides preliminary evidence for an association between DNA methylation and serum Hcy levels in patients with hypertension. This study may give an insight into the role of DNA methylation in cardiovascular injury underlying HHcy in patients with hypertension.
CASE SERIES OF DILATED CARDIOMYOPATHY STUDIED WITH WHOLE GENOME SEQUENCING
Authors: Yaneva-Sirakova Teodora , Tzveova Reni , Shumkova Monika , Kaneva Radka , Vassilev Dobrin , Karamfiloff Kiril 
Published: June 2023

Objective:
The explanation of the genetic aspects of dilatative cardiomyopathy (DCM) is important for at least two major reasons: 1. there is a phenotypic and clinical overlap between the various cardiomyopathies with DCM - thus it might be suggested DCM may be an end phenotype; 2. genetic predisposition to DCM might render the myocardium susceptible to various exogenous factors such as infections, alcohol, toxins, etc.

Design and method:
We share the results from the Next Gene sequencing of 10 patients with DCM. They were of various ages, with the inclusion requirement to be without coronary or hypertensive disease, and clinical manifestations of the DCM from yearly age. Bioinformatics analysis of the data was done with the appropriate protocol on a Dragen server, as well as VarSeq (Goldenhelix) for all NGS data.

Results:
This case series of Caucasian patients with DCM presented with mutations in TTN, TTN-AS1, SCN5A, RYR2, DSG2, DSG2-AS1, FLNC, LAMA4, ACTN2, GATA6, DMD genes. All these genes are responsible for structural sarcomere, nucleus proteins or ion transporters. They are common also in arrhythmogenic right ventricular dysplasia, hypertrophic cardiomyopathy, muscular dystrophy and Brugada syndrome. Omim search found them as VUS or weak pathogenic and only a mutation in TTN as likely pathogenic. Nevertheless, the cumulation of data for the genetic aspects of cardiomyopathies is important. The echocardiographic ejection fraction of the patients varied with the medical treatment and could not be used as guiding in their risk assessment.

Conclusions:
As far as the ejection fraction and left ventricular morphology are modifiable factors, we need a more specific way to assess the inherent risk in our cardiac patients. NGS might provide the necessary information, but we need to accumulate clinical and genetic data to make specific cardiomyopathy risk profiles. These risk profiles should be based on genetic analysis and not on ejection fraction or other morphological criteria, as we have cardiomyopathies’ overlap.