bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C07-10: DYNAMICS OF BLOOD PRESSURE ON SPIRONOLACTONE TREATMENT IN PATIENTS WITH RESISTANT HYPERTENSION AND RHEUMATOID ARTHRITIS DEPENDING ON THE ACTIVITY
Authors: Stakhova Alina , Kondratiuk Vitalii 
Published: January 2023

Objective:
to determine the features of the dynamics of blood pressure (BP) in patients with resistant hypertension (RH) and rheumatoid arthritis (RA) depending on the decrease in laboratory activity of RA.

Design and methods:
60 patients with RH in combination with RA were included in the study. Outpatient BP measurement and ambulatory blood pressure monitoring (ABPM) were performed. Patients after 12 months of treatment with spironolactone were divided into two groups: A - reached the target value of low laboratory activity of RA - CRP < 5.0 mmol / l (n = 27), B - did not reach (n = 33). The average age of patients in group A was 62.7 ± 8.4 years (81.6% women), group B - 63.1 ± 7.4 years (78.4% women). RA activity was determined by the disease activity index (DAS 28-CRP) and was 5.7 ± 2.3 in group A, 5.8 ± 1.8 in group B before the treatment.

Results:
After reduction of RA activity, the improvement of BP control is more pronounced: in group A the levels of office systolic BP (SBP) were reduced by 15.0 mm Hg, diastolic (DBP) by 7.5 mm Hg and pulse (PBP) by 10.0 mm Hg (all p < 0.01) in comparison to reduction of SBP in group B by 10.0 mm Hg (p < 0.05). After ABPM performing identical results were obtained: in group A the average day-night (dn), day (d) and night (n) SBP, DBP and PBP were decreased (average SBPdn by 13.7 mm Hg, DBPdn by 9.7 mm Hg, PBPdn by 7.7 mm Hg; average SBPd by 10.5 mm Hg, DBPd by 5.8 mm Hg, PBPd by 6.6 mm Hg; average SBPn by 19.2 mm Hg, DBPn by 7.0 mm Hg, PBPn by 9.1 mm Hg (all p < 0.05)) against a less significant decrease in group B. Nocturnal SBP and DBP decrease were increased by 8.2% (from 4.5 (-2.8–13.8)% to 12.7 (7.4–25.4)%), p < 0.05) and 8.8% (9 .9 (4.2–18.7)% to 18.7 (10.4–25.4)%), p < 0.01) with the level of CRP < 5.0 mmol / l after 12 months of treatment.

Conclusions:
In patients with RA in combination with RH administration of spironolactone to existing triple therapy enhances the antihypertensive effect of drugs, which is manifested by more frequent achievement of target blood pressure levels.
PS-C08-2: WEARABLE CUFFLESS BLOOD PRESSURE MONITORING DEVICES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Shariful Islam Sheikh Mohammed , Maddison Ralph 
Published: January 2023

Background:
High blood pressure (BP) is the most common modifiable cardiovascular risk factor, yet its monitoring remains problematic. Wearable cuffless BP devices offer a potential solution for improved monitoring over time, however little is known about their validity and utility. We aimed to systematically review the validity, features, and clinical use of wearable cuffless BP devices.

Methods:
We searched MEDLINE, Embase, IEEE Xplore and the Cochrane Database till December 2019 for studies that reported validating cuffless BP devices. We extracted information about study characteristics, device features, validation processes, and clinical applications. Devices were classified according to their functions and features. We defined devices with a mean systolic BP (SBP) and diastolic BP (DBP) biases of < 5 mmHg as valid as a consensus. Our definition of validity did not include assessment of device measurement precision, which is assessed by standard deviation of the mean difference- a critical component of ISO protocol validation criteria. Study quality was assessed using the QUADAS-2 tool. A random-effects model meta-analysis was performed to summarise the mean biases for systolic and diastolic BP across studies.

Results:
Of the 430 studies identified, 16 studies (15 devices, N = 974) were selected. The majority of devices (81.3%) used photoplethysmography to estimate BP against a reference device; other technologies included tonometry, auscultation and electrocardiogram. In addition to BP and heart rate, some devices also measured night-time BP (n = 5), sleep monitoring (n = 3), oxygen saturation (n = 3), temperature (n = 2) and electrocardiogram (n = 3). Eight devices showed mean biases of < 5 mmHg for SBP and DBP compared to a reference device and three devices were commercially available. The meta-analysis showed no statistically significant differences between the wearable and reference devices for SBP (pooled mean difference = 3.42 mmHg, 95%CI −2.17, 9.01, I2 95.4%) and DBP (pooled mean = 1.16 mmHg, 95%CI -1.26, 3.58, I2 87.1%).

Conclusion:
Available cuffless BP devices utilise different sensing technologies, offering the potential for continuous BP monitoring. The variation in standards and validation protocols limited the comparability of findings across studies and the identification of the most accurate device. Challenges such as validation using standard protocols and in real-life settings must be overcome before they can be recommended for uptake into clinical practice.
PS-C08-4: TEC4HOMEBP: DEVELOPING A HOME BLOOD PRESSURE TELE-MONITORING PATHWAY TO SUPPORT PATIENTS DISCHARGED FROM THE EMERGENCY DEPARTMENT WITH ELEVATED BLOOD PRESSURE
Authors: Tran Karen C , Kuyper Laura , Bittman Jesse , Mangat Birinder , Sing Chad Kim , Lindsay Heather , Dawes Martin , Wong Hubert , Khan Nadia A , Mak Meagan Y , Corderio Jennifer , ho Kendall 
Published: January 2023

Objectives:
Elevated blood pressure (BP) in the emergency department (ED) is common, but clinical uncertainty exists on how best to manage asymptomatic hypertension. Telehealth for Emergency-Community Continuity of Care Connectivity via Home Blood Pressure Telemonitoring (TEC4Home BP) evaluates how home blood pressure telemonitoring (HBPTM) can support patients with elevated BP manage their health at home after visiting the ED. The aim of this study is to assess the effect of HBPTM on BP control among those discharged home from the ED with severely elevated BP. We also examined adherence to HBPTM, medical therapy and patient satisfaction.

Methods:
We conducted a prospective, single-centre, observational study and recruited 50 participants from Vancouver General Hospital (VGH), ED with hypertensive urgency, asymptomatic severely uncontrolled BP (> 160/100 mm Hg averaged over 3 readings) or referred to the VGH Hypertension Clinic from the ED for high BP. All participants received a validated home BP monitor (A&D UA-651BLE) and App (Sphygmo App, Calgary, AB) to automatically teletransmit 2 readings in the morning and evening daily for 3 months. Proportion of patients diagnosed with hypertension with controlled home BP defined as less than 135/85 mmHg, adherence to HBPTM, and medication therapy using the Hill Bone medication adherence scale, at 1and 3 months following discharge from the ED.

Results:
From May to December 2021, 50 participants (60 years old, 61% females, average baseline BP (SD) in ED 191 +/−26/ 99 +/−15 mm Hg) were recruited. Our recruitment and enrollment rate were 41% and 88%, respectively. At 1 and 3 months, average home BP (SD) was 136 +/−15/80 +/−11 and 128 +/−10 /77 +/−10 mm Hg. At 3 months, there was a 66% improvement in proportion of those who achieved target BP control. Adherence to HBPTM at 1 and 3 months was 84 and 54%, respectively. There were no differences in medication adherence at baseline and 3 months of study. Participants were highly satisfied with the HBPTM program and 79% would highly recommend the program. More detailed data analysis is currently underway and will be presented.

Conclusions:
HBPTM is a feasible, effective, and acceptable strategy to triage and monitor patients with significantly elevated BP when discharged from the ED. Future studies are need to advise the integration of HBPTM pathway a key clinical strategy to improve patient flow in the ED, reduce length of stay in the ED, and improve BP control in patients with hypertension.
PS-C08-7: TIME IN THERAPEUTIC RANGE IS NOT A RISK FACTOR FOR CARDIOVASCULAR DISEASE WHEN ADJUSTED FOR MEAN SYSTOLIC BLOOD PRESSURE
Authors: Brunstrom Mattias , Rietz Helene , Ortendahl Lina 
Published: January 2023

Background:
Time in therapeutic range (TTR) has been suggested as a novel metric to assess blood pressure (BP) control, the quality of antihypertensive therapy, and the risk of cardiovascular events in people with hypertension.

Methods:
We used a validated electronic health record dataset, including all BP recordings in primary care in two Swedish counties from 1993 to 2011. People were eligible if they were 18 years or older, had a diagnosis of hypertension, no previous cardiovascular events, and at least five BP recordings during the first five years from the date of hypertension diagnosis. TTR was defined as the percentage of BP readings with a systolic value less than 140 mmHg. Participants were followed until death, migration or the 31st of December 2019. The risk of myocardial infarction and stroke was assessed using Cox proportional hazards model with TTR as independent variable, with and without mean systolic BP as a covariate. All analyses were adjusted for age, sex, diabetes, county, income and educational level.

Results:
72 724 participants (56% female, mean age 62 years) were included in the analyses. The mean BP level during the first five years after diagnosis was 151/85 mmHg, with a median TTR of 17.7% (interquartile range 0–40%). During an average 7.7 years of follow-up, 6551 participants experienced a first-ever stroke and 5513 a first-ever myocardial infarction. In the unadjusted analyses, the risk of stroke decreased by 7% (HR 0.93, 95%CI 0.92–0.94) and the risk of myocardial infarction decreased by 6% (0.94, 0.93–0.95) for each 10 percentage points increase in TTR. When including mean systolic BP as a covariate, however, TTR was not associated with either stroke (0.99, 0.97–1.01) or myocardial infarction (1.00, 0.99–1.02).

Conclusion:
TTR for systolic BP is not an independent risk factor for stroke and myocardial infarction in clinical practice and does not add importantly to mean systolic BP as a measure of BP control.
PS-C09-9: AMBULATORY BLOOD PRESSURE CHARACTERISTICS IN CHINESE OBESE HYPERTENSIVE PATIENTS: A POPULATION-BASED AMBULATORY BLOOD PRESSURE MONITORING COHORT STUDY
Authors: Cai Qiujing , Zhao Xiaolei , Zeng Mingfa , Zhou Heng , Zhang Yuqing , Zhang Xuezhong , Liu Lisheng , Hu Aihua 
Published: January 2023

Background:
Ambulatory blood pressure monitoring (ABPM) is increasingly recommended for clinical practice, but more knowledge about the characteristics of Chinese obese hypertensive patients ABPM remains to further explore. This study aimed to assess the features in Chinese obese and hypertensive patients from multi-regions ambulatory blood pressure database in China.

Methods:
In this cohort, 35,367 hypertensive patients who were eligible for this study including 19,380 men (54.8%) and 15,987 women (45.2%) aged from 19 to 99 were recruited. ABPM characteristics were defined according to European guidelines. Overweight was defined as BMI 18.5 kg/m2 or greater, and obesity BMI 25 kg/m2 or greater. Hypertension was defined as elevated mean ambulatory BP (135/85 mmHg greater in day-time, 120/70 mmHg greater in night-time, 130/80 mmHg greater over 24-h). There are four kinds of blood pressure circadian rhythm, dippers, non-dippers, reverse dippers and extreme dippers.

Results:
Based on the ABPM recordings, 70.5% of participants had 24-h hypertension, 26.1% had dippers rhythm. 2.6% of participants had normal weight, 51.0% were overweight, 38.2% were obesity, and 8.2% were in severe obesity state. Considering blood pressure circadian rhythm, 48% non-dippers rhythm, 23.6% reverse dippers rhythm and 2.3% extreme dippers rhythm. Among participants who were obesity and severe obesity, 48% and 45.1% of patients were non-dippers. Severe obesity patients had higher 24-h blood pressures, especially in independent nocturnal hypertension. The prevalence of reverse dippers rhythm hypertension increased with age and the obesity degree. A positive association between blood pressure level and variability was observed, and within-person and between-person SD and CV were of similar magnitude.

Conclusions:
In Chinese obese hypertensive population, circadian rhythm blood pressure variation is an underappreciated problem on the population level. Therefore, the ambulatory blood pressure monitoring in obese hypertensive population needs to be expanded.
PS-C09-12: RELIABILITY AND RELEVANCE OF 24 H AMBULATORY BLOOD PRESSURE MONITORING IN DAY-TO-DAY TREATMENT OF ARTERIAL HYPERTENSION TREATMENT
Authors: Neumann Claas Lennart , Wietoska Torsten , Schulz Egbert G 
Published: January 2023

Introduction:
Blood pressure measurements are the basis of diagnosis, treatment and research of arterial hypertension and its sequelae. All decisions hinge on the validity of the measurement method. Here, the ABPM is considered best practice. Evaluation of ABPM, notwithstanding known issues like availability and economy, regarding its validity, accuracy and applicability to clinical practice was investigated.

Methods and materials:
We retrospectively consider 450 ABPMs executed using validated devices from Nephrology Center Göttingen (ESH-Excellence-Center). This work evaluates the measurements adherence to diagnostic guidelines (ESH) with respect to sources of error, count of valid measurements and cancellation by patient.
Criteria for validity are:

Cancellation by the patient is assumed if:

Results and conclusion:
23 % (n = 106) of 450 ABPM considered to meet all guideline criteria. Remaining 77 % of measurements failed at least one criterion. In 27 % (n = 120), measurement duration was below 24 hours and for 22 % (n = 98) it was below 22 hours. In 2.6 % (n = 12) minimum amount of daytime (n = 3) and night-time (n = 9) data points was not met. Requirement for at least 70 % of valid data points was failed by 23.5 % (n = 105). Here the source of error were motion artefacts in about 50 % of cases, pressurisation issues during the day in 17 % (n = 15) and 27 % (n = 11) at night and kinks in tubing in 14 % (n = 12) during daytime. About 20.6 % (n = 93) of ABPM were preliminary cancelled by the patient which amounts to approximately a quarter (25.4 %) of all measurements failing the guideline criteria. In total 16 % (n = 72) of ABPM were cancelled by patient without recording data of early morning blood pressure which strongly correlates with cardiovascular risk.
The value of ABPM hinges on guideline conforming execution of measurements and should therefore be explicitly discussed with the patient. Due to limitations of ABPM, we recommend introduction of additional methods, e.g. telemetric blood pressure measurements (idTM), with additional options for intervention. Quality of data obtained by an ABPM needs to be examined for every case to ensure its validity to justify a course of action.
PS-C09-13: NEW COMPREHENSIVE THERAPEUTIC STRATEGY FOR HYPERTENSION AND UREMIA USING INORGANIC SUBSTANCES WITH SPECIAL ADSORPTION PROPERTIES
Authors: Kobayashi Yusuke , Kimura Yuki , Kamijo Yuka , Shibata Kazuhiko , Morita Ryutaro , Azushima Kengo , Wakui Hiromichi , Tamura Kouichi 
Published: January 2023

Background:
In order to remove uremic toxins accumulated in patients with chronic kidney disease (CKD), removal of uremic toxin-causing substances from the intestinal tract by administration of spherical adsorbed charcoal and removal of uremic toxins from the blood by hemodialysis are being performed. However, existing treatment methods are still inadequate for the removal of protein-bound uremic toxins (PBUT) and other medium- to large-sized uremic toxins, which leads to a decreased quality of life and worse prognosis in CKD patients. In order to solve this remaining problem, we are currently investigating the use of inorganic materials for the treatment of uremia.

Methods:
To evaluate the adsorption performance of our inorganic material, we compared the adsorption performance of various uremic substances in solution, healthy subjects’ plasma, and hemodialysis patients’ plasma, using Kremezin® as a control.

Results:
Kremezin® was able to adsorb small molecular weight substances in each solution and plasma, while medium to large molecules were poorly adsorbed. On the other hand, the inorganic material we are developing has high adsorption performance not only for small molecules but also for medium to large molecules including inflammatory cytokines and PBUT, and selectively adsorbs cations such as sodium, potassium, and inorganic phosphorus.

Conclusion:
Inorganic substances with special adsorption performance adsorbed not only uremic substances but also cations, whose accumulation is a problem in CKD patients. Therefore, the inorganic adsorbent may contribute not only to the treatment of uremia but also to the comprehensive treatment of hypertension, hyperkalemia, and CKD-MBD, which are common complications in CKD patients.
PS-C11-7: STUDY OF 24-HOUR CUFF-LESS, CONTINUOUS AND NON-INVASIVE BLOOD PRESSURE MEASUREMENT IN 100 CHILDREN AND ADOLESCENTS SHOWS CLINICAL VALIDITY
Authors: Bothe Tomas Lucca , Wette Martin Hulpke , Patzak Andreas , Pilz Niklas 
Published: January 2023

Objective:
The reduction of discomfort caused by conventional, cuff-based blood pressure (BP) determination is a promising trend in ambulatory, cuff-less BP measurement devices. Mitigating these discomforts is especially desirable when performing measurement in children. In this study we want to assess the clinical validity of a cuff-less BP measurement device for 24-hour measurements in children and adolescents.

Methods:
We compared the simultaneously retrieved BP data of the cuff-less SOMNOtouch(TM) NIBP and the cuff-based Mobil-O-Graph® in 24-hour use in 100 children in the range from 5–17 years old.

Results:
A total of 1245 valid measurement pairs showed a mean deviation of 1.08 mmHg (limits of agreement: 24.10 / -21.93) for systolic and 3.32 mmHg (limits of agreement: 25.13 / -18.48) for diastolic BP values. Patient specific difference of means was within 15 mmHg in 95.6% (systolic BP) and 92.3% (diastolic BP) patients. 24.3% of nocturnal cuff inflations led to determinable, BP relevant arousal reactions.

Conclusion:
The SOMNOtouch(TM) NIBP showed desirable measurement accuracy over a broad spectrum 24-hour, ambulatory BP measurements in children and adolescents. Cuff-less blood pressure measurement relieves the issue of nocturnal arousal reactions which showed to be frequently induced by cuff-based measurements. We encourage the use of this cuff-less BP measurement device in everyday practice, driven by this clear indication of clinical validity and benefits in patient comfort.
PS-C12-6: ASSOCIATION BETWEEN DEFECATION STATUS AND BLOOD PRESSURE VARIABILITY
Authors: Kubozono Takuro , Akasaki Yuichi , Kawasoe Shin , Ojima Satoko , Kawabata Takeko , Salim Anwar Ahmed , Ikeda Yoshiyuki , Ohishi Mitsuru 
Published: January 2023

Background:
Blood pressure variability (BPV) is an independent predictor for cardiovascular disease. Defecation status has also been linked to the risk of developing cardiovascular disease.

Aim:
To investigate the association between BPV and defecation status

Methods:
A total of 184 participants who were able to measure their home blood pressure at least 8 days per month at both baseline and 1 year later were included in the study. All participants measured home blood pressure (BP) using HEM-9700T (OMRON Healthcare). Day-to-day variability of systolic BP were evaluated by coefficient of variation (CV) of home systolic BP during one month. Data on defecation status was obtained by questionnaire survey and good defecation status was defined as having a bowel movement every day.

Results:
In multivariate regression analysis with the change of CV from baseline to 1 year later as the objective variable and age, gender, Good defecation status, taking medication including antihypertensive drugs, laxatives, intestinal preparations, and CV at baseline as independent variables, good defecation status is independently negatively associated with the elevated CV (β;: -0.669, P = 0.0019).

Conclusion:
Good defecation status is shown to be significantly associated with decreased BPV.
PS-C13-3: MORTALITY RATE AND REDUCTION OF HOSPITALIZATION FOR ACUTE MYOCARDIAL INFARCTION IN RESEARCH INSTITUTE OF CARDIOLOGY<RIC>,BAKU IN COVID-19 PANDEMIC
Authors: Gasimov Zaur Ismayil , Dadashova Gulnaz , Javadova Tarana , Yusifov Tavakkul 
Published: January 2023

Aims:
To study the impact of quarantine during COVID19 pandemic on admission of patients with myocardial infarction to the intensive cardiac care unit of Research Institute of Cardiology

Methods and Results:
We conducted a single-centre,observational survey to collect data on admissions for acute myocardial infarction(AMI) at ICCU RIC during strict quarantine in April-May 2020,in Baku,Azerbaijan,compared with April-May 2019. We observe 10% reduction in admission rate for AMII patients admitted at intensive cardiac care unit in April-May 2020 in comparison to April-May 2019. We observed significant 40% reduction in admissions for AMI in April 2020 compared with April 2019, it also turned out to be the lowest number of intensive cardiac care unit admissions for AMI among all months of the last 5 years.
Fatality cases of patients admitted in April-May 2020, was 70% higher than in the equivalent period of 2019.
The month of May, following the month of April 2020, had the mortality rate of 26.6% among acute myocardial infarction patients admitted to the intensive cardiac care unit, and it was the highest mortality rate among all months in the last 5 years. During the April 2020, the first month of strict quarantine, in 86,6% < 13 out of 15>of AMI patients admitted to ICCU used narcotic analgesics to relieve pain. In May, narcotic analgesics for pain relief were used in 36.6% or in 11 out of 30 patients.86,6%, the percentage of patients with AMI who received narcotic analgesics for pain relief in April 2020 was the highest among 15 months, from April 2019 to June 2020.<see table 2>