bluuebunny/crossref_metadata_2025_split huggingface dataset:
RECORDING OF BLOOD PRESSURE IN PATIENTS WITH DELIRIUM AND HISTORY OF MENTAL ILLNESS
Authors: Anagnostaki Maria-Emmanuela , Anagnostaki Ismini , Irini Kourambie 
Published: June 2023

Objective:
Psychiatric diseases are often manifested by delirium either at the diagnosis or during the course of the disease. As is well known, delirium, due to the activation of the sympathetic nervous system, is characterized by Arterial Hypertension (AH) which can reach the limits of a hypertensive crisis, endangering the health of the patient.
PURPOSE To record BP in delirious patients, in relation to history, previous values and treatment.

Design and method:
136 patients hospitalized in the Psychiatric hospital with the diagnosis of delirium were retrospectively studied. BP was recorded with a mercury manometer at least three times a day, depending on the patient's clinical picture, and the maximum and average values were recorded. Percentage and absolute change from pre- and post-delirium values were also recorded. The comparison of values during and outside of delirium was done with X2 and the level of significance was considered p<0.05.

Results:
90% of delirious psychiatric patients had BP above normal while only 42% had a history of BP. 28% of them had SBP > 100mmHg. Mean BP during the acute episode was 176/93 while before or after treatment it was 155/84 mmHg. BP rose on average 9/21 mmHg. 4% of patients experienced a major cardiovascular complication. The rise was greater in patients with higher baseline BP values

Conclusions:
BP elevation is a frequent finding in delirium. Sometimes it is pronounced and contributes to cardiovascular mortality. The greater vulnerability of already hypertensive patients indicates the need for better regulation
HYPERTENSIVE URGENCIES AND EMERGENCIES. A QUESTIONNAIRE AMONG EXCELLENCE CENTERS OF THE EUROPEAN SOCIETY OF HYPERTENSION
Authors: Muiesan Maria Lorenza , Weber Thomas , Paini Anna , Salvetti Massimo , Fragouilis Christos , Tsioufis Konstantinos 
Published: June 2023

Objective:
The diagnostic approach as well as drug treatment algorithms for hypertensive urgencies(HU), hypertensive emergencies(HE) and malignant hypertension(MH)may be different across Europe,which may also be true for the knowledge of recently updated scientific information. We aimed to explore these items in the Excellence Center(EC)network of the European Society of Hypertension.

Design and method:
We conducted an anonymized electronic survey among our ECs

Results:
Overall, 65 ECs from 17 European and 5 non-European countries participated, mostly residents, clinical specialty was mainly Internal Medicine, Cardiology and Nephrology. The definition of HU was correctly identified by 46.1%, the definition of MH was correctly identified in 27.7%. The use of COX-1 antagonists, COX-2 antagonists, steroids and illicit drugs (cocaine, meth) is regularly investigated in 63.1, 69.2, 87.7 and 89.2%, respectively. Small, standard, large and extra large cuffs are available in 73.8, 93.8, 95.4 and 63.1 %, respectively. BP is measured more than once in almost all centers. Common measures/investigations of organ damage performed are renal function(96.9%), electrocardiogram (95.4%), urinary protein(89.2%), echocardiography(80%), fundoscopy(69.2%), myocardial injury markers (64.6%), and chest radiography(53.8%). Dedicated protocols for management of HU/HE are available in 70.8% of centers. HUs are treated with oral antihypertensives in 70.8%, with i.v. antihypertensives in 20%, and combinations of both in the remainder. HEs are treated with i.v. antihypertensives in 84.6%, with oral antihypertensives in 4.6%, and combinations of both in the remainder. Commonly used antihypertensives in HE are i.v. nitrates(73.8%), i.v. furosemide (64.6%), i.v. labetalol(61.5%), i.v. nitroprusside(41.5%), i.v. urapidil (38.5%), i.v./i.m. clonidine (27.7%), i.v. nicardipine(24.6%), oral captopril(26.2%) and s.l. nifedipine (24.6%), while some of these drugs are not available in up to one quarter of ECs. BP reduction goals in HE have a tendency to depend on the clinical presentation in 44.6%, while achieving less than 25% of BP decrease in 36.9%. Reasons to admit patients to hospital include signs of acute organ damage(90.8%), and inability to decrease BP inspite of i.v. medications(47.7%), whereas a hypertension specialist is consulted in 10.8%.

Conclusions:
This survey higlights the need to further spread the updated scientific information on the management and treatment of HE and HU.
KIDNEY TRANSPLANTATION AND KIDNEY DONATION DO NOT AFFECT SHORT-TERM BLOOD PRESSURE VARIABILITY
Authors: Xagas Efstathios , Sarafidis Pantelis , Iatridi Fotini , Theodorakopoulou Marieta , Pella Eva , Korogiannou Maria , Argyris Antonis , Protogerou Athanase , Boletis Ioannis , Marinaki Smaragdi 
Published: June 2023

Objective:
Blood pressure variability (BPV) is an independent cardiovascular risk factor in CKD. Kidney transplantation (KTx) is associated with improved BP levels for kidney transplant recipient (KTRs), without evoking significant changes in donors. The aim of this study was to assess the short- and mid-time effects of KTx and donation on short-term BPV in KTRs and their respective living kidney donors.

Design and method:
Forty KTRs and their respective donors were evaluated with 24-h ABPM (Mobil-O-Graph-NG) at baseline (1 month before), 3-months and 12-months after KTx. Standard-deviation (SD), weighted-SD (wSD), coefficient-of-variation (CV), average-real-variability (ARV) and variability independent of mean (VIM) for SBP/DBP were calculated with validated formulas.

Results:
All 24-h systolic and diastolic BPV indexes studied did not change significantly from baseline to 3-month (SBP-wSD: 12.8±3.0 vs 13.2±3.4 mmHg, p = 0.608; SBP-ARV: 10.3±2.4 vs 10.8±2.6 mmHg, p = 0.463) and 12-month evaluation (SBP-wSD 12.8±3.0 vs 12.1±2.8; p = 0.424 and SBP-ARV: 10.3±2.4 vs 10.2±2.5; p = 0.615) after kidney transplantation in the KTRs. In kidney donors, all 24-h systolic BPV indices displayed a trend towards higher values at 3 months compared to baseline, but without reaching statistical significance (SBP-wSD: 12.2±2.8 vs 13.6±4.2 mmHg, p = 0.107 and SBP-ARV: 10.1±2.1 vs 11.2±3.1 mmHg, p = 0.099), the levels of 24-h systolic SBP indices at 12-months were almost identical to baseline values. 24-h diastolic BPV indices at 3-month and 12-month evaluation were similar to baseline.

Conclusions:
Short-term BPV did not change significantly 3 and 12 months after kidney transplantation/donation neither in KTRs nor in living kidney donors. Longitudinal studies examining associations of BPV with adverse outcomes in these individuals are needed.
ASSOCIATION OF LOW RENIN ACTIVITY WITH UNCONTROLLED NIGHT-TIME AND MORNING BLOOD PRESSURE AS RESIDUAL RISK IN GOOD BLOOD PRESSURE CONTROLLED ELDERLY SUBJECTS
Authors: Nishizawa Masafumi , Hoshide Satoshi , Kario Kazuomi 
Published: June 2023

Objective:
To achieve optimal nighttime blood pressure (BP) and morning BP is often challenging especially in elderly subjects. Although low renin revels are seen especially in the elderly, data are sparse about the association between renin-angiotensin-aldosterone (RAA) system and uncontrolled nighttime and morning BP.

Design and method:
Ambulatory BP (ABP) was assessed in 315 Minamisanriku Study participants with aldosterone and plasma renin activity (PRA). Multivariable linear and logistic regression analyses were used to analyze the association of aldosterone and PRA with awake and asleep ABP and hypertension defined by ABP, adjusting for important confounders included the use of RAA inhibitors. We divided them into non-elderly (<80 years, n = 164) and elderly group (>80 years, n = 151).

Results:
In total participants, 95% was treated hypertension and average 24-hour BP was 114.2±8.9/67.5±5.9 mmHg. The prevalence of uncontrolled 24-hour (>130 mmHg), daytime (>135 mmHg), nighttime (>120 mmHg) and morning systolic BP (SBP) (>135 mmHg) was 5.6%, 7.4%, 8.6%, 26.8%, respectively. In elderly group, Lower log-PRA was associated with higher 24-hour, daytime, nighttime, and SBP (all P<0.01) after adjusted confounders. These associations were also observed in non-elderly group except for nighttime and morning SBP. Lower log-aldosterone was associated with higher 24-hour and daytime SBP only in elderly group (both P<0.01). A 1-unit higher log-PRA was associated with lower odds of uncontrolled nighttime SBP (odds ratio [OD] 0.19 [95%CI, 0.06-0.64) and uncontrolled morning SBP (OR, 0.43 [95%CI, 0.21-0.91]) but not in uncontrolled 24-hour and daytime SBP in elderly group, while these findings were not seen in non-elderly group. Similar results were observed in log-aldosterone. There was no association between aldosterone/PAC ratio and the presence of uncontrolled ABP.

Conclusions:
Suppressed renin activity and aldosterone were associated with uncontrolled nighttime and morning SBP in treated and good 24-hour BP controlled elderly population. Even in good 24-hour BP, low renin activity may be associated with residual ABP risk in elderly population.
SEASONALITY IN NIGHT-TIME BLOOD PRESSURE AND ITS ASSOCIATIONS WITH TARGET ORGAN DAMAGE
Authors: Cheng Yi , Sheng Chang-Sheng , Huang Jian-Feng , Zhang Dong-Yan , Li Ming-Xuan , Cheng Yi-Bang , An De-Wei , Guo Qian-Hui , Wang Ying , Huang Qi-Fang , Xu Ting-Yan , Li Yan , Wang Ji-Guang 
Published: June 2023

Objective:
There is some evidence that nighttime blood pressure varies between seasons. And it is unclear if the higher nighttime blood pressure in summer than in other seasons would be associated with target organ damage and if the associations would be different between summer and other seasons.

Design and method:
In 1054 untreated patients referred for ambulatory blood pressure monitoring, we performed measurements of urinary albumin-to-creatinine ratio (ACR, n = 1044), carotid-femoral pulse wave velocity (cfPWV, n = 1020) and left ventricular mass index (LVMI, n = 622). We investigated seasonality in nighttime blood pressure in our untreated outpatient sample and then its associations with various measures of target organ damage in comparison with those in other seasons.

Results:
Patients referred in spring (n = 337, 32.0%), summer (n = 210, 19.9%), autumn (n = 196, 18.6%) and winter (n = 311, 29.5%) had similar 24-h ambulatory systolic/diastolic blood pressure (P>0.25). However, both before and after adjustment for confounding factors, nighttime systolic/diastolic blood pressure differed significantly between seasons (P<0.001), being highest in summer and lowest in winter (adjusted mean values 117.0/75.3 mm Hg vs. 111.4/71.1 mm Hg). After adjustment for confounding factors, nighttime systolic/diastolic blood pressure were significantly and positively associated with ACR, cfPWV and LVMI (P<0.006). In season-specific analyses, statistical significance was reached for all the associations of nighttime blood pressure with target organ damage in summer (P<0.02), and for some of the associations in spring, autumn and winter. The association between nighttime systolic blood pressure and ACR was significantly stronger in patients examined in summer than those in winter (standardized beta, 0.31 vs 0.11 mg/mmol, P for interaction = 0.03).

Conclusions:
There is indeed seasonality in nighttime blood pressure level, as well as in its association with renal injury in terms of urinary albumin excretion.
OFFICE BLOOD PRESSURE VARIABILITY: WITHIN SESSION STABILITY ACROSS CONSECUTIVE MEASUREMENTS USING OSCILLOMETRIC DEVICES
Authors: Dekie Luc , Connor Kalvin , Heilbraun Jeff , Rudo Todd 
Published: June 2023

Objective:
Blood pressure (BP) is routinely monitored by healthcare providers and during drug development. For improvement in accuracy, several oscillometric devices perform multiple sequential inflations, rather than relying on a single inflation, to determine a mean systolic and diastolic blood pressure (SBP, DBP). Blood pressure is known to vary physiologically throughout a day, and over the course of days and weeks, due to intrinsic and extrinsic factors. Little data has been published describing the variability of SBP and DBP recorded minutes apart using oscillometric methods (i.e. within session variability).

Design and method:
We investigated the stability of within session SBP and DBP across 4 datasets by evaluating differences between 3 consecutive inflations recorded 1-2 minutes apart using a clinically validated oscillometric BP monitor that passed the ANSI/AAMI/ISO 2013, ESH-IP 2002 and BHS 1993 protocols (Table 1). These datasets included patients with controlled or uncontrolled hypertension.

Results:
Data were available from over 10.000 measurement pairs. The differences between inflation 1 and 2 were within ±10, 20 and 30 mmHg for 78.1, 94.4 and 97.9% of the SBP measurements, respectively. For the DBP, 90.7, 95.5 and 97.3 % of the differences between inflation 1 and 2 were within ±10, 15 and 20 mmHg, respectively. A similar trend was seen between inflation 2 and 3.
Table 1: Categorical Analysis of BP changes between consecutive inflations.

Conclusions:
Our data demonstrate substantial variability between consecutive oscillometric BP measurements performed a few minutes apart. Over 20% of the time, consecutive inflations show an absolute change in SBP of at least 10 mmHg. It is unclear whether this represents true physiologic changes in BP or is partly artefactual due to failure of a device's algorithm to determine BP accurately from the oscillometric waveform. These data suggest that criteria for within session variability for automated oscillometric blood pressure devices should be established, including a threshold for repeating the session after 10 minutes of rest.
CARDIOVASCULAR RISK STRATIFICATION AND CORRELATION BETWEEN SUBCLINICAL ORGAN DAMAGE IN BOTH GENDERS OF HYPERTENSIVE PATIENTS
Authors: Posadzy-Malaczynska Anna , Woznicka-Leskiewicz Lucyna 
Published: June 2023

Objective:
Assessment of correlation between subclinical organ damage and cardiovascular risk stratification in both genders of hypertensive patients.

Design and method:
We divided 50 patients with arterial hypertension in two groups: A: 25 women; B: 25 men. The average age of them [yrs]: 55 yrs and 57 yrs.
Pulse wave velocity (PWV), ankle-brachial index (ABI) and carotid intima-media thickness (IMT) were evaluated. We assessed cardiovascular risk according to: SCORE2 and SCORE2- OP scales.
Statistical calculations were performed in the StatSoft Statistica 10. The t-student test was used for the statistical analysis, ⇑ Spearmana was taken to analyze the correlation of statistically significant values.

Results:
We revealed following results in both groups: A (women) and B (men) respectively (SD) [*for p< = 0,05; **for p<0,001; NS- negligible statistically]: ABI: 0,94(0,16) NS 1,01(0,14); IMT [mm]: 0,73(0,15) * 0,81(0,17); PWV [m/s]: 10,68(2,29) * 12,54(3,01); SCORE2/ SCORE2-OP: 3,16(2,49) ** 7,00(5,10).
In the group with hypertension women were characterized by a lower IMT and PWV. The cardiovascular risk according to risk SCORE2/ SCORE2-OP scales in men was significantly higher than in women.
In this group the parameters were correlated with the cardiovascular risk according to SCORE2 and SCORE 2 OP scales.
In the women there were significant correlations between: ABI and SCORE2/ SCORE2-OP scale, IMT and SCORE2/SCORE2-OP scale.

Conclusions:
SEX DIFFERENCES AND SUBCLINICAL ORGAN DAMAGE IN CARDIOVASCULAR RISK STRATIFICATION IN PATIENTS WITH OR WITHOUT HYPERTENSION
Authors: Posadzy-Malaczynska Anna , Woznicka-Leskiewicz Lucyna 
Published: June 2023

Objective:
Assessment of sex differences and subclinical organ damage in cardiovascular risk stratification in patients with or without hypertension.

Design and method:
We divided 100 patients in two groups: A: HT+: patients with arterial hypertension (25 women and 25 men); B: HT-: patients without arterial hypertension (25 women and 25 men). The average age of them [yrs]: 56 and 53 (*p<0,05).
Pulse wave velocity (PWV), ankle-brachial index (ABI) and carotid intima-media thickness (IMT) were evaluated. We assessed cardiovascular risk according to SCORE2 and SCORE 2-OP scales.:
Statistical calculations were performed in the StatSoft Statistica 10. For comparison of variables with a normal distribution and equal variances we used the t-test for unrelated samples.

Results:
We revealed following results in both groups: CAD-HT+ and CAD-HT- respectively [*for p< = 0,05; **for p<0,001; NS- negligible statistically].
In the group with hypertension women were characterized by a lower IMT and PWV than men. The cardiovascular risk according to risk SCORE2 and SCORE2-OP scales in men was significantly higher than in women in both groups.

Conclusions:
CHARACTERISTICS OF DYSLIPIDEMIA IN THE CROATIAN RURAL AREA DAMAGED BY AN EARTHQUAKE. “THE SILENT KILLER HUNT” - CROATIAN SOCIETY OF HYPERTENSION PROJECT
Authors: Vuksan-Cusa Zrinka , Bogdanic Jakov Emanuel , Jurkovic Ana Marija , Bosnic Klara , Brcic Alojzija , Bozic Katarina , Jelakovic Bojan 
Published: June 2023

Objective:
Dyslipidemia is one of the most prevalent cardiovascular risk factors, making its detection and control essential due to the risk of serious complications. Prevention and sensible management of dyslipidemia can markedly alter cardiovascular morbidity and mortality.
This study aimed to determine the prevalence of dyslipidemia among the adult population in a rural part of Croatia seriously damaged by the earthquake and evaluate the gender-associated differences in lipid profiles.

Design and method:
Blood samples of 244 subjects (188 women) (opportunistic screening) were collected under fasting conditions. The bloodwork results were analyzed using descriptive statistics and t-tests were used for checking differences between the sexes.

Results:
The average age of the whole group was 61.9 ± 14.3 years. Prevalence of hypercholesterolemia, hypertriglyceridemia, elevated LDL cholesterol levels and low HDL cholesterol levels were 59.0%, 34.8%, 57.0%, and 32.0%, respectively. Average values of total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol were 5.4 ± 1.7mmol/l, triglyceride 1.8 ± 1.1 mmol/l, 1.4 ± 0.3 mmol/l, and 3.3 ± 1.02 mmol/l. We failed to find a significant difference in total cholesterol and LDL cholesterol between men and women (p>0.05). There was a statistically significant difference in triglyceride and HDL cholesterol levels between men and women with men showing higher levels of triglycerides (t = 2.08, p<0.05) and lower levels of HDL cholesterol (t = -4.1, p<0.05) than women.

Conclusions:
The prevalence of dyslipidemia in this rural area is high, higher than in other rural parts of Croatia indicating that stressful life after the earthquake and an unhealthy diet might contribute to this. Primary prevention i.e. education and regular examination of this vulnerable population should be in focus and even more intensive than in other rural, remote areas.
THE PLASMA HDL-SUBFRACTION PROFILE IN HYPERTENSIVE PATIENTS WITH HIGH HDL-CHOLESTEROL LEVELS
Authors: Triantafyllidi Helen , Benas Dimitrios , Tellis Constantinos , Tselepis Alexandros , Iliodromitis Efstathios 
Published: June 2023

Objective:
The evaluation of cardiovascular risk (CVR) in arterial hypertension includes the estimation of high density lipoprotein (HDL-C). Although HDL-C is considered as a favorite CVR factor, the exact role that HDL-C subfraction profile play in the pathogenesis of atherosclerosis, especially in higher than usual HDL-C levels (>60 mg/dl) is currently under investigation. The aim of this study was to evaluate the plasma HDL subfraction profile of high HDL-C levels in hypertensive patients compared to normotensive subjects.

Design and method:
We studied 74 hypertensive patients (60 + 13 years, 62 females) and 24 normotensives, apparently healthy subjects (49 + 14 years, 22 females) with HDL-C equal or above 55 mg/dl. Cholesterol, HDL-C, and TG were determined enzymatically while LDL-C was calculated using the Friedewald formula. Plasma HDL particles were separated and determined electrophorically using Lipoprint System HDL Subfractions Kit. Aortic stiffness (c-f PWV) and central BP (cBP) were evaluated by carotid-femoral pulse wave velocity (Complior apparatus).

Results:
We found that hypertensive patients had increased age, BMI, office systolic and diastolic BP, PWV compared to normotensives. Regarding HDL, 10 HDL fractions were separated: fractions 1-3 were denoted as Large-HDL (L-HDL), fractions 4-7 constituted the Intermediate-HDL (I-HDL), and fractions 8-10 were denoted as Small-HDL (S-HDL) subfraction. Although HDL-C levels were similar between groups (76 + 13 vs. 81 + 17 mg/dl, p = 0.10), the percent distribution (%) of L-HDL was lower in hypertensives compared to normotensives (29.8±4.7% vs. 36.6±6.3%, p<0.001), % I-HDL was similar while % S-HDL was increased (27.3±3.7% vs. 20.4±4.4%, p<0.001). We found a significant negative correlation between L-HDL and SBP (rho = -0.48, p = 0.01) as well as cBP (rho = -0.52, p = 0.008) in younger hypertensive females before menopause (n = 26, 49 + 5 years).

Conclusions:
L-HDL particles, the most antiatherogenic HDL-C subfraction, were reduced in hypertensive patients with high HDL-C levels compared to normotensive subjects, suggesting that these patients are probably less protected against CV disease compared to normotensive subjects with similar HDL-C and LDL-C levels. Therefore, plasma HDL-subfraction profile might replace the HDL-C evaluation as a better biomarker of CVR in hypertensive patients, especially females before menopause.
DIABETES INDUCED LIPID PANEL PARTICULARITIES IN HYPERTENSIVE PATIENTS: A PILOT NMR SPECTROSCOPY STUDY
Authors: Stanciulescu Laura , Nicolescu Alina , Duduianu Catalin , Deleanu Calin , Dorobantu Maria 
Published: June 2023

Objective:
Cardiovascular diseases are the leading cause of death globally, despite significant advances in diagnosis and treatment. Among the multiple already well-known cardiovascular risk factors, hypertension, diabetes mellitus type II and dyslipidaemia are the most frequent and show the best correlations with the risk of further developing a major cardiovascular event.
The main objective consists in identifying the potential particularities that diabetes could have on the lipid profile in hypertensive patients, while also discovering bio-markers with a higher potential accuracy of predicting further major cardiovascular events, using NMR spectroscopy.

Design and method:
We have selected a group of 30 hypertensive patients and a control group of 17 otherwise healthy individuals in order to assess the influence of diabetes on the lipid panel in hypertensive patients. A blood sample of 6 mL was collected before and after meals and 5 types of NMR spectroscopy experiments were performed for each sample.

Results:
It was noted that the fasten triglycerides levels, VLDL and IDL particle number, apolipoprotein A1, A2, B100 levels, as well as the ratio apolipoprotein B100/apolipoprotein A1 are all potentially useful markers that could be successfully used to differentiate between the strictly hypertensive patients and the ones that associate type II diabetes mellitus. The study also confirmed once more our previous reports that the fasting status upon sampling has little influence on the lipid panel final values.

Conclusions:
We have evaluated the lipid panel differences induced by diabetes mellitus type II in hypertensive patients and we have compared the results with an otherwise healthy control group. We have identified the NMR spectroscopy markers that could be able to spot subtle differences in the lipid profiles of the two study groups (two hypertensive groups, one consisting in strictly hypertensive patients, the other one including hypertensive patients with already known type II diabetes mellitus), even when LDL levels have been lowered to normal levels due to statin treatment. We have once more concluded that the patient's fasting status has no influence on the final analysis.