bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPC09-2: EFFECTIVENESS OF OROPHARYNGEAL EXERCISES AND PRANAYAMA ON BLOOD PRESSURE, AND QUALITY OF SLEEP AMONG HYPERTENSIVE WITH MODERATE OBSTRUCTIVE SLEEP APNEA.
Authors: Kaur Amrit , Mitra Mahesh , Msp Ganesh 
Published: January 2023

Introduction and Objectives:
Burden of cardiovascular disease around the global is a major health concern and prevalence is high in adults with obstructive sleep apnea (OSA). Lowering blood pressure (BP) can greatly reduce cardiovascular disease risk and lifestyle modification including regular physical activity is routinely prescribed to achieve this goal. The relationship between sleep disordered breathing especially obstructive sleep apnea (OSA) and hypertension has been well investigated in both cross sectional and longitudinal studies. Many people with OSA suffer from severe fatigue and daytime sleepiness with poor exercise intolerance due to poor sleep quality and nocturnal hypoxemia. The objectives of this study was To evaluate the efficacy of a 6 week oropharyngeal exercises and Pranayama training program for reducing blood pressure and improving sleep quality in hypertensive patients with OSA .

Design and method:
This is a single site double blind randomized clinical trial. Total 40 patients with history of hypertension and moderate sleep apnea were selected that further divided into two groups oropharyngeal exercises and Pranayama group and control group. Patients were evaluated at study entry and at end by evaluating blood pressure pulse rate anthropometric measurements snoring frequency (range 0 to 4) and Pittsburgh sleep quality (0 to 21) questionnaires.
After initial evaluation oropharyngeal exercises and Pranayama along with regular brisk walking for 30 to 40 mins 5 days in week is prescribed to experimental group. Pranayama consists of three phases: Puraka (inhalation) kumbhaka (retention) and rechaka (exhalation) that can be either fast or slow. Oropharyngeal exercises refers to 12 exercises of the 20 minutes duration involving tongue (4 exercises) soft palate (2 exercises) jaw (2 exercises) and lateral pharyngeal wall (4 exercises) to be performed twice a day for 6 weeks. The exercises were taught individually and were supplemented with a pamphlet for reinforcement. And only regular brisk walking for 30 to 40 mins 5 days in week is prescribed to control group.

Results:
Experimental group significantly (p < 0.05) decreased systolic & diastolic blood pressure snoring neck circumference and improved sleep quality. Heart rate changes were insignificant (p = 0.9).

Conclusions:
Oropharyngeal exercises and Pranayama are effective in reducing blood pressure and snoring in hypertensive patients with moderate OSA. Its also effective in improving in quality of sleep in these patients.
PS-BPC09-3: THE ASSOCIATION BETWEEN THE FRAILTY CLASSIFICATION AND ANTIHYPERTENSIVE TREATMENT IN OLDER PATIENTS: A CROSS-SECTIONAL STUDY.
Authors: Akasaka Hiroshi , Yasunobe Yukiko , Onishi Yuri , Minami Tomohiro , Sugimoto Ken , Yamamoto Koichi , Rakugi Hiromi 
Published: January 2023

Objective:
The prevalence of frailty and hypertension are both increases with age. However, the treatment target in older hypertensive patients with frailty has not yet been clearly defined. Therefore, we conducted a registry study to clarify the current status of antihypertensive treatment for older patients at our institution.

Design and method:
We recruited the study participants from consecutive patients who visited the Department of Geriatrics and Hypertension, Osaka University Hospital, between April 2012 and March 2022 and underwent physical function tests and comprehensive functional assessment. We obtained the data on blood pressure and treatment regimen from the medical record. All participants gave informed consent, and our institutional review board approved the study protocol. We defined frailty according to the Japanese version of the cardiovascular health study (J-CHS) criteria. Then, we performed a cross-sectional analysis of frailty and antihypertensive treatment.

Results:
The participants were 1,228 (537 men, aged 75.1 + /-8.5 years), classified according to the J-CHS criteria: 234 (19.0%) robust, 778 (63.4%) pre-frail, and 216 (17.6%) frail. The percentage of antihypertensive medication use was lower in the order of frail/ pre-frail/ robust (chi-square 6.71, p = 0.035). Blood pressure levels were not associated with the frailty classification. When examined by gender, neither antihypertensive treatment nor blood pressure was associated with frailty classification in women. On the other hand, in men, the antihypertensive treatment decreased with an increasing degree of frailty, and blood pressure values and pulse pressure tended to increase. Still, the mean office blood pressure in the male frailty group was 127/69 mmHg. The association between frailty classification and antihypertensive medication remained significant after adjustment for age and gender.

Conclusions:
At our institution, we found that antihypertensive prescriptions have decreased with the degree of frailty in older patients, especially men. The reasons for withholding antihypertensive treatment for frail older patients and its impact on the risk of cardiovascular disease require further investigation.
PS-BPC09-4: THE FACTORS RELATED TO HYPERTENSION IN YOUNG MALE ATHLETES
Authors: Yasuda Hisayo , Yasuda Osamu , Ohishi Mitsuru 
Published: January 2023

Objective:
There are many studies on hypertension in middle-aged or older athletes, however few studies in young athletes are reported. The purpose of this study is to clarify the factors related to hypertension in young athletes.

Design and Methods:
The subjects are 256 young male athletes (18.3 ± 1.0 years) of the College of Physical Education. Physiological measurement data and blood samples as fasting status were collected at the time of admission by medical checkup. Muscle mass was evaluated by bioelectrical impedance.

Results:
Mean height was 172.0 ± 6.4 cm, body weight (BW) 69.3 ± 11.8 kg, body mass index (BMI) 23.4 ± 3.3 kg/m2, systolic blood pressure (SBP) 123.8 ± 12.0 mmHg, and diastolic blood pressure (DBP) 63.4 ± 8.5 mmHg. Using the severity classification of the Japanese Society of Hypertension Guidelines 2019, there were 83 normal blood pressure (BP), 74 high normal BP, 91 elevated BP, 7 grade I hypertension, and grade II hypertension or higher were not present.
We investigated correlations between physiological, laboratory parameters and blood pressure (BP). SBP had significant correlations with body surface area (p < 0.001), height (p < 0.01), weight (p < 0.0001), BMI (p < 0.0001), muscle mass (p < 0.0001), Heart Rate (HR) (p < 0.0001), Red blood cell (p < 0.05), and uric acid (p < 0.01). SBP showed no significant correlations with LDL-cholesterol, hemoglobin, fasting blood glucose, AST, ALT, Cr, eGFR. Multiple regression analysis showed that only BW and HR were significantly associated with SBP (y = 89.63 + 0.329 × BW + 0.16 × HR, p < 0.0001). Blood pressure in young athletes is associated with body weight. Strength-trained athletes such as judo are heavier than endurance trained athletes, and tend to have a high percentage of people with high blood pressure. Subsequent years of strength-trained exercise can lead to hypertension.

Conclusions:
Prehypertension and hypertension in young athletes are more strongly associated with body weight than lipids and blood glucose levels. The type of sport, strength-trained or endurance-trained, may affect the development of hypertension.
PS-BPC10-1: SAFETY AND EFFICACY OF USING CEREAL FOOD (FRUGRA®) TO IMPROVE BLOOD PRESSURE AND BOWEL HEALTH IN PATIENTS WITH CKD
Authors: Okuma Teruyuki , Ueda Seiji , Kobayashi Takashi , Nagasawa Hajime , Otsuka Tomoyuki , Nakata Masami , Sato Koji , Kaifu Kumiko , Matsushita Satoshi , Murakoshi Maki , Gohda Tomohito , Suzuki Yusuke 
Published: January 2023

Background:
Hypertension is known to increase the risk of developing cardiovascular disease, chronic kidney disease (CKD), and death. One of the main causes of hypertension is excessive salt intake. Frugra®, a cereal food that has a low salt content of 0.5 g per serving, may help reduce salt intake. Additionally, Frugra is rich in dietary fiber, thereby beneficial for CKD patients.

Methods:
We enrolled 11 patients who underwent maintenance hemodialysis (HD), and 20 non-dialysis CKD patients. The usual breakfast was replaced with Frugra for 8 weeks, and the effects on blood pressure, urinary toxins, bowel movements, and body composition were examined.

Results:
In HD patients, Frugra reduced BNP and significantly decreased systolic and diastolic blood pressure. In addition, almost all subjects showed improved bowel movements, and blood levels of indoxyl sulfate, a urea toxin derived from intestinal bacteria, were significantly reduced. In non-dialysis CKD patients, decreasing blood pressure levels, improvement in stool characteristics measured by bristol scale and improvement in bowel movements and indoxyl sulfate levels were also tended to be decreased.

Conclusion:
These results suggest that intake of Frugra in patients with CKD could be a useful tool for health and may contribute to the prevention of cardiovascular disease by correcting blood pressure and fluid retention, improving the intestinal environment, and lowering urinary toxins.
PS-BPC11-1: ASSOCIATION BETWEEN INCREASED ABDOMINAL CIRCUMFERENCE AND FUTURE DEVELOPMENT OF HYPERTENSION IN MILDLY OBESE MIDDLE-AGED INDIVIDUALS
Authors: Ninomiya Yuichi , Kawasoe Shin , Kubozono Takuro , Tokushige Akihiro , Ichiki Hitoshi , Ikeda Yoshiyuki , Miyahara Hironori , Tokushige Koichi , Ohishi Mitsuru 
Published: January 2023

Objective:
While increased abdominal circumference is reportedly associated with an increased risk of hypertension, few studies have examined sex-specific differences in this relationship. Here, we investigated sex-specific differences in the association between increased abdominal circumference and future development of hypertension.

Design and method:
Among 53,281 middle-aged (40 to 59 years old) individuals who underwent a health examination at least once between 2007 and 2014, we examined 890 of 1,744 individuals with mild abdominal obesity (above the median waist circumference) because examination data at 3- and 8-year follow-ups for these individuals were available. Propensity score (PS) matching, based on the first examination data, was used to match participants with an increased waist circumference (IWC; ≧ 3 cm at the 3-year time point, IW group) with those not meeting this criterion (non-IW group). Variables, such as age, body mass index, smoking status, alcohol consumption, estimated glomerular filtration rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (defined as SBP ≧ 140 mmHg and/or DBP ≧ 90 mmHg), were used for PS matching. Blood pressure and hypertension incidence were compared between two groups at the 8-year time point.

Results:
PS matching resulted in 91 men and 85 women in each group. In men, SBP and hypertension incidence at the 8-year time point were significantly higher in the IW than in the non-IW group (SBP: 126.2 ± 12.8 vs. 121.7 ± 14.8 mmHg, P < 0.05; hypertension incidence: 44.0% vs. 27.5%, P < 0.05). In women, there were no significant differences in these two parameters between the two groups (SBP: 123.3 ± 15.8 vs. 120.2 ± 16.8 mmHg, P = 0.22; hypertension incidence: 24.7% vs. 29.4%, P = 0.49).

Conclusions:
A sex-specific association between increased abdominal circumference and future development of hypertension was observed in mildly obese middle-aged men, but not women.
PS-BPC11-2: PEDIATRIC BLOOD PRESSURE CATEGORY PREDICTS LONGITUDINAL VARIABILITY IN BLOOD PRESSURE IN YOUTH
Authors: Azegami Tatsuhiko , Uchida Keiko , Sato Yasunori , Takeda Ayano , Inokuchi Mikako , Itoh Hiroshi , Mori Masaaki 
Published: January 2023

Objectives:
In order to identify risk factors that cause elevated blood pressure during adolescence, we aimed to evaluate the predictive effect of childhood factors on longitudinal variability of individual blood pressure during youth.

Methods:
Childhood data were obtained from medical checkups of Japanese male and female junior high school students aged 12–13 years during the period from 2009 to 2010. Childhood measurements were height, body weight, body mass index (BMI), systolic and diastolic blood pressures, complete blood counts, uric acid, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. Childhood blood pressure was categorized as normal, elevated blood pressure, or hypertension according to the American Academy of Pediatrics (AAP) clinical practice guideline. Linear mixed-effects models for repeated measures were used to estimate the effect of baseline childhood factors on longitudinal changes in systolic and diastolic blood pressures.

Results:
A total of 1304 participants were followed up to the 10th year. At baseline, the mean age was 12.6 years [SD, 0.3] and 26.2% were female. Among male participants, 6.3% were categorized as having elevated blood pressure and 8.8% were categorized as having hypertension, while among female participants 6.1% were categorized as having elevated blood pressure and 8.5% were categorized as having hypertension. Boys in the hypertension category had higher BMI, higher uric acid, and lower HDLC compared with those in the normal blood pressure category, but this trend was not statistically significant in girls. Of each childhood factor, the baseline blood pressure category according to AAP clinical practice guideline fit best with longitudinal changes in both systolic and diastolic blood pressure in the linear mixed-effects models.

Conclusion:
These results suggest that the AAP pediatric blood pressure category is the strongest predictor of longitudinal variability in individual blood pressure in youth.
PS-BPC11-4: LOW SOLUBLE KLOTHO IS ASSOCIATED WITH RESISTANT HYPERTENSION IN CKD: FROM THE KNOW-CKD STUDY
Authors: Koh Jaehee , Jo Sangmin , Yang Jihyun , Lee Kyubeck , Kim Hyang , Oh Kookhwan , Hyun Young Youl 
Published: January 2023

Objective:
Apparent treatment-resistant hypertension (ATRH) is highly prevalent in chronic kidney disease (CKD) and is a risk factor for rapid progression of CKD. Soluble klotho is an extracellular domain of klotho released into the circulation. Although soluble klotho is known to be a risk factor for hypertension, the association between soluble klotho and ATRH is unknown. The aim of this study is to evaluate the association of soluble klotho with ATRH in CKD.

Design and method:
In this cross-sectional study, we analyzed 1,737 predialysis CKD patients enrolled in the prospective Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). Apparent treatment-resistant hypertension was defined as systolic blood pressure > = 140 mm Hg or diastolic blood pressure > = 90 mm Hg with concurrent use of three antihypertensive medication classes or use of four or more antihypertensive medication classes regardless of blood pressure level. Serum klotho levels were measured using an enzyme-linked immunosorbent assay. Participants were divided into quartiles.

Results:
Among study subjects, 303 patients (17.4%) had ATRH. Prevalence of ATRH were 21.9%, 18.9%, 18.2% and 10.8% for the 1st to 4th quartiles of soluble klotho, respectively (p for trend < 0.001). The adjusted OR [95% CI] of 1st to 3th quartile of soluble klotho in reference to 4th quartile were 2.01 (1.32–3.06), 1.59 (1.04–2.42) and 1.69 (1.11–2.57).

Conclusions:
Soluble klotho level was inversely associated with the presence of ATRH in Korean predialysis CKD patients. This relationship was independent of various cardiovascular risk factors.
PS-BPC11-6: USEFULNESS OF BONE BROTH SOUP FOR THE REDUCTION OF SALT INTAKE
Authors: Ohta Yuko , Kuwahara Yukie , Fukamatsu Yuki , Tsuruta Hiroshi , Nakamura Hidetoshi , Tsuchihashi Takuya 
Published: January 2023

Objective:
Salt reduction is most important in guidance regarding lifestyle modifications in Japanese hypertensive patients as well as for the health of the general population. However, low-salt diets have not been preferred because they are not delicious. Thus, we investigated the influence of bone broth soup on the saltiness and palatability in this study.

Design and method:
Subjects comprised 103 staffs working at Kokura Daiichi Hospital (22 males, 81 females, mean age 35 ± 12 years old). They tested 0.9% NaCl solutions (A), 0.6% NaCl solutions (B) and 0.6% NaCl solutions with bone broth soup (C). Evaluations of saltiness and palatability for each solution were conducted using a visual analog scale in a double-blinded randomized manner. We estimated 24-hour salt excretion using spot urine samples and also assessed BP, the awareness of salt intake using self-description questionnaire score (range 0 to 35, from the lowest to the highest), medication and other confounding factors including lifestyles.

Results:
In all subjects, average estimated salt intake was 9.0 ± 2.0 g/day and each rate of achievement of salt intake was 15.1% in 73 female without hypertension (< 6.5 g/day), 23.5% in 17 male without hypertension (< 7.5 g/day), 0.0% in 13 hypertension (< 6.0 g/day). Both in saltiness and palatability, B was significantly lower than A, but C was significantly higher than B. Salt intake levels were categorized into quantile (Q1, lowest; Q3, highest). C in palatability was significantly higher in the Q1 group than in the Q3 group (0.6 ± 1.4 vs -0.2 ± 1.1, p < 0.01). Urinary sodium-to-potassium ratio and total average score for the awareness of salt intake on the questionnaire in the Q1 group was significantly lower and compared to that in the Q3 group (2.34 ± 2.34 vs 4.54 ± 2.16, p < 0.01; 11.7 ± 5.1 vs 13.5 ± 4.5, p < 0.05).

Conclusions:
Most subjects failed to achieve the goal of salt intake. Group with high salt intake might be able to feel less palatable. Our results indicate that bone broth soup seems effective in reducing salt intake without loss of palatability.
PS-BPC11-10: BLOOD PRESSURE IN PATIENTS WITH FABRY DISEASE
Authors: Higuchi Koji , Ohishi Mitsuru 
Published: January 2023

Background:
Fabry disease is a lysosomal storage disorder caused by a deficiency of α-galactosidase A (α-gal A) activity, one of the lysosomal hydrolases. A defect in α-gal A activity leads to the systemic accumulation of glycosphingolipids resulting in multiple organ involvement such as acroparesthesia, hypohidrosis, angiokeratoma, and corneal opacities. In many patients with Fabry disease, cardiac and/or cerebrovascular disease is the primary cause of death. Control of hypertension, which is a risk factor for cardiac and cerebrovascular disease, is therefore important. The prevalence of uncontrolled hypertension in patients with Fabry disease is unknown.

Method:
We st udied uncontrolled hypertension (systolic blood pressure(SBP)< 130 mmHg or diastolic blood pressure(DBP) < 80 mmHg) at the first visit of 31 patients who were diagnosed with Fabry disease in our department from April 2015 to December 2021. Of these, two children and four whose blood pressure had not been measured were excluded.

Results:
We examined 7 males(28%) and 18 females(72%). Uncontrolled hypertension was present in 76% of the patients with Fabry disease (males; 57,1%, females; 83.3%). Median SBP was 125 mmHg and median DBP was 83mmHg.

Conclusion:
In our study, we found a very high prevalence of uncontrolled hypertension in patients with Fabry disease, especially in women. Given that the leading causes of death in Fabry disease are cardiac and cerebrovascular disease, our data suggest the importance of blood pressure control in patients with Fabry disease. Our study was limited by the single-center data and the limited number of cases.
PS-BPC12-6: ASSESSMENT OF LDL CONTROL IN POST-ACUTE CORONARY SYNDROME PATIENTS: STATINS ARE NOT ENOUGH
Authors: Chan Yin Chun Alex , Osman Hanad , Doddamani Parveen , Rufus Prabha , Rahman Faiz , Patel Prashanth , Gupta Pankaj 
Published: January 2023

Objective:
Cardiovascular disease (CVD) is one of the leading causes of death worldwide, with nearly 18 million people dying from CVD in 2019. In the UK, CVD was responsible for the premature deaths of nearly 170,000 people with around 65,000 being attributed to acute coronary syndrome (ACS). High levels of low-density lipoprotein (LDL) is one of the main risk factors associated with ACS. A recent European guideline has set out a target for secondary prevention in ACS patients of a LDL < 1.4 mmol/l and 50% or more reduction from baseline.
This study seeks to identify the proportion of patients meeting the LDL reduction target for secondary prevention and also to assess whether there are other alternative treatments that are more effective in achieving satisfactory lipid control.

Design and Methods:
The Myocardial Ischaemia National Audit Project (MINAP) database was used to identify patients admitted into the University Hospitals of Leicester NHS Trust (UHL) between May 2017 and May 2018. The MINAP database records information on how patients admitted into hospital with ACS are cared for.
694 patients were identified. Hospital records were reviewed at 6 months post discharge to determine medications prescribed on discharge and LDL levels. The study was part of a quality improvement project to optimise lipids in patients with ACS (UHL internal audit number 9397).

Results:
This study found that 97.5% of patients were prescribed a statin upon discharge, which is marginally higher than the national average of 96.4%. 83.4% of patients were discharged with a high-intensity statin as recommended by national guidelines.
However only 37.6% of patients reached a LDL level of below 1.4 mmol/l at follow-up. Furthermore of those patients with a baseline LDL prior to or during the myocardial infarction related admission, only 25.1% of patients also achieved a LDL reduction of 50% or more.
Patients that were prescribed Ezetimibe showed a slightly better reduction in LDL with 57.1% of patients achieving a LDL level of below 1.4 mmol/l at follow-up and 28.6% of them also achieving a LDL reduction of 50% or more.

Conclusions:
This study suggests that patients are not achieving a reduction in their LDL levels to < 1.4 mmol/l and 50% or more reduction from baseline despite the majority of patients being prescribed a high-intensity statin as recommended by national guidelines.
Therefore there may be a need for the most high risk of patients being offered Ezetimibe in addition to ensure LDL reduction targets are reached.