bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C17-7: PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH TYPE 1 AND TYPE 2 DIABETES MELLITUS AT AMANG RODRIGUEZ MEMORIAL MEDICAL CENTER
Authors: De Guzman Ronnel Vergara 
Published: January 2023

Introduction:
Diabetes Mellitus is a global public health challenge with a high epidemiological and economic burden. Its progression may be delayed with correct medications and lifestyle modification. One of the most common microvascular complication and one of the leading causes of preventable blindness is Diabetic Retinopathy.

Methodology:
A descriptive, retrospective, analytical study design was used. All diabetic patients of ARMMC in the OPD from January 2017 to June 2021 were included in this study. All 18-year-old and above with type 1 or type 2 diabetes mellitus and diabetic retinopathy that are seen in ARMMC OPD were included. Excluded are those who have vision loss caused by diseases other than diabetic retinopathy. Charts were reviewed and 107 charts are qualified for the study. All statistical tests will be two tailed test. STATA 13.1 will be used for data analysis.

Results:
Majority of patients are between 47 and 59 years old. Mean age of patients is 53 years old with standard deviation of 11.28. Median is 55 years of age, meaning half of patients are below 55 years old. Almost half of the participants are female with duration diabetes mellitus of more than 5 years, however on review of participants chart, 39.25% had no duration of illness written in the chart. Most of the partici pants are using oral hypoglycemic agents. The result shows the significant associations were found between the duration, insulin use, oral hypoglycemic agent use, and the diabetic retinopathy. The p-values are all 0.00 which are less than 0.05 level of significance.

Conclusion:
This study yielded a prevalence of 1.6% for patients diagnosed with diabetic retinopathy. Majority of diabetic retinopathy patients has type 2 diabetes mellitus with at least 5 years of duration. Most of them are using oral hypoglycemic agents for the main treatment for the diabetes. Age and sex are not associated with diabetic retinopathy.
PS-C18-8: MEAN ANNUAL INTRADIALYTIC BLOOD PRESSURE DECLINE AND CARDIOVASCULAR EVENTS IN JAPANESE MAINTENANCE HEMODIALYSIS PATIENTS
Authors: Takahashi Rina , Uchiyama Kiyotaka , Washida Naoki , Shibagaki Keigo , Yanai Akane , Nakayama Takashin , Morimoto Kohkichi , Itoh Hiroshi Itoh 
Published: January 2023

Objective:
A decline in the intradialytic systolic blood pressure (SBP), which defines intradialytic hypotension, is associated with a greater risk of intradialytic symptoms. Intradialytic SBP decline may be associated with higher all-cause mortality. However, this association has neither been studied in Japanese hemodialysis (HD) patients, nor has seasonal variations in intradialytic SBP decline been considered. We evaluated the association between the mean annual intradialytic SBP decline in Japanese HD patients and clinical outcomes, including major adverse cardiovascular events (MACEs).

Design and method:
This retrospective cohort study included 47,219 HD sessions in 307 patients undergoing HD over one year (April 2019 to March 2020) in three dialysis clinics. The mean annual intradialytic SBP decline (predialysis SBP-nadir intradialytic SBP) for each patient was determined. The association of the mean annual intradialytic SBP decline with clinical outcomes, including MACEs, was assessed from April 2020 until March 2022. MACEs included cardiovascular death, nonfatal myocardial infarction or unstable angina, stroke, heart failure, and other severe cardiovascular events requiring hospitalization.

Results:
The study participants included 202 males (66%). The mean patient age was 69.0 ± 12.4 years and the median duration of HD was 4.1 (2.0–7.7) years. The mean annual intradialytic SBP decline was 28.2 ± 14.8 mmHg. MACEs occurred in 77 cases (25%), death or hospitalization due to a decline in Activities of Daily Living (death or hospitalization) occurred in 56 (18%) cases, and all-cause hospitalization occurred in 184 cases (60%). A Cox regression analysis adjusted for age, sex, HD duration, Charlson comorbidity index, and the mean annual predialysis SBP and ultrafiltration rate, showed that a greater intradialytic SBP decline (per 10) was significantly associated with increased risk of MACEs (hazard ratio [HR], 1.30; 95% confidence interval [CI], 1.09–1.54). Moreover, the greater intradialytic SBP decline (per 10) was associated with increased risks of death or hospitalization (HR, 1.32; 95% CI, 1.08–1.62) and all-cause hospitalization (HR, 1.22; 95% CI, 1.07–1.39).

Conclusions:
In Japanese maintenance HD patients, a greater intradialytic SBP decline was associated with worse clinical outcomes, including increased risks of MACEs, death or hospitalization, and all-cause hospitalization. Further studies are warranted to investigate interventions to attenuate intradialytic SBP decline and improve the prognosis of Japanese HD patients.
PS-C19-6: STUDY ON THE EFFICACY AND SAFETY OF TENG FU JIANGYA TABLET IN THE TREATMENT OF HYPERTENSION
Authors: Yang Wen qing , Li Yun lun , Wang Yu , Zhu Yu Shuo , Qi Yu Chen 
Published: January 2023

Background:
At present, the most important task of cardiovascular disease health management that is to improving the blood pressure compliance rate of Hypertensive Patients. Traditional Chinese medicine (TCM) is an important part of complementary and alternative medicine. Research shows that traditional Chinese medicine has antihypertensive effect from multiple pathways and multiple targets. However, lack of clinical evidence-based medical evidence of TCM in the treatment of hypertension. The purpose of this study was to investigate the efficacy and safety of Teng Fu Jiangya tablet (TJT) in the treatment of hypertension.

Methods:
A prospective, randomized, single-blind, placebo-controlled clinical trial was conducted in order to evaluating the effectiveness and safety of TJT in the treatment of grade 1 hypertension (N = 130). On this basis, a multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted on the treatment of grade 2 hypertension with TJT combined with valsartan / amlodipine (N = 288). During the experiment, the efficacy index of the subjects were recorded for effectiveness evaluation, and the safety index and adverse reaction events of the subjects were recorded for safety evaluation.

Results:
1. After 4 weeks of intervention in patients with grade 1 hypertension, there were significantly difference in the SBP and DBP compared with placebo group. The compliance rate of blood pressure of TJT group is 67.19% and in placebo group is 43.08%. TJT can improve the standard rate of blood pressure. There were also significantly difference in the level of Arachidonic acid, the thromboxaneB2 and the Prostaglandin E2 between the two groups. And there was no serious adverse event reported.
2. After 4 weeks of intervention in patients with grade 2 hypertension, in accordance blood pressure compliance rate, the systolic blood pressure compliance rate of the treatment group was 61.65%, and the placebo group was 37.68%. The treatment group could more effectively reduce the levels of arachidonic acid and thromboxane B2 and increase the level of prostaglandin E2, reduce inflammatory factors, so as to reduce the inflammatory.

Conclusion:
TJT tablet has good effectiveness and safety in the clinical treatment of hypertension. TJT also can effectively reduce the damage of vascular endothelium in the treatment of hypertension. Therefore, TJT play a key role in reducing blood pressure and protecting target organ damage. This is an innovative method for the treatment of hypertension.
PS-C20-2: HYPERTENSION DUE TO LENVATINIB INDUCTION
Authors: Shibata Keisuke , Tokushige Akihiro , Nitta Mina , Akasaki Yuichi , Higuchi Koji , Ikeda Yoshiyuki , Ohishi Mitsuru 
Published: January 2023

Background:
Lenvatinib (LEN) is a multi-kinase inhibitor that blocks vascular endothelial growth factor and other factors and is often associated with hypertension due to its mechanism of action. However, there is insufficient information on LEN-related hypertension. The purpose of this study was to compare the degree, timing, and risk of developing Grade 2 or higher hypertension after LEN induction with those who did not develop.

Methods:
Of 36 patients who newly started LEN between January 2021 and March 2022 at our hospital, 33 patients were included, excluding those younger than 20 years and those who were introduced as outpatients.

Results:
The median age was 73 years, 57.6% were female, and 54.5% had hypertension. Hypertension was observed in 23 patients (69.7%) after the start of LEN, and 13 patients (39.4%) had Grade 3 or higher hypertension. The most common time of onset of hypertension was the day of LEN induction in 12 patients (52.2%). There were no differences in age, BMI, underlying disease, or stage of disease between the hypertension-onset group and the non-hypertension-onset group. The hypertension-onset group was significantly more likely to be female, have thyroid cancer, receive a higher initial dose of LEN, and have higher pre-start blood pressure. The mean blood pressure before LEN administration was 124/77 mmHg, which was significantly increased to 139/84 mmHg the morning after the day of administration (P < 0.00001). Systolic blood pressure was also significantly higher in the non-hypertensive group (P = 0.02), 100 mmHg before start vs. 116 mmHg the next morning. Ca antagonists were most frequently prescribed for hypertension.

Conclusion:
Early induction of LEN is associated with a high risk of blood pressure fluctuations and requires caution.
PS-C21-6: RENOPROTECTIVE EFFECT OF ALISKIREN MONOTHERAPY IN HYPERTENSIVE PATIENTS WITH OBESITY AND TYPE 2 DIABETES MELLITUS
Authors: Seki Yasufumi , Morimoto Satoshi , Kimura Shihori , Takano Noriyoshi , Yamashita Kaoru , Bokuda Kanako , Sasaki Nobukazu , Watanabe Daisuke , Ichihara Atsuhiro 
Published: January 2023

Objective:
Renin-angiotensin system inhibitors have been reported to have protective effects from end-organ damages. However, roles of the direct renin inhibitor monotherapy have been still unknown. Therefore, in the present study, we compared effects of aliskiren monotherapy with those of amlodipine monotherapy on visceral fat area (VFA) and end-organ damages in hypertensive patients with obesity and type 2 diabetes.

Design:
A single-center, prospective, open-label and randomized study.

Methods:
Adult hypertensive patients with body mass index ≧ 25 kg/m2 and VFA ≧ 100 cm2 or those with type 2 diabetes, who had an office blood pressure 140–160/90–100 mmHg with or without antihypertensive drugs were randomly allocated to 24-week aliskiren or amlodipine monotherapy. The dose of amlodipine or aliskiren was increased up to 10 mg/day and 300 mg/day, respectively, and only doxazosin could be added at maximum to 8 mg/day if needed. The primary outcome of the study was the changes of waist circumference and VFA at 24 weeks of the study period. Changes in outcomes were analyzed using mixed-effects models for repeated measures, which included treatment, time, treatment-by-time interaction and the baseline values as fixed effects.

Results:
In a total of 62 participants (age, 57 ± 13 y.o.; 40 men; body mass index, 28.8 ± 4.8 kg/m2; waist circumference, 99.3 ± 11.9 cm; VFA, 134.8 ± 47.0 cm2; blood pressure, 141 ± 16/86 ± 13 mmHg), waist circumference and visceral fat area as a primary endpoint did not significantly change from baseline in both groups. Systolic blood pressure significantly decreased at 12 weeks (change in least squares means: -10 mmHg, P = 0.001) and 24 weeks (-10 mmHg, P = 0.001) in the amlodipine group and at 24 weeks (-11 mmHg, P = 0.001) in the aliskiren group. Diastolic blood pressure significantly decreased at 24 weeks (-6 mmHg, P = 0.009) only in the amlodipine group. Estimated glomerular filtration rates were not statistically different between the groups. Logarithm of urinary albumin excretion significantly decreased at 24 weeks only in the aliskiren group (-0.60, P < 0.001). The 24-weeks-changes in logarithm of serum pentraxin 3 levels, an inflammatory marker, were significantly lower in the aliskiren group than in the amlodipine group (-0.09 vs + 0.09, P = 0.017).

Conclusions:
These data suggested that aliskiren monotherapy may have a better renoprotective effect than amlodipine monotherapy while it does not affect VFA in hypertensive patients with obesity and type 2 diabetes mellitus.
PS-C22-2: UNDERSTANDING CLINICAL EFFECTIVENESS OF TELMISARTAN AS MONOTHERAPY FOR HYPERTENSION MANAGEMENT IN NEPAL
Authors: Tripathee Ashish , Jha Bipin Kumar , Sha Ram Krishna , Gupta Amit , Sharma Tripti 
Published: January 2023

Background:
Telmisartan, a highly selective angiotensin II receptor blocker, approved for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive agents and provides full 24-h blood pressure control. It also has established data with respect to long-term efficacy and safety.

Objective:
The present study aimed to evaluate the clinical effectiveness and safety of telmisartan as monotherapy for the management of patients with hypertension from Nepal.

Methods:
This was a multicentric, survey analysis conducted in patients aged > 18 years receiving telmisartan as monotherapy for the management of hypertension. Study was conducted between Nov 2020 and Jan 2021. Data was collected during each visit at baseline, day 45, and day 90, from selected clinics/hospitals.

Results:
A total of 185 patients (mean age, 54.6 years) were included in this study. Out of 185, 139 patients received telmisartan as monotherapy of various dosage patterns. Majority of patients (48.9%) received telmisartan 40 mg followed by telmisartan 60 mg (38.9%) and telmisartan 20 mg (12.2%). Diabetes was the most common comorbid condition observed in 45.9% of patients with hypertension. A significant reduction in the SBP/DBP was observed during the course of telmisartan monotherapy (Figure 1). The mean (95% confidence interval) change in SBP and DBP from baseline to day 45 and day 90 was 16.6 (15.4–17.9); P < 0.001 and 8.6 (7.7–9.5); P < 0.001, 26.0 (24.5–27.5); P < 0.001 and 13.6 (12.5–14.7); P < 0.001, and 9.3 (8.2–10.3); P < 0.001 and 5.0 (4.2–5.9); P < 0.001, respectively.

Conclusion:
Telmisartan as monotherapy was found to be effective in reducing blood pressure and achieving the blood pressure target in Nepalese patients with hypertension.
Conflict of interest: All other authors have nothing to disclose.
PS-C24-5: PEGUERO LO PRESTI CRITERIA MODIFIED BY QRS DURATION AS PREDICTOR OF HFPEF IN HYPERTENSIVE PATIENTS
Authors: Jagannatha Gusti Ngurah Prana , Antara I Made Putra Swi , Yusrika Mirani Ulfa , Pertiwi Putu Febry Krisna 
Published: January 2023

Objectives:
ECG markers as a predictor for heart failure (HF) with preserved ejection fraction (HFpEF) are not specific, however hypertension is the most common comorbid cause of HFpEF. A recent study found Cornell Product (CP) can be an ECG marker for HFpEF but has low sensitivity and specificity. Peguero Lo Presti is an LVH criterion with good sensitivity compared to other criteria. Since increasing LV mass also prolongs QRS duration, the Peguero Lo Presti modified with QRS (PMQ) duration can potentially be a good ECG marker for HFpEF. Aim of this study was to find out the relationship between PMQ ECG parameters and HfpEF, also finding the optimal cutoff in predicting HFpEF.

Design and method:
This study was a cohort retrospective using medical records that include ECG and Echo data of hypertensive patients at Sanglah General Hospital from 2018 until 2022, and 190 patients were enrolled. Subjects were divided into hypertensive patients who develop in to HFpEF and non develop in to HFpEF. Subjects with IVCD were excluded. PMQ is defined: (S wave amplitude in V4 + deepest S amplitude in any precordial lead) x QRS duration. The Mann-Whitney test was used to compare the mean ECG parameters and mean echocardiographic parameters between the HFpEF and non-HFpEF groups. An optimal cutoff value for PMQ and CP to predict the develop of HFpEF was evaluated using receiver operating characteristics (ROC).

Results:
Based on data, subjects with HFpEF were 52.1%, and non-HFpEF was 47.9%. The HFpEF group had higher LVMI (136.13 ± 34.55vs76.23 ± 14.11), higher mean E/E’ (16.97 ± 6.71vs13.25 ± 2.62), higher LAVI (52.46 ± 42.63vs28.97 ± 6.95) with all p-value < 0.05. On ECG parameters, the HFpEF group had a significantly longer QTc duration (486.53 ± 75.78vs437.33 ± 24.08), higher CP outcome (1823.6 ± 429.6vs1476.9 ± 273.8), and higher PMQ outcome (2919.8 ± 732.8 vs 2097.9 ± 535.2) with better sensitivity and specificity of PMQ cutoff than CP (PMQ > 2655, sensitivity 54.2%, specificity 92.6% vs CP > 1770, sensitivity 36.5%, specificity 91.5%). Subjects with a cutoff of PMQ (> 1770ms) were also significantly associated with HFpEF (PR 1.773; 95%CI 1.170–2.687; P < 0.001).

Conclusion:
Modified Peguero Lo Presti by QRS duration is an easy-to-apply ECG marker for HFpEF and has relatively good sensitivity and specificity reflecting the severity of diastolic dysfunction and LV hypertrophy.
PS-C25-3: THE EFFECT OF MOUNTAINEERING ON THE ASSOCIATION BETWEEN BLOOD PRESSURE AND PHYSICAL ACTIVITY. THE MOUNT FUJI STUDY
Authors: Komori Takahiro , Hoshide Satoshi , Kario Kazuomi 
Published: January 2023

Objective:
It has not been fully investigated whether the response of blood pressure (BP) to activity at high altitudes differs from that at low altitudes or how temperature is involved in these differences. We hypothesized the BP response to activity during mountaineering would be increased compared to that in daily living, and conducted this study to compare physiological BP response to accelerometer measurements during mountaineering and daily living.

Design and method:
In 15 healthy people (mean age 33 ± 6 years), a new multi-sensor ambulatory BP monitoring (ABPM) device equipped with barometer, thermometer, and accelerometer was used to measure blood pressure responses to activity during a trip to Mt. Fuji and during daily life at low altitudes on another day. Associations between physical activity (log-transformed 5-min average values of accelerometer just before each ambulatory BP) and the corresponding BP were obtained from 843 and 676 readings during the Mt. Fuji trip and daily living, respectively.

Result:
All ambulatory systolic BP (SBP) parameters were significantly higher during the Mt. Fuji trip than during daily living at low altitudes (all p < 0.01). There were significant positive correlations between physical activity and corresponding BPs in both mountaineering and daily living (all P < 0.01), and there was an interaction between BPs and physical activity according to the two conditions (P < 0.01). On Mt. Fuji, multivariate regression analysis showed that increased physical activity and lower temperature were associated with increased 24-hr SBP and diastolic BP (DBP) (all P < 0.05). The goodness-of-fit values of the association between activity and 24-hr SBP or DBP were improved by adding temperature to the model of both 24-hr SBP and DBP. However, these associations were not found in the daily living model.

Conclusions:
BP response to activity was more pronounced during mountaineering than daily living. Lower temperature compounded the BP response to activity in the mountains but not in daily living.
PS-C25-7: PROGNOSTIC VALUE OF COMPUTED TOMOGRAPHY PSOAS MUSCLE SIZE IN PREDICTING MAJOR ADVERSE CARDIOVASCULAR EVENTS IN THE ELDERLY: A META-ANALYSIS.
Authors: Sanchez Alexis Joyce Tolentino , Bandong Irene 
Published: January 2023

Background:
Cardiovascular diseases (CVD) are the leading cause of death globally (WHO). It accounts for > 17 million deaths each year (30% of all deaths) (WONG, 2014). Aging is associated with body composition changes such as a reduction in the muscle mass and an increase in visceral fat that shift the metabolism to an unfavorable state which increases the risk of CVD (EVANS, 2021). Psoas muscle mass index (PMI) has been growing recognition as an objective and quantitative marker to assess muscle wasting and has been suggested as a useful predictive marker for long-term outcome after cardiovascular surgery (MATSUMOTO, 2020). The aim of this study is to determine the prognostic value of psoas muscle size for development of major adverse cardiovascular events.

Methodology:
We searched PubMed and Google scholar. The Newcastle-Ottawa Scale assessment was used for quality assessment. Two investigators independently extracted patient baseline characteristics, CT psoas muscle size, and research endpoint such as all-cause mortality, myocardial infarction, and stroke. The hazard ratio (95% CI) and relative risk (95% CI) was calculated using a generic inverse variance approach. The overall effects was determined by Z-test and P-value < 0.05 were considered as statistically significant.

Results:
Out of 37 articles, 10 citations fulfilled the inclusion criteria. Sarcopenia was not associated with MACE (HR 14.6, 95% CI:5.69 - 37.48, p value < 0.00001, I2 0%) and all cause mortality (RR 2.04, 95% CI:1.55 - 2.69, p value of < 0.00001, I2 0%). The sub-group analysis shows no association between sarcopenia and MACE among patients > 60 years (HR 15.36, 95% CI: 5.54 - 42.53, p value < 0.0001, I2 0%), myocardial infarction (RR 1.96, 95% CI: 0.63 - 6.10, p value of < 0.24, I2 0%), and stroke (RR 1.62, 95% CI: 0.84 - 3.15, p value of < 0.15, I2 0%).

Conclusion:
Sarcopenia is not associated with MACE and all cause mortality. Among patients > 60 years, sarcopenia shows no association between myocardial infarction and stroke. Further studies should be done to determine the cut-off value for psoas muscle size for sarcopenia and sarcopenic obesity among elderly patients.