bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C31-5: COMPARISON OF THE BLOOD PRESSURE MANAGEMENT BETWEEN SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS AND GLUCAGON-LIKE PEPTIDE 1 RECEPTOR AGONISTS
Authors: Kobayashi Kazuo , Tamura Kouichi , Hatori Nobuo , Toyoda Masao , Kanamori Akira 
Published: January 2023

Background:
Several large clinical studies using not only sodium-glucose co-transporter 2 inhibitors (SGLT-2is) but also glucagon-like peptide 1 receptor agonists (GLP-1Ras) showed the superiority on the renal outcome on patients with type 2 diabetes (T2DM). There is no direct comparison of renoprotective effects between these two drugs, further, the mechanism for the renoprotective effects is not fully understood. Our previous survey revealed the superiority of SGLT2i treatment for the renoprotective effects compared to GLP1Ra. We also reported the importance of the reduction of BP during treatment, however, there is no direct comparison between their BP lowering efficacies.

Aim:
This study aimed to compare the rates of achieving a target BP and the renal effects, with SGLT-2i and GLP-1Ra treatments, administered in Japanese patients with T2DM and poorly controlled BP.

Methods:
Kanagawa Physicians Association separately carried out retrospective surveys that included patients with T2DM receiving therapy with SGLT-2i or GLP-1Ra for more than one year. After excluding the patients who used both SGLT2i and GLP1Ra, 384 SGLT-2i- and 160 GLP-1Ra-treated patients, with a BP more than 130/80 mmHg, before treatment were included in this study. Propensity score (PS) for the SGLT2i treatment were calculated using logistic regression and the inverse probability weighting method with average effect for treatment (ATE) weight and the trimming of patients with 0.05 ≦ PS≦ 0.95. The BP control rates were compared using a generalized linear model.

Results:
In this study, the rage of the standardized difference between two treatments was form 0.02 to0.20. SGLT-2i treatment resulted in significantly higher BP control rates than GLP1Ra treatment (odds ratio [95%confidence interval] = 2.09 [1.08, 4.03], p = 0.03). Compared with GLP-1Ra-treated patients, SGLT-2i-treated patients had significantly larger decreases in diastolic BP, mean arterial pressure, and body weight (-3.8[-6.6, -1.1] mmHg, P = 0.006; -4.1[-7.2, -1.0] mmHg, P = 0.01; and -1.5 [-2.7, -0.4], P = 0.008, respectively) and increased annual estimated glomerular filtration rate (eGFR; 1.5 [0.05, 2.9] mL/min/1.73 m2/year, P = 0.04).

Conclusion:
In T2DM patients with poorly controlled BP, compared with GLP-1Ra, SGLT-2i treatment significantly improved BP management and increased eGFR. When the renoprotective effect is expected in the clinical practice, it is necessary to consider the degree of contribution to the achievement of BP control in addition to the characteristics of the drugs.
PS-C31-11: THE RELATION BETWEEN ANTIHYPERTENSIVE DRUGS AND DIURETICS AND ADVERSE DRUG REACTIONS IN THE OLDER INPATIENTS
Authors: Hamaie Chie , Takeya Yasushi , Nakajima Tsuneo , Nozato Yoichi , Yokoyama Serina , Takahashi Toshimasa , Hongyo Kazuhiro , Nakagami Futoshi , Akasaka Hiroshi , Takami Youichi , Yamamoto Kouichi , Rakugi Hiromi 
Published: January 2023

Aim:
We investigated whether antihypertensive drugs and diuretics were associated with adverse drug reactions in the older inpatients.

Methods:
We retrospectively investigated factors related to adverse drug reactions(ADRs) in inpatients aged 65 and over in the geriatrics and hypertension ward of Osaka University Hospital in Japan. We identified drug information and ADRs from the medical records of 1031 inpatients during the 7 years from September 2014 to August 2021.

Results:
There were 94 ADRs in 81 patients(7.9%) of the total of 1031 patients (female 54.0%, mean age 78.1 ± 6.7 years), there happened the most in 24 cases is with antihypertensive drugs, and the second most in 15 casess is with diuretics. Of the 24 cases of ADRs thought to be caused by antihypertensive drugs, 20 cases of ADR occurred with antihypertensive drugs taken before admission. The details of ADRs by antihypertensive drugs were hypotention / orthostatic hypotension in 16 cases, bradycardia in 7 cases, and edema in 1 case. Of the 15 cases of ADRs thought to be caused by diuretics, 10 cases of ADRs occurred with diuretics that had been taken before admission. The details of ADRs by diuretics were electrolyte abnormalities in 8 cases, hypotension / orthostatic hypotension in 6 cases, and renal dysfunction in 1 case. Of the 24 cases in which antihypertensive drugs were suspected to be ADRs, the most common disease were heart failure in 7 cases, followed by hypertension in 4 cases. Of the 15 cases in which diuretics were suspected to be ADRs, the most common diseases were heart failure (3 cases) and diabetes (3 cases). However, the results of multivariate analysis showed no significant association between the disease that triggered admission and the occurrence of ADRs.

Conclusions:
The subjects of this study included many patients with hypertension and heart failure, and since they used many antihypertensive drugs and diuretics, there were many ADRs caused by them. The same situation seems to be naturally accepted in medical care for the older people. It is important to be aware that antihypertensive drugs and diuretics, being the most common in medical care for the older people, may cause ADRs.
PS-C34-2: CORRELATION BETWEEN SERUM URIC ACID AND RENIN - ANGIOTENSIN - ALDOSTERONE SYSTEM IN COLLEGE STUDENTS
Authors: Ji Xiaoyi , Zhao Haiying , Li Yaru , Wang Xinyu , Wang Menglin , Wang Hao , Jiang Ling 
Published: January 2023

Objective:
To study the correlation between serum uric acid (SUA) and renin-angiotensin-aldosterone(RAAS) in college students.

Design and method:
A total of 228 college students (age 20.44 ± 2.09 years, male 108 cases) without cardiovascular complications and any treatment were enrolled by random sampling method. The whole study population was divided into three groups according to the SUA level(umol/L) from low to high: Q1 (139∼325), Q2(326∼396), Q3 (398∼670). The participants were divided into SUA-tertiles according to sex-specific cut-off values of SUA: q1 (males 240∼370, females 139∼279), q2 (males 375∼458, females 280∼343), q3 (males 461∼670, females 345∼641). We investigated the relationship among SUA, plasma renin concentration(PRC) and plasma aldosterone concentration(PAC).

Results:
In this study, the numbers of SUA tertile groups were 8 (10.5%), 40 (52.6%) and 60 (78.9%) in males. Compared with females, men have higher SUA [410.5 (358.5–487.0) VS 315 (265.0–367.5), P < 0.001] and lower PAC[29.95 (19.03–53.33) VS 46.80 (26.93–82.48), P < 0.001], PRC [23.06(16.93–30.22) VS 22.92 (17.56–29.70) pg/ml, P = 0.941] was not significantly different. PAC in Q1 and Q3 was different (P = 0.001). PRC in male group q1 and q3 was different (P = 0.017). There was no statistical difference in RAAS among the three groups in female population.
There was a negative correlation between SUA and PAC in the general population (P < 0.05), and a negative correlation between SUA and PRC and PAC in males (P < 0.05). After adjusting confounding factors, there was still a negative correlation between SUA and PRC in males (R = -0.209, P = 0.041). The model was constructed with uric acid triquartile as dependent variable, including gender, SBP, DBP, BMI, BaPWV, fasting blood glucose, blood lipids (triglyceride, HDL-C, LDL-C, except total cholesterol due to collinearity), eGFR, PRC, Ang2, PAC and other independent variables. Multivariate Logistic regression analysis showed that with the first quartile of uric acid as the control group, there were significant differences in renin concentration in causing different quartile uric acid levels. For every 1pg/ml increase of renin concentration in males, the possibility of developing high-quartile uric acid was 0.931 times higher than that of low-quartile uric acid.

Conclusions:
SUA was negatively correlated with PRC in college students, but not with PAC.
PS-C34-9: ASSESSMENT OF BLOOD PRESSURE IN TOBACCO CONSUMERS: A PILOT STUDY
Authors: Singh Anjali , Verma Narsingh 
Published: January 2023

Background:
Tobacco and hypertension are respectively the first and second leading cause of preventable mortality worldwide. The effect of tobacco on blood pressure is complex with evidence that tobacco increase blood pressure acutely and increase the risk of developing hypertension.

Objective:
The objective of this study was to examine the impact of tobacco use on blood pressure among tobacco users.

Methodology:
In this study we recruited total 101 tobacco using subjects and measured their systolic and diastolic blood pressure in the outpatient department (OPD) of KGMU.

Results:
The effects of tobacco use on the risk of development of hypertension were assessed from a lifelong perspective. Study participants aged between 49 ± 13. Use of tobacco was positively associated with the risk of hypertension. Systolic BP of these tobacco using subjects was 131.86 ± 21.11 mmHg and the diastolic BP of was 84.32 ± 10.95 mmHg.

Conclusion:
Study concluded that use of tobacco is a risk factor for hypertension and it has association to cardiovascular and cerebrovascular complications. However, both use of tobacco and smoking increase the risk of development of hypertension as well as atherosclerosis. Tobacco causes an acute increase in blood pressure.
PS-C35-1: SPOT URINE SODIUM: CREATININE RATIO: A SIMPLE METHOD TO ESTIMATE SODIUM INTAKE
Authors: Kunanon Sirisawat , Mukdaloy Yatip , Srithongkul Thatsaphan 
Published: January 2023

Objective:
High sodium intake is a worldwide problem and contributes to high blood pressure and target organ damage. Measurement of 24-hour urine sodium excretion is gold standard for sodium intake evaluation but it is difficult to practice. In this study, the correlation between spot urine sodium: creatinine ratio from second void (AM), before dinner (PM), before bedtime (HS) and 24-hr samples with 24-hour urine sodium were evaluated.

Methods:
The participants were recruited from single hospital. Participants with age > 20 years, eGFR > 60 ml/min/1.73 m2 and no history of diuretics use were included. Urine sodium, urine creatinine and urine volume of each sample were measured. Urine sodium (mmol/L): urine creatinine (mg/dL) ratio of AM, PM, HS and 24-hour samples were calculated. Correlations of each ratio with 24 hour urine sodium (mmol/day) were studied by Pearson correlation coefficients.

Results:
43 participants were included in this study. Mean age was 46.9 ± 13.6 years. Hypertension was diagnosed in 31 participants (72%). Mean blood pressure was 134 ± 15/81 ± 9 mmHg. Estimated eGFR was 100 ± 16 ml/min/1.73 m2. Mean 24 hour urine sodium was 178 + 92 mmol/day (equivalent to sodium intake 4,094 + 2,116 mg/day). Urine sodium: creatinine ratio of AM, PM, HS and 24-hr samples (correlation coefficient, r, with 24-hour urine sodium excretion) were 1.6 ± 0.8 (r = 0.11, P = 0.49), 1.9 ± 1.1 (r = 0.71, P < 0.001), 1.7 ± 1.1 (r = 0.59, P < 0.001) and 1.8 ± 0.7 (r = 0.77, < 0.001) respectively. Spot urine sodium: creatinine ratio from PM sample cut-off point of 1.2 had sensitivity of 81% and specificity of 73% to determine 24-hr urine sodium of 100 mmol/day.

Conclusions:
Spot urine sodium: creatinine ratio from PM sample correlates well with 24-hr urine sodium (r = 0.62) and ratio of 1.2 is equivalent to 24-hr urine sodium of 100 mmol/day. Sodium intake of study participants was 178 mmol/day which higher than recommended level.
PS-C35-4: ASSOCIATION OF SODIUM INTAKE WITH ADVERSE LEFT ATRIAL FUNCTION AND LEFT ATRIOVENTRICULAR COUPLING
Authors: Yin Lili , Mei Jiajie , Jiang Yinong , Dong Jianli 
Published: January 2023

Objective:
In this study, we investigated the relationship between 24-hour urinary sodium (a surrogate for estimating dietary sodium intake), ambulatory blood pressure parameters, cardiac MRI-assessed left atrial function and left atrioventricular coupling, as well as the influence of nighttime blood pressure and body mass index(BMI) on 24-hour urinary sodium and subclinical cardiac function.

Design and method:
Participants in our study included 398 individuals, all of whom were subjected to 24-hour urine collection, 24-hour ambulatory blood pressure measurement, and cardiac magnetic resonance imaging to determine left atrial function (myocardial strain) as well as left atrioventricular coupling index. LACI is defined as the ratio of left atrial end-diastolic volume divided by left ventricular end-diastolic volume. Our study evaluated the relationship between 24-hour urinary sodium and ambulatory blood pressure parameters, left atrial function, and left atrioventricular coupling index, and used mediation analysis to explain the indirect effects of nighttime blood pressure and BMI between 24-hour urinary sodium and left atrial function and left atrioventricular coupling index.

Results:
It was found that the average age of the participants was 55.70 ± 11.30 years old, with 58% of the participants being male and 47.5% experiencing hypertension. The mean urinary sodium value was 172.01 ± 80.24mmol/24 hours, and the average body mass index was 25.46 ± 3.78 kg/m2. After adjusting for age, gender, history of diabetes, smoking status, alcohol consumption, and use of diuretics, 24-hour urinary sodium was correlated with multiple ambulatory blood pressure parameters, especially with nighttime diastolic blood pressure. Left atrial structure and function (left atrial reservoir function and left atrial conduit function) and left atrioventricular coupling index were correlated (P < 0.05). Mediation analysis showed that BMI explained 16% of the indirect effect of 24-hour urinary sodium and left atrial function (left atrial reservoir function and left atrial conduit function), and 30% of the indirect effect of LACI. Independent of the mediator, 24-hour urinary sodium had a significant direct effect on left atrial reservoir function, left atrial conduit function, and left atrioventricular coupling.

Conclusions:
Higher 24-hour urinary sodium was associated with a greater BMI as well as poor left atrial function and left atrioventricular coupling, and the BMI mediated the relationship between 24-hour urinary sodium and subclinical left cardiac function, and, more importantly, 24-hour urinary sodium may directly affect the left atrial function and left atrioventricular coupling independent of intermediary factors.
PS-C36-2: COMPARATIVE STUDIES OF DRUG-DRUG INTERACTIONS AMONG HYPERTENSIVE PATIENTS AT DIFFERENT PRIVATE CLINICAL SETUPS OF HYDERABAD, PAKISTAN
Authors: Arain Mudassar Iqbal , Fricovsky Eduardo 
Published: January 2023

Objective:
To Evaluate the degree of drug-drug interactions and their comparison among known hypertensive patients in government hospital and charitable hospital.

Methodology:
This study involved the assessment of 1500 patients prescription selected by random sampling technique from the OPDs of 02 different private clinical setups of Hyderabad, Sindh, Pakistan. Patients prescription was evaluated for drug-drug interactions using drug interaction software, Lexi-comp Lexi-Interact, Drug Information website, Hansten and Horn drug interactions: Analysis and Management.

Results:
Randomly collected samples have been arranged according to their flow in private clinical setups i.e 663 and 837 were collected from government and charitable setups respectively. While on gender wise 62% were male and 38% of female in charitable, 59% and 41% were of male and female respectively in government setup. Out of 1500 Prescriptions, 645 (43%) prescriptions having different degree of interactions. Furthermore, 44% of total interactions were found in government setup that was more than charitable setup i.e 42%. Out of 44%, 61% of interactions were belong to moderate type of interactions, which is less as compared to charitable setup i.e 64%. Mostly 37 cases b/w Diuretics with Laxatives, Antidiabetic, NSAIDS and Antihistamines in government setups in a total of moderate interactions, while 55 cases of interaction b/w ACEIs with NSAIDS, Antihistamines, Antidiabetic and vasodilators in a total of moderate interactions in charitable setups.

Conclusion:
It was clearly stated that drug-drug interactions may leads to morbidities and treatment failures that may leads to unnecessary economic burden on the patients. A proper vigilance system should be established in clinical setups of government and charitable hospitals to sort out the problem. A series of training session will be started to cope up the situation.
PS-C36-7: FACTORS ASSOCIATED WITH NONACHIEVEMENT OF TARGET BLOOD PRESSURE IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON ANTITHROMBOTIC THERAPY
Authors: Odaguchi Naoyuki , Sakima Atsushi , Shimoji Yoko , Sunakawa Haruna , Yonamine Reina , Yamada Iori , Uezato Madoka , Uehara Masaki , Kinjo Kazushi 
Published: January 2023

Background:
Patients with chronic kidney disease (CKD) can become at risk for thromboembolism and bleeding such as hemorrhagic stroke. The Japanese Society of Hypertension Guidelines for the Management of Hypertension 2019 (JSH2019) recommend that blood pressure (BP) should be cautiously controlled in patients on antithrombotic therapy, with a target value of < 130/80 mmHg to prevent hemorrhagic complications during antithrombotic therapy.

Objective:
The current study aimed to investigate the achievement rate of target BP, and factors associated with nonachievement of target BP in patients with CKD on antithrombotic therapy.

Methods:
This cross-sectional study was conducted at an outpatient clinic in 2018. Of 2,427 outpatients who received antithrombotic therapy, patients without CKD, those with CKD stage 5 or on hemodialysis, and those with missing data on body mass index, urinalysis results, and estimated glomerular filtration rate were excluded from the study. Finally, 786 outpatients met the inclusion criteria. Clinical parameters were obtained from the center's electronic database. The office BP value was classified according to the JSH2019 guidelines. The target office BP was set at < 130/80 mmHg in patients with CKD on antithrombotic therapy. The odds ratio (OR) for nonachievement of target BP was calculated via multivariable logistic regression analyses.

Results:
The majority of patients were on antihypertensive therapy. Calcium channel blockers were the most frequently prescribed drugs, followed by angiotensin II receptor blockers and then diuretics. Acetylsalicylic acid was the most commonly prescribed antithrombotic agent, followed by P2Y12 receptor inhibitors and warfarin. The distribution of BP in this population is 16.2%, 14.1%, 29.1%, 29.5%, 10.1%, and 1.0% had normal BP, high-normal BP, elevated BP, grade I hypertension, grade II hypertension, and grade III hypertension, respectively. Approximately 30% achieved the target BP of < 130/80 mmHg. Multivariable logistic regression analyses indicated that obesity (OR = 1.849, P < 0.001) and proteinuria (OR = 1.846, P < 0.001) were significantly correlated with nonachievement of target BP. Moreover, heart failure and cerebrovascular disease were negatively associated with the nonachievement of target BP.

Conclusions:
Only a small proportion of patients with CKD on antithrombotic therapy achieved the target BP. Obesity and proteinuria were associated with nonachievement of the target BP in patients with CKD on antithrombotic therapy.
PS-C36-10: HYPERTENSION KNOWLEDGE AND MAGNITUDE OF NON-ADHERENCE TO ANTIHYPERTENSIVE TREATMENT IN YOUNG ADULTS AGED 18–39 YEARS IN GABORONE, BOTSWANA
Authors: Maoto Jakoba Jacob , Mbenge Chidzani , Dipebe Tears , Lehelepa Meshack , Mhlanga Niketiwe , Zongwa Tefo , Masupe Tiny 
Published: January 2023

Objective:
We sought to determine hypertension knowledge and magnitude of non-adherence to treatment among hypertension patients aged 18–39 years attending selected clinics in Gaborone, Botswana.

Design and Methods:
This was a cross sectional survey across five high volume primary care clinics among young adults conducted between March and April 2021. Stratified sampling was used to estimate sample size per clinic followed by systematic random sampling to select participants and an adapted questionnaire plus Morisky 8-Item Medication Adherence checklist were used to measure non-adherence.

Results:
135 participants enrolled in the study with mean and median ages of 27, majority 90 (66.7%) being female. 15 (11.1%) were smokers while 57 (42.2%) consumed alcohol. Most common comorbidities were asthma 14(10.4%) and HIV/AIDS 9(6.7%).
100% participants had been told they have hypertension. 68 (50.4%) correctly stated that hypertension means increased blood pressure, 73 (54.0%) thought hypertension is curable and 8 (5.93%) thought there is no danger in not taking antihypertensives.
69/135 (51.2%) were on antihypertensives with almost half, 49.3%, of those being on treatment for more than 12 months. Only 43/69 (62.3%) knew their medication by name. Main reasons of not being on medication was: 22/66 (33.3%) did not want lifelong medication and 12/66 (18.2%) feared of side effects.
Pre- treatment adherence counselling was received by 78 (58%) while post-treatment counselling was received twice or more by 59 (43.7%). 35 (25.9%) missed some clinical appointments - reasons being feeling better 18 (31.6%), followed by depression/lack of interest 14 (24.6%). Very few, 11 (19.3%) forgot appointments. Majority of total participants, 75 (81.5%), experienced some side effects after medication mainly nausea 44 (58.7%), headaches 43 (55.1%), dizziness 24 (30.8%) and depression 16(20.5%).
On the Morisky questionnaire for those currently on antihypertensives: 27/69 (39.1%) admitted to sometimes forgetting to take medication. 49/69 (71.0%) sometimes stopped medication without doctor's consultation as they felt worse. A similar number, 68.1%, sometimes stopped medication when feeling better and 28/69 (40.5%) reported that it was a hassle to take medication. A few 5/69 (7.7%) forgot to take medication the day before the consultation.

Conclusion:
Most participants had limited knowledge of hypertension and were not adherent to medication. Reasons for non-adherence were predominantly related to side effects and feeling better. A significant proportion stopped medications without consultation with a healthcare worker. These results highlight the need to enhance hypertension awareness and continuous adherence counselling in young people to curb hypertension related complications.