bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHANGES IN THE NORMAL BP PROFILE IN A PATIENT WITH HYPERTENSION DURING THE WAR IN UKRAINE
Authors: Torbas Olena , Progonov Serhii , Sirenko Yuriy 
Published: June 2023

Objective:
To assess the influence of various external factors and stress due to a large-scale military invasion on the daily blood pressure (BP) profile in the population of patients with arterial hypertension (AH) in Ukraine.

Design and method:
This was a retrospective analysis of examined patients who underwent ABPM in the last 5 years. We conditionally divided the observation period into several time intervals: the ‘War’ group, the ‘Before the war’ group, the ‘Covid-19’ group, and the ‘Peace’ group, in which each of the 20 patients was selected by the method of random numbers. All patients underwent ABPM using the Watch BP 03 device (Microlife AG, Switzerland). The database was formed, and statistical analysis of the results was carried out using the IBM SPSS 26.0 software package.

Results:
All groups were comparable according to the age, gender, average daily BP, and heart rate parameters of participants. Patients of all groups were middle-aged, the number of men and women was equal in all groups, and groups were comparable according to the results of average daily SBP, DBP, PBP, and heart rate. We found that the ‘War’ group had a significantly lower percentage of SBP and DBP decrease at night compared to all other groups (7.6 ± 1.3% for SBP and 10.2 ± 1.4% for DBP). The standard deviation of SBP and DBP was significantly higher in the ‘Before the war’ group (19.8 ± 1.1 and 14.2 ± 0.7, respectively) compared to the ‘War’ group (16.0 ± 0.9 and 11 .7 ± 0.6, respectively) and ‘Covid-19’ (16.2 ± 0.7 and 11.8 ± 0.7, respectively). The highest frequency of non-dippers for SBP and DBP was observed in the ‘War’ group (60% and 45% respectively).

Conclusions:
During the war, the reduction of SBP and DBP at night in patients with hypertension was significantly lower than in the ‘Before the war’, ‘Covid’, and ‘Peace’ groups. There was also a higher number of non-dippers during the war in Ukraine.
VISIT-TO-VISIT 24 HOUR BLOOD PRESSURE VARIABILITY VS OFFICE BLOOD PRESSURE VARIABILITY UNDER ANTIHYPERTENSIVE DRUG TREATMENT
Authors: Trevano Fosca Quarti , Facchetti Rita , Dell’Oro Raffaella , Cuspidi Cesare , Grassi Guido , Mancia Giuseppe 
Published: June 2023

Objective:
In any treated hypertensive patient office blood pressure (BP) values differ between visits and this variability (V) has an adverse prognostic impact. Almost no information is available on visit-to-visit 24-hour(h) BPV and the consistency of its therapeutic control.

Design and method:
In 1114 differently treated hypertensive patients of the ELSA and PHYLLIS trials we calculated 24-h BPV by the coefficient of variation of the mean BP from yearly measurements during a 3-4 year treatment period. Calculation was also made of yearly variation of the percentage of patients achieving 24-h BP control (<130/80mmHg). Calculations were extended to day and night BP. Data were compared with office visit-to visit BPV and yearly office BP control (<140/90mmHg) and variations .

Results:
Visit-to-visit 24-h BPV was 20% to 30% less than office BP variability, similarly for systolic and diastolic BP and consistently for different demographic, clinical and treatment conditions. BPV was considerably greater for the night than for the daytime (%, p < 0.01) . Yearly 24-h BP control was considerably less frequent and variable than yearly office BP control and was considerably than daytime BP control. In the whole study and subgroups there was a linear correlation between office and 24-h but the correlation coefficients were never >0.20, indicating that office BPV does not precisely correspond to it is impossible to precisely predict 24-h BPV from office in individual patients.

Conclusions:
24-h BPV across visits is noticeably more stable than across visit office BPV, although with a greater variability of night BP. The correlation between office and 24-h BPV is significant but the low correlation coefficient makes office BPV hardly predictive of the 24-h BP stability across visits.
SHORT TERM 24HOUR VARIABILITY OF BOTH BRACHIAL AND AORTIC BLOOD PRESSURE IS INCREASED IN PATIENTS WITH IMMUNE-MEDIATED INFLAMMATORY DISEASE
Authors: Anyfanti Panagiota , Triantafyllou Areti , Margouta Anastasia , Malliora Anastasia , Lazaridis Antonios , Chionidou Agapi , Theocharis Konstantinos , Lazaridou Elissavet , Patsatzi Aikaterini , Gkaliagkousi Eugenia 
Published: June 2023

Objective:
Short term 24hour brachial blood pressure (BP) variability (24hbBPV) has emerged as an indicator of hypertension-mediated organ damage (HMOD) and a predictor of cardiovascular disease (CVD) events in highrisk populations. At the same time, the clinical significance of short term central BPV (24hcBPV) remains under investigation. To our knowledge, no study so far has assessed 24hbBPV and 24hcBPV in patients with psoriasis, who are characterized by subclinical chronic inflammation and increased CVD risk.

Design and method:
Patients with psoriasis and non-psoriasis individuals were recruited in the absence of diabetes and established CVD. 24h ambulatory BP was measured with the Mobil-O-Graph device. Both 24hbBPV and 24hcBPV during the whole 24h and the respective daytime and nighttime periods were extracted from the relevant ambulatory BP profiles. More specifically, in-house software was applied for the automated calculation of brachial and central average real variability (bARV/cARV) of systolic/diastolic BP (SBP/DBP), and the weighted standard deviation (wSD) of 24h SBP as a classic BPV index, using raw ambulatory BP monitoring data.

Results:
A total of 114 participants were studied (mean age 49.7 ± 12.1years; 39.5% females; 21.9% hypertensives). Patients with psoriasis (n = 74) did not significantly differ compared to controls (n = 40) in terms of age, sex, office BP, hypertension prevalence, and body mass index. Comparison of brachial and central 24hBP measurements showed lower 24h and nighttime brachial and central DBP in the psoriasis group compared to controls, but similar SBP values in the respective periods (Table 1a). By contrast, both bARV and cARV of 24h and daytime SBP, as well as bARV and cARV of 24h and daytime DBP, were significantly elevated in psoriasis patients (Table 1b).

Conclusions:
This is the first study reporting increased 24h BPV of both brachial and central SBP/DBP in patients with psoriasis. Whether 24hbBPV and 24hcBPV may be used as a subtle marker of preclinical HMOD warrants further investigation in patients with chronic immune-mediated inflammation.
COMPARISON OF EFFECTS OF BLOOD PRESSURE, BLOOD GLUCOSE AND LIPID VARIABILITY ON CARDIOVASCULAR PROGNOSIS IN DIABETIC PATIENTS
Authors: Joo Hyung Joon , Chung Se Hwa , Kim Yong Hyun , Kim Eung Ju 
Published: June 2023

Objective:
Metabolic abnormalities such as dyslipidemia, glucose and high blood pressure are common in diabetic patients. Variabilities in these measures have been reported as a potential residual cardiovascular risk factors. This study aimed to analyze the relationship between variabilities of blood pressure, blood glucose, total cholesterol and triglyceride levels (metabolic variability parameters) and their effects on cardiovascular prognosis in diabetic patients.

Design and method:
A total of 22,310 diabetic patients aged 40 years or older who had their blood pressure, blood glucose, total cholesterol, and triglyceride levels measured three or more times for three years after January 1, 2017 at three tertiary general hospitals were selected. They were divided into high/low groups based on their systolic blood pressure (SBP), blood glucose, total cholesterol (TC) and triglyceride coefficient of variation (CV) over a 3-year period. The incidence of major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, and stroke, was compared between groups, and significant risk factors for MACE were estimated by multivariable Cox regression analysis.

Results:
The number of measurements for 3 years was 15.1 times for SBP, 7.8 times for TC, 6.9 times for triglyceride, and 8.6 times for glucose. The correlation between the CV of SBP and the CV of glucose was highest, and the correlation between the CV of SBP and the CV of triglycerides was the lowest. All groups with high CV had a higher incidence of MACE than those with low CV (2.5% vs 6.0% for SBP CV groups, 3.0% vs 5.5% for TC CV groups, 3.8% vs 4.7% for triglyceride CV groups, 2.7% vs 5.8% for glucose CV groups). Multivariable Cox regression analysis suggested male, creatinine, prior myocardial infarction, SCORE2, SBP CV, TC CV, mean TC, and mean triglyceride as independent risk predictors for MACE in diabetic patients (HR 1.087 (95% CI 1.068 – 1.107) for SBP CV, 1.023 (1.016 – 1.031) for TC CV).

Conclusions:
Metabolic variability parameters, especially SBP CV and TC CV are important residual risk factors for cardiovascular events in diabetic patients.
WHITE COAT EFFECT DURING BLOOD PRESSURE SELF SCREENING: PREVALENCE AND DETERMINANTS IN THE FRENCH HYPERTENSION OBSERVATORY
Authors: Girerd Xavier , Buyer Paul De , Boualit Robert , Pathak Atul , Asmar Roland , Lopez-Sublet Marilucy 
Published: June 2023

Objective:
To evaluate the frequency and determinants of the white coat effect in subjects performing a standardized self monitoring of blood pressure.

Design and method:
The French Hypertension Observatory is a non profit initiative set up by the Hypertension French Research Fundation to evaluate the cardiovascular risk of employees working in companies in France. During ‘prevention days’ organized in the company's premises between 9:00 a.m. and 5:00 p.m., volunteer employees performed a self-test of their blood pressure using a validated automatic blood pressure monitor with arm cuff. Self unattended BP measurements were performed with 3 measures 1 minute apart. 4012 subjects were included. The difference between SBP 1 and 3 measurements were considered to define the white coat effect (WCE).

Results:
The prevalences of WCE (for at least 10 or 20 mmHg of WCE) when first measure indicates 140 for SBP are detailed in the table.

Conclusions:
The white coat effect is also observed in subjects who measure their blood pressure unattended. During a blood pressure self-screening testing, subjects aged less than 35 years, those with a BMI < 20 or female participants more frequently present a white coat effect than other subjects.
IMPACT OF SEASONAL BLOOD PRESSURE CHANGES ON VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY
Authors: Dell’Oro Raffaella , Schumacher Helmut , Böhm Michael , Grassi Guido , Koon Teo K. , Mahfoud Felix , Parati Gianfranco , Redon Josep , Yusuf Salim , Mancia Giuseppe 
Published: June 2023

Objective:
Visit-to-visit blood pressure (BP) variability (V) associates with an increased risk of cardiovascular events. Limited information is available, however, on the factors responsible for this phenomenon. We investigated the role of seasonal BP modifications on the magnitude of BPV and its impact on cardiovascular risk.

Design and method:
In 28365 patients included in the ONTARGET and TRANSCEND trials the on-treatment systolic (S) BP values were grouped according to the month in which they were obtained. SBP differences between winter and summer months were calculated for each BPV quintile (Q), quantified by the coefficient of variation (CV) of between-visits mean SBP. The differences in the risk of morbid and fatal cardiovascular events between Qs were assessed by the Cox regression model.

Results:
SBP was 4 mmHg lower in summer than in winter regardless of sex, age, diabetes, baseline SBP and achieved SBP of the patients. Winter/summer SBP differences contributed significantly to each SBP-CV and the contribution increased progressively from Q1 to 5. Increase of SBP-CV from Q1 to Q5 was associated with a progressive increase in the adjusted hazard ratio of the primary endpoint of the trials, i.e.morbid and fatal cardiovascular events (Q5 vs Q1: 1.51, 95% CI 1.36 - 1.67). A similar trend was observed for secondary endpoints. This was also the case after subtraction of the SBP seasonality.

Conclusions:
Winter/summer SBP differences significantly contribute to visit-to-visit SBP variability and more so as variability becomes greater. This contribution, however, does not explain the adverse prognostic significance of visit-to-visit BP variations.
ASSOCIATION BETWEEN NOCTURNAL VARIATION IN BLOOD PRESSURE AND RISK OF ACUTE ISCHEMIC STROKE: A SYSTEMATIC REVIEW
Authors: Ztriva Eleftheria , Daios Stylianos , Kachtsidis Vasileios , Dimas Grigorios , Toumpouras Theodoros , Andronoglou Markos , Kakaletsis Nikolaos , Kanellos Ilias , Polychronopoulos Georgios , Kaiafa Georgia , Tegos Thomas , Savopoulos Christos 
Published: June 2023

Objective:
Blood pressure (BP) is a dynamic parameter characterized by fluctuations during the 24-hour period. Variability of BP has been associated with cardiovascular risk and the occurrence of acute ischemic stroke (AIS). Circadian variation in BP during the night shows some basic patterns. The purpose of this study is to to correlate deviations from baseline patterns of circadian BP variation with the risk of AIS to select the optimal therapeutic intervention.

Design and method:
To complete our study, we systematically reviewed the literature from 1990-2022 through electronic medical databases (MEDLINE, Scopus and Cochrane).

Results:
During the nighttime hours, BP drops 10 - 20% in normotensive and untreated hypertensive patients - a dipping phenomenon, followed by a rapid and gradual increase during waking hours. In the studies being reviewed, patients were classified according to the rate of fall in systolic BP during 24-hour recording into four categories: the extreme-dippers drop >20%, dippers drop >10% and <20%, non-dippers drop <10% and >0%, and reverse-dippers or risers drop <0%. Deviating from standard dipping patterns is associated with an increased risk of AIS and highlights the value of chronotherapy, whereas no significant difference is observed in stroke prognosis. The extreme-dipping phenomenon is associated with the occurrence of ischemic stroke (IS), either due to under-treatment or due to subsequent morning hypertensive spike, whereas aggressive antihypertensive treatment seems to be significantly responsible. Interestingly, the occurrence of microbleeds in IS territory has been strongly associated with the reverse-dipping pattern.

Conclusions:
Overnight BP variation is an independent and robust predictor of cardiovascular risk, including AIS. Nocturnal BP may constitute a therapeutic target for the prevention of AIS. However, the available data on the effect of antihypertensive drugs and the implementation of chronotherapy with pre-sleep medication are conflicting in terms of improving cardiovascular risk. Therefore, at present, current guidelines for the treatment of BP do not recommend the aforementioned therapeutic approach as the best treatment in day-to-day clinical practice. More extensive and targeted studies are needed in the future to confirm the potential benefits of the application of chronotherapy in the prevention of AIS.
VARIATIONS IN THE PERCEPTION OF BITTER TASTE MAY MODULATE THE RISK OF HYPERTENSION
Authors: Oliveira Alda Pereira da Silva , Costa Marta , Santos Carolina , Ferreira Joana , Barbosa Paula , Mascarenhas Mário , Bicho Manuel 
Published: June 2023

Objective:
The perception of bitter taste conditioned by the TAS2R38 gene (combined Proline/Alanine/Valine and Isoleucine phenotypes) may be associated with food consumption. Individuals with one copy of PAV are bitter tasters, with two copies of AVI are non-bitter tasters, and with AAV < AAI < PAI are intermediate bitter tasters. Consumption salt balance is determined by the function of the epithelial sodium channels that lead to its preference and the bitter taste receptors associated with its aversion. In turn, a chronic high salt intake was associated with the inhibition of bitter receptors with less salty taste aversion leading to potential higher consumption and risk of hypertension. The objective was to evaluate the influence of bitter taste perception on the risk of arterial hypertension.

Design and method:
DNA from 339 individuals was quantified and genotyped by reverse transcription followed by polymerase chain reaction (RT-PCR). Blood pressure was determined by standard methods. Arterial hypertension was diagnosed in 141 individuals who were compared with 198 normotensive individuals. Thyroid functional status is determined by clinical history, physical examination, FT4, FT3, TSH, antiperoxidase, antithyroglobulin, and TRAB antibodies. Hypothyroidism at 33.3%, hyperthyroidism 14.3% and euthyroidism 52.35%. Statistics: chi2 and t-Student, considering significance <0.05.

Results:
The frequencies of the TAS2R38 diplotypes were: PVI/PVI (26%); PVV/PVI (0.9%); PVV/AVI(10.6%); PVV/AVV(0.9%); AVV/AVV(2.4%); PAI/PVI(0.3%); PAV/PVI(5.95%); PAV/AVI(37.5%); AAV/AAV(12.7%); PAV/AAV(2.75%) and PAV/AAI(0.3%). The TAS2R38 AAV/AAV and PAV/AAV diplotypes showed a lower risk of hypertension adjusted for thyroid dysfunction, compared to the remaining diplotypes of this gene, with OR = 0.458[0.236-0.887], p = 0.021. Other diplotypes showed no significant association.

Conclusions:
Individuals with bitter tasting associated with AAV genotypes may be less likely to develop hypertension compared to other bitter tasters. The lower risk of hypertension in these genotypes may be associated with greater functionality of bitter taste receptors associated with aversion to salt intake. In conclusion, the genetic polymorphisms of the bitter taste gene may influence the risk for arterial hypertension and may therefore be considered potential future therapeutic targets. The absence of bitter-insensitive individuals (AVI/AVI) in this sample limits the understanding of the influence of these genotypes on the risk of hypertension.
OVERWEIGHT OR OBESITY DOES NOT CARRY AN INCREASED RISK OF ADVERSE OUTCOME IN YOUNG TO MIDDLE AGE PEOPLE WITHOUT METABOLIC ABNORMALITIES
Authors: Palatini Paolo , Saladini Francesca , Mos Lucio , Fania Claudio , Battista Francesca , Ermolao Andrea , Garavelli Guido , Rattazzi Marcello 
Published: June 2023

Objective:
Overweight or obesity (OvOb) is a risk factor for the development of cardiometabolic complications. However, according to some investigators, OvOb developed without hypertension and insulin resistance may be considered as a benign phenotype. The aim of the present study was to investigate the prognostic significance of OvOb (BMI> = 25 kg/m2) without concomitant metabolic abnormalities in young-to-middle-age subjects screened for stage 1 hypertension.

Design and method:
We examined 1208, 18-to-45-year-old participants from the HARVEST study. Mean age was 33.1 ± 8.6 years and BP 145.5 ± 10.6/93.5 ± 5.7 mmHg. Participants were classified into four groups according to whether they had OvOb or not (0/1) and had normal (group 0) or at least one abnormal (group 1) metabolic syndrome parameter (glucose, triglyceride, HDL-cholesterol, and average 24-hour BP). The predictive role of OvOb/metabolic group for incident hypertension and cardiovascular or renal events (MACE) was evaluated in Cox survival analyses, adjusting for other risk factors and several confounders.

Results:
ObOv was present in 51.1% of the participants and at least one metabolic abnormality was present in 74.5%. Among the subjects with OvOb, 20.2% had no metabolic abnormalities, 40.5% had one metabolic abnormality, and 39.3% had two or more metabolic abnormalities. During a median follow-up of 17.4 years, 80.6% of the participants developed hypertension requiring pharmacological treatment and 8.9% had a MACE. In adjusted Cox models, OvOb participants with at least one metabolic abnormality had an increased risk of incident hypertension (HR, 1.43; 95%CI,1.12 - 1.81, p = 0.003) and MACE (2.34,1.03 - 5.36, p = 0.043) compared to those with normal metabolic parameters. Among the participants with normal BMI, a similar metabolic-related increase in risk was found for the hypertension outcome (HR, 1.52;95%CI,1.21 - 1.92, p = 0.0003), but not for MACE (1.64,0.70 - 3.81, p = 0.25). In a Cox model in the whole population, when controlled for each other the metabolic group (0/1) was a predictor of hypertension (p < 0.0001) and MACE (p = 0.028) whereas the ObOv group was not (p>0.05).

Conclusions:
These data show that in young-to-middle-age people, an abnormal metabolic profile is an important predictor of future hypertension needing treatment and MACE. OvOb without metabolic abnormalities does not carry an increased risk of adverse outcomes.
URIC ACID RELATIONSHIPS WITH LIPID PROFILE AND ADIPOSITY INDICES: IMPACT OF DIFFERENT HYPERURICEMIC TRESHOLDS
Authors: Maloberti Alessandro , Vanoli Jennifer , Finotto Alessandra , Bombelli Michele , Facchetti Rita , Redon Pau , Mancia Giuseppe , Grassi Guido 
Published: June 2023

Objective:
Previous studies focused on the relationships between Serum Uric Acid (SUA) and lipids have found an association mainly with triglycerides. Furthermore, previous studies on adiposity indices have been focused on the evaluation of the Visceral Adiposity Index (VAI). The present study was aimed at providing within the same population a systematic evaluation of lipids and adiposity indices with SUA, employing both the classic cutoff for hyperuricemia and the newly one identified by the Uric Acid Right for Heart Health (URRAH) study.

Design and method:
We analyzed data collected in 1892 subjects of the Pressioni Arteriose Monitorate E loro Associazioni (PAMELA) study with available SUA, lipid profile and variables necessary to calculate VAI, Cardio-Metabolic Index (CMI) and Lipid Accumulation Product (LAP).

Results:
At linear regression model (corrected for confounders) SUA correlated with all the lipids values (with the strongest for triglycerides) and adiposity indices. When the two different cutoffs were compared, the URRAH one was significantly related to atherogenic lipids profile (OR 1.207 for LDL and 1.33 for non-HDL, P < 0.001) while this was not the case for the classic one. Regarding adiposity indices the classic cutoff displays highest OR as compared to the URRAH one.

Conclusions:
Newly reported URRAH cutoff for hyperuricemia better relate to atherogenic lipoprotein (LDL and non-HDL) when compared to the classic one. The opposite has been found for adiposity indexes where the classic cut-off seems to present highest performance. Among adiposity indexes, LAP present the highest OR for the relationship with hyperuricemia.