bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-P07-3: EFFICACY AND SAFETY OF NIFEDIPINE GASTROINTESTINAL THERAPEUTIC SYSTEM VERSUS RAMIPRIL IN CHINESE AND EUROPEAN PATIENTS WITH HYPERTENSION
Authors: Zhang Wei , Liu Changyuan , Grzegorz Bilo , Soranna Davide , Zamabon Antonella , Kyriakoulis Konstantinos , Kollias Anastasios , Ceravolo Isabella , Cassago Silvia , Pengo Martino , Stergiou George , Parati Gianfranco , Wang Jiguang 
Published: January 2023

Objective:
In a post-hoc analysis of a multinational, randomized trial, we investigated whether the efficacy and safety of nifedipine gastrointestinal therapeutic system (GITS) and ramipril differed between Chinese and European patients with hypertension.

Method:
Previously treated (2-week washout) and untreated patients with hypertension were randomly assigned to treatment with nifedipine GITS 30 mg or ramipril 10 mg for 12 months, if they had elevated clinic (≧ 140/90 mmHg) and daytime (≧ 135/85 mmHg) ambulatory systolic/diastolic blood pressure (BP) and standard deviation of home (> 7 mmHg) and daytime systolic BP (> 12 mmHg). BP was measured at each of the clinic visits at baseline and during follow-up. Ambulatory and 7-day home BP monitoring were performed at baseline and 10 weeks and 12 months of follow-up.

Results:
The 67 Chinese and 101 European patients significantly differed in age (50.9 vs. 54.6 years), body mass index (24.5 vs. 27.0 kg/m2), clinic diastolic BP (87.9 vs. 92.5 mmHg), clinic heart rate (75.0 vs. 70.8 beats/minute) and nighttime diastolic BP (79.3 vs. 75.9 mmHg). However, within each ethnicity, patients were comparable between the nifedipine GITS and ramipril groups (P≧ 0.05). In both Chinese and European patients, BP was similarly reduced in the nifedipine GITS and ramipril groups, except that daytime systolic/diastolic BP reductions were 7.4/4.1 mmHg greater in the ramipril than nifedipine GITS group in Chinese (P = 0.02). The safety profile significantly (P for drug*ethnicity interaction ≦ 0.046) differed between the Chinese and European patients for the incidence of all adverse events (lower on nifedipine GITS in Chinese), ankle edema (higher on nifedipine GITS in Europeans) and dry cough (higher on ramipril in Chinese).

Conclusion:
In the Chinese and European patients with hypertension, nifedipine GITS and ramipril had similar BP lowering efficacy, but different safety profile and tolerability.
PS-P07-9: USE OF INITIAL AND SUBSEQUENT ANTIHYPERTENSIVE COMBINATION TREATMENT IN THE CLINICAL PRACTICE. EVIDENCE FROM A POPULATION-BASED INVESTIGATION IN ITALY
Authors: Savare Laura , Rea Federico , Corrao Giovanni , Mancia Giuseppe 
Published: January 2023

Objective:
Hypertension guidelines issued in the last twenty years have consistently recommended use of a combination of two or more antihypertensive drugs to treat most hypertensive patients. Two-drug combinations have also been recommended as initial treatment. Aim of this study was to assess the use of antihypertensive combination treatment, both as the initial and as subsequent therapeutic step over a three-year treatment period, based on data from a large Italian population. Three temporal cohorts (2012, 2015, 2018) were identified to determine whether mono versus combination treatment strategies had changed over the years.

Design and method:
The residents of the Lombardy Region (Italy), aged > 40 years, who were newly treated with antihypertensive drugs during 2012, 2015 and 2018 were identified through the regional healthcare utilization database. The drug treatment strategy (monotherapy and combination of two, three and > 3 antihypertensive drugs) was assessed at treatment initiation, and after 6 months, 1, 2, and 3 years of treatment. Data were also analysed after stratification for demographic and clinical categories, i.e. sex, age, signs of cardiovascular disease, co-treatments, and clinical status.

Results:
About one-hundred thousand patients were identified for each cohort. About four out of ten patients were aged > 65 years, half of them were women, one in four patients was prescribed > 5 co-medications, and one in 6 patients had a poor clinical status. In the 2012 cohort, monotherapy was the most common initial treatment strategy (74%), followed by two-drug single-pill combination (17%), two-drug free combination (6%), and combination of > 3 drugs (3%). There were no significant differences between the 2012, 2015 and 2018 cohorts, and among strata of age, sex, clinical status, co-treatments, number of co-medications and evidence of cardiovascular disease.
Use of two and three or more antihypertensive drugs increased during follow-up and reached about 32% (two drugs) and 11% (> 2 drugs) of the patients after 3 years from treatment initiation. Among patients prescribed a two-drug combination, the single-pill was the most common approach, whereas the use of the three-drug single-pill combination was extremely rare. There were no substantial differences in the use of combination treatment between the three cohorts and the results were similar in all demographic and clinical categories.

Conclusions:
In a real-life setting, use of antihypertensive drug combinations is low at treatment initiation and inferior to use of monotherapy during chronic treatment Contrary to guidelines recommendations, antihypertensive combination treatment did not show any noticeable increase over the years.
PS-P08-7: HYPERTENSION AND ITS CORRELATES AMONG PREGNANT WOMEN CONSUMING TOBACCO IN INDIA: FINDINGS FROM THE NATIONAL FAMILY HEALTH SURVEY-4
Authors: Anand Tanu , Grover Shekhar , Kishore Jugal , Sinha Dhirendra N , Malhotra Sumit , Dhawan Priyanka , Goel Sonu 
Published: January 2023

Background:
Hypertension or high blood pressure during pregnancy has significant implications on maternal and perinatal morbidity and mortality. Tobacco use amplifies this burden and increases the risk of hypertensive disorders along with adverse birth outcomes. The current study aimed to evaluate the joint risk at the population level of tobacco use and hypertension among pregnant women in India.

Methodology:
Data of 32428 currently pregnant women aged 15 to 49 years were obtained from the National Family Health Survey NFHS4 to estimate bivariate i.e. tobacco user vs non-user and binomial logistic regression analysis in order to get odds ratios of having hypertension. The analysis included sociodemographic variables such as the respondents age, type of residence, wealth index, and education status.

Results:
The prevalence of hypertension among pregnant tobacco users 7.5% was significantly higher than that of non-users 6.1%. The odds of having hypertension were 1.17 95% CI 1.02 to 1.35 times among tobacco users than non-users and increased with age p less than 0.001 and in rural areas p 0.02. However, it varied inversely with education status p more than 0.05; NS and wealth quintile p 0.01.

Conclusion:
The present study identifies the higher co-existence of hypertension among tobacco-using pregnant women and highlights the need for tobacco control/cessation and hypertension prevention and management during pregnancy considering socio-demographic disparities.
PS-P09-10: ASSESSING THE RELATIONSHIP OF DIET QUALITY TO NUTRITIONAL STATUS AND BLOOD PRESSURE: IMPLEMENTATION OF THE DEVELOPED INDONESIA DIETARY INDEX
Authors: Faza Farah , Susetyowati Susetyowati 
Published: January 2023

Objective:
Indonesia faces a surge of metabolic diseases such as obesity, hypertension, and type 2 diabetes mellitus. The main factor that triggered the diseases is a lifestyle, which was primarily contributed by dietary patterns. Recently, the developed Indonesia dietary index (IDI) was developed to rapidly assess diet quality in adults. Therefore, we aim to evaluate the IDI towards nutritional status and blood pressure as health outcomes.

Design and method:
Cross sectional study was conducted from 2016 to 2018 and involved 350 healthy adults 19 to 64 years of age in urban and rural areas in a province in Indonesia. The urban represented the most populated area and the rural represented lowland and mountainous areas. The underweight and pregnant or breastfed women were excluded. Data collection included sociodemographic, body mass index (BMI), and blood pressure. A BMI of 25.00 kg/m2 and above was categorized as obese. A blood pressure of 120 to 139 mmHg (systolic) or 80 to 89 mmHg (diastolic) was classified as prehypertension. The data was collected by trained nutritionists as enumerators. Diet quality was assessed by the IDI, which consisted of 12 multiple choice questions about the food consumed in the previous day and week. The scoring category for IDI: less than 40 was poor, 40 to 59 was need improvement, and 60 and above was good. Logistic regression was run to determine the factors that influenced prehypertension.

Results:
Subjects were dominated by females (56%). The prevalence of overweight and obesity was 62.9% and prehypertension was 69.1%. Based on the IDI, most adults had poor diet quality (50.6%), followed by a need for improvement (48%) and good diet quality (1.4%). Poor diet quality tended to increase the risk of overweight and obesity (PR unadjusted = 1.8, p = 0.06, 95%CI 0.9 to 7.5) yet not with blood pressure, even after being adjusted with covariates (gender, age, dwelling area, and smoking habit). The IDI scores were not significantly lower in the overweight and obese adults than in normal (36.8 vs. 38.3, p = 0.216) yet no difference in prehypertension adults than in normal (37.7 vs. 37.9, p = 0.835).

Conclusion:
Even though diet quality was not associated with BMI and blood pressure, overweight and obese adults had lower IDI scores than normal. Evaluating diet quality among Indonesian is quite challenging relating to various food and dishes consumed by people. Regardless of the insignificant findings, body weight and blood pressure should be managed by encouraging adults to improve their diet quality according to a healthy balanced diet.
PS-R03-3: INTERMITTENTLY SCANNED CONTINUOUS GLUCOSE MONITORING IN A DIFFICULT PATIENT WITH GESTATIONAL DIABETES MELLITUS AND SUBCLINICAL CUSHING'S SYNDROME: A CASE REPORT
Authors: Iwahara Akihide , Sugiyama Kazutoshi , Tsuchiya Tami , Itoh Arata , Nakajima Yuya , Saisho Yoshifumi , Kinouchi Kenichiro , Kobayashi Sakiko , Miyashita Kazutoshi , Irie Junichiro , Meguro Shu , Ikenoue Satoru , Tanaka Mamoru , Itoh Hiroshi 
Published: January 2023

A 41-year-old woman was admitted to the obstetrics department because of epigastric pain, nausea, and fatigue at 31 weeks of gestation. She was suspected of subclinical Cushing's syndrome based on high plasma cortisol and low ACTH levels along with an incidentally discovered tumor in the left adrenal gland 4 years prior to conception. 3 months before admission, 75 g oral glucose tolerance test yielded one point positive (81–169–174 mg/dL) and diagnosis of gestational diabetes mellitus was made. Diet and exercise therapy was started on an outpatient basis. While blood glucose control had been favorable, she discontinued visits to outpatient clinics due to difficulty in physical activity.
At the time of admission, blood glucose level was running more than 200 mg/dl, and self-monitoring of blood glucose (SMBG) and insulin self-injection therapy were proposed for immediate blood glucose control accordingly. However, the patient had psychiatric symptoms that were presumably associated with delusional disorder and subclinical Cushing's syndrome. As such, she refused to implement both procedures on account of a strong fear against puncture, which caused blood glucose management difficult. Despite understanding the necessity of SMBG and potential risks to the fetus, the patient frequently expressed anxiety and could not perform SMBG. Given the difficult circumstance, intermittently scanned continuous glucose monitoring was installed to reduce invasive procedures. As a result, blood glucose levels were under good control with 0.43 U/kg of insulin per day until the delivery by cesarean section at 34 weeks of gestation. A healthy infant weighing 2442 g was delivered without complications.
Here we highlight utility and efficacy of intermittently scanned continuous glucose monitoring in a difficult patient with gestational diabetes mellitus and subclinical Cushing's syndrome.
PS-R05-4: PREVENTION OF HYPOTENSION DURING LDL-APHERESIS BY NAFAMOSTAT MESYLATE: A CASE REPORT
Authors: Fujii Kentaro , Suji Wataru , Kato Ai , Yoshifuji Ayumi , Komatasu Motoaki , Ryuzaki Munekazu 
Published: January 2023

Objectives:
The prevalence of peripheral artery disease (PAD) is high in hemodialysis patients and has a poor prognosis. More than 10,000 hemodialysis patients require lower-extremity amputation. LDL-apheresis has been initiated as a supportive treatment for patients with chronic limb-threatening ischemia (CLTI), especially in cases where revascularization by endovascular therapy (EVT) is not sufficiently effective. In 2021, a new adsorption-type blood purification device, Rheocana, that can selectively remove LDL-C and fibrinogen, was developed. In a clinical trial, 45.9% of the ulcers were healed using Rheocana. Since then, it has been widely used for dialysis patients with CLTI in Japan; however, hypotension during LDL-apheresis is still a major adverse event.

Design and Methods:
Case report.

Results:
An 83-year-old Japanese man presented with a right leg ulcer. He had started undergoing hemodialysis 3 years prior because of diabetic kidney disease. CLTI was recognized 6 months prior, and repeated EVT was ineffective and failed to improve the ulcer. His blood pressure was 129/71 mmHg and antihypertensive agents were not used. LDL-apheresis with Rheocana was initiated; however, his systolic blood pressure decreased to 60 mmHg, and LDL-apheresis was stopped immediately. After discontinuing LDL-apheresis, the his blood pressure recovered. Anticoagulants were changed from heparin to nafamostat mesylate, and LDL-apheresis was restarted. His blood pressure did not decrease after anticoagulation therapy, and his leg ulcer was successfully healed.

Conclusion:
During LDL-apheresis, factor VIII and kallikrein are activated when the plasma comes in contact with the negatively charged dextran surface, resulting in a decrease in blood pressure by promoting bradykinin production. And thus, in case of ACEI use is contraindicated. Nafamostat mesylate is thought to reduce bradykinin production by suppressing kallikrein. Blood pressure often decreases by approximately 30 mmHg when LDL-apheresis is started; however, nafamostat mesylate was dramatically effective in preventing decrease in blood pressure. Nafamostat mesylate should be used in patients with CLTI and low blood pressure.
PS-R05-5: A CASE OF SEPTIC PULMONARY EMBOLISM DUE TO MITRAL VALVE ENDOCARDITIS OCCURRING EARLY IN THE INDUCTION PHASE OF HEMODIALYSIS
Authors: Kishi Seiji , Nishimura Kenji , Kashihara Naoki , Nagai Kojiro 
Published: January 2023

A 66-year-old man with end-stage kidney disease (ESKD) due to chronic glomerulonephritis who was scheduled to start hemodialysis after surgery for radiocephalic arteriovenous fistula (AVF) was admitted to our hospital because of volume overload. He developed fever and cough after an upper endoscopy was performed on the 20th hospital day. Chest CT revealed an infiltrative shadow in the right lower lung and he was diagnosed with bacterial pneumonia and treated with sulbactam/ampicillin and azithromycin. Two sets of blood cultures were negative. There were no findings suggesting infection of the AVF. His fever persisted and repeated CT on day 37 showed multiple nodule shadows along the blood vessels in the left lower lobe. We suspected septic pulmonary embolism (SPE) and transthoracic/esophageal echocardiography showed a newly developed MV regurgitation (MVR (II/IV), with a 17 mm vegetation and partial perforation. Repeat physical examination revealed nontender, small erythematous (Janeway) lesions on the toes and a new holosystolic murmur at the apex (II/VI). (The patient said he had similar lesions on his hands but they had disappeared.) Due to the accumulation of Ga-67 citrate in the peri-oral area and the MV, caries and periodontal disease were thought to be the source of infection.
Infectious endocarditis (IE) was diagnosed based on modified Duke criteria. Ceftriaxone was added to cover gram-negative bacilli in the oral cavity, including HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella). Antibacterial treatment reduced the size of the vegetation and the MVR improved. Pulmonary nodules also disappeared. Dental treatment was performed after the vegetation had almost disappeared. Three additional sets of blood cultures were also negative. There have been few reports of SPE due to left sided IE. The onset of SPE in this case may have been caused by an embolus that formed in the MV and flowed into the right sided heart via an AVF, as emboli were also found in the peripheral extremities.
PS-B10-11: PATHOPHYSIOLOGICAL STUDY OF COGNITIVE FRAILTY USING A MOUSE MODEL OF ALZHEIMER'S DISEASE
Authors: Takeshita Hikari , Yamamoto Koichi , Takeda Shuko , Ito Yuki , Rakugi Hiromi 
Published: January 2023

Objective:
Hypertension is known to increase the risk of developing dementia including Alzheimer's disease (AD). The concept of cognitive frailty or motoric cognitive risk syndrome, representing a coexistence of physical and cognitive decline, has been attracting attention in the global aging society. However, the molecular mechanisms underlying the pathological interplay between these conditions remain largely unknown.

Methods:
We investigated the effects of AD pathogenesis on skeletal muscle by using APP23 mice, a mouse model of AD. Three-month-old male APP23 mice and wild-type mice from the same litter were evaluated for skeletal muscle function by grip strength, for cognitive function by passive avoidance and open field tests, and for glucose tolerance and 24-hour voluntary locomotion using a running wheel as factors related to both skeletal muscle function and cognitive function. After dissection, various organs, mainly skeletal muscle, were harvested and wet weight was evaluated.

Results:
Grip strength and some skeletal muscle weights of APP23 mice were lower than those of wild-type mice. The ipGTT was used to assess glucose tolerance, and the passive avoidance test and open field test were used to assess cognitive function, but there were no significant differences between genotypes. In the running wheel test, which measures voluntary locomotion, APP23 mice were significantly more active than wild-type mice suggesting that the muscle weakness in APP23 mice was not due to disuse.

Conclusions:
This study demonstrates that APP23 mice exhibit skeletal muscle deficits, including muscle weakness, along with cognitive dysfunction. In addition, APP23 mice showed behavioral abnormalities such as increased voluntary locomotion, which should contribute to increased skeletal muscle function, but skeletal muscle function was conversely decreased, suggesting that the effect of AD on skeletal muscle function is mediated by factors other than behavioral abnormalities due to cognitive dysfunction.
PS-B10-12: A NOVEL PLATFORM FOR A LARGE-VOLUME CSF COLLECTION IN THE FREE-BEHAVING MICE AS A PRECLINICAL MODEL FOR BIOMARKER DEVELOPMENT.
Authors: Nakajima Tsunoe , Takeda Shuko , Ito Yuki , Oyama Akane , Takami Yoichi , Takeya Yasushi , Yamamoto Koichi , Sugimoto Ken , Rakugi Hiromi , Morishita Ryuichi 
Published: January 2023

Objectives:
With the emergence of disease-modifying therapies for dementia including Alzheimers disease and vascular dementia, there is an urgent need for the development of better biomarkers detecting early stage of dementia and predicting rate of progression. Cerebrospinal fluid (CSF) provides close representation of pathophysiological changes occurring in the central nervous system, and CSF biomarkers have proven to be useful for the diagnosis and prognosis of dementia. Preclinical work using mouse models would be useful to explore novel CSF biomarkers; however, detailed characterization of CSF has been challenging due to the difficulty in collecting large amount of CSF from mice. Here, we developed a novel technique that allows consistent recovery of CSF in the awake, free-moving mouse.

Methods:
Three-month-old C57/B6 male mice were used in this study. A small incision was made on the dura mater over the cisterna magna and a collecting tube was placed and fixed on the surface of the dura mater that CSF can be drawn via the small hole. Roller pump was connected to the tubing and CSF was continually collected in awake mobile mice.

Results:
We were able to collect a large volume of CSF from an awake mouse over a few days. Brain tissue had no apparent damage after the long-term collection and no detectable level of blood contamination was found in the collected CSF. This technique allowed a serial measurement of CSF biomarkers in a high-temporal resolution and a continuous administration of compounds / drugs into the subarachnoid space of awake mice.

Conclusions:
This technique would provide the opportunity to identify novel CSF biomarkers using mouse models of dementia.
PS-B11-2: MODULATORY EFFECT OF PPAR-GAMMA BY ACETATE ON CARDIORENOMETABOLIC DISTURBANCE ASSOCIATED WITH HIGH FAT DIET-FED INSULIN-RESISTANT MALE WISTAR RATS
Authors: Olaniyi Kehinde Samuel , Amusa Oluwatobi Aminat , Ajadi Isaac Olatoye 
Published: January 2023

Objectives:
Insulin resistance (IR) and its comorbidities are critical pathogenic factors to cardiovascular disease (CVD) and chronic kidney disease (CKD). Cardiovascular disease and CKD are the leading cause of death and morbidity worldwide. Short chain fatty acids, particularly acetate has been demonstrated to elicit cardioprotective effects. Herein, we investigated its effects on IR-driven cardiorenal disorder and the possible involvement of peroxisome proliferator-activated receptor-gamma (PPAR-Gamma) in rats exposed to high fat diet (HFD).

Methods:
Ten-week-old male Wistar rats were assigned into three groups (n = 6/group): The groups received distilled water as vehicle (po), 40% HFD with or without 200 mg/kg sodium acetate (po) respectively. The treatments were carried out for 12 weeks.

Results:
HFD caused IR with impaired glucose tolerance and increased cardiac mass without altering the renal mass. Besides, HFD also increased cardiac/renal lipid indices and low-density lipoprotein, malondialdehyde, uric acid and gamma-glutamyl transferase as well as decreased glutathione, nitric oxide concentration and PPAR-Gamma. It also increased plasma urea, creatinine, troponin, and creatinine kinase and increased cardiac but not renal lactate and lactate dehydrogenase. Nevertheless, supplementation with acetate ameliorated theses alterations.

Conclusions:
The present results demonstrate cardiorenometabolic disturbance in HFD-induced IR and accompanied by deficiency in PPAR-Gamma. The results in addition suggest that acetate ameliorates cardiorenometabolic disturbance by increasing PPAR-Gamma and insulin sensitivity with attenuation of oxidative and pro-inflammation.