bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C36-4: ASSESSMENT OF AWARENESS TOWARDS PROPER MANAGEMENT FOR HYPERTENSIVE AND DIABETIC PATIENTS AT VARIOUS CLINICS OF HYDERABAD, SINDH, PAKISTAN
Authors: Arain Mudassar Iqbal , Shahnaz Saira 
Published: January 2023

Objective:
Diabetes is a metabolic disorder characterized by a collection of other associated organ impairment i.e. Retinopathy, Cardiomyopathy and Nephropathy. While hypertension termed as silent killer. However, the cases of diabetes rise on daily basis throughout the world. Moreover, it is predicted that by year 2025, diabetes will prevail throughout the globe by 75–80% population if better steps would not be taken to curb it. Similarly as per USP, therapy based proper counseling is very important in management of Diabetes. At the other hand, Pakistan among those countries, which includes a huge number of diabetic and hypertensive patients and the figure, increases day by day.

Design and method:
For the purpose of study, 300 patients enrolled via random sampling technique from various clinical settings of Hyderabad a city of Sindh, Pakistan. Similarly, the samples were further classified into two groups, i.e. controlled group and test group respectively. However, 50% of total collected sample was placed in each group. Similarly, most of the patients with DM-2 were belonged to urban areas i.e. 68%. Subsequently 42% patients were among the age range 40 to 49 years. However, the malignant patients with certain cancer or tumors were not a part of this study.

Result and Conclusion:
Based on various collected data it was concluded that most of the patients were unaware about proper management of this fatal disorders. Therefore, it is the keen responsibility of the healthcare providers to properly educate the patient with such lethal disorder regarding the life style modification and medication therapy concomitantly in order to curtail disorder-induced mortality.
PS-C36-9: A REVIEW OF THE PHARMACOKINETIC PROFILES OF THE 40 MOST COMMONLY PRESCRIBED CARDIOMETABOLIC MEDICATIONS
Authors: Salim Farah , Osman Hanad , Alghamdi Randah , Lane Dan , Bernieh Dennis , Jones Donald , Gupta Pankaj 
Published: January 2023

Objective:
To collate the pharmacokinetic (PK) parameters of the 40 most commonly prescribed cardiometabolic medications from published literature to provide a useful reference source for clinicians when interpreting results of chemical adherence testing.

Design and Methods:
Non-adherence to medication is a prime cause of treatment failure and costs the UK health system approximately £500 million annually. A recent meta-analysis on adherence to 7 cardiovascular drug classes revealed a non-adherence rate of 43%. Chemical adherence testing (CAT) by liquid chromatography tandem mass spectrometry (LC-MS/MS) is an objective method for testing patient adherence to medication and has been proven to be effective in managing disease progression. To improve result interpretation, factors including dose time, sample collection, and PK need to be better understood.
The list of the most commonly prescribed drugs was obtained using the NHS Prescription Cost Analysis 2020/2021. Data on the pharmacokinetic parameters was collected from original papers from the following sources:
Lexicomp: Medical Library
Goodmans & Gilmans: The pharmacological basis of therapeutics, 13th edition
Clarks analysis of drugs and poisons 4th edition
Martindale: The complete drug reference
All original manuscripts were reviewed, filtered and graded, following a robust criteria. The collected PK parameters focused on the bioavailability, volume of distribution, peak concentration, minimum plasma concentration, time to peak concentration, half-life, clearance and urine excretion.

Results:
A total of 3004 papers were initially screened for pharmacokinetic data, of which, 274 papers were relevant. These papers were further filtered, a total 84 papers adhered to the criteria for grading. Propranolol was one of the most prescribed cardiometabolic drugs with 6,124,180 prescriptions issued in the UK between 2020–2021. The half-life for Propranolol 80 mg (3.5 h), the peak time (1.5 h), the peak concentration (49 ± 8 ng/mL). Edoxaban was prescribed 1,584,638 times in the time period selected. Mean PK parameters for steady state levels of Edoxaban were: bioavailability (99.7%), urine excretion (44.7 ± 14.8%), clearance (535 ± 15.5 mL/min), volume of distribution (426 ± 30.7 L), half-life (9.2 ± 30.5 h), peak time (2 ± 1.03) and peak concentration (507 ± 17.3 ng/mL).

Conclusions:
This is one of the first studies to utilise a criteria for collecting and grading of PK parameters from published literature for common cardiometabolic medications. Medications have diverse pharmacokinetic profiles hence; systematic collection of these parameters will be a useful reference for clinicians when interpreting results of CAT for medication presence in patient samples.
PS-C36-12: PRESCRIPTION PATTERN OF ANTIHYPERTENSIVE MEDICATIONS, COMPLIANCE AND CONTROL OF BLOOD PRESSURE AMONG HYPERTENSIVE OUTPATIENTS AT TERTIARY CARDIAC HOSPITAL IN BANGLADESH
Authors: Ishraquzzaman Mir , Malik Fazila Tunnesa , Choudhury Sohel Reza , Mamun Abdullah al , Kalimuddin Md , Banik Dhiman , Ahmed Nazir , Badiuzzaman Mohammad , Dutta Ashok , Nesaruddin Mir , Haq Tawfiq Shahriar , Rahman Md Habibur 
Published: January 2023

Objectives:
Blood pressure control in hypertensive patients depends not only on antihypertensive medications but drug compliance and lifestyle changes. The aim of the study is to look at the commonly used antihypertensive drugs and patients adherence to drug and lifestyle modification and their blood pressure control.

Method:
This is a cross sectional descriptive study among known hypertensive patients visited at hypertension clinic at National Heart Foundation Hospital and Research institute. Data was collected and entered according to structured questionnaire in software. Then data was analyzed using SPSS 20.

Result:
A total number of 920 patients were included in this study. Male and female were almost equal, 468 (50.9%) and 452 (49.1%) respectively. Mean age was 49.1 + 12.33 (min. 14 years and max. 90 years). Body mass index (BMI) is 26.57(+3.97) with 21% has obesity. 19% of patients were current smokers (male to female, 14.89% to 5.1%) and 8.1% are smokeless tobacco users. 14% of patient consume extra salt in main meal. Among other risk factors diabetes mellitus was 5.86% (54 patients), dyslipidemia was 2.3% (in 21 patients) and family history was positive in 78 patients (8.5%), chronic kidney disease was noted in < 1%. Mean duration of hypertension was 5.44 (+5.29) years. Single drug was prescribed in 246 (26.7%) patients where ARB prescribed in 119 (12.9%) patients followed by betablocker in 60 (6.5%) and CCB in 38 (4.1%) patients. ARB and CCB were used most (78 patients, 8.5%) as combination of dual drug (or single pill combination), followed by betablocker and CCB combination in 47 (5.1%) patients and ARB and betablocker in 38 (4.1%) patients. ARB, betablocker and CCB were used combinedly in 44 (4.8%) patients when three drugs were used. Overall, most commonly used antihypertensive drug was amlodipine in 188 (20.4%) patients followed by losartan potassium (15.2%), Olmesartan (13.3%) and Bisoprolol (10.9%). Out of 920 patients 171 (18.6%) were non-adherent to drug in whom control of blood pressure is poor (28.2% vs 7.3%, p. < 0.0001) and almost similar was seen in patients who were non-adherent to lifestyle changes (280 patients, 30.4%) (uncontrol vs control, 33.3% vs 27.1%, p < 0.04).

Conclusion:
Prescribing drugs is not enough to control hypertension. Drug compliance and adherence to lifestyle modification are important part of management plan that every physician should give emphasis to improve blood pressure control among hypertensive patients.
PS-C37-4: COMPARISON OF A SALT CHECK SHEET WITH ESTIMATED URINARY SALT EXCRETION MEASUREMENT IN HYPERTENSIVES OF AIZU REGION IN TOHOKU AREA
Authors: Inomata Rie , Hashimoto Shigeatsu 
Published: January 2023

Objective:
We evaluated the salt check sheet developed by Tsuchihashi et al. for the patients with hypertension in Aizu region in Tohoku area of rural, high ageing population ratio and higher salt concentration within foods, because there have been very few such evaluation in this area.

Methods:
In outpatients with hypertension of our hospital of Aizu region, we analyzed the correlation between check-sheet scores and estimated 24-h urinary salt excretion levels to assess the appropriateness of the check sheet. We asked 150 patients to complete the salt check sheet and spot urine specimens; 24-h urinary salt excretion levels were estimated with the formula reported by Tanaka.

Result:
138 subjects completed the study (men/women: 89/49, mean ± s.d., age: 65.4 ± 12.3 years, blood pressure: 130.8 ± 13.9/75.4 ± 11.5 mm Hg), of whom all were treated antihypertensive drugs. Mean body mass index (BMI) was 25.5 ± 4.8 kg/m2, and 46.4% (64/138) of the subjects were obese (BMI> 25 kg/m2. The total salt check-sheet scores were distributed from 1 to 13 points (mean ± s.d.: 9.3 ± 2.88 points). The mean estimated 24-h urinary salt excretion level was 10.2 ± 3.1 g (3.6–19.6 g). The total salt check-sheet scores significantly correlated with the 24-h urinary salt excretion levels (r = 0.882; P < 0.01), also in both of 65 years old age or younger group (r = 0.848; P < 0.05; n = 63) and the > 65 years old age group (r = 0.924; P < 0.05; n = 75), both men (r = 0.869; P < 0.05, n = 89) and women (r = 0.924; P < 0.05, n = 48) and both in the obese group (r = 0.910; P < 0.05; n = 65), but not in the nonobese group (r = 0.851; P < 0.05; n = 73).

Conclusion:
The salt check sheet is applicable for the hypertensives of Aizu region of rural and high elderly population ratio.
PS-P11-4: ASSOCIATION OF HOME AND OFFICE SYSTOLIC AND DIASTOLIC HYPERTENSION WITH GLUCOSE METABOLISM IN A GENERAL POPULATION
Authors: Tatsumi Yukako , Satoh Michihiro , Asayama Kei , Murakami Takahisa , Hirose Takuo , Hara Azusa , Tsubota Megumi Utsugi , Inoue Ryusuke , Kikuya Masahiro , Nomura Kyoko , Metoki Hirohito , Hozawa Atsushi , Katagiri Hideki , Imai Yutaka , Ohkubo Takayoshi 
Published: January 2023

Objective:
The aim of this study was to investigate the association of hypertension subtypes with glucose metabolism among the general population.

Methods:
The study involved 646 residents (mean age: 62.4 years) without treatment for hypertension or a history of diabetes from a rural community, who underwent an oral glucose tolerance test from 1997 to 2019. Hypertension subtypes [normotension (NT), isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH)] were defined based on home and office systolic and diastolic blood pressure (HBP and OBP, respectively). The estimated means of blood glucose levels during OGTT, homeostasis model assessment (HOMA)-insulin resistance (IR), Matsuda-DeFronzo index, HOMA-beta and insulinogenic index among the groups were compared by analysis of covariance adjusted for possible confounding factors.

Results:
BG-related indices were not different among the morning HBP-defined hypertension subtypes. Participants with evening HBP-defined ISH had a significantly higher estimated mean BG at 120 min, higher homeostasis model assessment-insulin resistance (HOMA-IR), and lower Matsuda-DeFronzo index than participants with NT (the adjusted mean: 146 vs 127 mg/dl, 1.3 vs 1.0, and 6.6 vs 8.1, respectively) (all p < 0.021). Participants with OBP-defined SDH had a significantly higher estimated mean fasting BG; BG at 30, 60, and 120 min; and HOMA-IR and a lower Matsuda-DeFronzo index than participants with NT (the adjusted mean: 101 vs 94 mg/dl, 177 vs 158 mg/dl, 182 vs 157 mg/dl, 145 vs 125 mg/dl, 1.3 vs 1.0, and 6.3 vs 8.3, respectively) (all p < 0.0025).

Conclusion:
The BG-related indices were different among hypertension subtypes. Participants with evening HBP-defined ISH and OBP-defined SDH had higher BG levels and insulin resistance than participants with correspondingly defined NT, while those with morning HBP did not. These findings suggest the importance of measuring evening HBP and OBP for early detection of coexisting hypertension and diabetes.
PS-P11-6: ESTABLISHING A RELATINSHIP BETWEEN BMI AND HYPERTENSION IN UNIVERSITY STUDENTS
Authors: Deshmukh Akshada T , Patil Mansi , Patil Vishal 
Published: January 2023

Introduction:
The Body Mass Index (BMI) has been identified as a key predictor of Blood Pressure (B.P).

Objective
The goal of the study is to discover the pattern of relationship between BMI and blood pressure in 1000 university students.

Materials and methods:
Blood pressure, weight, and height were all taken into account. The BMI was computed by dividing the weight in kilogrammes by the height in metres squared (kg/m).

Results:
Females were underweight in greater numbers than males (8.4% versus 4.7%). Males were more overweight than females (9% versus 5%). Males were more likely than females to be obese (7% versus 0.9%). Blood pressure parameters increased significantly with BMI (p0.0001), with higher values in males than females; (the mean systolic blood pressure 125.8 ± 8.3mmHg in males versus 117 ± 5.8mmhg in females and the mean diastolic blood pressure 94.6 ± 6.8mmhg in males versus 71 ± 7.7 in females) (p < 0.05).

Conclusion:
Among university students, a strong link between BMI and blood pressure was observed. Higher blood pressures were observed with higher BMI.
PS-P12-3: RELATIONSHIP BETWEEN SOCIOECONOMIC STATUS AND HEALTH LITERACY AMONG HEALTHY JAPANESE PEOPLE
Authors: Morimoto Akiko , Furuki Hideaki , Sonoda Nao 
Published: January 2023

Objective:
In today's society, people are encouraged to take more active roles in their own health. For that purpose, a wide range of health information has become available to the public, and increased attention is being paid to health literacy worldwide. The World Health Organization defines health literacy as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health. On the other hand, low socioeconomic status is associated with higher blood pressure. Clarifying the relationship between socioeconomic status and health literacy could be useful to develop appropriate interventions to prevent hypertension in people with low socioeconomic status. This study clarified the relationship between socioeconomic status and health literacy among healthy Japanese people.

Design and Method:
This cross-sectional mail survey was conducted in 2020 that involved all community residents with municipal National Health Insurance aged 40–64 years in five cities in three areas of A Prefecture, Japan. This survey included 33,902 community residents, and 12,446 (36.7%) agreed to participate in the survey. After exclusion of those with regular visits to medical institutions (n = 8,174) and those with missing data (n = 690), the analysis included 3,582 participants. Socioeconomic status (education level, self-reported economic status, and occupation) and health literacy were obtained using the self-administered questionnaire. Health literacy was measured using the Communicative and Critical Health Literacy (CCHL) scale. Participants were classified into two groups, low and medium/high health literacy groups, by their CCHL scale scores. The study protocol was approved by the Institutional Review Boards.

Results:
In this study, 53.0% of those had < = 12 years of education, and 14.4% of those did not have an occupation. Regarding self-reported economic status, 18.3% were categorized as good, 22.3% as average, and 59.4% as poor. After adjusting for confounding factors, low education level [multivariable-adjusted odds ratio (OR) 1.61, 95% confidence interval (CI) 1.38–1.88, < = 12 years vs. > 12 years], poor economic status [multivariable-adjusted OR 1.75, 95% CI 1.39–2.19, poor vs. good], and no occupation [multivariable-adjusted OR 1.45, 95% CI 1.18–1.78, absence vs. presence] were positively associated with low health literacy.

Conclusions:
Low socioeconomic status was associated with low health literacy among healthy Japanese people. In order to prevent hypertension in people with low socioeconomic status, it may be useful to develop easy-to-understand materials.
PS-P12-4: AWARENESS OF HYPERTENSION AND DEMOGRAPHIC FACTORS INFLUENCING HYPERTENSION TREATMENT AMONG RURAL POPULATION OF KRISHNA DISTRICT IN SOUTH INDIA
Authors: Munganda Hariharan Ranga Satya , Ponnaganti Satyanarayana Chowdary , Shaikh Salma , Amle Dnyanesh 
Published: January 2023

Introduction:
Being ascertained as single biggest risk factor for myocardial infarctions and stroke and cause of 10.8% of deaths in India, ICMR has already labelled HTN as silent killer. HTN is predicted to have higher prevalence than Diabetes mellitus and affect 1/3rd of our world population by year 2020. Prevalence of hypertension in India is predicted to be 200 million with only 40% being actually aware of the disease and only 20% of them being treated adequately. Thus, this study was aimed to assess awareness and demographic factors influencing treatment of HTN among rural population of Krishna district

Methods:
A cross sectional observational analytical study was carried out in out patient department setting of a tertiary level institute in Andhra Pradesh. Five hundred and eleven patients presenting with hypertension as per AHA guidelines were included in the study after informed written consent. Detailed clinical history was sought and thorough examination was performed. Treatment history was verified by reviewing prescriptions. Data regarding demographics, awareness of hypertension, awareness on hypertension therapy and compliance to therapy was collected using predesigned validated questionnaire. Data on compliance of treatment was also obtained.

Results:
Maximum subjects were noted to be in fifth and sixth decade of their age (60.4%). About a third of them were alcoholic while 3/4th were non vegetarian. Known hypertensive comprised 61.8% of these while 38.2% were diagnosed for first time. DM was observed as co-morbidity in 237 (46.4%) subjects and events of MI/CVA/CAD/AF was found in 33 (6.5%) subjects
Commonest factor in undiagnosed hypertension was not visiting the clinic followed by absence of health clinic in vicinity. Significantly higher frequency of incorrect drug combinations, incorrect dosage and poor adherence to drug therapy was noted in newly diagnosed hypertensive subjects.

Conclusion:
Undiagnosed hypertensive comprised of 38.2% of subjects visiting our health facility. Lack of assess and visit to clinic were the most common factors in undiagnosed cases. Significant inadequacy and non-compliance to treatment was also noted in newly diagnosed case.
PS-P12-7: IDENTIFYING THE EVIDENCE-POLICY GAP IN TASK-SHARING WITH COMMUNITY HEALTH WORKERS FOR MANAGEMENT OF HYPERTENSION: A MIXED-METHOD STUDY
Authors: Inagaki Yoko , Matsushita Kunihiro , Appel Lawrence John , Perry Henry B , Neupane Dinesh 
Published: January 2023

Objective:
Few studies are addressing the evidence-policy gap in task-sharing with community health workers (CHWs) to manage hypertension. We aimed to identify the gap by 1) performing a scoping review of peer-reviewed journals and 2) conducting in-depth interviews with key informants who have been involved in national CHW programs.

Design and Methods:
We searched PubMed for studies published from 2010–2021 following the PRISMA extension for scooping review guideline. We included all type of studies on task-sharing with CHWs for hypertension management. We extracted data on types, places, and the frequency of CHWs’ activities and other relevant indicators. The primary outcomes were changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), BP control, and medication adherence. In the corresponding countries, key informants with policy and implementation experience in national CHW programs were identified and interviewed.

Result:
A single reviewer screened 2,316 records, of which 166 were assessed for eligibility, and 85 were included in the final review. There were 29 randomized controlled trials, 2 quasi-experimental trials, 11 pre-post studies, 2 prospective cohorts, 19 cross-sectional studies, and 22 qualitative studies. CHWs performed health education and BP measurement in 80% (60/75) and 63% (47/75) of studies, respectively. 89% (33/37) used digital BP device. Patients’ home (64%, 47/71) was used the most with a median of one visit per month, followed by public space (11%, 8/71) and home/clinic (6%, 4/71). One CHW was responsible for an average of 116 participant with the range from 3 to 612. Significant reduction in SBP was seen in 56% (9/16) of the included trials. Eight informants from six countries (Brazil, India, Iran, Liberia, Thailand, Zimbabwe) participated in in-depth interviews. Brazil, India, Iran, Thailand, and Zimbabwe involved CHWs in health education, whereas only Thailand and Iran involved in BP measurement and both use manual BP devices. In these five countries, one CHW was responsible for an average of 1,250 people with the range from 250 to 3,000 in a national program.

Conclusion:
Despite clinically relevant BP reduction in CHW programs, there was suboptimal translation of this evidence into policy. The size of the population served per CHW and the type of BP device differed between research studies and national programs. Global health partners (i.e. those who generate evidence) and local governments need to work together to bridge the gap between evidence and policy.
Figure 1: Forest plot of difference in systolic and diastolic blood pressure change in included studies.