bluuebunny/crossref_metadata_2025_split huggingface dataset:
24 HOURS CHRONOMICS OF AMBULATORY BLOOD PRESSURE/HEART RATE IN TERMS OF ACROPHASE & HYPERBARIC INDEX IN NIGHT SHIFT NURSING PROFESSIONALS: RISK FOR CARDIOVASCULAR DISEASES
Authors: Anjum B. Anjum , Verma Narsingh , Tiwari Sandeep , Naz Qulsoom , Ahmad Kaleem , Singh Ranjana , Mahdi Abbas Ali 
Published: June 2023

Objective:
This study was aimed to investigate the effect of Light at night and Rotating night shift as risk factor for cardiovascular diseases. 24 hours chronomics of BP/HR in terms of Double amplitude, Acrophase and Hyperbaric index and its relation with circadian rhythm of salivary cortisol and 6 sulfatoxy melatonin levels in night shift nursing professional.

Design and method:
56 night shift nurses, aged 20 to 40 years, performing day and night shift duties were recruited from the Trauma Center, KGMU, India, and 56 age sex matched actual day workers were also enrolled as controls. During their night and day shift duties, BP/HR were recorded by Ambulatory Blood Pressure Monitoring (ABPM) along with circadian pattern of cortisol in saliva, metalonin in urine also tested.

Results:
Highly significant difference was found in double amplitude (2DA) of among between night (23.10 ± 14.68) and day shift (34.27 ± 16.44) (p < 0.0005). In night shift, hyperbaric index (HBI) of mean SBP was found to be increased at 00 to 03 am (midnight) while during day shift, peak was found at 06 to 09 am. HBI of mean HR was found to be increased at 18 to 21 pm during night shift while in controls, peak was found at 09 to 12 & again 15 to 18 pm of SBP, DBP & HR. Alterations in Acrophase of BP/HR were very common among night shift workers and Ecphasia was found in few nights shift workers. Difference was found in night cortisol levels among night (4.08 ± 3.28) vs day shift (2.62 ± 2.37), while in comparison to night shift or day shift with controls (1.82 ± 1.18) these difference was significant (p < 0.05).

Conclusions:
Alteration in morning melatonin and Night cortisol level were found during night shift. Reverse pattern of Acrophase and HBI of BP/HR along with salivary cortisol during night shift represents desynchronization. It indicates that the circadian rhythm was disrupted during night shift and incomplete recovery occurs during day shift. It may leads to future cardio vascular diseases risk.
THE TRIGLYCERIDE-TO-ADMISSION GLUCOSE RATIO AS AN INDEPENDENT PREDICTOR OF POOR OUTCOME AFTER ISCHEMIC STROKE
Authors: Gasecki Dariusz , Kowalczyk Kamil , Kwarciany Mariusz , Rojek Agnieszka , Narkiewicz Krzysztof , Karaszewski Bartosz 
Published: June 2023

Objective:
The serum triglyceride to glucose ratio (TGR) has been shown a reliable surrogate index to screen for risk of insulin resistance, and a marker of high risk in subjects with cardiovascular disease. The gradient of arterial stiffness, as reflected by the pulse wave velocity (PWV) ratio, has been found to be independently related with poor outcome in patients with acute ischemic stroke (AIS).
The aim of the study was to assess the relationship between TGR and stroke severity and to evaluate its potential role as a predictor of functional outcome in patients with AIS.

Design and method:
We enrolled 150 AIS patients (115 males, age 63.1 ± 12.4 years, median NIHSS score 6(3 - 8) points). Carotid-femoral and radial–carotid PWV were measured (SphygmoCor®) within several (6 ± 2) days after stroke onset. TGR was calculated by dividing fasting serum triglycerides by admission glucose. Functional outcome was evaluated 90 days after stroke using the modified Rankin Scale (mRS) with an mRS score of 3 to 6 (dependency or death) considered as a poor outcome.

Results:
TGR was significantly lower, while admission glucose was significantly higher in patients with poor compared to those with good functional outcome (0.87 ± 0.63 vs 1.14 ± 0.68; p = 0.02, and 168.4 ± 71.1 vs 132.5 ± 56.0 mg/dL; p = 0.001, respectively). In a multivariate analysis, TGR was significantly associated with functional outcome after controlling for age, sex, PWV ratio, stroke severity and use of rtPA (adjusted OR = 0.31; 95% CI, 0.11 - 0.91; p = 0.03), while glucose was not (adjusted OR = 1.00; 95% CI, 1.00 - 1.01; p = 0.07).

Conclusions:
Triglyceride-to-glucose ratio might be a useful predictor of functional outcome in patients with acute ischemic stroke, independent of traditional and new vascular factors, including arterial stiffness gradient.
TRANSITION PRACTICES OF HYPERTENSIVE YOUTH FROM PEDIATRIC TO ADULT HEALTH CARE AMONG ESH EXCELLENCE CENTRES
Authors: Stabouli Stella , Persu Alexandre , Aujoulat Isabelle , Weber Thomas , Kreutz Reinhold , Grassi Guido , Lurbe Empar 
Published: June 2023

Objective:
Transition refers to the process of changeover from pediatric to adult health care. In the light of the increasing prevalence of arterial hypertension in children and adolescents we aimed to assess transition practices from pediatric to adult health care among Excellence Centres of the European Society of Hypertension (ESH).

Design and method:
A 22-question survey was sent out to ESH Excellence Centres in July 2022. Only one answer per excellence center from the center leader was allowed.

Results:
Forty-nine ESH Excellence centres responded the survey, almost all (98%) affiliated in hospital settings. Specific transition clinics do not exist in 64% of the settings. The median number of young adults diagnosed with childhood hypertension transferred from pediatric clinics to ESH Excellence Centres is 5 per year (interquartile range 2 - 13). In 66% of the centres, the transition process is limited to written medical history (transfer letter). Only 23% centres reported coordinated visits at pediatric and adult clinics. The main criterion for patient transfer to adult clinics is patient age (87% of the centres) with transfer age being at 18 years in 75% of the centres, while 20% reported transfer ages younger than 18 years. In only 9% of the centres patient self-management skills are assessed to decide readiness for transfer to adult clinics. The ESH 2016 guidelines hypertension staging criteria in children and adolescents (Lurbe et al J Hypertens) are applied in 52% of the centres, the ESC/ESH 2018 adult hypertension guidelines (Williams B et al J Hypertens) are used in 21% and national guidelines are used in the remaining centres. Adherence is considered the main challenge during transition process as reported by 68% of the centres, lifestyle by 66%, patients’ lack of understanding of their condition by 50%, and psychosocial issues by 50% of the centres. Fifty-one percent of centres modify treatment after transfer according to adult recommendations, 93% for uncontrolled hypertension and 75% to change in single (combination) pill.

Conclusions:
Coordination and communication between pediatric and adult units should be reinforced as they are major factors for effective transition into adult health care.
THE IMPACT OF COVID-19 PANDEMIC ON BLOOD PRESSURE CONTROL IN PATIENTS WITH TREATED HYPERTENSION. RESULTS OF EUROPEAN SOCIETY OF HYPERTENSION STUDY (ESH ABPM COVID-19 STUDY)
Authors: Wojciechowska Wiktoria , Rajzer Marek , Weber Thomas , Chrostowska Marzena , Doumas Michalis , Fréminville Jean -Baptiste De , Lewandowski Jacek , Wuerzner Gregoire , -Przybylek Maria Gosk , Parati Gianfranco , Niepen Patricia Van Der , Kahan Thomas , Bursztyn Michael , Persu Alexandre , Stergiou George S. , Bilo Grzegorz , Grassi Guido , Mancia Giuseppe , Kreutz Reinhold , Januszewicz Andrzej 
Published: June 2023

Objective:
We aimed to assess the impact of the COVID-19 pandemic on blood pressure (BP) control assessed by office and ambulatory blood pressure monitoring (ABPM) in patients with treated hypertension.

Design and method:
Clinical and BP data were collected from 32 centres including Excellence Centres of the European Society of Hypertension. Two groups of patients were compared. Group1 (‘pandemic’) consisting of participants who have undergone two ABPM recordings (visits): visit-2 during the COVID-19 pandemic, and visit-1 performed 9 - 15 months prior to visit-2. Participants in Group2 (‘pre-pandemic’) had two repeated ABPMs, both performed before the pandemic within 9 - 15 months interval between visits.

Results:
Overall, 3384 ABPMs were collected from 1692 patients (50.5% men). 759 patients constituted Group1 and 933 patients Group2. Study groups did not differ regarding sex, age, or body weight. The duration of hypertension and frequency of first-line antihypertensive drug use at visit-1 were also similar in both groups. Beta-blockers were the only class of drugs with a significant decrease between visits (difference between visit-2 and visit-1) in Group1. At visit-1, there were no differences in all BP phenotypes (office and ABPM values) or hypertension control rates (27% vs 26.6%; p = 0.62) between study groups. At visit-2 significantly higher office BP was observed in Group1 compared to Group2, with a mean difference of +2.09 mmHg (p = 0.028) and +1.39 mmHg (p = 0.026) for systolic (SBP) and diastolic (DBP) BP, respectively. Moreover, on visit-2, higher 24-hour daytime and nighttime SBP and DBP were observed in Group1 as compared to Group2. Of note, the prevalence of uncontrolled hypertension (when considering both office and ABPM) was also higher at visit-2 in Goup1 than in Group2 (25.8% vs 20.0%; p = 0.005). Both SBP and DBP, regardless of the measurement method, dropped between visit-1 to visit-2, but to a lesser extent in Group1. Thus, the magnitude of BP decrease between visits was smaller in Group1 (delta24SBP: -1.04 vs -3.2 mmHg; p < 0.001 and delta24DBP: -1.22 vs -1.93 mmHg; p = 0.038).

Conclusions:
The results of the study indicate a negative impact of the COVID-19 pandemic on BP control both in office and during ABPM.
COMBINING RENIN-ANGIOTENSIN SYSTEM (RAS) BLOCKADE AND SODIUM-GLUCOSE COTRANSPORTER-2 (SGLT2) INHIBITION IN EXPERIMENTAL DIABETES RESULTS IN SYNERGISTIC BENEFICIAL EFFECTS
Authors: Ye Dien , Cruz-Ló Edwyn O. , Veghel Richard Van , Garrelds Ingrid M. , Danser A.H. Jan 
Published: June 2023

Objective:
To study the combined effect of RAS blockade and SGLT2i in experimental diabetes.

Design and method:
TGR (mREN2)27 rats (a model of angiotensin II-dependent hypertension) were made diabetic with streptozotocin for 12 weeks and treated with either vehicle, the angiotensin receptor blocker valsartan (VAL: 4 mg/kg/day), the SGLT2 inhibitor empagliflozin (EMPA: 10 mg/kg/day) or their combination during the final 3 weeks. Mean arterial blood pressure (MAP) was measured by telemetry.

Results:
MAP before treatment was 120 ± 14 mm Hg. Diabetes resulted in albuminuria, accompanied by glomerulosclerosis, without a change in glomerular filtration rate (GFR). EMPA did not lower MAP, while VAL did (by 29 ± 7 mm Hg), and when combined the MAP drop was largest (44 ± 6 mm Hg). Only EMPA+VAL reduced the heart weight/tibia length ratio (P = 0.04 vs. vehicle). VAL, but not EMPA, increased plasma renin, and the largest renin rise was observed during EMPA+VAL (P < 0.0001 vs. vehicle) Although both VAL and EMPA alone tended to diminish albuminuria, the reduction was significant (P = 0.01 vs. vehicle) only when both drugs were combined (vehicle, VAL, EMPA and EMPA+VAL 108 ± 18, 89 ± 24, 55 ± 8 and 26 ± 6 ug/mL, respectively). This was accompanied by a reduction in glomerulosclerosis index and no change in GFR. EMPA either alone or in combination with VAL increased water intake and urine production and induced urinary glucose loss, and as a consequence reduced blood glucose and body weight. Renal expression of the fibrosis and inflammatory markers TIMP2, collagen 1alpha 1, fibronectin, Neph1, nephrin was lowest in the dual treatment group.

Conclusions:
RAS blockade and SGLT2i display synergistic beneficial effects on blood pressure, kidney jury and cardiac hypertrophy in a rat with hypertension and diabetes.
EVALUATION OF THE EFFICACY AND SAFETY OF MEDICAL TREATMENT WITH LOWER DOSES OF SPIRONOLACTONE IN A COHORT OF PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Sconfienza Elisa , Riancho Julien , Gebara Nicole , Ferrão Diana , Freminville Jean -Baptiste De , Lorthioir Aurélien , Azizi Michel , Amar Laurence 
Published: June 2023

Objective:
Treatment with mineralocorticoid receptor antagonists is recommended for patients with bilateral forms of primary aldosteronism or with unilateral forms unwilling or unable to undergo surgery, using spironolactone as the primary choice, with a suggested dose of 1 to 2 mg/Kg/day. In clinical practice, however, the dose prescribed has been progressively decreased to achieve a better tolerance of the drug and, consequently, a higher compliance to treatment. Our aim was to evaluate how the lowering of spironolactone dose could have impacted on arterial blood pressure control and on the prevalence of adverse effects.

Design and method:
We retrospectively included 394 patients with primary aldosteronism receiving a medical treatment with spironolactone, with a minimum follow-up of 1 month after the initiation of medical treatment. Patients were divided into two groups, according to the median prescribed dose of spironolactone in our population (50 mg, 25 – 75): subjects treated with >50 mg and patients treated with < = 50 mg of spironolactone daily.

Results:
The median follow-up after the introduction of spironolactone was 6 months, and 135 patients experienced spironolactone-related adverse effects (34.3%), with a higher proportion in men than in women (76.30% vs. 23.70%). The most frequently reported adverse effect was gynecomastia, followed by erectile dysfunction. Subjects receiving a dose >50 mg of spironolactone daily displayed a significantly higher prevalence of side effects (42.2%), while a prevalence of 30.5% was described in the < = 50 mg group. Patients in the lower dose group were treated with a higher number of anti-hypertensive drugs, especially diuretics. No statistically significant differences were seen between the two subgroups in blood pressure measurements at follow-up.

Conclusions:
Treatment with low doses of spironolactone could help achieve a better adherence in patients with primary aldosteronism, with a lower rate of adverse effects compared to patients treated with higher doses, with no differences in blood pressure control at follow-up. This goal could be achieved by prescribing a higher number of anti-hypertensive drugs. These findings could help the clinician in choosing the best therapeutical option for each patient.
UNILATERALLY SELECTIVE ADRENAL VEIN SAMPLING FOR IDENTIFICATION OF SURGICALLY CURABLE PRIMARY ALDOSTERONISM
Authors: Rossi Gian Paolo , Bagordo Domenico , Amar Laurence , Azizi Michel , Riester Anna , Reincke Martin , Degenhart Christoph , Widimsky Jiri , Naruse Mitsuhide , Deinum Jaap , Kocjan Tomaz , Negro Aurelio , Rossi Ermanno , Kline Gregory , Tanabe Akiyo , Satoh Fumitoshi , Rump Lars Christian , Vonend Oliver , Willenberg Holger S. , Fuller Peter J. , Yang Jun , Chee Nicholas Yong Nian , Magill Steven B. , Shafigullina Zulfiya , Quinkler Marcus , Oliveras Anna , Lee Bo -Ching , Chang Chin -Chen , Wu Vin Cent , Kratka Zuzana , Battistel Michele , Rossitto Giacomo , Seccia Teresa Maria 
Published: June 2023

Objective:
Adrenal venous sampling (AVS) is recommended for the identification of unilateral surgically curable primary aldosteronism (PA) but, owing to failed bilateral adrenal vein cannulation, is often clinically useless.

Design and method:
We investigated if only unilaterally selective AVS studies can allow identification of the responsible adrenal.

Methods:
Among 1625 patients consecutively submitted to AVS in tertiary referral centers, we selected those with a unilaterally selective AVS result and a final diagnosis of unilateral PA. Using the latter as gold reference, we examined the accuracy of the relative aldosterone secretion index (RASI), which estimates the amount of aldosterone produced in each adrenal gland corrected for catheterization selectivity.

Results:
The RASI values distribution showed prominent differences between patients with and without unilateral PA. The area under ROC curves (AUROC) was 0.714 and 0.855 for RASI values of the responsible and the contralateral side, respectively. While RASI values >2.55 on the culprit side and less than 0.96 on the contralateral side furnished the highest accuracy for detection of surgically cured unilateral PA, only 20% and 16% had RASI values less than 0.96 and >2.55, respectively, in the patients without unilateral PA.

Conclusions:
With the strength of the gold standard entailing an unambiguous diagnosis of unilateral PA and large real-life dataset, these results indicate the feasibility of identifying unilateral PA using unilaterally selective AVS results.
A NOVEL ELECTRO-HYDRAULIC ACOUSTIC THERAPY REDUCES BLOOD PRESSURE IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE: PRELIMINARY RESULTS
Authors: Wolak Talya , Lerman Amir , Glikson Michael , Sukholutsky Ivetta , Silberman Shuli , Lerman Lilach O. 
Published: June 2023

Objective:
Electro-Hydraulic Acoustic Therapy (eHAT), using ∼10% of the energy used in shockwave lithotripsy, is a promising technique to ameliorate ischemia and regenerate tissues. eHAT has been demonstrated to enhance healing in tissues such as bone, muscle, and myocardium, via several mechanisms, particularly by promoting neovascularization. Furthermore, previous animal studies demonstrated that eHAT reduces blood pressure (BP) and preserves renal function after ischemic kidney injury.
The present pilot study explored the clinical safety and efficacy of eHAT and tested the hypothesis that eHAT would reduce BP and preserve renal function in patients with medically-treated hypertension and CKD.

Design and method:
So far, a total of 15 patients with HTN and Stage III a/b CKD were enrolled in this prospective, single-arm study. The patients were treated with six sessions of eHAT during a 3-week period. At each session, 2400 shockwaves were applied to each kidney with 0.09 mJ/mm2 at 2.66Hz (NephrospecTM by Curespec LTD, Yehud, Israel). Follow-up (FU) visits were performed at 1, 3, and 6 months.

Results:
The treatment was well tolerated with no major adverse events or need for analgesic treatment.
Average Automated Office BP (AOBP) showed a strong tendency for a decrease in diastolic BP from baseline to the Primary Efficacy Objective at FU II (3 months post-last treatment), which progressively decreased further at FU III (6 months) (Table 1). Similarly, average Office BP (OBP) detected a strong trend for a progressive decrease in systolic BP from baseline to the Primary Efficacy Objective (Table 1). Levels of eGFR appeared to slightly rise throughout the study, but this change has not reached statistical significance levels (Table 1).

Conclusions:
The current study demonstrates that the eHAT procedure is tolerable and safe in this cohort. Moreover, a 3-week regimen tended to reduce BP and preserve eGFR in patients with controlled HTN and CKD. Therefore, electro-Hydraulic Acoustic Therapy may emerge as a novel, safe, and non-invasive alternative therapeutic approach in the management of HTN in the context of CKD.
STUDY ON THE MECHANISM OF CARDIAC HYPERTROPHY INDUCED BY TESTOSTERONE THROUGH MTORC2 IN OVARIECTOMIZED FEMALE SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Wang Wenting , Yu Jing 
Published: June 2023

Objective:
The estrogen level of postmenopausal women decreased sharply, while the androgen level did not decrease significantly, which was characterized by the inversion of estrogen / androgen ratio. Therefore, it could be observed that relative excess androgen in the circulation of postmenopausal women, which may be one of the reasons for the increase of cardiovascular disease in postmenopausal women. In this study, the model of postmenopausal hypertension was established by bilateral ovariectomy in spontaneously hypertensive rats (SHR), and the specific mechanism of testosterone-induced myocardial hypertrophy in ovariectomized SHR was explored.

Design and method:
Twenty-four SHR were randomly divided into three groups: sham operation group (Sham group, n = 8), bilateral ovariectomized group (OVX group, n = 8) and testosterone propionate intervention group (OVX+T group, 2.85mg/kg Weekly, im for4 weeks, n = 8). The systolic blood pressure, diastolic blood pressure and heart rate of SHR were monitored and recorded twice a week. Western Blot was used to detect the protein expression of mTOR, p-mTOR, mTORC2 and its subunits Rictor and p-Rictor. Moreover, the expression of autophagy-related proteins LC3 and P62/SQSTM1 and Mitofusin2 (MFN2) and Dynamin related protein 1 (DRP1) in cardiac myocytes was observed.

Results:
1. Testosterone could activate the expression of mTORC2 in myocardial tissue: testosterone could activate the expression of mTORC2 and the Rictor of mTORC2 in ovariectomized SHR(Figure 1).
2. Testosterone could inhibit cardiomyocyte autophagy: there was no significant difference in the expression of autophagy-related proteins LC3 and P62/SQSTM1 between Sham and OVX groups, while testosterone could decrease the expression of LC3 protein and increase the expression of P62/SQSTM1 protein in OVX+T group (Figure 2).
3. Testosterone could activate the mitochondrial cleavage of cardiomyocytes: the expression of DRP1 was increased in OVX+T group (Figure 3).

Conclusions:
In bilateral ovariectomized SHR, testosterone may inhibit cardiomyocyte autophagy by activating the expression of mTORC2, which leads to cardiac hypertrophy in SHR. And in cardiomyocyte mitochondria, testosterone can promote mitochondrial cleavage.
SALT SENSITIVITY IS MODULATED BY LANOSTEROL SYNTHASE RS2254524 POLYMORPHISM
Authors: Citterio Lorena , Faienza Sipontina , Messaggio Elisabetta , Zagato Laura , Lanzani Chiara , Simonini Marco , Manunta Paolo 
Published: June 2023

Objective:
The blood pressure (BP) response to different salt intakes (salt sensitivity-SS), shows variability among individuals, with more frequency in hypertensives compared to the general population. Elevated levels of the Endogenous Ouabain (EO) have been associated with hypertension (HT) and SS.
We characterized the missense variation rs2254524 (Val642Leu; C>A) of the Lanosterol Synthase gene (LSS) coding for an enzyme in steroid biosynthesis, since AA patients on a low-salt diet showed a greater reduction in BP compared to the LSS CC, with only CC having an increase in plasma EO.
We aim at dissecting the functional correlation between LSS polymorphism, EO and SS-HT.

Design and method:
We generated by CRISPR-Cas9 a knock-in mouse model carrying the Lss V643L (LssV643L/V643L), homologous to V642L. Male mice were fed with a normal-salt diet (0.5% NaCl), high-salt diet (4% NaCl), or low-salt diet (<0.03% Na) and BP was measured every two days by the tail-cuff system.

Results:
LssV643L/V643L mice were viable, healthy, and undistinguishable phenotypically from WT.
At baseline, the Lss AA affected kidney weight that was significantly enlarged at 3 and 12 months of age, compared to WT.
The Lss V643L mutation did not affect EO and SBP at 3 and 12 months, per se, but affects SBP responsiveness to salt stimulus. We observed a decreased SBP after 10 days of a low-salt diet and increased SBP upon a high-salt diet only in LssV643L/V643L mice compared to the control diet at 3 and 12 months, respectively. Moreover, 12-month-old mice in high-salt diet showed cardiac hypertrophy, and LssV643L/V643L showed a higher incidence of heart fibrosis.
In the adrenal gland of LssV643L/V643L mice, Lss mRNA level was reduced upon high-salt diet.
At 12 months, RNASeq analysis of renal differentially expressed genes revealed a different regulation of multiple Slc genes, both in control and high-salt diet, but also of Cbr2, and Arhgap26.

Conclusions:
The new LssV643L/V643L mouse model resembles the SS-HT phenotype together with EO non-responsiveness observed in HT patients, thus providing a good model of SS-HT. Our results reveal a role of Lss gene in the regulation of BP upon salt stimulus.