bluuebunny/crossref_metadata_2025_split huggingface dataset:
ARTERY ELASTICITY INDICES AND TESTOSTERONE- LONGITUDINAL STUDY IN VARA- SKÖVDE COHORT
Authors: Szalo Gabor , Hellgren Margareta , Lindblad Ulf , Daka Bledar 
Published: June 2023

Objective:
To determine the associations between testosterone, sex hormone-binding globulin (SHBG) and arterial elasticity in men in a longitudinal observational study.

Design and method:
2816 randomly selected individuals were examined (Men = 1400) between 2002 and 2005. After excluding participants with known hypertension and without data for arterial elasticity and testosterone, we include 1202 men in cross-sectional analyses. After a mean follow-up of 9.7 ± 1.4 years, a representative sample of 1327 original participants was re-examined. In the longitudinal analysis, 473 men were included. Body height, weight, heart rate and blood pressure were measured. Total testosterone (TT) and SHBG were analyzed using RIA. Bioavailable testosterone (BioT) is calculated by the Vermeulen coefficient. Arterial elasticity was measured based on pulse contour analysis of arterial waveform using the HDI/Pulse WaveTM CR2000 and C1 and C2 were obtained. Linear regression models were used to investigate these associations in three models: in model 1 adjusting for age, in model 2 we added heart rate, systolic blood pressure and in model 3 we added BMI. Multivariable general linear models were used to investigate the differences in C1 and C2 based on testosterone deficiency.

Results:
Mean age at baseline was 46.2±10.9 years. In cross-sectional analysis, an increase in TT and BioT was associated with an increase of C1 (beta = 0.08, CI: 0.02-0,14, p = 0.01 resp beta = 0.14, CI: 0.001-0.272, p = 0.05) in model 1, but not in the other models. In model 1 participants with testosterone deficiency had significantly lower C1 (C1 in TD: 17.6±5, C1 in the normal level of TT: 18.2±5, delta C1: 0.6, CI: 0.06- 1.1; p = 0.05), but not in the other models. Other associations between TT, BioT, SHBG, TD and C1 respective C2 were not significant in the models.

Conclusions:
We found weak associations between artery elasticity indices and testosterone levels. Surprisingly these associations were not significant after adjustments for pulse and blood pressure, even though the sample was large enough to reveal clinically significant associations.
PRESCRIPTIVE APPROPRIATENESS OF CHOLESTEROL-LOWERING DRUGS AMONG PATIENTS ATTENDING CARDIAC REHABILITATION AFTER ATHEROSCLEROTIC CARDIOVASCULAR DISEASE. RETROSPECTIVE STUDY
Authors: Saladini Francesca , Baggio Stefania , Marcato Federica , Campisi Francesco , Ferri Nicola , Verlato Roberto 
Published: June 2023

Objective:
Cardiovascular (CV) diseases still represent one on the main causes of death. The promotion of a healthy lifestyle and active treatment of CV risk factors such as cholesterol level is mandatory to reduce risk of unfavourable outcome. Aim of the present study was to investigate the prescriptive appropriateness of cholesterol-lowering drugs among patients who experienced an atherosclerotic CV disease (ASCVD).

Design and method:
We investigate 155 patients who experienced an ASCVD and underwent cardiac rehabilitation in 2020. The ESC 2021 guidelines on CVD prevention and 2019 ESC Guidelines on dyslipidaemias were followed to detect appropriateness; SCORE2 and SCORE2-OP risk estimation were used to detect patients’ CV risk profile. For the analysis patients were divided into two groups: 1 (n = 118) patients admitted for the first CV event, 2A (n = 18) patients who experienced a previous CV event and were admitted for a second event, 2B (n = 19) patients within a previous CV event within 2 years. LDL cholesterol (c-LDL) was detected at admission to hospital, during rehabilitation and at the first visit after rehabilitation, within 6 to 12 months.

Results:
Mean age of study participants was 66 years (41-88), 88.4% were males, 72% were overweight/obese, 25% diabetic, 37% smokers, 60% hypertensives, 57% dyslipidemic. Among group 1 patients, with no previous CV events, only 5.1% had low/moderate risk, 44.1% high risk and 50.8 very high risk according to SCORE2 or SCORE2-OP calculator. Mean c-LDL at admission to hospital was 121.5 mg/dl, 58.8 mg/dl during rehabilitation 58mg/dl at the subsequent medical visit. 32.6% reached c-LDL<55 mg/dl, 96.6% with high intensity statin (as monotherapy or associated to ezetimibe). 67.4% did not reach c-LDL<55mg/dl, despite 93.3% were treated with high intensity statin alone or plus ezetimibe. Among group 2A patients 47.1% reached c-LDL<55 mg/dl by mean of high intensity statin (87.5%), while among 2B patients only 3 subjects reached c-LDL<40 mg/dl.

Conclusions:
This retrospective study confirmed the importance of primary prevention and the utility to calculate CV risk profile. The main limitations for the efficacy lipid lowering drugs resulted: patient's compliance, drugs side effects, lifestyle habits and collaboration with general practitioner.
CORONARY MICROVASCULAR DISEASE IS ASSOCIATED WITH ARTERIAL STIFNESS IN PATIENTS WITH ISCHEMIA AND NO OBSTRUCTIVE CORONARY ARTERIES
Authors: Sakalidis Athanasios , Dimitriadis Kyriakos , Konstantinidis Dimitrios , Dri Irene , Leontsinis Ioannis , Bora Margarita , Iliakis Panagiotis , Mantzouranis Emmanouil , Vlachakis Panagiotis K. , Siafi Irene , Manta Eleni , Kariori Maria , Mavroudis Andreas , Tsioufis Panagiotis , Fragkoulis Christos , Aznaouridis Konstantinos , Thomopoulos Konstantinos , Tsioufis Konstantinos 
Published: June 2023

Objective:
There is a gap in the literature regarding the association between stiffness and myocardial ischemia. Arterial stiffness (AS) is an independent risk factor for cardiovascular disease, directly related to coronary atherosclerosis, an entity with an unfavorable cardiovascular prognosis frequently encountered in patients with hypertension.
The aim of this study was to investigate the relationship between AS and Coronary Microvascular Dysfunction (MVD).

Design and method:
We examined 23 hypertensive patients [10 female, 43%, mean age: 61.5±10.1 years, mean office blood pressure (BP): 147/88±10/9 mmHg] and 28 MVD patients (19 female, 68%, mean age: 58.3±4.6 years, average office BP: 139/81±16/13 mmHg). In the group of patients with angina, MVD was defined by a standardized systematic protocol in which coronary flow reserve (CFR) and index of microvascular resistance (IMR) were measured in the left anterior descending coronary artery using a temperature/pressure sensor-tipped guidewire. MVD patients were classified into 2 groups, structural and functional endotype, based on commonly used cut-offs (impaired CFR < 2.5, increased IMR > 25). In addition, in all participants, arterial stiffness was assessed using the aortic augmentation index (AIx), derived from the analysis of central pulse waveforms, recorded by applanation tonometry directly from the radial artery.

Results:
In the MVD group, the coronary flow reserve (CFR) was 1.4±0.9 and the index of microvascular resistance (IMR) was 43.9±30 IU. Of the 28 patients with impaired CFR, 8 (28%) had normal IMR consistent with functional CMD endotype, and 20 (71%) had abnormal IMR associated with structural alterations of the microvasculature. AIx was found to be increased in MVD patients compared to hypertensives (35.4±10.8 vs 27.4±12.6%, p = 0.031). This difference in AIx between the CMD and asymptomatic hypertensive controls was found to be statistically significant after adjustment for gender and age (p<0.05). No statistically significant difference was found in body mass index, renal function, history of dyslipidemia, diabetes mellitus, and smoking between groups.

Conclusions:
Arterial stiffness was found to be increased in patients with MVD compared to asymptomatic hypertensive individuals. These results suggest that therapies targeting vascular stiffening could provide additional clinical benefit in patients with impaired coronary microvasculature.
CLINICAL EFFECTS OF SINGLE PILL COMBINATION THERAPY OF ANTIHYPERTENSIVES AND STATIN ON BLOOD PRESSURE, LIPID, AND CARDIOVASCULAR RISK PROFILES IN PATIENTS WITH NEWLY DIAGNOSED HYPE
Authors: Park Sang Min , Cho Eun Jeong 
Published: June 2023

Objective:
Hypertension and dyslipidemia are the major risk factors for athersclerotic cardiovascular disease (ASCVD). The single pill combination (SPC) covering these risk factors are commonly used but has little data. The clinical effect of these SPCs on blood pressure and lipid profile with ASCVD risk change were evaluated in middle aged borderline risk group.

Design and method:
Seventy-two patients (age: 53.6±10 years) who were simultaneously diagnosed with hypertension and dyslipidemia were randomized to the two SPC groups: amlodipine 5 with atorvastatin 20 (AA) versus (vs.) olmesartan20 with rosuvastatin 10mg (OR). Before and after medication for six months under the active life style change, 24-hour ambulatory blood pressure (BP) monitoring (ABPM), lipid profile, carotid ultrasonography, ankle-brachial index (ABI), and ASCVD risk parameters including glucose profiles were also compared.

Results:
Baseline 24-hr mean systolic BP were higher in OR group (AA vs. OR: systolic BP 142.8±8.9 vs. 148.3±8.8mmHg, p = 0.039). The level of LDL cholesterol were slightly higher without significance in OR group (LDL 121.3±31.2 vs. 136.4±26.6mg/dL, p = 0.091). Follow-up mean BP were similar on 24-hr ABPM (systolic BP 127.3±9.4 vs. 125.1±7.3mmHg, p = 0.416; diastolic BP 85.6±6.6 vs. 81.4±7.8mmHg, p = 0.083). The changes in reduction of mean systolic BP markedly greater in OR group (systolic BP -15.1±11.5 vs -22.8±11.7, p = 0.048). Reduction of LDL cholesterol were similar (-53.1±24.7 vs. -62.5±29.1 mg/dL, p = 0.331). The level of fasting glucose was increased in only OR group and those of hemoglobin A1c were increased at both group and its changes were greater in OR group (0.12±0.30 vs. 0.23±0.28%, p = 0.048). The carotid intima-media thicknesses were slightly reduced in both group while ABI were not changed. ASCVD risk score were decreased after treatment (5.3 to 2.9 vs. 6.9 to 3.8%) with its similar rate between both group (45.3 vs 45.6%).

Conclusions:
In treating the middle aged patients with newly diagnosed hypertension and dyslipidemia using SPCs of AA and OR, OR is beneficial in blood pressure control while AA is advantageous to glucose control. After 6-months simultaneous treatment of hypertension and dyslipidemia, their grades of ASCVD risks were shifted from borderline to lower group.
INFLUENCE OF CHRONIC AT1 RECEPTOR BLOCKADE ON GASTRIC BARRIER FUNCTION IN MICE
Authors: Nickel Laura , Rawish Elias , Suenderhauf Annika , Sina Christian , Raasch Walter 
Published: June 2023

Objective:
The AT1 receptor blocker Telmisartan (TEL) is beneficial for the treatment of individuals suffering the Metabolic Syndrome as TEL reveals not only antihypertensive effects but also improves the glucose and lipid control and lowers body weight. As we have recently shown that TEL has impact on gut microbiota and brain barrier function we here investigated whether TEL influences gut barrier function which may participate in decrease of energy intake.

Design and method:
BL6 mice were fed with chow or high fat diet (45% fat) and were additionally treated with vehicle (CONchow or CONHFD) or TEL (8 mg/kg/d, 12 w, TELchow or TELHFD). Visceral and subcutaneous fat mass was quantified by MRI. Segments of large intestine were Canoy fixed to determine thickness of mucus by immunohistochemistry. PAS staining was performed for depicting goblet cells. The signalling pathway being involved in necroptosis was investigated by Western blots and qPCR.

Results:
Compared to chow feeding, gain in body weight increased by HFD (3.4±0.5 vs. 14.4g±1.2 g) and was reduced by TEL (1.7±0.5 vs. 2.8±0.5g). Visceral fat and liver mass was higher in CONHFD than CONchow but remained normal by TEL treatment. The mucus thickness was lower in CONHFD than CONchow. Independent on feeding, TEL additionally reduced mucus thickness. Numbers of goblet cells were not affected by HFD feeding and TEL treatment. RIP3 was particularly increased in TELHFD mice, while muc2 and ki67 almost remained unaffected by TEL.

Conclusions:
In contrast to our expectation, the antiobese effect of TEL was associated with a decrease in mucus thickness. Increase in RIP3 indicates that necroptosis may be enhanced by TEL. Further studies have to be performed to elucidate whether this detrimental TEL effect is true and be relevant for gastrointestinal function.
DIABETES MELLITUS AND ASSOCIATED HYPERTENSION, A TOXIC COMBINATION FOR CARDIOVASCULAR RISK
Authors: Nelaj Ergita , Gjata Margarita , Kecaj Irida , Gjermeni Ilir , Tase Mihal 
Published: June 2023

Objective:
The coexistence of hypertension in diabetic patients greatly enhances their likelihood of developing CVD. Other important risk factors for CVD in these patients include the following: obesity, atherosclerosis, dyslipidemia, microalbuminuria, inflammation, retinopathy, and “diabetic cardiomyopathy”. We aimed to assess the impact of type 2 diabetes mellitus associated with high blood pressure over these cardiovascular risk factors.

Design and method:
We performed a transversal study, lasting 12 months, in which 100 patients with essential hypertension, and type 2 diabetes, with medium age 60.7 ± 9.3 years were evaluated in comparison with 100 patients with only hypertension. We evaluate these patients for: BMI; waist circumference; IMT by carotid ultrasonography; microalbuminuria in a spot morning urine; fundus oculi, LVMI for left ventricular hypertrophy by echocardiography. Serum PCR and lipid concentrations were measured.

Results:
The diabetic hypertensive subjects significantly had higher BMI (p = 0.01) and waist circumference statistically significant (p = 0.005). Patients with hypertension and diabetes had a greater left ventricular mass index (66% vs 51%, P = 0.04). Mean value for IMT was 1.1 ± 0,3 mm for diabetic patients and 0.93 ± 0,2 mm for the other group (P < 0.001) and its prevalence was high in diabetics (75% vs 64%, P = 0.1). Prevalence of microalbuminuria was significantly high in diabetics (44% vs 14%, P < 0.001). PCR as marker of inflammation was prevalently high in people with diabetes and hypertension (32% vs 16%, P = 0.013) Also, prevalence of retinopathy was significantly high in people with diabetes and hypertension compare to other group (27% vs 12%, P = 0.012). There was strong relation between LVMI, microalbuminuria, IMT and PCR. Waist circumference had correlation with IMT and microalbuminuria.

Conclusions:
DM is an independent risk factor for the increased LV mass and impaired diastolic function regardless of association with hypertension or not. Central obesity is associated with an increased risk for cardio metabolic diseases such as atherosclerosis and diabetic nephropathy. Atherosclerosis is characterized by chronic inflammation affecting the arterial intimae. Thus, individuals with type 2 diabetes and hypertension had increased risk for CVD.
THE NEW PCSK9-INHIBITOR INCLISIRAN: AN EXCEPTIONAL REDUCTION IN LDL CHOLESTEROL FROM THE FIRST PATIENTS OF THE NIGUARDA HOSPITAL
Authors: Merlo Anna , Maloberti Alessandro , Ossola Paolo , Caccia Andrea , Busti Andrea , Garofani Ilaria , Fabbri Saverio , Senni Michele , Giannattasio Cristina 
Published: June 2023

Objective:
Dyslipidemia is one of the most prominent risk factors in coronary artery disease. With the new strict target of Low Density Lipoprotein (LDL) cholesterol in secondary prevention in some patients oral medication may not be sufficient. Inclisiran is a small interfiring RNA that inhibits the hepatic PCSK-9 synthesis inducing a reduction in low-density lipoprotein levels up to 50%. Conveniently, it only requires one administration every six months.

Design and method:
A 53-year-old man, with no previous cardiologic history, presented to our emergency department reporting acute chest pain and left arm paresthesia developed after an emotional stress. Electrocardiogram was normal with a slightly and stable increased of high sensitivity troponin T levels (18 ng/l). The patient had the following cardiovascular risk factors: type 2 diabetes mellitus, dyslipidemia, obstructive sleep apnea syndrome, obesity (body mass index 30), sedentary lifestyle. Taking into consideration his clinical presentation and his cardiovascular risk, a coronary computer tomography was performed showing severe stenosis in Left Anterior Descending (LAD) and right coronary arteries. The subsequent coronary angiography confirms the severe stenosis in the proxymal LAD and the mild stenosis (30%) in the right coronary artery. The LAD was treated with a drug eluting stent. At the time of the event the patient was already on therapy with rosuvastatina/ezetimibe 10/10 mg that we increased to a dosage of 20/10 mg. At the first medical examination after the hospitalization, his blood tests showed uncontrolled LDL cholesterol (70 mg/dl). We therefore decided to try lowering his cholesterol levels with addition of inclisiran.

Results:
After 3 months of inclisiran therapy, his blood test showed a surprisingly decrease in cholesterol levels (total cholesterol 78 mg/dl and LDL 11 mg/dl) reaching the desirable target.

Conclusions:
Inclisiran is a valid therapeutic strategy for reaching the desiderable cholesterol target in patient at high cardiovascular risk. In our first patients inclisiran, added to statin and ezetimibe therapy, successfully lowered LDL to the desirable target. Surprinsigly, it lowered LDL up to 85%, much more than expected. Further studies will be needed to identify which patients may be super responders to Inclisiran.
ASSOCIATION OF SERUM RETINOL CONCENTRATION WITH CARDIOVASCULAR DISEASES IN THE US NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES) 2001-2006
Authors: Liang Xiaopeng , Chou Oscar Hou In , Cheung Bernard Man Yung 
Published: June 2023

Objective:
The association between serum retinol concentration and cardiovascular disease is controversial. This study aimed to investigate the relationship between serum retinol concentration and cardiovascular diseases.

Design and method:
This cross-sectional study included 8240 non-pregnant participants aged over 20 in the National Health and Nutrition Examination Survey (NHANES) 2001-2006. Cardiovascular diseases were defined as a self-reported history of coronary heart diseases, heart attacks, angina pectoris, and stroke. Restricted cubic spline and logistic regression were employed to examine the association of serum retinol concentration with cardiovascular diseases with adjustments for potential confounders (i.e., demographics, socioeconomic status, body mass index, physical activity, alcohol, smoking, medical history, and use of vitamin A supplements).

Results:
6.8% (95% CI, 6.0-7.6) of the participants had cardiovascular diseases. The mean (±standard error) serum retinol concentration was 2.06±0.13 μmol/L. Serum retinol concentration had a J-shaped relationship with cardiovascular diseases, with the lowest risk observed between 0.82 and 1.20 μmol/L. Stratified by gender, the serum retinol concentration with the lowest odds ratio was 0.99 μmol/L in men and 1.07 μmol/L in women. The lower and upper tail of serum retinol concentrations (< 0.82μmol/L or >1.20μmol/L) were associated with cardiovascular diseases [OR = 1.70, 95%CI (1.23-1.85), P<0.01] after adjusting for covariates.

Conclusions:
Serum retinol concentration has a J-shaped association with cardiovascular diseases. While serum retinol may be an independent predictor of cardiovascular diseases, further studies are needed to determine if this is a causal relationship.
POSSIBLE PREDICTORS CONTRIBUTING TO ATRIAL FIBRILLATION OCCURRENCE IN HYPERTENSIVE PATIENTS
Authors: Grigoryan Svetlana , Zelveian Parunak , Hazarapetyan Lusine 
Published: June 2023

Objective:
Arterial hypertension (HT) and atrial fibrillation (AF) are two important public health problems. Their prevalence is increasing worldwide, and often coexist in the same patient. HT and AF are strikingly related to an excess risk of cardiovascular disease and death. HT ultimately increases the risk of AF and several factors underlying the higher risk of AF in patients with HT are still incompletely known. HT is one of the main reasons for the remodeling process in and makes a significant contribution to the development of structural changes of the heart.
The aim of this study is to identify possible predictors of paroxysmal/persistent AF occurrence and progression in hypertensive patients.

Design and method:
In this study where enrolled 219 hypertensive patients with non-valvular paroxysmal/persistent AF (mean age 63.6±7.4). As a control group 94 patients with HT and without AF were also examined. Echocardiography examination and 24-hour ambulatory Holter monitoring ECG were registered in each patient. The database consisting of 19 indicators that characterize the clinical, hemodynamic and structural-functional state of the heart, as well as markers of inflammation and fibrosis was created. Data were analyzed by SPSS 13 program using logistic analysis by odds ratio (OR).

Results:
The obtained results showed that in hypertensive patients with paroxysmal/persistent AF, OR of more episodes of hypertensive crises, deterioration of electrical remodeling and left ventricular (LV) diastolic function, as well as a significant increase in the levels of concentrations of inflammatory and fibrosis markers in comported with hypertensive patients without AF were detected.

Conclusions:
The multifactorial analysis revealed significant impact of LA and LV dysfunction, inflammation and fibrosis as well as hypertensive crises on the possible risk of AF occurrence and progression in hypertensive patients.