bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF HIGH NORMAL BLOOD PRESSURE DEFINED BY DIFFERENT CRITERIA WITH ALL-CAUSE AND CARDIOVASCULAR MORTALITY
Authors: Zhao Yifan , Li Moran , Zhang Yi , Han Jun 
Published: June 2023

Objective:
To evaluate the association of the all-cause and cardiovascular mortality with the guideline-based classification criteria and systolic blood pressure (SBP)-based classification for high normal blood pressure.

Design and method:
We collected data from the NHANES Database,which is a large, serial, cross-sectional survey designed to be nationally representative of the civilian adult population in the United States
Inclusion Criteria: SBP > 90mmHg; Without any antihypertensive treatment; Having complete record for a history of major cardiovascular-related disease including hypertension, coronary heart disease, myocardial infarction, heart failure, stroke, diabetes and hyperlipemia.
All the participants were divided into 3 groups according to the latest guidelines or systolic blood pressure.
Group1: Normotensivel; Group2: High normal blood pressure; Group3: Hypertension

Results:
By grouping population according to guideline definition, in terms of all-cause mortality and cardiovascular death, there was no significant difference between population with normal blood pressure (NT) and with high normal blood pressure (HNBP). But both groups had significantly lower risk compared with hypertension group (HTN). Multivariate Cox regression results indicated the lowest risk of all-cause mortality in the HNBP group and no difference in risk of all-cause mortality between the NT and HTN groups, which was illogical and inconsistent with real-world clinical practice.
By grouping population according to SBP, we found that the grouping better distinguished all-cause and cardiovascular mortality among groups. Multivariate COX regression analysis found that NT and HNBP groups had no difference in risk of all-cause and cardiovascular death.
The restricted cubic spline curve of DBP showed the lowest HR were found when DBP was between 83 and 95 mmHg, which were defined as high normal blood pressure or hypertension according to guideline-directed classification. This result may be the primary reason for the difference between guideline and SBP-directed classification.

Conclusions:
In this study, our analysis showed that the blood pressure based on SBP had a higher association with both all-cause mortality and cardiovascular mortality than the guide-directed definition. DBP inclusion could be a confounding factor for the classification. People with high normal blood pressure did not show a worse prognosis than those with normal blood pressure.
ANTIHYPERTENSIVE EFFICACY OF A STRATEGY FOR SWITCHING FROM FREE COMBINATIONS TO A FIXED TRIPLE COMBINATION AS ASSESSED BY VASCULAR STIFFNESS PARAMETERS
Authors: Zbyshevskaya Elizaveta , Makeeva Tatiana , Erinchek Vadim , Zheming Wang , Jalolov Faridun 
Published: June 2023

Objective:
To evaluate the 24-hour blood pressure (BP) control and the effect of the triple fixed combination (TFC) amlodipine/indapamide/perindopril on the arterial stiffness parameters according to 24-hour blood pressure monitoring (ABPM) data in patients with uncontrolled hypertension (HTN).

Design and method:
The study involved 78 patients with insufficient BP control, against the background of previous combination therapy. All patients received TFC amlodipine/indapamide/perindopril. The patients were divided into three amlodipine/indapamide/perindopril therapy groups: 1-5/1.25/5mg, 2-5/2.5/10mg, 3-10/2.5/10mg. Control visits were after 4 weeks, 12 weeks, 24 weeks of therapy. At each visit, the achievement of the target BP level <130/80mmHg was assessed, as well as the effect of therapy on the parameters of arterial stiffness (pulse wave velocity (PWVao), pulse pressure (PP), agumentation index (Aix), arterial stiffness index (ASI) and central aortic pressure parameters (systolic aortic pressure (SBPao), diastolic pressure in the aorta (DBPao), central pulse pressure (PPao)) according to ABPM.

Results:
When screening, AHT included 2 drugs - 12 (15.3%) patients, 3 or more - 66 (84.6%), free combinations of drugs 56 (71.8%), FC - 32.1%, respectively. Data analysis showed a decrease PWVao (11.39 ± 1.32 m/s vs 9.98 ± 0.91 m/s, p < 0,05) as well as ASI (174 (138,253) vs 139 (107,196) mmHg; p <0.001) and Aix -29,9(-41,12) vs - 33,7(-53, 9) p<0,05. There was a statistically significant decrease in the parameters the central pressure in the aorta.
In the analyzed group of patients, the initial blood pressure was 160.8 ± 10.3/91.5 ± 8.1 mm Hg, after 24 weeks the blood pressure decreased to 121.3 ± 3.5/73.6 ± 4.2mm Hg.st. (p <0.001). According to ABPM data, daily BP significantly (p <0.001) decreased from 153.9 ± 9.04/8.38 ± 9.18 to 120.3 ± 4.7/73.4 ± 4.7 mm Hg after 24 weeks of TFC therapy. Similar patterns were received for the night BP.

Conclusions:
Indicators of vascular stiffness, together with target BP figures, can serve as criteria for monitoring the quality of blood pressure and have been used to assess the effectiveness of antihypertensive therapy when switching patients to TFC amlodipine/indapamide/perindopril.
REMISSION OF HYPERTENSION AT SIX MONTHS OF WHOLE BODY DIGITAL TWIN TECHNOLOGY
Authors: Paramesh Shamanna , Mohammed Jahangir , Mohamed Maluk , Poon Terrence , Thajudeen Mohamed , Keshavamurthy Ashok , K Ranjita , Patil Shashikiran , Joshi Shashank 
Published: June 2023

Objective:
Twin Precision Treatment (TPT) is a novel Whole-Body Digital Twin (WBDT) enabled precision nutrition which has been shown to reverse diabetes, that uses AI and the Internet of Things, to integrate multidimensional data, from non-invasive sensors, to give precision nutrition and health recommendations via the TPT app and by coaches

Design and method:
We conducted a pilot, prospective randomized trial (n = 20) to evaluate the impact of TPT on the blood pressure in hypertensives. Remission of hypertension was defined as conversion to normotensive status (SBP < 140mmHg and DBP < 90mmHg and no use of antihypertensive medication) at the follow-up visit. We did not enroll people with diabetes.

Results:
Mean age 49 years (±7.9, 95% CI 45 to 52). There were 12 males and 8 females. There was a significant change at 6 months in the SBP (mmHg) 140.2±15.8 reduced to 127.1±8.3, decrease by 13.1, p = 0.02, DBP 94.7±11.7 reduced to 86.8±6.4, decrease by 8, p = 0.014, body weight (kg) 83.4±17.2 reduced to 73±14.9, decrease by 10, p<0.001, BMI (kg/m2) 30.9±4.8 reduced to 26.7±3.9, decrease by 4.2, p<0.001 and waist circumference (cm) 103.8±13 reduced to 94.1±11.4, decrease by 9.7, p<0.001. There were 12 patients who discontinued the medications that were needed to manage hypertension, with a remission rate of 60% (12/20).

Conclusions:
Our initial results of the pilot, prospective study demonstrate that TPT has the potential to induce remission of hypertension at six months. However, the continuity of this study in terms of a larger number of patients and longer duration will further provide insights into the consistency and the scalability of the novel TPT to achieve remission of hypertension.
BLOOD PRESSURE REDUCTION WITH 3 FIXED- SINGLE PILL COMBINATION TREATMENTS OF RAS-BLOCKERS PLUS CCB AMONG PREDIABETIC HYPERTENSIVE PATIENTS. A RANDOMIZED 12-WEEK OPEN-LABEL STUDY
Authors: Liontos Angelos , Biros Dimitrios , Papagiannopoulos Christos , Tsiakas Ilias , Christaki Eirini , Liberopoulos Evangelos , Elisaf Moses , Milionis Haralampos , Liamis George 
Published: June 2023

Objective:
The effect of various antihypertensive drugs on both SBP and DBP levels has been studied extensively. Dual combination treatment is advised with current guidelines as first treatment step. Herein, we present comparative data of the effect of delapril/manidipine versus valsartan/amlodipine versus telmisartan/amlodipine combination treatments on blood pressure levels, before and after a 12-week treatment, in hypertensive prediabetic patients.

Design and method:
Data were collected from 158 patients from the outpatient clinic for patients with lipid disorders, hypertension and diabetes of our hospital, during the period 2014-2018 with stage II arterial hypertension and prediabetes. A total of 53 patients was randomized in the delapril/manidipine group 30/10 mg per day while 51 persons had been randomized in the group of telmisartan/amlodipine 80/5mg per day and 54 patients in the valsartan/amlodipine 160/5 mg per day. All patients successfully completed the study. Baseline characteristics are presented in Table 1A.

Results:
The resulting alternations on BP levels, before and after the 12-week treatment are presented on Table 1B for the 3 treatment groups.

Conclusions:
there was a statistically significant difference observed in SBP levels, at the end of the 12-week treatment, for each treatment group (p-value<0,001) with a change of -18 mmHg for DEL/MANI treatment group (reduction rate: -11.54%), -24 mmHg for TEL/AMLO treatment group (decrease rate of -14.72%) and -22 mmHg for VAL/AMLO treatment group (reduction rate: -13.58%). DBP levels showed a significant difference at the end of the treatment, for each group (p-value<0,001) with a change of -12 mmHg for DEL/MANI treatment group (reduction rate:-12%), -15 mmHg for TEL/AMLO treatment group (reduction rate: -15%) and -13 mmHg for VAL/AMLO treatment group (reduction rate: -13%).
In comparison between treatment groups, a statistically significant difference was observed in the change of SBP levels from the start of treatment to its end, for DEL/MANI treatment group, compared to VAL/AMLO (p-value<0.05) as well as compared to TEL/AMLO treatment group (p-value <0001). The smallest decrease in SBP levels was observed In DEL/MANI treatment group, of all the 3 treatment groups.
BASELINE DATA OF A 3-YEAR RANDOMIZED CONTROLLED TRIAL ASSESSING THE EFFECTS OF THE REDUCTION OF ANTIHYPERTENSIVE TREATMENT IN NURSING HOME RESIDENTS >80 YO. THE RETREAT FRAIL TRIAL
Authors: Gautier Sylvie , Freminet Anne , Metz Alice , Georgiopopulos Ioannis , Labat Carlos , Rossignol Patrick , Benetos Athanase , Consortium Retreat Frail 
Published: June 2023

Objective:
Although the benefits of blood pressure (BP) lowering treatments in patients over 80 years with preserved functional status have been shown, the benefits in treated hypertensive patients of this age-group with several co-morbidities and loss of functionality, remain controversial: data from observational studies show rather inverse relationships between BP and prognosis, whereas there is a total lack of interventional trials in these subjects.

Design and method:
RETREAT FRAIL is a multicenter randomized controlled trial aiming to evaluate the effect of the step-down of antihypertensive medications on all-cause mortality (mean follow-up, 36 months) in nursing home (NHs) residents over 80 years, treated with >1 antihypertensive drug and presenting an SBP<130 mmHg. The only clinical exclusion criterion was an estimated life expectancy <3 months. Enrolled patients were randomized into one of the 2 groups: treatment step-down or control group. In both groups, the follow-up is performed in the NHs every 2 months, including a comprehensive geriatric assessment every 6 months.

Results:
Between April 2019 and July 2022, 1048 patients (842 women), mean age 90±5, from 108 NHs were randomized (528 step-down and 520 controls). They were receiving at mean 9.4±3.4 different medications including 2.5±0.7 antihypertensive medications. Mean SBP: 118±11mmHg, DBP: 65±10 mmHg and HR: 71±12 bpm. Based on ADL, MMSE, and mobility criteria, 52% had severe loss of autonomy, 32 % partial loss of functionality and autonomy and 16% had preserved autonomy and functionality. No differences were observed for all these parameters between the 2 randomization groups. The 3-year follow-up of this trial will be completed June 2024.

Conclusions:
Despite the difficulties in NHs dramatically aggravated during the COVID-19 pandemic, we were able to complete the enrolment of the residents and to respect the follow-up protocol. RETREAT FRAIL will be the first randomized trial to provide information concerning the long-term effects of a progressive standardized down-titration of the BP lowering treatment in very old frail patient i.e. those who have so far been completely excluded from clinical trials.
HOW DOES THE ANTIHYPERTENSIVE THERAPY OF EVERYDAY PATIENTS FOLLOW THE DIFFERENT GUIDELINES?
Authors: Fejes Imola , Kiss Dávid , Ábrahám György , Légrády Péter 
Published: June 2023

Objective:
The different guidelines have got therapeutic recommendations for different conditions with hypertension. It sounds perfect. But what is the situation in the real life? How does the antihypertensive therapy of everyday patients follow the different guidelines?

Design and method:
Medications of alltogether 453 patients were analysed retrospectively from case reports. The selection of the patients was not based on specific criteria, but they arrived for their next visit at one of the Hypertension Outpatient Clinics of the Nephrology-Hypertension Center of the University of Szeged between 06/01/2021 and 31/12/2021. The authors used the guidelines valid in 2021 of the European Hypertension Society, the Hungarian Hypertension Society, the American Heart Association, the Hypertension Canada and the NICE as a base. Diabetes mellitus, angina pectoris, acute myocardial infarction, atrial fibrillation, congestive heart failure, chronic kidney disease without proteinuria, renal failure with proteinuria and stroke/TIA were the analysed conditions.

Results:
The rates of recommendation follow-up are summarized in the table.

Conclusions:
The antihypertensive medication of the patients proved to follow recommendations well. There were only non-significant differences between the following recommendations. In cardiovascular conditions, which can be considered more serious, it was completely the same.
A STUDY OF BRACHIAL AND CENTRAL 24HOUR BLOOD PRESSURE VARIABILITY ACROSS DIFFERENT HYPERTENSION PHENOTYPES
Authors: Lazaridis Antonios , Anyfanti Panagiota , Malliora Anastasia , Triantafyllou Areti , Zarifis Ippokratis , Mastrogiannis Konstantinos , Doumas Michalis , Gkaliagkousi Eugenia 
Published: June 2023

Objective:
Masked hypertensives (MHs) are considered a group of increased cardiovascular risk similar to sustained hypertensives. Brachial short term blood pressure (BP) variability (BPV) has been increasingly related to a higher risk of hypertension-mediated damage. Accordingly, central BP (cBP) has been considered to be more closely associated with target-organ damage. Limited data exists regarding BPV in MHs whereas no study has ever investigated BPV of 24hour cBP in MHs. Therefore, this study aimed to investigate and compare brachial and central BPV measures across different hypertension phenotypes.

Design and method:
Untreated essential hypertensive patients (UHTs) including MHs and normotensive individuals (NTs) were included in the study. Ambulatory BP was measured with the Mobil-O-Graph device, according to standard guidelines. The BPV parameters including the weighted standard deviation (wSD) and average real variability (ARV) of 24hour brachial and central systolic BP (SBP) and diastolic BP (DBP) were calculated according to a standardized formula based on the ambulatory BP monitoring (ABPM) measurements.

Results:
A total of 141 participants were studied (49.4±8.6 years; 62.4% males) including 79 UHTs, 22 MHs and 40 NTs. Baseline characteristics were similar between groups. As expected, groups differed significantly in terms of office and ABPM-derived BPs. Remarkably, all markers of 24h brachial BPV and 24h central BPV were comparable between MHs and UHTs and significantly higher compared to NTs (Table 1).

Conclusions:
Brachial and central BPV parameters in MHs don’t differ compared to UHTs, but are significantly higher compared to NTs. Whether this observation is clinically meaningful in terms of cardiovascular risk and target organ damage prediction, merits further investigation.
INTEREST OF TROPONIN ASSAY IN BREAST CANCER PATIENTS ON ANTHRACYCLINES
Authors: Nawal Habak , Nadjet Rouibah , Ammar Chikouche 
Published: June 2023

Objective:
anthracyclines objectives sont des médicaments anticancéreux utilisés dans le traitement de différents types de cancer, principalement lors de la chimiothérapie du cancer du sein. Les lésions cardiaques secondaires peuvent entraîner des problèmes cardiaques asymptomatiques ou symptomatiques pendant et après le traitement du cancer, ce sont les principaux effets secondaires des anthracyclines. La toxicité peut entraîner une toxicité aiguë ou chronique.
L’objectif de nos travaux est de déterminer l’intérêt de mesurer la troponine chez les patientes atteintes d’un cancer du sein traitées par anthracycline, dans la détection des lésions cardiaques.

Design and method:
Nous avons recruté 16 femmes du service d’oncologie médicale du CPMC, atteintes d’un cancer du sein sous antracyclines, Des échantillons de sang ont été prélevés dans un tube héparinisé lors des différents traitements de chimiothérapie. Nous avons mesuré les paramètres : urée, créatinine sur l’appareil de Cobas Roche ; Troponine par immunofluorescence (Tosoh).

Results:
Nous avons trouvé un équilibre rénal normal chez tous les patients : sauf pour le patient n̊ 12 : l’urée est passée de 0,35 à 0,48 g/L ; La créatinine augmente de 16 à 23 mg/L. Pour la troponine, tous les résultats sont normaux
Chez Deux Patients:
- Chez le patient n̊ 12; Les taux de troponine étaient normaux à l’inclusion à 0,02 ng / mL, puis ont augmenté à 0,04, puis 0,11 au troisième rendez-vous de suivi.- Chez le patient n̊ 16; Les taux de troponine étaient normaux au départ, puis ont augmenté à 0,04 et 0,08 au troisième rendez-vous de suivi.

Ces résultats positifs à la troponine sont en corrélation avec la présence d’une lésion cardiaque confirmée par un électrocardiogramme ECG et un scanner cardiaque. Les deux patients sont suivis dans le service de cardiologie. Pour la patiente n̊12, elle a développé une néphrotoxicité et une cardiotoxicité

Conclusions:
de la troponine comme biomarqueur pour la détection des lésions cardiaques a été démontrée dans plusieurs études. La combinaison de la troponine et du test Pro-bnp augmenterait la spécificité de la détection de la cardiotoxicité, qui est l’une de nos prochaines perspectives.
CARFILZOMIB-BASED REGIMEN AND CARDIOTOXICITY IN MULTIPLE MYELOMA: INCIDENCE OF CARDIOVASCU-LAR EVENTS AND ORGAN DAMAGE IN CARFILZOMIB-DEXAMETHASONE VERSUS CARFIL-ZOMIB-LENALIDOMIDE
Authors: Astarita Anna , Mingrone Giulia , Airale Lorenzo , Cesareo Marco , Leone Dario , Colomba Anna , Catarinella Cinzia , Gay Francesca , Bringhen Sara , Veglio Franco , Milan Alberto , Vallelonga Fabrizio 
Published: June 2023

Objective:
Cardiotoxicity is a known adverse effect of Carfilzomib therapy, nevertheless few data are available on cardiovascular complications induced by different Carfilzomib-regimens in a real-life setting. The aim of this perspective study was to investigate the difference in incidence and time of onset of cardiovascular adverse events between Kd and KRd in MM patients in real-life conditions. Furthermore, we investigated differences in subclinical organ damage (both cardiac and vascular ) induced by the two regimens, and offer a discussion on how these data might support different follow up strategies for patients treated with Kd or KRd regimen

Design and method:
In this prospective study, adults with MM who had haematological indication to Kd or KRd, were consecutively enrolled. They underwent a baseline cardiovascular assessment before treatment initiation and a follow-up evaluation at 6 months, including office blood pressure measurements, ambulatory blood pressure monitoring, 12-leads EKG, trans-thoracic echocardiography with global longitudinal strain assessment (GLS), and estimation of arterial stiffness by the carotid-femoral pulse wave velocity (cfPWV) measurement.

Results:
A total of 109 patients were enrolled, 47 (43%) received Kd and 62 (57%) KRd. All-types of cardiovascular and hypertensive events occurred more frequently in Kd group compared to KRd (59% vs 40% and 55% vs 35.5% patients, respectively, p<0.05), with higher incidence of hypertensive urgencies. Furthermore, the time of onset of all-type of CVAEs, major and hypertensive event was shorter in Kd regimen compared to KRd (3.6 vs. 10.2 months, 4.0 vs. 10.8 months and 8.6 vs. 14.6 months, respectively (p < 0.05)). At follow-up, Kd patients developed more frequently signs of cardiac as decline of global longitudinal strain (-19.7 vs -21.3, p = 0.009) and vascular organ damage demonstrated by a rise of pulse wave velocity (8.5 vs 1.9, p = 0.009), with respect to KRd.

Conclusions:
In conclusion, Kd regimen showed greater cardiovascular toxicity with respect to KRd and earlier onset of events. Thus, a closer and careful follow-up should be considered.
ASSOCIATION OF DIABETES AND DYSLIPIDEMIA IN HYPERTENSIVE PATIENTS IN NEPHROLOGY CONSULTATION: PREVALENCE AND CARDIOVASCULAR COMPLICATIONS
Authors: Triqui Chifa , Khadhar Mariem , Jerbi Mouna , Hadded Sarra , Gaied Hanene , Aoudia Raja , Goucha Rim 
Published: June 2023

Objective:
Diabetes, dyslipidemia and hypertension are increasing in prevalence worldwide and they are among the most cardiovascular factors.
The aim of this work was to know the cardiovascular complications found in hypertensive patients with diabetes and dyslipidemia followed in nephrology consultation.

Design and method:
We conducted a descriptive retrospective study over a period of two years (January2020- January2022) including hypertensive patients aged over 18 years followed in nephrology consultation. Cardiovascular risk was estimated by calculating the Framingham score. The stage of chronic kidney disease (CKD) was defined according to the KDIGO 2012 classification.

Results:
Our study included 73 patients followed in our nephrology consultation for hypertension associated or not with nephropathy. The mean age was 69.62+/-9.59 [30-96] with a sex ratio M/F = 1.35. Diabetic patients were 44(60.27%) and dyslipidemic patients were 25 (34.24%). Diabetes associated with dyslipidemia were found in 21 patients (28.76%).
Among the diabetic patients, hypertension was diagnosed before diabetes in 24 patients (54.54%) and it was considered as diabetic macro angiopathy in 20 patients (45.45%).
Diabetic nephropathy was found in 32 patients (72.72%) and diabetic retinopathy in 20 patients (45.45%). The average Framingham score was (22.94%) and (21.52%) in diabetic and dyslipidemic patients respectively.
Obesity was found in 15 patients of our population (20.54%), of which, 12 patients were diabetic (80%) and 7 patients were dyslipidemic (46.66%). Coronary artery disease was found in 14 patients in our population (19.17%) of whom 8 were diabetic (57.14%) and 3 were dyslipidemic (21.42%).
Heart failure was found in 8 patients, 6 of whom were diabetic (75%) and 3 of whom were dyslipidemic (37.5%). Six patients in our population had a stroke (8.21%), 5 of whom were diabetic (83.33%) and 2 were dyslipidemic (33.33%).
Regarding the renal impact, we noted the presence of chronic kidney disease stage 3 or more in 55 patients (75.34%) among which 19 patients had dyslipidemia (34.54%).

Conclusions:
We noted a multitude of cardiovascular events in patients with diabetes and/or dyslipidemia associated with hypertension.
Early identification and management of these risk factors are necessary to prevent cardiovascular complications.