bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPB09-3: CIGARETTE SMOKE EXTRACT INDUCES DNA DAMAGE AND TRIGGERS AN INNATE IMMUNE RESPONSE
Authors: Ishida Mari , Ueda Keitaro , Sakai Chiemi , Kobayashi Yusuke , Yoshizumi Masao , Nakano Yukiko , Ishida Takafumi 
Published: January 2023

Objective:
Elevated blood pressure and tobacco smoking are causes of preventable mortality. The effects of tobacco smoking on blood pressure are complex and chronic effects are inconsistent. We have previously reported increased DNA damage in peripheral mononuclear cells of smokers compared to nonsmokers. In this study, we investigated the effects of cigarette smoke extract (CSE) on DNA damage and the physiological influence of DNA damage in endothelial cells.

Design and method:
The effect of CSE extracted from tobacco smoke was examined in human umbilical vein endothelial cells (HUVECs). CSE was added to HUVECs and the formation of DNA damage was quantified by fluorescent immunostaining. The mRNA expression of inflammatory cytokines was quantified by real-time RT PCR.

Results:
CSE increased double-strand breaks in HUVEC by 72 hours. CSE also increased oxidative DNA damage both in the nucleus and mitochondria, and decreased mitochondria membrane potential. Mitochondrial dysfunction partially induced mitochondrial outer membrane permeabilization, resulting in the partial activation of caspase-3 and nuclear translocation of caspase-activated deoxyribonuclease, which fragments DNA in the nucleus. It was suggested that this is one of the mechanisms of nuclear DNA double-strand breaks. CSE induced the accumulation of nuclear and mitochondrial DNA in the cytosol. We further examined whether accumulated cytosolic DNA activated cytosolic DNA-sensing pathways. The production of cGAMP, a second messenger in cGAS (a DNA-sensing receptor) signaling, was increased by CSE, followed by nuclear translocation of NF-kB and increased mRNA expression of IL-6. The increase in IL-6 expression was suppressed by si-cGAS.

Conclusions:
Our study revealed that continuous exposure to CSE induces DNA damages not only in the nucleus but also in the mitochondria, which leads to cytosolic DNA accumulation, and evokes chronic inflammation via the cGAS pathway.
PS-BPC03-1: DEVELOPMENT OF CUFFLESS AND CALIBRATION-LESS BLOOD PRESSURE MEASUREMENTS
Authors: Shimizu Kosuke 
Published: January 2023

Objective:
The characteristics of dynamic short-term blood pressure variability caused by numerous triggers vary greatly among individuals. Wearable devices that continuously and noninvasively capture beat-by-beat blood pressure values are a necessity to further study blood pressure.
The development of cuffless blood pressure measurements, which, unlike sphygmomanometers, do not require pressurization and depressurization time, has attracted much attention in recent years for its potential to capture beat-by-beat blood pressure values. However, cuffless blood pressure measurements approved in Europe and the United States require calibration before use. This indicates that the function is limited to estimation of blood pressure variation from the time of calibration.
In this study, we conducted a measurement test aiming at the practical application of the cuffless and calibration-less blood pressure measurements.

Design and Method:
In this study, we recruited adults aged 20 years and older to evaluate whether a wearable device without pre-calibration could meet the standards of BHS, ESH, ISO81060–2:2018 and IEEE1708a-2019 and ensure the same accuracy as existing sphygmomanometers.
For each measurement test, the cuff was wrapped around the subject's upper left arm and a wearable device was attached to the ipsilateral wrist, and the subject was asked to maintain a sitting posture. Measurements were taken with the reference sphygmomanometer every 3 minutes for 7 times. To minimize the effect of the venous congestion on the measurements, the measurement period with the wearable device was from 30 seconds after the completion of the cuff depressurization until the start of the next pressurization. The blood pressure value measured by the wearable device was evaluated against the average of the values measured by the reference sphygmomanometer before and after.

Results:
219 participants were included in the analysis. Participants with systolic blood pressure values ranging from 80 to 204 and diastolic blood pressure values ranging from 46 to 140 were included. The mean and SD of the differences between the estimates and the reference were -1.27 ± 4.97 mmHg for SBP and 0.74 ± 2.55 mmHg for DBP.

Conclusion:
The overall accuracy of the cuffless and calibration-less blood pressure measurements device satisfied the criteria shown in ISO81060–2 against various adults in the sitting posture. This study showed the strong potential of the cuffless and calibration-less blood pressure measurements.
PS-BPC04-1: CHARACTERISTICS OF MONTH-BY-MONTH BLOOD PRESSURE VARIABILITY IN HEMODIALYSIS PATIENTS
Authors: Amari Yoshifumi , Morimoto Satoshi , Okuda Hidenobu , Bokuda Kanako , Oyama Yasuo , Yurugi Takatomi , Nakajima Fumitaka , Ichihara Atsuhiro 
Published: January 2023

Objectives:
It is well known that blood pressure (BP) exhibits BP variation in patients with hemodialysis (HD). We have previously reported that high visit-to-visit blood pressure variability is independently correlated with cardiovascular mortality in maintenance HD patients. However, the characteristics of long-term BP variability remains to be elucidated in these patients. The present study, therefore aimed to investigate the characteristics of month-by-month blood pressure variability, as an indicator of long-term blood pressure variability, and the relationship between month-by-month blood pressure variability and cardiovascular mortality in these patients.

Design and method:
A total of 324 maintenance HD patients, who could be followed for 60 months, were recruited. We used variation independent of the mean (VIM), which was estimated using systolic BP (SBP) in pre-dialysis and post-dialysis at the beginning of the month in 12 consecutive months (pre-VIM-SBP and post-VIM-SBP), as an index of month-by-month BP variability. We also estimated the average of 12 values of differences between the highest and lowest SBP values during a dialysis session (average Δ SBP) and the difference between SBP in January and February and SBP in July and August (seasonal variability of SBP).
We investigated (1) the reproducibility of these values, (2) the relationship between these values and background factors, and (3) the association between these values and mortality.

Results:
(1) Pre-VIM-SBP and post-VIM-SBP showed significant reproducibility (intraclass correlation, 0.456 (P < 0.001) and 0.522 (P < 0.001), respectively]. Seasonal variability of pre-SBP and Δ SBP was observed both at beginning / after 12 months [5.0 (-5.0–19.0) / 5.3 ± 18.3, 7.2 ± 16.7 / 5.0 ± 12.8, respectively]. (2) Higher pre-VIM-SBP was associated with higher interdialytic weight gain and poor nutritional status. Higher post-VIM-SBP was associated with glucose intolerance, higher interdialytic weight gain and poor nutritional status. Higher Δ SBP was associated with glucose intolerance and higher interdialytic weight gain. (3) Higher post-VIM-SBP was associated with a higher rate of cardiovascular deaths independent of other factors (hazard ratio: 1.104, 95% confidence interval: 1.011–1.207, P = 0.028).

Conclusions:
Month-by-month blood pressure variability in HD patients is reproducible and associated with various background factors. Month-by-month blood pressure variability in post-dialysis SBP is independently correlated with cardiovascular mortality. Further studies are necessary to confirm the mechanism of increased month-by-month blood pressure variability and to clarify whether reducing month-by-month blood pressure variability will improve the prognosis for HD patients.
PS-BPC04-3: LOWER NOCTURNAL SYSTOLIC BLOOD PRESSURE IS ASSOCIATED WITH CARDIOVASCULAR MORTALITY IN HEART FAILURE WITH REDUCED EJECTION FRACTION PATENTS
Authors: Kim Andrew T , Ito Asahiro , Ito Ayaka , Hayashi Hiroya , Ogawa Mana , Kitada Ryoko , Ishikawa Sera , Iwata Shinichi , Izumiya Yasuhiro , Fukuda Daiju 
Published: January 2023

Objective:
Blood pressure (BP) and its variability, especially nocturnal were associated with all-cause death and cardiovascular mortality in general population. However, little is known about the association between nocturnal BP variables (average value and variability) and cardiovascular mortality in patients with heart failure with reduced ejection fraction (HFrEF).

Design and method:
This study population consisted of 230 patients (mean age, 65 ± 13 years) who were admitted to our hospital due to HFrEF. Nocturnal BP was measured hourly using a home BP monitoring device, and its variability were expressed as the coefficient of variation of all readings.

Results:
During median follow-up period of 37 months, 19 (8%) patients had cardiovascular mortality. Compared with survivors, nocturnal systolic BP was significantly lower in cardiovascular mortality patients (125 ± 24 mmHg vs 110 ± 17 mmHg, p = 0.007). Univariate analysis showed that age, chronic kidney disease, nocturnal systolic and diastolic BP were associated with cardiovascular mortality. Cox proportional hazards models showed that nocturnal systolic BP was associated with cardiovascular mortality after adjustment for age and CKD (odds ratio: 0.97; 95% confidence interval: 0.94–0.99; P = 0.01), whereas nighttime diastolic BP and their variables (average value and variability) were not. Similarly, nocturnal systolic BP < 108 mmHg was predictive of cardiovascular mortality (odds ratio: 3.84; 95% confidence interval: 1.53–9.67; P = 0.004),

Conclusion:
Lower nocturnal systolic BP was associated with cardiovascular mortality in patients with HFrEF. Intervention for nocturnal systolic BP could avoid cardiovascular events and consequently reduce the risk of cardiovascular mortality.
PS-BPC05-2: ADMISSION AND DISCHARGE BLOOD PRESSURE INFLUENCE MEDICAL PRESCRIPTION AND CLINICAL OUTCOMES OF PATIENTS WITH DECOMPENSATED HEART FAILURE
Authors: Jo Sang Ho 
Published: January 2023

Background:
There has been no study evaluating whether admission blood pressure (BP) influences medical treatment and clinical outcomes in acute decompensated heart failure patients.

Methods:
We analyzed the data form Korean Acute Heart Failure (KorHF) Registry. A total of 3,200 acute decompensated heart failure patients were included in the registry. We investigated the association of initial blood pressure at admission and clinical outcomes and prescription of ACEI, ARB and beta-bolcker(BB). The primary outcome was composite of mortality and readmission during 1-year after hospital discharge.

Results:
Admission systolic (SBP) and diastolic BP (DBP) increase was associated with decrease in primary outcomes (by 1mmHg increase of SBP, crude hazard ratio [HR] 0.9963, 95% CI: 0.9943–0.9982, p < 0.0001 and by 1mmHg increase of DBP, crude HR 0.99, 95% CI: 0.9867–0.9932, p < 0.0001). By multiple regression analysis DBP was an independent risk factors of mortality and re-hospitalization (HR 0.9927, 95% CI 0.9867–0.9988, p < 0.0196), but SBP was not. Age, history of heart failure, hypertension, cholesterol level and ACE/ARB use were also associated with primary outcomes. The cut-off value of SBP and DBP for increasing clinical outcomes were 118.5 mmHg (sensitivity 0.3965, specificity 0.6727) and 78.5mmHg (sensitivity 0.5682, specificity 0.5228), respectively by ROC curve. The SBP < 118.5 mmHg and DBP < 78.5mmHg were independent predictor for primary outcomes (adjusted HR 1.33, 95% CI 1.15–1.54, p < 0.0001 and adjusted HR 1.23, 95% CI 1.12–1.48, p = 0.0004, respectively).
The cut off SBP/ DBP value of not using in-hospital ACE/ARB/BB were 129.5/80.5mmHg. DBP of 80.5mmHg was an independent determinants of not prescribing the drugs (adjusted OR 0.755, 95% CI: 0.582–0.977, p = 0.0329). Both lower SBP (< 129.5) and DBP (< 80.5mmHg) combined with no use of the drugs were independent predictor of poor clinical outcomes at 1-year. (adjusted HR 1.677, 95% CI: 1.380–2.037, p < 0.0001 and adjusted HR 1.653, 95% CI: 1.355–2.017, P < 0.0001, respectively)

Conclusions:
Lower blood pressure at admission increase mortality, re-hospitalization at 1-year and decrease in-hospital prescription of ACE/ARB and BB in patients with acute decompensated heart failure. The cut-off value of SBP/DBP for primary outcome was 118.5/78.5 mmHg and that for use of ACE/ARB/BB was 129.5/80.5mmHg.
PS-BPC06-2: CLINICAL CHARACTERISTICS OF COMORBID HYPERTENSION AND CORONARY ARTERY DISEASE IN 10 YEARS: RESULTS FROM CHINA
Authors: Wang Chi , Liu Tongbo , Xue Hao 
Published: January 2023

Background:
Little is known regarding the clinical profiles of patients with comorbid hypertension and coronary artery disease (HT-CAD) in China.

Methods:
The current study was conducted in a large-scale tertiary hospital that gathered nationwide patients of China. A total of 32,355 CAD patients with and without hypertension admitted from 5 August 2008 to 22 July 2018 were identified in this cross-sectional study. The demographic characteristics, diagnosis records, relevant examinations, treatment patterns, and in-hospital outcomes of patients were abstracted via electronic medical record database. We analyzed the overall comorbidity rate, blood pressure control, clinical characteristics and their temporal change of patients with HT-CAD in the current study.

Results:
The overall comorbidity rate of hypertension in patients with CAD was 64.12% (N = 20,747) and did not significantly change during 2008 to 2018. Female CAD patients and CAD patients in east coastal regions had significantly higher comorbidity rate of hypertension. Among patients with HT-CAD, the BP was controlled at < 140/90 mmHg in 52.39% and < 130/80 mmHg in 27.03%. The control rate of < 130/80 mmHg increased during 2008 to 2018, whereas the control rate of < 140/90 mmHg did not change significantly. Compared with the counterparts with nonHT-CAD, patients with HT-CAD had higher incidence of cardiovascular-related comorbidities, and most of these comorbidities showed an increasing trend over the study period.

Conclusions:
Hypertension is the most prevalent comorbidity in Chinese patients with CAD. Patients with HT-CAD have an increasing health burden and should be paid with special attention to improve their cardiovascular outcomes.
PS-BPC06-4: RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS VERSUS CALCIUM CHANNEL BLOCKERS IN ASSOCIATION WITH MORTALITY RATE IN COVID-19 HYPERTENSIVE PATIENTS: THE EFFECT OF AGE
Authors: Hassan Dina Ahmed , Elamin Maha Ismail , Bashir Intisar Abdelrahim , Mahmoud Tarig Elhadi 
Published: January 2023

Objective:
To study the association of calcium channel blockers (CCBs), the renin-angiotensin-aldosterone system (RAAS) inhibitors or their combination as antihypertensive medications and the clinical outcome of COVID-19 infection.

Design and method:
This is a retrospective cohort study using de-identified data retrieved from clinical records of COVID-19 patients in two isolation centers. Medical history, demographic data, symptoms, complications and laboratory investigations were extracted from clinical records of 406 confirmed COVID-19 hospitalized patients between Feb 2020 and July 2021. Hypertension and antihypertensive treatments were confirmed by medical history and clinical records. Continuous variables were presented as means ± standard deviation (SD) while categorical variables were presented as percent proportions. Logistic regression was used to assess the impact of antihypertensive drugs (RAAS inhibitors, CCBs, combination of RAAS inhibitors and CCBs and those not receiving medication) on the prognosis of COVID-19 patients and to explore the risk factors associated with mortality.

Result:
Out of 406 hospitalized COVID-19 patients, 242 (59.6%) had a history of hypertension. Hypertensive patients under the age of 65 years and receiving RAAS inhibitors or the combination of both RAAS inhibitors and CCBs were at higher risk of mortality than those on CCBs only (odds ratio [OR]: 4.45, 95% confidence interval [CI]: 1.56–12.56, P = 0.005 and OR:3.57, CI: 1.03–12.36, P = 0.045 respectively). Antihypertensive medications did not seem to influence mortality rates among hypertensive patients above 65 years. Routine laboratory investigations were not significantly different between the subgroups receiving different antihypertensive medications regardless of age.
Cough was the only symptom associated with mortality among patients under 65 years (OR:2.34, CI:1.24–4.41, P = 0.009). Type II respiratory failure was significantly associated with death among hypertensives under 65 years (OR:5.43, CI:1.08–28.07, P = 0.044) whereas acute kidney injury and septic shocks are the common complications related to death among hypertensives above 65 years (OR:3.59, CI:1.54–8.36, P = 0.003 and OR:7.87, CI: 1.68–36.78, P = 0.009 respectively).

Conclusion:
Administration of CCBs may improve the outcome of COVID-19 hypertensive patients under 65 years of age. Antihypertensive treatment does not seem to influence the prognosis of COVID-19 patients above 65 years. Such results may affect management strategy of COVID-19 hypertensive patients. Type-II respiratory failure among patients under 65 years of age, acute kidney injury and septic shock among those above 65 years are the most serious complications that can lead to death regardless of blood pressure.
PS-BPC06-7: ASSOCIATION BETWEEN ISOLATED DIASTOLIC HYPERTENSION AND MICROALBUMINURIA AMONG KOREAN ADULTS
Authors: Moon Jenny , Lee Hokyou , Kim Hyeon Chang 
Published: January 2023

Objective:
Microalbuminuria acts as a sensitive marker of early nephropathy development and increased cardiovascular risk. Studies have reported that isolated diastolic hypertension (IDH) has an age-dependent association with cardiovascular disease (CVD) risks. However, little is known regarding renal dysfunctions associated with IDH. Therefore, this cross-sectional study aimed to evaluate the age-stratified association between IDH and microalbuminuria.

Design and method:
A total of 13,818 adults, including 5,916 men and 7,897 women, from Korea National Health and Nutritional Examination Survey (KNHANES) between 2011–2014 were included. Participants were categorized as having IDH or no IDH according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio of 30 to 300 mg/g from single-spot morning urine sample in accordance with the International Diabetes Federation definition. The youngest age group was defined as 19–39 years. The association between IDH and microalbuminuria was evaluated using logistic regression analysis with adjustment for covariates.

Results:
The mean age of participants with IDH was 47 years, younger than those with no IDH. There was a two-fold higher proportion of women than men with no IDH, and a higher proportion of men with IDH. Prevalence of microalbuminuria was higher in IDH group compared to no IDH group. With no IDH as a reference, the odds ratio (OR) of IDH for microalbuminuria in total was 1.21 (95% CI: 1.14–1.68). IDH also had significant ORs for prevalence of microalbuminuria in both of the older age groups (OR: 1.57, 95% CI: 1.17 -2.13 at 40–59 years, OR: 1.17, 95% CI: 1.06–2.10 at age ≧ 60). However, opposite result was found in the youngest age group (OR: 1.35, 95% CI: 0.98–2.38).

Conclusion:
IDH was positively associated with prevalence of microalbuminuria among middle-aged Koreans, but not with young adults. This study suggests potential significance of IDH in the development of cardiovascular diseases.
PS-BPC07-2: EFFECTS OF MINERALOCORTICOID RECEPTOR ANTAGONISTS ON SEX HORMONES AND BODY COMPOSITION IN PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Ishikawa Toru , Morimoto Satoshi , Ichihara Atsuhiro 
Published: January 2023

Objective:
Mineralocorticoid receptor antagonists are frequently used for the treatment of primary aldosteronism. Steroidal mineralocorticoid receptor antagonists may have antagonistic actions on androgen receptors, agonistic actions on progesterone receptors, and antagonistic actions on mineralocorticoid receptors. Because anti-androgen effects may cause body fat accumulation and skeletal muscle atrophy, there are concerns that this drug may have adverse effects on body composition.

Design and method:
Therefore, in this randomized prospective study, we compared the adverse effects of spironolactone, a steroidal mineralocorticoid receptor antagonist, and esaxerenone, a nonsteroidal mineralocorticoid receptor antagonist, on sex hormone levels and body composition in patients with primary aldosteronism without severe renal dysfunction.

Results:
The serum concentration of free testosterone was significantly higher in the spironolactone group than in the esaxerenone group in both males and females. However, the levels of estradiol, progesterone, luteinizing hormone, and follicle-stimulating hormone did not significantly increase. Changes in body fat percentage and muscle mass rate were not significantly different between the two groups. No patient showed a serum potassium level > 6.0 mEq/L; however, serum potassium levels were significantly higher in the spironolactone group than in the esaxerenone group.

Conclusions:
These data indicate that spironolactone may have antagonistic effects on androgen receptors. Esaxerenone did not show any apparent adverse effects, suggesting that it can be safely used in patients with primary aldosteronism.
PS-BPC07-7: REDUCED EFFICACY OF BLOOD PRESSURE LOWERING DRUGS IN THE PRESENCE OF DIABETES MELLITUS: RESULTS FROM THE TRIUMPH RANDOMISED CONTROLLED TRIAL.
Authors: Gnanenthiran Sonali Rukshana , Webster Ruth , Silva Asita de , Salam Abdul , Schutte Aletta E , Patel Anushka , Rodgers Anthony 
Published: January 2023

Objective:
People with diabetes mellitus (DM) have a higher prevalence of suboptimal blood pressure (BP) control compared to those without DM. Whether the presence of DM affects the ability of antihypertensive therapies to lower blood pressure (BP) is uncertain. We investigated whether DM affects the efficacy of a low dose triple combination pill or usual care among people with mild-moderate hypertension.

Design and method:
TRIUMPH (TRIple pill vs Usual care Management for Patients with mild-to-moderate Hypertension) was a randomized controlled open-label trial of patients requiring initiation or escalation of antihypertensive therapy. Patients were randomised to a once-daily low-dose triple combination polypill (telmisartan 20 mg/amlodipine 2.5 mg/chlorthalidone 12.5 mg) or usual care. This analysis compared BP reduction and percentage of time below target BP in people with and without DM, both in the intervention and control groups over 24-week follow-up. Predicted efficacy of prescribed therapy was calculated using the estimation methods of Law et al.

Results:
The trial randomized 700 patients (56 ± 11yrs, 31% DM). There was no difference in the number of drugs prescribed or predicted efficacy of therapy between people with DM and without DM. However, the observed BP reduction from baseline to week 24 was lower in those with DM compared to non-diabetics in both the triple pill (25/11 vs 31/15 mmHg, p ≦ 0.01) and usual care (17/7 vs 22/11, p ≦ 0.01) groups. People with DM achieved lower time at target BP than non-diabetics on both the triple pill (44% vs 73%, p < 0.001) and usual care (27% vs 51%, p < 0.001). DM was a negative predictor of change in BP (beta-coefficient -0.08, p = 0.02) and spending majority of time at target BP (OR 0.54, p = 0.006).

Conclusions:
Patients with DM experienced reduced efficacy of BP lowering therapies as compared to patients without DM, irrespective of the type of BP lowering therapy received. The triple pill still produced greater BP reduction compared to usual care in patients with mild-moderate hypertension even in the presence of DM.