bluuebunny/crossref_metadata_2025_split huggingface dataset:
S-28-6: URINARY METABOLOMICS, DIETARY SALT INTAKE AND BLOOD PRESSURE: THE AFRICAN-PREDICT STUDY
Authors: Strauss-Kruger Michél , Zyl Tertia van , Pieters Marlien , Kruger Ruan , Mokwatsi Gontse , Gafane-Matemane Lebo , Mbongwa Hlengiwe , Jacobs Adriaan , Schutte Aletta Elisabeth , Louw Roan , Mels Carina 
Published: January 2023

Objective:
Excessive salt intake is the leading dietary risk factor for cardiovascular disease (CVD). This increased risk may be attributed to alterations in the human metabolome. Salt sensitivity is associated with ethnicity, and ethnic differences in the interaction between sodium intake and the metabolome may play an integral part in CVD development. We therefore investigated 1) the urinary metabolomic profiles of Black and White adults according to low, moderate and high dietary salt intake; and 2) explored the relationships of identified metabolites with blood pressure.

Design and Methods:
This study included data of White (N = 447) and Black (N = 380) adults aged 20 to 30 years from the African-PREDICT study. Estimated salt intake was determined from 24hr urinary sodium. Urinary amino acids and acylcarnitines were measured using liquid chromatography tandem mass spectrometry. Clinic, 24hr and central systolic blood pressure (SBP) were measured.

Results:
Whites with a high salt intake (> 10 g/day) had higher SBP (clinic, 24hr and central) compared to those with low (< 5 g/day) or moderate (5 to 10 g/day) salt intakes (all p < 0.05). The metabolites GABA (q = 0.020), citrulline (q = 0.020), glutamic acid (q = 0.046), serine (q = 0.054) and proline (q = 0.054) were lower in those with higher salt intake. In stepwise multivariable adjusted regression analyses, we found that clinic SBP of white adults were inversely associated with GABA (Adj. R2 = 0.35; Std. β=-0.123; p = 0.005), serine (Adj. R2 = 0.35; Std. β=-0.099; p = 0.022) and proline (Adj. R2 = 0.35; Std. β=-0.099; p = 0.021), and central SBP with GABA (Adj. R2 = 0.34; Std. β=-0.094; p = 0.036), glutamic acid (Adj. R2 = 0.34; Std. β=-0.090; p = 0.035) and proline (Adj. R2 = 0.034; Std. β=-0.106; p = 0.015). In Black adults, there were no differences in SBP or metabolites between low, moderate or high salt intake groups, with no relationships between SBP and GABA, glutamic acid, citrulline, serine or proline.

Conclusion:
In White adults, high salt intake was associated with low levels of GABA, glutamic acid, serine and proline, which in turn were related to high SBP. We hypothesise that metabolomic changes are related to salt intake and may contribute to pathophysiological mechanisms associated with increased blood pressure.
S-30-4: SEX DIFFERENCES IN IMPACT OF CUMULATIVE SYSTOLIC BLOOD PRESSURE FROM CHILDHOOD TO ADULTHOOD ON ALBUMINURIA: A 30-YEAR PROSPECTIVE COHORT STUDY
Authors: Wang Dan , Mu Jianjun 
Published: January 2023

Background and Objectives:
Albuminuria is recognized as being a predictor of cardiovascular and renal disease. The aim of this study was to identify the impact of the long-term burden and trends of systolic blood pressure on albuminuria in midlife, as well as to explore sex differences concerning this relationship.

Methods:
This longitudinal study consisted of 1,683 adults aged 6–15 years who had been examined 4 or more times for blood pressure starting in childhood, with a follow-up time period of 30 years. The cumulative effect and longitudinal trend of blood pressure were identified by using the area under the curve (AUC) of individual systolic blood pressure measurement with a growth curve random effects model. Albuminuria was defined as a urine albumin-to-creatinine ratio (uACR)¡Ù30 mg/g.

Results:
Over 30 years of follow-up, 190 people developed albuminuria, including 53.2% males and 46.8% females. The uACR values increased as the total and incremental AUC values increased. Additionally, women had a higher albuminuria incidence in the higher SBP AUC groups than men do (13.3% for men vs. 33.7% for women). Logistic regression showed that the ORs of albuminuria for males and females in the high group were 1.34 (0.70–2.60) and 2.94 (1.50–5.74), respectively, after adjustments. Similar associations were found in the incremental AUC groups. Moreover, there was a significant interaction between AUC groups and sex on the outcomes of albuminuria.

Conclusions:
The presence of higher cumulative SBP was correlated with higher uACR levels and a risk of albuminuria in middle age, especially in women. The identification and control of cumulative SBP levels from an early age may assist in reducing the incidences of renal and cardiovascular disease for individuals in later life.
S-36-1: TYPE OF EXERCISE AND ARTERIAL STIFFNESS
Authors: Miyachi Motohiko 
Published: January 2023

Arterial stiffness increases with age and is an independent risk factor for death from future cardiovascular diseases. Habitual exercise has been recommended as one of the effective treatments and prevention for hypertension and cardiovascular diseases. In this presentation, I would like to introduce the results of research on the effects of different types of exercise on arterial stiffness.
A lot of studies have reported that habitually moderate- to vigorous- intensity aerobic exercise, e.g., walking, running, and swimming reduces arterial stiffness, especially in middle-aged and elderly. Our study also reveals that arterial stiffness is lower in elderly with more light-intensity physical activity and less sedentary behavior. Surprisingly, bodybuilders and American football players who do a lot of strength training recommended along with aerobic exercise have higher arterial stiffness and blood pressure than sedentary peers. We have reported for the first time that several months of high-intensity strength training in young subjects have the unfavorable effect of increasing arterial stiffness. On the other hand, systematic review and meta-analysis also suggests that moderate-intensity strength training in middle-aged and elderly with increased arterial stiffness has less adverse effects. Strength and aerobic combined exercise suppress the increase in arterial stiffness. In addition, we found that the arteries were stiff in middle-aged and elderly with lower whole-body flexibility. It has also been reported that several months of yoga and stretching interventions reduce arterial stiffness.
Since the effect on arterial stiffness differs depending on the type of exercise, it is necessary to carefully select the exercise type when using exercise for treatment of hypertension. The mechanism of changes in arterial stiffness due to exercise has not been fully elucidated. Further research is needed to provide more reliable exercise prescription for hypertension.
S-38-4: ASSOCIATION BETWEEN DNA METHYLATION AGE OR DNA DAMAGE IN URINARY SHEDDING CELLS AND EARLY CKD
Authors: Hishikawa Akihito , Hayashi Kaori , Sugita Erina , Yoshimoto Norifumi , Nakamichi Ran , Yoshida Eriko , Shimizu Ryoko , Takaishi Hiromasa , Itoh Hiroshi 
Published: January 2023

Objective:
Recent studies have identified that aggregate DNA methylation status of specific sites measures biological age, referred to as the DNA methylation clock. However, the relationship between kidney diseases and DNA methylation clock has been unclear. In this study, we aimed to investigate the association between DNA methylation age or DNA damage in urinary shedding cells and early CKD.

Design and method:
Individuals aged 45–81 years old, who visited Keio University Hospital for annual health check-up were enrolled. A total of 22 participants (14 males, 8 females) aged 61.6 ± 10.0 years old were eligible for this study. We evaluated a 71 CpG epigenetic age predictor, referred to as the Hannum's clock, which lacks 6 probes on the EPIC array using blood samples from the patient. 50 ml of urine samples were collected and centrifuged, and mRNA was extracted to analyze the expression of phenotypical markers and epigenetic modulators in urine derived cells by quantitative RT–PCR method as previously described. DNA was also extracted from urine derived cells, and DNA double strand breaks (DSBs) were evaluated by the quantitative long distance PCR method as previously described (Hishikawa, et al. Sci rep 2020). The association between biological aging (Hannum's clock age − chronological age) and clinical data was investigated.

Results:
Hannum's clock correlated with chronological age, and biological aging (Hannum's clock age − chronological age) was promoted in CKD patients (eGFR 43–59). DNA DSBs of the nephrin gene was also promoted in CKD patients. DNMT3 expression in urinary shedding cells correlated with biological aging.

Conclusions:
To our knowledge, this is the first study to demonstrate the possible association of biological aging measured by DNA methylation clock and CKD, especially in early stage. Podocyte DNA DSBs and urine DMNT3 expression may be a potential marker of biological aging.
S-43-3: INTRAUTERINE GROWTH RESTRICTION CAUSES AN ALTERATION IN KIDNEY GENE EXPRESSION
Authors: Intapad Suttira 
Published: January 2023

High blood pressure (BP) and kidney disease are the leading cause of death in the world population. Experimental and epidemiological studies indicate that the fetal environment is critical in determining adult cardiovascular (CV)-renal outcome. It is known that intrauterine growth restriction (IUGR) or low birth weight (LBW) induces an increased risk of hypertension and kidney disease in later life. Placental insufficiency is the common cause of IUGR. Low birth weight is a significant public health problem globally and is associated with short- and long-term consequences. About 15–20% of all births worldwide are LBW, representing more than 20 million births a year. Clinical studies indicate that birth weight is positively associated with glomerular filtration rate (GFR) and negatively associated with BP. Also, animal models of IUGR exhibit a higher susceptibility to ANGII induced high BP and kidney damage in response to acute ischemic reperfusion injury. Thus, these data suggest that IUGR programs greater risk of hypertension and renal dysfunction. However, the exact mechanisms linking an adverse fetal environment with a later increased risk of these diseases are unclear.

Objective:
This study aims to evaluate the global genetic change in the kidney of the animal model of IUGR.

Design:
female C57Bl/6J were mated with male C57bl/6J. Upon confirming the pregnancy by sperm plug (day 0 of gestation), the pregnant animal will be undergone reduced uterine perfusion surgery (RUP) or shame surgery at day 13 of gestation. The offspring of RUP mom will be labeled as IUGR, and from the sham will be labeled as control. The offspring will be used for blood pressure measurement using radio-telemetry and kidney microarray analysis when they reach 24 weeks.

Results:
Th IUGR offspring significantly has an increase in blood pressure compared to the control. The kidneys of male IUGR have 6529 gene upregulation compared to male control. The make IUGR also has 5713 genes dow-regulation as compared to same-sex control. The female IUGR has 1635 genes upregulated and 1513 genes downregulated compared to the kidney from the female control group.

Conclusion:
the complication during pregnancy, such as reduced uterine perfusion, which is commonly found in preeclampsia programs, alters gene expression in the kidneys of their offspring. This finding suggests that IUGR causes the gene alteration in the kidneys, which is the primary organ in controlling the blood pressure of the offspring, and may lead to the development of hypertension and kidney disease.
S-46-6: COMPARING OFFICE, CENTRAL, HOME AND AMBULATORY BLOOD PRESSURE IN PREDICTING LEFT VENTRICULAR MASS
Authors: Aparicio Lucas Sebastian , Peuchot Verónica Andrea , Giunta Diego Hernan , Martinez Rocio , Barochiner Jessica 
Published: January 2023

The blood pressure measurement method that more accurately predicts a left ventricular mass is controversial, and the evidence suggesting superiority of central over brachial measurements is contradictory. The aim of this study was to compare the relationship between the different clinic and out-of-clinic blood pressure measurements methods with left ventricular mass in patients who attended a specialised hypertension centre for a central blood pressure measurement. An analysis was performed on the correlations between left ventricular mass and central and brachial blood pressure measurements made in the clinic, and home, as well as 24-h systolic blood pressure measurements. A linear regression analysis was then performed to assess the independent relationship of each blood pressure measurement with left ventricular mass. The results on 824 treated and 123 untreated patients showed no significant differences between correlations, although home readings tended to have the best correlations. In regression adjusted models, for each 10 mmHg increase in systolic home blood pressure the left ventricular mass increased 10 g/m2 (95% CI; 3.7–27, P = .01, adjR2 0.38), and for 24-h ambulatory systolic blood pressure it increased 2.3 g/m2 (95% CI 0.76–3.9, P < .01, adjR2 0.15) in treated and untreated patients, respectively. The association of systolic blood pressure with left ventricular mass was better explained by home and 24-h ambulatory monitoring than to clinic-based measurements in treated and untreated patients, respectively. In the clinic, however, the central measurement was not superior to brachial blood pressure.
S-53-6: ANALYSIS OF BP SCREENING IN PAKISTAN (MMM EXPERIENCE)
Authors: Ishaq Mohammad 
Published: January 2023

Pakistan Hypertension League, under the banner of MMM, conducted a cross-sectional survey by involving all of its 14 regional chapters, throughout Pakistan. More than 150 volunteers were selected to conduct this survey with the help of pharmaceutical industry and were trained at PHL regional chapters. Screening camps were arranged in the month of May, at public places, hospitals and various institutions to allow general public to be screened for their BPs after taking their informed consent. MMM pre piloted data tool was used to record the demographic data including age and gender. Blood pressure of every individual was recorded in sitting position by using an OMRON digital BP apparatus. A subject was classified as having hypertension if the BP reading of >140/90mmHg or in those taking medication for high BP. All data were coded and analyzed by the MMM statistics team.
We present the screening results from three consecutive years (2017,18,19).A total of 37328 individuals screened of which 21270 (66.32%) were male and 16058 (33.8%) females. Mean age was 45.1 years. Mean systolic and diastolic B.P were 128.7 by 82.7 mmHg. A total of 21270 (55.3%) were found to be hypertensive.
Further analysis of largest data from 2018, screened 25076, out of which 14726 (58.7%) were hypertensive. Out of them 11681 (79.3%) were aware and 10759 (73.1%) were taking antihypertensives. Only 47.3% of those on medications had controlled BP, while only 34.5% of screened had their BP controlled less than or equal to 140/90 mmHg. Those who never had their BP checked were 26.3%. Diabetes Mellites was the commonest co-morbidity 29.2%, followed by previous MI and Stroke 12.9% and 12.4% respectively. In summary the prevalence of High BP in Pakistan was very high compared to other countries in the region. This data for logistic purposes belongs to urban & semi urban population. More surveys are required including rural communities.
S-54-1: SUBSTITUTING THE WORLDS SALT SUPPLY
Authors: Neal Bruce 
Published: January 2023

The adverse effects of excess dietary sodium intake on blood pressure levels are well-established. On average the world eats dietary sodium, mostly in the form of salt, at twice the level recommended by the World Health Organization and five times the level consumed during a million years of hominid evolution. At the same time, average dietary potassium intake is below recommended intake levels in many populations, and inadequate potassium intake is also associated with high blood pressure.
Potassium-enriched salt substitute, in which some of the sodium chloride is replaced with potassium chloride, was first showed to lower blood pressure more than a decade ago. Most recently, in 2021, the Salt Substitute and Stroke Study showed that potassium-enriched salt can also reduce the risks of stroke (rate ratio 14%; p = 0.006), major cardiovascular events (13%; p < 0.001) and premature death (12%; p < 0.001). This large-scale randomised trial done amongst 21,000 individuals followed for 5 years also showed that these benefits were achieved without harm, and in particular, with no evidence of hyperkalemia (rate ratio 1.04; p = 0.76).
Potassium-enriched salts are a pragmatic means of reducing dietary sodium intake and supplementing dietary potassium intake in parallel. Unlike many other sodium reduction strategies, they are easy to implement because potassium-enriched salt can be used in just the same way as regular salt. This provided for excellent adherence in the Salt Substitute and Stroke Study, with 93% of participants still using the salt substitute at the end of the study.
The potential health gains from a switch to potassium-enriched salt are very large. Modelling done for China indicates that about 1 million strokes and heart attacks could be prevented each year if the switch was made nationwide. Several million more events might be averted if implementation was global. Another key feature of potassium-enriched salt is that it can be provided at low cost. While on average about twice as expensive as regular salt, potassium-enriched salt has a median price of less than $3 per kilogram in low- and middle-income countries.
Over the last 50 years, the fight against iodine deficiency disorders has seen the global salt supply switched from salt to iodized salt. It is now time to make a second switch from iodized salt to iodized and potassium-enriched salt to also prevent blood pressure related diseases.
AW-AD-2: ASSOCIATION BETWEEN AMBULATORY BLOOD PRESSURE AND RISK OF HOME HYPERTENSION IN A NORMOTENSIVE POPULATION
Authors: Nakayama Shingo , Satoh Michihiro , Metoki Hirohito , Murakami Takahisa , Tatsumi Yukako , Asayama Kei , Hara Azusa , Hirose Takuo , Utsugi Megumi Tsubota , Kikuya Masahiro , Mori Takefumi , Hozawa Atsushi , Imai Yutaka , Ohkubo Takayoshi 
Published: January 2023

Objective:
Most of the hypertension management guidelines recommend out-of-office blood pressure (BP) measurement such as self-measured BP at home (home BP) and ambulatory BP monitoring for the accurate diagnosis and management of hypertension. Both out-of-office BP measurements are more useful than office BP as prognostic indicators of cardiovascular risk. However, no prospective study has assessed the longitudinal association between the two types of out-of-office BP measurements. Therefore, we investigated the association between ambulatory BP and the risk of home BP-based hypertension in a normotensive population and whether considering ambulatory BP improves the 10-year prediction model for home hypertension risk, which was developed in the previous study.

Desigh and method:
We followed up 410 participants (83.2% women; age, 53.6 years) without home and ambulatory hypertension in the general population of Ohasama, Japan. The Cox model was used to assess the hazard ratios for home hypertension (home BP ≧135/≧85 mmHg or initiation of antihypertensive treatment). In addition, the predictive ability for home hypertension incidence between the models adjusted for the covariates with 24-h, daytime, or nighttime SBP was examined using Harrell's C-statistics, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). The NRI considers changes in the estimated prediction probabilities that imply a change from one category to another between different models. IDI is defined as the difference between the discrimination slopes of a basic model and an extended model.

Results:
During a mean 14.2-year follow-up, 225 home hypertension incidences occurred. The hazard ratio (95% confidence interval) for home hypertension incidence per 1-standard deviation increase in 24-h systolic BP (SBP) was 1.59 (1.33–1.90) after adjustments for possible confounding factors, including baseline home SBP. Harrell's C-statistic was 0.72 (0.69–0.75) for the basic 10-year risk prediction model, which includes sex, age, BMI, current or ex-smoker status, office SBP, and baseline home SBP. By adding 24-h, daytime, or nighttime SBP to the basic model, continuous NRI and IDI significantly improved although no significant improvement in Harrell's C-statistics was observed.

Conclusions:
Independent of the baseline home SBP, 24-h SBP was associated with the risk of home hypertension in a normotensive population. The prediction model for home hypertension risk was improved by the addition of 24-h SBP to the basic model. It could be useful to measure ambulatory BP for the early detection of home hypertension.
AW-AD-4: RENOPROTECTIVE EFFECTS OF CANAGLIFLOZIN VIA LESSENING HYPERINSULINEMIA IN DIABETIC PATIENTS WITH HEART FAILURE: A POST-HOC ANALYSIS OF THE CANDLE TRIAL
Authors: Yamaguchi Satoshi , Shimabukuro Michio , Tanaka Atsushi , Node Koichi 
Published: January 2023

Objective:
The mechanisms by which sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce proteinuria in patients with type 2 diabetes mellitus (T2DM) remain unclarified. We evaluated factors associated with proteinuria regression in patients with T2DM treated with canagliflozin.

Design and method:
This study was a post-hoc analysis of the CANDLE trial (UMIN000017669), which compared the effect of 24 weeks treatment canagliflozin and glimepiride for changes in NT-proBNP in patients with T2DM and chronic heart failure (CHF). Factors associated with regression of proteinuria at 24 weeks were evaluated with multivariate logistic models.

Results:
The rate of regression of proteinuria was higher and that of progression was lower in the canagliflozin versus the glimepiride group. There were no differences in the change in systolic and diastolic blood pressure and eGFR category between groups at baseline. Systolic blood pressure and insulin levels significantly decreased in the canagliflozin group but not in the glimepiride group. Insulin level, HOMA-β, HOMA-IR, and estimated plasma volume were decreased at 24 weeks in the proteinuria regression subclass but not in the proteinuria progression subclass, suggesting that regression of proteinuria is associated with the declines in these values in the canagliflozin group. Systolic and diastolic blood pressure did not change significantly in either the proteinuria progression or regression groups in both the canagliflozin and glimepiride groups. Higher insulin level was solely associated with proteinuria regression in the multivariate logistic regression model.

Conclusion:
In patients with T2DM and CHF, regression of proteinuria with canagliflozin treatment was associated with the pre-treatment insulin level. These results suggest new mechanistic intuitions into the beneficial effects of canagliflozin on renal outcomes and warrant discussion for selecting preferred patient profiles, including pre-treatment insulin levels.