bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPACT OF ARTERIAL HYPERTENSION VERSUS AGING TO THE STRUCTURES OF EPICARDIAC NERVES IN SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Ranceviene Dalia , Azukaite Joana , Rysevaite-Kyguoliene Kristina , Pauziene Neringa 
Published: June 2022

Objective:
To detect changes of epicardiac nerves due to arterial hypertension along with aging.

Design and method:
12 Spontaneously hypertensive rats (SHR) and 9 Wistar-Kyoto rats (WKY) were examined in the following age groups (weeks): juvenile (8–9), adult (12–16), and old (46–47). Neural structures of transverse ventricular cryosections were stained immunohistochemically for protein gene product 9.5 (PGP9.5 – general neuronal marker) and calcitonin gene-related peptide (CGRP – potent vasodilator). The stained neural structures and total cross-section area of epicardiac nerves were measured, and the area stained with each neuromarker was expressed as a percentage. Results were described as means (standard error) and compared by the Mann-Whitney test, p-value < 0.05.

Results:
In the juvenile group, the area stained by PGP9.5 did not differ between WKY and SHR nerves. However, the area of PGP9.5 was 12.0% smaller in the adult SHR than in the adult WKY. Furthermore, the PGP9.5 area was 5.7% larger in the old SHR than in the old WKY group. On the other hand, the distribution of CGRP remained similar between all age groups (Table 1).
Comparing WKY age groups, the PGP9.5 area tends to increase from juvenile to adult by 5.7% (p = 0.032) but decreases from adult to old by 17.5% (p = 0.000). In contrast, the PGP9.5 ratio in the SHR was highest in the juvenile group but decreased in the adult group by 5.5% (p = 0.008). The ratio between SHR adult and old groups did not differ significantly.
CGRP area tends to decrease during senility in both groups. In WKY, just like in SHR, the CGRP area did not differ between juveniles and adults but significantly decreased from adult to old by 41.8% (p = 0.000) and 40.0% (p = 0.005) correspondingly.

Conclusions:
In normotensive rats, neuronal structures stained by PGP9.5 tend to peak up in epicardiac nerves to adulthood and decrease during senility. At the same time, in hypertensive rats, neural components start to degenerate gradually from a young age up to old age. Vasodilator component ratio tends to decrease during senility only in normotensive and hypertensive groups.
PROGNOSTIC SIGNIFICANCE OF BLOOD PRESSURE PARAMETERS FOR PREDICTING CARDIOVASCULAR DEATH
Authors: Wang Weiting 
Published: June 2022

Objective:
The nycterohemeral rhythm of blood pressure (BP) and heart rate has been associated with cardiovascular outcomes. However, long-term prognostic significance of BP at different levels of heart rates has rarely been studied. We therefore conducted the present analysis to investigate the prognostic values for cardiovascular outcome by the ambulatory BP parameters during different time windows

Design and method:
We enrolled 5 large cohorts from whole world, including CARDIA, IDACO, JHS, SPRINT to find out independent prognostic factors for cardiovascular disease mortality, feature engineering and feature transformation were used. Several statistical and machine learning methods including the stepwise procedure, lasso penalty, and random survival forest with bootstrap technique were used to screen important candidates of risk factors. Models building are based on systolic BP replacement into the established Framingham risk score. Directly one to one replacement and indirectly two stage replacement methods are considered with variable diversity. C-statistics, NRI are used for model performance evaluation.

Results:
In model building procedure, nighttime BP combined with pulse pressure, morning-evening difference of SBP and weighted SBP consistently had a higher C-statistics than had office systolic BP. In validation datasets, equations incorporating mean BP and pulse pressure had best performance in C-index (0.754). In contrast, the C-index (higher is better), of the usual Framingham risk score with office systolic BP are 0.744. Furthermore, the best model had acceptable predicted accuracy based on model calibration statistics (p > 0.05).

Conclusions:
Our study demonstrated that mean BP at night combined with pulse pressure, morning-evening difference of SBP and weighted SBP, throughout 24 hours had the largest predictive power of 20-year cardiovascular death in population with ABPM recordings. The transportability of the proposed cardiovascular risk function should be evaluated in future studies.
WHITE-COAT HYPERTENSION WITHOUT ORGAN DAMAGE: IMPACT OF LONG-TERM MORTALITY, NEW HYPERTENSION AND NEW ORGAN DAMAGE
Authors: Seravalle Gino , Facchetti Rita , Vanoli Jennifer , Dell’oro Raffaella , Grassi Guido , Mancia Giuseppe 
Published: June 2022

Objective:
According to some guidelines white-coat hypertension (WCH) carries little or no increase of cardiovascular (CV) risk in absence of organ damage (OD) but no data are available on this issue.

Design and method:
Using the population data from Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA), we evaluated CV and total mortality over a median follow-up of 29 years in WCH (elevated office and normal 24-hour or home blood pressure, BP) and normotensive controls (N, normal in- and out-of-office BP) with no echocardiographic left ventricular hypertrophy and no reduction of estimated glomerular filtration rate. Analysis was extended to sustained hypertension (SH, in- and out-of-office BP elevation) and to N, WCH and SH with cardiac and renal OD.

Results:
During the 29 years follow-up there were in the 1423 subjects nalysed 165 CV and 526 all cause deaths. OD was detected in 10.6%, 30.5% and 43.8% of N, WCH and SH, respectively. After adjustment for confounders no-ODWCH exhibited a risk of fatal CV events lower than that of no-ODSH but greater than that of no-ODN (HR 2.0, 95% CI: 1.1–3.6, P = 0.02), this being the case also for all cause mortality. Compared with no-ODN, no-ODWCH also exhibited a greater 10 year adjusted risk to develop new SH or OD. Similar findings were obtained in N, WCH and SH with OD. The present study provides the first evidence that WCH with no cardiac and renal OD is accompanied by an increased long-term risk of mortality, new hypertension and new OD, thereby not representing a clinically innocent condition.

Conclusions:
The present study provides the first evidence that WCH with no cardiac and renal OD is accompanied by an increased long-term risk of mortality, new hypertension and new OD, thereby not representing a clinically innocent condition.
SIMPLE PREDICTIVE SCORE FOR NOCTURNAL HYPERTENSION AND MASKED NOCTURNAL HYPERTENSION USING HOME BLOOD PRESSURE MONITORING IN CLINICAL PRACTICE
Authors: Narita Keisuke , Hoshide Satoshi , Kario Kazuomi 
Published: June 2022

Objective:
The decision whether to measure nighttime blood pressure (BP) is challenging because these values cannot be easily evaluated due to problems with measurement devices and related stress. Using the nationwide, practice-based Japan Morning Surge-Home BP Nocturnal BP study data, we developed a simple predictive score that physicians can use to diagnose nocturnal hypertension.

Design and method:
We divided 2,765 outpatients (mean age 63 years; hypertensives 92%) with cardiovascular risks who underwent morning, evening, and nighttime home BP (HBP) measurements (2:00, 3:00, and 4:00 a.m.) into a calibration group (n = 2,212) and validation group (n = 553). We used logistic-regression models in the calibration group to identify the predictive score for nocturnal hypertension (nighttime HBP > = 120/70 mmHg) and then evaluated the score's predictive ability in the validation group.

Results:
In the logistic-regression model, male sex, increased body mass index (BMI) (> = 25 kg/m2), diabetes, elevated urine-albumin creatinine ratio (UACR) (> = 30 mg/g Cr), elevated office BP (> = 140/90 mmHg), and elevated morning and evening HBP (> = 135/85 mmHg) had positive relationships with nocturnal hypertension. The predictive scores for nocturnal hypertension were 1-point (male, BMI, diabetes, and UACR); 2-points (office BP > = 140/90 mmHg); 3-points (evening HBP > = 135/85 mmHg); 4-points (morning HBP > = 135/85 mmHg); total 13 points. Over 80% of the nocturnal hypertension cases in the validation group showed > = 10-points (AUC = 0.705, 95%CI: 0.661–0.748). We also developed a score for masked nocturnal hypertension, i.e., nocturnal hypertension despite controlled daytime HBP.

Conclusions:
We developed a simple predictive score for nocturnal hypertension that can be used in clinical settings and for diagnoses.
ARM BASED ON LEG BLOOD PRESSURES (ABLE-BP): CAN SYSTOLIC LEG BLOOD PRESSURE MEASUREMENTS PREDICT BRACHIAL BLOOD PRESSURE? AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS
Authors: McDonagh Sinead , Sheppard James , Warren Fiona , Boddy Kate , Farmer Leon , Shore Helen , Williams Phil , Lewis Philip , Fordham A Jayne , Martin Una , Aboyans Victor , Clark Christopher 
Published: June 2022

Objective:
Hypertension is diagnosed and managed using brachial blood pressures; accurate measurement can be impeded by several temporary or permanent factors, including fractures, presence of vascular access devices, limb deformities and altered muscle tone after stroke. Leg (ankle) blood pressure measurement is a practical alternative, but limited data exist to guide clinicians’ interpretation of leg blood pressure values for hypertension diagnosis and treatment.

Design and method:
Individual participant data meta-analyses were undertaken, using data from 14 studies within the international inter-arm blood pressure difference individual participant data (INTERPRESS-IPD) Collaboration, to 1) determine the relationship between arm and leg systolic blood pressure, 2) develop and validate a multivariable model predicting arm from leg systolic blood pressure, and 3) investigate the prognostic association between leg systolic blood pressure and cardiovascular disease and mortality.

Results:
Arm and leg systolic blood pressure data existed for 33,710 individuals (mean age: 58 years, mean arm systolic/diastolic blood pressure at baseline: 138/80 mmHg, 45% female). Mean leg systolic blood pressure was 12.0 (95% CI, 8.8 to 15.2) mmHg higher than arm systolic blood pressure. The multivariable model derived to predict highest arm from highest leg systolic blood pressure demonstrated excellent performance (area under receiver operating characteristic curves, sensitivity and specificity remained above 0.89, 0.80 and 0.81, respectively, across blood pressure thresholds from 160 to 130 mmHg). Lowest leg systolic blood pressure was a predictor of all-cause mortality and cardiovascular events over a 10-year period. Cardiovascular risk scores were similar for observed arm systolic blood pressure and the highest arm systolic blood pressure predicted from lowest leg systolic blood pressure [Atherosclerotic Cardiovascular Disease Score: 16.73% (12.65) vs 17.17% (12.61), Framingham Score: 19.33% (15.05) vs 19.91% (15.06)].

Conclusions:
These results provide a robust evidence-based method for describing the arm-leg systolic blood pressure relationship and estimating individual brachial systolic blood pressure and cardiovascular risk from leg blood pressure measurements using individual participant data. A freely available and easy-to-use web-based calculator has been created to support patients and clinicians in estimating equivalent arm blood pressure when only leg blood pressure measurements and patient characteristics are available.
SCREENING FOR ATRIAL FIBRILLATION WITH ROUTINE AUTOMATED BLOOD PRESSURE MEASUREMENT IN THE ELDERLY: THE NATIONAL HEALTH SURVEY EMENO IN GREECE
Authors: Stergiou George S. , Menti Ariadni , Kalpourtzi Natasa , Gavana Magda , Vantarakis Apostolos , Chlouverakis Gregory , Hadjichristodoulou Christos , Trypsianis Gregory , Voulgari Paraskevi , Alamanos Yannis , Karakosta Argiro , Touloumi Giota 
Published: June 2022

Objective:
Atrial fibrillation (AF) is the most common sustained arrhythmia which often is asymptomatic and undiagnosed. An automated blood pressure (BP) monitor with an algorithm which detects atrial fibrillation with high diagnostic accuracy during routine measurement was used for AF screening in the elderly general population Greece.

Design and method:
EMENO health survey (2013 to 2016) applied a multi-stage stratified random sampling method to select a random sample of the general adult (> = 18 years) population of Greece. For participants aged > = 65 years screening for AF was performed with triplicate automated BP measurements using a validated automated upper-arm cuff oscillometric device with embedded algorithm for detecting AF (Microlife BPA100 Plus AFIB).

Results:
A total of 1,838 individuals aged > = 65 years were recruited and 975 with AF data on at least 1 BP measurement were analysed (mean [SD] age 75.3 (6.6)) years, men 45.1%, BMI 30.3 (5.2) kg/m2, hypertensives 80.7%). Of them, 65 (7.1%) had AF detected in all their 3 BP readings (AF group), 661 (69.5%) have no AF in all 3 readings (no AF group), and 249 (23.4%) had AF in 1 or 2 readings (uncertain AF group). Participants with AF were older than non-AF (by 3.4 years on average, p < 0.001), had lower systolic BP (by 4.6 mmHg, p < 0.05), and more frequent cardiovascular disease (29% vs 14%, p < 0.01). Among AF patients, 43% reported a previous AF diagnosis compared to 8.8% and 11.9% in no AF and uncertain AF group respectively (p < 0.001). Hypertension tended to be more common in the AF than the non-AF group (88% vs. 80%, p = NS). Of the 65 AF group, 57% were undiagnosed and all required anticoagulant therapy (men with CHA2DS2-VASc > = 1 or women > = 2).

Conclusions:
Almost 7% of people aged > = 65 years in Greece had AF detected during routine automated BP measurement. 57% of them were undiagnosed and all required anticoagulant treatment for stroke prevention. Screening for AF using routing automated BP measurement in the elderly appears to be a useful method for early detection and management of asymptomatic AF.
ACUTE CORONARY SYNDROMES DURING PREGNANCY AND POST-PARTUM IN FRANCE, THE NATIONWIDE CONCEPTION STUDY
Authors: Blacher Jacques , Lailler Gregory , Gabet Amélie , Grave Clémence , Regnault Nolwenn , Deneux-Tharaux Catherine , Kretz Sandrine , Tsatsaris Vassilis , Plu-Bureau Geneviève , Olié Valérie 
Published: June 2022

Objective:
Very different estimated incidences have been reported concerning pregnancy-related acute coronary syndrome (ACS). The objective of our study was to assess the incidence of ACS during pregnancy, peripartum and postpartum, to compare it with the incidence of ACS in non-pregnant women of childbearing age and to study characteristics associated with pregnancy-related ACS.

Design and method:
All women without ischemic heart disease who delivered between 2010 and 2018 in France were included in the CONCEPTION cohort. We used Poisson regression to estimate the crude incidence of ACS and age-adjusted Poisson models to estimate the incidence risk ratio (IRR) of ACS in pregnant versus nonpregnant women, with 95% confidence interval (CI).

Results:
Among 6 298 967 pregnancies in France, 225 experienced a first ever ACS. The global ACS incidence in women giving birth was 4.34 per 100 000 person-years, stable between 2010 and 2018 (1 ACS every 23 000 pregnancies). Compared with nonpregnant women, age-adjusted incidence rates of ACS were lower during pregnancy IRR: 0.76 (95%CI: 0.57–0.98) (p < 0.05). In a multivariate analysis, independent factors associated with ACS were age, social deprivation (OR = 1.91 (1.42–2.58)), obesity (OR = 1.73 (1.13–2.65)), tobacco use (OR = 3.43 (2.55–4.61)) (Table). The risk of ACS associated with chronic hypertension and hypertensive disorders of pregnancy was 4.5 (2.90–6.95) and 2.09 (1.43–3.06) respectively.

Conclusions:
Global incidence of pregancy-related ACS was 4.34 per 100 000 person-years. The pregnancy-related ACS incidence was 24% lower than the ACS incidence in age-adjusted non-pregnant women. More efforts should be made in terms of prevention, considering the frequency of treatable cardiovascular risk factors such as tobacco use and hypertensive disorders of pregnancy.
MICROCIRCULATION AND SARS-COV-2 INFECTION: A FOLLOW UP STUDY
Authors: Malerba Paolo , Rosei Claudia Agabiti , Chiarini Giulia , Nardin Matteo , Petelca Alina , Gaggero Andrea , Lemoli Matteo , Famà Francesca , Boari Gianluca Edoardo , Baresi Mattia , Bondioli Nicolò , Porteri Enzo , Paini Anna , Salvetti Massimo , Muiesan Maria Lorenza , Rizzoni Damiano , De Ciuceis Carolina 
Published: June 2022

Objective:
SARS-CoV2 infection can lead to several clinical scenarios, named COVID-19, ranging from mild manifestations to acute respiratory distress syndrome (ARDS), coagulation alterations and endothelial dysfunction. The functional impairment of the microcirculation seems play a key role in the pathophysiology and clinical consequences of COVID-19. However, to date there is no evidence of structural microvascular damage related to COVID-19.

Design and method:
The aim of this study is to investigate microvascular alterations by adaptive optics and vide-ocapillaroscopy in patients recently admitted for COVID-19 and re-evaluated one year later.
Methods: We enrolled 153 patients admitted between February and April 2020 at the Hospital of Montichiari (Brescia) and at the Internal Medicine Department of ASST Spedali Civili - University of Brescia for respiratory failure due to SARS-CoV2-related interstitial pneumonia. Patients were evaluated two months after nalysedsation and after one year. All patients underwent a venous blood sampling for hematochemical tests, evaluation of retinal arteriolar morphology by adaptive optics, assessment of basal and total capillary density (BCD and TCD respectively) at the dorsum of the fourth finger of the non-dominant hand by videocapillaroscopy.

Results:
Fifty patients with completed follow-up were nalysed. An increase of internal lumen (93.8 ± 13.3 vs. 97.3 ± 14.2 micron, p < 0.001) and a reduction of wall to lumen ratio (WLR 0.30 ± 0.03 vs. 0.27 ± 0.03, p < 0.001) were observed at the follow up visit after one year (Figure). No significant differences were observed in BCD in the dorsum of the finger after one year, whereas a significant reduction in TCD was observed (p < 0.001). Microvascular changes were independent of body mass index and the presence of hypertension or diabetes mellitus.

Conclusions:
Preliminary data from this study show that patients with SARS-Cov2 infection present an improvement of microvascular structure after one year from the disease, such as a reduction in WLR of retinal arterioles. This suggests that COVID19 might induce structural alterations in the microcirculation which contribute to vascular damage. These changes do not seem to be influenced by the weight, presence of hypertension or diabetes.
EFFECT OF THE COVID-19 PANDEMIC ON THE NYCHTHEMERAL BLOOD PRESSURE PROFILE
Authors: Nzokou Daryl Tcheutchoua , van de Borne Phillipe , Chaumont Martin 
Published: June 2022

Objective:
The world is currently facing the fourth wave of the COVID-19 pandemic. The purpose of this study was to assess the effect of this pandemic on ambulatory blood pressure measurements and to compare the blood pressure profile between COVID-19 positive and negative patients.

Design and method:
We performed a unicentric, retrospective study on the register of ambulatory blood pressure measurements (ABPM) of the ERASME Hospital from 2010 to 2021. ABPMs performed during the pandemic period (January 2020 to October 2021) were compared with those from 5 previous control periods. In order to improve the comparison of the different periods, we considered variations (delta) of each period from the previous 3 months. For all patients whose ABPM was performed during the COVID-19 period, we looked for COVID test results preceding the ABPM. These patients were classified into 2 groups COVID positive, if at least one PCR or serological test was positive, and COVID negative if not. Data analysis was performed using SPSS version 23.0.

Results:
After exclusion of incomplete and poor-quality ABPMs, 18766 were retained, of which 1796 (9.57%) were for the COVID-19 period. The control periods represented 14.77% to 18.81% of the MAPAs in the study. We observed that diurnal, nocturnal and 24-hour diastolic blood pressures (BP) were higher in the COVID-19 period than in the previous 5 periods ranging from January 2010 to October 2019. Pulse pressure was lower in the COVID-19 period compared to the previous periods. Of the 1796 patients in the COVID-19 period, pre-ABPM COVID-19 status were obtained from 368 patients, 322 negatives and 46 positives. In COVID-19 positive patients, daytime systolic BP was higher than in COVID-19 negative patients (88,41 ± 11,74 vs 84,63 ± 12,24; p = 0.047). Also, the pulse pressure of COVID-19 positive patients was lower (44,46 ± 7,72 vs 47,57 ± 8,84). No significant differences were observed between the two groups for the other parameters.

Conclusions:
The COVID-19 pandemic resulted in increased daytime and night-time diastolic blood pressures. Also, this study suggests an increase in diurnal diastolic blood pressure after COVID-19 infection.
COMPARATIVE TRANSCRIPTOMIC ANALYSIS IDENTIFIES EPITHELIAL-MESENCHYMAL TRANSITION AND INFLAMMATION AS COMMON PATHOGENETIC MECHANISMS IN HYPERTENSIVE AND DIABETIC NEPHROPATHY
Authors: Nordb⊘ Ole Petter , Landolt Lea , Eikrem Øystein , Scherer Andreas , Leh Sabine , Palmer Jessica Furriol , Apeland Terje , Mydel Piotr , Marti Hans-Peter 
Published: June 2022

Objective:
Type 2 diabetic (T2DN) and hypertensive nephrosclerosis (HN) are the main causes of chronic kidney disease (CKD). To obtain novel insights into pathogenetic mechanisms, potentially suggesting common therapeutic procedures, we comparatively nalysed transcriptomes of kidney biopsies obtained from patients with T2DN or HN and control archived formalin-fixed and paraffin-embedded (FFPE) kidney biopsies.

Design and method:
FFPE kidney biopsies from adult patients were selected from the Norwegian Kidney Biopsy Registry. Specimens from patients with HN, T2DN and normal-appearing control renal biopsies (Ctrl) (n = 6 for each group) were assessed. Total RNA was extracted from 10 μm whole kidney sections and processed for RNA sequencing, while immunohistochemistry (IHC) was performed on 3-μm tissue sections. Enzyme-Linked ImmunoSorbent Assay (ELISA) targeting the AXL receptor tyrosine kinase was performed on serum from separate cohorts with HN and T2DN/T1DN.

Results:
Gene expression analysis showed 769 differentially expressed genes (DEG) for T2DN and 284 HN genes (log fold change > 1, adjusted P < 0.05). Only 39 of the HN genes were uniquely DEG compared to T2DN. Cluster analysis on the RNA seq data separated diseased and normal tissues, also with a distinct overlap between HN and T2DN profiles. Detailed analysis of gene expression profiles revealed upregulation of pathways related to partial epithelial to mesenchymal transition, including extracellular matrix organisation in both diseases. AXL and vimentin expression was also enhanced at the protein level in both HN and T2DN biopsies, as detected by immunohistochemistry (IHC). AXL abundance was also increased in serum from T2DN/T1DN and HN patients. Pathways related to inflammation was also overexpressed, particularly related to TH1 and TH2 helper cell pathways. The presence of CD4 and CD8 positive T- cells were confirmed by IHC.

Conclusions:
Similarities of T2DN and HN proteomes suggest common pathogenetic mechanisms and the possibility to envisage targeted treatments addressing both main causes of CKD.