bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGREEMENT BETWEEN DIFFERENT TYPES OF BLOOD PRESSURE MONITORING: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS
Authors: Yeh Jiunn-Tyng , Lee Chun-Wei , Chen Yu-Jen , Huang Shao-Li , Wang Wei-Ting , Huang Chi-Jung , Chiu Tzu-Jung , Chen Chen-Huan , Chiang Chern-En , Cheng Hao-Min 
Published: June 2022

Objective:
An accurate blood pressure measurement (BPM) is important for diagnosing and managing hypertension. Several monitoring techniques of BPM, including office BPM (OBPM), ambulatory BPM (ABPM), and home BPM (HBPM) have been widely utilized; however, the corresponding agreement and conversion between these modalities remained elusive. With emerging evidence suggesting the utility of out-of-office blood pressure (BP) for hypertension management, an investigation into the relationship between BPMs is crucial. Therefore, we performed a systematic review and network meta-analysis from published studies and compared the reported BP values between different BPM modalities.

Design and method:
We searched MEDLINE and Scopus for observational studies and andomised controlled trials reporting more than one type of BPM by Apr 6, 2021. Studies with participants that were over 18 years old and received at least two different BPM within a week were included. The risk of bias of included studies was assessed by the quality of the study and BPM techniques. We calculated the mean differences (MD) between modalities and pooled the measurements using random-effects network meta-analysis. Furthermore, the agreement between BPMs within different BP levels was investigated using network meta-regression.

Results:
We identified 10970 studies and included 486/482 studies (467654/466167 individuals) for SBP/DBP measurements. With reference to OBPM, the MDs of SBP of casual OBPM, HBPM, 24 hours ABPM, daytime ABPM, and night time ABPM, were 2.8, -5.5, -10.0, -6.4, -19.5mmHg, respectively. For DBP the MDs were 1.3, -3.0, -6.3, -3.19, and -13.76mmHg. Network meta-regression (see figure) showed that the MDs between OBPM and casual OBPM were rather fixed; however, those between OBPM/HBPM or OBPM/ABPM followed a negatively associated linear relationship across BP levels. The diagnostic thresholds of different BPMs corresponding to OBPM 140/90mmHg and 130/80mmHg were generally in agreement with current guidelines.

Conclusions:
Our study demonstrated the agreement between common BPM modalities by synthesizing the body of evidence from a comprehensive search. Furthermore, the regression model showed that the MDs of measurements between modalities may vary depending on the mean BP. Our systematic review supports the diagnostic thresholds for different BPM recommended by current guidelines.
VITAL SIGNS GUIDED THERAPY AT THE CARDIAC CARE UNIT: INTERVENTIONS BY A CARDIOLOGY PHARMACIST
Authors: Yaseen Israa Fadhil , Farhan Hasan Ali 
Published: June 2022

Objective:
To identify the role of a cardiology pharmacist in ptimisation of cardiovascular treatment depending on vital signs including heart rate (HR) and blood pressure (BP) for patients with acute coronary syndrome (ACS)

Design and method:
A prospective interventional study conducted at the cardiac care unit (CCU) over 3 months (July-October 2021). A senior consultant cardiologist noticed frequent uncontrolled vital signs of patients at the CCU particularly those with ACS, therefore, he asked the cardiology pharmacist to observe the missed uncontrolled HR and BP without optimum treatment for all patients at the CCU after completing the daily morning round and make drug interventions collaboratively. The drug intervention for this group of patients was called ‘Vital Signs Guided Therapy’.

Results:
Among 147 patients who got drug interventions by the pharmacist over 3 months, 41 (28%) of patients included in the vital signs guided therapy cohort, the main diagnosis of the patients: ACS 88%, complete heart block 5%, atrial fibrillation 5%, and acute decompensated heart failure 2%. Mean HR (79 ± 15) beat per minute, systolic BP (136 ± 28) mmHg, and diastolic BP (86 ± 14) mmHg. HR control was done for 56% of patients and BP control for 61% of patients. Control of both HR and BP were done for 20% of the cohort. Types of drug interventions and ptimisation are shown in Figure 1.

Conclusions:
Team work; including a cardiology pharmacist, is essential for drug therapy ptimisation guided by vital signs for patients at CCU.
REVERSE WHITE-COAT EFFECTS ACCORDING TO THE ACHIEVED BLOOD PRESSURES BELOW THE TARGET BLOOD PRESSURES FOR INTENSIVE BLOOD PRESSURE CONTROL
Authors: Shin Jinho , Shin Jeong-Hun , Park Sungha , Kim Ju-Han , Ihm Sang-Hyun , Pyun Wook-Bum 
Published: June 2022

Objective:
In the application of nalysedd controlled trial data for intensive blood pressure (BP) control into clinical practice, the corresponding BPs among office, home, and ambulatory BPs were suggested to be similar if achieved clinic systolic BP (SBP) become 130 mmHg or lower. But the magnitude and its clinical implication of reversed white-coat effect (WCE) was not clearly reported.

Design and method:
From the 1843 data of treated hypertension patients in Korean ambulatory blood pressure monitoring (Kor-ABP) registry, WCE were calculated according to the range of achieved clinic SBPs, < 120 mmHg (group1), 120~130 mmHg (group2), 130–140 mmHg (group3), and > = 140 mmHg (group4). The factors related to WCE were nalysed using multivariable regression analysis. WCE was defined by clinic SBP minus daytime ambulatory SBP.

Results:
Mean age was 59 years and the proportion of female was 55%. Significant factors for the WCE were BMI (beta = -0.342), smoking (beta = -3.394), good sleep quality (beta = 0.872 per each 4 point likert scale), and clinic SBP(beta = 0.578). Mean SBPs for group 1 to 4 were 111.4 mmHg, 124.0 mmHg, 134.1 mmHg, and 157.5 mmHg, respectively. WCEs for the group were -8.3 mmHg for group1, -4.5 mmHg for group2, -1.9 mmHg for group3, and 9.9 mmHg for group4. The difference in WCEs between the group 4 and untreated hypertension patients (SBP, 155.6 +/-13.6) was not statistically significant (9.9 +/- 16.1 mmHg 9.0 +/-16.8, p = 0.2).

Conclusions:
Reverse WCE should be considered to estimate the safety of intensive BP control when SBP lowered below 120 mmHg. The presence of reverse WCE instead of WCE highlights more reassuring aspect than previously thought when the patient is asymptomatic or tolerable.
HYPERREACTIVITY TO STANDING IS ASSOCIATED WITH INCREASED AMBULATORY BP A RELATIONSHIP AMPLIFIED BY ENHANCED SYMPATHOADRENERGIC ACTIVITY
Authors: Saladini Francesca , Mos Lucio , Vriz Olga , Rattazzi Marcello , Mazzer Andrea , Palatini Paolo 
Published: June 2022

Objective:
Previous research showed that elevated systolic blood pressure (SBP) reaction to standing (RS), a condition that may be accompanied by sympathoadrenergic hyperactivity, is a predictor of cardiovascular events. This might be due to the influence of RS on ambulatory BP (ABP). Thus, we investigated whether RS is a determinant of ABP and if this putative relationship is stronger in a milieu of hyperadrenergic activity.

Design and method:
We studied 630 young-to-middle-age (mean age 33.6 ± 8.5 years), stage I untreated hypertensives from the HARVEST study. RS was defined as the difference between 6 SBP measurements in the orthostatic and the supine posture. Participants were divided into tertiles of SBP RS (<-5.34, -5.34–0.30 and > 0.30 mmHg, respectively) and of 24 h urinary epinephrine (UE) (<8.3, 8.3–14 and > 14 mcg/24 h, respectively). The relationship with 24 h average SBP was tested in a two-way ANCOVA adjusting for age, sex and office SBP.

Results:
Mean office SBP was 145.8 ± 10.5/93.9 ± 5.2 mmg, mean RS -3.0 ± 7.4 mmHg and median UE 10.5 (IQR, 7.0–16.0) mcg/24 h, in the entire group. Subjects in the highest UE tertile had a higher (mean ± SEM) 24 h SBP (132.2 ± 0.8 mmHg) than the lower tertiles (129.9 ± 0.7 mmHg and 129.8 ± 0.7 mmHg, p = 0.041). The same trend was observed for the RS tertiles, as 24 h SBP was 134.3 ± 0.7 mmHg in the highest tertile vs 129.5 ± 0.7 in the intermediate and 128.3 ± 0.7 mmHg in the lowest tertile (p < 0.001). 24 h SBP was positively and significantly correlated with both RS (r = 0.16 p < 0.001) and UE (r = 0.10 p = 0.028). In a two-way ANCOVA analysis a significant interaction was observed between RS and UE (p = 0.033): average 24 h SBP was 136.5 ± 1.2 mmHg in the group with the highest RS and UE levels and was 127.2 ± 1.2 mmHg in the group with the lowest RS and UE levels.

Conclusions:
Our data show that RS is a significant determinant of average 24 h SBP and that this association is amplified by sympathoadrenergic hyperactivity. This can account for the increased risk of cardiovascular events found in hypertensive subjects with hyperreactivity to standing.
THE DESIGNING EXPERIMENT OF ESSENTIAL HYPERTENSION: THE CHOICE OF A CONTROL GROUP FOR SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Ranceviene Dalia , Zigmantaite Vilma , Jurevicius Jonas , Pauziene Neringa 
Published: June 2022

Objective:
The spontaneously hypertensive rat (SHR) is the most widely studied animal model of essential hypertension. The Wistar-Kyoto rats (WKY) were originally bred as normotensive controls for the SHR, while the Wistar (WIS) strain is generally the most popular in research. The objective of the study was to check whether Wistar could be used as controls for SHR by comparing blood pressure levels in three groups of animals.

Design and method:
Adult male WIS (n = 5), WKY (n = 6), and SH (n = 4) rats, 20th week of age, were used. The animals were housed in the Animal Research Center of the Lithuanian University of Health Sciences under permission No. G2–137. They were kept in collective cages and allocated in a controlled environment with a light/dark cycle (12/12 h), the temperature at 22 ± 2C, and had free access to food and water. Following animal sedation, heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured using the on-invasive method of tail-cuff (AD Instruments IN125/R NIBP system, UK and LabChart software). Each measurement was performed ten times, and the median value was used. All measurements were performed by the same researcher in a quiet environment. Mean arterial pressure (MAP) was calculated by the following equation: DBP+1/3(SBP-DBP). The Kruskal-Wallis test was used to determine group differences. The Mann-Whitney test was used for two groups comparisons.

Results:
SHR BP values were highest, WKY - in the middle, and WIS - the lowest. Measured parameters differed statistically significantly between the three rat groups (p < 0.05) (Table 1). The two groups comparison revealed that all parameters in SHR had statistically significant differences between the WKY as well as WIS (p < 0.05), except HR in WIS. HR did not differ between SHR and WIS rats (p = 0.190). Comparing WKY and WIS groups, there was no significant difference between SBP (p = 0.284), DBP (p = 0.524), MAP (p = 0.354), except HR, which was significantly higher in WIS (p = 0.002).

Conclusions:
Adult spontaneously hypertensive rats have significant arterial hypertension. Blood pressure measurements of Wistar-Kyoto and Wistar rats do not differ, so both of them can be used as controls for hypertensive rats.
PULSE WAVE VELOCITY ASSESSMENT IN PATIENTS SEEN AT THE OUTPATIENT CLINIC OF MEDICAL SCHOOL IN BRAZIL
Authors: Paffer Matheus Toscano , Paffer Pedro Toscano , Terra Vitória , Tenório Maria Fernanda , De Castro Camila , Torres Licia , Barros Ramon , Lucena Lucas , Menezes Pedro Affonso , Barbosa Priscilla , Paffer Silvio 
Published: June 2022

Objective:
Characterize the pulse wave velocity (PWV) of patients seen at the outpatient clinic of a medical school in Brazil

Design and method:
102 patients were analyzed and underwent central pressure and pulse wave velocity assessment using the Mobil O’’Graph device.

Results:
Among the 102 patients analyzed, 63 (61.7%) were female and the mean age was 58.7 years (+-13.2) and mean body mass index of 23.6 (+-17.2). Peripheral systolic pressure had a mean of 144.7mmHg (+-23.9) and peripheral diastolic pressure of 89.9mmHg (+-14.4). The central systolic pressure had a mean of 148.7mmHg (+-26.7) and central diastolic of 92.3 mmHg (+-15.0). The pulse wave velocity in the analyzed patients had an average of 7.0 m/s (+-3.1). PWV is the gold standard test for assessing arterial stiffness. The increase in this rigidity can occur for physiological reasons, being part of the physiology of aging, but also for pathological causes, with the support of increased blood pressure. This occurs because the increase in pressure generates an increase in pulsatile stress on the vascular wall, resulting in faster degradation of elastin fibers. Increased arterial stiffness also results in early return of pulse waves reflected from the periphery to the left ventricle, still in systole rather than diastole, increasing pressure in the late systole. Due to this correlation with arterial stiffness and target organ damage in hypertension, when available, pulse wave analysis is mandatory in hypertensive patients.

Conclusions:
The incorporation of this new technology using handheld devices is feasible and very useful to identify high-risk patients and be performed in a clinical setting.
PREDICTORS OF BISOPROLOL ON-TREATMENT STATUS AT THE TIME OF INCLUSION OF HYPERTENSIVE PATIENTS IN THE STUDY: POST-HOC ANALYSIS OF THE TRICOLOR STUDY
Authors: Logunova Natalia , Karpov Yuri , Khomitskaya Yunona 
Published: June 2022

Objective:
To describe proportion of patients with uncontrolled hypertension (HTN) receiving bisoprolol additionally to perindopril/indapamide/amlodipine single-pill combination (SPC) and predictors of its prescription in patients included in the TRICOLOR study.

Design and method:
TRICOLOR (NCT03722524) was a multicenter, open-label, 3-month observational study that included 1 247 patients with uncontrolled HTN despite receiving antihypertensive treatment, who were initiated with the SPC in outpatient settings in Russia. Univariate logistic regression analysis was performed to describe the relationship between clinically relevant baseline (BL) patients’ characteristics and bisoprolol on-treatment status at the inclusion in the study.

Results:
At baseline 19.1% of patients (n = 238) were receiving bisoprolol. Mean age of the patients receiving bisoprolol was 60.3 ± 9.6 years, 59.2% (n = 141) of them were female. Patients receiving bisoprolol at BL had a significantly longer duration (p< 0.0001) and more severe HTN (p = 0.001) as well as more frequent concomitant comorbid status (p < 0,0001) compared to those not receiving bisoprolol at BL. They were less frequently male (40.8% vs 61.2%; p < 0.0001), had significantly higher body mass index (BMI) (30.4 ± 5.1 vs 28.8 ± 4.4 kg/m2; p < 0.0001). Statistically significant, but not clinically meaningful, relationship between bisoprolol on-treatment status at BL and BMI (OR = 1.07, 95% CI 1.03 to 1.10), waist circumference (OR 1.03, 95% CI 1.02 to 1.04), heart rate (OR 1.02, 95% CI 1.00 to 1.04) and duration of HTN (OR 1.04, 95% CI 1.02 to 1.06) were revealed. However, presence of dyslipidemia (OR 1.72, 95% CI 1.20 to 2.51), left ventricular hypertrophy (OR 1.98, 95% CI 1.25 to 3.30), chronic heart failure (OR 2.23, 95% CI 1.62 to 3.08;), coronary artery disease (OR 2.66, 95% CI 1.90 to 3.70), a history of myocardial infarction (OR 3.15, 95% CI 1.90 to 5.14), and a history of stroke / transient ischemic attack (OR 2.53, 95% CI 1.37 to 4.53) significantly increased the likelihood of being on bisoprolol at the inclusion in the study.

Conclusions:
In the post-hoc analysis of the TRICOLOR study, patients receiving bisoprolol in addition to SPC at BL had predominantly more severe HTN, with presence of concomitant cardiovascular disease.
A RANDOMIZED N-OF-1 STUDY COMPARING BLOOD PRESSURE MEASURED ON A CLOTHED ARM AND ON AN ARM WITH A ROLLED-UP SLEEVE
Authors: Lins Robert Lins 
Published: June 2022

Objective:
It is recommended that blood pressure (BP) should be measured on a bare upper arm with an appropriately sized cuff. However, in practice, it is more convenient to measure BP on a bare arm below a rolled-up sleeve or on a sleeved arm. A n-of-1 randomized controlled trial was performed to assess the difference between measuring BP over or below a thin rolled-up sleeve.

Design and method:
The study subject is male, white, 72 years, with BMI 26, arm circumference 29 cm, and under stable antihypertensive treatment. BP was measured 3 times according to guidelines. The order of measurements was determined by chance and 2 devices were used: OMRON HEM-907 and Microlife Afib. 316 measurements needed to be done to detect a difference of 3 mm Hg in systolic blood pressure (SBP). Descriptive statistics and the 2-side T test were used for comparison. Significance was set at the 0.05 level.

Results:
504 measurements were performed, 50 % over a sleeve and 50 % on the bare arm below a rolled-up sleeve. The mean SBP was 116.9 ± 9. 2 (95% CI 115.7–118.0, range 96–135) and 122.8 ± 9.2 (95% CI 121.7–124.0, range 103–139, p = 0.001) mm Hg, respectively for sleeved and bare arm. The mean diastolic blood pressure (DBP) was respectively 67.6 ± 6.8 (95% CI 66.8–68.4, range 52–84) and 71.8 ± 6.8 (95% CI 71.0–72.7, range 55–85, difference p = 0.001) mm Hg. There was no significant difference (SBP 118.3 ± 6.8 vs 116.8 ± 5.9, p = 0.97; DBP 68.5 ± 5.5 vs 67.0 ± 5,0 p = 0.44) between measurements over a sleeve and on the bare arm after removing all clothes (n = 96).

Conclusions:
Blood pressure measurements over a thin sleeve were clinically significantly lower than measurements on a bare arm with rolled-up sleeve and match measurements on a completely bare arm as standard method proposed by guidelines.
ORTHOSTATIC HYPOTENSION AT DISCHARGE - ASSOCIATED CHARACTERISTICS AND OUTCOMES
Authors: Gouveia Rita , Matias Paula F. , Matos Mariana , Madureira Sergio , Veiga Hugo , Vale Catarina , Almeida Jorge , Marques Pedro S. 
Published: June 2022

Objective:
Orthostatic hypotension (OH) is a fall in systolic blood pressure (BP) > = 20 mmHg or diastolic BP > = 10 mmHg in the 3 minutes after standing. OH is associated with falls, cognitive impairment and cardiovascular disease. Hospitalized patients may be particularly prone to OH and vulnerable to its consequences due to acute illness, prolonged bed rest and drug treatment. We aimed to evaluate the prevalence of OH at discharge, determine the characteristics of these patients and understand if a positive OH test (+OHt) was associated to worse outcomes.

Design and method:
Retrospective analysis of 150 patients ospitalised in an internal medicine ward, who were able to tolerate an OH test according to the European Society of Cardiology recommendations. Test was performed at discharge using Erkameter 125 Pro device validated by the European Society of Hypertension. The primary outcome was a composite of death, rehospitalization or emergency department visit for any cause. Data was analysed using IBM SPSS 28. Student t and chi-square tests were used to compare continuous and categorical variables, respectively, and Kaplan-Meier test to perform survival analysis.

Results:
Table 1 describes patients’ characteristics. 58 (39%) had a discharge + OHt but only 7 (12%) were symptomatic. Age was significantly associated with +OHt (p < 0.001), while sex, past medical history or medication at discharge weren’t. 71 primary outcome events were considered for survival analysis during a median (interquartile range) follow up of 4 (2–7) months. There were no differences between OHt result groups (p = 0.476). Although there were a small number of symptomatic +OHt patients, these had a higher event rate after discharge (p = 0.02).

Conclusions:
In an old, predominantly male population with excessive cardiovascular risk, comorbidities and polypharmacy there was a high OH prevalence at discharge. Only age seemed to correlate with OH. Short time prognosis was not affected by OH. The study limitations, small sample size, low number of events and short follow up, may have impacted the analysis. Nevertheless, patients with a symptomatic +OHt at discharge seem to be at higher event risk in which intervention could be helpful.
FEATURES OF THE DAILY BLOOD PRESSURE PROFILE IN YOUNG WOMEN ACCORDING TO PRECLINICAL CHECK UP
Authors: Evsevyeva Maria , Sergeeva Oksana , Penzova Violetta , Prokhorenko-Kolomoitsev Irina , Gachkova Irina , Ovchinnikova Olga 
Published: June 2022

Objective:
The problem of effective prevention arterial hypertension (AH) is extremely important, which should be as primary and early as possible. It can be carried out at young age The aim is to evaluate the indicators of daily blood pressure monitoring (DBPM) in young women (YW) from the general population in the process of preclinical check up (PCU).

Design and method:
During the population survey in the conditions of the Stavropol City Health Center, 75 women aged 18 to 30 years were examined. In addition to risk factors (RF) screening, DBPM was also performed with determination of more than 20 indicators. In accordance with current clinical recommendations, on base of DBPM results, 4 groups with different variants of pressure regulation were distinguished: 1gr. - persistent normotension; 2gr - isolated office arterial hypertension (IOAH); 3gr - latent hypertension (LH) and 4gr. - persistent hypertension (PH).

Results:
The following distribution of examined YW in these groups was revealed: 1gr. - persistent normotonia 34.7% (26); 2gr– - IOAH 9.3% (7); 3gr. - latent hypertension 36.0% (27) and 4gr. - persistent hypertension 20.0% (15). In women with LH, indicators such as daytime and nighttime SAP, nighttime DAP and variability index of nighttime DAP were almost equal to those of peers with PH, and variability indices of daytime and nighttime DAP, as well as morning rise were significantly higher by 11.6%, 7.5% and 19.1% (p = 0.0273, p = 0.0561 and p = 0.0266). Such parameters as degree of nocturnal decrease in SAP and DAP, on the contrary, were 2–4 times less (p = 0.0570 and p = 0.0609). At the same time, office SAP and DAP in the group of LH were significantly lower compared to the group of women with PH (p = 0.0000 and p = 0.0157).

Conclusions:
The obtained results indicate the need for timely detection of LP in YW, because in terms of occurrence in such general population, it reaches level of representation of two variants of office hypertension – IOAH and PH combined. Therefore, it should be recommended to include DBPM in plan of PCU of YW who usually consider themselves practically healthy.