bluuebunny/crossref_metadata_2025_split huggingface dataset:
OPEN-ANGLE GLAUCOMATOUS OPTIC NEUROPATHY IS RELATED TO DIPS RATHER THAN INCREASES IN THE MEAN ARTERIAL PRESSURE OVER 24-H
Authors: Melgarejo Jesus , Eijgen Jan V. , Maestre Gladys E. , Al-Aswad Lama A. , Thijs Lutgarde , Mena Luis J. , Terwilliger Joseph D. , Petitto Michele , Chavez Carlos A. , Brito Miguel , Calmon Gustavo , Silva Egle , Wei Dong-Mei , Cutsforth Ella , Keer Karel V. , De Moraes Gustavo , Vanassche Thomas , Janssens Stefan , Stalmans Ingeborg , Verhamme Peter , Staessen Jan A. , Zhang Zhen-Yu 
Published: June 2022

Objective:
Mean arterial pressure (MAP) drives ocular perfusion. Excessive 24-h MAP variability relates to glaucoma, however, whether this is due to dips or increases in the blood pressure (BP) is undocumented. We investigated the association of open-angle glaucoma (OAG) in relation to the five largest MAP dips/increases over 24-h, henceforth called dips/blips.

Design and method:
In the Maracaibo Aging Study (MAS), 93 participants aged 40y or older (women, 87.1%; mean age, 61.9y) underwent baseline ophthalmological and 24-h ambulatory BP monitoring assessments. OAG was the presence of optic nerve damage and visual field defects. Statistical methods included logistic regression and the generalized R2 statistic. For replication, 48 OAG cases at the Leuven Glaucoma Clinic were matched with 48 controls recruited from Flemish population.

Results:
In MAS, 26 had OAG. OAG compared to non-OAG participants experienced longer and deeper dips (116.5 vs. 102.7 minutes; to 60.3 vs. 66.6 mmHg; 21.0 vs. 18.0 mmHg absolute or 0.79 vs. 0.81 relative dips compared to the preceding reading). The adjusted odds ratios associated with dip measures ranged from 2.25 (95% confidence interval [CI], 1.31–4.85; P = 0.009) to 3.39 (95% CI, 1.36 8.46; P = 0.008). On top of covariables and 24 MAP level/variability, the dip measures increased the model performance (P values below 0.025). Blips did not associate with OAG. The case-control study replicated the MAS observations.

Conclusions:
Dips rather than increases in the 24-h MAP level were associated with increased risk for OAG. An ophthalmological examination combined with 24-h BP monitoring might be precautious steps required in normotensive and hypertensive patients at risk of OAG.
IMPACT OF BLOOD PRESSURE VARIABILITY ON CARDIOVASCULAR MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Manousopoulos Konstantinos , Spiliopoulou Sotiria , Tsoutsoura Nefeli , Lykka Aikaterini , Dimitriou Athina , Manios Efstathios 
Published: June 2022

Objective:
It is well known that blood pressure (BP) variability is associated with development of target-organ damage and adverse cardiovascular outcome in hypertensive patients. However, the impact of BP variability (BPV) on cardiovascular outcome in chronic kidney disease patients (CKD) is unclear. Aim of the study was to examine the impact of home BPV on cardiovascular mortality in chronic kidney disease patients.

Design and method:
A total of 137 CKD patients, referred for evaluation at the Hypertension Unit of our department, underwent home BP monitoring. Participants were instructed to take duplicate morning and evening measurements in the sitting position, after 5-min sitting rest and with 1 min between measurements for 7 working days. The average home BP value of the morning, evening and all measurements was analyzed. Home BPV was quantified by using standard deviation (SD), coefficient of variation (CV) and morning minus evening BP values. Median follow-up for fatal cardiovascular events was 3 years. Statistical analysis was performed by means of cox regression analysis.

Results:
The study population consisted of 102 men (75%). Mean age was 70 years, mean office BP was 142/76 mmHg and mean home BP was 137/74 mmHg. During follow-up, there were 12 fatal cardiovascular events. The multivariate Cox regression analyses revealed that the SD of systolic home BP was an independent predictor of cardiovascular mortality (HR: 1.19, 95%CI 1.02–1.38, p = 0.022) after adjustment for age, sex, history of diabetes mellitus and hyperlipidemia, smoking, antihypertensive treatment and mean systolic home BP.

Conclusions:
Home BPV is an independent predictor of cardiovascular mortality in CKD patients
ANALYSIS OF AMBULATORY BLOOD PRESSURE MONITORING AND BLOOD PRESSURE MANAGEMENT IN A GERIATRIC REHABILITATION UNIT
Authors: Lennon Sarah-Jane , Connell Liam O. , Delos Re Juliana , Dolan Eamon 
Published: June 2022

Objective:
Blood pressure variability (BPV) has proven prognostic importance. Research has shown that controlling BPV in addition to overall reduction of BP in hypertension improves cardiovascular risk. Patients with diagnosed hypertension have an increased association with wider BPVs. Ambulatory blood pressure monitoring (ABPM) is the gold standard in diagnosis of HTN and measuring BPV. We aimed to analyse ABPM data on rehabilitation inpatients and assess hypertension (HTN) management.

Design and method:
A retrospective analysis of ABPM data of 32 patients sequentially admitted to a geriatric rehabilitation unit in an orthopaedic hospital from Jan 2019 – Jan 2020. We measured the change in medication, quantifying it by escalation and de-escalation (addition/reduction in antihypertensives) or no change if nothing was done. In addition we measured OH. We also analysed BPV by subdividing patients into three groups – High, Medium, and Low daytime BPV based on the standard deviation of daytime SBP.

Results:
Patient demographics summary (Table 1). There was increased OH detected in the High variability compared to the Low group this had borderline significance (High 75% vs Low 29%, P – 0.06). 37.5% of patients on anti-HTN treatment had an average SBP > 140mmHg. 66.6% of patients with an average SBP > 140mmHg had postural hypotension. 34% of the cohort had OH. 44% of patients with an SBP > 140mmHg had no previous diagnosis of HTN. In this cohort 87% were non night-time dippers. Increased frequency of OH detected in the High variability compared to the Low. (High 75% vs Low 29%, P – 0.06). The High variability also had a significantly higher eGFR when compared to the Low variability (High 88 vs Low 60, P – 0.04) (Table 2).

Conclusions:
These results show that a significant sub-group of rehabilitation inpatients in our unit had inadequate blood pressure control, underdiagnosed HTN/BPV. This study has shown that ABPM is an effective method for detecting PBV, HTN and sustained night-time HTN in a geriatric rehab population. ABPM should be used as standard of care to detect BPV and OH so that labile BP can be effectively treated and falls risk reduced.
AMBULATORY BLOOD PRESSURE TRAJECTORIES AND BLOOD PRESSURE VARIABILITY IN KIDNEY TRANSPLANT RECIPIENTS: A COMPARATIVE STUDY AGAINST CHRONIC KIDNEY DISEASE PATIENTS
Authors: Korogiannou Maria , Theodorakopoulou Marieta , Sarafidis Pantelis , Alexandrou Maria Eleni , Pella Eva , Xagas Efstathios , Argyris Antonis , Protogerou Athanase , Papagianni Aikaterini , Boletis Ioannis N. , Marinaki Smaragdi 
Published: June 2022

Objective:
Hypertension is a major cardiovascular risk factor in both kidney transplant recipients (KTRs) and patients with chronic kidney disease (CKD). Ambulatory blood pressure monitoring (ABPM) is considered the gold-standard method for hypertension management in these subjects. This is the first study evaluating in comparison the full ambulatory BP profile and short-term BP variability (BPV) in KTRs versus CKD patients without kidney replacement therapy.

Design and method:
93 KTRs were matched with 93 CKD patients for age, sex and eGFR. All participants underwent 24-h ABPM; mean ambulatory BP levels, BP trajectories and BPV indices [standard deviation (SD), weighted-SD and average real variability] were compared between the two groups.

Results:
There were no significant between-group differences in 24-hour SBP/DBP (KTRs:126.9 ± 13.1/79.1 ± 7.9 vs CKD:128.1 ± 11.2/77.9 ± 8.1mmHg, p = 0.522/0.293), daytime SBP/DBP and nighttime SBP; nighttime DBP was slightly higher in KTRs (KTRs:76.5 ± 8.8 vs CKD:73.8 ± 8.8mmHg, p = 0.040). For both ambulatory SBP/DBP, repeated-measurements-ANOVA showed a significant effect of time (SBP: F = [19, 3002] = 11.735, p < 0.001, partial 2 = 0.069) but not of KTR/CKD status(SBP: F = [1, 158] = 0.668, p = 0.415, partial 2 = 0.004). Ambulatory systolic/diastolic BPV indices were not different between KTRs and CKD patients, except for 24-hour DBP-SD that was slightly higher in the latter (KTRs:10.2 ± 2.2 vs CKD:10.9 ± 2.6mmHg, p = 0.041). No differences were noted in dipping pattern between the two groups.

Conclusions:
Mean ambulatory BP levels, BP trajectories and short-term BPV indices are not significantly different between KTRs and CKD patients, suggesting that KTRs have a similar ambulatory BP profile compared to CKD patients without kidney replacement therapy.
INFLUENCE OF SYSTOLIC BLOOD PRESSURE CONTROL IN ELDERLY PATIENTS WITH CHRONIC HFPEF
Authors: Qin Jiwei Chen , Sanchez Marcos Sanchez , Esmel Esther Viñas , Mas Miriam Costafreda , Babkowski Miguel Camafort 
Published: June 2022

Objective:
Heart failure is a major public health problem and one of the leading causes of ospitalisation and death. Since HFPEF increases with age, it is an increasingly worrisome health problem in countries with higher life expectancies. Since the influence of BP is essential in HFPEF, and its control in the outpatient is not clear, we propose to evaluate this variable in a retrospective cohort.

Design and method:
Retrospective study of patients with HFPEF, older than 80 years, followed up in outpatient consultation after ospitalisation for HF, in a Teaching Hospital. Data were obtained from electronic medical records with prior authorization from the Ethics Committee.

Results:
106 patients were included. For analysis we use a cut-off point of SBP (measured in the office at the first visit) below 90 mmHg, between 90 and 139 mmHg and equal or above 140 mm Hg. For DBP we used a a cut-off point of DBP od 70 mmHg. As for the characteristics the only differences were that those with Low SBP had significantly lower LVEF as those with normal or high SBP (54% vs 59 p 0.035). As for DBP, those with low DBP had significantly lower Heart Rate than those with High DBP (72 bpm vs 79 bpm, p 0.039) There were no mortality differences between those with low SBP, normal SBP and high SBP, neither on those with low DBP or Normal High DBP. Kaplan Meier curve showed a non-significant trend to higher mortality on those with lower BP

Conclusions:
In our study, we have not observed differences in mortality between those patients with BP with good control versus those with poor control.
Although there may be a selection bias and this is a retrospective study, more studies are needed to assess the influence of BP controls on the evolution of HF in octogenarian patients
TWO-YEAR RESPONSES OF HEART RATE AND HEART RATE VARIABILITY TO FIRST OCCUPATIONAL LEAD EXPOSURE
Authors: Yu Yuling , Thijs Lutgards , Yu Caiguo , Yang Wenyi , Melgarejo Jesus , Wei Dongmei , Wei Fangfei , Nawrot Tim , Verhamme Peter , Roels Harry , Staessen Jan , Zhang Zhenyu 
Published: June 2022

Objective:
Because of the falling lead exposure, the literature relating autonomous nervous function to blood lead has limited relevance.

Design and method:
In the longitudinal Study for Promotion of Health in Recycling Lead (URL: https://www.clinicaltrials.gov; Unique identifier: NCT02243904), we recorded the 2-year responses of heart rate, heart rate variability (Cardiax, International Medical Equipment Developing, Budapest, Hungary), and median nerve conduction velocity (Brevio, NeuMed, West Trenton, NJ), a routine test in occupational medicine, to first lead exposure in 195 newly hired workers (91.3% men; mean age, 27.8 years). High- and low-frequency heart rate variability power and orthostatic heart rate variability responses were derived from 5-minute eletrocardiograms in the supine and standing positions by Fourier transform and autoregression. Blood lead was determined by inductively coupled plasma mass spectrometry.

Results:
From baseline to follow-up, blood lead increased from 4.22 to 14.1 ug/dL and supine/standing HR from 63.6/75.5 to 67.1/78.8 beats per minute. In analyses stratified by fourths of blood lead changes, trends in heart rate and Fourier/autoregressive heart rate variability did not reveal a dose-response curve (0.074< = P< = 0.98). In multivariable-adjusted mixed models, heart rate, Fourier/autoregressive heart rate variability, and nerve conduction velocity changes were unrelated to blood lead except for a weak inverse association between supine heart rate and blood lead changes (-0.55%; P = 0.029). The expected associations between heart rate variability and heart rate changes were preserved with no differences at baseline/follow-up. Analyses ichotomised by baseline median blood lead or cumulative blood lead index (4.30 ug/dL or 32.1 ug/dL × year) suggested an heart rate variability increase versus decrease in the low versus high baseline exposure group.

Conclusions:
Thus, a > 3-fold blood lead increment did not affect autonomous neural function as captured by heart rate variability.
EFFECT OF HYPOKALEMIA ON LEFT VENTRICULAR STRUCTURE AND FUNCTION IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Wang Qiongying , Zhang Haodong , Wang Wenjuan , Fan Xin , Yu Jing 
Published: June 2022

Objective:
Analyzing the changes of left ventricular structure and function in essential hypertension patients with hypokalemia, we want to provide an evidence for clinical diagnosis and treatment of early heart damage caused by hypertension and hypokalemia.

Design and method:
413 patients with hypertension were selected, including 270 cases of essential hypertension and 143 cases of essential hypertension with hypokalemia.Collect patient general information, biochemistry, urine routine, office blood pressure, 24 h ambulatory blood pressure, left atrial diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter, ventricular septal thickness, left ventricular posterior wall thickness and other indicators.After propensity score matching, 108 cases in the essential hypertension group and the essential hypertension with hypokalemia group were each, and statistical analysis was performed.

Results:
Albumin, and urea-creatinine ratio levels of the essential hypertension with hypokalemia group were significantly reduced, and the ratios of sodium ions and sodium potassium were lower than those of the primary hypertension group. Correlation analysis shows that the left ventricular mass index was positively correlated with and the course of hypertension, systolic blood pressure, diastolic blood pressure, mean arterial pressure, creatinine, sodium-to-potassium ratio, mean systolic blood pressure during the day, mean diastolic blood pressure during the day, mean systolic blood pressure at night, mean night diastolic blood pressure. Multiple linear regression analysis showed that the left ventricular mass index was independently positively correlated with systolic blood pressure, hypertension course, creatinine, sodium-to-potassium ratio, night systolic blood pressure, 24 h average systolic blood pressure, and 24 h systolic blood pressure load rate; potassium ion, low density Lipoprotein, angiotensin II and left ventricular mass index are independently and negatively correlated.

Conclusions:
There are more obvious ventricular structural changes in essential hypertension patients with hypokalemia; serum potassium ion concentration and sodium-to-potassium ratio are independent risk factors for left ventricular mass index in essential hypertension patients with hypokalemia.
CORRELATION BETWEEN ESTIMATED PULSE WAVE VELOCITY FROM DERIVATED FROM REFERENCE OR HEALTHY POPULATION EQUATION AMONG INDIVIDUALS COM CARDIOVASCULAR RISK FACTORS
Authors: da Silva Marco Antonio Vieira , Dias Valdo Jose , de Resende Luiz Antonio Pertili R. , Vieira Livia Marchiori , Mesquita Mariana Dornfeld Soffiatti , Martins Maria Julia Sousa , Segawa Maria Eduarda Fernandes , Ferreira Pedro Paulo Soares , Nogueira Marianna de Freitas Rocha , dos Santos Flávia Hermano Rodrigues , dos Santos Giovanna C. Ferreira , Oliveira Guilherme Rodrigues , de Oliveira Rodovalho Euler , Filho André Breda Bauab , Pasquar Danilo R. Goulart 
Published: June 2022

Objective:
To evaluate the correlation between estimated pulse wave velocity (ePWV) from two different equations in individuals with cardiovascular (CV) risk factors.

Design and method:
It selected five hundred sixty-five patients who presented at least one cardiovascular risk factor among treated hypertension, an elevated BP (cut off 140–90 mmHg), diabetes, dyslipidemia, smoking, body, and abdominal obesity. Using an automatic device, a non-physician trained observer performed three sequential BP measurements. The ePWV was calculated from age and mean blood pressure (MBP). Two equations derived from reference population (equation 1) and healthy population (equation 2) estimated ePWV (Greeve et al.).
Eq. (1) = 9.58748315543126–0.402467539733184*age+4.56020798207263*10–3*age2–2.6207705511664*10-5*age*MBP+3.1762450559276*10-3*age*MBP-1.83215068503821*10-2MBP.
Eq. (2) = 4.62–0.13*age+0.0018*age2+0.0006*age*MBP+0.0284*MBP.
MBP was calculated as diastolic BP + 0.4 (ystolic BP - diastolic BP). We calculated the mean ePWV with both equations, performed a t-test to compare the means. The concordance correlation coefficient Pc evaluated the precision and accuracy between the measurements. We used the Bland Altman plot to assess an agreement between two ePWV better.

Results:
The Clinical characteristics of the sample: mean age 48.9 ± 13.9 years, 282 (49.9%) women, 219 (38.8%) treated hypertensives, 161 (28.5%) non treated hypertensives, 94 normotensives (16.6%), 38 (6.7%) masked hypertensives, 53 (9.4%) white coat hypertensives, 187 (33.1%) with dyslipidemia, 69 (12.2%) diabetics, 243 (43.1%) obese, 335 (60.3%) with waist circumference at risk, 47 smokers (8.3%). Figure 1 shows the Scatter diagram of correlation between epWV Eq. (1) and Eq. (2). The concordance correlation coefficient was 0.996 (95%CI: 0.995 – 0.997); Pearson coefficient p (precision) = 0.996; bias correction factor Cb (accuracy) = 0.999. On Figure 2 the Bland Altman plot considering the Eq. (1) as a gold standard demonstrates the agreement between two measurements.
The mean difference was 0.03 ((95%CI: -0.28 – 0.33). There was no difference in ePWV with Eq. (1) - 9.17 ± 1.80 m/s and utilizing Eq. (2) - 9.14 ± 1.77 m/s (p = 0.77).

Conclusions:
Our data indicated an almost perfect correlation and values equivalency between ePWV from Eqs. (1) and 2. Therefore both equations could be utilized in individuals with cardiovascular risk factors to estimate PWV.
REDUCED ENDOTHELIAL GLYCOCALYX IS ASSOCIATED WITH HYPERTENSION BURDEN ONLY IN MALE SMOKERS WITH FIRST DIAGNOSED AND NEVER TREATED STAGE I AND II ESSENTIAL HYPERTENSION
Authors: Triantafyllidi Helen , Fabri Anastasia , Benas Dimitris , Birmpa Dionyssia , Schoinas Antonios , Thymis Ioannis , Kostell Gavriela , Ikonomidis Ignatios 
Published: June 2022

Objective:
Endothelial dysfunction may be estimated by reduced endothelial glycocalyx (EG). However, the role of EG as a hypertension mediated organ damage (HMOD) still remains controversial. Cigarette smoking represents a significant CV risk factor. Aim of this study is the investigation of the EG’s role in first diagnosed and never treated patients with stage I and II essential hypertension regarding smoking habit.

Design and method:
We studied 194 non-diabetic, first diagnosed and never-treated hypertensive patients (mean age=49 + 10 years, 60% males, 35% smokers). Ambulatory blood pressure monitoring (24 h ABPM) and endothelial dysfunction (PBR5–25) were estimated in each patient before treatment initiation.

Results:
We found that mean 24 h systolic and diastolic ABPM levels were 140 + 8 mmHg and 87 + 9 mmHg, respectively. Regarding EG, mean values of PBR5–25, PBR5-9, PBR10-19 and PBR20-25 were 2.08 + 0.3 m, 1.16 + 0.2 m, 2.22 + 0.34 m and 2.65 + 0.8 m, respectively. No correlations were found between PBR levels and 24 h ABPM regarding the whole population. However, when we performed multiple regression analysis in a subgroup of male smoker hypertensives (n = 46, mean age=47 + 11 years), a significant association (Beta = 0.29, p = 0.05) was revealed between PBR20-25 and 24 h systolic ABPM.

Conclusions:
In first diagnosed and never treated arterial hypertension, endothelial dysfunction, represented by reduced EG, is independently related to systolic BP burden only in male smokers. Probably EG might play a significant role regarding CV risk estimation in specific groups of hypertensive patients.
SMOKING HABIT IS NOT RELATED WITH HYPERTENSION MEDIATED ORGAN DAMAGE IN YOUNG PATIENTS WITH FIRST DIAGNOSED AND NEVER TREATED ESSENTIAL HYPERTENSION
Authors: Triantafyllidi Helen , Benas Dimitris , Fabri Anastasia , Birmpa Dionyssia , Schoinas Antonios , Thymis Ioannis , Kostelli Gavriela , Ikonomidis Ignatios 
Published: June 2022

Objective:
Early onset arterial hypertension (AH) is associated with a considerably increased risk for cardiovascular (CV) disease. Cigarette smoking represents a significant CV risk factor. Aim of this study is the investigation of any differences between smokers and non smokers first diagnosed and never treated young patients with essential hypertension regarding the burden of blood pressure and the presence of hypertension-mediated organ damage (HMOD).

Design and method:
We studied 272 non-diabetic, first diagnosed and never-treated young hypertensive patients, [median age=43(39-48), 68% males]. Ambulatory blood pressure monitoring (24 h ABPM), CV risk factors [smoking, obesity (BMI), hyperlipidemia and HMOD [aortic stiffness (PWV), left ventricular diastolic dysfunction (EEa), cardiac hypertrophy (LVMI), coronary arteries microcirculation (CFR), carotid intima-media thickness (cIMT) and endothelial dysfunction (PBR5-25)] were estimated in each young patient before treatment initiation.

Results:
Young patients’ population was divided regarding smoking habit in smokers group [n = 105, age = 43(38–47), 75 males)] and non-smokers [n = 167, age = 43 (39–48), 119 males]. LDL-C levels, triglycerides, 24 h and daytime systolic ABPM, systolic and diastolic BP variability (BPV) and systolic BP load (BPL) during daytime were increased in smokers compared to non-smokers. No significant differences between smokers and non-smokers regarding age, BMI, E/Ea, LVMI, PWV, MAU, CFR, cIMT and PBR5–25 were found. However, the incidence of LVH (13% vs. 6%, p = 0.04) and impaired CFR (p = 0.05) was increased in smokers compared to non-smokers. In multiple regression analysis, we noted that 24 h systolic ABPM was independently associated with PWV (beta = 0.31, p < 0.001), LVMI (beta = 0.32, p < 0.001) and CFR (beta = -0.18, p = 0.01) regardless of smoking habit.

Conclusions:
In young people with first diagnosed arterial hypertension, HMOD is independently related to BP burden, irrespective of smoking habit. As HMOD may regress with successful antihypertensive treatment, there is still time for those young patients to treat hypertension disease and hyperlipidemia and quit smoking, in order to reduce future CV risk.