bluuebunny/crossref_metadata_2025_split huggingface dataset:
RADIOFREQUENCY RENAL SYMPATHETIC DENERVATION WITH MULTIELECTRODE CATHETERS IN PATIENTS WITH RESISTANT HYPERTENSION: EARLY PROCEDURAL RESULTS
Authors: Ionov Mikhail , Emelyanov Igor , Vakhrushev Aleksander , Alieva Asiyat , Avdonina Natalia , Yudina Yulia , Lebedev Dmitry , Mikhaylov Evgeny , Konradi Aleksandra 
Published: June 2022

Objective:
Renal sympathetic denervation (RD) is the most promising invasive options to treat resistant hypertension (HTN). In Russian practice radiofrequency (RF) is the only feasible option. Emergence of the new RF RD multielectrode catheter systems in Russian HTN Excellence Centers provide a way to test this method.
The aim of the study was to investigate the baseline characteristics of patients with resistant HTN undergoing RF RD and to determine immediate postprocedural clinical effects.

Design and method:
During 2018–2019, two series of RF RD procedures were performed in patients with truly resistant HTN using balloon-type (bipolar ablation) or spiral-type (unipolar ablation) multielectorde catheters. A comparative analysis of two groups of patients was carried out according to the type of catheter used. Dynamics of office systolic blood pressure (SBP) were assessed as delta between the two timepoints: at screening and at hospital discharge. The safety assessment of RF RD was performed. We applied multiple linear regression method to determine the factors associated with the delta of office SBP after RF RD.

Results:
A total of 48 patients taking 4 (4;6) antihypertensive drugs were included. Radiofrequency RD was performed with a balloon-type catheter in 27 patients (mean age 56 ± 12 y.o.; 12 males) and with a spiral-type catheter in 21 patients (50 ± 14 y.o.; 8 males). The duration of RF RD was significantly longer in the spiral catheter group (110 vs 60 min, p < 0.001), but twice as much RF ablations (24 vs 12, p = 0.002). None had acute kidney injury after RD (delta creatinine -0.6 micromol/L; 95% CI [-3.97; 2.78]). At discharge there was a pronounced decrease in office SBP (adjusted for baseline covariates) of -26 mm Hg (95% CI [-29; -23]). The main factors associated with the delta of office SBP were: smoking status (beta = -7.95; positive if “yes’’), baseline office SBP (beta = -0.48; positive), and blood glucose (beta = 5.28; negative).

Conclusions:
Radiofrequency renal denervation using multielectode catheters is characterized by pronounced and favorable short-term hemodynamic effects. We have found new potential predictors of these effects. Further research will focus on testing initial hypotheses in the long term run.
ARTERIAL STIFFNESS ASSESSMENT IN DIABETIC PATIENTS IN A CARDIOLOGY CLINIC
Authors: Paffer Matheus Toscano , Paffer Pedro Toscano , Paffer Tatiana , Castro Camila De , Caminha Natália , Terra Vitória , Didier Kamille , Paffer Silvio 
Published: June 2022

Objective:
Arterial stiffness is a complex phenomenon characterized by decreased compliance of the great arteries. In diabetes, the arterial wall undergoes a series of biomechanical changes, which can result in arterial stiffness. The mechanisms of these structural and functional arterial alterations in diabetes include insulin resistance, collagen accumulation due to inadequate enzymatic glycation, endothelial and autonomic nervous system dysfunction. Increased arterial stiffness is a marker of cardiovascular risk in diabetic patients.
We aimed to evaluate the arterial stiffness of diabetic pateients in a private cardiology clinic

Design and method:
We evaluated 46 patients in cardiology service, who underwent central pressure assessment with the Mobil O’Graph device. All additional information about the patients conditions were taken from their medical records.

Results:
A total of 46 patients underwent the examination, being 26 of them women (56%), with a mean age of 58.93 years (+-35). Of these patients, 22 (47.8%) were diabetic, reported by their medical records. The mean central systolic pressure of diabetic patients was 142.9mmHg (+-35.1) and the central diastolic pressure was 86.9mmHg (+-19.9). The mean pulse wave velocity was 9.68 (+-5.31), with 11 (50%) above the normal value, according to the Brazilian Guideline of Hypertension 2020.

Conclusions:
As seen in the analyzed patients, diabetic patients are at high risk for an increase in arterial stiffness. This is possibly because the mechanisms that cause changes in endothelial collagen loss, such as advanced glycation end products and the inhibitor of formation of these products, aminoguanidine, are exacerbated in diabetic patients.
The importance of assessing arterial stiffness, through pulse wave velocity, in diabetic patients is evident.
IMPACT OF LONG-TERM USE OF CPAP TREATMENT ON BLOOD PRESSURE AMONG REFRACTORY HYPERTENSIVE PATIENTS WITH OBSTRUCTIVE SLEEP APNEA
Authors: Nemer Camila Bello , Chedier Bernardo , de Hollanda Cavalcanti Aline , Nejm Roderjan Christian , Viegas Bianca , dos Santos Taissa Lorena , de Azevedo João Carlos Moreno , Alves Hugo Farah Affonso , de Sá Kimura Lucca Hiroshi , de Carvalho Fortes Carolina , da Silva Marcus Vinicius Serejo Borges V. , Lobo Sofia Luz Coutinho Botelho , de Souza Fabio , Muxfeldt Elizabeth Silaid 
Published: June 2022

Objective:
To assess blood pressure response to long-term continuous positive airway pressure (CPAP) treatment among patients with refractory hypertension (RfHTN) with moderate and severe obstructive sleep apnea (OSA).

Design and method:
An observational prospective study was performed in 26 patients (35.7% male, average age 59.3 ± 7.9 years) with diagnostic of RfHTN and moderate and severe OSA who were divided in 2 groups to use CPAP (CPAP group, n = 13) or not (control group, n = 15). All of them were submitted to clinical follow-up and their anti-hypertensive medication was adjusted according to the assistant physician. 24-hour ABPM was performed both at the beginning and at the end of the study. Primary outcomes were changes in office and ambulatory blood pressure (BP) and BP control. The comparison between groups of BP changes were calculated by a general linear model with group allocation as a fixed factor and adjusted by its respective BP basal values in addition to gender and age.

Results:
The median follow-up time was 68 months (IQR: 49–81 months). CPAP and control groups were similar in their baseline demographic, anthropometric, laboratory characteristics, and office and ambulatory BP. They had mean systolic and diastolic 24-hour BP of 142 (15) and 83 (14), respectively. At the end of follow-up, refractory patients using CPAP had a reduction of 8.5 and 5.0 mmHg of office systolic and diastolic BP with an intergroup difference (CPAP and control) of 13.5 (-15.2 – 42.3) mmHg and 10.1 (-7.5 – 5.4) mmHg, respectively. The most important difference between groups was noticed at nighttime with an intergroup difference of 10.0 (-8.6 – 28.7) mmHg of systolic BP and 6.7 (-3.9 – 17.3) mmHg of nighttime diastolic BP. Out of 28 initial refractory patients, 12 are not refractory anymore, being 3 (20%) in control group and 9 (69.2%) in CPAP group with a significant difference between the groups (p = 0.02)

Conclusions:
Long-term use of CPAP among refractory hypertensive patients with moderate/severe OSA seems to be effective to reduce and control blood pressure measured both in the office BP and 24-hour ABPM, especially lowering nighttime blood pressure.
ADHERENCE TO PHYSICAL ACTIVITY IN OLDER ADULTS WITH HYPERTENSION: LESSONS FROM THE HOLDAGE RANDOMIZED CONTROLLED TRIAL
Authors: Pinto Diogo , Rato Nuno D. , Garcia Catarina , Teixeira Manuel , Marques Maria J. , Amaral Teresa , Amaral Leonor , Ruivo Pedro , Abreu Ricardo , Oliveira Ana P. , Carneiro Cristiana , Figueiredo Daniela , Polónia Jorge , Mesquita-Bastos José , Viana João L. , Pescatello Linda S. , Ribeiro Fernando , Alves Alberto J. 
Published: June 2022

Objective:
Isometric exercise training (IHT) may be a practical, inexpensive and time efficient modality to reduce blood pressure (BP). We report preliminary exercise adherence data from HoldAge (NCT04275037) among older adults with high-normal BP to stage I hypertension.

Design and method:
Participants performed a total of 24 sessions of IHT or aerobic exercise training (AET), 3 times/week, for 8 wks. IHT was 4x45 min contractions, alternatively with both hands, at an intensity of 50% of the maximum voluntary contraction, with 1 min rest between sets. AET was walking 20–30 min at an intensity of 50–70% of the estimated peak maximal oxygen consumption (VO2peak) assessed with a submaximal step test. The attention control (AC) group received standardized optimal medical care including lifestyle advice. The adherence to IHT was a mean quality score recorded in the digital dynamometer, representing the % time participants performed the exercise sessions at the prescribed intensity. The adherence to AET was the time spent exercising at the prescribed intensity, recorded with a heart rate monitor.

Results:
95 eligible people were contacted to participate and 72 agreed to participate (76%). Of these, 49 participants have finished the study (IHT:19; AET:18; AC:12) with 4 dropouts (AET:1; AC:3). Three participants changed their antihypertensive medication and were excluded (AET:1; AC:2). IHT had a self-reported exercise adherence of 96.7 ± 9.3%, while data downloaded from the exercise devices showed an adherence of 88.6 ± 13.9% of the sessions, with 2.3 ± 3.3% incomplete sessions. IHT registered a mean quality score of 91.8 ± 11.2% for the right hand (mean strength: 22.6 ± 7.7 kg), 91.7 ± 13.5% for the left-hand (mean strength: 20.9 ± 8.6 kg), and 91.6 ± 12.2% for both hands. AET had a self-reported exercise adherence of 83.8 ± 33.6%, consistent with the data downloaded from the heart rate monitors. AET participants spent a total of 578.1 ± 263.6 min exercising, of which 153.3 ± 152.4 min (22.6 ± 23.2%) was spent walking at the prescribed intensity, 286.3 ± 210.5 min (45.4 ± 35.2%) was below and 137.8 ± 154.7 minutes (19.4 ± 21.7%) was above.

Conclusions:
Exercise adherence in HoldAge is high in both IHT and AET, but the time spent at the prescribed intensity appears to be higher in IHT than AET.
INFLUENCE OF TRIATHLON ON AORTIC STIFFNESS: THE ATLAS STUDY
Authors: Piscitello Tessy Cuffaro , Dupont Anne Charlotte , Labat Carlos , Salvi Paolo , Joly Laure 
Published: June 2022

Objective:
Arterial stiffness is a strong predictor of future cardiovascular events and all-cause mortality. Endurance exercise is efficacious in reducing arterial stiffness. Triathlon, i.e., swimming, cycling and running over long to ultra-long distances in a row, is one of the most demanding endurance sports disciplines inducing major cardiovascular adaptations. However, acute and long-term effects of triathlon on arterial stiffness are still unknown. Therefore, we investigated arterial stiffness modification during a triathlon season.

Design and method:
The ATLAS study is a prospective interventional controlled and age matched study. We included thirty-four 19–39-years-old male long-distance triathletes (Tri) and twenty-nine healthy sex- and age-matched volunteers who were insufficiently active (Ctrl) according to World Health Organization recommendations. All participants attended three visits (V1, V2, V3) each separated by five months intervals, spread over the course of the race season. Each visit included an aortic stiffness evaluation by applanation tonometry.

Results:
After a race season, aortic pulse wave velocity (aoPWV) was significantly lower in the triathletes group (aoPWV tri = 6,11 ± 0,95 versus aoPWV ctrl = 7,17 ± 1,24 m/s with p = 0,0009). Triathletes had central systolic blood pressure (cSBP) and central pulse pressure (cPP) significantly higher than in control group (respectively, cSBP tri = 122,60 ± 11,43 versus cSBP ctrl = 116,64 ± 6,88 mmHg with p = 0,01, and cPP tri = 54,18 ± 10,04 versus cPP ctrl = 45, 44 ± 7,55 mmHg with p = 0,0002). Triathlon was correlated with a statistically significant positive impact on subendocardial viability ratio (SEVR) (SEVR tri = 162,89 ± 26,55 versus SEVR ctrl = 133,22 ± 26,99 with p = 0,00009). No statistically significant longitudinal variation of aoPWV was observed in triathletes during the race season.

Conclusions:
These results suggest that triathlon has persistent beneficial effects on arterial stiffness, and even on myocardial perfusion. This improvement cardiovascular health for triathletes seems to reach its peak at the end of the sportive season.
EPLERENONE VS IRBESARTAN AS FIRST LINE THERAPY IN OBESE HYPERTENSIVE PATIENTS: PRELIMINARY RESULTS FROM HEBRO STUDY
Authors: Kouremeti Maria , Iliakis Panagiotis , Konstantinidis Dimitrios , Polyzos Dimitrios , Andrikou Ioannis , Drogkaris Sotirios , Tatakis Fotis , Manta Eleni , Leontsinis Ioannis , Zamanis Ioannis , Siafi Eirini , Dimitriad Kyriakos , Thomopoulos Costas , Tsioufis Konstantinos 
Published: June 2022

Objective:
Obesity is significantly associated with adverse cardiovascular outcomes. The relationship between obesity and hypertension is well described with obese patients having two times the incidence of developing increased blood pressure (BP). However, little is known about the impact of aldosterone blockade using eplerenone on hypertensive obese patients as first line therapy. The aim of this study was to compare the efficacy between eplerenone and irbesartan in obese hypertensive subjects.

Design and method:
A prospective, randomized, open-labeled, multicenter trial enrolled 54 hypertensive patients aged 30 to 75 years old, with obesity [body mass index BMI > or = 30 kg/m2)], evaluated by home BP, office BP and ambulatory BP measurements. Subjects randomly received 25 mg eplerenone twice daily or 150 mg irbesartan every morning. The primary endpoint were systolic and diastolic BP after 2 months of follow up.

Results:
In 54 hypertensive obese patients [53.7% women, mean age 55.8 ± 10.9 years, BMI 34.6 ± 3.1 kg/m2, mean office BP 146.4 ± 9.7/91.8 ± 9.8 mmHg and mean ABP 140.9 ± 7.9/84.6 ± 8.2 mmHg] there was no significant difference in the reduction of systolic ABP between irbesartan and eplerenone (11 ± 14.8 vs. 7 ± 14.7, p = 0.11), nor in the reduction of diastolic ABP (5 ± 8.3 vs. 3.8 ± 9.7, p = 0.13). Moreover, there was no difference in the reduction of OBP in irbesartan group (12 ± 11.3 vs. 9.4 ± 12.7, p = 0.14) in comparison with eplerenone group (7.1 ± 8.7 vs. 2.8 ± 8.7, p = 0.11). Also, there was no statistical significant change in renal function parameters and electrolytes levels in both groups

Conclusions:
this study suggests that eplerenone does not differ in efficacy and safety compared to irbesartan, an established angiotensin receptor antagonist, as first line therapy in obese hypertensive patients.
GENDER AS A RISK FACTOR FOR CARDIOVASCULAR EVENTS IN PATIENTS WITH HYPERTENSIVE CRISES AFTER 12-MONTH FOLLOW-UP: A GREEK REGISTRY
Authors: Fragoulis Christos , Polyzos Dimitrios , Konstantinidis Dimitrios , Mavroudis Andreas , Dimitriadis Kyriakos , Karior Maria , Leontsinis Ioannis , Manta Eleni , Drogkaris Sotirios , Tatakis Fotis , Zammanis Ioannis , Siafi Eirini , Papakonstantinou Pantelis , Mantzouranis Emmanouil , Thomopoulos Costas , Tsioufis Konstantinos 
Published: June 2022

Objective:
Currently, epidemiological data on prognosis of patients with hypertensive crises (HC) are limited. The purpose of our study was to register the prevalence and clinical characteristics of patients with hypertensive urgencies (HU) and emergencies (HE) admitting to the emergency department (ED) and during hospitalization and a 12-month follow-up to record new end points in a Greek tertiary hospital.

Design and method:
The study population included patients reporting to the ED with acute rise in blood pressure (BP) (systolic BP> or = 180mmHg and/or diastolic BP> or = 120mmHg), categorizing as HE and HU depending on the presence or absence of acute hypertension-mediated target organ damage, respectively. In all patients the demographic and clinical information were registered for 12 consecutive months. In addition, there was a 12-month follow-up for new events.

Results:
Out of 38,589 patients assessed in the ED during a period of 12 months, 353(0.91%) had HC, out of whom 256(72.5%) had HU and 97(27.5%) had HE. The mean age of the HE patients was 73 ± 12years, 51.5% were males and 86.4% had a history of hypertension. During the study period 3 HE patients did not complete the follow-up. After stratification of HE population by gender, we created two subgroups, males and females, and analyzed the composite end point involving deaths or hospitalizations by cardiovascular causality. Men reported more composite events than women (21 vs 11 events, p = 0.042, HR for males 2.2, 95% CI 1.03–4.6). Cox regression models were adjusted for age, gender, cardiovascular disease, chronic kidney disease and diabetes mellitus.

Conclusions:
The results indicate male gender as an independent risk factor for deaths or hospitalizations caused by cardiovascular disease in patients with HE. Our registry highlights the commitment for a more intensive follow-up of HE patients, especially for men, and underlines the need for further research in this pathological entity.
OBSERVATIONAL PROSPECTIVE STUDY OF AZILSARTAN MEDOXOMIL/ CHLORTALIDONE COMPARED WITH IRBESARTAN/ HYDROCHLOROTHIAZIDE COMBINATION THERAPY IN OBESE HYPERTENSIVES (PUZZLE)
Authors: Shupenina Elena , Vasyuk Yury , Namazova Gulnar 
Published: June 2022

Objective:
Attainment of blood pressure (BP) control is important to successful management of arterial hypertension (AH). It is more difficult to reach recommended BP goals in obese hypertensives. Combination of ARB and thiazide diuretics is recommended. Azilsartan medoxomil/chlorthalidone (AZL-C) is potent and currently the only fixed combination of ARB and thiazide-like diuretic used for AH. The objective of this study was to evaluate influence of AZL-C on office, 24-hour brachial, central blood pressure and aortic stiffness parameters compared with irbesartan/hydrochlorothiazide (IRB-H).

Design and method:
We included 94 patients 35–55 years old with I-II grade AH and obesity at high cardiovascular risk. Patients with symptomatic organ damage, intolerance of ARB, thiazide diuretics, secondary AH were exluded. All patients underwent phisical exam, office, ambulatory BP measurement with arterial stiffness analysis on inclusion, during 1, 3 and 6 months visit. After inclusion 47 patients received AZL-C dose 40/12.5 or 40/25 mg, 47 patients received IRB-H dose 150/12.5 or 300/25 mg. The study was approved by local ethic committee and registered on clinicaltrials.gov (NCT03006796).

Results:
On 1 month visit 37(79%) patients reached office BP goals in AZL-C group vs 32(68%) in IRB-H, finally the proportion was 45(96%) vs 41(87%). After 3 months significantly more patients received higher doses of IRB-H: 18(38%) vs 9(19%) in AZL-C group. The mean office systolic/diastolic BP on the final visit was 126,4/84,5 in AZL-C vs 132,7/89,9 mmHg in IRB-H group. The mean ambulatory SBP/DBP was 124,6/77,6 in AZL-C vs 127,4/81,7 mmHg in IRB-H group. After 6 months the mean ambulatory central SBP and aortic augmentation index reduced in both groups, more significantly in AZL-C patients: from 129,4 to 115,3 vs. from 129,5 to 117,6 mmHg in IRB-H group; from 26% to 17% vs. from 28% to 21% in IRB-H. There were no changes in ambulatory PWV in both groups, which may be due to the variability of this parameter during the day.

Conclusions:
Both fixed combinations of ARB and diuretic are safe and effective treatment of AH in obese patients, but long-term treatment with AZL-C allows to achieve more stable peripheral and central BP decrease.
THE OPEN-LABEL MULTICENTRAL STUDY OF ANTIHYPERTENSIVE FIXED-DOSE COMBINATION EFFECTIVENESS IN UKRAINE
Authors: Radchenko Ganna , Sirenko Yuriy , Torbas Olena 
Published: June 2022

Objective:
The aim of this study was to evaluate the effectiveness of new 2- or 3-component fixed-dose combinations (FDC) with Olmesartan in comparison with general clinical practice antihypertensive treatment.

Design and method:
72 physicians were involved in the multicenter open-label study. They included patients with uncontrolled systolic (SBP)/diastolic(DBP) blood pressure in spite of at least one-month therapy and without exclusion criteria. The one group(n = 604) was treated by Olmesartan/HTC or Olmesatan/HTC/Amlodipin (with up-titration). The other group(n = 311) was treated according to general clinical practice. The physicians were asked to use the FDC more frequently. The follow-up period was 3 months.

Results:
There were included 1055 patients (59.9 ± 0.5 yr), but only 915 (SBP/DBP–164.9 ± 4.2/93.3 ± 0.3mmHg) were examined at 3 month, the others were lost of follow up. 62.5% at baseline and 94% at the end were on FDC therapy. Baseline 56.7% missed the pills vs 9% at the end of study (P < 0.001). The main reasons were forgetfulness, consideration of not need taking due to BP normalization, not convenient regime, unwilling - 35.5, 30.9, 10.7 and 12.4% at baseline vs 8.1, 0.3,1.4 and 1.4% at the end of study (P < 0.001). 48.6% at baseline vs 9.5% at the end considered the missing of one or more pills could not influence on treatment results and 35.4 vs 3.4% receptively considered they take a lot of pills. Baseline in the group of non-FDC treatment the not-compliant, partly compliant, compliant patients consist 68.1, 11.3 and 20.8% vs 63.4, 18.5 and 18.1% (NS) in the group of FDC therapy. At the end of study there were 59.7, 6,5 and 33.9 vs 17.7, 25.9 and 58 % respectively (P < 0.05).  SBP/DBP was -48/23, 44/21 and 28/14 mmHg (P < 0.001/0.039) in Olmesartan 2-, 3-component FDC and in other therapy groups. The target BP (<140/90mmHg) was achieved in 83.5% of Olmesartan FDC group vs 71.2% (P < 0.05) in other therapy group.

Conclusions:
Only 62.5% of hypertensive patients are on FDC therapy in Ukraine. More frequently use of FDC was associated with improving patient compliance. The 2- or 3-component Olmesartan based FDCs were more effective in BP decreasing than routine antihypertensive therapy.