bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTEREST OF MEASURING THE INTIMA MEDIA THICKNESS IN THE EVALUATION OF HYPERTENSIVE
Authors: Ouail Djamel Eddine , Tebbani Meriem , Bouali Fayçal 
Published: June 2022

Objective:
The measurement of the Intima Media Thickness (IMT) allows the diagnosis of the early stages of atherothrombosis. There is a direct correlation between the intima media thickness and CVRF in particular hypertension.
The objective of our study is to describe the profile of IMT in hypertensive patients and to analyze the correlations with subclinical damage to target organs.

Design and method:
Descriptive and analytical prospective study of a cohort of asymptomatic hypertensive patients aged over 35 received in consultation. All the patients had benefited from a measurement of the intima media thickness. An intima-media thickness > 0.9 mm is considered pathological.
At the same time, patients benefit from a systematic assessment in search of other target organ damage, namely cardiac, neurological, renal and ophthalmological damage.

Results:
252 patients included in our work, it is 146 women or 58%. The average age of our series is 59.5 years.
The EIM is pathological in 34.9% of patients.
In multivariate analysis, the two independent factors associated with pathological ADR are age > 55 years and smoking.
Chi-square correlation analysis shows us a highly significant correlation between pathological IMT and LVH on ultrasound, carotid plaques and stenosing plaques, and urinary albumin excretion and kidney disease chronic.
Intima Media thickness values are positively correlated with indexed left ventricular mass values (pearson 0.190**, p = 0.004), pulse pressure values (pearson = 0.226**[0.123, 0.344] p = 0.000), to the values of the Sokolow index (0.145*[0.032, 0.261] p = 0.029) and to the values of proteinuria and particularly to microalbuminuria (0.187**[0.013, 0.369] p = 0.008) The values of the media intima thickness are negatively correlated with MDRD clearance values (-0.140* [-0.250, -0.019] p = 0.037)

Conclusions:
Carotid intima media thickness is an excellent screening test for target organ damage in hypertensive patients. It is a simple and non-invasive measure, it reflects early lesions of atherosclerosis. Our study clearly shows the strong correlation between the values of the intima media thickness and the values of all the screening tests for target organ damage.
WHAT ARE THE FACTORS ASSOCIATED WITH UNCONTROLLED BLOOD PRESSURE IN BRAZILIAN HYPERTENSIVE PATIENTS?
Authors: De Paula Araujo Thayza , Borges Lucas Gabriel S. , Barroso Weimar K. Sebba , Batista Sandro Rodrigues , Vitorino Priscila V.O. 
Published: June 2022

Objective:
Uncontrolled arterial hypertension (AH) is defined by BP > or = 140/90 mmHg. It has a high prevalence, is associated with the causes of pseudoresistance and is related to several complications and negative health outcomes. Thus, the objective of this study was to investigate the factors associated with the lack of blood pressure control in hypertensive Brazilians treated in public and private services.

Design and method:
Cross-sectional, analytical, multicenter and national study, carried out with hypertensive adults and elderly individuals, followed by 45 outpatient clinics, included from September 2013 to October 2015 and submitted to interview, clinical and anthropometric evaluation. The outcome variable was uncontrolled pressure (BP > or = 140mmHg systolic and/or > or = 90 mmHg diastolic). Simple and multiple logistic regression analysis was performed.

Results:
A total of 2,643 participants with a mean age of 61.6 (11.9), 55.7% female and 46.4% with uncontrolled BP were evaluated. Uncontrolled BP was associated: age over 60 years (OR: 1.31 [1.11 - 1.55]); practice of irregular physical activity (OR: 1.28 [1.06 - 1.55]); attending the emergency room for hypertensive crises in the last six months (OR: 1.80 [1.46 - 2.22]); increase in body mass index (OR: 1.02 [1.01 - 1.04]); low adherence to drug treatment (OR: 1.22 [1.04 - 1.44]) and menopause (OR: 1.36 [1.07 - 1.72]). The following were negatively associated: fruit consumption (OR: 0.90 [0.85 - 0.94]); presence of dyslipidemia (OR: 0.75 [0.64 - 0.89]), acute myocardial infarction (OR: 0.59 [0.46 - 0.76]) and peripheral arterial disease (OR: 0.52 [0.34 - 0.78]).

Conclusions:
Factors associated with non-BP control were: advanced age, increased body mass index, practice of irregular physical activities, need for emergency care and low adherence to pharmacological treatment and protective factors: presence of acute myocardial infarction and peripheral arterial disease, and higher daily fruit intake.
ANTIHYPERTENSIVE TREATMENT PRESCRIBING BEHAVIOURS IN FRENCH GENERAL PRACTICE IN 2021
Authors: Mourad Jean Jacques , Jamet Philippine , Huguet Michael , Bourbia Sami , Hubert Sidonie , Azria Philippe , Ferreira Emmanuel , Antakly Yara 
Published: June 2022

Objective:
Hypertension (HT) is the leading reason for visits to general practitioners (GPs). Due to insufficient adherence and marked therapeutic inertia, there is room for improving blood pressure control in France. The objective of this study is to describe the antihypertensive treatment prescribing behaviours in French general practice.

Design and method:
Data from the IQVIA Longitudinal Patient Database (LPD) France were used. LPD France is a permanent observatory to which a nationally representative panel of physicians – including GPs (n=1200) – contribute anonymised electronic medical records (EMR). The analysis included all antihypertensive treatment prescriptions from July 2020 to June 2021, which were then extrapolated to the entire population. The following definitions were used to categorise the prescribing behaviours: INITIATION - for hypertensive patients already registered with the GP and who had been prescribed an antihypertensive treatment for the first time in 24 months; RENEWAL - for hypertensive patients whose therapeutic class had not changed, apart from dosage modifications, changes of molecule within the same class and titrations; CHANGE - for hypertensive patients for whom a therapeutic class had been added, withdrawn, and/or changed.

Results:
In 2021, a total of 11 557 545 hypertensive patients had received an antihypertensive treatment prescription following consultation with a GP. These were distributed as follows:

Conclusions:
These findings provide informative data on the prescribing behaviours of GPs, primarily marked by a renewal rate that does not appear to reflect the reality of blood pressure control in France. Prescription modifications are in the minority, and essentially consist of class rotations. This observation requires urgent reflection when it comes to the training of prescribers and the value placed on blood pressure control under the French public health objectives pay-for-performance scheme.
*IQVIA EMR LPD Médecins Généralistes ‘. EMR = Electronic Medical Records, LPD = Longitudinal Patient Data
HYPERTENSION, THE MAIN RISK FACTOR FOR STROKE IN A UNIVERSITY HOSPITAL CENTER IN NORTHWEST ALGERIA
Authors: Abdrebbi Samira Benbekhti , Meguenni Kaouel 
Published: June 2022

Objective:
High blood pressure is the most important risk factor associated with cerebrovascular accidents and one of the main risk factors associated with heart disease.
The objective of our study was to determine the place of arterial hypertension among the risk factors for stroke at the University Hospital Center of TLEMCEN.

Design and method:
Prospective descriptive study, on a sample of patients with stroke and admitted to the TLEMCEN University Hospital. A questionnaire was administered by interview to the patients. Data were entered and analyzed using Epi-info 6 software.

Results:
2/3 of patients with arterial hypertension were found out of a total of 205 stroke victims.
Arterial hypertension Hypertension is the main risk factor for stroke, ischemic or hemorrhagic. It occupies a prominent place in the personal medical history (63.40%), as well as the family history, found in 61.06% of patients. Other risk factors were: hypercholesterolemia, diabetes, heart disease and transient ischemic attack; with respectively 27.80%, 20.50%, 14.10% and 11.70%.
Arterial hypertension was frequent in the acute phase of the stroke and often proportional to the extent of the stroke.

Conclusions:
Screening and effective treatment of high blood pressure, the main risk factor for stroke, as well as the fight against other risk factors are essential elements of stroke prevention.
IDENTIFYING A METABOLOMICS PROFILE ASSOCIATED WITH MASKED HYPERTENSION IN TWO INDEPENDENT COHORTS: DATA FROM THE AFRICAN-PREDICT AND SABPA STUDIES
Authors: Strauss-Kruger Michél , Kruger Ruan , Vuren Esmé Jansen Van , Jacobs Adriaan , Louw Roan , Mels Carina 
Published: June 2022

Objective:
Individuals with masked hypertension (MHT) have a greater risk of adverse cardiovascular outcomes compared to normotensives (NT). Exploring metabolomic differences between NT and MHT individuals may help provide a better understanding of the aetiology of MHT.

Design and method:
We analysed the data of N = 910 young apparently healthy participants (83% NT and 17% MHT) (mean age 24 ± 3 years) from the African-PREDICT and N = 210 older participants (63% NT and 37% MHT) from the SABPA (mean age 42 ± 9.6 years) studies. Clinic and ambulatory blood pressures (BPs) were used to define BP phenotypes. Urinary amino acids and acylcarnitines were measured using liquid chromatography time-of-flight mass spectrometry in the SABPA and liquid chromatography tandem mass spectrometry in the African-PREDICT studies.

Results:
Clinic and 24hr BPs were higher in MHT compared to NT adults (all p < 0.001). In the SABPA study, amino acids (leucine/isoleucine, valine, methionine and phenylalanine) and acylcarnitines (C0-, C3-, C4- and total acylcarnitines) were more abundant in MHT than NT adults. In the African-PREDICT study, only C0- and C5-carnitines were higher in MHT. When adjusting for waist circumference, all differences between NT and MHT individuals became non-significant for both studies (all q> 0.05). With unadjusted analyses in NT adults from the SABPA study, 24hr SBP correlated positively with only C3-carnitine. Conversely in MHT, positive correlations of 24hr SBP with leucine/isoleucine, valine, methionine, phenylalanine, C0- and C3-carnitine were evident (all p < 0.05). In the African-PREDICT study, 24hr SBP correlated positively with C0- (r = 0.101; p = 0.006) and C5-carnitine (r = 0.195; p < 0.001) in NT adults, and C5-carrnitine in MHT (r = 0.169; p = 0.034).

Conclusions:
Using two independent cohorts, we demonstrated significant differences between the metabolomic profiles of NT and MHT adults, which may reflect different stages in the alteration of branched-chain amino acid (BCAA) metabolism early on and later in life. These changes in BCAA metabolism are also likely modulated by central adiposity.
EFFECT OF A COMBINATION OF POLYMORPHIC VARIANTS OF THE PPARG2 (PRO12ALA), ADRB2 (GLN27GLU), ADRB2 (AGR16GLY), ADRB3 (TRP64AGR), AND FABP2 (THR54ALA) GENES AND THE RISK OF ARTERIAL
Authors: Komir Iryna , Isayeva Ganna 
Published: June 2022

Objective:
To establish the relationship between different combinations of polymorphic variants of PPARG2 (Pro12Ala), ADRB2 (Gln27Glu), ADRB2 (Agr16Gly), ADRB3 (Trp64Agr), and FABP2 (Thr54Ala) genes and hypertension

Design and method:
191 adults (33.1% of men and 66.9% of women), mean age (52.7 ± 10.8) years with hypertension were examined. Blood pressure was measured according to the guidelines for the management of patients with hypertension of the European Society of Cardiology (2018). Conducted daily monitoring of blood pressure. Determination of polymorphisms in the genes PPARG2 (Pro12Ala), ADRB2 (Gln27Glu), ADRB2 (Agr16Gly), ADRB3 (Trp64Agr), and FABP2 (Thr54Ala) of the PPARG2 (Pro12Ala) receptor by the method of real-time polymerase chain reaction polymerase chain reaction. Statistical processing of the obtained data was performed using the statistical package SPSS 17 (IBM)

Results:
In the study population, target blood pressure reduction was observed in 63% of patients after 12 months of follow-up. Patients with controlled arterial hypertension (60.7%) predominated in the group of those who reached the target blood pressure values, while patients with overt hypertension (42.9%) predominated in the group with those who did not reach the target blood pressure values. Patients were divided into groups depending on the phenotype of hypertension. The odds ratio for hypertension was found to be 1.11 for PPARG2 (CC vs CG+GG); 1.32 for ADRB2 (CG vs CC+CG); 1.05 for ADRB2 (AG vs. AA+AG); 2.0 for ADRB3 (TT vs. CC) and 1.33 for FABP2 (GG vs. AG+AA) (95% confidence interval). The odds ratio of the combination of the polymorphic CC variant of the ADRB3 gene (Trp64Agr) and the AA variant of the ADRB2 gene (Agr16Gly) in groups with overt AH was 2.33. Other combinations of genes and their polymorphic variants did not provide a reliable diagnostic criterion for the relationship with arterial hypertension phenotypes

Conclusions:
The combination of the CC variant of the ADRB3 gene (Trp64Agr) and the AA variant of the ADRB2 gene (Agr16Gly) is a reliable marker of overt arterial hypertension
SPONTANEOUSLY HYPERTENSIVE RATS EXHIBIT ENHANCED CARDIAC CONNEXIN-43 AND REDUCED PRO-FIBROTIC MARKERS IN RESPONSE TO COLD ACCLIMATION
Authors: Andelova Katarina , Bacova Barbara Szeiffova , Sykora Matus , Pavelka Stanislav , Pravenec Michal , Tribulova Narcis 
Published: June 2022

Objective:
We have previously shown that down-regulation of myocardial gap junction channel protein, connexin-43 (Cx43), and up-regulation of extracellular matrix (ECM) proteins in hearts of spontaneously hypertensive rats (SHR) promote occurrence of lethal arrhythmia. Cold acclimation has a potential for reducing cardiovascular risk, especially in setting of various pathological conditions, but there is a gap of knowledge concern the heart response to adaptive thermogenesis. The purpose of the study is to explore myocardial Cx43 and ECM proteins in genetically hairless strain of SHR (SHRM) that represents rewarding model of increased adaptive thermogenesis.

Design and method:
Adult hairless males and females SHRM strain that harbors mutated desmoglein-4 gene and their wild type SHR were housed at standard 22 C (that is below thermo-neutrality for these animals) and 12:12 hour light: dark cycle. WKY control rats were used as reference normotensive strain. Heart samples of the left ventricular tissue from euthanatized rats were used for the proteomics of Cx43, protein kinases, which phosphorylates Cx43, and for ECM markers TGF-, SMAD2/3, MMP-2, collagen-1. Immunofluorescence detection of Cx43 was performed to examine its myocardial topology.

Results:
Cx43 protein and its phosphorylated status was reduced in males and females SHR vs WKY rat hearts. In contrast, adaptive thermogenesis resulted in increased both parameters in SHRM regardless the sex. Moreover, pathological topology of Cx43 attributed to its enhanced localization at lateral sides of the cardiomyocytes in SHR was attenuated in SHRM. In addition, there were gentle differences in protein levels of PKA, PKG, PKC, MAPK, Akt between SHR and SHRM. Protein level of TGF- and SMAD 2/3 were increased in SHR compare to WKY rat hearts but decreased in SHRM unlike collagen-1 that was not altered in SHRM compare to SHR.

Conclusions:
Findings revealed beneficial up-regulation of myocardial Cx43 along with down-regulation of extracellular matrix proteins in response of hairless SHR to increased thermogenesis.
DIFFERENT APPROACHES FOR THE ASSESSMENT OF LEFT ATRIAL VOLUME IN A LARGE SAMPLE OF PATIENTS UNDERGOING AN ECHOCARDIOGRAM FOR CARDIOVASCULAR RISK STRATIFICATION
Authors: Paini Anna , Aggiusti Carlo , Bertacchini Fabio , Stassaldi Deborah , Capellini Sara , Arnoldi Chiara , Caletti Stefano , Cannata Marco , Gatta Roberto , Muiesan Maria Lorenza , Salvetti Massimo 
Published: June 2022

Objective:
Left atrial (LA) enlargement (LAE) is associated to an increased risk of cardiovascular complications, and in particular of atrial fibrillation. When LA size is measured by echocardiography, LA volume measurement is preferred over linear measurements. In fact, the strength of the relationship between cardiovascular diseases is stronger for LA volume than for LA linear dimensions. Recently it has been proposed a new method (LAV_e) to estimate LA volume in order to provide a surrogate of biplane LA volume when direct measurement is not available.
The aim of our study was to evaluate the correlation between LA volume assessed by the biplane method(LAV_bip) and LA volume estimated by the linear measurements(LAV_e) and to assess the prevalence of LA enlargement in a large sample of patients undergoing an echocardiogram for cardiovascular risk stratification at an ESH excellence centre in Italy.

Design and method:
4941 subjects undergoing a diagnostic work-up for arterial hypertension (known or suspect) were analysed. LAV_bip was assessed as by the area-length method using the apical 4-chamber and 2-chamber views and LAV_e was calculated according to the formula: 2.323*(LA parasternal linear diameter2.071). LAV was indexed to height2.

Results:
Mean age was 56 ± 16 years, BMI 26 ± 5, 43% of subjects had normal weight, 39% overweight, 18% obese, 54% males, 84 % were hypertensives.Mean LAV_bip was 46.2 ± 18.4 and LAV_e was 35.4 ± 11.6 ml. Mean LAV_bip/h2 was 16.2 ± 6.3 and LAV_e/h2 was 12.4 ± 4.1 ml/h2. The correlation coefficients between the two variables were respectively 0.62 and 0.60 (p < 0.0001). Bland & Altman analysis showed a progressive increase in discrepancy between the two measures with increasing LAV_bip. The prevalence of LA enlargement was 32% with the biplane method and 10 % with the elliptical estimation.

Conclusions:
In a large sample of subjects undergoing a diagnostic work-up for arterial hypertension we observed a possible underestimation of LAV and a lower prevalence of left atrial enlargement when the elliptical approach is used. These results, if confirmed in other populations, suggest that direct measurement of left atrial volume should be preferred, if available.
ANALYSIS OF THE VENTRICULAR-ARTERIAL COUPLING DERIVED FROM PROXIMAL AORTIC STIFFNESS: IMPACT ON AEROBIC CAPACITY ACROSS THE HEART FAILURE SPECTRUM
Authors: Pugliese Nicola Riccardo , Balletti Alessio , Armenia Silvia , Biase Nicolo De , Faita Francesco , Mengozzi Alessandro , Paneni Francesco , Ruschitzka Frank , Virdis Agostino , Ghiadoni Lorenzo , Taddei Stefano , Williams Bryan , Antonini-Canterin Francesco , Masi Stefano 
Published: June 2022

Objective:
Ventricular-arterial coupling (VAC) can be evaluated as the ratio between arterial stiffness (pulse wave velocity, PWV) and myocardial deformation (global longitudinal strain, GLS). We aimed at evaluating VAC across the spectrum of heart failure (HF).

Design and method:
We introduced a Doppler-derived, single-beat technique to estimate aortic arch PWV (aa-PWV) in addition to tonometry-derived carotid-femoral PWV (cf-PWV). We measured PWVs and GLS in 155 healthy controls, 75 subjects at risk of developing HF (American College of Cardiology/American Heart Association Stage A-B) and 236 patients in HF Stage C with preserved (HFpEF, n = 104) or reduced ejection fraction (HFrEF, n = 132). We evaluated peak oxygen consumption (VO2) and peripheral extraction (AVO2diff) using combined cardiopulmonary-echocardiography exercise stress.

Results:
aa-PWV was obtainable in all subjects and significantly lower than cf-PWV in all subgroups (p < 0.01). PWVs were directly related and increased with age (all p < 0.0001). cf-PWV/GLS was similarly compromised in HFrEF (1.08 ± 0.36) and HFpEF (1.05 ± 0.22), while aa-PWV/GLS was more impaired in HFpEF (0.69 ± 0.11) than HFrEF (0.60 ± 0.15; p < 0.01). Stage A-B had values of cf-PWV/GLS and aa-PWV/GLS (0.66 ± 0.25 and 0.47 ± 0.12) higher than controls (0.47 ± 0.10 and 0.40 ± 0.10) but lower than Stage C (all p < 0.01). Peak AVO2diff was inversely related with cf-PWV/GLS and aa-PWV/GLS (all p < 0.01). cf-PWV/GLS and aa-PWV/GLS independently predicted peak VO2 in the overall population (adjusted R2 = 0.32 and 0.35; all p < 0.0001) but only aa-PWV/GLS was independently associated with flow reserve during exercise (R2 = 0.51; p < 0.0001).

Conclusions:
Abnormal VAC is directly correlated with greater severity of HF and worse functional capacity. HFpEF shows a worse VAC than HFrEF when expressed by aa-PWV/GLS.
LEFT ATRIAL VOLUME INDEX (LAVI) AS A PREDICTOR OF PAROXYSMAL ATRIAL FIBRILLATION IN PATIENTS WITH RESISTANT ARTERIAL HYPERTENSION
Authors: Kocianova Eva , Kamasova Monika , Hanajikova Barbora , Jelinek Libor , Obrova Jana , Kvapil Tomas , Taborsky Milos 
Published: June 2022

Objective:
Heart damage in hypertension occurs at three stages, a compensatory, reversible subclinical and irreversible clinical phase. Atrial fibrillation appears in the third phase, but we can find echocardiographic signs pointing to it in the subclinical phase. Although cardioembolic stroke is a feared cardiovascular complication with a possible life-long impact on a patient’s health, silent atrial fibrillation is not routinely screened in patients with advanced hypertension. The aim of the work was to assess the relationship of left atrial dilation and silent atrial fibrillation in patients with resistant arterial hypertension.

Design and method:
Data were collected in 211 patients with arterial hypertension treated with at least three combinations of antihypertensives with no prior history of atrial fibrillation. The first 109 patients with paroxysmal atrial fibrillation detected at 24-hour monitoring were assigned 102 age-appropriate controls with normal ECG Holter. Transthoracic echocardiography was performed on all patients, comparing baseline parameters of systolic and diastolic function - ejection fraction (EF), E/A velocity ratio, E/e motion velocity ratio, LAVI and peak tricuspid regurgitation gradient (PPG TR).

Results:
Patients with arterial hypertension and newly captured paroxysmal atrial fibrillation had a significantly higher E wave height (p = 0.005), a higher E/A ratio (p = 0.0004), a comparable E/e’ (p = 0.21), a higher PPG TR (p = 0.045) and a significantly greater left atrial indexed volume-LAVI (36.1 ± 10.3 vs 31.0 ± 9.6, p = 0.0002).

Conclusions:
Patients with resistant arterial hypertension and paroxysmal atrial fibrilation have significantly higher indexed left atrial volume. Patients with increased LAVI may benefit from performing extended cardiac rhythm monitoring in the prevention of cardioembolic events.