bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF FREE ANDROGEN INDEX AND SEX HORMONE BINDING GLOBULIN AND LEFT VENTRICULAR HYPERTROPHY IN POSTMENOPAUSAL HYPERTENSIVE WOMEN
Authors: Chen Jianshu , Yu Jing 
Published: June 2022

Objective:
The aim of the present study was to explore the relationship between androgen and LVH in postmenopausal hypertensive women.

Design and method:
Enrolled in this study were 378 postmenopausal hypertensive women who were admitted to the department of cardiology between December 2018 and December 2020.

Results:
According to left ventricular mass index (LVMI) evaluated by echocardiography, the patients were divided into LVH group (n = 172) and non-LVH group (n = 206). Their clinical characteristics were collected. Based on the result of propensity score matching analysis, 160 cases in each group were matched successfully. After correcting for confounding factors by various models, the results showed that free androgen index (FAI)and sex hormone-binding globulin (SHBG)were the influencing factors of LVH in postmenopausal women with hypertension. Patients with elevated SHBG were 5% less likely to develop LVH than those without elevated SHBG (OR:0.950, 95%CI 0.922–1.578). Postmenopausal hypertensive patients with elevated FAI were 16% more likely to have LVH than those without elevated FAI (OR:1.608, 95%CI 0.807–3.202). Multiple linear regression showed that LVMI increased by 61.82 g/m2 for every 1 unit increase in FAI. In addition, SHBG decreased by 1 nmol/l, and LVMI increased by 0.177 g/m2. Subgroup analysis showed that patients in the controlled BP group had a lower risk of LVH for every additional unit of SHBG compared with the uncontrolled BP group. The risk of LVH for each additional unit of FAI in the uncontrolled BP group was higher than that in the controlled BP group.

Conclusions:
The results of this present study showed that the occurrence of LVH was positively correlated with FAI and negatively correlated with SHBG in postmenopausal women with hypertension. The increase of FAI level and the decrease of SHBG level may be related to the occurrence and development of LVH in postmenopausal hypertension.
SYNERGISTIC EFFECT OF HIGH HOMOCYSTEINE AND LOW VITAMIN B12 LEVELS ON THE PREVALENCE OF ATRIAL FIBRILLATION IN HYPERTENSIVE PATIENTS
Authors: Liakos C. , Karpanou E. , Markou M. , Grassos C. , Tousoulis D. , Vyssoulis G. , Tsioufis C. 
Published: June 2022

Objective:
Atrial fibrillation (AF) is common arrhythmia in hypertensive patients. Besides hypertension, several other conditions are deemed to be associated with AF. High blood homocysteine levels (hyperhomocysteinemia) is a known risk factor for cardiovascular disease and are associated with vitamin B12 deficiency that possibly increase cardiovascular risk, as well. The present study assessed the possible effect of high homocysteine and low B12 levels on AF prevalence in hypertensive patients.

Design and method:
This retrospective study comprised all hypertensives referred to our institutions and had a blood sample measurement of homocysteine and B12 (n = 32800). The presence of sustained AF (SAF; Long-standing/Persistent or Permanent AF) was recorded with a resting electrocardiogram (ECG). Paroxysms of AF (PAF) were confirmed with previous relevant ECGs provided by the patient. The population was divided in quartiles according to homocysteine levels (groups 1, 2, 3 and 4 for increasing levels) and B12 levels (groups 1, 2, 3 and 4 for decreasing levels). The prevalence of AF (SAF and PAF) was calculated for each homocysteine and B12 quartile group as well as for each of the 16 homocysteine/B12 combination quartile subgroups.

Results:
The mean values for homocysteine were 13.3 ± 7.2 ?mol/l and for B12 525 ± 196 pg/ml. The prevalence of SAF, PAF and all-type AF (SAF and PAF) was 5.0%, 6.1% and 11.1%, respectively. For homocysteine quartiles 1, 2, 3, 4, SAF prevalence was 2.9%, 5.3%, 11.7%, 24.3% (pfor trend 0.049), PAF prevalence was 0.6%, 0.9%, 4.6%, 14.0% (pfor trend 0.090) and all-type AF prevalence was 3.2%, 5.4%, 11.5%, 22.2% (pfor trend 0.051), respectively. For B12 quartiles 1, 2, 3, 4, SAF prevalence was 2.9%, 6.4%, 11.0%, 20.2% (pfor trend 0.030), PAF prevalence was 2.5%, 5.1%, 7.7%, 9.0% (pfor trend 0.009) and all type-AF prevalence was 2.4%, 7.1%, 16.8% 21.0% (pfor trend 0.019), respectively. The synergistic effect of increasing homocysteine and decreasing B12 values on SAF, PAF and all-type AF prevalence is presented in Figure.

Conclusions:
High homocysteine levels and low vitamin B12 levels are individually and synergistically associated with the prevalence of AF in hypertensive individuals. Underlying mechanisms merit further examination.
STAGE-DEPENDENT RESPONSES OF VASCULAR AND PARENCHYMAL CELLS IN THE HYPERTENSIVE RAT BRAIN
Authors: Ulbrich Philipp , Morton Lorena , Briese Michael , Lämmlin Naomi , Mattern Hendrik , Hasanuzzaman Mohammed , Westhues Melina , Garz Cornelia , Becker Axel , Dityatev Alexander , Jandke Solveig , Yilmazer-Hanke Deniz , Sendtner Michael , Dunay Ildiko , Schreiber Stefanie 
Published: June 2022

Objective:
Long-term hypertension doubles all-cause dementia risk in aging by structural and functional alterations of the cerebral microvasculature and its surrounding tissue. However, therapeutical blood pressure lowering by itself is limited in its effectiveness depending on the progression of structural vessel remodeling, microvascular dysfunction and parenchymal tissue damage.

Design and method:
Therefore, the aim of this study was to investigate pathophysiological processes in different stages of hypertension. We explored acute, early- and late-chronic hypertension effects in the frontal brain of hypertensive rats, applying behavioral tests, histology, immunofluorescence, FACS and vascular/neural tissue RNA sequencing.

Results:
In response to initial increasing blood pressure and in absence of vascular pathology, microglia cells were found in close proximity to blood vessels and with morphological features of activation. Early chronic hypertensive animals showed frontal brain specific behavioral deficits, blood-brain-barrier leakage, leukocyte immigration, loss of glial reactivity and altered pathways related to cellular energy supply, protein synthesis and catabolism. In late chronic hypertension behavioral deficits and glial reactivity loss persisted. We also observed active angiogenesis, vascular fibroblast-related collagen aggregation and pathways related to decreased responsiveness to nutrients and increased metabolic demand. Additionally, we identified late-chronic vascular accumulation of insulin-like growth factor 1 (IGF1) binding proteins in brains of rats and humans with hypertensive cerebral small vessel disease, possibly attenuating protective IGF1 signaling in the cerebral microvasculature.

Conclusions:
Our results point towards stage-dependent reactions of vascular, glial, immune and neuronal cells in response to hypertension. Future studies have to verify, whether these mechanisms are valid in humans as well and whether they might be targeted to attenuate small vessel disease progression.
INCIDENCE AND TIME-TRENDS OF PREGNANCY-RELATED STROKE, THE NATIONWIDE CONCEPTION STUDY
Authors: Olié Valérie , Martin Alice , Lailler Gregory , Béjot Yannick , Gabet Amélie , Grave Clémence , Regnault Nolwenn , Deneux-Tharaux Catherine , Claire Mounier-Vehier , Tstatsaris Vassilis , Kretz Sandrine , Plu-Bureau Geneviève , Blacher Jacques 
Published: June 2022

Objective:
Despite the potentially devastating effects of pregnancy-related stroke, few studies have been done on the incidence by type of stroke. We aimed to study the nationwide incidence rates and recent temporal trends for all types of pregnancy-related stroke and to compare this incidence with that of stroke in nonpregnant women.

Design and method:
We conducted a study of 6 297 698 women aged 15 to 49 years who gave birth in France between 2010 and 2018 with no history of stroke before pregnancy by collecting data from the French National Health Insurance Information System database. Poisson regression were used to estimate incidence by types of stroke for the different pregnancy periods and the incidence rate ratio of stroke in pregnant versus nonpregnant French women.

Results:
Among the 6 297 698 women, 1261 (24.0 per 100,000 person-years) experienced a first ever stroke during pregnancy, peripartum, or the first 6 weeks of postpartum. Of the pregnancy-related strokes, 42.9% were ischemic (IS), 41.9% were hemorrhagic (with similar proportion of intracerebral and subarachnoid hemorrhage) and 17.4% were cerebral venous thrombosis (CVT). Compared with nonpregnant women, incidence rates of stroke were similar during pregnancy for IS (aIRR = 0.9(0.8–1.1), slightly higher for all hemorrhagic strokes (IRR = 1.4(1.2–1.8), and considerably increased for CVT (IRR = 8.1(6.5–10.1). Pregnancy-related stroke incidence rose between 2010 and 2018 for ischemic and hemorrhagic stroke but was stable for CVT. In a multivariate model, hypertensive disorders of pregnancy and chronic hypertension before pregnancy were associated with pregnancy-related stroke (OR = 4.65 (4.08–5.30); OR = 2.41 (1.89–3.06)). The risk associated with hypertensive disorders was double for hemorrhagic stroke (OR = 8.60 (7.18–10.30)).

Conclusions:
The risk of pregnancy related CVT was more than eight-fold higher than that observed in nonpregnant women.The incidence of pregnancy-related ischemic and hemorrhagic stroke is increasing over time, and efforts should be made in terms of prevention considering treatable cardiovascular risk factors and hypertensive disorders in pregnant women.
NEUROLOGICALLY ASYMPTOMATIC PATIENTS FREQUENTLY PRESENT CEREBRAL INJURIES DURING MALIGNANT HYPERTENSION: A MRI STUDY
Authors: Boulestreau Romain , Lucas Ludovic , Cremer Antoine , Doublet Julien , Rubin Sebastien , Sibon Igor , Gosse Philippe 
Published: June 2022

Objective:
Acute and diffuse microvascular damage characterizes malignant hypertension (MHT), the deadliest form of hypertension. Although its ophthalmological, renal and cardiological repercussions are well known, brain involvement is considered rare with few descriptions, although it is one of the main causes of death. We aim to describe brain MRI abnormalities in patients admitted for MHT crisis but without objective neurological signs.

Design and method:
This single-center, cross-sectionnal observational study recruited patients with malignant Hypertension (MHT). MHT was defined by severe hypertension and severe hypertensive retinopathy OR subacute damage of three among the target organs: heart, kidney, brain, vessels (thrombotic microangiopathy). Patients under 18 years old, under chronic dialysis and not willing to participate were excluded. Brain MRI was performed within 21 days following diagnosis and was reviewed by a stroke neurologist who recorded the following markers: acute ischemic stroke(DWI and FLAIR positive), acute intracerebral hemorrhage (T2* and FLAIR positive), acute brain edema with extensive posterior white matter hyperintensity suggesting a PRES, and small vessel disease including old lacunar infarct, white matter hyperintensities (WMH), presence of dilated perivascular spaces.

Results:
We included 58 patients without neurological signs, 66% were men, and mean age was 45.6+/-11.3 years. Brain MRI were normal in 26% of patients but we found at least one acute abnormality on brain MRI in 29% and an Small Vessel Disease score (SVD score) of two or higher in 52%.In patients with neurological signs, these findings were 9, 53 and 70%, respectively. A PRES was found in 16% of asymptomatic patients and 31% had an ischemic stroke and/or a cerebral hematoma.

Conclusions:
PRES, recent hematoma, ischemic stroke and severe cerebral microangiopathy are common findings in MHT patients without neurological signs on admission. The impact of these findings on patient management, and their cerebrovascular and cognitive prognostic value, should be established. Brain MRI might need to become systematic in patients suffering from MHT episodes.
HYPERTENSION PHENOTYPES IN YOUNG INDIVIDUALS BASED ON COMBINED OR ISOLATED ELEVATION OF OFFICE, HOME AND AMBULATORY BLOOD PRESSURE MEASUREMENTS AND ASSOCIATION WITH ORGAN DAMAGE
Authors: Kollias Anastasios , Ntineri Angeliki , Zeniodi Maria Elena , Stambolliu Emelina , Servos George , Moyssakis Ioannis , Destounis Antonios , Vazeou Andriani , Stergiou George S. 
Published: June 2022

Objective:
To assess the prevalence of white-coat (WCH) and masked (MH) hypertension detected by only ambulatory or only home blood pressure (BP) monitoring (isolated), or both (dual), and their association with preclinical target organ damage (TOD).

Design and method:
Young individuals referred for elevated BP and healthy volunteers aged 6–25 years were evaluated with office (2–3 visits; triplicate measurements), home (7 days, duplicate morning and evening measurements) and 24-hour ambulatory BP monitoring. TOD assessment included echocardiographic left ventricular mass index (LVMI), carotid intima-media thickness (IMT) and pulse wave velocity (PWV; Complior). Normotension (NT) was defined as normal office, home and ambulatory BP and sustained hypertension (SH) as all measurements being elevated. WCH and MH phenotypes were identified based on isolated or combined (dual) home and ambulatory BP values.

Results:
Analysis included 320 individuals (mean age 13.8 ± 3.8 years, 66.6% males, 32.2% children, 55.9% adolescents, 11.9% young adults, BMI 24.1 ± 4.8 kg/m2), of whom 276 had LVMI, 212 IMT and 168 PWV assessment. 182 (56.9%) participants had NT and 39 (12.2%) SH. Among 54 (16.9%) participants with WCH, 35 had dual WCH (64.8%) and 19 (35.2%) isolated ambulatory or home WCH. Among 45 (14.1%) with MH, 17 had dual MH (37.8%) and 28 isolated ambulatory or home MH (62.2%). Participants with dual and isolated intermediate phenotypes didn’t differ according to age, sex and BMI. Individuals with SH had higher LVMI, IMT and PWV than NT (all P < 0.05; Figure). Intermediate phenotypes based on selective or combined elevation of out-of-office BP presented intermediate values of indices of TOD between NT and SH. Isolated ambulatory or home WCH was associated with higher LVMI values than NT (P < 0.05), whereas dual MH was associated with higher IMT than NT (all P < 0.05).

Conclusions:
These findings suggest that in young individuals intermediate hypertension phenotypes with selective (isolated WCH) or combined elevation of BP (dual MH) in out-of-office measurement methods appear to carry an increased risk of preclinical TOD compared with NT.
MEAN PLATELET VOLUME IS A PREDICTOR OF BLOOD PRESSURE NORMALIZATION IN PEDIATRIC HYPERTENSION
Authors: Skrzypczyk Piotr , Bujanowicz Adam , Pawlik Katarzyna , Wroniewicz Tobiasz , Szyszka Michal , Ofiara Anna , Wabik Anna , Panczyk-Tomaszewska Malgorzata 
Published: June 2022

Objective:
Arterial hypertension in adolescents is a risk factor for elevated blood pressure and cardiovascular sequelae in adult life. The study aimed to analyze factors influencing blood pressure tracking in pediatric patients with primary hypertension (PH).

Design and method:
We analyzed retrospectively 77 children with primary hypertension (53 boys, 24 girls, 13.9 ± 2.7 years) and observation period at least 12 months, in whom we assessed clinical data, anthropometric parameters, office blood pressure, ABPM, and biochemical data, including markers of subclinical inflammation: mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR).

Results:
At the onset of the observation, all patients had arterial hypertension – newly diagnosed (n = 51) or already treated with antihypertensive drugs (n = 26). The observation period was from 1 to 5.25, mean: 2.1 ± 1.0 years. Blood pressure (BP) normalized in 13 (16.9%) patients; seven were previously treated with antihypertensive medications. Patients in whom BP normalized compared to those with sustained hypertension were not-significantly younger (12.9 ± 3.1 vs. 14.1 ± 2.6 [years], p = 0.171), had higher birth weight (3866 ± 425 vs. 3163 ± 614 [g], p = 0.024) and lower initial MPV (9.2 ± 1.4 vs. 10.1 ± 1.3 [fL], p = 0.041) and lower BMI Z-score (0.5 ± 1.0 vs. 1.2 ± 1.2, p = 0.047) and total cholesterol (143.4 ± 26.0 vs. 167.6 ± 33.6 [mg/dL], p = 0.047) after the observation period. Z-score of systolic blood pressure (SBP) at the end of observation correlated with initial values of: BMI Z-score (R = 0.248, p = 0.032), MPV (R = 0.237, p = 0.046), PLR (R = 0.240, p = 0.044), and with nighttime diastolic BP dipping in ABPM (R = -0.309, p = 0.009). SBP Z-score at the end of the observation period also correlated with Z-scores of body weight and BMI (R = 0.327, p = 0.004; R = 0.384, p<0.001) and LDL-cholesterol (R = 0.297, p = 0.031) at the end of observation and with the increase in body weight during the observation period (R = 0.384, p < 0.001). At the end of the observation period, the Z-score of diastolic blood pressure correlated with MPV (R = 0.371, p = 0.003).

Conclusions:
1. The chance of normalization of blood pressure in pediatric patients with primary hypertension is influenced by birth weight, body mass loss, and degree of subclinical inflammation.
2. Mean platelet volume might serve as a predictor of blood pressure change in pediatric patients with primary hypertension.
THE SALT STUDY - SALT INTAKE IN ADOLESCENTS TODAY
Authors: Shah Kriya , Shah Hardik , Vijan Shradha , Kamat Shambhavi , Kirpalani Dilip , Kirpalani Ashok 
Published: June 2022

Objective:
High daily salt consumption amongst adolescents is one of the most relevant etiological factors for future risk of hypertension and other lifestyle diseases. The aim of this study is to evaluate and compare the amount and pattern of sodium (Na) consumption in urban and rural school-going adolescents and identify high risk groups for conducting awareness and intervention programs.

Design and method:
Subjects aged 12 - 15 years from 3 schools in and around Mumbai were given a questionnaire detailing their demographic, anthropometric data and eating habits. A self-administered semi-quantitative Food Frequency Questionnaire was used to record consumption pattern of 22 high salt containing food items, divided into 5 categories (bakery, fried, packed, preserved and fast foods). Each participant`s sodium consumption from these food items was calculated. Additional sodium consumption from regular meals was excluded.Data analysed with MS Excel.

Results:
1141 (urban- 565; rural- 576; Males-612,Females -524) participated. 13 % subjects added table salt while 62 % ate frozen foods < twice a month. Median Sodium consumption of the study population was 473 mg/day (~ 1 g salt) (Q1-Q3: 254 - 851 mg/day). Daily Median Na consumption was significantly higher (p < 0.05) in urban students (724 mg/day) as compared to rural (292 mg/day). Bakery and fried foods comprised 51% of sodium consumption amongst rural, whereas all five food categories had equal representation in the urban population. An alarming 54 % subjects’ BMI (34 % urban, 20 % rural) was above the normal range. Higher BMI values correlated significantly with higher daily Na consumption (p = 0.001, Mann-whitney test).

Conclusions:
The salt intake over and above the usual dietary salt consumption was high (~ 2 g per day for urban and ~1 g/day for rural adolescents). More than half the study population was found to be either overweight or obese. This double whammy has a singular potential for producing future hypertensives. Thus targeted awareness, counselling and intervention programs for salt reduction in adolescents is the urgent need of the hour.
HYPERTENSIVE HEART DISEASE IN ADOLESCENCE. PRELIMINARY RESULTS OF THE PESESCAD-HTA STUDY
Authors: Fernandez Guillermo Albert Perez 
Published: June 2022

Objective:
Identify the presence of hypertensive heart disease and its relationship with prehypertension and hypertension

Design and method:
A descriptive, cross-sectional study was carried out in 385 prehypertensive adolescents and 128 adolescents with essential hypertension, aged 12–15 years, from among a total of 1,545 adolescents screened in the School Screening for High Blood Pressure in Adolescents Project (PESESCAD-HTA). An echocardiogram was performed in 513 adolescents (prehypertensive plus hypertensive). For the multivariate analysis of risk factors related to LVH, a decision tree was obtained using the chi square automatic interaction detector (CHAID) technique.

Results:
Among prehypertensive and hypertensive adolescents, the prevalence of left ventricular hypertrophy was 6.49% (CI = 4.43–9.41) and 21.09% (CI = 14.92–58.95), respectively. In the sample of 513 individuals with prehypertension and hypertension, a decision tree was designed, using the chi square automatic interaction detector (CHAID) technique, with the presence of left ventricular hypertrophy as the dependent variable.

Conclusions:
The best predictors of left ventricular hypertrophy were a family history of obesity, and its interaction with the age and the sex of the adolescent.
ESTIMATION OF DAILY SALT INTAKE IN CHILDREN WITH ESSENTIAL HYPERTENSION
Authors: Kos Martina , Mihalj Martina , Hamidovic Nikolina , Dumancic Dijana , Kolobaric Nikolina , Stupin Ana , Drenjancevic Ines , Puseljic Silvija , Jukic Ivana 
Published: June 2022

Objective:
The development of arterial hypertension is influenced by genetic and environmental factors, with high salt intake being a known environmental contributor. This study aimed to estimate daily salt intake in children with essential arterial hypertension and in normotensive children, and to assess the relationship between their blood pressure values and 24-h urinary sodium excretion.

Design and method:
Total of 26 children participated in this study; 12 children with essential arterial hypertension (HT) and 14 normotensive children (NT) (both sexes, age ranged 12–17). Systolic, diastolic and mean blood pressure and heart rate were measured. 24-h urine samples were analysed for excreted sodium concentration whereas daily salt intake based on 24-h urinary sodium excretion was calculated using appropriate formula. Statistical analysis was conducted by t-test (between groups), and Pearson’s or Spearman’s correlation test was used to determine the correlations between blood pressure (SBP, DBP and MAP) and 24-h urinary sodium excretion (p < 0.05 was considered statistically significant).

Results:
Body mass index (BMI) was similar between groups. Calculated salt intake was significantly higher in children with essential hypertension compared with normotensive children. Systolic (SBP), diastolic (DBP) and mean (MAP) arterial blood pressure were significantly higher in children with essential arterial hypertension compared with normotensive children, while there were no difference in heart rate between HT and NT groups. 24-h urinary sodium excretion was significantly higher in the HT compared with the NT group. 24-h urinary sodium excretion was positively associated with SBP (r = 0.673), DBP (r = 0.513) and MAP (r = 0.651).

Conclusions:
Even though BMI was similar, 24-h urinary sodium excretion was significantly higher in hypertensive children indicating their higher daily salt intake, which is associated with higher blood pressure in these children.