bluuebunny/crossref_metadata_2025_split huggingface dataset:
ARE COMMERCIAL CUFFLESS BLOOD PRESSURE DEVICES BEING VALIDATED?
Authors: Cox James , Louka Kyrollos , Avolio Alberto P. , Tan Isabella , Butlin Mark 
Published: June 2022

Objective:
Hypertension is an increasingly prevalent global disease with an overwhelming burden on society and the healthcare system. Undiagnosed hypertension and poor adherence to monitoring have been highlighted in the literature to be a key factor in addressing this issue. Wearable devices are a potential solution to this problem through offering continuous and convenient blood pressure (BP) measurements, unlike current cuff-based approaches. However, the validity of such novel devices is a limiting factor to their integration as a medical tool. This literature review aims to highlight the lack of validity of current commercial cuffless BP devices and the resulting impact on BP measurement and monitoring.

Design and method:
Investigators generated a list of commercial cuffless BP devices and search terms based on a preliminary search performed in Google and literature databases. Google Scholar, PubMed and Scopus were then systematically searched. Articles were included following a criterion on the basis that they must mention a cuffless BP device and have performed a comparison of measurements with a reference device, either cuff-based or invasive. Statistical analyses were then undertaken.

Results:
Two hundred and five search terms were generated. Following the systematic search there were 932 articles captured. After the inclusion and exclusion criteria was applied more than 90% of papers were excluded on the basis that they did not perform a validation, were in another language and/or were not relevant to blood pressure measurement. Of the 205 commercial devices initially searched only 11 of these had performed some sort of validity test. None of the devices had undertaken a validity test in accordance with the 2014 IEEE Standard for Wearable, Cuffless BP Measuring Devices or the 2019 amendment.

Conclusions:
Current cuffless BP devices lack published validity and as a result clinical utility. Performing stringent testing on the accuracy and reliability of devices will result in the progression and acceptance of such devices with the capacity to revolutionise BP measurement and therefore hypertension.
CORRELATION OF BLOOD PRESSURE CHANGES WITH THE FUNCTIONAL CAPACITY IN HEART FAILURE PATIENTS WITH PRESERVED AND MID-RANGE EJECTION FRACTION
Authors: Algamal Abdulsalam , Osman Adel , Elhusseiny Shady , Elshal Abdallah , Salem Mahmoud 
Published: June 2022

Objective:
6-minute walk test (6-MWT) reflects the daily activity of heart failure (HF) patients who develop progressive limitation of functional capacity (FC). Our aim was to assess different blood pressure (BP) parameters and their changes after 6-MWT in patients with HF with mid-range ejection fraction (EF) (HFmEF) and HF with preserved EF (HFpEF) and correlate them with the FC assessed by 6-minute walk distance (6-MWD).

Design and method:
Patients presented with clinical manifestations of HF were admitted to Cardiology Department and medically stabilized. 40 HFmEF patients and 50 HFpEF patients underwent 6-MWT according to the American Thoracic Society guidelines 2002. Different BP parameters before and after 6-MWT were recorded including systolic blood pressure, diastolic blood pressure (DBP), mean BP, pulse pressure (PP), and proportionate pulse pressure (PPP) defined as the ratio of PP and SBP. Limited FC was defined as 6-MWD < 300 M. Abnormal BP response to exercise (ABPRE) was defined as a decrease, no increase or an increase of the SBP after exercise by < 20 MMHG.

Results:
The mean 6-MWD was 325.3 ± 56.84 meters (M), 316.1 ± 61.33 M, 332.66 ± 52.44 M in all patients, HFmEF patients, and HFpEF patients respectively. 6-MWD and limited FC showed no significant difference between the 2 groups. Limited FC affected 42.5 % and 33 % of HFmEF and HFpEF patients respectively. ABPRE affected 28 (31.1 %) of patients and was significantly higher in HFmEF than HFpEF patients. Independent predictors of limited FC were lower EF, PP and PPP and higher DBP in HFmEF patients and lower EF in HFpEF patients. Cut-off points for prediction of limited included PP < 32.5 MMHG and PPP < 30.22 % in HFmEF patients, PP < 37.5 MMHG and PPP < 32.67 % in HFpEF patients, and EF < 42.5 % in all patients (figure 1).

Conclusions:
The 6-MWT is well tolerated by HF patients and easy to perform in clinical practice. Simple bed-side measurement of BP parameters correlated with the FC and predicted limited FC in HFmEF and HFpEF patients.
BLOOD PRESSURE ADAPTATIONS AND ARTERIAL STIFFNESS IN THE GENERAL POPULATION
Authors: Johansson Madeleine , Fedorowski Artur , Engström Gunnar , Nilsson Peter M. , Hamrefors Viktor 
Published: June 2022

Objective:
Arterial stiffness is independently associated with orthostatic hypotension (OH) in older individuals. The relationship between orthostatic blood pressure (BP) and arterial stiffness has not been thoroughly examined in the younger population. To investigate the relationship between orthostatic BP adaptations, central aortic hemodynamics, and arterial stiffness in the general population of young and mid-aged adults.

Design and method:
A cross-sectional, observational, population-based study of 4223 individuals. We assessed arterial stiffness and central hemodynamics by carotid-femoral pulse wave velocity (c-f PWV) and pulse wave analysis (PWA) at the arteria radialis in relation to an orthostatic BP adaptation after 3 min standing.

Results:
The mean age of the population was 41.9 ± 14.5 years and 52.1% were women. We found that higher standing BP was associated with lower arterial stiffness after full adjustment in both men (unstandardized beta coefficient () -0.09, p = 0.02) and women (-0.08, p = 0.03). An increased diastolic BP on standing was inversely correlated with PWV and central aortic hemodynamics in both younger (PWV -0.01, p = 0.02) and older individuals (-0.02, p = 0.001). The lowest arterial stiffness was observed in the lowest and highest quartiles of standing systolic BP differences (p < 0.001), while a gradual reduction in arterial stiffness was observed across increasing quartiles of standing diastolic BP difference for both PWV and measurements of central aortic hemodynamics (p < 0.001).

Conclusions:
The co-existence of orthostatic hypotension, increased blood pressure variability, and vascular stiffness represents a hemodynamic ageing syndrome with important prognostic implications for public health. Our findings demonstrate that impaired hemodynamic response to orthostatic challenges, traditionally observed in older individuals, are independently and inversely associated with markers of arterial stiffness (vascular ageing) and hemodynamic changes also in a younger population. Further studies are required to assess the relationship between impaired blood pressure adaptations on standing in younger subjects and risk of future incident cardiovascular events.
THE ROLE OF MILD SEDATION AND/OR ANALGESIA IN THE NURSING CARE OF PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION. EMPHASIS ON BLOOD PRESSURE AND PATIENTS’ PERCEPTIONS OF RESILIENCE AND SELF-COMPASSION
Authors: Sarrou Maria , Skoularigkis Ioannis , Stougiannos Pavlos , Trikas Athanasios 
Published: June 2022

Objective:
Percutaneous coronary interventions create stress and anxiety in patients, which usually affect blood pressure. Safe sedation is considered cornerstone therapy as relieves stress and pain. In chronic heart diseases the patient tries to negotiate the challenges of his illness which often aggravate his anxiety. The patient experiences the inability to manage and respond to others and/or his expectations, and as a result he “hurts” himself mentally. Self-compassion and self-esteem contribute to resilience. Resilience is a protective psychological factor in heart diseases.

Purpose: The purpose of the research is the nursing monitoring and recording of the effects of the administered mild sedatives or analgesia during a percutaneous coronary intervention and the patients’ perception of the care provided.

Materials & Method: Questionnaires were used, answered by cardiac patients undergoing percutaneous coronary interventions (coronary angiography and angioplasty). The sample of participants is 100 people, where the 50 received midazolam (Dormixal) and fentanyl (Fentanyl) (group 1) five minutes before the examination and the remaining 50 did not (group 2). Blood pressure was measured and recorded before the start of the procedure, during, and at the end of it, in both groups to investigate a possible effect of the treatment.

Design and method:
During those three periods, there was a significant change in blood pressure (decrease) after the procedure in group 1 (120.76. 10.75 versus 129.86 ± 22.26 in group 2, p = 0.007). In group 1 the self-compassion scale was significantly and negatively correlated with the STAI scale and positively with the Connor scale. Those with a moderate financial level were less resilient while those with a high financial level showed less stress.

Results:
The majority of studies use these medications based on the adoption of the line “zero pain tolerance” in order to reduce or eliminate it. This difference is indicative of a possible effect of the treatment on the change (reduction) of blood pressure. In addition, it turns out that the higher the self-compassion, the greater the resilience and lower the stress
BLOOD PRESSURE VARIABILITY AND MIND COGNITION IMPAIRMENT: A SYSTEMIC REVIEW AND META-ANALYSIS
Authors: Zhao Xu , Lin Xin , Kou Chenkun , Wang Qiongying , Yu Jing 
Published: June 2022

Objective:
Blood pressure variability is hypothesized to play important role in development of cognition impairment. We aimed to explore the relationship of blood pressure variability and cognition impairment.

Design and method:
We searched the following databases, EMBASE, Cochrane Library, Web of Science, up to October 2021 using blood pressure variability, cognition impairment, cognition dysfunction. Randomized double blind and observational trials were included. Dementia and Alzheimer’s disease cases were excluded. Two reviewers confirmed the inclusion of studies and extracted the data independently. STATA V.15.1 was used to synthesize data.

Results:
We included 23 studies and enrolled 42964 hypertensive patients. All studies assessed cognition function using Mini-Mental State Examination (MMSE) or other cognition function test. Ambulatory blood pressure variability, visit-to-visit blood pressure variability, measure to measure blood pressure variability, day-to-day blood pressure variability and beat-to-beat systolic blood pressure variability were applied in included trials. The variability of systolic blood pressure has significant relationship with cognition impairment (OR,1.747[1.25,2.44], P < 0.01), however, the variability of diastolic blood pressure did not show relationship with decreasing cognition function scale(OR,0.912[0.81,1.03], P> 0.05) by nalysing data which trial used MMSE scale. Results showed higher systolic blood pressure variability had negative relationship with attention (OR,1.63, [1.28,1.98], P < 0.01). In the aspect of memory and language function, blood pressure variability did not show a significant relationship. Higher blood pressure variability in both systolic and diastolic was associated with lower hippocampal volume and cortical infarcts.

Conclusions:
The variability of systolic blood pressure is dependently risk factor for cognition impairment in older adults with hypertension. For unsuccessfully treated hypertensive individuals (with blood pressured more than 140/90 mmHg),higher variability in both systolic and diastolic blood pressure was associated with cognitive damage, but these associations were not found in those controlled hypertension older adults.
RELATIONSHIP OF 24-HOUR AMBULATORY BLOOD PRESSURE VARIABILITY WITH MICRO- AND MACROVASCULAR PARAMETERS AND HYPERTENSION STATUS
Authors: Papadopoulou Stella-Lida , Gkaliagkousi Eugenia , Dipla Konstantina , Koletsos Nikolaos , Zafeiridis Andreas , Karamaounas Polykarpos , Stergiou George S. , Douma Stella , Triantafyllou Areti 
Published: June 2022

Objective:
Existing evidence shows that increased values of blood pressure variability (BPV) are associated with a higher risk of subclinical organ damage and cardiovascular events, independently of elevated average BP values. We sought to investigate the relation of novel BPV indices with micro- and macrovascular parameters that have not all been previously studied and to identify differences according to hypertension status.

Design and method:
We evaluated the relationship between BPV indices and micro- and macrovascular parameters in a selected population of 344 individuals (233 never-treated, newly diagnosed hypertensive and 111 normotensive individuals).Using data from 24-h ambulatory blood pressure monitoring device, BPV was assessed by average real variability (ARV) during 24-hours, daytime and nighttime and as systolic weighted standard deviation (wSD). Nonmydriatic retinal photography was used to assess retinal microvascular diameters. Arterial stiffness was evaluated by measurement of pulse wave velocity(PWV) and aortic augmentation index (AIx). Myocardial perfusion was evaluated using subendocardial variability ratio (SEVR).The carotid intima-media thickness (cIMT) was measured by ultrasound. We performed a multiple regression analysis for all the parameters which were statistically significant in the univariate analyses.

Results:
After adjusting for potential confounders, all vascular parameters [venular retinal diameter (p = 0.036), PWV (p < 0.007), cIMT (p < 0.06)], except for SEVR were independently associated with ARV components in the total population. Further analysis based on hypertension status showed that in hypertensives only macrocirculation indices such as PWV and cIMT were independently associated with ARV (for PWV: 24-h systolic, p = 0.025, nighttime systolic, p = 0.001 and nighttime diastolic, p = 0.012 respectively; and for cIMT, p = 0.001 for both 24-h and daytime systolic). In normotensive individuals, venular diameter was associated with 24-h systolic and diastolic and daytime systolic and diastolic ARV (p = 0.004, p = 0.002, p = 0.001 and p = 0.049 respectively). The arteriovenous ratio was associated with daytime systolic ARV (p = 0.022), and AIx was associated with daytime diastolic ARV (p = 0.022). None of the univariate correlations between vascular parameters and wSD remained significant after adjustment for potential confounders.

Conclusions:
We concluded that short-term BPV represented by ARV is independently associated with macrovascular parameters in untreated hypertensive patients and microvascular parameters in normotensives.
ASSOCIATION OF SHORT-TERM BLOOD PRESSURE VARIABILITY WITH DIABETES IN HYPERTENSIVE INDIVIDUALS
Authors: Sousa Andréa Cristina , Magalhães Fabrício Galdino , Silva Suelen Benta , Simeoni Adélia Rocha , Inuzuka Sayuri , Batista Sandro Rogério , Vale Raquel Mendonça , De Souza Weimar Kunz Barroso , Sousa Ana Luiza Lima 
Published: June 2022

Objective:
Evaluation of short-term blood pressure (BP) variability and its associations with blood pressure measurements, in the different periods nalysed by Ambulatory Blood Pressure Monitoring (ABPM), in hypertensive patients with or without diabetes.

Design and method:
Analytical cross-sectional study, developed with a database containing 25-year historical series (1993 - 2018) of ABPM exams; diabetes is considered as comorbidity for hypertension. Variables nalysed: Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) of 24 h, daytime and nighttime; Standard deviation; coefficient of variation SBP and DBP, nocturnal drop, age and body mass index. Accomplished logistic regression analysis, Confidence Interval of 95% and 5% of significance level.

Results:
Analyzed 1591 exams, identified 281 (17.7%) as diabetic hypertensives. Diabetics were older, (63.0; ± 10.9) than non-diabetics 57.7 (±13.9) and also had higher body mass index (28.9; ± 5.0 - 26.7; ± 4.4); with similar gender distribution. A higher proportion of uncontrolled nocturnal BP was identified among diabetics with 77.5% and 68.1% among non-diabetics. In the multivariate logistic regression analysis, considering in the model the presence or absence of DM as the dependent variable, the associated predictor variables were age (OR 1.04; 95% CI 1.01 - 1.08); media DBP in wakefulness (OR 1.34; IC95% 1.04 - 1.85), IMC (obese/non obese) (OR 2.35; 95%CI 1.18 - 4.66). The Coefficients of variation of blood pressure, systolic or diastolic, showed no significant association with the presence of DM morbidity along with HA. Analysis of the medium Coefficient of Variation of Systolic Blood Pressure showed decreasing measures in 24 hours, daytime, nighttime, similarly between diabetics and non-diabetics. A total of 229 (83.3%) no dipper diabetics and 973 (74.5%) of non-diabetics were identified. (p = 0,002). Diabetics had significantly lower control rate than non-diabetics in the 24-hour period and during nigttime.

Conclusions:
It was identified that diabetic hypertensives were older, had lower blood pressure control during the nighttime period, with a lower proportion of non-dippers and were more obese. The pressure variation coefficients showed the same pattern between diabetics and non-diabetics.
CORRELATION BETWEEN BP VARIABILITY, INSULIN RESISTANCE AND MICROALBUMINURIA
Authors: Sapojnic Nadejda , Bitca Angela , Caraush Alexandru , Durnea Aliona , Moscal Vitalie 
Published: June 2022

Objective:
Fueled by a global pandemic of cardiovascular diseases, hypertension (HT) remains the leading cause of early mortality in the world. Blood pressure variability (BPV) is considered to be in relation to a worse prognosis. Disrupted blood pressure variability (BPV) and insulin resistance (IR) often coexist as” satellite conditions”. This association potentiate the target organ damages (TOD). Microalbuminuria (MA) is an important biomarker of extra-cardiac damage, and subsequently, hypertension and/or carbohydrate metabolism’s alteration can lead to abnormalities in urinary albumin excretion. Each of these conditions can increase adverse hazards per se or via promoting hypertension or extracardiac injuries.
Aim: To determine the correlation between disrupted BPV, level of carbohydrate metabolism’s alteration and microalbuminuria.

Design and method:
101 patients with essential hypertension (49,5% men; mean age 50,11 ± 0,79 years, mean BMI 24.4 ± 0.5 kg/m2; eGRF > 60 ml/min/1.73m2) with excessive BPV (systolic BP> 15 mmHg; diastolic BP > 14 mmHg), IR and microalbuminuria. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE), HOMA-IR and Ma were performed. The BPV was referred to the software analysis of ABPM data. To define IR was used The Homeostasis Model Assessment of insulin resistance (HOMAIR) levels; threshold values was considered > 2. MA was appreciated according to the current guidelines (30–300 mg/24 h). Correlation analysis was performed using Pearson’s test. The correlation coefficient was considered weak at < 0.3, medium-0.3–0.7 and strong> 0.7–1.0. Statistical significance was appreciated at a P-value < 0.05 and highly significant at a P-value < 0.001.

Results:
Excessive BPV, HOMA-IR and MA indices demonstrate a statistically significant correlation (p < 0.001). Systolic BPV demonstrated a particularly strong relationship with higher HOMA-IR levels and MA (p < 0.05) (Table 1).

Conclusions:
In hypertensive patients, disrupted BP variability strongly correlates with microalbuminuria and carbohydrate metabolism abnormality. This association appears to have a particularly strong relationship with systolic BPV and correlates with higher HOMA-IR levels.
ISCHEMIC REPERFUSION INJURY IN HYPERTENSIVE RAT HEART
Authors: Lin Zhijun , Zhang Yin Hua 
Published: June 2022

Objective:
In patients with cardiovascular disease, myocardial ischaemia reperfusion damage is the leading cause of death. Sustained myocardial ischaemia–reperfusion causes cardiomyocyte death and coronary microvascular injury in different ways. Patients with hypertension who undergo cardiac ischemia-reperfusion have more severe clinical outcomes.

Design and method:
The mechanism, on the other hand, is missing. We use an angiotensin II successfully produced hypertension rat model to investigate the effect of hypertension on cardiac ischemia-reperfusion injury. We successfully established in vitro myocardial ischemia-reperfusion in normal and hypertensive rat hearts using the Langendorff perfusion system.

Results:
Our results reveal that after 30 minutes of ischemia and an hour of reperfusion, the beating pattern of the hypertensive heart was poorer than that of the sham heart.
We also used a Transmission Electron Microscope to examine the morphology of myocardial cells and mitochondria, and discovered that the mitondria structure was dramatically destroyed in the hypertension model compared to the sham model, and that some myocytes in the hypertension model have abnormal morphology after 30 minutes of ischemia and an hour of reperfusion.
To assess mitochondrial function, mitochondria were extracted from an ischemia-reperfused heart and Mitochondrial Function Indexes were calculated. When oligomycin was used to block ATP synthase, the formation of reactive oxygen species (ROS) and mitochondrial membrane potential MMP increased considerably in the hypertension group. Furthermore, when FCCP was utilized as a proton collapser and antimycin A was used to block mitochondrial complex III, the generation of reactive oxygen species (ROS) mitochondrial membrane potential MMP in the hypertension group rose significantly at add additional oil substrate. When the hypertension group is given the substrate succinate or oligomycin to block ATP synthase, oxygen consumption increases significantly.

Conclusions:
Taken together, our research reveals that hypertension can significantly increase the damage caused by myocardial ischemia reperfusion. As a result, hypertension during myocardial ischemia should be given special attention.