bluuebunny/crossref_metadata_2025_split huggingface dataset:
SYMPATHETIC NERVOUS SYSTEM ACTIVITY AND BLOOD PRESSURE IN HYPERTENSIVE PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE
Authors: Kakouri Niki , Andrikou Ioannis , Konstantinidis Dimitrios , Siafi Eirini , Kariori Maria , Drogkaris Sotirios , Polyzos Dimitrios , Manta Eleni , Tatakis Fotis , Grigoriou Kalliopi , Zammanis Ioannis , Iliakis Panagiotis , Papakonstantinou Pantelis , Thomopoulos Costas , Tsioufis Konstantinos 
Published: June 2022

Objective:
Nonalcoholic fatty liver disease (NAFLD) is associated with hypertension and predicts future cardiovascular events. The purpose of this study was to investigate the effect of sympathetic nervous system (SNS) overactivity on blood pressure levels in hypertensive patients with and without NAFLD.

Design and method:
111 newly diagnosed untreated hypertensive patients (mean age 55 ± 10 years, 48 males, mean office systolic/diastolic BP 140 ± 14.8/88 ± 9.9 mmHg) without history of cardiovascular disease underwent office blood pressure (BP) measurements. NAFLD was diagnosed by liver ultrasound to separate patients into those with and without NAFLD. SNS activity was assessed by muscle sympathetic nerve activity (MSNA) based on established methodology (microneurography).

Results:
Hypertensive patients with NAFLD (n = 71) compared to those without NAFLD (n = 40) were younger (53 ± 10 vs 58 ± 9 years, respectively, p = 0.01) with greater body mass index (33 ± 10 vs 26 ± 3 kg/m2, p < 0.001). Also, male gender was more prevalent in the NAFLD group compared to the non-NAFLD group (52% vs 29%, respectively, p = 0.03), whereas there were no differences in glucose, low density lipoprotein levels and glomerular filtration rate. In NAFLD patients, MSNA was correlated with office diastolic BP (r = 0.24, p = 0.02) and in linear multiple regression analysis MSNA levels were an independent determinant of office diastolic BP levels (beta = 0.185, p = 0.05), while in the non NAFLD group, MSNA was not related to office BP levels (p = ns). MSNA levels were greater in hypertensives with NALFD compared to those without NAFLD (44.3 ± 9.5 vs 40 ± 7.5 bursts per minute, respectively, p < 0.04). Moreover, in multiple logistic regression analysis, MSNA was proven as an independent determinant of the presence of NAFLD (OR 1.2, 95% CI 1.01–1.5), p = 0.04).

Conclusions:
higher sympathetic nervous system activity, as assessed by MSNA, is associated with greater diastolic BP in NAFLD patients compared to their non-NAFLD counterparts. These findings suggest that SNS may contribute importantly to the regulation of BP in NAFLD patients.
HEPATIC STEATOSIS INDEX IS INDEPENDENTLY RELATED TO HYPERTENSION MEDIATED ORGAN DAMAGE IN PATIENTS WITH FIRST DIAGNOSED AND NEVER TREATED ESSENTIAL HYPERTENSION AND SMOKING HABIT
Authors: Triantafyllidi Helen , Vlachos Stefanos , Benas Dimitris , Fabri Anastasia , Birmpa Dionyssia , Schoinas Antonios , Thymis Ioannis , Kostelli Gavriela , Ikonomidis Ignatios 
Published: June 2022

Objective:
Non-alcoholic fatty liver disease (NAFLD) is closely related to the metabolic syndrome, arterial hypertension and overall cardiovascular (CV) disease. We aimed to investigate if those first diagnosed and never-treated patients with essential hypertension at high risk for NAFLD, measured by the Hepatic Steatosis Index (I), already have an impaired CV risk profile estimated by increased blood pressure burden and accompanied by the presence of hypertension-mediated organ damage (HMOD).

Design and method:
We studied 254 non-diabetic, first diagnosed and never-treated young hypertensive patients, [mean age=51 + 11 years, 59% males, 31% smokers]. 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 patient before treatment initiation. HIS was calculated as 8 times (ALT/AST ratio) + BMI (+2, if female; + 2, if diabetes mellitus).

Results:
The whole hypertensive population was divided regarding I median value=39.3 in Group A (high risk NAFLD group, n = 127, age = 50 + 10) and Group B (low risk NAFLD group, n = 127, age = 52 + 11). Group A had increased BMI (32 + 5 vs. 27 + 3, p < 0.001), systolic night-time ABPM (128 + 15 vs. 124 + 11, p = 0.04), Chol (217 + 40 vs. 206 + 35, p = 0.01) and Trigl (141 + 79 vs. 112 + 65, p = 0.002), E/Ea (7 + 2 vs. 6 + 2, p = 0.4) and LVMI (83 + 17 vs. 79 + 15, p = 0.03) compared to Group B while all other studied demographic/laboratory/ABPM/HMOD parameters (PWV, MAU, CFR and cIMT) were similar. I was related to BMI (p < 0.001) and office BP, systolic (p < 0.001) and diastolic (p = 0.01), in total population as well as to LVMI (r = 0.24, p = 0.03) in smokers. Finally, in multiple regression analysis, we noted that I was independently associated with LVMI (beta = 0.28, p = 0.05) only in male smokers.

Conclusions:
Our findings underscore the augmented CV risk (smoking, obesity, hyperlipidemia, BP burden and HMOD) in people with first diagnosed arterial hypertension who are at high risk for NAFLD. As successful antihypertensive treatment may lead to HMOD regression, there is still time for those patients to be treated for hypertension disease and hyperlipidemia and quit smoking, in order to reduce future CV risk
LONG SLEEP DURATION AND AMBULATORY BLOOD PRESSURE
Authors: Rietz Hermine , Hellqvist Henrik , Kahan Thomas , Hedner Jan , Grote Ludger , Spaak Jonas 
Published: June 2022

Objective:
Studies show a link between short sleep duration and hypertension. The mechanistic associations between sleep duration and blood pressure (BP) are less clear. We studied the association between sleep duration, blood pressure, metabolic profile as well as obstructive sleep apnoea in participants with suspected or confirmed hypertension undergoing 24 h ambulatory blood pressure measurement (ABPM).

Design and method:
We included 177 participants (mean age 57 ± 11 years, 67 women) referred for ABPM, with available exact time-points for bedtimes during the recording. Daytime and night-time BP values were calculated accordingly. Biochemistry included triglycerides (TG), high- and low-density lipoproteins (HDL, LDL) and total cholesterol. The HDL/TG ratio was calculated as a marker of glucose intolerance. Sleep apnoea was quantified by simultaneous ambulatory polygraphy.

Results:
Participants were stratified into those with short (n = 16) /normal (n = 139) /long (n = 22) sleep (< = 6 h, > 6 < = 9 h and > 9 h). There were no differences in age, body mass index (BMI) or apnoea hypopnea index (AHI) between groups. Mean office BP was 146 ± 19/89 ± 11 mmHg and mean 24 h ABPM 133 ± 14/80 ± 8 mmHg. By standard ABPM definitions 81, 86, and 77% in the short/normal/long sleep group were hypertensive, and 56, 56 and 73% were on antihypertensive medication. The long sleep group had lower 24 h diastolic BP than the short and normal sleep groups (p < 0.05 by ANOVA). TG levels and TG/HDL ratio were higher in the long sleep group than in the short sleep group (both p < 0.05 by ANOVA; not adjusted for statin treatment). No differences were found in HDL, LDL, or total cholesterol between groups. In a multiple linear regression model, longer sleep duration, older age, and female sex were all independently associated with lower 24 h ABPM diastolic BP (all p < 0.01; full model R2 = 0.25, p < 0.001) while BMI, AHI, TG, and the TG/HDL ratio were not related.

Conclusions:
Longer sleep duration was independently associated with lower ABPM 24 h diastolic BP together with older age and female sex. The observation with increased TG and TG/HDL ratio in the long sleep group warrants further study.
INCIDENT ATRIAL FIBRILLATION AND THROMBO-EMBOLIC RISK – A REPORT FROM MAY MEASUREMENT MONTH 2019 SCREENING PROGRAMME IN BULGARIA
Authors: Postadzhiyan Arman , Yotov Yoto , Tisheva Snejana , Nikolov Fedya , Raev Dimitar , Gruev Ivan , Ramchev Konstantin 
Published: June 2022

Objective:
Despite the increased prevalence of atrial fibrillation (AF), data for the implementation of nationwide screening programmes are limited. The use of automatic devices for blood pressure measurement with AFIB technology during May Measurement Month (MMM) give a unique possibility to increase nationwide awareness about AF and stroke risk, to determine the prevalence of AF using a validated BP machine and its feasibility to identify new cases.

Design and method:
Three BP readings and self-reported demographic, lifestyle and cardiovascular risk factors were collected from participants during MMM2019 campaign in Bulgaria. BP was measured using a Microlife WatchBP Office BP monitor with patented AFIB algorithm in 2075 participants. A regression analysis was performed excluding all the subjects with previous AF to establish clinical factors significantly associated with incident AF.

Results:
The mean age of participants was 62.11 ± 14.9 years, 65% were female and 66% with known hypertension with a median duration of 11 years. Past history of AF was present in 223 (10,7%) and during the campaign additional 83 (4%) cases were identified. Among 306 subjects with AF, low-risk patients (i.e. CHA2DS2VASc score 0 in males or CHA2DS2VASc score 1 in females) was found in 5 (3.8%) males and in 13 (7.6%) females, respectively. We didn’t found any significant difference in classical risk factors or cardiovascular diseases between the groups of previous and incident AF and both groups had identical CHA2DS2VASc score 3.56 vs 3.62, p = 0.8. On multivariable logistic regression CHF (P = 0.011), age 65–74 (P < 0.001) and = >75 (P < 0.001), diabetes (P < 0.01), previous stroke (P < 0.01) or vascular disease (P < 0.01), and prolonged history of hypertension with uncontrolled systolic BP during the screening (P = 0.012) or home systolic BP (P = 0.05) were significantly associated with incident AF.

Conclusions:
The use of automatic devices for BP measurement with AFIB technology is feasible to identify a significant number of new AF cases, most with a high thrombo-embolic risk. Given the low OAC use recorded, greater efforts in AF detection and treatment are urgently needed to reduce the burden of stroke associated with this arrhythmia.
STUDYING THE SITUATION OF CAROTID ATHEROSCLEROSIS OF HYPERTENSIVE PATIENTS IN THE NORTH OF BINH DINH PROVINCE VIETNAM 2019
Authors: Long Nhon Phan , Kim Nhung Hoang Thi 
Published: June 2022

Objective:
To evaluate the rate of carotid atherosclerosis in hypertensive patients and the correlations between age, blood pressure, BMI, total cholesterol and atherosclerotic plaque numbers.

Design and method:
A Cross-sectional descriptive study of 207 hypertensive patients in the North of Binh Dinh province, Vietnam (2019), examined by oppler ultrasound to evaluate atherosclerotic plaque numbers of the extra-cranial carotid arteries.

Results:
1. Carotid atherosclerotic results
-  The rate of atherosclerosis in hypertensive patients: 69.6%
-  The percentage of right carotid atherosclerosis is 14.6%.
-  The percentage of left carotid atherosclerosis is 19.4%.
-  The percentage of atherosclerosis on both of right and left carotid are 66%.
-  The percentage of carotid atherosclerosis at before bifurcation: 75%
-  The percentage of carotid atherosclerosis at bifurcation 46.52%.
-  The percentage of carotid atherosclerosis at after bifurcation 4.16%.
-  There are 29.2% of hypertension have 01 atherosclerotic plaque; 54.2% have -   02; 12.5% have 03; 3.5% have 04 and 0.7% have over 04 plaques.
2. Some correlative results
-  There is no correlation between age, systolic blood pressure, diastolic blood pressure, height and atherosclerotic plaque numbers.
-  There is a weak correlation between weight and atherosclerotic plaque numbers (r = 0.20), y = 47.9399 + 2,881 x, R2 = 0.042. p < 0.001.
-  There is a weak correlation between total cholesterol and atherosclerotic plaque numbers (r = 0.18), y = 4.7018 + 0.2839 x, R2 = 0.033. p < 0.001.

Conclusions:
Carotid atherosclerotic injuries are 69.6% in hypertensive patients. That is very high rate. Should be examined early to treatment and prevent cardio-vascular complications.
ALPHA ADDUCIN GENE POLYMORPHISM IS MORE COMMON IN MALE AS COMPARE TO FEMALE IN ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Naz Qulsoom , Verma Narsingh , Serajuddin M. , Patel M.L. 
Published: June 2022

Objective:
Essential hypertension is a complex and multifactorial disorder resulting from environmental and genetic factors, and their interactions. Alpha nalysed-1 (ADD1) gene is salt sensitive gene which has its role in etiology of essential hypertension via renal sodium reabsorption. Therefore, the G460T polymorphism of ADD1 gene may be associated with new onset of CVD & stroke under the influence of essential hypertension.
Aim: To assess the relationship between male & female genetic polymorphism (ADD1 G460T polymorphism) under influence of essential hypertension.

Design and method:
Materials and Methods: We recruited total 255 study subjects, 110 normotensive as control (63 male and 47 females), 145 hypertensive patients (85 male and 60 females) and 240 hypertensive. All study samples were genotyped for ADD1 polymorphic alleles and nalysed the relationship between different genotypes with respect to anthropometric and clinical parameters.

Results:
Results-Clinical and anthropometric parameters (such as SBP, DBP, FBG, height, weight, HbA1c, BMI & urinary electrolyte) of study population were found highly statistically significant (p < 0.05) at base value. Further, genotype wise comparison of all the above parameters revealed most of them as non-significant (p> 0.05). Whereas, comparison between genotype frequencies in essential hypertensive patients, specifically in female (p = 0.027) and male (p = 0.015) and in combination with both female (p = 0.017) and male (p = 0.005) revealed a higher HbA1c level in variant T allele. In case of essential hypertensive patients, male population showed a highly statistically significant (p = 0.003) difference in GT & TT allele frequency in aplpha adducing gene polymorphism.

Conclusions:
Anthropometric & Clinical parameters may be the indicative factors for essential hypertension. Variant T allele of ADD1 gene may be considered as the risk factor for the development of stroke & cardiovascular diseases in essential hypertensive patients.
PRESCRIPTIVE APPROPRIATENESS IN PRIMARY CARDIOVASCULAR PREVENTION: DATA FROM NIGUARDA HOSPITAL
Authors: Maloberti Alessandro , Ceruti Davide , Gualini Elena , Colombo Valentina , Giani Valentina , Milani Martina , Sun Jinwei , Alloni Marta , Giannattasio Cristina 
Published: June 2022

Objective:
The main cause of waste of health resources is represented by overuse of diagnostic and therapeutic procedures. Given its high prevalence and the importance of identifying hypertensive-mediated organ damage, management of patients with arterial hypertension can lead to a lack of appropriateness. The aim of this study was to evaluate the prescriptive appropriateness of non-invasive diagnostic tests (Echocardiography, Carotid ultrasound, ECG exercise testing, 24 h Ambulatory blood pressure monitoring) in outpatients referring to an ambulatory of primary cardiovascular prevention.

Design and method:
559 specialistic ambulatory visits were retrospectively analysed and appropriateness of every prescription was evaluated. An integration of different Italian and European guidelines was used to define appropriateness. Moreover, we evaluated the correlation between prescriptions, appropriateness and clinical characteristics of the population.

Results:
During the 559 ambulatory visits analysed, 449 prescriptions were made, including 198 echocardiographies, 148 carotid ultrasound, 85 24 h ABPM and 18 ECG exercise testing. The global percentage of appropriate prescriptions was 40.3%. Focusing on each test, appropriateness rate was 49.4% in 24 h ABPM, 43.9% in echocardiography, 38.9% in ECG exercise testing and 30.4% in carotid ultrasound. A significant correlation was identified between the age and cardiovascular risk category of patients and the appropriateness of echocardiography, 24 h ABPM and carotid ultrasound, and a correlation between appropriateness of echocardiography and the duration of hypertension and the presence of valvular heart disease.

Conclusions:
Our study shows a relevant percentage of inappropriate prescriptions of non-invasive cardiologic exams; moreover, there might be a greater lack of appropriateness in young and low risk patients.
EARLY MORNING HEMODYNAMIC CHANGES AND LEFT VENTRICULAR HYPERTROPHY AND MORTALITY IN HEMODIALYSIS PATIENTS
Authors: Mallamaci Francesca , Tripepi Rocco , Torino Claudia , Tripepi Giovanni , Sarafidis Pantelis , Zoccali Carmine 
Published: June 2022

Objective:
An exaggeration of the early morning increase in BP, a phenomenon accompanied by a parallel rise in heart rate (HR), is a marker of high cardiovascular risk. The early morning changes in these parameters have not been investigated in the hemodialysis population.

Design and method:
In a pilot, single center, study including a series of 58 patients we measured the pre-awakening BP and HR surges and the nocturnal dipping of the same parameters as well as other established indicators of autonomic function (weighted 24 h systolic BP and HR variability) and tested their relationship with the left ventricular mass index (LVMI) and with the risk of death over a median follow up of 40 months.

Results:
The pre-awakening HR surge (r = -0.46, P = 0.001) but not the corresponding BP surge (r = -0.1, P = 0.98) associated with LVMI and the risk of death [HR (1 unit): 0.89, 95% CI: 0.83–0.96, P = 0.001]. The link between the pre-awakening HR surge with these outcome measures was robust and largely independent of established risk factors in the hemodialysis population including the systolic BP dipping. Weighted 24 h systolic BP (SD) and HR (SD) variability did not correlate with LVMI (all P> 0.11) nor with the risk of death (P > 0.11). Overall, among markers of early morning hemodynamic changes and of hemodynamic variability, the pre-awakening HR surge was the strongest correlate of LVMI and a the strongest predictor of death.

Conclusions:
This pilot study suggests that low early morning changes in HR, a biomarker reflecting sympathetic activity, entail a high risk for LVH and mortality in the hemodialysis population.
INCREASED IONIZED CALCIUM-MAGNESIUM-RATIO IN ELDERLY HYPERTENSIVES - RELATIONSHIP TO ARTHERIOSCLEROSIS
Authors: Klaus Kisters Kisters , Lukas Kisters , Bernhard Gremmler , Jutta Sprenger , Uwe Gröber 
Published: June 2022

Objective:
Changes in calcium and magnesium metabolism are involved in the pathogenesis of primary hypertension. The calcium and magnesium flux across the external membrane is regulated by a calcium pump (calcium-magnesium-ATPase), calcium and magnesium channels (TRPM 6 and 7) and a sodium-magnesium-antiport. An increased calcium-magnesium-ratio is known to be involved in the development of atherosclerosis. Early onset of these disorders are known in hypertension. In earlier animal studies this phenomenon has been described, too.

Design and method:
Our study was performed in 18 elderly hypertensives (9 male/9 female, with normal renal function, age beyond 60 years). No patient had diabetes mellitus, no diuretic therapy for at least 4 weeks before entry in study and no magnesium supplementation.
In each patient ionized calcium and magnesium was measured and the calcium-magnesium-ratio was calculated.
Measurements were performed by a Prime Plus Apparatus by NOVA Medical, Rödermark, Germany.

Results:
Ionized magnesium was measured 0.55 + /-0.04 mmol/L, normal range 0.54–0.80 mmol/L) in patients.
The ionized calcium-magnesium-ratio was 2.33+/-0.18 (normal range below 2.40).
About 40% of elderly hypertensives showed an increased ratio of ionized calcium and magnesium, which is known to be a marker for the development of artheriosclerosis.

Conclusions:
As described earlier, a magnesium deficiency can be involved in the pathogenesis of hypertension and in elderly.
The increased calcium-magnesium-ratio is also a pathogenetic factor for artheriosclerosis often found in elderly hypertensives with vascular damage, e.g. stroke, renal insufficiency or heart disease.
SEX SPECIFIC CHANGES OF CAROTID ARTERIAL FUNCTION IN RESPONSE TO VITAMIN D DEFICIENCY
Authors: Horváth Eszter Mária , Sipos Miklós , Gerszi Dóra , Dalloul Hicham , Bálint Bálint , Sziva Réka Eszter , Kollarich Réka , Magyar Péter , Török Marianna , Ács Nándor , Szekeres Mária , Hadjadj Leila , Nádasy György L. , Várbíró Szabolcs 
Published: June 2022

Objective:
Male sex and Vitamin D deficiency is associated with increased ischemic stroke risk that may be partially explained by local changes of circulatory control. Our aim was to examine the vascular reactivity and histological changes of isolated carotid artery of female and male rats in Vitamin D deficient and Vitamin D supplemented state.

Design and method:
Female and male Wistar rats were fed with vitamin D reduced rat chow for eight weeks. Another group received normal chow with further supplementation of vitamin D. Phenylephrine induced contraction, acetylcholine and estrogen induced relaxation of carotid arteries was examined by wire myography. Elastic fiber density was evaluated on resorcin-fuchsin stained tissue sections. Smooth muscle cell actin (SMA), thromboxane A2 receptor and endothelial nitric oxide synthase (eNOS) density and protein tyrosine nitration (NT) was measured by immunohistochemistry.

Results:
Both male sex and vitamin D deficiency resulted in increased phenylephrine induced contraction. Inhibition of cyclooxygenases by indomethacin increased the degree of contraction only in vitamin D supplemented females. Male gender was associated with reduced acetylcholine induced relaxation, and it was not altered by vitamin D deficiency. Indomethacin increased relaxation in male vessels. Estrogen induced relaxation was significantly reduced by vitamin D deficiency in female but not in male animals. Vitamin D deficiency resulted in reduced elastic fiber density in female, but decreased smooth muscle cell actin density in male rats. Thromboxane A2 receptor density was increased in vitamin D deficient males. NT immunohistochemistry was low in both male group, whereas eNOS was reduced in vitamin D deficient males.

Conclusions:
In rats male gender was associated with increased phenylephrine induced contraction and reduced acetylcholine induced relaxation of the carotid artery. Vitamin D deficiency caused increased contraction in both sexes; did not change acetylcholine induced relaxation, but reduced the estrogen induced relaxation in female arteries. These functional differences were accompanied with sex specific histological changes of the vessel. The observed sex specific properties and responses of carotid artery to vitamin D deficiency may play a role in the gender difference of cardiovascular and stroke risk.