bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF CONTINUOUS MEAN ARTERIAL PRESSURE BY A WEARABLE CUFF-LESS DEVICE AGAINST INTRA-ARTERIAL MEASUREMENTS
Authors: Heimark Sondre , Bøtker-Rasmussen Kasper Gade , Rindal Ole Marius Hoel , Seeberg Trine Margrethe , Stepanov Alexey , Boysen Elin Sundby , Søraas Camilla Lund , Stenehjem Aud-Eldrid , Fadl Elmula Fadl Elmula M. , Waldum-Grevbo Bård 
Published: June 2022

Objective:
Wearable cuff-less blood pressure (BP) devices may overcome cuff limitations and offer continuous non-invasive BP monitoring. However, their accuracy in different clinical settings is not yet clarified. This study aimed to evaluate the accuracy of mean arterial pressure (MAP) measurements from a novel continuous cuff-less chest belt against intra-arterial measurements.

Design and method:
Patients in an intensive care unit with an indication of intra-arterial BP monitoring were included. Reference BP was measured with a radial artery catheter connected to a pressure transducer. Cuff-less measurements were obtained continuously with a chest belt, of which a model for BP estimation was trained on a non-intensive care unit population and consisted of a one-channel electrocardiogram, a photoplethysmography sensor and a tri-axis accelerometer. The data collection was monitored by an investigator to reliably exclude periods where the transducer was not properly levelled. Estimated MAP from the chest-belt was calibrated initially with intra-arterial MAP. In cases where the pressure transducer had to be repositioned, re-calibration was performed due to variability of the repositioned transducer levels. Pairwise comparisons of reference and cuff-less MAP were performed in 15-second epochs.

Results:
Preliminary data from 9 subjects were analysed. The subjects had a median (interquartile range) age of 64 (58–73) years, median BMI was 28.6 (25.4–32.7) kg/m2and 77.7% were males. A total of 21.5 h of data were analysed with an average of 2.39 ± 1.05 h per subject. The mean difference of estimated versus reference MAP was 3.9 ± 4.2 mmHg. The Bland-Altman bias was 2.06 mmHg with limits of agreement from -9.7 mmHg to 14 mmHg. The Figure displays typical data for one subject (A) and the Bland Altman plot for all subjects (B).

Conclusions:
After initial calibration with a reference measurement, the cuff-less chest belt estimated changes in mean arterial pressure in close agreement with reference intra-arterial measurements. This study illustrates the potential of a wearable cuff-less device for estimating mean arterial pressure continuously and non-invasively in ospitalised patients.
METHODS AND NUMBER OF BLOOD PRESSURE ASSESSMENTS USED TO ASSESS BLOOD PRESSURE VARIABILITY IN INDIVIDUALS WITH DIABETES
Authors: Silva Antonia Fabiana , Cruz Rebeca Chaves , Albuquerque Nila Larisse Sil , Silva Viviane Martins , De Aráujo Thelma Leite 
Published: June 2022

Objective:
To map the methods and number of blood pressure (BP) assessments used to assess the very short, short, medium, and long term variability of blood pressure (VBP) in adults and elderly patients with type 1 or 2 Diabetes Mellitus (DM)

Design and method:
A cooping review was conducted, following the Jonna Briggs Institute (JBI) methodology, in January and February 2021, in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase electronic databases. Studies carried out in the last 10 years, without language restrictions, that cooping VBP in adults and elderly with type 1 or 2 DM were included. After the extraction process, the articles were imported into Zotero reference manager for duplicate removal, followed by screening by two reviewers. The PRISMA extension for cooping reviews (PRISMA-ScR) guidelines was used to organize and present the process of selection of articles.

Results:
A total of 3,795 articles were identified, of which 25 made up the final sample. Most studies were published in 2016 (60%) and used a cross-sectional (44%) approach. There was a predominance of studies with type 2 DM, and Japan had the highest number of publications (44%). There was a predominance of the oscillometric method of assessing BP (88%), and the predominant type of variability in the studies was long-term VBP (40%). There was variation in the number of measurements depending on the assessment method. In the assessment of short-term VBP, the performance of a measurement every 30 minutes during the day and every 60 minutes at night (16%) stood out; on the other hand, for medium and long-term VBP, three measurements were performed in the morning and at night (20%).

Conclusions:
Evidence points to the growing use of the oscillometric method. Furthermore, long-term VBP, obtained from visit to visit, was highlighted in the studies in the event of diabetes-related complications, and it was observed that there was a variation in the number of measurements adopted, which can be attributed to the lack of consensus on the recommendations for each type of BP assessment method.
VARIATION IN MEAN ARTERIAL PRESSURE AND ITS HEMODYNAMIC COMPONENTS DURING 24-HOUR AMBULATORY PULSE WAVE ANALYSIS: IMPACT OF AGE, RACE, AND GENDER
Authors: Izzo Joseph , Nagpal Sagar , Mukhopadhyay Debduti , Osmond Peter , Schwartz Joseph 
Published: June 2022

Objective:
Blood pressure (BP) is highly variable but the concomitant variations of the underlying hemodynamic components [heart rate (HR), stroke volume (SV), and total vascular resistance (TVR)] are not known. We postulated that covariance (cov) analysis of 24-hour ambulatory pulse wave analysis (PWA) could reveal relevant trends in hemodynamic variability (var) within and between-individuals.

Design and method:
Ambulatory BP with PWA (Mobil-O-Graph, IEM, Stolzberg, DE) was performed every 20 minutes for 24 hours. Mean arterial pressure (MAP) components were indexed to body surface area: MAP = HR*[SV index (SVI)]*[TVR index (TVRI)] and ln(MAP) = ln(HR) + ln(SVI) + ln(TVRI). For cov analysis, var[ln(MAP)] = cov[ln(HR), ln(MAP)] + cov[ln(SVI), ln(MAP)] + cov[ln(TVRI), ln(MAP)]. Contributions of hemodynamic components to var[ln(MAP)] were expressed as %; other associations were nalysed by correlation and t-test.

Results:
We studied a convenience sample of 152 people (49% women, 23% black). Data are mean(SD): # readings 57(11), age 59(16) years, BMI 29.9(6.5) kg/m2, systolic BP 135(18) and MAP 106(14) mmHg. Mean 24-hr values were: ln(MAP) 4.64 (0.13), ln(HR) 4.20 (0.15), ln(SVI) -3.32 (0.15), and ln(TVRI) 3.75 (0.18). Relative contributions to 24-hour varMAP were: varTVRI 54(36)%, varHR 33(38)%, and varSVI 13(40)%. The large SDs in these component contributions prompted further analysis: varTVRI correlated with 24-hr mean MAP (r = 0.24, p = 0.003) and was higher (>54%) in males (p = 0.03) and blacks (p = 0.04); varHR was inversely related to MAP (r = -0.26, p = 0.001), age (r = -0.29, p = 0.0003) and BMI (r = -0.17 p = 0.05) and was lower (<33%) in blacks (p = 0.008); varSVI correlated with age (r = 0.31, p < 0.0001) and BMI (r = 0.23, p = 0.005) and was higher (>13%) in women (p = 0.03).

Conclusions:
Covariance analysis can be used with 24-hr ambulatory PWA to analyze BP and hemodynamic variability in everyday life. Within-individual total varMAP is related to varTVR > varHR > varSV but between-individual factors also affect these trends, including greater influence of varTVR in males and blacks, varHR in younger people, and varSV in younger people and women. HR varies inversely with SV and SVR suggesting counter-regulation. Diagnostic subclassifications or treatment modifications for variation extremes [e.g. vasodilators (TVR), beta-blockers (HR), or diuretics (SV)] may be possible.
NOCTURNAL DIPPING PATTERN IN 24-HOUR AMBULATORY BLOOD PRESSURE RECORDINGS OF HYPERTENSIVE INDIVIDUALS IN THE BAY OF PLENTY (BOP)
Authors: Kerridge Tahlia , Gupta Ankur 
Published: June 2022

Objective:
24-Hour Ambulatory blood pressure monitoring (ABPM) is gold standard for diagnosis/management of hypertension (HT). Untreated and poorly controlled HT leads to increased rates of cerebrovascular, cardiovascular, and renal disease. Data is lacking on dipping patterns in different ethnicities of New Zealand (NZ). The primary aim was to compare nocturnal dipping pattern between Maori and Non-Maori ethnicities. Secondary aims included comparison of nocturnal HT, morning surge index (MSI) and ambulatory arterial stiffness index (AASI) amongst them and comparison as per socio-economic deprivation index (NZDep 2018).

Design and method:
ABPM data of hypertensive adults > 18 years of age (on antihypertensives) in EBOP was collected retrospectively from Midland Clinical Portal from 1st December 2018 to 31st July 2021. Duplicates or unsuccessful ABPM results were excluded from the analysis. Normal dipping was defined as 10–20%, non-dipping being 0- < 10%, reverse dipping < 0% and extreme dipping > 20%. Statistics were processed using Excel.

Results:
Of 213 ABPMs nalysed, 20% were of Maori individuals. 39.5% of Maori were non-dippers and 9.3% were reverse dippers. Amongst Non-Maori, 34.1% were non-dippers and 13.5% were reverse dippers (p = 0.840). Uncontrolled nocturnal HT was more likely in Maori (60.5%) as compared to Non-Maori (54.1%), though not significant (p = 0.454). AASI was significantly higher (p = 0.001) in Non-Maoris, though MSI was not different (p = 0.865). Lower socio-economic demographic individuals or Maori are less likely to receive ABPM.

Conclusions:
There was no statistical difference between dipping status of Maori and Non-Maori. However, it is evident up to 55% of patients in this data set have uncontrolled nocturnal HT suggesting that EBOP is receiving subtherapeutic management of their HT. Therefore, all hypertensives should have ABPM in NZ to manage HT. As HT is more prevalent in Maori, researchers recommend a commitment from Bay of Plenty District Health Board to address this inequity to improve cardiac, cerebrovascular and renal health.
ASSOCIATION BETWEEN VARIABILITY IN SYSTOLIC BLOOD PRESSURE AND CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS: 60 MONTHS FOLLOW UP
Authors: Ilic Marina Deljanin , Stojanovic Sanja , Krstic Ivana , Stojanovic Milovan , Ilic Stevan 
Published: June 2022

Objective:
To investigate the association between variability in systolic blood pressure (SBPV) and development of cardiovascular events (CVE): angina pectoris (AP), myocardial infarction (MI), cerebrovascular accident (CVA) and cardiovascular death (CVD) in hypertensive patients (pts), and to estimate whether SBPV could be a predictor of CVE and CVD.

Design and method:
300 hypertensive pts (148 men and 152 women, mean age 67.7 ± 9.8y) were studied. The study comprised 3 visits (at the beginning, after 30 and 60 months) during a follow-up period of 60 months. Blood pressure values were defined by the arithmetic mean of three measurements at each visit. SBPV for each patient was defined using the standard deviation from 3 values of systolic BP (SBP-SD). In order to estimate distribution SBPV, quartiles of SBP-SD were introduced. High SBPV were defined as SBP-SD above the 4th and 3th quartile.

Results:
During follow up period, in 86 pts (28.7%) CVE were occurred: AP 18.7%, MI 7.7%, CVA 2.3%, CVD 4%. The first quartile included SBPV values < 5.81 mmHg, the second quartile 5.82–10.61 mmHg, the third quartile 10.62–17.08 mmHg, and the fourth quartile > 17.08 mmHg. Univariate analysis showed that there was a significant relationship between SBPV and CVE (OR = 1.305; 95% CI 1.223–1.393, p < 0.001). During 60 months follow up, the highest SBPV was recorded in the 3rd and 4th quartile in patients who had CVA (17.08 and 42.07, p < 0.01), in the 4th quartile in patients who had MI (25.18), and the lowest in patients with AP (4th: 29.16, 3th: 16.64, p < 0,01). A cut-off value of SBPV = 14.08 mmHg predicted the CVE with a sensitivity of 84.2% and specificity of 83.3%. A cut-off value of SBPV = 16.13 mmHg predicted the CVD with a sensitivity of 80.7% and specificity of 75.5%.

Conclusions:
Our results showed an association between increased SBPV and the development of CVE in hypertensive pts. Value of SBPV> 14.08 mmHg may be a useful marker for predicting future cardiovascular events, and value of SBPV> 16.13 mmHg may be a useful marker for predicting cardiovascular death.
DIURETIC ASSOCIATED WITH CONCURRENT EXERCISE PROMOTES ADDITIONAL PHYSICAL, AUTONOMIC AND INFLAMMATORY ADAPTATIONS IN HYPERTENSIVE RATS SUBMITTED TO OVARIAN HORMONE PRIVATION
Authors: Ferreira Maycon Junior , Silva Gabriel Do Carmo , Bernardes Nathalia , De Araujo Amanda Aparecida , Da Silva Dias Danielle , Irigoyen Maria Cláudia , De Angelis Kátia 
Published: June 2022

Objective:
To evaluate the effects of hydrochlorothiazide (HCTZ) combined or not with concurrent exercise training on physical capacity and neurohumoral mechanism of blood pressure (BP) control in a model of hypertension and menopause.

Design and method:
Female spontaneously hypertensive rats were allocated into sedentary (S) and ovariectomized groups: sedentary (OS), sedentary treated with HCTZ (OSH) and trained treated with HCTZ (OTH). Ovariectomy procedure was performed at initial of protocol. HCTZ (30 mg/kg) was administrated orally in drinking water. Aerobic and resistance exercises (40–60% maximal capacity) were conducted 3 days/wk for 8 weeks. BP, heart rate and its variabilities were nalysed using signals of direct recording of BP. Vasopressin receptor antagonist, losartan and hexamethonium were sequentially injected to evaluate vasopressor system. Inflammatory profile was evaluated.

Results:
Systolic and mean BP (mmHg) were lower in OTH (178 ± 17 and 153 ± 17, respectively) compared with OS group (205 ± 15 and 176 ± 16, respectively). Treadmill (OTH vs. OSH) and ladder physical test performance (OTH vs. OS, OS and OSH) were higher in OTH group. Baroreflex sensitivity (bpm/mmHg) was lower in OS group (vs. S) and both bradycardic (OTH:- 1.6 ± 0.3 vs. OS:-0.6 ± 0.3) and tachycardic response (OSH:-2.2 ± 0.7 and OTH:-2.4 ± 0.8 vs. OS:- 1.3 ± 0.4) were improved after HCTZ treatment. OTH showed higher (high-frequency band: OTH:77.8 ± 4.9 vs. OS:69.8 ± 4.0nu) and lower cardiac sympathetic modulation (low-frequency band: OTH:22.2 ± 4.9 vs. OS:30.2 ± 4.0nu) and LF/HF ratio (OTH:0.30 ± 0.08 vs. OS:0.45 ± 0.09). In addition, reduced variance (OTH:30.3 ± 10.5 vs. OS:60.1 ± 13.1) and low-frequency band of systolic BP (mmHg2) (OTH:6.2 ± 5.2 vs. S:16.3 ± 6.7, OS:18.8 ± 6.1 and OSH:15.8 ± 5.5) was observed in trained group. Drop in BP (mmHg) after hexamethonium was higher in OS group (- 75.7 ± 19.2 vs. S:-53.2 ± 12.6, OSH:-54.9 ± 9.0 and OTH:-49.8 ± 12.4). IL-10 (OTH:78.1 ± 17.3 vs. OS:52.8 ± 23.2 and OSH:45.1 ± 10.6) and IL-10/TNF-a ratio (OTH:1.99 ± 0.07 vs. S:1.32 ± 0.21, OS: 1.18 ± 0.12 and OSH:1.18 ± 0.27) was higher in trained group.

Conclusions:
We concluded that HCTZ combined with exercise training is more efficient than HCTZ alone to improve BP control, probably due to a better adjustment on autonomic modulation and inflammation profile, in addition to induce cardiofunctional benefits. This data reinforces the key role of exercise in the attenuation of hypertension-induced damage in menopaused rats. Grants: FAPESP (2019/06277–0).
RHO KINASE BLOCKADE ALLEVIATE BLOOD PRESSURE ELEVATION AND INHIBIT VASCULAR REMODELING IN APATINIB-INDUCED HYPERTENSION–TO BE CONFERMED
Authors: Li Caie , Wang Qiongying , Ma Liping , Wang Wenjuan , Yu Jing 
Published: June 2022

Objective:
Hypertension and kidney injury are two of the major adverse effects of the targeted anti-tumor drug apatinib, it was suspected that hypertension may be the result of renal dysfunction in some of the previous studies. The present study was designed to explore the different responses of blood pressure and kidney in the apatinib-induced hypertensive rat model.

Design and method:
30 Wistar-Kyoto rat were randomly divided into 3 groups, each group was administered with 2 mL 0.9% saline, 30 mg/d of apatinib or 15 mg/d of apatinib by oral gavage for 2 weeks. Blood pressure was monitored at the baseline and during the treatment. Level of creatinine, urea nitrogen, sodium, albumin and protein in blood and urine were tested both at baseline and at the end of the treatment. Urinary sodium excretion and glomerular filtration rate was calculated. Specific mRNA and proteins were detected at the end of the treatment.

Results:
Average mean blood pressure (MBP) in the high dose apatinib group was 105 mmHg at the 9th day and 113 mmHg at the 15th day, average MBP in the low dose apatinib was 98 mmHg at the 9th day and 108 mmHg at the 15th day. MBP were significantly high in apatinib group, no matter in the high dose or low dose (p < 0.01). Compared with the control group, the level of endothelin 1(ET-1) and college-1 were significantly high in both apatinib group (p < 0.01). There was no significant differences of urinary sodium excretion, glomerular filtration rate and microalbuminuria between the control group and the low dose apatinib group, while that in the high dose apatinib group were significantly high (p < 0.01).

Conclusions:
There are differences in the response to different doses of apatinib between blood pressure and kidney, blood pressure was elevated even at a relevantly lower dose of apatinib, which was accompanied with the elevation of ET-1 level and vascular emodelling, while the kidney injury occurred only at higher dose of apatinib. The hypertension induced by apatinib was independent with kidney injury caused by the drug, not the consequence of it.
CARDIOVASCULAR RISK AND SUBCLINICAL VASCULAR ORGAN DAMAGE IN PATIENTS WITH AND WITHOUT HYPERTENSION
Authors: Woznicka-Leskiewicz Lucyna , Posadzy-Malaczynska Anna 
Published: June 2022

Objective:
Assessment of subclinical organ damage and sex differences in cardiovascular risk stratification in patients with or without hypertension.

Design and method:
We divided 100 patients in two groups: HT+: patients with arterial hypertension (25 women and 25 men); HT-: patients without arterial hypertension (25 women and 25 men). The average age of them [yrs]: 56 and 53 (*p < 0,05).
Ankle-brachial index (ABI), pulse wave velocity (PWV) and carotid intima-media thickness (IMT) were evaluated. We assessed cardiovascular risk according to: SCORE and Framingham scales.
Statistical calculations were performed in PQStat 1.6. For comparison of variables we used the t-test for unrelated samples. To perform the correlation we used Spearman’s rank correlation RS.

Results:
We revealed following results in both groups: HT+ and HT- respectively [*for p< = 0,05; **for p < 0,001; NS- negligible statistically].
In the group with hypertension women were characterized by a lower IMT and PWV than men. The cardiovascular risk according to risk SCORE and Framingham scales in men was significantly higher than in women in both groups.
In female with hypertension, there was a significant negative correlation between ABI and IMT. In male without hypertension, there was a significant negative correlation between ABI and IMT.

Conclusions:
1. There was no difference in values of: ABI, PWV and IMT between the sexes in normotensive patients.
2. Women with hypertension were characterized by a lower IMT and PWV.
3. There were significant negative correlation between ABI and IMT in female and male groups.
THE ASSOCIATION OF URINARY MATRIX GLA PROTEIN WITH CIRCULATING INACTIVE MATRIX GLA PROTEIN, RENAL FUNCTION AND MORTALITY RISK: A POPULATION STUDY
Authors: Wei Dongmei , Melgarejo Jesus , Vanassche Thomas , Van Aelst Lucas , Janssens Stefan , Verhamme Peter , Zhang Zhen-Yu 
Published: June 2022

Objective:
Matrix Gla protein (MGP) is a small protein for the protection of vascular calcification. High circulating desphospho-uncarboxylated MGP (dp-ucMGP), indicative of poor vitamin K status, has been associated with renal dysfunction and mortality. However, whether the impaired renal clearance would contribute to high dp-ucMGP and confound these associations remains unclear.

Design and method:
We measured urinary MGP using capillary electrophoresis coupled with mass spectrometry in 776 Flemish (mean age: 51.2 years; 50.9% women), of whom 646 were assayed for plasma dp-ucMGP. The endpoint was defined as mortality or fatal and nonfatal cardiovascular events. Statistical analyses included Spearman correlation, linear regression, and Cox proportional hazard models.

Results:
Urinary MGP was neither correlated with serum creatinine (P = 0.15) nor associated with estimated glomerular filtration rate (eGFR) after adjustment (P = 0.057). Circulating dp-ucMGP was correlated with urinary MGP and eGFR (r = 0.40 and -0.40, P < 0.0001) and their association remained significant after adjustment (P < 0.0001). Over 9.2 (median) years, 47 individuals died, including 15 cardiovascular deaths. For a doubling of urinary MGP, the hazard ratios (HRs) were 1.45 (95% confidence interval [CI]: 1.11–1.90, P = 0.007) for all-cause mortality, 2.31 (1.21–4.43, P = 0.011) for cardiovascular mortality after adjustment for eGFR and other clinical risk factors. For dp-ucMGP, the corresponding adjusted HRs were 2.13 (1.31–3.48, P = 0.003) and 1.52 (0.66–3.53, P = 0.33). Neither urinary MGP nor dp-ucMGP was significantly associated with cardiovascular events after adjustment (P> = 0.88). Urinary MGP further improved the prognostic accuracy for all-cause mortality, as suggested by the increased net reclassification improvement (64.1% [32.8–94.6], P < 0.0001) and integrated discrimination improvement (4.6% [0.9–9.0], P = 0.012).

Conclusions:
The association of high circulating dp-ucMGP with decreased renal function might be driven by vitamin K deficiency and vascular calcification, instead of by impaired renal clearance. Urinary MGP might serve as a novel marker for vitamin K status and mortality.