bluuebunny/crossref_metadata_2025_split huggingface dataset:
FACTORS THAT INFLUENCE THE SURVIVAL RATE IN PATIENTS WITH COVID-19 WITH A PREVIOUS DIAGNOSIS OF HYPERTENSION AND/OR DIABETES: A SYSTEMATIC REVIEW
Authors: Montealegre Leslie , Amador Eulalia , Pulido Tammy , Rebolledo Roberto , Olvera Lisbeth , Pacheco Brenda 
Published: June 2022

Objective:
To determine through the systematic review the survival rate of patients infected by SARS-CoV-2 and previously diagnosed with arterial hypertension and/or diabetes

Design and method:
A systematic review of the literature, in eight electronic and bibliographic databases, was conducted from July 8 to 21, 2020. Different combinations of the terms DECS and MESH were used as: (‘SARS-CoV-2’ OR ‘COVID-19’) AND (‘diabetes’ OR ‘arterial hypertension’) AND (‘Survival rate’ OR ‘Prevalence rates’). The selected articles are retrospective, single-center or multi-center, observational cohort studies of patients with COVID-19 disease who had diabetes and/or arterial hypertension. These were subjected to risk of bias assessment, with the help of critical and methodological guidelines (STROBE) and level of evidence (CEBM).

Results:
326 articles were analyzed by title and type of study, of which 20 were considered relevant. Finally, five retrospective cohort studies that met the inclusion criteria, made in Wuhan, China, were included in this review. All the selected studies affirm that diabetes and hypertension are related to a decrease in the survival rate in patients with COVID-19. Three studies with evidence level 2b and grade of recommendation B, mention factors related to an increase in the survival rate, these are: well-controlled blood glucose, which maintains glycemic variability within 70.26 to 180.16 mg/dL (3.9 to 10.0 mmol/L), patients on pre-admission antihypertensive therapy for SARS-CoV-2 and diabetic patients who do not require insulin may have a lower risk of disease progression and a better prognosis. Additionally, two articles with evidence level 2b and grade of recommendation B, mention the survival rates of 10.6 and 13.9% for diabetics, while 18.8 and 23.4% for hypertensive patients.

Conclusions:
Based on the evidence included in this review, until now, having comorbidities predisposes patients with COVID-19 to a lower probability of survival. It is recommended to consider that adequate glycemic control and blood pressure are guidelines that benefit the recovery of these patients. However, more studies are needed to identify possible preventive and therapeutic strategies for a more comprehensive management of these patients.
SELF-ASSESSMENT OF VITAL SIGNS AND SYMPTOMS OF COVID-19: BLOOD PRESSURE MEASUREMENTS RESULTS FROM THE HYTECC STUDY
Authors: Michaud André , Cloutier Lyne , Vadeboncoeur Alain , Goupil Rémi 
Published: June 2022

Objective:
Little is known about the impact of a positive SARS-CoV-2 PCR test and self-isolation at home on blood pressure (BP) values. Moreover, the association between BP values and COVID-19 symptoms is poorly described. The objective of this study was to assess the feasibility of a remote initiation of home health surveillance, including home blood pressure monitoring (HBPM), carried out by confined hypertensive adults diagnosed with COVID-19.

Design and method:
Individuals included in the study were between 40 and 69 years old with a known diagnosis of hypertension and a recent positive SARS-CoV-2 PCR test. After initial phone contact, each participant received at home the equipment needed for vital signs assessment, including a LifeSourceâ UA-651BLE BP monitoring device and access to a web-based platform. The Sphygmoâ mobile app was used by the participants for the electronic transmission of results. Participants had to assess their symptoms and complete vital signs including two BP measurements, twice a day, for 14 consecutive days. Abnormally low BP was defined as a systolic BP < 100 mm Hg. Written guidance was provided to participants on the correct method to perform the various vital signs measurements and data collection. Correlation test was calculated between the proportions of abnormal values of vital signs and severe symptoms.

Results:
A total of 46 participants completed the study. The mean age was 54.1 ± 6.9 years and 54% of participants were men. On average, participants performed 54 BP measurements, 12.3 days of measurements, and 4.4 BP measurements per day. 30.4% (n = 14) of participants had at least 1 systolic BP measurement that was abnormally low (mean of 2.5 abnormally low systolic BP, range 1 to 6). Abnormally low systolic BP was not significantly correlated with the severity of COVID-19 symptoms.

Conclusions:
In a pandemic context, among hypertensive participants with a positive SARS-CoV-2 PCR test, the remote initiation of HBPM with electronic transmission of results is feasible. Moreover, participants were able to perform nearly fourteen days of BP measurements including self-assessment of symptoms, twice a day, and transmit their data using a mobile app and a web-based platform.
THE PROGNOSTIC VALUE OF THE BIOLOGICAL PROFILE OF INFLAMMATION AND COAGULATION AT HYPERTENSIVE PATIENTS AFTER COVID-19
Authors: Gavrila Adrian 
Published: June 2022

Objective:
The objective of the study was to estimate how the proinflammatory and prothrombotic imbalances correlates with cardiovascular and renal events at hypertensive patients (pts) after Covid-19.

Design and method:
40 hypertensive pts, (mean age 58.5 ± 9.6 years, 52.5% males)=group 1 and 40 hypertensive pts recovered after Covid-19, matched for age and sex (mean age 60.4 ± 10.8 years, 55% males)=group 2. Inflammation profile was estimated by serum measurement of C reactive protein (CRP), ferritin (F), interleukin 6 (IL6) and fibrinogen (Fb). Prothrombotic profile was determined by serum measurement of D-Dimer (DD). All pts were evaluated during one year, in order to detect the following complications: unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), ischemic stroke (IS), renal dysfunction (RD): microalbuminuria, proteinuria, chronic kidney disease.

Results:
In group 1, UA was significantly associated with higher level of CRP (2.25 ± 0.65 mg/L vs 7.32 ± 1.18 mg/L, p = 0.04). In the same group, RD was found in a higher proportion at pts with increased CRP (2.10 ± 0.56 mg/L vs 8.11 ± 1.21 mg/L, p = 0.02).
In group 2, UA was also significantly associated with higher level of CRP (3.44 ± 0.62 mg/L vs 9.68 ± 1.15 mg/L, p = 0.03) and with greater proportion of DD (0.35 ± 0.08 mcg/ml vs 1.53 ± 0.12 mcg/ml, p = 0.01). NSTEMI was found in a higher proportion at pts with increased DD (0.42 ± 0.07 mcg/ml vs 1.87 ± 0.15 mcg/ml, p = 0.01). In the same group, RD was significantly more frequent at pts with higher level of IL6 (4.55 ± 0.92 pg/ml vs 8.32 ± 0.85 pg/ml, p = 0.04) and with greater level of F (76 ± 15 ng/ml vs 635 ± 26 ng/ml, p = 0.01).

Conclusions:
Proinflammatory status seems to predict a worse midterm outcome (one year) concerning cardiovascular and renal events at hypertensive pts, especially after Covid-19.
Moreover, proinflammatory and prothrombotic imbalances appears to have more powerful midterm prognostic value for incidence of acute coronary syndromes without ST-segment elevation and for incidence of RD at hypertensive pts recovered after Covid-19.
SURGICAL MASKS AND UNATTENDED BLOOD PRESSURE CHANGES IN TREATED HYPERTENSIVE PATIENTS
Authors: Polyzos Dimitris , Konstantinidis Dimitris , Drogkaris Sotiris , Tatakis Fotis , Manta Eleni , Kariori Maria , Siafi Eirini , Filippou Christina , Chalmoukou Konstantina , Thomopoulos Costas , Tsioufis Konstantinos 
Published: June 2022

Objective:
Although the effect of face masks on preventing airborne transmission of SARS-CoV-2 is well studied, few data are available on their effects on physiological measures and no study has evaluated their effect on blood pressure (BP). The purpose of our study was to investigate the effect of surgical masks on BP in drug-treated hypertensive patients who had a routine follow-up visit to a university hospital outpatient hypertension clinic.

Design and method:
The study included already treated hypertensive patients aged > 18 years, while the exclusion criteria were atrial fibrillation or any other arrhythmia affecting the BP measurement, an arm circumference > 42 cm, mental disorders, Parkinson’s disease, pregnancy, intolerance to the BP measurement method, or unwillingness to participate. Following the routine mask-on office BP measurement, patients were left alone and randomized to automated office BP measurement, with measurements taken after first wearing a mask for 10 min, then without wearing the mask for 10 min, and vice versa.

Results:
A total number of 265 patients were included in the study. Among the participants, 115 were women (43.4%), the mean age was 62 ± 12 years, and the mean office BP was 134 ± 15/81 ± 12 mmHg. There was no significant difference between mask-on unattended systolic BP (133 ± 15 mmHg) and mask-off unattended systolic BP (132 ± 15 mmHg) (P = 0.13) or between mask-on unattended diastolic BP (77 ± 13 mmHg) and mask-off unattended diastolic BP (76 ± 13 mmHg) (P = 0.32). Moreover, there was no difference in the heart rate (mask-on, 69 ± 11 bpm; mask-off, 69 ± 11 bpm, P = 0.7).

Conclusions:
The results of our study indicate that common surgical masks do not affect systolic/diastolic BP levels during unattended BP measurements.
EFFECT OF HYPERTENSION AND RAS INHIBITORS TO ADULT PATIENTS (OVER 18 YEARS OLD) WITH SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV2) INFECTION WHO WERE ADMITTED TO HOSPital
Authors: Fejes Imola , Róka Richárd , Ábrahám György , Várkonyi Tamás , Lengyel Csaba , Légrády Péter 
Published: June 2022

Objective:
A meta-analysis published in March 2021 concluded that neither the ACE inhibitor nor ARB treatment came together with a higher COVID-19 mortality rate. Our aim was to assess the prevalence of treated HT, the number of antihypertensives and ACE-inhibitors or ARBs of them among Covid-positive patients older than 18 years admitted to the Center for Disease Control 1 of Department of Medicine of the University of Szeged.

Design and method:
Data of 165 randomly selected patients (mean age 59.9 ± 12.9 yrs., mean BMI 30.7 + 6.6 kg/m2.) were analysed retrospectively. They were admitted between middle of February and end of April 2021.

Results:
At the time of admission there were 103 (62.4% of all) HT patients (56 men, 47 women). The mean duration of HT was 12.9 ± 6.1 years. The mean number of antihypertensive drugs were 1.6 ± 1.6 pieces (max. 6) at the time of admission. At home 23 patients took more than 3 antihypertensives and 25 patients took exactly 3 drugs. At home 20 patients had monotherapy. The antihypertensive therapy did not change in 74 cases, decreased in 6 cases and increased in 31 cases. In one case we could reduce therapy with 100%, monotherapy was finished, in the other 5 cases it was reduced by 50%.
HT patients spent more days in hospital than non-HT patients (10.9 ± 6.8 vs. 9.2 ± 6.3). Spontaneous oxygen saturation (SatO2) was lower in HT patients compared to non-HTs at admission (89.6 ± 9.7% vs. 92.6 ± 4.8) and patients who were on ARBs had the lowest SatO2 (87.5 ± 8.5%, p = 0.01 vs. non-HT). The total mortality rate was 8.7 % in HT patients and it was just 1.6% in non-HT patients. 16.3% of HT patients with RAS-inhibitors and 13.0% without it required admission to the intensive care unit. The mortality rate was 10 % of patients with RAS-inhibitors and 4.3 % of them without it. The mortality rate was 10% of patients with RAS-inhibitors and 4.3% without it. This rate was 13% in patients with ARB and 8.8% with ACE-inhibitor.

Conclusions:
According to our results, HT may have higher risk for Covid outcomes, including RAS-inhibitors also have a higher risk.
EFFECTS OF SGLT-2 INHIBITORS ON 24H AMBULATORY BLOOD PRESSURE IN PATIENTS WITH TYPE 2 DIABETIC AND HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Wang Qiongying , Tian Li , Sun Runmin , Qi Miaomiao , Yu Jing , Bai Feng 
Published: June 2022

Objective:
To analyze the effects of different types of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on 24-hour ambulatory blood pressure in patients with type 2 diabetes mellitus and hypertension.

Design and method:
In the meta-analysis, The PubMed, Web of science, and Cochrane Library were searched for relevant literature, and the references obtained from these sources were retrieved from inception till December 2020. The inclusion and exclusion criteria were formulated in accordance with the requirements of Cochrane systematic review. A total of 1354 articles were retrieved, 592 duplicate articles were excluded, 372 articles were excluded after reading the title and abstract, 87 articles were excluded from non-randomized control and irrelevant outcome indicators, and 7 studies with 2343 patients were finally included. Use RevMan5.3 software to compare the changes in 24-hour ambulatory blood pressure, day and night blood pressure of patients with type 2 diabetes and hypertension before and after treatment with different types and doses of SGLT2i.

Results:
A total of four types of SGLT-2i were evaluated in the application of patients with type 2 diabetes and hypertension. The result showed that compared with placebo,SGLT2i could reduce the 24-hour systolic blood pressure of patients with type 2 diabetes and hypertension by 4.36mmHg (95%CI -5.92--2.79,p < 0.001),among which the antihypertensive effects of empagliflozin, canagliflozin, dapagliflozin and ertugliflozin were -4.59mmHg, -3.74mmHg, -5.06mmHg, -3.64mmHg, respectively; similarly, the 24-hour dynamic diastolic blood pressure decreased by 2.20mmHg (95%CI -2.74, -1.65,p < 0.001), among which the antihypertensive effects of empagliflozin, canagliflozin, dapagliflozin and ertugliflozin were -2.38mmHg, -1.22mmHg, -2.00mmHg,- 2.69mmHg, respectively. At the same time, the systolic and diastolic blood pressure during the day and night decreased significantly.

Conclusions:
his meta-analysis shows that SGLT2i can have beneficial effects on the cardiovascular system by reducing 24-hour ambulatory blood pressure in patients with type 2 diabetes and hypertension, other than reducing blood sugar. Therefore, for patients with type 2 diabetes and hypertension, SGLT2i may be the best hypoglycemic choice.
NIGHT-TIME BLOOD PRESSURE IN DIABETES TYPE-1 ASSESSED BY HOME VS. AMBULATORY MONITORING: A PILOT STUDY
Authors: Menti Ariadni , Kollias Anastasios , Bountzona Ioanna , Konstantakopoulos Sotiris , Servos George , Vazeou Andriani , Stergiou George S. 
Published: June 2022

Objective:
To compare night-time (asleep) blood pressure (BP) evaluated by home monitoring (HBPM) vs. ambulatory monitoring (ABPM) in adolescents and young adults with diabetes type-1 (DM1) and examine their association with indices of preclinical target organ damage (TOD).

Design and method:
Individuals aged 12–30 years with DM1 were subjected to 24-hour ABPM (every 20 min, Microlife WatchBP O3) and 7-day HBPM (daytime: duplicate morning and evening measurements; night-time: 3 measurements per night for 3 nights; Microlife WatchBP Home-N), as well as TOD assessment (left ventricular mass index, carotid intima media thickness, urine albumin excretion).

Results:
Data from 24 individuals were analysed (mean age 19.8 ± 5.3 [SD] years, men 62.5%, BMI 25.6 ± 4.1 kg/m2, 13% with elevated 24-hour ABPM]. The number of valid ABPM readings was 45.7 ± 1.4/22.4 ± 4.8 (awake/asleep, mean ± SD) and HBPM 26.3 ± 2.1/8.3 ± 2.0 respectively (p < 0.001/ < 0.001). Daytime HBPM was lower than ABPM (by 2.7 ± 0.1/1.9 ± 0.7 mmHg, systolic/diastolic, p < 0.05/ < 0.05), but night-time was higher (difference 5.0 ± 0.6/3.2 ± 0 mmHg, p < 0.01/ < 0.05). There was a strong association between HBPM and ABPM (daytime r = 0.85/0.88, night-time r = 0.68/0.49, systolic/diastolic). There was fair agreement (88%; kappa = 0.33) between ABPM and HBPM in diagnosing nocturnal hypertension (age > = 16 years > = 120/70 mmHg; < 16 years > = 95th centile;) and poor agreement in detecting non-dippers (38%, kappa = 0.032). No significant association of night-time ABPM or HBPM and indices of TOD was found, probably due to small sample size and low prevalence of TOD.

Conclusions:
These preliminary data in young individuals with DM1 show that nocturnal HBPM is feasible and provides values similar to ABPM. Further research is needed to extend these finding and investigate their clinical relevance in DM1.
REAL WORLD IMPACT OF BLOOD PRESSURE CHANGES ON MORBIDITY AND MORTALITY IN TYPE 2 DIABETES
Authors: Martinez Fernando , Calderon Jose Miguel , Sauri Inmaculada , Fernandez Antonio , Diaz Javier , Bea Carlos , Redon Josep 
Published: June 2022

Objective:
To assess the impact of BP changes on the risk of cardiovascular events and mortality in type 2 diabetes.

Design and method:
The sample was selected using the HER of the Valencian Community. Type 2 diabetics were selected through ICD codes and retrospectively evaluated from January 2012 to December 2016. To evaluate BP changes, the follow-up time was divided in six-month blocks and the average of BP for each interval was considered. SBP was categorized: < 120 mmHg; 120–129 mmHg (reference); 130–139 mmHg; 140–149 mmHg; > 150 mmHg. To evaluate the influence of DBP, the population was stratified according to categories of average DBP: < 60 mmHg; 60–69 mmHg; 70–79 mmHg; > 80 mmHg. Information about cardiovascular events, including Stroke and Acute Coronary Syndrome (ACS) was extracted from the ICD codes. Total mortality was determined by matching records and death certificates. Time-varying Cox regression for SBP stratified by DBP categories was used to assess the risk associated with changes of SBP. The models were adjusted by age, sex, HBA1c, KDIGO, previous cardiovascular events and use of cardiovascular drugs.

Results:
156 363 type 2 diabetics patients were included (mean age 69.5(11.5), 48.7% females, mean glycated Hb 7.05 (1.35%) 21% in secondary prevention, 21.4% under insulin treatment). The average number of BP measurements was 14. During an average follow-up of 4.18 y, there were 13399 deaths, 15100 strokes and 6295 ACS. In the fully adjusted time-varying Cox regression, having a SBP< 120 mmHg was a significant risk factor for death across all categories of DBP, whereas SBP> 130 mmHg conferred protection. For the case of ACS and stroke, a J-curve phenomenon was observed with significantly higher risk for those with SBP> 150 mmHg or < 120 mmHg across categories with DBP> 60 mmHg. This J-curve phenomenon was also observed graphically using restricted cubic splines (Figure).

Conclusions:
Although difficult to achieve in clinical practice, lower boundaries for BP goals in diabetics have to be taking into account.
META-ANALYSIS ASSESSING THE IMPACT OF PRIOR HEART FAILURE AND CHRONIC KIDNEY DISEASE ON THE CARDIOVASCULAR EFFICACY OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Zografou Ioanna , Kefas Aristides , Toumpourleka Maria , Boulmpou Aristi , Kassimis George , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Chronic kidney disease (CKD) and heart failure (HF) represent common co-morbidities in patients with type 2 diabetes mellitus (T2DM), constituting an additional burden that boosts overall morbidity and mortality. Therefore, we sought to determine whether history of HF or CKD affects the cardiovascular efficacy of GLP-1RAs, also utilizing data from the recently published FREEDOM Cardiovascular Outcomes Trial, which evaluated the cardiovascular safety of delivering a continuous subcutaneous infusion of the GLP-1RA exenatide (ITCA 650) in T2DM.

Design and method:
We searched the relevant, hallmark, cardiovascular outcome trials of GLP-1RAs in T2DM. We set as primary efficacy outcome the effect of GLP-1RAs versus placebo on the risk for a major adverse cardiovascular event (MACE) according to the prior history of HF, while we also assessed as a secondary efficacy outcome the effect of GLP-1RAs on the risk for MACE according to a prior diagnosis of CKD.

Results:
We finally pooled data from 4 trials for a total of 26,272 enrolled participants with T2DM. Regarding the primary efficacy outcome, we demonstrated that GLP-1RAs versus placebo resulted in a significant decrease by 14% (RR = 0.86, 95% CI; 0.76 – 0.97, I2 = 50%), regardless of history of HF (p-value for subgroup differences = 0.88). Concerning the secondary efficacy outcome, we showed that GLP-1RA treatment was superior to placebo in reducing the risk for a MACE (RR = 0.87, 95% CI; 0.75 – 1.02, I2 = 70%), while prior status of CKD did not affect the generated results (p-value for subgroup differences = 1.00).

Conclusions:
GLP-1RAs seem to constitute a safe and efficacious treatment option in patients with T2DM and established or at high risk for atherosclerotic cardiovascular disease, while HF or CKD status at baseline do not substantially affect the observed cardio-protective effect against hard cardiovascular endpoints.
META-ANALYSIS ADDRESSING THE EFFECT OF SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITORS ON FLOW-MEDIATED DILATION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Authors: Patoulias Dimitrios , Siskos Fotios , Katsimardou Alexandra , Imprialos Konstantinos , Koutsampasopoulos Konstantinos , Stavropoulos Konstantinos , Zografou Ioanna , Kefas Aristides , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Endothelial dysfunction seems to play a pivotal role in the pathogenesis of cardiovascular disease and related complications among high-risk patients, such as those suffering from type 2 diabetes mellitus (T2DM). Non-invasive peripheral endothelial function assessment with measurement of brachial artery flow-mediated dilation (FMD) has been demonstrated to predict adverse cardiovascular events. Herein, we sought to determine whether SGLT-2 inhibitors provide a significant effect on endothelial function, as assessed through FMD.

Design and method:
We searched PubMed, Cochrane Library and grey literature from inception to 10th October 2021 for parallel group randomized controlled trials (RCTs) enrolling adult subjects with T2DM, assigned to a SGLT-2 inhibitor versus placebo or active comparator and addressing their effect on FMD. We set as primary efficacy outcome the change in FMD with SGLT-2 inhibitor versus control.

Results:
We pooled data from 4 trials in a total of 270 subjects with T2DM. We demonstrated that treatment with SGLT-2 inhibitor versus placebo or active comparator produced a significant increase in FMD by 1.66% (95% CI; 0.56 – 2.76, I2 = 28%, p = 0.003). Notably, all eligible RCTs utilized dapagliflozin. Overall risk of bias was evaluated as low across the selected studies.

Conclusions:
The present meta-analysis demonstrated a clear benefit on endothelial function with SGLT-2 inhibitors compared to placebo or active comparator. Although the sample size is small, it seems that amelioration of endothelial dysfunction with SGLT-2 inhibitors constitutes another significant mechanism that confers to cardio-protection with this drug class. Larger RCTs will shed further light on this important pathophysiologic link.