bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSESSMENT OF THE KNOWLEDGE ABOUT HYPERTENSION IN THE TUNISIAN ELDERLY
Authors: Mzoughi Khadija , Bergaoui Zeineb , Soltani Chayma , Belkahla Noufeil , Bouzidi Hela , Kammoun Sofien , Zairi Ihsen , Labbene Sonia , Mrad Imtinene Ben , Kraiem Sondos 
Published: June 2022

Objective:
Knowledge about hypertension is a key point for treatment observance. The aim of our study was to evaluate the ducation about hypertension in the Tunisian elderly

Design and method:
We conducted a descriptive study including 101 Tunisian hypertensive treated subjects, aged 65 years and over, followed on outpatient basis between November and December 2019. The knowledge about hypertension was assessed by a questionnaire submitted to the patients in the interview time.

Results:
Twelve percent of the patients had information about hypertension and 18% had a good knoldege of their treatment.
The information source was the doctor in 6.9% of cases, followed in 2% by relatives.
Forty-five percent of patients did not know their blood pressure targets and 65% of patients were unable to name at least two dietary measures to put in place as part of blood pressure control.
Eighty-six percent of patients considered antihypertensive therapy to be lifelong therapy.
Eighty-nine percent of patients knew the dosage and schedule for their medication.
About antihypertensive medication, 89% thought it was beneficial, 5.9% thought it was not beneficial, and 5% said they did not know.

Conclusions:
Our study shows a big lack in the knowledge about hypertension in the ducati showing that an ducational strategy has to be put on.
PHYSICAL PERFOMANCE IN HYPERTENSE ELDERLY PEOPLE AND RISK OF FALL
Authors: D’Amico Ferdinando , Grasso Rosetta , D’Amico Rossella 
Published: June 2022

Objective:
This study assessed the physical efficiency and the risk of fall in hypertense elderly people.

Design and method:
25 women (mean age 76 + 5) and 12 men (mean age 75 + 3) with a history of Hypertension and already under specific treatment have been included opposed to a non-hypertense control group (23 women mean age 76 + 2 anni;12 men mean age 78 + 5). The design of the study included: 1) Clinical Measurement of Blood Pressure (MBP); 2) Short Physical Performance Battery (SPPB); 3) Tinetti balance and gait Scale (TS).

Results:
Among hypertense subjects 7 women and 4 men had a mean 24 + 4 Tinetti score showing a low risk of fall; 8 women and 6 men had a mean 14 + 5 score indicating a high risk of fall. 6 women and 5 men in the control group scored 25 + 3 showing a low risk of fall, while 3 women and 3 men scored average 16 + 3 showing a high risk of fall. Those hypertense subjects whose Tinetti score indicated a high risk of fall also showed significant relations between risk of fall and physical efficiency (p < 0.01) while the control group did not show a relevant connection. Hypertense patients who were also diagnosed a reduced efficiency through a mean score 6 at the SPPB in 89% cases scored an average value 12 at the TS, therefore showing a risk of fall. To improve the physical efficiency in the eldest with a high risk of fall we also proposed an occupational therapy home programme.

Conclusions:
This study shows a significant connection among hypertension and reduced physical efficiency. Therefore the evaluation of people affected by hypertension and with a high risk of fall is relevant and we strongly recommend the prevention of this risk at home via an occupational therapy programme.
BLOOD PRESSURE CONTROL AMONG AN ELDERLY NORTHERN-ITALIAN POPULATION, EFFECT OF BETA-ADDUCIN POLYMORPHISMS. A CROSS-SECTIONAL STUDY
Authors: Betti Paolo , Lanzani Chiara , Citterio Lorena , Zagato Laura , Messaggio Elisabetta , Brioni Elena , Magnaghi Cristiano , Simonini Marco , Querini Patrizia Rovere , Manfredi Angelo , Manunta Paolo 
Published: June 2022

Objective:
Evaluate role of nvironmental and genetic factors on Blood Pressure (BP) control among an Italian elderly population.

Design and method:
Cross-sectional study on 1250 elderly subjects of north Italy aged over 65y, recruited in recreative centers. BP was measured with an automated device (Omron) and the average of 2nd and 3rd measure was recorded. According to ESC-ESH-2018 guidelines we defined suboptimal BP control for patients presenting with systolic BP>140 or diastolic BP>80 mmHg. Anthropometric measurements were taken, blood and urines samples for biochemical and targeted genetic analysis were acquired. Genotyping was performed by OpenArray system. All participants signed informed consent. The protocol was approved by the Ethical Committee.

Results:
746 subjects (59.9%) were on antihypertensive therapy. 385 (51.6%) had a systolic BP over 140 mmHg, and 419 (56.2%) had a diastolic BP over 80 mmHg, thus classified as on suboptimal BP control. Among those, 153 (20.4%) presented SBP> 160 or DBP > 100 (stage 2 hypertension) despite treatment. 28.6% were on optimal BP control. Factors associated with poor BP control on univariate analysis showed gender (p = 0.002), higher waist circonference (p = 0.014), high visceral fact index (p < 0.01) and minor number of total medications (p < 0.01). Age, eGFR, and urine albumin/creatinine ratio were non significantly different between the two groups. Inferential tree analysis showed that urine sodium is relevant on BP level in ‘younger’ and untreated subjects (p < 0.001). Among genetic variants, rs4984 T allele in beta-adducin gene (ADD2) was associated with poor BP control (17.3% vs 11.4%; p = 0.016). Similarly, T allele in the overall elderly subjects showed a high frequency compared to general population (EUR - 1000 Genome Project) (16% vs 12.5%; p = 0.023).

Conclusions:
Gender, visceral fat and therapies are associated with poor BP control, suggesting the relevant role of clinical management. Surprisingly, even in this elderly population, a genetic factor already associated with salt-sensitive hypertension and response to anti-hypertensive therapy as ADD2 was found related to poor BP control.
Most of of elderly patients treated for hypertension have suboptimal control of BP. Moreover, genetic factors besides environmental factors, seem to play a role in BP control even in elderly.
THE COURSE OF ATRIAL FIBRILLATION AFTER A PREVIOUS INFECTION WITH COVID-19 DEPENDING ON THE PRESENCE OF ARTERIAL HYPERTENSION
Authors: Sychov Oleg , Stasyshena Oksana , Ilchyshyna Olena , Zinchenko Yu , Getman Taisiya , Romanova Olena , Sribna Olga 
Published: June 2022

Objective:
It is known that arterial hypertension (AH) is the main etiological factor in the development of atrial fibrillation (AF).
The aim of our study was to assess the course of AF after infection with COVID-19 (CI) depending on the presence of hypertension.

Design and method:
We examined 72 patients with AF, aged 64.5 + 1.2 years, who, on average, 6.2 + 0.5 months underwent CI. 59 (81.9%) people had AH (group ‘A’ patients). The remaining 13 (18.1%) patients did not have hypertension (group ‘B’ patients).

Results:
When nalysing the course of AF after CI in these groups, it was found that an increase in the frequency of AF paroxysms was observed in a significantly larger number of patients in group ‘A’ (32 out of 59 people, 54.2%) than in patients in group ‘B’ (in 3 out of 13 people, 23.1%), p < 0.001, the duration of AF paroxysms also increased more significantly in a larger number of patients in group ‘A’ (in 29 out of 59 people, 49.2%), than in patients of group ‘B’ (in 4 of 13 people, 30.8%), p < 0.001, and the surrogate indicator of deterioration in the course of AF (an increase in the frequency or duration of AF paroxysms) was also higher in group ‘A’ (in 36 of 59 patients, 61.0%), compared with group ‘B’ (5 out of 13 patients), p < 0.001.

Conclusions:
The presence of AH significantly worsens the course of AF after CI, increasing the frequency of paroxysms of this arrhythmia and their duration.
EXERCISE CAPACITY AND ATRIAL FIBRILLATION RISK IN 459,592 HYPERTENSIVES: A COHORT STUDY
Authors: Pittaras Andreas , Faselis Charles , Samuel Immanuel Babu Henry , Doumas Michael , Grassos Haralampos , Murphy Rayelyn , Myers Jonathan Jonathan , Kokkinos Peter 
Published: June 2022

Objective:
To assess the association between exercise capacity and the risk of developing atrial fibrillation (AF) in hypertensive patients.

Design and method:
We identified 459,675 hypertensives (63 ± 8.6 years, females: 4.9%), free of AF, who completed a normal Bruce exercise treadmill test (ETT). We established 5 fitness categories (quartiles) based on age-specific peak metabolic equivalents (METs) achieved: Least-fit (4.5 ± 1.22 METs; n = 107,593); Low-fit (6.9 ± 1.07; n = 119,433); Moderate-fit (8.3 ± 1.19; n = 88,923); Fit (10.3 ± 0.89; n = 106,921), and High-fit (13.1 ± 1.55; n = 36,722). Hazard regression models were adjusted for age, BMI, smoking (33.5%), DM (43.6%), dyslipidemia (69.8%) and CKD (5.8%).

Results:
During a median follow-up of 9.8 ± 5.0 years, 42,639 (9.6%) developed AF (9.6 per 1000 person-years). EXCP was inversely related to AF incidence. The risk was 11% lower (HR:0.89, 95% CI, 0.88–0.90) for each 1-MET increase in exercise capacity. Compared to the Least-fit category (Referent), the HRs were 0.72 (95% CI, 0.71–0.74) for Low-fit individuals, 0.61 (95% CI, 0.60–0.63) for Moderate-fit, 0.52 (95% CI, 0.50–0.54) for Fit, and 0.45 (95% CI, 0.43–0.47) for High- fit individuals. Similar trends for those < 65 years & > 65 years of age.

Conclusions:
Our findings support that increased fitness offer a marked protection against AF. The association was inverse, independent, and graded. Significantly lower AF risk was evident in those with only modest increases in exercise capacity and declined by > 50% for individuals in the High-fit category. These findings counter previous suggestions that even moderate increases in physical activity, (recommended by guidelines), increase the risk of AF.
META-ANALYSIS EVALUATING THE EFFICACY OF SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITORS IN SUBJECTS WITH HEART FAILURE WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Toumpourleka Maria , Zografou Ioanna , Petidis Konstantinos , Imprialos Konstantinos , Kassimis George , Boulmpou Aristi , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Heart failure (HF) is a chronic, disabling and deadly disease. Subjects with HF feature an increased risk for death and recurrent ospitalisation for HF decompensation. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are a novel class of drugs primarily developed for patients with diabetes mellitus. SGLT-2 inhibitors have proven cardiovascular efficacy in HFrEF; however, their efficacy in subjects with HFpEF has not be elucidated. Therefore, we sought to determine the effect of SGLT-2 inhibitors on surrogate cardiovascular outcomes in HFpEF, utilizing both data from ospitalis controlled trials and real-world studies.

Design and method:
We searched PubMed and the Cochrane Library for RCTs and observational studies enrolling adult subjects with HFpEF regardless of concomitant type 2 diabetes mellitus (T2DM), assigned to a SGLT-2 inhibitor versus placebo or active comparator. We set as primary efficacy outcome the composite of cardiovascular death or ospitalisation for HF decompensation. We set as secondary efficacy outcome that of all-cause death.

Results:
We pooled data from four RCTs and one observational study for a total of 7,920 subjects with HFpEF. We demonstrated that treatment with SGLT-2 inhibitors versus placebo or active comparator produced a significant decrease in the risk for the primary composite outcome by 30% (RR = 0.70, 95% CI; 0.52 – 0.93, I2 = 48%, p = 0.01). As far as all-cause death is concerned, we showed that SGLT-2 inhibitors compared to control did not produce a significant effect on the corresponding risk (RR = 0.65, 95% CI; 0.34 – 1.26, I2 = 67%, p = 0.21). Overall risk of bias was evaluated as low across the selected studies.

Conclusions:
Current evidence suggests that SGLT-2 inhibitors are also efficacious in HFpEF. Although total mortality was not significantly reduced, the trend towards beneficial effects along with the demonstrated morbidity benefits point towards the use of SGLT-2 inhibitors in this patient population.
HYPERTENSION AND QUALITY OF LIFE OF PATIENTS WITH HEART FAILURE
Authors: Mzoughi Khadija , Zairi Ihsen , Marwa Chouaieb , Belkahla Noufeil , Bouzidi Hela , Kammoun Sofien , Ben Mrad Imtinene , Kraiem Sondos 
Published: June 2022

Objective:
The increasing prevalence and poor prognosis associated with chronic heart failure (CHF) have made the improvement of quality of life (QoL) one of the main goals in the treatment of CHF patients. The aim of the study was to assess if hypertension was associated with QoL in a sample of patients ospitalised with HF.

Design and method:
In this prospective study, we evaluated patients with CHF attending the cardiology department of Habib Thameur University Hospital in a four-month period. Echocardiography was performed and patients with left ventricular ejection fraction (LVEF) of 45% or less were selected. QoL assessment was performed with a disease-specific instrument: the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in a sample of 100 selected patients.

Results:
In the total sample (n = 100), mean age was 62.7 years. The majority were male (77%), married (76%), with a mean of 2.5 comorbidities, and in a New York Heart Association (NYHA) functional class III to IV (61%). Mean LVEF was 36%. Half of the patients had poor QoL on the total MLHFQ scale (median = 41,5) as well as on its physical (median = 17,5) and emotional (median = 11,25) domains. In univariate analysis, a history of hypertension was a factor of poor quality of life with a calculated odds ratio of 2.263, its presence alters the total score by approximately 14 points (p = 0.045), the physical score by approximately 11 points (p = 0.009) and the emotional by seven points (p = 0.005).
In multivariate analysis, hypertension was not associated with poor Qol.

Conclusions:
This study has found that hypertension was a factor of poor quality of life among patients with heart failure in univariate analysis.
DYNAMICS OF VENOUS CONGESTION (VEXUS) AND LIVER STIFFNESS BY TRANSIENT ELASTOGRAPHY IN PATIENTS WITH ARTERIAL HYPERTENSION AND DECOMPENSATED HEART FAILURE
Authors: Aslanova Rena , Lapshin Artem , Andriamanohery Robinson , Abdulloev Dzhakhongir , Efimova Viktoriia , Safarova Ayten , Sarlykov Bekbolot , Kobalava Zhanna 
Published: June 2022

Objective:
comprehensive assessment of venous congestion (VC) is relevant in patients with arterial hypertension (AH) and decompensated heart failure (DHF).

Design and method:
to assess the incidence and severity of VC according to the VExUS protocol (assessment of the IVC diameter, the shape of the portohepatic and renal veins blood flow) and to assess the relationship of VC to the liver stiffness (LS), estimated by transient elastography (TE), in patients with AH and DHF on admission and their dynamic changes during ospitalisation. The METAVIR scale was used to interpret the stages of fibrosis.
Routine clinical assessment, VExUS, TE was performed in 52 patients with AH and DHF (men 48%, age 70 ± 11 years (M ± SD), atrial fibrillation 60%, diabetes 40%, chronic anemia 27%, left ventricle ejection fraction (EF LV) 50 [40; 57] %, EF < 40% - 29%,NTproBNP 1421 [754; 2024] pg/ml (Me; IQR)). Exclusion criteria: primary chronic liver disease or acute hepatitis, severe tricuspid regurgitation

Results:
on admission mild, moderate and severe venous congestion were detected in 31%, 13%, 17% of patients, respectively. 79% of patients had increased liver stiffness - 22% had F1 / F2, 17% had F3 and 40% had F4.
At discharge, venous congestion was observed in 38% of patients. Mild, moderate and severe venous congestion was detected in 20%, 12%, 6% of cases respectively. An increase in liver stiffness at discharge was detected in 54%. 29% of patients had F1 / F2, 13% had F3, and 12% had F4.
The dynamics of clinical signs of congestion on admission and at discharge is presented in Diagram 1.
A significant correlation between severity of VC and degree of increase in LS was observed (r = 0.43, p = 0.001). There is a positive correlation between the LS and VC with NT-proBNP (r = 0.47, p = 0.04 and r = 0.30, p = 0.03, respectively), a significant negative correlation between the severity of VC and LVEF (r = -0.49; p = 0.000), and between the degree of LS with LVEF (r = -0.33; p = 0.018).

Conclusions:
Correlations were revealed between venous congestion, by VEXUS protocol, and LS in TE with LVEF in patients with AH and DHF
A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS OF PDE5 INHIBITOR SILDENAFIL IN THE TREATMENT OF HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Sun Runmin , Wang Qiongying , Yu Jing 
Published: June 2022

Objective:
he results of clinical trials of phosphodiesterase (PDE) 5 inhibitors for the treatment of HFpEF patients are inconsistent. Thus, we undertook a meta-analysis to evaluate the clinical value of sildenafil for HF with preserved EF (HFpEF) patients.

Design and method:
Relevant studies were searched and identified in the PubMed, Cochrane Library and EMBASE databases. We searched andomised controlled trials (RCTs) that compared PDE5i with placebo in HFpEF and extracted relevant clinical data.

Results:
Six RCTs enrolling 471 HFpEF patients were included in the meta-analysis.Compared with placebo, sildenafil was not significantly associated in death (OR = 1.12, 95%CI: 0.06 to 19.40), adverse events (OR = 2.55, 95%CI:0.67 to 9.62). Also, sildenafil therapy had no impact on the patient’s six-minute walk test, PASP, E/e’, peak VO2, NT-proBNP but improved at PVR(SMD = -1.04, 95% CI = -1.96 to -0.13) significantly compared to placebo in HFpEF patients. Whereas, if only the RCT study with HFpEF combined with pulmonary hypertension is included, sildenafil therapy was associated with a marked improvement in E/e’ (SMD = -0.745, 95% CI = -1.24 to -0.25) in HFpEF patients combined with pulmonary hypertension.

Conclusions:
Compared with placebo, sildenafil therapy was associated with the improvement of diastolic function in HFpEF patients combined with pulmonary hypertension, while sildenafil treatment of HFpEF patients does not increase death or rehospitalization.
AI FOR AF IN ASIANS-WHERE ARE WE AND WHERE RE WE GOING?
Authors: Syun Hu Wei 
Published: June 2022

Objective:
We aimed to construct a random forest model to predict atrial fibrillation (AF) in Chinese population.

Design and method:
This study was comprised of 682 237 subjects with or without AF. Each subject had 19 features that included the subjects’ age, gender, underlying diseases, CHA2DS2-VASc score, and follow-up period. The data were split into train and test sets at an approximate 9:1 ratio: 614 013 data points were placed into the train set and 68 224 data points were placed into the test set. In this study, weighted average F1, precision, and recall values were used to measure prediction model performance. The F1, precision, and recall values were calculated across the train set, the test set, and all data.

Results:
The area under receiving operating characteristic (ROC) curve was also used to evaluate the performance of the prediction model. The prediction model achieved a k-fold cross-validation accuracy of 0.979 (k = 10). In the test set, the prediction model achieved an F1 value of 0.968, precision value of 0.958, and recall value of 0.979. The area under ROC curve of the model was 0.948 (95% confidence interval 0.947–0.949). This model was validated with a separate dataset.

Conclusions:
This study showed a novel AF risk prediction scheme for Chinese individuals with random forest model methodology.
IMPACT OF ATRIAL FIBRILLATION ON RENAL FUNCTION IN HEART FAILURE PATIENTS USING REAL WORLD DATA
Authors: Diaz Jvier , Calderon Jose Miguel , Martinez Fernando , Sauri Inmaculada , Fernandez Antonio , Trillo Jose Luis , Uso Ruth , Redon Josep 
Published: June 2022

Objective:
The objective of the present study is to assess the nalysedional interaction between heart failure (HF) and atrial fibrillation (AF) in the renal function using Real World Data.

Design and method:
From an Electronic Health Recording with a population of 3,799,885 adult subjects, those with prevalent or incident HF were selected and followed throughout a study period of 5 years. Prevalence and incidence of AF, and their impact in worsening renal function (decrease eGFR> 20%), were identified. When both eGFR and albuminuria data was available, the patients were classified on the Kidney Disease Global Outcomes (KDIGO) risk scale. Two different sets of data were nalysed in two groups of HF patients: S1) included all patients with prevalent or incident HF, 128086 patients; S2) included subjects with a new diagnosis of HF during the study period in the absence of previous AF, 57354 patients.

Results:
In S1, the impact of AF on a reduction of eGFR by > 20% was observed in 18,513 patients, incidence 66.2/103 patients/year, Figure panel A with an increment of risk (HR 1.13, P95th CI 1.09–1.18, p < 0.001) higher than the present due to diabetes, hypertension, dyslipidemia or coronary heart disease. The increment of risk was also demonstrated in S2, Figure panel B. The number of subjects with decreased eGFR values was 7,067, incidence 94.0/103 patients/year with AF increasing the risk (HR 1.22, P95th CI 1.14–1.31, p < 0.001) independent of the other potential factors. In the subgroup of patients with KDIGO risk classification, 10,425 (27.8%) and 3,297 (23.2%) respectively in S1 and S2 cohorts increased by at least one category in S1 and S2, respectively.

Conclusions:
AF largely increases the risk of decline renal function contributing to the deterioration in the condition of these patients.