bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE INFLUENCE OF AMBULATORY BLOOD PRESSURE ON THE ASSOCIATIONS OF INTRADIALYTIC HYPERTENSION WITH FUTURE CARDIOVASCULAR EVENTS AND MORTALITY IN HEMODIALYSIS PATIENTS
Authors: Theodorakopoulou Marieta , Iatridi Fotini , Alexandrou Maria-Eleni , Karpetas Antonios , Bikos Athanasios , Raptis Vasilios , Tsouchnikas Ioannis , Giamalis Panagiotis , Papagianni Aikaterini , Sarafidis Pantelis 
Published: June 2022

Objective:
Patients with intradialytic hypertension (IDH) have higher mean 44-hour ambulatory blood pressure (BP) levels than patients without the phenomenon. IDH is associated with an increased risk of cardiovascular and all-cause mortality. Whether the excess risk for mortality in patients with IDH depends on the BP rise during dialysis per se or on elevated 44-h ambulatory BP is not known. This is the first study evaluating the association of IDH with cardiovascular events and all-cause mortality before and after adjustment for ambulatory BP and other cardiovascular risk factors.

Design and method:
A total of 242 hemodialysis patients underwent 48-h ABPM with Mobil-O-Graph-NG and were followed for a median of 45.7 months. IDH was defined as: SBP rise greater than or equal to 10 mmHg from pre- to post-dialysis and post-dialysis SBP greater than or equal to 150 mmHg. The primary end-point was all-cause mortality; the secondary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest, ospitalisation for heart failure, coronary or peripheral revascularization procedure.

Results:
During follow-up, a total of 122 patients died; 69 due to cardiovascular causes. Cumulative freedom from both the primary and secondary endpoint was significantly lower for patients with IDH (logrank-p = 0.048/0.022, respectively). The risk for all-cause mortality was significantly higher for patients with IDH (HR = 1.566 95%CI [1.001, 2.450]); similarly, the risk for the combined cardiovascular endpoint was higher for these individuals (HR = 1.675 95%CI [1.071, 2.620]). The observed associations attenuated after adjustment for 44-h SBP (all-cause mortality: HR = 1.529 95%CI [0.952, 2.457] and combined cardiovascular endpoint: HR = 1.388 95%CI [0.866, 2.225]. After additional adjustment for age, interdialytic weight gain, dialysis vintage, 44-h pulse wave velocity, history of coronary artery disease, diabetes mellitus and heart failure the respective HRs were 1.409 (95%CI [0.851, 2.332]) and 1.435 (95%CI [0.879, 2.343]).

Conclusions:
Patients with IDH presented higher risk for death and cardiovascular outcomes. Sustained high BP levels during the 44-h interdialytic period and not only intradialytic BP rise per se may be participating in the excess risk of this condition.
ARTERIAL ELASTICITY PREDICTS CARDIOVASCULAR MORBIDITY AND MORTALITY- A LONGITUDINAL STUDY IN THE VARA-SKÖVDE COHORT
Authors: Szalo Gabor , Hellgren Margareta , Allison Matthew , Lindblad Ulf , Daka Bledar 
Published: June 2022

Objective:
Background: Measures of arterial elasticity are used for early detection of vascular disease and identification of individuals at high risk for cardiovascular disease morbidity (CVD).
Aim: To investigate the association between arterial elasticity and risk for CVD in men and women.

Design and method:
A total of 2816 randomly selected individuals were examined (Men = 1400) between 2002 and 2005. The average follow-up time was 14.8 ± 2.4 years. After excluding participants with known cardiovascular disease, hypertension and diabetes mellitus, 2362 individuals (Men = 1186) were included in this study. Small Arterial Elasticity Index (SAEI) was measured using the HDI/Pulse Wave™ CR2000. Diagnoses of CVD were defined as acute myocardial infarction or stroke and based on Swedish Cause of Death Register and Swedish National Inpatient Register for period 2002–2019. Kaplan – Meijer and Cox- regression analyses were used to investigate the differences between SAEI quartiles and future CVD, adjusting for age, sex, heart rate, systolic blood pressure, LDL- cholesterol, HOMA-IR, C- reactive protein, smoking, alcohol consumption and physical activity. Of note, higher values of SAEI indicate more compliant arteries.

Results:
Mean age at baseline was 46 ± 10.6 years. Overall, 108 events were observed, 38 in women with 11 under 50 years. In the fully adjusted model, a one quartile higher SAEI score was associated with a 26% lower risk of incident CVD among men and women combined; (HR = 0.74, 95% CI: 0.55- 0.99, p = 0.041). Similar results were observed in men in the fully adjusted model (HR = 0.65, 95% CI: 0.45- 0.95, p = 0.024). Analogous, however nonsignificant, results were observed in women older than 50 years (HR = 0.59, 95% CI: 0.24- 1.45). The effect size was significantly lower in women younger than 50 years (HR = 0.93, 95% CI: 0.58- 1.45). However, the number of events in this group was low.

Conclusions:
We showed a strong and independent association between SAEI and CVD in men. Similar tendencies and effect size were observed in postmenopausal women. The diastolic pulse wave appears to provide additional information for cardiovascular risk assessments.
SYNERGISTIC EFFECT OF HIGH HOMOCYSTEINE AND LOW VITAMIN B12 LEVELS ON CARDIOVASCULAR AND STROKE RISK OF HYPERTENSIVE PATIENTS
Authors: Liakos C. , Karpanou E. , Markou M. , Grassos C. , Tousoulis D. , Vyssoulis G. , Tsioufis K. 
Published: June 2022

Objective:
Arterial hypertension is a risk factor for cardiovascular (CV) events, including stroke. High blood homocysteine levels (hyperhomocysteinemia) are also considered to increase CV risk and are associated with vitamin B12 deficiency that possibly increase CV and stroke risk, as well. The present study assessed the possible relation of high homocysteine and low vitamin B12 levels with the underlying CV and stroke risk of hypertensive patients.

Design and method:
This retrospective study comprised all hypertensives referred to our institutions and had a blood sample measurement of homocysteine and B12 (n = 32800). The 10-year fatal CV risk and stroke risk were calculated with the HeartScore and the FraminghamStrokeScore, respectively. The population was divided in quartiles according to homocysteine levels (groups 1, 2, 3 and 4 for increasing levels) and B12 levels (groups 1, 2, 3 and 4 for decreasing levels). Cardiovascular and stroke risk were calculated for each homocysteine and B12 quartile group as well as for each of the 16 homocysteine/B12 combination quartile subgroups.

Results:
The mean values for homocysteine were 13.3 ± 7.2 μmol/l and for B12 525 ± 196 pg/ml. For homocysteine quartiles 1, 2, 3, 4, CV risk was 3.4%, 5.5%, 9.0%, 17.9%, respectively (pfor trend 0.05). For B12 quartiles 1, 2, 3, 4, CV risk was 3.0%, 6.2%, 9.5%, 15.1%, respectively (pfor trend 0.01). Correlation coefficient ® between homocysteine and CV risk values was 0.416 (p < 0.0001) while between B12 and CV risk values was -0.369 (p < 0.0001). For homocysteine quartiles 1, 2, 3, 4, stroke risk was 4.2%, 7.3%, 12.9%, 25.0%, respectively (pfor trend 0.04). For B12 quartiles 1, 2, 3, 4, stroke risk was 5.4%, 9.2%, 13.4%, 19.3%, respectively (pfor trend 0.08). Correlation coefficient ® between homocysteine and stroke risk values was 0.474 (p < 0.0001) while between B12 and stroke risk values was -0.348 (p < 0.0001). The synergistic effect of increasing homocysteine and decreasing B12 values on CV and stroke risk increase is presented in Figure.

Conclusions:
High homocysteine levels and low vitamin B12 levels are individually and synergistically associated with the underlying CV and stroke risk of hypertensive individuals. Possible mechanisms merit further examination.
COMMON CAROTID ARTERY ELASTICITY, INTIMA-DIAMETER RATIO, AND TENSILE STRESS IN PEDIATRIC PATIENTS WITH PRIMARY HYPERTENSION
Authors: Szyszka Michal , Skrzypczyk Piotr , Ofiara Anna , Wabik Anna , Panczyk-Tomasz Malgorzata 
Published: June 2022

Objective:
Elevated blood pressure (BP) lead to increased thickness of arterial wall and increased diameter of arteries, are risk factors of cardiovascular sequelae in adult populations. Intima-diameter ratio (IDR) and tensile stress (TS) may reflect arterial wall-remodeling to elevated BP. The aim was to evaluate common carotid artery elasticity, IDR, and TS in children with primary hypertension (PH).

Design and method:
50 untreated patients with PH and we evaluated: common carotid artery(CCA) intima-media thickness (cIMT) and elasticity(E-tracking - ET), central BP and aortic elasticity (aPWV,AIx75HR), office BP and ABPM, and clinical, and biochemical data. IDR (cIMT/minimal diameter of CCA[D]) and TS (MAP∗D/cIMT) were calculated in all the subjects.

Results:
Patients with PH compared to CG were characterized by significantly higher peripheral, central office and ambulatory BP, BMI Z-score, uric acid, triglycerides, lower HDL-cholesterol and higher aPWV. PH patients had thicker cIMT and larger CCA D. The groups did not differ in parameters of CCA elasticity: beta stiffness index, CCA pulse wave velocity(PWVbeta) and pressure-strain elasticity modulus(Ep) and in IDR(0.08 ± 0.01vs.0.08 ± 0.02,p = 0.479) and TS(584.9 ± 135.5mmHg vs.529.7 ± 84.2,p = 0.095). We found correlations between cIMT(Z-score) and triglycerides, peripheral SBP Z-score, and ABPM MAP 24 h Z-score. CCA D correlated with BMI Z-score, uric acid and HDL-cholesterol, 24 h systolic blood pressure load(SBPL), Central systolic blood pressure(AoSBP) and peripheral diastolic BP Z-score. We found significant correlations between TS and uric acid, 24 h diastolic blood pressure load, and peripheral systolic and diastolic blood pressure Z-scores. There was no association between IDR and BP except for a weak correlation between IDR and SBPL. In PH patients, there was a strong correlation between cIMT and CCA D(r = 0.790,p < 0.001).

Conclusions:
In children with PH, structural changes and decreased elasticity primarily affect the aorta and to a lesser extent the muscular arteries.
In children with PH, both CCA wall thickness and internal diameter are associated with BP, and are significantly higher in children with PH. The changes observed in the carotid artery are probably adaptive in nature, not associated with impaired arterial function, thus intima-diameter ratio or tensile stress measurement does not appear to contribute additional information in this group of patients.
PERSISTENCE OF BLOOD PRESSURE PHENOTYPES ACCORDING TO OFFICE AND 24 HOUR AMBULATORY BLOOD PRESSURE IN CHILDREN
Authors: Martinez Fernando , Alvarez Julio , Ponce Francisco , Redon Josep , Lurbe Empar 
Published: June 2022

Objective:
To assess the persistence of BP phenotypes according to office and 24-h ABPM in youth over time.

Design and method:
Retrospective study including 582 children who underwent measurement of both office BP (OBP) and ABPM on the same day. The second office BP and ABPM was performed within 1 year apart. OBP was measured using an oscillometric device validated in children. ABPM was performed using oscillometric SpaceLabs 90207 monitors. OBP and ABPM were classified according to the criteria of the ESH (Lurbe et al J Hypertens 2016). Four phenotypes based on OBP and ABPM were defined: true normotensives, sustained hypertensives, white-coat hypertensives, and masked hypertensives. Persistence and Kappa statistic were used to evaluate the concordance of BP phenotypes. Factors related with persistence on BP phenotypes were evaluated using logistic regression models.

Results:
At the initial assessment, the majority of children fell within the category of true normotension (77%), followed by masked hypertension (13%), sustained hypertension (5%) and white coat hypertension (5%). The prevalence of true normotensive increased significantly in the follow-up. The flow through phenotypes is shown in the Figure.
Only 38 initial true normotensive patients changed to other categories, mainly masked (12); 63 of initial masked hypertension changed, mainly to normotensive (58); 24 of white coat changed predominantly to normotension (16); finally, 25 of sustained changed, largely to normotension (14), but 9 children migrated to masked. The overall agreement was 74.2% (kappa 0.20). The grade of agreement was slightly higher for boys than for girls. In the multivariable model, higher age showed to be a protective factor, whereas increased office SBP and waist circumference were significant risk factors. The masked hypertensive phenotype carried the highest risk for lack of persistence.

Conclusions:
Children with hypertensive BP phenotypes should be re-evaluated because a large percentage of them will become normotensive. High BP levels and high BMI z-score or waist circumference were significant risk predictors for the lack of persistence on BP phenotypes.
COVID-19 ASSOCIATED REDUCTION IN HYPERTENSION-RELATED DIAGNOSTIC AND THERAPEUTIC PROCEDURES IN EXCELLENCE CENTERS OF THE EUROPEAN SOCIETY OF HYPERTENSION
Authors: Weber Thomas , Kreutz Reinhold , Januszewicz Andrzej , Mayer Christopher , Tsioufis Konstantinos , Abraham György , Amar Jaques , Barna Istvan , Barroso Weimer Kunz Sebba , De Backer Tine , van der Giet Marcus 
Published: June 2022

Objective:
The Covid-19 pandemic necessitated a decrease in non-Covid-19 related diagnostic and therapeutic procedures in many countries. We explored the impact on hypertension care in the Excellence Center (EC) network of the European Society of Hypertension.

Design and method:
We conducted an electronic survey regarding 6 key procedures in hypertension care among our ECs.

Results:
Overall, 54 ECs from 18 European and 3 non-European countries participated. From 2019 to 2020, there was a significant decrease in the median number per center of ambulatory blood pressure monitorings (ABPMs; 544 vs 289), duplex ultrasound investigations of renal arteries (DUS RA; 88.5 vs 55), computed tomographic investigations of renal arteries (CT RA; 66 vs 19.5), percutaneous renal artery angioplasties (PTA RA; 5 vs 1), laboratory tests for catecholamines (2019: 116 vs 67.5) and for ennin/aldosterone (146 vs 83.5). All comparisons were statistically significant with p < 0.001, respectively (Figure). While the reduction in all diagnostic and therapeutic procedures was observed in all 3-months period comparisons between 2019 and 2020, the most profound decrease occurred from April to June 2020, which was the period of the first wave and the first lockdown in most countries. In this period, as compared to 2019, the median reduction in 2020 was 50.7% (ABPM), 47.1% (DUS RA), 50% (CT RA), 57.1% (PTA RA), 46.9% (catecholamines) and 41% (ennin/aldosterone), respectively. Based on Friedman test, overall differences in reduction between 3 months time intervals were statistically highly significant.

Conclusions:
Diagnostic and therapeutic procedures related to hypertension were dramatically reduced during the first year of the Covid-19 pandemic, with the largest reduction during the first lockdown. The long-term consequences regarding blood pressure control and, ultimately, cardiovascular events remain to be investigated.
COVID-19 AND NEW ONSET HYPERTENSION
Authors: Shalaeva Evgeniya , Shamsutdinova Maksuda , Shadmanov Alisher , Boymuradov Shukhrat , Azizova Feruza , Allaberganov Dilshod , Saner Hugo , Messerli Franz 
Published: June 2022

Objective:
COVID-19 has been identified as a possible risk factor for hypertension. It may be associated with new onset hypertension or aggravate pre-existing hypertension. The objective of the study was to evaluate systolic (SBP) and diastolic blood pressure (DBP) pattern in COVID-19 patients discharged from the hospital and followed for over 3 months.

Design and method:
This is a prospective single-center observational cohort study of 1442 hospitalized COVID-19 patients including 259 ICU patients followed over 3-months (52.4 ± 12.3 years, 49.8% male) in Uzbekistan January-June 2021. Patients were subclassified according to JNC 8 hypertension stages. For patients who died, the last confirmed BP was used.

Results:
In the whole cohort, all-cause mortality was 137 (9.5%). At 3-months in ospitalisat patients (no ICU treatment), mean SBP was raised on 7.4 mmHg, DBP 5.7 mmHg compared to the 1st day of admission due to COVID-19, in ICU patients SBP increased by 12.5 mmHg and DBP 7.2 9 mmHg (Table 1). The prevalence of hypertension in the whole cohort subclassified according to JNC8 criteria is presented in Table 2. In the whole cohort at the baseline, according to JNC8, hypertension was detected in 713 (49.4) patients, and by 3-months follow-up new incidence of hypertension was observed in 254 (17.6%) patients. 483 (65%) patients with diagnosed hypertension at the baseline were required to increase the doses of antihypertensive medications after discharge during 3-months follow-up.

Conclusions:
COVID-19 necessitating ospitalisation is a powerful risk factor for new onset hypertension or for aggravating pre-existing hypertension.
CUMULATIVE EXPOSURE TO JOB STRAIN AND PREDIABETES AMONG MALE AND FEMALE WHITE-COLLAR WORKERS
Authors: Riopel Camille , Brisson Chantal 
Published: June 2022

Objective:
Previous literature suggests an association between psychosocial stressors at work (PSWs) and the risk of type 2 diabetes mellitus (T2DM). According to the demand-control model, the combination of high psychological demands at work and low levels of control is called job strain, which increases the risk of T2DM. Prediabetes greatly increases the risk of developing T2DM and is also independently associated with an increased mortality risk. However, the evidence regarding the association between PSWs and prediabetes is scarce. The objective of this study is to clarify the relationship between cumulative exposure to PSWs, defined according to the demandcontrol
model, and both prediabetes prevalence in a longitudinal cohort.

Design and method:
Over 9000 white-collar workers (48.5% female) were recruited in 1991–1993 and were followed up 8 and 24 years later. Workers exposed to job strain at baseline and at the 8- year follow-up were considered exposed to chronic job strain. Glycated hemoglobin (HbA1c) was measured at the 24-year follow-up in 1461 workers and was used to measure prediabetes prevalence. Odds ratios (ORs) were computed using multiple logistic regressions which were adjusted for potential confounding factors.

Results:
In female workers, chronic job strain was associated more than twice the odds of prediabetes (OR = 2.21, 95% CI 1.05–4.67) compared to unexposed workers, even after adjusting for sociodemographic factors and lifestyle habits. There was no association between job strain and prediabetes in male workers.
Conclusion: Our results suggest that PSWs, when they are measured with the demand-control model, are associated with an increased prediabetes prevalence. Given the increasing burden of disease of prediabetes and T2DM in Canada and in other developed countries, addressing these frequent and modifiable occupational factors could improve the health of Canadian workers, especially female workers. Therefore, workplace interventions that aim to decrease adverse PSWs should be considered to reduce glucose metabolism imbalances at the population level.
EFFECT OF A WEB-BASED MANAGEMENT PLATFORM ON HYPERTENSION CONTROL IN COMMUNITY: A RANDOMIZED CLINICAL TRIAL
Authors: Zhou Haoqi , Wang Xin , Chen Zuo , Zhang Linfeng , Zheng Congyi , Chen Lu , Cai Jiayin , Cao Xue , Wang Zengwu 
Published: June 2022

Objective:
To assess the effect of multi-component intervention delivered by a web-based platform on improving blood pressure control rate.

Design and method:
A cluster andomised clinical trial of a hypertension management program was conducted from January 1 to December 31, 2018 in 66 communities. Communities were andomised to either the intervention group (usual care combined with multi-component intervention delivered by a web-based platform) or control group (usual care only). The intervention included health education, lifestyle modification, self-monitoring and treatment. In order to support the implementation of intervention program, a web based-platform was established. Automated classification and personalized follow-up schedule would be generated by prespecified algorithm according to the patients’ information. The primary outcome was the change in blood pressure control rate from baseline to 12 months among hypertension patients in the intervention and control group. The secondary outcomes were the changes in blood pressure and lifestyle factors.

Results:
A total of 3,872 participants (2,994 in the intervention group and 878 in control group) were included in the analysis. Blood pressure control rate at baseline was 31.4% in the intervention group and 30.2% in the control group. After 12 months of the intervention, the blood pressure control rate for the intervention group compared with the control group was significantly higher (65.9% vs 42.0%; odds ratio, 1.25; 95%CI,1.19–1.32; P < 0.001). The intervention effect on systolic blood pressure was -8.0 mmHg (95%CI, -9.8 to -6.2 mmHg; P < 0.001) and on diastolic blood pressure was -1.7 mmHg (95%CI, -2.8 to -0.6 mmHg, P = 0.003). The blood pressure control rate showed a gradual increment throughout the whole intervention duration. What's more, greater improvement was observed in the proportion of regular exercise (17.8%; 95%CI, 15.3%-20.3%; P < 0.001).

Conclusions:
This trial found that a multi-component intervention delivered by a web-based platform appeared to be more effective than usual care, leading to measurable benefits such as lower blood pressure, improved hypertension control, and adoption of healthy lifestyle habits. Telemedicine may be a better way to manage hypertension patients in community.